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Family/Client Service Interest Survey #2
Tell us what you need...
Lanterman Regional Center will be asking the Department of Developmental Services for funds to develop services that our clients need. Help us identify what services are needed by completing this brief survey.
OK
1.
Tell us about you...
Name (Optional)
Email Address (Optional)
Phone Number (Optional)
2.
I am a:
Client
Parent/Family Member
Service Provider
Community Member
3.
What age is the Regional Center Client
Under 3
3-12
13-18
19-34
35-64
65+
4.
What Language do you prefer?
English
Spanish
Chinese Mandarin or Cantonese
Japanese
Farsi
Arabic
Korean
Armenian
Tagalog
Other (please specify)
5.
Where do you (client) live?
Glendale
Burbank-Foothill
Pasadena
LA Wilshire
LA Hollywood
6.
Here are some services Service Coordinators say are needed. Select all that YOU think are needed.
Behavioral respite
Physical Therapy
Speech Therapy
Occupational Therapy
Behavior Management Services for Children
Behavior Management Services for Adults
After school program (Ages 6 - 10)
After school program (Ages 11 - 13)
After school program (Ages 14 - 17)
Social skills training (Ages 6 - 10)
Social skills training (Ages 11 - 13)
Social skills training (Ages 14 - 17)
Social Skills Training (Ages 18-25)
Social Skills Training (Ages 26+)
Specialized Homes
Client Money Management
Employment support
Community Integration
Other (please specify)
7.
Please provide any additional comments you may have on the services selected.
8.
Are there other areas or options that you feel are lacking in the community?
Affordable Housing
Social Opportunites (Clubs, Scouting, etc.)
Law/Forensic Advocacy
Parent Education/Training
Anger Management Training
Higher Education/College Support
Other (please specify)
9.
Are you using all of your FDLRC approved services?
Yes
No
10.
If you answered no to question 9, why have you not used your approved services? (Check all that apply)
Service provider does not have staff available to provide the service.
I am on a waitlist for the service.
Service provider does not have a bilingual staff available to provide the services.
Service provider cannot provide services during the time/s that I need it.
My work/family schedule makes it hard for me to participate in the service.
I stopped in-person services due to COVID and remote services do not work for our family.
I have services from other sources such as In Home Supportive Services, Department of Rehabilitation, my child’s school, and/or my private health insurance, which currently meet the needs of myself/my family at this time.
Not applicable to me
Other (please specify any other services not being used and why)
11.
Are there any other things that would help you to be more successful?
Current Progress,
0 of 11 answered