Online Consult Assessment Form

Welcome to Wofford ECE Consulting Group, LLC

100% of survey complete.

This needs assessment will help develop the most accurate and effective Action Plan specifically designed for the needs indicated.

We appreciate your participation and we look forward to speaking with you about making your vision a reality!

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* 1. Primary Contact Information

Name

Title or Role in the Business

Email Address

Phone Number

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* 2. Business Information

Name of the Business

Address of the Business

Apartment or Suite Number (if applicable)

City/Town

State/Province

ZIP/Postal Code

Company Website ( If no website, put N/A)

Email Address of Business

Phone Number of Business

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* 3. What type of business do you operate?

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* 4. How long have you been operating your facility?

Start-Up Business (less than 6 months)

1-5 Years

6-9 Years

10+ years

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* 5. Please select what issues you observe to be the reason(s) why your program is not where you want it to be.

High Staff Turnover

Not Enough Qualified Staff

Unable to Find Qualified Staff

Inconsistent Hiring Practices

Defiant Staff Members

Negative Staff Culture

Staff Needs More Training

We Are Lacking the Team Work Atmosphere

Difficult to Keep Client Files Organized and/or Up To Date

Difficult to Keep Staff Files Organized and/or Up To Date

Difficult to Keep Staff Professional Development Records Organized and/or Up To Date

Communication With Clients Are Not As Effective As It Could Be

Are Organization Needs More Community Involvement

Are Organization Needs More Family Culture Engagement

Other - My Program Issue(s) Is Not Listed Above. I Will Inform You Of The Issue On The Free Phone Consultation

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* 6. Please rank the following documents/services by using the options.

	I already deliver this document/service	I Want to Install this document/service	Need More Information	Not Interested at this time	There is a document/service that I wish to deliver that is not listed	There is a document/service that I already deliver that is not listed
Recruitment and Hiring System	Recruitment and Hiring System I already deliver this document/service	Recruitment and Hiring System I Want to Install this document/service	Recruitment and Hiring System Need More Information	Recruitment and Hiring System Not Interested at this time	Recruitment and Hiring System There is a document/service that I wish to deliver that is not listed	Recruitment and Hiring System There is a document/service that I already deliver that is not listed
Employment Application Packet	Employment Application Packet I already deliver this document/service	Employment Application Packet I Want to Install this document/service	Employment Application Packet Need More Information	Employment Application Packet Not Interested at this time	Employment Application Packet There is a document/service that I wish to deliver that is not listed	Employment Application Packet There is a document/service that I already deliver that is not listed
Orientation/Training Manual	Orientation/Training Manual I already deliver this document/service	Orientation/Training Manual I Want to Install this document/service	Orientation/Training Manual Need More Information	Orientation/Training Manual Not Interested at this time	Orientation/Training Manual There is a document/service that I wish to deliver that is not listed	Orientation/Training Manual There is a document/service that I already deliver that is not listed
Pay Period/Pay Date Form	Pay Period/Pay Date Form I already deliver this document/service	Pay Period/Pay Date Form I Want to Install this document/service	Pay Period/Pay Date Form Need More Information	Pay Period/Pay Date Form Not Interested at this time	Pay Period/Pay Date Form There is a document/service that I wish to deliver that is not listed	Pay Period/Pay Date Form There is a document/service that I already deliver that is not listed
Client Services Handbook	Client Services Handbook I already deliver this document/service	Client Services Handbook I Want to Install this document/service	Client Services Handbook Need More Information	Client Services Handbook Not Interested at this time	Client Services Handbook There is a document/service that I wish to deliver that is not listed	Client Services Handbook There is a document/service that I already deliver that is not listed
Routine Staff Meetings	Routine Staff Meetings I already deliver this document/service	Routine Staff Meetings I Want to Install this document/service	Routine Staff Meetings Need More Information	Routine Staff Meetings Not Interested at this time	Routine Staff Meetings There is a document/service that I wish to deliver that is not listed	Routine Staff Meetings There is a document/service that I already deliver that is not listed
Disciplinary Action Protocol	Disciplinary Action Protocol I already deliver this document/service	Disciplinary Action Protocol I Want to Install this document/service	Disciplinary Action Protocol Need More Information	Disciplinary Action Protocol Not Interested at this time	Disciplinary Action Protocol There is a document/service that I wish to deliver that is not listed	Disciplinary Action Protocol There is a document/service that I already deliver that is not listed
Client Intake Form	Client Intake Form I already deliver this document/service	Client Intake Form I Want to Install this document/service	Client Intake Form Need More Information	Client Intake Form Not Interested at this time	Client Intake Form There is a document/service that I wish to deliver that is not listed	Client Intake Form There is a document/service that I already deliver that is not listed
Client/Site Database	Client/Site Database I already deliver this document/service	Client/Site Database I Want to Install this document/service	Client/Site Database Need More Information	Client/Site Database Not Interested at this time	Client/Site Database There is a document/service that I wish to deliver that is not listed	Client/Site Database There is a document/service that I already deliver that is not listed
Cleaning Procedures Manual/Checklists	Cleaning Procedures Manual/Checklists I already deliver this document/service	Cleaning Procedures Manual/Checklists I Want to Install this document/service	Cleaning Procedures Manual/Checklists Need More Information	Cleaning Procedures Manual/Checklists Not Interested at this time	Cleaning Procedures Manual/Checklists There is a document/service that I wish to deliver that is not listed	Cleaning Procedures Manual/Checklists There is a document/service that I already deliver that is not listed
Quality Service Survey	Quality Service Survey I already deliver this document/service	Quality Service Survey I Want to Install this document/service	Quality Service Survey Need More Information	Quality Service Survey Not Interested at this time	Quality Service Survey There is a document/service that I wish to deliver that is not listed	Quality Service Survey There is a document/service that I already deliver that is not listed
Schedule Database	Schedule Database I already deliver this document/service	Schedule Database I Want to Install this document/service	Schedule Database Need More Information	Schedule Database Not Interested at this time	Schedule Database There is a document/service that I wish to deliver that is not listed	Schedule Database There is a document/service that I already deliver that is not listed
Employee Database	Employee Database I already deliver this document/service	Employee Database I Want to Install this document/service	Employee Database Need More Information	Employee Database Not Interested at this time	Employee Database There is a document/service that I wish to deliver that is not listed	Employee Database There is a document/service that I already deliver that is not listed
Incident Reports	Incident Reports I already deliver this document/service	Incident Reports I Want to Install this document/service	Incident Reports Need More Information	Incident Reports Not Interested at this time	Incident Reports There is a document/service that I wish to deliver that is not listed	Incident Reports There is a document/service that I already deliver that is not listed
Routine Supervision with Staff	Routine Supervision with Staff I already deliver this document/service	Routine Supervision with Staff I Want to Install this document/service	Routine Supervision with Staff Need More Information	Routine Supervision with Staff Not Interested at this time	Routine Supervision with Staff There is a document/service that I wish to deliver that is not listed	Routine Supervision with Staff There is a document/service that I already deliver that is not listed
Workplace Culture Development	Workplace Culture Development I already deliver this document/service	Workplace Culture Development I Want to Install this document/service	Workplace Culture Development Need More Information	Workplace Culture Development Not Interested at this time	Workplace Culture Development There is a document/service that I wish to deliver that is not listed	Workplace Culture Development There is a document/service that I already deliver that is not listed
Family Engagement Activities	Family Engagement Activities I already deliver this document/service	Family Engagement Activities I Want to Install this document/service	Family Engagement Activities Need More Information	Family Engagement Activities Not Interested at this time	Family Engagement Activities There is a document/service that I wish to deliver that is not listed	Family Engagement Activities There is a document/service that I already deliver that is not listed
Periodic Newsletters	Periodic Newsletters I already deliver this document/service	Periodic Newsletters I Want to Install this document/service	Periodic Newsletters Need More Information	Periodic Newsletters Not Interested at this time	Periodic Newsletters There is a document/service that I wish to deliver that is not listed	Periodic Newsletters There is a document/service that I already deliver that is not listed
Other	Other I already deliver this document/service	Other I Want to Install this document/service	Other Need More Information	Other Not Interested at this time	Other There is a document/service that I wish to deliver that is not listed	Other There is a document/service that I already deliver that is not listed

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* 7. Please list any services you currently deliver that are not listed above.

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* 8. How many hours per month are you ready to commit to in order to achieve your goals?

1-4 Hours

5-10 Hours

11-15 Hours

16-20 Hours

21-30 Hours

31-40 Hours

41-50 Hours

51-60 Hours

61-70 Hours

71-80 Hours

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* 9. Please select a date and time you would like to be contacted for your Free Phone Consultation. (Make sure to select a date at least 2 business days from the date you submit this assessment) Your Phone Consultation will last 30 minutes.

Date / Time

Date

Time

AM/PM