Child 4-12

* 1. Choose a smiley that describes how you feel

  Frown Neutral Smile
The people that are taking care of me are nice.
The people that are taking care of me listen to me
I can tell the person today what is bothering me.
It was easy to know what the person taking care of me was telling me.
I learned how to better take care of myself today.
I felt better after they took care of me.
I like the time the person taking care of me spent with me.
I will come back to see the person that took care of me again.
Nobody else knew why I was here, but the person taking care of me.
I feel safe when they take care of me.

* 2. What service did you receive today?

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