1. Walton Members / Stakeholders Survey

Stakeholders Survey

* 1. Your Services are what you need or require

  Yes No Sometimes N/A
Yes, No, Sometimes

* 2. Your Services are provided in a timely manner. If you are receiving home services your Aid arrives on time

  Yes No Sometimes N/A
Yes, No, Sometimes

* 3. The duties or activities that you request are done as needed or required to assist you in your services

  Yes No Sometimes N/A
Yes, No, Sometimes

* 4. Your Staff that provides your services is responsive and know what your needs are

  Yes No Sometimes N/A
Yes, No, Sometimes

* 5. Staff arrive time to provide your services

  Yes No Sometimes N/A
Yes, No, Sometimes

* 6. Staff is culturally sensitive to your needs ( or know the needs of your culture and customs) to provide your services

  Yes No Sometimes N/A
Yes, No, Sometimes

* 7. Your food ( if meals are prepared) is of good quality

  Yes No Sometimes N/A
Yes, No, Sometimes

* 8. Your food ( if meals are prepared) is of a good temperature for hot /warm foods served by your staff

  Yes No Sometimes N/A
Yes, No, Sometimes

* 9. Your food ( if meals are prepared) is cold, for cold foods, drinks served by the staff

  Yes No Sometimes N/A
Yes, No, Sometimes

* 10. Staff respects your rights, choices, privacy, dignity, property, and protect you from harm and exploitation

  Yes No Sometimes N/A
Yes, No, Sometimes

* 11. Staff display a courteous attitude towards you

  Yes No Sometimes N/A
Yes, No, Sometimes

* 12. Are you please with your current Staff

  Yes No Sometimes N/A
Yes, No, Sometimes

* 13. Are you satisfied with your present Services

  Yes No Sometimes N/A
Yes, No , Sometimes

* 14. Does the Nurse Supervisor come to your home every two month( for persons receiving in home services)

  Yes No Sometimes N/A
Yes, No, Sometimes

* 15. Does the Administrative Personnel respond to your concerns timely

  Yes No Sometimes N/A
Yes, No, Sometimes

* 16. Does the Administrative Peronnel courteous, and treat you with dignity and respect when you call the office, etc.

  Yes No Sometimes N/A
Yes, No, Sometimes

* 17. Are your telephone calls returned promptly within 30 minutes for non -emergencies and 15 minutes for emergencies

  Yes No Somtimes N/A
Yes, No, Sometimes

* 18. Are your emails returned within 24 hours

  Yes No Sometimes N/A
Yes, No, Sometimes

* 19. Do you feel involved in your services

  Yes No Sometimes N/A
Yes, No, Sometimes

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