Participant Survey Question Title * 1. Do you live in... (Required.) Auburn Opelika Lee County Russell County Question Title * 2. Is anyone in your household... (Required.) Select a response 60 years or older? Yes No 60 years or older? Select a response menu 4 years old or younger? Yes No 4 years old or younger? Select a response menu adult with disabilities? Yes No adult with disabilities? Select a response menu child with disabilities? Yes No child with disabilities? Select a response menu Question Title * 3. Did you receive any of the following services? (Required.) Select a response Head Start No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Head Start Select a response menu Early Head Start No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Early Head Start Select a response menu Bus transportation for HS child No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Bus transportation for HS child Select a response menu Sunshine shop No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Sunshine shop Select a response menu Question Title * 4. Did you receive any of the following services? (Required.) Select a response Energy Assistance No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Energy Assistance Select a response menu Rental Assistance No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Rental Assistance Select a response menu Housing Counseling No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Housing Counseling Select a response menu Home Maintenance No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Home Maintenance Select a response menu Weatherization No Yes - satisfied w/ service/program Yes - somewhat met expectations Received but did not meet needs Weatherization Select a response menu Question Title * 5. If you were not satisfied with any service, how can we improve? Program Services - about services listed above/overall Question Title * 6. When working with you, did staff... (Required.) Select a response Have a good attitude? All of the time Most of the time Some of the time Did not Have a good attitude? Select a response menu Handle your needs professionally? All of the time Most of the time Some of the time Did not Handle your needs professionally? Select a response menu Help you in a timely manner? All of the time Most of the time Some of the time Did not Help you in a timely manner? Select a response menu Question Title * 7. Have the services provided... (Required.) Select a response improved your living conditions? A lot Somewhat A little No improved your living conditions? Select a response menu been helpful to you or your child? A lot Somewhat A little No been helpful to you or your child? Select a response menu had a continued positive effect? A lot Somewhat A little No had a continued positive effect? Select a response menu Question Title * 8. Do you or have you had a child in Early Head Start or Head Start? If answered no, please skip to "Comments" section. (Required.) Yes No Question Title * 9. Child or children attended... Select a response Head Start Yes No Head Start Select a response menu Early Head Start - Center Based Yes No Early Head Start - Center Based Select a response menu Early Head Start - Home Based Yes No Early Head Start - Home Based Select a response menu Question Title * 10. About Early Head Start/Head Start Select a response Do/did you feel welcome to visit the class/program at any time? Yes Sometimes No Not Sure Do/did you feel welcome to visit the class/program at any time? Select a response menu Do/did you get the information you need such as about program activities? Yes Sometimes No Not Sure Do/did you get the information you need such as about program activities? Select a response menu Does/did your child's teacher communicate with you about progress (home visits, notes, conferences)? Yes Sometimes No Not Sure Does/did your child's teacher communicate with you about progress (home visits, notes, conferences)? Select a response menu Do/did you feel your child improved in areas like sentence length, vocabulary, motor skills, etc.? Yes Sometimes No Not Sure Do/did you feel your child improved in areas like sentence length, vocabulary, motor skills, etc.? Select a response menu Have/did your child's ability to get along with and play with others improve? Yes Sometimes No Not Sure Have/did your child's ability to get along with and play with others improve? Select a response menu Did the teacher provide helpful information at home and center visits during the year? Yes Sometimes No Not Sure Did the teacher provide helpful information at home and center visits during the year? Select a response menu Did you get help setting and meeting goals to help the family? Yes Sometimes No Not Sure Did you get help setting and meeting goals to help the family? Select a response menu Would you describe yourself as generally satisfied with EHS/HS? Yes Sometimes No Not Sure Would you describe yourself as generally satisfied with EHS/HS? Select a response menu Comments Question Title * 11. How can we improve our programs/services? (Required.) Question Title * 12. What needs do you have that are not being met? (Required.) Question Title * 13. What other services are needed in our community? (Required.) Done