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