Client Experience Questionnaire 2022- Caregiver Survey

Thank you for agreeing to participate in this brief 5 minute survey. We at Children’s Centre Thunder Bay, are committed to understanding the perspective of caregivers whose children/youth access our services. The following survey examines your experience with our services. All responses are anonymous and will help to develop service so they better meet the needs of those we serve.

At the end of the survey you will have the opportunity to provide us with your e-mail address and we will send you a $5 virtual gift card in thanks for completing this survey. Please note that your e-mail address will in no way be connected to your responses. Again, thank you for completing this survey, your input is greatly appreciated.

Question Title

* 1. Please identify the age of your child

0-5

6-13

14-18

19+

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* 2. Please identify the program(s) that you or your child is currently involved with (select all that apply)

Mental Health Counselling

Psychological Assessment

Coordinated Service Planning

Live-In Treatment (STAT)

Parenting Groups/Programs

Infant Child Development

Infant Hearing Program

School Based Behavioral Supports

Special Needs Resource Program (SNRP)

ASD services (assessment or transition)

Intensive Child and Family Intervention (ICFI)

Fetal Alcohol Spectrum Disorder (FASD)

Pre-School Speech and Language

Kindergarten Assessment and Consultation Program

Preschool Assessment and Consultation Program

Occupational Therapy

Day Treatment

Complex Special Needs

Supervised Access

Blind Low Vision

Other (please specify)

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* 3. Please answer the following questions based on your experience with services through Children's Centre Thunder Bay

	Strongly Disagree	Disagree	Agree	Strongly Agree	N/A
Services were provided at a time of the day that was convenient for me.	Services were provided at a time of the day that was convenient for me. Strongly Disagree	Services were provided at a time of the day that was convenient for me. Disagree	Services were provided at a time of the day that was convenient for me. Agree	Services were provided at a time of the day that was convenient for me. Strongly Agree	Services were provided at a time of the day that was convenient for me. N/A
The wait time for services was reasonable.	The wait time for services was reasonable. Strongly Disagree	The wait time for services was reasonable. Disagree	The wait time for services was reasonable. Agree	The wait time for services was reasonable. Strongly Agree	The wait time for services was reasonable. N/A
The services and supports my child received helped them deal more effectively with the challenges in their life.	The services and supports my child received helped them deal more effectively with the challenges in their life. Strongly Disagree	The services and supports my child received helped them deal more effectively with the challenges in their life. Disagree	The services and supports my child received helped them deal more effectively with the challenges in their life. Agree	The services and supports my child received helped them deal more effectively with the challenges in their life. Strongly Agree	The services and supports my child received helped them deal more effectively with the challenges in their life. N/A
I think the services or supports provided here are of high quality.	I think the services or supports provided here are of high quality. Strongly Disagree	I think the services or supports provided here are of high quality. Disagree	I think the services or supports provided here are of high quality. Agree	I think the services or supports provided here are of high quality. Strongly Agree	I think the services or supports provided here are of high quality. N/A
If a friend were in need of similar services or supports, I would recommend this service.	If a friend were in need of similar services or supports, I would recommend this service. Strongly Disagree	If a friend were in need of similar services or supports, I would recommend this service. Disagree	If a friend were in need of similar services or supports, I would recommend this service. Agree	If a friend were in need of similar services or supports, I would recommend this service. Strongly Agree	If a friend were in need of similar services or supports, I would recommend this service. N/A
Staff were sensitive to my child’s and my family’s cultural needs (e.g. religion, language, ethnic background, gender identify, race).	Staff were sensitive to my child’s and my family’s cultural needs (e.g. religion, language, ethnic background, gender identify, race). Strongly Disagree	Staff were sensitive to my child’s and my family’s cultural needs (e.g. religion, language, ethnic background, gender identify, race). Disagree	Staff were sensitive to my child’s and my family’s cultural needs (e.g. religion, language, ethnic background, gender identify, race). Agree	Staff were sensitive to my child’s and my family’s cultural needs (e.g. religion, language, ethnic background, gender identify, race). Strongly Agree	Staff were sensitive to my child’s and my family’s cultural needs (e.g. religion, language, ethnic background, gender identify, race). N/A
Staff treated my child with respect.	Staff treated my child with respect. Strongly Disagree	Staff treated my child with respect. Disagree	Staff treated my child with respect. Agree	Staff treated my child with respect. Strongly Agree	Staff treated my child with respect. N/A
Staff understood and responded to my needs and concerns.	Staff understood and responded to my needs and concerns. Strongly Disagree	Staff understood and responded to my needs and concerns. Disagree	Staff understood and responded to my needs and concerns. Agree	Staff understood and responded to my needs and concerns. Strongly Agree	Staff understood and responded to my needs and concerns. N/A
I felt as though I was a valued member of the care team for my child.	I felt as though I was a valued member of the care team for my child. Strongly Disagree	I felt as though I was a valued member of the care team for my child. Disagree	I felt as though I was a valued member of the care team for my child. Agree	I felt as though I was a valued member of the care team for my child. Strongly Agree	I felt as though I was a valued member of the care team for my child. N/A
Staff kept me up to date on my child’s progress.	Staff kept me up to date on my child’s progress. Strongly Disagree	Staff kept me up to date on my child’s progress. Disagree	Staff kept me up to date on my child’s progress. Agree	Staff kept me up to date on my child’s progress. Strongly Agree	Staff kept me up to date on my child’s progress. N/A

Client Experience Questionnaire 2022- Caregiver Survey

Question Title

* 1. Please identify the age of your child

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* 2. Please identify the program(s) that you or your child is currently involved with (select all that apply)

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* 3. Please answer the following questions based on your experience with services through Children's Centre Thunder Bay

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* 4. Please comment on aspects of your experience with services that were particularly helpful to you:

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* 5. Please comment on aspects of your experience with services that could be improved