Exit Survey

* 1. Information

Date of Interview

Completed By

Foster Parents

Service Area

Address

Phone

Number of attempts by staff to complete this interview

* 2. How long did you foster?

0-6 Months

7-11 Months

1 year

2 years

3 years

4 years

5 years

6-10 years

over 10 years

* 3. Have you been a foster parent for a child that was related or known to you?

Yes

* 4. What were the age ranges you cared for?

0 to 5

6 to 12

13 and up

All Ages

* 5. Do you have family members and/or close friends that are or were foster parents?

Yes

* 6. Preparation and Training

	Strongly Agree	Agree	Feel Neutral	Disagree	Strongly Disagree
The pre-service training I received was helpful in perparing me to foster	The pre-service training I received was helpful in perparing me to foster Strongly Agree	The pre-service training I received was helpful in perparing me to foster Agree	The pre-service training I received was helpful in perparing me to foster Feel Neutral	The pre-service training I received was helpful in perparing me to foster Disagree	The pre-service training I received was helpful in perparing me to foster Strongly Disagree
NE Health and Human Services/Agency policies were explained to me	NE Health and Human Services/Agency policies were explained to me Strongly Agree	NE Health and Human Services/Agency policies were explained to me Agree	NE Health and Human Services/Agency policies were explained to me Feel Neutral	NE Health and Human Services/Agency policies were explained to me Disagree	NE Health and Human Services/Agency policies were explained to me Strongly Disagree
I was aware of the need for continued training/education to maintain licensure	I was aware of the need for continued training/education to maintain licensure Strongly Agree	I was aware of the need for continued training/education to maintain licensure Agree	I was aware of the need for continued training/education to maintain licensure Feel Neutral	I was aware of the need for continued training/education to maintain licensure Disagree	I was aware of the need for continued training/education to maintain licensure Strongly Disagree
I was active in a foster parent support group	I was active in a foster parent support group Strongly Agree	I was active in a foster parent support group Agree	I was active in a foster parent support group Feel Neutral	I was active in a foster parent support group Disagree	I was active in a foster parent support group Strongly Disagree
In-service training opportunities were routinely made available	In-service training opportunities were routinely made available Strongly Agree	In-service training opportunities were routinely made available Agree	In-service training opportunities were routinely made available Feel Neutral	In-service training opportunities were routinely made available Disagree	In-service training opportunities were routinely made available Strongly Disagree
At least 12 of the 24 in-service hours required to re-license were acquired in a group workshop setting	At least 12 of the 24 in-service hours required to re-license were acquired in a group workshop setting Strongly Agree	At least 12 of the 24 in-service hours required to re-license were acquired in a group workshop setting Agree	At least 12 of the 24 in-service hours required to re-license were acquired in a group workshop setting Feel Neutral	At least 12 of the 24 in-service hours required to re-license were acquired in a group workshop setting Disagree	At least 12 of the 24 in-service hours required to re-license were acquired in a group workshop setting Strongly Disagree

* 7. Was there training that you needed, but didn't receive, which might have influenced your decision to quit fostering? If so, what training was that?

* 8. Placement, Communication, and Support

	Strongly Agree	Agree	Feel Neutral	Disagree	Strongly Disagree
I was satisfied with the information provided to me prior to placement.	I was satisfied with the information provided to me prior to placement. Strongly Agree	I was satisfied with the information provided to me prior to placement. Agree	I was satisfied with the information provided to me prior to placement. Feel Neutral	I was satisfied with the information provided to me prior to placement. Disagree	I was satisfied with the information provided to me prior to placement. Strongly Disagree
I felt free to make decisions to accept or decline placements without fear of negative repercussions.	I felt free to make decisions to accept or decline placements without fear of negative repercussions. Strongly Agree	I felt free to make decisions to accept or decline placements without fear of negative repercussions. Agree	I felt free to make decisions to accept or decline placements without fear of negative repercussions. Feel Neutral	I felt free to make decisions to accept or decline placements without fear of negative repercussions. Disagree	I felt free to make decisions to accept or decline placements without fear of negative repercussions. Strongly Disagree
The Case Managers I worked with were professional and knowledgeable.	The Case Managers I worked with were professional and knowledgeable. Strongly Agree	The Case Managers I worked with were professional and knowledgeable. Agree	The Case Managers I worked with were professional and knowledgeable. Feel Neutral	The Case Managers I worked with were professional and knowledgeable. Disagree	The Case Managers I worked with were professional and knowledgeable. Strongly Disagree
Agency/NDHHS personnel were available and open to hear my needs.	Agency/NDHHS personnel were available and open to hear my needs. Strongly Agree	Agency/NDHHS personnel were available and open to hear my needs. Agree	Agency/NDHHS personnel were available and open to hear my needs. Feel Neutral	Agency/NDHHS personnel were available and open to hear my needs. Disagree	Agency/NDHHS personnel were available and open to hear my needs. Strongly Disagree
Agency/NDHHS workers made face-to-face contact at least once a month with me and the children in my care.	Agency/NDHHS workers made face-to-face contact at least once a month with me and the children in my care. Strongly Agree	Agency/NDHHS workers made face-to-face contact at least once a month with me and the children in my care. Agree	Agency/NDHHS workers made face-to-face contact at least once a month with me and the children in my care. Feel Neutral	Agency/NDHHS workers made face-to-face contact at least once a month with me and the children in my care. Disagree	Agency/NDHHS workers made face-to-face contact at least once a month with me and the children in my care. Strongly Disagree
My phone calls to the agency/NDHHS worker were returned within 48 hours or two business days.	My phone calls to the agency/NDHHS worker were returned within 48 hours or two business days. Strongly Agree	My phone calls to the agency/NDHHS worker were returned within 48 hours or two business days. Agree	My phone calls to the agency/NDHHS worker were returned within 48 hours or two business days. Feel Neutral	My phone calls to the agency/NDHHS worker were returned within 48 hours or two business days. Disagree	My phone calls to the agency/NDHHS worker were returned within 48 hours or two business days. Strongly Disagree
It was clear who to contact at the agency/NDHHS when I had a question.	It was clear who to contact at the agency/NDHHS when I had a question. Strongly Agree	It was clear who to contact at the agency/NDHHS when I had a question. Agree	It was clear who to contact at the agency/NDHHS when I had a question. Feel Neutral	It was clear who to contact at the agency/NDHHS when I had a question. Disagree	It was clear who to contact at the agency/NDHHS when I had a question. Strongly Disagree
If issues arose with the agency/NDHHS worker, his or her supervisor was avialable to assist me in problem solving when requested.	If issues arose with the agency/NDHHS worker, his or her supervisor was avialable to assist me in problem solving when requested. Strongly Agree	If issues arose with the agency/NDHHS worker, his or her supervisor was avialable to assist me in problem solving when requested. Agree	If issues arose with the agency/NDHHS worker, his or her supervisor was avialable to assist me in problem solving when requested. Feel Neutral	If issues arose with the agency/NDHHS worker, his or her supervisor was avialable to assist me in problem solving when requested. Disagree	If issues arose with the agency/NDHHS worker, his or her supervisor was avialable to assist me in problem solving when requested. Strongly Disagree
The amount of contact the agency/NDHHS worker made with my family was sufficient.	The amount of contact the agency/NDHHS worker made with my family was sufficient. Strongly Agree	The amount of contact the agency/NDHHS worker made with my family was sufficient. Agree	The amount of contact the agency/NDHHS worker made with my family was sufficient. Feel Neutral	The amount of contact the agency/NDHHS worker made with my family was sufficient. Disagree	The amount of contact the agency/NDHHS worker made with my family was sufficient. Strongly Disagree
The agency/NDHHS supported my own family.	The agency/NDHHS supported my own family. Strongly Agree	The agency/NDHHS supported my own family. Agree	The agency/NDHHS supported my own family. Feel Neutral	The agency/NDHHS supported my own family. Disagree	The agency/NDHHS supported my own family. Strongly Disagree
I developed individuallized respite care plans for children in my home and utilized community resources and persons know to the children for respite.	I developed individuallized respite care plans for children in my home and utilized community resources and persons know to the children for respite. Strongly Agree	I developed individuallized respite care plans for children in my home and utilized community resources and persons know to the children for respite. Agree	I developed individuallized respite care plans for children in my home and utilized community resources and persons know to the children for respite. Feel Neutral	I developed individuallized respite care plans for children in my home and utilized community resources and persons know to the children for respite. Disagree	I developed individuallized respite care plans for children in my home and utilized community resources and persons know to the children for respite. Strongly Disagree
I received the services and resources I needed to meet the needs of the children in my home.	I received the services and resources I needed to meet the needs of the children in my home. Strongly Agree	I received the services and resources I needed to meet the needs of the children in my home. Agree	I received the services and resources I needed to meet the needs of the children in my home. Feel Neutral	I received the services and resources I needed to meet the needs of the children in my home. Disagree	I received the services and resources I needed to meet the needs of the children in my home. Strongly Disagree
I was involved as a team member in the service and case planning for children in my home.	I was involved as a team member in the service and case planning for children in my home. Strongly Agree	I was involved as a team member in the service and case planning for children in my home. Agree	I was involved as a team member in the service and case planning for children in my home. Feel Neutral	I was involved as a team member in the service and case planning for children in my home. Disagree	I was involved as a team member in the service and case planning for children in my home. Strongly Disagree
Networking with other resource families and relative caregivers was made available.	Networking with other resource families and relative caregivers was made available. Strongly Agree	Networking with other resource families and relative caregivers was made available. Agree	Networking with other resource families and relative caregivers was made available. Feel Neutral	Networking with other resource families and relative caregivers was made available. Disagree	Networking with other resource families and relative caregivers was made available. Strongly Disagree
I was given notice of and encouraged to attend court hearings for the children in my care.	I was given notice of and encouraged to attend court hearings for the children in my care. Strongly Agree	I was given notice of and encouraged to attend court hearings for the children in my care. Agree	I was given notice of and encouraged to attend court hearings for the children in my care. Feel Neutral	I was given notice of and encouraged to attend court hearings for the children in my care. Disagree	I was given notice of and encouraged to attend court hearings for the children in my care. Strongly Disagree
Efforts to maintain appropriate sibling contact were encouraged and made available to me.	Efforts to maintain appropriate sibling contact were encouraged and made available to me. Strongly Agree	Efforts to maintain appropriate sibling contact were encouraged and made available to me. Agree	Efforts to maintain appropriate sibling contact were encouraged and made available to me. Feel Neutral	Efforts to maintain appropriate sibling contact were encouraged and made available to me. Disagree	Efforts to maintain appropriate sibling contact were encouraged and made available to me. Strongly Disagree
Opportunities were made available to work with the child's birth parents.	Opportunities were made available to work with the child's birth parents. Strongly Agree	Opportunities were made available to work with the child's birth parents. Agree	Opportunities were made available to work with the child's birth parents. Feel Neutral	Opportunities were made available to work with the child's birth parents. Disagree	Opportunities were made available to work with the child's birth parents. Strongly Disagree
When a child left my care, I was given ample time to prepare that child and my family.	When a child left my care, I was given ample time to prepare that child and my family. Strongly Agree	When a child left my care, I was given ample time to prepare that child and my family. Agree	When a child left my care, I was given ample time to prepare that child and my family. Feel Neutral	When a child left my care, I was given ample time to prepare that child and my family. Disagree	When a child left my care, I was given ample time to prepare that child and my family. Strongly Disagree
I had input into the visitation plan for children in my home.	I had input into the visitation plan for children in my home. Strongly Agree	I had input into the visitation plan for children in my home. Agree	I had input into the visitation plan for children in my home. Feel Neutral	I had input into the visitation plan for children in my home. Disagree	I had input into the visitation plan for children in my home. Strongly Disagree
I was treated professionally, with courtesy and respect and felt like a valued member of the child welfare team.	I was treated professionally, with courtesy and respect and felt like a valued member of the child welfare team. Strongly Agree	I was treated professionally, with courtesy and respect and felt like a valued member of the child welfare team. Agree	I was treated professionally, with courtesy and respect and felt like a valued member of the child welfare team. Feel Neutral	I was treated professionally, with courtesy and respect and felt like a valued member of the child welfare team. Disagree	I was treated professionally, with courtesy and respect and felt like a valued member of the child welfare team. Strongly Disagree

* 9. Reason for Leaving

Personal Reason, including health issues

Family composition changed - Adopted or guardianship of placement

Received poor support

Change in family circumstances that helped kinship placement return home

Problems with placement - "child was the primary reason" - behavioral issues, etc.

Issue with re-licensing - QA of home, lack of training hours, etc.

Felt undervalued and disrespected

Allegation/Assessment

* 10. Would you consider becoming a foster parent again in the future?

Yes

* 11. Would you encourage someone else to foster?

Yes