RAPID TEMPORARY REPAIR SURVEY
FEMA Form 007-0-15
OMB Control Number 1660-0036
Expiration ___
Public reporting burden for this survey is estimated to average 15 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the survey. You are not required to respond to this collection of information unless it displays a valid OMB control number near the title of the electronic collection instrument, or for on-line applications, on the first screen viewed by the respondents. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (1660-0036) NOTE: Do not send your completed form to this address.
The following survey is voluntary.
Hello, I’m calling from FEMA, the Federal Emergency Management Agency. My name is _____. My ID # is ______. May I please speak with ____________________ (contact name)
Are you the person who met with the FEMA Housing Representative to perform the Emergency Temporary Repairs to your home? If not the person who met with the RTR staff, ask: Is that person available? And may I ask their name?
If no: Thank you for your time and have a nice day/evening. (Mark attempt)
If yes: We're looking for ways to improve the quality of our service and your opinion is very important to us.
Would you volunteer to take 5 - 8 minutes to answer some questions?
No (if no) I understand, Thank you for your time and have a nice day/evening
Yes (if yes) Thank you. The following questions have been approved by the Office of Management and Budget under number 1660-0036. Please be assured your answers will not affect the outcome of your application for FEMA assistance.
How did you hear about the FEMA program to make temporary / emergency repairs to your home?
From Friends / Family
Flyer or Staff at the Shelter
Newspaper or TV
DRC
Community Relations
Helpline
Inspector
Local Community (Govt, Church, etc)
Don’t know / Don’t remember
Other (Specify)
1a. How helpful was that information in explaining the qualifications for the temporary repairs?
If Not very Helpful or Not at all Helpful, go to 1b
Extremely Helpful
Very Helpful
Helpful
Not very Helpful
Not at all Helpful
1b. What would have made the information more helpful?
Didn’t understand would not be eligible to stay in a hotel / motel
Didn’t understand the quality of materials would be less due to the temporary nature of the program
Didn’t understand
Don’t know / No opinion
Other (Specify)
2. Who helped you complete your Right of Entry form?
If Self or None, skip to 3
Shelter Staff
DRC Staff
Inspection Staff
Volunteer Staff
Self
Do not know / do not remember
Other (Specify)
2a. How would you rate the customer service that person provided? Would you say he/she was…
Excellent
Good
Satisfactory
Below Average
Poor
2b. How would you rate him/her on explaining to you the next steps to have temporary/emergency repairs made to your home? Would you say he/she was…
If Below Average or Poor, go to 2c
Excellent
Good
Satisfactory
Below Average
Poor
2c What was he/she not able to explain?
Could not set an appointment
Could not state when the contractor would arrive
Could not state how long the repairs would take
Could not give me a contact phone number
Could not explain the program
(Other)
Next, I’d like to ask you about the quality of service you received when the temporary/emergency repairs were made to your home.
3. After the disaster, how many days did it take for you to get back into your home?
0-3 days
4-5 days
6-7 days
8-10 days
More than 10 days
Don’t remember
3a. How satisfied are you with the amount of time? Would you say you are…
(READ list)
If Below Average or Poor, go to 3b
Extremely satisfied
Very satisfied
Satisfied
Less than satisfied
Not at all satisfied
(DO NOT read) Don’t know / No opinion
3b. What caused you to give the amount of time that rating?
Had to stay in a shelter for too long
Had to stay with Friends / Family too long
Did not know what was going to happen next
No Contact Numbers provided
Contractor rescheduled
Applicant rescheduled
Other (Specify)
4a1. How satisfied are you with the temporary/emergency repairs that were made to your windows? Would you say you are...
(READ list)
(If “Less than” or “Not at all satisfied”, go to 4a1b otherwise, go to Q.4a2..
Extremely satisfied
Very satisfied
Satisfied
Less than satisfied
Not at all satisfied
(Do not Read) Did not Need Repair to My Windows
(DO NOT read) Don’t know / No opinion
4a1b. What caused you to be dissatisfied with the windows?
(DO NOT read list)
Did not save from more damage
Further damage occurred
RTR Windows leaked
RTR Windows not safe
Blue roof did not stay in place
Other windows not RTR are leaking or not safe
Home still not safe to stay in / insufficient security
Workmanship was poor quality
Materials were poor quality
Did not repair all my emergency damages
Poor Customer Service
Other (Specify)
Did not come at scheduled time
Took too Long
4a2. To your doors? (Read the question if necessary) [How satisfied are you with the temporary/emergency repairs that were made to your doors? Would you say you are...
(READ list)
(If “Less than” or “Not at all satisfied”, go to 4a2a, otherwise, skip to 4b.
Extremely satisfied
Very satisfied
Satisfied
Less than satisfied
Not at all satisfied
(Do not Read) Did not Need Repair to my Doors
(DO NOT read) Don’t know / No opinion
4a2a. What caused you to be dissatisfied with the doors?
(DO NOT read list)
Did not save from more damage
Further damage occurred
RTR Doors leaked
RTR Doors not safe
Blue roof did not stay in place
Other doors not RTR are leaking or not safe
Home still not safe to stay in / insufficient security
Workmanship was poor quality
Materials were poor quality
Did not repair all my emergency damages
Poor Customer Service
Other (Specify)
Did not come at scheduled time
Took too Long
4a3. To your roof? (Read the question if necessary) [How satisfied are you with the temporary/emergency repairs that were made to your roof? Would you say you are...
(READ list)
(If “Less than” or “Not at all satisfied”, go to 4a3a, otherwise, skip to 4a4.
Extremely satisfied
Very satisfied
Satisfied
Less than satisfied
Not at all satisfied
(Do not Read) Did not Need Repair to my Roof
(DO NOT read) Don’t know / No opinion
4a3a. What caused you to be dissatisfied with the roof?
(DO NOT read list)
Did not save from more damage
Further damage occurred
RTR roof leaked
RTR roof not safe
Blue roof did not stay in place
Home still not safe to stay in / insufficient security
Workmanship was poor quality
Materials were poor quality
Did not repair all my emergency damages
Poor Customer Service
Other (Specify)
Did not come at scheduled time
Took too Long
4a4. To your _____? (Read the question if necessary) [How satisfied are you with the temporary/emergency repairs that were made to your _____? Would you say you are...
(READ list)
(If “Less than” or “Not at all satisfied”, go to 4a3a, otherwise, skip to 5.
Extremely satisfied
Very satisfied
Satisfied
Less than satisfied
Not at all satisfied
(Do not Read) Did not Need Repair to my ____
(DO NOT read) Don’t know / No opinion
RTR 4a3a. What caused you to be dissatisfied with the _____?
(DO NOT read list)
Did not save from more damage
Further damage occurred
_______ leaked
_______ not safe
Blue roof did not stay in place
Home still not safe to stay in / insufficient security
Workmanship was poor quality
Materials were poor quality
Did not repair all my emergency damages
Poor Customer Service
Other (Specify)
Did not come at scheduled time
Took too Long
5. Thinking about being able to get back into your home, how satisfied are you with the temporary/emergency repairs that helped you return to your home? Would you say you are...
(READ list)
(If “Less than” or “Not at all satisfied”, go to 5a, otherwise, skip to Q.6..
Extremely satisfied
Very satisfied
Satisfied
Less than satisfied
Not at all satisfied
(DO NOT read) Don’t know / No opinion
5a. What caused you to be dissatisfied?
(DO NOT read list. Mark all that apply.)
Home still not safe to stay in / insufficient security
Workmanship was poor quality
Materials were poor quality
Did not repair all my emergency damages
Poor Customer Service
Other (Specify)
Did not come at scheduled time
Took too Long
Suggestion. FEMA is interested in getting your opinion on what we could do to improve our service. What other suggestions would you like to pass on to FEMA that you haven’t already shared?
Call back: Your opinion is very valuable to us, may we call you at a later date to ask you some additional questions?
Yes (If “yes”) Thank you very much for your time. Have a good day/evening.
No (If “no”) I understand. Thank you very much for your time. Have a good day/evening.
FEMA
Form 007-0-15
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | mbilling |
File Modified | 0000-00-00 |
File Created | 2021-02-02 |