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pdfCustomer Satisfaction Analysis
P.O. Box 90215
Denton, TX 76202
The Federal Emergency Management Agency (FEMA) Public Assistance (PA) Program is conducting surveys to determine customer satisfaction with the PA Program.
Importance of Completing the Survey: We recognize that your recovery efforts may still be underway, but your feedback on the PA Program is essential to help us
improve our performance. This survey is being sent to grantee, subgrantee, and tribal grantee participants. If you cannot answer this questionnaire, please share this
email with the appropriate person.
Use of the Survey Results: FEMA uses the survey to monitor satisfaction with PA Program performance both for this event and over time so we can identify potential
refinements and enhancements to the PA Program. Results of the survey are collected, analyzed, and presented in individual disaster reports, as well as a national
annual report, that will be distributed to FEMA headquarters and regional offices. The reports are also available to State and local governments.
If you have any questions regarding this questionnaire, please contact: 866-330-8286.
Thank you for taking the time to help us improve the quality of the FEMA Public Assistance Program.
Deborah Ingram
Assistant Administrator
Recovery Directorate
____________________________________________________________________________________
Department of Homeland Security
Federal Emergency Management Agency
Public Assistance Customer Satisfaction Survey
FEMA Form 519-0-1iNT
OMB Control Number 1660-0107
Expiration Date: 03-31-2012
____________________________________________________________________________________
FEMA PUBLIC ASSISTANCE CUSTOMER SATISFACTION SURVEY
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 20 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 this survey. You are not required to respond to this collection of information unless a valid OMB
control number is displayed.
Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to:
Records Management Division, Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency
(Paperwork Reduction Project 1660-0107)
500 C Street SW
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Washington, DC 20472
NOTE: Do not send your completed form to this address.
This survey is voluntary.
____________________________________________________________________________________
____________________________________________________________________________________
Questions 1-4 are for informational purposes only to assist in tracking completed questionnaires. This data will not be associated with your responses.
1. *Enter the Applicant Name (Business Entity/Facility)
2. *Enter Contact Name
3. *Enter Contact Phone Number
4. *Enter E-mail address of contact person
____________________________________________________________________________________
GENERAL QUESTIONS
The following questions ask for general information about your background.
Please answer the following questions about your experience with the Federal Emergency Management Agency (FEMA) Public Assistance Program. Please
select the appropriate response to the following questions. Your answers will help to improve FEMA's response in future disasters.
____________________________________________________________________________________
The following information is the disaster type, declaration date, State involved, and disaster number of your most recent disaster where FEMA provided assistance.
5. Type (flood, tornado, etc.)
SevereWinter
Winter
Storms
and Flooding
Severe
Storms
and Flooding
6. Date declared (month/day/year)
02/02/2010
02/02/2010
7. State involved
NorthCarolina
Carolina
North
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8. Disaster number
1871
1871
____________________________________________________________________________________
The following questions may not pertain to all respondents. Please follow instructions associated with the response chosen.
9. What is your organization type?
State Grantee - please answer question 10
Tribal Grantee - please skip to question 12
Subgrantee - please skip to question 11
10. What is your position within your State organization.
(After responding, skip to question 14)
State Director
Governor's Authorized Representative (GAR)
Alternate GAR
Public Assistance Officer (PAO)
Deputy PAO
State Coordination Officer (SCO)
Assistant SCO
*Other (Please specify in the text box below)
Other - Please specify your State position.
11. What is your position within your Subgrantee organization.
(After responding, please go to question 12)
Local government
State subgrantee
Special district
Private non-profit
Indian tribe/tribal organization/native village
Other (Please specify in the text box below)
Other - Please specify your subgrantee position.
12. What type(s) of projects(s) did you apply for?
Not applicable, state grantee (skip to question 14)
All large projects (over $64,200 in FY 2010) (After responding, skip to question 14)
All small projects ($64,200 and under)
More large than small projects
More small then large projects
Equal number of large and small projects
13. Applicants have the option of writing their own Project Worksheet(s) for small projects. For the small projects for which you applied, did you choose to write your own
Project Worksheet(s):
All of the time
Some of the time
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Most of the time
Half of the time
Never
Not applicable, did not apply for small projects
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PROGRAM RESULTS
Please select the response that best describes your satisfaction level:
Very
Satisfied
14. Overall, how satisfied are you with the Public Assistance
Program?
Satisfied
Slightly
satisfied
Slightly
dissatisfied
Dissatisfied
Very
dissatisfied
15. Overall, how satisfied are you with the Public Assistance
process?
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INFORMATION
The following questions pertain to your initial contact with FEMA.
16. How satisfied were you with the published information FEMA provided on the Public Assistance Program (e.g., documents on FEMA's website, documents received at
the Kickoff Meeting, etc.)?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
17. How satisfied were you with staff's communication of information?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Never dealt with staff
18. How satisfied were you with the information FEMA provided you concerning the availability of Public Assistance mitigation funding?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
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Dissatisfied
Very dissatisfied
Did not receive any information on mitigation
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PERSONAL INTERACTION AND CUSTOMER SERVICE
The following questions concern your interactions with staff.
19. The field staff understood the eligibility requirements:
All of the time
Most of the time
More than half of the time
Less than half of the time
Some of the time
Never
Do not know
20. The field staff that conducted the site visit(s) were competent and understood the types of damage they were assessing:
All of the time
Most of the time
More than half of the time
Less than half of the time
Some of the time
Never
Do not know
Not applicable - No site visit(s) necessary because always wrote own Project Worksheet(s)
Not applicable - Site visit(s) not yet conducted
21. The field staff that conducted the site visit(s) understood the local conditions that could influence the rebuilding process.
Strongly agree
Agree
Slightly agree
Slightly disagree
Disagree
Strongly disagree
Do not know
Not applicable - No site visit(s) necessary because always wrote own Project Worksheet(s)
Not applicable - Site visit(s) not yet conducted
22. How reliable were the decisions and information you received from staff?
Very reliable
Reliable
Slightly reliable
Slightly unreliable
Unreliable
Very unreliable
Do not know
23. Was staff turnover a problem?
Yes
No
Do not know
____________________________________________________________________________________
Please select the response that best describes your satisfaction level:
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Very
Satisfied
Satisfied
Slightly
satisfied
Slightly
dissatisfied
Dissatisfied
Very
dissatisfied
24. Overall, how satisfied were you with the customer service provided by
staff?
25. Overall, how satisfied were you with the responsiveness provided by
staff?
____________________________________________________________________________________
PROJECT WORKSHEET PROCESS
The following questions relate to the Project Worksheet process.
NOTE: Not all questions may apply to you. Some questions ask about very specific Project Worksheet activities. (Please select not applicable
where appropriate.)
26. Overall, how satisfied were you with the Project Worksheet process?
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
27. Did you receive Public Assistance mitigation funding?
Yes, received funding
No, applied for but did not receive funding (After responding, please skip to question 29)
Do not know (After responding, please skip to question 29)
Not applicable - Did not apply for funding (After responding, please skip to question 29)
28. How satisfied were you with the amount of Public Assistance mitigation funding you received?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know
29. If FEMA conducted a site visit, FEMA conducted the Project Worksheet site visit(s):
Too soon after the disaster
At the right time
Too late to be helpful
Do not know
Site visit(s) not yet conducted
Not applicable - No site visit(s) necessary because always wrote own Project Worksheet
30. If FEMA developed the scope(s) of work, how satisfied were you with their development?
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Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know
Not applicable - Always wrote own Project Worksheet(s)
31. If FEMA identified damage repair cost estimates, how satisfied were you with these estimates?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know
Cost estimates not yet completed
Not applicable - Always wrote own Project Worksheet(s)
32. If you wrote your own Project Worksheet(s), how satisfied were you with completing your Project Worksheet(s) in terms of its complexity, your time invested, and the
availability of necessary information?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know
Not applicable - Did not write any Project Worksheet(s)
33. If you had any small projects, and you chose not to write your own Project Worksheet(s), please briefly explain why you asked FEMA to write your Project
Worksheet(s).
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PROGRAM RESULTS
The following questions pertain to the overall results of the Public Assistance Program.
How satisfied were you with FEMA's timeliness: Very satisfied Satisfied Slightly satisfied Slightly dissatisfied Dissatisfied Very dissatisfied
34. Overall:
35. In relation to providing information:
36. In relation to making eligibility decisions:
37. In relation to providing funds:
How reasonable were administrative requirements for the
following?
Very
reasonable
Reasonable
Slightly
reasonable
Slightly
unreasonable
Unreasonable
Very
unreasonable
38. Overall program
39. Pre-disaster documentation
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40. Project Worksheet review
41. Payment of claims
42. Is there anything you would have liked FEMA to have done differently during this disaster recovery?
43. Please provide any additional comments or suggestions regarding the Public Assistance Program.
____________________________________________________________________________________
The Federal Emergency Management Agency (FEMA) Public Assistance Program appreciates your feedback!
Please click the "Submit" button to confirm your responses.
FEMA Form 519-0-1INT
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| File Type | application/pdf |
| File Title | http://localhost/publicassistance.html |
| File Modified | 2011-04-21 |
| File Created | 2011-04-18 |