Public Assistance Customer Satisfaction Survey

FEMA Form 519-0-1T
OMB Control No. 1660-0107
Expires March 31, 2012
DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY

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, 500
C Street, SW, Washington, DC 20472, Paperwork Reduction Project (OMB Control Number 1660-0107). NOTE: Do not
send your completed form to this address.  
This survey is voluntary. 

FEMA Form 519-0-1T

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PA Phone Survey Questionnaire

Hello, I'm calling from FEMA, the Federal Emergency Management Agency. My name is _________.
My ID is _______. May I please speak with [Contact Name] ?
If applicant is not available: Mark Attempt
If applicant is available:
We would like to ask you some questions about your experience with the Federal Emergency
Management Agency Public Assistance Program. Your answers will help to improve FEMA's
response in future disasters. Would you volunteer to take 15-20 minutes to answer some
questions?
If no: I understand, Thank you for your time and have a nice day/evening.
If yes: Thank you. The following questions have been approved by the Office of Management
and Budget under number 1660-0107. Please be assured your answers will not affect the
outcome of your application for FEMA assistance.
GENERAL INFORMATION & QUESTIONS
This call is related to the [Disaster Type], declared on [Declaration Date], in [State] under Disaster
Number [DR No].
The next few questions ask for general information.
1. What is your organization type? (read options)
State Grantee
Tribal Grantee
Subgrantee
If response = State Grantee go to 1a, If response = Subgrantee go to 1b else go to Q2
1a. What is your position? (read options)
State Director
Governor's Authorized Representative - GAR
Alternate GAR
Public Assistance Officer - PAO
Deputy PAO
State Coordinating Officer – SCO
Assistance SCO
Other
(Skip to Q4)
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1b. What is your position? (read options)
Local government
Sate subgrantee
Special district
Private non-profit
Indian tribe/tribal organization/native village
Other
GENERAL INFORMATION & QUESTIONS
2. For what type(s) of project(s) did you apply? (read options)
Not applicable, state grantee
All large projects (over $XX,XXX in FYXXXX)
All small project ($XX,XXX and under)
More large than small projects
More small than large projects
Equal number of large and small projects
If response = All large projects go to Q4 else go to Q3
3. Applicants have the option of writing their own Project Worksheet(s) for small projects. For the
small projects for which you applied, did you chose to write your own Project Worksheet(s): (read
options)
All of the time
Most of the time
Half of the time
Some of the Time
Never
Not applicable, did not apply for small projects
4. Overall, how satisfied are you’re the Public Assistance PROGRAM? (Read list)
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

5. Overall, how satisfied are you with the Public Assistance PROCESS? (Read list)
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

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INFORMATION
The next questions pertain to your initial contact with FEMA.
6. How satisfied were you with the PUBLISHED information FEMA provided on the Public Assistance
Program for example documents on FEMA's website, documents received at the Kickoff Meeting,
etc.?
(Read
list)
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

7. How satisfied were you with staff's communication of information?

(Read first 6)
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Never dealt with staff

8. How satisfied were you with the information FEMA provided you concerning the availability of
Public Assistance mitigation funding?
(Read first 6)
Very Satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Never dealt with staff
Did not receive any information on mitigation

PERSONAL INTERACTION AND CUSTOMER SERVICE
The next questions concern your interactions with staff
9. The field staff understood the eligibility requirements: (Read first 5)
All of the time
Most of the time
More than half of the time
Some of the time
Never
Do not know
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10. The field staff that conducted the site visit(s) were competent and understood the types of
damage they were assessing: (Read first 7)
All of the time
Most of the time
More than half of the time
Some of the time
Never
Not applicable – No site visit(s) necessary because always wrote own Project Worksheet(s)
Not applicable – Site visit(s) not yet conducted
Do not know
11. The field staff that conducted the site visit(s) understood the local conditions that could influence
the rebuilding process. (Read first 7)
Strongly agree
Agree
Slightly agree
Slightly disagree
Disagree
Strongly disagree
Not applicable – No site visit(s) necessary because always wrote own Project Worksheet(s)
Not applicable – Site visit(s) not yet conducted
Do not know
PERSONAL INTERACTION AND CUSTOMER SERVICE
12. How reliable were the decisions and information you received from staff? (Read first 6)
Very reliable
Reliable
Slightly reliable
Slightly unreliable
Unreliable
Very unreliable
Do not know

13. Was staff turnover a problem?

Yes
No
Do not know

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14. Overall how satisfied were you with the CUSTOMER SERVICES provided by staff? (Read List)
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

15. Overall, how satisfied were you with the responsiveness provided by staff: (Read List)
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

PROJECT WORKSHEET PROCESS
The next questions relate to the Project Worksheet Process.
16. Overall, how satisfied were you with the Project Worksheet process? (Read list)
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

17. Did you receive Public Assistance mitigation funding?
Yes, received funding
No – applied for but did not receive funding
Did not apply for funding
Do not know
If response = yes go to Q17a else go to Q18
17a. How satisfied were you with the amount of Public Assistance mitigation funding you
received?
(Read
List)
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Do not know
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18. If FEMA conducted a site visit, FEMA conducted the Project Worksheet site visits(s)
(Read first 3)
Too soon after the disaster
At the right time
Too Late to be helpful
Site visit(s) not yet conducted
No site visit(s) necessary because always wrote own Project Worksheet(s)
Do not know
19. If FEMA developed the scope(s) of work, how satisfied were you with their development?
(Read
first 6)
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Not applicable – always wrote own Project Worksheet(s)
Do not know

20. If FEMA identified damage repair cost estimates, how satisfied were you with these estimates?
(Read
first 6)
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied
Cost estimates not yet completed
Not applicable – Always wrote own Project Worksheet(s)
Do not know

21. 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
Not applicable - Did not write any Project
Worksheets

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22. 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).

PROGRAM RESULTS
The next questions pertain to the overall results of the Public Assistance Program.
23. How satisfied were you with FEMA's timeliness
23a. overall?

(Read list)
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

23b. In relation to providing information?
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

23c. In relation to making eligibility decisions:
Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

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23d. In relation to providing funds:

Very satisfied
Satisfied
Slightly satisfied
Slightly dissatisfied
Dissatisfied
Very dissatisfied

24. How reasonable were administrative requirements for the following:
24a. Overall program

(Read list)
Very reasonable
Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable

24b. Pre-disaster documentation

(Read list as needed)
Very reasonable
Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable

24c. Project Worksheet review

(Read list as needed)
Very reasonable
Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable

24d. Payment of claims

(Read list as needed)
Very reasonable
Reasonable
Slightly reasonable
Slightly unreasonable
Unreasonable
Very unreasonable
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25. Is there anything you would have liked FEMA to have done differently during this disaster
recovery?

26. Please provide any additional comments or suggestions regarding the Public Assistance
Program.

Thank you very much for your time. Have a good day/evening.

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