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FORM BC-1294 (11-20-2012)
OMB No. 0607-0404: Approval Expires 08/31/2015
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU
A. Field Representative Information
2. FR Code
1. RO
3. FR Name
CENSUS
FIELD REPRESENTATIVE (FR)
EXIT QUESTIONNAIRE
4. Telephone Number(s)
5. Effective Date of Separation
6. Reason for Separation (See Section F)
B. Record of Contact
Date/Time of Contact
Interviewer
(1)
Date
Start Time
Stop Time
(2)
Result of
Contact
(See Section C)
Interview
Type
(See Section D)
Comments
(3)
(4)
(5)
C. Result of Contact – Use to fill in column 3 above.
1
2
3
4
5
= Ring, no answer
= Line was busy
= Number was a FAX line
= Telephone disconnected
= Left message on answering machine/
Voice Mail
6 = Spoke with someone other
than respondent
a = left message for respondent
b = respondent not accepting calls
7 = Spoke with respondent
a = conducted interview
b = he/she will call back
c = asked to call back on different
phone number
d = respondent refused interview
D. Interview type – Use to
fill in Column 4 above.
1 = Complete Interview
2 = Partial/Incomplete
Interview
3 = Non-Interview, Refusal
4 = Non-Interview, Other
8 = Other – Specify
E. If final interview type is Non-interview, Other –
please explain reason for noninterview.
F. Reason for Separation –
Use to fill item A6 above.
1
2
3
4
= Resignation
= Lack of work
= Term Expired
= Unsatisfactory
Performance
5 = Misconduct
6 = Retired
7 = Other
Script for Answering Machines/Nonrespondent: Hello, I’m [Your name] from the U.S. Census Bureau in Washington,
D.C. I’m calling to talk to [field representative’s first and last name] to ask a few questions about your employment with
the Census Bureau. Please call me back at the following toll free number: 1–877–560–7370. Thank you. I look forward to
hearing from you.
This page intentionally left blank.
FORM BC-1294 (11-20-2012)
Page 2
[Telephone introduction]: Hello, I would like to speak with [FR’s first and last name]. Hello, I’m
from the U.S.
Census Bureau in Washington, D.C. We are concerned with the job satisfaction among our Field Representatives so we are interviewing
a sample of FRs who have recently left the Census Bureau. I would like to ask you a few questions about why you quit working for the
Census Bureau. This information is being collected to determine the reasons for turnover among Field Representatives, and will be used
to develop effective policies and procedures designed to retain Field Representatives and reduce turnover. Routine uses of this
information will be in accordance with the System of Records Notice that applies to this collection of information. The information will be
protected from disclosure under the Freedom of Information Act (5 U.S.C. section 552) and the Privacy Act (5 U.S.C. section 552a) to
the extent provided by law. This survey is voluntary and will only take about seven minutes. The OMB control number, 0607-0404
expires on 08/31/2015. The Census Bureau may not conduct or sponsor, and a person is not required to respond to, the information
collection unless it displays a currently valid OMB control number.
Section 1 – BACKGROUND
1. How long did you work for the Census Bureau?
(Mark (X) one box only.)
5a. Did the job meet your expectations? Mark (X) one box only.
1
1
2
3
4
5
6
7
8
Less than 3 months
3 months to less than 6 months
6 months to less than one year
One year to less than 3 years
3 years to less than 6 years
6 years to less than 10 years – Go to 3
10 years or more – Go to 3
Quit during or right after training
2
Yes – Go to 6.
No – Go to 5b
b. Which expectations were not met?
2. Before you were hired, you conducted a Mock Interview
during the interview phase of the FR testing process. Do
you feel the Mock Interview gave you a complete picture
of the job of a Field Representative? (Mark (X) one box.)
6. [In the last five years,] on what surveys did you work?
Please answer "Yes or "No" after I read each survey
name. (Note if the respondent quit right after or during training, ask
which survey he/she was being trained on when he/she decided to
quit.) (Mark (X) one box for each item.)
Yes No
1
2
Yes
No – Explain
3. What was it about this job that appealed to you and
made you apply initially? (Mark (X) all that apply.)
1
2
3
4
5
6
7
8
9
10
Like interacting with people/like that job involves working
with and talking to people
Like that job allows you to work in your own community
Like setting own hours
Like flexibility of job
Like that job allows you to work independently
Like pay scale
Like that job is not an office job
Wanted to work for government
Nothing in particular, just needed a job
Other – Specify
a. ACS – HU (American Community Survey –
Housing Units)
b. ACS – GQ (American Community Survey –
Group Quarters)
c. AHS (American Housing Survey)
d. CE (Consumer Expenditure)
e. CPS (Current Population Survey)
f. NAMCS (National Ambulatory Medical
Care Survey)
g. NCVS (National Crime and Victimization Survey)
h. NHAMCS (National Hospital Ambulatory Medical
Care Survey)
i. NHIS (National Health Interview Survey)
j. SIPP (Survey of Income and Program Participation)
k. SOC (Survey of Construction)
l. Other – Specify
2
3
Yes – Go to 4b.
No – Go to 5a
Don’t know/Don’t remember – Go to 5a
2
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
b. How many hours would you have liked to work per
month on all surveys? (Enter a whole number.)
_______ Hours
Yes
No
FORM BC-1294 (11-20-2012)
1
_______ Hours
b. Did participation in the pre-training observation help
provide you with a more realistic understanding of the
demands of the job?
(Mark (X) one box only.)
1
2
7a. On average how many hours did you work per month on
all surveys? (Enter a whole number.)
4a. Did you participate in a pre-training observation of
actual interviewing before going to initial training?
(Mark (X) one box only.)
1
1
Page 3
Section 2 – REASONS FOR TURNOVER
8.
What was/were the reason(s) you left your job? (Do not
read the lists below. Mark "Yes or "No" for each reason that best
describes the response given by the former FR. When reasons are
too broad and/or vague, probe to clarify and/or explain the reason
so you can check the appropriate box.)
A. AUTOMATION
8.
h1. Disliked interacting with hostile and/or
unfriendly people
h2. Disliked trying to convince people to participate
h3. Difficult to find someone at home to interview
Yes No
a1. Hardware problems – Specify
a2. Software problems – Specify
a3. Did not like using laptops
1
2
1
2
1
2
a4. Other – Specify
1
2
b4. Other – Specify
1
2
1
2
1
2
1
2
1
2
1
2
1
2
c5. Other – Specify
1
2
1
2
1
2
1
2
1
2
1
2
d6. Other – Specify
1
2
e4. Other – Specify
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
f6. Other – Specify
1
2
2
1
2
g6. Other – Specify
FORM BC-1294 (11-20-2012)
1
2
1
2
1
2
1
2
i6. FS/FL gave me new/different surveys to work on
1
2
i7. FS/FL was too involved in how I do my work/felt
micromanaged
1
2
i8. Other – Specify
1
2
1
2
j2. Increased pressure to safeguard laptop
1
j3. Increased pressure to protect PII and Title 13 Data 1
2
j4. Other – Specify
1
2
K1. Did not provide the support needed
k2. Too demanding
k3. Difficult to work with
1
2
1
2
1
2
k4. Other – Specify
1
2
1
2
1
2
1
2
1
2
m1. Initial training was overwhelming
m2. Training did not prepare me for the job
m3. Not enough refresher training
m4. Too many different training materials
1
2
1
2
1
2
1
2
m5. Other – Specify
1
2
1
2
l1. Disliked asking personal/sensitive
questions – Go to 11
l2. Thought survey(s) was/were too long
l3. Didn’t believe respondent data was kept
confidential
l4. Other – Specify
2
M. TRAINING
G. PERSONAL
g1. Health problems (personal and/or family)
1
g2. Conflicted with other personal/family obligations 1
g3. Got new job/conflicted with other employment
1
g4. Went back to school/conflicted with school
1
schedule
1
g5. Lack of Transportation
2
L. SURVEYS/SURVEY QUESTIONS
F. PERFORMANCE
1
1
K. SUPERVISOR
2
f1. Too much pressure to improve response rates
f2. Too much pressure to improve production rates
f3. Too difficult to meet deadlines
f4. Too much pressure to improve quality
f5. Unfair appraisal
2
j1. Data security procedures were too burdensome
E. PAY
e1. Pay per hour was too low – go to 9a
e2. Supervisor would not approve overtime
e3. Mileage and expense reimbursement was
insufficient
2
1
J. SECURITY
D. NATURE OF THE JOB
d1. Worked in unsafe neighborhoods
d2. Disliked working alone
d3. No chance for advancement
d4. Disliked interviewing (personal visit & telephone)
d5. Disliked traveling
2
1
i1. New structure made my job more difficult to
do – Go to 10a
i2. New supervisor (FS/FL) was too
demanding/difficult to work for
i3. FS/FL did not have enough time for me/my
questions
i4. FS/FL could not adequately answer my questions
– Go to 10b
i5. FS/FL increased/decreased my workload
C. HOURS
1
2
1
I. RO REALIGNMENT
2
c1. Wanted more hours
c2. Wanted less hours
c3. Wanted a full time job
c4. Disliked working nights, weekends, holidays
Yes No
1
h4. Other – Specify
B. BENEFITS (Health, Life, Retirement, Leave)
b1. Not enough coverage provided
b2. Cost too much
b3. Unreasonable criteria to qualify/takes too long
to qualify
Continued
H.RESPONDENTS
N. WORKLOAD/ASSIGNMENTS
2
n1. Workload was too light
n2. Workload was too heavy
n3. Locations were too dispersed
n4. Did not like working on multiple surveys
2
2
2
n5. Other – Specify
Page 4
1
2
1
2
1
2
1
2
Section 2 – REASONS FOR TURNOVER – Continued
Ask question 9a and question 9b only if question (8e1)
was answered "Yes".
Ask question 11 only if question (8l1) was answered "Yes".
9a. Would an increase in pay per hour have caused you to
continue working for the Census Bureau? (Mark (X) one
box.)
Yes – Go to 9b
1
No
2
11. You reported that asking sensitive or personal questions
was one of the reasons you left your job. Which
questions did you feel uncomfortable asking the
respondent? Please answer "Yes" or "No" after I read
each one. (Mark (X) one box for each item.)
Yes No
b. What increase in pay per hour would have been enough
for you to continue working for the Census Bureau?
Please answer yes or no after I read each item.
(Mark (X) one box for each item.)
Yes No
1. Less than one dollar
2. Between one and two dollars
3. Between two and three dollars
4. Between three and four dollars
5. More than four dollars
1
2
1
2
1
2
1
2
1
2
1. Income
2. Drugs and alcohol
3. Health
4. Race/ethnicity
1
2
1
2
1
2
1
2
5. Other – Specify
1
2
12a. In addition to the reasons already given, were there any
other aspects of the field representative’s position that
you really disliked which contributed to your decision to
leave the Census Bureau? (Mark (X) one box.)
1
2
Ask question 10a only if question (8i1) was answered "Yes".
Yes
No – Go to 13a
10a. You reported that the realignment made it more difficult
for you to do your job. Please tell me how the
b. What were they? (Enter letter/number of additional reasons using
realignment made your job more difficult? (Do not read the
the letters/numbers from the question 8 series.)
list. Mark "yes" or "no" for each reason that best describes the
response given by the FR. When the response is too broad/general,
probe to clarify and/or explain so you can check the appropriate box.)
Yes No
13a. Ask question 13a only if more than one reason was checked in
1. It took too long to get respondent
1
2
letters/materials and supplies
question 8. Of the reasons you gave for leaving your job,
what was the most important reason? If you like, I can
2. It took too long to get answers to
read the reasons you gave back to you. (Enter reason
questions
1
2
letter/number as appropriate from question 8 on the line below.)
3. When the FS/FL was not available, I
had to wait to get help
1
2
__________ Most important reason
4. The new RO changed the performance
measures/standards
1
2
5. The new RO changed the survey
b. Ask question 13b only if more than two (2) reasons were checked in
1
2
response/production rates
question 8. What was the second most important reason?
6. Other – Specify
1
2
If you like, I can read the reasons you gave back to you.
(Enter reason letter/number as appropriate from question 8 on the
line below.)
Ask question 10b only if question (8i4) was answered "Yes".
b. You reported that your Field Supervisor’s/Field Leader’s
inability to adequately answer your questions was a
reason/the reason why you left your job. What did you
ask your FS/FL about that he/she could not adequately
answer? (Do not read the list. Mark "yes" or "no" for each reason
that best describes the response given by the FR. When the
response is too broad/general, probe to clarify and/or explain so you
can check the appropriate box.)
Yes No
1. Your workload
2. Survey concepts or procedures
3. A difficult respondent
4. Respondent letters
5. Problem referrals
6. Automation
7. Payroll
8. Leave
9. Safety issues
10. Supplies and materials
11. PII and confidentiality
12. Personal matters
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2
13. Other – Specify
1
2
FORM BC-1294 (11-20-2012)
__________ Second most important reason
Section 3 – GENERAL ATTITUDE TOWARDS JOB
14. What did you like best about the job?
Page 5
Section 3 – GENERAL ATTITUDE TOWARD JOB – Continued
15. The next set of questions ask about your first line
supervisor. Although you may have had more than one
supervisor and your satisfaction may have varied for
different supervisors, in general, would you say that you
were very satisfied, somewhat satisfied, somewhat
dissatisfied, or very dissatisfied with . . . (Please read each
item. Circle one response for each item.)
18a. To what extent did the amount of contact you had with
your first line supervisor impact your decision to leave
the Census Bureau. Did the amount of contact you had
with your first line supervisor have a little, a lot or no
impact on your decision to leave? (Mark (X) one box only.)
1
2
3
VERY
SOMEWHAT SOMEWHAT
VERY
SATISFIED SATISFIED DISSATISFIED DISSATISFIED
a. The availability
of your first line
supervisor
b. Your first line
supervisor’s
ability to help
you solve
work-related
problems
c. Communication
between you
and your first
line supervisor
d. Monitoring of
your
performance
by your first line
supervisor
e. Your first line
supervisor’s
knowledge of
survey concepts
f. Your first line
supervisor’s
knowledge of
interviewing
techniques
g. Your first line
supervisor’s
knowledge of
the laptop
computer
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
1
2
1
2
3
b. How did the amount of contact you had with your first
line supervisor impact (either a little or a lot) your
decision to leave? Please specify.
19. Next I’m going to read you a list of field
representative tasks. For each task I read, please tell
me if the training you received to help you perform
the task was outstanding, very good, good, fair or
poor. (Circle one response for each item.)
4
3
OUTSTANDING
VERY
GOOD
GOOD
FAIR
POOR
a. Introducing and
explaining the
purpose of
the survey
1
2
3
4
5
b. Answering
respondents’
questions
1
2
3
4
5
c. Selling the survey
1
2
3
4
5
d. Getting
respondents to
cooperate
1
2
3
4
5
e. Completing a
survey for an
occupied unit
1
2
3
4
5
f. Determining when
to take a proxy
1
2
3
4
5
g. Dealing with
vacant and out of
scope units
1
2
3
4
5
h. Converting a
refusal
1
2
3
4
5
4
3
4
16. How often did you have contact, either by phone or in
person, with your first line supervisor? For each item
I read, please tell me whether your contact with your
first line supervisor was daily, several times a week,
once a week, less than once a week or never. (Please
read each item. Circle one response for each item.)
SEVERAL
TIMES
DAILY A WEEK
1. Prior to going to
classroom training
2. During classroom
training
3. Following classroom
training, but before
completing your 1st
assignment
4. During your first
month’s assignment
5. During your second
and third month’s
assignment
ONCE
A WEEK
LESS
THAN
ONCE
A WEEK NEVER
1
2
3
4
5
i. Probing for
accurate answers
1
2
3
4
5
1
2
3
4
5
j. Completing a
payroll
1
2
3
4
5
k. Using the laptop
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
l. Using ALMI
(Address Listing
and Mapping
Instrument)
5
m. Resolving
address and
listing problems
1
2
3
4
5
n. Using CHI
(Contact History
Instrument)
1
2
3
4
5
o. Using GPS
(Global
Positioning
System)
1
2
3
4
5
1
2
3
4
17. Overall, do you think your contact with your first line
supervisor was too much, too little, or just right?
(Mark (X) one box only.)
1
2
3
Too much
Too little
Just right
FORM BC-1294 (11-20-2012)
A little –Go to 18b
A lot – Go to 18b
No impact – Go to 19
Page 6
Section 3 – GENERAL ATTITUDE TOWARD JOB – Continued
20. [Read these instructions to the FR]: Lastly we would also like
to get your overall opinion of the job you had with the
Census Bureau, your training, your pay and your first
line supervisor. I will read a statement and afterwards
I want you to tell me to what extent you agree or
disagree with the statement. There are five possible
responses: Strongly Agree, Agree, Disagree, Strongly
Disagree, and if the statement does not apply to you,
you can respond by saying not applicable. Now I’m
going to read you the list of statements. For each
statement, tell me if you strongly agree, agree,
disagree, strongly disagree, or if it is not applicable.
(Please read each item. Circle one response for each item.)
STRONGLY
STRONGLY
AGREE AGREE DISAGREE DISAGREE N.A.
a. My job was
adequately
described
before I
began work.
b. The initial
training I
received
adequately
prepared me on
the concepts
and procedures
of the survey I
worked.
c. My initial
training
adequately
prepared me
to do my job
using a
computer.
d. The refresher
training I
received
adequately
reinforced the
concepts and
procedures of
the survey(s) I
worked.
e. My pay was
adequate for the
type of work I
did
1
2
1
2
3
4
5
Yes – Go to 21b.
No – Go to 22.
b. Are you currently working as an interviewer?
(Mark (X) one box only.)
1
2
Yes
No
c. Is your current job part-time or full-time? (Mark (X) one box
only.)
1
2
Full-time (more than 32 hours per week)
Part-time (32 or fewer hours per week)
22. Would you work for the Census Bureau again?
(Mark (X) one box only.)
1
2
3
Yes
No – Explain
Depends/Maybe – Explain
Read the following to the FR . . .
1
2
3
4
5
As I said at the beginning of this interview, we estimated
that this interview would take about seven minutes.
Send comments regarding the burden or any other
aspect of this collection of information, including
suggestions for reducing this burden to the:
1
2
3
4
5
Paperwork Project 0607-0404
U.S. Census Bureau
4600 Silver Hill Rd., Room 3K138
Washington, DC 20233
You may e-mail comments to
[email protected]; use
"Paperwork Project 0607-0404" as the subject
1
2
3
4
5
Thank you very much for your time.
NOTE TO INTERVIEWER:
1
2
3
4
5
f. My first line
supervisor
usually let me
know when I did
a good job.
1
2
3
4
5
g. I usually felt
safe in the
areas that I
worked
1
2
3
4
5
h. I was given
adequate
opportunity to
share my
experiences
with and learn
from peers and
fellow
interviewers.
1
2
3
4
5
FORM BC-1294 (11-20-2012)
21a. Are you currently working? (Mark (X) one box only.)
Remember to specify on the front cover, whether this
was a complete interview.
Notes
Page 7
File Type | application/pdf |
File Title | untitled |
File Modified | 2012-11-20 |
File Created | 2012-11-20 |