Worksite Supervisor Implementation Questionnaire

Subsidized and Transitional Employment Demonstration (STED) and Enhanced Transitional Jobs Demonstration (ETJD)

Appendix_H_Worksite Supervisor Implementation Questionnaire 10-3-12

Worksite Supervisor Implementation Questionnaire

OMB: 0970-0413

Document [docx]
Download: docx | pdf

Appendix H

Worksite Supervisor Questionnaire

OMB #: 0970-XXXX

Expiration Date: XX/XX/XXXX

Appendix H

Worksite Supervisor Questionnaire

Updated 10.3.12

The U.S. Department of Health and Human Services and the U.S. Department of Labor have contracted with MDRC to evaluate innovative subsidized and transitional employment models targeting TANF recipients, noncustodial parents, former prisoners, and other low-income parents. The goal is to better understand what kinds of employment programs are most effective at helping people with these kinds of disadvantages gain and hold regular employment.


As part of our research, we are speaking with worksite supervisors to learn about their experiences with the program and working with subsidized workers through the program. This document is a short questionnaire. It should take about 10 minutes to complete. All of your responses on this questionnaire will be kept private; the research staff has been trained in protecting private information and your name will not appear in any written reports we produce. Your responses to these questions are also completely voluntary; you are not required to answer any questions you do not wish to answer. All of the study results will be reported for groups of individuals; no results will be analyzed or reported for individuals.

According to the Paperwork Reduction Act (PRA), an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is 0970-XXXX and it expires XX/XX/XXXX.

Thanks in advance for your time helping us with this valuable research. If you have any questions or would like any more information about the project, please contact Dan Bloom, the project director, at 212-340-8611 or at [email protected].


Worksite Supervisor Questionnaire

Subsidized and Transitional Employment Demonstration (STED)/Enhanced Transitional Jobs Demonstration (ETJD)



The first few questions are about your organization and role.


  1. What is the name of the company/organization you work for?


___________________________________________________


  1. How long have you worked for this company/organization? (write in the number of months or the number of years):


________ months or ________years


  1. Is your organization:

  • 1 For profit

  • 2Non-profit

  • 3Government/Public

  1. How many (total) people do you supervise on a typical day? ___________


Of the number you entered in question #4, how many are:

(total for a, b, and c should add up to number in question #4):


a. From the <PROGRAM NAME> program? ______________


b. From another employment program for disadvantaged people? _______________


c. Other employees? _______________








The next couple of questions are about your role as a supervisor.


  1. As I see it, part of my role is to help employees from the <PROGRAM NAME> program learn about “employability skills” or “soft skills” like how to show up for work on time, how to take direction, how to behave appropriately at work, and how to work well with other people.

1Agree a lot

2Agree a little

3Neither agree nor disagree

4Disagree a little

5Disagree a lot


  1. As I see it, part of my role is to help employees from the <PROGRAM NAME> program learn occupational or “hard” skills (such as computer skills, specialized equipment skills, manufacturing, or construction skills) that will help them get a good paying job.

1Agree a lot

2Agree a little

3Neither agree nor disagree

4Disagree a little

5Disagree a lot













If everyone you supervise is part of the <PROGRAM NAME> program or another job training program, skip to Question 14.


  1. Compared with other employees, how much do you expect out of the <PROGRAM NAME> participants?

1A lot more

2A little more

3About the same

4A little less

5A lot less


  1. Compared with other employees, how much time do you typically spend supervising employees from the <PROGRAM NAME> program?

1A lot more

2A little more

3About the same

4A little less

5A lot less


  1. Compared with other employees, how well prepared for the job were the <PROGRAM NAME> participants on their first day?

1A lot more

2A little more

3About the same

4A little less

5A lot less


  1. Compared with other employees, how much has the performance of the <PROGRAM NAME> participants improved over the course of their employment?

1A lot more

2A little more

3About the same

4A little less

5A lot less


  1. Compared with other employees, how much time do you spend giving feedback to employees from the <PROGRAM NAME> program?

1A lot more

2A little more

3About the same

4A little less

5A lot less


  1. Compared with other employees, how productive are employees from the <PROGRAM NAME> program?

  • 1A lot more

  • 2A little more

  • 3About the same

  • 4A little less

  • 5A lot less

  1. Generally speaking, how do the work habits of employees from the <PROGRAM NAME> program compare with the habits of employees who aren’t a part of the program?

  • 1A lot better

  • 2A little better

  • 3About the same

  • 4A little worse

  • 5A lot worse


The next set of questions asks about your relationship with the <PROGRAM NAME> program and your experience supervising people from the <PROGRAM NAME> program. If you are an employee of <PROGRAM NAME>, please skip to question 21.


  1. Approximately how often are you in contact with a <PROGRAM NAME> staff member?

  • 1Once a week

  • 2Twice a month

  • 3Less than once a month

  • 4Hardly ever


  1. I use staff from the <PROGRAM NAME> program as a resource to help resolve issues for employees from the <PROGRAM NAME> program.

  • 1Yes

  • 2No


  1. Someone from the <PROGRAM NAME> program worked with me on what I could expect from participants from the <PROGRAM NAME> program.

1 Yes

2 No


  1. People from the <PROGRAM NAME> program are usually ready to work when they start at my organization.

1 Yes

2 No


  1. People from the <PROGRAM NAME> program work side by side with other employees at my organization and perform similar tasks.

1 Yes

2 No


  1. The people I supervise from the <PROGRAM NAME> program have an excellent chance of getting hired into a permanent job with my organization if they do a good job.

  • 1Yes

  • 2No


  1. I would be likely to provide a good reference for most of the people I supervise from the <PROGRAM NAME> program, if they asked.

  • 1Yes

  • 2No

The last two questions ask about other supports needed by employees from the <PROGRAM NAME> program and challenges/issues you faced in working with the <PROGRAM NAME> program.


  1. Please indicate what additional types of training or supports people from the <PROGRAM NAME> program still appear to need in order for them to succeed in this or their next job? (Check all that apply.)

1 Help arranging child care

2 Transportation assistance

3 Help addressing housing problems

4 Anger management classes

5 Alcohol or substance abuse treatment

6 Counseling/parenting classes

7 Help with work-appropriate clothing

8 Computer training

9 Career planning/resume writing/job interview preparation/job search assistance

10 General money management assistance

11 Help setting up a bank account

12 Access to benefits (e.g., Social Security, food stamps, disability insurance, etc.)

13 Help understanding or changing child support payments

14 Other (please describe): ________________________________________________

15 None


  1. Finally, are there any other issues or challenges you have encountered working with people from the <PROGRAM NAME> program?





Thank you for completing this questionnaire!

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleWorksite Supervisor Implementation Questionnaire
AuthorJoseph Broadus
File Modified0000-00-00
File Created2021-01-29

© 2024 OMB.report | Privacy Policy