Form FEMA Form 007-0-4 FEMA Form 007-0-4 Direct Housing Operations Survey-Move In

DIRECT HOUSING OPERATIONS SURVEY-MOVE IN

OMB Control Number 1660-0036

Expiration Date 2/28/2014

PAPERWORK BURDEN DISCLOSURE NOTICE: Public reporting burden for this survey is estimated to average 6 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.

PRIVACY ACT STATEMENT

AUTHORITY: Government Performance and Results Act (GPRA), 5 U.S.C. Ch. 3 as amended and the GPRA of 2010 (P.L. 111-352); Executive Order (EO) 12862, “Setting Customer Service Standards;” and its March 23, 1995 Memorandum addendum, “Improving Customer Service;” Executive Order 13411 “Improving Assistance for Disaster Victims;” Executive Order 13571 “Streamlining Service Delivery and Improving Customer Service;” and its June 13, 2011 Memorandum “Implementing Executive Order 13571 on Streamlining Service Delivery and Improving Customer Service.”

PRINCIPAL PURPOSE(S): DHS/FEMA collects this information to measure Individual Assistance customers’ satisfaction with FEMA services.

ROUTINE USE(S): This information is used for the principal purpose(s) noted above and will not be shared outside of DHS/FEMA, except as allowed under DHS/FEMA-008 - Disaster Recovery Assistance Files (April 30, 2013, 78 FR 25282), or as required by law.

DISCLOSURE: The disclosure of information on this form is strictly voluntary and will assist FEMA is making improvements to its Individual Assistance program; failure to provide the information requested will not impact the provision of FEMA Individual Assistance to qualified entities.

PURPOSE STATEMENT

The purpose of the Direct Housing Questionnaire is to measure the customer’s satisfaction during the various phases of the disaster and the customer service provided during those phases.

Phase 1- PPI, Set Up, Assignment Processes

This phase of the study will be conducted about two weeks after assignment of the unit. The purpose of the study is to identify the applicant’s level of satisfaction with the pre-placement interview, set-up and assignment processes.

Introduction

Hello, I’m calling from FEMA, the Federal Emergency Management Agency. My name is ______________. My ID# is _____. May I please speak with ____________________?

If No: Thank you for your time and have a good day/evening.

If Yes: We’re looking for ways to improve the quality of our service and would like to check in with you several times to see how things are going during your stay in the FEMA temporary housing unit. Your opinions are very important to us. Would you volunteer to take 4-7 minutes to answer some questions? (Yes or No)

If No: I understand. Thank you for your time and have a good day/evening.

If Yes: Thank you. The following questions have been approved by the Office of Management and Budget under number 1660-0036. Please be assured that your responses will not affect the outcome of your application for FEMA assistance.

Q1 Series. Please think back to the time you were contacted to discuss your willingness to live in a FEMA temporary housing unit. I’m going to name some topics that may have been covered with you during that interview. As I read each topic please say “yes” if it was covered, “no” if it was not covered, or “don’t remember” if you do not recall. The first topic is:

Q1a. Unit Assignment Information and the Receipt for Government. Property (Yes, No, Don’t remember)

Q1b. Acceptable Site for the Unit (suitability or feasibility) (Yes, No, Don’t remember)

Q1c. Estimated time for delivery of unit (Yes, No, Don’t remember)

Q1d. Responsibilities for setting up the unit (: Yes, No, Don’t remember)

Q1e. Utility connection responsibilities (Yes, No, Don’t remember

Q1f. Recertification for continued use (Yes, No, Don’t remember)

Q2. Next: How would you rate the customer service you received during that interview? Would you say it was (Excellent, Good, Satisfactory, Below Average, or Poor; Don’t know / No opinion) (If Below Average or Poor go to Q2a)

Q2a In what way was it (Below Average/Poor)? (Poor attitude, Didn’t treat me with respect, Didn’t explain the guidelines clearly, Didn’t take time to listen to me, Didn’t seem interested in helping me, Didn’t answer my questions, Other __________)

Q3. How many days were there between the time FEMA called you about a temporary housing unit and the time you were told you were approved? (1-5 days, 6-10 days, 11-20 days, 21-30 days or more than 30 days.

Q3a. How would you rate that amount of time. Would you say it was… (Excellent, Good, Satisfactory, Below Average, or Poor; Don’t Know no Opinion). (Go to Q3b for all responses)

Q4. How many weeks were there between the time you were approved and the time you signed the paperwork (Receipt for Government Property)? (Less than 1 week, 1-2 Weeks, 3-4 weeks, 5-6 weeks, 7-8 weeks, more than 8 weeks)

Q4a. Was that amount of time… (Excellent, Good, Satisfactory, Below Average, or Poor; Don’t know/No opinion)

These next questions are about the signing of the paperwork (Receipt for Government Property) and your initial walk through of the unit.

Q5. How would you rate the customer service you received that day? Would you say it was (Excellent, Good, Satisfactory, Below Average, or Poor; Don’t know/No opinion) (If Below Average or Poor go to Q5a)

Q5a. In what way was it (Below average/poor)? (Poor attitude, Didn’t treat me with respect, Didn’t explain the guidelines clearly, Didn’t take time to listen, Didn’t seem interested in helping me, Didn’t answer my questions, Other ______)

Q5b. Was the unit the type and size you expected to receive? (Yes, No)(If No go to 5c)

Q5c. What was different? (Size: _____, Type: _____,)

Q5d. Was it equipped as you expected? (Yes, No) (If no go to Q5e)

Q5e. What was different? Furniture: _____, Expected Accessible:_____, Expected a Non Accessible:_____, Other _________)

Q5f. When you did the initial walk through, did everything work properly? (Yes or No) (If no go to Q5g.)

Q5g. What was not working (Keys___, Heating/AC___, Sewer___, Water___, Appliances___, Electricity___, Gas___, Door/Windows___, Other______)

[AutoPop Location of unit. Ask if commercial park or FEMA group site:]

Q6a. How satisfied are you with the location of your unit? Are you (Extremely Satisfied, Very Satisfied, Satisfied, Not Very Satisfied, or Not at all Satisfied, Don’t know/No opinion) (If Below Average or Poor go to Q6b)

Q6b. Why do you feel that way?

Location is not safe/secure___, No privacy___, Blocked access for repairs___, Not on school bus route___, Public transportation not accessible___, Store not accessible___, Inadequate parking for cars___, No parks or play area for children___, Sewage or drainage issue___, Other ___[Free Text box for other comments]

Q6c. How would you rate the actual unit in meeting your immediate housing needs? Would you say it was… (Excellent, Good, Satisfactory, Below Average, or Poor, Don’t know/No opinion) (If Below Average or Poor go to Q6d)

Q6d. In what way was it (Below average/poor? Too small___, location not convenient___, was not clean___, not accessible___, not well heated/ air conditioned___, Repair issues___, No start up kit included___, Other ___[Free Text box for other comments]

QSUG. 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 improve FEMA disaster housing that you have not already shared?

Close: That is all of the questions we have at this time. After you have lived in the unit for a while, we’ll be checking back with you again to see how things are going.

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

FEMA Form 007-0-4 4