Form FEMA Form 007-0-7 FEMA Form 007-0-7 Disaster Recovery Center Survey

Federal Emergency Management Agency (FEMA) Individual Assistance Customer Satisfaction Surveys

FEMA Form 007-0-7, Disaster Recovery Center Survey 12182013

Disaster Recovery Center Survey

OMB: 1660-0036

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Disaster Recovery Center Survey

OMB Control Number 1660-0036

Expiration Date: 2/28/2014



PAPERWORK BURDEN DISCLOSURE NOTICE: Public reporting burden for this survey is estimated to average 8 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.

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INTRODUCTION


Hello, I’m calling from FEMA, the Federal Emergency Management Agency. My name is ___ and my ID # is _________. May I please speak with (Applicant) or the person who visited the Disaster Recovery Center on (Visit Date)?


  • Yes

  • No



If no: What would be a better time to call back? 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 your opinion is very important to us.

Would you volunteer to take 5 - 9 minutes to answer some questions?


  • Yes

  • No


If No: What would be a better time to call back? Thank you for your time and have a good day/evening.

If Yes: Thank you. The following questions comply with the Privacy Act of 1974 have been approved by the Office of Management and Budget under number 1660-0036. Your answers will not affect the outcome of your application for FEMA assistance. This call may be monitored and/or recorded for quality assurance.



























QUESTIONS


  1. Considering everything you experienced at the Disaster Recovery Center, what would be your overall rating of the Center?

  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Excellent or Good go to 1a, If Below Average or Poor go to 1b, else go to 2]


1a. What specific reason caused you to give it that rating? (Text Box)



1b. What specific reason caused you to give it that rating? (Text Box)


  1. How did you hear about the location of the Recovery Center?


  • Community Group (club, church, school etc.)

  • Disaster Workers (ARC, Salvation Army, Local Gov., etc.)

  • FEMA Disaster Worker

  • FEMA Website

  • Flyers, Signs, Billboards, Posters, etc. (Including driving by).

  • Internet searches (Google, Bing, etc.)

  • Newspaper

  • Radio

  • Service Provider (Insurance, water, gas phone, etc.)

  • Social Media (Facebook, Twitter, etc.)

  • Television

  • Text, Phone, Email Alerts (reverse 911, robo call, RSS Feed, etc.)

  • Word of Mouth (friends, family, neighbors, employer, landlord etc.)

  • Other (Specify)

If only response = Word of Mouth… go to 2b else go to 2a


2a. How would you rate FEMA in letting you know the location of the Center in your area? Would you say they were…?


  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Below Average or Poor go to 2b]


2b.What would be the best way of advertising the Center? (Text Box)


  1. How convenient for you was the Center’s location? Would you say…


  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Below Average or Poor go to 3a else go to 4]


3a. What specific reason caused you to give it that rating? (Text Box)


4. How convenient for you were the Center’s hours of operation? Would you say…


  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Below Average or Poor go to 4a else go to 5]


4a. What specific reason caused you to give it that rating? (Text Box)


5. BEFORE you arrived at the Disaster Recovery Center what type of services and information did you EXPECT to find?


  • Apply/Register for FEMA assistance

  • Blue Tarp/Roof/Rapid Temporary Repair

  • Check Status

  • Crisis Counseling

  • Deliver Fax/Paperwork

  • FEMA Program Information

  • Food Assistance

  • Inspection Information

  • Insurance Information (Home owners/renters/flood, State Insurance Commission)

  • IRS

  • Legal Aid

  • Mitigation/Debris Removal/Water Purification Information

  • SBA

  • Supplies (Cleaning, Water, Formula, Diapers, etc.)

  • Temporary Housing Resources

  • Unemployment

  • Volunteer Organization (ARC, Salvation Army, United Way, etc.)

  • Had no Expectation

  • Other Federal, State, Local Agencies (Specify)

  • Other (Specify)


6. AFTER you entered the Center and saw what was available, what specifically did you want to accomplish during your visit?


  • Apply/Register for FEMA assistance

  • Blue Tarp/Roof/Rapid Temporary Repair

  • Check Status

  • Crisis Counseling

  • Deliver Fax/Paperwork

  • FEMA Program Information

  • Food Assistance

  • Inspection Information

  • Insurance Information (Home owners/renters/flood, State Insurance Commission)

  • Legal Aid

  • IRS

  • Mitigation/Debris Removal/Water Purification Information

  • SBA

  • Supplies (Cleaning, Water, Formula, Diapers, etc.)

  • Temporary Housing Resources

  • Unemployment

  • Volunteer Organization (ARC, Salvation Army, United Way, etc.)

  • Other Federal, State, Local Agencies (Specify)

  • Other (Specify)

(If response = Temporary Housing go to 6a, else go to 7]


6a. How would you rate the Center on helping you find available housing? Would you say…?


  • Extremely Helpful

  • Very Helpful

  • Somewhat Helpful

  • Not Very Helpful

  • Not At All Helpful

  • Don’t Know / No Opinion

[If response = Not Very Helpful or Not At All Helpful go to 6b]


6b. How could they have been more helpful? (Text Box)


7. Did you accomplish all the things you wanted to during your visit to the Center?

  • Yes

  • Some

  • No

[If response = Some or No go to 7a else go to 8]

7a. What things were not accomplished?


  • Apply/Register for FEMA assistance

  • Blue Tarp/Roof/Rapid Temporary Repair

  • Check Status

  • Crisis Counseling

  • Deliver Fax/Paperwork

  • FEMA Program Information

  • Food Assistance

  • Inspection Information

  • Insurance Information (Home owners/renters/flood, State Insurance Commission)

  • Legal Aid

  • IRS

  • Mitigation/Debris Removal/Water Purification Information

  • SBA

  • Supplies (Cleaning, Water, Formula, Diapers, etc.)

  • Temporary Housing Resources

  • Unemployment

  • Volunteer Organization (ARC, Salvation Army, United Way, etc.)

  • Other Federal, State, Local Agencies (Probe and Specify)

  • Other (Specify)


8. How would you rate the Recovery Center Staff on being courteous? Would you say…


  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Below Average or Poor go to 8a else go to 9]


8a. In what way were they not courteous?


  • Accusatory

  • Agent wasn’t Knowledgeable (Probe & Specify)

  • Condescending

  • Didn’t Answer Questions (Probe & Specify)

  • Impatient

  • Interrupted

  • No Empathy (Caring/Concern)

  • Rude/Disrespectful/Unprofessional

  • Tone of voice

  • Other (Specify)




9. And on showing an interest in your situation? Was the Recovery Center Staff…

  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Below Average or Poor go to 9a else go to 10]


9a. What made you feel he/she was not interested in helping?


  • Didn’t Answer Question(s) or fully explain (Probe & Specify)

  • Didn’t Listen

  • Didn’t make Me Eligible

  • Didn’t provide next steps

  • Minimized my losses

  • No confidence in agent’s knowledge

  • No Empathy (Indifference/lack of concern etc.)

  • Rushed Call

  • Other (Specify)


10. Using the same rating scale how would you rate the Disaster Recover Center Staff on letting you know what you needed to do next?


  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Below Average or Poor go to 10a else go to 11]


10a . What specific reason(s) caused you to give it that rating?


  • Explanations were confusing, inconsistent, incomplete etc.

  • Didn’t Answer Questions (Probe & Specify)

  • Didn’t make Me Eligible

  • Next Steps not given

  • No Empathy (Indifference/lack of concern etc.)

  • Poor customer service (Probe & Specify)

  • Too much info

  • Other (Specify)



11. and on making good use of your time?


  • Excellent

  • Good

  • Satisfactory

  • Below Average

  • Poor

  • Don’t Know / No Opinion

[If response = Below Average or Poor go to 11a else go to 12]


11a. What specific reason(s) caused you to give it that rating?


  • Computer Issues

  • Needed more Staff

  • Not well organized

  • Phone Issues

  • Upfront Info (Answer questions, tell eligibility)

  • Other [Specify]


12. While at the Disaster Recovery Center did you receive any FEMA brochures or information sheets?


  • Yes

  • No

  • Don’t Remember

[If response = Yes go to 12a else go to 13]


12a. How helpful was the written material? Would you say:


  • Very Helpful

  • Helpful

  • Not Very Helpful

  • Not at all Helpful

[If response = Not Very Helpful or Not at all Helpful go to 12b else go to 13]


12b. What changes are needed to make the information more helpful? (Text Box)


13. Did you request to use alternate communication tools such as an amplified phone, illuminated Magnifier or other types of accessibility while at the Recovery Center?


  • Yes

  • No

  • Don’t Remember

[If response = Yes go to 13a else go to 14]




13a. How satisfied were you with the device(s) provided?


  • Very Satisfied

  • Satisfied

  • Not Very Satisfied

  • Not at all Satisfied

[If response = Not Very Satisfied or Not at all Satisfied go to 13b else go to 14]


13b. What changes should be made at the Disaster Recovery Center to improve alternate communication and accessibility services? (Text Box)


14. Have you encouraged friends, family or others to visit the Disaster Recovery Center?


  • Yes

  • No

  • Don’t know/Don’t remember

(If response = Yes go to 14a else go to 15)


14a. Did you communicate that information:


  • Face to face

  • Text or e-mail

  • Telephone call

  • Social Media (Facebook, Twitter etc.)

  • Other (Specify)


15. FEMA is interested in getting your opinion on what we could do to improve our service. What recommendations would you like to pass on to improve the Disaster Recovery Centers [Text Box]


Close


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

FEMA Form 007-0-7 Page 20 of 20


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