Form CMS-10512 Survey on Core Competencies for the Direct Service Workf

Survey on Core Competencies for the Direct Service Workforce (CMS-10512)

DSW CC Revised Survey Screenshots OMB Control 0938-1229

Agency Administrators and Directors - Survey on Core Competencies for the Direct Service Workforce

OMB: 0938-1229

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TITLE: Survey on Core Competencies for the Direct Service Workforce

OMB CONTROL NUMBER: 0938-1229

This document contains screenshots of the online survey tool as it will appear to respondents. A dark blue bar reading “Survey on Core Competencies for the Direct Service Workforce” indicates the start of a new survey screen. The first two screens had to be captured as multiple images. The variations in font size will not occur. They are only in this document to allow screens to fit as one image here.



After respondents click “Done” they will see the following screen associated with the online survey program we are using (SurveyMonkey).

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBetsy Dilla
File Modified0000-00-00
File Created2021-01-27

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