Department of Labor Generic Clearance for the Job Accommodation Network (JAN) Customer Satisfaction Survey

OMB Control No. 1225-0059
Expiration Date 11/30/2020

JAN Self- Employment Survey
Start of Block: Default Question Block
Q1 How did you know to contact JAN?

o Used JAN service before/Previous user of JAN service (1)
o Internet search (2)
o Referral. Please explain. (3) ______________________________________________
o Other. Please explain. (4) ________________________________________________
o Do not know (5)
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According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such
collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average
15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is voluntary.
Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the U.S. Department of Labor, Office of the Chief Information Officer, Attention: Departmental Clearance
Officer, 200 Constitution Avenue, N.W., Room N-1301, Washington, DC 20210 or email [email protected] and
reference the OMB Control Number 1225-0059. Note: Please do not return the completed survey to this address.

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Q2 Before you contacted the Self-employment service, what did you expect the Selfemployment service to provide you?

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Developing a business concept (5)
Market research (6)
Writing a business plan (8)
Obtaining capital (7)
Loan guarantees (9)
Technical assistance resources (10)
Growing a business (11)
Personnel management (12)
Financial management (13)
Developing a marketing plan (14)
Social Security (15)
PASS Plans (16)
Health care (17)
Working at home (18)
Other. Please specify: (4) ________________________________________________

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Q3 Where are you now in the process of self-employment?

o Considering the idea of self-employment (1)
o
Planning stages (Writing the business plan, exploring opportunities and ways agencies
and organizations can help with a variety of issues in the planning process) (2)
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Initial start up stages (Submitting the business plan, organizing work incentive options,
approval from VR or other micro enterprise or funding source, licensing, zoning and tax
issues in place) (3)

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Near operation (Funding and operation is in place and business is about to open its
doors) (4)
o Business established (5)
o Business expansion (6)
o Hiring other employees (7)
o Do not know (8)
o Other. Please specify: (9) ________________________________________________
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Q8 Did the information you received from the Self-employment service help you to get in touch
with local resources?

o Yes (1)
o No (2)
o Do not know (3)
o Other. Please specify: (4) ________________________________________________
Skip To: Q10 If Did the information you received from the Self-employment service help you to get in
touch with l... = No
Skip To: Q10 If Did the information you received from the Self-employment service help you to get in
touch with l... = Do not know

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Q9 Which of the following resources did you contact based on your consultation with the Selfemployment service? Select all that apply.

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Financing, economic development, and/or microenterprise programs (1)

Business planning and technical assistance organizations (includes business
incubators, nonprofit organizations, local business development offices, community
development offices, women's business councils etc.) (2)

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State vocational rehabilitation (VR) program (includes programs providing small
business development assistance within VR) (3)

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Small Business Administration (SBA) office (includes Small Business Development
Centers, Women's Business Centers, Service Corps of Retired Executives (SCORE) or
other affiliated programs) (4)

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Veteran's Business Development programs (includes SBA Veteran's programs,
Department of Veteran's Affairs) (5)

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Social Security Administration and related programs (includes organizations that
provide information on work incentive and benefits counseling) (6)

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Federal government business resources (includes IRS, Department of Commerce,
Department of Housing and Urban Development) (7)

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Credit or personal financial counseling services (8)
Health insurance resources (9)
Other. Please specify: (10) ______________________________________________

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Q10 Have you visited the Self-employment Service website within the last year?
(Jan.wvu.edu/sbses)

o Yes (1)
o No (2)
o Do not know (3)
o Other. Please specify: (4) ________________________________________________
Q12 How difficult was the website to navigate?

o Easy (1)
o Somewhat easy (2)
o Neutral (3)
o Somewhat difficult (4)
o Difficult (5)
o Do not know (6)
Q14 How was it for you to obtain the information that you needed from the website?

o Easy (1)
o Somewhat easy (2)
o Neutral (3)
o Somewhat difficult (4)
o Do not know (6)
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Q16 What did you hope to find on the website?
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Q18 Did you find it?

o Yes (1)
o If no, please explain. (2) ________________________________________________
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Q20 How easy or difficult was it to contact JAN?

o Easy (1)
o Somewhat easy (2)
o Neutral (3)
o Somewhat difficult (4)
o Difficult (5)
o Do not know (6)
Q22 How were you treated by the receptionist at JAN?

o Courteously (1)
o Somewhat courteously (2)
o Neutral (3)
o Somewhat not courteously (4)
o Not courteously (5)
o Do not know (6)
Q24 Comments:
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Q26 How were you treated by the consultant at JAN?

o Courteously (1)
o Somewhat courteously (2)
o Neutral (3)
o Somewhat not courteously (4)
o Not courteously (5)
o Do not know (6)
Q28 Comments:
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Q30 How well did the consultant understand your needs?

o Understood (1)
o Somewhat understood (2)
o Neutral (3)
o Somewhat misunderstood (4)
o Misunderstood (5)
o Do not know (6)
Q32 Comments:
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Q34 How well did the information that you received meet your needs?

o Met my needs well (1)
o Met my needs somewhat well (2)
o Neutral (3)
o Did not really meet my needs (4)
o Did not meet my needs (5)
o Do not know (6)
Q36 How could the services you received have better met your needs?
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Q38 Where would you get the type of information that JAN provides if JAN did not exist?
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Q40 Would you use the service again?

o Yes (1)
o No (2)
o Do not know (3)
Q42 Have you referred other people to JAN?

o Yes (1)
o No (2)
Q44 How likely would you be to refer other people to JAN?

o Likely (1)
o Somewhat likely (2)
o Neutral (3)
o Somewhat unlikely (4)
o Unlikely (5)
o Do not know (6)
Q46 We would appreciate any comments or suggestions that you may have about JAN.
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