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pdfSCSEP Participant
Customer Satisfaction Survey
OMB Approval Number: 1205-0040
Expiration Date: 08/31/2018
OLDER WORKER CUSTOMERS
The Older Worker Program, also known as the Senior Community Service Employment
Program (SCSEP), wants to provide the highest quality services to its customers. You can
help us improve our services by answering the following questions about your experience
as a participant in the program. Please be completely honest. Your answers will be strictly
confidential. No one in the agency will see your individual responses.
Please fill in your response to each answer like this:
, NOT this
Choose the number on the scale below each question that best represents your opinion. The last
two questions allow you to express your ideas about the program in your own words. Thank you
in advance for your help.
1. Utilizing the scale below, what is your overall satisfaction with the services provided by the
Older Worker Program/SCSEP? (Choose one number)
Very
dissatisfied
1
2
3
4
5
6
7
8
Very
satisfied
Didn’t
receive
10
90
9
2. Considering all of the expectations you may have had about the services of the Older Worker
Program/SCSEP, to what extent have the services met your expectations? (Choose one number)
Fall
short
1
2
3
4
5
6
7
8
Exceed
Didn’t
receive
10
90
9
3. Now, think about the ideal services for people in your circumstances. How well do you think
the services you received compare with the ideal services? (Choose one number)
Not at all
close
1
2
3
4
5
6
7
8
Very
close
Didn’t
receive
10
90
9
4. The primary reason(s) I enrolled in the Older Worker Program/SCSEP were to:
(Choose all that apply)
1) Obtain a full-time job after completing
the program
2) Obtain a part-time job after completing
the program
3) Participate in the program’s training and
host agency activities
4) Provide service to my community
5) Meet new people
6) Increase my income
7) Feel more useful and independent
8) Other ___________________________
Please continue on other side
ETA-9124 – Part A (Rev. 2/28/2018)
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 10 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. Completion of this survey is
completely voluntary, and information collected will be kept private to the extent permitted by law and used for program evaluation purposes only. Thank you for your
participation. If you have any comments regarding this estimate or any other aspect of this survey, including suggestions for reducing this burden; please send them to
the U.S. Department of Labor, Office of Workforce Investment, Room C-4510, 200 Constitution Avenue, NW, Washington, DC 20210. (Please do not return surveys
to this address.)
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SCSEP Participant Customer Satisfaction Survey
5. At the time I enrolled, the Older Worker Program/SCSEP staff told me what I needed to
know about how the program worked and what to expect. (Choose one number)
Strongly
disagree
1
Strongly
agree
2
3
4
5
6
7
8
9
Don’t
know
10
90
6. The Older Worker Program/SCSEP staff understood my employment interests and needs.
(Choose one number)
Strongly
disagree
1
Strongly
agree
2
3
4
5
6
7
8
9
10
Don’t
know
90
7. The Older Worker Program/SCSEP helped me obtain the supportive services, such
as assistance with transportation, housing, or medical care, that I needed to meet my
employment goals. (Choose one number)
Strongly
disagree
1
2
3
4
5
6
7
8
9
Strongly
agree
Didn’t
need any
10
90
8. Given your transportation situation, was your host agency assignment convenient to where
you live? (Choose one answer)
Yes
No
Don’t know
9. There is someone in the Older Worker Program/SCSEP I can talk to when I need to.
(Choose one number)
Strongly
disagree
1
2
3
4
5
6
7
8
9
Strongly
agree
Doesn’t
apply
10
90
10. During my community service assignment, my host agency gave me the training I needed to
be successful in my assignment. (Choose one number)
Strongly
disagree
1
2
3
4
5
6
7
8
9
Strongly
agree
Didn’t
need any
10
90
Please continue on next page
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SCSEP Participant Customer Satisfaction Survey
11. I had a say in the types of skills I would gain during my host agency assignment.
(Choose one number)
Strongly
disagree
1
Strongly
agree
2
3
4
5
6
7
8
9
10
Don’t
know
90
12. Which of the following best describes your experience with computer training?
(Choose one number)
1) I received the computer training I needed.
2) I received computer training, but it didn’t meet my needs.
3) I needed computer training, but little or none was offered.
4) I didn’t need computer training but was given the training anyway.
5) I didn’t need computer training and didn’t receive any.
13. I feel comfortable at my host agency assignment. (Choose one number)
Strongly
disagree
1
Strongly
agree
2
3
4
5
6
7
8
9
10
Don’t
know
90
14. Compared to the time before you started working with the Older Worker Program/SCSEP,
would you say your physical health is better, worse, or about the same? (Choose one number)
Better
Worse
1
2
About the same
Don’t know
3
9
15. Compared to the time before you started working with the Older Worker Program/SCSEP,
how would you rate your outlook on life? (Choose one number)
Much more
negative
A little more
negative
1
A little more
positive
About the same
2
3
Much more
positive
4
Don’t
know
5
9
16. The pay I receive from the Older Worker Program/SCSEP is important for meeting my basic
expenses. (Choose one number)
Strongly
disagree
1
Strongly
agree
2
3
4
5
6
7
8
9
10
Don’t
know
90
17. During my host agency assignment, the Older Worker Program/SCSEP staff pressured me to
leave my host agency assignment for a job before I was ready. (Choose one answer)
Yes
No
Doesn’t apply
Please continue on other side
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SCSEP Participant Customer Satisfaction Survey
18. Overall, how helpful has the Older Worker Program/SCSEP been in preparing you for
success in the workforce? (Choose one number)
Not at all
helpful
1
Extremely
helpful
2
3
4
5
6
7
8
9
Don’t
know
10
90
If you have left the Older Worker Program/SCSEP and have a job, answer Questions 19-20,
and continue with the rest of the survey. If you do not have a job, skip to Question 21.
19. How much help did Older Worker Program/SCSEP staff give you in finding employment?
(Choose one number)
No
help
A great deal
of help
1
2
3
4
5
6
7
8
9
Don’t
know
10
90
20. Do you feel that your participation in the Older Worker Program/SCSEP prepared you for
employment in these organizations? (Choose all that apply)
1) I felt prepared for employment in a nonprofit organization
2) I felt prepared for employment in a government organization
3) I felt prepared for employment in a for-profit business
4) I did not feel prepared for employment in any organization or business
21. What is most valuable to you about the Older Worker Program/SCSEP?
22. Based on your experience, what changes would you recommend for the Older Worker
Program/SCSEP?
Thank you for taking time to complete this survey.
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| File Type | application/pdf |
| File Modified | 2018-08-24 |
| File Created | 2015-10-08 |