Tailored Services Satisfaction Survey

Tailored Services Satisfaction Survey

Domains Assessed:

• Liaison/Consultant Expertise

• Culturally Responsive & Respectful (Liaisons & Consultants)

• Usefulness

• Adaptable

• Endorsement

• General Satisfaction

OMB Control No.: 0970-0494

Expiration Date:XX/XX/XXXX

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is gathering information to assess the satisfaction with capacity building services provided by the Child Welfare Capacity Building Collaborative. Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information please contact James DeSantis, Project Director, by email at [email protected].

The following survey asks about how satisfied you were with the tailored services you received from the [Center]. The survey will take approximately 5 minutes to fill out.  Your participation in this survey is voluntary – your views are very important, but you are not required to take the survey. Survey data will be safeguarded by the Center Evaluators and the Cross-Center Evaluation Team. Data will be kept private. Your individual responses will not be shared with others in your agency, Center Liaisons and consultants, or the Children’s Bureau.

The Cross-Center Evaluation will use survey results to help interpret the effectiveness of Center services.  Evaluation findings will be reported to the Children’s Bureau and other audiences, but individual respondents will not be identified. The Children’s Bureau also intends to share evaluation findings based on this survey and other data sources with the public in future evaluation reports. If you have any questions about the survey, please contact your State’s Liaison or Dr. James DeSantis via email at [email protected] or toll-free via phone at 1-800-546-3230

Please answer the following questions about your experiences with your tailored service.	Strongly Disagree	Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Agree	Strongly Agree
Liaison/Consultant Expertise
As a group, the representatives from the Center(s) had the right level of subject-matter knowledge and expertise.
As a group, the representatives from the Center(s) had the skills to effectively guide the tailored service.
As a group, the representatives from the Center(s) facilitated a collaborative process for implementing our plan.
Culturally Responsive & Respectful
As a group, the representatives from the Center(s) were a good match for helping us build our program capacity.
As a group, the representatives from the Center(s) had a good understanding of our agency/community needs.
As a group, the representatives from the Center(s) communicated with us in a way that felt relevant to the values and context of our agency/tribe/court.
Our ideas and desires about the tailored service process were respected by Center representatives.
Usefulness
The Center(s) provided effective support for our agency/tribe/court throughout the service delivery process.
The materials and information were appropriate for our agency/tribe/court’s level of experience and knowledge.
Our agency/tribe/court’s knowledge and/or skills about the topic(s) addressed by the tailored service have increased.
The knowledge and skills our agency/tribe/court acquired through this tailored service are directly applicable to our work.
Adaptable
The Center(s) helped us to identify and set milestones and measurable outcomes to track progress and success.
The Center(s) helped us to use data to make adjustments to the intervention and/or implementation process as needed.
My agency/tribe/court is considering using a similar change process/implementation framework in other initiatives.
Endorsement
I would recommend working with Center(s) to other jurisdictions.
I will share what I learned during my experience with the Center(s) with others.

SKIP PATTERN: If Somewhat Agree, Agree, or Strongly Agree are selected for item above ask:

If so, how and with what groups of colleagues will you share what you learned?

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SKIP PATTERN: If Neither Agree nor Disagree, Somewhat Disagree, Disagree, or Strongly Disagree are selected for item above ask:

If not, why not?

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General Satisfaction
The services provided met the needs of our agency/tribe/court.
Overall, I was satisfied with the services I received.

General Satisfaction (Cont.)

Could your experience with the Center(s) have been improved? (Circle One)

YES NO

If yes, please describe how your experience with the Center(s) could have been improved.

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