ETA 9124A, 9124B, SCSEP Customer Satisfaction Surveys

SCSEP Participant
Customer Satisfaction Survey

OMB Approval Number: 1205-0040
Expiration Date: x/xx/xxxx

OLDER WORKER CUSTOMERS
The Older Worker Program, also known as the Senior Community Service Employment Program
(SCSEP) or Title V of the Older Americans Act, 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. No one in the agency will see your individual responses.
Please be frank in your responses. Your answers will be kept private to the extent permitted by law and
will be used for program evaluation and improvement purposes only. No one in the agency will see your
individual responses.
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

9

Very
satisfied

10

Didn't
receive

90

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

Exceed

2

3

4

5

6

7

8

9

10

Didn't
receive

90

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

9

Very
close

10

Didn't
receive

90

4. The primary reason(s) I enrolled in the Older Worker Program/SCSEP were to: (Choose all that apply)
1)
2)
3)
4)
5)
6)
7)
8)

Obtain a full-time job after completing the program
Obtain a part-time job after completing the program
Participate in the program’s training and host agency activities
Provide service to my community
Meet new people
Increase my income
Feel more useful and independent
Other ________________________________________________

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.)

Please continue on other side ETA-9124 – Part A
(Rev. 12/13/2019)

1

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

2

3

4

5

6

7

8

9

Strongly
agree

Don’t
know

10

90

6. The Older Worker Program/SCSEP staff gave me a host agency assignment that matched my
employment interests and needs. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Don’t
know

10

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

10

Didn’t need
any

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

10

Doesn’t
apply

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

10

Didn’t need
any

90

Please continue on next page
2

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

2

3

4

5

6

7

8

9

Strongly
agree

10

Don’t
know

90

12. Which of the following best describes your experience with computer training? (Choose
one number)
1)
2)
3)
4)
5)

I received the computer training I needed.
I received computer training, but it didn’t meet my needs.
I needed computer training, but little or none was offered.
I didn’t need computer training but was given the training anyway.
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

2

3

4

5

6

7

8

9

Strongly
agree

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)
1
Better

2
Worse

3
About the same

9
Don’t know

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)
1
Much more
negative

2
A little more
negative

3
About the same

4
A little more
positive

5
Much more
positive

9
Don’t know

16. The income I receive from the Older Worker Program/SCSEP is important for meeting my
basic expenses. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

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
3

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

2

3

4

5

6

7

8

9

Extremely
helpful

10

Don’t
know

90

If you have left the Older Worker Program/SCSEP and have a job, answer Questions 1920, 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

1

2

3

4

5

6

7

8

9

A great deal
of help

10

Don’t
know

90

20. Do you feel that your participation in the Older Worker Program/SCSEP prepared you for
employment in these organizations? (Choose all statements that apply)
1)
2)
3)
4)

I felt prepared for employment in a nonprofit organization
I felt prepared for employment in a government organization
I felt prepared for employment in a for-profit business
I did not feel prepared for employment in any organization or business

21. Based on your experience, what is the most effective aspect of the Older Worker
Program/SCSEP?
___________________________________________________________________
___________________________________________________________________
____________________________________________________________________
22. Based on your experience, what would you recommend to make the Older Worker
Program/SCSEP more effective?
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Thank you for taking time to complete this survey.
4

SCSEP Host Agency
Customer Satisfaction Survey

OMB Approval Number: 1205-0040
Expiration Date: x/xx/xxxx

HOST AGENCY CUSTOMERS
The Older Worker Program, also known as the Senior Community Service Employment Program
(SCSEP) or Title V of the Older Americans Act, wants to provide the highest quality services to
its customers. You can help improve services by answering the following questions about your
experiences as a host agency over the last twelve months. Please be frank in your responses.
Your answers will be kept private to the extent permitted by law and will be used for program
evaluation and improvement only. No one in the agency will see your individual responses.
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. If there is
someone else in your agency better suited to answer the survey, please give that person the
survey to complete. 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

9

Very
satisfied

Didn't
receive

10

90

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

9

Exceed

Didn't
receive

10

90

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

9

Very
close

Didn't
receive

10

90

4. The Older Worker Program/SCSEP staff make the process of assigning participants easy for
me. (Choose one number)
Strongly
disagree

1

Strongly
agree

2

3

4

5

6

Don’t
know

7
8
9
10
90
Please continue on other side

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
minutes per response,
se10continue
on oter
including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and co mpleting 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.)

ETA-9124 – Part B
(Rev. 12/13/2019)

1

side

SCSEP Host Agency Customer Satisfaction Survey
5. The Older Worker Program/SCSEP staff who make the assignments have a good
understanding of my business needs. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Don’t
know

10

90

6. I receive sufficient information about the backgrounds of the participants assigned to my
agency. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Don’t
know

10

90

7. Consider the last time the Older Worker Program/SCSEP staff proposed an assignment for
your agency. What choice did you feel you had at that time? (Choose one number )
1) I can accept the individual offered or not
2) I have a choice among several potential participants
3) I really have no choice

8. The participants assigned are a good match with my agency. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Don’t
know

10

90

9. Would you like the participants to have been better prepared in any of these areas? (Choose
Yes, No, or N/A for each statement)
1) Basic computer knowledge
2) Basic employability skills, like how to dress, how to interact
with co-workers and supervisors, and punctuality
3) Knowledge of what the assignment required
4) How to interact with the host agency’s customers or clients

Yes

No

N/A

Yes
Yes
Yes

No
No
No

N/A
N/A
N/A

10. The Older Worker Program/SCSEP staff stay in touch with my agency throughout the
assignment to make sure it goes well. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Don’t
know

10

90

Please continue on next page

2

SCSEP Host Agency Customer Satisfaction Survey
11. Do any of the older workers assigned to your agency need supportive services, such as
assistance with transportation, uniforms, safety equipment, or medical care, to be successful
in their assignments? (Choose one answer)
1
None

2
Few

3
Many

4
Nearly all

9
Don’t know

12. Has the Older Worker Program/SCSEP removed any participants from your agency before
you thought they were ready to leave? (Choose one number)
1
Never

2
Occasionally

3
Frequently

4
Nearly always

9
Don’t know

13. Has your agency requested that the Older Worker Program/SCSEP remove a participant
because the participant was not working out? (Choose one answer)
Yes

No

Don’t know

14. How has your participation in the Older Worker Program/SCSEP affected the amount of
service your agency provides to the community? (Choose one answer)
1
Decreased
significantly

2
Somewhat
decreased

3
Neither decreased
nor increased

4
Somewhat
increased

5
Increased
significantly

9
Don’t
know

15. Based on your experience, what makes the Older Worker Program/SCSEP most effective?
________________________________________________________________________
________________________________________________________________________

16. Based on your experience, what would you recommend to make the Older Worker
Program/SCSEP more effective?
________________________________________________________________________
________________________________________________________________________

Thank you for taking the time to complete this survey.

3

SCSEP Employer
Customer Satisfaction Survey

OMB Approval Number: 1205-0040
Expiration Date: XX/XX/20XX

EMPLOYER 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. Please be completely honest. Your answers will be kept private to the
extent permitted by law and used for program evaluation purposes only. Unless the question directs you
otherwise, please answer each question based on your experience hiring the participant identified in the cover
letter accompanying this survey.
Choose the number on the scale below each question that best represents your opinion. 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? (Choose one number)
Very
dissatisfied

1

2

3

4

5

6

7

8

9

Very
satisfied

10

Didn't
receive

90

2. Considering all of the expectations you may have had about the services of the Older Worker Program, to
what extent have the services met your expectations? (Choose one number)
Fall
short

1

Exceed

2

3

4

5

6

7

8

9

10

Didn't
receive

90

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

9

Very
close

10

Didn't
receive

90

4. The Older Worker Program/SCSEP staff that referred the participant for the job had a good
understanding of your business needs. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

10

Not
applicable

90

Please continue on other side
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. (Please do not return surveys to this address.)

ETA-9124 – Part C
Rev. 8/11/2015

1

SCSEP Employer Customer Satisfaction Survey
5. The participant referred by the Older Worker Program/SCSEP had the skills necessary to
start the job. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

10

Not
applicable

90

6. Would you have liked the participant to have been better prepared in any of these areas?
(Choose Yes, No, or N/A)
1) Computer knowledge
2) Basic employability skills, like how to dress, how to interact with
co-workers and supervisors, and punctuality
3) Knowledge of what the job required
4) How to behave with the employer’s customers or clients
5) Job-specific skills

Yes

No

Yes
Yes
Yes
Yes

No
No
No
No

7. The Older Worker Program/SCSEP staff stayed in touch with me after I hired the
participant to make sure that everything was going well. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

10

Don’t
know

90

8. Did the participant hired require supportive services, such as assistance with transportation,
uniforms, safety equipment, or health services? (Choose one answer)
Yes

No

Don’t know

9. After we hired the participant with the assistance of the Older Worker Program/SCSEP, the
Older Worker Program/SCSEP staff was helpful in resolving any problems we had. (Choose
one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

10

Not
applicable

90

10. I see the Older Worker Program/SCSEP as valuable for maintaining a wide range of ages
in my workforce. (Choose one number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

10

Not
applicable

90

Please continue on next page
2

SCSEP Employer Customer Satisfaction Survey
11. Which of the following factors made the Older Worker Program/SCSEP attractive for you:
(Choose Yes, No, or N/A for each of the statements below)
1) It paid the wages of the older workers for a number
of weeks while they are gaining work experience
through a subsidized on-the-job training program
2) It stays in touch about my hiring needs
3) It could fill my job openings quickly
4) It has people with the right skills
5) It has people with good attitudes and work habits
6) It does a good job in screening applicants

Yes
Yes
Yes
Yes
Yes
Yes

No
No
No
No
No
No

N/A
N/A
N/A
N/A
N/A
N/A

12. What is most valuable to you about the Older Worker Program/SCSEP?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
13 Based on your experience, what changes would you recommend for the Older Worker
Program/SCSEP?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Thank you for taking the time to complete this survey.

3