CFM Stakeholder Survey instrument copy

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Welcome
Thank you for participating in the Construction & Facilities Management Stakeholder Feedback
survey. We are committed to providing the highest quality facilities to veterans. Toward this end, we
have improved our ability to collect meaningful performance feedback from stakeholders at all levels,
across organizations, internal and external to VA.
You play an important role on the (PROJECT NAME). Your voluntary participation in this survey will
provide CFM with valuable insights, which we will use to improve performance on your project and
others. Only you can provide the feedback on your personal experiences and observations, and we
need to hear from you.
I strongly encourage you to take 5-10 minutes to complete this critical survey by Date, Month, Year.
CFM now collects feedback on major construction projects quarterly. Please think about the teams
you worked with on this project over the past three months when you answer the questions.
All responses to the survey are completely confidential, so please be completely candid in your
responses.
If you experience challenges accessing the survey, have questions, or would like to relay a concern,
please contact Sandra Martin, Program Manager, at [email protected].
Thank you very much for your feedback.
Sincerely,
(LEADERSHIP SIGNATURE BLOCK)
Respondent Burden: Title 38, United States Code, allows us to ask for this information. We estimate that you will
need an average of 8 minutes to review the instructions, find the information, and complete this survey. VA cannot
conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not
required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can
be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain. If desired, you can call
1-800-827-1000 to get information on where to send comments or suggestions about this survey.

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OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)
* For this major construction project, which functional team(s) have you worked closely with in the PAST 3
MONTHS? These are the teams you will provide feedback for. Please select all that apply, including your own
team.
CFM Project Team 1 (includes Project Manager, Planning, Historic Preservation and Environmental personnel)
CFM Project Team 2 (includes Contracting Officer and Finance personnel)
CFM Project Team 3 (includes Senior Resident Engineer, Resident Engineers, and Safety personnel)
VHA Medical Center/VISN/National Team
Architecture & Engineering Team
Construction Contractor Team
USACE Design Management Team
USACE Construction Management Team

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OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for CFM Project Team 1
During the PAST 3 MONTHS, CFM Project Team 1 (includes Project Manager, Planning, Historic
Preservation and Environmental personnel)...
Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

3

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for CFM Project Team 2
During the PAST 3 MONTHS, CFM Project Team 2 (includes Contracting Officer and Finance personnel)...

Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

4

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for CFM Project Team 3
During the PAST 3 MONTHS, CFM Project Team 3 (includes Senior Resident Engineer, Resident Engineers,
and Safety personnel)...
Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

5

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for the VHA Medical Center/VISN/National Team
During the PAST 3 MONTHS, the VHA Medical Center/VISN/National Team...
Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

6

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for the Architecture & Engineering Team
During the PAST 3 MONTHS, the Architecture & Engineering Team...
Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

7

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for the Construction Contractor Team
During the PAST 3 MONTHS, the Construction Contractor Team...
Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

8

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for the USACE Design Management Team
During the PAST 3 MONTHS, the USACE Design Management Team...
Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

9

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Feedback for the USACE Construction Management Team
During the PAST 3 MONTHS, the USACE Construction Management Team...
Never Rarely Sometimes Often Usually Always

N/A

...kept me thoroughly informed relevant to my role.
...communicated with me in a timely way.
...followed through on their commitments to me.
...delivered high quality work products (e.g., timely, accurate,
complete).
...exhibited the knowledge and skills necessary to successfully perform
their tasks.
...demonstrated a good understanding of my perspective and needs.
...demonstrated dedication to the project's success.
...worked collaboratively with others to solve problems.
…treated me respectfully.
…was easy to reach.

10

OMB Control Number 2900-XXXX

VA Office of Construction and Facilities Management
Stakeholder Feedback Survey for the
(PROJECT NAME)

Additional Thoughts
Please describe any unaddressed concerns identified during the PAST 3 MONTHS of this project.

Please describe the most positive aspect of this project during the PAST 3 MONTHS.

Would you like someone from CFM leadership to contact you about this project? If so please provide the
information below:
Name
Email Address
Phone Number

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