Instrument 9_Caregiver Experience Survey 06-02-23 clean

The Paperwork Reduction Act Statement: The described collection of information is voluntary and will be used to help us understand JCAMP implementation. 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. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number and expiration date for the described collection are OMB #: xxxx-xxxx, Exp: xx/xx/20xx. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Dr. Alicia Summers; [email protected] and Dr. Sophia Gatwoski; [email protected].

Caregiver Experience Survey¹

<<insert organization name>> is interested in learning more about your experience with the child welfare court system. Your opinion can help us learn more about current practice and ways that we can improve. The survey is voluntary. Your responses are completely anonymous and will not impact your case in any way. This survey should take about <<insert time>> minutes to complete. If you have any questions, you can contact <<provide contact information>>.

For each sentence below, please mark how much you agree using this scale:

1 = Strongly disagree, 2 = Disagree, 3 = Neither agree nor disagree, 4 = Agree, 5 = Strongly agree

DNA = Does not apply

Family engagement [1.4, 1,7, 1.14, 2.4, 3.6]	1	2	3	4	5	DNA
I regularly received timely notice of court hearings. [2.4]
I was made aware that I could submit information to the court. [1.7/1.14]
I felt like I was a part of the foster child/youth’s team preparing for court. [3.6]
I was made aware that I could attend the foster child/youth’s court hearings. [1.4]
I attended most of the foster child/youth’s court dates. [1.4]
If I submitted written information prior to court, the judge acknowledged my input prior to any ruling. [1.7]
I understood what was going on during the foster child/youth’s court hearings. [1.7]
I was made aware that I could speak in the foster child/youth’s court hearing. [1.7]
I spoke in court hearings. [1.7]
I felt like I could ask for additional support I needed to best serve the youth in my home. [1.14]
I felt like I was included in court. [1.14]
I felt satisfied with the court experience. [1.14]
I understood my rights as a caregiver or relative. [1.7/ 3.6]
I understood the rights of the foster child/youth. [1.7/ 3.6]
I felt that the judge valued my input. [1.14]
Safety [4.2]	1	2	3	4	5	DNA
If there were safety concerns, I was able to bring those concerns to the court. [4.2]
If I brought up safety concerns, I could trust the court would follow up to prevent future harm. [4.2]
Permanency [1.7, 3.6]	1	2	3	4	5	DNA
The court permanency process was explained to me. [1.7]
I was informed of my role in the permanency process. [1.7, 3.6]
High-quality legal representation [3.6]	1	2	3	4	5		DNA
I was satisfied with the child/youth’s representation. [3.6]
The child/youth’s attorney treated me with respect. [3.6]
I understood the role of the child/youth’s attorney. [3.6]
I was able to bring information to the child/youth’s attorney whenever I needed to. [3.6]
I knew what to do if I wanted to provide feedback about my child/youth’s attorney. [3.6]

Is there anything else you would like to tell us about your experience with the court?

__________________________________________________________________

What is your relationship to the child(ren) on the case? ___________________________________

What is your age? _______

What is your gender?

☐ Female

☐ Male

☐ Non-binary

☐Other

☐ Prefer not to answer

Are you of Hispanic, Latino, or Spanish origin?

☐ No

☐ Yes

What is your race? (mark all that apply)

☐ Black/African American	☐ White/Caucasian	☐ American Indian/Alaska Native
☐ Asian	☐ Native Hawaiian/Pacific Islander	☐ Prefer not to answer
☐ Other race ______________________________

1 Lily Colby, Esq., from With Lived Experience conducted focus groups with people with lived experience in the child welfare systems as youth, relatives, and parents. Thank you to Dr. Margaret Gorlin for assisting with drafting questions and a special thanks to the subject matter experts Starcia Ague, Margaret Coyne, Erica Hickey, Dorian Gervais, Ariella Stafanson, Cherie Shroeder, and Jennifer Rexroad.

JCAMP Caregiver Experience Survey 15