Form ETA 9124C1 ETA 9124C1 Employer Survey

SCSEP Employer
Customer Satisfaction Survey

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

HOST AGENCY EMPLOYERS
You recently hired an older worker who was a participant in the Older Worker Program, also known as the
Senior Community Service Employment Program (SCSEP) or Title V of the Older Americans Act. The
participant was assigned to your organization or another host agency for training before you hired the
participant. This survey requests your feedback as an employer of a SCSEP participant, not in your role as a
host agency training site.
The Older Worker 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 frank. Your
answers will be kept private to the extent permitted by law and used for program evaluation and improvement
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. If there is someone
else in your organization better suited to answer the survey, please give that person the survey to complete.

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. 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

Please continue on other side
ETA-9124 – Part C1
(Rev. 1/15/2023)
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.)

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SCSEP Employer Customer Satisfaction Survey
4. The participant we hired generally had the skills necessary to start the job. (Choose one
number)
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Not
applicable

10

90

5. At the time you hired the older worker, would you have liked the individual to have been
better prepared in any of these areas? (Choose Yes, No, or N/A for each statement)
Basic computer knowledge
Basic employability skills, like how to dress, how to interact with
co-workers and supervisors, and punctuality
Knowledge of what the job required
How to behave with our customers or clients
Job-specific skills

Yes

No

N/A

Yes
Yes
Yes
Yes

No
No
No
No

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

6. Someone from the Older Worker Program/SCSEP contacted us after we hired the
participant. (Choose one answer)
Yes

Don’t know

No

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

Don’t know

No

Programs like the Older Worker Program/SCSEP are valuable for maintaining a wide
range of ages in my workplace. (Choose one number)

Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Not
applicable

10

90

If the Older Worker Program/SCSEP referred the older worker participant to you or
otherwise assisted you with the hiring process, please answer Questions 9-11 that follow
immediately. If the older worker came to you on his or her own, skip to questions 12 and 13.

9.

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

Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Not
applicable

10

90

Please continue on next page

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SCSEP Employer Customer Satisfaction Survey

10. Which of the following factors influenced your decision to hire the participant? (Choose
Yes, No, or N/A for each statement)
The older worker had already proven a
good fit during his/her time as a trainee.
The local SCSEP program stays in touch about my hiring needs
The local program could fill my job openings quickly
The local program has people with the right skills
The local program has people with good attitudes and work habits
The local program 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

11. The Older Worker Program/SCSEP staff stayed in touch with us after we hired the
participant to make sure that everything was going well.
Strongly
disagree

1

2

3

4

5

6

7

8

9

Strongly
agree

Not
applicable

10

90

Please answer these final questions whether or not the Older Worker Program/SCSEP
staff assisted you in the hiring of this older worker.
12. Based on your experience, what makes programs that assist older workers with re-entry
into the workforce, like the Older Worker Program/SCSEP, most effective?
____________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________

13. Based on your experience, what changes would you recommend to make the Older Worker
Program/SCSEP more effective in helping older workers with re-entry into the workforce?
_____________________________________________________________________________________________________
______________________________________________________________________________________________________

___________________________________________________________________________________________

Thank you for taking the time to complete this survey.

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