SCSEP Host AgencyOMB Approval Number: 1205-0040

Customer Satisfaction SurveyExpiration Date: 3/31/2015

HOST AGENCY 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 improve services by answering the following questions. Please be completely honest. Your answers are strictly confidential. No one in the agency will see your individual responses. Unless directed otherwise, please answer based on your most recent experience with the Older Worker Program.

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 of 1 to 10 below, what is your overall satisfaction with the services provided by the Older Worker Program?(Choose one number)

VeryVeryDidn't
dissatisfiedsatisfiedreceive

1234567891090

  1. 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)

FallsExceedsDidn't
shortreceive

1234567891090

  1. 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 allVeryDidn't
closeclosereceive

1234567891090

  1. The Older Worker Program staff made the community service assignment process easy for me to use. (Choose one number)

StronglyStronglyDon’t
disagreeagreeknow

1234567891090

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.)

ETA-9124 – Part B

(Revised September 2014)

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SCSEP Host Agency Customer Satisfaction Survey

  1. The Older Worker Program staff that made the assignment had a good understanding of my business needs. (Choose one number)

StronglyStronglyDon’t
disagreeagreeknow

1234567891090

6.I received sufficient information about the work history and education of the participant assigned to my agency. (Choose one number)

StronglyStronglyDon’t
disagreeagreeknow

1234567891090

7.When program staff proposed a participant for our agency, I understood that: (Choose one)

1)I could accept the individual offered or not.

2)I had a choice among several potential participants.

3)I really had no choice.

8.The participant assigned to my agency was a good match with my agency. (Choose one number)

StronglyStronglyDon’t
disagreeagreeknow

1234567891090

9. The Older Worker Program staff was helpful in resolving any problems I had. (Choose one number)

StronglyStronglyNot
disagreeagreeapplicable

1234567891090

10. The Older Worker Program staff helped our agency identify the types of work experience and training that would be most helpful to the participant. (Choose one number)

StronglyStronglyNot
disagreeagreeapplicable

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11.The participant had a say in the types of skills he or she would gain during the community service assignment. (Choose one number)

StronglyStronglyNot
disagreeagreeapplicable

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Please continue on next page

12. Did any of the older workers assigned to your agency require supportive services, such as assistance with transportation, medical care, or housing, to be successful in their assignments? (Choose one answer)

Yes No (Skip to question #15) Don’t know (Skip to question #15)

13. If the answer to question 13 is “Yes,” to what extent did the Older Worker Program provide the participants the supportive services they needed? (Choose one number)

12349
NoneFewSomeNearly allDon’t know

14. Did the older worker program provide any of the following training when it was needed? (Choose“Yes” or “No” for items 1-5)

1)Basic computer trainingYes No

2)Advanced computer trainingYes No

3)Specific job skill trainingYes No

4)Customer service trainingYes No

5)Other training (specify)______Yes No

If “No” to all of the above, choose one of the two remaining responses.

6)No specific training needed

7)Don’t know

15. The Older Worker Program staff stayed in touch with my agency to make sure the assignment went well. (Choose one number)

StronglyStronglyDon’t
disagreeagreeknow

1234567891090

16. Did the Older Worker Program ever attempt to remove any participants from your agency before you thought they were ready to leave? (Choose one number)

12349
NeverOccasionally FrequentlyNearly alwaysDon’t know

17. How has your participation in the Older Worker Program affected your agency’s ability to provide services to the community? (Choose one answer)

123459
DecreasedSomewhat Neither DecreasedSomewhatIncreasedDon’t
SignificantlyDecreasednor IncreasedIncreasedSignificantlyknow

18. What do you think is most valuable about the Older Worker Program?

______

______

______

19. What part of the Older Worker Program do you think is most in need of improvement?

______

______

______

Thank you for taking the time to complete this survey.

ETA-9124 – Part B

(Revised September 2014)

1