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pdfSCSEP Participant
Customer Satisfaction Survey
OMB Approval Number: 1205-0040
Expiration Date: 10/31/2010
OLDER WORKER 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 strictly confidential. No one in the agency will see your individual responses.
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)
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)
Falls
short
1
Exceeds
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 staff told me everything I needed to know about how the
program worked. (Choose one number)
Strongly
disagree
1
2
3
4
5
6
7
8
9
Strongly
agree
10
Don’t
know
90
5. The Older Worker Program staff understood my employment interests and needs. (Choose
one number)
Strongly
disagree
1
2
3
4
5
6
7
8
9
Strongly
agree
10
Don’t
know
90
Please continue on other side
ETA-9124 – Part A
(Revised September 2010)
Your responses are confidential, and we appreciate your time and assistance. This voluntary information has been approved by the Office of
Management and Budget under OMB approval number 1205-0040. Without this approval, we would not be able to conduct this survey. The
time needed to complete the survey is estimated to average ten (10) minutes. 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, Divi sion of Adult
Services, Room S-4209, 200 Constitution Avenue, NW, Washington, DC 20210. (Please do not return surveys to this address.)
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SCSEP Participant Customer Satisfaction Survey
6. The Older Worker Program 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
Strongly
agree
10
9
Didn’t need
any
90
7. Before your community service assignment with your host agency, how much of the training
you needed to meet your employment goals did the Older Worker Program give you?
(Choose one number)
None of
the training
1
2
3
4
5
6
7
All of
the training
9
10
8
Didn’t need
any
90
8. The Older Worker Program helped me obtain a community service assignment that was just
right for me. (Choose one number)
Strongly
disagree
1
2
3
4
5
6
7
8
Strongly
agree
10
9
Don’t
know
90
9. I understand that I have the right to ask for a different community service assignment if I
don’t like the one the Older Worker Program gave me. (Choose one number)
Strongly
disagree
1
2
3
4
5
6
7
8
Strongly
agree
10
9
Don’t
know
90
10. Given your transportation situation, was your community service assignment convenient to
where you live? (Choose one answer)
Yes
Don’t know
No
11. There is someone in the Older Worker Program 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
12. 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
13. I feel comfortable at my community service 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, 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, 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 pay I receive from the Older Worker Program has made a substantial difference in the
quality of my life. (Choose one number)
Strongly
disagree
1
2
3
4
5
6
7
8
9
Strongly
agree
10
Don’t
know
90
17. During my community service assignment, the Older Worker Program pressured me, before
I was ready, to leave my community service assignment for unsubsidized employment.
(Choose one answer)
Yes
Don’t know
No
If you have an unsubsidized job, answer Questions 18, 19 and 20, and
continue with the rest of the survey. If you do not have an unsubsidized job,
skip to Question 21.
18. How much help did Older Worker Program staff give you in finding an unsubsidized job?
(Choose one number)
No
help
1
2
3
4
5
6
7
8
A great deal
of help
9
10
Don’t
know
90
19. How much of the skills and training you need for your current job did you gain from your
community service assignment? (Choose one number)
None of the
skills and training
1
2
3
4
5
6
7
8
Nearly all of the
skills and training
9
10
Don’t
know
90
Please continue on other side
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SCSEP Participant Customer Satisfaction Survey
20. Overall, how helpful was your community service assignment(s) in preparing you for
success in your current unsubsidized job? (Choose one number)
Not at all
helpful
1
2
3
4
5
6
7
8
Extremely
helpful
9
10
Don’t
know
90
21. Would you recommend the services of the Older Worker Program to other older workers?
(Choose one number)
Definitely
no
1
2
3
4
5
6
7
8
Definitely
yes
9
10
Don’t
know
90
22. What do you think is most valuable about the Older Worker Program?
___________________________________________________________________
___________________________________________________________________
____________________________________________________________________
23. What part of the Older Worker Program do you think is most in need of improvement?
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Thank you for taking time to complete this survey.
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| File Type | application/pdf |
| File Title | OLDER WORKER CUSTOMERS |
| Author | BARRY A GOFF |
| File Modified | 2010-10-14 |
| File Created | 2010-10-13 |