OMB Number:
2900–New CVE Site Inspection
Respondent Burden: 5
minutes
Expiration Date: xx/xx/xxxx
The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. The public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, and completing and reviewing the collection of information. No person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Customer satisfaction surveys are used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this survey will lead to improvements in the quality of service delivery by helping to shape the direction and focus of specific,programs and services. Submission of this form is voluntary and failure to respond will have no impact on benefits to which you may be entitled.
CVE Site Inspection Survey: Historical
How many times has your company been site inspected by CVE during the last 12 months?
_______
When was the most recent CVE site inspection conducted?
_____Month _____Year
For the following questions, please consider your experience during the most recent site inspection
Did you receive a complete site inspection by the CVE representative?
____Yes (site inspection was completed) (Go to Q. 5)
____No (the site inspection was not completed due to unavailability of Veteran or other reason)
(If
not completed)
Why was the site inspection
not
completed? Please
explain.
________________________________________________________________________
________________________________________________________________________
Were you told in advance that your company was going to be inspected?
____Yes
____No
Did the CVE representative present a VA Identification Card and a credential letter as proof of identity prior to beginning the site inspection?
_____VA PIV card
_____Credential letter
_____None of those
Did the site inspector tell you what he/she was seeking during the inspection?
____Yes
____No
Were additional documents requested during or after the site inspection?
____Yes
____No
(Go
to Q. 10)
Did the site inspector tell you why the documents were requested and provide uploading information and assistance?
____Yes
____No. Please explain_______________________________________________
Were you personally interviewed?
____Yes
____No
Were other managers/employees interviewed during the site inspection?
____Yes
____No
How long did the site inspection take?
_____Less
than 1 hour
_____1 to 3 hours
_____Over 3 hours
How
satisfied are you with the CVE representative who conducted the site
inspection?
____Very
Satisfied (Go
to Q. 15)
____Satisfied
(Go
to Q. 15)
____Unsatisfied
____Very
Unsatisfied
(If
Unsatisfied or Very Unsatisfied)
Why were you Unsatisfied or Very Unsatisfied with the CVE
representative who conducted the site inspection?
Please explain.
____________________________________________________________________
____________________________________________________________________
In
general, how satisfied are you with the site inspection
process?
____Very
Satisfied (Go
to Q. 17)
____Satisfied
(Go
to Q. 17)
____Unsatisfied
____Very
Unsatisfied
(If
Unsatisfied or Very Unsatisfied)
Why were you Unsatisfied or Very Unsatisfied with the site
inspection
process?
Please
explain.
____________________________________________________________________
____________________________________________________________________
Did
the inspector answer all your questions?
____Yes (Go
to Q. 19)
____No
(If
all questions were not answered)
What questions did the inspector not
answer?
____________________________________________________________________
____________________________________________________________________
How
long did it take for you to receive a formal notification on the
site inspection
outcome?
____Less
than a month
____1 to 3 months
____More than 3
months
____Never received one
Has
your company gone through a simplified renewal process prior to the
inspection?
____Yes
____No
Has
your company received contracts for the Department of Veterans
Affairs during the last 2 years?
____Yes
____No
Has your company received contracts for any Federal agency (other than VA) during the last 2 years?
____Yes
____No
How long has your company been in business?
____Less than a year
____1 to 3 years
____4 to 5 years
____More than 5 years
How many employees does your company have?
____1 (myself)
____2
to 25
____26 to 50
____51 to 100
____More than one
hundred
What type of firm do you own?
____Sole
proprietorship
____General
partnership
____LP
____LLP
____LLLP
____LLC
or Ltd. Co.
____PLLC
____Corp.
or Inc.
____PC
(Professional Corporations)
Do you have any suggestions on how to improve CVE’s site inspection process or any comments that you would like to share with the Executive Director? Please explain.
__________________________________________________________________________
__________________________________________________________________________
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | CVE Site Inspection Survey |
| Author | Ortiz, Milagros |
| File Modified | 0000-00-00 |
| File Created | 2021-01-27 |