Customer Satisfaction Survey

Customer Satisfaction Survey

Family satisfaction is very important to us at Hillside Family of Agencies. Your answers to this survey will help our programs improve the services they provide to families.

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Customer Satisfaction Survey - English

Date

County you live in

It is important to identify the program your family is receiving services from. If you are not sure about the correct name of the program, please check with program staff or refer to your family handbook, before continuing with this survey.

Does the person receiving service currently reside on a Hillside campus?

No, the person receiving service does not reside at any of these campusesYes, Crestwood Campus (Scottsville)Yes, Fingerlakes Campus (Auburn)Yes, Monroe Avenue CampusYes, Snell Farm CampusYes, Stillwater CampusYes, Varick Campus

Please select the correct unit (program).

Please select the correct program. Adoption ServicesChild and Family Treatment and Support Services - Central RegionChild and Family Treatment and Support Services - Monroe RegionChild and Family Treatment and Support Services - Southern Tier RegionChild and Family Treatment and Support Services - Western RegionCustomized Services - Central RegionCustomized Services - Monroe RegionCustomized Services - Southern TierCustomized Services - Western RegionDay Treatment - CreeksideDay Treatment - CrestwoodDay Treatment - HalpernDay Treatment - RCSDDay Treatment - Stepping Stones (Oswego)Emergency Respite Beds (ERB)Family Crisis Support Services (FCSS)Family FindingFamily ResiliencyFoster Care, RegularFoster Care, Therapeutic (TFC) - Central RegionFoster Care, Therapeutic (TFC) - Southern Tier RegionFoster Care, Therapeutic (TFC) - Western RegionFRC, Parent Education, Fathers GroupFRC, Parents as Advocates (PAA)FRC, PAT (Parents)FRC, PAT (Providers)GLOW Family SupportHCBS Waiver - Central RegionHCBS Waiver - Monroe RegionHCBS Waiver - NiGLOWIndividualized Residential Alternatives (IRA)In-Home ParentingOne FamilyOutpatient ClinicPreventive, Family PreservationPreventive, General - Erie CountyPreventive, General - Monroe CountyPreventive, Intensive Family SupportReinvesting in Youth (RIY)Residential - Critical Care - Crestwood CampusResidential - Critical Care - Monroe CampusResidential - Critical Care - Varick CampusResidential - DAS - Monroe CampusResidential - DAS - Varick CampusResidential - DAS Transitional - Varick CampusResidential - Enhanced - Monroe CampusResidential - Enhanced - Varick CampusResidential - GROW - Fingerlakes CampusResidential - Raise the Age, DAS - Snell Farm CampusResidential - Raise the Age, Specialized - Snell Farm CampusResidential - RTF - Crestwood CampusResidential - RTF - Fingerlakes CampusResidential - RTF - Monroe CampusResidential - RTF - Stillwater CampusResidential - Specialized - Snell Farm CampusResidential - Specialized - Varick CampusSubstance Abuse Clinic (OASAS)Youth Court, Community Service

After Selection

Please think about all the services you have received from this program in the past year (from unit, clinical, educational, and medical staff). Rate your level of satisfaction by selecting the number that best describes your experience:

Please think about the services you have received from this program in the past year. Rate your level of satisfaction by selecting the number that best describes your experience:

Overall, how satisfied do you feel with the services you receive from this program?

1

2

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10

Not Sure

Rating 1-10 (1 = Totally Dissatisfied, 10 = Totally Satisfied), or "Not Sure"

How can this program improve your satisfaction?

Please rate your level of agreement with each of these statements:

Staff listen to me and understand my family’s needs.

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10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

I help decide the goals for myself and my child.

1

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10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

Staff respect my family’s cultural values and customs.

1

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7

8

9

10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

Staff have the skills they need to work with me and my child.

1

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7

8

9

10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

The program provides the information I need to be an effective partner in my child’s care.

1

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10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

This program is helping my family.

1

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5

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8

9

10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

I would recommend this program to a family member or friend.

1

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8

9

10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

Have you experienced a problem with this program in the past year?

Yes

No

If “Yes”, please describe the problem.

How satisfied are you with the way the program handled this problem?

1

2

3

4

5

6

7

8

9

10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

What do you value most about this program?

FRC

Please rate your level of agreement with each of these statements:

Activities in the visits strengthen my relationship with my child.

1

2

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5

6

7

8

9

10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

This program motivates me to try new parenting strategies.

1

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10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

This program increases my understanding of my child’s development.

1

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10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

Section 5

Please rate your level of agreement with each of these statements:

My family has learned at least one new skill as a result of participating in this program.

1

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10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

This program has helped reduce stress for my family.

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9

10

Not Sure

Rating 1-10 (1 = Totally Disagree, 10 = Totally Agree), or "Not Sure"

Your name (optional)

When you have completed your survey, please make sure you hit "Submit" to send it to Hillside

We really appreciate your feedback. Your voice counts.

If you have an immediate question or concern, please contact a manager in the program, or call the HFA Customer Satisfaction Line at (585) 256-7500 or Toll Free at (877) 346-1190