Featherfist Client Survey Questions

Survey Instructions: Please enter the date you are taking the survey. Also enter the program where you receive services or the name of the facility where you are housed. If you don’t know the name of your program, please call your case manager and ask them. Select the number that best answers the question.

1. The project is helping me make progress towards my goals (income, education, etc.) *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
2. The staff I primarily work with is helping me make progress towards securing public benefits (e.g. SSI, TANF, CTA). *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
3. I understand what is expected of me in order to remain in the project (rules & regulations). *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
4. I fully understand my rights in this project. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
5. If I have a problem with a staff member there is a fair and effective way to appeal or file a grievance. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
6. I feel safe in this project (my safety, health and personal welfare). *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
7. I feel stable in this project. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
8. I am treated with dignity, respect and compassion. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
9. The information I share with staff is kept confidential and is only shared with other staff on an as needed basis. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
10. The project’s facility where I receive services is clean and well maintained. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
11. Services are delivered to me in a timely manner. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
12. My case manager and other staff are readily accessible to me at all times. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
13. I am allowed to assist in the development of my Individual Service Plan (ISP). *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
14. I am allowed to give feedback about my case and other agency operations without fear of recrimination. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
15. I am allowed to help choose the apartment where I live. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
16. Questions regarding my case are always answered in a timely manner. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]
17. My case manager and other staff assist me in becoming employed. *
[1=Strongly Disagree ] [2= Disagree] [3 = Neither Agree or Disagree] [4 = Agree] [5 = Strongly Agree]