Douglas ARC

Since 1958... an organization serving people with developmental disabilities.


Saturday, May 10, 2008

 

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Quality Assurance Satisfaction Survey

The purpose of this survey is to insure that Douglas ARC provides quality services for people with disabilities living in the Douglas area. Your input will be greatly appreciated.

Please rate the overall services:


1. Are you satisfied with the services Douglas ARC provides?
1 Outstanding
2 Good
3 Average
4 Fair
5 Poor


2. Are you satisfied with the support provided by Douglas ARC Staff?
1 Outstanding
2 Good
3 Average
4 Fair
5 Poor


3. Is Douglas ARC staff aware of the specialized supports and behavioral needs of the people we serve?
Yes
No

If not, how can we improve?


4. Are interactions between Douglas ARC staff and the people we serve respectful, positive, friendly, and display choice for each individual?
Yes
No

If not, how can we improve?


5. Does Douglas ARC provide ultimate opportunities for community involvement for the people we serve?
Yes
No

If not, how can we improve?


6. Does Douglas ARC support and advocates for the rights of the people we serve (i.e. respect, dignity, sensitivity, culture, privacy, etc.)?
Yes
No

If not, how can we improve?


7. Does Douglas ARC provide a safe, clean, and stimulating environment for the people we serve?
Yes
No

If not, how can we improve?


8. Does Douglas ARC meet the needs of the people we serve in a timely manner (i.e. personal care, nutrition, cognitive, and educational needs, etc.)
Yes
No

If not, how can we improve?


9. Are Douglas ARC staff and management sensitive to the cultural needs of the people we serve?
Yes
No

If not, how can we improve?


10. Does Douglas ARC provide safe and appropriate transportation targeting the specific needs of the people we serve?
Yes
No

If not, how can we improve?


11. Other Comments:

Signature of Person Completing Form (OPTIONAL) Date Your Name:

Your Email:

If you would like to become involved in helping Douglas people with disabilities help themselves, please call us at 364-7473.

For a confidential conversation with any member of the Douglas ARC Board of Directors, please contact Olga Santana, Board President, at 364-2500.

Douglas Arc P.O. Box 252 Douglas, Arizona 85608
USA Flag
Phone 520.364.7473 Fax 520.364.2236
Email: contact@douglasarc.org

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