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.
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: