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Family Satisfaction Survey


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2) As the person completing the survey, what is your relationship to the identified YAP client?









3) What state do you live in?
















4) Please select all of the answers below that relate to your experience in the YAP Program.

Our staff works with us in this area.Our life is better in this area as a result of our involvement in YAP.
YesNot SureNoNot ApplicableYesNot SureNot Not Applicable
Our relationships with each other
Connecting my family with Positive Activities and Organizations in my Community
Identifying constructive use of time
Planning for Safety and Emergencies
School and Education
Employment and Job Skills
Developing Skills
Requirements from Court, my PO or caseworker.
Additional comments

5) Please choose all of the things below that are true for you.













6) How important is your staff to you and your family?








7) Please answer the questions below regarding your staff.
Yes Not Sure No
Our staff is from my community.
Our staff is the same gender as my child.
Our staff the same race as my child.
Our staff shares interests with my child.
I feel like our staff fits very well with my family.
Our staff shares our culture.




8) Please select all the words below that you believe are true about your family's staff.














9) Please select all the things below that are true of your Staff AND how important these qualities are to you.
Is this true of your staff?How important is this quality to you?
YesNoVery ImportantImportantA Little ImportantNot Important
Trustworthy
Listens to us
Helps me get my needs and my family’s needs met
Always asks our opinion and consults us in planning
Respects our decisions
Gives us good advice
Helps us make better decisions
Cares about us
Schedules time around what works best for me and my family
Engages my family in meaningful activities based on our plan.
Does what s/he says; follows through
Helps us see our good qualities
Believes in us
Additional comments

10) Are you satisfied with the services that you are receiving?








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