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SERVICES AT SCHOOL FAMILY QUESTIONNAIRE
2007-2008 SCHOOL YEAR

Dear Family Members:
We believe families can provide valuable information about the quality of United Services’ programs. Our on-going program improvement process relies on input from parents/caregivers, staff and other stakeholders. Therefore we would ask that you complete the following questions concerning any programs or services utilized between August 2007 and May 2008.
  • Please complete one survey per family and return by May 19, 2008, using the attached self-addressed envelope
  • If you prefer, you may complete on-line at www.unitedsrvcs.org
  • The survey should take approximately 10 minutes to complete. Please look for the results of the survey to be posted on our website after June 15, 2008.
Should you wish to discuss any of these issues in person, please contact Phyllis Schneider (USWest – Dardenne Prairie) or Karen Stepson (US East – St. Peters) at 636.926-2700.

Thank you for your support in helping us help others!

Sincerely,
Karen Stepson
United Services East		 Phyllis Schneider
United Services West

  Contact Information (optional)
Name
Phone
Location
     
  Background Information
Check all services you have used this year
Child Care
Preschool
Special Education
Kids 'N Around (structured play group for children 18mo-3yrs with developmental delays)
PALS (structured play group for children 12mo-3yrs with developmental delays)
   
  Family Support
SIBSHOP
Early Childhood Parenting Made Fun
Resource/Referral/Consultation
Parent Library
   
  Age of Child(ren) Enrolled
  0-1 2-3 4-5
   
  Length of Time Enrolled
Less than Six Months
Six Months to One Year
One to Two Years
More than Two Years
   
  School District
 
  (if you selected "Other", please specify)
   
  For each statement select SA=Strongly Agree, A=Agree, U=Uncertain, D=Disagree, SD=Strongly Disagree
Staff is knowledgeable and provides a rich educational environment for children.
Staff work with parents to establish and maintain regular, ongoing two-way communication.
Staff is sensitive to the needs of the children and families.
The program meets the individual needs of my child or children.
I see positive changes in my child’s development.
I have a positive feeling about the participation of both typically developing children and children with special needs in the programs.
I am satisfied with the variety of activities available to my child.
There are no barriers that prevent my child or my family from accessing programs or services.
There are adequate opportunities for parent participation.
Parent-teacher conferences help me to understand the progress and/or concerns of my child.
Support from child care and family support has reduced my family's stress.
The environment is safe and clean.
Nutritious meals/snacks are provided in child care.
   
  The Parent Handbook provides information on the following:
Philosophy
Health and Safety
Meals and Snacks
Hours, holidays and closings
Policies and Procedures
Payments
   
  Overall Opinion
My overall opinion of the quality of the programs: (on a scale of 1-5)
Please choose one: 5 being the highest and 1 being the lowest
 

Please write any comments on the last page.

 
  FOR PARENTS OF CHILDREN WHO RECEIVE THERAPY:
(If your level of satisfaction varies based on therapist, please explain in comments section)
   
  Check all therapies your child receives

Physical
Occupational
Speech
Vision
Developmental Therapy
   
The therapist(s) is knowledgeable and professional.
The therapist(s) provides helpful information on my child’s progress.
The therapist(s) communicates useful techniques and activities to be used with my child at home.
I understand how IEP goals are implemented in the classroom.
My child is progressing in development as a result of therapy.
   
  COMMENTS: 
 
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THANK YOU FOR YOUR TIME!
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