OMB 0970-0288
Public reporting burden for
this collection of information is estimated to be 1 hour to complete
this questionnaire. An agency may not conduct or sponsor, and a
person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The
control number for this project is 0970-0288. The control number
expires on X/X/XXXX.
National Technical Assistance and Evaluation Center
Improving Child Welfare Outcomes Through Systems of Care Program
Child Welfare Agency Survey
1. To what extent do you agree that your agency:
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Please respond to the following statements and questions:
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3. Please answer the following questions:
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Very Unsatisfied |
Unsatisfied |
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Neither Satisfied nor Dissatisfied |
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CASEWORKER SUPPLEMENT
4. The following statements refer to your own approach to working with children and families. Please indicate the what extent to which you agree with the following statements:
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Disagree |
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You are almost done! Before you finish, please complete the following questions:
5. What agency do you work for?
_______________________________________________________
(Name of Your Agency)
Where is this agency located?
________________________________________________________
(City, State or Name of Tribe)
Have you heard of the local Systems of Care initiative?
Yes No
Which best describes your role in your agency? (circle one)
Caseworker Assistant
Caseworker
Supervisor (I may work directly with families, but my primary role is to supervise other staff)
Senior manager (I am involved in policy planning, development, or evaluation)
Administrator (I run the organization)
Other (please specify): ____________________________________
9. Which unit do you work in? (circle ALL that apply)
Intake
Investigations
Assessment
Case Management
Family Preservation
Foster Care (including kinship care)
Subsidized guardianship, reunification
Adoptions
Independent living/Aging Out/Emancipated Minors
Other (please specify): ________________________________
Are you responsible for monitoring or providing oversight to a private agency that develops case plans, links children and families to services, and meets with families to monitor progress? For example, do you conduct case planning meetings for cases under your purview, as opposed to overseeing a private contractor or service provider that does this work?
Yes No
Are you employed by a private contractor?
Yes No
Do you currently work full-time or part-time?
Full-time Part-time _________ (indicate number of hours)
Over the past year, on average, how many children’s cases are currently on your caseload (1 case = 1 child)?
____________________ If none, enter 0 and skip items 14 and 15
Approximately what percent of your time do you spend working directly with clients?
_______________________%
Approximately what percent of time do you spend on paperwork?
_______________________%
How many years have you worked in this agency?
______________________________________________
(Years with this Agency)
How many years of experience, including your present job, have you had in full-time human services work?
______________________________________________
(Years of Human Services Experience)
What level of education have you completed? (circle one):
High school graduate
Associates/technical degree
Some college
Bachelor’s degree
Some graduate work
Masters degree
Doctoral degree
What field is your highest degree in? (circle ALL that apply)
Education
Medicine/Nursing
Psychology
Social Work
Sociology
Child Development
Counseling
Other (please specify) ____________________________
Are you male or female? (circle one)
Male Female
How old are you?
__________________________________
(Your Age in Years)
Are you Hispanic/Spanish/Latino? (circle all that apply)
No, not Hispanic/Spanish/Latino
Yes, Hispanic/Spanish/Latino
Select one or more of the following categories to best describe your race:
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
24. How many times have you taken this survey?
A. This is my first time
Two times
Three times
Not Sure/Don’t Know
Thank you for completing this survey!
We welcome your comments and feedback:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
File Type | application/msword |
File Title | Not At All |
Author | andrewst |
Last Modified By | ICF |
File Modified | 2008-06-20 |
File Created | 2008-04-28 |