Form 0917-0036 CSU Employee Survey 2015

Form Approved
OMB Form No. 0917-0036
Expiration Date:

CSU Employee Survey 2015
Ya’ah’teeh - We want to hear from you! Chinle Service Unit (CSU) Leadership is interested in hearing
from the CSU Employees. We want to understand what our Employees think about their job and
workplace. Your answers will help us take steps towards improvements in job satisfaction and the
work environment. Our goal is to create a happy and healthy workplace at CSU. This survey will take
approximately 10 minutes to complete. Your feedback is greatly appreciated. Thank you for sharing
your thoughts!
* 1. At which facility do you work most of the time?
Chinle (CCHCF)

Pinon (PHC)

Tsaile (THC)

Many Farms

Other

* 2. For which Division do you work?
Executive/Administration (Ron Tso, MPH & Shirley Lewis, HSA)
Clinical Services (Kevin Rand, MD)
Nursing (Johanna Bahe, RN & Charlene West, RN)
Public Health (Jill Moses, MD)
Quality Management (Thomas Lefebvre, MHA)
Pinon Health Center (Darlene Chee, RN)
Tsaile Health Center (Fawn Damon)

* 3. Which are you as the following?
Permanent Employee
Temporary Employee
Contractor
Volunteer
Emergency Hire
Tribal Employee/Staff
Non - IHS Employee/Staff

Other (please specify)

1

* 4. The following questions are on job satisfaction. Please select an answer for each line:
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Overall, I am satisfied
with my job.
I know exactly what is
expected of me at work.
I have the materials and
equipment I need to do
my work right.
At work, I have the
opportunity to do what I
do best every day.
In the past seven days, I
have received
recognition or praise for
doing good work (verbal
or written from a
supervisor, co-worker,
or customer).
My supervisor, or
someone at work, cares
about me as a person.
Someone at work
encourages my
development.
At work, my opinions
count.
Comments:

2

* 5. The following questions are on communication within our organization Chinle Service Unit (CCHCF, THC,
PHC, and Many Farms). Please select an answer for each line:
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

1. There is good
communication between
different levels of our
organization.
2. There is good
communication between
different levels at my
facility.
3. Progress on our
Tapestry of Wellness
(strategic plan) is
effectively
communicated to
employees.
Comments:

6. In the past 12 months, what improvements and changes have you noticed at your facility?

CSU Employee Survey 2015
The following question is on how well our co-workers provide culturally appropriate services to
everyone within all CSU Divisions (CCHCF, THC, PHC, and Many Farms).
* 7. Please select an answer for each line:
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

My co-workers in my
Division provide
culturally appropriate
services to everyone.
Comments:

CSU Employee Survey 2015
Internal Customer Service: How well do we work together (K’e bił na’anísh)?
The following questions are on customer service and communication between the Departments in

3

Chinle Service Unit (CCHCF, THC, PHC, and Many Farms).
* 8. Please select one answer for each question.
Strongly agree

Agree

Neutral

Disagree

Strongly disagree

1. I believe Departments
at my facility work well
together.

9. Please list any departments you feel provide great customer service within our Organization and explain
why.

10. Please list any Departments you feel have opportunities to improve their customer service to others within
our Organization and explain why.

CSU Employee Survey 2015
These questions are to help us understand how healthy our employees are.
* 11. Would you say that in general your health is -Excellent

Very good

Good

Fair

Poor

12. In the past month, how often have you exercised? Please include activities such as gardening and
chopping wood.
None
Once a week
Twice a week
Three times a week
More than three times a week

13. In the past month, how often have you used your facility's Wellness Center to exercise?
None
1-2 times in the past month
2-5 times in the past month
5-10 times in the past month
More than 10 times in the past month

4

14. Do you have a current Employee Wellness Contract?
Yes
No
Don't know

15. In the past year, have you participated in CSU healthy living activities such as "Just Move It" and the
Health Fair?
Yes
No

CSU Employee Survey 2015
We would like to ask Supervisors and New Employees about their experience with the job application
and hiring process.
* 16. We would like to ask Supervisors some questions about the hiring process. Are you a Supervisor?
Yes
No

CSU Employee Survey 2015

5

* 17. Please rate your satisfaction with each step in the hiring process by selecting a response for each row
below.
Very Satisfied

Satisified

Neutral

Unsatisfied

Very Unsatisfied

N/A

Approval to initiate
recruitment for a position
Classification of the
position description
Job assessment
(determining questions
applicants answer in
application)
Approval process to
announce a position
Posting of vacancy
announcement
Job application by
candidates
Closing announcements
HR evaluating
applications
Issuing certificate of
eligible candidates
Selection of candidate
Tentative job offer and
acceptance
Security pre-clearance
Placement (official job
offer)
Relocation
Processing and entry on
duty by HR
Onboarding by
supervisor

18. What part of the hiring process went well?

19. What part of the hiring process needs improvement?

6

* 20. We would like to ask New Employees about their experience with the job application and hiring process.
Were you hired within the past year?
Yes
No

CSU Employee Survey 2015
21. If you are a New Employee, what suggestions would you make for the job application and hiring
processes?

CSU Employee Survey 2015
Final question!
22. In your opinion, what would make our Service Unit better for our Patients and/or Employees?

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 0917-0036. The time required to complete this
information collection is estimated to average 6 minutes per response, including the time to review instructions, search existing data resources,
gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time
estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200
Independence Ave., S.W., Suite 336E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer.

7