Care for ME Community/Client Survey
2007-2008

The Care for ME Program would like to know your thoughts and ideas of how to improve its operations and services to clients and community members. Please complete this survey with your honest opinions so that we can incorporate your suggestions.

After filing out the survey, you can submit it electronically by clicking on the "Submit Survey" button, or you can print it out and mail it to us at:

Care for ME Program
99 Western Ave., Suite 6
Augusta, Maine 04330

1.

Did you receive names, addresses and
telephone numbers of Care for ME caregivers?

yes

no

2.

Did you choose a Care for ME Approved Caregiver
to care for you child?

yes

no

a. If NO, why not?

No openings
Location
Quality
Other:

b. If NO, what
did you do?

Found a certified provider
Found a friend or relative to provide care for a fee
Found a friend or relative to provide care for no fee
Changed my work or school plans
Other:

3.

In addition to referrals, Care for ME provides
information on choosing childcare.
Did you find this information helpful?

yes

no

4.

Did you receive a children's book?

yes

no

5.

How long did it take from the time you
made your request of the Care for ME staff,
for you to receive the information you requested?

More than a week
1 to 2 days
1 hour (emailed)
Do not remember

6.

How did you hear about the Care for ME Program?

7.

How would you rate the quality of the Care for ME services you received
in the following ways?

1
(low)
2
3
4
5
(high)
a. How promptly your call was answered/returned
b. How courteously you were treated
c. How well the staff understood your needs
d. How knowledgeable the staff was
e. How accurate the information you received was

8.

Is there anything else you would like to tell us about
your experience with Care for ME?

Thank you for completing this survey.

Name:

Date:

Care for ME
A Joint Project of Southern Kennebec
Child Development Corporation
and the Maine Department of Health and Human Services

Southern Kennebec Child Development Corporation
99 Western Ave. Suite 6 • Augusta, ME 04330
1-800-525-2229 • 207-626-3410 • Fax: 207-626-3412
info@skcdc.org