P.O. Box 659 • 540 West Fourth Street • Flora • Illinois 62839 • Phone: 618.662.4916 • FAX: 618.662.9354

Home>  History>  Board>  Mission>  Programs>  Services>  Staff>  Maps>  Events>  Jobs>  Links>  Contact Us>  Questionaire>  FAQ>  Welcome>  

Clay County Rehabilitation Center Customer Satisfaction Survey

 

 

 

 

 

 

I am: Customer Parent Funding/Regulatory Agency Other Interested Individual

 

 

 

 

 

 To which program does your feedback pertain?  Please mark all that apply.

 

 

Developmental Training Evaluation Supported Employment Specialized Services
Regular Work Secondary Transitional Employment Program
Work Adjustment Training  Community Living Services

 

 

 

 

 

 Are the facilities physically accessible to you?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 Are the company staff members courteous?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 

 

 

 

 Do staff members explain what services are offered?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 

 

 

 

 Do the premises appear to be well maintained, clean and safe?

 

 

 Yes No Needs Improvement N/A

 

 

 

 

 

 

 Are services begun in a reasonable period of time?

 

 

 Yes No Needs Improvement N/A

 

 

 

 

 

 Are customers involved in the planning, implementation, review, and modification of the program plan?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 With the assistance of the agency, are desired outcomes achieved?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 Do you feel you provide input that is used to assist the agency in planning, and improving services?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 Do you feel the staff members you are involved with are properly trained, and competent to do their jobs?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 Do you feel the company has an active safety program that involves the input of all individuals?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

 Overall, are you satisfied with the services that are provided by Clay County Rehabilitation Center?

 

 

Yes No Needs Improvement N/A

 

 

 

 

 

Comments:

 

 

 

 

 

 

 

 NOTICE OF PRIVACY PRACTICES:
Click here to view information on the Privacy Practices of Clay County Rehabilitation Center, Inc.

If you have questions or comments, please write Gary Whitehead at clayrhab@wabash.net
Clay County Rehabilitation Center, Inc. • P.O. Box 659 • 540 West Fourth Street • Flora • Illinois 62839 • Phone: 1.618.662.4916
Accredited by CARF . . . The Rehabilitation Accreditation Commission
Copyright(c) 2004 Clay Co. Rehabilitation Center, Inc., All rights reserved.