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service based key stakeholder survey template

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					3.8: KEY STAKEHOLDER SURVEY
(Insert your organisation’s name) is committed to delivering quality services to our consumers and other key stakeholders. As part of our quality improvement process, we are seeking feedback from your organisation on the way we:   Communicate with you Case manage clients   Receive referrals Respond to grievances   Make referrals Deliver business and partnership responses

Please assist us to better understand our service provision by providing feedback through this survey.

1.

What is your name, title and organisation?

2.

Which of the following activities best describe our business relationship with your organisation? (please tick all appropriate descriptors)

We make client referrals to your organisation We receive client referrals from your organisation We share joint case management of clients with your organisation We regularly network through meetings and working groups Other type of relationship, please detail

We purchase business resources from you (training, office space, administration activities etc) We supply business resources to you (training, office space, administration activities etc) We regularly undertake strategic business planning activities We have a Memorandum of Understanding or other formal protocol with you to guide business activities

3.

Please tick which of our client service delivery and business/administration programs you most frequently have contact with.
Location/site √ Business/Management
Governance or Management

Client Service Delivery
(insert your text)

Location

√

Finance H.R. Administration Special Projects Policy and Service Development

4.

How frequently do you have contact with our organisation? Fairly Regularly Occasionally Infrequently

Regularly

Pre Accreditation Kit: 3.8 – November 2006

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5.

Please indicate your level of satisfaction in each of the following areas.
Neither Satisfied nor Dissatisfied

Very Dissatisfied

Satisfied

1. How satisfied are you with the timeliness of our response to your client referrals? 2. How satisfied are you with the feedback we provide to you in response to your client referrals? 3. How satisfied are you with the way in which our organisation responds to clients who are jointly case managed? 4. How satisfied are you with the level of information we provide to your organisation and clients regarding the services we offer? 5. How satisfied are you with the appropriateness of information we provide to your organisation when we make a client referral? 6. How satisfied are you with the timeliness of our client referrals to your organisation? 7. How satisfied are you with the level of assistance you receive from our direct service delivery staff? 8. How satisfied are you with the crisis response we provide through our intake/refuge/hostel programs? 9. How satisfied are you with the level of safety we provide for our clients? 10. How satisfied are you with the level of support we provide to our clients? 11. How satisfied are you with the level of assistance you receive from our managers/program leaders? 12. How satisfied are you with the level of assistance you receive from our reception/administration and finance teams? 13. How satisfied are you with the standard (cleanliness, furnishings, space, resources) of our facilities? 14. How satisfied are you with punctuality and reliability of our staff? 15. How satisfied are you with the level of skills as demonstrated by our staff? 16. How satisfied are you with the level of access your clients have to our services? 17. How satisfied are you that we provide culturally appropriate services? 18. How satisfied are you that we respect the rights of our clients? 19. How satisfied are you with our response to grievances? 20. How satisfied are you with our level of collaboration with your organisation? 21. How satisfied are you with our level of proactiveness and community engagement with regard to homelessness/housing concerns and responses?

Very Satisfied

Please rate each of the following

Dissatisfied

Does not Apply

Pre Accreditation Kit: 3.8 – November 2006

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6.

What do you think we do well as an organisation?

7.

How could we improve our practice?

8.

Do you have any further feedback?

Disclaimer: This template is provided as a guide only for organisations undertaking self-assessment against the Victorian Homelessness Assistance Service Standards. Use of this tool should not be considered as meeting any future eviden ce requirements for accreditation.

Pre Accreditation Kit: 3.8 – November 2006

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