2026 Basic Care Center Survey

2026 Youth Services Basic Care Center Survey

Please take this short survey.

Your answers will help us improve!
1. How long were you at a Host Home?
Please choose 1 answer for each question.

1=Strongly Disagree 2=Disagree 3=Neutral or N/A 4=Agree 5=Strongly Agree
2. I felt safe at the Host Home.

1

2

3

4

5

1 is , 5 is
3. The services I got were what I needed.

1

2

3

4

5

1 is , 5 is
4. I was satisfied with the recreational activities I could do while in the program.

1

2

3

4

5

1 is , 5 is t
5. The Host and Youth Services staff treated me with respect.

1

2

3

4

5

1 is , 5 is
6. Rules were consistently enforced.

1

2

3

4

5

1 is , 5 is
7. My voice was reflected in my Service Plan.

1

2

3

4

5

1 is , 5 is
8. My time in the program helped me.

1

2

3

4

5

1 is , 5 is t
9. I have more independent living skills because of my time in the program.

1

2

3

4

5

1 is , 5 is
10. It was easy to find out about this program.

1

2

3

4

5

1 is , 5 is
11. I would recommend this program to a friend.

1

2

3

4

5

1 is , 5 is
12. Please give any comments or ideas to help us do better.
13. IF YOU WANT TO, write your FIRST NAME ONLY.
14. IF YOU WANT TO, tell us who your Host was and share any comments about the Host Home you stayed in.
15. I give my permission for Child & Family Services to use comments above (without my name) for reports and promotion.
Thank you for taking the time to fill out this survey. We value your input!
Should be Empty:

Please choose 1 answer for each question.