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  1. Surveys
  2. 2008
  3. October
  4. Y
  5. YMCA ADC Participant
0%
 
 
Age
 
60-69
 
70-79
 
80-89
 
90 and Over
 
 
 
Gender
 
Female
 
Male
 
 
 
Race
 
Non Minority
 
African American
 
Hispanic
 
American Indian
 
Native Hawaiian/Pacific Islander
 
Asian
 
Other
 
 
 
 
What is your home zip code?
   
 
 
 
How did you first learn about our program?
 
Home Health Agency
 
Friend/Relative
 
Media (TV,Newspaper)
 
Other
 
Doctor's Office
 
Church

 
 
 
How many days per week do you attend ADC?
 
1 Day
 
2-3 Days
 
4-5 Days
 
 
 
How long have you attended ADC?
 
Less than 1 year
 
1-3 years
 
4-6 years
 
7 or more years
 
 
 
Reasons for attending ADC... Please check all that apply
 
Socialization
 
Supervision
 
Structured Activites
 
Health Services
 
To avoid placement in a nursing home
 
To allow caregiver to work
 
Other
 

 
 
 
Do you feel your level of social interaction has significantly increased since you started attending the ADC?
 
Yes
 
To some extent
 
No
 
 
 
How satisfied are you with the current days and hours of operation of our facility?
 
Very Satisfied
 
Satisfied
 
Dissatisfied
 
 
 
Excellent Good Fair Poor Do not use it N/A
How would you rate the variety of activities offered at the ADC?
How would you rate the quality of activities offered at the ADC?
If center transportation is available, how would you rate it?
What rating would you give the ADC programming in meeting your current needs?
How are we doing in helping you meet your goals through using our services?
 
 
 
How satisfied are you with the meals served at the ADC?
 
Very Satisfied
 
Satisfied
 
Dissatisfied
 
 
 
Do you find our staff courteous and professional?
 
Always
 
Usually
 
Sometimes
 
Rarely
 
 
 
How would you rate the ADC's communication in informing you of policies, events, news, etc.?
 
Excellent
 
Good
 
Fair
 
Poor
 
 
 
Based on your experiences at the ADC, would you recommend it to other seniors?
 
Yes
 
No
 
Not sure
 
 
 
Overall, how satisfied are you with the services/ programs offered at the ADC center?
 
Very Satisfied
 
Satisfied
 
Dissatisfied
 
 
 
If you are the caregiver for the ADC participant, has this service been beneficial to you?
 
Yes
 
No
 
 
 
If YES, please check all that apply
 
It allows me to continue to work
 
It provides me with respite
 
I feel less stressed
 
My social life has improved
 
Other
 

 
 
 
Additional Comments:
   
 
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