Client Experience Survey

1.Who is filling out this survey?(Required.)

Resident/Patient

Family on behalf of Resident/Family

Family

3.Were you served in the official language in which you are most comfortable?

Yes

No

4.If you received services in French, were you satisfied with the services provided?

Yes

No, Why?

5.You and your loved one received a warm welcome and had everything explained to you when you first came(Required.)

6.You and your loved ones are always welcomed and treated with kindness and respect.(Required.)

7.You and your loved ones are encouraged to participate in discussions about your care.(Required.)

8.Staff respect your day to day routines and habits without rushing you.(Required.)

9.The home offers a variety of food that is flavourful.(Required.)

10.The home offers a variety of food that is culturally appropriate.(Required.)

13.Staff regularly wash their hands and there is information available to encourage others to properly wash their hands.(Required.)

14.You and your visitors are informed about infection and how to control them.(Required.)

15.All areas, including common areas are clean(Required.)

16.All areas, including common areas are welcoming(Required.)

18.Your information is shared with only the right people, at the right time and in a way that is easy to understand.(Required.)

19.You have been informed of who to bring compliments, comments and or complaints to for resolution.(Required.)

20.Staff offer activities to you and your loved ones that are based on physical and cognitive ability, wishes and desires(Required.)

21.You and your loved ones are encouraged to participate in activities that are based on physical and cognitive ability, wishes and desires(Required.)

22.As necessary, the home asks service providers to assist in your care(Required.)

23.You and your loved ones can speak to staff when you need to(Required.)

24.You and your loved ones can speak to physicians when you need to(Required.)

25.At all times you and your loved ones feel safe.(Required.)

26.Continence care products are appropriate and of good quality.(Required.)

28.Team members identify themselves when providing services.(Required.)

29.Comments:

Client Experience Survey

MICs Group of Health Services