Quality Assurance

Please answer and submit the following questions as honestly as possible. Check one of the ratings that corresponds to your response on each statement. Please provide your comments at the end of this survey as it relates to your needs.

Quality of Service
  1. The overall service that I received from my ILS Instructor within the last year has been:
  2. The quality of services provided by the ILS instructor(s) is:
  3. My ILS Instructor treats me with respect and courtesy.
  4. My ILS Instructor returns my phone calls promptly and answers all questions that I have.
  5. My ILS Instructor listens to my needs.
  6. There were no communication or physical barriers to receiving services.
  7. My ILS Instructor(s) shares all relevant information about services available in the community.
  8. My ILS Instructor(s) asks me for my ideas and choices when planning activities.
  9. My ILS Instructor(s) provides me the opportunity to learn about my options in planning my goals.
  10. My ILS Instructor(s) respects my rights as an individual and keeps information confidential.
  11. My ILS Instructor(s)assist me in maintaining a personal network of family and friends in order to increase my social interaction skills.
  12. My ILS Instructor knows the goals stated on my ILS Plan of Instruction.
  13. My ILS Instructor returns my calls in a timely manner.
  14. My ILS Instructor comes to appointments and meetings on time and comes prepared.
  15. My ILS Instructor encourages me to make my own choices and gives me the information I need to make those choices.
  16. My ILS Instructor seems to be sensitive to my culture.
  17. My ILS Instructor listens carefully to my concerns and seems to understand me.
Satisfaction Rating
  • Please check the box that indicates whether you are satisfied with and would like to continue working with your instructor.
Comments
Contact Information

Quick Contact
P.O Box 10365
Glendale, CA 91209
818-244-2677