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Your feedback is important!
The intention of the survey is to collect information from current and previous service users. Simcoe Muskoka Family Connexions (SMFC) is committed to providing services and spaces that are inclusive, safe and barrier free. As such, we would like to find out about your experiences of our services and facilities (spaces) towards ensuring we are meeting, if not exceeding our stated commitment to all who we service and interact with. The information you graciously share will teach us insights on how we are doing and how we can improve our service and facilities (spaces).We want to hear about your experience working with Simcoe Muskoka Family Connexions (SMFC) and being in our spaces/using our facilities. Your participation is completely voluntary. Your personal responses to the survey will be kept confidential and all identifying information will be removed. This survey is two pages long. We thank you in advance for your willingness to share your experiences and suggestions.
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SECTION 1: IDENTITY-BASED
The following identity-based section helps us to get a better understanding of the rich and varied identities of those we serve towards ensuring our services are inclusive, safe and responsive to the needs of everyone.
1. Please select as many identities as possible that you would like to share with us from the drop-down list provided, then fill-in the blank space provided. The list is by no means complete, so please feel free to enrich it with any identity/identities you would like to share that is/are not listed
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Race (e.g., Black, white, brown, Asian, etc.)
Indigenous Identity/ies (e.g., First Nation, Métis, Inuk, Mi’kmag, Cree, Haudenosaunee, Ojibway, Chippewa, etc.)
Ethno-cultural identities (e.g., French/Francophone, British, Trinidadian, Jamaican, Albanian, Serbian, etc.)
Religion/Faith (e.g., Sikh, Hindu, Buddhist, Muslin, Jewish, Christian, etc.)
Non-religious (e.g., Secular, Agnostic, Atheist, etc.)
First Language (e.g., French, English, Punjabi, Hindi, Arabic, Portuguese, Amharic, German, etc.)
Disability/ies (e.g., Anxiety, Panic Disorder, Autism, AD/ADHD, hearing disorders, learning disorder, physical disorder, etc.)
Sex (e.g., female, male, intersex, etc.)
Gender (e.g., Transgender, cis-gender, gender-fluid, Two-Spirit, etc.)
Gender Expression
Sexual Orientation (e.g., bisexual, bicurious, heterosexual, homosexual, pansexual, etc.)
Pronouns (e.g., he, them, they, she, etc.)
Please list any other identities that you would like to share
Please add comments below for any of your selection(s) above separating each identity with a semicolon (;) (e.g., Black; French; I have anxiety; female):
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2. We are interested in your relationships/connections with SMFC staff, care providers, volunteers, and/or others associated with our agency as well as the services you have, or are currently receiving. Are you a…
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Young person currently in care of SMFC
Young person currently receiving services on a Voluntary Youth Services Agreement (ages 16-17)
Young person currently receiving services on a Ready, Set, Go agreement (18+)
Young person currently receiving services with SMFC and living at home with parent(s) or family(kin)
Young person previously in care and no longer receiving services with SMFC
Young person who was not in care and no longer receiving services with SMFC
Parent/caregiver currently receiving services with SMFC
Parent/caregiver no longer receiving services with SMFC
Family member (kin) or otherperson (kith) taking care of a young person (currently or formerly)
Prefer not to answer
3. How long have you received services from SMFC?
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0-2 Months
More than 2 months
Prefer not to answer
4. What timeframe have you received service from SMFC?
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In the last six months
Six months to a year ago
1 – 3 years ago
3 years ago or more
Prefer not to answer
5a. My worker asked me about what is important to me
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Please Select
Yes
No
Sometimes
5b. Please select all areas that your worker asked you about:
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Cultural beliefs and needs
Religious practices
Parenting/discipline style
Preferred language
Indigenous identity (ies)
Ethno-cultural identities
Gender identity and affirming needs
Racial identity and affirming needs
Disability (ies) and affirming needs
Support system
Socio-economic needs/challenges (e.g. housing, education, employment, health, etc.)
My worker did not ask me what is important to me
Other
6. I engage in religious activities (e.g., attending church, prayer, receiving sacraments)
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Never
Once in a while
Weekly
Daily
Prefer not to answer
7. My worker respected and supported my social or cultural practices, or my background and ancestry, when planning with myself, my child(ren) and family, and ensured that other supports and services offered did the same.
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Never
Rarely
Sometimes
Often
Always
Prefer not to answer
If you have any comments on the previous question, please add them here:
8. I am/was aware that my worker can consult with the following identity affirming groups that are in the Agency (check all that apply)
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ACCC Black Affirming Services Consultation Panel
Indigenous Advisory Consultation
2S-LGBTQIA+ and/or SOGIE Consultation
French Language and Culture Consultation
Latin Language and Culture Consultation
Neurodiversity Practice Leads
Accessibility Committee
I am not aware
Other (please specify)
9. My worker discussed any reports or recommendations they received about me:
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Yes
No
I don't know
Not applicable (they did not attend a consultation)
10. My worker worked with me to ensure that services were accessible and provided an accommodation as needed (e.g., mental health accommodation, an accommodation for a physical disability, an accommodation for a learning disability, a faith-based accommodation, a racial/ethno-cultural-affirming accommodation, gender-based accommodation, etc.)
*
Yes
No
I don't know
Not applicable
Prefer not to answer
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SECTION 2: SERVICE PROVISION
11. My worker asked me about my history and any stressful life experiences that may have impact my sense of identity (e.g., racial identity, gender identity, sexual orientation, etc.)
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Never
Rarely
Sometimes
Often
Always
Prefer not to answer
12. My worker asked me about my history and any stressful life experiences that may have impacted my health:
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Never
Rarely
Sometimes
Often
Always
Prefer not to answer
13. My worker asked me about my history and any stressful life experiences that may have impacted my emotional well-being:
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Never
Rarely
Sometimes
Often
Always
Prefer not to answer
14. My worker asked me about my history and any stressful life experiences that may have impacted my parenting:
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Never
Rarely
Sometimes
Often
Always
Prefer not to answer
15. My worker and I talk about my strengths and the strengths of my family:
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Never
Rarely
Sometimes
Often
Always
Prefer not to answer
16a. My worker supports me to find the services I need:
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Never
Rarely
Sometimes
Often
Always
Not applicable
16b. These are the services my worker supported me in finding:
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Counselling/Therapy
Medical Services
Legal Services
Parenting Support
Addiction Services
Other
17a. My worker supports me and offers to assist me to get things I need:
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Never
Rarely
Sometimes
Often
Always
Not applicable
17b. These are the things my worker has assisted with:
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Groceries
Transportation
Housing
Employement
Babysitting
One to one support
Other
18. My worker follows through with what they say (e.g., return phone calls, looking into other services we need, following through with agreed plans):
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Never
Rarely
Sometimes
Often
Always
Not applicable
If you have any comments on the previous question, please add them here:
19. I have input into the services I receive and the goals I wish to achieve:
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Never
Rarely
Sometimes
Often
Always
Not applicable
If you have any comments on the previous question, please add them here:
20. My worker helps me identify and reach out to family, friends and/or community members who could be part of a safety network for support
*
Please Select
Yes
No
Not sure
21a. I feel my point of view is/has been misinterpreted or misunderstood by the worker or others I had contact with at SMFC:
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Never
Rarely
Sometimes
Often
Always
Not applicable
21b. If other than your worker, please select all that may have misinterpreted or misunderstood you: (select all that apply)
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Executive Director
Director of Service
Senior Service Lead
Service Manager
Family Service Worker
Family Contact Worker
Receptionist or Administrative Assistant
Other
22. I know who to call if I feel that my rights or voice has been ignored:
*
Please Select
Yes
No
Not sure
23. I feel safe to have honest conversations with _______________ without feeling like it will be used against me (select all that apply)
*
My child protection worker
My child and youth services worker
My child protection worker’s manager
My Youth Service Worker
My Family Support Worker
A Family Contact Worker
The Director of Service
A Senior Service Lead
A Service Manager
I do not feel safe to have honest conversations
Other
24. Some of the things I would like to see changed or improved about services at SMFC are…
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25. If there was anything that was said or done at SMFC that had a strong impact on me, good or bad, I would say it was…
*
26. What are three things you appreciated about SMFC work with you and your family?
*
27. I would like to add…
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