Attachment B-1: Congregate Meals Services | ADMINISTRATION-5600-MANUAL

When administering the Congregate Meals Survey, please include in the cover letter and/or in your talking points that this survey is assessing the meals eaten at the senior center only. However, if they have complaints about the services received at the senior center or any other service related to their attendance, they should ask to be contacted by the AAA.

Item #	Congregate Meals Survey Questions	Answer Options
	How often are you satisfied with each of the following…	Always Sometimes Never
1.	With the way the food smells?
2.	With the way the food looks (color of food, messy)?
3.	With the way the food tastes?
4.	With the different kinds of foods served from day-to-day?
5.	That hot foods are hot (the temperature of hot food right after it is cooked)?
6.	That cold foods are cold (the temperature of chilled food right out of the refrigerator)?
	Please answer the following questions about the meals program at the Senior Center. Do services received at the meals program help you to…	Yes No
7.	Eat healthier foods?
8.	Improve your health?
9.	Feel Better?
10.	Overall, how satisfied are you with the meals you eat at the Senior Center?	Satisfied Somewhat Satisfied Dissatisfied
11.	Who would you contact first if you had a problem with the meals or services you receive at the Senior Center?	Senior Center Site Manager Agency that hired the Site Manager Area Agency on Aging Division of Aging Services Do Not Know Others:
12.	In your opinion, in addition to what you have told us above, how could we improve the meals you eat at your Senior Center? Please mark all that apply.	Use a better quality of meats and less filler. Cook foods just right (not over cooked and not under cooked) Vegetables with less water More green, leafy vegetables More say so "in planning the meals" and/or "what foods I am served to eat each day"
13.	Please tell us any other suggestions you have to improve the quality of the meals you eat at the Senior Center.	Comments:

Item #

Congregate Meals Survey Questions

Answer Options

How often are you satisfied with each of the following…

Always
Sometimes
Never

With the way the food smells?

With the way the food looks (color of food, messy)?

With the way the food tastes?

With the different kinds of foods served from day-to-day?

That hot foods are hot (the temperature of hot food right after it is cooked)?

That cold foods are cold (the temperature of chilled food right out of the refrigerator)?

Please answer the following questions about the meals program at the Senior Center. Do services received at the meals program help you to…

Eat healthier foods?

Improve your health?

Feel Better?

10.

Overall, how satisfied are you with the meals you eat at the Senior Center?

Satisfied
Somewhat Satisfied
Dissatisfied

11.

Who would you contact first if you had a problem with the meals or services you receive at the Senior Center?

Senior Center Site Manager
Agency that hired the Site Manager
Area Agency on Aging
Division of Aging Services
Do Not Know
Others:

12.

In your opinion, in addition to what you have told us above, how could we improve the meals you eat at your Senior Center? Please mark all that apply.

Use a better quality of meats and less filler.
Cook foods just right (not over cooked and not under cooked)
Vegetables with less water
More green, leafy vegetables
More say so "in planning the meals" and/or "what foods I am served to eat each day"

13.

Please tell us any other suggestions you have to improve the quality of the meals you eat at the Senior Center.

Comments:

If the survey is to be administered by mail, please do not ask the consumer to identify him/herself, unless he or she wishes to be contacted for follow-up. Add lines at the end of the survey for the consumer to indicate voluntarily a desire for a contact and to provide his or her name and telephone contact information.