Attachment B-2: Home Delivered Meals Services

Item # Home Delivered Meals Survey Questions Answer Options

How often are you satisfied with each of the following…
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  • 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 different kinds of foods served from day-to-day?

5.

That the person who delivers the meals is friendly and respectful?

How often are you satisfied with each of the following…

(Please mark “N/A” if you only receive frozen meals or meals that can be stored on a shelf.)

  • Always

  • Sometimes

  • Never

  • N/A (Not Applicable)

6.

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

7.

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

8.

Overall, how satisfied are you with the home delivered meals you receive?

  • Satisfied

  • Somewhat Satisfied

  • Dissatisfied

Please answer the following questions about the home delivered meals program. Do the services received from the home delivered meals program help you to…

  • Yes

  • No

9.

To eat a healthier variety of foods?

10.

To be more able to continue to live on your own?

11.

Feel better?

12.

Improve your health?

13.

Have something to look forward to when you receive the meals because someone comes and talks to you?

14.

Who would you contact first if you had a problem with the Home Delivered Meals you receive?

  • Person Delivering the Meals

  • People who prepare the meals/Senior Center

  • Area Agency on Aging

  • Division of Aging Services

  • Do Not Know

  • Others:

15.

In your opinion, in addition to what you have told us above, how could we improve the home delivered meals you receive? 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"

16.

Please tell us any other suggestions you have to improve the quality of the Home Delivered Meals you receive.

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.