Attachment B-3: Senior Center Services

Item # Senior Center Services Survey Questions Answer Options

To what extent do you agree with the following statements?

Because I go to the Senior Center, I…
aaa

  • Agree

  • Somewhat Agree

  • Disagree

1.

My overall health (physical, mental and nutritional) has improved.

2.

I have learned how to do more for myself.

3.

Have something to look forward to each day.

4.

See friends more often/make new friends.

5.

Eat meals that are better for me.

6.

Am more physically active.

7.

I participate in learning activities I would not otherwise, such as nutrition and health.

8.

I know more about other health services and benefits (such as Medicare, health screenings, transportation, flu shots).

9.

Overall, how satisfied are you with the services you receive at your Senior Center?

  • Satisfied

  • Somewhat Satisfied

  • Dissatisfied

10.

Who would you contact first if you had a problem with 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:

11.

In your opinion, how could we improve the services you receive at your Senior Center? Please mark all that apply.

  • More helpful and useful information

  • Workers/Volunteers more personable and friendly

  • Workers/Volunteers more respectful

  • Open the Senior Center afternoons, evenings and weekends

  • More choices for Senior Center program activities (such as trips, outings, art classes, games, dancing, picnics, and nutrition and wellness activities)

  • More opportunities to be involved in planning Senior Center program activities

12.

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