Attachment 5 A English Customer Service Survey.doc

U.S. Department of Homeland Security

FEDERAL EMERGENCY MANAGEMENT AGENCY

Housing Inspection Services OMB Control Number 1660-0102 Expiration Date: Jan. 31, 2014

OMB Control Number 3067-0256 Expiration Date: August 31, 2004

Customer Satisfaction Survey

This survey is voluntary. Your information will used for statistical and program improvement purposes and be kept private to the extent permitted by law. You have been selected for this survey because you recently attained a FEMA housing inspection. The purpose of this survey is to measure the housing inspector’s performance.

Instructions: To be filled out by a member of the household who was at home during the housing inspection. For the following questions, please check the box to respond to each question. Do not sign or put your name on the form. All responses are anonymous and confidential, and will be reported ONLY in aggregate form.

1. Before the inspection, what level of service did you expect to receive from the FEMA inspector?

Very good

Not at all good

I didn’t know what to expect

2. Compared to your expectation, what level of service do you feel you received?

Better than expected

Worse than expected

3. Did the inspector come to your home at the scheduled time?

Yes

No

Inspector came without an appointment

4. How important was it for you to have a set time for your inspection?

Very Important

Not at all important

5. How long was the inspector’s visit?

Less than 30 minutes

30-45 minutes

More than 45 minutes

6. The length of the inspector’s visit was:

Too Long

About Right

Too Short

7. Were you with the inspector during the inspection?

Yes

No

8. Did the inspector explain why he/she was performing the inspection?

Yes

No

9. How complete do you feel your inspection was?

Very Complete

Not at all Complete

10. Did the inspector take time to listen to what you had to say?

Yes

No

I didn’t have anything to say

11. How satisfied are you with the effort the inspector made to answer your questions?

Very satisfied

Not at all satisfied

I didn’t ask any questions

12. Were there any questions that the inspector did not answer?

Yes

No

If yes, please tell us what they were under Question17.

13. At the end of the inspector's visit, how good was your understanding of what would happen after the inspection?

Very good

Not at all good

14. How did the inspector's visit make you feel?

A lot better

No different(

A lot worse

15. Overall, how satisfied are you with the FEMA inspection?

Very satisfied

Not at all satisfied

16. The check I received from FEMA was:

Larger than I expected

Exactly what I expected

Smaller than I expected

I did not receive a check from FEMA

If smaller than expected, please explain.

17. Please write additional comments about FEMA’s inspection services, including ideas to improve the process, unanswered questions, or unmet expectations you may have had. Use a separate sheet of paper if necessary.

Thank You!

Paperwork Reduction Act Notice: Public reporting burden for this survey is estimated to be an average of 15 minutes per response. The burden includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing, reviewing and submitting the form. Although voluntary, you are not required to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Paperwork Reduction Act Project (1660-0102), Information Collections Management, Federal Emergency Management Agency, Department of Homeland Security, 500 C St. SW, Washington, DC 20472. NOTE: Please do not send your completed form to the above address.

Please Return Survey to:

Federal Emergency Management Agency

C/O J & E Associates, Inc.

Customer Service Survey Contractor

Attn: Survey Center

8601 Georgia Avenue, Suite 505

Silver Spring, MD 20910

FEMA Form 007-0-1,(1/2011)

More On Back