Senior Center Evaluation Survey

Q.1

Please enter your name.

This survey is a part of the Johnson County Senior Center's national accreditation process. Names are purely for assuring no duplicates are entered. All opinions and comments will be kept anonymous.

First Name

Last Name

Demographics

Q.2

What is your gender? *

Male
Female

Q.3

What is your age? *

60-70
71-80
81+

Q.4

What is your race? *

White/Caucasian
Asian/Native Hawaiian/Pacific Islander
African American
American Indian/Alaska Native
Other

Q.5

How often do you visit the senior center?

Every day (of operation)
2-4 times a week
1 time a week
1-3 times a month
less than once a month

Q.6

How long have you been a member?

Less than a year
1-2 years
3-4 years
5-6 years
7 or more years

Q.7

Where do you get the most information about senior center activities?

Newspaper
Center Flyers/Newsletter
Website
Friends or Family
Radio

Personal Effect

This section focuses on your experience at the Johnson County Senior Center.

Q.8

I do more volunteer work.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.9

I see friends and/or make friends more often.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.10

I take better care of my health.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.11

I eat meals that are better for me.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.12

I have more energy.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.13

I'm happier and/or feel more satisfied with my life.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.14

I have something to look foward to each day.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.15

I know what resources to use/who to call if I need a ride.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.16

I feel more able to be independent.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.17

I feel the senior center has/has had a positive effect on my life.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.18

I learn new things.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.19

I have learned about services and benefits available to me.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.20

I am more physically active.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.21

I would recommend the senior center to family, friends, or etc.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Comments:

Center and Staff Evaluation

This section focuses on your personal opinion on the center. We want your feedback to know what areas we can improve.

Q.22

The center is clean and visually attractive.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.23

The staff is professional.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.24

The staff is responsive to my needs (ex: helpful, knowledgable about problems, etc).

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.25

The Staff is friendly and courteous.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.26

For Volunteers: I feel appreciated as a volunteer.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Activities

Q.27

I am pleased with the exercise and fitness classes available.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.28

I am pleased with the health and wellness education presentations and screenings available.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.29

I am pleased with the educational classes available.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.30

I am pleased with the recreational and social activities available.

Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree

Q.31

OPTIONAL: Do you have any suggestions, concerns, or comments you would like to share with the center?