Family Group Decision-Making Satisfaction Survey Questionnaire

Texas Department of Family and Protective Services Form 0625 Child Protective Services November 2012

Date: ______Facilitator: ______Agency: ______

My role/relationship to the family is: Type of Conference: ___ Parent ___ Attorney ___ Family Group Conference (FGC) ___ Child or youth ___ CASA representative ___ Permanency Conference (PC) ___ Relative ___ DFPS staff ___ Circles of Support (COS) ___ Friend ___ Transition Planning Meeting (TPM) ___ Other (please specify): ______

e e t y y l l e e o r r g g N g g n n (

a A o o r r s A i Please check one response for each question t t N S S D ) e e e l e e r r b g g a a c A i l s i p D p A 1. The facilitator (the person who ran the meeting) gave everyone a chance to speak. 2. The meeting was run in such a way that I felt comfortable sharing information. 3. The facilitator was fair to everyone. 4. The facilitator encouraged everyone to join in discussion and decision making. 5. The facilitator was successful in getting people to offer support that was helpful in developing the plan. 6. Future support for the family or youth was included in the plan. 7. The resulting plan is realistic. 8. The next steps needed to complete the plan are clear and can be done. 9. The meeting started and ended as scheduled. 10. The setting for the meeting was comfortable (e.g., accessible, safe, clean, convenient) to everyone.

If some family member(s) did NOT participate: 11. Was the ONLY reason that the family member(s) did not attend Yes No NA (Not or otherwise participate because of the time/location of the Applicable) meeting?

Comments: ______

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Thank you. We value your feedback! Texas Department of Family and Protective Services Form 0625 Child Protective Services November 2012