Tennessee Department of Children's Services
Child Abuse Prevention Customer Survey
Agency Name:
Report:
Fiscal Year:
Section A:  Descriptive Information

Include a copy of the instrument used with the first monthly report of the fiscal year (July).
1.
Survey data is solicited:
Other
2.
Percent of clients/customers served for which data was sought:
3.
Number of surveys solicited this month:
4.
Number of surveys completed/returned this month:
Section B:  Statistical Data

This section should include year-to-date information only.
5.
Number of surveys solicited year-to-date:
6.
Number of surveys completed/returned year-to-date:
Overall Survey Data
7.
Number satisfied with service provided:
8.
Number not satisfied with service provided:
9.
Number indicating a combination of both satisfied and not satisfied responses.
10.
Number where satisfaction could not be determined.
Survey Statistics
11.
Number completed/returned indicating satisfied or not satisfied with service provided (7 plus 8):
12.
Percent satisfied with service provided - DCS goal is 85% (7 divided by 11):