Resident Satisfaction Survey Template

Use this Resident Satisfaction Survey Template to gather feedback on care services and amenities and assess resident needs to improve satisfaction.

Resident Satisfaction Survey Template



Resident Care

1. There are opportunities for my involvement in decisions relating to my care


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2. Food served is in line with my choices / dietary requirements and of good quality & variety


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3. Personal care (bathing, grooming, dressing) is sensitive and appropriate


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4. Going to the bathroom – staff respect my privacy and dignity


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5. My privacy is respected


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6. My choices and wishes are respected


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7. My abilities and strengths are supported and encouraged


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8. I can express my opinion without fear of consequences


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Staff & Services

1. Staff listen to me


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2. PSW staff are available, helpful and care for me


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3. Registered staff are available, helpful and care for me


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4. Physicians are available, helpful and care for me


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5. A good quality and variety of recreational programs are offered


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6. A good quality and variety of spiritual and religious programs are offered


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7. If you are receiving social services, does the quality of the program leave you happy?


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8. If you are currently receiving therapy services, is the quality of the program (physio/ occupational/ speech) leave you happy?


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9. Do the volunteers’ services in the home leave you happy?


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10. Recreation staff are available and helpful


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Infection, Prevention And Control

1. You receive appropriate education and information regarding Infection Prevention and Control, Covid and visitation restrictions at the home


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2. You were informed and educated on hand hygiene techniques


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3. You were shown how to don and take off your personal protective equipment (gloves, gowns, masks, eyewear)


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4. Do you feel safe at the home?


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House Keeping And Building Services

1. Does the home share information that promotes client safety?


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2. Opportunities are available for input/feedback into resident care


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3. Opportunities are available to provide input/feedback into programs and services


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4. Opportunities are available for input/feedback into home operations


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General

1. Cleanliness of the home


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2. General repair and upkeep of the building and grounds


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3. Laundry services


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4. Availability and helpfulness of the Housekeeping, Laundry and Building Services staff


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Administration

1. Efficiency in dealing with my finances/accounting


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2. Availability and helpfulness of the Administration Staff


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Overall

1. Food choices


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2. Food quality


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3. Dining experience


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4. Food quantity


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5. Availability and helpfulness of the Food Services Staff


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6. Please indicate your overall rating of the home as a place to live


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Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

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