Ask for Contact Name
Received Letter
Appreciate your cooperation.
Verify agency name
Program or agency?
PROGRAMS WITHIN AGENCIES STATEMENT
Private or public?
City, county, state, or federal government?
Grant monies funding
Grant money proportion
Stable finding?
Take services to clients?
Amount of materials in non-English?
Non-English speakers seeking services?
Who translates?
Physical disability access?
Developmental, cognitive or emotional disability access?
Primarily serve families?
Clients of all ages?
Children ages zero to eight?
Children age 9 to 18?
Youth age 9 to 18
Serve certain race or ethnic groups?
Serve clients with certain disabilities?
Serve clients of a certain religion?
Services free?
Fee based on a sliding scale?
Could serve more clients on current budget?
Able to serve all clients?
Waiting list?
Provide service directly?
Help with food, clothing, utility bills?
Help with transportation services?
Help finding jobs?
Help with training?
Help with child development or childcare?
Help with child, youth or teen services?
Help with child out-of-home placement?
Help for children w/ learning disabilities?
Help for children w/ phy, dev, cog, or emot disabilities?
Mental health care, counseling, or crisis intervention?
Higher levels of mental health care, counseling, intervention?
Health or medical treatment for children?
Health or medical wellness and preventative services?
Parenting education or support?
Legal services or referrals?
Community recreation, culture, or art programs?
Domestic violence, child abuse, or child neglect?
Set procedure for helping get AFS?
Barriers: Clients not knowing services available
Barriers: Inability to pay costs and fees for service?
Barriers: Literacy issues
Barriers: Lack of childcare or elder care
Barriers: Fear of the law
Barriers: People think it will be too much hassle
Barriers: People think too much personal information
Barriers: Lack of transportation or telephone
Barriers: Shame, embarrassment or pride
Barriers: People thinking they don’t need help
Barriers: Agency in an inconvenient location.
Barriers: Agency having inconvenient hours
Barriers: Staff too busy to be nice
Barriers: Staff culturally insensitive
Barriers: Waiting list to get help
Barriers: Too much red tape
Barriers: Not available in parts of County
Barriers: Agency not giving information or help?
Part of Gov't