The Regional Quality Improvement Assistant will contact the closed foster home and conduct a phone interview. These results will be entered into a web based survey tool. QI will make three attempts to make contact with the foster home before listing the home as “unresponsive/unable to contact".
SAFY strives to provide constant support to foster and adoptive parents during all phases of parenting. As a recently closed home, your input is very important to us.
Foster Home Name:
Foster Home Phone Number:
Kaleidacare Facility ID:
Divisional Office: -- Northern Kentucky South Bend Cincinnati DRC Columbia Las Vegas Columbus/Groveport Montgomery Shelter Services Oklahoma City Huntsville Cleveland Louisville Lawton SAFY Behavioral Health Charleston Lexington Somerset Arlington Findlay/Lima Muncie Dayton Birmingham Tiffin Sidney Greenville Canton/Akron Ft. Wayne Merrillville AMERICA RANCHO DRIVE PATRICK LANE DCR DESERT COTTAGE
Date Foster Home Closed:
How many attempts were made by staff to contact the foster home for the exit interview? -- 1 Attempt 2 Attempts 3 Attempts More than 3 Unable to Contact SAFY Closed Home For Cause
How would you describe your overall experience with SAFY as a foster parent? -- Positive Neutral Negative
If Negative, please specify:
What was POSITIVE about your experience with SAFY?
What was NEGATIVE about your experience with SAFY?
Why are you no longer a foster parent with SAFY? -- Abuse/ Neglect (Allegations) Abuse/ Neglect (Substantiated Charges) Adoption Burn Out Death Divorce Employment Issues Family Obligations Health Issues Incomplete Training No Placements Not Satisfied Relocated Retired Transferred Other
If other, please specify:
If you are no longer a foster parent because of lack of placements, were you offered any placements? -- Yes No
Do you feel an effort was made to retain you as a foster parent? -- Yes No Other
Would you recommend SAFY to a prospective foster parent? -- Yes No Other
Were your concerns and communications addressed timely? -- Yes No Other
Were you treated in a courteous and respective manner? -- Yes No Other
Were the members of our staff professional and skilled to do their job effectively? -- Yes No Other
Additional Comments or Suggestions:
We appreciate your feedback. It is your thoughts and input that makes SAFY what it is today and shares out future. Thanks again!