Unbridled Spirit Logo
Home
Entry
OLD Exit Interview for Separating Employees Logging
System Information 
Logging Type:
  17 
Logging Item:
  0 
Create Date:
   
WELCOME
  • The Cabinet for Health and Family Services is committed to identifying ways to continuously improve the workplace for its employees. This questionnaire is used to seek feedback from employees leaving the Cabinet which then cam be used to enact positive change within our Cabinet.
  • Note: Any information alleging improper or illegal activities will be referred to the Office of Human Resource management for appropriate action.
  • Thank you in advance for your participation!
EXIT INFORMATION
Effective Date of Separation
Reason(s) for Separation












If Other, Specify:
  • Identify the organizational unit in which you were last employed.
Last Position
If DIS, Select Department
If DBHDID, Select Facility
If DCBS, Select Region
If DCBS, Identify Program
If DCBS, SSW or SSC?
Classification
What type of work did you do?
DEMOGRAPHIC INFORMATION (OPTIONAL)
Years of Service w/State Gov.
Years of Service w/CHFS
Birth Date
Age
Gender
Hispanic or Latino
Race
EMPLOYEE SATISFACTION
  • Please check the response best reflecting your opinion.
  • 1. Overall satisfaction - I was satisfied with my employment at CHFS.
Select One
  • 2. I know what I was expected to do in my job.
Select One
  • 3. I received the training necessary to be successful in my job.
Select One
  • 4. I was provided the computer technology I needed to do my job effectively.
Select One
  • 5. I was provided with the resources (supplies, furniture, and equipment) needed to do my job.
Select One
  • 6. I received Cabinet and office information in a timely manner.
Select One
  • 7. My office was inclusive and accepting of diversity.
Select One
  • 8. I felt safe in my work environment.
Select One
  • 9. I had the opportunity to use my best skills at work.
Select One
  • 10. In the last two weeks, I received recognition or praise for doing good work.
Select One
  • 11. My immediate team treated me fairly and with respect.
Select One
  • 12. My supervisor completed my performance evaluations timely, thouroughly, and according to administrative regulation and Cabinet policy.
Select One
  • 13. I felt senior management understood and worked to resolve the problems we faced.
Select One
  • 14. My ideas and opinions were valued at work.
Select One
  • 15. My fellow employees were committed to doing quality work.
Select One
  • 16. The workload was fairly distributed.
Select One
  • 17. My supervisor encouraged my professional job development and growth.
Select One
  • 18. This last year, I had opportunities at work to learn and grow.
Select One
  • 19. My supervisor was knowledgeable in the work and followed policies and procedures.
Select One
  • 20. My supervisor worked with staff to resolve problems and to seek prositive change.
Select One
GENERAL COMMENTS
  • What did you enjoy most about working with us?
Comments
  • What could we have done to make your employment more satisfying?
Comments
 
Privacy | Disclaimer | Individuals with Disabilities
Copyright © 2009 Commonwealth of Kentucky
All rights reserved.
CHFS Application Name