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Group Home Staff Safety Questionnaire

Worksite Redesign Technical Advisory Project

I request that you complete this questionnaire, however, this is completely voluntary. We are conducting a study on staff safety in group homes. All of your answers will be anonymous and strictly confidential. No signatures are requested or required. Our mission is to process your technical suggestions to improve staff safety in all group home settings. Thanking you in advance for your assistance.
  1. Are there any structural changes you would suggest in this home that would make your job safer?
  2. Are there any features of this home you feel are unsafe?
  3. What is the most dangerous part of your job? Why?
  4. Can you think of something that would help you do your job more safely?
  5. Have you or other staff in this home been hurt?
    If so, where? (bathroom, kitchen, outside?)
    What happened?
  6. Are there any safety devices or features in this home that work really well?
  7. Are there locations in this home where traction is a problem? Where?
  8. Are there places in this home too small or cramped for you to work comfortably and safely?
  9. Is there enough light in necessary places for you to work well? Explain.
  10. Any other comments pertaining to staff safety?
Thank you very much for your time and assistance! If you have any questions or problems, please give me a call at 541-683-8280.Please mail or fax this to: 

Llwynne Caullay
1457 East 24th Ave.
Eugene, OR 97403
FAX 541-342-4812