STAFF EXIT SURVEY

Name _______________________ Department ___________________ Date of Hire _________

Last Day Worked ______________ Supervisor ____________________ Position ____________

Reason for Leaving: Please check the line that best describes your reason for leaving:

_____ Family/Personal/Health Reasons _____ Relocation Out of Area

_____ Wages/Benefits _____ No Advancement Opportunities

_____ Lack of Recognition/Appreciation _____ Quality of Supervision/Management

_____ Other ___________________________________________________________________

(Rate the following using the scale from 1 to 5: Poor=1 Excellent=5)

1. Quality of initial training necessary to perform effectively. 1 2 3 4 5

   Comments_______________________________________________________________________________________________________________________________________

2. Quality of ongoing training necessary to perform properly. 1 2 3 4 5

   Comments_______________________________________________________________________________________________________________________________________

3. Clear understanding and explanation of what was expected of you in your job. 1 2 3 4 5

   Comments_______________________________________________________________________________________________________________________________________

4. Please rate your supervisor/manager on the following:

Models the YW Mission 1 2 3 4 5

Follows policies and procedures 1 2 3 4 5

Recognizes individual performance 1 2 3 4 5

Develops cooperation/teamwork 1 2 3 4 5

Resolves complaints, grievances, and conflict 1 2 3 4 5

Is Accessible -available and approachable 1 2 3 4 5

Keeps staff informed about issues and problems 1 2 3 4 5

Involves staff in decision making process 1 2 3 4 5

Communication/Interpersonal relationship with staff 1 2 3 4 5

Comments___________________________________________________________________________________________________________________________________________________

5. How would you rate the YW on the following:

Work environment/culture 1 2 3 4 5

Hiring process 1 2 3 4 5

New hire orientation process (Human Resources) 1 2 3 4 5

New hire orientation process (Program) 1 2 3 4 5

Employee benefits 1 2 3 4 5

Opportunities for advancement 1 2 3 4 5

Management's communication with employees 1 2 3 4 5

Wages 1 2 3 4 5

On the job training 1 2 3 4 5

Other formalized training 1 2 3 4 5

Visibility and accessibility of senior management 1 2 3 4 5

Staff input into decision effecting their work or role 1 2 3 4 5

Comments_______________________________________________________________________________________________________________________________________

6. How would you rate the YW on the following:

Opportunity to channel ideas into system to promote change 1 2 3 4 5

Management appreciation and recognition 1 2 3 4 5

Workload that allows for quality performance 1 2 3 4 5

Family friendly/considerate of personal needs 1 2 3 4 5

Overall 1 2 3 4 5

Comments___________________________________________________________________________________________________________________________________________________

7. What did you like best about working at the YW?

____________________________________________________________________________________________________________________________________________________________

8. What did you like least about working at the YW?

____________________________________________________________________________________________________________________________________________________________

9. If you could wave a wand and make the YW a better place to work, what would you change?

____________________________________________________________________________________________________________________________________________________________



Thank you for responding to this exit survey. Your input is greatly appreciated.

To be Completed by Human Resources Department

Interviewed by ________________________________ Date______________________

Eligible for Rehire? ______ Yes ______ No (explain) ______________________________

________ Returned handbook ________ Keys