Chester County Government Forms

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Parent Post-Placement Evaluation Form

  1. Placement Evaluation for Parents & Caregivers

  2. Surveys are only reviewed by Chester County Juvenile Probation Department and will NOT be shared directly with the placement provider

  3. 1. The program was as explained to me.

  4. Please check one:*

  5. 2. The placement staff listened to what I had to say.

  6. Please check one:*

  7. 3. I had input into my child's treatment plan.

  8. Please check one:*

  9. 4. The placement staff followed the treatment plan.

  10. Please check one:*

  11. 5. My child's education needs were met.

  12. Please check one:*

  13. 6. The placement staff were committed to my child's best interest and safety.

  14. Please check one:*

  15. 7. The Probation Officer communicated with me while my child was in placement.

  16. Please check one:*

  17. 8. I was able to reach the placement staff without difficulty.

  18. Please check one:*

  19. 9. I was able to reach my child without difficulty.

  20. Please check one:*

  21. 10. Placement provided appropriate medical and dental care.

  22. Please check one:*

  23. 11. I had input into my child's discharge plan.

  24. Please check one:*

  25. 12. Overall, I was pleased with the placement's service.

  26. Please check one:*

  27. PLEASE NOTE- The Chester County Juvenile Probation Department is legally mandated to report all abuse allegations, so you will be contacted directly if you note any concerns of that nature.

  28. Leave This Blank:

  29. This field is not part of the form submission.