This survey is to be completed by the individual receiving services from Homeplace Support Services, assisted, if necessary, by a family member/legal guardian or residential provider staff. The survey is written as if it is being answered by the individual, regardless of who reads the statements to the individual or assists them in responding. If you are assisting the individual, please think in terms of the individual’s reaction, not your own experience or from your point of view. The results of this survey are confidential.