Page 230 - QAP Manual 2020
P. 230
NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21
80. Who decides your daily schedule (like when to get up, when to eat, when to go to
sleep)?
Other respondent: Who decides this person’s daily schedule—like when to get up, when to eat,
when to go to sleep?
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other
□ 2. Person decides
□ 3. Person has help deciding
□ 1. Someone else decides
□ 99. Don’t know, no response, unclear response
81. Do you have enough choice about your daily schedule?
Other respondent: Does this person have enough opportunities to make choices about his/her
daily schedule?
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other
□ 2. Yes
□ 1. No
□ 99. Don’t know, no response, unclear response
82. Who decides how you spend your free time (when you are not working, in school, or
at the day program)?
Other respondent: Who decides how this person spends his/her free time?
Note to surveyors: Free time is time in which the person doesn’t have something he/she has to
do.
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other
□ 2. Person decides
□ 3. Person has help deciding
□ 1. Someone else decides
□ 99. Don’t know, no response, unclear response
83. Do you have enough choice about what to do in your free time?
Other respondent: Does this person have enough opportunities to make choices about what
he/she does in his/her free time?
Respondent: ( ) 1-individual ( ) 2-family/friend ( ) 3-staff ( ) 4-other
□ 2. Yes
□ 1. No
□ 99. Don’t know, no response, unclear response
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