PAPER BASED
SELF-ASSESSMENT QUESTIONNAIRE
The Self-Assessment Questionnaire is based on the requirements outlined in the LBS
Service Provider Guidelines and LBS agreement. It provides the Service Delivery Site
with the opportunity to demonstrate the processes and activities it has in place in order
to ensure success in meeting requirements and learner objectives. Employment and
Training Consultants (ETC) will use the questionnaire as a starting point for discussion
about your organization and your program.
Instructions:
1. Complete and submit to MTCU by the due date indicated on the correspondence
received from your MTCU consultant (typically one week ahead of the scheduled
monitor).
2. The question prompts are included to support you in providing fulsome responses.
3. Note: Question numbers may not be in sequence in certain sections of the
questionnaire as not all monitoring questions apply to this level of monitor.
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 1
PAPER BASED SELF-ASSESSMENT QUESTIONNAIRE
Agreement Number and Type
Service Provider Legal Name
SDS Name
SDS ID
Site Address (Physical)
Site Contact Name and Position
Site Contact Telephone Number
Site Contact E-Mail
Name and Position of the Service Delivery Site
staff (manager level or higher) who completed
this form.
Date when the form was completed
GENERAL QUESTIONS
1.1
Describe how you seek out and respond
to feedback from clients and learners to
improve on customer service
expectations.
Provide examples.
Is there a customer complaint resolution
process in place?
How do you incorporate suggestions?
Aside from the customer satisfaction
question on the Exit and Follow-up form,
what other feedback mechanisms do you
use to evaluate and improve service
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 2
GENERAL QUESTIONS
1.2
In the event of a planned or emergency
closure, please describe how you will
maintain continuity of operations to
support clients and learners.
delivery?
Do you reduce service during the summer
months?
What do you do to ensure continuity of
service for your learners during closures?
How do you contact learners during
emergency closures?
1.3
Describe the process used to ensure that
your site’s information on the MTCU’s
Find Employment and Training Service is
always up-to-date.
1.5
What processes and plans are in place to
ensure that the following three key
pieces of information are up-to-date in
EOIS-CaMS:
1. the service delivery site contact
information,
2. the “Available for Service” field to
indicate when your service
delivery site is available to receive
applications, and
3. an EOSS-specific email address
that can receive notifications when
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 3
GENERAL QUESTIONS
an application has been submitted
to your service delivery site.
1.6
Describe the measures you have in place
to protect, prevent and detect the
unauthorized or inadvertent collection,
use, disclosure, loss, alteration or
destruction of personal information.
How do you ensure learners are aware of
your privacy policy?
1.7
Describe what you have done to make
your site and materials more accessible
to persons with disabilities.
For more information on your obligations,
please refer to the Section 4.1.3 of the
LBS Service Provider guidelines. As well,
please visit the Ministry of Community
and Social Services website, Making
Ontario Accessible.
This may include: HR policies, IT policies,
records retention and destruction policy,
regular data validation, security checks,
back-up of data, deactivation of staff who
have left or changed positions, data
recovery, etc.
This may include materials in alternative
formats, modifications to your website, site
accessibility improvements, referrals to
services that support persons with
disabilities, service offerings at alternative
locations, etc.
1.8
Describe how your Service Provider
Registration Authority (SPRA) manages
the EOIS-CaMS licences and user
accounts allocated to your organization.
Does your SPRA verify users are current
and active on a regular basis and deactivate
users in a timely fashion?
1.9
Do you have a system in place to ensure
What is your system to store completed
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 4
GENERAL QUESTIONS
1.10
1.11
that milestones and the culminating task
are kept secure?
milestones and culminating tasks?
Describe how you ensure your LBS
program adheres to the Employment
Ontario Visibility Guidelines for agencies
contracted to deliver Employment
Ontario services and/or projects (as it
relates to signage, communication
products, events, advertisements,
website, etc.).
Describe your best practices for ensuring
that the visibility guidelines are met:
How do you ensure that staff have the
appropriate skills and training to select,
administer, interpret and track
assessment results?
What training and ongoing professional
development do they receive?
What is your system to store any blank or
unused milestones and culminating tasks?

Submit event template as required

Submit marketing documents prior to
publication to ETC for review.
SERVICE DELIVERY
2.2
Describe the assessment strategies and
tools you use with clients and learners to
determine:

Provide evidence of the process that is used
to review and adjust learner plans on an
ongoing basis to meet the needs of learners.
Eligibility and Suitability
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 5
SERVICE DELIVERY
2.4

Strengths and Areas for
Development

OALCF level at entry into the
program

Learning Style

Goal Path

Competencies Required by the
Goal Path

Learning Activities

Milestones

Culminating Task

Learner Progress

Readiness to Exit.
Describe how your learner plans are
developed for the individual.
Describe how you ensure they capture
the following components specifically to
each individual learner:
Explain how learner plans and decisions
regarding service delivery are made to
reflect the OALCF.
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 6
SERVICE DELIVERY




2.13
background information
goal path
assessment results
learning styles and method of
training delivery
 competencies required
 learning activities
 assessment strategy for
incorporating milestones and
culminating task
 learner’s estimated weekly
commitment time
 timelines/program duration
 competencies achieved
 additional supports/referrals
required by the learner (and their
results).
Describe how you evaluate the
effectiveness of your training activities to
support learner transitions. How do you
use learner feedback to make
improvements?
Based on your evaluation, were learners
prepared for their next step?
What changes have you made as a result of
learner feedback?
Provide examples.
DATA INTEGRITY
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 7
DATA INTEGRITY
3.1
Describe how your site ensures that you
have the capacity to effectively use and
manage EOIS-CaMS.
Which resource materials or online training
modules have you accessed?
How do you support new staff with system
training?
Have you identified an EOIS-CaMS ‘expert’
who acts as a resource to staff?
FINANCIAL MANAGEMENT
4.1
How does your organization manage the
budget to ensure full expenditure of the
approved allocation?
Describe the financial processes and
systems your organization has in place.
How does your site ensure timely
processing of invoices?
Describe the financial forecasting practices
your site uses.
Who analyzes financial reports and when?
4.2
How does the analysis of your financial
What information is analyzed from your
reports contribute to your overall program financial reports?
evaluation and business planning?
Does this analysis form part of your overall
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 8
FINANCIAL MANAGEMENT
evaluation and support business planning?
PERFORMANCE MEASURES
5.2
Describe how you are able to develop,
implement, monitor, and modify action
plans to achieve your contracted
commitments with the ministry.
REPORTING
6.1
Describe the process your site has to
ensure mandatory reporting
requirements are submitted by their
deadlines.
SERVICE COORDINATION
7.2
What system is in place to track and
analyze learner referrals to and from your
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 9
SERVICE COORDINATION
organization?
Based on your analysis, have you
identified any gaps in referrals? What
steps are you taking to strengthen
referrals with EO providers and other
community organizations?
LBS Strategic Monitoring Pilot: Paper Based Self-Assessment Questionnaire
August 2015
Page 10