Cwm Taf Morgannwg University Health Board Housekeeping (Cleanliness) - Patient Satisfaction Survey Question Title * 1. Which of these best describes you? Female Male Prefer not to say Something else Question Title * 2. What is your age? 16 and under 17 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 3. Which University Hospital Site did you attend/visit? Prince Charles Hospital Royal Glamorgan Hospital Ysbyty Cwm Cynon Ysbyty Cwm Rhondda Pinewood House Ysbyty George Thomas Princess of Wales Hospital Glanrhyd Hospital (Angelton Clinic) Maesteg Hospital Glan Yr Afon (Quarella Road, Bridgend) Dewi Sant Keir Hardie Health Park Question Title * 4. Please identify your ward below: A B C D PICU ST DAVIDS ECU ITU HDU 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 SEREN CDU 35 Childrens A&E Cambrian Ward (YGT) Fern Hill Ward (YGT) SRU (YGT) L M Day Unit (YGT) AMU ICU YBwthyn (POW) SSU PPU Discharge Llynfi Ward CAMHS Coity Clinic Question Title * 5. Did you visit/attend our site as an: Inpatient Outpatient Question Title * 6. Were you satisfied with the overall cleanliness of the single room and ensuite facility you stayed in? Yes No N/A Question Title * 7. Were you satisfied with the overall cleanliness of the bay that you stayed in? Yes No N/A Question Title * 8. Were you satisfied with the overall cleanliness of the toilet/bathroom facilities? Yes No N/A Question Title * 9. Were you satisfied with the overall cleanliness of the ward area? Yes No N/A Question Title * 10. Were you satisfied with the overall cleanliness of the outpatient/clinic treatment area? Yes No N/A Question Title * 11. Was soap, hand gel, hand towels and toilet rolls readily available? Yes No Question Title * 12. Were you satisfied with the cleanliness and quality of the bed linen and towels provided? Yes No N/A Bed Linen Bed Linen Yes Bed Linen No Bed Linen N/A Towels Towels Yes Towels No Towels N/A Question Title * 13. Do you feel our Housekeeping Assistants are polite, friendly and professional? Yes No Question Title * 14. Were the Housekeeping Assistants' ID badges clearly visible? Yes No Question Title * 15. Feedback is important to us. Please leave comments below or use this space to explain your answers, if applicable. (N.B. do not include names of staff or any other personal identifiable information) Done
