RESEARCH QUESTIONNAIRE

This survey is intended to gather broad details on the systems, rules, and
practices in your organization. Your suggestions will help the entire company
as it works to develop into a thriving, competitive enterprise in the community.

The supplied information is private and will only be applied to this study.

Kindly respond to all inquiries.

SECTION A: PERSONAL INFORMATION

Please tick where appropriate

Gender ( )Male ( )Female

What is your age

( ) 18 to 25 ( ) 50 - 64

( ) 26 to 34 ( ) 65 and over

( ) 35 to 49

Highest Level of education

( ) Primary ( ) University Graduate

( ) Secondary ( ) Post Graduate

( ) College ( ) No formal education

For how long have you worked in this organization?

( ) less than a year

( ) 4 – 6 years

( ) 7 – 10 years

( ) 10 and above

SECTION B: DENTAL CLINIC ORGANIZATIONAL ASSESSMENT

Assessment Item Yes No

Mission, Vision, goals and Formal organizational structure

1. I clearly know the mission and vision of the clinic

2. The goals of the clinic are clearly stated and known to all
employees

3. Are the duties of key employees of the organization defined?

4. Are there any policies and procedures in place?

5. Does the organization structure set forth the actual lines of

Assessment item Yes No

Human Resource Policy

1. Is there a policy and process for recruitment of staff ?

2. Does the management follow the guidelines in the policy when

4. Does the remuneration package adequately commensurate the

6. Is there a staff manual or staff handbook in place?

7. Are new employees take through an induction process?

8. Does the organization carry out staff appraisals?

9. Does the staff undergo periodic trainings?

10. A
re the trainings conducted beneficial to the work,
organizational goals and personal development?

11. A
re there clear reporting procedures in place?

12. D
oes the organization have a career progression line in place?

13. A
re you motivated in your work?

14. D
oes the organization have a sick leave and annual leave
policy and procedure?

15. A
re you satisfied with your employer?

16. T
he pay scale and benefits of this organization treat each
employee equitably
 17. A
re you aware of staff grievance and disciplinary procedures?

Assessment Item YES NO

FINANCIAL POLICY AND PROCEDURE ASSESSMENT

1. Does the clinic have a financial policy and procedures in place?

2. Are the employees conversant with the financial policy and

3. We the staff involved in the drafting the organizations financial

4. Does the financial policy and procedure act as a guide in all

5. Has there been any positive change since the policy was
implemented?

6. Does the clinic have an accounting system in place?

7. Are the financial internal controls in place adequate?

8. Does the organization have competent staff in the Finance

9. Does the organization have an insurance policy?

10. Are budgets emphasized in the organization?