Developing a Self-Assessment Toolfor Culturally - Office of Minority ...

7. Please indicate, if you know, the percentage of your employed staff, contractors, and partnershipmembers who are conversationally fluent in languages other than English that are spoken by yourclients. (Your best estimate is fine.)Actual EstimatedRecord Percentage % ~ ~If reporting the actual percentage, what is the source used for your response? ~ Don’t know8. Do your management information systems allow for linking client information with information on anyof the following for performance assessments and QI activities?MARK ALL THAT APPLY~ Staff information~ Contractor information~ Partnership member information~ Other, please specify _______________________________________~ Don’t know~ None of the above9. Please indicate the size of your agency’s employed staff by marking the appropriate box. (Your bestestimate is fine.)~ Fewer than 50~ 50–99~ 100–499~ 500–999~ 1,000–5,000~ Greater than 5,000~ Don’t know10. Please indicate the number of contractors your agency is currently working with by marking theappropriate box. (Your best estimate is fine.)~ Fewer than 50~ 50–99~ 100–499~ 500–999~ 1,000–5,000~ Greater than 5,000~ Don’t know11. Please indicate the number of partners your agency is currently working with. (Your best estimate is fine.)~ Fewer than 50~ 50–99~ 100–499~ 500–999~ 1,000–5,000~ Greater than 5,000~ Don’t knowCOSMOS Corporation, December 2003 6