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<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><st1:place =
w:st=3D"on"><st1:PlaceName
 w:st=3D"on"><b style=3D'mso-bidi-font-weight:normal'><span style=3D'font-s=
ize:12.0pt'>Morrow</span></b></st1:PlaceName><b
 style=3D'mso-bidi-font-weight:normal'><span style=3D'font-size:12.0pt'> <s=
t1:PlaceType
 w:st=3D"on">County</st1:PlaceType></span></b></st1:place><b style=3D'mso-b=
idi-font-weight:
normal'><span style=3D'font-size:12.0pt'> Board of MR/DD<o:p></o:p></span><=
/b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'font-size:12.0pt'>Annual Plan Survey<o:p></o:p></spa=
n></b></p>

<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><o:p>&nbsp;=
</o:p></p>

<p class=3DMsoNormal>As part of the annual planning process for 2009, the M=
orrow
County Board of Mental Retardation and Developmental Disabilities (MCBMRDD)
assesses community needs and the services provided by our agency.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Consumers, families, staff, service
providers, board members and the community are encouraged to take a few min=
utes
to complete and respond to this important survey.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>Please feel free to print the surv=
ey,
complete it and either mail it back to us at the address listed below or fa=
x it
to 419-947-9102.<span style=3D'mso-spacerun:yes'>&nbsp; </span>Your feedbac=
k will
be used to determine which needed services and supports the Board will prov=
ide
as resources permit.<span style=3D'mso-spacerun:yes'>&nbsp; </span></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>Please respond to the following questions:</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<table class=3DMsoTableGrid border=3D1 cellspacing=3D0 cellpadding=3D0
 style=3D'border-collapse:collapse;border:none;mso-border-alt:solid windowt=
ext .5pt;
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h:
 .5pt solid windowtext;mso-border-insidev:.5pt solid windowtext'>
 <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'>
  <td width=3D427 valign=3Dtop style=3D'width:4.45in;border:solid windowtex=
t 1.0pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>The <st1:pl=
ace
  w:st=3D"on"><st1:PlaceType w:st=3D"on">County</st1:PlaceType> <st1:PlaceN=
ame
   w:st=3D"on">Board</st1:PlaceName></st1:place> is committed to providing
  quality services in key strategic areas that are the responsibility of the
  Board.<span style=3D'mso-spacerun:yes'>&nbsp; </span>How are we doing?<o:=
p></o:p></b></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border:solid windowtext =
1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
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  style=3D'mso-bidi-font-style:normal'>Strongly Agree<o:p></o:p></i></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border:solid windowtext =
1.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><i
  style=3D'mso-bidi-font-style:normal'>Agree<o:p></o:p></i></p>
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  <td width=3D67 valign=3Dtop style=3D'width:.7in;border:solid windowtext 1=
.0pt;
  border-left:none;mso-border-left-alt:solid windowtext .5pt;mso-border-alt:
  solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><i
  style=3D'mso-bidi-font-style:normal'>Do Not Agree<o:p></o:p></i></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:1'>
  <td width=3D427 valign=3Dtop style=3D'width:4.45in;border:solid windowtex=
t 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal>Are needed services available in a timely manner</p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D67 valign=3Dtop style=3D'width:.7in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:2'>
  <td width=3D427 valign=3Dtop style=3D'width:4.45in;border:solid windowtex=
t 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><span class=3DGramE>Are MCBMRDD staff</span> helpful=
 with
  the needs of children and adults?</p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
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text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D67 valign=3Dtop style=3D'width:.7in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:3'>
  <td width=3D427 valign=3Dtop style=3D'width:4.45in;border:solid windowtex=
t 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal>Do current facilities best serve enrolled individual=
s?</p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D67 valign=3Dtop style=3D'width:.7in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:4'>
  <td width=3D427 valign=3Dtop style=3D'width:4.45in;border:solid windowtex=
t 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal>Are services delivered in a professional manner?</p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D67 valign=3Dtop style=3D'width:.7in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-irow:5'>
  <td width=3D427 valign=3Dtop style=3D'width:4.45in;border:solid windowtex=
t 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal>Does information flow from MCBMRDD in a reasonable m=
anner?</p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D67 valign=3Dtop style=3D'width:.7in;border-top:none;border-le=
ft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
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 <tr style=3D'mso-yfti-irow:6;mso-yfti-lastrow:yes'>
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  padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal>Are we using financial resources wisely?</p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
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  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
  <td width=3D72 valign=3Dtop style=3D'width:.75in;border-top:none;border-l=
eft:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
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text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal><o:p>&nbsp;</o:p></p>
  </td>
 </tr>
</table>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>What are we d=
oing
well?</b><span style=3D'mso-spacerun:yes'>&nbsp;
</span>______________________________________________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>______________________________________________________=
______________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>______________________________________________________=
______________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>What could we=
 do
differently?</b><span style=3D'mso-spacerun:yes'>&nbsp; </span>____________=
_____________________________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>______________________________________________________=
______________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>______________________________________________________=
______________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>Additional co=
mments
you wish to make:<span style=3D'mso-spacerun:yes'>&nbsp; </span></b>_______=
_________________________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>______________________________________________________=
______________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>______________________________________________________=
______________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>______________________________________________________=
______________________________</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>Please tell u=
s who
you are:<o:p></o:p></b></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>__________<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp; </span>Individual
receiving services</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>__________<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp; </span>Parent
or family member <span class=3DGramE>of an individual receiving services</s=
pan></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>__________<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp; </span>Service
Provider/Staff</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>__________<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp; </span>Member
of the community</p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>Once you have completed the survey, you may mail it to=
 the
MCBMRDD, <st1:address w:st=3D"on"><st1:Street w:st=3D"on">406 Bank Street</=
st1:Street>,
 <st1:City w:st=3D"on">Mt. Gilead</st1:City>, <st1:State w:st=3D"on">OH</st=
1:State>
 <st1:PostalCode w:st=3D"on">43338</st1:PostalCode></st1:address>, or fax i=
t to
419-947-9102 (no later than November 3, 2008).<span
style=3D'mso-spacerun:yes'>&nbsp; </span></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>Thank you!<span style=3D'mso-tab-count:11'>&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
; </span></p>

<p class=3DMsoNormal align=3Dright style=3D'text-align:right'><b style=3D'm=
so-bidi-font-weight:
normal'><span style=3D'font-size:9.0pt'>Revised:<span
style=3D'mso-spacerun:yes'>&nbsp; </span>10/14/2008<o:p></o:p></span></b></=
p>

</div>

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