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Questionnaire on work life balance We are are keen keen expl explor oree whet whethe herr ther theree are are any any part partic icul ular ar issu issues es for for empl employ oyee eess responsibil responsibilities ities within within this organization organization.. We want to find out what we are doing well in assist employees balance their work and family life and how we could improve. Thank you for your help. NAME…………………………………………………… NAME……………………… ……………………………………………………… ………………………………… ……… DEPARTMENT: ………………………… ……………………………………………………… ……………………………………………….. ………………….. Please tick the Most Appropriate Options:-
1. Male [ ]
Female [
]
2. Age Group Under 30 year 31 to 40 years Over 40 years 4.
3. Martial Status [ ] [ ] [ ]
How many children do you have? None [ ] 1 [ ] 2[ ] 3[ ]
Married Unmarried
[ [
More than 3 [
]
] ]
5. How old are your children? Under 2 years [ ] 2-5 years [ ] 6-10 years [ ] 11-14 years [ ] 15-18 years [ ] 6. Factors making Work Life Balance harder. Lot A No Doesn’t Harder Little Difference apply to my Harder job
Sr. 1
Deadlines and schedules
2
Type of work you do
3 4
No. of hours you need to work Expec pectati ations ons/attitude of supervisor or mgr Expectations/attitude of of wo work ma males
5
6 7 8
How easy/ difficult it is to take leave Amt. of notice you get about the hours/overtime you need to work Having to take additional work home
9
Amount of travel required
10
Times meeting/training are scheduled
11
Starting and finishing time
12
Flexible timings
7. How big an impact work has on work life balance? Sr. No 1
Spending time with friends
2
Get home on time
3
Do any study or training you want to do Take care of personal business Keep healthy and fit, play sports other leisure activities Take part in community activities or fulfill religious commitments Take care of family ad spend time with them
4 5 6
7
Often Rarely
Don’t know
Sometimes Never
8 Do you generally feel you are able to balance your work and family life? Yes
[ ]
No [ ]
9 Do you believe that your superiors style support your work life balance? Sometimes [ ]
Always [ ]
Rarely [ ]
10 Can you openly discuss issues related to your work life with your superior? Yes, all the time Yes, sometimes Depends on the matter Not at all
[ [ [ [
] ] ] ]
No response
[ ]
11. Please tick the most appropriate option on statements on work life balance.
Sr. 1 2
3
Strongly Agree
Agree
Disagree
Strongly Disagree
WLB enables people to work better WLB entirely employers , partly individuals responsibility WLB is entirely an employer’s responsibility
12. Please tick if you have any of the responsibilities as primary career? a. b. c. d. e. f.
Child care Elder care Caring for sick child Caring for disable adult Caring for sick adult Caring for disabled
[ [ [ [ [ [
] ] ] ] ] ]
13. How much time do you spent on the following activities in a working day (in percentage)? Office Hobbies Household activities Study Care
14. Please tick the following services, which you have used?
a. Medical facilities b. Educational allowance c. Holiday pay scheme
[ [ [
] ] ]
15. What could this organization do to help you balance your work and family life?
16. I am very busy and impatient. Always [ ]
Often [
]
Sometimes [ ]
Rarely [ ]
Never [ ]
Sometimes [ ]
Rarely [ ]
Never [ ]
17. I get angry on a frequent basis. Always [ ]
Often [
]
18. I have to cope with too many organizational or job task changes. Always [ ]
Often [
]
Sometimes [ ]
Rarely [ ]
Never [ ]
19. I feel pressured by too many demands from clients/customers /boss. Always [ ]
Often [
]
Sometimes [ ]
Rarely [ ]
Never [ ]
Rarely [ ]
Never [ ]
Rarely [ ]
Never [ ]
20. I dislike turning over responsibility to others. Always [ ]
Often [
]
Sometimes [ ]
21. Worry robs me of time and energy. Always [ ]
Often [
]
Sometimes [ ]
22. I put things off until it's too late, or no longer matters. Always [ ]
Often [
]
Sometimes [ ]
23. Planning my day-every day is difficult for me.
Rarely [ ]
Never [ ]
Always [ ]
Often [
]
Sometimes [ ]
Rarely [ ]
Never [ ]
24. I am unable to establish a clear direction and develop personal and career goals. Always [ ]
Often [
]
Sometimes [ ]
Rarely [ ]
Never [ ]
25. I find it difficult to create a health work and life balance. Always [ ]
