Questionnaire on work life balance

We are keen explore whether there are any particular issues for employees
responsibilities within this 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

DEPARTMENT: ..

Please tick the Most Appropriate Options:-

1. Male [ ] Female [ ]

2. Age Group 3. Martial Status

Under 30 year [ ] Married [ ]
31 to 40 years [ ] Unmarried [ ]
Over 40 years [ ]

4. How many children do you have?
None [ ] 1 [ ] 2 [ ] 3 [ ] 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.


Sr.


Lot
Harder

A
Little
Harder
No
Difference

Doesnt
apply to my
job
1 Deadlines and schedules
2 Type of work you do
3 No. of hours you need to work
4 Expectations/attitude of supervisor or
mgr

5 Expectations/attitude of work males
6 How easy/ difficult it is to take leave
7

Amt. of notice you get about the
hours/overtime you need to work

8 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
Often Rarely Dont
know
Sometimes Never
1 Spending time with friends
2 Get home on time
3 Do any study or training you
want to do

4 Take care of personal
business

5 Keep healthy and fit, play
sports other leisure activities

6 Take part in community
activities or fulfill religious
commitments

7 Take care of family ad
spend time with them


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. Strongly
Agree
Agree Disagree Strongly
Disagree
1 WLB enables people to
work better

2 WLB entirely employers
, partly individuals
responsibility

3 WLB is entirely an
employers responsibility



12. Please tick if you have any of the responsibilities as primary career?

a. Child care [ ]
b. Elder care [ ]
c. Caring for sick child [ ]
d. Caring for disable adult [ ]
e. Caring for sick adult [ ]
f. Caring for disabled [ ]

13. How much time do you spent on the following activities in a working day (in
percentage)?









14. Please tick the following services, which you have used?

a. Medical facilities [ ]
b. Educational allowance [ ]
c. Holiday pay scheme [ ]


Office
Hobbies
Household activities
Study
Care



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 [ ]

17. I get angry on a frequent basis.

Always [ ] Often [ ] Sometimes [ ] Rarely [ ] Never [ ]

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 [ ]

20. I dislike turning over responsibility to others.

Always [ ] Often [ ] Sometimes [ ] Rarely [ ] Never [ ]

21. Worry robs me of time and energy.

Always [ ] Often [ ] Sometimes [ ] Rarely [ ] Never [ ]

22. I put things off until it's too late, or no longer matters.

Always [ ] Often [ ] Sometimes [ ] Rarely [ ] Never [ ]

23. Planning my day-every day is difficult for me.

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 [ ] Often [ ] Sometimes [ ] Rarely [ ] Never [ ]


Thank you for your time