English Impact Monterey County Survey · Monterey County, 60 Garden Ct # 350, Monterey, CA 93940....
Transcript of English Impact Monterey County Survey · Monterey County, 60 Garden Ct # 350, Monterey, CA 93940....
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey
Impact Monterey County is a collaborative community planning effort. Working with you, your local nonprofits, businesses, and public agencies are trying to identify the most effective ways to improve our county. We all want Monterey County to be the best possible place to live; by taking this survey, you will be able to tell us what that looks like to you. Thank you for agreeing to participate! Things to Keep in Mind: • The survey should take you 1520 minutes to complete. • There are no right answers, nor are there any wrong answers. All you have to do is draw from your own experiences, views and perspectives. • Your responses will remain anonymous. The survey will NOT collect any information that could identify you. Your responses cannot be linked with your name or email address. Results from this survey will only be presented in aggregate form. • Your completed survey will help ensure we have input from a broad range of people in our community. The few questions about demographics are to help ensure all communities are represented. • If there’s a question you don’t want to answer, just skip it and go on to the other questions. • The survey submission deadline is October 31, 2014 at 5:00 p.m. If you have any questions or need assistance with the survey, please contact Zuleima Arevalo at [email protected]. For more information about Impact Monterey County, please go to www.impactmontereycounty.org.
Instructions for Paper Survey Participants: Please complete the paper survey by circling or checkingoff your selected choices and/or writing your answers in the comment boxes provided. Once you complete the survey, please give it to an Engagement Team member (if they are assisting you) or insert the survey into the selfaddressed/stamped envelope provided and mail to: United Way of Monterey County, 60 Garden Ct # 350, Monterey, CA 93940. If at any time you have questions or need assistance entering the information, please contact Zuleima Arevalo at [email protected] and she will be happy to assist you.
1. Please tell us the zip code in which you live. (This question is required.)
Welcome to the Impact Monterey County Community Survey
Survey Instructions
Please tell us a little bit about yourself.
*
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey2. What is your age?
3. Please tell us what you like most about your community.
4. Are you currently employed?
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Employment Information
Employment Status
017 Years
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1824 Years
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2529 Years
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3039 Years
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4049 Years
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5059 Years
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6069 Years
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70 79 Years
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8089 Years
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90+ Years
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Choose not to answer
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Yes
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No
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Choose not to answer
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey5. Please tell us about your current employment status.
6. Please tell us about your benefits status.
Fulltime Parttime Does not apply
Permanent employee nmlkj nmlkj nmlkj
Temporary or seasonal employee
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Selfemployed (work for myself)
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Semiretired and working nmlkj nmlkj nmlkj
Other type of paid employment (please specify)
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Unemployment Status
Employed with full benefits (including health, dental, vacation, sick leave, pension, etc.)
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Employed with some benefits (please specify)
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Employed without any benefits
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Other (please specify)
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Comments:
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey7. Please select which of the following reasons best describe why you are not currently working. (Please check all that apply.)
Education Information
Disability that limits my employment options
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Not able to find work because of my age
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Lack of education or job skills
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Laid off from my job
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Recent illness and/or hospitalization
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Retired, do not work for pay
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Student
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Temporarily not working, seeking employment
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Voluntarily not working
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Choose not to answer
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Other (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey8. Please check the option that best describes your highest level of schooling.
No schooling completed
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Elementary school (Grades 1 5)
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Middle school (Grades 6 8)
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High school (Grades 9 12) No Diploma
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High school diploma or GED
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Trade school / certificate
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Some college credit No Diploma
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Associate’s degree (for example: AA, AS)
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Bachelor’s degree (for example: BA, BS)
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Master’s degree (for example: MA, MS, MSW)
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Professional degree (for example: doctor, dentist, lawyer)
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Doctorate degree (for example: PhD, EdD)
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Choose not to answer
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Other (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey9. If given the opportunity, what is the highest level of education you would like to achieve in your lifetime?
10. Are you currently enrolled in a school, college or other educational program?
If currently enrolled in a school, college or other educational program:
I have already achieved the highest degree/level of education desired
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Elementary school (Grades 15)
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Middle school (Grades 68)
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High school (Grades 9 12) No Diploma
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High school diploma or GED
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Some college credit No Diploma
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Associate’s degree (for example: AA, AS)
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Bachelor’s degree (for example: BA, BS)
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Master’s degree (for example: MA, MS, MSW)
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Professional degree (for example: doctor, dentist, lawyer)
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Doctorate degree (for example: PhD, EdD)
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Don't know
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Choose not to answer
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Other (please specify)
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Yes
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No
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Choose not to answer
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Other
Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey11. Please tell us what type of degree are you currently pursuing.
12. Please indicate if any of the following is an obstacle to your education:Yes, this is an obstacle No, this is not an obstacle Choose not to answer
Cost of education nmlkj nmlkj nmlkj
Family obligations nmlkj nmlkj nmlkj
Immigration status nmlkj nmlkj nmlkj
Transportation nmlkj nmlkj nmlkj
Work obligations nmlkj nmlkj nmlkj
Other nmlkj nmlkj nmlkj
High school diploma or GED
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Trade school/Certificate
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Associate’s degree (for example: AA, AS)
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Bachelor’s degree (for example: BA, BS)
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Master’s degree (for example: MA, MS, MSW)
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Professional degree (for example: doctor, dentist, lawyer)
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Doctorate degree (for example: PhD, EdD)
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Other training program
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Does Not Apply
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Choose not to answer
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Other (please specify)
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If Other (please specify)
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Other
Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey13. Please tell us which of the following motivates you to pursue your current educational goals. (Please check all that apply.)
14. Please tell us what could be done to improve educational opportunities in your community.
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If not currently enrolled in a school, college or other educational program...
Better/more job opportunities
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Career advancement
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Change in career
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Higher income/more money
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More independence
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Lifelong learning
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Personal satisfaction
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Make a difference in the world
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Other
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey15. Please tell us why you are not currently enrolled in a school, college, or other educational program. (Please check all that apply.)
16. Please tell us what could be done to improve educational opportunities in your community.
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Military Information
I have already achieved the highest degree/level of education desired
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Cost of education
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Criminal record
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Do not feel well prepared for the next level of education
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Family obligations
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Immigration status
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No local options available in my area of interest
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Not interested in pursuing more education at this time
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Transportation
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Work obligations
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Choose not to answer
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Other
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If Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey17. Please tell us if you have military experience.
18. Please indicate your current military status.
19. Please tell us what factors would motivate you to stay in Monterey County after you complete your military service.
Military status
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Parent or guardian
Yes
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No
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Choose not to answer
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Active duty military
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Inactive statusretired
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Inactive statusreserve
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Inactive statusdischarged
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Does not apply
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Choose not to answer
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Other (please specify)
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Other
Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey20. Are you a parent or guardian (for example: grandparents) with primary responsibility for a child of any age?
21. Are you a parent or guardian of children 3 years and under?
22. Do any of your children attend a daycare center?
Children 3 years and under
Daycare Information
Daycare Information
Yes
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No
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Choose not to answer
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Yes
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No
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Choose not to answer
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Yes
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No
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Choose not to answer
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey23. What factors are most important to you in selecting daycare? (Please check all that apply.)
24. Please tell us how your community could best support families with young children.
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Child not attending daycare center
Cost of daycare
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Safe pickup/drop off system
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Friendly environment
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Helps children improve academically
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Hours of operation
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Kindergarten preparedness
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Location of daycare
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Parent/teacher conferences
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Staff experience and training
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Transportation services
gfedc
Choose not to answer
gfedc
Other (please specify)
gfedc
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey25. Who provides childcare for your child(ren)? (Please check all that apply.)
26. What are the main reasons your child is not attending daycare? (Please check all that apply.)
Self
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Family member (paid)
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Family member (unpaid)
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Nonfamily member or friend (paid)
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Nonfamily member or friend (unpaid)
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Child Care/Day Care Center (paid)
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Family Child Care Home (paid)
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Choose not to answer
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Other (please specify)
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Cost of daycare in my area is too high
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Lack of daycare options in my area
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Low quality daycare in my area
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Lack of transportation
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Child is too young
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Parent/guardian at home with child(ren)
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Choose not to answer
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey27. Would you like your child(ren) to attend daycare?
28. If you would like your child(ren) to attend daycare, what factors are most important to you in selecting daycare? (Please check all that apply.)
Yes
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No
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Other (please specify)
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Cost of daycare
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Safe pickup/drop off system
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Friendly environment
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Helps children improve academically
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Hours of operation
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Kindergarten preparedness
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Location of daycare
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Parent/teacher conferences
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Staff experience and training
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Transportation services
gfedc
Other (please specify)
gfedc
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey29. Please tell us how your community could best support families with young children.
30. Are you a parent or guardian of children 5 years and under?
31. Do any of your children attend preschool?
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Children 5 years and under
Parent or guardian of child 5 years and under
Children not attending preschool
Yes
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No
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Choose not to answer
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Yes
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No
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Choose not to answer
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey32. What are the main reasons your child(ren) are not attending preschool? (Please check all that apply.)
33. Would you like your child(ren) to attend a preschool?
Cost of preschools in my area is too high
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Lack of preschools in my area
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Low quality preschools in my area
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Lack of transportation
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Child is too young
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Parent/guardian at home with child(ren)
gfedc
Choose not to answer
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Other (please specify)
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Yes
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No
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey34. If you would like your child(ren) to attend preschool, what factors are most important to you in selecting a preschool? (Please check all that apply.)
35. Please tell us how your community could best support families with young children.
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Children attend preschool
Cost of preschool
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Hours of operation
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Location of preschool
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Kindergarten preparedness
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Parent/teacher conferences
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Transportation services
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Friendly environment
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Safe pickup/Drop off system
gfedc
Helps children improve academically
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Staff experience and training
gfedc
Choose not to answer
gfedc
Other (please specify)
gfedc
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey36. What factors are most important to you in selecting a preschool? (Please check all that apply.)
37. Please tell us how your community could best support families with young children.
To shorten the length of time for you to complete this survey, you are being asked to respond to the following questions for only one child (either your oldest or only child).
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Grade of oldest or only child in school
Cost of preschool
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Hours of operation
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Location of preschool
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Kindergarten preparedness
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Parent/teacher conferences
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Transportation services
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Friendly environment
gfedc
Safe pickup/Drop off system
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Helps children improve academically
gfedc
Staff experience and training
gfedc
Choose not to answer
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Other (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey38. Please tell us in what grade is your oldest (or only) schoolaged child.
Parent or guardian of child ages 618
Kindergarten
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1st grade
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2nd grade
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3rd grade
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4th grade
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5th grade
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6th grade
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7th grade
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8th grade
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9th grade
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10th grade
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11th grade
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12th grade
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None of these options
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Other
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey39. What type of school did your oldest (or only) child attend last year?
40. Please tell us what you like most about your oldest (or only) child's school.
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Private School
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Public School
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Charter School
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Home school
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Don't Know
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Choose not to answer
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey41. Please tell us which of the following you agree or disagree with regarding your oldest (or only) child's school.
42. Please tell us what improvements you would like to see at your oldest (or only) child's school.
Agree Disagree Don't Know
I feel welcome in my child's school nmlkj nmlkj nmlkj
My child has one or more teachers who are positive role models
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My child enjoys being at school nmlkj nmlkj nmlkj
Teachers encourage my child's creativity nmlkj nmlkj nmlkj
School is preparing my child well for the future nmlkj nmlkj nmlkj
Teachers care about my child's feelings nmlkj nmlkj nmlkj
Teachers make learning exciting nmlkj nmlkj nmlkj
Teachers help my child to improve academically nmlkj nmlkj nmlkj
My child feels safe at school nmlkj nmlkj nmlkj
Other nmlkj nmlkj nmlkj
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Other (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey43. When thinking about the future of your oldest (or only) child, please tell us what is the highest level of education you would like her/him to achieve?
44. Please tell us what could be done to improve educational opportunities in Monterey County.
Question for all respondents
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Income Information
Elementary school (Grades 1 – 5)
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Middle school (Grades 6 – 8)
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High school (Grades 9 12) Diploma
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Trade school/Certificate
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Associate’s degree (for example: AA, AS)
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Bachelor’s degree (for example: BA, BS)
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Master’s degree (for example: MA, MS, MSW)
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Professional degree (for example: doctor, dentist, lawyer)
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Doctorate degree (for example: PhD, EdD)
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Don't know
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Choose not to answer
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey45. What is your current household income?
46. How many people live in your household?
Less than $25,000
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$25,00034,999
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$35,00049,999
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$50,00074,999
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$75,00099,999
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$100,000149,999
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$150,000 +
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Don't know
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Choose not to answer
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Other (please specify)
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1 (Self)
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2
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3
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4
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5
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6
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7
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8+
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Choose not to answer
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey47. In the past year, how often were you able to pay for the following:
Always Almost alwaysOccasionally/ Sometimes
Almost never NeverDoes not Apply
Caring for aging parents and relatives nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Childcare/daycare nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Children’s education (e.g. tuition, books, school suplies. etc.)
nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Clothing nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Consumer/credit card debt (minimum monthly payment) nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Food nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Health Insurance (monthly premiums) nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Healthcare expenses (e.g. prescriptions/medicine, supplies, equipment, etc.)
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Housing maintenance and other additional housing costs nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Monthly rent (If home owner please check “does not apply”)
nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Mortgage (if renter please check “does not apply) nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Recreational and leisure activities nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Student loans for yourself (tuition and other educational expenses)
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Auto expenses (e.g. insurance, loan payments, maintanence, gas)
nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Other transportation (e.g. bus, taxi, carpool) nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Utilities nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Other nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj
Other (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey48. How satisfied are you with your current financial situation?
49. Please tell us what could help you to become more financially secure in the future.
The following section asks you to share your thoughts about health issues in your community.
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Community Health Issues
Very Satisfied
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Satisfied
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Unsatisfied
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Very Unsatisfied
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Don’t Know
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Choose not to answer
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey50. Please tell us what you think are the most significant health problems facing your community. (Please check all that apply.)
51. Please tell us what could be done in your community to help teens delay pregnancy.
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Alcohol abuse (esp.underage drinking)
gfedc
Anxiety disorders
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Bullying among children and teens
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Cancer
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Chronic illness
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Child abuse
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Elder abuse
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Dental/oral health problems
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Depression
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Diabetes
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Domestic abuse/violence
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Drug abuse: Marijuana
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Drug abuse: Prescription drugs
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Drug Abuse: Other illegal "street" drugs
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Heart disease
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HIV/AIDS
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Homicide
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Lack of nutritious food
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Lack of exercise
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Lack of safe drinking water
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Overweight/Obesity
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Lack of needed medical care
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Lack of needed dental care
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Lack of needed mental health care
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Lack of affordable prescription medicines
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Pollution (please specify types below)
gfedc
Post Traumatic Stress Disorder (PTSD)
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Sexual abuse or rape
gfedc
Sexually transmitted diseases (for example: chlamydia,
gonorrhea, hepatitis C)
gfedc
Smoking (tobacco use, especially by youth)
gfedc
Street (or gang) violence
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Stroke
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Suicide
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Teen pregnancy/births
gfedc
Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey52. Please tell us what helps (or would help) you to exercise regularly. (Please check all that apply.)
53. Please tell us what could be done in your community to address childhood obesity.
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A safe neighborhood
gfedc
Time spent with family or friends
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Sports field nearby my home
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Exercise classes nearby my home
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Team sports nearby my home
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Access to nature (for example: parks, beaches)
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To stay healthy as I age
gfedc
Enough free time
gfedc
BIke lanes, walking paths, streets with less traffic
gfedc
Cost of exercise classes or fitness center fees
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My physical appearance
gfedc
Staying healthy
gfedc
Choose not to answer
gfedc
Other (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey54. Please tell us what could be done in your community to improve access to healthy foods.
55. How do you usually get health information? (Please check all that apply.)
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Advice from nurse at doctor's office
gfedc
Contact family or friends for advice
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Community organization
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Health hotline (phone)
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Internet search
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Medical doctor/physician
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Nurse practitioner
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Nonphysician health professional (for example: acupuncturist, chiropractor)
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Radio
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Social media (egs.Facebook, Web MD, You Tube, etc.)
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Television
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey56. Please tell us what could be done to improve health in your community (related to any health issue that you care about).
57. Please indicate if you currently have health insurance and which type of insurance. (Please check all that apply.)
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Health Care Insurance and Services
I do not have health insurance. (I am uninsured.)
gfedc
I am insured through an individually purchased health insurance plan
gfedc
I am insured through my employer
gfedc
I am insured through Covered California (Health Benefits Exchange)
gfedc
I am insured through Medicare
gfedc
I am insured through MediCal (Medicaid)
gfedc
I am insured through the Military
gfedc
I am insured, but don't know what type of insurance
gfedc
Choose not to answer
gfedc
Other
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Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey58. If you are currently uninsured, please indicate the reason(s) for not having insurance. (Please check all that apply.)
The person in family who had health insurance lost job or changed employers
gfedc
The person in family who had health insurance is no longer part of the family because of divorce, separation, or death
gfedc
Family member's employer does not offer coverage or not eligible for employer's coverage
gfedc
Lost eligibility for Medicaid
gfedc
Cost of health insurance is too high
gfedc
Don't need insurance
gfedc
Don't know how to get insurance
gfedc
Traded health insurance for another benefit or higher pay
gfedc
Can't get health insurance because of my immigration status
gfedc
Other (please specify)
gfedc
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey59. If you currently have health insurance, please indicate if you are satisfied with the following:
Very Satisfied Satisfied Unsatisfied Very Unsatisfied Does not apply
Adequate coverage for my health needs
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Adequate coverage for my family's health needs
gfedc gfedc gfedc gfedc gfedc
Amount of copays or deductibles
gfedc gfedc gfedc gfedc gfedc
Cost of monthly or annual insurance premiums
gfedc gfedc gfedc gfedc gfedc
The selection of doctors and clinics that accept my insurance.
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Types of services covered by my insurance
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Other gfedc gfedc gfedc gfedc gfedc
Other (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey60. Which of the following would increase your satisfaction with your doctor or clinic? (Please check all that apply.)
Expand the days the doctor’s office or clinic is open to include weekends
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Expand the hours the doctor’s office or clinic is open to include evenings (later than 6:00PM)
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Reduce the amount of time I need to wait once I arrive for an appointment at the doctor's office or clinic
gfedc
Healthcare providers who speak my language
gfedc
Translation/interpretation services in my language
gfedc
Better health insurance coverage
gfedc
Doctor’s office or clinic’s willingness to accept different types of health insurance
gfedc
Accommodations for people with disabilities (for example: physical, vision or hearing impairments)
gfedc
Childcare/daycare
gfedc
Telehealth options (talk to a doctor over the internet)
gfedc
Transportation
gfedc
I am currrently satisfied with my doctor or clinic
gfedc
I do not have my own doctor or clinic
gfedc
Other (please specify)
gfedc
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey61. Where do you go for general (nonemergency) healthcare services? (Please check all that apply.)
62. Please tell us what do you think should be done to improve access to healthcare services (for example: doctors, clinics, and hospitals) in your community.
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Community Safety
A private doctor, medical group or clinic in Monterey County
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A private doctor, medical group or clinic in Santa Cruz County (including Watsonville)
gfedc
A private doctor, medical group or clinic in San Benito County
gfedc
A private doctor, medical group or clinic in San Luis Obispo County
gfedc
A private doctor, medical group or clinic in another county (please specify which county below)
gfedc
An emergency room in Monterey County
gfedc
An emergency room in Santa Cruz County (including Watsonville)
gfedc
An emergency room in another county (please specify which county below)
gfedc
Other (please specify)
gfedc
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey63. In the past 12 months, have you or any member of your family (living in Monterey County) been threatened or harmed physically by someone in your community?
64. Please tell us what could be done to make your community a safer place to live.
65. In the past 12 months, have you or any member of your family (living in Monterey County) been treated unfairly by someone in your community based on any of the following? (Please check all that apply.)
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Social Issues
Yes No Don't Know Choose not to answer
Age nmlkj nmlkj nmlkj nmlkj
Class/Income status nmlkj nmlkj nmlkj nmlkj
Disability nmlkj nmlkj nmlkj nmlkj
Gender nmlkj nmlkj nmlkj nmlkj
Language nmlkj nmlkj nmlkj nmlkj
Race/ethnicity nmlkj nmlkj nmlkj nmlkj
Religion nmlkj nmlkj nmlkj nmlkj
Sexual orientation nmlkj nmlkj nmlkj nmlkj
Other nmlkj nmlkj nmlkj nmlkj
Yes
nmlkj
No
nmlkj
Don't Know
nmlkj
Choose not to answer
nmlkj
Other (please specify)
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey66. Please tell us what could be done in your community to ensure fair treatment for all community members.
67. Please tell us what you are currently doing or plan to do to maintain independence as you age. (Please check all that apply.)
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Independent Living
Engage in activities to stay socially connected in my community
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Take a course or study to keep my mind active
gfedc
Downsize to a smaller and more affordable home
gfedc
Find information about how to stay independent as I get older
gfedc
Make changes to my house to allow me to remain in my home as long as possible
gfedc
Pay into a pension or retirement plan
gfedc
Save money to use as I get older
gfedc
Work past retirement age (65+ years)
gfedc
Maintain my health
gfedc
Don't Know
gfedc
I have not started planning for my retirement
gfedc
Choose not to answer
gfedc
Other (please specify)
gfedc
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey68. Please tell us which, if any, of the following are important retirement aspirations for you? (Please select all that apply.)
69. Please tell us how your community could help people remain independent and age well in Monterey County.
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Disability Information
Travelling
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Spending more time with friends and family
gfedc
Pursuing new hobbies
gfedc
Volunteering in my community
gfedc
Living abroad (outside the U.S.)
gfedc
Continue working in the same field
gfedc
Studying/learning for pleasure and personal enrichment
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Starting a new business
gfedc
None of the above
gfedc
Don't know
gfedc
Other (please specify)
gfedc
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey70. Do you or someone close to you in Monterey County have a disability that interferes with a major life function?
71. Please tell us if you or someone close to you has a disability that interferes with one or more major life functions and if you provide care for them. (Please check all that apply.)
72. Please tell us what major life functions are affected by their disability. (Please check all that apply.)
Disability Issues
This person has a disability I provide care for this person Does not apply
Self gfedc gfedc gfedc
My spouse or partner gfedc gfedc gfedc
My child gfedc gfedc gfedc
My parent or grandparent gfedc gfedc gfedc
Other family member gfedc gfedc gfedc
Other nonfamily member gfedc gfedc gfedc
Ability to manage activities of daily living
Ability to obtain/maintain
housing
Ability to drive or take the bus
Ability to engage in social relationships
Ability to attend school or work
Self gfedc gfedc gfedc gfedc gfedc
My spouse or partner gfedc gfedc gfedc gfedc gfedc
My child gfedc gfedc gfedc gfedc gfedc
My parent or grandparent gfedc gfedc gfedc gfedc gfedc
Other family member gfedc gfedc gfedc gfedc gfedc
Other nonfamily member gfedc gfedc gfedc gfedc gfedc
Yes
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No
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Comments
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey73. Please tell us the living arrangement for those you have identified as having a disability. (Please check all that apply.)
74. Please tell us how your community could best support family caregivers.
75. Please tell us what are the most serious concerns facing your community.
Lives in my home
Lives alone in their own home
Lives with a spouse or partner
Lives in a caregivers home
Lives in a licensed care
facility
Lives in an unlicensed care
facilityOther
Self gfedc gfedc gfedc gfedc gfedc gfedc gfedc
My spouse or partner gfedc gfedc gfedc gfedc gfedc gfedc gfedc
My child gfedc gfedc gfedc gfedc gfedc gfedc gfedc
My parent or grandparent gfedc gfedc gfedc gfedc gfedc gfedc gfedc
Other family member gfedc gfedc gfedc gfedc gfedc gfedc gfedc
Other nonfamily member gfedc gfedc gfedc gfedc gfedc gfedc gfedc
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Neighborhood and Community
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Other
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey76. Please tell us what could be done to make your community a better place to live.
77. Please tell us how you share your opinions with your elected officials (e.g., City Council members or County Board of Supervisors). (Please check all that apply.)
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Attend an official City or County meeting
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Attend cultural community meetings
gfedc
Attend community meetings dealing with specific issues
gfedc
Attend official public hearings
gfedc
Attend regularly scheduled neighborhood meetings
gfedc
Contact the media (for example: radio, television, newspapers, etc.)
gfedc
Contact elected officials
gfedc
Get together with my neighbors
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Go to an official City or County government website
gfedc
Organize or join a group in your neighborhood
gfedc
Organize or participate in protests
gfedc
Participate in online blogs or email groups
gfedc
Send letters to the editor
gfedc
Serve on a City or County Board or Commission
gfedc
Write a letter to neighbors
gfedc
None of the above
gfedc
Choose not to answer
gfedc
Other (please specify)
gfedc
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey78. Please tell us what could be done to improve communication between your community and local elected officials.
The following information will help us to better identify important issues for different community groups across Monterey County. We very much appreciate your taking a couple of minutes to complete a few final questions about yourself. Thank you.
79. Please tell us what gender you identify with.
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Demographic Information
Female
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Male
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Transgender
nmlkj
Choose not to answer
nmlkj
Other (please specify)
nmlkj
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey80. Please tell us what race you primarily identify with. (Please choose only one)
White
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Black or African American
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American Indian or Alaskan Native
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Asian Indian
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Chinese
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Filipino
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Japanese
nmlkj
Korean
nmlkj
Vietnamese
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Other Asian (for example: Hmong, Laotian, Thai, Pakistani, Cambodian, etc.)
nmlkj
Native Hawaiian
nmlkj
Guamanian or Chamorro
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Samoan
nmlkj
Other Pacific Islander (for example: Fijian, Tongan, etc.)
nmlkj
More than one race (please specify)
nmlkj
Don’t know
nmlkj
Choose not to answer
nmlkj
Other race (please specify)
nmlkj
If you answered "Other" or "More than one race" (please specify)
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey81. Please tell us if you consider yourself to be of Hispanic, Latino or Spanish origin.
82. Please tell us how long have you lived in Monterey County.
THANK YOU FOR COMPLETING THE IMPACT MONTEREY COUNTY COMMUNITY
No, not of Hispanic, Latino or Spanish origin
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Yes, Mexican, Mexican American, Chicano
nmlkj
Yes, Mexican Indigenous (for example: Nahuatl, Yucatec/Maya, Zapotec, Mixtec, etc.)
nmlkj
Yes, Central American (for example: Salvadoran)
nmlkj
Yes, South American (for example: Peruvian)
nmlkj
Yes, Puerto Rican
nmlkj
Yes, Cuban
nmlkj
Yes, other (please specify below)
nmlkj
Choose not to answer
nmlkj
Other (please specify)
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Less than 1 year
nmlkj
12 years
nmlkj
35 years
nmlkj
69 years
nmlkj
1020 years
nmlkj
More than 20 years
nmlkj
I do not live in Monterey County
nmlkj
Other (please specify)
nmlkj
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English Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County SurveyEnglish Impact Monterey County Survey
We very much appreciate that you have taken the time to complete the Impact
Monterey County Community Assessment Survey. Thank you for adding your
voice to the conversation! We look forward to working together to identify our
collective community aspirations and explore ideas for improving life in
Monterey County.
Please consider asking people you know to take this survey too, so that we can
collect as much community input as possible. All you have to do is forward the
link in your email to your family, friends and neighbors or share it on FACEBOOK
and TWITTER.
To stay involved and to learn more about what happens next with Impact
Monterey County, please visit our website @ www.impactmontereycounty.org.
SURVEY!