City of Pasadena Policy on Children, Youth, and Families Questionnaire

 
1. Name of Service Provider/Department/Organization
2. In operation since:
3. Name/Title of Person Filling Out this Survery:
4. Address:
5. Phone Number:
6. Fax Number:
7. Email Address:
8. Please check all individual strategies that specifically apply to your agency’s mission and most closely match your agency’s purpose, aims, and goals for the key issue area: "GOOD HEALTH"
9. Please describe programs and services your agency provides that address the issue area: "GOOD HEALTH"
10. Please check all individual strategies that specifically apply to your agency’s mission and most closely match your agency’s purpose, aims, and goals for the key issue area: "SAFETY AND SURVIVAL"
11. Please describe programs and services your agency provides that address the issue area: "SAFETY AND SURVIVAL"
12. Please check all individual strategies that specifically apply to your agency’s mission and most closely mAtch your agency’s purpose, aims, and goals for the key issue area: "ECONOMIC WELL-BEING"
13. Please describe programs and services your agency provides that address the issue area: "ECONOMIC WELL-BEING"
14. Please check all individual strategies that specifically apply to your agency’s mission and most closely match your agency’s purpose, aims, and goals for the key issue area: "SOCIAL AND EMOTIONAL WELL-BEING"
15. Please describe programs and services your agency provides that address the issue area: "SOCIAL AND EMOTIONAL WELL-BEING"
16. Please check all individual strategies that specifically apply to your agency’s mission and most closely match your agency’s purpose, aims, and goals for the key issue area: "EDUCATION"
17. Please describe programs and services your agency provides that address the issue area: "EDUCATION"
18. Please check all individual strategies that specifically apply to your agency’s mission and most closely match your agency’s purpose, aims, and goals for the key issue area: "INFORMATION AND ACCESS TO SERVICES"
19. Please describe programs and services your agency provides that address the issue area: "INFORMATION AND ACCESS TO SERVICES"
20. What is the mission of your organization?
21. What method do you use to track the outcomes of your services for Pasadena residents?
22. How many residents does your agency serve on average annually?
23. In your opinion, please identify which of the 6 Issue Areas most relates to the accomplishment of the service you provide/d to the children, youth and families in Pasadena either directly or indirectly?
24. Please provide an estimation of annual funding that your organization budgets to support your programs, services, and activities in support of the Strategies for Action goals.
25. What other agencies do you partner with in carrying out the mission of your agency?
26. Please provide an estimation of annual funding that your organization allocates to other organizations, agencies, and key partners in support of the Strategies for Action goals.
27. As a result of the prolonged economic downturn, please identify any fiscal impacts or reductions in services that have impacted your organization, including any impacts to key partners.
28. How well do you think the City and School District work together with the non-profit community? Please check the box that most closely represents your perspective.
29. What additional programs, services and/or activities are needed in the community to support children, youth and families? Please share any possible opportunities for collaboration in delivering these services your agency might be interested in becoming involved in.
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