Community Needs Assessment - Community Survey

Let Your Voice Be Heard

The Olympic Community Action Programs needs your voice as a foundation for the next 3 years of our programming. The needs assessment results will help the OlyCAP Board create a strategic plan to initiate and support these programs and services.

We do NOT ask for your name in this survey. Your information will be kept anonymous.

Thank you for taking a few minutes of your time to provide your views and recommendations!

(If you have completed this survey before, please don't fill it out again.)

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* 1. Are you a resident of Jefferson or Clallam County? (NOTE: If you are not a resident, please do not proceed.)

Jefferson County

Clallam County

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* 2. Please think about your basic needs. Please list the top 3 or 4 items that you and your family have needed help with recently.

Need:

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* 3. Are you able to meet your basic needs every month?

Yes, on my own.

Yes, with help from a service organization

Sometimes

Not very often

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* 4. Do you know where to get assistance when you need it?

Yes

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* 5. Please think about yourself and your family when answering the following questions:

	Yes	No
Do you have a checking account?	Do you have a checking account? Yes	Do you have a checking account? No
Do you have a savings account?	Do you have a savings account? Yes	Do you have a savings account? No
Have you ever applied for a payday or quick loan?	Have you ever applied for a payday or quick loan? Yes	Have you ever applied for a payday or quick loan? No
Have you ever applied for a bank loan?	Have you ever applied for a bank loan? Yes	Have you ever applied for a bank loan? No
Does each member of your household have medical insurance coverage?	Does each member of your household have medical insurance coverage? Yes	Does each member of your household have medical insurance coverage? No
Do you use e-mail regularly?	Do you use e-mail regularly? Yes	Do you use e-mail regularly? No
Do you text regularly?	Do you text regularly? Yes	Do you text regularly? No

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* 6. Please let us know of any financial literacy services that you would like...

Banking services education

Budgeting

Credit counseling

Savings for retirement

Savings in general

Avoiding predatory lending

None

Other (please specify)

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* 7. Which healthcare services are hardest to get?

Physical

Mental health

Ongoing conditions

Emergency care

Dental

Vision

None

Other (please specify)

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* 8. Which counseling services are hardest to get?

Overcoming trauma

Grief

Relationship

Depression

None

Other (please specify)

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* 9. What barriers / challenges have you or your family experienced recently? For example: discrimination due to age, gender, race or disability

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* 10. Are there stores close to you that sell fresh fruits and vegetables?

Yes

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* 11. Are there enough opportunities for children and youth in your county?

Yes

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* 12. Is quality education available for children of all ages in your county?

Yes

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* 13. Is affordable and adequate childcare available?

Yes

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* 14. Are recreational opportunities available?

Yes

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* 15. Are support groups available to meet your emotional needs?

Yes

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* 16. Do you feel part of your community and welcome to attend public meetings / events?

Yes

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* 17. Do you feel safe in your community?

Always

Usually

Rarely

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* 18. Which housing service is most needed in your community? (Check one)

Emergency shelter

Rent / Mortgage assistance

Address vacant properties

Repair assistance

None

Other (please specify)

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* 19. Which transportation service is most needed in your community? (Check one)

Improve public transportation

Help with cost of public transportation

Assistance with personal vehicle

None

Other (please specify)

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* 20. Please share what you like the least about living in Jefferson or Clallam County.

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* 21. How familiar are you with OlyCAP services for low-income households and communities?

Very familiar

Somewhat familiar

Not at all familiar

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* 22. Which describes you best?

I am currently using OlyCAP services

I have previously used OlyCAP services

I have not used OlyCAP services, but I know people who have

None of these describe me

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* 23. Please list what OlyCAP services you or your family have used or participated in during the past 12 months.

Utility Assistance

Head Start/Early Childhood Services

Home Fund/Emergency Services

Weatherization

Staying at a shelter (Jefferson County Legion Shelter, Sequim Warming Center, Haines Street, Caswell-Brown Village)

Staying at OlyCAP managed or owned Property (South 7, Northwest Passage)

Received rental assistance

Pick up food at congregate meal site (Port Angeles Senior Center, Tri-Area Community Center)

Receive senior nutrition home delivered meals

I have used a food bank or pantry on the Peninsula

Workforce Development Services (workfirst, community jobs)

Other (please specify)

None of the above

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* 24. Demographic Question: What zip code do you live in?

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* 25. Demographic Question: Age

17 or younger

18 - 29

30 - 44

45 - 64

65 or over

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* 26. Demographic Question: Race / Ethnicity

American Indian or Alaska Native

Asian or Asian American

Black or African American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White or Caucasian

Two or more races

Other not listed above (please specify)

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* 27. Demographic Question: Annual Income

No income

Under $15,000

Between $15,000 and $29,999

Between $30,000 and $49,999

Between $50,000 and $74,999

Between $75,000 and $99,999

Over $100,000

Other (please specify)

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* 28. Demographic Question: Household Information

One person in house

Single adult female with children

Single adult male with children

Two adults with no children

Two adults with children

More than two adults with children

Other (please specify)

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* 29. How many dependents (age 0 to 17) live in your home?

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* 30. Demographic Question: What is the highest level of education you have completed?

Grade school

Some high school

High school diploma

GED / HSE

Certification program

Some college

2-year degree

4-year degree

Over 4-year degree