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Community Needs Assessment Survey - Customer/Community/Client/Staff
Tri-County Community Action Agency, Inc. (TCCAA) is performing our triennial Community Needs Assessment. Please help us by filling out our quick survey.
OK
1.
Which best describes you and your relationship with Tri-County Community Agency, Inc.?
Community Member
Customer/Client
Head Start Parent
Staff
*
2.
What county do you live in?
(Required.)
Harrison
Jasper
Newton
Panola
Sabine
San Augustine
Shelby
Tyler
Upshur
Angelina
*
3.
What is your age
(Required.)
18-24
25-34
35-44
45-54
55-64
65+
*
4.
What is your gender
(Required.)
Male
Female
Transgender
Prefer Not To Disclose
Other (please specify)
*
5.
What is your education level?
(Required.)
8th Grade or Less
Some High School
High School Diploma/GED
Technical or Occupational Certificate
Some College
Associates's Degree
Bachelor's Degree or Higher
*
6.
What is your race?
(Required.)
White or Caucasian
Black or African American
Hispanic or Latino
Asian or Asian American
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Other (please specify)
*
7.
What Language is spoken in your household? If "Other", please provide what language is spoken.
(Required.)
English
Spanish
Vietnamese
Other (please specify)
*
8.
What is your family situation?
(Required.)
Single Person
Two Adults - No Children
Single Parent
Two Parent Household
Non-Related Adults with Children
Multigenerational Household
Other (please specify)
*
9.
Please indicate the number of people living in your home
(Required.)
1
2
3
4
5
6
7
8
Other (please specify)
*
10.
Please indicate the total gross income for your entire household
(Required.)
$12,880 - $17,419
$17,420 - $21,959
$21,960 - $31,030
$31,040 - $40,119
$40,120 - $44,659
$44,660 - $49,199
$49,200 or more
*
11.
Which of the following categories best describes your employment status?
(Required.)
Employed, working full-time
Employed, working part-time
Not employed, looking for work
Not employed, NOT looking for work
Retired
Disabled, not able to work
Migrant Seasonal Worker
Self-Employed
*
12.
How many minor children, by age, are currently live in your household?
(Required.)
0
1
2
3
4
5
6
7
N/A
12 years old
0
1
2
3
4
5
6
7
N/A
13 years old
0
1
2
3
4
5
6
7
N/A
5 years old
0
1
2
3
4
5
6
7
N/A
15 years old
0
1
2
3
4
5
6
7
N/A
2 years old
0
1
2
3
4
5
6
7
N/A
17 years old
0
1
2
3
4
5
6
7
N/A
6 years old
0
1
2
3
4
5
6
7
N/A
8 years old
0
1
2
3
4
5
6
7
N/A
11 years old
0
1
2
3
4
5
6
7
N/A
9 years old
0
1
2
3
4
5
6
7
N/A
3 years old
0
1
2
3
4
5
6
7
N/A
1 year old
0
1
2
3
4
5
6
7
N/A
4 years old
0
1
2
3
4
5
6
7
N/A
Less than 1 year old
0
1
2
3
4
5
6
7
N/A
16 years old
0
1
2
3
4
5
6
7
N/A
10 years old
0
1
2
3
4
5
6
7
N/A
7 years old
0
1
2
3
4
5
6
7
N/A
14 years old
0
1
2
3
4
5
6
7
N/A
None of the above
0
1
2
3
4
5
6
7
N/A
*
13.
What statement is true regarding your housing status?
(Required.)
Own
Rent
Staying with Friends/Relatives
Homeless
*
14.
Do you or anyone in your household have any of the following housing related needs? (Please select your top 5. With 5 being the most important to you and your household)
(Required.)
Most Important
Somewhat Important
Important
Not as Important
Least Important
Not Imporant
N/A
Mortgage or Rent Assistance
Most Important
Somewhat Important
Important
Not as Important
Least Important
Not Imporant
N/A
Home Not Safe - Structure
Most Important
Somewhat Important
Important
Not as Important
Least Important
Not Imporant
N/A
Housing Not Affordable
Most Important
Somewhat Important
Important
Not as Important
Least Important
Not Imporant
N/A
Need Handicap Accessibility
Most Important
Somewhat Important
Important
Not as Important
Least Important
Not Imporant
N/A
Home Repairs
Most Important
Somewhat Important
Important
Not as Important
Least Important
Not Imporant
N/A
None of the above
Most Important
Somewhat Important
Important
Not as Important
Least Important
Not Imporant
N/A
*
15.
Do you or anyone in your household need any of the following assistance with transportation? (Please select your top 5. With 5 being the most important to you and your household)
(Required.)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Transportation with someone with a disability
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Assistance with Insurance
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Transportation from someone for local area for travel
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Auto Repairs
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Driver's License
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
In need of a vehicle
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Vehicle Registration
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Transportation from someone for out of town travel
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
*
16.
Do you have reliable phone access
(Required.)
Yes
No
*
17.
Do you have access to the Internet?
(Required.)
Yes
No
*
18.
Please select what assistance you or anyone in your household receives. (Please select your top 5)
(Required.)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
CHIPS
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Medicaid
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Medicare
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Housing Voucher (Section 8)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
SNAP (Food Stamps)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
TANF
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
WIC
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Utility Assistance
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Rental Assistance
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
*
19.
Do you or anyone in your household need assistance in any of these areas? (Please select your top 5. With 5 being the most important to you and your household)
(Required.)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Alcohol/Drug Abuse
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Anger Management
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Caregiver Support
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Depression/Anxiety
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Disability Counseling
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Elder Abuse
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Parenting Classes
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Goal Setting
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Mental Health/Behavioral Issues
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Financial Money Management
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Domestic Violence Abuse (Adult or Child)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Family Conflicts
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Thoughts of Suicide (in the past 6 months)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Making Decisions/Problem Solving
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Additional Education
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Housing Assistance
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
English as a Second Language (ESL)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
*
20.
Do you or anyone in your household need help with these healthcare needs? (Please select your top 5. With 5 being the most important to you and your household)
(Required.)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Adult with Disability
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
AIDS/HIV Risk
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Child with Disability
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Dental Care
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Diabetes
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Eye/Vision Care
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
General Medical Care
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Hearing Aid Care
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Heart Disease
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Hypertension (High Blood Pressure)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Medical Equipment
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Mental Health Care
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Prescription Medication
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
STDs (Sexually Transmitted Disease)
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Substance Abuse Treatment
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Teen Pregnancy
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
Transportation to Appointments
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
None of the Above
Most Important
Somewhat Important
Important
Not As Important
Least Important
Not Important
N/A
*
21.
Do you or anyone in your household have health insurance?
(Required.)
Yes
No
*
22.
Are you or anyone in your household a veteran?
(Required.)
Yes
No
*
23.
Do you or anyone in your household have any of these financial needs or problems? (Please select your top 5 of the highest needs for you or your household).
(Required.)
High Need
Moderate Need
Somewhat Need
Don't Need
Earning a living wage
High Need
Moderate Need
Somewhat Need
Don't Need
Health Insurance
High Need
Moderate Need
Somewhat Need
Don't Need
Car Insurance
High Need
Moderate Need
Somewhat Need
Don't Need
Home/Renter's Insurance
High Need
Moderate Need
Somewhat Need
Don't Need
Assistance with collecting Child Support
High Need
Moderate Need
Somewhat Need
Don't Need
Financial Budgeting
High Need
Moderate Need
Somewhat Need
Don't Need
Improving Credit
High Need
Moderate Need
Somewhat Need
Don't Need
*
24.
Have you or anyone in your household been referred to any of these services in the past 12-months?
(Required.)
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Employment Assistance
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Educational Assistance
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Social/Emotional/Well-being
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Childcare Assistance
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Housing Assistance
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Financial Literacy
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Transportation Assistance
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Nutrition Assistance
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Healthcare Assistance
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
Head Start/Early Headstart
Yes, the referral WAS helpful
Yes, but the referral WAS NOT helpful
Referral WAS NOT used
Resource was Unavailable
No - I've had no referral
*
25.
Are you or anyone in your household doing volunteer work? If so, please provide the typical volunteer schedule.
(Required.)
Yes
No
Other (please provide the typical volunteer schedule)
*
26.
What type of childcare (if any) are you currentl using other than Head Start/Early Head Start? (Choose all that apply)
(Required.)
Older Sibling
Relatives
Babysitter
Childcare Center
Licensed Family Childcare Center
None of the above
*
27.
What are the top 5 issues from the list below that you feel are major problems or concerns in your community? Please select your top 5 of the highest concerns/issues for you or your household).
(Required.)
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Lack of Affordable Housing
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Child Safety
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Lack of Affordable Childcare
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Crime/Violence
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Domestic Violence
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Drug and Alcohol Abuse
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Lack of Services for Non-English Speaking Families
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Cost of Living Too High
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Gangs
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Immigration/Citizenship
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Health Problems
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Obesity
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Child Nutrition
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Lack of Jobs
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Transportation Issues
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Lack of Affordable Healthcare
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Difficulty getting needed services or resources
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Access to Personal Protection Equipment (PPE)
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Unemployment/Furlough
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Foreclosure/Eviction
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Loss of Health Insurance Coverage
High Issue
Moderately High Issue
Somewhat High Issue
Not As Important of an Issue
Less of an Issue
Not an Issue
N/A
Current Progress,
0 of 27 answered