At “Opening Abraham's Tent: The Disability Inclusion Initiative” conference in November, 2012 following the Jewish Federations of North America General Assembly meeting in Baltimore, several providers of Jewish residential services for individuals with disabilities met to exchange best practices. They began a conversation which has evolved into an ongoing national task force. One of the first projects tackled by this Jewish Residential Task Force strives to create a national directory of Jewish residential programs.

The survey below is designed to collect relevant and up to date information about Jewish residential programs in the United States, Canada and Israel. The questions included in the survey represent basic needs and determinants for residential services.

Please complete the survey as comprehensively as possible. When the directory is compiled, there will be a disclaimer attached indicating that services may have changed since the information was collected.

Thank you for taking the time to complete this survey and contributing to this resource which, we believe, will meet an important need to families and professionals assisting those who have disabilities to secure housing, services, and/or programs.

We look forward to sharing the outcomes of the survey and sharing a link to the completed resource guide. If you have questions regarding the survey please contact Marni Litvack, quality assurance and program evaluation manager at mlitvack@jfshouston.org. If you know of programs that should be included in this survey, please forward this link or email Marni with the information and she will follow up.

Please complete this survey by Tuesday, December 31, 2013.

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* 1. Name of organization

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* 2. Street address

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* 3. City

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* 4. State

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* 5. Zip Code

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* 6. Web address

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* 7. Contact person

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* 8. Phone number for contact person

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* 9. E-mail for contact person

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* 10. Please describe what type of residential options are available? (Please check all that apply)

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* 11. Please describe the population the agency serves in the residential program? (Please check all that apply)

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* 12. Please describe the age of the clients you provide residential services for? (Please check all that apply)

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* 13. Approximately what percentage of the clients you serve are Jewish?

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* 14. Please identify which of the following services are included?

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* 15. Are group homes kosher?

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* 16. Do group homes offer a living space that is Shomer Shabbat?

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* 17. Do residents have regular access to Jewish community events, services, celebrations, etc.?

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* 18. Please list any National membership organizations the agency affiliates with? For example: AJFCA or The Alliance for Children and Families.

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* 19. Does the Residential program maintain licensure?

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* 20. Does the agency maintain national accreditation? If yes, by whom?

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* 21. What type of payments are accepted for residential care? (Please check all that apply)

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* 22. Is there a sliding fee scale based on financial need?

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* 23. What other sources of funding does the agency receive? (Please check all that apply)

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