2021 CAP MCCAA Community Needs Assessment Survey Complete this survey for your chance to win a $100 Target gift card! Question Title * 1. Today's Date Date / Time Date Question Title * 2. What zip code in Merced County do you live in? Question Title * 3. How old are you? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 4. What is your gender? Female Male Let me type: Question Title * 5. How would you describe your race or ethnicity? 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 Another Race (please specify) Question Title * 6. How would you describe your household's income level? 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 Question Title * 7. Has COVID-19 (coronavirus) affected your employment, financial, housing, education, or health conditions? No Impact Slight Impact Moderate Impact Severe Impact Question Title * 8. Do you have any comments about how COVID-19 has affected your household? Question Title * 9. What services do you think are most needed in Merced County? Greatly Needed Needed Not really a need Not a need at all Affordable Housing Affordable Housing Greatly Needed Affordable Housing Needed Affordable Housing Not really a need Affordable Housing Not a need at all Affordable Day Care Affordable Day Care Greatly Needed Affordable Day Care Needed Affordable Day Care Not really a need Affordable Day Care Not a need at all Employment Opportunities Employment Opportunities Greatly Needed Employment Opportunities Needed Employment Opportunities Not really a need Employment Opportunities Not a need at all Training Oppurtunties Training Oppurtunties Greatly Needed Training Oppurtunties Needed Training Oppurtunties Not really a need Training Oppurtunties Not a need at all Health (access to healthcare) Health (access to healthcare) Greatly Needed Health (access to healthcare) Needed Health (access to healthcare) Not really a need Health (access to healthcare) Not a need at all Community Involvement Community Involvement Greatly Needed Community Involvement Needed Community Involvement Not really a need Community Involvement Not a need at all Homelessness Homelessness Greatly Needed Homelessness Needed Homelessness Not really a need Homelessness Not a need at all Other (please specify) Question Title * 10. What community services, training, or education have you used in the past 12 months? Rental Assistance Utility Assistance Job Training Services Employment Services Food Services (Pantry or Food Box) Homeless Shelter Financial Services (Budgeting and Counseling) Vocational School College Other (please specify) None of the above Question Title * 11. What services have you utilized through Merced County Community Action Agency WIC Program (Nutrition Education and Vouchers) Weatherization/Energy Assistacne Child Care Centers Housing/Meals/Shelter Other (please specify) Question Title * 12. Of the services received how have they affected your life? Question Title * 13. What changes would you like to see happen in your community? Question Title * 14. What is the biggest issue or barrier that stops you from achieving your goals? Question Title * 15. For a chance to win a $100 gift card to Target, please input your contact information below! Name City/Town ZIP/Postal Code Email Address Phone Number Done
