Skip to content

Coconino County Community Health Needs Assessment (CHNA)

Partner Capacity and Asset Mapping Survey

Thank you for taking the time to complete the Coconino County Health and Human Services CHNA Partner Capacity and Asset Mapping Survey. This survey will be used for asset mapping to identify the types of services and supports offered, the populations served, and overall agency capacity throughout Coconino County.

Please remember, there are no right or wrong answers for this survey. Your responses will be a great help in assessing the type of work we collectively do serving the residents of Coconino County.
1.What is the full name of your organization?(Required.)
2.Which best describes your position or primary role in your organization?(Required.)
3.Which of the following best describe(s) your organization?(Required.)
4.What are your organization’s 1–3 most valuable resources and strongest assets you would like other agencies to know? (e.g., what makes your organization great?)(Required.)
5.Does your organization have priority populations they serve based on organizational mission, service contracts, and/or specific funding (please list if applicable)?(Required.)
6.What racial and ethnic populations do your organization work with? (check all that apply)(Required.)
7.What age groups does your agency typically serve? (check all that apply)(Required.)
8.What area(s) of Coconino County does your organization serve? (check all that apply)(Required.)
9.Does your agency offer remote (phone/online) or mobile (traveling) services?(Required.)
10.Does your agency offer home visitation services?(Required.)
11.Is your building ADA accessible?(Required.)
12.Does your organization offer specialized services for people with physical, mental, intellectual, or emotional disabilities?(Required.)
13.Does your organization work with or serve disconnected youth, or young people between the ages of 16-24 who are not in school and not working?(Required.)
14.Does your organization work with or serve immigrants, refugees, asylum seekers, and/or other populations who speak English as a second language?(Required.)
15.Does your organization work with or serve individuals who use substances or who are in recovery?(Required.)
16.Does your organization work with or serve veterans?(Required.)
17.Does your organization work with other populations or groups who are not addressed in the previous questions?

For example, groups identifiable by gender, sexual orientation, socioeconomic status, education, disability, elderly, religion, insurance status, housing status, occupation, age, neighborhood, involvement in the juvenile justice and/or juvenile dependency system, and involvement in the criminal legal system.(Required.)
18.For the table below, please select on a scale of 1-4 (4 representing a strong agency focus for this area and 1 representing no agency focus for this area).

Does your organization focus on any of the areas below?(Required.)
(4) Primary/ exclusive focus of our work
(3) A lot of focus in this area, but not exclusive
(2) Somewhat focused on this area
(1) Not at all focused on this area
Economic Stability: The connection between people’s financial resources—income, cost of living, and socioeconomic status—and their health. This includes issues such as poverty, employment, food security, and housing stability.
Education Access and Services: The connection of education to health and well-being. This includes
issues such as graduating from high school, educational attainment in general, language and literacy,
and early childhood education and development.
Healthcare Access and Quality: The connection between people’s access to and understanding of
health services and their own health. This includes issues such as access to healthcare, access to
primary care, health insurance coverage, and health literacy.
Neighborhood and Built Environment: The connection between where a person lives—housing, neighborhood, and environment— and their health and well-being. This includes topics like quality of housing, access to transportation, availability of healthy foods, air and water quality, and public safety.
Social and Community Context: The connection between characteristics of the contexts within which
people live, learn, work, and play, and their health and well-being. This includes topics like cohesion
within a community, civic participation, discrimination, conditions in the workplace, violence, and
incarceration.
19.Has your organization ever participated in a community health improvement or needs assessment process?(Required.)
20.Has your organization ever participated in or facilitated community-led decision-making around policies, actions, or programs?(Required.)
21.For the following section, we are asking questions regarding Program Feedback and Service Capacity.

Please select on a scale of 1-4 (4 being Strongly Agree and 1 being Strongly Disagree)(Required.)
(4) Strongly Agree
(3) Somewhat Agree
(2) Somewhat Disagree
(1) Strongly Disagree
Not Applicable
Our organization regularly collects data on participant satisfaction and how their needs are met.
Our organization’s participants have regular opportunities to provide feedback (including anonymous feedback) on their experience with the organization.
Our organization analyzes participant feedback data at least annually to enhance service satisfaction and ensure services meet community needs.
Our organization designs its programs and services on other program models in our field that have proven effective or are evidence-based.
Our organization’s services reflect the current needs of the community.
Our organization experiences staffing shortages in more than one program or service that negatively impact our ability to meet client or participant needs.
Our staff, at all levels, are well trained to provide the services we offer to clients or participants.
22.Which of the following human service categories does your organization work on or support through community initiatives, formal partnerships, or informal partner networks? (check all that apply)(Required.)
23.Which of the following health topics does your organization work on or support through community initiatives, formal partnerships, or informal partner networks? (check all that apply)(Required.)
24.For the following section, we are asking questions regarding Community Partnership Capacity. Community Partnerships reference formal partnerships, community initiatives or alliances, and informal community or provider networks.

Please select on a scale of 1-4 (4 being Strongly Agree and 1 being Strongly Disagree)(Required.)
(4) Strongly Agree
(3) Somewhat Agree
(2) Somewhat Disagree
(1) Strongly Disagree
Not Applicable
Our organization has key partnerships, alliances, and networks that support our work and align with our mission.
Our organization has limited engagement in partnerships, alliances, or community networks due to limited resources (e.g., staffing, time, financial capacity, size, etc.).
Our partnerships, alliances, and networks enrich and support our work in a way that aligns with our mission and values.
Our partnerships, alliances, and networks enhance the flow of information between us and the community.
Our organization has partnerships, alliances, and networks that complement and/or enhance service or resource offerings for residents.
25.How are the services at your agency funded? (check all that apply)(Required.)
26.For the following section, we are asking questions regarding Financial Capacity.

Please select on a scale of 1-4 (4 being Strongly Agree and 1 being Strongly Disagree)(Required.)
(4) Strongly Agree
(3) Somewhat Agree
(2) Somewhat Disagree
(1) Strongly Disagree
Not Applicable
Our organization’s funding is consistent and reliable.
Our organization has seen reduced revenue or funding cuts in the last year.
Our organization would close or dramatically reduce services if it lost 1-2 key fund sources.
Our organization has difficulty identifying or cultivating new funders or donors.
Our organization has a viable fundraising plan for the upcoming year.
Our organization has enough discretionary funds independent of project-restricted funds.
27.Does your organization have access to interpretation and translation services?(Required.)
28.What language(s) do staff at your organization speak? (check all that apply)(Required.)
29.What language(s) do you use to hold meetings for the public? (check all that apply)(Required.)
30.What language(s) do you use for publications and printed outreach materials? (check all that apply)(Required.)
31.For the following section, we are asking questions regarding Communication and Outreach Capacity.

Please select on a scale of 1-4 (4 being Strongly Agree and 1 being Strongly Disagree)(Required.)
(4) Strongly Agree
(3) Somewhat Agree
(2) Somewhat Disagree
(1) Strongly Disagree
Not Applicable
Our organization attends community events and engages in community outreach as a marketing strategy.
Our organization has updated communications tools and relevant resource and service publications.
Our organization has limited or no social media presence.
Our organization’s website is updated and easy to use for residents interested in service information.
Our organization engages in community and/or political advocacy.
Our organization has a current internal communications strategy that addresses program and agency changes so staff are in the know.
Our organization has an updated external communications strategy that addresses agency changes, crisis communications, marketing, and public relations.
32.Does your organization utilize volunteers or interns for service delivery and daily operations (including both consistent or occasional/one-time volunteers)?(Required.)
33.For the following section, we are asking questions regarding Volunteer and Internship Management Capacity.

Please select on a scale of 1-4 (4 being Strongly Agree and 1 being Strongly Disagree)(Required.)
(4) Strongly Agree
(3) Somewhat Agreement
(2) Somewhat Disagree
(1) Strongly Disagree
Unsure/Not Applicable
Our organization has capacity and uses volunteers consistently to help run our programs and/or services.
Our organization has a clear volunteer management recruitment and onboarding process.
Our organization often struggles to recruit and/or retain volunteers.
Our organization hosts college and graduate-level interns for field-based internship experiences towards their degree programs.
Our organization hosts interns at the high school-level for internships, vocational training, and/or general work experience.
Our volunteers and/or interns are clear on their role in the organization.
Our volunteers and/or interns have the resources, support, and training they need to work effectively.
Our organization has established partnerships to help with volunteer and intern recruitment.
Thank You for Completing the Survey!

Your responses will help us gather data on how the collective system of services in Coconino County functions, and our strengths and areas of opportunity. We appreciate your partnership and all you do to serve Coconino County residents.