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Yolano & Donnelly Resident Needs Assessment

Section 1: Household Information

Thank you for participating in the Yolano and Donnelly Household Survey. This survey is being conducted by Yolo County Housing as part of HUD Choice Neighborhoods. This survey will explore your current employment, health, childcare and educational or job training situation, the results of which will provide current data regarding the strengths, challenges, and needs of the community members. Your participation will give all of us a greater understanding of our community needs.
1.Contact Information (this will be used to ask follow-up questions and to connect you to available services that may be helpful)(Required.)
2.How many people currently live in your household?(Required.)
3.Do any children under the age of 18 live with you?(Required.)
4.What language do you speak most at home?(Required.)
5.Do you speak any other languages at home? If yes, what languages?(Required.)
6.Does anyone in your household need translation services during the process?(Required.)
7.Household Composition(Required.)
Age
Race / Ethnicity
Gender Identity
Education Level
Adult 1
Adult 2
Adult 3
Adult 4
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
8.Is anyone in your household a veteran?(Required.)
9.Does anyone in your household have a physical or mental disability?(Required.)
10.How much money do you make in a year?(Required.)
11.Where does most of the money for the household come from?(Required.)
12.Are you or anyone in your household getting any government assistance? If so, what types?(Required.)
13.How long have you lived at Yolano Village or Donnelly Circle?(Required.)
14.Have you ever gotten help with things like rent, electricity, or food? If so, who helped you? (non-profits, churches, etc.)(Required.)
15.What are the two biggest challenges facing your household now?(Required.)
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