Community Needs Assessment

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* 1. In your opinion, what is the most pressing community need(s) relating to adults in our community?

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* 2. Please rate how important each of the following items that relate to adults is to you.

	Don't Know	Unimportant	Somewhat important	Important	Very Important
Availability of services aimed at engaging the entire family unit	Availability of services aimed at engaging the entire family unit Don't Know	Availability of services aimed at engaging the entire family unit Unimportant	Availability of services aimed at engaging the entire family unit Somewhat important	Availability of services aimed at engaging the entire family unit Important	Availability of services aimed at engaging the entire family unit Very Important
Adults are supported in practicing positive habits that include physical activity and healthy eating	Adults are supported in practicing positive habits that include physical activity and healthy eating Don't Know	Adults are supported in practicing positive habits that include physical activity and healthy eating Unimportant	Adults are supported in practicing positive habits that include physical activity and healthy eating Somewhat important	Adults are supported in practicing positive habits that include physical activity and healthy eating Important	Adults are supported in practicing positive habits that include physical activity and healthy eating Very Important
Availability of service or volunteer opportunities for adults	Availability of service or volunteer opportunities for adults Don't Know	Availability of service or volunteer opportunities for adults Unimportant	Availability of service or volunteer opportunities for adults Somewhat important	Availability of service or volunteer opportunities for adults Important	Availability of service or volunteer opportunities for adults Very Important
Presence of safe and secure community spaces for adults	Presence of safe and secure community spaces for adults Don't Know	Presence of safe and secure community spaces for adults Unimportant	Presence of safe and secure community spaces for adults Somewhat important	Presence of safe and secure community spaces for adults Important	Presence of safe and secure community spaces for adults Very Important
Presence of community spaces where adults can develop connections with others	Presence of community spaces where adults can develop connections with others Don't Know	Presence of community spaces where adults can develop connections with others Unimportant	Presence of community spaces where adults can develop connections with others Somewhat important	Presence of community spaces where adults can develop connections with others Important	Presence of community spaces where adults can develop connections with others Very Important
Adults receive support from groups within the community	Adults receive support from groups within the community Don't Know	Adults receive support from groups within the community Unimportant	Adults receive support from groups within the community Somewhat important	Adults receive support from groups within the community Important	Adults receive support from groups within the community Very Important
Availability of learning opportunities for adults	Availability of learning opportunities for adults Don't Know	Availability of learning opportunities for adults Unimportant	Availability of learning opportunities for adults Somewhat important	Availability of learning opportunities for adults Important	Availability of learning opportunities for adults Very Important
Availability of services that engage senior populations	Availability of services that engage senior populations Don't Know	Availability of services that engage senior populations Unimportant	Availability of services that engage senior populations Somewhat important	Availability of services that engage senior populations Important	Availability of services that engage senior populations Very Important
Adults have convenient access to structured activities in a community facility	Adults have convenient access to structured activities in a community facility Don't Know	Adults have convenient access to structured activities in a community facility Unimportant	Adults have convenient access to structured activities in a community facility Somewhat important	Adults have convenient access to structured activities in a community facility Important	Adults have convenient access to structured activities in a community facility Very Important

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* 3. Please rate how satisfied you are with each of the following items that relate to adults.

	Not Satisfied	Somewhat Satisfied	Neither Satisfied or Dissatisfied	Satisfied	Very Satisfied
Availability of services aimed at engaging the entire family unit	Availability of services aimed at engaging the entire family unit Not Satisfied	Availability of services aimed at engaging the entire family unit Somewhat Satisfied	Availability of services aimed at engaging the entire family unit Neither Satisfied or Dissatisfied	Availability of services aimed at engaging the entire family unit Satisfied	Availability of services aimed at engaging the entire family unit Very Satisfied
Adults are supported in practicing positive habits that include physical activity and healthy eating	Adults are supported in practicing positive habits that include physical activity and healthy eating Not Satisfied	Adults are supported in practicing positive habits that include physical activity and healthy eating Somewhat Satisfied	Adults are supported in practicing positive habits that include physical activity and healthy eating Neither Satisfied or Dissatisfied	Adults are supported in practicing positive habits that include physical activity and healthy eating Satisfied	Adults are supported in practicing positive habits that include physical activity and healthy eating Very Satisfied
Availability of service or volunteer opportunities for adults	Availability of service or volunteer opportunities for adults Not Satisfied	Availability of service or volunteer opportunities for adults Somewhat Satisfied	Availability of service or volunteer opportunities for adults Neither Satisfied or Dissatisfied	Availability of service or volunteer opportunities for adults Satisfied	Availability of service or volunteer opportunities for adults Very Satisfied
Presence of safe and secure community spaces for adults	Presence of safe and secure community spaces for adults Not Satisfied	Presence of safe and secure community spaces for adults Somewhat Satisfied	Presence of safe and secure community spaces for adults Neither Satisfied or Dissatisfied	Presence of safe and secure community spaces for adults Satisfied	Presence of safe and secure community spaces for adults Very Satisfied
Presence of community spaces where adults can develop connections with others	Presence of community spaces where adults can develop connections with others Not Satisfied	Presence of community spaces where adults can develop connections with others Somewhat Satisfied	Presence of community spaces where adults can develop connections with others Neither Satisfied or Dissatisfied	Presence of community spaces where adults can develop connections with others Satisfied	Presence of community spaces where adults can develop connections with others Very Satisfied
Adults receive support from groups within the community	Adults receive support from groups within the community Not Satisfied	Adults receive support from groups within the community Somewhat Satisfied	Adults receive support from groups within the community Neither Satisfied or Dissatisfied	Adults receive support from groups within the community Satisfied	Adults receive support from groups within the community Very Satisfied
Availability of learning opportunities for adults	Availability of learning opportunities for adults Not Satisfied	Availability of learning opportunities for adults Somewhat Satisfied	Availability of learning opportunities for adults Neither Satisfied or Dissatisfied	Availability of learning opportunities for adults Satisfied	Availability of learning opportunities for adults Very Satisfied
Availability of services that engage senior populations	Availability of services that engage senior populations Not Satisfied	Availability of services that engage senior populations Somewhat Satisfied	Availability of services that engage senior populations Neither Satisfied or Dissatisfied	Availability of services that engage senior populations Satisfied	Availability of services that engage senior populations Very Satisfied
Adults have convenient access to structured activities in a community facility	Adults have convenient access to structured activities in a community facility Not Satisfied	Adults have convenient access to structured activities in a community facility Somewhat Satisfied	Adults have convenient access to structured activities in a community facility Neither Satisfied or Dissatisfied	Adults have convenient access to structured activities in a community facility Satisfied	Adults have convenient access to structured activities in a community facility Very Satisfied

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* 4. In your opinion, what is the most community need(s) relating to youth and teens in our community?

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* 5. Please rate how important each of the following items that relate to teens and youth is to you:

	Don't Know	Unimportant	Somewhat important	Important	Very Important
Availability of services aimed at engaging youth and teens	Availability of services aimed at engaging youth and teens Don't Know	Availability of services aimed at engaging youth and teens Unimportant	Availability of services aimed at engaging youth and teens Somewhat important	Availability of services aimed at engaging youth and teens Important	Availability of services aimed at engaging youth and teens Very Important
Teens and youth are supported in practicing positive habits that include physical activity and healthy eating	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Don't Know	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Unimportant	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Somewhat important	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Important	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Very Important
Availability of service or volunteer opportunities for teens and youth	Availability of service or volunteer opportunities for teens and youth Don't Know	Availability of service or volunteer opportunities for teens and youth Unimportant	Availability of service or volunteer opportunities for teens and youth Somewhat important	Availability of service or volunteer opportunities for teens and youth Important	Availability of service or volunteer opportunities for teens and youth Very Important
Presence of safe and secure community spaces for teens and youth	Presence of safe and secure community spaces for teens and youth Don't Know	Presence of safe and secure community spaces for teens and youth Unimportant	Presence of safe and secure community spaces for teens and youth Somewhat important	Presence of safe and secure community spaces for teens and youth Important	Presence of safe and secure community spaces for teens and youth Very Important
Presence of community spaces where teens and youth can develop connections with others	Presence of community spaces where teens and youth can develop connections with others Don't Know	Presence of community spaces where teens and youth can develop connections with others Unimportant	Presence of community spaces where teens and youth can develop connections with others Somewhat important	Presence of community spaces where teens and youth can develop connections with others Important	Presence of community spaces where teens and youth can develop connections with others Very Important
Teens and youth receive support from groups within the community	Teens and youth receive support from groups within the community Don't Know	Teens and youth receive support from groups within the community Unimportant	Teens and youth receive support from groups within the community Somewhat important	Teens and youth receive support from groups within the community Important	Teens and youth receive support from groups within the community Very Important
Availability of learning opportunities for teens and youth	Availability of learning opportunities for teens and youth Don't Know	Availability of learning opportunities for teens and youth Unimportant	Availability of learning opportunities for teens and youth Somewhat important	Availability of learning opportunities for teens and youth Important	Availability of learning opportunities for teens and youth Very Important
Availability of services that engage teens and youth populations	Availability of services that engage teens and youth populations Don't Know	Availability of services that engage teens and youth populations Unimportant	Availability of services that engage teens and youth populations Somewhat important	Availability of services that engage teens and youth populations Important	Availability of services that engage teens and youth populations Very Important
Teens and youth have convenient access to structured activities in a community facility	Teens and youth have convenient access to structured activities in a community facility Don't Know	Teens and youth have convenient access to structured activities in a community facility Unimportant	Teens and youth have convenient access to structured activities in a community facility Somewhat important	Teens and youth have convenient access to structured activities in a community facility Important	Teens and youth have convenient access to structured activities in a community facility Very Important

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* 6. Please rate how satisfied you are with each of the following items that relate to youth and teens:

	Not Satisfied	Somewhat Satisfied	Neither Satisfied or Dissatisfied	Satisfied	Very Satisfied
Availability of services aimed at engaging youth and teens	Availability of services aimed at engaging youth and teens Not Satisfied	Availability of services aimed at engaging youth and teens Somewhat Satisfied	Availability of services aimed at engaging youth and teens Neither Satisfied or Dissatisfied	Availability of services aimed at engaging youth and teens Satisfied	Availability of services aimed at engaging youth and teens Very Satisfied
Teens and youth are supported in practicing positive habits that include physical activity and healthy eating	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Not Satisfied	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Somewhat Satisfied	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Neither Satisfied or Dissatisfied	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Satisfied	Teens and youth are supported in practicing positive habits that include physical activity and healthy eating Very Satisfied
Availability of service or volunteer opportunities for teens and youth	Availability of service or volunteer opportunities for teens and youth Not Satisfied	Availability of service or volunteer opportunities for teens and youth Somewhat Satisfied	Availability of service or volunteer opportunities for teens and youth Neither Satisfied or Dissatisfied	Availability of service or volunteer opportunities for teens and youth Satisfied	Availability of service or volunteer opportunities for teens and youth Very Satisfied
Presence of safe and secure community spaces for teens and youth	Presence of safe and secure community spaces for teens and youth Not Satisfied	Presence of safe and secure community spaces for teens and youth Somewhat Satisfied	Presence of safe and secure community spaces for teens and youth Neither Satisfied or Dissatisfied	Presence of safe and secure community spaces for teens and youth Satisfied	Presence of safe and secure community spaces for teens and youth Very Satisfied
Presence of community spaces where teens and youth can develop connections with others	Presence of community spaces where teens and youth can develop connections with others Not Satisfied	Presence of community spaces where teens and youth can develop connections with others Somewhat Satisfied	Presence of community spaces where teens and youth can develop connections with others Neither Satisfied or Dissatisfied	Presence of community spaces where teens and youth can develop connections with others Satisfied	Presence of community spaces where teens and youth can develop connections with others Very Satisfied
Teens and youth receive support from groups within the community	Teens and youth receive support from groups within the community Not Satisfied	Teens and youth receive support from groups within the community Somewhat Satisfied	Teens and youth receive support from groups within the community Neither Satisfied or Dissatisfied	Teens and youth receive support from groups within the community Satisfied	Teens and youth receive support from groups within the community Very Satisfied
Availability of learning opportunities for teens and youth	Availability of learning opportunities for teens and youth Not Satisfied	Availability of learning opportunities for teens and youth Somewhat Satisfied	Availability of learning opportunities for teens and youth Neither Satisfied or Dissatisfied	Availability of learning opportunities for teens and youth Satisfied	Availability of learning opportunities for teens and youth Very Satisfied
Availability of services that engage teens and youth populations	Availability of services that engage teens and youth populations Not Satisfied	Availability of services that engage teens and youth populations Somewhat Satisfied	Availability of services that engage teens and youth populations Neither Satisfied or Dissatisfied	Availability of services that engage teens and youth populations Satisfied	Availability of services that engage teens and youth populations Very Satisfied
Teens and youth have convenient access to structured activities in a community facility	Teens and youth have convenient access to structured activities in a community facility Not Satisfied	Teens and youth have convenient access to structured activities in a community facility Somewhat Satisfied	Teens and youth have convenient access to structured activities in a community facility Neither Satisfied or Dissatisfied	Teens and youth have convenient access to structured activities in a community facility Satisfied	Teens and youth have convenient access to structured activities in a community facility Very Satisfied

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* 7. Please indicate how strongly you agree or disagree with the following statements:

	Strongly Agree	Somewhat Agree	Somewhat Disagree	Strongly Disagree	Not sure
The YMCA helps strengthen the community.	The YMCA helps strengthen the community. Strongly Agree	The YMCA helps strengthen the community. Somewhat Agree	The YMCA helps strengthen the community. Somewhat Disagree	The YMCA helps strengthen the community. Strongly Disagree	The YMCA helps strengthen the community. Not sure
The YMCA is an important community resource for nurturing the potential of every child.	The YMCA is an important community resource for nurturing the potential of every child. Strongly Agree	The YMCA is an important community resource for nurturing the potential of every child. Somewhat Agree	The YMCA is an important community resource for nurturing the potential of every child. Somewhat Disagree	The YMCA is an important community resource for nurturing the potential of every child. Strongly Disagree	The YMCA is an important community resource for nurturing the potential of every child. Not sure
The YMCA is an important resource for improving the health and well-being of the community.	The YMCA is an important resource for improving the health and well-being of the community. Strongly Agree	The YMCA is an important resource for improving the health and well-being of the community. Somewhat Agree	The YMCA is an important resource for improving the health and well-being of the community. Somewhat Disagree	The YMCA is an important resource for improving the health and well-being of the community. Strongly Disagree	The YMCA is an important resource for improving the health and well-being of the community. Not sure
The YMCA provides people an opportunity to give back and support their neighbors.	The YMCA provides people an opportunity to give back and support their neighbors. Strongly Agree	The YMCA provides people an opportunity to give back and support their neighbors. Somewhat Agree	The YMCA provides people an opportunity to give back and support their neighbors. Somewhat Disagree	The YMCA provides people an opportunity to give back and support their neighbors. Strongly Disagree	The YMCA provides people an opportunity to give back and support their neighbors. Not sure

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* 8. Which of the following describes your relationship to the YMCA? Check all that apply.

Current Y member

Current program participant (not a member)

Donated money or made a charitable financial contribution to the Y

Have children and/or other household members who have attended or used Y facilities, programs, activities, etc.

Past YMCA member (not currently a member)

Volunteered, helped organize Y activities or programs, served on the Y board, etc.

Worked as Y employee (camp counselor, lifeguard, etc)

I have no connection to the YMCA

Other (please specify)

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* 9. Please state your gender. Check ONE.

Man

Woman

Rather not say

____________(tell us how else you identify)

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* 10. Do you currently have children under the age of 18 living at home?

Yes

Rather not say

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* 11. What is your age?

17 and under

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 and over

Rather not say

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* 12. What is your zip code?

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* 13. What is your 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

Rather not say

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* 14. If you would like to learn more about the results of this survey, please list your name and a method of contact; the Y will be in touch once the results are finalized.

Name:

Email: