TEAM 2022/2023 Community Planning Survey

The following confidential survey is sponsored by TEAM - we are in the process of planning how we can best serve individuals and families over the next 4 years.

To help this process, TEAM would like to hear from you. It will take you between 10 and 15 minutes to complete these multiple choice questions.

To say thank you for taking the time to complete this survey, we will be holding a raffle for 2 $100 gift card to a local grocery store. The winner will be drawn at the end of April 2023. To enter the raffle, please type your name and contact information at the end of the survey.

Your contact information will only be used to contact you if you are the raffle winner.

Thank you for your time and valued input.

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* 1. Below are many identified community needs within TEAM's region - please select & rank (in order of importance what you believe to be the top 5 needs in your community:

	Most important	2nd most important	3rd most important	4th most important	5th most important
Adult Education & Training	Adult Education & Training Most important	Adult Education & Training 2nd most important	Adult Education & Training 3rd most important	Adult Education & Training 4th most important	Adult Education & Training 5th most important
Child Care Access	Child Care Access Most important	Child Care Access 2nd most important	Child Care Access 3rd most important	Child Care Access 4th most important	Child Care Access 5th most important
Elderly Services	Elderly Services Most important	Elderly Services 2nd most important	Elderly Services 3rd most important	Elderly Services 4th most important	Elderly Services 5th most important
Food Access/Affordability	Food Access/Affordability Most important	Food Access/Affordability 2nd most important	Food Access/Affordability 3rd most important	Food Access/Affordability 4th most important	Food Access/Affordability 5th most important
Healthcare Access	Healthcare Access Most important	Healthcare Access 2nd most important	Healthcare Access 3rd most important	Healthcare Access 4th most important	Healthcare Access 5th most important
Living Wage Employment Opportunities	Living Wage Employment Opportunities Most important	Living Wage Employment Opportunities 2nd most important	Living Wage Employment Opportunities 3rd most important	Living Wage Employment Opportunities 4th most important	Living Wage Employment Opportunities 5th most important
Mental Health	Mental Health Most important	Mental Health 2nd most important	Mental Health 3rd most important	Mental Health 4th most important	Mental Health 5th most important
Safe, Affordable Housing	Safe, Affordable Housing Most important	Safe, Affordable Housing 2nd most important	Safe, Affordable Housing 3rd most important	Safe, Affordable Housing 4th most important	Safe, Affordable Housing 5th most important
Substance Abuse	Substance Abuse Most important	Substance Abuse 2nd most important	Substance Abuse 3rd most important	Substance Abuse 4th most important	Substance Abuse 5th most important
Transportation	Transportation Most important	Transportation 2nd most important	Transportation 3rd most important	Transportation 4th most important	Transportation 5th most important
Youth/Adolescent Services	Youth/Adolescent Services Most important	Youth/Adolescent Services 2nd most important	Youth/Adolescent Services 3rd most important	Youth/Adolescent Services 4th most important	Youth/Adolescent Services 5th most important

A need not listed?

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* 2. How much would you agree that finding or keeping a good paying job is an issue for you or someone in your household?

Strongly agree

Agree

Disagree

Strongly disagree

Not applicable

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* 3. Please identify what you believe are the top 3 reasons you or someone in your household have not been able to find a job. If this isn’t the case in your household, please share your opinion based on your experiences in the community.

	Biggest reason	2nd biggest reason	3rd biggest reason
Don't have the right skills or education	Don't have the right skills or education Biggest reason	Don't have the right skills or education 2nd biggest reason	Don't have the right skills or education 3rd biggest reason
Lack of available training to obtain a job	Lack of available training to obtain a job Biggest reason	Lack of available training to obtain a job 2nd biggest reason	Lack of available training to obtain a job 3rd biggest reason
There's no reliable way (bus, car) to get to the good jobs	There's no reliable way (bus, car) to get to the good jobs Biggest reason	There's no reliable way (bus, car) to get to the good jobs 2nd biggest reason	There's no reliable way (bus, car) to get to the good jobs 3rd biggest reason
There's no one to take care of the kids	There's no one to take care of the kids Biggest reason	There's no one to take care of the kids 2nd biggest reason	There's no one to take care of the kids 3rd biggest reason
There's no jobs	There's no jobs Biggest reason	There's no jobs 2nd biggest reason	There's no jobs 3rd biggest reason
Low wage jobs are not worth taking	Low wage jobs are not worth taking Biggest reason	Low wage jobs are not worth taking 2nd biggest reason	Low wage jobs are not worth taking 3rd biggest reason
I have a mark on my record (current or past) that keeps me from being hired	I have a mark on my record (current or past) that keeps me from being hired Biggest reason	I have a mark on my record (current or past) that keeps me from being hired 2nd biggest reason	I have a mark on my record (current or past) that keeps me from being hired 3rd biggest reason
A health issues keeps me from being employed	A health issues keeps me from being employed Biggest reason	A health issues keeps me from being employed 2nd biggest reason	A health issues keeps me from being employed 3rd biggest reason
A reason not listed here (please specify below)	A reason not listed here (please specify below) Biggest reason	A reason not listed here (please specify below) 2nd biggest reason	A reason not listed here (please specify below) 3rd biggest reason

Please place here any reason you did not see in the above list (i.e. language barrier)

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* 4. How much of a challenge has getting affordable, safe housing been for you or someone in your household?

A big challenge

Somewhat a challenge

Not that much a challenge

Not at all a challenge

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* 5. What do you believe the top 3 reasons you or someone in your household has had trouble finding a place to live? If this isn’t the case in your household, please share your opinion based on your experiences in the community.

	Biggest reason	2nd biggest reason	3rd biggest reason
Rent/mortgage payments are too expensive	Rent/mortgage payments are too expensive Biggest reason	Rent/mortgage payments are too expensive 2nd biggest reason	Rent/mortgage payments are too expensive 3rd biggest reason
There are not enough units available	There are not enough units available Biggest reason	There are not enough units available 2nd biggest reason	There are not enough units available 3rd biggest reason
Utility (gas, electric, oil, etc.) payments will be too costly	Utility (gas, electric, oil, etc.) payments will be too costly Biggest reason	Utility (gas, electric, oil, etc.) payments will be too costly 2nd biggest reason	Utility (gas, electric, oil, etc.) payments will be too costly 3rd biggest reason
Few places that are affordable have enough space for my household	Few places that are affordable have enough space for my household Biggest reason	Few places that are affordable have enough space for my household 2nd biggest reason	Few places that are affordable have enough space for my household 3rd biggest reason
Available housing is in unsafe neighborhoods	Available housing is in unsafe neighborhoods Biggest reason	Available housing is in unsafe neighborhoods 2nd biggest reason	Available housing is in unsafe neighborhoods 3rd biggest reason
I cannot afford the required security deposit	I cannot afford the required security deposit Biggest reason	I cannot afford the required security deposit 2nd biggest reason	I cannot afford the required security deposit 3rd biggest reason
Bad credit history	Bad credit history Biggest reason	Bad credit history 2nd biggest reason	Bad credit history 3rd biggest reason
Someone in the household has a criminal record	Someone in the household has a criminal record Biggest reason	Someone in the household has a criminal record 2nd biggest reason	Someone in the household has a criminal record 3rd biggest reason
A reason not listed here (please specify below)	A reason not listed here (please specify below) Biggest reason	A reason not listed here (please specify below) 2nd biggest reason	A reason not listed here (please specify below) 3rd biggest reason

Other (please specify)

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* 6. How much of a problem is transportation (getting to jobs, shopping, elsewhere) for you or someone in your household?

A really big problem

Somewhat of a problem

Not that much of a problem

Not at all a problem

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* 7. What are the 3 main reasons you think transportation is a problem for you or someone in your household? If this isn’t the case in your household, please share your opinion based on your experiences in the community.

	Biggest reason	2nd biggest reason	3rd biggest reason
Cannot afford a personal car, the ability to insure it, or the ability to fix it when broken	Cannot afford a personal car, the ability to insure it, or the ability to fix it when broken Biggest reason	Cannot afford a personal car, the ability to insure it, or the ability to fix it when broken 2nd biggest reason	Cannot afford a personal car, the ability to insure it, or the ability to fix it when broken 3rd biggest reason
No driver’s license	No driver’s license Biggest reason	No driver’s license 2nd biggest reason	No driver’s license 3rd biggest reason
Taxis and other public transportation are too expensive	Taxis and other public transportation are too expensive Biggest reason	Taxis and other public transportation are too expensive 2nd biggest reason	Taxis and other public transportation are too expensive 3rd biggest reason
Buses don't go to where I need to go or I'm not on the bus line	Buses don't go to where I need to go or I'm not on the bus line Biggest reason	Buses don't go to where I need to go or I'm not on the bus line 2nd biggest reason	Buses don't go to where I need to go or I'm not on the bus line 3rd biggest reason
Buses go where I need to, but their schedules aren't very good for getting to work, doctors, etc.	Buses go where I need to, but their schedules aren't very good for getting to work, doctors, etc. Biggest reason	Buses go where I need to, but their schedules aren't very good for getting to work, doctors, etc. 2nd biggest reason	Buses go where I need to, but their schedules aren't very good for getting to work, doctors, etc. 3rd biggest reason
A reason not listed (please specify below)	A reason not listed (please specify below) Biggest reason	A reason not listed (please specify below) 2nd biggest reason	A reason not listed (please specify below) 3rd biggest reason

Please put here any reason you did not see in the list.

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* 8. How much of a problem is getting childcare for you or someone in your household?

A lot

Somewhat

Not at all

I don't know

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* 9. Please rank the top 3 reasons you or someone in your household has had difficulty getting a childcare provider when one was needed. If this isn’t the case in your household, please share your opinion based on your experiences in the community.

	Biggest reason	2nd biggest reason	3rd biggest reason
Couldn't find a provider that was affordable	Couldn't find a provider that was affordable Biggest reason	Couldn't find a provider that was affordable 2nd biggest reason	Couldn't find a provider that was affordable 3rd biggest reason
Couldn't find a provider that was nearby	Couldn't find a provider that was nearby Biggest reason	Couldn't find a provider that was nearby 2nd biggest reason	Couldn't find a provider that was nearby 3rd biggest reason
Couldn't find a provider that took infant and 2-year-olds	Couldn't find a provider that took infant and 2-year-olds Biggest reason	Couldn't find a provider that took infant and 2-year-olds 2nd biggest reason	Couldn't find a provider that took infant and 2-year-olds 3rd biggest reason
Couldn't find a quality provider that could prove it had a quality program	Couldn't find a quality provider that could prove it had a quality program Biggest reason	Couldn't find a quality provider that could prove it had a quality program 2nd biggest reason	Couldn't find a quality provider that could prove it had a quality program 3rd biggest reason
Provider hours conflict with work schedule	Provider hours conflict with work schedule Biggest reason	Provider hours conflict with work schedule 2nd biggest reason	Provider hours conflict with work schedule 3rd biggest reason
A reason not listed here (please specify below)	A reason not listed here (please specify below) Biggest reason	A reason not listed here (please specify below) 2nd biggest reason	A reason not listed here (please specify below) 3rd biggest reason

Please specify any other reasons here.

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* 10. Please say whether you think there's enough of the following services for seniors.

	There's enough of these services	There could be more	These services don't really exist	I don't really know
Adult Day Care	Adult Day Care There's enough of these services	Adult Day Care There could be more	Adult Day Care These services don't really exist	Adult Day Care I don't really know
Opportunities to get out and socialize	Opportunities to get out and socialize There's enough of these services	Opportunities to get out and socialize There could be more	Opportunities to get out and socialize These services don't really exist	Opportunities to get out and socialize I don't really know
Getting support to stay in one’s own home	Getting support to stay in one’s own home There's enough of these services	Getting support to stay in one’s own home There could be more	Getting support to stay in one’s own home These services don't really exist	Getting support to stay in one’s own home I don't really know
Affordable home health care	Affordable home health care There's enough of these services	Affordable home health care There could be more	Affordable home health care These services don't really exist	Affordable home health care I don't really know
Assisted living facilities	Assisted living facilities There's enough of these services	Assisted living facilities There could be more	Assisted living facilities These services don't really exist	Assisted living facilities I don't really know
Transportation for seniors	Transportation for seniors There's enough of these services	Transportation for seniors There could be more	Transportation for seniors These services don't really exist	Transportation for seniors I don't really know
A service not listed here (please specify below)	A service not listed here (please specify below) There's enough of these services	A service not listed here (please specify below) There could be more	A service not listed here (please specify below) These services don't really exist	A service not listed here (please specify below) I don't really know

Specify service not listed above here:

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* 11. How accessible do you believe the Senior Center nearest to you is to seniors?

Very accessible

Somewhat accessible

Somewhat difficult to access

Not at all accessible

I don't know

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* 12. How much of a problem do you believe elder abuse is in the community?

A really big problem

Somewhat a problem

Not much of a problem

Not at all a problem

I don't know

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* 13. How much of a problem has getting health care services been for you or someone in your household?

A really big problem

Somewhat a problem

Not much of a problem

Not at all a problem

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* 14. How much do you agree with the following statements?

	I very much agree	I sort of agree	I don't at all agree	I don't know
Health care insurance is too expensive	Health care insurance is too expensive I very much agree	Health care insurance is too expensive I sort of agree	Health care insurance is too expensive I don't at all agree	Health care insurance is too expensive I don't know
Prescription medicines are too expensive	Prescription medicines are too expensive I very much agree	Prescription medicines are too expensive I sort of agree	Prescription medicines are too expensive I don't at all agree	Prescription medicines are too expensive I don't know
Most doctors in the area do not accept my insurance	Most doctors in the area do not accept my insurance I very much agree	Most doctors in the area do not accept my insurance I sort of agree	Most doctors in the area do not accept my insurance I don't at all agree	Most doctors in the area do not accept my insurance I don't know
Dental services are too expensive	Dental services are too expensive I very much agree	Dental services are too expensive I sort of agree	Dental services are too expensive I don't at all agree	Dental services are too expensive I don't know
Alcohol and drug treatment services are to expensive	Alcohol and drug treatment services are to expensive I very much agree	Alcohol and drug treatment services are to expensive I sort of agree	Alcohol and drug treatment services are to expensive I don't at all agree	Alcohol and drug treatment services are to expensive I don't know
There aren't enough alcohol and drug treatment services	There aren't enough alcohol and drug treatment services I very much agree	There aren't enough alcohol and drug treatment services I sort of agree	There aren't enough alcohol and drug treatment services I don't at all agree	There aren't enough alcohol and drug treatment services I don't know
Mental health services are too expensive	Mental health services are too expensive I very much agree	Mental health services are too expensive I sort of agree	Mental health services are too expensive I don't at all agree	Mental health services are too expensive I don't know
There aren't enough mental health services	There aren't enough mental health services I very much agree	There aren't enough mental health services I sort of agree	There aren't enough mental health services I don't at all agree	There aren't enough mental health services I don't know
Home health services are too expensive	Home health services are too expensive I very much agree	Home health services are too expensive I sort of agree	Home health services are too expensive I don't at all agree	Home health services are too expensive I don't know
Health insurance application process is too confusing	Health insurance application process is too confusing I very much agree	Health insurance application process is too confusing I sort of agree	Health insurance application process is too confusing I don't at all agree	Health insurance application process is too confusing I don't know
Waitlists to see a provider are too long	Waitlists to see a provider are too long I very much agree	Waitlists to see a provider are too long I sort of agree	Waitlists to see a provider are too long I don't at all agree	Waitlists to see a provider are too long I don't know

Have you any additional comments to make on this topic?

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* 15. Have you and/or your family struggled to have enough food to eat in the last 30 days?

I and/or my family has struggled to have enough food to eat in the last 30 days.

I and/or my family had enough food to eat in the 30 days.

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* 16. Are you aware of anyone who has struggled to have enough food to eat in the last 30 days?

I am aware of at least one person who has struggled to have enough food to eat in the last 30 days

I am not aware of anyone who has struggled to have enough food to eat in the last 30 days

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* 17. How much do you agree with the following reasons that you or someone you know may not have had enough food to eat at least one day in the last three months?

	I very much agree	I sort of agree	I don't agree at all	I don't know
There wasn't a food pantry in the neighborhood	There wasn't a food pantry in the neighborhood I very much agree	There wasn't a food pantry in the neighborhood I sort of agree	There wasn't a food pantry in the neighborhood I don't agree at all	There wasn't a food pantry in the neighborhood I don't know
The food pantry didn't have healthy food	The food pantry didn't have healthy food I very much agree	The food pantry didn't have healthy food I sort of agree	The food pantry didn't have healthy food I don't agree at all	The food pantry didn't have healthy food I don't know
Food stamps (SNAP) ran out before the end of the month	Food stamps (SNAP) ran out before the end of the month I very much agree	Food stamps (SNAP) ran out before the end of the month I sort of agree	Food stamps (SNAP) ran out before the end of the month I don't agree at all	Food stamps (SNAP) ran out before the end of the month I don't know
Income was too high to qualify for food stamps (SNAP)	Income was too high to qualify for food stamps (SNAP) I very much agree	Income was too high to qualify for food stamps (SNAP) I sort of agree	Income was too high to qualify for food stamps (SNAP) I don't agree at all	Income was too high to qualify for food stamps (SNAP) I don't know
Food was too expensive	Food was too expensive I very much agree	Food was too expensive I sort of agree	Food was too expensive I don't agree at all	Food was too expensive I don't know
Lack of transportation	Lack of transportation I very much agree	Lack of transportation I sort of agree	Lack of transportation I don't agree at all	Lack of transportation I don't know
I am or someone I know is homebound and unable to obtain enough nutritious foods	I am or someone I know is homebound and unable to obtain enough nutritious foods I very much agree	I am or someone I know is homebound and unable to obtain enough nutritious foods I sort of agree	I am or someone I know is homebound and unable to obtain enough nutritious foods I don't agree at all	I am or someone I know is homebound and unable to obtain enough nutritious foods I don't know

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* 18. What do you think about your food shopping options? Please check all that apply

Healthy food is more expensive at most food stores in the area

I'm not sure exactly what food is healthy or not

Healthy food is not sold at most food stores in the area

The stores and markets that sell healthy food are not close to where I live

Another comment:

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* 19. How important has TEAM been in addressing my needs or the needs in my community?

Really important

Somewhat important

Not that important

Not at all important

I don't know

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* 20. Please tell us your age.

Under 18

18-23

24-44

45-59

60-64

65 or over

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* 21. Are you a person living with a disability?

Yes

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* 22. What town do you live?

Ansonia

Beacon Falls

Bethany

Derby

Milford

Orange

Oxford

Seymour

Shelton

Woodbridge

Other (please specify)

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* 23. Which of the following best describes your household?

Single adult

Two adults, NO children

Two-parent household

Single-parent female

Single-parent male

Other (please specify)

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* 24. Regarding housing arrangements, do you:

Own

Rent

Homeless

Some other arrangement?

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* 25. How many people (total adults & children) live in your house/apartment?

One

Two

Three

Four

Five

Six

Seven

Eight or more

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* 26. Which of the following looks most like your whole household's annual income?

$0-$26,999 a year

$27,000-$54,999 a year

$55,000-$82,999 a year

$83,000-$110,999 a year

$111,000+ a year

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* 27. Check which ethnicity best describes you

Hispanic, Latino, or Spanish origins

Not Hispanic, Latino, or Spanish origins

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* 28. Check which race describes you

Asian

Black or African-American

White

American Indian or Alaska Native

Native Hawaiian and other Pacific Islander

Multi-Race (any two or more of the above)

If checked OTHER, enter here:

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* 29. Please check what best describes your highest level of education/school

Not graduated from high school

High school graduate/GED

Some post-secondary course work or certifications

2 or 4 year college graduate

More than 4 year college graduate

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* 30. Please identify your gender.

Male

Female

Other (please specify)

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* 31. If you want to add more comments, you can do it in the box below. Otherwise, you are done. Thank you for your information and time in helping to inform TEAM!

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* 32. If you would like to be entered into the raffle for a gift card to a local grocery store, please enter your contact information below. This contact information will be kept confidential and will only be used if you are the winner.

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number