Evaluation of Family Emergency Readiness Question Title * 1. Does your household have an emergency plan that includes instructions for household members about where to go and what to do in the event of a disaster? Yes No Not Sure Question Title * 2. Do you have the following at your home? Yes No Not Sure A working smoke detector? Yes No A working smoke detector? Yes menu Yes No A working smoke detector? No menu Yes No A working smoke detector? Not Sure menu A working carbon monoxide detector? Yes No A working carbon monoxide detector? Yes menu Yes No A working carbon monoxide detector? No menu Yes No A working carbon monoxide detector? Not Sure menu A working weather radio? Yes No A working weather radio? Yes menu Yes No A working weather radio? No menu Yes No A working weather radio? Not Sure menu A working fire extinguisher? Yes No A working fire extinguisher? Yes menu Yes No A working fire extinguisher? No menu Yes No A working fire extinguisher? Not Sure menu A working home generator? Yes No A working home generator? Yes menu Yes No A working home generator? No menu Yes No A working home generator? Not Sure menu Question Title * 3. Are you trained or certified in CPR (Cardiopulmonary Resuscitation)? Yes No Not anymore Question Title * 4. Are you aware of the hazards associated with recreation on the Chattahoochee River? Very Aware Somewhat but I need more info Not at all Question Title * 5. Using a scale of 1 to 5 with 5 being “very familiar” and 1 being “not at all familiar,” how familiar are you with… 1 2 3 4 5 Alerts and warning systems in your community. Alerts and warning systems in your community. 1 Alerts and warning systems in your community. 2 Alerts and warning systems in your community. 3 Alerts and warning systems in your community. 4 Alerts and warning systems in your community. 5 Official sources of public safety information. Official sources of public safety information. 1 Official sources of public safety information. 2 Official sources of public safety information. 3 Official sources of public safety information. 4 Official sources of public safety information. 5 Community Evacuation routes. Community Evacuation routes. 1 Community Evacuation routes. 2 Community Evacuation routes. 3 Community Evacuation routes. 4 Community Evacuation routes. 5 Shelter location near you. Shelter location near you. 1 Shelter location near you. 2 Shelter location near you. 3 Shelter location near you. 4 Shelter location near you. 5 Information on local hazards. Information on local hazards. 1 Information on local hazards. 2 Information on local hazards. 3 Information on local hazards. 4 Information on local hazards. 5 Question Title * 6. Are you aware of the details of the emergency or evacuation plan of the city schools and how to get information about students in the event of a disaster? Yes No Don't know Question Title * 7. Are there children under the age of 18 living in your residence? Yes No Question Title * 8. In a natural disaster, such as an ice storm, a flood, a tornado, or power outages, which of the following statements best represents your belief? I am very prepared. I am not prepared at all. No preparation is needed in my city. I do not know. Question Title * 9. Your belief that some type of natural disaster will ever occur in your community? 05 It will happen eventually 04 Very Likely 03 Possible but not likely 02 Not Going to Happen 01 I Have No Idea Question Title * 10. How confident are you about your own ability to prepare for a disaster? Please use a scale of 1 to 5, with 5 being “very confident” and 1 being “not at all confident.” 5 4 3 2 1 Question Title * 11. In the first 72 hours following a disaster, please indicate how much you would expect to rely on each item listed below for assistance. Please use a scale of 1 to 5, with 5 being “expect to rely on a great deal” and 1 being “do not expect to rely on at all.” Household Members People in my Neighborhood Non Profit organizations like the Red Cross or Salvation Army My religious organization Local Fire, Police & EMS State and Federal Government agencies such as F.E.M.A. Question Title * 12. Do you or anyone in your household have a disability that would affect your capacity to respond to an emergency situation? Yes NO Question Title * 13. Would you consider participating in ongoing citizen emergency response team training with your neighbors to help your community prepare for and recover from disasters? Yes No Possibly Question Title * 14. Which area of safety preparedness training interests you most? 1 2 3 4 5 6 Fire Extinguisher use 1 2 3 4 5 6 CPR & First Aid 1 2 3 4 5 6 Home Fire Safety & Escape Drills 1 2 3 4 5 6 Light Search & Rescue 1 2 3 4 5 6 Business Fire Safety 1 2 3 4 5 6 Weather & Natural Disaster Preparedness Question Title * 15. What is the highest level of education that you attained? High School Graduate Bachelor's Degree Masters Degree Doctorate Degree Page1 / 1 100% of survey complete. Done
