Pro Action 2019 Community Needs Assessment Survey - Community Member

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* 1. How many people live in your household?

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* 2. Of those living in your household, how many are in each age category below?

0-5

6-13

14-24

25-55

56-65

66- or older?

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* 3. What County do you live in?

Steuben

Yates

Other (please specify)

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* 4. What Steuben County ZIP code do you live in?

14801

14803

14806

14807

14808

14809

14810

14812

14814

14815

14818

14819

14820

14821

14823

14826

14827

14830

14837

14839

14840

14843

14855

14856

14858

14870

14871

14873

14874

14877

14879

14885

14897

14898

14437

14512

14529

14572

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* 5. OR - What Yates County ZIP Code do you live in?

14415

14418

14441

14456

14478

14507

14512

14527

14544

14561

14837

14842

14878

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* 6. Rank in order of 1 (highest) through 5, the top five needs that you and/or your neighbors experienced in the last month?

	1	2	3	4	5
Access to enough food	Access to enough food 1	Access to enough food 2	Access to enough food 3	Access to enough food 4	Access to enough food 5
Adult Education/ literacy	Adult Education/ literacy 1	Adult Education/ literacy 2	Adult Education/ literacy 3	Adult Education/ literacy 4	Adult Education/ literacy 5
Child care	Child care 1	Child care 2	Child care 3	Child care 4	Child care 5
Dental care	Dental care 1	Dental care 2	Dental care 3	Dental care 4	Dental care 5
Domestic violence assistance	Domestic violence assistance 1	Domestic violence assistance 2	Domestic violence assistance 3	Domestic violence assistance 4	Domestic violence assistance 5
Family counseling	Family counseling 1	Family counseling 2	Family counseling 3	Family counseling 4	Family counseling 5
Financial assistance	Financial assistance 1	Financial assistance 2	Financial assistance 3	Financial assistance 4	Financial assistance 5
Health care	Health care 1	Health care 2	Health care 3	Health care 4	Health care 5
Heating/ utility assistance	Heating/ utility assistance 1	Heating/ utility assistance 2	Heating/ utility assistance 3	Heating/ utility assistance 4	Heating/ utility assistance 5
Job skills training	Job skills training 1	Job skills training 2	Job skills training 3	Job skills training 4	Job skills training 5
Legal services	Legal services 1	Legal services 2	Legal services 3	Legal services 4	Legal services 5
Mental health services	Mental health services 1	Mental health services 2	Mental health services 3	Mental health services 4	Mental health services 5
Parenting education	Parenting education 1	Parenting education 2	Parenting education 3	Parenting education 4	Parenting education 5
Preschool programs	Preschool programs 1	Preschool programs 2	Preschool programs 3	Preschool programs 4	Preschool programs 5
Safe, affordable housing	Safe, affordable housing 1	Safe, affordable housing 2	Safe, affordable housing 3	Safe, affordable housing 4	Safe, affordable housing 5
Safety/ crime prevention	Safety/ crime prevention 1	Safety/ crime prevention 2	Safety/ crime prevention 3	Safety/ crime prevention 4	Safety/ crime prevention 5
Senior citizen services	Senior citizen services 1	Senior citizen services 2	Senior citizen services 3	Senior citizen services 4	Senior citizen services 5
Substance abuse services	Substance abuse services 1	Substance abuse services 2	Substance abuse services 3	Substance abuse services 4	Substance abuse services 5
Summer recreation	Summer recreation 1	Summer recreation 2	Summer recreation 3	Summer recreation 4	Summer recreation 5
Transportation	Transportation 1	Transportation 2	Transportation 3	Transportation 4	Transportation 5
Veteran services	Veteran services 1	Veteran services 2	Veteran services 3	Veteran services 4	Veteran services 5
Youth programs	Youth programs 1	Youth programs 2	Youth programs 3	Youth programs 4	Youth programs 5