BASIC COMMUNITY SERVICES

In this survey, we would like to ask you about a variety of issues and your opinions about: (1) how important these issues are, and (2) how satisfied you are about your community's efforts to deal with them.

Instructions: In the first column, select the number that shows how important each issue is to you. In the second column, select the number that shows how satisfied you are with your community's efforts to address this issue.

* 1. The services available to you in this community are helpful in meeting your needs.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 2. The services available are the ones you need.

  Very Somewhat Not at all
How important is this? 
Are you satisfied with the community effort?

* 3. Adequate services are provided to low-income people in your community.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 4. The staff of service agencies in your community take time to meet with you.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 5. The services offerered in your community are provided to all who need them.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 6. The eligibility requirements of different services and programs are reasonable.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 7. You are able to get a decent job.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 8. You are able to find safe and affordable housing for you and your family.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 9. You have or can get adequate clothing for yourself and family for all seasons.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 10. You and your family have an can afford adequate medical care.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 11. You and your family have and can afford adequate dental care.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 12. Safe and affordable day care services are available.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 13. You can get the education or training you need.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 14. You have safe and affordable means of transportation.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 15. You have the necessary resources to give adequate care for your children.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 16. You can get adequate school supplies for your children.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 17. Help is available for persons with alcohol or drug problems.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 18. Help is available for parents to use positive discipline, without using violence.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 19. Help is available for women and children who are victims of violence.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 20. Help is available for the elderly who wish to remain in their homes.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 21. Help is available for disabled persons who live in your community.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 22. You can get help with paying utility bills, if needed.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 23. You can get temporary shelter, if needed.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 24. You can talk with a helpful counselor to solve personal problems, if needed.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 25. You can get help dealing with landlord problems, if needed.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 26. You can get help weatherizing your home, if needed.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 27. You can get help with pre-school education for your children.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 28. You can get help with nutritious and fresh food, if needed.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 29. You can get legal assistance at an affordable cost.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?

* 30. Overall, this community meets the social service needs of families.

  Very Somewhat Not at all
How important is this?
Are you satisfied with the community effort?
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