Needs Assessment 2

Thank you for agreeing to participate in our community needs assessment. The Nash Edgecombe Wilson Community Action Agency (NEW CAA) is a resource agency funded by the federal government. Our mission is to help families in need of housing, jobs, and preschool or early childhood education meet those needs with our assistance. Based on the family's income level, we help with financial assistance to find housing, job preparation, and Head Start services for preschool children. We are asking questions to determine what services the community needs and how our agency can best provide those services to families in our community.
Section I - Service and Resource Needs
1.To assess your family's need for services, please tell me how many people live in your household in the following age groups?
0
1
2
3
4
18 years or older
6-17 years
3-5 years
0-2 years
2.In what county do you currently reside?
Family Housing Resources Need:
3.What type of housing assistance are you are most in need of now?
Support for becoming Employed or maintaining employment:
4.What is your most pressing need for services to secure and maintain a job or find employment?
5.If you need to finish high school or attain higher education, what things would help you advance your education? How about…
Section II - Financial Status and Need
6.In the past 12 months, did your family have any cash income?
7.Are any of these a source of income/entitlements? Yes, No, or Unknown
Yes
No
Unknown
Employment earnings
Unemployment benefits
TANF/TANF "child only."
Social Security Disability Insurance (SSDI)
Social Security Retirement (OASI)
Other retirement or pension
Supplemental Security Income (SSI)
Foster care payments
Income from spouse, family, or friends (including alimony and child support)
Federal Payments for COVID relief
Other cash income
8.How much monthly Income did you have from all sources per month?
9.Did your family have any non-cash income or entitlements? Yes, No, or Unknown. If yes, continue with question 5 or skip to question 6.
10.Are any of these a source of non-cash income/entitlements? Yes, No, or Unknown
Yes
No
Unknown
Medicaid
Housing subsidy/public housing
WIC (Women, Infants & Children)
Food stamps
Other non-cash income
11.What is the most pressing financial need in your household right now?
Transportation Needs
12.Do you currently own a car or another vehicle?
13.Do you live near public transportation?
14.If public transportation were made available, how likely would you be to use it?
Next, let's consider a list of destinations where most people need to go, at least occasionally. Then, please select whether you currently have access to transportation for travel to and from these sites, if needed.
15.Do you have access to transportation to get to… Yes or No
Yes
No
Need Transportation
Work
Childcare
School for child
School for self
Doctor/dentist
Social services
Other – Specify
Grocery Store
Fresh Vegetables and Fruits
16.Currently, what is your most pressing need for transportation?
Service for children under age 6: Early Care and Preschool Education:

Complete this section if children from birth to age 17 are living in the home.
17.Would you please tell me which of these resources would support you in your role as a parent? How about…
18.Currently, do you need information about preschool or childcare?
Services for School-aged Children (ages 6-17)
19.Do you have any children ages 6-17 living in the home?
20.Please tell us what services you need for your children ages 1-17
Section III --Complete this section for families with children under aged 6 with daycare needs.
Childcare and Child Development
21.Currently, what proportion of your children under age 6 attend any daycare or preschool?
22.Would you like for all of your children to be in childcare?
23.Why not? Is it because you…
24.What is the main reason you need daycare or preschool?
25.What kind of daycare or preschool does/do your child(ren) attend?
26.How do you pay for daycare for your child(ren)?
27.How much do you pay out of your funds weekly for each child?______________
28.Do you have any child(ren) under age 6 currently enrolled in daycare or preschool for children with a physical or emotional disability or special need?
29.What kind of special services does that daycare or preschool offer that your child(ren) needs?
30.What time of day does/do your child(ren) most often attend daycare or preschool?
31.What day(s) of the week does/do your child(ren) most often attend daycare or preschool (including a home setting)?
32.People choose childcare arrangements for a variety of reasons. Would you please tell me the most important reason you chose your current childcare provider for each child under age 6? Would you say it was the…
33.Do you have children for whom you have been unable to find satisfactory childcare?
34.As you have watched your child(ren) grow, please tell me whether you have been concerned that the child(ren) might be having difficulties in any of the following areas.
SECTION IV Access to Services and Resource Needed
35.Now please think about services or helping resources in general that are available in your community, not just those related to children. What is the best way to hear about these services? Would you say the best way is through…
36.Sometimes families experience problems getting the help they need. Have any of the following issues kept you and your child(ren) from getting needed services? How about…
SECTION V Demographics
37.Please tell me about yourself.
38.What race or ethnic background do you consider yourself?
39.How old were you on your last birthday?________ (age in yrs.)
40.What is the highest grade in school you have completed?
41.What is our marital status?
42.Are you the head of the household?
43.Are you currently pursuing additional education?
44.Currently, how many people (adults and children), including yourself, live in your home?
45.Number of adults 18 and older living in the home:
46.What are your household sources of income? (all income that comes into your household)
47.What is your annual household income (including all sources that you have access to)?
48.What is your employment status?
49.How long have you lived at your current address?