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Polk County Community Needs Assessment Survey
Polk County wants
YOU
to have a voice in
how the Federal Grants are invested
!
Please assist us by filling out this survey.
OK
1.
Please check three (3) improvements below the County should prioritize.
Resurfacing roads
More sidewalks
Senior living facilities
More parks and trails
More street lighting
Access to high-speed Internet
Other (please specify)
2.
How reliable do you find your internet connection at home?
Very reliable, the connection never drops
Speed varies from time to time, but the connection never drops
Speed varies considerably and the connection regularly drops
Very poor connection, which drops out all the time
I do not have internet at home.
Other (please specify)
3.
Please check if the following apply to your home:
Water and sewage from toilets, drains, and sinks are backing up into the home
Bathtubs, showers, and sinks drain very slowly.
Bad odors around the septic tank or drain field.
Bright green, spongy lush grass over the septic tank or drain field, even during dry weather.
4.
Would you consider connecting to the central wastewater system if connection costs were waived? This would mean your home would no longer rely on a septic tank.
Yes
No
Not Applicable
5.
Is your septic tank failing (verified by the Health Department)?
Yes
No
Not Applicable
6.
Please provide your name and address if you would like to be contacted by Polk County.
Please rank the importance and need of the following:
7.
Infrastructure Improvements
Extremely important
Very important
Somewhat important
Not at all important
Drainage
Extremely important
Very important
Somewhat important
Not at all important
Water/sewer
Extremely important
Very important
Somewhat important
Not at all important
Sidewalk
Extremely important
Very important
Somewhat important
Not at all important
Street lighting/ streetscapes
Extremely important
Very important
Somewhat important
Not at all important
8.
Neighborhood Services
Extremely important
Very important
Somewhat important
Not at all important
Code enforcement /property maintenance
Extremely important
Very important
Somewhat important
Not at all important
Demolition of unsafe buildings
Extremely important
Very important
Somewhat important
Not at all important
Emergency home repairs
Extremely important
Very important
Somewhat important
Not at all important
9.
Housing
Extremely important
Very important
Somewhat important
Not at all important
Residential Rehabilitation (repairs)
Extremely important
Very important
Somewhat important
Not at all important
Homeownership assistance
Extremely important
Very important
Somewhat important
Not at all important
Housing for disabled
Extremely important
Very important
Somewhat important
Not at all important
Senior Housing
Extremely important
Very important
Somewhat important
Not at all important
Single-Family Housing
Extremely important
Very important
Somewhat important
Not at all important
Affordable Rental Housing
Extremely important
Very important
Somewhat important
Not at all important
Fair Housing
Extremely important
Very important
Somewhat important
Not at all important
Energy Efficient Improvements
Extremely important
Very important
Somewhat important
Not at all important
10.
Special Needs Services
Extremely important
Very important
Somewhat important
Not at all important
Centers/Services for Disabled
Extremely important
Very important
Somewhat important
Not at all important
Accessibility Improvements
Extremely important
Very important
Somewhat important
Not at all important
Domestic Violence
Extremely important
Very important
Somewhat important
Not at all important
Substance Abuse
Extremely important
Very important
Somewhat important
Not at all important
Homeless Shelters
Extremely important
Very important
Somewhat important
Not at all important
Neglected/Abused Children
Extremely important
Very important
Somewhat important
Not at all important
11.
Business & Jobs
Extremely important
Very important
Somewhat important
Not at all important
Employment Training
Extremely important
Very important
Somewhat important
Not at all important
Business Mentoring
Extremely important
Very important
Somewhat important
Not at all important
Job Creation/Retention
Extremely important
Very important
Somewhat important
Not at all important
Building Façade Improvements
Extremely important
Very important
Somewhat important
Not at all important
12.
Community Facilities
Extremely important
Very important
Somewhat important
Not at all important
Senior Centers
Extremely important
Very important
Somewhat important
Not at all important
Youth Centers
Extremely important
Very important
Somewhat important
Not at all important
Childcare Centers
Extremely important
Very important
Somewhat important
Not at all important
Parks & Recreation Facilities
Extremely important
Very important
Somewhat important
Not at all important
13.
Community Services
Extremely important
Very important
Somewhat important
Not at all important
Senior Activities
Extremely important
Very important
Somewhat important
Not at all important
Youth Activities
Extremely important
Very important
Somewhat important
Not at all important
Child Care Services
Extremely important
Very important
Somewhat important
Not at all important
Anti Crime
Extremely important
Very important
Somewhat important
Not at all important
Health Services
Extremely important
Very important
Somewhat important
Not at all important
Transportation
Extremely important
Very important
Somewhat important
Not at all important
14.
Have you ever experienced discrimination in housing?
Yes
No
15.
Who do you believe discriminated against you?
Landlord/Property Manager
Real Estate Agent
Mortgage Insurer
Not Applicable
Other (please specify)
16.
On what basis do you believe you were discriminated against?
Race
Color
National Origin
Gender
Disability
Familial Status
Not Applicable
Other (please specify)
17.
If you believe you have been discriminated against, have you reported the incident?
I haven’t been discriminated against
No, don’t know where to report
No, don’t believe it makes a difference
No, afraid of retaliation
No, too much trouble
Yes
18.
Do you own or rent your home?
Own
Rent
Other (please specify)
19.
How concerned are you about your community being impacted by a natural disaster or man-made hazard event?
Extremely concerned
Somewhat concerned
Not concerned
Depends on the hazard
Other (please specify)
20.
What is your zip code?
21.
Please provide additional comments:
Current Progress,
0 of 21 answered
