Screen Reader Mode Icon Check SCREEN READER MODE to make this survey compatible with screen readers. 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 Question Title * 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) OK Question Title * 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) OK Question Title * 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. OK Question Title * 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 OK Question Title * 5. Is your septic tank failing (verified by the Health Department)? Yes No Not Applicable OK Question Title * 6. Please provide your name and address if you would like to be contacted by Polk County. OK Please rank the importance and need of the following: OK Question Title * 7. Infrastructure Improvements Extremely important Very important Somewhat important Not at all important Drainage Drainage Extremely important Drainage Very important Drainage Somewhat important Drainage Not at all important Water/sewer Water/sewer Extremely important Water/sewer Very important Water/sewer Somewhat important Water/sewer Not at all important Sidewalk Sidewalk Extremely important Sidewalk Very important Sidewalk Somewhat important Sidewalk Not at all important Street lighting/ streetscapes Street lighting/ streetscapes Extremely important Street lighting/ streetscapes Very important Street lighting/ streetscapes Somewhat important Street lighting/ streetscapes Not at all important OK Question Title * 8. Neighborhood Services Extremely important Very important Somewhat important Not at all important Code enforcement /property maintenance Code enforcement /property maintenance Extremely important Code enforcement /property maintenance Very important Code enforcement /property maintenance Somewhat important Code enforcement /property maintenance Not at all important Demolition of unsafe buildings Demolition of unsafe buildings Extremely important Demolition of unsafe buildings Very important Demolition of unsafe buildings Somewhat important Demolition of unsafe buildings Not at all important Emergency home repairs Emergency home repairs Extremely important Emergency home repairs Very important Emergency home repairs Somewhat important Emergency home repairs Not at all important OK Question Title * 9. Housing Extremely important Very important Somewhat important Not at all important Residential Rehabilitation (repairs) Residential Rehabilitation (repairs) Extremely important Residential Rehabilitation (repairs) Very important Residential Rehabilitation (repairs) Somewhat important Residential Rehabilitation (repairs) Not at all important Homeownership assistance Homeownership assistance Extremely important Homeownership assistance Very important Homeownership assistance Somewhat important Homeownership assistance Not at all important Housing for disabled Housing for disabled Extremely important Housing for disabled Very important Housing for disabled Somewhat important Housing for disabled Not at all important Senior Housing Senior Housing Extremely important Senior Housing Very important Senior Housing Somewhat important Senior Housing Not at all important Single-Family Housing Single-Family Housing Extremely important Single-Family Housing Very important Single-Family Housing Somewhat important Single-Family Housing Not at all important Affordable Rental Housing Affordable Rental Housing Extremely important Affordable Rental Housing Very important Affordable Rental Housing Somewhat important Affordable Rental Housing Not at all important Fair Housing Fair Housing Extremely important Fair Housing Very important Fair Housing Somewhat important Fair Housing Not at all important Energy Efficient Improvements Energy Efficient Improvements Extremely important Energy Efficient Improvements Very important Energy Efficient Improvements Somewhat important Energy Efficient Improvements Not at all important OK Question Title * 10. Special Needs Services Extremely important Very important Somewhat important Not at all important Centers/Services for Disabled Centers/Services for Disabled Extremely important Centers/Services for Disabled Very important Centers/Services for Disabled Somewhat important Centers/Services for Disabled Not at all important Accessibility Improvements Accessibility Improvements Extremely important Accessibility Improvements Very important Accessibility Improvements Somewhat important Accessibility Improvements Not at all important Domestic Violence Domestic Violence Extremely important Domestic Violence Very important Domestic Violence Somewhat important Domestic Violence Not at all important Substance Abuse Substance Abuse Extremely important Substance Abuse Very important Substance Abuse Somewhat important Substance Abuse Not at all important Homeless Shelters Homeless Shelters Extremely important Homeless Shelters Very important Homeless Shelters Somewhat important Homeless Shelters Not at all important Neglected/Abused Children Neglected/Abused Children Extremely important Neglected/Abused Children Very important Neglected/Abused Children Somewhat important Neglected/Abused Children Not at all important OK Question Title * 11. Business & Jobs Extremely important Very important Somewhat important Not at all important Employment Training Employment Training Extremely important Employment Training Very important Employment Training Somewhat important Employment Training Not at all important Business Mentoring Business Mentoring Extremely important Business Mentoring Very important Business Mentoring Somewhat important Business Mentoring Not at all important Job Creation/Retention Job Creation/Retention Extremely important Job Creation/Retention Very important Job Creation/Retention Somewhat important Job Creation/Retention Not at all important Building Façade Improvements Building Façade Improvements Extremely important Building Façade Improvements Very important Building Façade Improvements Somewhat important Building Façade Improvements Not at all important OK Question Title * 12. Community Facilities Extremely important Very important Somewhat important Not at all important Senior Centers Senior Centers Extremely important Senior Centers Very important Senior Centers Somewhat important Senior Centers Not at all important Youth Centers Youth Centers Extremely important Youth Centers Very important Youth Centers Somewhat important Youth Centers Not at all important Childcare Centers Childcare Centers Extremely important Childcare Centers Very important Childcare Centers Somewhat important Childcare Centers Not at all important Parks & Recreation Facilities Parks & Recreation Facilities Extremely important Parks & Recreation Facilities Very important Parks & Recreation Facilities Somewhat important Parks & Recreation Facilities Not at all important OK Question Title * 13. Community Services Extremely important Very important Somewhat important Not at all important Senior Activities Senior Activities Extremely important Senior Activities Very important Senior Activities Somewhat important Senior Activities Not at all important Youth Activities Youth Activities Extremely important Youth Activities Very important Youth Activities Somewhat important Youth Activities Not at all important Child Care Services Child Care Services Extremely important Child Care Services Very important Child Care Services Somewhat important Child Care Services Not at all important Anti Crime Anti Crime Extremely important Anti Crime Very important Anti Crime Somewhat important Anti Crime Not at all important Health Services Health Services Extremely important Health Services Very important Health Services Somewhat important Health Services Not at all important Transportation Transportation Extremely important Transportation Very important Transportation Somewhat important Transportation Not at all important OK Question Title * 14. Have you ever experienced discrimination in housing? Yes No OK Question Title * 15. Who do you believe discriminated against you? Landlord/Property Manager Real Estate Agent Mortgage Insurer Not Applicable Other (please specify) OK Question Title * 16. On what basis do you believe you were discriminated against? Race Color National Origin Gender Disability Familial Status Not Applicable Other (please specify) OK Question Title * 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 OK Question Title * 18. Do you own or rent your home? Own Rent Other (please specify) OK Question Title * 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) OK Question Title * 20. What is your zip code? OK Question Title * 21. Please provide additional comments: OK DONE
