Screen Reader Mode Icon Check SCREEN READER MODE to make this survey compatible with screen readers. Pilot Rock Fire District external survey Question Title * 1. Do you have any of the following in your residence that are operational? (Check all that apply) Smoke Alarms Fire Extinguisher Fire Sprinkler system Carbon Monoxide Detector OK Question Title * 2. Do you have a current home fire escape plan and do you practice it? Yes to both Yes, but don't or haven't practiced it. No OK Question Title * 3. Has anyone in your household had any recent medical training (past 1-2 years) or hold any current medical certifications or licenses? (check all that apply) CPR (cardiopulmonary resuscitation) First Aid Community Emergency Response Team (CERT) Other (MD, DO, RN, EMT, etc.) OK Question Title * 4. Are you prepared to be without water, electricity, heat and food for up to 72 hours in the event of a disaster? Yes No OK Question Title * 5. Which of the following describes your home's heat source(s) (check all that apply) Radiant (baseboard heat, portable space heaters) Forced air / central heat (warm is pushed with a fan through the air ducts) Alternative heat source (wood stove, pellet stove) OK Question Title * 6. Is your house address clearly visible on your house or driveway during daylight and in the dark? Yes No OK Question Title * 7. Please check the box on how you would rate (or how you perceive) the effectiveness of Pilot Rock Fire District in the following areas. Excellent Good Average Below Average Poor Don't know Response to fire emergencies Response to fire emergencies Excellent Response to fire emergencies Good Response to fire emergencies Average Response to fire emergencies Below Average Response to fire emergencies Poor Response to fire emergencies Don't know Response to medical emergencies Response to medical emergencies Excellent Response to medical emergencies Good Response to medical emergencies Average Response to medical emergencies Below Average Response to medical emergencies Poor Response to medical emergencies Don't know Response to other emergencies (technical rescue, hazmat) Response to other emergencies (technical rescue, hazmat) Excellent Response to other emergencies (technical rescue, hazmat) Good Response to other emergencies (technical rescue, hazmat) Average Response to other emergencies (technical rescue, hazmat) Below Average Response to other emergencies (technical rescue, hazmat) Poor Response to other emergencies (technical rescue, hazmat) Don't know Public education about fire safety Public education about fire safety Excellent Public education about fire safety Good Public education about fire safety Average Public education about fire safety Below Average Public education about fire safety Poor Public education about fire safety Don't know Professionalism of Fire District personnel Professionalism of Fire District personnel Excellent Professionalism of Fire District personnel Good Professionalism of Fire District personnel Average Professionalism of Fire District personnel Below Average Professionalism of Fire District personnel Poor Professionalism of Fire District personnel Don't know Cost-effectiveness Cost-effectiveness Excellent Cost-effectiveness Good Cost-effectiveness Average Cost-effectiveness Below Average Cost-effectiveness Poor Cost-effectiveness Don't know Public relations Public relations Excellent Public relations Good Public relations Average Public relations Below Average Public relations Poor Public relations Don't know OK Question Title * 8. Have you interacted with Fire District personnel in the past year? Yes No OK Question Title * 9. If YES to question #8 above which one of the following would you classify your interaction? (Please check all that apply) Emergency (911 activation) Non-emergency Public Education Program Community Event Other (please specify) OK Question Title * 10. Do you think the Fire District needs to improve its customer service? Yes No If YES, how can the Fire District improve its customer service? OK Question Title * 11. Which of the following emergency services do you think the Fire District provides? (check all that apply) Fire response (structure fires, grass fires, vehicle fires etc) Emergency medical response Response to Hazardous Materials incidents Water rescue Confined space rescue OK Question Title * 12. Which emergency service do you think is most valuable to the community? Fire Response Emergency Medical Response Response to Hazardous Materials incidents Technical rescue incidents (water rescue, confined space, rope rescue) OK Question Title * 13. Which of the following non-emergency services do you think the Fire District provides? (check all that apply) Emergency preparedness planning Station tours Home wildland inspections Public education in the schools Smoke detector canvassing Intervention with youth who show fire setting behaviors Inspection of buildings for code violations Control and removal of safety hazards in the community OK Question Title * 14. Which non-emergency service do you think is most valuable to your community? Emergency preparedness planning Station tours Home wildland inspections Public education in the schools Smoke detector canvassing Intervention with youth who show fire setting behaviors Inspections of buildings for code violations Control and removal of safety hazards in the community Car seat inspections and installations Other (please specify) OK NEXT