City of Santa Maria - ADA Self-Evaluation and Transition Plan Survey

COMMUNITY OUTREACH QUESTIONNAIRE #1

This questionnaire is also available, by request, in an alternate format. Please contact the City Manager’s Office at (805) 925-0951 or dsummerfield@cityofsantamaria.org to request a different format as a request for accommodations under the Americans with Disabilities Act (ADA).

The City of Santa Maria is gathering feedback as part of the process to develop an ADA Self-Evaluation and Transition Plan (SETP) for City facilities, in compliance with the Americans with Disabilities Act (ADA).

This questionnaire is one of several ways that the City is identifying and addressing accessibility needs to improve our programs, services, and activities. Your input will help strengthen the final recommendations for policies and procedures.

1.Have you encountered physical barriers or difficulties in accessing City facilities (parks, parking lots, buildings, sidewalk or bus stops, etc.)? (Select Yes or No below)
(Required.)

Yes

If yes, please describe the facility and the condition(s) or situation(s) that caused the difficulty.

2.Have you encountered policies or practices that make it difficult to access City programs, services or activities? (Select Yes or No below)
(Required.)

Yes

If yes, please describe the policy or practice and its impact.

3.Have you encountered barriers or difficulties at City facilities that prevented or complicated access to programs, activities or services provided? (Select Yes or No below)
(Required.)

Yes

If yes, please describe the situation(s), the response and/or outcome (if any).

4.Have you encountered barriers or difficulties using the City website or web pages? (Select Yes or No below)
(Required.)

Yes

If yes, please describe the situation(s), the response and/or outcome (if any).

5.Are you aware of any successful solutions to accessibility issues that have been used at other facilities that could serve as a model for the City? (Comment box provided below)(Required.)

6.Do you have other suggestions for improving accessibility or mobility around or at City facilities to support full participation in programs, services or services? (Comment box provided below)(Required.)

Thank you for taking the time to fill out this questionnaire!

We would appreciate the completion of the information below. This information is optional. If completed, it will provide our team with the opportunity to contact you for further comment and to notify you of future disability-related events.

7.Please select below

My responses may be published

8.Please fill in your contact information below. Order of contact information is as follows: Name, Address, Phone Number, and Email

Name

Address

Phone Number

Email Address

9.Are you affiliated with any organizations that specifically serve people with disabilities (example: California Council for the Blind, Etc.)? Please list any affiliations. (Comment box provided below)