Accompanying Documents for Housing Providers LGBT designation

Question Title

* 1. Has your staff received training in the past year on LGBT-specific issues?
If yes, please provide the following information: Title of Training(s), Date(s), Number of Staff
Attended Position of Staff within Facility

Question Title

* 2. If no, please answer the following question: Have 60% of your current staff received
LGBT training at some point during their employment at your agency? If yes, please
provide the following information: Title of Training(s), Date(s), Number of Staff Attended Role
of Staff within Facility

Question Title

* 3. Do your intake forms include language or options for unmarried couples. (i.e.,
"partner", or "relationship status"?

If Yes please upload a copy of intake form below

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 4. Is your senior living environment doing anything to educate or
complement existing knowledge on diversity issues? (no accompanying
documents required)

Yes

Question Title

* 5. Would your agency be interested in credential training known as sageCARE?
(No points will be received for this question and no accompanying documents
required)

Yes

Question Title

* 6. Does your non-discrimination policy include sexual identity?

If yes, please upload a copy of the nondiscrimination policy below

DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only.

Choose File

Question Title

* 7. Does your non-discrimination policy for staff include gender identity or expression?

If Yes, please upload a copy of the nondiscrimination policy below

DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only.

Choose File

Question Title

* 8. Does your non-discrimination policy for residents include gender identity or expression?

If yes, please upload a copy of the nondiscrimination policy below

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 9. Does your resident bill of rights or lease agreement include sexual identity and gender
identity/expression?

If yes, please upload a copy of this document below

DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only.

Choose File

Question Title

* 10. Does your senior housing community have a process in place for how to handle residents making discriminatory comments to one another?

If yes, please upload a copy of this document below

DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only.

Choose File

Question Title

* 11. Does your senior housing community have a process in place on how to handle staff making discriminatory comments to residents?

If Yes please upload a copy of the process below

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 12. Do any of your senior housing promotional materials contain images of LGBT individuals?
If Yes, does your community provide outreach, advertising/marketing to LGBT
people?

Please upload examples of your outreach materials below

DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only.

Choose File

Question Title

* 13. Does your senior housing community offer LGBT programming, services, or events
for your residents?
If Yes, do these include LGBT themed programming, services and events
for your residents?

Please upload examples below

DOCX, DOC, JPG, GIF, JPEG, PDF, PNG file types only.

Choose File

Question Title

* 14. Does your senior housing community post any LGBT flyers, media or other resources in a public space?

If Yes please provide upload a copy of your flyer below

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

Question Title

* 1. Has your staff received training in the past year on LGBT-specific issues?If yes, please provide the following information: Title of Training(s), Date(s), Number of StaffAttended Position of Staff within Facility

Question Title

* 2. If no, please answer the following question: Have 60% of your current staff receivedLGBT training at some point during their employment at your agency? If yes, pleaseprovide the following information: Title of Training(s), Date(s), Number of Staff Attended Roleof Staff within Facility

Question Title

* 3. Do your intake forms include language or options for unmarried couples. (i.e.,"partner", or "relationship status"?

Question Title

* 4. Is your senior living environment doing anything to educate orcomplement existing knowledge on diversity issues? (no accompanyingdocuments required)

Question Title

* 5. Would your agency be interested in credential training known as sageCARE?(No points will be received for this question and no accompanying documentsrequired)

Question Title

* 6. Does your non-discrimination policy include sexual identity?

Question Title

* 7. Does your non-discrimination policy for staff include gender identity or expression?

Question Title

* 8. Does your non-discrimination policy for residents include gender identity or expression?

Question Title

* 9. Does your resident bill of rights or lease agreement include sexual identity and genderidentity/expression?

Question Title

* 10. Does your senior housing community have a process in place for how to handle residents making discriminatory comments to one another?

Question Title

* 11. Does your senior housing community have a process in place on how to handle staff making discriminatory comments to residents?

Question Title

* 12. Do any of your senior housing promotional materials contain images of LGBT individuals? If Yes, does your community provide outreach, advertising/marketing to LGBTpeople?

Question Title

* 13. Does your senior housing community offer LGBT programming, services, or eventsfor your residents? If Yes, do these include LGBT themed programming, services and eventsfor your residents?

Question Title

* 14. Does your senior housing community post any LGBT flyers, media or other resources in a public space?

* 1. Has your staff received training in the past year on LGBT-specific issues?
If yes, please provide the following information: Title of Training(s), Date(s), Number of Staff
Attended Position of Staff within Facility

* 2. If no, please answer the following question: Have 60% of your current staff received
LGBT training at some point during their employment at your agency? If yes, please
provide the following information: Title of Training(s), Date(s), Number of Staff Attended Role
of Staff within Facility

* 3. Do your intake forms include language or options for unmarried couples. (i.e.,
"partner", or "relationship status"?

* 4. Is your senior living environment doing anything to educate or
complement existing knowledge on diversity issues? (no accompanying
documents required)

* 5. Would your agency be interested in credential training known as sageCARE?
(No points will be received for this question and no accompanying documents
required)

* 9. Does your resident bill of rights or lease agreement include sexual identity and gender
identity/expression?

* 12. Do any of your senior housing promotional materials contain images of LGBT individuals?
If Yes, does your community provide outreach, advertising/marketing to LGBT
people?

* 13. Does your senior housing community offer LGBT programming, services, or events
for your residents?
If Yes, do these include LGBT themed programming, services and events
for your residents?