TCCA Community Assessment Survey-Key Officials

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* 1. Which of the following best describes you? (Check all that apply)

☐ Board/Committee of a Group or Organization

☐ Public Official, Elected/Appointed (City/Town, School District, County, State Legislature)

☐ Community Betterment Group Executive/Employee (Chamber, Economic Development, Church, Civic Group/Club

☐ Member of the Business Community

☐ Human/Social Services Executive/Employee

☐ Member of the General Public/Community

☐ Other (please specify)

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* 2. Where are you currently employed?

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* 3. What is your position with your employer?

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* 4. What organization(s)/group(s) are you involved with in your community? Please provide the name below.

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* 5. In what zip code do you reside? (enter the 5-digit zip code)

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* 6. What communities do you represent as a participant in this survey? (i.e., work, volunteer, civic, or other activities) Please list all communities. If county or area wide, please list the county.

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* 7. Please describe your awareness and knowledge of the needs or
conditions that exist in the community in which you live and/or work. The goal is to use your answers to determine what is most needed in your
community. Please answer following questions

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient-There is a great need for this resource 5
Helping Individuals Find Full and Part time Jobs	Helping Individuals Find Full and Part time Jobs Sufficient 1	Helping Individuals Find Full and Part time Jobs 2	Helping Individuals Find Full and Part time Jobs Sufficient Somewhat 3	Helping Individuals Find Full and Part time Jobs 4	Helping Individuals Find Full and Part time Jobs Not Sufficient-There is a great need for this resource 5	Helping Individuals Find Full and Part time Jobs	Helping Individuals Find Full and Part time Jobs	Helping Individuals Find Full and Part time Jobs	Helping Individuals Find Full and Part time Jobs
Employment that includes Benefits-Health/Dental, Retirement, Sick Leave	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave Sufficient 1	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave 2	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave Sufficient Somewhat 3	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave 4	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave Not Sufficient-There is a great need for this resource 5	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave	Employment that includes Benefits-Health/Dental, Retirement, Sick Leave
Job Interest Testing and Career Counseling	Job Interest Testing and Career Counseling Sufficient 1	Job Interest Testing and Career Counseling 2	Job Interest Testing and Career Counseling Sufficient Somewhat 3	Job Interest Testing and Career Counseling 4	Job Interest Testing and Career Counseling Not Sufficient-There is a great need for this resource 5	Job Interest Testing and Career Counseling	Job Interest Testing and Career Counseling	Job Interest Testing and Career Counseling	Job Interest Testing and Career Counseling
Help with Resume Writing and Interviewing Skills	Help with Resume Writing and Interviewing Skills Sufficient 1	Help with Resume Writing and Interviewing Skills 2	Help with Resume Writing and Interviewing Skills Sufficient Somewhat 3	Help with Resume Writing and Interviewing Skills 4	Help with Resume Writing and Interviewing Skills Not Sufficient-There is a great need for this resource 5	Help with Resume Writing and Interviewing Skills	Help with Resume Writing and Interviewing Skills	Help with Resume Writing and Interviewing Skills	Help with Resume Writing and Interviewing Skills
Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient Sufficient 1	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient 2	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient Sufficient Somewhat 3	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient 4	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient Not Sufficient-There is a great need for this resource 5	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient	Clothes to Wear for Interviewing and/ or On-the-Job Not Sufficient
Information and/or Loan to start a business	Information and/or Loan to start a business Sufficient 1	Information and/or Loan to start a business 2	Information and/or Loan to start a business Sufficient Somewhat 3	Information and/or Loan to start a business 4	Information and/or Loan to start a business Not Sufficient-There is a great need for this resource 5	Information and/or Loan to start a business	Information and/or Loan to start a business	Information and/or Loan to start a business	Information and/or Loan to start a business
Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.)	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.) Sufficient 1	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.) 2	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.) Sufficient Somewhat 3	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.) 4	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.) Not Sufficient-There is a great need for this resource 5	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.)	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.)	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.)	Support to stay on the Job (i.e. Mentors, Employment Counselors, etc.)
Transportation to and from	Transportation to and from Sufficient 1	Transportation to and from 2	Transportation to and from Sufficient Somewhat 3	Transportation to and from 4	Transportation to and from Not Sufficient-There is a great need for this resource 5	Transportation to and from	Transportation to and from	Transportation to and from	Transportation to and from

Other (please specify)

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* 8. Regarding the topic of EDUCATION as it relates to your community do
you believe there is sufficient amount of access and availability to
resources that can address the following items?

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient There is a great need for this resource 5
Basic Skills Training	Basic Skills Training Sufficient 1	Basic Skills Training 2	Basic Skills Training Sufficient Somewhat 3	Basic Skills Training 4	Basic Skills Training Not Sufficient There is a great need for this resource 5
GED/ABE	GED/ABE Sufficient 1	GED/ABE 2	GED/ABE Sufficient Somewhat 3	GED/ABE 4	GED/ABE Not Sufficient There is a great need for this resource 5
Computer Skills	Computer Skills Sufficient 1	Computer Skills 2	Computer Skills Sufficient Somewhat 3	Computer Skills 4	Computer Skills Not Sufficient There is a great need for this resource 5
English as a Second Language	English as a Second Language Sufficient 1	English as a Second Language 2	English as a Second Language Sufficient Somewhat 3	English as a Second Language 4	English as a Second Language Not Sufficient There is a great need for this resource 5
High School Diploma	High School Diploma Sufficient 1	High School Diploma 2	High School Diploma Sufficient Somewhat 3	High School Diploma 4	High School Diploma Not Sufficient There is a great need for this resource 5
Special Trade/ Vocational Training	Special Trade/ Vocational Training Sufficient 1	Special Trade/ Vocational Training 2	Special Trade/ Vocational Training Sufficient Somewhat 3	Special Trade/ Vocational Training 4	Special Trade/ Vocational Training Not Sufficient There is a great need for this resource 5
College Degree	College Degree Sufficient 1	College Degree 2	College Degree Sufficient Somewhat 3	College Degree 4	College Degree Not Sufficient There is a great need for this resource 5
Help Returning to College as an Older Student	Help Returning to College as an Older Student Sufficient 1	Help Returning to College as an Older Student 2	Help Returning to College as an Older Student Sufficient Somewhat 3	Help Returning to College as an Older Student 4	Help Returning to College as an Older Student Not Sufficient There is a great need for this resource 5
Transportation To and From School (Post-Secondary and Vocational Schools	Transportation To and From School (Post-Secondary and Vocational Schools Sufficient 1	Transportation To and From School (Post-Secondary and Vocational Schools 2	Transportation To and From School (Post-Secondary and Vocational Schools Sufficient Somewhat 3	Transportation To and From School (Post-Secondary and Vocational Schools 4	Transportation To and From School (Post-Secondary and Vocational Schools Not Sufficient There is a great need for this resource 5
Help Obtaining Financial Aid to Attend College or Vocational Training School	Help Obtaining Financial Aid to Attend College or Vocational Training School Sufficient 1	Help Obtaining Financial Aid to Attend College or Vocational Training School 2	Help Obtaining Financial Aid to Attend College or Vocational Training School Sufficient Somewhat 3	Help Obtaining Financial Aid to Attend College or Vocational Training School 4	Help Obtaining Financial Aid to Attend College or Vocational Training School Not Sufficient There is a great need for this resource 5

Other (please specify)

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* 9. Regarding the topic of FOOD AND NUTRITION as it relates to your
community, do you believe there is a sufficient amount of access and
availability to resources that can address the following items?

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient There is a great need for this resource 5
Access to a Well Balanced, Nutritious Meal	Access to a Well Balanced, Nutritious Meal Sufficient 1	Access to a Well Balanced, Nutritious Meal 2	Access to a Well Balanced, Nutritious Meal Sufficient Somewhat 3	Access to a Well Balanced, Nutritious Meal 4	Access to a Well Balanced, Nutritious Meal Not Sufficient There is a great need for this resource 5
Tips on How to shop for and Prepare Well- Balanced Nutritious Meals with Limited Income	Tips on How to shop for and Prepare Well- Balanced Nutritious Meals with Limited Income Sufficient 1	Tips on How to shop for and Prepare Well- Balanced Nutritious Meals with Limited Income 2	Tips on How to shop for and Prepare Well- Balanced Nutritious Meals with Limited Income Sufficient Somewhat 3	Tips on How to shop for and Prepare Well- Balanced Nutritious Meals with Limited Income 4	Tips on How to shop for and Prepare Well- Balanced Nutritious Meals with Limited Income Not Sufficient There is a great need for this resource 5
Access to Food Shelters/ Pantries	Access to Food Shelters/ Pantries Sufficient 1	Access to Food Shelters/ Pantries 2	Access to Food Shelters/ Pantries Sufficient Somewhat 3	Access to Food Shelters/ Pantries 4	Access to Food Shelters/ Pantries Not Sufficient There is a great need for this resource 5
Help Obtaining Free or Reduced School Meals	Help Obtaining Free or Reduced School Meals Sufficient 1	Help Obtaining Free or Reduced School Meals 2	Help Obtaining Free or Reduced School Meals Sufficient Somewhat 3	Help Obtaining Free or Reduced School Meals 4	Help Obtaining Free or Reduced School Meals Not Sufficient There is a great need for this resource 5
Summer Lunch Programs	Summer Lunch Programs Sufficient 1	Summer Lunch Programs 2	Summer Lunch Programs Sufficient Somewhat 3	Summer Lunch Programs 4	Summer Lunch Programs Not Sufficient There is a great need for this resource 5
Assistance Applying for Food Stamps	Assistance Applying for Food Stamps Sufficient 1	Assistance Applying for Food Stamps 2	Assistance Applying for Food Stamps Sufficient Somewhat 3	Assistance Applying for Food Stamps 4	Assistance Applying for Food Stamps Not Sufficient There is a great need for this resource 5
Free Community Meals	Free Community Meals Sufficient 1	Free Community Meals 2	Free Community Meals Sufficient Somewhat 3	Free Community Meals 4	Free Community Meals Not Sufficient There is a great need for this resource 5
Access to Grocery Stores	Access to Grocery Stores Sufficient 1	Access to Grocery Stores 2	Access to Grocery Stores Sufficient Somewhat 3	Access to Grocery Stores 4	Access to Grocery Stores Not Sufficient There is a great need for this resource 5
Transportation to Grocery Stores, Food Shelters/ Pantries	Transportation to Grocery Stores, Food Shelters/ Pantries Sufficient 1	Transportation to Grocery Stores, Food Shelters/ Pantries 2	Transportation to Grocery Stores, Food Shelters/ Pantries Sufficient Somewhat 3	Transportation to Grocery Stores, Food Shelters/ Pantries 4	Transportation to Grocery Stores, Food Shelters/ Pantries Not Sufficient There is a great need for this resource 5

Other (please specify)

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* 10. Regarding the topic of FINANCIAL AND LEGAL SERVICES as it relates
to your community, do you believe there is sufficient amount of access
and availability to resources that can address the following items?

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient-There is a great need for this resource 5
Starting a Savings Plan	Starting a Savings Plan Sufficient 1	Starting a Savings Plan 2	Starting a Savings Plan Sufficient Somewhat 3	Starting a Savings Plan 4	Starting a Savings Plan Not Sufficient-There is a great need for this resource 5
Understand and Filling out Taxes	Understand and Filling out Taxes Sufficient 1	Understand and Filling out Taxes 2	Understand and Filling out Taxes Sufficient Somewhat 3	Understand and Filling out Taxes 4	Understand and Filling out Taxes Not Sufficient-There is a great need for this resource 5
Budgeting and Managing Money	Budgeting and Managing Money Sufficient 1	Budgeting and Managing Money 2	Budgeting and Managing Money Sufficient Somewhat 3	Budgeting and Managing Money 4	Budgeting and Managing Money Not Sufficient-There is a great need for this resource 5
Resolving Bad Debt	Resolving Bad Debt Sufficient 1	Resolving Bad Debt 2	Resolving Bad Debt Sufficient Somewhat 3	Resolving Bad Debt 4	Resolving Bad Debt Not Sufficient-There is a great need for this resource 5
Understanding, Establishing, and Restoring Credit	Understanding, Establishing, and Restoring Credit Sufficient 1	Understanding, Establishing, and Restoring Credit 2	Understanding, Establishing, and Restoring Credit Sufficient Somewhat 3	Understanding, Establishing, and Restoring Credit 4	Understanding, Establishing, and Restoring Credit Not Sufficient-There is a great need for this resource 5
Completing a Will/Estate Planning Document	Completing a Will/Estate Planning Document Sufficient 1	Completing a Will/Estate Planning Document 2	Completing a Will/Estate Planning Document Sufficient Somewhat 3	Completing a Will/Estate Planning Document 4	Completing a Will/Estate Planning Document Not Sufficient-There is a great need for this resource 5
Understanding Living Willis/Health Care Directives	Understanding Living Willis/Health Care Directives Sufficient 1	Understanding Living Willis/Health Care Directives 2	Understanding Living Willis/Health Care Directives Sufficient Somewhat 3	Understanding Living Willis/Health Care Directives 4	Understanding Living Willis/Health Care Directives Not Sufficient-There is a great need for this resource 5
Information on Custody/Guardian and Visitation Rights	Information on Custody/Guardian and Visitation Rights Sufficient 1	Information on Custody/Guardian and Visitation Rights 2	Information on Custody/Guardian and Visitation Rights Sufficient Somewhat 3	Information on Custody/Guardian and Visitation Rights 4	Information on Custody/Guardian and Visitation Rights Not Sufficient-There is a great need for this resource 5
Retirement and Long-Term Care Planning	Retirement and Long-Term Care Planning Sufficient 1	Retirement and Long-Term Care Planning 2	Retirement and Long-Term Care Planning Sufficient Somewhat 3	Retirement and Long-Term Care Planning 4	Retirement and Long-Term Care Planning Not Sufficient-There is a great need for this resource 5
Understanding of Applying for Social Security	Understanding of Applying for Social Security Sufficient 1	Understanding of Applying for Social Security 2	Understanding of Applying for Social Security Sufficient Somewhat 3	Understanding of Applying for Social Security 4	Understanding of Applying for Social Security Not Sufficient-There is a great need for this resource 5
Establishing or Collecting Child Support	Establishing or Collecting Child Support Sufficient 1	Establishing or Collecting Child Support 2	Establishing or Collecting Child Support Sufficient Somewhat 3	Establishing or Collecting Child Support 4	Establishing or Collecting Child Support Not Sufficient-There is a great need for this resource 5
Accessing Veterans Benefits	Accessing Veterans Benefits Sufficient 1	Accessing Veterans Benefits 2	Accessing Veterans Benefits Sufficient Somewhat 3	Accessing Veterans Benefits 4	Accessing Veterans Benefits Not Sufficient-There is a great need for this resource 5
Completing Applications for Public Assistance	Completing Applications for Public Assistance Sufficient 1	Completing Applications for Public Assistance 2	Completing Applications for Public Assistance Sufficient Somewhat 3	Completing Applications for Public Assistance 4	Completing Applications for Public Assistance Not Sufficient-There is a great need for this resource 5
Knowing Where to Go for Public Assistance	Knowing Where to Go for Public Assistance Sufficient 1	Knowing Where to Go for Public Assistance 2	Knowing Where to Go for Public Assistance Sufficient Somewhat 3	Knowing Where to Go for Public Assistance 4	Knowing Where to Go for Public Assistance Not Sufficient-There is a great need for this resource 5

Other (please specify)

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* 11. Regarding the topic of HOUSING as it relates to your community, do you believe there is a sufficient amount of access and availability to
resources that can address the following items?

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient-There is a great need for this resource
Housing for Large Families	Housing for Large Families Sufficient 1	Housing for Large Families 2	Housing for Large Families Sufficient Somewhat 3	Housing for Large Families 4	Housing for Large Families Not Sufficient-There is a great need for this resource
Financial Help with Damage/Security Deposits	Financial Help with Damage/Security Deposits Sufficient 1	Financial Help with Damage/Security Deposits 2	Financial Help with Damage/Security Deposits Sufficient Somewhat 3	Financial Help with Damage/Security Deposits 4	Financial Help with Damage/Security Deposits Not Sufficient-There is a great need for this resource
Advice on How to Purchase a home	Advice on How to Purchase a home Sufficient 1	Advice on How to Purchase a home 2	Advice on How to Purchase a home Sufficient Somewhat 3	Advice on How to Purchase a home 4	Advice on How to Purchase a home Not Sufficient-There is a great need for this resource
Help with Payments for Home Utility Expenses	Help with Payments for Home Utility Expenses Sufficient 1	Help with Payments for Home Utility Expenses 2	Help with Payments for Home Utility Expenses Sufficient Somewhat 3	Help with Payments for Home Utility Expenses 4	Help with Payments for Home Utility Expenses Not Sufficient-There is a great need for this resource
Help with Household Chores (Mowing, Minor Repairs, Painting)	Help with Household Chores (Mowing, Minor Repairs, Painting) Sufficient 1	Help with Household Chores (Mowing, Minor Repairs, Painting) 2	Help with Household Chores (Mowing, Minor Repairs, Painting) Sufficient Somewhat 3	Help with Household Chores (Mowing, Minor Repairs, Painting) 4	Help with Household Chores (Mowing, Minor Repairs, Painting) Not Sufficient-There is a great need for this resource
Help with Making Changes in Home Layout to Better Meet the Needs of Disabled Residents (door widths, grab bars, ramps, etc.)	Help with Making Changes in Home Layout to Better Meet the Needs of Disabled Residents (door widths, grab bars, ramps, etc.) Sufficient 1	Help with Making Changes in Home Layout to Better Meet the Needs of Disabled Residents (door widths, grab bars, ramps, etc.) 2	Help with Making Changes in Home Layout to Better Meet the Needs of Disabled Residents (door widths, grab bars, ramps, etc.) Sufficient Somewhat 3	Help with Making Changes in Home Layout to Better Meet the Needs of Disabled Residents (door widths, grab bars, ramps, etc.) 4	Help with Making Changes in Home Layout to Better Meet the Needs of Disabled Residents (door widths, grab bars, ramps, etc.) Not Sufficient-There is a great need for this resource
Affordable Housing that is Healthy and Safe	Affordable Housing that is Healthy and Safe Sufficient 1	Affordable Housing that is Healthy and Safe 2	Affordable Housing that is Healthy and Safe Sufficient Somewhat 3	Affordable Housing that is Healthy and Safe 4	Affordable Housing that is Healthy and Safe Not Sufficient-There is a great need for this resource
Subsidized Rental Housing	Subsidized Rental Housing Sufficient 1	Subsidized Rental Housing 2	Subsidized Rental Housing Sufficient Somewhat 3	Subsidized Rental Housing 4	Subsidized Rental Housing Not Sufficient-There is a great need for this resource
Transitional/ Emergency Housing for Homeless People	Transitional/ Emergency Housing for Homeless People Sufficient 1	Transitional/ Emergency Housing for Homeless People 2	Transitional/ Emergency Housing for Homeless People Sufficient Somewhat 3	Transitional/ Emergency Housing for Homeless People 4	Transitional/ Emergency Housing for Homeless People Not Sufficient-There is a great need for this resource
Housing with Supportive Services ( Case Manager, Assisted Living, etc.)	Housing with Supportive Services ( Case Manager, Assisted Living, etc.) Sufficient 1	Housing with Supportive Services ( Case Manager, Assisted Living, etc.) 2	Housing with Supportive Services ( Case Manager, Assisted Living, etc.) Sufficient Somewhat 3	Housing with Supportive Services ( Case Manager, Assisted Living, etc.) 4	Housing with Supportive Services ( Case Manager, Assisted Living, etc.) Not Sufficient-There is a great need for this resource
Housing for Victims of Domestic Violence	Housing for Victims of Domestic Violence Sufficient 1	Housing for Victims of Domestic Violence 2	Housing for Victims of Domestic Violence Sufficient Somewhat 3	Housing for Victims of Domestic Violence 4	Housing for Victims of Domestic Violence Not Sufficient-There is a great need for this resource
Housing that Accepts People with: Chemical Dependency, Mental Health, Criminal Background, etc.)	Housing that Accepts People with: Chemical Dependency, Mental Health, Criminal Background, etc.) Sufficient 1	Housing that Accepts People with: Chemical Dependency, Mental Health, Criminal Background, etc.) 2	Housing that Accepts People with: Chemical Dependency, Mental Health, Criminal Background, etc.) Sufficient Somewhat 3	Housing that Accepts People with: Chemical Dependency, Mental Health, Criminal Background, etc.) 4	Housing that Accepts People with: Chemical Dependency, Mental Health, Criminal Background, etc.) Not Sufficient-There is a great need for this resource
Hands on Training for Home Maintenance	Hands on Training for Home Maintenance Sufficient 1	Hands on Training for Home Maintenance 2	Hands on Training for Home Maintenance Sufficient Somewhat 3	Hands on Training for Home Maintenance 4	Hands on Training for Home Maintenance Not Sufficient-There is a great need for this resource
Loans to Fix Existing House	Loans to Fix Existing House Sufficient 1	Loans to Fix Existing House 2	Loans to Fix Existing House Sufficient Somewhat 3	Loans to Fix Existing House 4	Loans to Fix Existing House Not Sufficient-There is a great need for this resource
Preventing Mortgage Foreclosure and Counseling	Preventing Mortgage Foreclosure and Counseling Sufficient 1	Preventing Mortgage Foreclosure and Counseling 2	Preventing Mortgage Foreclosure and Counseling Sufficient Somewhat 3	Preventing Mortgage Foreclosure and Counseling 4	Preventing Mortgage Foreclosure and Counseling Not Sufficient-There is a great need for this resource
Education about Rental Costs, Utilities, Deposits, and Lease Terms	Education about Rental Costs, Utilities, Deposits, and Lease Terms Sufficient 1	Education about Rental Costs, Utilities, Deposits, and Lease Terms 2	Education about Rental Costs, Utilities, Deposits, and Lease Terms Sufficient Somewhat 3	Education about Rental Costs, Utilities, Deposits, and Lease Terms 4	Education about Rental Costs, Utilities, Deposits, and Lease Terms Not Sufficient-There is a great need for this resource
Education about Tenants and Landlords Rights and Responsibilities	Education about Tenants and Landlords Rights and Responsibilities Sufficient 1	Education about Tenants and Landlords Rights and Responsibilities 2	Education about Tenants and Landlords Rights and Responsibilities Sufficient Somewhat 3	Education about Tenants and Landlords Rights and Responsibilities 4	Education about Tenants and Landlords Rights and Responsibilities Not Sufficient-There is a great need for this resource

Other (please specify)

Question Title

* 12. Regarding the topi of TRANSPORTATION as it relates to your
community, do you believe there is a sufficient amount of access and avavailability to resources that can address the following items

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient- There is a great need for this resource 5
Learning how to drive or obtain a driver's license	Learning how to drive or obtain a driver's license Sufficient 1	Learning how to drive or obtain a driver's license 2	Learning how to drive or obtain a driver's license Sufficient Somewhat 3	Learning how to drive or obtain a driver's license 4	Learning how to drive or obtain a driver's license Not Sufficient- There is a great need for this resource 5
Financial Help Buying a Car	Financial Help Buying a Car Sufficient 1	Financial Help Buying a Car 2	Financial Help Buying a Car Sufficient Somewhat 3	Financial Help Buying a Car 4	Financial Help Buying a Car Not Sufficient- There is a great need for this resource 5
Affordable Repairs for a car Already Owned	Affordable Repairs for a car Already Owned Sufficient 1	Affordable Repairs for a car Already Owned 2	Affordable Repairs for a car Already Owned Sufficient Somewhat 3	Affordable Repairs for a car Already Owned 4	Affordable Repairs for a car Already Owned Not Sufficient- There is a great need for this resource 5
Help with Transportation costs (i.e. Gas, Car Insurance, Taxi Fare, etc.)	Help with Transportation costs (i.e. Gas, Car Insurance, Taxi Fare, etc.) Sufficient 1	Help with Transportation costs (i.e. Gas, Car Insurance, Taxi Fare, etc.) 2	Help with Transportation costs (i.e. Gas, Car Insurance, Taxi Fare, etc.) Sufficient Somewhat 3	Help with Transportation costs (i.e. Gas, Car Insurance, Taxi Fare, etc.) 4	Help with Transportation costs (i.e. Gas, Car Insurance, Taxi Fare, etc.) Not Sufficient- There is a great need for this resource 5
Hands-On Training about Car Repair and Maintenance	Hands-On Training about Car Repair and Maintenance Sufficient 1	Hands-On Training about Car Repair and Maintenance 2	Hands-On Training about Car Repair and Maintenance Sufficient Somewhat 3	Hands-On Training about Car Repair and Maintenance 4	Hands-On Training about Car Repair and Maintenance Not Sufficient- There is a great need for this resource 5
Transportation to look for a Job, or Access Job Training	Transportation to look for a Job, or Access Job Training Sufficient 1	Transportation to look for a Job, or Access Job Training 2	Transportation to look for a Job, or Access Job Training Sufficient Somewhat 3	Transportation to look for a Job, or Access Job Training 4	Transportation to look for a Job, or Access Job Training Not Sufficient- There is a great need for this resource 5
Transportation to Access Services ( Medical, Shopping, Banking, Daycare, etc.)	Transportation to Access Services ( Medical, Shopping, Banking, Daycare, etc.) Sufficient 1	Transportation to Access Services ( Medical, Shopping, Banking, Daycare, etc.) 2	Transportation to Access Services ( Medical, Shopping, Banking, Daycare, etc.) Sufficient Somewhat 3	Transportation to Access Services ( Medical, Shopping, Banking, Daycare, etc.) 4	Transportation to Access Services ( Medical, Shopping, Banking, Daycare, etc.) Not Sufficient- There is a great need for this resource 5

Other (please specify)

Question Title

* 13. Regarding the topic of HEALTH as it relates to your community, do you believe there is a sufficient amount of access and availability to
resources that can address the following items?

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient- There is a great need for this resource
Affordable Health Insurance	Affordable Health Insurance Sufficient 1	Affordable Health Insurance 2	Affordable Health Insurance Sufficient Somewhat 3	Affordable Health Insurance 4	Affordable Health Insurance Not Sufficient- There is a great need for this resource
Assistance Applying for Public or Private Health Insurance Programs (i.e. Affordable Care Act, Medicare, Medicaid, etc.)	Assistance Applying for Public or Private Health Insurance Programs (i.e. Affordable Care Act, Medicare, Medicaid, etc.) Sufficient 1	Assistance Applying for Public or Private Health Insurance Programs (i.e. Affordable Care Act, Medicare, Medicaid, etc.) 2	Assistance Applying for Public or Private Health Insurance Programs (i.e. Affordable Care Act, Medicare, Medicaid, etc.) Sufficient Somewhat 3	Assistance Applying for Public or Private Health Insurance Programs (i.e. Affordable Care Act, Medicare, Medicaid, etc.) 4	Assistance Applying for Public or Private Health Insurance Programs (i.e. Affordable Care Act, Medicare, Medicaid, etc.) Not Sufficient- There is a great need for this resource
Help with Filling out Insurance Forms for Billing and Payments	Help with Filling out Insurance Forms for Billing and Payments Sufficient 1	Help with Filling out Insurance Forms for Billing and Payments 2	Help with Filling out Insurance Forms for Billing and Payments Sufficient Somewhat 3	Help with Filling out Insurance Forms for Billing and Payments 4	Help with Filling out Insurance Forms for Billing and Payments Not Sufficient- There is a great need for this resource
Dentist in Community who Accept Medical Assistance	Dentist in Community who Accept Medical Assistance Sufficient 1	Dentist in Community who Accept Medical Assistance 2	Dentist in Community who Accept Medical Assistance Sufficient Somewhat 3	Dentist in Community who Accept Medical Assistance 4	Dentist in Community who Accept Medical Assistance Not Sufficient- There is a great need for this resource
Paying for Medical Care	Paying for Medical Care Sufficient 1	Paying for Medical Care 2	Paying for Medical Care Sufficient Somewhat 3	Paying for Medical Care 4	Paying for Medical Care Not Sufficient- There is a great need for this resource
Paying for Prescription Drugs	Paying for Prescription Drugs Sufficient 1	Paying for Prescription Drugs 2	Paying for Prescription Drugs Sufficient Somewhat 3	Paying for Prescription Drugs 4	Paying for Prescription Drugs Not Sufficient- There is a great need for this resource
Access to Low-Cost Birth Control or Family Planning Services	Access to Low-Cost Birth Control or Family Planning Services Sufficient 1	Access to Low-Cost Birth Control or Family Planning Services 2	Access to Low-Cost Birth Control or Family Planning Services Sufficient Somewhat 3	Access to Low-Cost Birth Control or Family Planning Services 4	Access to Low-Cost Birth Control or Family Planning Services Not Sufficient- There is a great need for this resource
Information on Immunization and General Family Care	Information on Immunization and General Family Care Sufficient 1	Information on Immunization and General Family Care 2	Information on Immunization and General Family Care Sufficient Somewhat 3	Information on Immunization and General Family Care 4	Information on Immunization and General Family Care Not Sufficient- There is a great need for this resource
Assistance with Finding Mental Health Services	Assistance with Finding Mental Health Services Sufficient 1	Assistance with Finding Mental Health Services 2	Assistance with Finding Mental Health Services Sufficient Somewhat 3	Assistance with Finding Mental Health Services 4	Assistance with Finding Mental Health Services Not Sufficient- There is a great need for this resource
Paying for Mental Health Services	Paying for Mental Health Services Sufficient 1	Paying for Mental Health Services 2	Paying for Mental Health Services Sufficient Somewhat 3	Paying for Mental Health Services 4	Paying for Mental Health Services Not Sufficient- There is a great need for this resource
Relief (Respite Care) for Someone Taking Care of an Elderly or Disabled Person	Relief (Respite Care) for Someone Taking Care of an Elderly or Disabled Person Sufficient 1	Relief (Respite Care) for Someone Taking Care of an Elderly or Disabled Person 2	Relief (Respite Care) for Someone Taking Care of an Elderly or Disabled Person Sufficient Somewhat 3	Relief (Respite Care) for Someone Taking Care of an Elderly or Disabled Person 4	Relief (Respite Care) for Someone Taking Care of an Elderly or Disabled Person Not Sufficient- There is a great need for this resource
Education about Nutrition, Obesity Prevention and/or Exercise	Education about Nutrition, Obesity Prevention and/or Exercise Sufficient 1	Education about Nutrition, Obesity Prevention and/or Exercise 2	Education about Nutrition, Obesity Prevention and/or Exercise Sufficient Somewhat 3	Education about Nutrition, Obesity Prevention and/or Exercise 4	Education about Nutrition, Obesity Prevention and/or Exercise Not Sufficient- There is a great need for this resource

Other (please specify)

Question Title

* 14. Regarding the topic of QUALITY OF LIFE, as it relates to your
community, do you believe there is a sufficient amount of access and
availability to resources that can address the following items?

	Sufficient 1	2	Sufficient Somewhat 3	4	Not Sufficient-There is a great need for this resource 5
Affordable Health Insurance	Affordable Health Insurance Sufficient 1	Affordable Health Insurance 2	Affordable Health Insurance Sufficient Somewhat 3	Affordable Health Insurance 4	Affordable Health Insurance Not Sufficient-There is a great need for this resource 5
Finding Volunteer Opportunities in the Community	Finding Volunteer Opportunities in the Community Sufficient 1	Finding Volunteer Opportunities in the Community 2	Finding Volunteer Opportunities in the Community Sufficient Somewhat 3	Finding Volunteer Opportunities in the Community 4	Finding Volunteer Opportunities in the Community Not Sufficient-There is a great need for this resource 5
Dealing with Problems Related to Gambling	Dealing with Problems Related to Gambling Sufficient 1	Dealing with Problems Related to Gambling 2	Dealing with Problems Related to Gambling Sufficient Somewhat 3	Dealing with Problems Related to Gambling 4	Dealing with Problems Related to Gambling Not Sufficient-There is a great need for this resource 5
Learning How to be a Better Parent/Find Parenting Programs	Learning How to be a Better Parent/Find Parenting Programs Sufficient 1	Learning How to be a Better Parent/Find Parenting Programs 2	Learning How to be a Better Parent/Find Parenting Programs Sufficient Somewhat 3	Learning How to be a Better Parent/Find Parenting Programs 4	Learning How to be a Better Parent/Find Parenting Programs Not Sufficient-There is a great need for this resource 5
Affordable Family Recreation and Community Activities	Affordable Family Recreation and Community Activities Sufficient 1	Affordable Family Recreation and Community Activities 2	Affordable Family Recreation and Community Activities Sufficient Somewhat 3	Affordable Family Recreation and Community Activities 4	Affordable Family Recreation and Community Activities Not Sufficient-There is a great need for this resource 5
Support for Family Issues Relating to Issues such as Safety, Divorce, Domestic Violence, etc.)	Support for Family Issues Relating to Issues such as Safety, Divorce, Domestic Violence, etc.) Sufficient 1	Support for Family Issues Relating to Issues such as Safety, Divorce, Domestic Violence, etc.) 2	Support for Family Issues Relating to Issues such as Safety, Divorce, Domestic Violence, etc.) Sufficient Somewhat 3	Support for Family Issues Relating to Issues such as Safety, Divorce, Domestic Violence, etc.) 4	Support for Family Issues Relating to Issues such as Safety, Divorce, Domestic Violence, etc.) Not Sufficient-There is a great need for this resource 5
Learning to Protect Oneself against Fraud, Telephone Scams, and/or Identity Theft	Learning to Protect Oneself against Fraud, Telephone Scams, and/or Identity Theft Sufficient 1	Learning to Protect Oneself against Fraud, Telephone Scams, and/or Identity Theft 2	Learning to Protect Oneself against Fraud, Telephone Scams, and/or Identity Theft Sufficient Somewhat 3	Learning to Protect Oneself against Fraud, Telephone Scams, and/or Identity Theft 4	Learning to Protect Oneself against Fraud, Telephone Scams, and/or Identity Theft Not Sufficient-There is a great need for this resource 5
Finding a Group of People to Talk about Problems or Concerns	Finding a Group of People to Talk about Problems or Concerns Sufficient 1	Finding a Group of People to Talk about Problems or Concerns 2	Finding a Group of People to Talk about Problems or Concerns Sufficient Somewhat 3	Finding a Group of People to Talk about Problems or Concerns 4	Finding a Group of People to Talk about Problems or Concerns Not Sufficient-There is a great need for this resource 5
Obtaining Basic Furniture and Household Items	Obtaining Basic Furniture and Household Items Sufficient 1	Obtaining Basic Furniture and Household Items 2	Obtaining Basic Furniture and Household Items Sufficient Somewhat 3	Obtaining Basic Furniture and Household Items 4	Obtaining Basic Furniture and Household Items Not Sufficient-There is a great need for this resource 5
Obtaining Clothing	Obtaining Clothing Sufficient 1	Obtaining Clothing 2	Obtaining Clothing Sufficient Somewhat 3	Obtaining Clothing 4	Obtaining Clothing Not Sufficient-There is a great need for this resource 5
Support in Raising Grandchildren or another Relative's Children	Support in Raising Grandchildren or another Relative's Children Sufficient 1	Support in Raising Grandchildren or another Relative's Children 2	Support in Raising Grandchildren or another Relative's Children Sufficient Somewhat 3	Support in Raising Grandchildren or another Relative's Children 4	Support in Raising Grandchildren or another Relative's Children Not Sufficient-There is a great need for this resource 5
Support in Caring for a Senior or Disabled Relative, Friend, or Neighbor	Support in Caring for a Senior or Disabled Relative, Friend, or Neighbor Sufficient 1	Support in Caring for a Senior or Disabled Relative, Friend, or Neighbor 2	Support in Caring for a Senior or Disabled Relative, Friend, or Neighbor Sufficient Somewhat 3	Support in Caring for a Senior or Disabled Relative, Friend, or Neighbor 4	Support in Caring for a Senior or Disabled Relative, Friend, or Neighbor Not Sufficient-There is a great need for this resource 5
Access to a Computer, E-Mail, Internet, or Other Various Technological and Digital Devices	Access to a Computer, E-Mail, Internet, or Other Various Technological and Digital Devices Sufficient 1	Access to a Computer, E-Mail, Internet, or Other Various Technological and Digital Devices 2	Access to a Computer, E-Mail, Internet, or Other Various Technological and Digital Devices Sufficient Somewhat 3	Access to a Computer, E-Mail, Internet, or Other Various Technological and Digital Devices 4	Access to a Computer, E-Mail, Internet, or Other Various Technological and Digital Devices Not Sufficient-There is a great need for this resource 5
Voter Education and/or Voter Rights Information	Voter Education and/or Voter Rights Information Sufficient 1	Voter Education and/or Voter Rights Information 2	Voter Education and/or Voter Rights Information Sufficient Somewhat 3	Voter Education and/or Voter Rights Information 4	Voter Education and/or Voter Rights Information Not Sufficient-There is a great need for this resource 5

Other (please specify)

Question Title

* 15. Of the selections provided below, please choose all of the answers you
believe are the services that TCCA currently offer.

☐ Energy/Utility Assistance

☐ Early Childhood Development Education

☐ Homeless Housing

☐ Transportation

☐ Home Healthcare

☐ Prescription Assistance

☐ Food Stamps

☐ Section 8 Housing

☐ Mental Health Counseling

☐ Head Start

☐ Daycare Assistance

☐ Weatherization and/or other home repair/renovation services

☐ Food Pantry

☐ Case Management/Family Development

☐ Employment Assistance

☐ GED/High School Diploma Training and Assistance

☐ Special Skills/Vocational Training

☐ College Assistance

☐ Clothing Assistance

Question Title

* 16. Does TCCA, Inc. currently have a service center in your area?

☐ Yes

☐ No

☐ I don’t know

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* 17. Considering the issues you feel are important in your community and surrounding area, what major barriers do you believe exist that prevent access to help? (choose all that apply)

☐ No Transportation To and From Available Assistance

☐ Can't Afford Fees or Costs for Assistance

☐ Available Services are Unreliable, Substandard or Possibly Unsafe; Prior Bad Experience with Services/Programs

☐ Services are Not Available within a 25 Mile Radius

☐ Services are Not Available within a 50 Mile Radius

☐ Have to Work During Service Hours

☐ No Childcare while Receiving/Obtaining Services

☐ Prideful (Really Do Not Want to Ask for Help)

☐ Health or Other Disability Prevents Getting Help from Available Services

☐ Most do not know where to go for help

Other (please specify)

Question Title

* 18. What additional services do you feel TCCA, or other organizations,
should provide to create the highest level of assistance for you or others you may know who have needs in your community? Please list as many items as you'd like.

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* 1. Which of the following best describes you? (Check all that apply)

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* 2. Where are you currently employed?

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* 3. What is your position with your employer?

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* 4. What organization(s)/group(s) are you involved with in your community? Please provide the name below.

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* 5. In what zip code do you reside? (enter the 5-digit zip code)

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* 6. What communities do you represent as a participant in this survey? (i.e., work, volunteer, civic, or other activities) Please list all communities. If county or area wide, please list the county.

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* 7. Please describe your awareness and knowledge of the needs or conditions that exist in the community in which you live and/or work. The goal is to use your answers to determine what is most needed in your community. Please answer following questions

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* 8. Regarding the topic of EDUCATION as it relates to your community do you believe there is sufficient amount of access and availability to resources that can address the following items?

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* 9. Regarding the topic of FOOD AND NUTRITION as it relates to your community, do you believe there is a sufficient amount of access and availability to resources that can address the following items?

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* 10. Regarding the topic of FINANCIAL AND LEGAL SERVICES as it relates to your community, do you believe there is sufficient amount of access and availability to resources that can address the following items?

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* 11. Regarding the topic of HOUSING ﻿﻿ as it relates to your community, do you believe there is a sufficient amount of access and availability to resources that can address the following items?

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* 12. Regarding the topi of ﻿TRANSPORTATION ﻿ as it relates to your community, do you believe there is a sufficient amount of access and avavailability to resources that can address the following items

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* 13. Regarding the topic of HEALTH as it relates to your community, do you believe there is a sufficient amount of access and availability to resources that can address the following items?

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* 14. Regarding the topic of ﻿QUALITY OF LIFE, as it relates to your community, do you believe there is a sufficient amount of access and availability to resources that can address the following items?

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* 15. Of the selections provided below, please choose all of the answers youbelieve are the services that TCCA currently offer.

Question Title

* 16. Does TCCA, Inc. currently have a service center in your area?

Question Title

* 17. Considering the issues you feel are important in your community and surrounding area, what major barriers do you believe exist that prevent access to help? (choose all that apply)

Question Title

* 18. What additional services do you feel TCCA, or other organizations, should provide to create the highest level of assistance for you or others you may know who have needs in your community? Please list as many items as you'd like.

* 7. Please describe your awareness and knowledge of the needs or
conditions that exist in the community in which you live and/or work. The goal is to use your answers to determine what is most needed in your
community. Please answer following questions

* 8. Regarding the topic of EDUCATION as it relates to your community do
you believe there is sufficient amount of access and availability to
resources that can address the following items?

* 9. Regarding the topic of FOOD AND NUTRITION as it relates to your
community, do you believe there is a sufficient amount of access and
availability to resources that can address the following items?

* 10. Regarding the topic of FINANCIAL AND LEGAL SERVICES as it relates
to your community, do you believe there is sufficient amount of access
and availability to resources that can address the following items?

* 11. Regarding the topic of HOUSING as it relates to your community, do you believe there is a sufficient amount of access and availability to
resources that can address the following items?

* 12. Regarding the topi of TRANSPORTATION as it relates to your
community, do you believe there is a sufficient amount of access and avavailability to resources that can address the following items

* 13. Regarding the topic of HEALTH as it relates to your community, do you believe there is a sufficient amount of access and availability to
resources that can address the following items?

* 14. Regarding the topic of QUALITY OF LIFE, as it relates to your
community, do you believe there is a sufficient amount of access and
availability to resources that can address the following items?

* 15. Of the selections provided below, please choose all of the answers you
believe are the services that TCCA currently offer.

* 18. What additional services do you feel TCCA, or other organizations,
should provide to create the highest level of assistance for you or others you may know who have needs in your community? Please list as many items as you'd like.