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Warner Center COVID Employer Worksite Survey
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1.
Contact Information
(Required.)
Name
Company
Email Address
Phone Number
*
2.
What is your role/position at your worksite?
(Required.)
*
3.
How has COVID-19 affected operations? (Select all that apply)
(Required.)
Temporarily closed business
Reduced operations to essential workers only
Transitioned core business (e.g., shifted to serving take out)
Transitioned to work from home
Other (please specify)
*
4.
How has it affected your workforce? (Select all that apply)
(Required.)
Laid off employees
Furloughed all employees
Furloughed some employees
Able to retain all employees
Reduced certain benefits
Other (please specify)
*
5.
Approximately how many employees did you have working at your worksite before the COVID-19 pandemic?
(Required.)
*
6.
Roughly what percentage of employees are currently working?
(Required.)
100% - 75%
75%-50%
50%-25%
Less than 25%
N/A
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7.
Out of those still working, how many are physically working on-site?
(Required.)
100% - 75%
75%-50%
50%-25%
Less than 25%
N/A
*
8.
How are they commuting to work? (Select all that apply)
(Required.)
Drive alone
Transit
Carpool
Biking
Walking
N/A
Other (please specify)
9.
What types of policy adjustments have been implemented to facilitate social distancing? For example, staggered schedules, assigned parking based on proximity to assigned building, etc.
