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COVID-19 Community Needs Assessment Survey
Thank you participating in our survey. With your feedback, we will be able to better prepare our resources to support and enhance the important work you do each day in the community. We anticipate this survey will take about 15 minutes to complete.
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1.
Organization name
(Required.)
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2.
Your name
(Required.)
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3.
What is the primary geographic scope of your organization? (Select all that apply)
(Required.)
Butler County
Warren County
City of Cincinnati Only
Eastern Area Region (Clermont, Brown, Adams Counties)
Hamilton County Only
Northern Kentucky
Southeast Indiana
Other (please specify)
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4.
Is your organization led by a person of color (i.e. president/CEO/ED)?
(Required.)
Yes
No
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5.
Is your client population more than 50% people of color?
(Required.)
yes
No
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6.
What is your primary focus as an organization?
(Required.)
Arts/ Culture/ Humanities
Education
Environment/ Animals
Health
Human Services
Capacity Building
Other (please specify)
7.
Please estimate the percent in each age demographic for the core population you serve (% Estimates for each )
Young Children (0-5)
School Aged Children (6-18)
Adults (18-64)
Seniors (65+)
I serve other nonprofit organizations (no direct population care) -if so enter YES
Other (please specify and include %)
8.
Please estimate the percent of your core clients meeting the description below (if applicable) (% Estimates for each- may exceed 100%)
Homeless
Economically disadvantaged (less than 200% FPL)
Immigrants/limited English proficiency
I serve other nonprofit organizations (no direct population care) -if so enter YES
Other (please specify and enter %)
9.
Approximately how many clients does your organization
typically
serve monthly (pre-COVID-19)?
10.
Has the number of clients served changed since the COVID-19 pandemic?
It has increased.
It has decreased.
It has remained the same.
Comments:
11.
If YES, clients served increased, by what additional percent?
10% more from last year
20% more from last year
30% more from last year
40% more from last year
50% more from last year
60% more from last year
70% more from last year
80% more from last year
90% more from last year
100% more from last year
Double last year
150% more from last year
N/A
12.
If YES, clients served decreased, by what percent? (approximately)
10% less from last year
20% less from last year
30% less from last year
40% less from last year
50% less from last year
60% less from last year
70% less from last year
80% less from last year
90% less from last year
100% less from last year
150% less from last year
N/A
13.
What is your core/primary service? (select one)
Food access
Housing (emergency/ temporary/ transitional)
Housing (housing stability/advocacy)
Health-related (Physical)
Health-related (Mental/Behavioral/Substance Use Treatment)
Employment/workforce/Economic stability
Family violence
Senior care
Childcare/Early education
Transportation
Education
Capacity building
Arts
Other (please specify)
14.
What is/are your
secondary
service(s)? (Select all that apply)
Food access
Housing (emergency/ temporary/ transitional)
Housing (housing stability/advocacy)
Health-related (Physical)
Health-related (Mental/Behavioral/Substance Use Treatment)
Employment/workforce/Economic stability
Family violence
Senior care
Childcare/Early education
Transportation
Education
Capacity building
Arts
Other (please specify)
15.
What core services and programs do you typically provide that you are now not able to offer? (If you are providing all of your normal core services and programs, enter N/A)
16.
What new services, if any, are you providing due to COVID-19? Please describe the changes.
17.
Have you considered or established any new collaborations/partnerships as a result of the pandemic?
Yes
No
If answered yes, with what organization?
18.
Do you have serious concerns about your organization’s viability in the next 12 months?
No
Yes
If YES, please describe
19.
Over the past two months, how have your staffing levels been impacted by COVID-19? (check all that apply)
We are experiencing a higher than usual absenteeism rate of our staff.
We are struggling to maintain necessary staffing levels.
We do not have enough work for our employees.
We have laid off or furloughed employees.
Our staffing levels are unaffected by COVID-19.
Our volunteer force has retreated due to COVID-19.
Other
20.
What methods have you used to sustain your business operations? (check all that apply)
We applied for financial assistance through an SBA (Small Business Administration) program.
We applied for financial assistance through a non-SBA (Small Business Administration) source of grants or lending, such as the CARES Act Paycheck Protection Program.
We began promoting new/different programs and/or services to create extra revenue.
We have reduced wages, adjusted hours or actively looked for other ways to preserve cash flow.
We have continued to work remotely to sustain business operations.
We have shut down completely.
Not applicable
Other
21.
From which of the following sources, if any, have you received financial assistance? (check all that apply)
The COVID-19 Regional Response Fund (GCF/ UW)
The SBA Economic Injury Disaster Loan (EIDL)
The SBA Emergency Economic Injury Grant in tandem with the EIDL
The CARES Act Payroll Protection Program (PPP)
A business loan or line of credit from my financial institution
We have applied for financial assistance but haven't yet received any.
We have not applied for financial assistance.
Other
Short-Term Gaps (Next 1-6 Months)
Please provide information on the short-term impact on your target population that you anticipate or forecast over the next 1-6 months as a result of COVID-19.
22.
What primary needs/challenges do you anticipate your core population will have in the next 1-6 months? (Select all that apply)
Translation services
Essential worker support
Technology (including hardware, software, training and connectivity)
Basic Food and Toiletries
Basic Medical/Prescription
Rent/Mortgage Assistance
Homelessness
Utilities
Transportation
Unemployment
Child Abuse
Domestic Violence
Elderly Care
Mental Health
Substance Use Treatment
Personal Protection Equipment (PPE)
Access to childcare
Other (please specify)
23.
What are key factors that could exacerbate the needs identified or alleviate them?
24.
Please provide information on short term gaps in services or resources that you anticipate or forecast for your organization over the next 1-6 months. Describe the gaps:
25.
Provide a cost estimate of the gaps over the next 1-6 months
26.
What, if any, plans are your organization already considering to help address the short-term gaps?
Near-Term Gaps (Next 6mo – 1yr)
Please provide information on the near-term impact on your core population that you anticipate or forecast over the next 6 months to 1 year as a result of COVID-19.
27.
What primary needs/challenges do you anticipate your core population will have? (Select all that apply)
Translation services
Essential worker support
Technology (including hardware, training, software, and connectivity)
Basic Food and Toiletries
Basic Medical/Prescription
Rent/Mortgage Assistance
Homelessness
Utilities
Transportation
Unemployment
Child Abuse
Domestic Violence
Elderly Care
Mental Health
Substance Use Treatment
Personal Protection Equipment (PPE)
Access to childcare
Other (please specify)
28.
What are key factors that could exacerbate the needs identified or alleviate them?
29.
Please provide information on near term gaps in services or resources that you anticipate or forecast for your organization over the next 6 months to 1 year. Describe the gaps
30.
Provide a cost estimate of the gaps over the next 6 months – 1 year
31.
What, if any, plans are your organization already considering to help address the short-term gaps?
Long-Term Gaps (over 1 year +)
Please provide information on the long-term impact on your target population that you anticipate or forecast in the next 1 year + as a result of COVID-19.
32.
What primary needs/challenges do you anticipate your core population will have in a year and over?
33.
What systemic issues do you foresee occurring in this time frame (1 yr+) ?
34.
On which issues would systems-level or advocacy support be most helpful to you in the next year?
35.
From a capacity building perspective, what resources, training or information does your organization need?
36.
What actions would be most helpful for the community to take to support your organization right now?
37.
What other information would you like to share with us as it relates to your organization and the COVID-19 pandemic?
