COVID-19 West End Community Needs Assessment Survey

Cornerstone is currently assessing the needs of our community as a result of the ongoing COVID-19 pandemic. It’s important to know how this pandemic is currently affecting our community. Your input will help inform the programs and resources that our community needs.

Your responses will not only help us decide how to best utilize current programming but can help guide future opportunities to better serve individuals and families in the West End Neighborhood. Please take a few minutes to complete this survey. All answers are anonymous and confidential. Thank you for your time.

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* 1. What is your relationship to Cornerstone?

I am a community member.

I have received services, or am enrolled in a program offered by Cornerstone.

I work with Cornerstone as a community partner.

I am a Cornerstone board member.

I am a Cornerstone committee member.

I have participated in the West End Planning Process

Other (please specify)

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* 2. What block do you live on?

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* 3. How have your work conditions changed due to COVID-19?

No change

Decreased hours

Increased hours

Furloughed

Laid off

Terminated

Working from home or working remotely

Self-employed & a decrease in work opportunities

Self-employed & an increase in work opportunities

I was unemployed prior to COVID-19 (March 2020)

N/A (I am retired or disabled)

Other (please specify)

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* 4. Please rank your primary concern for you and your family during this time.

	Extremely Concerned	Moderately Concerned	Somewhat Concerned	Slightly Concerned	Not at all Concerned	N/A
Making Rent or Mortgage Payments	Making Rent or Mortgage Payments Extremely Concerned	Making Rent or Mortgage Payments Moderately Concerned	Making Rent or Mortgage Payments Somewhat Concerned	Making Rent or Mortgage Payments Slightly Concerned	Making Rent or Mortgage Payments Not at all Concerned	Making Rent or Mortgage Payments N/A
Making Bill or Utility Payments	Making Bill or Utility Payments Extremely Concerned	Making Bill or Utility Payments Moderately Concerned	Making Bill or Utility Payments Somewhat Concerned	Making Bill or Utility Payments Slightly Concerned	Making Bill or Utility Payments Not at all Concerned	Making Bill or Utility Payments N/A
Accessing Groceries and/or Household Cleaning Supplies	Accessing Groceries and/or Household Cleaning Supplies Extremely Concerned	Accessing Groceries and/or Household Cleaning Supplies Moderately Concerned	Accessing Groceries and/or Household Cleaning Supplies Somewhat Concerned	Accessing Groceries and/or Household Cleaning Supplies Slightly Concerned	Accessing Groceries and/or Household Cleaning Supplies Not at all Concerned	Accessing Groceries and/or Household Cleaning Supplies N/A
Accessing Childcare	Accessing Childcare Extremely Concerned	Accessing Childcare Moderately Concerned	Accessing Childcare Somewhat Concerned	Accessing Childcare Slightly Concerned	Accessing Childcare Not at all Concerned	Accessing Childcare N/A
Internet Access	Internet Access Extremely Concerned	Internet Access Moderately Concerned	Internet Access Somewhat Concerned	Internet Access Slightly Concerned	Internet Access Not at all Concerned	Internet Access N/A
Mental Health/Physical Health	Mental Health/Physical Health Extremely Concerned	Mental Health/Physical Health Moderately Concerned	Mental Health/Physical Health Somewhat Concerned	Mental Health/Physical Health Slightly Concerned	Mental Health/Physical Health Not at all Concerned	Mental Health/Physical Health N/A

Other (please specify)

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* 5. Please rank your primary concern for our community during this time.

	Extremely Concerned	Moderately Concerned	Somewhat Concerned	Slightly Concerned	Not at all Concerned
Housing Stability	Housing Stability Extremely Concerned	Housing Stability Moderately Concerned	Housing Stability Somewhat Concerned	Housing Stability Slightly Concerned	Housing Stability Not at all Concerned
Accessing Groceries	Accessing Groceries Extremely Concerned	Accessing Groceries Moderately Concerned	Accessing Groceries Somewhat Concerned	Accessing Groceries Slightly Concerned	Accessing Groceries Not at all Concerned
Cleaning Supplies or Personal Protective Equipment	Cleaning Supplies or Personal Protective Equipment Extremely Concerned	Cleaning Supplies or Personal Protective Equipment Moderately Concerned	Cleaning Supplies or Personal Protective Equipment Somewhat Concerned	Cleaning Supplies or Personal Protective Equipment Slightly Concerned	Cleaning Supplies or Personal Protective Equipment Not at all Concerned
Childcare	Childcare Extremely Concerned	Childcare Moderately Concerned	Childcare Somewhat Concerned	Childcare Slightly Concerned	Childcare Not at all Concerned
Education	Education Extremely Concerned	Education Moderately Concerned	Education Somewhat Concerned	Education Slightly Concerned	Education Not at all Concerned
Internet Access	Internet Access Extremely Concerned	Internet Access Moderately Concerned	Internet Access Somewhat Concerned	Internet Access Slightly Concerned	Internet Access Not at all Concerned
Employment/Unemployment	Employment/Unemployment Extremely Concerned	Employment/Unemployment Moderately Concerned	Employment/Unemployment Somewhat Concerned	Employment/Unemployment Slightly Concerned	Employment/Unemployment Not at all Concerned
Mental Health/Physical Health	Mental Health/Physical Health Extremely Concerned	Mental Health/Physical Health Moderately Concerned	Mental Health/Physical Health Somewhat Concerned	Mental Health/Physical Health Slightly Concerned	Mental Health/Physical Health Not at all Concerned

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* 6. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 7. What is your race?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Other (please specify)

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* 8. How many people live in your household?

6 or more

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* 9. What is your total household income?

Less than $20,000

$20,000 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

$150,000 or More

COVID-19 West End Community Needs Assessment Survey

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* 1. What is your relationship to Cornerstone?

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* 2. What block do you live on?

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* 3. How have your work conditions changed due to COVID-19?

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* 4. Please rank your primary concern for you and your family during this time.

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* 5. Please rank your primary concern for our community during this time.

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* 6. What is your age?

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* 7. What is your race?

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* 8. How many people live in your household?

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* 9. What is your total household income?

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* 10. What is the highest level of education you have completed?