2023-2024 Community Needs Assessment Survey

San Benito County Community Needs Assessment

San Benito County Community Action Board is responsible for administering services in San Benito County to support low-income residents. Please help our organization identify the top services needs for 2022-2023 program by sharing your experience and opinion.

1. What area of San Benito County do you consider your community? *This question is required.

2. Please rank what you feel are the most important needs for your family. #1 most important - #13 least important *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5	6	7	8	9	10	11	12	13
Access to Food	Rank Access to Food as 1 out of 13	Rank Access to Food as 2 out of 13	Rank Access to Food as 3 out of 13	Rank Access to Food as 4 out of 13	Rank Access to Food as 5 out of 13	Rank Access to Food as 6 out of 13	Rank Access to Food as 7 out of 13	Rank Access to Food as 8 out of 13	Rank Access to Food as 9 out of 13	Rank Access to Food as 10 out of 13	Rank Access to Food as 11 out of 13	Rank Access to Food as 12 out of 13	Rank Access to Food as 13 out of 13
Domestic Violence	Rank Domestic Violence as 1 out of 13	Rank Domestic Violence as 2 out of 13	Rank Domestic Violence as 3 out of 13	Rank Domestic Violence as 4 out of 13	Rank Domestic Violence as 5 out of 13	Rank Domestic Violence as 6 out of 13	Rank Domestic Violence as 7 out of 13	Rank Domestic Violence as 8 out of 13	Rank Domestic Violence as 9 out of 13	Rank Domestic Violence as 10 out of 13	Rank Domestic Violence as 11 out of 13	Rank Domestic Violence as 12 out of 13	Rank Domestic Violence as 13 out of 13
Drug and Substance Abuse Prevention	Rank Drug and Substance Abuse Prevention as 1 out of 13	Rank Drug and Substance Abuse Prevention as 2 out of 13	Rank Drug and Substance Abuse Prevention as 3 out of 13	Rank Drug and Substance Abuse Prevention as 4 out of 13	Rank Drug and Substance Abuse Prevention as 5 out of 13	Rank Drug and Substance Abuse Prevention as 6 out of 13	Rank Drug and Substance Abuse Prevention as 7 out of 13	Rank Drug and Substance Abuse Prevention as 8 out of 13	Rank Drug and Substance Abuse Prevention as 9 out of 13	Rank Drug and Substance Abuse Prevention as 10 out of 13	Rank Drug and Substance Abuse Prevention as 11 out of 13	Rank Drug and Substance Abuse Prevention as 12 out of 13	Rank Drug and Substance Abuse Prevention as 13 out of 13
Foster Care & Child Protective Services	Rank Foster Care & Child Protective Services as 1 out of 13	Rank Foster Care & Child Protective Services as 2 out of 13	Rank Foster Care & Child Protective Services as 3 out of 13	Rank Foster Care & Child Protective Services as 4 out of 13	Rank Foster Care & Child Protective Services as 5 out of 13	Rank Foster Care & Child Protective Services as 6 out of 13	Rank Foster Care & Child Protective Services as 7 out of 13	Rank Foster Care & Child Protective Services as 8 out of 13	Rank Foster Care & Child Protective Services as 9 out of 13	Rank Foster Care & Child Protective Services as 10 out of 13	Rank Foster Care & Child Protective Services as 11 out of 13	Rank Foster Care & Child Protective Services as 12 out of 13	Rank Foster Care & Child Protective Services as 13 out of 13
Homeless Services	Rank Homeless Services as 1 out of 13	Rank Homeless Services as 2 out of 13	Rank Homeless Services as 3 out of 13	Rank Homeless Services as 4 out of 13	Rank Homeless Services as 5 out of 13	Rank Homeless Services as 6 out of 13	Rank Homeless Services as 7 out of 13	Rank Homeless Services as 8 out of 13	Rank Homeless Services as 9 out of 13	Rank Homeless Services as 10 out of 13	Rank Homeless Services as 11 out of 13	Rank Homeless Services as 12 out of 13	Rank Homeless Services as 13 out of 13
Housing Assistance	Rank Housing Assistance as 1 out of 13	Rank Housing Assistance as 2 out of 13	Rank Housing Assistance as 3 out of 13	Rank Housing Assistance as 4 out of 13	Rank Housing Assistance as 5 out of 13	Rank Housing Assistance as 6 out of 13	Rank Housing Assistance as 7 out of 13	Rank Housing Assistance as 8 out of 13	Rank Housing Assistance as 9 out of 13	Rank Housing Assistance as 10 out of 13	Rank Housing Assistance as 11 out of 13	Rank Housing Assistance as 12 out of 13	Rank Housing Assistance as 13 out of 13
Gang Issues	Rank Gang Issues as 1 out of 13	Rank Gang Issues as 2 out of 13	Rank Gang Issues as 3 out of 13	Rank Gang Issues as 4 out of 13	Rank Gang Issues as 5 out of 13	Rank Gang Issues as 6 out of 13	Rank Gang Issues as 7 out of 13	Rank Gang Issues as 8 out of 13	Rank Gang Issues as 9 out of 13	Rank Gang Issues as 10 out of 13	Rank Gang Issues as 11 out of 13	Rank Gang Issues as 12 out of 13	Rank Gang Issues as 13 out of 13
Job Training & Placement	Rank Job Training & Placement as 1 out of 13	Rank Job Training & Placement as 2 out of 13	Rank Job Training & Placement as 3 out of 13	Rank Job Training & Placement as 4 out of 13	Rank Job Training & Placement as 5 out of 13	Rank Job Training & Placement as 6 out of 13	Rank Job Training & Placement as 7 out of 13	Rank Job Training & Placement as 8 out of 13	Rank Job Training & Placement as 9 out of 13	Rank Job Training & Placement as 10 out of 13	Rank Job Training & Placement as 11 out of 13	Rank Job Training & Placement as 12 out of 13	Rank Job Training & Placement as 13 out of 13
Library Services	Rank Library Services as 1 out of 13	Rank Library Services as 2 out of 13	Rank Library Services as 3 out of 13	Rank Library Services as 4 out of 13	Rank Library Services as 5 out of 13	Rank Library Services as 6 out of 13	Rank Library Services as 7 out of 13	Rank Library Services as 8 out of 13	Rank Library Services as 9 out of 13	Rank Library Services as 10 out of 13	Rank Library Services as 11 out of 13	Rank Library Services as 12 out of 13	Rank Library Services as 13 out of 13
Medical Assistance/Health Education	Rank Medical Assistance/Health Education as 1 out of 13	Rank Medical Assistance/Health Education as 2 out of 13	Rank Medical Assistance/Health Education as 3 out of 13	Rank Medical Assistance/Health Education as 4 out of 13	Rank Medical Assistance/Health Education as 5 out of 13	Rank Medical Assistance/Health Education as 6 out of 13	Rank Medical Assistance/Health Education as 7 out of 13	Rank Medical Assistance/Health Education as 8 out of 13	Rank Medical Assistance/Health Education as 9 out of 13	Rank Medical Assistance/Health Education as 10 out of 13	Rank Medical Assistance/Health Education as 11 out of 13	Rank Medical Assistance/Health Education as 12 out of 13	Rank Medical Assistance/Health Education as 13 out of 13
Senior Services	Rank Senior Services as 1 out of 13	Rank Senior Services as 2 out of 13	Rank Senior Services as 3 out of 13	Rank Senior Services as 4 out of 13	Rank Senior Services as 5 out of 13	Rank Senior Services as 6 out of 13	Rank Senior Services as 7 out of 13	Rank Senior Services as 8 out of 13	Rank Senior Services as 9 out of 13	Rank Senior Services as 10 out of 13	Rank Senior Services as 11 out of 13	Rank Senior Services as 12 out of 13	Rank Senior Services as 13 out of 13
Veteran Services	Rank Veteran Services as 1 out of 13	Rank Veteran Services as 2 out of 13	Rank Veteran Services as 3 out of 13	Rank Veteran Services as 4 out of 13	Rank Veteran Services as 5 out of 13	Rank Veteran Services as 6 out of 13	Rank Veteran Services as 7 out of 13	Rank Veteran Services as 8 out of 13	Rank Veteran Services as 9 out of 13	Rank Veteran Services as 10 out of 13	Rank Veteran Services as 11 out of 13	Rank Veteran Services as 12 out of 13	Rank Veteran Services as 13 out of 13
Youth Services	Rank Youth Services as 1 out of 13	Rank Youth Services as 2 out of 13	Rank Youth Services as 3 out of 13	Rank Youth Services as 4 out of 13	Rank Youth Services as 5 out of 13	Rank Youth Services as 6 out of 13	Rank Youth Services as 7 out of 13	Rank Youth Services as 8 out of 13	Rank Youth Services as 9 out of 13	Rank Youth Services as 10 out of 13	Rank Youth Services as 11 out of 13	Rank Youth Services as 12 out of 13	Rank Youth Services as 13 out of 13

3. Please rank what you feel are DOMESTIC VIOLENCE needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Domestic Violence Counseling/Medical Services	Rank Domestic Violence Counseling/Medical Services as 1 out of 5	Rank Domestic Violence Counseling/Medical Services as 2 out of 5	Rank Domestic Violence Counseling/Medical Services as 3 out of 5	Rank Domestic Violence Counseling/Medical Services as 4 out of 5	Rank Domestic Violence Counseling/Medical Services as 5 out of 5
Financial Support	Rank Financial Support as 1 out of 5	Rank Financial Support as 2 out of 5	Rank Financial Support as 3 out of 5	Rank Financial Support as 4 out of 5	Rank Financial Support as 5 out of 5
Legal Assistance with Court Issues/Restraining Orders/Custody	Rank Legal Assistance with Court Issues/Restraining Orders/Custody as 1 out of 5	Rank Legal Assistance with Court Issues/Restraining Orders/Custody as 2 out of 5	Rank Legal Assistance with Court Issues/Restraining Orders/Custody as 3 out of 5	Rank Legal Assistance with Court Issues/Restraining Orders/Custody as 4 out of 5	Rank Legal Assistance with Court Issues/Restraining Orders/Custody as 5 out of 5
Safe House/Housing	Rank Safe House/Housing as 1 out of 5	Rank Safe House/Housing as 2 out of 5	Rank Safe House/Housing as 3 out of 5	Rank Safe House/Housing as 4 out of 5	Rank Safe House/Housing as 5 out of 5
Resources (food, clothing, etc)	Rank Resources (food, clothing, etc) as 1 out of 5	Rank Resources (food, clothing, etc) as 2 out of 5	Rank Resources (food, clothing, etc) as 3 out of 5	Rank Resources (food, clothing, etc) as 4 out of 5	Rank Resources (food, clothing, etc) as 5 out of 5

4. Please rank what you feel are DRUG & SUBSTANCE ABUSE PREVENTION needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Group Counseling/Sober Living Environment	Rank Group Counseling/Sober Living Environment as 1 out of 5	Rank Group Counseling/Sober Living Environment as 2 out of 5	Rank Group Counseling/Sober Living Environment as 3 out of 5	Rank Group Counseling/Sober Living Environment as 4 out of 5	Rank Group Counseling/Sober Living Environment as 5 out of 5
Medical Services/Insurance/Financial Assistance	Rank Medical Services/Insurance/Financial Assistance as 1 out of 5	Rank Medical Services/Insurance/Financial Assistance as 2 out of 5	Rank Medical Services/Insurance/Financial Assistance as 3 out of 5	Rank Medical Services/Insurance/Financial Assistance as 4 out of 5	Rank Medical Services/Insurance/Financial Assistance as 5 out of 5
Care for child(ren) while in recovery	Rank Care for child(ren) while in recovery as 1 out of 5	Rank Care for child(ren) while in recovery as 2 out of 5	Rank Care for child(ren) while in recovery as 3 out of 5	Rank Care for child(ren) while in recovery as 4 out of 5	Rank Care for child(ren) while in recovery as 5 out of 5
Transportation Service to Treatment Program	Rank Transportation Service to Treatment Program as 1 out of 5	Rank Transportation Service to Treatment Program as 2 out of 5	Rank Transportation Service to Treatment Program as 3 out of 5	Rank Transportation Service to Treatment Program as 4 out of 5	Rank Transportation Service to Treatment Program as 5 out of 5
In/Out Patient Treatment	Rank In/Out Patient Treatment as 1 out of 5	Rank In/Out Patient Treatment as 2 out of 5	Rank In/Out Patient Treatment as 3 out of 5	Rank In/Out Patient Treatment as 4 out of 5	Rank In/Out Patient Treatment as 5 out of 5

5. Please rank what you feel are FOSTER CARE & CHILD PROTECTIVE SERVICES needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Legal Assistance/Placement Assistance	Rank Legal Assistance/Placement Assistance as 1 out of 5	Rank Legal Assistance/Placement Assistance as 2 out of 5	Rank Legal Assistance/Placement Assistance as 3 out of 5	Rank Legal Assistance/Placement Assistance as 4 out of 5	Rank Legal Assistance/Placement Assistance as 5 out of 5
Behavioral Health Services/Youth Therapy	Rank Behavioral Health Services/Youth Therapy as 1 out of 5	Rank Behavioral Health Services/Youth Therapy as 2 out of 5	Rank Behavioral Health Services/Youth Therapy as 3 out of 5	Rank Behavioral Health Services/Youth Therapy as 4 out of 5	Rank Behavioral Health Services/Youth Therapy as 5 out of 5
Financial Services for Foster Parents	Rank Financial Services for Foster Parents as 1 out of 5	Rank Financial Services for Foster Parents as 2 out of 5	Rank Financial Services for Foster Parents as 3 out of 5	Rank Financial Services for Foster Parents as 4 out of 5	Rank Financial Services for Foster Parents as 5 out of 5
Training Support for Foster Parents/Foster Parent Support Group	Rank Training Support for Foster Parents/Foster Parent Support Group as 1 out of 5	Rank Training Support for Foster Parents/Foster Parent Support Group as 2 out of 5	Rank Training Support for Foster Parents/Foster Parent Support Group as 3 out of 5	Rank Training Support for Foster Parents/Foster Parent Support Group as 4 out of 5	Rank Training Support for Foster Parents/Foster Parent Support Group as 5 out of 5
Foster Parent Support Group/Respite Care/Child Education Navigation/Guidance	Rank Foster Parent Support Group/Respite Care/Child Education Navigation/Guidance as 1 out of 5	Rank Foster Parent Support Group/Respite Care/Child Education Navigation/Guidance as 2 out of 5	Rank Foster Parent Support Group/Respite Care/Child Education Navigation/Guidance as 3 out of 5	Rank Foster Parent Support Group/Respite Care/Child Education Navigation/Guidance as 4 out of 5	Rank Foster Parent Support Group/Respite Care/Child Education Navigation/Guidance as 5 out of 5

6. Please rank what you feel are HOMELESS needs #1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Transitional Housing for families	Rank Transitional Housing for families as 1 out of 5	Rank Transitional Housing for families as 2 out of 5	Rank Transitional Housing for families as 3 out of 5	Rank Transitional Housing for families as 4 out of 5	Rank Transitional Housing for families as 5 out of 5
Transitional Housing for individuals	Rank Transitional Housing for individuals as 1 out of 5	Rank Transitional Housing for individuals as 2 out of 5	Rank Transitional Housing for individuals as 3 out of 5	Rank Transitional Housing for individuals as 4 out of 5	Rank Transitional Housing for individuals as 5 out of 5
Year-Round Homeless Shelter	Rank Year-Round Homeless Shelter as 1 out of 5	Rank Year-Round Homeless Shelter as 2 out of 5	Rank Year-Round Homeless Shelter as 3 out of 5	Rank Year-Round Homeless Shelter as 4 out of 5	Rank Year-Round Homeless Shelter as 5 out of 5
Homeless Supportive Services	Rank Homeless Supportive Services as 1 out of 5	Rank Homeless Supportive Services as 2 out of 5	Rank Homeless Supportive Services as 3 out of 5	Rank Homeless Supportive Services as 4 out of 5	Rank Homeless Supportive Services as 5 out of 5
Housing Navigation	Rank Housing Navigation as 1 out of 5	Rank Housing Navigation as 2 out of 5	Rank Housing Navigation as 3 out of 5	Rank Housing Navigation as 4 out of 5	Rank Housing Navigation as 5 out of 5

7. Please rank what you feel are HOUSING needs #1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Affordable Housing/Low-Income Housing	Rank Affordable Housing/Low-Income Housing as 1 out of 5	Rank Affordable Housing/Low-Income Housing as 2 out of 5	Rank Affordable Housing/Low-Income Housing as 3 out of 5	Rank Affordable Housing/Low-Income Housing as 4 out of 5	Rank Affordable Housing/Low-Income Housing as 5 out of 5
1st Months/Deposit Payment Assistance/Rent Payment Assistance	Rank 1st Months/Deposit Payment Assistance/Rent Payment Assistance as 1 out of 5	Rank 1st Months/Deposit Payment Assistance/Rent Payment Assistance as 2 out of 5	Rank 1st Months/Deposit Payment Assistance/Rent Payment Assistance as 3 out of 5	Rank 1st Months/Deposit Payment Assistance/Rent Payment Assistance as 4 out of 5	Rank 1st Months/Deposit Payment Assistance/Rent Payment Assistance as 5 out of 5
Housing Assistance for Homeless Youth (ages 16-24)	Rank Housing Assistance for Homeless Youth (ages 16-24) as 1 out of 5	Rank Housing Assistance for Homeless Youth (ages 16-24) as 2 out of 5	Rank Housing Assistance for Homeless Youth (ages 16-24) as 3 out of 5	Rank Housing Assistance for Homeless Youth (ages 16-24) as 4 out of 5	Rank Housing Assistance for Homeless Youth (ages 16-24) as 5 out of 5
Landlord/Tenant Mediation	Rank Landlord/Tenant Mediation as 1 out of 5	Rank Landlord/Tenant Mediation as 2 out of 5	Rank Landlord/Tenant Mediation as 3 out of 5	Rank Landlord/Tenant Mediation as 4 out of 5	Rank Landlord/Tenant Mediation as 5 out of 5
Utility Payment Assistance	Rank Utility Payment Assistance as 1 out of 5	Rank Utility Payment Assistance as 2 out of 5	Rank Utility Payment Assistance as 3 out of 5	Rank Utility Payment Assistance as 4 out of 5	Rank Utility Payment Assistance as 5 out of 5

8. Please rank what you feel are GANG needs # 1 being most important and #5 being least important *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Assistance for my child(ren) with gang involvement	Rank Assistance for my child(ren) with gang involvement as 1 out of 5	Rank Assistance for my child(ren) with gang involvement as 2 out of 5	Rank Assistance for my child(ren) with gang involvement as 3 out of 5	Rank Assistance for my child(ren) with gang involvement as 4 out of 5	Rank Assistance for my child(ren) with gang involvement as 5 out of 5
Gangs are a real concern in my community	Rank Gangs are a real concern in my community as 1 out of 5	Rank Gangs are a real concern in my community as 2 out of 5	Rank Gangs are a real concern in my community as 3 out of 5	Rank Gangs are a real concern in my community as 4 out of 5	Rank Gangs are a real concern in my community as 5 out of 5
Gangs are somewhat of a concern in my community	Rank Gangs are somewhat of a concern in my community as 1 out of 5	Rank Gangs are somewhat of a concern in my community as 2 out of 5	Rank Gangs are somewhat of a concern in my community as 3 out of 5	Rank Gangs are somewhat of a concern in my community as 4 out of 5	Rank Gangs are somewhat of a concern in my community as 5 out of 5
Help identifying gang activity	Rank Help identifying gang activity as 1 out of 5	Rank Help identifying gang activity as 2 out of 5	Rank Help identifying gang activity as 3 out of 5	Rank Help identifying gang activity as 4 out of 5	Rank Help identifying gang activity as 5 out of 5
I don't think our community has a gang problem	Rank I don't think our community has a gang problem as 1 out of 5	Rank I don't think our community has a gang problem as 2 out of 5	Rank I don't think our community has a gang problem as 3 out of 5	Rank I don't think our community has a gang problem as 4 out of 5	Rank I don't think our community has a gang problem as 5 out of 5

9. Please rank what you feel are JOB TRAINGING & EMPLOYMENT needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Vocational Training/Work Experience/Apprenticeship/Internship	Rank Vocational Training/Work Experience/Apprenticeship/Internship as 1 out of 5	Rank Vocational Training/Work Experience/Apprenticeship/Internship as 2 out of 5	Rank Vocational Training/Work Experience/Apprenticeship/Internship as 3 out of 5	Rank Vocational Training/Work Experience/Apprenticeship/Internship as 4 out of 5	Rank Vocational Training/Work Experience/Apprenticeship/Internship as 5 out of 5
Job Readiness Training	Rank Job Readiness Training as 1 out of 5	Rank Job Readiness Training as 2 out of 5	Rank Job Readiness Training as 3 out of 5	Rank Job Readiness Training as 4 out of 5	Rank Job Readiness Training as 5 out of 5
Career Counseling (workshops or coaching)	Rank Career Counseling (workshops or coaching) as 1 out of 5	Rank Career Counseling (workshops or coaching) as 2 out of 5	Rank Career Counseling (workshops or coaching) as 3 out of 5	Rank Career Counseling (workshops or coaching) as 4 out of 5	Rank Career Counseling (workshops or coaching) as 5 out of 5
Job Search Support	Rank Job Search Support as 1 out of 5	Rank Job Search Support as 2 out of 5	Rank Job Search Support as 3 out of 5	Rank Job Search Support as 4 out of 5	Rank Job Search Support as 5 out of 5
Youth Employment Services	Rank Youth Employment Services as 1 out of 5	Rank Youth Employment Services as 2 out of 5	Rank Youth Employment Services as 3 out of 5	Rank Youth Employment Services as 4 out of 5	Rank Youth Employment Services as 5 out of 5

10. Please rank what you feel are LIBRARY needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Access to On-Line Books & Movies	Rank Access to On-Line Books & Movies as 1 out of 5	Rank Access to On-Line Books & Movies as 2 out of 5	Rank Access to On-Line Books & Movies as 3 out of 5	Rank Access to On-Line Books & Movies as 4 out of 5	Rank Access to On-Line Books & Movies as 5 out of 5
Books and programs for children (classes, story-time) or Internship	Rank Books and programs for children (classes, story-time) or Internship as 1 out of 5	Rank Books and programs for children (classes, story-time) or Internship as 2 out of 5	Rank Books and programs for children (classes, story-time) or Internship as 3 out of 5	Rank Books and programs for children (classes, story-time) or Internship as 4 out of 5	Rank Books and programs for children (classes, story-time) or Internship as 5 out of 5
Collection of books, DVDs and other reference material	Rank Collection of books, DVDs and other reference material as 1 out of 5	Rank Collection of books, DVDs and other reference material as 2 out of 5	Rank Collection of books, DVDs and other reference material as 3 out of 5	Rank Collection of books, DVDs and other reference material as 4 out of 5	Rank Collection of books, DVDs and other reference material as 5 out of 5
Computer & Internet Access/Access to free WiFi/Printers & Other Stationary	Rank Computer & Internet Access/Access to free WiFi/Printers & Other Stationary as 1 out of 5	Rank Computer & Internet Access/Access to free WiFi/Printers & Other Stationary as 2 out of 5	Rank Computer & Internet Access/Access to free WiFi/Printers & Other Stationary as 3 out of 5	Rank Computer & Internet Access/Access to free WiFi/Printers & Other Stationary as 4 out of 5	Rank Computer & Internet Access/Access to free WiFi/Printers & Other Stationary as 5 out of 5
Hours of Operation/Study Rooms/Meeting Rooms	Rank Hours of Operation/Study Rooms/Meeting Rooms as 1 out of 5	Rank Hours of Operation/Study Rooms/Meeting Rooms as 2 out of 5	Rank Hours of Operation/Study Rooms/Meeting Rooms as 3 out of 5	Rank Hours of Operation/Study Rooms/Meeting Rooms as 4 out of 5	Rank Hours of Operation/Study Rooms/Meeting Rooms as 5 out of 5

11. Please rank what you feel are MEDICAL ASSISTANCE/HEALTH EDUCATION needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Help applying for Medical Insurance/Medicare	Rank Help applying for Medical Insurance/Medicare as 1 out of 5	Rank Help applying for Medical Insurance/Medicare as 2 out of 5	Rank Help applying for Medical Insurance/Medicare as 3 out of 5	Rank Help applying for Medical Insurance/Medicare as 4 out of 5	Rank Help applying for Medical Insurance/Medicare as 5 out of 5
Help paying my Medical Bills	Rank Help paying my Medical Bills as 1 out of 5	Rank Help paying my Medical Bills as 2 out of 5	Rank Help paying my Medical Bills as 3 out of 5	Rank Help paying my Medical Bills as 4 out of 5	Rank Help paying my Medical Bills as 5 out of 5
Health Education	Rank Health Education as 1 out of 5	Rank Health Education as 2 out of 5	Rank Health Education as 3 out of 5	Rank Health Education as 4 out of 5	Rank Health Education as 5 out of 5
Managing my Health/Diabetes	Rank Managing my Health/Diabetes as 1 out of 5	Rank Managing my Health/Diabetes as 2 out of 5	Rank Managing my Health/Diabetes as 3 out of 5	Rank Managing my Health/Diabetes as 4 out of 5	Rank Managing my Health/Diabetes as 5 out of 5
Social Security Disability	Rank Social Security Disability as 1 out of 5	Rank Social Security Disability as 2 out of 5	Rank Social Security Disability as 3 out of 5	Rank Social Security Disability as 4 out of 5	Rank Social Security Disability as 5 out of 5

12. Please rank what you feel are SENIOR needs # 1 being most important and #5 being least important *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Food Assistance	Rank Food Assistance as 1 out of 5	Rank Food Assistance as 2 out of 5	Rank Food Assistance as 3 out of 5	Rank Food Assistance as 4 out of 5	Rank Food Assistance as 5 out of 5
Financial Constraints	Rank Financial Constraints as 1 out of 5	Rank Financial Constraints as 2 out of 5	Rank Financial Constraints as 3 out of 5	Rank Financial Constraints as 4 out of 5	Rank Financial Constraints as 5 out of 5
Lack of awareness of services	Rank Lack of awareness of services as 1 out of 5	Rank Lack of awareness of services as 2 out of 5	Rank Lack of awareness of services as 3 out of 5	Rank Lack of awareness of services as 4 out of 5	Rank Lack of awareness of services as 5 out of 5
Language barriers	Rank Language barriers as 1 out of 5	Rank Language barriers as 2 out of 5	Rank Language barriers as 3 out of 5	Rank Language barriers as 4 out of 5	Rank Language barriers as 5 out of 5
Transportation difficulties	Rank Transportation difficulties as 1 out of 5	Rank Transportation difficulties as 2 out of 5	Rank Transportation difficulties as 3 out of 5	Rank Transportation difficulties as 4 out of 5	Rank Transportation difficulties as 5 out of 5

13. Please rank what you feel are VETERAN'S needs # 1 being most important and #5 being least important Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Connecting to Veteran Organization	Rank Connecting to Veteran Organization as 1 out of 5	Rank Connecting to Veteran Organization as 2 out of 5	Rank Connecting to Veteran Organization as 3 out of 5	Rank Connecting to Veteran Organization as 4 out of 5	Rank Connecting to Veteran Organization as 5 out of 5
Help getting/understanding benefits/VA Claim Appeals	Rank Help getting/understanding benefits/VA Claim Appeals as 1 out of 5	Rank Help getting/understanding benefits/VA Claim Appeals as 2 out of 5	Rank Help getting/understanding benefits/VA Claim Appeals as 3 out of 5	Rank Help getting/understanding benefits/VA Claim Appeals as 4 out of 5	Rank Help getting/understanding benefits/VA Claim Appeals as 5 out of 5
Mental/Health Care	Rank Mental/Health Care as 1 out of 5	Rank Mental/Health Care as 2 out of 5	Rank Mental/Health Care as 3 out of 5	Rank Mental/Health Care as 4 out of 5	Rank Mental/Health Care as 5 out of 5
Transportation assistance	Rank Transportation assistance as 1 out of 5	Rank Transportation assistance as 2 out of 5	Rank Transportation assistance as 3 out of 5	Rank Transportation assistance as 4 out of 5	Rank Transportation assistance as 5 out of 5
Women Veteran Health Services	Rank Women Veteran Health Services as 1 out of 5	Rank Women Veteran Health Services as 2 out of 5	Rank Women Veteran Health Services as 3 out of 5	Rank Women Veteran Health Services as 4 out of 5	Rank Women Veteran Health Services as 5 out of 5

14. Please rank what you feel are YOUTH needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
Youth Center	Rank Youth Center as 1 out of 5	Rank Youth Center as 2 out of 5	Rank Youth Center as 3 out of 5	Rank Youth Center as 4 out of 5	Rank Youth Center as 5 out of 5
Before/After School Activities/Recreational & Enrichment Activities	Rank Before/After School Activities/Recreational & Enrichment Activities as 1 out of 5	Rank Before/After School Activities/Recreational & Enrichment Activities as 2 out of 5	Rank Before/After School Activities/Recreational & Enrichment Activities as 3 out of 5	Rank Before/After School Activities/Recreational & Enrichment Activities as 4 out of 5	Rank Before/After School Activities/Recreational & Enrichment Activities as 5 out of 5
Child/Youth Education Support	Rank Child/Youth Education Support as 1 out of 5	Rank Child/Youth Education Support as 2 out of 5	Rank Child/Youth Education Support as 3 out of 5	Rank Child/Youth Education Support as 4 out of 5	Rank Child/Youth Education Support as 5 out of 5
Mentoring/Tutoring	Rank Mentoring/Tutoring as 1 out of 5	Rank Mentoring/Tutoring as 2 out of 5	Rank Mentoring/Tutoring as 3 out of 5	Rank Mentoring/Tutoring as 4 out of 5	Rank Mentoring/Tutoring as 5 out of 5
Summer Programs	Rank Summer Programs as 1 out of 5	Rank Summer Programs as 2 out of 5	Rank Summer Programs as 3 out of 5	Rank Summer Programs as 4 out of 5	Rank Summer Programs as 5 out of 5

15. Please rank what you feel are ACCESS to FOOD needs # 1 being most important and #5 being least important. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5
I have a need for access to food/Food Bank	Rank I have a need for access to food/Food Bank as 1 out of 5	Rank I have a need for access to food/Food Bank as 2 out of 5	Rank I have a need for access to food/Food Bank as 3 out of 5	Rank I have a need for access to food/Food Bank as 4 out of 5	Rank I have a need for access to food/Food Bank as 5 out of 5
Affordable food options	Rank Affordable food options as 1 out of 5	Rank Affordable food options as 2 out of 5	Rank Affordable food options as 3 out of 5	Rank Affordable food options as 4 out of 5	Rank Affordable food options as 5 out of 5
Information on CalFRESH (food stamps), Women & Infant Children (WIC)	Rank Information on CalFRESH (food stamps), Women & Infant Children (WIC) as 1 out of 5	Rank Information on CalFRESH (food stamps), Women & Infant Children (WIC) as 2 out of 5	Rank Information on CalFRESH (food stamps), Women & Infant Children (WIC) as 3 out of 5	Rank Information on CalFRESH (food stamps), Women & Infant Children (WIC) as 4 out of 5	Rank Information on CalFRESH (food stamps), Women & Infant Children (WIC) as 5 out of 5
Healthy Food & Nutrition	Rank Healthy Food & Nutrition as 1 out of 5	Rank Healthy Food & Nutrition as 2 out of 5	Rank Healthy Food & Nutrition as 3 out of 5	Rank Healthy Food & Nutrition as 4 out of 5	Rank Healthy Food & Nutrition as 5 out of 5
Cooking Classes	Rank Cooking Classes as 1 out of 5	Rank Cooking Classes as 2 out of 5	Rank Cooking Classes as 3 out of 5	Rank Cooking Classes as 4 out of 5	Rank Cooking Classes as 5 out of 5

16. Additional Comments/Services Needed?

17. Please rank what has impacted you most during COVID? #1 being most impacted and #6 being least impacted *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5	6
Loss of Job/Business	Rank Loss of Job/Business as 1 out of 6	Rank Loss of Job/Business as 2 out of 6	Rank Loss of Job/Business as 3 out of 6	Rank Loss of Job/Business as 4 out of 6	Rank Loss of Job/Business as 5 out of 6	Rank Loss of Job/Business as 6 out of 6
Loss of friends or family member either to COVID-19 or other illness	Rank Loss of friends or family member either to COVID-19 or other illness as 1 out of 6	Rank Loss of friends or family member either to COVID-19 or other illness as 2 out of 6	Rank Loss of friends or family member either to COVID-19 or other illness as 3 out of 6	Rank Loss of friends or family member either to COVID-19 or other illness as 4 out of 6	Rank Loss of friends or family member either to COVID-19 or other illness as 5 out of 6	Rank Loss of friends or family member either to COVID-19 or other illness as 6 out of 6
Worried about how I will pay my rent, mortgage, and other bills	Rank Worried about how I will pay my rent, mortgage, and other bills as 1 out of 6	Rank Worried about how I will pay my rent, mortgage, and other bills as 2 out of 6	Rank Worried about how I will pay my rent, mortgage, and other bills as 3 out of 6	Rank Worried about how I will pay my rent, mortgage, and other bills as 4 out of 6	Rank Worried about how I will pay my rent, mortgage, and other bills as 5 out of 6	Rank Worried about how I will pay my rent, mortgage, and other bills as 6 out of 6
Health condition and am worried about accessing treatment or services	Rank Health condition and am worried about accessing treatment or services as 1 out of 6	Rank Health condition and am worried about accessing treatment or services as 2 out of 6	Rank Health condition and am worried about accessing treatment or services as 3 out of 6	Rank Health condition and am worried about accessing treatment or services as 4 out of 6	Rank Health condition and am worried about accessing treatment or services as 5 out of 6	Rank Health condition and am worried about accessing treatment or services as 6 out of 6
Student or teacher dealing with online classes	Rank Student or teacher dealing with online classes as 1 out of 6	Rank Student or teacher dealing with online classes as 2 out of 6	Rank Student or teacher dealing with online classes as 3 out of 6	Rank Student or teacher dealing with online classes as 4 out of 6	Rank Student or teacher dealing with online classes as 5 out of 6	Rank Student or teacher dealing with online classes as 6 out of 6
Coping with Social Distancing, cocooning or working from home	Rank Coping with Social Distancing, cocooning or working from home as 1 out of 6	Rank Coping with Social Distancing, cocooning or working from home as 2 out of 6	Rank Coping with Social Distancing, cocooning or working from home as 3 out of 6	Rank Coping with Social Distancing, cocooning or working from home as 4 out of 6	Rank Coping with Social Distancing, cocooning or working from home as 5 out of 6	Rank Coping with Social Distancing, cocooning or working from home as 6 out of 6

18. Do you have access to the Internet? *This question is required.