2019 Community Needs Assessment

Community Action Partnership of Orange County (CAP OC) is conducting this survey to better
understand the needs and resources of the residents of Orange County. By completing this survey,
you will help our organization identify important issues affecting our community.

Your participation in this research study is voluntary. You may choose not to participate. If you
decide to participate in this research survey, you may withdraw at any time. This survey is taken
anonymously (no names), and your responses will be kept confidential. There is no possibility of
later contact, long term follow-up calls, or follow-up visits.

Questions will be asked regarding education, employment, housing, healthcare, and other basic
needs. This survey will take approximately 10-15 minutes of your time.

Thank you for taking the time to participate. Your opinions are important to us!

1. Would you like to participate in the Community Needs Assessment?

Yes

No
2. In what ZIP code do you reside? (Enter 5-digit ZIP code.)

3. What is your age? (in years)

4. What is your gender?

Female

Male

Transgender

Prefer not to answer

Other (Please Specify)

5. How would you describe your race/ethnicity? (select all that apply)
Asian/Pacific Islander White/Caucasian

Black/African American Native American/American Indian/Alaska Native

Hispanic/Latino

Other (please specify)

6. What is the HIGHEST level of education you have completed?

No schooling completed

Nursery school to 8th grade

some high school, no diploma

High school diploma or GED

Some college/post-secondary education (trade/technical school, community college)

Associate's Degree (AA, AS)

Bachelor's degree (BA, BS, BN)

Graduate/professional degree (MS, MBA, Ph.D etc.)

7. At home, in what language do you speak most often?

8. How many people, including yourself, currently live in your household?

Children, 0-17

Adults, 18-24

Adults, 25-44

Adults, 45-59

Adults, 60+

9. My household's total income last year (before taxes) was:

Under $9,999

$10,000-$19,999

$20,000-$29,999

$30,000-$49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$149,999

$150,000-$199,999

$200,000 (+)

10. What is the primary mode of transportation?

Personal vehicle Bicycle

Walking Motorized scooter

Bus Rideshare / Taxi (i.e. Uber or Lyft)

Light rail / Train

Other (please specify)

11. On a typical day, how many miles do you travel to work ? (one way)
12. Have you ever considered purchasing an electric vehicle?
No I have never considered it

Yes I would buy an electric vehicle

I have considered it but unfortunately it does not meet my needs

I already own an electric vehicle

13. What keeps you from purchasing an electric vehicle? (Check all factors that apply)

*If you already own an electric vehicle you may skip this question.
Range (distance traveled between charges)

Price

Design

Access to charging stations (work, home, or other places I frequent)

Lack of knowledge of electric vehicles

Not interested in an electric vehicle

Other (please specify)

14. Do you have access to the internet by any means?

Yes

No

15. Where do you access the internet most often? (Check all that apply)

*If you answered 'No' to the previous question (#14) you may skip this question
At home from a computer, tablet, or IPAD

On a mobile phone

At a library or other community place

At a friend or family member's home

At work

Other (please specify)

16. What is your housing status?
Own

Rent

Homeless

Other (please specify)

17. What type of housing do you live in?

Single family home Staying at a shelter

Multi-family housing (an apt, condo etc.) Transitional housing (HUD temporary)

Section 8 housing Hotel/motel

Staying with friends or family Nursing/long term care

Living on the streets Assisted living

Living in a car Halfway house

Other (please specify)

18. What is your monthly income?

19. How much do you pay for rent/mortgage on a monthly basis, including utilities?

20. How do you rate your current health status?

Excellent

Good

Fair

Poor

Very Poor
21. In general your mental health is...
Excellent

Good

Fair

Poor

Very Poor

22. Does your family have a history of ...

Drugs and/or alcohol abuse

Mental Health

Both drug and/or alcohol abuse AND mental health

None of the above

I am not sure

23. About how long has it been since you last visited a doctor for a routine checkup?
Within the past year (less than 12 months)

Within the past 2 years

Within the past 5 years

Don't know

Other (please specify)

24. In a typical week, how many minutes of physical activity do you do each day?
Minutes

25. Where do you typically exercise or engage in physical activity? (Check all that apply)
I do not exercise

Home

Park

Public Recreation Center

Private Gym

Other (please specify)

26. In the past 12 months, did you or the people in your household ever cut the size of your meals or skip
meals because there wasn't enough money for food?
Yes

No

27. Where do you get most of your food?

Grocery store

Food pantry

Convenience store

Warehouse stores (Costco, Sam's Club, Smart & Final etc)

I use a meal program (Meals-on-wheels, work/ school cafeteria, etc)

I don't buy groceries

Other (please specify)

28. What type of food do you typically buy? (Check all that apply)
Ready to eat meals Frozen

Fast food Canned

Fresh food Not Applicable

Other (please specify)

29. How frequently do you eat...

Once a day More than once a week Never

At fast food chains (i.e.

McDonald's, Jack in the
Box, Taco Bell, etc.)

At sit-down restaraunts
(i.e. Chilli's, Applebee's,
TGI Fridays, etc.)

Food delivery (i.e.

PostMates, GrubHub,
Uber eats, etc.)

Other (please specify)

30. When I eat, it is important that the food is: (Check all that apply)
Affordable

Healthy/ nutritious

Tastes good/ is enjoyable

Easy to prepare

I haven't given this much thought

Other (please specify)

31. ______________ would help me eat healthier/nutritious food. (Check all that apply)
Additional finances

Cooking classes

Transportation

Time for preparation

I haven't given this much thought

Other (please specify)

32. What is your current employment status? (Check all that apply)
Full-time Underemployed

Part-time Retired

Self-employed Disabled

Unemployed Student

Unemployed, but currently looking for a job Homemaker

2 or more jobs
33. If someone is unemployed in your household, what are the barriers to finding adequate
employment? (Check all that apply.)
Lack of childcare No legal right to work in the United States

Lack of skills/education Language barriers

Health problems/disability Available jobs do not pay enough

Inadequate transportation Discrimination

Criminal record Not applicable

Other (please specify)

34. Please indicate all sources of income in your household last year. (Check all that apply.)
Employment (including self-employment) Unemployment

Pension Child support

Temporary Assistance for Needy Families (TANF) Student grants/loans

Supplemental Social Security/State Disability Insurance/ Capital gains/ investment

Social Security Disability Insurance (SSI/SDI/SSDI)

Social Security

Other (please specify)

35. In the last 12 months, were you late or are you currently behind on any of your utility bills? (i.e
gas, water, electricity)
Yes

No

36. What kind of debt do you have? (Check all that apply)
None Student loans

Credit card Mortgage

Personal loans Money owing to family/ friends

Short term cash loans Fines and/ or traffic infringements

Car loans

Other (please specify)

 37. How much of your monthly income goes towards paying your debt(s)?

38. Please indicate your financial situation?

Very unstable

Unstable

Fairly stable

Moderately stable

Stable

Very stable

39. Please choose what you believe to be the top three (3) issues affecting Orange County. (Select
three choices)
Lack of affordable education High cost of living

Single parent households Racial discrimination

Drug and alcohol abuse/addiction Gender discrimination

Not enough jobs LGBTQ+ discrimination

Crime Homelessness

Lack of affordable housing Immigration

Other (please specify)

Please select services you would like to see more of:

40. Employment Services

Help finding employment

Job training

Language development
 41. Family Services
Affordable Daycare

Affordable before/after school programs

Youth/Teen programs

Parenting support/education

Educational tutors

Senior services and programs

42. Health Services

Help meeting health goals

Drug/alcohol prevention/abuse services

Mental health/wellness services

Services for the disabled (transportation, food, etc.)

43. Financial Assistance

Help with utilities

Tax preparation

Help with food insecurity

Financial workshops

44. Any other services we missed?

45. Have you heard of Community Action Partnership of Orange County (CAP OC)?
Yes

No

*If you answered 'No' to the previous question (#45) you may skip questions 46-48.

46. Has anyone in your household contacted CAP OC in the last 12 months?
Yes

No
47. Has anyone in your household ever used services provided by CAP OC?
Yes

No

48. Which of the following CAP OC services/programs are you familiar with or have you heard of? (Check
all that apply)
Utility assistance Tax filing services

Weatherization services Stanton and Tina Pacific community gardens

Senior food box program Nutrition education programs

CalFresh (formerly known as Food Stamps) enrollment Backpacks for Success

Healthy Marriage and Family Program OC Food Bank

You Money, Your Goals: Financial Empowerment Programs The Giving Farm

Anaheim Independencia Family Resource Center None

El Modena Family Resource Center

Other (please specify)

49. Is there anything we have not asked you about that you feel is important to disclose?

Thank you for taking the time to take this survey! Your contribution matters!