Form Center

2. Survey Type

   This survey should be completed by residents of Inglewood or on behalf of organizations that work with residents of Inglewood with low- and moderate incomes, special needs, and those experiencing or at risk or experiencing homelessness. Special needs populations include the elderly, those with disabilities including substance addiction, victims of domestic violence and human trafficking, and those struggling with mental illness including post traumatic stress disorder (PTSD). Organizations may include service providers, housing developers, schools, and more.

4. 1. Are you completing this survey as a resident or on behalf of an organization?

   1. Resident
   2. Organization
6. 2. What zip code do you live in?*

   1. 90301
   2. 90302
   3. 90303
   4. 90304
   5. 90305
8. 3. What is your age?*

   1. Under 24
   2. 25-40
   3. 41-56
   4. 57-75
   5. 75+
   6. Prefer not to answer
10. 4. What gender do you identify as? *

    1. Prefer not to answer
    2. Female
    3. Non-binary
    4. Male
12. 5. Please specify your race.*

    1. Black or African American
    2. White
    3. Asian
    4. Multi-racial (two or more)
    5. Native American
    6. Native Hawaiian or Pacific Islander
    7. Prefer not to answer
    8. Other
14. Other Race
16. 6. Do you identify as hispanic?*

    1. Prefer not to answer
    2. No
    3. Yes
18. 7. What is your annual household income? *

    1. Less than $30,000
    2. Prefer not to say
    3. $30,000 - $60,000
    4. $60,000 - $90,000
    5. More than $90,000
20. 8. If you would like to receive updates regarding the Consolidated Plan, please input your e-mail address below.
22. 9. Do you have reliable internet access at home?*

    1. Yes
    2. No
24. 10. How prepared do you feel for a natural disaster?*

    Examples of natural disasters include earthquakes, wildfires, tsunamis, etc.

    1. Extremely prepared
    2. Somewhat unprepared
    3. Extremely unprepared
    4. Somewhat prepared
26. 11. If the above questions did not mention a need that you believe the City should consider, please provide your comments below.
28. Assessment of Fair Housing
30. 12. Have you ever experienced housing discrimination in obtaining or maintaining housing in Inglewood?*

    Fair housing is a condition in which individuals of similar income levels in the same housing market have like ranges of choices available to them regardless of race, color, ancestry, national origin, religion, sex, disability, marital status, familial status, or any other arbitrary factor.

    1. Yes
    2. I'm not sure
    3. No
32. 13. Who do you believe discriminated against you?*

    1. Landlord/Property manager
    2. Real estate agent
    3. Mortgage insurer
    4. Mortgage lender or Servicer
    5. Other
    6. N/A
34. Other
36. 14. On what basis do you believe you were discriminated against?*

    1. Sex, gender
    2. Gender identity, gender expression
    3. Citizenship, immigration status
    4. Ancestry, National origin
    5. Marital status
    6. Source of income
    7. Primary language
    8. Age
    9. Disability, mental or physical
    10. Genetic information
    11. Race, color
    12. Veteran/Military status
    13. Sexual orientation
    14. Religion
    15. Other
    16. N/A
38. Other
40. 15. Did you report your experience of housing discrimination to a local fair housing service provider or the California Department of Fair Employment and Housing?*

    1. Yes
    2. No
    3. N/A
42. 16. Why did you decide to not report the incident of housing discrimination?*

    1. Don't believe it makes a difference
    2. Don't know where to report
    3. Too much trouble
    4. Afraid of retaliation
    5. Other
    6. N/A
44. Other
46. Organizational information
48. 17. Please provide the name of your organization as well as your organization's corporate and local address.
50. 18. Please provide the name and contact information (phone and email) for the point of contact for your organization.
52. Feedback

    The next 2 questions will ask you to reflect on the projects have worked well for the City and what should be high priorities in the near term future.

54. 19. What do you consider to be the most effective community development projects in the City during the past 5 to 10 years?
56. 20. What are the high priority housing, community development, or economic development needs for the City over the next 5 years? Why?
58. 21. Please provide any additional comments below.
60. Community Needs Assessment
62. 22. What is the level of need for the following public facilities in the City?
64. Senior centers*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
65. Childcare centers*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
67. Parks*

    1. High need
    2. Moderate need
    3. Low need
    4. High need
    5. No opinion
68. Community centers (inclusive of Youth centers)*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
70. Health care facilities*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
71. Fire stations*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
73. Libraries*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
74. Accessibility improvements*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
76. Homeless facilities*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
77. Facilities for persons with disabilities*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
79. Parking facilities*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
80. Facilities for abused and neglected children*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
82. Facilities for persons with HIV/AIDS*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
83. Facilities equipped with technology*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
85. 23. What is the level of need for the following public infrastructure improvements in the City?
87. Water/Sewer improvements*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
88. Street/ Alley improvements*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
90. Street lighting*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
91. Sidewalk improvements*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
93. Accessibility improvements*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
94. High-speed internet infrastructure*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
96. 24. What is the level of need for the following public services in the City?
98. Senior services*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
99. Youth services*

    1. High need
    2. Moderate need
    3. Low need
    4. No need
    5. No opinion
101. Childcare services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
102. Transportation services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
104. Anti-crime programs*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
105. Health care services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
107. Mental health services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
108. Legal services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
110. Services for persons with disabilities*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
111. Services for survivors of domestic violence*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
113. Substance abuse services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
114. Homeless services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
116. Services for persons with HIV/AIDS*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
117. Services for abused and neglected children*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
119. Digital literacy services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
120. Services for survivors of sexual assault*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
122. 25. What is the level of need for the following housing facilities in the City?
124. Housing for persons with disabilities*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
125. Senior housing*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
127. Single family housing*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
128. Large family housing*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
130. Affordable rental housing*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
131. Transitional and supportive housing*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
133. Accessory Dwelling Units*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
134. Clustered housing with 3+ units compatible with single-family homes*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
136. 26. What is the level of need for the following housing services in the City?
138. Housing rehabilitation including energy efficient improvements*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
139. Assistance to purchase a home*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
141. Fair housing discrimination services*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
142. Lead-based paint removal*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
144. Code enforcement (e.g. compliance with building, health and safety codes & property appearance)*

     1. High need
     2. Moderate need
     3. Low need
     4. No need
     5. No opinion
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146. Email address

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