Ontario County Community Survey

Ontario County Community Survey

Name

Address

City/Town/Village*

Select

Other Jurisdiction

Telephone Number

Phone

Community Preparedness Questions

Natural Hazards*

Which of the following natural hazard events have you (or someone in your household/business) experienced in the last 10 years?

(Select all that apply)

Flood (flash flood, inland/urban flooding)

Major Winter Storm (blizzard, ice, extreme prolonged cold)

Wind Related (Hurricane, tornado, straight line winds)

Wildfire (drought, extreme heat)

Sustained Power Outage (3 days or more)

Other not listed

None

Other Natural Hazard

Other Incident Type

Preparedness*

How prepared is your household (or business) to deal with a natural, technological or man-made incident?

Preparedness Steps*

What steps have you and your household/business taken to better prepare for the types of emergencies and disasters that might happen in your community?

(Select all that apply)

Collected preparedness information

Attended meetings about emergency preparedness

Assembled a Disaster Supply Kit

Prepared and talked about a family emergency plan

Designated a safe meeting location

Taken a special training (first aid, CPR, CERT, etc.)

Other not listed

None

Other Preparedness Step

Preparedness Information*

How do you obtain information that helps you prepare for natural, technological or man-made incident?

(Select all that apply)

Attend meetings/classes about disaster preparedness

Participate in volunteer programs associated with disaster preparedness (MRC, CERT)

Local news

Personal experiences

Social Media

Other not listed

Other not listed Prep Info

Other Info Preference

Preparedness Communication Procedures*

Do you maintain procedures to communicate after a disaster with family and friends; and if you own a business, with employees, suppliers, vendors, and customers?

Yes

PrivateTransportation*

Do you have private transportation available in your household?

Yes

PublicTransportation*

Do you have reasonable access to public transportation?

Yes

Unsure

Back Up Power*

Do you have back up emergency power should a disaster occur that shuts down your primary power source?

Yes

Unsure

Volunteer Interest*

Would you be interested in volunteering with local groups such as a Fire or EMS agency, Community Emergency Response Team or COAD (Community Organization Active in Disasters)?

Yes

Unsure, need more information

Volunteer Interest (Email)

Volunteer Interest (Telephone)

Functional Needs*

Do you or anyone in your household/business have access or functional needs that would require support services in an emergency/disaster?

**Functional Needs Support Services (FNSS) are services that enable individuals with access and functional needs to maintain their independence in a general population shelter. Examples of support services include durable medical equipment (DME), consumable medical supplies (CMS), and personal assistance services (PAS). Individuals requiring FNSS may have physical, sensory, mental health, and cognitive and/or intellectual disabilities affecting their ability to function independently without assistance. Others who may benefit from FNSS include women in the late stages of pregnancy, seniors, and people whose body mass requires special equipment.

**Source: United States Health & Human Services

Yes

Sheltering & Sheltering with Pets or Livestock

General Sheltering*

If your home was damaged by fire, flood or other disaster, which of these would you utilize?

Stay with friends or family

Stay in a Hotel/Motel

Stay at County Red-Cross shelter

Other not listed

Other Shelter Type

Household Pets*

Do you have household pets?

Yes

Sheltering with Pets/Livestock*

If your home was damaged by fire, flood or other disaster, which of these would you utilize?

Stay with family or friends with my pets

Stay at a pet friendly hotel/motel

Stay at a pet friendly shelter

Arrange for livestock sheltering with family/friends

Other not listed

Other Pet Shelter

Pet Livestock Preparedness*

What steps have you and your household taken to better prepare for your pets and livestock for the types of emergencies and disasters that might happen in your community?

(Select all that apply)

Collected preparedness information

Assembled a disaster supply kit for the animals

Designated locations for pets/livestock

Taken special training

Have crates, ropes and leads, collars and identification

Other not listed

None

Other Pet Preparedness

Agriculture Community/Small Hobby Farms

Agriculture Member*

Are you a member of the farming/agriculture community, including small hobby farms?

Yes

Farm Name (If applicable)

Farm Emergency Plan*

Do you have an emergency plan for your business that considers all types of emergencies that could potentially disrupt your farm/agriculture business?

Yes

Unsure

Small Hobby Farms*

Do you have household pets or livestock such as (Rabbits, Chickens, Horses, Goats)?

Yes

Farm Partnerships*

Have you established partnerships with other farms or agricultural organizations that can assist with resources when a disaster occurs?

Yes

Unsure

Emergency Supplies*

Do you maintain emergency supplies for your farm/agricultural business to address immediate needs, such as if employees are able to go home?

Yes

Unsure

County Mitigation Efforts

Hazard Mitigation Plan*

Have you or anyone in your household ever accessed the County Hazard Mitigation Action Plan?

Yes

FEMA Question*

Is your property in a FEMA designated floodplain?

Yes

Unsure

Flood Insurance*

Do you have flood insurance for your property?

Yes

Unsure

Special Projects*

What types of projects do you think Ontario County and local government could do to reduce damage/disruption from natural disasters?

Retrofit/Strengthen public infrastructure (roadways, drainage, etc)

Retrofit/Strengthen essential public facilities (schools, public safety buildings)

Replace/repair vulnerable bridges

Strengthen ordinances/building codes to control development in high hazard areas

Buy out flood prone properties and create open space

Provide information to property owners and residents about ways to reduce damage caused by natural events and hazard risks and high hazard areas

Assist vulnerable property owners to secure funding to make their properties more resilient

Other not listed

Other Special Project

County Business Member*

Are you an owner or representative of the business community in the County?

Yes

Business Name

Business Community Questions: Completed by Business Only Please

Emergency Plans*

Do you have an emergency plan for your business that considers all types of emergencies that could potentially disrupt your workplace?

Yes

Unsure

Preparedness Procedures*

Do you maintain procedures to communicate after a disaster with employees, suppliers, vendors, customers, and the public?

Yes

Unsure

Emergency Supplies*

Do you maintain emergency supplies for your businesses to address immediate needs, such as if employees are unable to go home?

Yes

Unsure

Community Partnerships*

Have you established partnerships with other businesses, government and/or community organizations that can serve as resources when the next crisis arrives?