[Hpn] Shelter Survey instrument

Coalition on Homelessness, SF coh@sfo.com
Sun, 24 Sep 2000 16:24:57 -0700


so, the way you actually conduct a survey like this is to interview 
people. it takes 10-15 minutes. having cigarettes to hand out is a 
good icebreaker.

the listed answers aren't there for the interviewer to ask. we held a 
couple of focus groups to 'dry-run' the survey, then added common 
answers to the survey form so the interviewer could just check them 
off. repeat: do NOT cue people, just ask the questions as they are 
written and record the answers or you'll wind up with a bunch of 
statistics that can be easily refuted.

welcome to the exciting world of 'quick and dirty' ethnographic research!

peace,

chance

############################################################

						Location _____________
						Survey #  ____________
						Date ________________



Hello, my name is _________________, and I am a volunteer with the 
Coalition on Homelessness.  All of the City Departments along with 
Advocates, Service Providers and current and formerly homeless people 
in San Francisco are working to create a plan for changes in the 
shelter system.

Your participation in this survey is very important; the Coalition 
will use it to represent homeless people's viewpoints, and it will 
inform the planning process as to why and how the shelters should be 
changed to address issues that are important to homeless people.


1. Do you stay in the Shelters?
	1.   Yes 	2.   No (skip to question 6)


2.  When were you last in a shelter (approx. month/year)?  ___/____
(if currently in shelter, skip question, but enter current month/year)

3. What do you like most about shelter(s) in SF?  (circle all those that apply)
1. 	Shelters get you off the Streets and out of the wind / Rain
2. 	Sleep
3. 	Food
4. 	Place to think/plan
5. 	Shower
6. 	Services
7.  	Staff
Other (please describe) 
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

  4. What do you like least about them?  (circle all those that apply)
1. 	Lack of Privacy.
2. 	Noise
3. 	Dirty Facilities
4. 	Isolation/loneliness
5.	Staff
Other (Please Describe) 
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5.  What changes, if any, would you like to see to rules and regulations?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The next set of questions are meant to get at what your ideal shelter 
would be like, if  you were to design it.   First of all,

6. What would the philosophy of your shelter(s) be?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


7. How would people access the shelter?  (circle all those that apply)
1. 	Lottery for each individual shelter
2. 	Lottery for all Shelters in SF
3.	Social worker decides based on need
4.	Drop-In/ just show up
Other (Please Describe)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
8. What kinds of services would be available?  (circle all those that apply)
1. 	Case Management
2.	Housing Services
3.	Job Training
4.	Job Listings
5.	Resume Services
6. 	Peer Conferences for information sharing
7.	Medical appointment service
8.	Medical Treatment
9.	Mental Health Treatment
10	Substance Abuse Treatment
Other (Please Describe)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


9. What would the physical environment look like?   (circle all those 
that apply)
1. 	Quiet Space set aside
2.	Colorful
3.	Clean
4.	Comfortable
5.	Small  Spaces
6.	Separate TV areas from Smoking and Sleeping areas.
7.	Private Sleeping areas
8.	Congregate Sleeping areas
Other (Please Describe)
__________________________________________________________________________________________________________________________________________________________________

  10. How would people exit the shelter and homelessness?  (circle all 
those that apply)

1.	Permanent Affordable housing
2.	Living Wage Job
3.	Transitional Housing
4.	Disability Benefits
5.	Supportive Housing
6.	Mental Health Treatment
7.	Substance Abuse Treatment
Other (Please Describe)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________





11. How would people's various cultures be embraced and respected? 
(circle all those that apply)

1.. 	Activities in Languages other than English
2. 	Announcements and Bulletin Boards in multiple Languages
3. 	Staff that speaks multiple Languages.
4.	Staff of various cultures
5.	Respect for different cultures
Other (Please Describe)
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

  12. How would the shelter deal with Seniors and People with 
Disabilities?  (circle all those that apply)

1. 	Medication's Storage with Refrigeration available.
2. 	Flexible hours
3. 	Flexible Policies
4.	24 hour Emergency Telephone number for Advice Nurse
5. 	Accessible Bath and Toilet
6. 	Trained Staff on senior and disability issues
7. 	Phone services
8.	E-mail services
9.	Special diet/ food
10.	Separate shelter for Seniors
11.	Separate shelter for people with disabilities
Other (Please Describe)
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

You do not have to answer any questions that you are not comfortable 
with, the following questions will help us ensure that we have 
adequate representation of homeless people in the San Francisco 
community.

13. What is your ethnicity
1. ___ African American
2. ___ Asian
3. ___ Caucasian
4. ___ Latino/a
5. ___ Native American/Indigenous
6. ___ Pacific Islander
7. ___ Other (please describe) ____________

14. What is Your Age ______
15. What is your gender ?
	1.   female		2.   male	3.   transgender  4.  other

16. Are you a Veteran?
	1.   Yes	2.   No

17.  Do you have children living with you?
	1. _____Yes	2.  _____  No

THANK YOU!  OUR MEETINGS ARE OPEN AND YOU ARE WELCOME TO ATTEND THEM.


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8000+ articles by or via homeless & ex-homeless people
INFO & to join/leave list - Tom Boland <wgcp@earthlink.net>
Nothing About Us Without Us - Democratize Public Policy
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Coalition on Homelessness, San Francisco
468 Turk St.
San Francisco, CA 94102
vox: (415) 346.3740
Fax: (415) 775.5639
coh@sfo.com
http://www.sfo.com/~coh