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* 1. Are there programs or activities sponsored by the City of West Covina, or facilities owned by the City of West Covina, that you or someone you know cannot participate in or enjoy because of a disability?

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* 2. Have you encountered any communication barriers within a City of West Covina facility or park which prevented you from utilizing or participating in a program, service, or activity?

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* 3. Have you participated in a program, activity or visited a City of West Covina facility or park that you particularly enjoyed?

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* 4. Do you or someone you know require visual interpretive services or assisted listening systems at the City of West Covina’s programs or public meetings?

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* 5. Which City buildings do you visit most often? (Check all that applies)

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* 6. Which City parks do you visit most often? (Check all that applies)

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* 7. Rate the following features of the City of West Covina’s facilities in order of importance to you from 1 to 5, with the most important as 1:

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* 8. Is the City of West Covina’s website and phone system accessible to you?

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* 9. Do you feel that the City of West Covina provides adequate emergency response services to assist citizens with disabilities?

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* 10. Have you encountered street or intersection crossings near a city building or park where missing or inoperable pedestrian crossing push buttons affect your ability to cross the street?

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* 11. Do you have difficulty accessing city parks, buildings, or schools due to inaccessibility of public sidewalks or curb ramps?

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* 12. Have you encountered inaccessible conditions at public transit stops, including adjacent sidewalks?

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* 13. Have you experienced physical barriers to accessibility on a public pedestrian circulation path, such as broken / damaged concrete, missing curb ramp(s)?

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* 14. What program, activity or facility improvements would promote accessibility to the City of West Covina’s programs, services, and facilities?

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* 15. Please select which of the following best describes you.

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