All Children Thrive - CA: Needs Assessment Phase 1 - Public
1.
Which of these needs or issues are you currently experiencing or have experienced in the past? Select all that apply.
Food Insecurity i.e. lack of nutritious food, lack of enough food in the household, skipping meals due to food scarcity, etc.
Domestic Violence i.e. witnessing abuse (emotional, physical, mental, sexual) within the home or in your personal relationship
Loneliness i.e. feeling isolated or alone either from social interactions or friend groups
Lack of Self-Esteem i.e. feeling confident in your self / self-identity
Mental Health difficulties i.e. depression, anxiety, hopelessness, etc.
Family Dynamics issues i.e. lack of communication with parents or siblings, challenges in connecting to family members, dysfunctional or toxic qualities within the family
Bullying i.e. at school, within the community, or online
Drug Abuse i.e. street drug usage
Alcohol Abuse i.e. drinking alcohol underage
Nicotine Abuse i.e. any type of cigarettes or vaping
Lack of Opportunities for Personal Development i.e. extracurricular activities or programs to experience personal growth
Lack of Mentors i.e. absence of adults who you look up to and that take an interest helping you grow personally
Lack of College Prep / Info Sessions
Lack of Arts Programs
Lack of Access to Technology i.e. computers or tablets
Lack of High Speed Internet
Low-Income Household i.e. household income is below $30,000 annually
Single parent/guardian Household i.e. you live with only 1 parent or guardian
Other (please specify)
None of the above
2.
Which of these needs or issues have you experienced in the last 12 months? Select all that apply.
Food Insecurity i.e. lack of nutritious food, lack of enough food in the household, skipping meals due to food scarcity, etc.
Domestic Violence i.e. witnessing abuse (emotional, physical, mental, sexual) within the home or in your personal relationship
Loneliness i.e. feeling isolated or alone either from social interactions or friend groups
Lack of Self-Esteem i.e. feeling confident in your self / self-identity
Mental Health difficulties i.e. depression, anxiety, hopelessness, etc.
Family Dynamics issues i.e. lack of communication with parents or siblings, challenges in connecting to family members, dysfunctional or toxic qualities within the family
Bullying i.e. at school, within the community, or online
Drug Abuse i.e. street drug usage
Alcohol Abuse i.e. drinking alcohol underage
Nicotine Abuse i.e. any type of cigarettes or vaping
Lack of Opportunities for Personal Development i.e. extracurricular activities or programs to experience personal growth
Lack of Mentors i.e. absence of adults who you look up to and that take an interest helping you grow personally
Lack of College Prep / Info Sessions
Lack of Arts Programs
Lack of Access to Technology i.e. computers or tablets
Lack of High Speed Internet
Low-Income Household i.e. household income is below $30,000 annually
Single parent/guardian Household i.e. you live with only 1 parent or guardian
Other (please specify)
None of the above
3.
Which of the following describe your current needs? Select all that apply.
Basic Needs - food, clean water, access to bathroom facilities
Shelter Needs - safe housing, adequate space
Economic Needs - annual income under $30,000
Food Scarcity - not enough food in the household, lack of nutritious food, skipping meals
Emotional Security - lack of a support system for emotional needs
Mental Health - no access to mental health services, inability to access services
Healthy Relationships - absence of positive relationships, either friendships or romantic relationships
Transportation Needs - no personal vehicle, no access to public transit
Enriching Hobbies - inability to do hobbies due to overwork, cost, or lack of availability
4.
Can you describe in detail how you identify what your needs are? How do you notice?
5.
How do you feel when you realize you have an unfulfilled need? i.e. do you feel sad, anxious, motivated, etc.
6.
Can you think of your neighborhood and what are some immediate needs of your neighbors?
7.
Is it weird to think about or talk about your needs or the issues you are going through?
Yes
No
Other (please specify)
8.
What is one need you have that if it was fulfilled, it would drastically change your life?
9.
What is your age?
10.
What city do you live in?
Current Progress,
0 of 10 answered