City of Rocklin Americans with Disabilities Act (ADA) Community Survey Question Title * 1. I am a (please check all that apply) Person with a disability Family member, friend, or caregiver of a person with a disability Employed or volunteer at an organization that provides services to people with disabilities Merchant or businessperson Resident of Rocklin Employed with the City of Rocklin I do not work or live in the City of Rocklin, but I visit sometimes Other (please specify) Question Title * 2. How would you rate the overall accessibility of the City of Rocklin for people with disabilities? Very Good Good Fair Poor Very Poor Question Title * 3. Within the City of Rocklin, have you experienced any barriers, areas that are not accessible, or feel you are unable to participate in programs or activities because they are not accessible? Yes No Not Applicable Unsure If yes, please explain location, program, or physical barrier: Question Title * 4. Have you ever experienced any physical barriers (parking, ramps, restrooms, accessibility) while visiting any Rocklin parks or playgrounds? Yes No Not Applicable Unsure If yes, please explain location or physical barrier: Question Title * 5. Have you ever experienced any physical barriers (parking, ramps, restrooms, accessibility) while visiting any City of Rocklin facilities (City Hall, Police Department, Fire Stations, Public Works Building, Parks & Recreation Buildings)? Yes No Not Applicable Unsure If yes, please explain location or physical barrier: Question Title * 6. Are the sidewalks and pedestrian pathways in your neighborhood accessible and safe for travel for people with mobility challenges? Yes No Somewhat If no or somewhat, please explain location or physical barrier: Question Title * 7. Do you encounter any issues with curb ramps, crosswalks, or pedestrian signals in the City of Rocklin? Yes No If yes, please describe location and physical barrier: Question Title * 8. Have you experienced any barriers to accessing City services or events due to a disability? Yes No If yes, please describe: Question Title * 9. Do you know whom to contact at the City of Rocklin to request an accommodation or discuss accessibility for a facility, program, service, or activity? Yes No Not Applicable Unsure Question Title * 10. Have you ever contacted the City’s ADA Coordinator to report a physical barrier or accessibility issue? Yes No If yes, was your issue addressed? Done