Community Assessment Survey
Thank you for taking Close to Home's Community Assessment Survey!

Close to Home is a Community action team whose mission is to promote healthy relationships and improve the overall climate of San Luis Obispo. This survey is our first step in fostering community engagement around ending sexual and intimate partner violence at the local level.

This survey is meant for people who live or spend a majority of their time in SLO City and will ask several questions about your experience here. All answers will remain anonymous. Some questions of this survey may deal with sensitive topics, so feel free to skip any questions you do not feel comfortable answering.

Para español:
shorturl.at/ejtX5
What city do you live in?
Your answer
How old are you?
Your answer
What is your race?
Your answer
What is your gender identity?
Your answer
What is your sexual orientation?
Your answer
How well represented do you feel in San Luis Obispo?
Not represented at all
Very well represented
[Optional] Would you like to tell us more about your answer regarding representation?
Your answer
How accepted do you feel in the community?
Not accepted at all
Very accepted
[Optional] Would you like to tell us more about your answer regarding acceptance?
Your answer
How involved are you in the community?
Not involved at all
Very involved
Do you know of local resources that support people impacted by sexual assault and/or intimate partner abuse?
How accessible do you think those resources are?
Not accessible at all
Very accessible
[Optional] Would you like to tell us more about the accessibility of local resources?
Your answer
If someone were to tell you they are a survivor of sexual assault and/or intimate partner abuse, how confident are you that you would be able to support them?
Not at all confident
Very confident
How safe and comfortable do you feel in the following community spaces?
Not safe and comfortable
Adequately safe and comfortable
Very safe and comfortable
Mission Plaza
Downtown at Night
Cal Poly
Meadow Park
How available are affordable and welcoming events in San Luis Obispo?
Not available at all
Very available
How available are affordable and welcoming events for people under the age of 21 in San Luis Obispo?
Not available at all
Very available
How would you rate the quality of education around healthy relationships in San Luis Obispo?
Not available at all
Very available
[Optional] Would you like to tell us more about your answer about healthy relationship education?
Your answer
If there is not sufficient education on healthy relationships available, where in our community would you like to see more education happening?
Your answer
Do you know anyone who has been impacted by sexual violence or intimate partner abuse?
Do you feel comfortable reporting to law enforcement in the following situations:
Yes
No
Violent theft
Vehicle accidents
Sexual assault
Violence
Non-violent theft
Dating Abuse
Hate speech/Hate crime
Harassment
Our next section is optional, and gives you a chance to elaborate on some of your answers (5-15 minutes). Would you like to answer more questions for a chance to win a $50 Target gift card? *
Thank you for taking our survey! If you would like to speak with our Close to Home team about your experience in San Luis Obispo and the changes you would like to see, please leave your name and the best way to contact you in the space below.
Your answer
If you would like to receive updates on Close to Home and community projects we are working on, please leave us your E-mail below.
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy