Community Emergency Preparedness Survey

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This survey should only take a couple of minutes. We appreciate any information you are willing to share. All questions are optional. You may answer anonymously, or not answer any question for any reason. PLEASE, complete the survey even if you skip questions. The detail you provide will give emergency planners valuable insight as to how our residents may react during an actual evacuation and how we can best assist YOU to prepare.

(Google Sign In Is NOT Required)

Please indicate which of the following preparedness actions that you have taken. (Please check all that apply)

Create an Emergency Contact list including at least one out of state contact. Share copies with your family & all contacts on the list.

Have an Evacuation Route & Family Reunification plan, including multiple routes and safe meeting spots.

Pack a Go Bag

Have an accessible 'Stay Box' with emergency drinking water, food, other essentials to shelter in place

Talk to your neighbors about Emergency Preparedness.

How well prepared are you are for a disaster? (Earthquake, Wildfire)

Completely Unprepared

Very Well Prepared

Clear selection

The Community Warning System (CWS) is the primary means for county agencies to communicate in critical events. All land lines are automatically enrolled. What other type of notifications are you registered to receive? (check all that apply):

A CWS (Community Warning System) VOICE call to my CELL phone

A CWS (Community Warning System) TEXT to my cell phone

A CWS (Community Warning System) email

Do you the have CWS number ("925-655-0195") added to your cell phone as a VIP contact so that alerts will ring through when your phone is set to "Do Not Disturb"?

Yes

No. Please sent me an email with instructions to set up my phone to receive all future alerts. (Please add your email address below)

Clear selection

During an actual evacuation would you be willing/able to check on your neighbors before leaving in your vehicle?

Yes

Clear selection

During an actual evacuation do you have any condition or situation which make you likely to NEED ADDITIONAL TIME OR ASSISTANCE before leaving in your vehicle?

Yes

Are you a member of an organized block or neighborhood?

Yes, my block or neighborhood is organized

No, but I am interested in participating (Please add your address and email below)

Clear selection

Are you interested in any of the following opportunities: (check all that apply)

Household Preparedness Course (Listos) 4 hours, flexible delivery

Block Organization and Preparedness Course (Be Ready Together, Map Your Neighborhood)

C.E.R.T (Community Emergency Response Team) Training (20 hours, Certificate)

I'm interested in a Household Preparedness Course for my organization/business

Group purchase opportunities for Emergency Preparedness Supplies

Vegetation Management & Home Hardening Property Assessments

Have you or another member of your household attended basic the CERT course? (20 hour program)

Yes

Clear selection

Would you like to be added to your local Fire Agency & CERT email lists? Your email address will not be shared and we will only contact you with information about emergency preparedness and resilience in your community.

Yes, Opt In

No, Opt Out

Clear selection

Do you have radio training or participate in a radio nets (GMRS, HAM) related to preparedness?

Yes

No, but I'm interested in learning about using radios in my block/neighborhood for emergencies.

Cities in Contra Costa County, and other surrounding communities use a platform called Zonehaven for planning and efficient communication in the event of an actual evacuation. Would you like to receive email with more information about your zone directly from Zonehaven? (To Opt In, you will also need to enter an email address below)

Yes

Clear selection

Your email address:

Please enter your zip code (required) *

Your street address:

(ex. 123 Main St)

Questions, comments, or suggestions?

Submit

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