IPM Coordinator Pre-IPM Questionnaire
The questionnaire is being done under a USDA-HUD contract to gather information about housing providers' pest management strategies from the person(s) most familiar and knowledgeable about them. This questionnaire should be completed for the pilot property. Information from this discussion will help us plan further IPM implementation.

The survey should take less than 30 minutes to complete, and your participation is voluntary. This is not an inspection.
All the information you give will be kept completely confidential and that none of it will be released in any way that would permit identification of you.
Your participation in this study is, of course, voluntary, and you may choose not to participate at any time.
You will not be formally compensated for participating, but we hope you will participate in return for the training and consultation you will receive while being involved with the StopPests in Housing Program.

Sign in to Google to save your progress. Learn more
Pilot Site *
Name
Pesticides are applied inside or to the outside of housing units on a routine basis regardless of infestation level to prevent pest problems. *
Pesticides are applied on the housing development grounds on a routine basis regardless of infestation level. *
Only licensed pesticide applicators are permitted to apply pesticides inside or to the outside of housing units (occupied or vacant). *
In our residential lease, we discourage residents from using their own pesticides and encourage residents to report all pest complaints to housing staff. *
Written records are kept on site or in a searchable online system of all pesticide applications in housing units. *
Written records are kept on site or in a searchable online system of all pesticide application to housing grounds. *
Records are kept of all pest complaints. *
Pesticide applications are counted and evaluated at least once a year, e.g., compared to the previous year. *
Pest complaints are counted and evaluated at least once a year, e.g., compared to the previous year. *
Cockroach presence is monitored on an ongoing basis using sticky traps in each unit. *
Bed bug presence is monitored on an ongoing basis using interception devices in each unit. *
Housekeeping requirements are included in the residential lease. *
We have clearly outlined procedures in place for how to deal with residents that are not complying with housekeeping standards, which are followed and carried out at least 75% of the time. *
There is a system in place to notify residents and staff of pesticide use. *
Estimate the amount of money that you spent on pest control (interior and exterior) during the last 12 months. *
Please note the severity of the pests present in the housing development. *
None
Very Few
Some
Severe
Very Severe
I prefer not to say
Cockroaches
Ants
Bed bugs
Rats
Mice
Approximately, how often are pesticides applied to control pests at your property? *
Who applies pesticides at your property? *
Required
How often are the following methods of pest control used? *
Never
Seldom
Often
I don't know
I prefer not to say
Education of residents and staff
Cockroach monitoring
Bed bug monitoring
Termite monitoring
Sealing pest entry points to exclude pests
Vacuuming/physical removal
Traps (rodents)
Insecticidal dust
Insect baits
Rodent baits
Liquid (spray) pesticides
Aerosols/foggers
Approximately, how often do you discuss pest management with your supervisor? *
How do you rate your current pest management program? *
Residents request transfers due to pest infestations *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report