Safe Clean Water Program Community Survey

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Thank you for participating in our short survey. Input from community members like you helps us make sure that we are prioritizing projects and issues that matter most to your community. This survey should take 3-5 minutes to complete.

Some of these questions are adapted from the WaterTalks Survey (watertalks.csusb.edu).

What 𝘄𝗮𝘁𝗲𝗿-𝗿𝗲𝗹𝗮𝘁𝗲𝗱 𝗶𝘀𝘀𝘂𝗲𝘀 are of greatest concern in your community? Choose up to 3. *

Drought

Reliance on imported water

Flooding

Trash, industrial contamination, and other pollution in streets and waterways

Ocean pollution

Other

Required

What do you want to see more of in your community? Choose up to 3. *

Drought resilience

Flood protection

Cleaner beaches & rivers

LA river recreation opportunities

Trees

Community gardens

Green schoolyards

Wildlife habitat

Bike paths

Public recreation facilities

Walking paths

Park maintenance

Other

Required

Where? Please specify location (street(s), zip code, and/or neighborhood) for each option selected in response to the previous question.

What is one outdoor area in your community that is in need of beautification or improvement? This could be anything from an abandoned lot, a local park that could be improved, or a street corner prone to flooding. Please be specific about the location and what changes you'd like to see. (Optional)

List 3 things you 𝗹𝗶𝗸𝗲 about your community. (Optional)

The following questions help us understand what neighborhoods we've reached with this survey.

This information is necessary to ensure the survey is inclusive and representative.

What is your home 𝘇𝗶𝗽 𝗰𝗼𝗱𝗲? *

What is the 𝗻𝗲𝗮𝗿𝗲𝘀𝘁 𝗶𝗻𝘁𝗲𝗿𝘀𝗲𝗰𝘁𝗶𝗼𝗻 to your home? *

What 𝗰𝗶𝘁𝘆 is this community located in? *

What race(s) and/or ethnicities do you identify with? Select all that apply.

This information is necessary to ensure the survey is inclusive and representative.

Caucasian

Black or African-American

Latino or Hispanic

Asian

Native American

Native Hawaiian or Pacific Islander

Two or more

I prefer not to say

Please share your email if you would like to receive 𝗲𝗺𝗮𝗶𝗹 𝘂𝗽𝗱𝗮𝘁𝗲𝘀 in the future about water infrastructure projects in your community. (Optional)

Date

YYYY

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