OMB Control Number: 1660-0057
Expiration Date: 06/30/2011
PUEBLO EPZ SITE SURVEY
General Introduction…
S1. Hello, this is (FIRST AND LAST NAME) of CR Dynamics, working with the Department of Homeland Security and on behalf of Pueblo County Department of Emergency Management. We are not selling anything. We are conducting a survey among people living near the U. S. Army Pueblo Chemical Depot. This survey has been approved by the Office of Management and Budget (OMB) under FEMA Information Collection 1660-0057 and has an estimated response time of 10 to 15 minutes. Your participation is strictly voluntary and FEMA is not maintaining any personally identifiable information about you for this survey. Do you have a few minutes to answer a few questions?
S2. IF YES: Are you 18 years of age or older?
S3. IF YES: Start Survey. IF NOT: Is there someone else I can talk to who is 18 years of age or older? If unavailable, schedule callback and terminate.
s4: IF ADULTS IN HOUSEHOLD ONLY SPEAK SPANISH MARK AS SPANISH LANGUAGE BARRIER AND KEEP PHONE NUMBER FOR CLIENT.
Do you know what the Chemical Stockpile Emergency Preparedness Program, also known as CSEPP (SEE-SEP) is?
1. Yes
2. No
Are you aware of the chemical agents at the Pueblo Chemical Depot?
1. Yes
2. No
How would you know if there were a chemical emergency at the Pueblo Chemical Depot? (DON’T READ; CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
Tone alert radio (TAR)
Siren/Loudspeaker
AM/FM radio
Television
Family/Friend
Work (Depot, police, fire)
Mobile sign board/Highway message board
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97. Other (PLEASE SPECIFY)
99. Don’t know
What actions would you take if you found out there was a chemical emergency at the Pueblo Chemical Depot? (DON’T READ, CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
WAIT AND ASK: Are there any other actions you would take?
Shelter in place
Evacuate
Turn on/Watch television
Turn on/Listen to AM/FM radio
Listen to tone alert radio
Follow instructions given on TV, radio, or tone alert radio
Await instructions to shelter in place or evacuate
Call 911
Contact family/friends
Go to work (Depot, hospital, fire dept, police)
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Other (PLEASE SPECIFY)
Nothing
Don’t know
Why do you say that? (RECORD RESPONSE VERBATIM)
CLARIFY IF RESPONDENT SAYS “THEY” OR “THEM”: Who do you mean by they/them?
To get away from the chemicals, gas, or danger
To find out what to do/Get more information
I live close to the Depot
I want to get out of the area
It’s safer to evacuate
It’s safer to shelter in place
Depends on the wind direction
I don't know what else to do
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97. Other (PLEASE SPECIFY)
Don’t know
If you were instructed to shelter in place, what actions would you take? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS; ACCEPT MULTIPLE RESPONSES)
WAIT AND ASK: Are there any other actions you would take to shelter in place?
SHELTER IN PLACE CLARIFICATION: Shelter in place is a protective action that involves taking cover in a home, business, or other permanent building.
Close doors and windows
Close heating/air conditioning vents
Evacuate
Follow instructions/Do what told
Get food/water supply
Go inside/Stay inside
Go into shelter room of your home/workplace
Get supplies (clothes, cell phone, book, candles, games, medicine, flashlight, ect.)
Go to work (Depot, hospital, fire department, police)
Listen to radio/TV for further instructions
Locate/collect pets
Lock doors and windows
Seal doors and windows of shelter room
Take radio/TV into shelter room
Turn off heating/air conditioning systems
Use emergency kit
Use shelter-in-place kit
-----------
Other (PLEASE SPECIFY)
Nothing
Don’t know
How would you know when it would be safe to stop sheltering-in-place? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
AM/FM radio
Chemical Stockpile Emergency Preparedness Program (CSEPP) Office
Emergency Alert System (EAS)
Family/Relative
Fire department
Friend/Neighbor
Pueblo County Department of Emergency Management
Police
Sheriff's department
Siren/Loudspeaker
Television
Tone alert radio (TAR)
Work
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Other (PLEASE SPECIFY)
99. Don't know
If you were instructed to evacuate, what actions would you take? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS; ACCEPT MULTIPLE RESPONSES)
WAIT AND ASK: Are there any other actions you would take to evacuate?
Await instructions/Listen for help
Follow instructions/Do what told
Get personal items (pack clothes, food, water, gas)
Leave home or workplace/Get out of town/Get in car and go
Listen to TV/radio/tone alert
Locate/collect pets
Turn off heating/air conditioning systems
Turn on TV/radio/tone alert radio (general)
Wait for/Contact family members before leaving
Would not evacuate
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Other (PLEASE SPECIFY)
Nothing
Don’t know
In the event of an evacuation, do you have a pre-planned direction, route or destination? (ACCEPT MULTIPLE RESPONSES, SPECIFY RESPONSES)
Yes, direction (North, South, East, West)
East
North
Northeast
Northwest
South
Southeast
Southwest
West
Other (PLEASE SPECIFY)
Yes, route (road, highway, freeway)
Highway 50 Business/Bypass, Eastbound
Highway 50 Business/Bypass, Westbound
Highway 50, Eastbound
Highway 50, Westbound
Highway 96, Eastbound
Highway 96, Westbound
Highway 209, Northbound
Highway 209, Southbound
Highway 231/36th Lane, Northbound
Highway 231/36th Lane, Southbound
Highway 233/Baxter road, Northbound
Highway 233/Baxter road, Southbound
Interstate 25, Northbound
Interstate 25, Southbound
Other (PLEASE SPECIFY)
Yes, destination (city, state, reception center)
Colorado Springs
Denver
Pueblo
Rocky Ford
Other (PLEASE SPECIFY)
No, none
Depends on the wind direction
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Other (PLEASE SPECIFY)
If a chemical accident occurred at the Pueblo Chemical Depot, where would you get instructions on how to protect yourself and your family when you hear the warning signals? (DON’T READ, CATEGORIZE RESPONSE AS FOLLOWS; ACCEPT MULTIPLE RESPONSES)
AM/FM radio
Emergency alert system (EAS)
Pueblo County Department of Emergency Management
Mobile sign board/Highway message board
Package/kit on preparedness
Pamphlet
Police, local or State
Pueblo Chemical Depot
Television
Tone alert radio (TAR)
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Other (PLEASE SPECIFY)
None/Nowhere
Don’t know
What do you currently do when you hear the sirens go off? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
Can’t hear sirens/Sirens are too far away
Can't understand the sirens
Check if it is a test/drill
Don't pay attention / Ignore sirens / Don’t listen
Listen to siren announcement
Assume it is a test/drill
Turn on or listen to TV/radio
Check the calendar to see if it is a test/drill
-------------
Other (PLEASE SPECIFY)
Nothing
Don’t know
Do you or your family have an emergency plan?
1. Yes
2. No
Please answer yes or no to the following questions:
Are you familiar with the names of the major roads and highways in your area?
In the event of an emergency, do you have a family meeting place?
Do you have an out-of-area (out-of-town) telephone contact?
Do you have a shelter-in-place kit with duct tape, plastic, and instructions?
Do you have a disaster supply kit or a 72-hour kit (emergency supplies, such as food, blankets, flashlight, etc.)?
Do you have a tone alert radio (TAR)?
How confident are you that you know how to shelter in place in the event of a chemical emergency?
SHELTER IN PLACE CLARIFICATION: Shelter in place is a protective action that involves taking cover in a home, business, or other permanent building.
If the respondent says “don’t know” say: “Please choose the one that most closely reflects your opinion.” (READ 1-4)
1. Very confident
2. Somewhat confident
3. Not very confident
4. Not confident at all
Do you have children in a local school in grades K–12?
1. Yes GO TO 16
2. No GO TO 21
3. N/A or refused GO TO 21
Which school(s) do they attend? (RECORD CATEGORY, ACCEPT MULTIPLE RESPONSES)
Avondale Elementary School
Futures Academy
North Mesa Elementary School
Pleasant View Middle School
Pueblo County High School
South Mesa Elementary
Vineland Elementary School
Vineland Middle School
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Other (PLEASE SPECIFY) GO TO 17
Home School GO TO 21
Don’t know GO TO 21
RESPONDENTS WITH CHILDREN AND RESPONSES TO Q16 OTHER THAN “HOME SCHOOL,” AND “DON’T KNOW”ANSWER QUESTIONS 17–20
Are you familiar with the emergency plan at your child(ren)’s school(s)?
Yes
No
How confident are you that the school(s) your child(ren) attend(s) will take care of your child(ren) appropriately in any emergency?
If the respondent says “don’t know” say: “Please choose the one that most closely reflects your opinion.” (READ 1-4)
1. Very confident
2. Somewhat confident
3. Not very confident
4. Not confident at all
In the event of a chemical emergency at the the Pueblo Chemical Depot, are you likely or unlikely to go to the school to get your child(ren)?
WAIT AND ASK: Is that very likely/unlikely or somewhat likely/unlikely?
If the respondent says “don’t know” say: “Please choose the one that most closely reflects your opinion.” (READ 1-4)
1. Very likely GO TO q19b
2. Somewhat likely GO TO q19b
3. Somewhat unlikely GO TO q20b
4. Very unlikely GO TO q20b
19b. Would you pick up your children immediately or when notified that it is safe to do so?
1. Immediately GO TO 20 and SKIP 20b
2. When notified it is safe GO TO 20 and SKIP 20b
Why do you say that? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
IF RESPONDENT SAYS “THEY” OR “THEM” CLARIFY: “Who do you mean by they/them?”
Likely to pick up child(ren)
Child(ren) are safer with me
Don’t trust the school
Don’t want to place self or others at risk
I want my child(ren) with me so we can leave the area
I want my child(ren) with me (general)
Live/work close to the school
Make sure my child(ren) are safe
Protect my child(ren)
School is not prepared
School has a plan/School is safe
Want to wait until it is safe
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Other (PLEASE SPECIFY)
99. Don’t know/Refused
20b. Why do you say that you are unlikely to get your child/children from school? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
IF RESPONDENT SAYS “THEY” OR “THEM” CLARIFY: “Who do you mean by they/them?”
Unlikely to pick up child(ren)
Child drives himself/herself to school
I’ll be at work
My child(ren) is/are safer at the school
My child(ren) would be evacuated/bused elsewhere
Not able to get child(ren) even if I tried
School has a plan/ School is prepared
School is too far away
Told not to try to get child(ren)/Told not to go to school
Trust the school
Want to wait until it is safe
-----------
97. Other (PLEASE SPECIFY)
99. Don't know
ALL RESIDENTS
How would you prefer to receive emergency preparedness information? (ACCEPT MULTIPLE RESPONSES, READ 1-8, 8-1)
AM/FM radio
Calendar
Direct mail
Fairs
Internet
Newspaper (PLEASE SPECIFY)
One to one communication
Public presentations or meetings
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97. (DON’T READ) Other (PLEASE SPECIFY)
When was the last time you heard, saw, or read any information about how to prepare for a chemical emergency?
Within the last week
Within the last month
Within the last year
More than a year
(DON’T READ) Never GO TO 25
(DON’T READ) Don’t recall receiving CSEPP information GO TO 25
(DON’T READ) Have received CSEPP information but don’t recall when it was received GO TO 23
How have you received information about how to prepare for a chemical emergency? (CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
AM/FM radio
Calendar
Community event/Fair/Booth
CSEPP representative
The CSEPP update (quarterly newsletter)
Informational package/kit
Informational pamphlet/flyer
Internet
Magazine
Newspaper
Pueblo Chemical Depot representative
Pueblo County Department of Emergency Management representative
Siren/Loudspeaker drills/testing
Speaker/Speech/Presentation
Television
Tone alert radio
Word-of-mouth
Work/Training
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97. Other (PLEASE SPECIFY)
What information do you recall from what you heard, saw, or read? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
Be prepared/alert
Chemical agents/gases
Children will be safe in school
Didn’t listen or read/Didn’t pay attention
Drills/Tests
Evacuation plan
Evacuation directions
Evacuation route
Evacuation zones
Follow instructions
Food/Water storage
General instructions on what to do or how to get prepared
Listen to tone alert radio(TAR)/Siren
Pueblo Chemical Depot plans and procedures
School’s plan for an emergency
Shelter in place
Shelter-in-place kit
Shelter/Reception center
Wait for instructions
-----------
Don't remember
Other (PLEASE SPECIFY)
Nothing
Don’t know
Which of the following have provided you with useful information to prepare for a possible chemical emergency? Please say yes or no to the following options. (READ 1-6, ACCEPT MULTIPLE RESPONSES)
Chemical Stockpile Emergency Preparedness Program (CSEPP)
Pueblo Chemical Depot
Pueblo Chemical Outreach Office
Pueblo County Department of Emergency Management
Area, City, or County Meetings
Local Media (PLEASE SPECIFY)
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(DON’T READ)Other (PLEASE SPECIFY)
(DON’T READ) None
In general, how often do you hear, see, or read any information about how to prepare for a chemical emergency? (READ 1-5)
If the respondent says “don’t know” say: “Please provide your best estimate.”
At least once a week or more
Every two weeks to once a month
Every two to six months
Every six months to a year
Less than once a year
(DON’T READ) Never SKIP 29 and 29b
Would you like to receive information more frequently, less frequently, or at the same frequency that you are currently receiving information?
If the respondent says “don’t know” say: “Please choose the one that most closely reflects your opinion.” (READ 1-3)
More frequently
Less frequently
Same frequency
Do you feel that you are receiving enough information in order to prepare for a chemical emergency?
Yes GO TO 29
No GO TO 28b
28b. What additional information would help you to prepare for a chemical emergency? (RECORD VERBATIM RESPONSE)
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99. Don't know
How would you rate the quality of the information you have received? (READ LIST)
Very useful
Somewhat useful
Not useful
29b. Why do you say that? (RECORD VERBATIM RESPONSE)
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99. Don't know
How confident are you that the public will be notified quickly in case of a chemical emergency at the Pueblo Chemical Depot?
If the respondent says “don’t know” say: “Please choose the one that most closely reflects your opinion.” (READ 1-4)
1. Very confident
2. Somewhat confident
3. Not very confident
4. Not confident at all
Why do you say that? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
CLARIFY IF RESPONDENT SAYS “THEY” OR “THEM”: Who do you mean by they/them?
Confident
Alert system is good
Always been told when something happens
County/government officials are prepared
County/government officials have kept the public informed
Depot does a lot of drills/tests
Depot is prepared
Depot has kept the public informed
I trust the Depot
I trust the county/government officials
I work/worked at the Depot
Local media would let us know
Public is well informed/Public gets a lot of information
Someone I know works/worked at the Depot
Not confident
Alert system does not work
County/government officials are not prepared
County/government officials would try to cover up a chemical release
Depot is not prepared
Depot would try to cover up a chemical release
I do not trust the Depot
I don’t trust the county/government officials
Not enough time to alert everyone
There have been incidents before and we were not told
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Other (PLEASE SPECIFY)
99. Don’t know
Please tell me if you agree or disagree with the following statement:
”I am able to protect myself and my family in the event of a chemical emergency.”
WAIT AND ASK: Is that strongly agree/disagree or somewhat agree/disagree?
If the respondent says “don’t know” say: “Please choose the one that most closely reflects your opinion.” (READ 1-4)
1. Agree strongly
2. Agree somewhat
3. Disagree somewhat
4. Disagree strongly
To conclude, I have a few questions for statistical purposes.
What is your approximate age, please? (READ 1–7)
1. 18–29
2. 30–34
3. 35–44
4. 45–54
5. 55–59
6. 60–64
7. 65+
8. (DON’T READ) Refused
Gender (BY OBSERVATION)
1. Male
2. Female
Is there anyone in your household whose first language is something other than English?
Yes
No (skip 35b and 35c)
35b. What is that language?
Spanish
Italian
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Other (PLEASE SPECIFY)
35c. Do you think your household would benefit by receiving emergency preparedness information such as public service announcements and the annual CSEPP calendar, in that language?
Yes
No
How long have you lived in the vicinity of the Pueblo Chemical Depot? (READ 1–6)
Less than one year
1-5 years
6–10 years
11–15 years
16–20 years
More than 20 years
(DON’T READ) Don’t know/Refused
Do you have access to the Internet?
Yes………… Give internet address at the end of the survey
No…………. Don’t give Internet address at the end of the survey
Are you, or any member of your household, a member of the local emergency management or first responder community (fire, police, etc.)?
1. Yes
No
Are you, or any member of your household, employed by the Pueblo Chemical Depot or a contractor of the Depot?
Yes, Pueblo Chemical Depot
Yes, Contractor of Pueblo Chemical Depot
No
IRZ
PAZ
(DON’T READ)Don’t know
What city or community do you live in or closest to? (SINGLE RESPONSE)
IF RESPONSE IS NOT ON THE LIST, READ THE LIST
IRZ
Avondale
Boone
Chico Ranch
Fort Reynolds
North Avondale
Nyberg
PAZ
Baxter
Lombard Village
Orchard Park
The Mesa
Nepesta
Vineland
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Other (PLEASE SPECIFY)
ZIP code (recorded in CATI from sample)
Thanks for your time—we really appreciate it.
Thanks again!
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Suggested survey methodology: Use "open-ended" questions, categorize the response into pre-identified categories, and follow up |
Author | ROUSSEL |
File Modified | 0000-00-00 |
File Created | 2021-02-01 |