OMB Control Number: 1660-0057
Expiration Date: 06/30/2011
PUEBLO EPZ BUSINESS 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 businesses near the U. S. Army Pueblo Chemical Depot. You may have received a postcard from Pueblo County Department of Emergency Management announcing this survey. 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?
S1a Does your business have a designated safety officer or safety manager? (James: We want to keep track of this)
1. Yes
2. No
IF YES: May I please speak with that individual?
IF NO: May I please speak with the manager or person in charge?
S2. IF AVAILABLE ASK: Do you have a few minutes to answer a few questions?
If unavailable schedule callback time/date and terminate
S2b. Person completing the questionnaire (BY OBSERVATION)
1. Designated safety officer/manager (Said “Yes” in S1a and the safety officer/manager answers the survey)
2. Manager/Person in charge (all others)
I appreciate your time. I will be typing some of your answers word-for-word, so please be patient if there is a pause while I am entering your response.
MAIN SURVEY
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 confident are you that your business 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 you are confident/not confident? (RECORD VERBATIM RESPONSE)
CLARIFY IF RESPONDENT SAYS “THEY” OR “THEM”: Who do you mean by they/them?
Confident
There are sirens
We have a tone alert radio
There is an alarm system
The Depot/people in charge are prepared
Our proximity to the Depot
There are drills/tests
Because of the media/news
We are part of the response team
Not confident
Can't hear sirens
Can’t understand sirens
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97. Other (RECORD VERBATIM)
99. Don’t know
How would your business be notified of a chemical emergency at the Pueblo Chemical Depot? (DON’T READ, CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
AM/FM radio
Fire department
Friend/Neighbor
Sheriff’s department
Siren/Loudspeaker
Telephone call
Television
Tone alert radio (TAR)
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97. Other (RECORD VERBATIM)
99. Don’t know
Where would you get instructions on how to protect yourself and your co-workers when you hear the warning signals? (DON’T READ, CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
AM/FM radio
Fire department
Pre-written plans/procedures
Pueblo County Department of Emergency Management
Sheriff’s department
Siren/Loudspeaker
Telephone
Television
Tone alert radio (TAR)
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Other (RECORD VERBATIM)
99. Don’t know
If notified of a chemical emergency at the Pueblo Chemical Depot, how would your business alert their employees? (DON’T READ, CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
In person
Telephone
CB radio/Walkie-Talkie
PA/Intercom system
I’m the only employee
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97. Other (RECORD VERBATIM)
99. Don’t know
How long do you think it would take your business to alert all of the employees?
Under 1 minute
1-5 minutes
6-10 minutes
10-15 minutes
More than 15 minutes
(DON’T READ) Don’t know
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97. Other (RECORD VERBATIM)
After co-workers have been alerted of a chemical emergency, what actions would your business take? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
1. Shelter in place
2. Evacuate
3. Await instructions to shelter in place or evacuate
Listen to TV/radio/TAR/sirens
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Other (RECORD VERBATIM)
Nothing
Don’t know
If
your business were advised to evacuate, do you believe your business
could evacuate successfully?
1. Yes GO TO 12
2. No GO TO 11
Why do you believe that your business would not be able evacuate successfully? (RECORD VERBATIM)
In the event of an evacuation, does your business have a pre-planned direction, route, or off-site destination for employees?
Yes GO TO 13
No GO TO 14
Can you please describe it? (RECORD VERBATIM)
Would your business evacuate if instructed to do so?
1. Yes
2. No
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97. Other (RECORD VERBATIM)
If your business were advised to shelter in place, do you believe your business could successfully 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.
1. Yes GO TO 17
2. No GO TO 16
Why do you believe that your business would not be able to shelter-in-place successfully? (RECORD VERBATIM)
We can't seal out the air
We don't have the knowledge/materials to shelter in place
We don't have a place to shelter
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Other (RECORD VERBATIM)
99. Don’t know
If your business was instructed to shelter in place, which actions would you and your co-workers take? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
Close doors and windows
Close heating/air conditioning vents
Evacuate
Follow instructions
Go inside
Go into shelter room of workplace
Listen to radio/TV for further instructions
Lock doors and windows
Put on respirators/chemical gear
Seal doors and windows of shelter room
Stay inside
Take radio/TV into shelter room
Turn off heating/air conditioning systems
Use shelter-in-place kit
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Other (RECORD VERBATIM)
Nothing
Don’t know
Please answer yes or no to the following questions: (Please also provide a “Don’t know” category for each of these subquestions)
Does your business have a shelter-in-place kit with duct tape, plastic, and instructions?
Does your business have a pre-identified room for employees to shelter in place?
Does your business have a written emergency plan?
Does your business have a business contigency or recovery plan in case of emergencies that may interrupt business for an extended period of time?
In the event of an emergency, do you have a designated on-site meeting place?
Does your business have a tone alert radio (TAR)?
What does your business currently do when you hear the sirens go off? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
Listen to the siren announcement
Can't hear the sirens
Check if it is a test/drill
Listen to AM/FM radio/TAR/TV/other for more information
Can't understand the sirens
Ignore the sirens
Check the calendar to see if it is a test/drill
Assume it is a test/drill
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Other (RECORD VERBATIM)
Nothing
99. Don’t know
Where would your business get additional information about how to get prepared for a possible chemical accident at the Pueblo Chemical Depot? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)
Army Depot
AM/FM radio
Bulletins/Flyers/Mailings
Chemical Stockpile Emergency Preparedness Program (CSEPP)
Fire department
Internet
Television
Pueblo County Department of Emergency Management
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Other (RECORD VERBATIM)
99. Don’t know
How would you prefer to receive emergency preparedness information for your business? (ACCEPT MULTIPLE RESPONSES, READ 1-8, 8-1)
AM/FM radio
Calendar
Direct mail
Fairs
Internet
Newspaper (PLEASE SPECIFY)
One to one communication
Business presentations or meetings
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(DON’T READ) Other (RECORD VERBATIM)
99. Don’t know
To conclude, I have a few questions for statistical purposes
How long have you been employed at this business?
1. Less than one year
2. 1-5 years
3. 6–10 years
4. 11–15 years
5. 16–20 years
6. More than 20 years
7. (DON’T READ) Don’t know/refused
How long has this company or franchise been in business at your location?
1. Less than one year
2. 1-5 years
3. 6–10 years
4. 11–15 years
5. 16–20 years
6. More than 20 years
7. (DON’T READ) Don’t know/refused
Do employees at your business work indoors, outdoors, or both indoors and outdoors?
Indoors
Outdoors
Indoors and Outdoors
IRZ
PAZ
(DON’T READ) Don’t know
Approximately how many employees work at your location?
1–4 employees
5–9 employees
10–19 employees
20–49 employees
50–99 employees
100–249 employees
250+ employees
None or 0%
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97. Other (RECORD VERBATIM)
What are the hours of operation for your business? Please include days of the week and hours that you regularly have employees on site.
Monday–Sunday, 24 hours a day
Monday–Friday, 9am to 5pm
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97. Other (RECORD VERBATIM)
99. (DON’T READ) Don’t know/Refused
Which description best categorizes your business? (READ 1-12)
BUSINESSES IN PARENTHESES ALSO FIT IN THAT CATEGORY
Agricultural (farm, ranch)
Automotive repair
Construction (carpentry, structural services)
Convenience store (service station)
Home office
Industrial facility with one building
Industrial facility with multiple buildings
Non-profit organization
Public service or government organization
Professional office
Restaurant (Bar)
Retail store
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97. Other (RECORD VERBATIM)
What is your position at this business? (ACCEPT MULTIPLE RESPONSES)
Owner
President
Vice President
Director
Manager
Safety Officer
Employee
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97. Other (RECORD VERBATIM)
Zip code (recorded in CATI from sample)
ALL RESPONDENTS:
Thanks for your time--we really appreciate it. Your responses to this survey will be combined with the answers from other surveyed businesses and reported to Pueblo County Emergency Management. They might want to follow up with you to discuss emergency planning for your business. Do we have your permission to release your business name along with your survey responses to them?
Permission granted
Remain anonymous
IF PERMISSION GRANTED: May I please get your name? (enter name) __________________
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 |