GQ Facilities Ques GQ Facilities Questionnaire

Attachment R

Group Quarters Facility Questionnaire
Screen
Hello. My name is _______. I’m with the U.S. Census Bureau. We are
currently conducting an important survey in your community, the
American/Puerto Rico Community Survey, and I’d like to verify that this is
[fill: GQNAME]?

Screen

SPECIAL PLACE NAME:
GROUP QUARTERS NAME:

Fill in SPECPLACE
Fill in GQNAME

What is the name of this place?
Update GQ name (GQNAME - 100 characters)
Fields available to enter contact information (and variable name and length). Use
these titles for the form pane:

Instrument: Prefill all of these fields with the current value.
Valid Values: Alphanumeric (field length 100), Do not accept DK or R.

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Attachment R
Screen

SPECIAL PLACE NAME:
GROUP QUARTERS NAME:

Fill in SPECPLACE
Fill in GQNAME

Is [fill: GQNAME] owned by or affiliated with [fill:SPECPLACE]?
Fields available to enter contact information (and variable name and length). Use
these titles for the form pane:

Screen

SPECIAL PLACE NAME:
GROUP QUARTERS NAME:

Fill in SPECPLACE
Fill in GQNAME

Is [fill: GQNAME] owned by or affiliated with another organization or
company?

Input Options

1. Yes
2. No
Valid Values: 1,2,DK,R

Screen

SPECIAL PLACE NAME:
GROUP QUARTERS NAME:

Fill in SPECPLACE
Fill in GQNAME

What is the name of that company or organization that [fill: GQ name] is
associated with?

Skip Instructions

1. Go to VERIFYADDR.

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Attachment R
Variable Name
Screen

VERIFYADDR
Special Place Name: [fill: SPNAME]
Group Quarters Name: [fill: GQNAME]

I have your address listed as [fill: GQADDLINE1
GQADDLINE2].
Is this correct?
Input Options

Skip Instructions

1. Yes
2. No
Valid Values: 1,2, Do not accept DK or R.
1. If Yes, go to SRCHKNWLRESP.
2. If No, go to NHNO

Variable Name

NEWHNO, NEWHNOSUF, NEWSTRPRXD,NEWSTRPRXT,
NEWSTRNAME,NEWSTRSFXT, NEWSTRSFXD, NEWSTRNAMX,
NEWUNITDES, NEWRRDESC, NEWRRID, NEWBOXDESC, NEWBOXID,
NEWPO, NEWST, NEWZIP5, NEWZIP4, NEWPRADDR1, NEWPRADDR2,
NEWPHYSDES

Universe

[VERIFYADDR= 2]

Screen

OLD ADDRESS:

Fill in GQADDLINE1
Fill in GQADDLINE2

What is the correct address for [Fill: GQNAME]?
 Update the [fill: full field name.] Press if the field is not applicable.

Skip Instructions

Instrument: “Full field name” is “house number”, “house number suffix”, etc.
1. Go to ADDRCHNG
Valid Values: Do not accept DK or R.

3

Variable Name

ADDRCHNG

Attachment R

Input Options
1. Yes
2. No
Valid Values: 1,2, Do not accept DK or R
Fill Instructions
Question fill if INITSCREEN=2:
Does the address change represent a physical location that is different from the
sample GQ Address?
FR Instruction Fill if INITSCREEN=3
Does the address change represent a physical location that is different from the
sample GQ Address? If so, select Option 1 for Yes. If not, select Option 2 for No.
Skip Instructions

If ADDRCHNG=1 or 2, go to SRCHKNWLRESP.

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Attachment R

Variable Name
Screen

SRCHKNWLRESP
SPECIAL PLACE NAME:
GROUP QUARTERS NAME:

Fill in SPECPLACE
Fill in GQNAME

ADDRESS:

Fill in GQADDLINE1
Fill in GQADDLINE2

GENERAL/MAIN PHONE #:

Fill in GQPHONE, GQEXT

CONTACT PERSON 1:
CONTACT TITLE:
CONTACT PHONE:

Fill in CP1NAME
Fill in CP1TITL
Fill in CP1PHON, CP1EXT

CONTACT PERSON 2:
CONTACT TITLE:
CONTACT PHONE:

Fill in CP2NAME
Fill in CP2TITL
Fill in CP2PHON, CP2EXT

I’d like to speak with someone who can give me the authority to conduct this
survey which means getting access to interview selected people staying at [fill:
GQNAME]. Would that person be you or should I speak to someone else?

Input Options

1. Yes, this is the correct person.
2. No, need to speak to someone else.
Valid Values: 1,2, DK, R
**Input Options for BoP:
1. Yes, they are available.
2. No, you’ll need to call back.
Valid Values for BoP only: 1,2 only

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Attachment R

Variable Name
Screen

NEWCP1NAME, NEWCP1TITL, NEWCP1PHON, NEWCP1EXT
[fill #1 May I have your name, title and phone number?]
[fill #2 May I have the name of the person who can help me?]
 Enter Contact #1’s information. Press if a field is not applicable.
CONTACT PERSON 1:
CONTACT TITLE:
CONTACT PHONE:

Variable Name
Screen
Input Options

Fill in CP1NAME
Fill in CP1TITL
Fill in CP1PHON, CP1EXT

SPEAKNOW
May I talk to [fill: CP1NAME] now?
1. Yes
2. No
Valid Values: 1,2,R, Do not accept DK

Skip Instructions

1.
2.
3.
4.
5.

If SPEAKNOW = 1 and INITSCREEN = 2, go to INTRO.
If SPEAKNOW = 1 and INITSCREEN = 3, go to INTRO.
If SPEAKNOW = 2 and INITSCREEN = 2, go to TCALLBACK.
Is SPEAKNOW = 2 and INITSCREEN = 3, go to TCALLBACK.
If SPEAKNOW = R and INITSCREEN = 2 or 3, go to TCALLBACK.

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Attachment R

Variable Name
Screen

INTRO
CONTACT PERSON 1:
CONTACT TITLE 1:
CONTACT PHONE 1:
APPOINTMENT DATE/TIME:
APPOINTMENT1

Fill in CP1NAME
Fill in CP1TITL
Fill in CP1PHON, CP1EXT
Fill in Response TCALLBACK or

Question
Fill #1
{Hello. My name is _____________. I’m with the U. S. Census Bureau. We are
currently conducting an important survey in your community, the American /
Puerto Rico Community Survey. Did you receive the letter and brochure we
mailed to you recently?
* If no, ask if they would like you to FAX them a copy.
*Press Shift + F2 and use FAQ #1 to provide further info on the survey. Use
other FAQs to answer additional questions.
To conduct this survey, I need to schedule a day and time to meet with you. On
the day of our meeting, I will collect additional information from you about [fill:
GQNAME]. Then, I will ask you for a current list of all the people that are
living/staying there. On the day of this visit, I will also need access to the people
that are selected for the survey so I can conduct the interviews while I'm there.
Do you have any questions?}
Fill #2
We are currently conducting an important survey in your community, the
American / Puerto Rico Community Survey. Did you receive the letter and
brochure we mailed to you recently?
* If no, ask if they would like you to FAX them a copy.
*Press Shift + F2 and use FAQ #1 to provide further info on the survey. Use
other FAQs to answer additional questions.
To conduct this survey, I need to schedule a day and time to meet with you. On
the day of our meeting, I will collect additional information from you about [fill:
GQNAME]. Then, I will ask you for a current list of all the people that are
living/staying there. On the day of this visit, I will also need access to the people
that are selected for the survey so I can conduct the interviews while I'm there.
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Attachment R

Do you have any questions?}
Fill #3
{Hello. My name is _____________. I’m with the U. S. Census Bureau. We are
currently conducting an important survey in your community, the American /
Puerto Rico Community Survey. Did you receive the letter and brochure we
mailed to you recently?
*If no, give them a copy of the letter and brochure.
 Show GQ contact the questionnaire.

*Press Shift + F2 and use FAQ #1 to provide further info on the survey. Use
other FAQs to answer additional questions.
I want to describe what I would like to do during the rest of my visit here today.
First, I will collect additional information from you about [fill: GQNAME].
Second, I will ask you for a list of all people staying here as of today. Then, I will
need access to the people I select for the survey. I will do all of these tasks today.
I would like to continue with the interview. Do you have any questions?}
Fill #4
Did you receive the letter and brochure we mailed to you recently?
*If no, give them a copy of the letter and brochure.
 Show GQ contact the questionnaire.
*Press Shift + F2 and use FAQ #1 to provide further info on the survey. Use
other FAQs to answer additional questions.
I want to describe what I would like to do during the rest of my visit here today.
First, I will collect additional information from you about [fill: GQNAME].
Second, I will ask you for a list of all people staying here as of today. Then, I will
need access to the people I select for the survey. I will do all of these tasks today.
Do you have any questions?}
Fill #5
{Hello. My name is _____________. I’m with the U. S. Census Bureau.
Thanks for agreeing to meet with me today.
I have a few more questions about [fill:GQNAME].}

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Attachment R

Input Options

1. Enter ‘1’ to Continue.
Valid Values:
1, DK, R

Fill Instructions

Skip Instructions

Skip Instructions
for BoP

1. Display Fill #1 if INITSCREEN = 2 and PEAS_FL = 1 and SRCHKNWLRESP =
2 and SPEAKNOW =1
2. Display fill #2 if INITSCREEN = 2 and PEAS_FL = 1 and SRCHKNWLRESP =
1
3. Display fill #3 if INITSCREEN = 3 and PEAS_FL = 1 and SRCHKNWLRESP =
2 and SPEAKNOW = 1
4. Display fill #4 if INITSCREEN = 3 and PEAS_FL=1 and SRCHKNWLRESP = 1
5. Display fill #5 if INITSCREEN = 4, PEAS_FL= 1
6. Display fill #2 if INITSCREEN = 2 and PEAS_FL = 1 and SRCHKNWLRESP =
DK or R]
7. Display fill #4 if INITSCREEN = 3 and PEAS_FL = 1 and SRCHKNWLRESP =
DK or R
Special BoP Fill Instruction:
1. Display Fill #6 if INITSCREEN=2 and PEAS_FL=1 and SRCHKNWLRESP=1
and BoP_Flag = 1.
1. If INTRO = 1 and INITSCREEN = 2 and PEAS_FL = 1, go to
APPOINTMENT
2. If INTRO = 1 and INITSCREEN =3 and PEAS_FL = 1, go to
CONDINTNOW
3. If INITSCREEN = 4 and PEAS_FL = 1, go to MAILADDYSAME
4. If DK or R, go to INTSTAT
1. If INTRO = 1 and INITSCREEN = 2 and PEAS_FL = 1 and BoP flag = 1,
go to APPOINTMENT.

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Attachment R

Variable Name
Screen

Input Options

Skip Instructions

Screen

CONDINTNOW
Question
 Are you going to conduct the interview now?
*Try to convince the contact person to continue and finish the interviews today.
1. Yes
2. No
Valid Values: 1,2, Do not accept DK, R.
1.
[If CONDINTNOW = 1] and [HNO or STRNAME = blank] go to
MAILHNO
2.
[If CONDINTNOW = 1] and [HNO and STRNAME ne blank] go to
MAILADDYSAME
3.
If CONDINTNOW = 2, go to APPOINTMENT

SPECIAL PLACE NAME:
GROUP QUARTERS NAME:

Fill in SPECPLACE
Fill in GQNAME

ADDRESS:

Fill in GQADDLINE1
Fill in GQADDLINE2

PHYSICAL DESCRIPTION: Fill in PHYSDES
Is this (read address above) also the mailing address for fill in GQNAME?
Instrument: Update GQADDRESS1 and GQADDRESS2 based on the responses to
Question 2.9.
Input Options

1. Yes
2. No
Valid Values: 1,2 Do not accept DK or R

Skip Instructions

1. If MAILADYSAME = 1, go to NEWBLDGNAME
2. If MAILADDYSAME = 2, go to MAILHNO

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Attachment R
Variable Name
Screen

MAILHNO to MAILZIP4
SPECIAL PLACE NAME:
GROUP QUARTERS NAME:
ADDRESS:

Fill in SPECPLACE
Fill in GQNAME
Fill in GQADDLINE1
Fill in GQADDLINE2

What is the mailing address for fill in GQNAME?
 Mail full field name. Press if the field is not applicable.
Instrument: “Full field name” is “house number”, “house number suffix”, etc.

Input Options

Fields available to enter address information (and variable name and length):
Same as in Question 2.10, except that building name and physical description are
not included.
Valid Values: Do not accept DK or R

Skip Instructions

1. Go to NEWBLDGNAME

Variable Name
Screen

NEWBLDGNAME
SPECIAL PLACE NAME:
GROUP QUARTERS NAME:
ADDRESS:

Fill in SPECPLACE
Fill in GQNAME
Fill in GQADDLINE1
Fill in GQADDLINE2

Is there a unique name for this building?
 The GQ building name is the actual name on the GQ structure or on a sign
easily seen in front of the GQ structure. Examples are: Building 202 or Building
A-1.
Input Options

1. Yes
2. No
Valid Values: 1, 2, DK, R

Skip Instructions

1. If 1, go to BLDGNAME
2. If 2, DK, or R go to UPDATECONTACT2INFO

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Attachment R

Variable Name
Screen

UPDATEBLDGNAME
NEWBLDGNAME = 1
Question
SPECIAL PLACE NAME:
GROUP QUARTERS NAME:
ADDRESS:

BUILDING NAME:

Fill in SPECPLACE
Fill in GQNAME
Fill in GQADDLINE1
Fill in GQADDLINE2

Fill in BLDGNAME

 Enter the building name.
Fields available to enter address information (and variable name and length):
·
Update GQ building name (BLDGNAME - 60 characters)

Input Options
Skip Instructions

Valid Values: alphanumeric, DK, R (go to UPDATECONT2INFO)
Go to UPDATECONTACT2INFO

Variable Name
Screen

UPDATECONT2INFO
CONTACT PERSON 2:
CONTACT TITLE2:
CONTACT PHONE2:

Fill in CP2NAME
Fill in CP2TITL
Fill in CP2PHON, CP2EXT

Is there another person who might be able to help us if needed?
*Update the Second GQ contact name.

Input Options

Skip Instructions

1. Yes
2. No
Valid Values: 1,2
1. If 1, go to NEWCP2NAME
2. If 2, go to NEWGENPHON

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Attachment R

Variable Name
Screen

NEWCP2NAME, NEWCP2TITL, NEWCP2PHON, NEWCP2EXT
CONTACT PERSON 2:
Fill in CP2NAME
CONTACT TITLE2:
Fill in CP2TITL
CONTACT PHONE2:
Fill in CP2PHON, CP1EXT

·
·
·
·

For CP2NAME display “Enter Contact #2 Name (CP1NAME - 42
characters)”
For CP2TITLT display “Enter Contact #2 Title (CP1TITL - 20
characters)”
For CP2PHON display “Enter Contact #2 Phone (CP1PHON - 10
characters)”
For CP2EXT display “Enter Contact #2 Extension (CP1EXT - 5
characters)”

Instrument: Field is name, title, phone number, or phone number
extension, whichever is appropriate.
Fields available to enter contact information (and variable name and
length). Use these tiles for the form pane:
All variables are not must fill. If CP2PHON is not filled, do not fill CP2EXT.
Instrument: Prefill all of these fields with the current value.
Skip Instructions

Go to NEWGENPHON

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Attachment R

Variable Name
Screen

NEWGENPHON and NEWGENEXT
What is the general or main phone number for fill in GQNAME?
GENERAL/MAIN PHONE #:

Fill in GQPHONE, GQEXT

 Update the main or general phone number of the group quarters/special place.
Field available to enter general contact information (and variable name and length).
Use these tiles for the form pane:
·
General phone number (GQPHONE - 10 characters)
·
General phone extension (GQEXT - 5 characters)
R is allowed for GQPHONE. If GQPHONE is not filled or R, do not fill GQEXT.
Instrument: Prefill all of these fields with the current value.
Input Options

See screen section
Valid Values: numeric only, R, Blank

Skip Instructions

1. If entry, blank or R, go to STAY_NOW

Variable Name
Screen

STAY_NOW
SPECIAL PLACE NAME:
GROUP QUARTERS NAME:

Fill in SPECNAME
Fill in GQNAME

Are people currently living or staying at fill in GQNAME ?

Input Options

Skip Instructions

1. Yes
2. No
Valid Values: 1,2, R. Do not accept blank.
1. If STAY_NOW = 1,2 or R, go to GQMAIN1.

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Attachment R

Variable Name
Screen

APPOINTMENT1
I want to schedule a date and time in the next few days to complete our
interview and the interviews with the people I select for the survey. What date
and time would be the best to visit?

Special BoP Question text
We would like to schedule this visit to happen as soon as possible. What date and
time would be the best for someone to visit you?
*Ask for directions if necessary. Press Ctrl + F7 keys simultaneously and record
details in Notes.

Input Options
Skip Instructions

Variable Name
Screen

Appointment Date/Time: _________________________
1. If INITSCREEN = 2 and PEAS_FL = 1, go to SECPROCS
2. If INITSCREEN = 3 and PEAS_FL = 1, go to SECPROCS

SECPROCS
I will have a picture ID with me on the day of my visit. Are there any specific
procedures I need to know of prior to my visit for entering this place or
interviewing the residents.
*If yes, press Ctrl + F7 keys simultaneously and record details in Notes.

Input Options

1. Yes
2. No
Valid Values: 1,2

Skip Instructions

1. Go to THANKYOU

15

Variable Name
Screen

INTSTAT
 Is the respondent able to complete the interview?

Attachment R

If this is a Federal Prison or a Federal Detention Center select option 3 for Other
noninterview. (This option does not apply to privately operated correctional
facilities that house mostly federal prisoners.)
If you are at a privately operated correctional facility that contains federal, state,
or local prisoners, do not exit the interview. Continue with the GQFQ interview,
sampling and interviewing the persons selected for sample. Select the F8 to return
to the interview. Instructions are directly below on how these GQs will be
classified.
If you are at a privately operated correctional facility that contains
mostly federal prisoners, you will continue with the interview. This GQ
will be coded out as a 102, Federal Prison.
If you are at a privately operated correctional facility that contains
mostly state prisoners, you will continue with the interview. This GQ
will be coded out as a 103, State Prison.
If you are at a privately operated correctional facility that contains
mostly local prisoners, you will continue with the interview. This GQ
will be coded out as a 104, Local Jail. (Local jails include tribal as well.)
Input Options

Skip Instructions

1.
2.
3.
1.
2.
3.

Inconvenient Time. Try again later.
Refusal.
Other noninterview
If 1, go to PCALLBACK
If 2, go to REFREASON
If 3, go to REASONINT

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Attachment R
Variable Name

PCALLBACK

Screen

What day and time would be best to contact you again?

Input Options

Date/Time:
[Fill in the blank. Allow 25 characters]

Skip Instructions

1. Go to THANKYOU

Variable Name

REFREASON

Screen

Question
 Mark all that apply.

Input Options

Answer Categories
1.
Respondent busy.
2.
Interview too long
3.
Survey is a waste of taxpayers money
4.
Respondent questions legitimacy of survey
5.
Confidentiality reasons
6.
Respondent says that he/she cannot comply because of legal restrictions
7.
Other – Specify in Notes

Skip Instructions

1. If 1-5 OR 7, go to THANKYOU
2. If 6, go to REASON811

17

Attachment R

Block
Variable Name

BF10_Exit BExit
REASON811

Field Description

4.8 Reason for 811 Outcome

Universe

REFREASON=6

Screen

Question
 What is the legal restriction cited by the respondent? Get the name of the law, if
possible, and whether it is a federal or state law.

Input Options

Fill in the blank – 60 characters.

Fill Instructions
Skip Instructions
Skip Instructions for
BoP
Special Instructions
BoP Special
Instruction

Go to THANKYOU.

Variable Name

TCALLBACK

Screen

When is a good time for me to call back?
Callback date/time: ____________________

Skip Instructions

1. Go to THANKYOU

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Attachment R

Variable Name

REASONINT

Screen

Question
 Indicate the reason for the noninterview.
Answer Categories
1.
Unable to locate
2.
Other Type A - Specify in Notes.
3.
GQ no longer exists
4.
GQ is actually a housing unit (in addition to standard housing units, this
includes assisted / independent living units, RV parks, campgrounds,
marinas, or racetracks)
5.
GQ is a domestic violence shelter or sensitive place
6.
Other Type C - Specify in Notes.
7.
Natural disaster - Type B
8.
Type C - no residents during survey period
9.
Federal Prison
10.
Federal Detention Center

Skip Instructions

1.
2.
3.
4.

If REASONINT = 1,3, 4, 5, 7, 8, 9, 10 go to NOTES
If REASONINT = 2, go to REASON819
If REASONINT = 6, go to REASON844.
If REASONINT = 9, display soft error that says the following:
This facility is out of scope at this time. You have reached a Federal Prison
outside of the data collection period for Federal Prisons. You will be exited out
of the interview and your case will be closed. Please read the script below to
the contact person.
“I’m sorry, we have contacted you at a time outside of the data collection
period for Federal Prisons. This ends the interview. Those Federal
correctional facilities, selected for sample for the ACS, will be visited
beginning in September, in which your facility may be one of those. You
will be notified prior to our return. Thank you for your time.”
Suppress exits the instrument. Close and Go to returns to REASONINT.
Set GQTYPE CODE = 102
5. If REASONINT = 10, display soft error that says the following:

This facility is out of scope at this time. You have reached a Federal
Detention Center outside of the data collection period for Federal Detention
19

Attachment R

Centers. You will be exited out of the interview and your case will be closed.
Please read the script below to the contact person.
“I’m sorry, we have contacted you at a time outside of the data collection
period for Federal Detention Centers. This ends the interview. Those
Federal correctional facilities, selected for sample for the ACS, will be
visited beginning in September, in which your facility may be one of those.
You will be notified prior to our return. Thank you for your time.”
*****Suppress exits the instrument. Close and Go to exit the instrument.
SET GQTYPE = 101

Variable Name

REASON819

Screen

Question
 Specify the reason for this Other Type A outcome.

Skip Instructions

Go to THANKYOU.

Variable Name

REASON844

Screen

Question
 Specify the reason for this Other Type C outcome.

Skip Instructions

Go to Notes.

Variable Name

THANKYOU

Screen

Thank you for helping the Census Bureau with the [fill in
American/Puerto Rico] Community Survey

Fill Instructions

1. If ST = 72, display “Puerto Rico”, else display “American”

Skip Instructions

Go to Notes
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Attachment R
Variable Name

GQMAIN1

Screen

Special Place Name:
fill in SPECNAME
Group Quarters Name: fill in GQNAME
This is a list of places where people live, could live, or stay and/or
receive services. Using this list, please select ONLY ONE category
that BEST describes [fill in GQNAME]
Give the contact person time to read all the categories on the
flashcard and provide you with a selection. If they choose more than
one category, ask for the one that has the most residents and note that
we’ll ask about the other categories later.

Input Options

Answer Categories
1. Educational Facility
2. Correctional Facility
3. Group Home
4. Health Care or Treatment Facility
5. Military
6. Other Group Living Facilities
7. None of the Above”
Valid Values
1 through 7
Do not accept DK, R

Skip Instructions

1. If 1, go to EDU_DD
2. If 2, go to CORRECTIONAL_DD
3. If 3, go to GROUPHOME_DD
4. If 4, go to HEALTH_DD
5. If 5, go to MILITARY_DD
6. If 6, go to OGLF_DD
7. If 7, go to OUTOFSCOPE

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Attachment R
Variable Name
Screen

EDU_DD
Select category based on GQ contact’s response.

Input Options

1. College/University, Student Housing
2. Residential School for People with Disabilities

Skip Instructions

1. If EDU_DD = 1, go to COLLEGE
2. If EDU_DD = 2, go to MAXCAP1

Variable Name

College

Screen

“Is [fill: GQNAME] used solely to provide housing for college
students?”
1. Yes
2. No

Input Options

Skip Instructions

1. If College=1, go to MAXCAP1
2. If College = 2, go to OUTOFSCOPE_TY

Variable Name

CORRECTIONAL_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. Adult Correctional Residential Facility
2. Juvenile Correctional Facility

Skip Instructions

1. If CORRECTIONAL_DD = 1, go to CF_DESC.
2. If CORRECTIONAL_DD = 2, go to MAXCAP1.

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Attachment R

Variable Name

CF_DESC

Screen

Which of the following categories describes [fill in GQNAME]?
If more than one flashcard category applies, mark the one with the
most prisoners.
♦ If this is a Federal Prison or a Federal Detention Center, select
either Option 5 or Option 6 respectively to exit out of the interview.
♦ If you are at a privately operated facility that contains federal, state
or local prisoners, do not exit the interview. Continue with the
GQFQ interview, sampling and interviewing the persons selected for
sample. Instructions are directly below on how to code privately
operated facilities out.
♦ If you are at a privately operated correctional facility that contains
mostly state prisoners, you will select Option 1 and continue with the
interview. This case will have the GQ Type code of 103, State
Prison.
♦ If you are at a privately operated correctional facility that contains
mostly local/county prisoners, you will select Option 2 and continue
with the interview. This case will have the GQ Type code of 104,
Local Jail. (Local jails include tribal as well)
♦ If you are at a privately operated correctional facility that contains
mostly federal prisoners, you will select Option 4 and continue with
the interview. This case will have the GQ Type code of 102.

Input Options

1. State Prison/Privately Operated Facility housing mainly state
prisoners
2. Local or County Jail/Privately Operated Facility housing mainly
local or county prisoners.
3. Adult Residential Correctional Facility
4. Privately Operated Facility housing mainly federal prisoners.
5. Federal Prison
6. Federal Detention Center

Skip Instructions

1. If CF_DESC = 1 through 4 go to MAXCAP1
2. If CF_DESC = 5, display soft error that says:
This facility is out of scope at this time. You have reached a
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Attachment R

Federal Prison outside of the data collection period for Federal
Prisons. You will be exited out of the interview and your case
will be closed. Please read the script below to the contact person.
“I’m sorry, we have contacted you at a time outside of the data
collection period for Federal Prisons. This ends the interview.
Those Federal correctional facilities, selected for sample for the
ACS, will be visited beginning in September, in which your
facility may be one of those. You will be notified prior to our
return. Thank you for your time,”
Suppress exits the instrument. Close and GO returns to CF_DESC.
Set GQTYPE = 102
3. If CF_DESC = 6 display soft error that says:
This facility is out of scope at this time. You have reached a
Federal Detention Center outside of the data collection period
for Federal Detention Centers. You will be exited out of the
interview and your case will be closed. Please read the script
below to the contact person.
“I’m sorry, we have contacted you at a time outside of the data
collection period for Federal Detention Centers. This ends the
interview. Those Federal correctional facilities, selected for
sample for the ACS, will be visited beginning in September, in
which your facility may be one of those. You will be notified
prior to our return. Thank you for your time,”
Suppress exits the instrument. Close and GO returns to CF_DESC.
Set GQTYPE = 101

Variable Name
Screen

GROUPHOME_DD
Select category based on GQ contact’s response.

Input Options

1. Adult Group Home
2. Juvenile Group Home

Skip Instructions

1. If GROUPHOME_DD = 1 go to MAXCAP1.
2. If GROUPHOME_DD = 2, go to MAXCAP1.

24

Attachment R
Variable Name
Screen

HEALTH_DD
Select category based on GQ contact’s response.

Input Options

1. Adult Residential Treatment Center (non-correctional)
2. Assisted Living, Independent Living or Continuing Care Facility
3. Nursing or Skilled Nursing Facility
4. In-Patient Hospice Facility
5. Hospital
6. Juvenile Residential Treatment Center (non-correctional)

Skip Instructions

1. If 1,3, 4 or 6 go to MAXCAP1.
2. If 2, go to ALF
3. If 5, go to HOSP_DESC

Variable Name

ALF

Screen

Does [GQNAME] have a skilled nursing unit or a nursing unit?

Input Options

1. Yes
2. No

Skip Instructions

1. If ALF = 1, go to MAXCAP1
2. If ALF = 2, got to OUTOFSCOPE_TY

Variable Name

HOSP_DESC

Screen

Does [GQNAME] provide treatment or care that includes:
If more than one Information Card category applies, enter the one
with the most patients.

Input Options

1. Mental / Psychiatric Hospital or Unit
2. Skilled Nursing Unit
3. Patients Who Have No Usual Home Elsewhere.
4. None Of The Above Apply To This Hospital

Skip Instructions

1. If HOSP_DESC = 3, go to UHE_COUNT
2. If HOSP_DESC = 1 or 2, go to MAXCAP1.
3. If HOSP_DESC = 4, go to OUTOFSCOPE_TY.

25

Attachment R
Variable Name

UHE_COUNT

Screen

Fill #1 [What is the maximum number of people who have no
usual home elsewhere who live or stay here?]
Fill #2 [What is the maximum number of people experiencing
homelessness who can live or stay in this building?]

Skip Instructions

Go to SECGQ.

Variable Name

MILITARY_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. Barracks or Academy Residence Hall
2. Disciplinary Barracks or Jail
3. Ship
4. Military Treatment Facility with Assigned Patients

Skip Instructions

MILITARY_DD – 1 through 4, go to MAXCAP1.

26

Attachment R
Variable Name
Screen

OGLF_DD
Select category based on GQ contact’s response.

Input Options

1. Commune, Recreational Vehicle Park, Campground,
Marina, Racetrack.
2. Religious Facility
3. Hotel, Motel, Inn, Resort, Lodge, or Bed and Breakfast.
4. Job Corps or Vocational Training Facility
5. Shelter
6. Worker’s Group Living Facility

Skip Instructions

1. If OGLF_DD = 1, go to OUTOFSCOPE_TY.
2. If OGLF_DD = 2,4,6, go to MAXCAP1.
3. If OGLF_DD = 3, go to HOTEL_UHE.
4. If OGLF_DD=5, go to DVS_DD.

27

Attachment R

Variable Name

DVS_DD

Screen

Interviewer instruction in blue –
♦ Domestic Violence Shelters are always out of scope for the
American Community Survey.
Scripted question:

Input Options

Is this facility a Domestic Violence Shelter?
1. Yes
2. No

Skip Instructions

1. If DVS_DD = 1, go to OUTOFSCOPE_TY.
2. If DVS_DD= 2 go to MAXCAP1.

Variable Name

HOTEL_UHE

Screen

Does [fill GQNAME] or part of [fill GQNAME] provide shelter
for people experiencing homelessness?

Input Options

1. Yes
2. No

Skip Instructions

1. If HOTEL_UHE = 1, go to UHE_COUNT.
2. If HOTEL_UHE = 2, go to OUTOFSCOPE_TY.

28

Attachment R
Variable Name

OUTOFSCOPE_DD

Screen

Is [fill GQNAME] a..?

Input Options

1. Soup Kitchen
2. Regularly Scheduled Mobile Food Van
3. Targeted Non-Sheltered Outdoor Location
4. Natural Disaster Shelter
5. Maritime/Merchant Vessel
6. None of these

Skip Instructions

1. If OUTOFSCOPE = 1 through 5, go to OUTOFSCOPE_TY.
2. If OUTOFSCOPE = 6, go to HU.

Variable Name

HU

Input Options

1. Yes
2. No
Valid Values
1, 2, do not accept DK or R

Skip Instructions

1. If HU = 1 or 2, go to OUTOFSCOPE_TY.

Variable Name

OUTOFSCOPE_TY

Screen

This place is not in scope for this part of the American / Puerto Rico
Community Survey.
In the future, you may be contacted again for an interview.

Input Options

Enter 1 to continue

Fill Instructions

If ST = 72, display “Puerto Rico”, else display “American”

Skip Instructions

Go to Notes.

29

Attachment R

Variable Name

MAXCAP1

Screen

What is the maximum number of people who can live or stay at
[fill GQNAME]? Include only those people who are part of the
[fill GQTYPECODE1DESC] section of [fill GQNAME]. Please
include any staff living or staying at [fill GQNAME].

Skip Instructions

GO to SECGQ

Variable Name

SECGQ

Screen

This is the same list of places where people live, could live or stay
and/or receive services. Is [fill GQNAME] also one of the
categories on the card?
Give the contact person some time to read all the categories and
provide you with a selection.

Input Options

1. Yes
2. No

Skip Instructions

1. If SECGQ = 1, go to SECGQ_NAME.
2. If SECGQ = 2 and STAY_NOW = 1, go to PEOPLEATGQ.
3. If SECGQ = 2 and STAY_NOW = 2, go to RI_BCT.

Variable Name

SECGQNAME

Screen

What is the name of this place?
Enter the name that accurately describes only that part of the GQ
that the contact identified on the Information Card.

Skip Instructions

PRIMARY GQ NAME:
PRIMARY GQ TYPE:

[fill GQNAME]
[fill GQTYPE1CODE]

SECOND GQ NAME:
SECOND GQ TYPE:

[fill GQNAME#2]
[fill GQTYPE2CODE]

Go to GQMAIN2

30

Attachment R

Block
Variable Name

BGQtype2
GQMAIN2

Field Description 11.5 Second GQ Category
Universe

SECGQ_NAME ne blank

Screen

Special Place Name: fill SPECNAME
Group Quarters name: fill GQNAME
Please tell me which is the category that best describes [fill
GQNAME#2]?
This type code must be different from the first type code.
The second GQ name must accurately describe only the GQ that
reflects the second type code.

Input Options

1. Educational Facility
2. Correctional Facility
3. Group Home
4. Health Care Treatment Facility
5. Military
6. Other Group Living Facilities
Valid Values
1 through 6, do not accept DK, R

Fill Instructions
Skip Instructions

1. If GQMAIN2 = 1, go to EDU_DD
2. If 2, go to CORRECTIONAL_DD
3. If 3, go to GROUPHOME_DD
4. If 4, go to HEALTH_DD
5. If 5, go to MILITARY_DD
6. If 6, go to OGLF_DD

31

Attachment R

Variable Name

EDU_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. College/University Student Housing
2. Residential School for People with Disabilities

Skip Instructions

1. If EDU_DD = 1, go to COLLEGE
2. If EDU_DD = 2, go to MAXCAP2

Variable Name

College

Screen

“Is [fill: GQNAME] used solely to provide housing for college
students?”
1. Yes
2. No

Input Options

Skip Instructions

1. If College = 1, go to MAXCAP2
2. If College = 2, go to PEOPLEATGQ.

Variable Name

CORRECTIONAL_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. Adult Correctional Residential Facility
2. Juvenile Correctional Facility

Skip Instructions

1. If CORRECTIONAL_DD = 1, go to CF_DESC.
2. If CORRECTIONAL_DD = 2, go to MAXCAP2.

32

Attachment R

Variable Name

CF_DESC

Screen

Which of the following categories describes [fill in GQNAME#2]?
If more than one flashcard category applies, mark the one with the
most prisoners.

Input Options

Skip Instructions

1. State Prison
2. Local or County Jail
3. Adult Residential Correctional Facility
4. Privately Operated Correctional Facility (federal)
5. Federal Prison
6. Federal Detention Center
1. If CF_DESC = 1 through 4 go to MAXCAP2 This Goes to
PEOPLEATGQ and should be going to MAXCAP2
2. If CF_DESC = 5, display soft error that says:
“ You have attempted to collect GQ information for Federal
Prison outside of the data collection period for Federal
Prisons. Please read the script below to the respondent and
continue with the interview.
Federal facilities are out of scope at this time of data
collection. Is this GQ another of the categories on this card?
Suppress is off line. Close and GO returns to SECGQ.
3. If CF_DESC = 6 display soft error that says:
You have attempted to collect GQ information for Federal
Prison outside of the data collection period for Federal
Prisons. Please read the script below to the respondent and
continue with the interview.
Federal facilities are out of scope at this time of data
collection. Is this GQ another of the categories on this card?
Suppress is off line. Close and GO returns to SECGQ.

33

Attachment R

Variable Name
Screen

GROUPHOME_DD
Select category based on GQ contact’s response.

Input Options

1. Adult Group Home
2. Juvenile Group Home

Skip Instructions

1. If GROUPHOME_DD = 1 go to MAXCAP2.
2. If GROUPHOME_DD = 2, go to MAXCAP2.

Variable Name

HEALTH_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. Adult Residential Treatment Center (non-correctional)
2. Assisted Living, Independent Living or Continuing Care Facility
3. Nursing or Skilled Nursing Facility
4. Hospice
5. Hospital
6. Juvenile Residential Treatment Center (non-correctional)

Skip Instructions

1. If 1, 3, 4 or 6 go to MAXCAP2.
2. If 2, go to ALF
3. If 5, go to HOSP_DESC

34

Attachment R

Variable Name
Screen

ALF
Does [GQNAME#2] have a skilled nursing unit or a nursing unit?

Input Options

1. Yes
2. No

Skip Instructions

1. If ALF = 1, go to MAXCAP2
2. If ALF = 2, got to PEOPLEATGQ

Variable Name

HOSP_DESC

Screen

Does [GQNAME#2] provide treatment or care that includes:
If more than one Information Card category applies, enter the one
with the most patients.

Input Options

1. Mental /Psychiatric Hospital or Unit.
2. Skilled Nursing Unit
3. Patients Who Have No Usual Home Elsewhere.
4. None Of The Above Apply To This Hospital

Skip Instructions

1. If HOSP_DESC = 3, go to UHE_COUNT
2. If HOSP_DESC = 1 or 2, go to MAXCAP2.
3. If HOSP_DESC = 4, go to PEOPLEATGQ.

35

Attachment R

Variable Name

UHE_COUNT

Screen

Fill #1 [What is the maximum number of people who have no usual
home elsewhere who live or stay here?]
Fill #2 [What is the maximum number of people experiencing
homelessness who can live or stay in this building?]

Skip Instructions

Go to TERGQ.

Variable Name

MILITARY_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. Barracks or Academy Residence Hall
2. Disciplinary Barrack or Jail
3. Ship
4. Military Treatment Facility with Assigned Patients

Skip Instructions

MILITARY_DD – 1 through 4, go to MAXCAP2.

36

Attachment R

Variable Name
Screen

OGLF_DD
Select category based on GQ contact’s response.

Input Options

1. Commune, Recreational Vehicle Park, Campground,
Marina, Racetrack.
2. Religious Facility
3. Hotel, Motel, Inn, Resort, Lodge, or Bed and Breakfast.
4. Job Corps or Vocational Training Facility
5. Shelter
6. Worker’s Group Living Facility

Skip Instructions

1. If OGLF_DD = 1, go to PEOPLEATGQ.
2. If OGLF_DD = 2,4,6 go to MAXCAP2.
3. If OGLF_DD = 3, go to HOTEL_UHE.
4. If OGLF_DD=5, go to DVS_DD

Variable Name

DVS_DD

Screen

Domestic Violence Shelters are always out of scope for the
American Community Survey. Is this facility a Domestic
Violence Shelter?

Input Options

1. Yes
2. No

Skip Instructions

1. If DVS_DD = 1, go to OUTOFSCOPE_TY.
2. If DVS_DD= 2 go to MAXCAP2.

Variable Name

HOTEL_UHE

Screen

Does [fill GQNAME#2] or part of [fill GQNAME#2] provide
shelter for people experiencing homelessness?

Input Options

1. Yes
2. No

Skip Instructions

1. If HOTEL_UHE = 1, go to UHE_COUNT.
2. If HOTEL_UHE = 2, go to PEOPLEATGQ.
37

Attachment R

38

Attachment R

Variable Name

MAXCAP2

Screen

“What is the maximum number of people who can live or stay at
[fill GQNAME#2]? Include only those people who are part of the
[fill GQTYPECODE2DESC] section of [fill GQNAME#2]. Please
include any staff living or staying at [fill GQNAME#2].”
This was in the last spec sent up – re-sending it in this one.

Skip Instructions

GO to TERGQ

Variable Name

TerGQ

Screen

This is the same list of places where people live, could live or stay
and/or receive services. Is [fill GQNAME] also one of the
categories on the card?
Give the contact person some time to read all the categories and
provide you with a selection.

Input Options

1. Yes
2. No

Skip Instructions

1. If TerGQ = 1, go to TERGQNAME.
2. If TerGQ = 2 and STAY_NOW = 1, go to PEOPLEATGQ.
3. If TerGQ = 2 and STAY_NOW = 2, go to RI_BCT.

39

Attachment R

Variable Name

TERGQNAME

Screen

What is the name of this place?
Enter the name that accurately describes only the part of the GQ
that the contact identified on the Information Card.
PRIMARY GQ NAME:
PRIMARY GQ TYPE:

[fill GQNAME]
[fill GQTYPE1CODE]

SECOND GQ NAME:
SECOND GQ TYPE:

[fill GQNAME#2]
[fill GQTYPE2CODE]

THIRD GQ NAME:
THIRD GQTYPE:

[fill: GQNAME#3 for third GQ]
[fill: GQTYPE3CODE]

Skip Instructions

Go to GQMAIN3

Variable Name

GQMAIN3

Screen

Special Place Name: fill SPECNAME
Group Quarters name: fill GQNAME
Please tell me which is the category that best describes [fill
GQNAME#3]?
This type code must be different from the first type code.
The third GQ name must accurately describe only the GQ that
reflects the third type code.

Input Options

1. Educational Facility
2. Correctional Facility
3. Group Home
4. Health Care Treatment Facility
5. Military
6. Other Group Living Facilities
Valid Values
1 through 6, do not accept DK, R

Skip Instructions

1. If GQMAIN3 = 1, go to EDU_DD
2. If GQMAIN3 = 2, go to CORRECTIONAL_DD
3. If GQMAIN3 = 3, go to GROUPHOME_DD
4. If GQMAIN3 = 4, go to HEALTH_DD
5. If GQMAIN3 = 5, go to MILITARY_DD
6. If GQMAIN3 = 6, go to OGLF_DD
40

Attachment R

Variable Name
Screen

EDU_DD
Select category based on GQ contact’s response.

Input Options

1. College/University Student Housing
2. Residential School for People with Disabilities

Skip Instructions

1. If EDU_DD = 1, go to COLLEGE
2. If EDU_DD = 2, go to MAXCAP3

Variable Name

College

Field Description
6.1 College/University Student Housing
Screen
“Is [fill: GQNAME] used solely to provide housing for college
students?”
Input Options
1. Yes
2. No
Skip Instructions

1. If College=1, go to MAXCAP3
2. If College = 2, go to PEOPLEATGQ

Variable Name

CORRECTIONAL_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. Adult Correctional Residential Facility
2. Juvenile Correctional Facility

Skip Instructions

1. If CORRECTIONAL_DD = 1, go to CF_DESC.
2. If CORRECTIONAL_DD = 2, go to MAXCAP3.

41

Attachment R
Variable Name

CF_DESC

Screen

“Which of the following categories describes [fill in GQNAME#3]?
If more than one flashcard category applies, mark the one with the
most prisoners.”

Input Options

Skip Instructions

1. State Prison
2. Local or County Jail
3. Adult Residential Correctional Facility
4. Privately Operated Correctional Facility (federal)
5. Federal Prison
6. Federal Detention Center
1. If CF_DESC = 1 through 4 go to MAXCAP3 Going to
PEOPLEATGQ and it should be going to MAXCAP3
2. If CF_DESC = 5, display soft error that says:
“ You have attempted to collect GQ information for Federal
Prison outside of the data collection period for Federal
Prisons. Please read the script below to the respondent and
continue with the interview.
“Federal facilities are out of scope at this time of data collection.
Is this GQ another one of the categories on this card?”
Suppress is off line. Close and GO returns to TERGQNAME.
3. If CF_DESC = 6, display soft error that says:
You have attempted to collect GQ information for Federal
Prison outside of the data collection period for Federal
Prisons. Please read the script below to the respondent and
continue with the interview.
“Federal facilities are out of scope at this time of data collection.
Is this GQ another one of the categories on this card?”
Suppress is off line. Close and GO returns to TERGQNAME.

42

Attachment R

Variable Name
Screen

GROUPHOME_DD
Select category based on GQ contact’s response.

Input Options

1. Adult Group
2. Juvenile Group

Skip Instructions

1. If GROUPHOME_DD = 1 go to MAXCAP3.
2. If GROUPHOME_DD = 2, go to MAXCAP3.

43

Attachment R

Variable Name
Screen

HEALTH_DD
Select category based on GQ contact’s response.

Input Options

1. Adult Residential Treatment Center (non-correctional)
2. Assisted Living, Independent Living or Continuing Care Facility
3. Nursing or Skilled Nursing Facility
4. In-Patient Hospice Facility
5. Hospital
6. Juvenile Residential Treatment Center (non-correctional)

Skip Instructions

1. If 1, 3, 4 or 6 go to MAXCAP3.
2. If 2, go to ALF
3. If 5, go to HOSP_DESC

Variable Name

ALF

Screen

Does [GQNAME#3] have a skilled nursing unit or a nursing
unit?

Input Options

1. Yes
2. No

Skip Instructions

1. If ALF = 1, go to MAXCAP3
2. If ALF = 2, got to PEOPLEATGQ

44

Attachment R

Variable Name

HOSP_DESC

Screen

Does [GQNAME#3] provide treatment or care that includes:
If more than one Information Card category applies, enter the one
with the most patients.”

Input Options

1. Mental/Psychiatric Hospital or Unit
2. Skilled Nursing Unit.
3. Patients Who Have No Usual Home Elsewhere.
4. None Of The Above Apply To This Hospital

Skip Instructions

1. If HOSP_DESC = 3, go to UHE_COUNT
2. If HOSP_DESC = 1 or 2, go to MAXCAP3.
3. If HOSP_DESC = 4, go to PEOPLEATGQ.

Variable Name

UHE_COUNT

Screen

Fill #1 [What is the maximum number of people who have no usual
home elsewhere who live or stay here?]
Fill #2 [What is the maximum number of people experiencing
homelessness who can live or stay in this building?]

Skip Instructions

1. If STAY_NOW = 1, go to PEOPLEATGQ
2. If STAY_NOW = 2, go to RI_BTC

45

Attachment R

Variable Name
Screen

MILITARY_DD
Select category based on GQ contact’s response.

Input Options

1. Barracks or Academy Residence Hall
2. Disciplinary Barracks or Jail
3. Ship
4. Military Treatment Facility with Assigned Patients

Skip Instructions

MILITARY_DD – 1 through 4, go to MAXCAP3.

Variable Name

OGLF_DD

Screen

Select category based on GQ contact’s response.

Input Options

1. Commune, Recreational Vehicle Park, Campground,
Marina, Racetrack.
2. Religious Facility
3. Hotel, Motel, Inn, Resort, Lodge, or Bed and Breakfast.
4. Job Corps or Vocational Training Facility
5. Shelter
6. Worker’s Group Living Facility

Skip Instructions

1. If OGLF_DD = 1, go to PEOPLEATGQ.
2. If OGLF_DD = 2,4,6, go to MAXCAP3.
3. If OGLF_DD = 3, go to HOTEL_UHE.
4. If OGLF_DD=5, go to DVS_DD.

46

Attachment R
Variable Name

DVS_DD

Screen

Domestic Violence Shelters are always out of scope for the
American Community Survey. Is this facility a Domestic
Violence Shelter?

Input Options

1. Yes
2. No

Skip Instructions

1. If DVS_DD = 1, go to OUTOFSCOPE_TY.
2. If DVS_DD= 2 go to MAXCAP3.

Variable Name

HOTEL_UHE

Screen

Does [fill GQNAME#3] or part of [fill GQNAME#3] provide
shelter for people experiencing homelessness?

Input Options

1. Yes
2. No

Skip Instructions

1. If HOTEL_UHE = 1, go to UHE_COUNT.
2. If HOTEL_UHE = 2, go to PEOPLEATGQ.

Variable Name

MAXCAP3

Screen

What is the maximum number of people who can live or stay at
[fill GQNAME#3]? Include only those people who are part of the
[fill GQTYPECODE3DESC] section of [fill GQNAME#3]. Please
include any staff living or staying at [fill GQNAME#3]. The
instruction should be up in the question, not as an FR instruction
any longer. Thanks!

Skip Instructions

GO to PEOPLEATGQ

47

Attachment R

Variable Name

PEOPLEATGQ

Screen

“We need to take a sample of the residents and staff of [fill:
GQNAME] to determine who I should interview. To take the
sample, I will now need a list of all occupied beds as of TODAY.
The list needs to include sufficient information so that I can locate
that person. For example: the resident’s name, floor number, room
number and bed designation. Can you provide me with this type of
list?
Be sure to include any staff members living of staying at the GQ.
Do not include Held Beds.”

Input Options

1. Yes
2. No
Valid Values
1,2,R

Skip Instructions

1. If PEOPLEATGQ = 1, go to CURRENTPOP
2. If PEOPLEATGQ = 2,R go to ALLBEDS

Variable Name

ALLBEDS

Screen

Is there an up-to-date list of all beds at [fill: GQNAME]
Be sure to include any staff members living or staying at the GQ.

Input Options

1. Yes
2. No
Valid Values
1, 2, R

Skip Instructions

1. If ALLBEDS = 1, go to CURRENTPOP
2. If ALLBEDS = 2,R go to CREATE_OCCBEDS
48

Attachment R
Variable Name

CREATE_OCCBEDS

Screen

Can you help me create a list of occupied beds?
Be sure to include any staff members living of staying at the GQ.
Do not include Held Beds.

Input Options

1. Yes
2. No
Valid Values
1,2,R

Skip Instructions

1. If CREATE_OCCBEDS = 1, go to CURRENTPOP
2. If CREATE_OCCBEDS = 2, R go to CREATE_ALLBEDS.

Variable Name

CREATE_ALLBEDS

Screen

Can you help me create a list of all beds?

Input Options

1. Yes
2. No
Valid Values
1,2,R

Skip Instructions

1. If CREATE_ALLBEDS = 1, go to CURRENTPOP
2. If CREATE_ALLBEDS = 2, R go to INSTAT

Variable Name

CURRENTPOP

Screen

“What is the total number of [fill 1: occupied beds] or [fill 2: all beds]
at this place?
Be sure you have the resister/list that you just received from or
created with the GQ contact person.”

Skip Instructions

Go to CONFIRMATION
49

Attachment R

Variable Name

CONFIRMATION

Screen

You have entered that the total number of [fill1: occupied beds] or
[fill2: all beds] is [fill3: CURRENTPOP]. Verify, using your list,
that this number is accurate and then re-enter the correct number.

Fill Instructions

1. If PEOPLEATGQ = 1 or CREATE_OCCBEDS = 1. then fill 1
with “occupied beds”.
2. If ALLBEDS = 1 or CREATE_ALLBEDS = 1, then fill 2 with “all
beds”.
3. Fill 3 and Fill 4 is the value from CURRENTPOP
4. Fill 5 is the value from CONFIRMATION.

Variable Name

RI_BCT

Screen

Thank you for your help with the [fill American / Puerto Rico]
Community Survey.
In order to evaluate the quality of my work, my supervisor may
contact you to verify that I am doing my job correctly. What is the
best time to contact you?

Skip Instructions

1. If STAY_NOW = 1, go to GQCONTACTFINISH
2. If STAY_NOW = 2, go to NOTES
3. If STAY_NOW = R, go to NOTES

Variable Name

GQCONTACTFINISH

Screen

You are now finished getting the information you need from the
GQ contact. Let the GQ contact know that it will take a few minutes
to take the sample. Let the GQ contact know that you will need to
meet with them once you are finished sampling so they can help you
find the people in sample to interview. Ask the GQ contact if there is
a room that you can sit in to finish the sampling.

Skip Instructions

Go to TAKESAMPLE

50

Attachment R
Variable Name

TAKESAMPLE

Screen

You need to have you register in front of you. You are about to
draw the sample for [fill: GQNAME].
Reminders:
Be sure to only include those people who are currently staying at
the GQ.
For those GQs where you have determined there is a mix of
housing units and GQs, ONLKY include those people currently
staying in the sample GQ.
Do not include Held Beds.

Input Options

Enter 1 to continue

Skip Instructions

Go to SAMPROSTER, PHONENUM, and EXTENSION for each
person.

51

Attachment R

Variable Name

SAMPROSTER, PHONENUM , and EXTENSION

Screen

Enter Name of person, bed, or room
Using you register and referring to the sample line below, enter
the room #, bed #, floor # and / or sample person’s name for each of
the GQ residents that were selected in the sample.
Sample line number (This column is prefilled and cannot be changed
by the interviewer)
Phone Number
Enter the telephone number for the sample person, room, or bed if
you were able to get a telephone number.
Phone Number extension
Enter the telephone number extension for the sampled person, room,
or bed if one exists. If phone number is blank, DK or R only accept
blank.
ACS Control Number (This column is prefilled and can not be
changed by the interviewer.
D, R or no answer are acceptable for Phone number and Phone
Number extension. If Phone number is blank, D or R, only accept no
answer for Phone number extension.

Skip Instructions

Go to COLLINDV

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Variable Name

GCDREMIND

Screen

Geocode verification is required for this case and has not yet been
completed. Please verify the geocodes during this personal visit to the
sample unit.

Attachment R

Select the Geocoding Tab or Press Ctrl+G to proceed to the
geocode verification screens now, or enter 1 to continue exiting the
instrument.
If you exit the instrument before Geocoding, this case will not be
complete and you will not be able to transmit.

Input Options
Skip Instructions

Enter 1
If GCDREMIND=1 and GeocodeCmplt=1, Goto NOTES FINISH.

Variable Name

COLLINDV

Screen

You have completed sampling at this GQ. You must now prepare
the ACS-1(GQ) questionnaires to be distributed to each sampled
person. Remember that the contact(s) must be sworn in if he/she/they
will be handling completed questionnaires.

Since this is a completed interview, you must select the Geocode
tab or press Ctrl+G to verify that this GQ has the correct Geocodes.

Input Options

Enter 1 to continue

Skip Instructions

1. If INITSCREEN = 3 or 4; PEAS_FL = 1 and GeocodeCmplt = 1,
set STOREOUT = 801, set GeocodeReqd = 1 goto FINISH.
2. If INITSCREEN = 3 or 4; PEAS_FL = 1 and GeocodeCmplt = 0,
set OUTCOME =807, set STOREOUT = 801, set GeocodeReqd = 1
goto GCDRemind.
3. If INITSCREEN = 3 or 4; PEAS_FL = 0, set STOREOUT = 801,
goto FINISH.
4. If Ctrl+G is pressed, go to GCDCORRECT.

53

Attachment R
Variable Name
Screen

FINISH
This case is ready to be transmitted. Enter 1 to continue.

Skip Instructions

If FINISH = 1 and STOREOUT ne blank, set OUTCOME =
STOREOUT and Goto NOTES.

54