Pueblo EPZ Business Survey/ FEMA Form 008-0-5

Chemical Stockpile Emergency Preparedness Program (CSEPP) Evaluation and Customer Satisfaction Survey

Pueblo_Business_Questionnaire 008-0-5

Pueblo EPZ Business Survey/ FEMA Form 008-0-5

OMB: 1660-0057

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CSEPP Public Affairs IPT Questionnaire

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


  1. Do you know what the Chemical Stockpile Emergency Preparedness Program, also known as CSEPP (SEE-SEP) is?


1. Yes

2. No


  1. Are you aware of the chemical agents at the Pueblo Chemical Depot?


1. Yes

2. No


  1. 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


  1. 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

  1. There are sirens

  2. We have a tone alert radio

  3. There is an alarm system

  4. The Depot/people in charge are prepared

  5. Our proximity to the Depot

  6. There are drills/tests

  7. Because of the media/news

  8. We are part of the response team


Not confident

  1. Can't hear sirens

  2. Can’t understand sirens

-----

97. Other (RECORD VERBATIM)

99. Don’t know


  1. 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)


  1. AM/FM radio

  2. Fire department

  3. Friend/Neighbor

  4. Sheriff’s department

  5. Siren/Loudspeaker

  6. Telephone call

  7. Television

  8. Tone alert radio (TAR)

-----

97. Other (RECORD VERBATIM)

99. Don’t know

  1. 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)


  1. AM/FM radio

  2. Fire department

  3. Pre-written plans/procedures

  4. Pueblo County Department of Emergency Management

  5. Sheriff’s department

  6. Siren/Loudspeaker

  7. Telephone

  8. Television

  9. Tone alert radio (TAR)

-----------

  1. Other (RECORD VERBATIM)

99. Don’t know


  1. 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)


    1. In person

    2. Telephone

    3. CB radio/Walkie-Talkie

    4. PA/Intercom system

    5. I’m the only employee

-------------

97. Other (RECORD VERBATIM)

99. Don’t know


  1. How long do you think it would take your business to alert all of the employees?


  1. Under 1 minute

  2. 1-5 minutes

  3. 6-10 minutes

  4. 10-15 minutes

  5. More than 15 minutes

  6. (DON’T READ) Don’t know

-------------

97. Other (RECORD VERBATIM)



  1. 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

  1. Listen to TV/radio/TAR/sirens

-------------

  1. Other (RECORD VERBATIM)

  2. Nothing

  3. Don’t know


  1. 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


  1. Why do you believe that your business would not be able evacuate successfully? (RECORD VERBATIM)

  2. In the event of an evacuation, does your business have a pre-planned direction, route, or off-site destination for employees?


  1. Yes GO TO 13

  2. No GO TO 14


  1. Can you please describe it? (RECORD VERBATIM)


  1. Would your business evacuate if instructed to do so?


1. Yes

2. No

-------------

97. Other (RECORD VERBATIM)


  1. 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


  1. Why do you believe that your business would not be able to shelter-in-place successfully? (RECORD VERBATIM)


  1. We can't seal out the air

  2. We don't have the knowledge/materials to shelter in place

  3. We don't have a place to shelter

-----------

  1. Other (RECORD VERBATIM)

99. Don’t know



  1. 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)


  1. Close doors and windows

  2. Close heating/air conditioning vents

  3. Evacuate

  4. Follow instructions

  5. Go inside

  6. Go into shelter room of workplace

  7. Listen to radio/TV for further instructions

  8. Lock doors and windows

  9. Put on respirators/chemical gear

  10. Seal doors and windows of shelter room

  11. Stay inside

  12. Take radio/TV into shelter room

  13. Turn off heating/air conditioning systems

  14. Use shelter-in-place kit

-----------

  1. Other (RECORD VERBATIM)

  2. Nothing

  3. Don’t know


  1. Please answer yes or no to the following questions: (Please also provide a “Don’t know” category for each of these subquestions)


  1. Does your business have a shelter-in-place kit with duct tape, plastic, and instructions?

  2. Does your business have a pre-identified room for employees to shelter in place?

  3. Does your business have a written emergency plan?

  4. Does your business have a business contigency or recovery plan in case of emergencies that may interrupt business for an extended period of time?

  5. In the event of an emergency, do you have a designated on-site meeting place?

  6. Does your business have a tone alert radio (TAR)?


  1. What does your business currently do when you hear the sirens go off? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)


  1. Listen to the siren announcement

  2. Can't hear the sirens

  3. Check if it is a test/drill

  4. Listen to AM/FM radio/TAR/TV/other for more information

  5. Can't understand the sirens

  6. Ignore the sirens

  7. Check the calendar to see if it is a test/drill

  8. Assume it is a test/drill

-----------

  1. Other (RECORD VERBATIM)

  2. Nothing

99. Don’t know


  1. 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)


  1. Army Depot

  2. AM/FM radio

  3. Bulletins/Flyers/Mailings

  4. Chemical Stockpile Emergency Preparedness Program (CSEPP)

  5. Fire department

  6. Internet

  7. Television

  8. Pueblo County Department of Emergency Management

-------------

  1. Other (RECORD VERBATIM)

99. Don’t know


  1. How would you prefer to receive emergency preparedness information for your business? (ACCEPT MULTIPLE RESPONSES, READ 1-8, 8-1)


  1. AM/FM radio

  2. Calendar

  3. Direct mail

  4. Fairs

  5. Internet

  6. Newspaper (PLEASE SPECIFY)

  7. One to one communication

  8. Business presentations or meetings

-------------

  1. (DON’T READ) Other (RECORD VERBATIM)

99. Don’t know


To conclude, I have a few questions for statistical purposes


  1. 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


  1. 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


  1. Do employees at your business work indoors, outdoors, or both indoors and outdoors?


  1. Indoors

  2. Outdoors

  3. Indoors and Outdoors


  1. Is your business in the Immediate Response Zone (IRZ) or the Protective Action Zone (PAZ)?


  1. IRZ

  2. PAZ

  3. (DON’T READ) Don’t know



  1. Approximately how many employees work at your location?


  1. 1–4 employees

  2. 5–9 employees

  3. 10–19 employees

  4. 20–49 employees

  5. 50–99 employees

  6. 100–249 employees

  7. 250+ employees

  1. Of these employees, what percentage would you estimate live outside of Pueblo County? (DON’T READ)


  1. None or 0%

-------------

97. Other (RECORD VERBATIM)


  1. What are the hours of operation for your business? Please include days of the week and hours that you regularly have employees on site.


  1. Monday–Sunday, 24 hours a day

  2. Monday–Friday, 9am to 5pm

-------------

97. Other (RECORD VERBATIM)

99. (DON’T READ) Don’t know/Refused


  1. Which description best categorizes your business? (READ 1-12)


BUSINESSES IN PARENTHESES ALSO FIT IN THAT CATEGORY


  1. Agricultural (farm, ranch)

  2. Automotive repair

  3. Construction (carpentry, structural services)

  4. Convenience store (service station)

  5. Home office

  6. Industrial facility with one building

  7. Industrial facility with multiple buildings

  8. Non-profit organization

  9. Public service or government organization

  10. Professional office

  11. Restaurant (Bar)

  12. Retail store

-------------

97. Other (RECORD VERBATIM)


  1. What is your position at this business? (ACCEPT MULTIPLE RESPONSES)


  1. Owner

  2. President

  3. Vice President

  4. Director

  5. Manager

  6. Safety Officer

  7. Employee

-------------

97. Other (RECORD VERBATIM)



  1. 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?

    1. Permission granted

    2. Remain anonymous


IF PERMISSION GRANTED: May I please get your name? (enter name) __________________



Thanks again!

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleSuggested survey methodology: Use "open-ended" questions, categorize the response into pre-identified categories, and follow up
AuthorROUSSEL
File Modified0000-00-00
File Created2021-01-26
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