Form FEMA FORM 008-0-9 FEMA FORM 008-0-9 Pueblo EPZ Site Survey

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

FEMA Form 008-0-9 Pueblo EPZ Residential Survey

Pueblo EPZ Residential Survey/ FEMA Form 008-0-9

OMB: 1660-0057

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CSEPP Public Affairs IPT Questionnaire

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.


  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 would you know if there were a chemical emergency at the Pueblo Chemical Depot? (DON’T READ; CATEGORIZE RESPONSE AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)


  1. Tone alert radio (TAR)

  2. Siren/Loudspeaker

  3. AM/FM radio

  4. Television

  5. Family/Friend

  6. Work (Depot, police, fire)

  7. Mobile sign board/Highway message board

-----

97. Other (PLEASE SPECIFY)

99. Don’t know


  1. 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?


  1. Shelter in place

  2. Evacuate

  3. Turn on/Watch television

  4. Turn on/Listen to AM/FM radio

  5. Listen to tone alert radio

  6. Follow instructions given on TV, radio, or tone alert radio

  7. Await instructions to shelter in place or evacuate

  8. Call 911

  9. Contact family/friends

  10. Go to work (Depot, hospital, fire dept, police)

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

  1. Other (PLEASE SPECIFY)

  2. Nothing

  3. Don’t know


  1. Why do you say that? (RECORD RESPONSE VERBATIM)


CLARIFY IF RESPONDENT SAYS “THEY” OR “THEM”: Who do you mean by they/them?


  1. To get away from the chemicals, gas, or danger

  2. To find out what to do/Get more information

  3. I live close to the Depot

  4. I want to get out of the area

  5. It’s safer to evacuate

  6. It’s safer to shelter in place

  7. Depends on the wind direction

  8. I don't know what else to do

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

97. Other (PLEASE SPECIFY)

  1. Don’t know



  1. 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.


  1. Close doors and windows

  2. Close heating/air conditioning vents

  3. Evacuate

  4. Follow instructions/Do what told

  5. Get food/water supply

  6. Go inside/Stay inside

  7. Go into shelter room of your home/workplace

  8. Get supplies (clothes, cell phone, book, candles, games, medicine, flashlight, ect.)

  9. Go to work (Depot, hospital, fire department, police)

  10. Listen to radio/TV for further instructions

  11. Locate/collect pets

  12. Lock doors and windows

  13. Seal doors and windows of shelter room

  14. Take radio/TV into shelter room

  15. Turn off heating/air conditioning systems

  16. Use emergency kit

  17. Use shelter-in-place kit

-----------

  1. Other (PLEASE SPECIFY)

  2. Nothing

  3. Don’t know


  1. How would you know when it would be safe to stop sheltering-in-place? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)


  1. AM/FM radio

  2. Chemical Stockpile Emergency Preparedness Program (CSEPP) Office

  3. Emergency Alert System (EAS)

  4. Family/Relative

  5. Fire department

  6. Friend/Neighbor

  7. Pueblo County Department of Emergency Management

  8. Police

  9. Sheriff's department

  10. Siren/Loudspeaker

  11. Television

  12. Tone alert radio (TAR)

  13. Work

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

  1. Other (PLEASE SPECIFY)

99. Don't know

  1. 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?


  1. Await instructions/Listen for help

  2. Follow instructions/Do what told

  3. Get personal items (pack clothes, food, water, gas)

  4. Leave home or workplace/Get out of town/Get in car and go

  5. Listen to TV/radio/tone alert

  6. Locate/collect pets

  7. Turn off heating/air conditioning systems

  8. Turn on TV/radio/tone alert radio (general)

  9. Wait for/Contact family members before leaving

  10. Would not evacuate

-----------

  1. Other (PLEASE SPECIFY)

  2. Nothing

  3. Don’t know


  1. In the event of an evacuation, do you have a pre-planned direction, route or destination? (ACCEPT MULTIPLE RESPONSES, SPECIFY RESPONSES)


  1. Yes, direction (North, South, East, West)

    1. East

    2. North

    3. Northeast

    4. Northwest

    5. South

    6. Southeast

    7. Southwest

    8. West

    9. Other (PLEASE SPECIFY)

  2. Yes, route (road, highway, freeway)

    1. Highway 50 Business/Bypass, Eastbound

    2. Highway 50 Business/Bypass, Westbound

    3. Highway 50, Eastbound

    4. Highway 50, Westbound

    5. Highway 96, Eastbound

    6. Highway 96, Westbound

    7. Highway 209, Northbound

    8. Highway 209, Southbound

    9. Highway 231/36th Lane, Northbound

    10. Highway 231/36th Lane, Southbound

    11. Highway 233/Baxter road, Northbound

    12. Highway 233/Baxter road, Southbound

    13. Interstate 25, Northbound

    14. Interstate 25, Southbound

    15. Other (PLEASE SPECIFY)

  3. Yes, destination (city, state, reception center)

    1. Colorado Springs

    2. Denver

    3. Pueblo

    4. Rocky Ford

    5. Other (PLEASE SPECIFY)

  4. No, none

  5. Depends on the wind direction

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

  1. Other (PLEASE SPECIFY)



  1. 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)


  1. AM/FM radio

  2. Emergency alert system (EAS)

  3. Pueblo County Department of Emergency Management

  4. Mobile sign board/Highway message board

  5. Package/kit on preparedness

  6. Pamphlet

  7. Police, local or State

  8. Pueblo Chemical Depot

  9. Television

  10. Tone alert radio (TAR)

-----------

  1. Other (PLEASE SPECIFY)

  2. None/Nowhere

  3. Don’t know


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


  1. Can’t hear sirens/Sirens are too far away

  2. Can't understand the sirens

  3. Check if it is a test/drill

  4. Don't pay attention / Ignore sirens / Don’t listen

  5. Listen to siren announcement

  6. Assume it is a test/drill

  7. Turn on or listen to TV/radio

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

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

  1. Other (PLEASE SPECIFY)

  2. Nothing

  3. Don’t know


  1. Do you or your family have an emergency plan?


1. Yes

2. No

  1. Please answer yes or no to the following questions:


  1. Are you familiar with the names of the major roads and highways in your area?

  2. In the event of an emergency, do you have a family meeting place?

  3. Do you have an out-of-area (out-of-town) telephone contact?

  4. Do you have a shelter-in-place kit with duct tape, plastic, and instructions?

  5. Do you have a disaster supply kit or a 72-hour kit (emergency supplies, such as food, blankets, flashlight, etc.)?

  6. Do you have a tone alert radio (TAR)?


  1. 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


  1. 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


RESPONDENTS WITH CHILDREN aNSWER question 16

  1. Which school(s) do they attend? (RECORD CATEGORY, ACCEPT MULTIPLE RESPONSES)


  1. Avondale Elementary School

  2. Futures Academy

  3. North Mesa Elementary School

  4. Pleasant View Middle School

  5. Pueblo County High School

  6. South Mesa Elementary

  7. Vineland Elementary School

  8. Vineland Middle School

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

  1. Other (PLEASE SPECIFY) GO TO 17

  2. Home School GO TO 21

  3. 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

  1. Are you familiar with the emergency plan at your child(ren)’s school(s)?


  1. Yes

  2. No


  1. 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


  1. 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


  1. 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)

  1. Child(ren) are safer with me

  2. Don’t trust the school

  3. Don’t want to place self or others at risk

  4. I want my child(ren) with me so we can leave the area

  5. I want my child(ren) with me (general)

  6. Live/work close to the school

  7. Make sure my child(ren) are safe

  8. Protect my child(ren)

  9. School is not prepared

  10. School has a plan/School is safe

  11. Want to wait until it is safe

-----------

    1. 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)

  1. Child drives himself/herself to school

  2. I’ll be at work

  3. My child(ren) is/are safer at the school

  4. My child(ren) would be evacuated/bused elsewhere

  5. Not able to get child(ren) even if I tried

  6. School has a plan/ School is prepared

  7. School is too far away

  8. Told not to try to get child(ren)/Told not to go to school

  9. Trust the school

  10. Want to wait until it is safe

-----------

97. Other (PLEASE SPECIFY)

99. Don't know


ALL RESIDENTS

  1. How would you prefer to receive emergency preparedness information? (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. Public presentations or meetings

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

97. (DON’T READ) Other (PLEASE SPECIFY)



  1. When was the last time you heard, saw, or read any information about how to prepare for a chemical emergency?


  1. Within the last week

  2. Within the last month

  3. Within the last year

  4. More than a year

  5. (DON’T READ) Never GO TO 25

  6. (DON’T READ) Don’t recall receiving CSEPP information GO TO 25

  7. (DON’T READ) Have received CSEPP information but don’t recall when it was received GO TO 23


  1. How have you received information about how to prepare for a chemical emergency? (CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)


  1. AM/FM radio

  2. Calendar

  3. Community event/Fair/Booth

  4. CSEPP representative

  5. The CSEPP update (quarterly newsletter)

  6. Informational package/kit

  7. Informational pamphlet/flyer

  8. Internet

  9. Magazine

  10. Mail

  11. Newspaper

  12. Pueblo Chemical Depot representative

  13. Pueblo County Department of Emergency Management representative

  14. Siren/Loudspeaker drills/testing

  15. Speaker/Speech/Presentation

  16. Television

  17. Tone alert radio

  18. Word-of-mouth

  19. Work/Training

-----------

97. Other (PLEASE SPECIFY)

99. Don't know


  1. What information do you recall from what you heard, saw, or read? (DON’T READ, CATEGORIZE RESPONSES AS FOLLOWS, ACCEPT MULTIPLE RESPONSES)


  1. Be prepared/alert

  2. Chemical agents/gases

  3. Children will be safe in school

  4. Didn’t listen or read/Didn’t pay attention

  5. Drills/Tests

  6. Evacuation plan

  7. Evacuation directions

  8. Evacuation route

  9. Evacuation zones

  10. Follow instructions

  11. Food/Water storage

  12. General instructions on what to do or how to get prepared

  13. Listen to tone alert radio(TAR)/Siren

  14. Pueblo Chemical Depot plans and procedures

  15. School’s plan for an emergency

  16. Shelter in place

  17. Shelter-in-place kit

  18. Shelter/Reception center

  19. Wait for instructions

-----------

  1. Don't remember

  2. Other (PLEASE SPECIFY)

  3. Nothing

  4. Don’t know


  1. 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)


  1. Chemical Stockpile Emergency Preparedness Program (CSEPP)

  2. Pueblo Chemical Depot

  3. Pueblo Chemical Outreach Office

  4. Pueblo County Department of Emergency Management

  5. Area, City, or County Meetings

  6. Local Media (PLEASE SPECIFY)

-----------

  1. (DON’T READ)Other (PLEASE SPECIFY)

  2. (DON’T READ) None



  1. 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.”


  1. At least once a week or more

  2. Every two weeks to once a month

  3. Every two to six months

  4. Every six months to a year

  5. Less than once a year

  6. (DON’T READ) Never SKIP 29 and 29b


  1. 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)


  1. More frequently

  2. Less frequently

  3. Same frequency


  1. Do you feel that you are receiving enough information in order to prepare for a chemical emergency?


  1. Yes GO TO 29

  2. No GO TO 28b


28b. What additional information would help you to prepare for a chemical emergency? (RECORD VERBATIM RESPONSE)


-----------

99. Don't know


  1. How would you rate the quality of the information you have received? (READ LIST)


  1. Very useful

  2. Somewhat useful

  3. Not useful


29b. Why do you say that? (RECORD VERBATIM RESPONSE)


-----------

99. Don't know


  1. 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


  1. 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

  1. Alert system is good

  2. Always been told when something happens

  3. County/government officials are prepared

  4. County/government officials have kept the public informed

  5. Depot does a lot of drills/tests

  6. Depot is prepared

  7. Depot has kept the public informed

  8. I trust the Depot

  9. I trust the county/government officials

  10. I work/worked at the Depot

  11. Local media would let us know

  12. Public is well informed/Public gets a lot of information

  13. Someone I know works/worked at the Depot


Not confident

  1. Alert system does not work

  2. County/government officials are not prepared

  3. County/government officials would try to cover up a chemical release

  4. Depot is not prepared

  5. Depot would try to cover up a chemical release

  6. I do not trust the Depot

  7. I don’t trust the county/government officials

  8. Not enough time to alert everyone

  9. There have been incidents before and we were not told


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

  1. Other (PLEASE SPECIFY)

99. Don’t know


  1. 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.


  1. 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


  1. Gender (BY OBSERVATION)


1. Male

2. Female


  1. Is there anyone in your household whose first language is something other than English?


    1. Yes

    2. No (skip 35b and 35c)


35b. What is that language?


  1. Spanish

  2. Italian

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

  1. 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?


  1. Yes

  2. No


  1. How long have you lived in the vicinity of the Pueblo Chemical Depot? (READ 1–6)


  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 you have access to the Internet?


  1. Yes………… Give internet address at the end of the survey

  2. No…………. Don’t give Internet address at the end of the survey


  1. Are you, or any member of your household, a member of the local emergency management or first responder community (fire, police, etc.)?


1. Yes

  1. No


  1. Are you, or any member of your household, employed by the Pueblo Chemical Depot or a contractor of the Depot?


  1. Yes, Pueblo Chemical Depot

  2. Yes, Contractor of Pueblo Chemical Depot

  3. No


  1. Do you live in the Immediate Response Zone (IRZ) or the Protective Action Zone (PAZ)?


  1. IRZ

  2. PAZ

  3. (DON’T READ)Don’t know


  1. What city or community do you live in or closest to? (SINGLE RESPONSE)


IF RESPONSE IS NOT ON THE LIST, READ THE LIST


IRZ

  1. Avondale

  2. Boone

  3. Chico Ranch

  4. Fort Reynolds

  5. North Avondale

  6. Nyberg


PAZ

  1. Baxter

  2. Lombard Village

  3. Orchard Park

  4. The Mesa

  5. Nepesta

  6. Vineland


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

  1. Other (PLEASE SPECIFY)


  1. ZIP code (recorded in CATI from sample)


Thanks for your time—we really appreciate it.


Thanks again!




FEMA FORM 008-0-9

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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