Download:
pdf |
pdfIntroduction
OMB Control # 0693-0078
Expiration 07/31/2022
We understand that the COVID-19 pandemic is disrupting
your business. We are gathering information to learn how
businesses like yours are adapting to the circumstances
and how this situation may or may not be connected to
broader weather-related stressors your business may face
or have faced.
We realize your time is at a minimum with the current
situation. We sincerely appreciate your participation and
our efforts will be greatly enhanced if you can spend a few
minutes filling out this survey. We ask for no sensitive
information and we will not identify you or your business at
any time. If your business has more than one location,
please answer for only one location.
We would like to know how this business is being impacted
by COVID-19 and how it has affected your recovery from
Hurricane Matthew and Hurricane Florence. We are also
interested in learning about practices taken that have
helped reduce the impact of COVID-19, especially in the
face of future hazard events.
If you feel uncomfortable answering any of the questions,
you can skip them, or exit the survey at any time. This
survey should take less than 15 minutes to complete. Thank
you for your time and participation
If you would like to download an information sheet on the
project please click here.
A Federal agency may not conduct or sponsor, and a
person is not required to respond to, nor shall a person be
subject to a penalty for failure to comply with an
information collection subject to the requirements of the
Paperwork Reduction Act of 1995 unless the information
collection has a currently valid OMB Control Number. The
approved OMB Control Number for this information
collection is 0693-0078 with an expiration date of July 31,
2022. Public reporting burden for this collection is
estimated to be 15 minutes per survey, including the time
for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed and
completing and reviewing the collection of information. All
responses to this information collection are voluntary. Send
comments regarding this burden estimate or any aspect
of this collection of information, including suggestions for
reducing this burden, to the National Institute of Standards
and Technology, Attn: Dr. Jennifer Helgeson, NIST, 100
Bureau Drive, MS 8603, Gaithersburg, MD 20899-1710,
telephone 301-975-6133, or
via email:[email protected].
1. Are you over the age of 18 and willing to proceed to the
survey?
Yes
No
2. What is the name of the business you are responding
for?*
3. What is the physical address of the business?*
*If you prefer not to answer the previous questions, Please
enter the PIN number provided in the email to begin the
survey:
(THE FOLLOWING QUESTIONS SHOULD BE ANSWERED BY
BUSINESS OWNER, MANAGER, OR EMPLOYEE FAMILIAR ENOUGH
WITH THE MANAGEMENT OF THE BUSINESS)
This survey section asks about direct effects of COVID-19
Pandemic on your business.
The COVID-19 Pandemic was declared a National
Emergency on March 13, 2020. Please answer the following
questions considering the period since then.
5. What is your role with this business?
Owner
Manager
Owner &
Senior Employee
Manager
(5+ years at the
business)
Other
6. If there were any public health restrictions (e.g., stay-athome orders, operational limitations, limits on public
gatherings, or requirements for social distancing), is/was
your organization designated as:
Essential
Non-essential
Some segments Not sure/don't know
were essential, some
were not
7. Compared to before the pandemic, what is the %
capacity at which you are currently operating?
(note: this does not relate to occupancy capacity. For
“capacity,” consider aspects of the business that are most
important to you, like the quality and/or quantity of service
or product offerings. For example: 50% for reduced
capacity, 110% for increased capacity, or 0% for businesses
that have not resumed operations.)
8. How has the pandemic impacted this business in terms
of revenue, customers, and operation? Please check the
months the business experienced a change in these items,
even if only part of that month:
Lower
revenue
Higher
revenue
Loss of
customers
Gain in
customers
Temporary
closure
Increase in
staffing
Decrease
in staffing
March
April
May
June
July
August
September
October
November
9. How profitable was your business prior to the
pandemic?
Highly
Profitable
Profitable
Breaking Even Unprofitable
Highly
Unprofitable
Closed
10. Where do you feel your business is in the process of
recovery from the pandemic?
Still in survival/response mode
Recovering
Mostly recovered
Fully recovered
Sill in operation but will never recover (please explain):
11. Have an employees* reported issues working Did you
have any employee(s) who could not report to work due
to any of the following issues during the pandemic
(including yourself):
children not back to school?
Yes
No
children not back to daycare?
pandemic-related physical health issues
and/or risk?
Yes
No
pandemic-related mental health issues and/or
risk?
other
12. Immediately before the pandemic, how many full time
and part time employees did this business have? What
about now?
Employees
Full time
Part time
Before
Now
13. Was this business damaged by flooding related to
Hurricane Matthew (September 2016) or Hurricane
Florence (October 2018)?
Yes, Hurricane Matthew but not Hurricane Florence
Yes, Hurricane Florence but not Hurricane Matthew
Yes, both
No, neither
14. What kind of damage was caused by Hurricane Matthew and/or Hurricane Florence and how
severe was the damage (see guide below)?
a. Building Damage
(Matthew)
c. Building Damage
(Florence)
None
Minor
Moderate
Severe
Complete
d.
Contents/inventory
damage (Matthew)
None
Minor
Moderate
Severe
Complete
e. Contents/inventory
damage (Florence)
15. Where do you feel your business was in the process of
recovery from the hurricanes immediately prior to the
pandemic?
Still in survival/response mode
Recovering
Mostly recovered
Fully recovered
Sill in operation but will never recover (please explain):
16. How has the pandemic affected your on-going
recovery from Hurricane Matthew and/or Hurricane
Florence (positively or negatively)?
Not at all
A little
Moderately
Severely
N/A (already fully recovered)
RESPONSE, MITIGATION, AND PREPAREDNESS:
17. Did the business take any of the following adaptive
actions in response to the hurricanes or the pandemic?
Does the business plan to take this action in the future?
(Please mark ALL time periods that apply with an X)
Changed product or service
offering (new product/service,
or limited quantity or variety of
product/service)
Changed product or service
delivery (contactless pick-up, e-
commerce)
Changed store policies (mask
requirements, more frequent
cleanings, limiting number of
customers)
Changed inventory
management strategy
No adoption
Adopted for
Hurricane
Matthew or
Florence
Adopted for
the
pandemic
Plan to
adopt for a
future
event
Changed employee work
strategy (work from home,
alternating schedules)
Shared resources with suppliers
or other businesses
No adoption
Adopted for
Hurricane
Matthew or
Florence
Adopted for
the
pandemic
Plan to
adopt for a
future
event
Other
Other
18. Did this business previously have, currently has, or will
have any of the following insurance coverage?
Business property insurance
on contents
Flood insurance on contents
(NFIP)
Business interruption
insurance
Never had
Had for
Hurricane
Matthew or
Florence
Had for the
pandemic
Plan to havet
for a future
event
Business liability insurance
Never had
Had for
Hurricane
Matthew or
Florence
Had for the
pandemic
Plan to havet
for a future
event
19. Please indicate your level of agreement with the
following statements:
This business’s experience during Hurricane Matthew
and/or Hurricane Florence has helped me handle
challenges related to the pandemic.
Strongly
disagree
Somewhat
disagree
Neither agree
nor disagree
Somewhat
agree
Strongly agree
20. The strategies this business has taken during the
pandemic will help during or after a future hurricane/flood
event
Strongly
disagree
Somewhat
disagree
Neither agree
nor disagree
Somewhat
agree
Strongly agree
21. The pandemic impacted this business’s preparation for
the 2020 hurricane season
Strongly
disagree
Somewhat
disagree
Neither agree
nor disagree
Somewhat
agree
Strongly agree
Social and Institutional Networks
22. How has your business supported the local community
during the pandemic? (Check all that apply)
Donated to local charities
Supported (other) local businesses
Offered additional income/paid leave to non-working employees (e.g.
Laid-off, furloughed, sick)
Provided customer financial relief/delayed payments
Offered discounts to healthcare workers/essential workers
Assisted the local government pandemic response
Set different hours for vulnerable populations (e.g. Senior-only hours)
Other
None of the above
23. What community support has the business received
during the pandemic?
Local government support(e.g. Loans, parking space for curbside pick-up,
sidewalk dining, signs about COVID- 19, etc.)
Customer support (e.g. Gift card purchases, shop local website)
Support from other businesses (e.g. Discounts, technical support,
environmental cleaning, etc.)
Rent or mortgage relief
Other
no support received
24. What financial support has the business applied for
and received during the pandemic? (Check all that apply)
Applied (If
yes, provide
the month,
otherwise
mark "X")?
Yes
Federal assistance, e.g. Paycheck Protection Program (please
specify):
State assistance, e.g. North Carolina COVID-19 Rapid Recovery
Lending Program (please specify)
Local assistance (please specify):
No
Received (If yes,
provide the month
otherwise mark
"X")?
Yes
No
Applied (If
yes, provide
the month,
otherwise
mark "X")?
Yes
No
Received (If yes,
provide the month
otherwise mark
"X")?
Yes
Other
Other
Business Information
24. In what year was this business established at this
location?
25. Does this business own or rent the building?
Own (including buying the building with mortgage)
Rent
Other (please specify):
No
26. What is the ownership structure of the business?
Single owner
Partnership (multiple owners)
Corporation or franchise
Cooperative
Other (please specify):
27. How many years have you worked as a business
owner/manager here or for another business?
28. What is your age (years)?
29. What is your number of years of schooling?
30. Indicate highest type of diploma or degree achieved:
Some High School
High School
Some College
Associates Degree
Bachelor's Degree
Master's degree or higher
31. How would you describe your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
32. What is your race? (select one or more)
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Pacific Islander
33. Is this business a minority-owned business, womanowned business, or veteran-owned business? (select
none, one, or more)
Minority-owned business
Woman-owned business
Veteran-owned business
other
24. Would you be interested in or willing to participate in a
phone interview about your experience?
Yes
No
We would like to get some additional information from you
in order to make future surveys easier and at your
convenience. Would you be willing to provide your first
name and email address? YOU WILL NOT RECEIVE ANY
EMAILS BEYOND OUR REQUEST FOR ADDITIONAL
CLARIFICATION ON THIS SURVEY.
Name:
Business email:
If you have any comments about the survey and/or
business recovery after the flood, please write them down
in the space below.
Powered by Qualtrics
File Type | application/pdf |
File Modified | 2020-11-24 |
File Created | 2020-11-24 |