North Minneapolis Comprehensive Strategy

You can take the survey online or if you would rather you can print it and mail it to us. Click here to print survey

Resource Assessment Survey - Sponsored by ...

Please enter the name and organization of the person that told you
about the survey -  Name

YOUR ORGANIZATION NAME   

ORGANIZATION CONTACT 

ADDRESS  ,     Minneapolis, MN  Zip 

PHONE    E-MAIL   URL-web site

1. How would you categorize your organization?

(check all that apply)

2. How long has your organization been serving North Minneapolis?

0-2 years         3-5 years          6-10 years       11-20 years      20+ or more years

        3.      What is the PRIMARY target population for your services?

Youth          Elderly                            Physically Disabled               Veterans         

Homeless    Criminal Offenders           Poor                                    Mentally Ill

Athletes      Artists                              Developmentally Disabled     

North Minneapolis Residents in general    Religious (please specify)

Ethnic (please specify)   Other (please specify)

4.      How many programs does your organization facilitate? 

5. Does your organization provide these general services?

   Yes
   		General Transportation (i.e. medical appointments, shopping, etc.)
   		Program Transportation (organizational specific programs or services)
   		Meals (In-Home or communal)
   		Special Diet needs (in-home or communal)
   		Social events/recreation (i.e. game nights, dances, fellowship)
   		Drop-In Center (general fellowship site)
   		Emergency Assistance (rent, utilities, food)

        6.      Does your organization engage in the following youth-focused programs and services?

(please answer only if you circled response in Question 1)

7. Does your organization engage in the following family focused programs/services?

8.  Does your organization engage in the following programs/ services for older adults?

9. Does your organization engage in the following programs/ services for veterans?

10. Does your organization engage in the following programs/services for persons with disabilities?

11. Does your organization engage in the following community focused programs/services?

12. What are the days and hours of operations for your programs?

(Indicate the hours under the days of the week)

13. What are the program sites/settings for your services? (Check all that apply)

14. Please list any dedicated service sites for your programs other than the address listed at the top of this form.  (continue on back if necessary)

 Address City Zip-Code Phone

Address City Zip-Code Phone

Address City Zip-Code Phone

Address City Zip-Code Phone

15.  Are all your program sites ADA compliant for accessibility for persons with disabilities?  Yes No Some

16.  Is this program expected to continue indefinitely?

Yes          No

If No:  Date of Conclusion

Reason for Conclusion                                   

17.  Does your organization use a formal client satisfaction survey or other tool?

Yes          No

18.  Has your program ever been modified as a result of a client satisfaction survey?

Yes          No 

19.  Have your programs ever undergone an outside evaluation?

Yes          No 

20.  Does this program receive or make referrals from any of the following types of organizations?

Yes          No

                        (if YES score all that apply   1=rarely     3=occasionally     5=often)

21. What forms of payment do you accept for your programs? (check all that apply)

22.  What is the funding percentage for your programs from the following categories?

23.  What is the overall estimated budget for your organization?

24.  How many staff are dedicated to your programs?

25.  We would like to explore the racial diversity of community service staff serving North Minneapolis.  Please fill in the following table.

Estimated total full-time equivalents (number of people employed full time if summing up above categories)               

26.  Are there income requirements or other eligibility criteria for your programs?

Yes                     No (If yes, please list below)

27.  Are program materials available in other languages?

Yes                     No

            (If yes, please list those languages) 

28. Does your organization utilize the following to accommodate non-English speaking clients?  (Check all that apply)

29. During your last completed fiscal year how many clients did you serve? 

30. What is an estimate of the maximum number of clients that you could have served?

31.  What were the causes of your program serving fewer clients than it could have IF IT DID NOT OPERATE AT MAXIMUM CAPACITY? (Check all that apply)

32. If needed how could the capacity of your programs be expanded?

(please Check all that apply and  rate TOP THREE)

33. With whom does your organization network, or would like to network?

(if you do network with them please rate the frequency          1=rarely     3=occasionally     5=often) 

34.  I am interested in attending a meeting  to discuss the results of this survey. 

Yes     No

35. The most important information about social services for North Minneapolis not addressed in this survey is…

36.  In our effort to reach as many organizations serving the North Minneapolis Community as possible do you know of any organizations that may be interested in having their services documented?

1. Name   Phone 2. Name   Phone

3. Name   Phone 4. Name   Phone

The Community Assessment Project will build a template on ho is gathered to equip our community to better meet the needs of their members in every avenue of life.

The need for community assessment is three pronged

1. To inform ministries  & agency and services of potential partners that   are found in their local community
2. To build bridges within the Urban communities
3. To promote reliance on local services that understand the particular culture and needs of people within the community