SC-351 Group Quarters Initial Contact Checklist

SC-351

U.S. DEPARTMENT OF COMMERCE
BUREAU OF THE CENSUS

INITIAL CONTACT CHECKLIST
Special Place Operations
Section 1. Introduction
Hello. My name is (Your Name). I’m from the U.S. Census Bureau. We are conducting a special census in this area to
update the housing and population count. I’d like to speak with someone who can verify the information we have about
your facility and to set up an appointment for Census Bureau employees to enumerate the residents or clients at your
facility.
It should take about 3 minutes to collect this information.

Section 2. Facility Name and Address
. Is this name correct?

2.1 We have your facility listed as
(Name of Facility)

9 Yes ----> Go to Q2.2

9No ----> (enter correct name)

2.2 We have your address listed as

.
(Facility Address)

Is this address correct?

9 Yes ----> Go to Q2.3 9 No ----> (enter correct address)

2.3 (If the facility address does not include a house number/street name ASK:) Please describe
where your facility is located -- for example, the intersection of two streets, or the
approximate distance from intersecting road(s).

2.4 (If you are on the telephone, ASK:) Is this a military facility?

9 Yes ----> Set up appointment to visit the facility

9 No ----> Continue

Section 3. Contact Information
3.1 May I have your full name please, including your middle initial?
3.2 Do you have a job title that we can note for our records?
3.3 I called you at

. Is this the best number to reach you?
(Telephone number, including area code)

9 Yes ----> Continue

9 No ----> Enter telephone number, including Area Code and
extension number, if applicable

999

999-9999 9999

(Area Code) (Telephone number) (Extension)

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For added GQs ----> Continue with Section 4

For all other GQs ----> SKIP to Section 5

Section 4. Type of Facility
4.1 We have your facility listed as a

.
(Type of facility)

9 Yes ----> SKIP to Section 5
9 No ----> GO TO Q 4.2

Is this correct?
4.2 If you can determine the type of facility by the name or by something the respondent told you,
verify and mark (X) the appropriate category.
I’m going to read a list of facilities where people live or stay. Please tell me which category
BEST describes your facility.
Is this facility PRIMARILY a – (Read all categories until you receive a response. If the facility has
more than one function, ask the respondent to pick the primary function of the facility.)
GQ Code

9 College/university with dormitories

995

9 Emergency shelter or transitional shelter

990

9 Hotel/motel/single room occupancy

--

9 Transient location, such as an RV park, race track, marina, public or
commercial campground, or carnival

9 Correctional institution intended for adults 18 and over, but also may include
juveniles. This group also includes halfway houses operated for correctional
purposes

9 Juvenile institution intended for people under 18 years old, but may also

--

991

992

include people 18 and over

9 Military quarters, ship, or vessel

996

9 Military disciplinary barracks

998

9 Non-military hospital, hospice, or institution or school for people with mental or

994

physical impairments

9 Military hospital or ward for the chronically ill

999

9 Nursing home, including long-term care facilities, rooms in wards, or building

993

on grounds of hospitals

9 Other non-institutional group quarters such as workers dorms, convents and
monasteries, YMCAs and YWCAs, group homes and staff residential quarters

997

Section 5. Facility Records
5.1 Does your facility keep records that provide information
on age, race, and sex of your residents and/or clients?

9 Yes
9 No ----> SKIP to Section 6

5.2 Are these paper records, computer records, or both?

9 Paper 9 Computer 9 Both

5.3 If requested, could you make these records available to
the Census Bureau?

9 Yes
9 No

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Section 6. Method of Enumeration
6.1 (Ask only for hotels/motels) Do you have units where staff or
guests live permanently?

9 Yes
9 No

6.2 (Ask only for hotels/motels) Does your facility or part of your
facility operate as a shelter for people who are homeless?

9 Yes ----> GQ Code = 990
9 No

6.3 (Ask only for transient locations) Will your facility have clients
and/or staff who will be staying there overnight on (Special
Census Day)?

9 Yes
9 No

6.4 (Ask only for correctional institutions, hospitals, shelters, or military facilities) You may want to
designate your facility as a “self-enumerating” facility. This means that YOUR OWN staff
would enumerate your residents with the help of a Census Bureau employee. If members
of your staff conduct the enumeration, they MUST take an oath to protect the
confidentiality of the answers they collect. (Be prepared to explain further.)

9 Yes

Do you want to self-enumerate?

9 No

6.5 (Ask for added GQs only) What is the maximum number of
(residents/clients/units) your (facility/location) can accommodate?
6.6 Do you have any additional requirements or information that the enumerator will need
when he/she conducts the enumeration (for example, the facility may require female
enumerators only or may have special security requirements)? 9 No ----> GO to Section 7
9 Yes ----> Specify

Section 7. Appointment Information
7.1 When can we conduct the enumeration at your facility?

Date:
Time:

7.2 When the enumerator comes to conduct the enumeration, are you the person he/she
should speak with?

9 Yes ----> GO to Section 8

9 No ----> Who should we contact?

(Name and Title)

999

999-9999 9999

(Area Code) (Telephone number)

(Extension)

Section 8. Closing the Interview
Thank you very much for your time. We have the enumeration of your facility scheduled for
(appointment date) at (appointment time). We’ll call you the day before to remind you.

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