OMB CONTROL NO. 0693-0078
Expiration date: 07/31/2022
Please confirm you are a Lumberton resident above 18 years of age, and consent to participate in this survey by marking the circle. ⃝ I am above 18 years of age and consent to participate in this survey.
The first set of questions is
about your household in general.
How many adults (18 years or older) live in your household?.....………….. #_________Adults
How many children (younger than 18 years) live in your household?...... #_________Children
When did you move into your current home? ………………………………Month:_________ Year:__________
Was your home damaged by Hurricane Matthew or Hurricane Florence?
(Please mark the choice that most closely matches)
⚪ Hurricane Matthew, only ⚪ Yes, by both Hurricanes Matthew and Florence ⚪ Hurricane Florence, only ⚪ No, neither hurricane damaged my home
⚪ Don’t know
If yes, how would you characterize the status of repairs on your home?
Completed
Somewhat completed
Very little completed
Not at all completed
The next questions are going to ask about your household’s perceived preparedness now. Please mark the option that most closely matches your experience or situation.
Do you rent or own your home? ⚪Own ⚪Rent ⚪Other, please specify:________________
If you own your home, Yes No Don’t Know
Do you have flood insurance?.............…………………………………………………… ⚪ ⚪ ⚪
Do you have homeowners’ insurance?....................................................... ⚪ ⚪ ⚪
Do you believe you have adequate insurance coverage for a flood event?.⚪ ⚪ ⚪
Do you have a mortgage?...…………………………………………………………………… ⚪ ⚪ ⚪
Did you apply for, and/or receive a home repair grant from the government (HUD/CDBG-DR)?
Apply? (Y/N)
Receive? (Y/N)
If received, when? (MM/YY)
How has your participation with neighborhood and/or community groups changed since the COVID-19 pandemic?
⚪Decreased ⚪Stayed the Same ⚪Increased ⚪Don’t know
How has your contact with neighbors and/or extended family and friends changed since the COVID-19 pandemic?
⚪Decreased ⚪Stayed the Same ⚪Increased ⚪Don’t know
How many major floods or hurricanes have you experienced first-hand in your lifetime? #________Floods
How likely do you think your home is to be damaged during a major flood event, similar to Hurricane
Matthew or Hurricane Florence?
⚪Extremely unlikely ⚪Unlikely ⚪Neutral ⚪Likely ⚪Extremely likely
If given evacuation orders, how likely is your household to evacuate your home during a future major flood event, similar to Hurricane Matthew or Hurricane Florence?
⚪Extremely unlikely ⚪Unlikely ⚪Neutral ⚪Likely ⚪Extremely likely
The next set of questions asks about the recovery of your home, your household, your neighborhood and Lumberton from Hurricanes Matthew and Florence and the COVID-19 pandemic.
When thinking about your home (the physical building in which you live), would you say your home is:
Fully recovered
Partially recovered
Still in survival/response mode
Will never recover
When thinking about your household, would you say your household is:
Fully recovered
Partially recovered
Still in survival/response mode
Will never recover
When thinking about your neighborhood, would you say your neighborhood is:
Fully recovered
Partially recovered
Still in survival/response mode
Will never recover
When thinking about Lumberton, would you say Lumberton is:
Fully recovered
Partially recovered
Still in survival/response mode
Will never recover
Do you and your household have the same access to school, work, grocery stores, and other essential needs in this home as you did before the hurricanes and COVID-19?
Yes
No
DK
Do you and your household plan to move to a different housing unit within the next year?
Yes
No
DK
The next set of questions ask about mitigation and preparedness strategies used by your household now or that you plan to put in place in the next six months.
Currently, has your household: Yes No Don’t Know
Elevated hot water heater and/or HVAC?................................................ ⚪ ⚪ ⚪
Re-routed ductwork from below floor to attic space? …………………………. ⚪ ⚪ ⚪
Developed an emergency plan with household members? ………………... ⚪ ⚪ ⚪
Gathered supplies to last 3 or more days?.............................................. ⚪ ⚪ ⚪
Sought information on mitigation or preparedness? ………………………….. ⚪ ⚪ ⚪
Set money aside for recovery or repairs? ………………………………………….. ⚪ ⚪ ⚪
In the next 6 months, does your household plan to: Yes No Don’t Know
Elevate hot water heater and/or HVAC?................................................ ⚪ ⚪ ⚪
Re-routed ductwork from below floor to attic space? …………………………. ⚪ ⚪ ⚪
Develop an emergency plan with household members? ………………….. ⚪ ⚪ ⚪
Gather supplies to last 3 or more days?................................................ ⚪ ⚪ ⚪
Seek information on mitigation or preparedness? ……………………………. ⚪ ⚪ ⚪
Set money aside for recovery or repairs? …………………………………………. ⚪ ⚪ ⚪
Do you have the option to provide any utility services, even if temporarily, for your household?
(please select all that apply)
⚪ Yes, power generator ⚪ Yes, solar panels ⚪ Yes, water storage tank(s)
⚪ Yes, gas tank(s) ⚪ Yes, community wi-fi ⚪ Yes, community information hub
⚪ Other, please explain: ⚪ No ⚪ Don’t know
_____________________
_____________________
a. Do you have the option to provide utility services, even if temporarily for yourself for the following utilities? |
b. If yes, indicate how: (e.g., generator, solar panels, water storage tanks, gas tanks, community Wi-Fi, other) |
c. With your resources in mind, for how long, in days, could you tolerate a future service disruption? |
|
Power |
Yes No |
|
# ________Days |
Gas |
Yes No |
|
# ________Days |
Water |
Yes No |
|
# ________Days |
Cellular |
Yes No |
|
# ________Days |
Internet |
Yes No |
|
# ________Days |
Are you informed of any planned outages in a timely manner for …? |
|
Power |
Yes No DK NA |
Gas |
Yes No DK NA |
Water |
Yes No DK NA |
Cellular |
Yes No DK NA |
Internet |
Yes No DK NA |
if it meant improved performance during and after hazards, are you willing to have a rate increase for …? |
|
Power |
Yes No DK NA |
Gas |
Yes No DK NA |
Water |
Yes No DK NA |
Cellular |
Yes No DK NA |
Internet |
Yes No DK NA |
The next set of questions are intended to capture the impacts of COVID-19 on your household.
How has COVID-19 impacted repairs to your home?
No impact Minor impact Neutral Moderate impact Major impact Don’t know
⚪ ⚪ ⚪ ⚪ ⚪ ⚪
How has COVID-19 impacted your household’s recovery from Hurricane Florence?
No impact Minor impact Neutral Moderate impact Major impact Don’t know
⚪ ⚪ ⚪ ⚪ ⚪ ⚪
Were members of your household unable to work because of COVID-19?
⚪ Yes ⚪ No ⚪ Don’t know
If yes, how long was your household member unable to work? (Please enter the number of days) #______Days
Were members of your household reduced to part-time work because of COVID-19?
⚪ Yes ⚪ No ⚪ Don’t know
If yes, how long was your household member reduced to part-time work? # ________Days
If you answered YES to either question 18 or 19, please also answer questions 20 and 21:
Were you or other household members unable to work or reduced to part-time because of:
(Mark all that apply):
⚪ Temporary closure of place of employment ⚪ Childcare issues
⚪ Permanent closure of place of employment ⚪ Health issues
⚪ Other, please explain_________________________________________________
Would you say the disruption to your household’s income has been:
⚪ Significant ⚪ Moderate ⚪ Minimal ⚪ None ⚪ Don’t know
Finally, there are six questions about your household in general.
Do you have any individuals with special electricity-dependent medical needs in your house? ⚪ Yes ⚪No
(Examples include individuals who require power wheelchairs, ventilators, oxygen
concentrators, CPAP and other sleep apnea devices.)
When considering all members in your household, what is the highest level of schooling completed?
⚪ Less than high school ⚪ Associate’s degree ⚪Master’s degree or higher
⚪ High school diploma ⚪ Bachelor’s degree
While we often ask about each member of a household, in general, when considering your household, how would you describe its ethnicity? You may skip this question.
⚪ Hispanic or Latino ⚪ Not Hispanic or Latino
While we often ask about each member of a household, in general, when considering your household, how would you characterize its racial makeup? (Select one or more) You may skip this question.
⚪ American Indian or Native American ⚪ Asian ⚪ Black or African American
⚪ Native Hawaiian or Pacific Islander ⚪ White or Caucasian
Do you consider your household a female-headed household? ⚪ Yes ⚪ No ⚪ Don’t know
This is when a household is maintained by a female with no spouse present.
Finally, we do not want to know the exact amount, but please mark the category that best captures your household’s combined annual income:
⚪ $1 to $3,999 ⚪ $4,000 to $5,999 ⚪ $6,000 to $7,999 ⚪ $8,000 to $9,999
⚪ $10,000 to $11,999 ⚪ $12,000 to $14,999 ⚪ $15,000 to $19,999 ⚪ $20,000 to $24,999
⚪ $25,000 to $29,999 ⚪ $30,000 to $39,999 ⚪ $40,000 to $49,999 ⚪ $50,000 to $59,999
⚪ $75,000 to $99,999 ⚪ $100,000 to $149,999 ⚪ $150,000 or higher
Thank you again for completing our survey!
This collection of information contains Paperwork Reduction Act (PRA) requirements approved by the Office of Management and Budget (OMB). Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the PRA unless that collection of information displays a currently valid OMB control number. For this collection, the OMB Control number is:0693-0078 with an expiration date: 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. 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 240-672-2575, or via email:jennifer.helgeson@nist.gov
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Sutley, Elaina J |
File Modified | 0000-00-00 |
File Created | 2024-07-20 |