My Neighbourhood, My Future - Guildford West
 
My Neighbourhood, My Future: Community Assets Survey

My Neighbourhood, My Future is a community-based project designed to improve developmental outcomes for children under age six in the community of Guildford West.

The information collected will be used to help MNMF project staff learn what it is like to live in Guildford West, understand your needs, and seek your ideas about what could help to improve your neighbourhood for you and your family.

All personal information will be kept confidential. Any data collected will only be analyzed at the neighbourhood level, names will never be used and individual results will not be reported.

Information collected may be used to help promote the project, inform the direction of future activities and as a basis for comparison to measure change over time.

Any questions or concerns, please contact us at www.guildfordwest-mnmf.ca.

Q1 .     If you agree to participate in this project, please check 'yes' to proceed with the survey.
Yes  
No  
Q2 .     Please answer the following in the space provided
How old are you (years)? :
Total number of children in your household? :
Number of children under age 6 in your household? :
What language did you first learn to speak as a child? :
What country were you born in? :
What language do you speak most often at home? :
If you immigrated to Canada, what year did you arrive? :
What is your postal code? : *
Q3 .     Please check all that apply to you about your understanding of English.
I can READ English
I can WRITE English
I can SPEAK English
None of the above
Q4 .     How often is language a barrier to your participation in activities in your community?
All of the time  
Most of the time  
Some of the time  
A little of the time  
None of the time  
Q5 .     How long have you lived in your neighbourhood (Guildford West)?
less than 1 year  
1-2 years  
3-5 years  
5-10 years  
11+ years  
I live outside of Guildford West  
Q6 .     Please indicate your level of agreement with the following statements:
  Strongly Agree Agree Disagree Strongly Disagree N/A
Guildford West is a good place to live :
I feel my neighbourhood is a safe place for my children. :
I trust my neighbours :
In an emergency, I feel like I could ask my neighbours for help. :
People in my neighbourhood are friendly and willing to help each other :
I know my neighbours and feel like I am a part of my community :
I feel myself and my children are welcome in local businesses, services and other places in my community :
People in my neighbourhood care about each other. :
There are safe outdoor (green) spaces for my children to play outside near my home. :
There are sufficient opportunities for my children to participate in recreational and educational activities in my neighbourhood :
I can meet the needs of my family without having to go too far outside of my neighbourhood. :
A lot of people in my neighbourhood are struggling :
I am involved in my community :
Q7 .     What was the main reason you chose to live in Guildford West? (Please check only one)
Affordable housing  
Near friends or relatives  
Grew up here  
Close to work  
Close to child's school  
Close to amenities  
N/A  
Q8 .     What is your most commonly used mode of transportation?
Walk  
My Own Vehicle  
Public Transit  
Other  
Q9 .     If you responded 'Other' to the above, please tell us what you mean.
Answer :
Q10 .     Please tell us how far you live (in walking distance) from the following services/amenities.
  less than 5 min 5-10 min 11-20 min 21-30 min 31-60 min >1 hr N/A
Library :
Grocery Store :
Doctor's Office :
Community/Recreation Centre :
Day Care :
Shopping Mall :
Park (outdoor - green space) :
Food Bank :
Guildford Family Place :
Strong Start Program :
Your Work Place :
Child's School/Preschool :
Headstart Pre-school :
Stay and Play :
Q11 .     During the day, my child(ren) under age 6 are usually cared for by
Parents/Guardians  
A relative in your own home  
A relative in his/her home  
A non-relative in your own home  
A non-relative in his/her home  
Preschool  
Child care centre  
Other  
Q12 .     If you responded 'Other' to the above, please tell us what you mean.
Answer :
Q13 .     In the past year, how often has finding childcare for your child(ren) been a challenge? (i.e., day care, baby sitter, etc.)
All of the time  
Most of the time  
Some of the time  
A little of the time  
None of the time  
N/A  
Q14 .     Please answer the following about your employment in the past year
  YES NO N/A
I have had trouble finding work :
I have had trouble finding enough work :
I have had trouble finding work that uses my skills :
Q15 .     Please indicate your gender.
Female  
Male  
Transgender  
Q16 .     Please indicate your level of agreement with the following statements:
  Strongly Agree Agree Disagree Strongly Disagree N/A
With my family’s current income, I feel I am able to adequately provide for my family. :
I am usually able to get enough food to meet the needs of my family. :
My housing is affordable :
My housing is in need of major repairs :
My housing is safe :
There is enough space for everyone living in my residence :
If I lost my wallet in my neighbourhood, I believe it would be returned to me :
My neighbourhood is walkable (I live within walking-distance of needed services: grocery store, park, child care, rec centre, library...) :
There are people in my neighbourhood I can trust to look after my children. :
There is affordable childcare available in my neighbourhood. :
I am able to access the services and supports I need to care for my children (ex. doctor, dentist, family counselling, family support, etc.) :
Q17 .     What skills do you have that you would like to contribute to community improvement? (ex. gardening, cooking, child-minding, maintenance/repair, teaching, parenting skills, athletics/sports, etc.)
Q18 .     Please tell us what SKILLS you are most interested in learning (ex. language, culture, cooking, repairs, carpentry, other trades, business management, etc.).
Q19 .     Please tell us any areas of PERSONAL DEVELOPMENT you are most interested in (ex. parenting, child development, stress management, fitness, etc.).
Q20 .     Given the chance, I would like to become more involved in my community.
Yes  
No  
Q21 .     Please tell us one or two ways you think that the neighbourhood residents could build a better neighbourhood.
Q22 .     What kinds of neighbourhood activities interest you?
  YES NO
Park clean-up :
Community gardening :
Community Party/Dinner for Families :
Film or other cultural events :
Shared cooking or food preparation :
Clothing exchange :
Tool exchange :
Library or reading project for children :
Photography project of neighbourhood :
An informal, regular dialogue group :
Child development workshop :
Other :
Q23 .     If you responded 'Other' to the above, please tell us what you mean.
Answer :
Q24 .     If you are interested in potentially attending a community event organized by the "My Neighbourhood, My Future" project please provide your contact information so that we can send you an invitation (POSTAL CODE required).
Name :
Address :
City :
Province :
Postal Code :
Phone :
Email :

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