Covid-19 Community Survey for Davis and Yolo County

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As the Covid-19 pandemic continues, International House Davis is working with other non-profit organizations and the community members in the Covid-19 Yolo Community Response Facebook Group to assess the needs of our community, gather and share information, and bring us together (virtually) to take care of one another and flatten the curve. Please complete this community survey as a first step in assessing the immediate needs in our community as well as the opportunities to help each other. We hope to use the survey to inform an online community forum or follow-up communication and assistance. Please include your email address so that we can communicate further action and information with you.

La versión en español se puede encontrar aquí: https://forms.gle/z2hZaTLfWytPra9DA

We have also compiled a Covid-19 Resource List available here: https://docs.google.com/document/d/1fx_hJ-VADJOmS9sYzVyJSGThLJgcEBWvHYrTF8NrXo4/edit?usp=sharing

Email *

First Name

Last Name

Where are you located?

Central Davis

East Davis

North Davis

South Davis

West Davis

Unincorporated Area

Woodland

Winters

Dixon

West Sacramento

Other:

Clear selection

Please select up to 3 most fundamental needs or concerns regarding the Corona Virus. We recognize that these are ALL concerns and needs. We will use the aggregate data to guide decisions on next steps.

I am in need of food and basic supplies

I am concerned about paying rent/mortgage and utilities

I am concerned about loss of income or job loss

I am concerned about medical care for myself and/or those in my household

I am concerned about childcare

I am concerned that my business cannot survive this crisis

I am concerned about the spread of Covid-19 and flattening the curve

I am concerned about the welfare of others in my community

I am concerned about disparities in response and care for vulnerable communities

Option 10

Other:

If you are in immediate need, please answer this question. I am in immediate need of the following:

Information about food and supply distribution locations

Food delivery

Medicine delivery

Childcare during school closures

Financial support or payment forgiveness for rent/mortgage/utility bills (I will be unable to pay in the next two months)

I need resources on keeping my business viable during the pandemic

I have no immediate needs at this time

I need information about employment protection, Paid Leave and/or unemployment benefits

Other:

I can offer help in the following ways:

I can offer financial assistance to the Food Bank, STEAC, Davis Community Meals or other organizations that are offering front line assistance

I can volunteer to deliver food and supplies

I can volunteer to run errands for someone who cannot

I can purchase basic supplies such as diapers, baby essentials and food stuffs to donate

Other:

I am interested in participating in the following:

A video conference round table to discuss financial hardship and strategies to mitigate those

A video conference round table to activate volunteers in the community

A video conference informational panel discussion on the impacts of Covid-19

Other:

Submit

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