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The Reasons Why Covid Is Spreading Rapidly In Our Community.
Your help in completing this survey is essential to curbing the spread of Covid. The numbers are increasing daily and this survey aims to help locals understand why and then change their everyday behaviors accordingly. In California, 320,804 cases have been confirmed as of July 12th!
This shared information can help our community to keep family, friends, and essential workers safe.
Next Steps: We will consolidate all results, write up a detailed action plan to help stop the growing number of cases, and share the results and recommendations.
This survey takes less than 5 minutes to complete. Please do it now. Then share this survey with your network. We are all in this together!
CDC recommendations:
How to protect yourself and others:
https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/COVID-19/COVID19-ProtectYourselfandOthers.pdf
Spanish version:
https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/COVID-19/Covid19-Poster-SPANISH.pdf
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* Indicates required question
What is your zip code?
Your answer
What non-essential activities have you participated in since shelter in place has been lifted (March 2020)?
*
Beach
Walking on trail/Hiking
Playing in a park with others
Home Gatherings
Road Trips
Travel by air
Dining Out
Takeout
Shopping in Malls
Religious Services
I stayed at home
Required
Where have you been potentially exposed to the infection?
Home
Work
Business Travel
Social travel
Gathering outside of home
Gathering at home
Are you an essential worker?
Yes
No
Clear selection
How often are you using a face cover when outside home?
Never
Rarely
Sometimes
Most of the time
Always
Clear selection
How diligent are you with washing hands with soap and water for 20 secs or using alcohol sanitiser after touching public surfaces/cough/sneeze/mask?
Never
Rarely
Sometimes
Most of the times
Always
Clear selection
How diligent are you with 6 foot distance from people?
Never
Rarely
Sometimes
Most of the times
Always
Clear selection
How often do you clean frequently touched surfaces at home?
Once in a few days
Once a day
More than once a day
Clear selection
How old are you?
Less than 18 years
18-29
30-49
50-65
65+
Clear selection
What is the age of the youngest person in your household?
Less than 18
18-29
30-49
50-65
65+
Clear selection
What is the age of the oldest person in your household?
Less than 18
18-29
30-49
50-65
65+
Clear selection
What race do you identify with?
White
Black or African American
Asian
American-Indian/Alaska Native
Hispanic
Multi Racial
Clear selection
Have you ever tested positive for COVID 19?
Yes
No
Had symptoms, but not tested
I don't want to answer
Clear selection
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