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COVID 19 General Survey
COVID 19 General Survey
The COVID-19 outbreak has dramatically altered our lives. As your State Representative, I want to hear from you! Please take a moment to fill out this survey and let your voice be heard in Sacramento!
1. Has your employment status changed as a result of COVID-19? Please select your current status:
Classified as an Essential Worker
Furloughed From Work
Had to Close My Business Completely
Had My Work Hours Reduced
Working From Home
My Work Has Not Been Impacted/Changed
2. If you are a parent/guardian, has your child's school exceeded or fallen below expectations in regards to educating them remotely?
N/A I am not a Parent/Guardian
3. Do you know someone that has contracted COVID-19?
4. On a scale of 1-5, how are you coping with the stress of this pandemic? (with 5 being extremely stressed)
5. Have you had to utilize any assistance programs besides unemployment? If so, check all that apply
Community Volunteer Assistance
Financial Assistance (Loans etc.)
Food Bank Assistance
School Lunch Programs
I Have Not Had to Utilize Any Assistance Programs
6. What kind of relief would be HELPFUL for you? (Select all that apply)
Child Care Assistance
Health Care Relief
Small Business Loan
7. If you are a small business owner and have had to completely shut down due to COVID-19, what was the main reason and do you plan on reopening? (If this question does not apply to you, please leave it blank and skip to the next question)
Yes, I Plan on Re-Opening
No, I Have to Permanently Close
Do Not Know if I Will Be Able to Re-Open
My Business is Not Classified as “Essential”
I Do Not Have Enough Business to Remain Open
I Have Closed Out of an Abundance of Caution
8. On a scale of 1-5, how would you evaluate the State of California's handling of COVID-19? (with 5 being excellent)
9. Originally, California was slated to have over 6,000 deaths and now it is projected to be less than 2,000. Do you think this is because the social distancing guidelines worked or we overreacted?
Both the Guidelines Worked and We Overreacted
10. Some people are saying California should “reopen” immediately. What is your view?
Immediately. Lift All Restrictions
Gradually. Reopen Some Businesses Now with Modified Social Distancing Guidelines
Gradually Only When Testing is More Available
Once the Scientific/Medical Community Deems Appropriate
11. What additional barriers are you experiencing with the "stay at home order"?
12. Additional Comments:
Thank you for taking the time to share your opinion.