San Luis Obispo - Caltrans - State of California

SAN LUIS OBISPO REGION
COORDINATED HUMAN SERVICES-PUBLIC TRANSPORTATION PLAN
APPENDIX A-3
COORDINATED Human Services – Public Transportation STAKEHOLDER SURVEY
Winter 2006
Contact Name:
Title:
Telephone:
Fax:
E-Mail:
Agency Name:
Address:
Mailing Address: Yes___ No ___
Site Address: Yes___No__
City:
Zipcode:
1. Provide a brief description of your program. You may also attach a brochure or flyer at your discretion.
2. YOUR AGENCY TYPE (check one only):
 Private, for profit
 Public Agency
 Tribal organization
 Private, non-profit
 Church affiliated
3. NUMBER OF ACTIVE CLIENTS ON YOUR AGENCY’S ROSTER
LIVING WITHIN SAN LUIS OBISPO COUNTY
# Total clients / consumers enrolled or on caseload lists
# Average daily attendance
# Est. on site daily who require transportation assistance
# Est. in wheelchairs daily
Not applicable (check mark only)
4. PLEASE IDENTIFY THE PRIMARY CLIENT POPULATION YOUR
AGENCY SERVES: (check all that apply)
 Seniors, able-bodied
 Seniors, frail
 Persons with physical disabilities  Persons of low income
 Persons with behavioral disabilities  Other ____________
 Persons with sensory impairments ____________________
5. PLEASE SPECIFY THE TRANSPORTATION NEEDS THAT ARE
MOST OFTEN COMMUNICATED TO YOU BY YOUR CLIENT BASE:
(check all that apply)
 Getting to work between 8am – 5pm
 Night or early morning work shifts
 Weekend and holiday trips
 Recreational activities or events
 Visiting family or friends
 Kids to day care or school
 Going to the doctor / medical trips
 Shopping and morning errands
 Attending training, education classes or program sites
 Long distance trips for purposes of _____________________
 Specific trips by origin and destination that cannot now be made by your
consumers_________________________________
6. WHICH BEST DESCRIBES ANY TRANSPORTATION
SERVICE PROVIDED BY YOUR AGENCY:
 NO TRANSPORTATION operated, contracted, or arranged
 PUBLIC TRANSIT provided to the general public.
 OPERATE transportation with full responsibility for the
transportation by this agency.
 CONTRACT for transportation, services provided by another
entity under contract to this agency.
 SUBSIDIZE transportation through agency purchase of passes,
fares or mileage reimbursement.
 ARRANGE FOR public or private transportation by assisting
with information but clients responsible for follow-up.
 ARRANGE FOR volunteer drivers or private car
 Other (please specify) _____________________________
___________________________________________
7. PLEASE INDICATE YOUR AREAS OF INTEREST TO
LOWER COSTS OR IMPROVE TRANSPORTATION
SERVICES (check all that apply):
 Joint use, pooling, or sharing of vehicles among organizations
 Coordinated service operations
 Coordinated vehicle and capital purchases
 Shared fueling facilities
 Shared maintenance facilities
 Joint purchase of supplies or equipment
 Joint purchase of insurance
 Coordinated trip scheduling and/or dispatching
 Coordinated driver training and retraining programs
 Contracting out for service provision rather than direct operations
 Contracting to provide transportation to other agencies.
 Pooling of financial resources to better coordinate service
 Not interested in transportation coordination activities at this time.
 Other ________________________________________________
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OCTOBER 2007