Assignment: Community Assessment Part One

2.3CommunityAssessmentPartOneDataCollectionToolRevised6.1.21.docx

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Community Assessment Part One: Community Core (Due in Assignment 2.3)

Data Collection Tool

Name:_________________________________ Community:_________________________________

Instructions: Use this tool to document your assessment findings. Include a succinct synopsis in paragraph form for each of the assessment categories below. Remember to provide adequate depth and breadth for each category of the assessment. Be sure to cite the sources to support your findings and include your reference list.

Assessment Category

Findings

Historical overview of the community

Must Include:

· When the community was settled

· By whom

· First Business

· Important information about the community

Demographic description of the community population

Must Include:

· Birth rates

· Death rates

· Pertinent morbidity rates

· Distribution of

Age

· Sex

· Race

· Ancestry (i.e., German, Asian, Indian, etc.)

· Marital status

· Education status

· Household types & size

Values, beliefs, and perceptions within the community

Must Include:

· Community’s values, beliefs, and perceptions of importance of religion

· Degree of religious diversity in the community reflected in the faith groups

· Cultural influences reflected in any significant ethnic or religious traditions

Physical Environment

· Information will come from the windshield survey. You should state this in your own words.

· Provide dates of your survey.

Economic

· Financial status of people

· Individuals

· Households

· Occupational categories in the community

· Businesses/Industries

Transportation and Safety Types of transportation available

· personal

· public

· Police protection

· Crime statistics

· Fire protection

· Sanitation services

Key Informant Interview

Key points from the interview with a key informant.

References