2024-Housing-Poll 2024 Housing Survey Please enter your agent ID which is your first name and last initial with no spaces, Example: ashleyp FACILITY INFORMATION Before starting, go do your own quick research and fill in as much of the FACILITY INFORMATION information as possible. How many facility addresses do you operate? 1 2 or more If an organization operates a “campus” with multiple buildings grouped together, it’s one. If an organization has multiple sites (or operates in multiple counties) it’s 2 or more. Facility Name Address Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Email Website/URL Phone PA County AdamsAlleghenyArmstrongBeaverBedfordBerksBlairBradfordBucksButlerCambriaCameronCarbonCentreChesterClarionClearfieldClintonColumbiaCrawfordCumberlandDauphinDelawareElkErieFayetteForestFranklinFultonGreeneHuntingdonIndianaJeffersonJuniataLackawannaLancasterLawrenceLebanonLehighLuzerneLycomingMcKeanMercerMifflinMonroeMontgomeryMontourNorthamptonNorthumberlandPerryPhiladelphiaPikePotterSchuylkillSnyderSomersetSullivanSusquehannaTiogaUnionVenangoWarrenWashingtonWayneWestmorelandWyomingYork Fax For additional facilities, include the indicated information for each. If more than one additional one, leave a space between listings. If information is not relevant (such as there is no different website) you can delete that field. If this information is on their website URL, provide a link to that page instead. Facility Name/Descriptor: Address: Email (if different): Website (if different): Phone: County: Fax: Notes: Any other objective notes about the facility Survey Qualification Hi, my name is __________ and I’m a volunteer with a subcommittee of the Pennsylvania Reentry Council working on compiling housing resources for reentrants across the state. We had your information on a prior list, and we’re updating the database to better assist individuals seeking housing options. This will only take a few minutes. Can you provide details about your house/facility’s intake rules, or direct me to the appropriate person? Yes. [If it’s them continue or wait til you get someone on the line who can help. If you get a new person on the phone restart the script, and ensure they’re the right person.] No. [ask when to call back or who to ask for and fill that in here:No. [ask when to call back or who to ask for and fill that in here: Great, can I get your name please? Great, can I get your name please? First First Last (optional) Last (optional) Thanks, and do you have a direct email or phone number in case we get disconnected or we have later follow-up questions? Phone Email Stop here and go back to the top and confirm all the information provided/you gathered as far as basic information for the facility. Ok, Done! Do you accept applicants with a criminal background, including those re-entering society from prison or incarceration? Yes No I’m going to read a list of criteria some facilities may use in determining eligibility. You can say: yes we accept, no we don’t accept, or it depends.Okay, what about people with… Yes No It Depends substance use crimes. Yes No It Depends sexual offenses, including possession of illegal images. Yes No It Depends forced to register under Megan’s Law. Yes No It Depends with violent crimes. Yes No It Depends designated sexually violent predator (SVP) Yes No It Depends from other counties. Yes No It Depends If the contact responded 'it depends' to any of the above, ask them to clarify and describe here. Be sure to note which field you're clarifying before each note. Enter each response on a separate line. Next