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Americans with Disabilities Act People with Disabilities Citizen Survey

Purpose:

Under Title II of the Americans with Disabilities Act (ADA), state and local governments cannot discriminate against or exclude people with disabilities from their services or programs. The City of Sunny Isles Beach is providing this survey to make sure we are following ADA guidelines. If you are a person with a disability or have had experience with disabled persons, we would appreciate your completing this survey and returning it to the City.

If you need assistance in completing this form, please contact Human Resources at (305) 792-1708. For special needs call: (305) 792-1590 (TTY).

If you would like more information about the ADA, the U.S. Department of Justice tollfree number is 1-800-514-0301 (voice) or 1-800-514-0383 (TDD). You can also visit the ADA website at https://www.ada.gov/.

Section A - Personal Data: (Optional)

Phone Number

Section B - Completion of this section will allow us to know the needs of those with disabilities who use or wish to use our facilities.

My specific disability is: (OPTIONAL)

The following City activities, facilities, and/or services are accessible or available to me: (Please check all that apply and add any other if necessary.)

Applying for a job

Attending a meeting at City Hall

Using a park

Paying a bill

Using the library

Obtaining a license or permit

The following City activities, facilities, and/or services are not accessible or available to me: (Please check all that apply and add any other if necessary.)

Applying for a job

Attending a meeting at City Hall

Using a park

Paying a bill

Using the library

Obtaining a license or permit

What other activities would you participate in if proper accommodations were provided?

The following accommodations will help me gain equal participation in the activities and services provided: (Please describe the type of accommodations and how they will assist you.)

Have you had any difficulty traveling on City streets or sidewalks to get to a facility? If the answer is "yes" and you can remember the particular locations, please list them.

Section C - Completion of this section will help us determine the satisfaction level of our disabled citizens with City employees. If you have interacted with our staff, e.g. paying a bill, applying for a job, calling for service, etc. we would like to know how you were treated. Please check the area that most reflects your opinion. IF YOU HAVE NO EXPERIENCE WITH OUR STAFF, PLEASE SKIP THIS SECTION.

Overall Experience

Poor

Good

Excellent

Understand My Needs and Requirements

Poor

Good

Excellent

Accessible to Customers/Responsive to Special Requests

Poor

Good

Excellent

Provides Effective Support and Guidance

Poor

Good

Excellent

Facilitates Problem Resolution

Poor

Good

Excellent

Professional and Knowledgeable Staff

Poor

Good

Excellent

Courteous and Helpful Staff

Poor

Good

Excellent

Usefulness of Website

Poor

Good

Excellent

Please include any additional comments you wish to make about assistance provided by our staff relating to your disability.

The City of Sunny Isles Beach does not discriminate on the basis of disability in admission or access to our programs, services, or activities, and we do not discriminate on the basis of disability in hiring or employment practices.