Healthy Land Use Engagement Survey

Ubuntu Green’s Healthy Land Use Engagement Project (HELP) in South Sacramento
seeks to engage South Sacramento residents and stakeholders in healthy land use
decision-making, leadership development and advocacy. We want to hear your voice!
Please take 5-10 minutes to answer a few questions about your neighborhood and
interest in the project. Thank you for your participation.

Name: _________________________________________________________________

Email: ______________________________________ Phone: _____________________

Street Address:_______________________________ Zip: _______________________

What neighborhood do you live in?: -

__________________________________________

How long have you lived in the above listed neighborhood?:

______________________

Did you grow up in South Sacramento? (Check one): Yes _______ No _______

What (if any) land-use (i.e. transportation, food access, environmental,

green/outdoor
space, etc.) barriers do you see in your
neighborhood?:__________________________

Do you have a history of addressing these issues? (Check one): Yes ____ No
____

If yes, what specific actions have you taken?

__________________________________

_______________________________________________________________________

_______________________________________________________________________

What changes would you like to see occur in your community regarding land
use issues in the next 2-10 years?
____________________________________________________

_______________________________________________________________________
 Healthy Land Use Engagement Survey

_______________________________________________________________________

What other leaders in the neighborhood have championed these issues?

____________

_______________________________________________________________________

What is your general sense of the relationship between your community and
government agencies? With elected officials?
__________________________________

_______________________________________________________________________

_______________________________________________________________________

How responsive have government agencies been to the land use issues you
have described above?
________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

What challenges (language, apathy, time constraints, etc) exist that may
prevent engagement with your neighborhood?
________________________________________

_______________________________________________________________________

_______________________________________________________________________

What methods would you use to engage the residents of your community on
these issues?
_________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Would you be interested in assisting in a neighborhood specific visioning

process that would specify project and regulatory outcomes for the
community?
(Check one): Yes ______ No ______

How may we contact you? (Please circle): Phone Email

Healthy Land Use Engagement Survey