Home Assessment Sample Questionnaire

1. Do you change your security codes on a regular basis?

2. How many persons are given access to your home on a weekly or monthly basis?

3. How many access and exit routes are available to your home,
including water access?

4. Have you established a rally point, at a sufficient distance, from your
home, school and work in case of fire or other emergencies?

5. Do you have a disaster supply kit containing items such as adequate
food, water, and supplies available to sustain your family?

6. Have you established a rally point to meet your children near their
school in case of emergencies or crisis?

7. Have you established a safe place in your home in case of chemical, biological,
or nuclear attack?

8. Are you aware of the various types of chemical and biological agents and how to
protect yourselves against them?

9. Are you aware of your local or metropolitan emergency response plans and how
your “first responders” will aid you in a crisis?

10. Have you established a means for alternate communications, other than cellular
or local phones, with your family members?