Page 200 - QAP Manual 2020

NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21

Section I

Home

I’m going to start by asking you some questions about where you live.

1. Do you like your home or where you live? (Do you like living here?)

□ 2. Yes →Code 2 as ‘Not applicable’
□ 3. In-between →Ask 2
□ 1. No →Ask 2
□ 99. Don’t know, no response, unclear response →Code 2 as ‘Don’t

know, no response, unclear response’
2. If In-between or No: What don’t you like about where you live?

Check ALL THAT APPLY.

98. Not applicable
1. It’s not accessible
2. Feels unsafe in neighborhood or home
3. Home needs repairs or upkeep
4. It doesn’t feel like home
5. Problems with roommates
6. Problems with staff
7. Wants to be closer to family and/or friends
8. Wants more independence

9. Other_________________________________________________
99. Don’t know, no response, unclear response

3. Would you like to live somewhere else?
□ 2. Yes

□ 3. In-between
□ 1. No
□ 99. Don’t know, no response, unclear response

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