Poll Monitoring Questionnaire (DRAFT)

POLL MONITORING QUESTIONNAIRE
NOVEMBER 3, 2020 GENERAL ELECTION
Which County are you in?
Name
First NameLast Name
Voting Location Address
Building / Site Name
Street Address
CityCounty
Zip Code
Date monitored
MonthDayYear
Date
Arrival time
:HourMinutesAM/PM Option
Departure time
:HourMinutesAM/PM Option
Vote Center Observations
(1) Signage
YES NO
(a) Are directional signs indicating the vote center's location clearly posted? 1 2
(b) Are directional signs translated into languages other than English? 3 4
If YES to (1)(b), mark the languages provided:
ArmenianChineseFarsiHindiJapaneseKhmer/CambodianKoreanRussianSpanishTagalog/FilipinoThaiVietnameseOther

	YES	NO
(a) Are directional signs indicating the vote center's location clearly posted?	1	2
(b) Are directional signs translated into languages other than English?	3	4

(2) Accessibility

	YES	NO
Is voting accessible, private, and independent for people with disabilities? (See APPENDIX B for more.)	5	6
Is the vote center generally accessible (clear path of entry, accessible parking spaces, ramps where needed)?	7	8
Are all ballot marking devices powered on and functioning properly?	9	10
Is curbside voting available and advertised on outside signage with a phone number to call?	11	12

If NO to any of the above, please describe:
(3) COVID-19 Impacts (see APPENDIX C for more):
YES NO
Is the vote center large enough to fit all voting equipment and voters comfortably and enable social distancing? 13 14
If NO, please describe:

	YES	NO
Is the vote center large enough to fit all voting equipment and voters comfortably and enable social distancing?	13	14

	YES	NO
Were poll workers provided with (and wearing) face coverings and gloves?	16	17
Were voters/observers in need of face coverings provided them?	18	19
Did poll workers frequently disinfect commonly-used surfaces (e-Pollbooks, voting machines, rails, etc.)?	20	21
Were all common areas equipped with sanitation equipment (e.g., hand sanitizer)?	22	23
Were any voters prohibited from or unduly delayed in voting due to their refusal or inability to abide by COVID-19 precautions?	24	25

(4) Voter Check-in Process
YES NO
Did you observe any problems with the functioning of the e-Pollbook(s) as voters were checking in? 26 27
If YES, please describe (also describe whether poll workers were able to assist voters in resolving those problems):
YES NO
Did poll workers ask voter(s) to show ID? 29 30
If YES, did the poll worker explain the range of IDs that can be used to verify identity? 31 32
If YES, were voter(s) able to produce an ID? 33 34
(5) Bilingual Poll Workers (indicate # of bilingual workers based on language:)
# of Workers
Armenian
Chinese
Farsi
Hindi
Japanese
Khmer/Cambodian
Korean
Russian
Spanish
Tagalog/Filipino
Thai
Vietnamese
Other (list with #)

	YES	NO
Did you observe any problems with the functioning of the e-Pollbook(s) as voters were checking in?	26	27

	YES	NO
Did poll workers ask voter(s) to show ID?	29	30
If YES, did the poll worker explain the range of IDs that can be used to verify identity?	31	32
If YES, were voter(s) able to produce an ID?	33	34

	# of Workers
Armenian
Chinese
Farsi
Hindi
Japanese
Khmer/Cambodian
Korean
Russian
Spanish
Tagalog/Filipino
Thai
Vietnamese
Other (list with #)

	YES	NO	SOMEWHAT
If bilingual vote center workers are present, are they wearing name tags or badges that identify the non-English language(s) they speak?	36	37	38
Does a separate sign indicate the languages in which assistance is available?	39	40	41
If YES, is the sign itself translated?	42	43	44

Problems at the Polls
(1) POLL WORKER ISSUES (check all that apply):
Not enough poll workersVoter given incorrect info by poll workerBilingual support neededRude poll worker
Did you observe any discrimination against a certain demographic(s)? If so, describe:
Give the poll workers a score from 1-10 (10 being best):
Provide the name(s) of any problematic poll worker(s) and describe their behavior toward voter(s):
Provide the name(s) of any problematic poll worker(s):
(3) VOTING TECHNOLOGY ISSUES (check all that apply):
e-Pollbook(s) slow or not workingVoting machine(s) not workingMissing voter roster list/e-PollbookVoting location missing ballots/other voting materialsNot enough voting machines/booths
(4) VOTER ISSUES (check all that apply):
Voter name(s) not in roster/e-PollbookVoter asked to present IDVoter ID rejectedVoter(s) told to vote provisionallyVoter(s) never received mail ballotsVoter(s) turned away without offering registration/provisional ballot
(5) VOTER INTIMIDATION / CHALLENGER ISSUES (check all that apply):
Voter(s) right to vote challengedVoter(s) refuses to wear maskPoll observer(s) refuses to wear maskLaw enforcement presence/activity
If law enforcement presence/activity observed, list entities (e.g., "ICE"):
(6) ELECTIONEERING ISSUES (check all that apply):
Campaign materials within 100 feet of voting locationCampaign materials present inside voting location
Final Observations
About how large is the interior of the voting area?
ft (width) ft (length)
How many poll workers are present at the vote center?
How many e-Pollbooks are in use?
How many ballot marking devices are in use?
Was the vote center well-organized so that the voting process was efficient and convenient for voters?
YESNO
Please describe any additional problems you noticed (including long lines/wait time, difficulty in locating vote center, and difficulty parking/entering vote center):
Were there any interesting comments made by poll workers or voters? Did you observe anything else that you’d like to share, positive or negative? (E.g.: "An 18-year-old voted for the first time.")
Do you have any suggestions for improvements to this polling place, poll worker training, or election policies based on your observations? Did you observe any practice that other counties should implement?
APPENDIX A: Voter Exit Interviews
(Exit Interview 1)
Voter's Name
First NameLast Name
Voter's Phone Number
Area CodePhone Number
Voter's Email
example@example.com
Voter's Demographics
Description (in Voter's own words)
Age
Gender Identity
Race / Ethnicity
Sexual Identity
Nationality
Voter with Disability (if yes, describe)
If voter with disability, did voter experience any issue(s) because of their disability?
YESNO
If YES, does voter want DRC to follow-up with them (via phone or email)?
E.g., 'Yes, via email'
Other issue(s) experienced by voter:
Were all issue(s) resolved at vote center?
YESNO
(Exit Interview 2)
Voter's Name
First NameLast Name
Voter's Phone Number
Area CodePhone Number
Voter's Email
example@example.com
Voter's Demographics
Description (in Voter's own words)
Age
Gender Identity
Race / Ethnicity
Sexual Identity
Nationality
Voter with Disability (if yes, describe)
If voter with disability, did voter experience any issue(s) because of their disability?
YESNO
If YES, does voter want DRC to follow-up with them (via phone or email)?
E.g., 'Yes, via email'
Other issue(s) experienced by voter:
Were all issue(s) resolved at vote center?
YESNO
(Exit Interview 3)
Voter's Name
First NameLast Name
Voter's Phone Number
Area CodePhone Number
Voter's Email
example@example.com
Voter's Demographics
Description (in Voter's own words)
Age
Gender Identity
Race / Ethnicity
Sexual Identity
Nationality
Voter with Disability (if yes, describe)
If voter with disability, did voter experience any issue(s) because of their disability?
YESNO
If YES, does voter want DRC to follow-up with them (via phone or email)?
E.g., 'Yes, via email'
Other issue(s) experienced by voter:
Were all issue(s) resolved at vote center?
YESNO
APPENDIX B: Voting Accessibility Questions
APPENDIX C: COVID-19 Questions
Should be Empty:

	Description (in Voter's own words)
Age
Gender Identity
Race / Ethnicity
Sexual Identity
Nationality
Voter with Disability (if yes, describe)

POLL MONITORING QUESTIONNAIRE

Vote Center Observations

Problems at the Polls

Final Observations

APPENDIX A: Voter Exit Interviews

(Exit Interview 1)

(Exit Interview 2)

(Exit Interview 3)

APPENDIX B: Voting Accessibility Questions

APPENDIX C: COVID-19 Questions