Community Monitoring Quiz Form
Complete this quiz to record community monitoring observations and assess the situation using the same title consistently throughout the form.
Community Profile
Neighborhood / Community Name
*
Respondent Role or Affiliation
*
Observation Date or Monitoring Period
Monitoring Quiz
What is the primary issue observed?
*
Littering
Noise disturbance
Illegal dumping
Safety hazard
Unmaintained property
Vandalism
Other
Which secondary issues are also present?
Littering
Noise disturbance
Illegal dumping
Safety hazard
Unmaintained property
Vandalism
Pest activity
Poor lighting
Other
How severe or urgent is the situation?
*
1
2
3
4
5
Rate the observed conditions across key monitoring criteria
*
Rows
Never
Rarely
Sometimes
Often
Always
Visibility of issue
1
2
3
4
5
Frequency of occurrence
6
7
8
9
10
Impact on residents
11
12
13
14
15
Impact on public spaces
16
17
18
19
20
How confident are you in your assessment?
*
Very confident
Somewhat confident
Neutral
Slightly unsure
Not confident
Other
Notes and Submission
Additional Observations, Evidence Notes, or Context
Suggested Next Action or Follow-up Priority
*
No Follow-up Needed
Monitor Closely
Schedule Review
Escalate to Supervisor
Other
Submit Community Monitoring Quiz Form
Should be Empty: