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THIS SURVEY IS AVAILABLE IN ALTERNATE FORMATS Americans with Disabilities Act Survey for Organizations and Agencies Representing Individuals with Disabilities City of Modesto The City of Modesto is currently updating its Americans with Disabilities Act Self-Evaluation and Transition (Barrier Removal) Plans. In order to enhance access to programs and services for individuals with disabilities, the City is asking for your input. Name of organization/agency: Address: Contact person: Position: Phone: Today’s date: Name of person completing this form: Name of the ADA Coordinator(s) for your organization: The following questions have been developed to determine how organizations and advocacy agencies perceive the City of Modesto’s ability to provide services and accommodations for individuals with disabilities and to ask for input regarding how programs, services and activities can be more accessible for individuals with disabilities. 1. What direct communications have you had with the City of Modesto to facilitate services and accommodations for individuals with disabilities? 2. Are there any specific complaints or problems regarding access for individuals with disabilities to any of the programs, services or activities provided by the City of Modesto? 3. What information or other resources can you supply to help educate or inform the City of Modesto about your organization/agency and your services for individuals with disabilities? 4. What general guidance, advice or assistance could your organization/agency provide to the City of Modesto to protect against potential discrimination of individuals with disabilities in its programs, services and activities? 5. What do you feel is the highest priority for the City of Modesto to improve accessibility for individuals with disabilities? Please add any additional comments on the back of this survey or attach any additional documents. Thank you for your input. Please return this survey by January 8, 2016 to Paul Liu, ADA Coordinator, City of Modesto, 1010 10th Street, Modesto, CA 95354. Comments can also be made by calling (209) 577-5282, or by email at [EMAIL REDACTED]. Surveys can also be returned to Disability Access Consultants, 2243 Feather River Boulevard, Oroville, CA 95965. Comments can also be emailed to [EMAIL REDACTED], faxed to (530) 533-3001 or made by phone to (800) 743-7067. Print Form Email Form