The Shire of Peppermint Grove is committed to growing a welcoming, inclusive and accessible community. We are currently working on our Disability Access and Inclusion Plan (DAIP) for 2012 – 2016 and we are seeking your opinions.

Your feedback is important. An inclusive and accessible community makes life easier for everyone. Anyone can be involved and we urge you to help us by completing the attached survey and returning it to the Shire of Peppermint Grove by Friday, 18 November 2011. Surveys can be returned by post or delivered to the Shire administration office or The Grove library at 1 Leake Street, Peppermint Grove.

Our current Disability Access and Inclusion Plan 2007 – 2011 can be downloaded from the Quick Links on the homepage of our website at www.peppermintgrove.wa.gov.au

For more information on a Disability Access and Inclusion Plan, please visit Disability WA’s

website at www.disability.wa.gov.au

Surveys are available in a range of formats, including Braille, large print, in digital format

and audio on request.

For further information about the review please contact Vanessa O’Brien via email at or phone 9286 8600.

GENERAL

1.  Are you aware that the Shire of Peppermint Grove has a Disability Access and

Inclusion Plan? (Please tick)

Yes No

2. Are you a resident or ratepayer of the Shire of Peppermint Grove?

Yes No

3. Are you:

A person with a disability?

A family member, carer (unpaid) or friend of a person with a disability?

A support worker (paid) of a person with a disability?

From a disability service or advocacy organisation?

A business owner or operator in the Shire of Peppermint Grove?

An interested member of the general public?

CUSTOMER SERVICE

Including Staff awareness, communication, language, assistance etc.

4.  How would you rate your level of satisfaction with the Shire’s and The Grove library’s

customer service for people with disabilities?

Delighted Satisfied Neutral Unsatisfied Very Unsatisfied

5. Do you experience any difficulties or barriers when dealing with employees from the Shire or The Grove library?

Yes No

If yes, please give details: ______

______

BUILDINGS AND FACILITIES

Including council offices, The Grove Library, parking, parks and gardens, footpaths and bus stops, public toilets etc.

6. How would you rate the level of physical access to the Shire’s buildings and facilities?

Excellent Good Average Poor Very Poor

7. Do you experience any physical barriers when accessing the Shire’s buildings and

facilities?

Yes No

If yes, please give details: ______

______

INFORMATION

Including written materials, signage, website, electronic documents etc.

8. How would you rate your level of access to the Shire’s information?

Excellent Good Average Poor Very Poor

9. Do you have any difficulties accessing the Shire’s information?

Yes No

If yes, please give details: ______

______

POLICIES AND PROCEDURES

Including employment, elections, complaints, consultations etc.

10. Do you experience difficulty complying with the Shire’s policies or procedures because of a disability or other condition?

Yes No

If yes, please give details: ______

______

DAIP PLANNING

11. How would you rate the overall level of access and inclusion for people with disabilities provided by the Shire of Peppermint Grove?

Excellent Good Average Poor Very Poor

12. Please advise of any access and inclusion issues you would like addressed in the

reviewed DAIP.

Please give details: ______

______

13. What do you think the Shire of Peppermint Grove could do to become an even more

friendly and welcoming community?

Please give details: ______

______

14. Would you like to be consulted in the future about access and inclusion issues in the

Shire of Peppermint Grove?

Yes No

If yes, please provide contact details below:

Name:

Address:

Phone:

Email:

Privacy Note: These contact details will be used for Access and Inclusion-related purposes only and will not be disclosed for any other purpose.

Input into the DAIP review process closes on Friday 18 November, 2011.

Please return this survey to the Shire of Peppermint Grove

administration office, The Grove library, or by post to:

The Chief Executive Officer

The Shire of Peppermint Grove

PO Box 221

Cottesloe WA 6911

END OF SURVEY – THANK YOU VERY MUCH

Page 2 of 4 Shire of Peppermint Grove DAIP Review Survey 2011