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  2. 2014
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Exit Survey
 
 
Name of the Village
 
Aceh Jaya 0348
 
Aceh Jaya 4925
 
 
Name of Enumerator
 
Amoz
 
Jimmy
 
Fiona
 
 
Date
 
 
Time (e.g. 1600)
   
 
 
Household Profile
Status Gender (M/F) Age On/offsite (Onsite/Offsite) Affected by Tsunami? (Y/N)
Person 1
Person 2
Person 3
Person 4
Person 5
Person 6
Person 7
Person 8
Person 9
Person 10
 
 
What kinds of maintenance/repairs have you done?
Yes No
Structural Repairs (Walls, floor, ceiling etc)
Finishing and appliances (counters, furniture, stove etc)
Aesthetic (painting, changing colour, altering façade etc)
 
 
Are you able to maintain the house to your satisfaction?
 
Yes
 
No
 
 
Why not?
 
No need for modifications
 
Can't afford
 
Risk of future tsunami
 
Other
 
 
What kind of changes have you made and why?
Yes/No If Yes, why?
Adding or removing walls
Adding rooms vertically
Adding rooms horizontally
Changing the functions of rooms
Making new windows
Making new doors
Closing up windows
Additing exterior eatures (Verandah, porch, awning, etc.)
Adding work spaceshop.business to house