Pick a place to walk, like the route to school, a grocery store, library, public park, or somewhere fun to go. Read over the checklist before you head out. As you walk note the location of things you would like to change according to the checklist below. At the end of the walk, give an overall rating to each question. Then add up the numbers to see how you rated your walk.
When asked to assign a number, use this scale:
1 = awful
2 = still not so good
3 = not bad, but nothing to write home about
4 = good, enjoyable
5 = excellent, will definitely walk that way again
From: ___________________________
To: ___________________________
Date/Time: ___________________________
- Was there a specially-designated sidewalk, path or trail for your walk? YES/NO
- What was the route like?
Check the ones below where you can answer "YES"
- Enough room to walk
- Sidewalk/path continuous (or did it stop and start?)
- Sidewalk/path in good condition (or broken or cracked)
- Sidewalk/path blocked with poles, signs, shrubbery, trash cans, etc,
- Too much traffic
- Adequate buffer between pedestrians and traffic
- Other issues__________________________________________
Rate the overall condition of the sidewalks from 1 to 5_______
What and where were some of the worst problems?___________
- Was it easy to cross streets? YES/NO
Check the ones below where you can answer "YES"
- Road was too wide
- Traffic signals made us wait too long or did not give us enough time
- Needed striped crosswalks or traffic signals
- Other issues__________________________________________
Rate the overall traffic conditions from 1 to 5_______
What and where were some of the worst problems? __________________
- Did drivers behave well? GOOD/BAD
Check the ones below where you can answer "YES"
- Backed out of driveways without looking
- Did not yield to people crossing the street
- Turned into people crossing the street
- Sped up to make it through traffic lights or drove through red lights
- Something else__________________________________________
Rate the overall traffic conditions from 1 to 5_______
What and where were some of the worst problems? __________________
_____________________________________________________________
_____________________________________________________________Was it easy to follow safety rules? YES/NO
- Check the ones below where you can answer "YES"
Cross at crosswalks where you could see and be seen by drivers?
Walk on sidewalks or shoulders facing traffic where there were no sidewalks
Cross with the light?
- Was your walk fun and safe?
Rate the overall safety conditions of your route from 1 to 5_______
What and where were some of the worst
problems? __________________
_____________________________________________________________
_____________________________________________________________
Check the ones below where you can answer "YES"
Needed more grass, flowers and trees
Scary people
Scary dogs
Not well lighted
Dirty, lots of litter, trash and animal messes
Something else___________________________________________
