CM Professional Research Intl.

11/08/2026

COMMUNITY ASSESSMENT TOOL [CAT]

SSAAP: Simwatachela Sustainable Agricultural and Arts Program

Charity service organisation based in U.S.A., operating in Zambia and Sierra Leone, Africa

Contact in U.S.A.: 001-303-408-5775; Contact in Zambia: +260 978058678; Contact in Sierra Leone: +232 30178615

*

General:

1. Does your community have:
• Orphans? ________ How many?_________ Single? ________ Double?________
• Men? _______
• Women? ________
(Please write how many are in each category.)

2. What is the name of your community? _____________________
3. Where is your community located? _______________________
4. What chiefdom is your community located? ___________________
5. Are there headmen / headwomen in the community? _________ Are they active in development projects? _________________
6. What are the deep needs of the community? _____________________
________________________________________________________
7. Why have these needs not been previously met? __________________
________________________________________________________

Water:
1. Does your community have a source for extracting clean drinking water? ________________________________________________________
2. What is this source? __________ Where is it located? _____________
How many kilometers away? _________
3. Does this community have a need for clean drinking water? __________
4. Does the community have a nearby dam? _________ Irrigation source? _________________
5. What are this community's deep needs in terms of water? ___________
________________________________________________________
6. NGO laws require community contribute 50% to project. How will this community contribute 50%, and in what ways? _____________________
________________________________________________________
________________________________________________________
7. SSAAP currently has small funding to dig hand-dug, shallow wells which bear cement covers. These wells will extract clean drinking water from the ground. Is this community interested in such a project? _______________

*Kindly note, SSAAP does not hire employees or pay salaries. Work done within communities by beneficiaries in those respective communities is considered under the 50% of community contribution. SSAAP encourages sustainability and therefore does not hire people to do work intended to benefit beneficiaries of the project. Beneficiaries of projects will be those volunteering their services to implement community projects and will ultimately be serving themselves.*

Education ----> School:
1. Does your community have a school? _________ Where is it located? _____________ How many kilometers away? ___________
2. How many terms are in a school year in this community? __________
3. What are the school fees for the following grades in this community, per term?
• Grades 1-6 ______________
• Grades 7,8,9 _____________
• Grades 10, 11, 12 __________
(Please represent costs per term or per semester.)

4. Are school fees able to be paid by parents/guardians of students? ______
5. Is there a need for assistance via scholarship program from SSAAP? _________________ Why? ___________________________________
6. NGO requires community contribute 50% towards this program. What will 50% contribution be? _________________________________________

Education----> Student Pen Friend Exchange Program
1. Would this community be interested in an exchange program through students from local schools within the community writing letters to a school in the U.S.A.? ____________________
2. Program requires that both students and teachers participate, as well as read and write in English. Would this community be able to do this? ______
3. NGO requires community contribute 50% towards this program. What will 50% be? __________________________________________________

Women's Clubs & Groups
1. Are there women's clubs and/or groups in this community? ___________
How many? ____________ Names of women's clubs? _______________
2. What projects are the women currently and actively engaged in? _______
_________________________________________________________
3. Would the women's clubs be interested in working with SSAAP? ______
4. In what ways? ____________________________________________
_________________________________________________________
5. NGO requires women's clubs to contribute 50% towards this program. What will 50% be? ___________________________________________
_________________________________________________________

Income-Generation Activities
1. Is this community currently engaged in income-generation activities? ____
2. What are the activities? ______________________________________
_________________________________________________________
3. How might SSAAP be able to help these activities prosper? __________
_________________________________________________________
4. NGO requires community contribute 50% towards income-generation projects. What will the 50% be? _________________________________
_________________________________________________________

Other Areas
1. What other needs does this community have? _____________________
2. How can SSAAP work with the community to fulfill these needs? ______
_________________________________________________________
_________________________________________________________
3. How will the community contribute their required 50%?______________
_________________________________________________________

Contact Person for Community
• Name? ________________________________
• Phone Number? _________________________
• Signature ______________________________
• Date __________________________________
• Signature Headman _______________________
• Signature Chief __________________________

Disclaimer
Please note that completion of this assessment form does not promise or guarantee funding, payment of school fees, or construction of water resource in community. This is merely an assessment form in which SSAAP is gaining information about the community in order to organize how the community can work together with SSAAP most efficiently and proficiently.

SSAAP will contact stated contact person on this form if the community's needs are matched with SSAAP's.

* SSAAP is a water, food, and nutrition sustainability and empowerment organization created by the people and committed to serving the needs of the people. Founded in Simwatachela, Zambia in 2008, SSAAP continues to serve in multiple chiefdoms in Southern Province, Zambia region as well as in rural Sierra Leone, West Africa.*