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Wednesday, February 27, 2008

Los Angeles County Childhood Lead Poisoning Prevention Program

Los Angeles
w:st="on">County Childhood

Lead Poisoning Prevention Program



style='mso-bidi-font-weight:normal'>Parent Lead Knowledge
Questionnaire



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I.  General Informationstyle='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



style='mso-bidi-font-weight:normal'>a.style='font:7.0pt "Times New Roman"'>      
style='mso-bidi-font-weight:normal'>Sex



style='layout-grid-mode:line'>___ Male                                                     style='mso-bidi-font-weight:normal'>e. What is your highest level of education
achieved?



style='layout-grid-mode:line'>___ Female                                                                                    ___
0-6th grade



style='font-size:5.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:7'>                                                                                                                                                                        style='layout-grid-mode:line'>___ 7-9th grade                                                                              style='mso-spacerun:yes'>    



___ 10-12th grade style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>b.style='mso-spacerun:yes'>  Ethnic Backgroundstyle='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-spacerun:yes'>                                                                
___ Some college/trade school



style='layout-grid-mode:line'>                ___
Asian American                                                           ___
Graduated college



___ African
Americanstyle='mso-spacerun:yes'>                                                
  ___ Some graduate school



___ Hispanicstyle='mso-spacerun:yes'>                                                                 
___ Finished graduate school



style='layout-grid-mode:line'>___ White                                



___ Otherstyle='mso-tab-count:1'>                                                                             



style='mso-spacerun:yes'>                                                                        
f.style='mso-spacerun:yes'>  Zip code _________style='layout-grid-mode:line'>      style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



 



c.  Has your child/children ever
been tested for lead poisoning?
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style='layout-grid-mode:line'>                YESstyle='mso-tab-count:2'>                         NOstyle='mso-tab-count:2'>                          DON’T KNOWstyle='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



d.  Do you think your
child/children could get lead poisoned?



 



      style='mso-tab-count:1'>          YES                         NOstyle='mso-tab-count:2'>                          DON’T KNOWstyle='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>





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II.  INSTRUCTIONS:style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-spacerun:yes'>  Please
answer TRUE, FALSE or style='mso-bidi-font-weight:normal'>DON’T KNOW to each of the following
questions:



 



style='mso-bidi-font-weight:normal'>1.style='font:7.0pt "Times New Roman"'>     
style='mso-bidi-font-weight:normal'>Lead poisoning may cause serious learning and
behavioral problems in children.



 



style='layout-grid-mode:line'>TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



style='mso-bidi-font-weight:normal'>2.style='font:7.0pt "Times New Roman"'>     
style='mso-bidi-font-weight:normal'>Lead can be found in the paint of homes built
before 1978.



 



style='layout-grid-mode:line'>TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



3.  Lead found in the dirt cannot
harm children.



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



4.  Frequent hand washing helps
prevent lead poisoning.



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



style='mso-bidi-font-weight:normal'>5.style='font:7.0pt "Times New Roman"'>     
style='mso-bidi-font-weight:normal'>When renting an apartment, the owners are
required to tell renters about the possibility of lead in the paint.



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>            TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



style='mso-bidi-font-weight:normal'>6.style='font:7.0pt "Times New Roman"'>     
style='mso-bidi-font-weight:normal'>One way for children to get lead poisoned is
having lead dust on their hands and then putting their hands in their mouths.



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>            TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



7.  It is safe to cook, serve and
store food in imported pottery and ceramic ware.
style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



8.  Lead cannot be passed from a
pregnant woman to her unborn child. 
style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



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style='layout-grid-mode:line'>                TRUEstyle='mso-tab-count:2'>                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



9.  Some herbal or traditional home
remedies contain lead.



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



10. A child with lead poisoning always appears sick.style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



11. The only way to find out if your child has lead poisoning is to have
him/her take a blood lead test.



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



12. It is okay to sand or scrape old painted wood.style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



13. A healthy diet high in iron and calcium helps lessen a child’s chance
of becoming lead poisoned.



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



14. Lead poisoning can be prevented.



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



15. Parents, who work with lead at their jobs or have hobbies that
involve lead, can bring lead home



      on their clothes.



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>            TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



16. Parents may ask their children’s doctor to test them for lead even if
the doctor has not



      mentioned it before.style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



17. Cleaning floors with a wet mop and washing windowsills with a damp
cloth helps remove lead



      dust.style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>                TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 



18. Washing children’s toys often helps prevent lead poisoning.style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'> 



style='font-size:11.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>style='mso-tab-count:1'>            TRUE                     FALSEstyle='mso-tab-count:2'>                   DON’T KNOWstyle='font-size:9.0pt;mso-bidi-font-size:10.0pt;layout-grid-mode:line'>



 

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