2024 Census Test: Collective Dwelling Record - Form 1A

Final outcome code

Preparations for the 2026 Census have begun, and Statistics Canada is seeking your participation in this important test. Census information is important for you and your community and is used to plan services that support employment, schools, public transportation and hospitals. By law, all residents living in facilities and establishments that were selected for the 2024 Census Test must be counted. The information is collected under the authority of the Statistics Act and is kept strictly confidential. The information you provide may be used by Statistics Canada for other statistical and research purposes or may be combined with other survey or administrative data sources.

Confidential when completed

Section I - Identification

  • Survey Specific Identifier (SSID)
  • Crew leader district (CLD)
  • Block No.
  • Crew leader name
  • Name of collective dwelling
  • Address
  • Maximum occupancy
  • Collective dwelling type code
  • Total usual residents (URs)
  • Number of private dwellings attached
  • Contact name
  • Contact telephone number
  • Contact address
  • Contact email

Complete only if final outcome code is '324' (Cancelled)

  • Private dwelling
  • Business or establishment that does not provide overnight accommodation
  • Incorrect address
  • Demolished
  • Duplicate

Comments

Section 2 Collective dwelling type code and auxiliary questions

Select one collective dwelling type and answer the corresponding questions.

Hospital (10)

A1) Is this facility licensed as a hospital?

  • Yes
  • No

A2) What services are provided at this facility? (Mark one only.)

  • Short-term care
  • Long-term care
  • Both short-term and long-term care

Long-term care home or residence for older adults (20)

B1) Select the most applicable:

  • Long-term care home – A facility that provides 24-hour nursing care or personal care. Residents receive help for most or all daily activities.
  • Residence for older adults – A facility where residents pay rent, and may pay additional fees if assisted living or support services are required. This facility does not provide 24-hour nursing or personal care e.g., retirement home or assisted living home.
  • Both long-term care home and residence for older adults

Note: If no care and service is provided to residents, the facility should be enumerated as a private dwelling.

Residential care facility related to disabilities, mental health, addiction, etc. (30)

C1) Is this facility for? (Mark all that apply.)

  • Primarily children or minors
  • Persons with physical challenges or disabilities
  • Persons with psychological disabilities
  • Persons with developmental disabilities
  • Persons with an addiction
  • Persons with other disabilities – specify:

Shelter (40)

D1) Who is this facility for? (Mark one only.)

  • Persons lacking a fixed address, such as homeless persons
  • Victims of domestic violence or abuse
  • Persons released from custody or on conditional release
  • Refugees and asylum seekers
  • Other – specify:

Correctional or custodial facility including municipal detachments (50)

E1) What type of facility is this? (Mark one only.)

  • Federal correctional facility
  • Provincial or territorial detention centre or custodial facility
  • Young offenders' facility
  • Temporary lock-up (e.g., police holding cell)

Lodging or rooming house (60)

Religious establishment (70)

Hutterite colony (80)

Establishment with temporary accommodation services (90)

F1) What type of establishment is this? (mark one only.)

  • Hotel, motel or tourist establishment
  • Campground or park
  • Other establishment with temporary accommodation services such as a YMCA/YWCA, Ronald McDonald House or hostel

Other establishment (91)

G1) What type of establishment is this? (mark one only.)

  • Residence for school or training centre
  • Commercial vessel
  • Government vessel
  • Military base
  • Work camp
  • Other type of establishment

Section 3 Occupancy of residents

Complete only for collective dwelling types 60 and 8

Section 3 Occupancy of residents
  Room or unit number Unoccupied
( X )
Number of URs Name of main resident
(If name not available, enter "X".)
Temporary residents (TRs) or foreign residents (FRs)
(X)
Remarks
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