This paper presents the results from a survey of local Health Officers. The intent of the survey was to learn more about perceptions of the public health threat from, and preparation for, climate change among California’s local public health agencies. The survey found that local public health officials believe that climate change poses a significant threat to public health. The most often-cited concern is the potential increase in extreme heat, followed closely by water-related concerns. The survey also found that local health officers generally feel ill-prepared to respond to the public health threats posed by climate change.