Virginia
21st Century
Community Title IV, Part B of the No Child Left Behind Act of 2001
Learning Centers
Virginia Department of Education (VDOE)
21st Century Community Learning Centers (CCLC)
On-Site Monitoring Report
OVERVIEW: As the recipient of federal funds for 21st Century Community Learning Centers, the Virginia Department of Education (VDOE)
is required to monitor grantees’ implementation of activities and compliance with program requirements. The monitoring document will assist
in determining compliance with federal statutory requirements and identify areas in which technical assistance may be helpful to ensure the
objectives described in the grant proposal are met. The visit will also be used to identify promising practices to be shared with other grantees.
Grant Recipient: School(s) Served
SECTION ONE –GRANTEE INFORMATION
Site(s) Visited
VDOE Staff Completing Review
Date of Review School Year (SY)
Person(s) Interviewed
SECTION TWO – OPERATIONAL INFORMATION (Data in this section is to be reported for the previous year of operation unless the
grant project is in the first year of operation. In that case, use the current year’s data.)
Regular School Year Data
a. First Day of Full Services for Current SY Last Day of Previous Year’s Operation (2nd year projects only)
b. Days of Operation (Typical Week) Mon Tues Wed Thurs Fri Sat Sun
c. Was A Summer Program Operated? If so, complete the sections below for summer data. If not, enter
“N/A” in each section on rows d, e, f, and column II below. (This question applies to 2nd year projects only) Yes No N/A
Summer Data
d. Dates of Summer Program Operation through N/A
e. Days of Operation (Typical Summer Week) Mon Tues Wed Thurs Fri Sat Sun
f. Number of Hours Per Day of Services
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Title IV-B On-Site Monitoring Report
OPERATIONAL INFORMATION (continued)
I. II. TOTAL TOTAL HOURS
Combined Data School Year Summer (add columns I. and II.) PER YEAR
g. Hours Per Week of Services
h. Number of Weeks of Services
i. Average Daily Number of Students Attending
j. Date Annual Performance Report Completed and Certified in PP ICS (2nd year projects only) N/A
k. Date Annual Local Evaluation Report Template (ALERT) Completed and Submitted (2nd year projects only) N/A
l. Have reimbursements been submitted and claimed during each quarter in which program expenses occurred? Yes No
− Programs in year two of operation: Has the previous year’s award been fully expended and claimed? Yes No
m. Date most recent reimbursement request was submitted to VDOE
n. Has the annual Quality Self-Assessment for Continuous Improvement Planning Tool been completed
for centers operating under this grant? Yes No
o. Date the assessment was completed
p. Have any significant changes been made to the program design from those detailed in the original application? Yes No
q. If so, has a request for approval of the revisions to the program design been submitted and approved
by the Virginia Department of Education? Yes No N/A
r. If these changes have been made and have not been approved by the Virginia Department of Education, please briefly describe the nature of the
program design change(s) and reasons for the change(s) below, including suggested corrective action.
s. Second year projects: Date of independent single or program-specific audit conducted for first year of operation
(the RFP requires this for all non-school divisions).
PLEASE ENTER THE ITEM LETTER AND COMMENTS FOR ANY AREAS OF CONCERN FROM SECTION TWO ABOVE.
Item # Comments
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Title IV-B On-Site Monitoring Report
SECTION THREE – GRANTEE COMPLIANCE
Requirement Documentation Examples Requirement Met?
1. The grantee has identified and is serving eligible students and their Grant Application/Progress Reports
families consistent with the original grant application (or approved Participant list/Registration forms
Yes No
amendments). Participation eligibility data
Other:
2. The grantee is conducting outreach to eligible participants as Grant Application/Progress Reports
described in the original grant application (or approved Documentation of outreach activities (e.g. school
amendments). posting and announcements, press releases, program Yes No
fliers, informational notices to school staff)
Other:
3. The grantee is providing the number of hours of programming Section II data
described in the original grant application (or approved Grant Application/Progress Reports
amendments). Descriptions of programming Yes No
Program calendars/schedules
Other:
4. The grantee is implementing the academic and enrichment activities Grant Application/Progress Reports
described in the original grant application (or approved On-site observations Yes No
amendments). Other:
5. The grantee is implementing the parent/family programming or Grant Application/Progress Reports
activities described in the original grant application (or approved Description of programming
Yes No
amendments). Program calendars/schedules
Other:
PLEASE ENTER THE ITEM NUMBER AND COMMENTS FOR ANY AREAS OF CONCERN ON THIS PAGE.
Item # Comments
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Title IV-B On-Site Monitoring Report
Requirement Documentation Examples Requirement Met?
6. The grantee is addressing the transportation needs of children as Grant Application/Progress Reports
described in the original grant application (or approved Transportation logs
Yes No N/A
amendments). Notices to parents
Other:
7. The program is located in a safe and accessible facility. Written safety policies and procedures (e.g. building
security, emergency exit, student pick-up, student
health needs, emergency contact, student use of
science labs, machinery and other potentially Yes No
dangerous equipment)
Facility inspection records
Other:
8. The grantee is making adequate progress toward meeting the goals Report of Progress Meeting Objectives Stated in
and objectives set out in the original grant application (or approved Original Title IV-B Awarded Application
amendments) Attach completed Report of Progress Meeting Grant Application
Yes No
Objectives in Original Title IV-B Awarded Application. Student demographic and achievement data
Other program data
Other:
9. The grantee is adhering to the plan describing in the approved Sustainability Plan
application how the community learning center will continue after Description of resources (e.g. grants, leveraged funds,
funding from the grant has ended. and documented in-kind donations) the program has Yes No
secured or attempted to secure
Other:
10. Grantee staff members have attended the required state 21st CCLC Training registration
meetings, i.e. annual statewide grantee institute, new cohort Training materials Yes No
institute, if applicable. Other:
PLEASE ENTER THE ITEM NUMBER AND COMMENTS FOR AREAS OF CONCERN ON THIS PAGE.
Item # Comments
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Title IV-B On-Site Monitoring Report
Requirement Documentation Examples Requirement Met?
st
11. The grantee expends 21 Century funds according to original grant Financial summary reports
application (or approved amendments). Budget change requests/amendments
Yes No
Purchase invoices
Time and effort worksheets
12. The grantee maintains documentation for materials and equipment Purchase orders/invoices
purchased with 21st CCLC funds. Inventory List Yes No
Other:
13. Appropriate documentation for employees of the grant program is Staff timesheets
maintained. Time and effort worksheets
Yes No
Background check and citizenship documents
Other:
14. Observation and review of records indicate the grant recipient is Original RFP application budget narrative
using grant funds to supplement and not supplant existing school Continuation application budget narrative Yes No
division services. Reimbursement requests
15. The program works in genuine collaboration with at least one Agreements/MOUs/Contracts
partner to implement program services. Partners provide services in Documentation of Services/activities
Yes No
accordance with the original grant application (or approved Meeting minutes/summaries
amendments). Other:
16. The grantee completes the federal 21st Century Profile and Section II data
Performance Information Collection System (PPICS) and Completed PPICS/state monitoring and evaluation
Yes No
participates in the state monitoring and evaluation process as instruments
required and according to established deadlines. Other:
PLEASE ENTER THE ITEM NUMBER AND COMMENTS FOR AREAS OF CONCERN ON THIS PAGE.
Item # Comments
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Title IV-B On-Site Monitoring Report
Requirement Documentation Examples Requirement Met?
17. The program holds regular staff and partnership meetings that are Staff and partnership meeting schedule and minutes
more than administrative in nature, and that engage staff and Grant application Yes No
partners in collaboration and sharing promising practices. Other:
18. Program volunteers are recruited, screened, and trained. Volunteer job descriptions/ training materials
Volunteer handbook/policies Yes No N/A
Other:
19. Program staff communicates regularly and effectively with school Communications structure
day staff to supplement regular school educational activities and to Meeting schedules/minutes
inform and receive information from in-school teachers on students’ Homework logs/Correspondence Yes No
academic and behavioral progress. This includes facilities and Surveys of classroom teachers and administrators
resources. Other:
20. The program has the administrative capacity and infrastructure to Documentation regarding administrative systems
develop budgets, track expenses, and collect and maintain program Organizational chart/Qualifications of fiscal officer Yes No
data. Other:
21. Staff members are trained or hold appropriate licenses and/or Job descriptions
endorsements in core academic areas as appropriate for an Training records Yes No N/A
afterschool environment. Other:
PLEASE ENTER THE ITEM NUMBER AND COMMENTS FOR AREAS OF CONCERN ON THIS PAGE.
Item # Comments
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Title IV-B On-Site Monitoring Report
Requirement Documentation Examples Requirement Met?
22. Professional development/training opportunities are aligned with Staff needs assessment
program and corresponding needs and objectives. Professional development (PD) plan
Yes No
Agendas from PD opportunities
Other:
23. The program has established partners and collaborators to ensure Interviews
long-term commitments of resources in accordance with approved Meeting minutes/notes
Yes No
application. Agreements/MOUs/Contracts
Other:
24. The program’s hours, activity schedules, and location(s) are Registration information
accessible, and meet all local, state, and federal statutory Activity logs
Yes No
requirements. Documentation of outreach activities
Other:
25. Program staff members use positive techniques to guide the Program handbook Yes No
behavior of students. Staff training materials
Data on student behavior
Other:
26. The program provides regular communication with and outreach to Correspondence
participants’ families, including information regarding students’ Translation/assistive materials
experiences, behavior, and achievements in the program. Event/meeting announcements Yes No
Information is transmitted to limited English proficient families in Activity log
modes that are appropriate and easily understood, if applicable. Other:
PLEASE ENTER THE ITEM NUMBER AND COMMENTS FOR AREAS OF CONCERN ON THIS PAGE.
Item # Comments
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Title IV-B On-Site Monitoring Report
Requirement Documentation Examples Requirement Met?
27. The program provides high quality enrichment opportunities, Program policies/handbook
aligned with the state and local student achievement standards. Curricular materials/outlines/Training materials
Yes No
Surveys of classroom teachers
Other:
28. The program accommodates students with special needs as required Documentation of accommodations provided
by local, state, and federal statutory requirements. Attendance records of special needs students Yes No N/A
Other:
29. If not provided by the Local Education Agency (LEA), vehicles Inspection information
used for transportation are safely maintained and inspected on a Agreements/MOUs/Contracts Yes No N/A
regular basis. Other:
30. The program follows established procedures for authorized student Written policies/procedures
pick-ups and has provided notice of these procedures to staff and Phone logs/Attendance records
Yes No
families. Staff training agendas
Other:
31. Emergency contact information for students and staff is maintained Emergency response plan/ Emergency cards
in an easily accessible, but secure central location. Program handbook Yes No
Other:
PLEASE ENTER THE ITEM NUMBER AND COMMENTS FOR AREAS OF CONCERN ON THIS PAGE.
Item # Comments
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Title IV-B On-Site Monitoring Report
Requirement Documentation Examples Requirement Met?
32. If the program uses the Internet for academic or enrichment Policies related to Internet use
activities, the program avoids transmitting any material in violation Blocking software
of any U.S. or state regulation via the Internet. This includes, but is Other: Yes No N/A
not limited to, copyrighted materials and threatening or obscene
materials.
33. If site is not in a public school, the program conducts all required Record of drills conducted
Yes No N/A
fire/safety drills. Other:
34. The program has adequate security in place. Written security policies
Yes No
Other:
35. The program has adopted and applies an evaluation process to Original grant application
measure program goals and outcomes. This collection and reporting Evaluation plan, instruments, data collection system
Yes No
includes all program information and data required in the state’s Data reports
online local evaluation system. Other:
36. The program uses the information collected through the evaluation Progress reports
process in decision making, program refinement, and for purposes Program schedule
of quality improvement. Curricular materials Yes No
Meeting minutes/notes
Other:
PLEASE ENTER THE ITEM NUMBER AND COMMENTS FOR AREAS OF CONCERN ON THIS PAGE.
Item # Comments
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Title IV-B On-Site Monitoring Report
PLEASE ADD SUMMARY COMMENTS/RECOMMENDATIONS AND SUGGESTIONS FOR CORRECTIVE ACTION, IF
APPROPRIATE, INCLUDING COMMENTS ON EXEMPLARY PRACTICES.
Acknowledgement: The Virginia Department of Education developed this tool using resources made available by the Colorado Department of Education.
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