Senior Citizen Services by S4MCu46

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									                                    City of Jersey City
                             Community Development Block Grant
                                 Quarterly Activity Report

INSTRUCTIONS:

By completeing the data requested below, the Quarterly Activity Report will calculate the totals
and reduce the need to enter data more than once.

Input data cells are shaded yellow on all forms.

INPUT DATA:

1. Name of Agency:                                 Your Agency

2. Name of Program:                                Your Program

3. Name of Director:                               Your Director

4. Name of Report Preparer:                        Preparer's name
          Agency Name        Your Agency           Date Submitted
         Program Name       Your Program                  Period:          Projections        Senior citizen
               Director     Your Director              Start Date:                              Services
               Preparer    Preparer's name              End Date:
         Problem, Need,      Services or
Goals                                                   Measure                Outcome             Measure                 Evaluation Tools
            Situation     Activities/Outputs
  1            2                  3                          4                     5                    6                         7
Policy      Planning        Programming        Projection   Actual   YTD         Impact   Projection   Actual   YTD          Accountability
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          Agency Name        Your Agency           Date Submitted
         Program Name       Your Program                  Period:          Projections        Senior citizen
               Director     Your Director              Start Date:                              Services
               Preparer    Preparer's name              End Date:
         Problem, Need,      Services or
Goals                                                   Measure                Outcome             Measure            Evaluation Tools
            Situation     Activities/Outputs
  1            2                  3                          4                     5                    6                   7
Policy      Planning        Programming        Projection   Actual   YTD         Impact   Projection   Actual   YTD    Accountability
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          Agency Name        Your Agency           Date Submitted
         Program Name       Your Program                  Period:          Projections        Senior citizen
               Director     Your Director              Start Date:                              Services
               Preparer    Preparer's name              End Date:
         Problem, Need,      Services or
Goals                                                   Measure                Outcome             Measure            Evaluation Tools
            Situation     Activities/Outputs
  1            2                  3                          4                     5                    6                   7
Policy      Planning        Programming        Projection   Actual   YTD         Impact   Projection   Actual   YTD    Accountability
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          Agency Name        Your Agency           Date Submitted
         Program Name       Your Program                  Period:          Projections        Senior citizen
               Director     Your Director              Start Date:                              Services
               Preparer    Preparer's name              End Date:
         Problem, Need,      Services or
Goals                                                   Measure                Outcome             Measure            Evaluation Tools
            Situation     Activities/Outputs
  1            2                  3                          4                     5                    6                   7
Policy      Planning        Programming        Projection   Actual   YTD         Impact   Projection   Actual   YTD    Accountability
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          Agency Name        Your Agency           Date Submitted
         Program Name       Your Program                  Period:          Projections        Senior citizen
               Director     Your Director              Start Date:                              Services
               Preparer    Preparer's name              End Date:
         Problem, Need,      Services or
Goals                                                   Measure                Outcome             Measure            Evaluation Tools
            Situation     Activities/Outputs
  1            2                  3                          4                     5                    6                   7
Policy      Planning        Programming        Projection   Actual   YTD         Impact   Projection   Actual   YTD    Accountability
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          Agency Name        Your Agency           Date Submitted
         Program Name       Your Program                  Period:          Projections        Senior citizen
               Director     Your Director              Start Date:                              Services
               Preparer    Preparer's name              End Date:
         Problem, Need,      Services or
Goals                                                   Measure                Outcome             Measure            Evaluation Tools
            Situation     Activities/Outputs
  1            2                  3                          4                     5                    6                   7
Policy      Planning        Programming        Projection   Actual   YTD         Impact   Projection   Actual   YTD    Accountability
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                                                  CITY OF JERSEY CITY
                                         DIVISION OF COMMUNITY DEVELOPMENT
                                      COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG)
                                              QUARTERLY ACTIVITY REPORT
Agency:                                                               Your Agency
Program:                                                             Your Program
Director:                          Your Director                                       Report Preparer:            Preparer's name
Reporting
Period:                               April, May, June                                            Date Submitted:
I.   STATISTICAL DATA
      A.     QUARTERLY STATISTICS
             1. New Participants
             2. Carry Overs
             3. Reporting Period Levels of Service                                                                              0

Total of Lines 1 and 2 must equal Line 3. All participants are considered new in the first quarter of the fiscal year.
     COUNT NEW PARTICIPANTS ONLY FOR SECTIONS B - F
      B.    Ethnic Breakdown
            Hispanic or Latino                                                  Not Hispanic or Latino
     B1.        Race

                                                                                                                                    Non-
                                              Hispanic Non-Hispanic                                                      Hispanic Hispanic
                White                                          Black/African American
                Asian                                          Asian & White
                American Indian/Alaskan Native
                Native Hawaiian/Other Pacific Islander
                American Indian/Alaskan Native & White
                Black/African American & White
                Am. Indian/Alaskan Native & Black/African American
                Asian/Pacific Islander
                Other Multi-Racial
      C.        Gender Identification:                                 Female                                   Male
      D.        Number of Female Heads of Household:
      E.        Number of Handicapped Persons Served:
      F.        Number of Homeless Persons Served:
      G.        Number of low moderate income persons served
                (51 - 80% of median family income)
                Number of low-income persons served
                (31 - 50% of median family income)
                Number of very low-income persons served
                (30 - 0% of median family income)
                Over 80% of family median income


All clients who are served in the First Quarter are considered NEW regardless of previous participation. Only those clients that were not reported in the First
Quarterly Report are considered new in the remaining reports.

                      B. Ethnic Breakdown                                         B1. Race (Hispanic)                         B1. Race (Non-Hispanic)


                     C. Gender Identification                                                        G. Family Median Income
II. eLogic Model
Please use this page to report how services provided are impacting your clients. Goals must coincide with the goals your agency has identified
in the subgrantee agreement.


  Problem,
                     Services or
    Need,                                            Measure                  Outcome                        Measure             Evaluation Tools
                  Activities/Outputs
  Situation
      2                   3                             4                        5                              6                        7
   Planning          Programming        Projection    Actual    YTD            Impact           Projection    Actual   YTD          Accountability
      0                   0                            #N/A                       0                           #N/A
                                            0                    0                                  0                   0    A. Tools for Measurement

                          0                            #N/A                       0                           #N/A                         0

                                            0                    0                                  0                   0                  0
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                                            0                    0                                  0                   0                  0
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                                            0                    0                                  0                   0    B. Where Data Maintained
                          0                            #N/A                       0                           #N/A                         0
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                                            0                    0                                  0                   0                  0
      0                   0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    C. Source of Data
                          0                            #N/A                       0                           #N/A                         0
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                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    D. Frequency of Collection
                          0                            #N/A                       0                           #N/A                         0
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                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
      0                   0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    E. Processing of Data
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                          0                      #N/A       0       #N/A
                                             0          0       0          0



Please use additional sheets if necessary.
III. PROBLEMS (PLEASE EXPLAIN)




IV. PERSONNEL CHANGES

Please use this space to report any additions/terminations in personnel. (Be specific. List names, titles, and dates of change).




V. ADDITIONAL COMMENTS
                                                  CITY OF JERSEY CITY
                                         DIVISION OF COMMUNITY DEVELOPMENT
                                      COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG)
                                              QUARTERLY ACTIVITY REPORT
Agency:                                                               Your Agency
Program:                                                             Your Program
Director:                          Your Director                                       Report Preparer:            Preparer's name
Reporting
Period:                           July, August, September                                         Date Submitted:
I.   STATISTICAL DATA
      A.     QUARTERLY STATISTICS
             1. New Participants
             2. Carry Overs
             3. Reporting Period Levels of Service                                                                              0

Total of Lines 1 and 2 must equal Line 3. All participants are considered new in the first quarter of the fiscal year.
     COUNT NEW PARTICIPANTS ONLY FOR SECTIONS B - F
      B.    Ethnic Breakdown
            Hispanic or Latino                                                  Not Hispanic or Latino
     B1.        Race
                                                                                                                                    Non-
                                              Hispanic Non-Hispanic                                                      Hispanic Hispanic
                White                                          Black/African American
                Asian                                          Asian & White
                American Indian/Alaskan Native
                Native Hawaiian/Other Pacific Islander
                American Indian/Alaskan Native & White
                Black/African American & White
                Am. Indian/Alaskan Native & Black/African American
                Asian/Pacific Islander
                Other Multi-Racial
      C.        Gender Identification:                                 Female                                   Male
      D.        Number of Female Heads of Household:
      E.        Number of Handicapped Persons Served:
      F.        Number of Homeless Persons Served:
      G.        Number of low moderate income persons served
                (51 - 80% of median family income)
                Number of low-income persons served
                (31 - 50% of median family income)
                Number of very low-income persons served
                (30 - 0% of median family income)
                Over 80% of family median income


All clients who are served in the First Quarter are considered NEW regardless of previous participation. Only those clients that were not reported in the First
Quarterly Report are considered new in the remaining reports.

                      B. Ethnic Breakdown                                         B1. Race (Hispanic)                         B1. Race (Non-Hispanic)


                     C. Gender Identification                                                        G. Family Median Income
II. eLogic Model
Please use this page to report how services provided are impacting your clients. Goals must coincide with the goals your agency has identified
in the subgrantee agreement.

  Problem,
                     Services or
   Need,                                             Measure                  Outcome                        Measure             Evaluation Tools
                  Activities/Outputs
  Situation
      2                   3                             4                        5                              6                        7
   Planning          Programming        Projection    Actual    YTD            Impact           Projection    Actual   YTD          Accountability
      0                   0                            #N/A                       0                           #N/A
                                            0                    0                                  0                   0    A. Tools for Measurement
                          0                            #N/A                       0                           #N/A                         0

                                            0                    0                                  0                   0                  0
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                                            0                    0                                  0                   0    B. Where Data Maintained
                          0                            #N/A                       0                           #N/A                         0
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                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
      0                   0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    C. Source of Data

                          0                            #N/A                       0                           #N/A                         0
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                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    D. Frequency of Collection
                          0                            #N/A                       0                           #N/A                         0
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      0                   0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    E. Processing of Data

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                          0                      #N/A       0       #N/A
                                             0          0       0          0


Please use additional sheets if necessary.
III. PROBLEMS (PLEASE EXPLAIN)




IV. PERSONNEL CHANGES

Please use this space to report any additions/terminations in personnel. (Be specific. List names, titles, and dates of change).




V. ADDITIONAL COMMENTS
                                                    CITY OF JERSEY CITY
                                           DIVISION OF COMMUNITY DEVELOPMENT
                                        COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG)
                                                QUARTERLY ACTIVITY REPORT
Agency:                                                                 Your Agency
Program:                                                               Your Program
Director:                          Your Director                                       Report Preparer:              Preparer's name
Reporting
Period:                       October, November, December                                         Date Submitted:
I.   STATISTICAL DATA
      A.     QUARTERLY STATISTICS
             1. New Participants
             2. Carry Overs
             3. Reporting Period Levels of Service                                                                                0

Total of Lines 1 and 2 must equal Line 3. All participants are considered new in the first quarter of the fiscal year.
     COUNT NEW PARTICIPANTS ONLY FOR SECTIONS B - F
      B.    Ethnic Breakdown
            Hispanic or Latino                                                  Not Hispanic or Latino
     B1.        Race
                                              Hispanic Non-Hispanic                                                      Hispanic Non-Hispanic
                White                                          Black/African American
                Asian                                          Asian & White
                American Indian/Alaskan Native
                Native Hawaiian/Other Pacific Islander
                American Indian/Alaskan Native & White
                Black/African American & White
                Am. Indian/Alaskan Native & Black/African American
                Asian/Pacific Islander
                Other Multi-Racial
      C.        Gender Identification:                                 Female                                   Male
      D.        Number of Female Heads of Household:
      E.        Number of Handicapped Persons Served:
      F.        Number of Homeless Persons Served:
      G.        Number of low moderate income persons served
                (51 - 80% of median family income)
                Number of low-income persons served
                (31 - 50% of median family income)
                Number of very low-income persons served
                (30 - 0% of median family income)
                Over 80% of family median income


All clients who are served in the First Quarter are considered NEW regardless of previous participation. Only those clients that were not reported in the First
Quarterly Report are considered new in the remaining reports.

                      B. Ethnic Breakdown                                         B1. Race (Hispanic)                           B1. Race (Non-Hispanic)


                     C. Gender Identification                                                          G. Family Median Income
II. ACCOMPLISHMENTS
Please use this page to report how services provided are impacting your clients. Goals must coincide with the goals your agency has identified in
the subgrantee agreement.

  Problem,
                     Services or
    Need,                                            Measure                  Outcome                        Measure             Evaluation Tools
                  Activities/Outputs
  Situation
      2                   3                             4                         5                             6                        7
   Planning          Programming        Projection    Actual    YTD             Impact          Projection   Actual    YTD          Accountability
      0                   0                            #N/A                       0                            #N/A
                                            0                    0                                  0                   0    A. Tools for Measurement
                          0                            #N/A                       0                            #N/A                        0

                                            0                    0                                  0                   0                  0
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                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0    B. Where Data Maintained
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0                  0
      0                   0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0    C. Source of Data
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0    D. Frequency of Collection
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0                  0
      0                   0                            #N/A                       0                            #N/A                        0
                                            0                    0                                  0                   0    E. Processing of Data
                          0                            #N/A                       0                            #N/A                        0
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      0                   0                      #N/A       0       #N/A
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                                             0          0       0          0
                          0                      #N/A       0       #N/A
                                             0          0       0          0


Please use additional sheets if necessary.
III. PROBLEMS (PLEASE EXPLAIN)




IV. PERSONNEL CHANGES

Please use this space to report any additions/terminations in personnel. (Be specific. List names, titles, and dates of change).




V. ADDITIONAL COMMENTS
                                                    CITY OF JERSEY CITY
                                           DIVISION OF COMMUNITY DEVELOPMENT
                                        COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG)
                                                QUARTERLY ACTIVITY REPORT
Agency:                                                                 Your Agency
Program:                                                               Your Program
Director:                          Your Director                                       Report Preparer:             Preparer's name
Reporting
Period:                          January, February, March                                         Date Submitted:
I.   STATISTICAL DATA
      A.     QUARTERLY STATISTICS
             1. New Participants
             2. Carry Overs
             3. Reporting Period Levels of Service                                                                                0

Total of Lines 1 and 2 must equal Line 3. All participants are considered new in the first quarter of the fiscal year.
     COUNT NEW PARTICIPANTS ONLY FOR SECTIONS B - F
      B.    Ethnic Breakdown
            Hispanic or Latino                                                  Not Hispanic or Latino
     B1.        Race
                                              Hispanic Non-Hispanic                                                      Hispanic Non-Hispanic
                White                                          Black/African American
                Asian                                          Asian & White
                American Indian/Alaskan Native
                Native Hawaiian/Other Pacific Islander
                American Indian/Alaskan Native & White
                Black/African American & White
                Am. Indian/Alaskan Native & Black/African American
                Asian/Pacific Islander
                Other Multi-Racial
      C.        Gender Identification:                                 Female                                   Male
      D.        Number of Female Heads of Household:
      E.        Number of Handicapped Persons Served:
      F.        Number of Homeless Persons Served:
      G.        Number of low moderate income persons served
                (51 - 80% of median family income)
                Number of low-income persons served
                (31 - 50% of median family income)
                Number of very low-income persons served
                (30 - 0% of median family income)
                Over 80% of family median income


All clients who are served in the First Quarter are considered NEW regardless of previous participation. Only those clients that were not reported in the First
Quarterly Report are considered new in the remaining reports.

                      B. Ethnic Breakdown                                         B1. Race (Hispanic)                           B1. Race (Non-Hispanic)


                     C. Gender Identification                                                          G. Family Median Income
II. ACCOMPLISHMENTS
Please use this page to report how services provided are impacting your clients. Goals must coincide with the goals your agency has identified in
the subgrantee agreement.

  Problem,
                     Services or
    Need,                                            Measure                  Outcome                        Measure             Evaluation Tools
                  Activities/Outputs
  Situation
      2                   3                             4                         5                             6                        7
   Planning          Programming        Projection    Actual    YTD             Impact          Projection   Actual    YTD          Accountability
      0                   0                            #N/A                       0                           #N/A
                                            0                    0                                  0                   0    A. Tools for Measurement
                          0                            #N/A                       0                           #N/A                         0

                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    B. Where Data Maintained
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
      0                   0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    C. Source of Data
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    D. Frequency of Collection
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
      0                   0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0    E. Processing of Data
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                                            0                    0                                  0                   0                  0
                          0                            #N/A                       0                           #N/A                         0
                          0                                 0
                                             0          0       0          0   0
                          0                      #N/A       0       #N/A       0
                                             0          0       0          0   0
                          0                      #N/A       0       #N/A       0
                                             0          0       0          0   0
      0                   0                      #N/A       0       #N/A
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      0                   0                      #N/A       0       #N/A
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                          0                      #N/A       0       #N/A
                                             0          0       0          0
                          0                      #N/A       0       #N/A
                                             0          0       0          0


Please use additional sheets if necessary.
III. PROBLEMS (PLEASE EXPLAIN)




IV. PERSONNEL CHANGES

Please use this space to report any additions/terminations in personnel. (Be specific. List   names, titles, and dates of change).




V. ADDITIONAL COMMENTS
                       Goals
                       Goals
Assist formerly incarcerated persons to successfully
reintegrate back into society
Assist TANF clients to become self-sufficient
Facilitate integration of immigrants
Improve employment opportunities for the Working
Poor, Chronically Unemployed and Underemployed
       Improve quality of life for Disabled Persons
        Improve quality of life for Senior Citizens
          Provide structured activities for Youth
                    CAMP e Logic Model™
                             Column 2
                       PROBLEM, NEEDS, SITUATION
Older adult and persons with disabilities are unable to perform
activities of daily living without supportive services
Older adults and persons with disabilities are at risk of
institutionalization without supportive services
Older adults and persons with disabilities are unable to participate in
community activities without support
                                                  Click here to allow
                                                   deletion of 'New'
                        CAMP e Logic Model™            Activities

                   Column 3
          SERVICES OR ACTIVITIES/OUTPUTS                UNITS
Adult Day Care-Attendant care provided            Persons
Adult Day Care-Persons                            Persons
Basic Necessities-Chore services                  Persons
Basic Necessities-Homemaker services              Persons
Basic Necessities-Older adults and persons with   Persons
disabilities care for friend
Basic Necessities-Older adults and persons with   Persons
disabilities care for spouse
Basic Necessities-Older adults and persons with   Persons
disabilities assume the role of legal guardian
Basic Necessities-Older adults and persons with   Persons
disabilities assume the role of parent
Basic Necessities-Older adults and persons with   Persons
disabilities care for children
Basic Necessities-Older adults and persons with   Persons
disabilities assume the role of grandparent
Behavioral Health-Group counseling                Persons
Behavioral Health-Group therapy                   Persons
Behavioral Health-Individual counseling           Persons
Behavioral Health-Individual therapy              Persons
Employment-Placed into volunteer position(s)      Persons
Employment-Recruited into volunteer program(s)    Persons
Food and Nutrition-Congregate meals               Persons
Food and Nutrition-Meals on Wheels                Persons
Health-AIDS prevention workshops                  Persons
Health-AIDS screenings                            Persons
Health-Exercise programs                          Persons
Health-Health screenings                          Persons
Health-Home health services                       Persons
Health-Recreation activities                      Persons
Health-STD education                              Persons
Health-STD screenings                             Persons
Health-STD Workshops                              Persons
Housing-Independent Living                        Persons
Housing-Independent Living-Support services       Persons
Housing-Senior citizen housing                    Persons
Recreation-Senior Center attendees                Persons
Training-Volunteer training                       Persons
Transportation-Shared ride services               Persons
Transportation-Para-transit services              Persons
 other                                            Other
                                                                                        Click here to allow
                                                                                         deletion of 'New'
                         CAMP e Logic Model™                                                Outcomes

                                   Column 5
           ACHIEVEMENT OUTCOMES GOALS AND INDICATORS                                         UNITS
Basic Needs-Children receive support from older adults or persons with disabilities    Persons

Basic Needs-Friends receive support from older adults or persons with disabilities     Persons

Basic Needs-Older adults remain active in their community through supportive           Persons
services
Basic Needs-Other adults receive support from older adults or persons with             Persons
disabilities
Basic Needs-Persons with disabilities avoid institutionalization through supportive    Persons
services
Basic Needs-Persons with disabilities maintain independent living independent for at   Persons
least 90 days
Basic Needs-Persons with disabilities remain active in their communities through       Persons
supportive services
Basic Needs-Spouses receive support from older adults or persons with disabilities     Persons

Employment-Employed as caregivers                                                      Persons
Employment-Employed in After School programs                                           Persons
Employment-Employed in Before School programs                                          Persons
Employment-Employed in community based organization                                    Persons
Employment-Employed in Head Start                                                      Persons
Employment-Employed in other setting                                                   Persons
Employment-Employed in Respite care                                                    Persons
Employment-Employed in subsidized program                                              Persons
Employment-Volunteer as Foster Grandparents                                            Persons
Employment-Volunteer in after school programs                                          Persons
Employment-Volunteer in before school programs                                         Persons
Employment-Volunteer in Childcare Centers                                              Persons
Employment-Volunteer in community group                                                Persons
Employment-Volunteer in Head Start                                                     Persons
Employment-Volunteer in Respite care                                                   Persons
Employment-Volunteer in RSVP                                                           Persons
Employment-Volunteer in Senior Companion program                                       Persons
Employment-Volunteer on government board or council                                    Persons
Employment-Volunteer to assist family member or friend                                 Persons
Health-Issues addressed or remediated as a result of health services/activities
Health-Reduction in doctor or medical visits                                           Persons
Health-Reduction in the use of psychotropic drugs                                      Persons
Housing-Older adults age in their own homes                                            Persons
Housing-Older adults avoid institutionalization through supportive services            Persons
Housing-Older adults maintain independent living                                       Persons
Housing-Older adults maintain independent living for at least 90 days through          Persons
supportive services
 other                                                                                 other
              CAMP eLogic Model™
A. Tools For Measurement
   Bank accounts
   Construction log
   Database
   Enforcement log
   Financial aid log
   Intake log
   Interviews
   Mgt. Info. System-automated
   Mgt. Info. System-manual
   Outcome scale(s)
   Phone log
   Plans
   Pre-post tests
   Post tests
   Program specific form(s)
   Questionnaire
   Recruitment log
   Survey
   Technical assistance log
   Time sheets
B. Where Data Maintained
   Agency database
   Centralized database
   Individual case records
   Local precinct
   Public database
   School
   Specialized database
   Tax Assessor database
   Training center
C. Source of Data
   Audit report
   Business licenses
   Certificate of Occupancy
   Code violation reports
   Counseling reports
   Employment records
   Engineering reports
   Environmental reports
   Escrow accounts
   Financial reports
   GED certification/diploma
   Health records
   HMIS
   Inspection results
   Lease agreements
   Legal documents
   Loan monitoring reports
   Mortgage documents
   Payment vouchers
   Permits issued
   Placements
   Progress reports
   Referrals
   Sale documents
   Site reports
   Statistics
   Tax assessments
   Testing results
   Waiting lists
   Work plan reports
D. Frequency of Collection
   Daily
   Weekly
   Monthly
   Quarterly
   Biannually
   Annually
   Upon incident
E. Processing of Data
   Computer spreadsheets
   Flat file database
   Manual tallies
   Relational database
   Statistical database

								
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