Central Alberta CFSA Family Wellness Worker Program
Quarterly Reporting FormatSeptember 1, 2014 – August 31, 2015
Name: ______
School Name: ______
Reporting Period:______
Number of FTE’s included in report: __21.94______# funded by CFSA______
A. Case Work: Provide caseload data for the quarter
Caseload Stats:
Age of client / # of open files on the 1st day of quarter / # of new files opened during the quarter / # of files closed in the quarter0 – years
7 – 18
Adults
Total
Open Files ____ + New Files _____ - Closed Files ______= _____ Caseload at end of quarter
Pre-Test Stats to be asked when files are opening
Record the scores for all new filesOn a scale of 1-6, I am good at handling whatever comes my way?
1------2------3------4------5------6
Strongly Disagree Somewhat Somewhat Agree Strongly
Disagree Disagree Agree Agree
Add up the number for the next pre-test question:
Are you feeling hopeful about managing your concern? / Yes ____
No ____
Maybe _____
What are you feeling hopeful about?
Post-Test Stats to be asked when files are closing
Record the scores for all new filesOn a scale of 1-6, I am good at handling whatever comes my way?
1------2------3------4------5------6
Strongly Disagree Somewhat Somewhat Agree Strongly
Disagree Disagree Agree Agree
Add up the number for the next pre-test question:
Are you feeling hopeful about managing your concern? / Yes ______
No ______
Maybe ______
Include 1 anecdotal answer for the last pre-test question:
What are you feeling hopeful about?
Number of Contacts: Walk-in/One time consult
Single Sessions
Age of client / # of clients0 – 6 years
7 – 18
Adults
Total
Quarterly Number of New Clients who live in town: _____ Year to date Total: _____
Quarterly Number of New Clients who live out of town: ______Year to date Total:_____
Quarterly Number of New Volunteers: ______Year to date Total:______
Quarterly Number of New Volunteer Hours: ______Year to date Total: ______
Major / common issues addressed during this quarter on entire caseload: (Focus on primary 2 issues per client)
Child / Parent / Child / ParentAbuse / Mental Illness
Academic performance / New Resident
Anger management / Parenting 0-6 years
Anxiety / stress management / Parenting issues/strategies
Bullying/Being bullied / Peer relations / social skills
Depression / Pregnancy / sexuality
Family / relationship violence / School attendance
Family / sibling conflict / School conflict
Financial stress / Self esteem
Grief and Loss / Self harm (cutting, eating issues)
Health Concerns (Physical) / Separation/divorce
Homelessness / Substance Abuse
Inappropriate Behavior / Suicide
Life skills / style / Other
Referrals: Please report on the number of referrals received by the program by source as well as what referrals were made by the program to other agencies / programs.
Agency / # of referrals to FWW program / # of referrals by FWW programCFSA
School
Parent
Self
Community Agency (e.g. food bank, employment centre, shelter)
Alberta Health Services (e.g. physician, Mental Health & Addictions)
Preventative Programs (e.g. FCSS, Parent Link, healthy Families, etc.)
Other (e.g. for profit supports such as private therapist)
TOTAL
B. Community Work
Preventative Education Presentations / Seminars / Workshops / Groups
Session name / Descriptor – describe program including target audience / # of ParticipantsCARSTAIRS
CREMONA
DIDSBURY
OLDS
SUNDRE
MOUNTAIN VIEW COUNTY TOTAL
BOWDEN
INNISFAIL
PENHOLD
SPRUCE VIEW
ELNORA
DELBURNE
SYLVAN LAKE
RED DEER COUNTY (BENALTO, RIVER GLEN, ETC.)
RED DEER COUNTY TOTALS
PROGRAM TOTALS
C. Networking/ Collaborative activities
Event / meeting name / Descriptor – briefly describe (e.g. other organizations involved, number of times attended/quarter)D. Staff Training / Professional Development
Session name / Descriptor / # ofFSW Staff Participated
E. Outcomes
1st Quarter – Sept. 1 – Nov. 30 – Innisfail Team
2nd Quarter – Dec. 1 – Feb 29 – Carstairs Didsbury Team
3rd Quarter – March 1 – May 31 – Sylvan Lake Team
4th Quarter – June 1 – August 31 – Olds Team
Outcome / Performance Measures / Target / Actual numbers (raw data) / Actual %’sChildren, youth and families will be empowered and have improved levels of functioning. / Clients have achieved one or more of their goals identified in their case / service plan. (Innisfail & Sylvan Lake)
Or
Parents report that the services have improved their child’s ability to be successful. (Carstairs/Didsbury & Olds/Sundre) / 90%
80%
Children, youth and families are supported to live successfully in their community. / Number of referrals made to other community supports / services
and ALL TEAMS DO BOTH
Clients report that they are more knowledgeable about supports and services in their community through their involvement in the FWW program. / Baseline #’s
80%
Programs will have improved relationships with other community partners and service providers to facilitate improved collaboration when meeting client needs. / Feedback / evaluations from community agencies report a positive working relationship with the program.(Innisfail & Sylvan Lake)
Or
Clients that were involved with multiple service providers in the course of their involvement with the FWW program, (ie case conference, transfer to another service provider etc.) report that their worker played a supportive role in coordinating the delivery of those services. (Carstairs/Didsbury & Olds/Sundre) / 80%
80%
E. Other
Please provide any comments or anecdotal notes that you feel CFSA should be aware of.
ie. program highlights, challenges, staff absences, etc