CALIFORNIA OFFICE OF EMERGENCY SERVICES (Cal OES)

UNDERSERVED VICTIMS UNIT, Attn: Danielle Nieto OR Valerie Espinosa

3650 SCHRIEVER AVENUE

MATHER, CA 95655

(916) 845-8878

AMERICAN INDIAN CHILD ABUSE TREATMENT (NA) PROGRAM

PROGRESS REPORT

Please provide the information as indicated. Leave no section(s) blank. This form may NOT be modified or altered. All reports must be received by Cal OES no later than 30 calendar days after the end of the reporting period. SUBMIT THE REPORT TO THE ABOVE ADDRESS.

1] / Project Title / American Indian Child Abuse Treatment Program (NA) / 2] / Grant Award # / NA16
3] / Recipient / 4] / Grant Period / 10/01/2016-09/30/2017
5] / Address (include zip code) / 6] / Report Period
7] / Report prepared by / 8] / Title
9] / Telephone Number / 10] / Email Address

PROGRESS REPORT

1st Progress Report: First 6 months of the grant period (10/1/16 - 3/31/17) Due April 28, 2017

2nd Progress Report: Entire 12 months of the grant period (10/1/16 - 9/30/17) Due October 31, 2017

Other Progress Report: ______

BUDGET

1. / Total grant award and match: / $
2. / Total funds expended to date: / $
3. / Funds encumbered but not paid for: / $
4. / Total grant balance: / $
5. / Report of expenditures submitted through (month/year):

YES NO Are grant funds being expended in accordance with the Grant Award Agreement?

If no, explain in the narrative section of this report.

I CERTIFY THAT THIS REPORT IS ACCURATE AND IN ACCORDANCE WITH THE CALIFORNIA OFFICE OF EMERGENCY SERVICES POLICIES AND PROCEDURES.

Signature - Project Director Title Date

REVIEWERS COMMENTS (For Cal OES use only) Approved Not Approved

______

Program Specialist Date

A. PERSONNEL

Positions Authorized in the Grant Award Agreement

Name of Staff / Position / Duties / % Grant Funded
1.
2.
3.
4.
5.

YES NO Have project personnel been hired in a timely manner?

If NO, please explain below.

YES NO Have any of the job duties, as detailed in the Grant Award Agreement changed?

If YES, please explain below.

YES NO Are there any personnel issues which may affect the project objectives and activities? If YES, please explain below.

YES NO Does the project need technical assistance? If YES, describe below.

B. EQUIPMENT

YES NO If the Grant Award Agreement allows for equipment purchases, has any equipment been purchased? If YES, please detail below:

Equipment Cost Date Ordered/ Assigned I.D. #

Received

1.

2.

3.

If the equipment list exceeds the space above, please attach a separate sheet to this report. Provide detail of any problems encountered in ordering/receiving grant equipment.
C. OBJECTIVES

Complete the below table with your actual reported numbers per quarter. Please make sure that you also include the total-to-date.

Objectives / 10/1/16-12/31/16 / 1/1/17-3/31/17 / 4/1/17-6/30/17 / 7/1/17-9/30/17
1st Qtr / 2nd Qtr / 3rd Qtr / 4th Qtr / Total
to Date
Number of Victims Served / / / / / / / / / /
Number of Clinical of culturally-centered therapeutic services provided / / / / / / / / / /
Number of Victims assisted in filing crime victim compensation claims
Number of Victims provided Criminal Justice advocacy and support while involved in the criminal justice system
Volunteers used in the program

D. ADDITIONAL OBJECTIVES

Additional objectives are not required; however, additional services may be provided which could include counseling, assistance with restraining orders, emergency transportation, and/or other grant appropriate activities.

Were any additional services provided to victims? If so, please enter the unduplicated information below.

10/1/16-12/31/16 / 1/1/17-3/31/17 / 4/1/17-6/30/17 / 7/1/17-9/30/17
ADDITIONAL OBJECTIVE 1 / 1st Qtr / 2nd Qtr / 3rd Qtr / 4th Qtr / Total
to Date
*ENTER additional services here*

E. NARRATIVE

SIX-MONTH PROJECT SUMMARY

It is imperative you submit this report by April 28th.

In a narrative form, thoroughly address the following items. Please Note: Include the bolded questions when responding to these questions.

1.  Describe difficulties experienced in the implementation of the Grant Subaward (i.e., problems encountered in ordering/receiving grant equipment, activities, and staffing issues supporting each objective which are not currently operational or in place).

2.  Describe the project's source documentation designed to track the project's statistical information (e.g., intake and client contact sheets, telephone logs, assessment and treatment plans, progress notes, type of database used, as well as who (position) enters/tracks project’s statistical data information, etc.).

3.  Identify areas in need of modification (e.g., budget changes due to staff changes, equipment changes, or revisions to program objectives).

4.  If there were problems or delays during the first six months of the grant year, please explain. How have these problems been resolved? What is the current status of the project?

5.  Are the objectives being met according to schedule? Please summarize successes and obstacles.

6.  Briefly elaborate in one or two paragraphs what the project would like to detail about its AI CHAT Program services (i.e., current trends/events happening in your community and how your agency is responding to the trends/events, e.g., Child Abuse Prevention Month events/activities, etc.)

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