PERFORMANCE PROGRESS REPORT
Strengthening Communities Fund, Nonprofit Capacity Building Program
Administration for Children and Families, Office of Community Services
U.S. Department of Health and Human Services
Page
|
of
|
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS Number
3b. EIN
|
|||
4. Recipient Organization (Name and complete address including zip code)
|
5. Recipient Identifying Number or Account Number
|
||||
6. Project/Grant Period |
7. Reporting Period End Date |
8. Final Report? Yes No |
|||
Start Date: (Month, Day, Year)
|
End Date: (Month, Day, Year)
|
(Month, Day, Year)
|
9. Report Frequency |
||
annual semi-annual quarterly other (If other, describe: __________ ________________________) |
|||||
10. Performance Narrative
|
|||||
11. Other Attachments
|
|||||
12. Certification: I certify to the best of my knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents. |
|||||
12a. Typed or Printed Name and Title of Authorized Certifying Official
, |
12c. Telephone (area code, number and extension)
|
||||
|
12d. Email Address
|
||||
12b. Signature of Authorized Certifying Official
|
12e. Date Report Submitted (Month, Day, Year)
|
||||
|
13. Agency use only
|
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)
Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
NOTE ON SECURITY SETTING (MACROS) FOR THIS FORM
To add rows in this form set your security level for Macros to Medium or Low. (Tools>Macros>Security for Word 2003 users). Field level instructions may be accessed by clicking F1 on any field.
Cover Page Instructions
Federal Agency and Organization Element to Which Report is Submitted: This form has been populated with the acronyms of the following Federal agency and organizational elements: the Office of Community Services (OCS), Administration for Children and Families (ACF), Department of Health and Human Services (DHHS). You may not change this field.
Federal Grant or Other Identifying Number Assigned by Federal Agency: Enter the grant/award number contained in the award document. This number is found in box 3 of ACF’s “Federal Financial Assistance Award” form.
DUNS: Enter the recipient organization’s Data Universal Numbering System (DUNS) number. This unique identifier is assigned by Dun & Bradstreet and was required for your grant application. You can search for your DUNS number at this website: http://fedgov.dnb.com/webform/displayHomePage.do.
EIN: Enter your Employer Identification Number as assigned by the Internal Revenue Service.
Recipient Organization: Enter the complete legal name and address (including zip code) of the recipient organization.
Recipient Identifying Number or Account Number: Enter the account number or any other identifying number assigned by the recipient to the award. This number is for the recipient's use only and is not required.
Project/Grant Period: Indicate the project period established in the award document during which Federal sponsorship begins and ends. See box 9 of the Financial Assistance Award for this grant.
Reporting Period End Date: Enter the ending date of the reporting period. For quarterly progress reports, the following calendar quarter reporting period end dates shall be used: 3/31, 6/30, 9/30, and 12/31. For final PPRs, the reporting period end date shall be the end date of the project period.
Final Report?: Select Yes or No. Note: The final report is due 90 days after the end of the entire project/grant period. In some cases, the final report may simply finalize information provided in the previous semiannual report.
Report Frequency: The Strengthening Communities Fund requires reporting on a semiannual basis, so the box “semiannual” has already been completed on this form.
Performance Narrative: Provide any significant stories or findings concerning the impact of your project on benefiting organizations, including outcomes where the level of achievement was beyond what was expected. If the narrative exceeds 1500 characters, attach additional pages.
Other Attachments:
Budget Progress Attachment - Provide a report on the progress of spending in each budget category from your most recent Financial Assistance Award (FAA). This attachment supplements, but does not replace, the SF-269 Financial Status Report, also due semiannually. See additional instructions under “Financial Status Attachment” below.
Training and Technical Assistance Attachment - Attach information about technical assistance and/or training engagements lasting an hour or longer during the budget period. See additional instructions under “Training and Technical Assistance Attachment” below.
Certification: The signature of the Authorizing Official is required to certify the accuracy of the performance reports. The Authorizing Official is listed beneath the organization address in box 11 of the Financial Assistance Award letter.
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS Number
3b. EIN
|
4. Reporting Period End Date (Month, Day, Year)
|
||
A. Grantee and Subrecipient Information |
|||||
(1) Label |
(2) Additional Information on Grantee or Grant Project |
(3) Provide Grantee or Grant Project information requested: |
|||
Grantee |
Contact Person, Email Address, & Telephone |
a) name: b) email address: c) telephone: |
|||
Grantee |
Organization Profile |
a) organization type: b) number of paid full-time equivalents: c) annual operating budget: d) previous Federal funding history: |
|||
Grant Project
|
Social Service Priorities |
Comment: |
|||
Grant Project
|
Geographic Scope |
State:
Comment: |
|||
Grant Project
|
Relationship to other Federal Initiatives |
Weed and Seed: TANF: VISTA: Other:
Description of relationship: |
|||
|
|
|
|||
Subrecipient 1 |
Organization Name and Complete Address |
, |
|||
Subrecipient 1 |
Contact Person, Email Address, & Telephone |
a) name: b) email address: c) telephone: |
|||
Subrecipient 1 |
Organization Profile |
a) organization type: b) number of paid full-time equivalents: c) annual operating budget: d) previous Federal funding history: |
|||
Subrecipient 1
|
Description of Programs Benefiting from SCF |
Other: |
|||
Subrecipient 1
|
Geographic Scope |
State: |
|||
Subrecipient 1
|
Relationship to other Federal Initiatives |
Weed and Seed: TANF: VISTA: Other:
Description of relationship: |
|||
Subrecipient 1
|
Start and end date of award |
|
|||
Subrecipient 1 |
Organization Name & Complete Address |
, |
|||
Subrecipient 2 |
Contact Person, Email Address, & Telephone |
a) name: b) email address: c) telephone: |
|||
Subrecipient 2 |
Organization Profile |
a) organization type: b) number of paid full-time equivalents: c) annual operating budget: d) previous Federal funding history: |
|||
Subrecipient 2
|
Description of Programs Benefiting from SCF |
Other: |
|||
Subrecipient 2
|
Geographic Scope |
State: |
|||
Subrecipient 2
|
Relationship to other Federal Initiatives |
Weed and Seed: TANF: VISTA: Other: Description of relationship: |
|||
Subrecipient 2
|
Start and end date of award |
|
|||
|
|
|
|||
Subrecipient 3 |
Organization Name & Complete Address |
, |
|||
Subrecipient 3 |
Contact Person, Email Address, & Telephone |
a) name: b) email address: c) telephone: |
|||
Subrecipient 3 |
Organization Profile |
a) organization type: b) number of paid full-time equivalents: c) annual operating budget: d) previous Federal funding history: |
|||
Subrecipient 3
|
Description of Programs Benefiting from SCF |
Other: |
|||
Subrecipient 3
|
Geographic Scope |
State: |
|||
Subrecipient 3
|
Relationship to other Federal Initiatives |
Weed and Seed: TANF: VISTA: Other: Description of relationship: |
|||
Subrecipient 3
|
Start and end date of award |
|
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS
3b. EIN
|
4. Reporting Period End Date (Month, Day, Year)
|
|||||||
B. Capacity-Building Services Provided Through SCF |
||||||||||
(1) Label |
(2) Objective/Goal Description |
(3) Measure |
(4) Base line |
(5) Target Year |
(6) Project Target |
(7) Actual To Date |
(8) Explanation |
|||
Output Measure |
Provide technical assistance |
Number of hours provided |
N/A |
2011 |
FORMTEXT |
|
since last report |
|||
Output Measure |
Provide technical assistance |
Number of organizations assisted |
N/A |
2011 |
|
|
since last report |
|||
Output Measure |
Provide training |
Number of hours provided |
N/A |
2011 |
|
|
since last report |
|||
Output Measure |
Provide training |
Number of organizations assisted |
N/A |
2011 |
|
|
since last report |
|||
Output Measure |
Provide financial assistance |
Amount of financial assistance provided |
N/A |
2011 |
$ |
$ |
$ since last report % of total award |
|||
Output Measure |
Provide financial assistance |
Number of organizations assisted |
N/A |
2011 |
|
|
since last report |
This section of the form collects information about the capacity-building services provided through the project. These services may be:
Technical assistance: long-term and ongoing one-on-one consultation that is specifically customized or tailored to needs of its recipients.
Training: group-based adult education or skill-building activities (such as workshops).
Financial assistance: SCF funds provided to subrecipients to implement SCF-approved capacity-building activities.
Provide technical assistance (Number of hours provided)
Project Target: Enter the number of hours of technical assistance to be provided by the end of the project according to the approved work plan.
Actual This Period: Enter the total number of hours of technical assistance provided through the end of the reporting period.
Provide technical assistance (Number of organizations assisted)
Project Target: Enter the number of organizations to be assisted by the end of the project according to the approved work plan.
Actual To Date: Enter the total number of organizations that the project has assisted through the end of the reporting period. Count each organization only once.
Provide training (Number of hours provided)
Project Target: Enter the number of hours of training to be provided by the end of the project according to the approved work plan.
Actual To Date: Enter the total number of hours of training that the project has supported through the end of the reporting period. Do not multiply the length of a training event by the number of attendees.
Provide training (Number of organizations assisted)
Project Target: Enter the number of organizations to be trained by the end of the project according to the approved work plan.
Actual To Date: Enter the total number of organizations trained through the end of the reporting period. Count each organization only once.
Provide financial assistance (Amount of financial assistance)
Project Target: Enter the amount of financial assistance to be provided to subrecipient organizations to help them build organizational capacity according to the approved work plan.
Actual To Date: Enter the amount of financial assistance delivered through the end of the reporting period..
Provide financial assistance (Number of organizations)
Project Target: Enter the number of organizations to be assisted financially by the end of the project according to the approved work plan.
Actual To Date: Enter the total number of organizations that your organization assisted financially through the end of the reporting period.
Explanation (8)
You may provide an explanation of your accomplishments, or the variance between your target and actual accomplishments for this reporting period, in this column.
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS
3b. EIN
|
4. Reporting Period End Date (Month, Day, Year)
|
|||
C. Project Milestones |
||||||
(1) Activity Label |
(2) Activity Description |
(3) Status |
(4) Explanation |
|||
Work plan development and approval |
|
|
|
|||
Outreach |
|
|
|
|||
Request for Applications |
|
|
|
|||
Training |
|
|
|
|||
Technical Assistance |
|
|
|
|||
Subaward Agreements Signed |
|
|
|
|||
Outcome Measurement Plan |
|
|
|
|||
Subaward Data Collection |
|
|
|
|||
Enter additional milestone here |
|
|
|
This section of the form collects information about your project’s progress toward significant project milestones. A list of standard activities appears in the first column. You may add any number of your organization’s other SCF-related activities to the bottom of the list by clicking the “Add Row” button.
Activity Description (2)
Enter a description of each of the activities that your organization has engaged in during the reporting period. These activities are the major milestones in your proposed SCF project.
Status (3)
Enter the status for each activity by entering the date that each activity was accomplished or will be accomplished.
Explanation (4)
You may provide an explanation of your organization’s activities in this column.
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS
3b. EIN
|
4. Reporting Period End Date (Month, Day, Year)
|
|||
D. Capacity-Building Financial Assistance to Subrecipients |
||||||
(1) Benefiting Organization |
(2) Description of budgeted expenditures |
(3) Total Estimated Expenditures
|
(4) Funding Expended |
|||
|
|
$ |
$ |
|||
|
|
$ |
$ |
|||
|
|
$ |
$ |
|||
|
|
$ |
$ |
|||
TOTAL |
|
$ |
$ |
This section of the form collects information on financial assistance to subrecipients.
Benefiting Organization (1)
Enter each of the subrecipient organization names listed in Section A, one benefiting organization in each row.
Description of budgeted expenditures (2)
Describe each planned expenditure, and itemize its anticipated cost. For example, “Staff time: $220, Office supplies: $32, Computer printer: $148.”
Total Estimated Expenditures (3)
Enter the total amount of financial assistance budgeted for this subrecipient.
Total Funding Expended (4)
Enter the total amount expended through the end of the reporting period for this subrecipient.
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS
3b. EIN
|
4. Reporting Period End Date (Month, Day, Year)
|
|||
E. Concerns/Problems - ongoing / since last report |
||||||
(1) Label |
(2) Activity Description |
(3) Deviation, Lesson, or Concern? |
(4) Explanation |
|||
Assessment |
|
|
|
|||
Training |
|
|
|
|||
Technical Assistance |
|
|
|
|||
Financial Assistance |
|
|
|
|||
Grant Management |
|
|
|
|||
Use of Technology |
|
|
|
|||
Other |
|
|
|
This section of the form collects information about challenges your project may face. Identify each challenge as a deviation, lesson, or concern.
Deviation refers to any change from your approved project plan.
Lesson refers practical knowledge gained when implementing a practice that did not go well.
Concern refers to an ongoing situation that may affect project performance.
Deviation, Lesson, or Concern (3)
For each of the activities listed in the first column, identify your concern or problem as a deviation, lesson, or concern by making a selection from the list. If there is nothing to report in this area, select “None.”
Explanation (4)
Enter a brief description for each concern or problem. For deviations, please indicate whether you have discussed the deviation with your program specialist.
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS
3b. EIN
|
4. Reporting Period End Date (Month, Day, Year)
|
|||
F. Promising Practices |
||||||
(1) Label |
(2) Activity Description |
(3) Indicator |
(4) Explanation |
|||
Assessment |
|
|
|
|||
Training |
|
|
|
|||
Technical Assistance |
|
|
|
|||
Financial Assistance |
|
|
|
|||
Grant Management |
|
|
|
|||
Use of Technology |
|
|
|
|||
Other |
|
|
|
This section of the form collects information about practices used to successfully implement your project. A promising practice is a program, activity, or strategy that has worked in an organization, which has an objective basis for claiming effectiveness, as well as the potential for replication.
Activity Description (2)
For each of the categories listed in the first column, describe any practices that have worked well for your project.
Indicator (3)
Briefly describe what indicates that this practice is successful.
1.Federal Agency and Organization Element to Which Report is Submitted
OCS/ACF/DHHS |
2. Federal Grant or Other Identifying Number Assigned by Federal Agency
|
3a. DUNS
3b. EIN
|
4. Reporting Period End Date (Month, Day, Year)
|
|||||
G. Capacity-Building Activities Completed and Outcomes |
||||||||
(1) Benefiting Organization |
(2) Activities Completed |
(3.1) Increase in persons served |
(3.2) Expansion of service |
(3.3) Improved success rate |
(3.4) Interagency Collaboration |
|||
|
|
|
:
|
|
:
|
|||
|
|
|
:
|
|
:
|
|||
|
|
|
:
|
|
:
|
This section of the form collects information on the completion of standard capacity building activities by the grantee or organizations receiving more than ten hours of training and technical assistance. It also collects information on the outcomes resulting from those capacity building activities.
Benefiting Organization (1)
In the first column enter the name of the grantee or organization receiving more than ten hours of training and technical assistance through the project. Click the “Add Row” button to add additional rows.
Activities Completed (2)
For each benefiting organization, enter the SCF-supported capacity-building activities completed during the project period by selecting them from the list.
Leadership Development
Create a volunteer management plan
Create a volunteer recruitment plan
Create board policies
Create an executive succession plan
Engage an executive coach
Implement a volunteer management plan
Provide management/leadership training to staff
Provide training/written information for board of directors
Recruit board members
Recruit volunteers (non-board)
Organizational Development
Create a staff performance review process
Create a strategic plan
Create financial management procedures/improve internal controls
Create job descriptions
Create marketing materials
Create/revise organizational identity
Create/update an annual report
Implement a new accounting system
Implement a new budgeting process
Implement a staff performance review process
Implement new financial management procedures
Incorporate as a legally recognized organization
Install IT infrastructure
Obtain 501(c)(3) status with the IRS
Create a revenue development plan
Identify potential funding sources
Implement donor tracking software
Provide revenue development training to staff
Program Development
Obtain program-related equipment and durable supplies
Research and develop new programs or services
Take steps to expand current services to new geographic area
Take steps to increase the effectiveness of existing services
Take steps to increase the number of clients served in existing geographic area
Take steps to increase the number or scope of services
Take steps to reach an underserved population in existing geographic area
Collaboration and Community Engagement
Assess effectiveness of existing collaborative efforts
Conduct assessment of community needs
Create a map/inventory of community assets
Create action plan for coordinating/collaborating
Create or update a brochure
Create or update a website
Create processes for collaborating with partners
Develop new strategic partnerships
Establish partnership agreements
Make presentations to community groups
Evaluation of Effectiveness
Implement systems to keep information related to client needs, referral sources, and services provided
Implement systems to keep records on service recipient satisfaction and/or service recipient outcomes
Collect information related to service recipient outcomes
Collect information related to service recipient satisfaction
Analyze outcome data/evaluate effectiveness of current services
Create an outcome measurement plan
Increase in persons served (3.1)
Enter the increased number of clients served by the benefiting organization. This increase may be based on an average number of clients served during a relevant period (daily, weekly, monthly, or quarterly) or on the total number served during a particular year.
Expansion of service (3.2)
If the benefiting organization has expanded its services, indicate the type of expansion by making a selection from the list. Enter a brief description (one or two sentences).
Improved success rate (3.3)
Enter a brief description (one or two sentences) of the benefiting organization’s improved success rates in achieving desired social service outcomes. If you have more information, you may include it in your Performance Narrative (entered in section 10 of the Cover Page).
Interagency Collaboration (3.4)
If the benefiting organization has contributed staff time, money, or volunteers to an inter-organizational effort, you should indicate the results of the collaboration by making a selection from the list. Enter a brief description (one or two sentences). The organization’s participation in the collaborative effort must be attributable to the SCF project, and efforts that would have occurred in the SCF project’s absence should not be reported.
Training and Technical Assistance Attachment
Grant Number:
Organization Name:
Reporting Period End Date:
Attach information about technical assistance and/or training engagements lasting an hour or longer during the budget period. The attachment should include dates of engagements, location, the type of organization(s) served, technical assistance or training methods used, and the capacity building needs identified or addressed. It should also provide the name of the organization assisted (if technical assistance), or the number of organizations attending (if training).
Any format is allowable. Below are instructions for this template.
TTA Method (1) - List technical assistance or training methods: needs assessment, one-on-one expert coaching, or training workshop
Date (2) - Provide the date of engagement
Location (3) - Provide the city and state
# of organizations (4) or name of organization assisted (5) – For training events, provide the number of organizations attending. If one-on-one assistance is provided, enter the name of organization assisted.
Type (6) - Indicate if the organization is faith-based charity (FBO), or secular non-profit (CBO), subrecipient or non-subrecipient
Training and Technical Assistance Engagements Table |
||||||
(1) TTA Method |
(2) Date |
(3) Location |
(4) # of FBCOs
|
(5) Name of organization assisted |
(6) Type
|
(7) Capacity building needs identified/ addressed |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
This table has seven columns and nine rows. The table should be read left to right, top to bottom. The second row is a header row reading “(1) TTA Method,” “(2) Date,” “(3) Location”, “(4) # of FBCOs,” “(5) Name of organization assisted,” “(6) Type,” and “(7) Capacity building needs identified/ addressed.” The remaining rows are left intentionally blank for user input.
Grant Number:
Organization Name:
Reporting Period End Date:
Federal Share - Indicate the progress of spending for the entire budget period in each budget category from your most recent Financial Assistance Award (FAA) letter, box 16. This approved budget may be different from the budget you submitted in your original application. Provide names of staff, contractors, and consultants where applicable.
Non-Federal Share (Cost sharing/match) - Provide the amount of spending on the total non-federal share of project budget, as documented in the grant application and subsequent continuation applications. The final progress report must substantiate the total non-federal match for the entire project. Failure to provide required match will result in the disallowance of Federal expenditures in proportion to the shortage of matching funds expended.
NOTE: Box 17 of the FAA reflects the minimum non-federal share for all program applicants. However, the grantee is responsible for the proposed applicant share, found on the Budget Information section of the Application for Federal Assistance, SF-424A.
SF-269 - The budget progress attachment supplements the SF-269. Be sure to also submit a complete, signed SF-269 Financial Status Report form.
Sample Table - The table below is a sample; you may provide the information in a spreadsheet or other file format. Be sure to indicate the grant number, organization name and reporting period.
Sample Budget Progress Table |
|||||
Budget Category |
Staff / Recipient Name |
Approved Budget (FAA) |
Amount Spent |
Under/Over Spending |
Approaches to Address Variations |
Personnel |
|
|
|
|
|
Fringe Benefits |
No Data Requested |
|
|
|
|
Travel |
No Data Requested |
|
|
|
|
Equipment |
No Data Requested |
|
|
|
|
Supplies |
No Data Requested
|
|
|
|
|
Contractual |
|
|
|
|
|
Other |
|
|
|
|
|
No Data Requested |
|
|
|
|
|
Total Federal Share |
|
|
|
|
|
Budget Period |
Staff / Recipient Name |
Proposed Cost Share (SF-424A) |
Amount Spent |
Under/Over Spending |
Approaches to Address Variations |
1 |
|
|
|
|
|
2 |
|
|
|
|
|
3 |
|
|
|
|
|
Total Non-Federal Share |
|
|
|
|
|
This table has five columns and twelve rows. The table should be read left to right, top to bottom. The first row is a header row that “Sample Financial Status Table.” The second row is also a header row with columns reading “Budget Category and Description,” “Staff/Recipient Name,” “Approved Budget (from FAA),” “Amount Spent,” “Under/Over Spending,” and “Approaches to Address Variations.” The first cell of each row in the Budget Category column contains a header. From top to bottom, they read “Personnel,” “Fringe Benefits,” “Travel,” “Equipment,” “Supplies,” “Contractual,” “Other,” “Indirect Costs,” “Non-Federal Share” and “Total Approved/Expended.” The remaining cells are left intentionally blank for user input.
ACF-OCS-SI SF-PPR-2 Cover Page OMB Control No. 0970-XXX
Expiration: 10/15/2010
File Type | application/msword |
File Title | Performance_Progress_Report_CEY |
Subject | Performance Progress Report CEY |
Author | CCF National Resource Center |
Last Modified By | Scott |
File Modified | 2010-04-06 |
File Created | 2010-04-06 |