Form 1122-0023 Semiannual Progress Report for the SASP Culturally Speci

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U.S. Department of Justice
Office on Violence Against Women
SEMI-ANNUAL PROGRESS REPORT FOR
SEXUAL ASSAULT SERVICES PROGRAM
GRANTS TO CULTURALLY SPECIFIC PROGRAMS
VIOLENCE AGAINST WOMEN GRANT PROGRAM
Brief Instructions: This form must be completed for each Sexual Assault Services Grants to Culturally
Specific Programs Violence Against Women Formula Grant Program (SASP Culturally Specific Program)
grant received. A grant administrator or coordinator must ensure that the form is fully completed with
regard to all grant-funded activities. Grant partners, however, may complete sections relevant to their
portion of the grant. Grant administrators or coordinators are responsible for compiling and submitting
a single report that reflects all information collected from grant partners.
All grantees should read each section to determine which questions they must answer, based on the
activities engaged in under this grant during the current reporting period. Sections B, D, and E and
subsections A1 and C1 of this form must be completed by all grantees. In subsections A2 and C2-C3,
grantees must answer an initial question about whether they engaged in certain activities during the
current reporting period. If the response is yes, then the grantee must complete that section/subsection.
If the response is no, the rest of that section/subsection is skipped.
For example, if you are an agency providing victim services and policy development, you would complete
A1, A2, B, C1, C2, D, and E (and answer ‘no’ in C3 if you are not funded to develop or revise products).
The activities of volunteers or interns should be reported if they were coordinated or supervised by SASP
Culturally Specific Program-funded staff or if SASP Culturally Specific Program funds substantially
supported their activities.
For further information on filling out this form, refer to the separate instructions which contain detailed
definitions and examples illustrating how questions should be answered.

Section A:

SECTION
General Information

A1:
A2:
Section B:
Section C:
C1:
C2:
C3:
Section D:
Section E:

Grant Information
Staff Information
Purpose Areas
Function Areas
Coordinated Community Response
Policies
Products
Victim Services
Narrative

Page Number
1
1
3
4
5
5
7
9
10
18

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A1

GENERAL INFORMATION
Grant Information

All grantees must complete this subsection.

(format date with 6 digits – 01/31/09)

1.

Date of report

2.

Current reporting period

3.

Grantee name

4.

Grant number
(the federal grant number assigned to your SASP Culturally Specific Program grant)

5.

Type of funded organization
(Check the one answer that best describes the organization receiving the SASP Culturally Specific
Program grant.)

January 1-June 30

July 1-December 31

(Year)

Private nonprofit organization focused primarily on culturally specific communities that provides
sexual assault services
Private nonprofit organization focused primarily on culturally specific communities that is
partnering with an organization with experience in providing sexual assault services
5a. Is this a faith-based organization?
Yes
No
6.

Point of contact
(person responsible for the day-to-day coordination of the grant)
First name

MI

Last name

Agency/organization name
Address
City

State

Telephone

Zip code

Facsimile

E-mail
7.

Does this SASP Culturally Specific Program grant specifically address Alaska Native/American
Indian tribal populations?
(Check yes if your SASP Culturally Specific Program grant focuses on tribal populations, and indicate
which tribes or nations you serve or intend to serve.)
Yes

No

If yes, which tribes / nations:

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8.

Which culturally specific populations do you serve?
(Check all that apply.)
African
American Indian or Alaska Native
Asian
Black or African American
D/deaf or hard of hearing
Gay, lesbian, bisexual, transgender, or intersex
Hispanic or Latino
Immigrants, refugees, or asylum seekers
Middle Eastern
Pacific Islander
Religious (specify):
Other (specify):

8a. Additional information
Provide additional information about the culturally specific populations served (for example that the
victims/survivors you are serving are: Spanish-speaking from Guatemala, the Dominican Republic,
or Mexico; victims/survivors of sex trafficking from Thailand, Cambodia, or Russia; Orthodox Jews).

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A2

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Staff Information

Were your SASP Culturally Specific Program grant funds used to fund staff positions during the current
reporting period?
(Check yes if SASP Culturally Specific Program funds were used to pay staff, including part-time staff
and contractors.)
Yes—answer question 9
No—skip to section B
9.

Staff
(Report the total number of full-time equivalent (FTE) staff funded by the SASP Culturally Specific
Program grant during the current reporting period. Report staff by the function(s) performed, not by
title or location. Include employees who are part-time and/or only partially funded with these grant
funds as well as consultants/contractors. If an employee or contractor was employed or utilized for
only a portion of the reporting period, prorate appropriately. For example, if you hired a full-time
advocate in October who was 100% funded with SASP Culturally Specific Program funds, you would
report that as .50 FTE. Report all FTEs in decimals, not percentages. One FTE is equal to 1,040
hours—40 hours per week x 26 weeks. See separate instructions for examples of how to calculate
and prorate FTEs.)
Staff

FTE(s)

Administrator (fiscal manager, executive director)
Counselor
Legal advocate (does not include attorney or paralegal)
Program coordinator (training coordinator, volunteer coordinator, hotline
coordinator, victim services coordinator)
Support staff (administrative assistant, bookkeeper, accountant)
Translator/interpreter
Victim advocate (non-governmental - includes sexual assault and dual)
Other (specify):
TOTAL

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0

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B

PURPOSE AREAS

All grantees must complete this section.
10. Statutory purpose areas
(Check all purpose areas that apply to activities supported with SASP Culturally Specific Program funds
during the current reporting period.)
Check ALL
that apply

Purpose Areas
To establish culturally specific intervention and related assistance for victims of
sexual assault.
To maintain culturally specific intervention and related assistance for victims of
sexual assault.
To expand culturally specific intervention and related assistance for victims of
sexual assault.

11. Program priority areas addressed by your grant
(In addition to the purpose areas identified above, the SASP Culturally Specific Program Grant
Application and Program Guidelines may have identified several areas that would receive priority
consideration. If your program addressed any of these priority areas during the current reporting
period, list them below.)

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C1

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FUNCTION AREAS
Coordinated Community Response

All grantees must complete this section.
12. Coordinated community-based response activities supported by SASP Culturally Specific Program
grant funds during the current reporting period
(Check the appropriate boxes to indicate the community-based agencies, organizations, or groups,
even if they are not partners with which you have a memorandum of understanding [MOU], that you
provided victim/survivor referrals to, received referrals from, engaged in consultation with, provided
technical assistance to, and/or attended meetings with, according to the usual frequency of the interactions. If the interactions were not part of a regular schedule, you will need to estimate the frequency
with which these interactions occurred during the current reporting period. If SASP Culturally Specific
Program-funded staff participated in a task force or work group, indicate that under “Meetings” by
checking the frequency of the meetings and the types of organizations participating. In the last
column, indicate the community-based agencies, organizations, or groups with which you have an
MOU for purposes of the SASP Culturally Specific Program grant.)

Agency/organization/group

Victims/survivor referrals,
consultations, technical
assistance
Daily

Weekly

Monthly

Meetings
Weekly

MOU
Partner

Monthly Quarterly

Advocacy organization (NAACP,
LGBTQ organization)
Culturally specific organization
(non-governmental)
Domestic violence organization
Dual sexual assault and domestic
violence organization
Educational institution/organization
Faith/spiritual-based organization
Government agency (ICE, food
stamps, TANF)
Health/mental health organization
Immigrant organization
(non-governmental)
Legal organization (legal services,
bar association, law school)
Sexual assault organization
Social service organization
Tribal government/Tribal government agency
Other (specify):

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12a. (Optional) Additional information
(Use the space below to discuss the effectiveness of coordinated community response [CCR] activities
funded or supported by your SASP Culturally Specific Program grant and to provide any additional
information you would like to share about your CCR activities beyond what you have provided in the
data above. An example might include greater availability of court-certified interpreters following
meetings of a task force that included your SASP Culturally Specific Program-funded legal advocate,
legal services attorneys, prosecutors, and court personnel.) (Maximum 2,000 characters)

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C2

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Policies

Were your SASP Culturally Specific Program funds used to develop, substantially revise, or implement
policies or protocols during the current reporting period?
(Check yes if SASP Culturally Specific Program-funded staff developed, substantially revised, or
implemented polices or protocols, or if SASP Culturally Specific Program funds were used to directly
support the development, revision, or implementation of policies or protocols.)
Yes—answer questions 13-14
No—skip to C3
13. Types of protocols and/or policies developed, substantially revised, or implemented during the
current reporting period.
(Check all that apply.)
Access to translators/interpreters
Appropriate response to underserved populations
Appropriate response to victims/survivors to avoid or eliminate re-traumatization
Appropriate response to victims/survivors with substance abuse issues and /or mental health
diagnoses
Appropriate response to victims/survivors who are D/deaf or hard of hearing
Appropriate response to victims/survivors who are elderly or have disabilities
Appropriate use of translators/interpreters
Confidentiality
Mandatory training standards for staff and volunteers
Procedures for anonymous, confidential, or Jane Doe reporting of sexual assault
Staff, board, and/or volunteers represent the diversity of your service area
Victim/survivor informed about Crime Victims Compensation and Victim Impact Statements
Other (specify):

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14. (Optional) Additional information
(Use the space below to discuss the effectiveness of policies you have developed or implemented that
were funded or supported by your SASP Culturally Specific Program grant and to provide any additional
information you would like to share about your activities relating to the developing, revising, or implementing of policies beyond what you have provided in the data above. An example might include an
increase in the number of victims/survivors who are deaf seeking services from your agency following
implementation of a protocol on interpretation that you helped to develop.) (Maximum 2,000 characters)

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C3

Products

Were your SASP Culturally Specific Program grant funds used to develop, substantially revise, and/or
distribute products during the current reporting period?
(Check yes if SASP Culturally Specific Program funded staff developed revised and/or distributed
products or if SASP Culturally Specific Program funds directly supported the development, revision,
or distribution of products.)
Yes—answer question 15
No—skip to section D
15. Use of SASP Culturally Specific Program funds for product development, substantial revision,
and/or distribution
(Report the number of products developed, substantially revised, and/or distributed with SASP Culturally Specific Program funds during the current reporting period. Report the number of new products
developed or substantially revised during the current reporting period; the title/topic and intended
audience for each product developed, revised, and/or distributed; and the number of products used
or distributed. If a product was created in or translated into a language other than English, including
Braille, indicate the language. Report on products that were newly developed during the current
reporting period, whether or not they were used or distributed, and on products that were previously
developed or revised that were used or distributed during the current reporting period. Do not report
the number of products printed or copied; only report the number developed or revised - in most
cases that number will be one for each product described - and/or the number used or distributed.
See separate instructions for examples of how to report under “developed or revised” and “used or
distributed.”)
Product

Number
developed
or revised

Title/topic

Intended
audience

Number
used or
distributed

Languages

Outreach
material
(brochures,
pamphlets,
information
packets,
posters,
television/
radio/other
media
spots, etc.)

Website

Other
(specify):

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D

VICTIM SERVICES

All grantees must complete this section.
16. Number of primary victims/survivors of sexual assault served, partially served, and victims/survivors
seeking services who were not served.
Please do not answer this question without referring to the separate instructions for further explanation
and examples of how to distinguish among these categories. (Report the following, to the best of your
ability, as an unduplicated count for each category during the current reporting period. This means that
each victim/survivor who was seeking or who received services during the current reporting period
should be counted only once in that reporting period. For purposes of this question, victims/survivors
are those against whom the sexual assault was directed. Do not report secondary victims here.)
Primary victims/survivors of sexual assault

TOTAL

A. Served: Victims/survivors who received the service(s) they requested, if
those services were funded by your SASP Culturally Specific Program grant
B. Partially served: Victims/survivors who received some service(s), but not
all of the services they requested, if those services were funded by your SASP
Culturally Specific Program grant
TOTAL SERVED and PARTIALLY SERVED (16A + 16B)

0

C. Victims/survivors seeking services who were not served: Victims/survivors who sought services and did not receive the service(s) they were seeking,
if those services were funded by your SASP Culturally Specific Program grant
17. Number of secondary victims served
Please do not answer this question without referring to the separate instructions for further explanation
and for examples of how and when to report secondary victims. (Report the following, to the best of
your ability, as an unduplicated count for each category during the current reporting period. This means
that each secondary victim who received services during the current reporting period should be
counted only once. For purposes of this question, secondary victims are those who are collaterally
affected by the victimization - e.g., children, siblings, spouses or intimate partners, grandparents, other
affected relatives, friends, neighbors, etc. - except for the perpetrator of such victimization. Secondary
victims do not need to be connected with a primary victim who is receiving services.)
Secondary victims

TOTAL

Secondary victims who received service(s) funded by your SASP Culturally
Specific Program grant

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18. Reasons that primary victims/survivors seeking services were not served or were partially served.
(Check all that apply.)
Reasons not served or partially served
Conflict of interest
Did not meet statutory requirements
Hours of operation
Insufficient/lack of culturally appropriate services
Insufficient/lack of language capacity (including sign language)
Insufficient/lack of services for victims/survivors who are D/deaf or hard of hearing
Insufficient/lack of services for victims/survivors with disabilities
Lack of child care
Program reached capacity
Program rules not acceptable to victim/survivor
Program unable to provide service due to limited resources/priority-setting
Services inappropriate or inadequate for victims/survivors with mental health issues
Services inappropriate or inadequate for victims/survivors with substance abuse issues
Services not appropriate for victim/survivor
Transportation
Other (specify):

[for developers: If a grantee enters a reason in “other” the following will pop up: “Victim declined
services,” “victim did not complete program,” and “victim could not be contacted” are all inappropriate reasons and should not be reported in the “other” category. They indicate a misunderstanding of when to report victims as partially served or not served. Please refer to the separate
instructions for further explanation and for examples.]

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19. Demographics of primary victims/survivors served or partially served
(Based on the primary victims/survivors reported in 16A and 16B, report the total numbers for all that
apply. Because victims/survivors may identify in more than one category of race/ethnicity, the total for
Race/ethnicity may exceed the total number of victims/survivors reported in 16A and 16B. However,
the total number of victims/survivors reported under Race/ethnicity should not be less than the total
number of victims/survivors reported in 16A and 16B. The total number of victims/survivors reported
under “Gender” and the total number reported under “Age” should equal the total number of victims/
survivors reported in 16A and 16B. Those victims for whom gender, age, and/or race/ethnicity are not
known should be reported in the “unknown” category. Do not report demographics for secondary
victims.)
Race/ethnicity (Victims/survivors should not be counted more
than once in either the category “American Indian or Alaska Native” or the category “Native Hawaiian or other Pacific Islander.”)
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Unknown
TOTAL RACE/ETHNICITY (should not be less than 0, the sum of 16A and
16B.)

Number of victims/survivors

0

Gender
Female
Male
Unknown
TOTAL GENDER (should equal 0, the sum of 16A and 16B.)

Number of victims/survivors

Age
0-6
7-12
13-17
18-24
25-59
60+
Unknown
TOTAL AGE (should equal 0, the sum of 16A and 16B.)

Number of victims/survivors

Other demographics
People with disabilities
People who are D/deaf or hard of hearing
People with limited English proficiency
People who are immigrants/refugees/asylum seekers
People who live in rural areas

Number of victims/survivors

0

0

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20. Victims/survivors’ relationships to offender
(For
reportedas
asserved
servedand
andpartially
partiallyserved
servedinin16A
16Aand
and16B,
16B,report
reportthe
(For those
those primary
primary victims/survivors
victims/survivors reported
the
victim/survivor’s
relationship
tooffender.
the offender.
If a victim/survivor
was victimized
by more
than one
victim/survivor’s
relationship
to the
If a victim/survivor
was victimized
by more
than one
perpetrator, count the
the victim/survivor
victim/survivor in
in all
all categories
categoriesthat
thatapply.
apply. The
Thetotal
totalnumber
numberofofrelationships
relationships
must be
be at
Do not
report
relationships
offender
for secondary
victims.)
must
at least
least 0.
[insert
sum
of sexual
assault to
victims
reported
in 16A and
16B. Do not report
relationships to offender for secondary victims.)
Victim/survivor’s relationship to offender
Current or former spouse or intimate partner
Other family or household member (son/daughter, stepson/
stepdaughter, sibling, etc.)
Dating relationship
Acquaintance (neighbor, employee, co-worker, student, schoolmate,
etc.)
Stranger
Relationship unknown
TOTAL

Number of relationships

0

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21A. Victim services
(Report
from 16A
16A and
and16B
16Bwho
whoreceived
receivedSASP
SASP
Culturally
(Report the
the number
number of
of primary
primary victims/survivors
victims/survivors from
Culturally
Specifi
c
Program-funded
services.
Count
each
victim/survivor
only
once
for
each
type
of
service
that
Specific Program-funded services. Count each victim/survivor only once for each type of service
that
victim received
received during the current reporting
victim
reporting period;
period; do
do not
not report
report the
the number
number of
of times
timesthat
thatservice
servicewas
was
provided to
to the
the victim.
victim. The
The total
total for
for each
each type
type of
of service
service should
should not
total
16A
provided
not be
be higher
higher than
than 0,
thethe
total
of of
16A
and
and 16B. Do not report secondary victims receiving services in this question.
16B
[insert total of 16A and 16B.]. Do not report secondary victims receiving services in this question.)
Type of service

Number of victims/
survivors served

Civil legal advocacy/court accompaniment (Assisting a victim/survivor with
civil legal issues, including preparing paperwork for a protection order and
accompanying victim/survivor to a protection order hearing, administrative
hearing, or other civil court proceeding.)
Counseling/support group (Short-term individual or group counseling or
support provided by a volunteer, peer, or professional.)
Criminal justice advocacy/court accompaniment (Assisting a victim/survivor
with criminal legal issues, including notifying the victim/survivor of case
status, hearing dates, plea agreements, and sentencing terms; preparing
paperwork such as victim impact statements; accompanying a victim/
survivor to a criminal court proceeding or law enforcement interview;
advocacy with probation/parole/corrections; supporting victims/survivors
through sex offender management process; and all other advocacy within
the criminal justice system.)
Crisis intervention (Crisis intervention is a process by which a person
identifies, assesses, and intervenes with an individual in crisis so as to
restore balance and reduce the effects of the crisis in her/his life. In this
category, report crisis intervention that occurs in person and/or over the
telephone.)
Employment counseling (Actions designed to assist a victim/survivor in
obtaining employment, e.g., coaching on career options, skills training, job
searches, resume-writing, marketing, job interviews, and preservation of
employment.)
Financial counseling (Actions designed to assist a victim/survivor with
issues related to improving credit, retiring debt, setting up bank accounts,
managing household finances, negotiating with lenders or landlords,
developing budgets, managing financial assets, making major purchases
such as a home or auto, filing tax returns.)
Hospital/clinic/other medical response (Accompanying a victim survivor to
or meeting a victim/survivor at a hospital, clinic, or medical office)
Job training (Providing training in specific employment-related skills to a
victim/survivor, e.g., on computer literacy.)
Language services (Interpretation, translation)
Material assistance (Providing victims/survivors with clothing, food, personal
items, etc.)
Transportation (Provision of transportation, either directly or through bus
passes, taxi fares, or other means of transportation)
Victim/survivor advocacy (Actions designed to assist the victim/survivor in
obtaining support, resources, or services, including employment, housing,
shelter services, health care, victim’s compensation, school/education, etc.)
Other (specify):

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21B. Immigration matters
(For
as receiving
receiving victim
victim services
servicesininquestion
question21A,
21A,report
reportthe
thenumber
numberwho
(For the
the victims/survivors
victims/survivors reported
reported as
who
received
assistance
with immigration
matters
the current
reporting
the
row
received
assistance
with immigration
matters
duringduring
the current
reporting
period.period.
In the In
row
marked
“Immigration
matters,”
provide provide
an unduplicated
count of count
victims/survivors
who received
marked
“Immigration
matters,”
an unduplicated
of victims/survivors
who assistance
received with
any immigration
issue,
even if they
received
with
more than
received
assistance
on
assistance
with any
immigration
issue,
even help
if they
received
help one
withissue
moreorthan
one issue
or received
more than one occasion. For specific categories of immigration matters, report the number of
assistance
on more
than
one occasion.
categories
of immigration
matters,
report
theonce
victims/survivors
who
received
assistanceFor
in specifi
each ofc the
categories.
Count a victim/
survivor
only
number
victims/survivors
who matter
received
each ofassistance.
the categories.
Count aofvictim/
for each of
category
of immigration
forassistance
which theyinreceived
The number
victims/survivors
either the
general category
of immigration
matters
or in
any specificThe
survivor
only oncereported
for eachincategory
of immigration
matter
for which they
received
assistance.
categoryof
should
not be greater
than 0.)
number
victims/survivors
reported
in either the general category of immigration matters or in any
specific category should not be greater than [insert sum of 16A+16B]. )
Number of victims/
survivors

Immigration matters addressed
Immigration matters (Unduplicated count of victims receiving assistance
in one or more of the categories below - do not add categories together.)
VAWA self-petition
Cancellation of removal
Work authorization
U visa
T visa
Other immigration matters (specify):
22.

Hotline calls/information and referral
Report the number of hotline calls and requests for information and referral received from primary
victims/survivors, and the total number of hotline calls received, on phone lines paid for with SASP
Culturally Specific Program funds or answered by SASP Culturally Specific Program-funded staff,
during the current reporting period. Also report the specific languages (other than English) used when
responding to these requests for information or assistance. Primary victims whose calls are reported
here should not be reported as victims served in question 16 unless they also received at least one of
the services listed in question 21A, Victim Services. Victims/survivors who receive services such as
crisis intervention or victim advocacy over the telephone, in addition to basic hotline information and/
or referrals, should also be reported in question 21A. Hotline calls that include victim advocacy or
crisis intervention services are those that require more time than the average call and involve a more
intensive focus on the immediate needs and situation of the victim. For examples of when to report
only the hotline call and when to report both the hotline call and a service or services in question 21A,
see separate instructions.)

Number of calls/
requests from
primary
victims/survivors

Total number of
calls/requests

Languages
(other than
English) used
when responding
to requests for
information or
assistance

Hotline calls (Crisis or information and
referral calls received by an agency’s
hotline or office telephone.)
Web-based information and referral
Walk-in information and referral

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23.

Outreach to victims/survivors
(Report the number of unsolicited letters, phone calls, or visits to victims/survivors of specific incidents
of sexual assault, informing them of services and/or providing information. Also report the specific
languages (other than English) used in outreach activities. Victims/survivors who are the recipients of
these outreach activities should not be reported as victims/survivors served in question 16 unless they
also received at least one of the services reported in question 21A Victim services. Victims/survivors
who receive services such as advocacy over the telephone should be reported in question 21A.)
Languages
Number of outreach
(other than English)
activities to
used in outreach
victims/survivors
activities
Outreach to victims/survivors (unsolicited letters,
phone calls, or visits.)

24.

Protection/restraining orders
(Report the total number of temporary and/or final protection orders requested and granted for which
SASP Culturally Specific Program-funded victim services staff provided assistance to victims/survivors
of sexual assault during the current reporting period. These orders may also be referred to as protection from abuse, protection from harassment or anti-harassment orders, restraining orders, or no-contact or stay-away orders.)
Protection orders

Temporary orders

Final orders

Number requested
Number granted

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25.

(Optional) Additional information
(Use the space below to discuss the effectiveness of victim services funded or supported by your SASP
Culturally Specific Program grant and to provide any additional information you would like to share
about your victim services activities beyond what you have provided in the data above. An example
might include that your agency, as a result of SASP Culturally Specific Program funding, was able to
provide culturally appropriate medical accompaniment to an increased percentage of sexual assault
survivors. This resulted in a higher percentage of survivors from the population you serve also seeking
additional support services.) (Maximum 2,000 characters)

SASP - Culturally Specific Program Semi-annual Progress Report • 17 • Office on Violence Against Women
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SECTION

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E

OMB Clearance # 1122-0023
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NARRATIVE

All grantees must answer questions 26 and 27.
PLEASE LIMIT YOUR RESPONSE TO THE SPACE PROVIDED.
26.

Report on the status of your SASP Culturally Specific Program grant goals and objectives as of the
end of the current reporting period.
(Report succinctly on the status of the goals and objectives for your grant as of the end of the current
reporting period, as they were identified in your grant proposal or as they have been added or revised.
Indicate whether the activities related to your objectives for the current reporting period have been
completed, are in progress, are delayed, or have been revised. Comment briefly on your successes
and challenges, and provide any additional explanation you feel is necessary for us to understand
what you have or have not accomplished relative to your goals and objectives. If you have not
accomplished objectives that should have been accomplished during the current reporting period,
you must provide an explanation.) Page 19.

27. What services or resources do you provide that are specifically tailored to reach the culturally
specific population(s) that you serve? Please limit your response to the space provided (8,000
characters).
(For example, your organization has staff, volunteers, or advisory board members who reflect the
community you serve.) Page 22.
All grantees must answer questions 28 and 29 on an annual basis. Submit this information on the
January to June reporting form only.
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED (8,000 CHARACTERS) FOR EACH QUESTION.
28. What do you see as the most significant areas of remaining need, with regard to improving services
to victims/survivors of sexual assault, increasing victims/survivors safety, and enhancing
community response (including offender accountability for sex offenders)?
(Consider geographic regions, underserved populations, service delivery systems, and challenges and
barriers unique to your service area and the population(s) you serve.) Page 24.
29. What has SASP Culturally Specific Program funding allowed you to do that you could not do prior to
receiving this funding?
(e.g., expand coordination and cross-referrals with sexual assault agencies in your community.) Page 26.
Questions 30 and 31 are optional.
PLEASE LIMIT YOUR RESPONSES TO THE SPACE PROVIDED (8,000 CHARACTERS) FOR EACH QUESTION.
30. Provide any additional information that you would like us to know about your SASP Culturally
Specific Program grant and/or the effectiveness of your grant.
(If you have any other data or information that you have not already reported in answer to previous
questions that demonstrate the effectiveness of your SASP Culturally Specific Program-funded program
please provide it below. Refer to separate instructions for a fuller explanation and examples.) Page 28.
31. Provide any additional information that you would like us to know about the data submitted.
(If you have any information that could be helpful in understanding the data you have submitted in this
report, please answer this question. For example, if you submitted two different progress reports for the
same reporting period, you may explain how the data was apportioned to each report; or if you reported
staff—e.g., victim advocates—but did not report any corresponding victim services you may explain why;
or if you did not use SASP Culturally Specific Program funds to support either staff or activities during
the reporting period, please explain how program funds were used, if you have not already done so.) Page 30.
Public Reporting Burden
Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. We try to create forms and instructions that
are accurate, can be easily understood, and which impose the least possible burden on you to provide us with information. The estimated average time to complete and file this form is 60 minutes per form. If you have comments regarding
the accuracy of this estimate, or suggestions for making this form simpler, you can write to the Office on Violence Against
Women, U.S. Department of Justice, 800 K Street, NW, Washington, DC 20531.
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Back to Instructions

Report on the status of your SASP Culturally Specific Program grant goals and objectives for the current
reporting period.
Question #26
Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

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Back to Instructions

Report on the status of your SASP Culturally Specific Program grant goals and objectives for the current
reporting period.
Question #26 (cont.)
Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

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Back to Instructions

Report on the status of your SASP Culturally Specific Program grant goals and objectives for the current
reporting period.
Question #26 (cont. 2)
Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

Goals/Objectives (1,750 characters)

Status

Key Activities (1,750 characters)

Comments (500 characters)

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Back to Instructions

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What services or resources do you provide that are specifically tailored to reach the culturally specific
population(s) that you serve?
Question #27

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Back to Instructions

OMB Clearance # 1122-0023
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What services or resources do you provide that are specifically tailored to reach the culturally specific
population(s) that you serve?
Question #27 (cont.)

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Back to Instructions

OMB Clearance # 1122-0023
Expiration Date: 01/31/2013

What do you see as the most significant areas of remaining need, with regard to improving services to
victims/survivors of sexual assault, increasing victims/survivors safety, and enhancing community response
(including offender accountability for sex offenders)?
Question #28

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Back to Instructions

OMB Clearance # 1122-0023
Expiration Date: 01/31/2013

What do you see as the most significant areas of remaining need, with regard to improving services to
victims/survivors of sexual assault, increasing victims/survivors safety, and enhancing community response
(including offender accountability for sex offenders)?
Question #28 (cont.)

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Back to Instructions

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What has SASP Culturally Specific Program funding allowed you to do that you could not do prior to receiving
this funding?
Question #29

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Back to Instructions

OMB Clearance # 1122-0023
Expiration Date: 01/31/2013

What has SASP Culturally Specific Program funding allowed you to do that you could not do prior to receiving
this funding?
Question #29 (cont.)

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OMB Clearance # 1122-0023
Expiration Date: 01/31/2013

Provide any additional information that you would like us to know about your SASP Culturally Specific
Program grant and/or the effectiveness of your grant.
Question #30

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OMB Clearance # 1122-0023
Expiration Date: 01/31/2013

Provide any additional information that you would like us to know about your SASP Culturally Specific
Program grant and/or the effectiveness of your grant.
Question #30 (cont.)

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Provide any additional information that you would like us to know about the data submitted.
Question #31

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Provide any additional information that you would like us to know about the data submitted.
Question #31 (cont.)

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Validate

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