5 Progress Report Supplement

AmeriCorps Seniors Grant Applications, Progress Reporting, Independent Living and Respite Surveys

20210730 PRS Revisions Draft

2021 Renewal

OMB: 3045-0035

Document [docx]
Download: docx | pdf

RSVP PRS


Demographics

Age Group

  • 55 to 59

  • 60 to 69

  • 70 to 79

  • 80 to 84

  • 85 and over


Gender

  • Female

  • Male

  • Gender Fluid/Does Not Identify as Male or Female


Ethnicity

  • Hispanic or Latino

  • Non-Hispanic or Latino


Racial Group

  • African American/Black

  • Asian/Asian American

  • Native American or Alaska Native

  • Native Hawaiian or Other Pacific Islander

  • White/Caucasian

  • Two or More Races


LGBTQIA+

  • Identify as a member of the member of the LGBTQ community

  • Does not identify as a member of the LGBTQ community

  • Unknown


Service Information

Volunteers

  • Total number of volunteers

  • Number of new RSVP recruited by RSVP volunteers

  • Number of community volunteers recruited by RSVP volunteers

  • Number of volunteers identifying as a member of the Disability community

  • Number of veterans serving as RSVP volunteers

  • Total number of US Armed Forces Service members serving as RSVP volunteers

  • Total number of volunteers service as RSVP with family member actively serving in the military

  • Total number of hours served

  • Total number of seniors recruited to by RSVP volunteers this year


Hours Serve

  • 4 or fewer hours per week

  • 5-10 hours per week

  • 11-19 hours per week

  • 20-29 hours per week

  • 30 or more hours per week


Volunteers Separated

  • Employment, moved, family, new interests,

  • Health problems, death

  • Transportation problems

  • Poor performance


Client Information

Clients Served

  • Total number of children mentored

  • Total number of veterans served

  • Total number of US Armed Forces Service members served

  • Total number of family members of US Armed Forces service members served

  • Number of adult ex-offenders served

  • Total number of Immigrants served

  • Number of seniors receiving independent living services

  • Number of caregivers provided with respite care

  • Total number of children benefiting indirectly from the presence of AmeriCorps Seniors volunteers


Stations

  • Total number of faith-based Stations/Volunteers

  • Total number of disaster services stations/volunteers

  • Total number of stations/volunteers supporting Legal Aid or Elder Justice initiatives

  • Total number of stations/volunteers supporting STEAM programs

  • Total number of stations/volunteers supporting evidence-based programs

  • Total number of stations/volunteers supporting prescription drug/opioid abuse prevention initiatives

  • Total number of stations/volunteers that are actively serving to address COVIDC-19. COVID-19 projects can include scheduling COVID-19 appointments, transporting individuals to vaccine appointments, supporting COVID-19 tracing initiatives, etc.




FGP PRS


Demographics

Age Group

  • 55 to 59

  • 60 to 69

  • 70 to 79

  • 80 to 84

  • 85 and over


Gender

  • Female

  • Male

  • Gender Fluid/Does Not Identify as Male or Female


Ethnicity

  • Hispanic or Latino

  • Non-Hispanic or Latino


Racial Group

  • African American/Black

  • Asian/Asian American

  • Native American or Alaska Native

  • Native Hawaiian or Other Pacific Islander

  • White/Caucasian

  • Two or More Races


LGBTQIA+

  • Identify as a member of the member of the LGBTQ community

  • Does not identify as a member of the LGBTQ community

  • Unknown


Service Information

Volunteers

  • Total number of volunteers

  • Total number of volunteers federally funded

  • Total number of volunteers non-federally funded

  • Total number of Non-Stipend volunteers

  • Number of volunteers identifying as a member of the Disability community

  • Total number of Foster Grandparents who served in private homes

  • Total number of US Armed Forces Services members serving as FGP volunteers

  • Total number of volunteers serving as FGP volunteers with family members actively serving in the military

  • Number of veterans serving as FGP volunteers

  • Total number of seniors on waiting lists to be FGP volunteers

  • Total number of hours served

  • Total number of seniors recruited to be FGP volunteers this year








Volunteers Separated

  • Employment, moved, family, new interests

  • Health problems, death

  • Transportation problems

  • Income became over allowable guidelines to receive stipend

  • Poor performance


Hours Served

  • Number of volunteers serving 5-19 Hours per week

  • 20-29 Hours per week

  • 30-40 Hours per week

  • 5-14 Hours per week


Volunteer Client Ratio

  • Serve 1 client weekly

  • Serve 2 clients weekly

  • Serve 3-5 clients weekly

  • Serve 6-10 clients weekly

  • Serve 11 or more clients weekly


Client Information

Ages of Clients Served

  • Birth to age 5

  • Ages 6-12

  • Ages 13-19

  • Youth Ages 20 and over


Clients Served

  • Total number of children/youth served

  • Number of children/youth awaiting service of a Foster Grandparent

  • Total number of children of National Guard Reservists served

  • Total number of children of US Armed Forces Service members served

  • Total number of children mentored

  • Total number of children benefitting indirectly from the presence of AmeriCorps Seniors Volunteers


Special Needs Served

Special Needs

  • Abused/Neglected Children

  • Children with HIV/AIDS

  • Developmental Disabilities

  • Emotional Disabilities

  • Hearing Impaired

  • Homeless

  • Adjudicated Youth / Juvenile Offenders

  • Language Barriers

  • Learning Disabilities

  • Physical Disabilities

  • Significantly Medically Impaired

  • Substance Abuse

  • Teen Pregnancy/Teen Parenting

  • Terminally Ill

  • Visually Impaired

  • Other Special Needs


Stations

Federal Priorities

  • Total number of stations/volunteers supporting STEM programs

  • Total number of stations/volunteers supporting evidence-based programs

  • Total number of stations/volunteers supporting prescription drug/opioid abuse prevention initiatives

  • Total number of faith-based Stations/volunteers

  • Total number of disaster services stations/volunteers

  • Total number of stations/volunteers supporting Legal Aid or Elder Justice initiatives

  • Total number of stations/volunteers that are actively serving to address COVID-19. COVID-19 projects can include scheduling COVID-19 appointments, transporting individuals to vaccine appointments, supporting COVID-19 tracing initiatives, etc.




SCP PRS


Demographics

Age Group

  • 55 to 59

  • 60 to 69

  • 70 to 79

  • 80 to 84

  • 85 and over


Gender

  • Female

  • Male

  • Gender Fluid/Does Not Identify as Male or Female


Ethnicity

  • Hispanic or Latino

  • Non-Hispanic or Latino


Racial Group

  • Two or More Races

  • African American/Black

  • Asian/Asian American

  • Native American or Alaska Native

  • Native Hawaiian or Other Pacific Islander

  • White/Caucasian

  • Two or More Races


LGBTQIA+

  • Identify as a member of the member of the LGBTQ community

  • Does not identify as a member of the LGBTQ community

  • Unknown


Service Information

Volunteers

  • Total number of volunteers

  • Total number of volunteers federally funded

  • Total number of volunteers non-federally funded

  • Total Number of Non-Stipend volunteers

  • Number of volunteers identifying as a member of the Disability community

  • Total number of volunteers who served in private homes

  • Number of veterans serving as SCP volunteers

  • Total number of US Armed Forces Services members serving as SCP volunteers

  • Total number of seniors on waiting list to be SCP volunteers

  • Total number of volunteers serving as SCP with family member actively serving in the military

  • Total number of hours served


Volunteers Separated

  • Employment, moved, family, new interests

  • Health problems, death

  • Transportation problems

  • Income became over allowable guidelines to receive stipend

  • Poor performance


Hours Served

  • Number of Volunteers serving 5-19 Hours per week

  • 20-29 Hours per week

  • 30-40 Hours per week

  • 5-14 Hours per week


Volunteer Leaders

  • Number of Senior Companion Leaders

  • Senior Companions recruited by Senior Companion Leaders

  • Community Volunteers recruited by Senior Companion Leaders


Volunteer Client Ratio

  • Serve 1 client weekly

  • Serve 2 clients weekly

  • Serve 3-5 clients weekly

  • Serve 6-10 clients weekly

  • Serve 11 or more clients weekly


Client Information

Clients Served

  • Total number of clients served

  • Number of potential clients awaiting services of a Senior Companion

  • Number of caregivers receiving respite

  • Total number of veterans served

  • Total number of US Armed Forces Service members served


Ages of Clients Served

  • Ages 22-44

  • Ages 45-64

  • Ages 65-74

  • Ages 75-84

  • Ages 85 or higher


Specials Needs Served

Special Needs

  • Alzheimer’s Disease

  • Chronic Care Disabilities/Frail Elderly

  • Developmentally Disabled Adult

  • Emotionally Impaired Adult

  • Hearing Impaired Adult

  • Short-Term Disabilities

  • Substance Abuse (Adult)

  • Terminally Ill Adult

  • Visually Impaired Adult

  • Other Special Needs


Stations

Federal Priorities

  • Total number of stations/volunteers supporting STEM programs

  • Total number of stations/volunteers supporting evidence-based programs

  • Total number of stations/volunteers supporting prescription drug/opioid abuse prevention initiatives

  • Total number of faith-based Stations/Volunteers

  • Total number of disaster services stations/volunteers

  • Total number of stations/volunteers supporting Legal Aid or Elder Justice initiatives

  • Total number of stations/volunteers that are actively serving to address COVID-19. COVID-19 projects can include scheduling COVID-19 appointments, transporting individuals to vaccine appointments, supporting COVID-19 tracing initiatives, etc.




SDP PRS (Added requirement for Senior Demonstration Programs)


Demographics

Age Group

  • 55 to 59

  • 60 to 69

  • 70 to 79

  • 80 to 84

  • 85 and over


Gender

  • Female

  • Male

  • Gender Fluid/Does Not Identify as Male or Female


Ethnicity

  • Hispanic or Latino

  • Non-Hispanic or Latino


Racial Group

  • Two or More Races

  • African American/Black

  • Asian/Asian American

  • Native American or Alaska Native

  • Native Hawaiian or Other Pacific Islander

  • White/Caucasian

  • Two or More Races


LGBTQIA+

  • Identify as a member of the member of the LGBTQ community

  • Does not identify as a member of the LGBTQ community

  • Unknown


Service Information

Volunteers

  • Total number of volunteers

  • Number of new volunteers recruited by AmeriCorps Seniors volunteers

  • Number of community volunteers recruited by AmeriCorps Seniors volunteers

  • Number of volunteers identifying as a member of the Disability community

  • Number of veterans serving as AmeriCorps Seniors volunteers

  • Total number of US Armed Forces Service members serving as AmeriCorps Seniors volunteers

  • Total number of volunteers service an AmeriCorps Seniors volunteers with family member actively serving in the military

  • Total number of hours served

  • Total number of seniors recruited to by AmeriCorps Seniors volunteers this year


Hours Serve

  • 4 or fewer hours per week

  • 5-10 hours per week

  • 11-19 hours per week

  • 20-29 hours per week

  • 30 or more hours per week


Volunteers Separated

  • Employment, moved, family, new interests,

  • Health problems, death

  • Transportation problems

  • Poor performance

  • COVID-19 related


Client Information

Clients Served

  • Total number of children mentored

  • Total number of veterans served

  • Total number of US Armed Forces Service members served

  • Total number of family members of US Armed Forces service members served

  • Number of adult ex-offenders served

  • Total number of Immigrants served

  • Number of seniors receiving independent living services

  • Number of caregivers provided with respite

  • Total number of children benefiting indirectly from the presence of AmeriCorps Seniors volunteers


Stations

  • Total number of faith-based Stations/volunteers

  • Total number of disaster services stations/volunteers

  • Total number of stations/volunteers supporting Legal Aid or Elder Justice initiatives

  • Total number of stations/volunteers supporting STEAM programs

  • Total number of stations/volunteers supporting evidence-based programs

  • Total number of stations/volunteers supporting prescription drug/opioid abuse prevention initiatives

  • Total number of stations/volunteers that are actively serving to address COVID-19. COVID-19 projects can include scheduling COVID-19 appointments, transporting individuals to vaccine appointments, supporting COVID-19 tracing initiatives, etc.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorWhite, Colin
File Modified0000-00-00
File Created2023-07-31

© 2024 OMB.report | Privacy Policy