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Annual Report 3.0
Annual Report
OMB No.: 0970-0492
Expires: December 31, 2027
PUBLIC BURDEN STATEMENT
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) The purpose of this collection is to
meet the requirement of the Community Services Block Grant (CSBG) Act (42 U.S.C. § 9901, et
seq) that all states that receive CSBG funding participate in a performance management
system (Section 678E(a)(1)(A))) and submit a report to the Secretary on an annual basis
(Section 678E(a)(2)). Public reporting burden for this collection of information is estimated to
average 4,629 hours per grant recipient, including the time for reviewing instructions,
gathering, and maintaining the data needed, and reviewing the collection of information.
This is a mandatory collection of information per the Community Services Block Grant (CSBG)
Act (42 U.S.C. § 9901, et seq) Section 678E(a)(1)(A)) and Section 678E(a)(2). An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information
subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a
currently valid OMB control number. If you have any comments on this collection of
information, please contact CSBGData@acf.hhs.gov.
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OMB No. 0970-0492
CSBG Annual Report Table of Contents
State and Territory Administration – Module 1 ......................................................................3
Section A: CSBG Administrative Information ......................................................................4
Section B: CSBG Eligible Entity Update ...............................................................................5
Section C: Organizational Standards for Eligible Entities.....................................................6
Section D: State Use of Funds ............................................................................................7
Section E: State Training and Technical Assistance ............................................................ 11
Section F: State Linkages and Communication .................................................................. 12
Section G: Monitoring, Corrective Action, and Fiscal Controls ........................................... 13
Section H: Performance Measurement ............................................................................. 16
Eligible Entity Administration – Module 2 ............................................................................ 18
Module 2, Section B: CSBG Eligible Entity Capacity Building .................................................. 20
Module 2, Section C: Allocated Resources per CSBG Eligible Entity....................................... 21
Individual and Family Level Module 3 .................................................................................. 24
Module 3, Section A: Individual and Family Services ............................................................. 25
Module 3, Section B: Individual and Family NPIs .................................................................... 34
Module 3, Section C: All Characteristics Report ...................................................................... 40
Community Level – Module 4 .............................................................................................. 46
Module 4, Section B: Community National Performance Indicators (NPIs) ............................ 0
Module 4, Section C: Community Strategies List ...................................................................... 0
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State and Territory Administration
Module 1
The reporting time frames for all information in the state or territory
administration module are based on the federal fiscal year (FY), which runs
from October 1 of a given calendar year until September 30 of the following
calendar year. When completing the annual report, respondents will first
indicate the FY for which the state is submitting data.
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OMB No. 0970-0492
Community Services Block Grant (CSBG)
Annual Report – State and Territory Administration Module
Section A: CSBG Administrative Information
A.1.
Lead Agency: Review and update (as applicable) the following information in relation to
the lead agency designated to administer the CSBG in the state or territory, as required
by Section 676(a) of the CSBG Act.
A.1a.
Lead agency
A.1b.
Cabinet or administrative department of this lead agency
☐
☐
☐
☐
☐
☐
Community Services Department
Human Services Department
Social Services Department
Governor’s Office
Community Affairs Department
Other, describe:
A.1c.
Cabinet or Administrative Department Name: Provide the name of the cabinet or
administrative department of the CSBG authorized official.
A.1d.
Authorized official of the lead agency
Name: _____________ Title: ______________
A.1e.
Street address
A.1f.
City
A.1g.
State
A.1h.
Zip code
A.1i.
Work Telephone number and Extension (if applicable)
A.1j.
Fax number
A.1k.
Email address
A.1l.
Lead agency website
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Section B: CSBG Eligible Entity Update
B.1.
Changes to Eligible Entities: The table below includes a list of CSBG eligible entities
receiving 90 percent funds within the state or territory, as reported within the CSBG
State Plan for this reporting period.
Did the list of eligible entities change during the reporting year (FFY)? If yes, briefly
describe the changes. Please also update the Master List prior to the submission of your
next CSBG State Plan.
If the eligible entity was designated or re-designated, de-designated or voluntarily
relinquished, or merged with another eligible entity(ies), provide additional details in
the next submission of the CSBG State Plan.
CSBG Eligible
Entity
Geographical
Area Served
(by county)
Public or
Nonprofit
Type of Entity
A change occurred
during the reporting
period (FFY)
Yes, please
describe.
No
Designated or redesignated
De-designated
or voluntarily
relinquished
Merged
Addition
Briefly describe
changes
Describe changes
for each eligible
entity for which you
select “Yes.”
Instructional Note: Limited Purpose Agency refers to a CSBG eligible entity that was designated
as a limited purpose agency under Title II of the Economic Opportunity Act of 1964 for the fiscal
year 1981, served the general purposes of a community action agency under Title II of the
Economic Opportunity Act, did not lose its designation as a limited purpose agency under Title II
of the Economic Opportunity Act as a result of failure to comply with that Act, and has not lost
its designation as a CSBG eligible entity under the CSBG Act.
Instructional Note: 90 percent funds are the funds a state provides to eligible entities to carry
out the purposes of the CSBG Act, as described under Section 675C of the CSBG Act. A state
must provide “no less than 90 percent” of their CSBG allocation, under Section 675B, to the
eligible entities.
B.2.
Total number of CSBG eligible entities:
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Section C: Organizational Standards for Eligible Entities
C.1. Assessment of Organizational Standards: Review and update, where applicable, how the
state or territory assessed CSBG eligible entities in meeting organizational standards.
C.1.b.
Peer-to-Peer Review
Self-Assessment
State-Authorized Third-Party Validation
Routine, On-Site CSBG Monitoring
Other
Describe in detail, the assessment process as implemented by the state or territory.
Include any changes in the assessment process occurring since the most recent CSBG State
Plan. With the exception of regular on-site CSBG monitoring, all assessment options above
may include on-site, desk review, or a combination of both. The specific state process
should be included in the response.
C.2. Technical Assistance for Unmet Organizational Standards: Did the state provide technical
assistance specifically for eligible entities with unmet organizational standards to assist in meeting the
standards in a reasonable time frame?
Yes No
C.2.a.
If yes, provide the number of eligible entities actively receiving technical assistance for
unmet organizational standards. The numerical response should be between 0-99.
C.2.b.
Describe in detail, how the state provided technical assistance. This can include the type
of tools, strategies, and outcome.
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Section D: State or Territory Use of Funds
Note: The purpose of this section is to report on the funds received and spent during the
FFY, October 1 to September 30. Please review the final award letter
received during the FFY for the reporting period and the Federal Financial Report
(FFR) submitted using standard form 425 (SF-425) for this reporting period. Please ensure all
allocations, obligations, and carry-over amounts reported below are for funds awarded in
this FFY and are reconciled with the amounts reported in the FFR.
D1.
Distribution Formula: Did the state or territory institute any changes in the distribution
formula for the CSBG eligible entities during the reporting period covered by this
report?
☐ Yes
☐
No
D.1.a. If yes, please describe any specific changes and describe how the state or territory complied
with the assurances provided in Question 14.8 of the CSBG State Plan as required under Section
676(b)(8) of the State CSBG Act?
D.2.
Planned vs. Actual Allocation and Expenditures: Using the table below, specify the
actual allocation of 90 percent of CSBG funds to CSBG eligible entities, as described
under Section 675C(a) of the CSBG Act. This table must be based on actual dollars
allocated, obligated to, and expended (liquidated) for each CSBG eligible entity during
the FFY. For each CSBG eligible entity receiving CSBG funds, provide the Funding
Amount allocated to the CSBG eligible entity during the FFY.
Note: The Amount Allocated and the Amount Obligated are going to be an exact match
the majority of the time. Amounts expended (liquidated) should reflect actual payments
made to eligible entities.
Actual Amount
of Allocations
CSBG Eligible
Entity
Planned
Allocations
(The Amount
Allotted to each
entity based on
State Formula
from current FFY
funding)
Actual Amount
of Obligations
(The actual
amount made
available
through subawards to each
entity during the
FFY from current
FFY
funding)
Actual
Expenditures
Carry-over
Expenditures
(The actual
amount
liquidated to
each entity
during the
FFY from
current FFY
funding)
(The actual
amount liquidated
to each entity
during the FFY
from prior FFY
funding)
Total
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Administrative Funds [Section 675C(b)(2) of the CSBG Act]
D.3.
Administrative Funds: What amount of state or territory CSBG funds did the state or
territory obligate for administrative activities during the FFY? The amount must be
based on actual dollars allocated during the FFY. If you provided a percentage in
Question 7.6 in the CSBG State Plan, please convert to dollars.
Actual Amount of
Allocation
CSBG State Plan
Target
D.4.
(The amount
allotted for state
or territory
administrative
activities)
Actual Amount of
Obligation
Actual Amount of
Expenditures
(The actual amount
formally committed
for procurement or
direct expenditure
activities during the
FFY through state
or territory)
(The actual amount
liquidated through
procurement or
direct expenditure
activities during the
FFY through state
or territory)
(The actual amount
liquidated through
procurement or
direct expenditure
activities from prior
year FFY through
State or territory)
Staff Positions Funded: How many state or territory staff positions were funded in whole
or in part with CSBG funds in the reporting period (FFY)?
CSBG State Plan
D.5.
Actual Carryover
Expenditures
Actual Number
State FTEs: How many state or territory Full Time Equivalents (FTEs) were funded with
CSBG funds in the reporting period (FFY)?
CSBG State Plan
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Remainder or Discretionary Funds [Section 675C(b) of the CSBG Act]
D.6.
Describe how the state or territory used remainder or discretionary funds in the table
below.
Instructional Note: This table in the administrative report must be based on actual dollars.
obligated to each budget category using funds awarded in this FFY. States and territories that
do not have remainder or discretionary funds will not complete this item. If a funded activity
fits under more than one category in the table, allocate the funds among the categories.
For example, if the state provides funds under a contract with the state or territory community
action association to provide TTA to CSBG eligible entities and create a statewide data system,
the funds for that contract should be allocated appropriately between Row a and Row c. If an
allocation is not possible, the state or territory may allocate the funds to the main category
with which the activity is associated.
Note: This information is associated with State Accountability Measures 3Sa.
Description of Activities
Remainder or Discretionary Fund Uses (See
675C(b)(1) of the CSBG Act)
Planned Allocation
Actual Allocation
(The Actual Amount Allotted)
D.6a. Training and Technical Assistance to
eligible entities
D.6b. Coordination of state-operated or
territory-operated programs or local programs
D.6c. Statewide coordination and
communication among eligible entities
D.6d. Analysis of distribution of CSBG funds to
determine if targeting greatest need
D.6e. Asset-building programs
D.6f. Innovative programs or activities by
eligible entities or other neighborhood groups
D.6g. State or territory charity tax credits
D.6h. Other activities, specify
Totals
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OMB No. 0970-0492
D.7.
What types of organizations, if any, did the state or territory work with (by grant or
contract using remainder or discretionary funds) to carry out some or all of the activities
in Table C.6. (above)? Check all that apply and provide a narrative where applicable.
☐ State or territory offices (if checked, include the name of the state or
territory office(s))
☐ CSBG eligible entities (if checked, include the expected number of CSBG
eligible entities to receive funds)
☐ Other community-based organizations
☐ State or territory community action association
☐ Regional CSBG technical assistance provider(s)
☐ National technical assistance provider(s)
☐
☐
☐
☐
D.8.
Individual consultant(s)
Tribes and tribal organizations
Other
None (the state will carry out activities directly)
Total Obligations and Expenditures: Total CSBG funds obligated and expended from
CSBG funds awarded for the FFY. Review and confirm from the chart below).
Category
Actual Obligations
Actual Expenditures
D.8a. CSBG Eligible Entities Funds
(from state or territory CSBG
90% formula funds)
D.8b. State or Territory
Administrative Costs
D.8c. Remainder or Discretionary
Funds
D.8d. Total
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Section E: State Training and Technical Assistance
E.1.
Training and Technical Assistance: Describe how the state or territory delivered CSBGfunded training and technical assistance to CSBG eligible entities by completing the
table below. Add a row for each activity: indicate the time frame; whether it was
training, technical assistance, or both; and the topic.
Training, Technical
Assistance, Both
From Table 8.1 of
the CSBG State Plan
• Training
• Technical
Assistance
• Both
Evaluation
Measures for
TTA
Topic
•
•
From Table
8.1 of the CSBG State Plan
• Fiscal
• Governance or Tripartite
Boards
• Organizational
Standards – General
• Organizational Standards
– for Eligible Entities with
unmet standards on TAPs
or QIPs
• Correcting Significant
Deficiencies Among
CSBG Eligible Entities
• Reporting
• ROMA
• Community
Assessment
• Strategic Planning
• Monitoring
• Communication
• Technology
• Other
CSBG Annual Report 3.0
TTA Organization
•
•
•
•
•
•
11
CSBG Eligible Entities
Other CommunityBased
Organizations
State Community
Action Association
Regional CSBG
Technical Assistance
Provider(s)
National Technical
Assistance Provider(s)
Individual consultant(s)
Tribes and Tribal
Organizations
Other
Brief Description
Provide additional
brief explanation of
the technical
assistance activities
implemented. If
“Other” was selected
in Column 3, describe
in this column.
Indicate the types of
organizations
through which the
state or territory
provided training or
technical assistance
and briefly describe
their involvement.
OMB No. 0970-0492
Section F: State Linkages and Communication
F.1.
Workforce Innovation and Opportunity Act (WIOA) Employment and Training
Combined Plan Activities (if applicable): If the state or territory included CSBG
employment and training activities as part of a WIOA Unified or Combined State Plan as
a required one-stop partner program designated under Section 121(b)(1)(B)(x) of WIOA
or as an optional combined plan partner program, provide a brief narrative describing
the status of WIOA coordination activities, including web links, if available, to any
publicly accessible WIOA plans and reports.
F.2.
Coordination and feedback among CSBG Eligible Entities and the State or Territory
Community Action Association: Review and update state or territory activities that took
place to support coordination among the CSBG eligible entities and the state or territory
community action association.
F.3.
State Linkages and Coordination at the State Level: Provide an update on the linkages
and coordination identified in the CSBG State Plan intended to ensure increased access
to CSBG services to people and communities with low –incomes.
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Section G: Monitoring, Corrective Action, and Fiscal Controls
G.1.
Monitoring Schedule: Update the monitoring schedule below. Briefly describe the
actual monitoring visits conducted during the FFY, including: full on-site reviews; on-site
reviews of newly designated entities; follow-up reviews—including return visits to
entities that failed to meet state or territory goals, standards, and requirements; and
other reviews as appropriate.
If a monitoring visit was planned during the year but not implemented, provide a brief
explanation in the far-right column of the table below.
CSBG Eligible
Entity
G.2.
Monitoring Type
Review Type
Dropdown
Options:
• Full on-site
• Newly
Designated
• Follow-up
• Other
• No Review
Dropdown
Options:
• On-site
Review
• Desk
Review
Monitoring
Start Date
[Enter Date]
Monitoring
End Date
[Enter End
Date]
Brief Description
of Purpose
Note: If the visit
was not a part of
the original
monitoring plan,
provide a brief
explanation for
the purpose of
the visit (e.g., a
follow-up
regarding a
special issue).
This section
should not be
used to outline
findings.
Monitoring Policies: Were any modifications made to the state or territory’s monitoring
policies and procedures during the reporting period (FFY)?
☐Yes
☐No
If changes were made to state or territory monitoring policies and procedures, attach or
provide a hyperlink to the modified documents.
G.3.
Initial Monitoring Reports: Were all state or territory monitoring reports conducted in a
manner consistent with state or territory monitoring policies and procedures and
disseminated to CSBG eligible entities within 60 calendar days?
☐Yes
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Corrective Action, Termination, and Reduction of Funding and Assurance Requirements
(Section 678C of the CSBG Act)
G.4.
G.5.
G.6.
Technical Assistance (TA): How many CSBG eligible entities within the state or territory
are receiving technical assistance due to issues of noncompliance during the FFY?
[INSERT NUMBER]
Of the CSBG eligible entities receiving technical assistance, how many were not resolved
during the FFY and why? [NARRATIVE]
Quality Improvement Plans (QIPs): How many CSBG eligible entities within the state or
territory are on a QIP due to issues of noncompliance during the FFY? [INSERT NUMBER]
Of the CSBG eligible entities on a QIP, how many were not resolved during the FFY and
why? [NARRATIVE]
Single Audit Review: Pass-through entities are required by 2 CFR 200.331(f) to verify
that every sub-recipient is audited as required by 2 CFR 200.501. In the table below,
provide the information for any CSBG eligible entity single audit in the Federal Audit
Clearinghouse (FAC) submitted during FFY.
2 CFR 200.521 requires pass-through entities to provide a management decision for
findings related to federal awards the pass-through makes to the sub-recipients. If
applicable, provide the information regarding these decisions.
Eligible
Entity
G.7.
Eligible
Entity
Required
to Report
Single
Audit in
FAC
Eligible
Entity
Submitted
a Single
Audit in
FAC?
Date Audit
was Accepted
by FAC
If Entity did
not submit
as required,
has the state
taken steps
to ensure
compliance?
State
Management
Decision
Required? (As
Applicable)
Date
Management
Decision
Issued (As
applicable)
Single Audit Management Decisions: Briefly describe any management decisions issued
according to state or territory procedures of CSBG eligible entity single audit. Provide
the audit finding reference number from the FAC and describe any required actions and
timelines for correction.
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G.8.
Actual Distribution Time Frame: Did the state or territory make funds available to CSBG
eligible entities no later than 30 days after OCS distributed the federal award?
☐No
☐Yes
G.8a.
If no, did the state or territory implement procedures to ensure funds were made
available to CSBG eligible entities consistently and without interruption?
☐Yes
G.8b.
☐No
If the state or territory was not able to make CSBG funds available within 30 calendar
days after OCS distributed the federal award and was not able to ensure that funds
were made available consistently and without interruption, provide an explanation of
the circumstances below along with a description of planned corrective actions.
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Section H: Performance Measurement
H.1.
Performance Measurement System Participation: Confirm the performance
measurement system that the state or territory and CBSG eligible entities use, as
required by Section 678E(a) of the CSBG Act and the assurance under Section 676(b)(12)
of the CSBG Act.
☐ The Results Oriented Management and Accountability (ROMA) System
☐ Performance measurement system that meets the requirements of Section
678E(b) of the CSBG Act
☐ An alternative system for measuring performance and results
H.1a.
If ROMA was selected in G.1, provide an update on any changes in procedures or to data
collection systems that were initiated or completed in the reporting period.
H.1b.
If ROMA was not selected in Item G.1, describe the system the state used for
performance measurement. Provide an update on any changes in procedures or to data
collection systems that were initiated or completed in the reporting period.
H.2.
Performance Measurement System Support: How did the state or territory support the
CSBG eligible entities in using a performance measurement system to promote
continuous improvement? For example, describe any data systems improvements,
support for community needs assessment, support for strategic planning, data analysis,
etc.
H.3.
State or Territory Review of CSBG Eligible Entity Data: Describe the procedures and
activities the state or territory used to review the performance measurement data from
CSBG eligible entities for completion and accuracy (e.g., methodology used for
validating the data submitted annually by the local agencies).
H.4.
State or Territory Feedback on Data Collection, Analysis, and Reporting: State
Accountability Measure 5S(ii) requires states or territories to submit written feedback to
each CSBG eligible entity regarding the entity’s performance in meeting goals, as
measured through National Performance Indicator (NPI) data, within 60 calendar days
of submitting the state’s Annual Report. Has the state provided each CSBG eligible entity
with timely feedback (within at least 60 days of the submission) regarding the entity’s
performance in meeting ROMA goals as measured through national performance data?
☐Yes
☐No
If no, please describe.
H.5.
State and CSBG Eligible Entity Continuous Improvement: Provide 2–3 examples of
changes made by CSBG eligible entities to improve service delivery and enhance impact
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OMB No. 0970-0492
for individuals, families, and communities with low incomes based on their in-depth
analysis of performance data.
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Eligible Entity Administration
Module 2
The reporting time frames for all information in the eligible entity expenditures,
capacity, and resources module are based on the federal fiscal year (FY), which
runs from October 1 of a given calendar year until September 30 of the following
calendar year.
Section A: CSBG Expenditures by CSBG Eligible Entity meets the
Congressional requirement for an explanation of the total amount of CSBG
funding expended during the reporting period (identified below) based on
categories referenced in the CSBG Act.
CSBG funding expended during the FFY should be identified in the domain
that best reflects the services delivered and strategies implemented, as well
as the administrative costs associated with the domains.
Section B: CSBG Eligible Entity Capacity Building provides detail on agency
capacity building funded by CSBG and other funding sources.
Section C: Allocated Resources per CSBG Eligible Entity provides data on
resources allocated to, administered through, and generated by the CSBG
eligible entity. This report provides valuable information on how CSBG
leverages funds from multiple federal, state, local, and private sources as
required in the CSBG Act.
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Section A: CSBG Expenditures by CSBG Eligible Entity
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
A.1. CSBG Expenditures Domains
A.1a. Employment
A.1b. Education
A.1c. Income and Asset Building
A.1d. Housing
A.1e. Health and Nutrition
A.1f. Civic Engagement and Community Involvement
A.1g. Transportation
A.1h. Linkages (e.g., partnerships that support multiple domains)
A.1i. Agency Capacity Building
A.1j. Other (e.g., emergency management or disaster relief)
CSBG Funds
A.2k. Total CSBG Expenditures (auto-calculated)
A.2. Of the CSBG funds reported above, report the total amount used for Administration.
A3. Total Amount of CSBG Funding Allocated for Federal Fiscal Year
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$0
Section B: CSBG Eligible Entity Capacity Building
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
B.1. Volunteer Hours of Agency Capacity Building (e.g., program support, service delivery, fundraising):
B.1a. Total number of volunteer hours donated to the agency
B.1a.1. Of the above, the total number of volunteer hours donated by individuals with low incomes
B.2. Number of organizations, both public and private, that the CSBG eligible entity actively works with to expand
resources and opportunities in order to achieve family and community outcomes:
B.2a. Non-Profit
B.2b. Faith Based
B.2c. Local Government
B.2d. State Government
B.2e. Federal Government
B.2f. For-Profit Business or Corporation
B.2g. Consortiums or Collaborations
B.2h. School Districts
B.2i. Institutions of Post-Secondary Education or Training
B.2j. Financial or Banking Institutions
B.2k. Health Service Organizations
B.2l. Statewide Associations or Collaborations
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Hours
Unduplicated Number
of Organizations
OMB No. 0970-0492
Section C: Allocated Resources per CSBG Eligible Entity
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
C.1. Federal Resources Allocated (Other than CSBG)
C.1a. Weatherization (DOE) (include oil overcharge $$)
C.1a.
C.1b. Health and Human Services (HHS)
C.1b.1.
LIHEAP - Energy Assistance (Excluding Weatherization) (include oil overcharge $$)
C.1b.1.
C.1b.2.
LIHEAP - Weatherization (include oil overcharge $$)
C.1b.2.
C.1b.3.
Head Start
C.1b.3.
C.1b.4.
Early Head Start
C.1b.4.
C.1b.5.
Older Americans Act
C.1b.5.
C.1b.6.
Social Services Block Grant (SSBG)
C.1b.6.
C.1b.7.
Medicare or Medicaid
C.1b.7.
C.1b.8.
Temporary Assistance for Needy Families (TANF)
C.1b.8.
C.1b.9.
Child Care Development Block Grant (CCDBG)
C.1b.9.
C.1b.10.
Community Economic Development (CED)
C.1b.10.
C.1b.11.
Other HHS Resource Description
C.1b.11.i.
C.1b.11.ii.
C.1b.11.iii.
C.1b.11.iv.
CFDA #:
CFDA #:
CFDA #:
CFDA #:
C.1b.12. Total Other HHS Resources
C.1b.11.i.
C.1b.11.ii.
C.1b.11.iii.
C.1b.11.iv.
C.1b.12.
C.1c. Department of Agriculture (USDA)
C.1c.1.
Special Supplemental Nutrition for Women, Infants, and Children (WIC)
C.1c.1.
C.1c.2.
All USDA Non-Food programs (e.g., rural development)
C.1c.2.
C.1c.3.
All other USDA Food programs
C.1c.3.
C.1d. Department of Housing and Urban Development (HUD)
C.1d.1.
Community Development Block Grant (CDBG) - Federal, State, and Local
C.1d.1.
C.1d.2.
Section 8
C.1d.2.
C.1d.3.
Section 202
C.1d.3.
C.1d.4.
Home Tenant-Based Rental Assistance (HOME TBRA)
C.1d.4.
C.1d.5.
HOPE for Homeowners Program (H4H)
C.1d.5.
C.1d.6.
Emergency Solutions Grant (ESG)
C.1d.6.
C.1d.7.
Continuum of Care (CoC)
C.1d.7.
C.1d.8.
All other HUD programs, including homeless programs
C.1d.8.
C.1e. Department of Labor (DOL)
C.1e.1.
Workforce Innovation and Opportunity Act (WIOA) *previously WIA
C.1e.1.
C.1e.2.
Other DOL Employment and Training programs
C.1e.2.
C.1e.3.
All other DOL programs
C.1e.3.
C.1f. Corporation for National and Community Service (CNCS) programs
C.1g. Federal Emergency Management Agency (FEMA)
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C.1f.
C.1g.
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C.1h. Department of Transportation
C.1h.
C.1i. Department of Education
C.1j. Department of Justice
C.1k. Department of Treasury
C.1l. Other Federal Resources
C.1i.
C.1j.
C.1k.
C.1l.i.
CFDA #:
C.1l.i.
C.1l.ii.
CFDA #:
C.1l.ii.
C.1l.iii.
CFDA #:
C.1l.iii.
C.1l.iv.
CFDA #:
C.1l.iv.
C.1m. Total Other Federal (Non-CSBG) Resources
C.1m.
C.2. State Resources Allocated
C.2a.
State appropriated funds used for same purpose as Federal CSBG funds
C.2a.
C.2b.
State Housing and Homeless programs (include housing tax credits)
C.2b.
C.2c.
State Nutrition programs
C.2c.
C.2d.
State Early Childhood Programs (e.g., Head Start, Day Care)
C.2d.
C.2e.
State Energy programs
C.2e.
C.2f.
State Health programs
C.2f.
C.2g.
State Youth Development programs
C.2g.
C.2h.
State Employment and Training programs
C.2h.
C.2i.
State Senior programs
C.2i.
C.2j.
State Transportation programs
C.2j.
C.2k.
State Education programs
C.2k.
C.2l.
State Community, Rural, and Economic Development programs
C.2l.
C.2m.
State Family Development programs
C.2m.
C.2n.
Other State Resources
C.2n.i.
C.2n.i.
C.2n.ii.
C.2n.ii.
C.2n.iii.
C.2n.iii.
C.2n.iv.
C.2n.iv.
C.2o. Total Other State Resources
C.2o.
C.2p. Total: State Resources Allocated
C.2p.
C.3. Local Resources Allocated
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C.3a.
Amount of unrestricted funds appropriated by local government
C.3a.
C.3b.
Amount of restricted funds appropriated by local government
C.3b.
C.3c.
Value of contract services
C.3c.
C.3d.
Value of in-kind goods or services received from local government
C.3d.
C.3e. Total: Local Resources Allocated
C.3e.
C.4. Private Sector Resources Allocated
C.4a.
Funds from foundations, corporations, United Way, other nonprofits
C.4a.
C.4b.
Other donated funds
C.4b.
C.4c.
Value of other donated items, food, clothing, furniture, etc.
C.4c.
C.4d.
Value of in-kind services received from businesses
C.4d.
C.4e.
Payments by clients for services
C.4e.
C.4f.
Payments by private entities for goods or services for low income
clients or communities
C.4f.
C.4g. Total: Private Sector Resources Allocated
C.4g.
C.5. Total Non-CSBG Resources Allocated: (Federal, State, Local, & Private)
C.6. Total Resources in CSBG Eligible Entity (including CSBG)
C.5.
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C.6.
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Individual and Family Level Services
Module 3
The reporting time frames for all information in the individual and family level
module are based on the federal fiscal year (FY), which runs from October 1 of a
given calendar year until September 30 of the following calendar year.
The data collected in this module relates to Goal 1: Individuals and families with
low incomes are stable and achieve economic security.
Section A: Individual and Family Services provides information on the work CSBG
eligible entities did to help individuals and families achieve the outcomes listed in
Section B. This standardized Individual and Family Services list will aid in analysis
of the relationship between individuals, services, and outcomes.
Section B: Individual and Family NPIs is comprised of indicators to report
outcomes that fall under National Goal 1: Individuals and families with low
incomes are stable and achieve economic security. The indicators are the vehicle
by which CSBG eligible entities measure and report the outcomes they have
achieved for individuals and families. All Individual and Family NPIs are optional.
Section C: All-Characteristics Report collects data on all individuals and
households, whether funded directly by CSBG. This demographic information
strengthens the CSBG Annual Report by demonstrating who is being served by
CSBG eligible entities.
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Module 3, Section A: Individual and Family Services
Service Delivery and Access
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Unduplicated Number
Served
Service Delivery
SDA 1a. The number of individuals receiving eligibility determinations
SDA 1b. The number of individuals receiving referrals
SDA 1c. The number of individuals receiving case management services
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Employment Services
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Unduplicated Number
Served
Employment Services (SRV 1)
Pre-Employment Readiness
SRV 1a. The number of youth who received skills training and opportunities for job
readiness (e.g., vocational training, apprenticeship, self-employment)
SRV 1b. The number of adults who received skills training and opportunities for job
readiness (e.g., vocational training, apprenticeship, self-employment)
SRV 1c. The number of individuals who received employment supplies for employment
readiness or sustainment (e.g., uniforms, work boots, equipment)
Post-Employment (Retention and Growth)
SRV 1d. The number of individuals who received services for employment retention and
growth (e.g., referrals, employer interaction, career pathways)
Other Employment Services
SRV 1e. Other employment services (please describe)
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Education Services
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Education and Youth Development Services (SRV 2)
Unduplicated Number
Served
Childcare, Early Childhood, Young Adult Education Services
SRV 2a. The number of individuals (age 0-5) who received Head Start services
SRV 2b. The number of individuals receiving childcare subsidies or payments
SRV 2c. The number of individuals who received early childhood education (0-5),
outside of Early Head Start and Head Start
SRV 2d. The number of individuals who received K-12 education support services
(e.g., English, literacy, etc.)
SRV 2e. The number of youth who attended young adult literacy classes
SRV 2f. The number of individuals who received college or post-secondary readiness
support (e.g., applications, scholarships, textbooks, computers)
School Supplies
SRV 2g. The number of individuals who received school supplies and equipment
Youth Programs and Skills Developments
SRV 2h. The number of youth who attended before and after school activities
SRV 2i. The number of youth who participated in summer youth programs (e.g.,
recreational and educational)
SRV 2j. The number of youth who received life skills and coaching services
SRV 2k. The number of individuals who received educational financial assistance for
post-secondary education (e.g.: scholarships, stipends, grants)
Adult Education and Skills Development Programs
SRV 2l. The number of individuals who attended adult literacy classes
SRV 2m. The number of individuals who attended English Language classes (e.g.,
English for Speakers of Other Languages)
SRV 2n. The number of individuals who attended high school equivalency classes
SRV 2o. The number of individuals who attended applied technology classes
SRV 2p. The number of individuals who received life skills and coaching services
SRV 2q. The number of individuals who received parenting supports (e.g.: parent
coaching, skills, etc.)
SRV 2r. The number of individuals who attended adult basic education classes
Home Visits
SRV 2s. The number of households that participated in a home visiting program
Other Childcare, Early Childhood, Youth Development, and Adult Education Services
SRV 2t. Other education, childcare, and youth development service (please describe)
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Income and Asset Building Services
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Income and Asset Building Services (SRV 3)
Unduplicated Number
Served
Training and Counseling Services
SRV 3a. The number of individuals who received training and counseling services
for income management and asset building (e.g., VITA, tax preparation services,
credit repair, financial literacy, financial management, budgeting, homebuying,
foreclosure avoidance)
SRV 3b. The number of individuals who received business or self-employment
services (e.g., micro-loans, business development loans, business development,
entrepreneurial support)
Benefit Coordination and Advocacy
SRV 3c. The number of individuals who received benefit coordination services
(e.g., child support, health insurance, SSI, Veterans, TANF, SNAP)
Other Income and Asset Building Services
SRV 3d. Other income and asset building services (please describe)
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Housing Services
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Unduplicated Number
Served
Housing Services (SRV 4)
Housing Assistance
SRV 4a. The number of individuals who received rental payment assistance (e.g.,
emergency rental payments and deposits)
SRV 4b. The number of individuals who received housing payment assistance
(e.g., down payments and emergency mortgage payments)
SRV 4c. The number of individuals who received rapid re-housing and housing
placement services (e.g., temporary, transitional, and permanent housing
placements)
Eviction Prevention Services
SRV 4d. The number of individuals who received eviction prevention services
(e.g., housing counseling, eviction counseling, landlord or tenant mediations and
rights)
Utility Assistance Services
SRV 4e. The number of individuals who received utility payment assistance (to
include deposits, arrears, and assistance)
Housing Maintenance & Improvements
SRV 4f. The number of households who received housing maintenance and
improvement services (e.g., structural, accessibility improvements, emergency
home repairs, water safety, healthy home)
Weatherization and Energy Efficiency Services
SRV 4g. The number of households that received weatherization or energy
efficiency services
Other Housing Services
SRV 4h. Other housing services (please describe)
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Health and Nutrition Services
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Health and Nutrition Services (SRV 5)
Unduplicated Number
Served
Health Services, Screening and Assessments
SRV 5a. The number of individuals who received immunizations
SRV 5b. The number of individuals who received health screenings (e.g.,
physicals, chronic health screenings)
SRV 5c. The number of individuals who received developmental delay screening
Health Insurance Coverage & Payment
SRV 5d. The number of individuals who received healthcare payment assistance
(e.g., prescription payments, doctor visit payments)
SRV 5e. The number of individuals who received health insurance options
counseling
Maternal and Child Health & Reproductive Health Services
SRV 5f. The number of individuals who received reproductive health services
(e.g., family planning, contraceptives, STI or HIV prevention)
SRV 5g. The number of individuals who received maternal child or health
services (e.g., breastfeeding support, safe sleeping, postpartum support)
Wellness Services and Education
SRV 5h. The number of individuals who received general wellness services (e.g.,
medication management, mindfulness, exercise, fitness)
SRV 5i. The number of older adults and individuals with disabilities who
received a home visit (e.g., nursing, chores, personal care services)
SRV 5j. The number of older adults who participated in elder day centers or
senior centers
Mental and Behavioral Health
SRV 5k. The number of individuals who received substance use or misuse
services (e.g., intake, screening, counseling, support groups, and hotline, crisis
or call in-response)
SRV 5l. The number of individuals who received mental health services (e.g.,
intake, screening, counseling, support group, hotline, crisis or call in-response)
SRV 5m. The number individuals who received domestic violence prevention
and support services (e.g., support groups and hotline, crisis or call in-response)
Dental Services, Screenings and Exams
SRV 5n. The number of adults who received dental services (e.g., screenings,
exams, procedures)
SRV 5o. The number of children who received dental services (e.g., screenings,
exams, procedures)
Food and Nutrition
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SRV 5p. The number of individuals who received food or nutrition skills classes
(cooking, nutrition)
SRV 5q. The number of prepared meals provided (e.g., through a congregate
nutrition site, Meals on Wheels, a prepared food delivery or pickup program)
SRV 5r. The number of food distribution package packages provided (bags,
boxes, food share, groceries)
SRV 5s. The number of individuals who participated in community gardening
activities
Basic Health Needs and Supplies
SRV 5t. The number of hygiene kits or supplies (e.g., hygiene kits, toothpaste,
soap, deodorant, menstrual products) provided to individuals and families
SRV 5u. The number of diapers or diapering supplies (e.g., diapers, wipes)
provided to individuals and families
SRV 5v. The number of individuals accessing hygiene utilization services (e.g.,
showers, toilets, sinks, laundry facilities)
SRV 5w. The number of individuals who received clothing assistance
Other Health and Nutrition
SRV 5x. Other health and nutrition services (please describe)
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Civic Engagement and Community Involvement Services
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Civic Engagement and Community Involvement Services
Unduplicated Number
Served
SRV 6a. The number of individuals who received voter education and access
services
SRV 6b. The number of individuals who participated in a tri-partite board
SRV 6c. The number of individuals who engaged in volunteer opportunities
Other Civic Engagement and Community Involvement
SRV 6d. Other civic engagement and community involvement services (please
describe)
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Transportation Services
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
Transportation Services (SRV 7)
Unduplicated Number
Served
Transportation
SRV 7a. The number of public transportation vouchers or passes provided to
individuals and families
SRV 7b. The number of gas cards provided to individuals and families
SRV 7c. The number non-medical transportation rides provided to individuals
and families
SRV 7d. The number of medical transportation rides provided to individuals and
families
SRV 7e. The number rideshare or taxi vouchers provided to individuals and
families
SRV 7f. The number of individuals receiving transportation repair services
(includes both automotive and non-automotive transportation)
SRV 7g. The number of individuals receiving automotive support (e.g., insurance
premiums, car payments assistance)
Other Transportation Service
SRV 7h. Other transportation services (please describe)
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Module 3, Section B: Individual and Family NPIs
Employment Performance Indicators
Employment (FNPI 1)
I.) Number
Served
in program(s) (#)
II.) Target (#)
III.) Actual
Results (#)
IV.)
Percentage
Achieving
Outcome
[III/I = IV]
V.)
Performance
Target
Accuracy
(III/II = V]
FNPI 1a. The number of unemployed youth
who increased skills to obtain employment
FNPI 1b. The number of unemployed adults
who increased skills to obtain employment
FNPI 1c. The number of youth who obtained
employment
FNPI 1d. The number of adults who obtained
employment
FNPI 1e. The number of employed individuals
who increased wage or salary income from
employment
FNPI 1f. Other (please describe)
Comments:
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Education Performance Indicators
Name of CSBG Eligible Entity Reporting:
State or Territory:
Education and Youth Development (FNPI 2)
UEI:
I.) Number
Served
in program(s) (#)
II.) Target (#)
III.) Actual
Results (#)
IV.)
Percentage
Achieving
Outcome
[III/I = IV]
V.)
Performance
Target
Accuracy
(III/II = V]
FNPI 2a. The number of children (0-5) who
showed developmental progress, including
school readiness, after early childhood
education or childcare services
FNPI 2b. The number of youth who improved
skills or competencies through education and
skills development programs.
FNPI 2c. The numbers of adults who improved
their basic education skills
FNPI 2d. The number of individuals who
increased their education by obtaining a high
school diploma or obtained an equivalency
certificate or diploma
FNPI 2e. The number of individuals who
increased their education by obtaining a
recognized credentiaor certificate that
improved educational or vocational skills
FNPI 2f. The number of individuals who
increased their education by obtaining a postsecondary degree program (e.g., associates,
bachelors, etc.)
FNPI 2g. Other (please describe)
Comments:
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Income and Asset Building Performance Indicators
Name of CSBG Eligible Entity Reporting:
State or Territory:
Income and Asset Building (FNPI 3)
UEI:
I.) Number
Served
in program(s) (#)
II.) Target (#)
III.) Actual
Results (#)
IV.)
Percentage
Achieving
Outcome
[III/I = IV]
V.)
Performance
Target
Accuracy
(III/II = V]
FNPI 3a. The number of individuals who
increased their financial capability, knowledge,
or skills as a result ofincome and asset building
training
FNPI 3b. The number of individuals who
increased one or more assets (e.g., savings
account, IDA, home purchase, reduced debt)
FNPI 3c. The number of individuals who
started a business.
FNPI 3d. The number of eligible individuals
with increased public benefits to assist with
economic self-sufficiency (e.g., child support,
health insurance, SSI, Veterans, TANF, SNAP,
WIC)
FNPI 3e. Other (please describe)
Comments:
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Housing Performance Indicators
Name of CSBG Eligible Entity Reporting:
State or Territory:
Housing (FNPI 4)
UEI:
I.) Number
Served
in program(s) (#)
II.) Target (#)
III.) Actual
Results (#)
IV.)
Percentage
Achieving
Outcome
[III/I = IV]
V.)
Performance
Target
Accuracy
(III/II = V]
FNPI 4a. The number of individuals
experiencing homelessness who obtained safe
temporary shelter
FNPI 4b. The number of individuals who
obtained and or maintained safe and
affordable housing
FNPI 4c. The number of individuals who
avoided eviction
FNPI 4d. The number of individuals who
avoided foreclosure
FNPI 4e. The number of households who
improved home health, safety, through home
improvements (e.g., water safety, reduction or
elimination of lead, radon abatement, carbon
monoxide or fire hazards or electrical issues,
etc.)
FNPI 4f. The number of households who
improved energy efficiency (e.g.,
weatherization, energy efficiency
enhancements)
FNPI 4g. The number of households who
avoided utility shut-off, had utility service
restored, or had reduced utility costs
FNPI 4h. Other (please describe)
Comments:
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Health and Nutrition Indicators
Name of CSBG Eligible Entity Reporting:
State or Territory:
Health and Nutrition (FNPI 5)
UEI:
I.) Number
Served
in program(s) (#)
II.) Target (#)
III.) Actual
Results (#)
IV.)
Percentage
Achieving
Outcome
[III/I = IV]
V.)
Performance
Target
Accuracy
(III/II = V]
FNPI 5a. The number of individuals served who
improved their health and well-being through
preventative measures
FNPI 5b. The number of individuals served with
increased access to health coverage
FNPI 5c. The number of individuals whose
health issue was treated by receiving health
services
FNPI 5d. The number of individuals served who
improved their reproductive health through
access to reproductive wellness services
FNPI 5e. The number of individuals served who
improved wellness through wellness services
(e.g., exercise, meditation, stress reduction,
healthy aging)
FNPI 5f. The number of older adults who
maintained an independent living situation
through increased access to home visiting
services
FNPI 5g. The number of individuals served who
then improved their mental health, behavioral
health, or well-being
FNPI 5h. The number of adults served who
improved their oral health through
participation in oral health services
FNPI 5i. The number of children served who
improved their oral health through
participation in oral health services
FNPI 5j. The number of individuals served who
improved food security through increased
access to healthy food options
FNPI 5k. Other (please describe)
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Civic Engagement and Community Involvement Indicators
Name of CSBG Eligible Entity Reporting:
State or Territory:
Civic Engagement and Community
Involvement Indicators (FNPI 6)
UEI:
I.) Number
Served
in program(s) (#)
II.) Target (#)
III.) Actual
Results (#)
IV.)
Percentage
Achieving
Outcome
[III/I = IV]
V.)
Performance
Target
Accuracy
(III/II = V]
FNPI 6a. The number of individuals with low
incomes who increased skills, knowledge, and
abilities to help improve conditions in their
community
FNPI 6b. Other (please describe)
Comments:
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Module 3, Section C: All Characteristics Report
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI
INVIDUALS SERVED
A. Total unduplicated number of all INDIVIDUALS about
whom one or more characteristics were obtained:
HOUSEHOLDS SERVED
B. Total unduplicated number of all HOUSEHOLDS
about whom one or more characteristics were
obtained:
INDIVIDUAL LEVEL CHARACTERISTICS
C1. Gender Identity
Number of Individuals
a. Male
b. Female
c. Transgender, non-binary, or another gender
d. Unknown or not reported
e. TOTAL (auto-calculated)
C2. Age
Number of Individuals
a. 0-4
b. 5-17
c. 18-24
d. 25-34
e. 35-44
f. 45-64
g. 65-84
h. 85 and older
i. Unknown or Not Reported
j. TOTAL
C3. Education Levels
Number of Individuals
[ages 5-24]
[ages 25+]
a. Grades 0-8
b. Grades 9-12 or Non-Graduate
c. High School Graduate, GED, or Equivalency Diploma
e. 12 grade + Some Post-Secondary
f. 2 or 4 year College Graduate
g. Graduate of other post-secondary school
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h. Unknown or Not Reported
i. TOTAL
C4. Disconnected Youth
Number of Individuals
a. Youth ages 14-24 who are neither working or in school
C5. Health
Number of Individuals
a. Provide the number of individuals with a disability.
Yes
No
Unknown
a. Health Insurance*
*If an individual reported that they had health insurance, please identify the source of health insurance below.
Health Insurance Sources
b.1. Medicaid
b.2. Medicare
b.3. State Children’s Health Insurance Program
b.4. State Health Insurance for Adults
b.5. Military Health Care
b.6. Direct-Purchase
b.7. Employment-Based
b.8. Unknown or Not Reported
b.9. TOTAL
C6. Race and Ethnicity
Number of Individuals
a. American Indian or Alaska Native
b. Asian
c. Black or African American
d. Hispanic or Latino
e. Middle Eastern or North African
f. Native Hawaiian and Pacific Islander
g. White
h. Multiracial or Multiethnic (two or more of the above)
i. Unknown or Not Reported
j. TOTAL
C7. Military Status
Number of Individuals
a. Veteran
b. Active Military
c. Never Served in the Military
d. Unknown or Not Reported
e. TOTAL
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C8. Work Status (Individuals 18+)
Number of Individuals
a. Employed Full-Time
b. Employed Part-Time
c. Migrant or Seasonal Farm Worker
d. Unemployed (Short-Term, 6 months or less)
e. Unemployed (Long-Term, more than 6 months)
f. Unemployed (Not in Labor Force)
g. Retired
h. Unknown or Not Reported
i. TOTAL
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HOUSEHOLD LEVEL CHARACTERISTICS
D9. Household Type
Number of Households
a. Single Person
b. Two Adults no children
c. Household with multiple adults with no children
d. Single Parent Female
e. Single Parent Male
f. Single Parent Non-Binary, Transgender, or Another Gender
g. Two Parent Household
h. Non-related Adults with Children
i. Multigenerational Household
j. Other
k. Unknown or Not Reported
l. TOTAL
D10. Household Size
Number of Households
a. Single Person
b. Two
c. Three
d. Four
e. Five
f. Six or more
g. Unknown or Not Reported
h. TOTAL
D11. Housing
Number of Households
a. Own
b. Rent
c. Other permanent housing
d. Homeless
e. Other
f. Unknown or Not Reported
g. TOTAL
D12. Level of Household Income
Number of Households
a. Up to 50%
b. 51% to 75%
c. 76% to 100%
d. 101% to 125%
e. 126% to 150%
f. 151% to 175%
g. 176% to 200%
h. 201% to 250%
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i. 251% and over
j. Unknown or Not Reported
k. TOTAL
Number of Households
D13. Sources of Household Income
a. Income from Employment Only
b. Income from Employment and Other Income Source
c. Income from Employment, Other Income Source, and NonCash Benefits
d. Income from Employment and Non-Cash Benefits
e. Other Income Source Only
f. Other Income Source and Non-Cash Benefits
g. No Income
h. Non-Cash Benefits Only
i. Unknown or Not Reported
j. TOTAL
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Community Level – Module 4
Section A: Community Initiative Status is where CSBG eligible entities identify
initiatives intended to achieve community level outcomes. This form provides a
central place to report valuable information about a single community initiative
that started, continued, or ended during the current reporting period. The
information reported on the status form will be selected via a dropdown menu.
Section B: Community NPIs Data provides an opportunity for CSBG eligible
entities to enter data for the community level outcomes reported in Section A,
Line 14. Entities may select from the indicators outlined in this section or create
their own indicator if none of the provided indicators capture what the CSBG
eligible entity is trying to achieve. To facilitate the reporting, use, and learning
from Community NPIs, the Annual Report provides two types of indicators
(Counts of Change and Rates of Change).
The first way to report impact is the Counts of Change indicators. These are basic
measures that provide the number of units being measured, e.g., jobs, houses,
resources, etc. that have been added (created) or subtracted (eliminated), and in
some cases maintained, in the community the CSBG eligible entity has targeted.
The second way to report impact is the Rates of Change indicators. While
requiring a bit more information, these indicators tell the full story of the
magnitude of the impact a community initiative (usually involving multiple
organizations) has had in a community.
Section C: Community Strategies List provides a basic identification of strategies,
arranged by domain and by topic area. The list cannot be all-inclusive; as such, an
“other” category is included. This standardized list will aid in local and state
analysis of the relationship between community-level strategies and outcomes.
CSBG Annual Report 3.0
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Module 4, Section A: Community Initiative Status
Name of CSBG Eligible Entity
Reporting:
State or Territory:
UEI:
Use the dropdown menu to select the response where appropriate.
1. Initiative Name
2. Initiative Year
3. Problem Identification
4. Goal or Agenda
5. Issue or CSBG Community Domains
6. Ultimate Expected Outcome
1-7+ years
Narrative
(Provide a narrative on the scope of the problem.)
Narrative
(Provide a narrative on the goal or agenda.)
Employment; Education and Cognitive Development; Income, Infrastructure, and
Asset Building; Housing; Health and Social or Behavioral Development; or Civic
Engagement and Community Involvement
Community-Level National Performance Indicators (NPIs)
(Reference the Community NPIs listed in Section B)
7. Identified Community
8. Expected Duration
9. Partnership Type
10. Partners
Neighborhood, City, School District, County, Service Area, State, Region, or Other
Narrative
(Provide the range in years, e.g., 1-3 years)
Independent CAA Initiative, CAA is the core organizer of multi-partner Initiative, or
CAA
is one of multiple active investors and partners
Narrative
(Provide a narrative on the key 1-3 partners)
11. Strategy(ies)
Select from the Community Level Strategies listed in Section C
12. Progress on Outcomes and
Indicators
No Outcomes to Report, Interim Outcomes, Final Outcomes
13. Impact of Outcomes
Narrative
(Provide additional information on the scope of the impact of these outcomes, e.g., if
an initiative created a health clinic, please describe how many individuals and
families are expected to be impacted.)
Community-Level National Performance Indicators (NPIs)
14. Outcomes and Indicators to Report
(Reference the Community NPIs listed in Section B)
Initiative Active, Initiative Ended Early, Initiative Ended as Planned, Completed Still
15. Final Status
Delivering Value
16. Lessons Learned
Narrative
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Module 4, Section B: Community National Performance Indicators (NPIs)
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
I.) Identified
Community
(auto-populated)
Counts of Change for Employment Indicators (CNPI 1)
II.) Target
(#)
III.) Actual
Results
(#)
IV.) Performance
target accuracy
(% auto-calculated)
Counts
CNPI 1a Number of jobs created to increase opportunities for individuals with low incomes in the identified
of
Change community
CNPI 1b Number of job opportunities maintained in the identified community
CNPI 1c Number of “living wage” jobs created in the identified community*
CNPI 1d Number of “living wage” jobs maintained in the identified community*
CNPI 1e Number of jobs created in the identified community with a benefit package
*When reporting on indicators related to living wage, agencies can provide their own definition or select from national or locally defined models. Please indicate the living wage definition used in the General Comment box.
I.) Identified
Community
Other Counts of Change for Employment Indicators (CNPI 1z) - Please specify below.
Other
Counts of CNPI 1z.1 Other
Change CNPI 1z.2 Other
II.) Target
(#)
(auto-populated)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
VI.) Actual %
change from
baseline
VII.) Performance
target accuracy
CNPI 1z.3 Other
I.) Identified
Community
Rates of Change for Employment Indicators (CNPI 1)
(auto-populated)
Rates of
Change
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
(Target % autocalculated)
(% auto-calculated)
(% autocalculated)
CNPI 1f Percent decrease of the unemployment rate
CNPI 1g Percent decrease of the youth unemployment rate
CNPI 1h Percent decrease of the underemployment rate
Other Rates of Change for Employment Indicators (CNPI 1z)
- Please specify below.
Other
Rates of
Change CNPI 1z.4 Other
CNPI 1z.5 Other
CNPI 1z.6 Other
CSBG Annual Report 3.0
I.) Identified
Community
(auto-populated)
0
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
(Target % autocalculated)
OMB No. 0970-0492
VI.) Actual %
change from
baseline
(% autocalculated)
VII.) Performance
target accuracy
(% auto-calculated)
General comments:
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
Counts of Change for Education and Cognitive Development Indicators (CNPI
2)
I.) Identified
Community
II.) Target
(#)
(auto-populated)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
CNPI 2a Number of accessible early childhood or pre-school education assets or resources added to the identified
community
CNPI 2b Number of accredited or licensed affordable childcare facilities added in the identified community
CNPI 2c Number of new early childhood screenings offered to children (ages 0-5) of families with low incomes in
Counts the identified community
of
CNPI 2d Number of accessible and affordable education assets or resources added for school age children in the
Change identified community (e.g., academic, enrichment activities, before and after school care, summer programs)
CNPI 2e Number of accessible and affordable post-secondary education assets or resources added for newly
graduating youth in the identified community (e.g., college tuition, scholarships, vocational training, etc.)
CNPI 2f Number of accessible and affordable basic or secondary education assets or resources added for adults in
the identified community (e.g., literacy, ESL, ABE, GED, etc.)
Other Counts of Change for Education and Cognitive Development Indicators (CNPI 2z) - Please specify below.
Other
Counts of CNPI 2z.1 Other
Change
CNPI 2z.2 Other
CNPI 2z.3 Other
I.) Identified
Community
II.) Target
(#)
(auto-populated)
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Rates of Change for Education and Cognitive Development
Indicators (CNPI 2)
I.) Identified
Community
(auto-populated)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
(Target % autocalculated)
VI.) Actual %
change from
baseline
VII.) Performance
target accuracy
(% auto-calculated)
(% autocalculated)
CNPI 2g Percent increase of children in the identified community
who are kindergarten ready
CNPI 2h Percent increase of children in the identified community
at (or above) the basic reading level
CNPI 2i Percent increase of children in the identified community
at (or above) the basic math level
CNPI 2j Percent increase in high school (or high school
Rates of equivalency) graduation rate in the identified community
Change
CNPI 2k Percent increase of the rate of youth in the identified
community who attend post-secondary education
CNPI 2l Percent increase of the rate of youth in the identified
community who graduate from post-secondary education
CNPI 2m Percent increase of adults in the identified community
who attend post-secondary education
CNPI 2n Percent increase of adults in the identified community
who graduate from post-secondary education
CNPI 2o Percent increase in the adult literacy rate in the
identified community
Other Rates of Change for Education and Cognitive Development
Indicators (CNPI 2z)
Other
Rates of
Change CNPI 2z.4 Other
CNPI 2z.5 Other
CNPI 2z.6 Other
- Please specify below.
I.) Identified
Community
(auto-populated)
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
(Target % autocalculated)
General comments:
CSBG Annual Report 3.0
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OMB No. 0970-0492
VI.) Actual %
change from
baseline
(% autocalculated)
VII.) Performance
target accuracy
(% auto-calculated)
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
Counts of Change for Infrastructure and Asset Building
Indicators (CNPI 3)
I.) Identified
Community
II.) Target
(#)
(auto-populated)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
CNPI 3a Number of new accessible assets and resources created in the identified community:
CNPI 3a.1 Commercial
CNPI 3a.2 Financial
CNPI 3a.3 Technological and Communications (e.g.,
broadband)
CNPI 3a.4 Transportation
Counts
CNPI 3a.5 Recreational (e.g., parks, gardens, libraries)
of
CNPI 3a.6 Other Public Assets and Physical Improvements
Change
CNPI 3b Number of existing assets and resources made accessible to the identified community:
CNPI 3b.1 Commercial
CNPI 3b.2 Financial
CNPI 3b.3 Technological and Communications (e.g.,
broadband)
CNPI 3b.4 Transportation
CNPI 3b.5 Recreational (e.g., parks, gardens, libraries)
CNPI 3b.6 Other Public Assets and Physical Improvements
Other Counts of Change for Infrastructure and Asset Building
Indicators (CNPI 3z) – Please specify below.
Other
Counts of CNPI 3z.1 Other
Change CNPI 3z.2 Other
I.) Identified
Community
(auto-populated)
II.) Target
(#)
CNPI 3z.3 Other
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OMB No. 0970-0492
I.) Identified
Community
Rates of Change for Infrastructure and Asset Building
Indicators (CNPI 3)
(auto-populated)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
(Target % autocalculated)
VII.)
Performance
target
accuracy
(% autocalculated)
CNPI 3c Percent decrease of abandoned or neglected
buildings in the identified community
CNPI 3d Percent decrease in emergency response time
Rates of measured in minutes in the identified community (EMT,
Change Police, Fire, etc.)
CNPI 3e Percent decrease of predatory lenders or lending
practices in the identified community
CNPI 3f Percent decrease of environmental threats to
households (toxic soil, radon, lead, air quality, quality of
drinking water, etc.) in the identified community
CNPI 3g Percent increase of transportation services in the
identified community
Other Rates of Change for Infrastructure and Asset Building
Indicators (CNPI 3z)
Other
Rates of
Change
I.) Identified
Community
(auto-populated)
- Please specify below.
IV.) Expected %
change from
baseline
(Target % autocalculated)
CNPI 3z.4 Other
CNPI 3z.5 Other
CNPI 3z.6 Other
General comments:
CSBG Annual Report 3.0
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OMB No. 0970-0492
VII.)
Performance
target
accuracy
(% autocalculated)
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
II.) Target
I.) Identified
Community
Counts of Change for Housing Indicators (CNPI 4)
(#)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
(auto-populated)
CNPI 4a Number of safe and affordable housing units developed in the identified community (e.g.,
Counts built or set-aside units for individuals with low incomes)
of
CNPI 4b Number of safe and affordable housing units maintained or improved through WAP or
Change other rehabilitation efforts in the identified community
CNPI 4c Number of shelter beds created in the identified community
CNPI 4d Number of shelter beds maintained in the identified community
Other
Counts of CNPI 4z.1 Other
Change
Other Counts of Change for Housing Indicators (CNPI 4z) - Please specify below.
I.) Identified
Community
II.) Target
(#)
(auto-populated)
CNPI 4z.2 Other
CNPI 4z.3 Other
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I.) Identified
Community
Rates of Change for Housing Indicators (CNPI 4)
(auto-populated)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
(Target % autocalculated)
V.) Actual Results VI.) Actual %
(%)
change from
baseline
VII.) Performance
target accuracy
(% auto-calculated)
(% autocalculated)
CNPI 4e Percent decrease in the rate of homelessness in the
Rates of identified community
Change CNPI 4f Percent decrease in the foreclosure rate in the identified
community
CNPI 4g Percent increase in the rate of home ownership of
individuals with low incomes in the identified community
CNPI 4h Percent increase of affordable housing in the identified
community
CNPI 4i Percent increase of shelter beds in the identified
community
I.) Identified
Community
Other Rates of Change for Housing Indicators (CNPI 4z)
- Please specify below.
Other
Rates of
Change
(auto-populated)
IV.) Expected %
change from
baseline
(Target % autocalculated)
V.) Actual Results VI.) Actual %
(%)
change from
baseline
(% autocalculated)
CNPI 4z.4 Other
CNPI 4z.5 Other
CNPI 4z.6 Other
General comments:
CSBG Annual Report 3.0
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VII.) Performance
target accuracy
(% auto-calculated)
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
I.) Identified
Community
Counts of Change for Health and Social or Behavioral Indicators (CNPI 5)
II.) Target
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
III.) Actual
Results
IV.) Performance
target accuracy
(#)
(% auto-calculated)
VI.) Actual %
change from
baseline
VII.) Performance
target accuracy
(#)
(auto-populated)
CNPI 5a Number of accessible and affordable physical health assets or resources created in the identified community
Counts
CNPI 5b Number of accessible and affordable behavioral and mental health assets or resources created in the identified
of
community
Change
CNPI 5c Number of public safety assets and resources created in the identified community
CNPI 5d Number of accessible and affordable healthy food resources created in the identified community
CNPI 5e Number of activities designed to improve police and community relations within the identified community
Other Counts of Change for Health and Social or Behavioral Indicators (CNPI 5z) - Please specify below.
Other
Counts of
Change CNPI 5z.1 Other
I.) Identified
Community
II.) Target
(#)
(auto-populated)
CNPI 5z.2 Other
CNPI 5z.3 Other
Rates of Change for Physical Health, Wellbeing, and Development
Indicators (CNPI 5)
I.) Identified
Community
(auto-populated)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
(Target % autocalculated)
CNPI 5f Percent decrease in infant mortality rate in the identified
community
Rates of
CNPI 5g Percent decrease in childhood obesity rate in the identified
Change community
CNPI 5h Percent decrease in adult obesity rate in the identified
community
CNPI 5i Percent increase in child immunization rate in the identified
community
CNPI 5j Percent decrease in uninsured families in the identified
community
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OMB No. 0970-0492
(% autocalculated)
(% autocalculated)
Rates of Change for Behavioral and Mental health, Emotional
Wellbeing, and Development Indicators (CNPI 5)
I.) Identified
Community
(auto-populated)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
VI.) Actual %
change from
baseline
(Target % autocalculated)
(% autocalculated)
VII.) Performance
target accuracy
(% autocalculated)
CNPI 5k Percent decrease in the teen pregnancy rate in the identified
community
CNPI 5l Percent decrease in unplanned pregnancies in the identified
community
CNPI 5m Percent decrease in substance use disorder rates in the identified
Rates of community (e.g., cigarettes, prescription drugs, narcotics, alcohol)
Change CNPI 5n Percent decrease in domestic violence rate in the identified
community
CNPI 5o Percent decrease in the child abuse rate in the identified
community
CNPI 5p Percent decrease in the child neglect rate in the identified
community
CNPI 5q Percent decrease in the elder abuse rate in the identified
community
CNPI 5r Percent decrease in the elder neglect rate in the identified
community
I.) Identified
Community
Rates of Change for Public Safety Indicators (CNPI 5)
Rates of
Change
(auto-populated)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
VI.) Actual %
change from
baseline
(Target % autocalculated)
(% autocalculated)
VII.) Performance
target accuracy
(% autocalculated)
CNPI 5s Percent decrease in recidivism rate in the identified community
CNPI 5t Percent decrease in non-violent crime rate in the identified
community
CNPI 5u Percent decrease in violent crime rate in the identified
community
CNPI 5v Percent decrease in teens involved with the juvenile court
system in the identified community
Other Rates of Change for Health and Social or
Behavioral Indicators (CNPI 5z)
Other
Rates of
Change CNPI 5z.4 Other
- Please specify below.
I.) Identified
Community
(auto-populated)
IV.) Expected %
change from
baseline
V.) Actual Results
(%)
VI.) Actual %
change from
baseline
(Target % autocalculated)
CNPI 5z.5 Other
CNPI 5z.6 Other
General comments:
CSBG Annual Report 3.0
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OMB No. 0970-0492
(% autocalculated)
VII.) Performance
target accuracy
(% autocalculated)
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
Rates of Change for Civic Engagement and
Community Involvement Indicators - Goal 2
(CNPI 6)
I.)
Identified
Community
(autopopulated)
II.) Baseline
III.) Target
existing
starting
point used for
comparisons
(%)
(%)
IV.) Expected
%
change from
baseline
V.) Actual Results
(%)
(Target % autocalculated)
VI.) Actual
%
change
from
baseline
VII.)
Performance
target accuracy
(% auto-calculated)
(% autocalculated)
Rates of CNPI 6 G2a Percent increase of donated time to support the
Change CSBG eligible entity's delivery of services or implementation
of strategies to address conditions of poverty in the
identified community
CNPI 6 G2b Percent increase of donated resources to support
the CSBG eligible entity’s delivery of services or
implementation of strategies to address conditions of poverty
in the identified community
CNPI 6 G2c Percent increase of individuals participating in
public hearings, policy forums, community planning, or other
advisory boards related to the CSBG eligible entity’s delivery of
service or implementation of strategies to address conditions
of poverty in the identified community
Other Rates of Change for Civic Engagement and Community
Involvement Indicators - Goal 2 (CNPI 6 G2z)
Other
Rates of
Change CNPI 6 G2z.1 Other
I.) Identified
Community
(auto-populated)
- Please specify below.
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
(Target % autocalculated)
V.) Actual Results VI.) Actual %
(%)
change from
baseline
VII.) Performance
target accuracy
(% auto-calculated)
(% autocalculated)
CNPI 6 G2z.2 Other
CNPI 6 G2z.3 Other
Other Counts of Change for Civic Engagement and Community
Involvement Indicators - Goal 2 (CNPI 6 G2z)
Other
Counts of
Change CNPI 6 G2z.4 Other
- Please specify below.
I.) Identified
Community
(auto-populated)
IV.) Expected %
change from
baseline
(Target % autocalculated)
V.) Actual Results VI.) Actual %
(%)
change from
baseline
(% autocalculated)
CNPI 6 G2z.5 Other
CNPI 6 G2z.6 Other
General comments:
CSBG Annual Report 3.0
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VII.) Performance
target accuracy
(% auto-calculated)
Name of CSBG Eligible Entity Reporting:
State or Territory:
UEI:
I.) Identified
Community
Rates of Change for Civic Engagement and Community
Involvement Indicators - Goal 3 (CNPI 6)
(auto-populated)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
(Target % autocalculated)
V.) Actual Results VI.) Actual %
(%)
change from
baseline
VII.) Performance
target accuracy
(% auto-calculated)
(% autocalculated)
Rates of
CNPI 6 G3a Percent increase of individuals with low incomes who
support the CSBG eligible entity’s delivery of service or implementation
of strategies to address conditions of poverty in the identified
community
CNPI 6 G3b Percent increase of individuals with low incomes who acquire
and maintain leadership roles with the CSBG eligible entity or other
organizations within the identified community
Other Rates of Change for Civic Engagement and Community
Involvement Indicators - Goal 3 (CNPI 6 G3z)
Other
Rates of
Change CNPI 6 G3z.1 Other
I.) Identified
Community
(auto-populated)
- Please specify below.
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
II.) Baseline
III.) Target
existing starting
point used for
comparisons
(%)
(%)
IV.) Expected %
change from
baseline
(Target % autocalculated)
V.) Actual Results VI.) Actual %
(%)
change from
baseline
VII.) Performance
target accuracy
(% auto-calculated)
(% autocalculated)
CNPI 6 G3z.2 Other
CNPI 6 G3z.3 Other
Other Counts of Change for Civic Engagement and Community
Involvement Indicators - Goal 3 (CNPI 6 G3z)
Other
Counts of
Change CNPI 6 G3z.4 Other
- Please specify below.
I.) Identified
Community
(auto-populated)
IV.) Expected %
change from
baseline
(Target % autocalculated)
V.) Actual Results VI.) Actual %
(%)
change from
baseline
(% autocalculated)
CNPI 6 G3z.5 Other
CNPI 6 G3z.6 Other
General comments:
CSBG Annual Report 3.0
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VII.) Performance
target accuracy
(% auto-calculated)
Module 4, Section C: Community Strategies List
Name of CSBG Eligible Entity Reporting:
State or Territory: UEI:
Employment Strategies (STR 1)
STR 1a
STR 1b
STR 1c
STR 1d
STR 1e
STR 1f
STR 1g
STR 1h
STR 1i
Minimum or Living Wage Campaign
Job Creation or Employment Generation
Job Fairs
Earned Income Tax Credit (EITC) Promotion
Commercial Space Development
Employer Education
Employment Policy Changes
Employment Legislative Changes
Other Employment Strategy: (please specify)
STR 2a
STR 2b
STR 2c
STR 2d
STR 2e
STR 2f
STR 2g
STR 2h
STR 2i
STR 2j
STR 2k
STR 2l
Education and Cognitive Development Strategies (STR 2)
Preschool for All Campaign
Charter School Development
After School Enrichment Activities Promotion
Pre-K to College or Community College Support
Children’s Trust Fund Creation
Scholarship Creation
Child Tax Credit (CTC) Promotion
Adoption Child Care Quality Rating
Adult Education Establishment
Education and Cognitive Development Policy Changes
Education and Cognitive Development Legislative Changes
Other Education and Cognitive Development Strategy: (please specify)
STR 3a
STR 3b
STR 3c
STR 3d
STR 3e
STR 3f
STR 3g
STR 3h
STR 3i
STR 3j
STR 3k
STR 3l
STR 3m
STR 3n
STR 3o
STR 3p
STR 3q
STR 3r
STR 3s
Infrastructure and Asset Building Strategies (STR 3)
Cultural Asset Creation
Police and Community Relations Campaign
Neighborhood Safety Watch Programs
Anti-Predatory Lending Campaign
Asset Building and Savings Promotion
Develop, Build, and Rehab Spaces
Maintain or Host Income Tax Preparation Sites
Community-Wide Data Collection Systems Development
Local 211 or Resource and Referral System Development
Water and Sewer System Development
Community Financial Institution Creation
Infrastructure Planning Coalition
Park or Recreation Creation and Maintenance
Rehabilitation or Weatherization of Housing Stock
Community Center and Community Facility Establishment
Asset Limit Barriers for Benefits Policy Changes
Infrastructure and Asset Building Policy Changes
Infrastructure and Asset Building Legislative Changes
Other Infrastructure and Asset Building Strategy: (please specify)
CSBG Annual Report 3.0
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STR 4a
STR 4b
STR 4c
STR 4d
STR 4e
STR 4f
STR 4g
STR 4h
STR 4i
STR 4j
Housing Strategies (STR 4)
End Chronic Homelessness Campaign
New Affordable Single Unit Housing Creation
New Affordable Multi-Unit Housing Creation (Single Resident Occupancy (SRO), temporary housing, transitional housing)
Tenants’ Rights Campaign
New Shelters Creation (including day shelters and domestic violence shelters)
Housing or Land Trust Creation
Building Codes Campaign
Housing Policy Changes
Housing Legislative Changes
Other Housing Strategy: (please specify)
STR 5a
STR 5b
STR 5c
STR 5d
STR 5e
STR 5f
STR 5g
STR 5h
STR 5i
STR 5j
STR 5k
STR 5l
STR 5m
STR 5n
Health and Social or Behavioral Development Strategies (STR 5)
Health Specific Campaign
Farmers Market or Community Garden Development
Grocery Store Development
Gun Safety and Control Campaign
Healthy Food Campaign
Nutrition Education Collaborative
Food Bank Development
Domestic Violence Court Development
Drug Court Development
Alternative Energy Source Development
Develop or Maintain a Health Clinic
Health and Social or Behavioral Development Policy Changes
Health and Social or Behavioral Development Legislative Changes
Other Health and Social or Behavioral Development Strategy: (please specify)
STR 6 G2a
STR 6 G2b
STR 6 G2c
STR 6 G2d
STR 6 G2e
STR 6 G2f
STR 6 G2g
STR 6 G2h
STR 6 G2i
STR 6 G2j
STR 6 G2k
Civic Engagement and Community Involvement Strategies - Goal 2 (STR 6 G2)
Development of Health and Social Service Provider Partnerships
Recruiting and Coordinating Community Volunteers
Poverty Simulations
Attract Capital Investments
Build and Support Increased Equity
Equity Awareness Campaign
Coordinated Community-wide Needs Assessment
Civic Engagement and Community Involvement in Advocacy Efforts
Civic Engagement Policy Changes
Civic Engagement Legislative Changes
Other Civic Engagement and Community Involvement Strategy: (please specify)
STR 6 G3a
STR 6 G3b
STR 6 G3c
STR 6 G3d
STR 6 G3e
STR 6 G3f
STR 6 G3g
Civic Engagement and Community Involvement Strategies - Goal 3 (STR 6 G3)
Empowerment of Individuals or Families with Low Incomes
Campaign to Ensure Individuals with Low Incomes are Represented on Local Governing Bodies
Social Capital Building Campaign for Individuals or Families with Low Incomes
Campaign for Volunteer Placement and Coordination
Civic Engagement Policy Changes
Civic Engagement Legislative Changes
Other Civic Engagement and Community Involvement Strategy: (please specify)
CSBG Annual Report 3.0
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OMB No. 0970-0492
STR 7a
STR 7b
STR 7c
STR 7d
STR 7e
STR 7f
STR 8a
STR 8b
STR 8c
STR 8d
STR 8e
STR 8f
Community Support Strategies (STR 7)
Off-Hours (Non-Traditional Hours) Child Care Development
Transportation System Development
Transportation Services Coordination and Support
Community Support Policy Changes
Community Support Legislative Changes
Other Community Support Strategy: (please specify)
Emergency Management Strategies (STR 8)
State or Local Emergency Management Board Enhancement
Community-Wide Emergency Disaster Relief Service Creation
Disaster Preparation Planning
Emergency Management Policy Changes
Emergency Management Legislative Changes
Other Emergency Management Strategy: (please specify)
CSBG Annual Report 3.0
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OMB No. 0970-0492
| File Type | application/pdf |
| File Modified | 2024-12-17 |
| File Created | 2024-12-17 |