Table of Activities

PERFORMANCE PROGRESS REPORT

HHS Administration for Children and Families

FYSB Abstinence Education Program

SF-PPR-D

Table of Activity Results

Page 1 of 8

1.Federal Agency and Organization Element to Which Report is Submitted Populated

2. Federal Grant or Other Identifying Number Assigned by Federal Agency Populated

3a. DUNS

Populated

4. Reporting Period End Date (Month, Day, Year) Populated

3b. EIN

Populated

Section A—UNDUPLICATED COUNT OF CLIENTS SERVED Indicate the number of all clients served by gender, ethnicity, and age. CBAE Grantees - do not provide data in the rows for clients ages 19 through 29.

Label

Summary

Ages 12-18

Ages 19-29

Others Served

TOTAL

AE-A-100

Unduplicated Count of Clients Served Females

Calculated

Calculated

Calculated

Calculated

Label

Race and Gender

Asian

Black

Hispanic

North American

Native Hawaiian

White

Other

TOTAL

AE-A-101

Female Client(s) age 12

     

     

     

     

     

     

     

Calculated

AE-A-102

Female Client(s) age 13

     

     

     

     

     

     

     

Calculated

AE-A-103

Female Client(s) age 14

     

     

     

     

     

     

     

Calculated

AE-A-104

Female Client(s) age 15

     

     

     

     

     

     

     

Calculated

AE-A-105

Female Client(s) age 16

     

     

     

     

     

     

     

Calculated

AE-A-106

Female Client(s) age 17

     

     

     

     

     

     

     

Calculated

AE-A-107

Female Client(s) age 18

     

     

     

     

     

     

     

Calculated

AE-A-108

Female Client(s) age 19

     

     

     

     

     

     

     

Calculated

AE-A-109

Female Client(s) age 20

     

     

     

     

     

     

     

Calculated

AE-A-110

Female Client(s) age 21

     

     

     

     

     

     

     

Calculated

AE-A-111

Female Client(s) age 22

     

     

     

     

     

     

     

Calculated

AE-A-112

Female Client(s) age 23

     

     

     

     

     

     

     

Calculated

AE-A-113

Female Client(s) age 24

     

     

     

     

     

     

     

Calculated

AE-A-114

Female Client(s) age 25

     

     

     

     

     

     

     

Calculated

AE-A-115

Female Client(s) age 26

     

     

     

     

     

     

     

Calculated

AE-A-116

Female Client(s) age 27

     

     

     

     

     

     

     

Calculated

AE-A-117

Female Client(s) age 28

     

     

     

     

     

     

     

Calculated

AE-A-118

Female Client(s) age 29

     

     

     

     

     

     

     

Calculated

AE-A-119

Female Parent(s)

     

     

     

     

     

     

     

Calculated

AE-A-120

Other female recipients of services or training

     

     

     

     

     

     

     

Calculated

AE-A-121

TOTAL

Calculated

Calculated

Calculated

Calculated

Calculated

Calculated

Calculated

Calculated

PERFORMANCE PROGRESS REPORT

SF-PPR-D

Page 2 of 8

1.Federal Agency and Organization Element to Which Report is Submitted Populated

2. Federal Grant or Other Identifying Number Assigned by Federal Agency Populated

3a. DUNS

Populated

4. Reporting Period End Date (Month, Day, Year) Populated

3b. EIN

Populated

Section A (Continued)—UNDUPLICATED COUNT OF CLIENTS SERVED Indicate the number of all clients served by gender, ethnicity, and age. CBAE Grantees - do not provide data in the rows for clients ages 19 through 29.

Label

Summary

Ages 12-18

Ages 19-29

Others Served

TOTAL

AE-A-200

Unduplicated Count of Clients Served Males

Calculated

Calculated

Calculated

calculated

AE-A-201

Unduplicated Count of Clients Served Males and Females

Calculated

Calculated

Calculated

calculated

Label

Race and Gender

Asian

Black

Hispanic

North American

Native Hawaiian

White

Other

TOTAL

AE-A-202

Male Client(s) age 12

     

     

     

     

     

     

     

Calculated

AE-A-203

Male Client(s) age 13

     

     

     

     

     

     

     

Calculated

AE-A-204

Male Client(s) age 14

     

     

     

     

     

     

     

Calculated

AE-A-205

Male Client(s) age 15

     

     

     

     

     

     

     

Calculated

AE-A-206

Male Client(s) age 16

     

     

     

     

     

     

     

Calculated

AE-A-207

Male Client(s) age 17

     

     

     

     

     

     

     

Calculated

AE-A-208

Male Client(s) age 18

     

     

     

     

     

     

     

Calculated

AE-A-209

Male Client(s) age 19

     

     

     

     

     

     

     

Calculated

AE-A-210

Male Client(s) age 20

     

     

     

     

     

     

     

Calculated

AE-A-211

Male Client(s) age 21

     

     

     

     

     

     

     

Calculated

AE-A-212

Male Client(s) age 22

     

     

     

     

     

     

     

Calculated

AE-A-213

Male Client(s) age 23

     

     

     

     

     

     

     

Calculated

AE-A-214

Male Client(s) age 24

     

     

     

     

     

     

     

Calculated

AE-A-215

Male Client(s) age 25

     

     

     

     

     

     

     

Calculated

AE-A-216

Male Client(s) age 26

     

     

     

     

     

     

     

Calculated

AE-A-217

Male Client(s) age 27

     

     

     

     

     

     

     

Calculated

AE-A-218

Male Client(s) age 28

     

     

     

     

     

     

     

Calculated

AE-A-219

Male Client(s) age 29

     

     

     

     

     

     

     

Calculated

AE-A-220

Male Parent(s)

     

     

     

     

     

     

     

Calculated

AE-A-221

Other male recipients of services or training

     

     

     

     

     

     

     

Calculated

AE-A-222

TOTAL

Calculated

Calculated

Calculated

Calculated

Calculated

Calculate

Calculate

Calculated

AE-A-223

TOTAL MALES & FEMALES

Calculated

Calculated

Calculated

Calculated

Calculated

Calculate

Calculated

Calculated

PERFORMANCE PROGRESS REPORT

SF-PPR-D

									Page 3 of 8
1.Federal Agency and Organization Element to Which Report is Submitted Populated		2. Federal Grant or Other Identifying Number Assigned by Federal Agency Populated				3a. DUNS		Populated			4. Reporting Period End Date (Month, Day, Year) Populated
						3b. EIN		Populated
Section B—HOURS OF SERVICE RECEIVED BY CLIENTS Indicate the number of clients, by age group, who received the total number of “program hours.” CBAE Grantees - do not provide data in the columns for clients ages 19 through 29.
Label	Summary		Ages 12-18	Ages 19-29							TOTAL
AE-B-100	Unduplicated Count of Clients Served		Populated	Populated							Populated
Label	Number of Hours Received		By 12-18 year olds	By 19-20 year olds							TOTAL
AE-B-101	1 hour		     	     							Calculated
AE-B-102	2 hours		     	     							Calculated
AE-B-103	3 hours		     	     							Calculated
AE-B-104	4 hours		     	     							Calculated
AE-B-105	5 hours		     	     							Calculated
AE-B-106	6 hours		     	     							Calculated
AE-B-107	7 hours		     	     							Calculated
AE-B-108	8 hours		     	     							Calculated
AE-B-109	9 hours		     	     							Calculated
AE-B-110	10 hours		     	     							Calculated
AE-B-111	11 hours		     	     							Calculated
AE-B-112	12 hours		     	     							Calculated
AE-B-113	13 hours		     	     							Calculated
AE-B-114	14 hours		     	     							Calculated
AE-B-115	15 hours		     	     							Calculated
AE-B-116	16 hours		     	     							Calculated
AE-B-117	17 hours		     	     							Calculated
AE-B-118	18 hours		     	     							Calculated
AE-B-119	19 hours		     	     							Calculated
AE-B-120	20 hours		     	     							Calculated
AE-B-121	21 hours		     	     							Calculated
AE-B-122	22 hours		     	     							Calculated
AE-B-123	23 hours		     	     							Calculated
AE-B-124	24 hours		     	     							Calculated
AE-B-125	25 hours		     	     							Calculated
AE-B-126	26 hours		     	     							Calculated
AE-B-127	27 hours		     	     							Calculated
AE-B-128	28 hours		     	     							Calculated
AE-B-129	29 hours		     	     							Calculated
AE-B-130	30 hours		     	     							Calculated
AE-B-131	31 hours		     	     							Calculated
AE-B-132	32 hours		     	     							Calculated
AE-B-133	33 hours		     	     							Calculated
AE-B-134	34 hours		     	     							Calculated
AE-B-135	35 hours		     	     							Calculated
AE-B-136	36 hours		     	     							Calculated
AE-B-137	37 hours		     	     							Calculated
AE-B-138	38 hours		     	     							Calculated
AE-B-139	39 hours		     	     							Calculated
AE-B-140	40 hours		     	     							Calculated
AE-B-141	41 hours		     	     							Calculated
AE-B-142	42 hours		     	     							Calculated
AE-B-143	43 hours		     	     							Calculated
AE-B-144	44 hours		     	     							Calculated
AE-B-145	45 hours		     	     							Calculated
AE-B-146	46 hours		     	     							Calculated
AE-B-147	47 hours		     	     							Calculated
AE-B-148	48 hours		     	     							Calculated
AE-B-149	49 hours		     	     							Calculated
AE-B-150	50 hours		     	     							Calculated
AE-B-151	TOTAL		Calculated	Calculated							Calculated

PERFORMANCE PROGRESS REPORT

SF-PPR-D

								Page 4 of 8
1.Federal Agency and Organization Element to Which Report is Submitted Populated			2. Federal Grant or Other Identifying Number Assigned by Federal Agency Populated	3a. DUNS		Populated				4. Reporting Period End Date (Month, Day, Year) Populated
				3b. EIN		Populated
Section C—PROGRAM COMPLETION DATA Report the number of all clients that complete the various types of program(s) offered.. CBAE Grantees - do not provide data in the columns for clients ages 19 through 29.
Label	Description	Select Type of Program			Distinct number of hours provided		No. of 12-18 year olds completing ≥75%.		No. of 19-29 year olds completing ≥75%.		Percent of clients that complete ≥75% of program.
AE-C-101	Counts of clients that complete at least 75% of the program	In-class abstinence curriculum After school abstinence curriculum Parent education Training for abstinence educators Mentoring (one-on-one) Conference, retreat Rally, assembly Add’l. programs (youth presenters, drama, etc.) Other (Describe)__________________			     		     				Calculated
					     				     		Calculated
AE-C-102	Counts of clients that complete at least 75% of the program	In-class abstinence curriculum After school abstinence curriculum Parent education Training for abstinence educators Mentoring (one-on-one) Conference, retreat Rally, assembly Add’l. programs (youth presenters, drama, etc.) Other (Describe)__________________			     		     				Calculated
					     				     		Calculated
AE-C-103	Counts of clients that complete at least 75% of the program	In-class abstinence curriculum After school abstinence curriculum Parent education Training for abstinence educators Mentoring (one-on-one) Conference, retreat Rally, assembly Add’l. programs (youth presenters, drama, etc.) Other (Describe)__________________			     		     				Calculated
					     				     		Calculated
AE-C-104	Counts of clients that complete at least 75% of the program	In-class abstinence curriculum After school abstinence curriculum Parent education Training for abstinence educators Mentoring (one-on-one) Conference, retreat Rally, assembly Add’l. programs (youth presenters, drama, etc.) Other (Describe)__________________			     		     				Calculated
					     				     		Calculated
AE-C-105	Counts of clients that complete at least 75% of the program	In-class abstinence curriculum After school abstinence curriculum Parent education Training for abstinence educators Mentoring (one-on-one) Conference, retreat Rally, assembly Add’l. programs (youth presenters, drama, etc.) Other (Describe)__________________			     		     				Calculated
					     				     		Calculated

Page can be duplicated or expanded if needed.

PERFORMANCE PROGRESS REPORT

SF-PPR-D

Page 5 of 8

1.Federal Agency and Organization Element to Which Report is Submitted Populated

2. Federal Grant or Other Identifying Number Assigned by Federal Agency Populated

3a. DUNS

Populated

4. Reporting Period End Date (Month, Day, Year) Populated

3b. EIN

Populated

Section D—COMMUNITIES SERVED

Label

Description

State (spell fully for consistency across states)

County

City/Town

AE-D-101

Area where services provided:

     

     

     

AE-D-102

Area where services provided:

     

     

     

AE-D-103

Area where services provided:

     

     

     

AE-D-104

Area where services provided:

     

     

     

AE-D-105

Area where services provided:

     

     

     

AE-D-106

Area where services provided:

     

     

     

AE-D-107

Area where services provided:

     

     

     

AE-D-108

Area where services provided:

     

     

     

AE-D-109

Area where services provided:

     

     

     

AE-D-110

Area where services provided:

     

     

     

AE-D-111

Area where services provided:

     

     

     

AE-D-112

Area where services provided:

     

     

     

AE-D-113

Area where services provided:

     

     

     

AE-D-114

Area where services provided:

     

     

     

AE-D-115

Area where services provided:

     

     

     

AE-D-116

Area where services provided:

     

     

     

AE-D-117

Area where services provided:

     

     

     

AE-D-118

Area where services provided:

     

     

     

AE-D-119

Area where services provided:

     

     

     

AE-D-120

Area where services provided:

     

     

     

AE-D-121

Area where services provided:

     

     

     

AE-D-122

Area where services provided:

     

     

     

AE-D-123

Area where services provided:

     

     

     

AE-D-124

Area where services provided:

     

     

     

AE-D-125

Area where services provided:

     

     

     

AE-D-126

Area where services provided:

     

     

     

AE-D-127

Area where services provided:

     

     

     

AE-D-128

Area where services provided:

     

     

     

AE-D-129

Area where services provided:

     

     

     

AE-D-130

Area where services provided:

     

     

     

AE-D-131

Area where services provided:

     

     

     

AE-D-132

Area where services provided:

     

     

     

AE-D-133

Area where services provided:

     

     

     

AE-D-134

Area where services provided:

     

     

     

AE-D-135

Area where services provided:

     

     

     

AE-D-136

Area where services provided:

     

     

     

AE-D-137

Area where services provided:

     

     

     

AE-D-138

Area where services provided:

     

     

     

AE-D-139

Area where services provided:

     

     

     

AE-D-140

Area where services provided:

     

     

     

AE-D-141

Area where services provided:

     

     

     

AE-D-142

Area where services provided:

     

     

     

AE-D-143

Area where services provided:

     

     

     

AE-D-144

Area where services provided:

     

     

     

AE-D-145

Area where services provided:

     

     

     

Page can be duplicated or expanded if needed.

INSTRUCTIONS FOR THE COMPLETION OF

PERFORMANCE PROGRESS REPORT

SF-PPR-D

HHS Administration for Children and Families

FYSB Abstinence Education Program

Table of Activity Results

General Purpose of SF-PPR-D, Table of Activity Results

U.S. Code 42, Section 710 references the application of Section 706 of the same code to the abstinence education grant program for states. Section 706 requires block grant recipients to submit reports as directed by HHS.

ACF will use the information collected to collect comparative data required to account for the annual expenditure of $50 million in Federal funds, assess the progress and impact of ACF’s federally funded abstinence education programs against ACF’s Strategic Plan goals, and provide feedback to assist State grantees.

The data collected also fulfill requirements of OMB for setting of performance targets and assessment and validation of accomplishments.

Section A—Unduplicated Count of Clients Served

Purpose of Section A

The purpose of Section A—Unduplicated Count of Clients Served, is to track and report the unduplicated number of clients served for each program year. Each client is counted only once.

General Instructions

Section A should be submitted as part of all required reports. Annual reports should provide cumulative data for 12 months.

Complete each cell in Section A for an unduplicated number of clients served in all programs funded by the abstinence education grant except for media campaigns.

In determining the age of a client, use the age of the client at the first point of contact during the program year. Since the purpose of the community-based abstinence education (CBAE) program grants is to provide services to youth ages 12-18, CBAE grantees should not provide any data in the rows for clients ages 19 through 29.

If a State program has served youth that are younger than 12 or during the report period, include that data in rows AE-A-120 (females) or AE-A-221 (males).

If you are helping young adults in making decisions related to abstinence, and the young adults happen to be young parents, record these clients under their ages. The row for tracking services to parents (AE-A-119 and AE-A-219) should be reserved for recording those efforts aimed at helping parents talk with their children about their children’s sexual choices.

Use the following definitions when determining race:

• Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

• Black or African American - A person having origins in any of the black racial groups of Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."

• Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. The term, "Spanish origin," can be used in addition to "Hispanic or Latino."

• American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

• Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

• White A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

• Other (not required by OMB) - A person wishing to identify himself or herself as “other” rather than one of the demographic groups described above.

If your program is implementing a media campaign, report such activities, and the numbers served, in the narrative of your program progress report.

Section B—Hours of Service Received by Clients

Purpose of Section B

The purpose of Section B, Hours of Service Received by Clients, is to track and report the total number of service hours that clients have received during the report period.

For example, a grantee may provide 1,000 ninth grade students with a 20-hour curriculum program while also providing 5,000 other youth with a one-hour event. Section B allows the grantee to report these numbers in greater detail, rather than averaging the program hours together. Averaged together, the result would show that 6,000 youth received an average of 4 hours of service, which would not clearly represent the nature of the programs. A more detailed report of the example is captured in the sample table rows below.

Number of Hours Received	By 12-18 year olds	By 19-29 year olds
	5,000
20	1,000
Total 12-18	6,000

General Instructions

Indicate the number of clients, by age group, who received the total number of hours listed for each row. CBAE grantees should leave blank (not provide any data) in the columns for 19-29 year olds.

An hour is equivalent to 60 minutes, and all sessions should be counted only for the actual number of minutes that a youth is served. A session that lasts for 30 minutes should be counted as 30 minutes; 43 minutes should be counted as 43 minutes. The total number of minutes of service that a youth receives must be converted into hours and rounded to the nearest ¼ hour. For example, 343 minutes will equal 5.75 hours.

For clients that receive services from multiple programs, program staff must add together the time received together so that only one number of program hours received will be recorded for each client served. For example, if a student participated in 17 hours of a 20-hour curriculum program and also participated in a one-half hour event, the total number of program hours for that student would be 17.5.

For clients that received more than 50 program hours, report their hours in the report form narrative. Do not include any media campaign activities in Section B. Rather, report such activities, and the numbers served, in form SF-PPR (general performance progress report).

The total number of clients served in each of the two age group columns should be equal to the unduplicated count of clients served for those age groups in Section A, row AE-A-201.

Section C—Program Completion Data

Purpose of Section C

The purpose of Section C, Program Completion Data, is to track and report the number of all clients that complete the various types of program(s) offered.

General Instructions

In each row, choose and report on one type of program offered by the grantee during the program year. A grantee may have several programs such as separate programs for middle school and high school students, events, or training programs, etc., and each row should be devoted to one program type with a distinct number of program hours. For example, if a program offers two after-school abstinence curriculum programs with one totaling 12 hours and the second totaling 24 hours, these should be recorded on separate rows. However, if a grantee offers three after-school programs that all provide 15 hours of programming, the data for these should be added together and recorded in one row.

In the fourth column, list the total number of hours that are provided by each program type.

In the fifth or sixth column, list the number of clients that completed at least 75% of the program above the total number of clients served for each of the age ranges indicated. CBAE grantees should leave blank (not provide any data) in the column for 19-29 year olds.

The total number of clients served by all programs, if they were to be added together, may be greater than the unduplicated count of all clients, as reported in Section A, if clients participated in more than one program.

Grantees with sub-grantees may wish to have each sub-awardee fill out this form separately and then compile the data into one form. In these cases, grantees will likely need to use more than one page.

Section D—Communities Served

Purpose of Section D

The purpose of Section D, Communities Served, is to track and report geographical areas in which the grantee has provided services.

General Instructions

Record the geographical areas in which all programs were provided during the budget year by state, county, and city/town. Grantees need not report the communities in which the clients reside.

Optional Narrative

If needed, submit with SF-PPR-D a narrative that describes any elements related to sections A-D that need to be explained. For example, the narrative may describe:

• clients served through media activities;

• groups that have been combined under “Other” in section A; or

• hours of service received by clients outside the age ranges of 12-18 or 19-29.

Organize the narrative in the order of sections A through D, and use headings to clearly identify which section the narrative is describing.

OMB Approval Number: 0970-0271