Form 1 MCP Quarterly Caseload Data Reporting Instrument

MCP Quarterly Caseload Data Reporting Instrument

(adapted from online version)

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Program Name:	MENTORING CHILDREN OF PRISONERS
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Report Progress

Initialized	Edit - Saved	Validated	Certified	Submitted	In Review	R/O Approved	C/O Approved

1a. Number of children beginning new matches (or rematches with a different mentor) during the past quarter

1b. The number of matches that were renewed after twelve or twenty four months or thirty six months to become sustained matches between the same children and the same mentors for the first time during the past quarter

2. Number of children in matches during the past quarter (includes children in Question 1)

3. Number of mentors currently mentoring children

4. Number of mentors with a single mentee during the whole past quarter

5a. Number of mentors mentoring multiple youths during any part of the past quarter

5b. Number of mentors trained and screened (ready to match) but not yet matched

6a. Number of children on a first time waiting list beginning in this quarter

6b. Average number of days that children have spent on the first time waiting list if they were matched during the past quarter

6c. Shortest first time waiting list period in days during the past quarter

6d. Longest first time waiting list period in days during the past quarter

7. Number of matches which ceased ahead of schedule during the past quarter

8a. The number of children who initiated the end of the match referred to in Question 7

8b. The number of parents or guardians who initiated the end of the match referred to in Question 7

8c. The number of mentors who initiated the end of the match referred to in Question 7

8d. The number of agencies who initiated the end of the match referred to in Question 7

8e. The number of others who initiated the end of the match referred to in Question 7

8f. The number of unknown who initiated the end of the match referred to in Question 7

9a. Number of children on a rematch waiting list (whose prior mentoring experience terminated prematurely during the pas

9b. Average number of days during the past quarter that such children have spent on the rematch waiting list if they were rematched during the quarter

9c. Shortest rematch waiting list period in days during the past quarter (at least 1 day)

9d. Longest rematch waiting list period in days during the past quarter

9e. Number of children whose matches concluded on schedule and who are not planning to be rematched in the next six months

   Frequency (Questions 10-12 refer to one-to-one contact)

10. Number of children with less than 12 hours of regular mentor/mentee contact during the past quarter

11. Number of children with at least 12 hours and up to 24 hours of regular mentor/mentee contact during the past quarter

12. Number of children with more than 24 hours of regular mentor/mentee contact during the past quarter

13. Number of children for whom the frequency or length of their contacts with mentors is unknown

Longevity (Cessations should be counted without regard for immediacy of rematching.)

14. Number of matches that had lasted up to/including 3 months and then ceased during the past quarter

15. Number of matches that had lasted more than 3 and up to/including 6 months and then ceased during the past quarter

16. Number of matches that had lasted more than 6 and up to/including 11 months and then ceased during the past quarter

17. Number of matches that had lasted more than 11 months and then concluded as planned in the 12th month or shortly thereafter during the past quarter

18. Number of active matches continuing through the end of the past quarter that had already lasted more than 12 months and up to/including 18 months.

19. Number of active matches continuing through the end of the past quarter that had already lasted more than 18 months

   Group Activities (if any)

20. The number of individual children participating in at least one quarterly group activity sponsored by the program during the past quarter

   Training, Support and Administration

21. Average number of hours of initial or pre-match training/orientation per mentor (formal, in person training, e.g., classroom style) in the past quarter

22. Average number of hours post-match training per mentor (formal, in person training, e.g., classroom style, seminar, etc, ) in the past quarter

23. Average number of staff follow-up contacts in person or by phone per mentor in the past quarter addressing key mentor skills or commitment or mentor's response to child crises or other critical issues in the child's life

24. Number of mentors whom the agency counseled during the past quarter because the mentor was not meeting his or her obligation

   Demographics

25. Average age of all children in matches during the past quarter

26. Age in years (and portion of a year) of youngest child in a match during the past quarter

27. Age in years (and portion of a year) of oldest child in a match during the past quarter

28. Number of children in matches during the past quarter at least age 4 and less than 6 (when first matched)

29. Number of children in matches during the past quarter at least age 6 and less than 10 (when first matched)

30. Number of children in matches during the past quarter at least age 10 and less than 12 (when first matched)

31. Number of children in matches during the past quarter over at least 12 and less than 15 (when first matched)

32. Number of children in matches during the past quarter age 15 (when first matched ) or turning 16 during the quarter (count such children once during the quarter)

33. Number of male children in matches during the past quarter

34. Number of female children in matches during the past quarter

35. Number of male mentors during the past quarter

36. Number of female mentors during the past quarter

37. Number of across-gender matches begun during the past quarter

38. Number of across-race or across ethnic matches begun during the past quarter

Comments

Additional information or comment.