Eta 9140

Annotated Sample Form ETA-9140.pdf

Reintegration of Ex-Offenders, Adult Reporting System

ETA 9140

OMB: 1205-0455

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STANDARDIZED QUARTERLY PERFORMANCE REPORT
PRISONER REENTRY INITIATIVE (PRI) GRANT

ETA-9140
Program Quarter/Year: 4/2014
Report Due Date: 08/15/2015

OMB No: 1205-0455
Expires: 3/31/2015

A. Grantee Identifying Information
Grantee Name:
Program/Project Name:
Address:

Grant Number:
Project or Sub-Project ID/Number:
Report Quarter End Date:
Enrollment Goal:

Prisoner Re-Entry Initiative

Performance Items

06/30/2015

Previous Quarter
(A)

Current Quarter
(B)

Cumulative for Program
Year (C)

Program-to-Date
(D)

B. Participant Summary Information
1

Total Exiters

49

12

100

141

2

Total Participants Enrolled

27

51

136

215

3

Total Participants Served

111

123

199

212

4a

Male

15

35

82

120

4b

Female

12

16

54

95

5a

Hispanic/Latino

0

1

3

9

5b

American Indian or Alaska Native

0

1

1

2

5c

Asian

0

0

0

0

5d

Black or African American

18

29

77

114

5e

Hawaiian Native or Other Pacific Islander

0

0

0

1

5f

White

9

21

55

89

6a

8th grade and under

1

0

3

9

6b

9th grade - 12th grade

9

24

58

91

6c

High School graduate or equivalent

8

20

47

67

6d

1-3 years of college, or full-time technical or vocational
school

5

3

11

16

6e

4 years of college or more

0

1

4

7

7a

Age 18-24

2

5

11

18

7b

Age 25-34

10

18

51

84

7c

Age 35-44

9

16

47

72

7d

Age 45-54

5

7

20

32

7e

Age 55 or older

1

5

7

9

8

Eligible Veterans

2

1

4

5

9

Limited English Proficient

7

4

29

53

10

Persons with a Disability

11

Not Employed at Program Participation

1

4

10

11

27

51

136

215

C. Additional Participant Information to be collected at enrollment
1a Own/rent apartment, room, or house

1

1

3

3

1b Staying at someone's apartment, room or house (Stable)

5

8

23

38

1c Halfway house/transitional house

0

0

0

0

1d Residential treatment

0

0

0

1

1e Homeless

3

1

8

15

1f Staying at someone's apartment, room or house (Unstable)

0

1

5

9

2

History of Alcohol Abuse/Drug Use

16

28

85

126

3

Average Number of Days Since Release

-34

-36

-36

-37

4

Average Number of Years Incarcerated

40

47

43

42

5a Parole

3

8

20

33

5b Probation

8

20

49

77

5c Other Post-Release Supervision

8

7

33

55

5d None

8

16

34

50

6a Property Crimes

5

13

32

47

6b Drug Crimes

14

15

60

90

6c Public Order Offenses

2

0

2

2

6d Other Offenses

10

22

45

78

7

0

0

0

0

DOJ Pre-Release Participants
Performance Items

Previous Quarter
(A)
Value

Numerator /
Denominator

Current Quarter
(B)
Value

Numerator /
Denominator

Cumulative for Program Year
(C)
Value

Numerator /
Denominator

Program-to-Date
(D)
Value

D. Program Services, Activities, and Other Related Assistance
1

Received Education or Job Training Activities

27

56

122

183

2

Received Workforce Preparation Activities

28

51

112

166

3

Community Involvement Activities

86

103

166

179

4

Received Mentoring Activities

6

50

56

59

5

Health Services

51

56

137

172

6

Received Supportive Services

91

92

164

179

7

Overall Participation Rate (participation in at least one
activity from 1 through 5. Does not include supportive
services)

269%

94 / 35

139%

103 / 74

Numerator /
Denominator

E. Short-Term Indicators of Performance
Leading Indicators of Performance
1

Enrollment Rate

2

Abstained from Alcohol Abuse or illegal Drug use (6 months
after enrollment)

64%

3

Stable Living Arrangements (6 months after enrollment)

84%

4a Number of Initial Job Placements
4b Average Hourly Wage Rate at Placement

77%

21 / 25

77%

26
$8.85

4c Number of Job Re-Placements
4d Average Hours Worked 1st Week of Placement

16 / 25

60%

23 / 30

82%

16
230 / 26

166 / 18

$9.38

2
1040 / 26

147%

215 / 146

70 / 117

60%

76 / 127

96 / 117

80%

85

$9.22

1
40.00

23 / 30

835 / 89

$9.20

5

40.00

720 / 18

40.25

101 / 127
117
1132 / 123
6

3582 / 89

40.18

4942 / 123

5

Number Obtained High School Diploma of GED

0

0

0

0

6

Number who Obtained a Certificate

14

25

73

104

7

Entered Post Secondary Education

14

25

73

104

8

Entered Vocational/Occupational Skills Training

21

31

91

121

9a Number of Re-arrests for a New Crime

0

0

0

0

9b Number of Re-Incarcerations for Revocation

0

0

0

0

F. Long-Term Indicators of Performance
Common Performance Measures
1

Entered Employment Rate

N/A

/

N/A

/

N/A

/

94%

121 / 129

2

Employment Retention (includes all participants who entered
employment, regardless of follow-up)

N/A

/

N/A

/

N/A

/

59%

77 / 130

3

Attainment of a Degree or Certificate

86%

12 / 14

100%

21 / 21

97%

66 / 68

97%

87 / 90

4

Average 6 Months Post-Program Earnings (includes only
those who have been successfully contacted during
follow-up)

N/A

/

N/A

/

N/A

/

$9,194

707920 / 77

Additional Performance Measures
5

Recidivism Rate

0%

0 / 29

0%

0 / 24

0%

G. Report Certification / Additional Comments
Grantee Remarks:
Name of Grantee Certifying Official:

Telephone Number:

Email:

0 / 76

0%

0 / 76


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