Form 1 ECSH Program Data Indicators

Generic Performance Progress Report

Final ECSH Data Indicators.xlsx

Ethnic Community Self-Help (ECSH) Program Data Indicators

OMB: 0970-0490

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Ethnic Commnity Self-Help (ECSH) Program Data Indicators OMB Control Number: 0970-0490
Expiration Date: 1/31/2020
1. Grantee Name:

2. Grant Number:

3. Reporting Period End Date:

DIRECT SERVICES
Program Activities First Reporting Period Second Reporting Period Cumulative Budget Period
4. Number of New Enrollments this Reporting Period



5. Number of Refugees Served



6. Number of Clients Served According to Status First Reporting Period Second Reporting Period Cumulative Budget Period
6a. Refugee



6b. Asylee



6c. Other status eligible for ORR services



7. Types of Services Provided First Reporting Period Yes ('1')/No ('0') Second Reporting Period Yes ('1')/No ('0')

7a. Navigation Services


7b. Cultural/community orientation


7c. Health-related services


7d. Home management services


7e. Transportation


7f. Translation and interpretation services


7g. Case management services


7h. English language training


7i. Employability services


7j. Academic enrichment/college preparation


7k. Emotional wellness services


7l. Referral services


7m. Citizenship preparation/civic engagement


7n. Other (list):








ORGANIZATIONAL DEVELOPMENT
Program Activities First Reporting Period Second Reporting Period Cumulative Budget Period
8. Number of New Partnerships Developed



9. Type of New Partnership Developed First Reporting Period Second Reporting Period Cumulative Budget Period
9a. Educational organization



9b. Local/state government entity



9c. Medical service provider



9d. Legal service provider



9e. Faith-based group



9f. Other (list)




10. Types of Training Provided to Staff First Reporting Period Yes ('1')/No ('0') Second Reporting Period Yes ('1')/No ('0')


10a. Case management


10b. Case documentation


10c. Interpretation


10d. Cultural sensitivity and awareness


10e. Self-care


10f. Cultural orientation provision


10g. Public benefits


10h. Health services and systems


10i. Non-profit management


10j. Other (list)


CIVIC ENGAGEMENT
11. Types of Community Engagement Activities Conducted First Reporting Period Second Reporting Period




















LOGIC MODEL OUTPUTS & OUTCOMES
Logic Model Outputs Progress Semi-Annual Results Cumulative Budget Period
First Reporting Period Second Reporting Period
Please list all planned Outputs from the Logic Model in the following spaces. Add more spaces as necessary. Identify progress towards each Output for Months 1-6 Identify progress towards each Output for Months 7-12. Describe progress towards Outputs for the current fiscal year.








































Logic Model Outcomes Progress Semi-Annual Results Cumulative Budget Period

First Reporting Period Second Reporting Period
Please list all planned Outcomes from the Logic Model in the following spaces. Add more spaces as necessary. Identify progress towards each Outcomes for Months 1-6 Identify progress towards each Outcomes for Months 7-12. Describe progress towards each Outcome for the current fiscal year.














































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