Form 1 ECSH Program Data Indicators

Generic Performance Progress Report

Final ECSH Data Indicators_202206.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: 1/31/2023
1. Recipient Name:

2. Grant Number:

3. Reporting Period End Date:

DIRECT SERVICES
Program Activities First Reporting Period Second Reporting Period

4. Number of New Enrollments



5. Number of Clients Served



6. Number of Clients Served According to Status

6a. Refugee



6b. Asylee



6c. Cuban/Haitian Entrants




6d. Special Immigrants Visa Holders




6e. Afghan Humanitarian Parolees




6f. Amerasians




6g. Victims of Human Trafficking




6h. Ukraine Humanitarian Parolees




7. Types of Services Provided First Reporting Period Second Reporting Period

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

8. Number of New Partnerships Developed



9. Type of New Partnership Developed

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 Second Reporting Period

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 (list) First Reporting Period Second Reporting Period




LOGIC MODEL OUTPUTS & OUTCOMES
Logic Model Outputs Progress Semi-Annual Results
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.








































Logic Model Outcomes Progress Semi-Annual Results

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.














































PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, the Office of Refugee Resettlement (ORR) is gathering data on your grant program to understand the design and effectiveness of the program and to inform technical assistance needs. Public reporting burden for this collection of information is estimated to average 2 hours per grantee recipient, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is required to retain a benefit (Pub. L. 105-285, section 680(b) as amended). 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. The OMB# is 0970-0490 and the expiration date is 01/31/2023. If you have any comments on this collection of information, please contact Zahra Cheema, ACF/ORR, by email at [email protected]
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