Form VETS-701 Technical Performance Report (TPR)

Veterans’ Employment and Training Service Competitive Grant Programs Reporting

VETS-701 TPR.xlsb

VETS-701 Competitive Grants Technical Performance Report

OMB: 1293-0014

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1293-0014 can be found here:

2023-10-17 - Revision of a currently approved collection

Document [xlsx]

Download: xlsx | pdf

Overview

Planned Goals
Tech Perf Report
New Enrollment Entry
Participant Info
Demographics Summary
Goals v. Actual

Sheet 1: Planned Goals

Accessibility key: Users may only edit unlocked cells. Strikethrough indicates a potential data entry error. Cells with dotted borders indicate missing data.

United States Department of Labor

Veterans' Employment & Training Service

Summary of Proposed Goals for the Program Year

Select the applicable Program Year for this report. Program Year

OMB Approval 1293-0014 | Expires 6/30/2023

PY 2023 7/1/2023 - 6/30/2024

Homeless Veterans' Reintegration Program (HVRP)

Total amount of federal funds requested if this is an application for funding. If a grantee, then enter the amount of the actual grant award. Funding Amount

The form MUST BE LOCKED once the user has entered the planned values and verified the accuracy of these figures. Contact your GOTR to modify locked values. Lock Status

UNLOCKED

Enter the name of your agency or organization. Applicant Name

Grantee State

Please enter a title for the name of your project. Grant Type

Select from Dropdown

Planned Measures

Total

A participant should be recorded as having been enrolled when an intake form has been completed, and services, referral, and/or employment has been received through the program. This will be an unduplicated count over the performance period, i.e., each participant is recorded only once, regardless of the number of times she or he receives assistance. The exception to this rule is reenrollment, which occurs when a participant exits, then returns more than 90 days after exit and the grantee chooses to reenroll the participant (assuming HVRP eligibility criteria is met). # of New Participants Enrolled

N/A

Err:520

Participants who were placed into employment or otherwise obtained employment as a result of grantee services used or received. The participant must be exited in order to obtain credit for a placement. # Placed into Employment

~~Err:520~~

N/A

Err:520

The average starting wage (dollars/hour) of all placements made in the quarter. Average Hourly Wage at Placement

N/A

Participants who were placed into employment or otherwise obtained employment as a result of grantee services used or received divided by the the number of exiters. Placement Rate (# employed/# exited)

N/A

Err:520

For the purposes of competitive grants, a participant who is placed or dropped during a quarter and is not scheduled to receive future homeless veterans program services for the next 90 or more days is considered an exiter. A participant not receiving a service for 90 consecutive days must be exited. The following services do not count as “future services”: - Additional career planning; - Contacting the employer; - Assisting with work-related problems; - Peer support groups; - Informational mailings; - Co-enrolled partner services extending beyond the end of the active period of performance for the competitive grant award; - Follow-up tracking services; and - Provision of post-exit supportive services for job retention. # of Participants Exited

N/A

Err:520

Enter the planned employment rate, computed by dividing the total number employed in the 2nd quarter after exit by the total number of exiters for the reporting period. Employment Rate in the 2nd Quarter After Exit

N/A

0.0%

The planned median quarter earnings for those participants employed in the 2nd quarter after exit. In simple terms, it may be thought of as the "middle" value of a data set. For example, in the data set...$1750, $3175, $3765, $4120, $5005, $6110, $6975, the median is $4120, the fourth number in the sample. For the 2nd quarter of PY21, the median quarterly earnings for those employed at the time of exit was $4,120. **Do not enter the same values as Average Hourly Wage at Placement. The entries should reflect one quarter’s worth of projected earnings for participants (1 quarter is approx. 13 weeks).** Median Earnings in the 2nd Quarter After Exit

N/A

Enter the planned employment rate, computed by dividing the total number employed in the 4th quarter after exit by the total number of exiters for the reporting period. Employment Rate in the 4th Quarter After Exit

N/A

0.0%

Cost Per Placement = FY Funding Amount divided by the number of participants placed into employment. Cost Per Placement (PoP Year 1 grantees only)

Err:520

N/A

Placement Rate - Episodic Homeless (PoP Year 2 and Year 3 grantees only)

Percentage of Participants Trained

80%

Direct costs for items such as stipends, travel allowances, and registration fees paid to or on behalf of participants or trainees (but not employees), tuition for participant training in connection with conferences, or training projects. This list is not inclusive, but all costs must reflect supportive services that directly benefit the participant. 2 CFR 200.1 Participant Support Costs

N/A

Err:520

You must have an agreement or claim de minimis to claim indirect costs. De minimis is only for grantees who have never had a negotiated indirect cost rate agreement. Indirect (F&A) costs mean those costs incurred for a common or joint purpose benefitting more than one cost objective, and not readily assignable to the cost objectives specifically benefitted, without effort disproportionate to the results achieved. To facilitate equitable distribution of indirect expenses to the cost objectives served, it may be necessary to establish a number of pools of indirect (F&A) costs. Indirect (F&A) cost pools must be distributed to benefitted cost objectives on bases that will produce an equitable result in consideration of relative benefits derived. 2 CFR 200.414 Indirect Costs

N/A

Err:520

All direct costs associated with the supervision and management of the program. Examples include: compensation of employees, cost of materials consumed or expended, travel, other allowable activities and items of expense incurred as allowable under 2 CFR Part 200.403.” Direct Costs

N/A

Err:520

Subtotal of direct and indirect costs associated with the supervision and management of the program. Subtotal, Indirect and Direct Costs

Err:520

N/A

Err:520

Total Planned Expenditures

Err:520

N/A

Err:520

Sheet 2: Tech Perf Report

Accessibility key: Strikethrough indicates a potential data entry error. Check mark icon indicates performance meets/exceeds expectations. Exclamation icon indicates underperformance, but considered to be meeting minimum performance expectations and does not require corrective action. X icon indicates performance failing to meet minimum expectations.	1	1	1	1	1	1	1	1	1	1	1	1	1	1
United States Department of Labor
Veterans' Employment & Training Service
*Competitive Grants Quarterly Technical Performance Report*

0
0			Enter your grant number. 5-digit grant #s must add a leading 0. (FY23 and newer grants will have 6 digits) Short Grant Number		OMB Approval 1293-0014\| Expires 6/30/2023									0
					Homeless Veterans' Reintegration Program (HVRP)
			Funding Amount

			Please select the quarter covered by this report. Reporting Period
			Q1 July 1 - September 30		Grantee State	Represents the primary state as assigned by the GOTR, this is pulled from the Planned Goals sheet. 0
			If this TPR is for the initial period covered by your grant award (i.e., a new award), please select "First Year." If this TPR is for the 1st option year funding for your award, please select "Second Year." If this TPR is for the 2nd option year funding for your award, please select "Third Year." Period of Performance Year		0
			First Year		Applicant Name	0
			0
			Actual Measures	For each measure flagged with a red “X” indicator meaning performance is failing to meet minimum expectations. Those with a yellow “!” indicator are considered to be meeting minimum performance expectations. For more information on TPN Actions and CAPs, refer to the VETS-702 Technical Performance Narrative (TPN). TPN Action	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Total
			A participant should be recorded as having been enrolled when an intake form has been completed, and services, referral, and/or employment has been received through the program. This will be an unduplicated count over the performance period, i.e., each participant is recorded only once, regardless of the number of times she or he receives assistance. The exception to this rule is reenrollment, which occurs when a participant exits, then returns more than 90 days after exit and the grantee chooses to reenroll the participant (assuming HVRP eligibility criteria is met). # of New Participants Enrolled	1	0	0	0	0	0	0	0	0	Err:520
			An HVRP participant who was in the grantee’s program during one program year whose participation continued into the following program year. Any individual who is showing as not exiting the grantee’s program by the last day of the program year must continue to receive services to be (1) carried over to the next program year should the grantee receive continuation funding; or (2) exited from the grantee’s program. Carryover participants retain the same participant identification number and name in the Technical Performance Report as assigned in the earlier year. # of Carry-over Participants from Prior PY	N/A	0	0	0	0	0	0	0	0	Err:520
			Enrollment in American Job Center (AJC) services, for the purposes of competitive grants reporting, occurs when the homeless veterans program participant receives a Wagner-Peyser Act-funded Employment Service (ES), a Jobs for Veterans State Grant (JVSG)-funded Disabled Veterans Outreach Program service or another WIOA title I-funded service, such as WIOA title I services for adults or dislocated workers. Please note that homeless veterans program grantees must enroll their participants into ES, JVSG or WIOA title I-funded services according to the service strategy and timeline outlined in each individual service plan. Enrollment of the homeless veterans program participant into an ES, JVSG or WIOA service must occur during the active period of performance outlined in the VETS’ competitive grant award. # of Participants Co-Enrolled in AJC Services	N/A	0	0	0	0	0	0	0	0	Err:520
			Participants who were placed into employment or otherwise obtained employment as a result of grantee services used or received. The participant must be exited in order to obtain credit for a placement. # Placed into Employment (cannot be greater than # exits)	N/A	0	0	0	0	0	0	0	0	Err:520
			The average starting wage ($/hour) of all placements made in the quarter. Average Hourly Wage at Placement	1	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	Err:520
			Participants who were placed into employment or otherwise obtained employment as a result of grantee services used or received divided by the the number of exiters. Placement Rate (# employed/# exited)	1	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	Err:520
			For the purposes of competitive grants, a participant who is placed or dropped during a quarter and is not scheduled to receive future homeless veterans program services for the next 90 or more days is considered an exiter. A participant not receiving a service for 90 consecutive days must be exited. The following services do not count as “future services”: - Additional career planning; - Contacting the employer; - Assisting with work-related problems; - Peer support groups; - Informational mailings; - Co-enrolled partner services extending beyond the end of the active period of performance for the competitive grant award; - Follow-up tracking services; and - Provision of post-exit supportive services for job retention. # of Participants Exited	N/A	0	0	0	0	0	0	0	0	Err:520
			An individual is at risk for homelessness when the individual lacks the resources and support networks needed to obtain housing. The risk must be real and imminent (within 60 days). In some sense, anyone living below the poverty level may be at risk of homelessness. An individual may be either at risk for homelessness or homeless, but not both at once. # of At-Risk - Enrolled	N/A	0	0	0	0	0	0	0	0	Err:520
			% of At-Risk - Enrolled	N/A	Err:520	Err:520	Err:520	Err:520	0.0%	0.0%	0.0%	0.0%	0.0%
			"Episodic Homeless’’ is defined as a homeless individual who has met the definition of homelessness continuously for at least 12 months, or on at least four separate occasions in the last 3 years, where the combined occasions total a length of time of at least 12 months. Episodic Homeless - # Enrolled	N/A	0	0	0	0	0	0	0	0	Err:520
			"Episodic Homeless’’ is defined as a homeless individual who has met the definition of homelessness continuously for at least 12 months, or on at least four separate occasions in the last 3 years, where the combined occasions total a length of time of at least 12 months. Episodic Homeless - # Exited	N/A	0	0	0	0	0	0	0	0	Err:520
			"Episodic Homeless’’ is defined as a homeless individual who has met the definition of homelessness continuously for at least 12 months, or on at least four separate occasions in the last 3 years, where the combined occasions total a length of time of at least 12 months. Episodic Homeless - # Placed into Employment	N/A	0	0	0	0	0	0	0	0	Err:520
			Veterans defined as homeless and have care of one or more minor dependents. Episodic Homeless - Placement Rate (PoP Year 2 and Year 3 grantees only)	N/A	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	Err:520
			Cost Per Placement = FY Funding Amount divided by the number of participants placed into employment. Cost Per Placement (PoP Year 1 grantees only)	1	$0	$0	$0	$0	$0	$0	$0	$0	$0
			Homeless Women Veteran - # Enrolled	N/A	0	0	0	0	0	0	0	0	Err:520
			Homeless Women Veteran - # Exited	N/A	0	0	0	0	0	0	0	0	Err:520
			Homeless Women Veteran - # Placed into Employment	N/A	0	0	0	0	0	0	0	0	Err:520
			Homeless Women Veteran - Placement Rate	N/A	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	Err:520
			Veterans defined as homeless and have care of one or more minor dependents. Homeless Veteran with Children - # Enrolled	N/A	0	0	0	0	0	0	0	0	Err:520
			Veterans defined as homeless and have care of one or more minor dependents. Homeless Veteran with Children - # Exited	N/A	0	0	0	0	0	0	0	0	Err:520
			Veterans defined as homeless and have care of one or more minor dependents. Homeless Veteran with Children - # Placed into Employment	N/A	0	0	0	0	0	0	0	0	Err:520
			Veterans defined as homeless and have care of one or more minor dependents. Homeless Veteran with Children - Placement Rate	N/A	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	Err:520
			A veteran who is a resident of a penal institution, or an institution that provides long-term care for mental illness, and is at risk for homelessness absent referral and counseling services provided under the program. Eligible Incarcerated Veterans Eligible - # Enrolled	N/A	0	0	0	0	0	0	0	0	Err:520
			A veteran who is a resident of a penal institution, or an institution that provides long-term care for mental illness, and is at risk for homelessness absent referral and counseling services provided under the program. Eligible Incarcerated Veterans Eligible - # Exited	N/A	0	0	0	0	0	0	0	0	Err:520
			A veteran who is a resident of a penal institution, or an institution that provides long-term care for mental illness, and is at risk for homelessness absent referral and counseling services provided under the program. Eligible Incarcerated Veterans Eligible - # Placed into Employment	N/A	0	0	0	0	0	0	0	0	Err:520
			A veteran who is a resident of a penal institution, or an institution that provides long-term care for mental illness, and is at risk for homelessness absent referral and counseling services provided under the program. Eligible Incarcerated Veterans Eligible - Placement Rate	N/A	0.0%	0.0%	0.0%	0.0%	0%	0%	0%	0%	Err:520
			The number of exiters for the reporting period who were employed (showed wages) in the 2nd quarter after exit. # Earned Wages in the 2nd Full Quarter After Exit	N/A	0	0	0	0	0	0	0	0	Err:520
			The percentage of program participants who are in unsubsidized employment during the second quarter after exit from the program. The rate is computed by dividing the number employed in the 2nd quarter after exit divided by number of exiters. Employment Rate in the 2nd Quarter After Exit	1	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	Err:520
			The median earnings of program participants who are in unsubsidized employment during the second quarter after exit from the program. The median of a finite list of earnings can be found by arranging all of the earnings in the 2nd quarter from lowest value to highest value and picking the middle one. The rate is computed by dividing the number employed in the 2nd quarter after exit divided by number of exiters. Median Quarterly Earnings in the 2nd Qtr. After Exit	1	$0.00	$0.00	Err:520	Err:520	Err:520	Err:520	$0.00	$0.00	Err:520
			The number of exiters for the reporting period who were employed (showed wages) in the 4th quarter after exit. # Earned Wages in the 4th Full Quarter After Exit	N/A	0	0	0	0	0	0	0	0	Err:520
			The percentage of program participants who are in unsubsidized employment during the fourth quarter after exit from the program. The rate is computed by dividing the number employed in the 4th quarter after exit divided by number of exiters. Employment Rate in the 4th Quarter After Exit		0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	0.0%	Err:520
			An unduplicated count of the number of enrollments who received training. Each enrollment may take more than one type of training. Unduplicated Count of Enrollments Trained		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Percentage of enrollments who received some type of training service whether provided directly by the grantee or referred to and provided by another training provider. The VETS goal for the percentage of enrollments who receive training services is 80%. This goal applies to all grantees regardless of funding amount or number of enrollments. % Participants Trained - Enrolled (cumulative) Goal is 80%	Err:520	Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			# of Participants Trained	N/A	Err:520	Err:520	Err:520	Err:520	0	0	0	0
			Apprenticeship	N/A	Err:520	Err:520	Err:520	Err:520	0	0	0	0	0
			On-the-Job Training	N/A	Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Job Readiness/Entrepreneurial/Customized/Other Trainings		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Career Technical Training	N/A	Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			# of Participants Receiving Services (Unduplicated)		Err:520	Err:520	Err:520	Err:520	0	0	0	0
			Work/Tools/ Equipment		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Educational Supplies & Fees		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Temporary Shelter		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Transportation		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Child / Dependent Care		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Accommodations for Persons w/ Disabilities		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Health Care		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Legal Aid Services		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Drug & Alcohol Counseling		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Financial Counseling		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Job Search Assistance		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Other Supportive Services		Err:520	Err:520	Err:520	Err:520	0	0	0	0	Err:520
			Direct costs for items such as stipends, travel allowances, and registration fees paid to or on behalf of participants or trainees (but not employees), tuition for participant training in connection with conferences, or training projects. This list is not inclusive, but all costs must reflect supportive services that directly benefit the participant. 2 CFR 200.1 Participant Support Costs	N/A									Err:520
			You must have an agreement or claim de minimis to claim indirect costs. De minimis is only for grantees who have never had a negotiated indirect cost rate agreement. Indirect (F&A) costs mean those costs incurred for a common or joint purpose benefitting more than one cost objective, and not readily assignable to the cost objectives specifically benefitted, without effort disproportionate to the results achieved. To facilitate equitable distribution of indirect expenses to the cost objectives served, it may be necessary to establish a number of pools of indirect (F&A) costs. Indirect (F&A) cost pools must be distributed to benefitted cost objectives on bases that will produce an equitable result in consideration of relative benefits derived. 2 CFR 200.414 Indirect Costs	N/A									Err:520
			All direct costs associated with the supervision and management of the program. Examples include: compensation of employees, cost of materials consumed or expended, travel, other allowable activities and items of expense incurred as allowable under 2 CFR Part 200.403. Direct Costs	N/A									Err:520
Subtotal of direct and indirect costs associated with the supervision and management of the program. Subtotal, Indirect and Direct Costs	N/A	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520
Total Actual Expenditures and Obligations	1	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520	Err:520
0
Public Burden Statement - According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information is 1293-0014. The time required to complete this information collection is 14 hours (for first year grantees) or 7 hours (for second and third year grantees) per Q1-Q4 response, and 2 hours ( second and third year grantees) per Q5-Q8 response. This includes the time to review instructions, search existing data sources, gather the data needed, and complete and review the information collection. The obligation to respond is required to obtain or retain a benefit (38 U.S.C. 2021 and 2023). If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Labor, Veterans' Employment and Training Service, 200 Constitution Avenue, N.W., Washington D.C. 20210.

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Sheet 3: New Enrollment Entry

Any blank fields will be considered a "No" for that participant. Participant Information

Training

Services

Participant Last Name (First 4 Letters) If fewer than 4 letters, enter "x" as a placeholder.

Enter only the first four letters of the participant's last name. If less than four letters, use "X". LastName

Ethnicity

Select Yes if the participant indicates that they are Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture in origin, regardless of race. Ethnicity

Training First Date Provided

Enter the date the individual first received training. DtFirstTrn

Employment Adjustment Services Last Date Provided

Employment adjustment services are designed to help a newly employed veteran adjust to a new job and are considered part of the veteran employment plan. These services are typically provided during the first 12 months of employment, depending on the needs of the veteran, by a career counselor or job coach. Services may include the following: --Adjusting to new routines, schedules, and work environments; --Building relationships with co-workers; --Enhancing customer service skills; ---Understanding and adapting to a company’s culture; --Working through the job situations that the veteran finds most troublesome; and --Providing clothing and professional attire such as uniforms or shoes required for the job. QtrLastEmpAdjSvc

Participant First Initial

FirstName

American Indian or Alaska Native

Enter Yes for 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. AmIndOrAkNtv

Apprenticeship: Last Date Provided

Enter the date the individual last received this training. DtLastTrn1

Job Search Assistance Last Date Provided

An activity focusing on building practical skills, identifying and initiating employer contact, and conducting successful interviews with employers. Various approaches may include job club participation, identifying personal strengths and goals, résumé application preparation, interviewing techniques, and receiving labor market information. Job search assistance is often self-service activities where individuals obtain information about job openings. QtrLastJobSrchAsst

View the field definition by hovering directly over the red triangles in the upper right corner of the cell.

Participant Middle Initial

Enter "#" if no middle initial. Intitial

Asian

Enter Yes for 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. Asian

Apprenticeship: # of Training Hours

Select the range of hours for this training during the latest quarter. TrnHrs1

Transitional Job Last Date Provided

QtrLastTransJob

Service Start Date Carry-Over<Program Year Start

Black or African American

Enter Yes for a person having origins in any of the black racial groups of Africa. BlkOrAfAmer

On-the-Job Training (OJT): Last Date Training Provided

Enter the date the individual last received this training. DtLastTrn2

Transportation Last Date Provided

QtrLastTransportation

Service Delivery State

Auto-populated based on the zip code. State

Native Hawaiian or Other Pacific Islander

Enter Yes for a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. NtvHawOrPacIsl

OJT: # of Hours

Select the range of hours for this training during the latest quarter. TrnHrs2

Child/Dependent Care Last Date Provided

QtrLastChildCare

Service Delivery City

Auto-populated based on zip code. City

White

Enter Yes for a person having origins in any of the original peoples of Europe, the Middle East, or North Africa. White

Job Readiness: Last Date Provided

Enter the date the individual last received this training. DtLastTrn3

Educational Supplies & Fees Last Date Provided

QtrLastEducFees

Service Delivery County

Date of Birth

Please input the participant's date of birth. DOB

Job Readiness: # of Hours

Select the range of hours for this training during the latest quarter. TrnHrs3

Accommodations for Persons w/ Disabilities Last Date Provided

QtrLastAccomDisab

Service Delivery Zip Code (5 digits)

Input the participant's 5-digit zip code at the time of enrollment. Zip

Date Entered Military Service

The date the veteran entered military service as indicated in the DD214. MilSvcEntryDate

Career Technical: Last Date Provided

Enter the date the individual last received this training. DtLastTrn4

Health Care Service Last Date Provided

QtrLastHealthCare

Co-Enrolled in American Job Center (AJC)

The participant is co-enrolled in Wagner-Peyser Act, Jobs for Veterans State Grant, and/or Workforce Innovation and Opportunity Act services via an American Job Center (AJC). CoEnrAjc

Date of Military Discharge

The date the veteran was discharged from military service as indicated in the DD214. MilSvcDischargeDate

Career Technical: # of Hours

Select the range of hours for this training during the latest quarter. TrnHrs4

Legal Aid Services Last Date Provided

QtrLastLegalSvcs

Date Co-Enrolled in American Job Center (AJC)

The date the participant was enrolled in Wagner-Peyser Act, Jobs for Veterans State Grant, and/or Workforce Innovation and Opportunity Act services via an American Job Center (AJC). AjcDate

Military Discharge Status

Select the participant's military discharge status. The DD 214 must have a Service Characterization of anything other than dishonorable to be considered a veteran. Value options include: 1=Honorable or “Under honorable conditions", 2=General under Honorable Conditions, 3=Other than Honorable (OTH), 4=Bad Conduct (BCD), 5=Entry Level (ELS) or Non-Characterized . DischargeStatus

Entrepreneurial: Last Date Provided

Enter the date the individual last received this training. DtLastTrn5

Drug & Alcohol Counseling Last Date Provided

QtrLastDrugAlcCouns

Co-Enrolled in VA's Grant and Per Diem (GPD)

Grant and per Diem (VA Transitional Housing). CoEnrGpd

Last Branch of Military Service

Enter the Last Branch of Military Service. LastMilSvcBranch

Entrepreneurial: # of Hours

Select the range of hours for this training during the latest quarter. TrnHrs5

Temporary Shelter Last Date Provided

A person living in a supervised public or privately operated shelter designed to provide temporary living arrangements. QtrLastTempShelt

Co-Enrolled in Veterans Affairs Supportive Housing (VASH)

Received a VA supported housing voucher through Veterans Affairs Supportive Housing (VASH) program. CoEnrVash

Highest Education Level (at First Service)

Enter the Highest Education Level at the time the first service was rendered: Attained secondary school diploma Attained a secondary school equivalency Completed one of more years of postsecondary education Attained a postsecondary technical or vocational certificate (non-degree) Attained an Associate's degree Attained a Bachelor's degree Attained a degree beyond a Bachelor's degree No Educational Level Completed HighestEdLvl

Customized: Last Date Provided

Enter the date the individual last received this training. DtLastTrn6

Financial Counseling Last Date Provided

Financial literacy activities that may include: (i) supporting the ability of participants to create household budgets, initiate savings plans, and make informed financial decisions; (ii) supporting the ability to manage spending, credit, and debt, including credit card debt, effectively; (iii) increasing awareness of the availability, usage and significance of credit reports and scores in obtaining credit, and their effect on credit terms; (iv) supporting the ability to understand, evaluate, and compare financial products, services, and opportunities; and (v) supporting activities that address the particular financial literacy needs of non-English speakers, including providing the support through the development and distribution of multilingual financial literacy and education materials. QtrLastFinCouns

Co-Enrolled in Supportive Services for Veteran Families (SSVF)

Supportive Services for Veteran Families (SSVF). CoEnrSsvf

At Risk of Homelessness

An individual is at risk for homelessness when the individual lacks the resources and support networks needed to obtain housing. The risk must be real and imminent (within 60 days. Recently housed veterans and veterans at imminent risk (14 days or less) of homelessness are considered homeless, not “at risk”. An individual may be either at risk for homelessness or homeless, but not both at once. AtRisk

Customized: # of Hours

Select the range of hours for this training during the latest quarter. TrnHrs6

Other Service Last Date Provided

Other Service refers to any type of relevant supportive service NOT listed in this document. QtrLastOthSupSvc

Co-Enrolled in SSVF-Shallow Subsidy

Receiving rental assistance from a SSVF provider. CoEnrSsvfSs

Homeless

Is a veteran who is homeless, meaning: 1. A person who lacks a fixed, regular, and adequate nighttime residence; 2. A person living in a supervised public or privately operated shelter designed to provide temporary living arrangements; 3. A person who resided in a shelter or place not meant for human habitation and who is exiting an institution where he or she temporarily resided; 4. A person with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground; 5. An individual who will imminently lose his or her housing, has no subsequent residence identified, and who lacks the resources or support network needed to obtain other permanent housing; 6. Unaccompanied youth and homeless families with children and youth defined as homeless under other federal statutes who have experienced a long period without permanent housing; have experienced persistent instability as measured by frequent moves over such period; and can be expected to continue in such status for an extended period of time because of chronic disabilities, chronic physical health or mental health conditions, substance addiction, histories of domestic violence or childhood abuse, the presence of a child or youth with a disability, or multiple barriers to employment; or 7. An individual or family who is fleeing, or is attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life-threatening conditions in the individual’s or family’s current housing situation, including where the health and safety of children are jeopardized, and who have no other residence and lack the resources or support network to obtain other permanent housing. Homeless

Other Training: Last Date Provided

Enter the date the individual last received this training. DtLastTrn7

Work/Tools/Equipment Last Date Provided

QtrLastTools

Co-Enrolled in FEMA

Federal Emergency Management Agency (FEMA). CoEnrFema

Episodic Homelessness

"Episodic Homeless’’ is defined as a homeless individual who has met the definition of homelessness continuously for at least 12 months, or on at least four separate occasions in the last 3 years, where the combined occasions total a length of time of at least 12 months. EpisHomeless

Other Training: # of Hours

Select the range of hours for this training during the latest quarter. TrnHrs7

Co-Enrolled in Native American Housing Assistance & Self-Determination Act (NAHASDA)

Native American Housing Assistance and Self-Determination Act. CoEnrNahasda

Homeless With Children (HWVHVWC)

Select Yes the veteran is homeless (not At Risk of Homelessness) and has children. For the definition of “children,” refer to the definition of “child” at 38 U.S.C. 101(4). HlessWfam

Service Delivery Area (SDA) Exception

Is the participant receiving services under an Service Delivery Area (SDA) exception? SDA

Eligible Incarcerated Veteran

A veteran who is a resident of a penal institution, or an institution that provides long-term care for mental illness, and is at risk for homelessness absent referral and counseling services provided under the program. IvtpElig

Sex (Assigned at Birth)

Please indicate the participant's sex assigned at birth. Sex

Disability Status

Select Yes if the veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Veterans Administration; or a person who was discharged or released from active duty because of a service-connected disability. Disabled

Gender Identity

Please indicate the participant's gender identity.

Sexual Orientation

Please indicate the participant's sexual orientation. Orient

Sheet 4: Participant Info

Subtotals:

1899/12/30

0.00

Any blank fields will be considered a "No" for that participant. Participant Information

Training

Services

Follow-Up

Miscellaneous Calculated Columns

Participant ID Auto-Populated

OPTIONAL
Grantee Participant ID (Enter organizational or system identifier)

Participant Last Name (First 4 Letters)

Participant First Initial

Participant Middle Initial

Service Start Date Carry-Over <Program Year Start

Service Delivery State

Service Delivery City

Service Delivery County

Service Delivery Zip Code

Co-Enrolled in American Job Center (AJC)

Date Co-Enrolled in American Job Center (AJC)

Co-Enrolled in VA's Grant and Per Diem (GPD)

Co-Enrolled in Veterans Affairs Supportive Housing (VASH)

Co-Enrolled in Supportive Services for Veteran Families (SSVF)

Co-Enrolled in SSVF-Shallow Subsidy

Co-Enrolled in FEMA

Co-Enrolled in Native American Housing Assistance & Self-Determination Act (NAHASDA)

Service Delivery Area (SDA) Exception

Sex (Assigned at Birth)

Gender Identity

Sexual Orientation

Ethnicity

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Date of Birth

Date Entered Military Service

Date of Military Discharge

Military Discharge Status

Last Branch of Military Service

Highest Education Level
(at First Service)

At Risk of Homelessness

Homeless

Episodic Homelessness

Homeless With Children (HWVHVWC)

Eligible Incarcerated Veteran

Disability Status

Date First Provided Training

Apprenticeship: Last Date Training Provided

Apprenticeship: # of Training Hours

On-the-Job Training (OJT): Last Date Training Provided

OJT: # of Hours

Job Readiness: Last Date Training Provided

Job Readiness: # of Hours

Career Technical Training: Last Date Training Provided

Career Technical Training: # of Hours

Entrepreneurial Training: Last Date Provided

Entrepreneurial Training: # of Hours

Customized Training: Last Date Provided

Customized Training: # of Hours

Other Training: Last Date Provided

Other Training: # of Hours

Employment Adjustment Services: Last Date Provided

Job Search Assistance: Last Date Provided

Transitional Job: Last Date Provided

Transportation: Last Date Provided

Child/Dependent Care: Last Date Provided

Educational Supplies & Fees: Date Last Provided

Accommodations for Persons w/ Disabilities: Last Date Provided

Health Care Service: Last Date Provided

Legal Aid Services: Last Date Provided

Drug & Alcohol Counseling: Last Date Provided

Temporary Shelter: Last Date Provided

Financial Counseling: Last Date Provided

Work/Tools/ Equipment Last Date Provided

Other Service: Last Date Provided

Service End Date
Auto-Populated

Date Last Provided Follow-Up Service

Occupation of Placement

Hourly Wage at Placement

Employment Placement Type

Total Hours Worked in 1st Quarter After Exit

Total Hours Worked in 2nd Quarter After Exit

Occupation 2nd Quarter After Exit

Hourly Wage in 2nd Quarter After Exit

Total Hours Worked in 3rd Quarter After Exit

Hourly Wage in 3rd Quarter After Exit

Total Hours Worked in 4th Quarter After Exit

Occupation 4th Quarter After Exit

Hourly Wage in 4th Quarter After Exit

Placed in Employment

Enrollment Quarter 0=Carry-Over

Date Provided Last Experiential Training

Carry Over

Exit Date

Exit Qtr

Quarter Employed

LGBTQIA+

Multiracial

Age

Last Military Service
(# Years Ago)

Date Provided First Training Service

Date Provided Last Training Service

Earnings in 2nd Quarter After Exit
(assumes 13 weeks/qtr)

Earnings for 3rd Quarter After Exit
(assumes 13 weeks/qtr)

Employed First Three Quarters After Exit

2nd & 3rd Quarter Earnings for those Employed First Three Quarters After Exit

A unique ID auto-generated from grant#, name fields, age, and military enlistment date). If all fields not populated, will appear red. ParticipantID

OptionalID

Enter only the first four letters of the participant's last name. If less than four letters, use "X". LastName

FirstName

Enter "#" if no middle initial. Intitial

This is the oldest (first) date auto-populated from all the service/training date fields. It represents the date the participant first received qualified (i.e., not self-service, informational, or follow-up) grant-funded services or benefits. If this is an option year award and the first service occurred in a prior program year, enter that original date. If a carry-over, enter the first date served (prior to current Program Year). SvcStartDate

Auto-populated based on the zip code. State

Auto-populated based on zip code. City

County

Input the participant's 5-digit zip code at the time of enrollment. Zip

The participant is co-enrolled in Wagner-Peyser Act, Jobs for Veterans State Grant, and/or Workforce Innovation and Opportunity Act services via an American Job Center (AJC). CoEnrAjc

The date the participant was enrolled in Wagner-Peyser Act, Jobs for Veterans State Grant, and/or Workforce Innovation and Opportunity Act services via an American Job Center (AJC). AjcDate2

Grant and per Diem (VA Transitional Housing). CoEnrGpd

Received a VA supported housing voucher through Veterans Affairs Supportive Housing (VASH) program. CoEnrVash

Supportive Services for Veteran Families (SSVF). CoEnrSsvf

Receiving rental assistance from a SSVF provider. CoEnrSsvfSs

Federal Emergency Management Agency (FEMA). CoEnrFema

Native American Housing Assistance and Self-Determination Act. CoEnrNahasda

Is the participant receiving services under an Service Delivery Area (SDA) exception? SDA

Please indicate the participant's sex assigned at birth. SAB

Please indicate the participant's gender identity. Gender

Please indicate the participant's sexual orientation. Orient

Select if the participant indicates that they are Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture in origin, regardless of race. Ethnicity

Enter Yes for 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. AmIndOrAkNtv

Enter Yes for a person having origins in any of the black racial groups of Africa. BlkOrAfAmer

Enter Yes for a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. NtvHawOrPacIsl

Enter Yes for a person having origins in any of the original peoples of Europe, the Middle East, or North Africa. White

Please input the participant's date of birth. DOB

The date the veteran entered military service as indicated in the DD214. MilSvcEntryDate

The date the veteran was discharged from military service as indicated in the DD214. MilSvcDischargeDate

Enter the Last Branch of Military Service. LastMilSvcBranch

Enter the Highest Education Level at the time the first service was rendered. HighestEdLvl

Is a veteran who is homeless, meaning: 1) An individual or family who lacks a fixed, regular, and adequate nighttime residence; 2) An individual or family with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground; 3) An individual or family living in a supervised publicly or privately operated shelter designated to provide temporary living arrangements (including hotels and motels paid for by federal, state, or local government programs for low-income individuals or by charitable organizations, congregate shelters, and transitional housing); 4) An individual who resided in a shelter or place not meant for human habitation and who is exiting an institution where he or she temporarily resided; 5) An individual or family who— a) will imminently lose their housing, including housing they own, rent, or live in without paying rent, are sharing with others, and rooms in hotels or motels not paid for by federal, state, or local government programs for low-income individuals or by charitable organizations, as evidenced by— i) a court order resulting from an eviction action that notifies the individual or family that they must leave within 14 days; ii) the individual or family having a primary nighttime residence that is a room in a hotel or motel and where they lack the resources necessary to reside there for more than 14 days; or iii) credible evidence indicating that the owner or renter of the housing will not allow the individual or family to stay for more than 14 days, and any oral statement from an individual or family seeking homeless assistance that is found to be credible shall be considered credible evidence for purposes of this clause; b) has no subsequent residence identified; and c) lacks the resources or support networks needed to obtain other permanent housing; 6) Unaccompanied youth and homeless families with children and youth defined as homeless under other federal statutes who— a) have experienced a long term period without living independently in permanent housing, b) have experienced persistent instability as measured by frequent moves over such period, and c) can be expected to continue in such status for an extended period of time because of chronic disabilities, chronic physical health or mental health conditions, substance addiction, histories of domestic violence or childhood abuse, the presence of a child or youth with a disability, or multiple barriers to employment; or 6) Any individual or family who is fleeing, or is attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life-threatening conditions in the individual’s or family’s current housing situation, including where the health and safety of children are jeopardized, and who have no other residence and lacks the resources or support networks to obtain other permanent housing. Homeless

Select 1 the veteran is homeless (not At Risk of Homelessness) and has children. For the definition of “children,” refer to the definition of “child” at 38 U.S.C. 101(4). HWVHVWC

Enter the date the individual first received training. DtFirstTrn

Enter the date the individual last received this training. DtLastTrn1

Select the range of hours for this training during the latest quarter. TrnHrs1

Enter the date the individual last received this training. DtLastTrn2

Select the range of hours for this training during the latest quarter. TrnHrs2

Enter the date the individual last received this training. DtLastTrn3

Select the range of hours for this training during the latest quarter. TrnHrs3

Enter the date the individual last received this training. DtLastTrn4

Select the range of hours for this training during the latest quarter. TrnHrs4

Enter the date the individual last received this training. DtLastTrn5

Select the range of hours for this training during the latest quarter. TrnHrs5

Enter the date the individual last received this training. DtLastTrn6

Select the range of hours for this training during the latest quarter. TrnHrs6

Enter the date the individual last received this training. DtLastTrn7

TrnHrs7

Employment adjustment services are designed to help a newly employed veteran adjust to a new job and are considered part of the veteran employment plan. These services are typically provided during the first 12 months of employment, depending on the needs of the veteran, by a career counselor or job coach. Services may include the following: Adjusting to new routines, schedules, and work environments; Building relationships with co-workers; Enhancing customer service skills; Understanding and adapting to a company’s culture; Working through the job situations that the veteran finds most troublesome; and Providing clothing and professional attire such as uniforms or shoes required for the job. DtLastEmpAdjSvc

DtLastTransJob

DtLastTransportation

DtLastChildCare

DtLastEducFees

DtLastAccomDisab

DtLastHealthCare

DtLastLegalSvcs

DtLastDrugAlcCouns

A person living in a supervised public or privately operated shelter designed to provide temporary living arrangements. DtLastTempShelt

DtLastTools

Other Service refers to any type of relevant service NOT listed in this document. DtLastOthSupSvc

This is the most recent date of service (including Training), auto-populated by the service and training date fields. The date represents the final date the participant received funded services that are not self-service, information-only, or follow up services. SvcEndDate

The most recent date (last) that follow-up services (post-exit) were provided to the participant. This date must be after the Service End Date. FlwUpDate

Select the most appropriate category for the employment placement: Driver (includes long-haul and local delivery) Customer Service (sales, retail, cashiers) Healthcare (medical assistant, nurse, technician) Information Technology (programmer, developers, computer operator) Food Service Administrative (office, finance, legal, or business-related jobs) Education (teachers, para-educators, education administration) Vocational/Technical (consruction, production, installation, repair, farming, fishing) PlaceJob

If the participant is reported as employed, then please provide the Hourly Wage paid to the individual. HrlyWgPlmt

Select the most appropriate employment type for the placement:: Full-Time (average of ≥ 30 hours per week) Part-Time (average of < 30 hours per week) Gig work (1099/ non-W2 work; hours on-demand) PlaceEmpType

Enter the total hours worked for the 13 weeks during the quarter. 520 hours= full-time employment the entire quarter. Hours1Qae

Hours2Qae

If the participant is reported as employed, then please provide the Hourly Wage paid to the individual. HrlyWg2Qae

Enter the total hours worked for the 13 weeks during the quarter. 520 hours= full-time employment the entire quarter. Hours3Qae

If the participant is reported as employed, then please provide the Hourly Wage paid to the individual. HrlyWg3Qae

Enter the total hours worked for the 13 weeks during the quarter. 520 hours= full-time employment the entire quarter. Hours4Qae

If the participant is reported as employed, then please provide the Hourly Wage paid to the individual. HrlyWg4Qae

Please indicate whether the participant was employed when they exited the program. PlacedInEmp

EnrollQtr

ExpTrn

Individuals actively enrolled on the last day of the period of performance for the prior grant AND whose enrollment was carried forward to the current grant. The same ID & Name from the prior grant should be reused. CarryOver

ExitDate

ExitQtr

EmployQtr

LGBTQIA+

Multiracial

Age

LastMilSvc

DtFirstTrain

DtLastTrain

Earnings2Qae

Earnings3Qae

EmplAll3Qae

Earnings2and3Qae

Err:520

Sheet 5: Demographics Summary

All figures are auto-calculated and derived from the Participants worksheet.
Demographic Attribute	Served_Total	Exited_Total	Employed_Total	Placement_Rate_Total	Average_Wage_Total
Male	0	0	0	0.0%	0.00
Female	0	0	0	0.0%	0.00
Intersex	0	0	0	0.0%	0.00
LGBTQIA+	0	0	0	0.0%	0.00
Hispanic or Latino	0	0	0	0.0%	0.00
Not Hispanic or Latino	0	0	0	0.0%	0.00
RACE (DUPLICATED) American Indian or Alaska Native	0	0	0	0.0%	0.00
RACE (DUPLICATED) Asian	0	0	0	0.0%	0.00
RACE (DUPLICATED) Black or African American	0	0	0	0.0%	0.00
RACE (DUPLICATED) Native Hawaiian or Other Pacific Islander	0	0	0	0.0%	0.00
RACE (DUPLICATED) White	0	0	0	0.0%	0.00
RACE (UNDUPLICATED) American Indian or Alaska Native	0	0	0	0.0%	0.00
RACE (UNDUPLICATED) Asian	0	0	0	0.0%	0.00
RACE (UNDUPLICATED) Black or African American	0	0	0	0.0%	0.00
RACE (UNDUPLICATED) Native Hawaiian or Other Pacific Islander	0	0	0	0.0%	0.00
RACE (UNDUPLICATED) White	0	0	0	0.0%	0.00
RACE (UNDUPLICATED) Multiracial	0	0	0	0.0%	0.00
AGE 18-24	0	0	0	0.0%	0.00
AGE 25-29	0	0	0	0.0%	0.00
AGE 30-34	0	0	0	0.0%	0.00
AGE 35-44	0	0	0	0.0%	0.00
AGE 45-54	0	0	0	0.0%	0.00
AGE 55-64	0	0	0	0.0%	0.00
AGE 65+	0	0	0	0.0%	0.00
LAST MILITARY SERVICE 0-3 Years Ago	0	0	0	0.0%	0.00
LAST MILITARY SERVICE 4-7 Years Ago	0	0	0	0.0%	0.00
LAST MILITARY SERVICE 8-11 Years Ago	0	0	0	0.0%	0.00
LAST MILITARY SERVICE 12-15 Years Ago	0	0	0	0.0%	0.00
LAST MILITARY SERVICE 16-19 Years Ago	0	0	0	0.0%	0.00
LAST MILITARY SERVICE 20+ Years Ago	0	0	0	0.0%	0.00
Episodic Homeless	0	0	0	0.0%	0.00
Homeless (not Episodic or Family)	0	0	0	0.0%	0.00
Homeless with Children	0	0	0	0.0%	0.00
Incarcerated/Rec. Incarcerated	0	0	0	0.0%	0.00
Homeless (any type) Women	Err:520	Err:520	Err:520	0.0%	Err:520
At Risk for Homelessness	0	0	0	0.0%	0.00
Disabled	0	0	0	0.0%	0.00
Army	0	0	0	0.0%	0.00
Navy	0	0	0	0.0%	0.00
Air Force	0	0	0	0.0%	0.00
Marines	0	0	0	0.0%	0.00
Coast Guard	0	0	0	0.0%	0.00
Guard/Reserves	0	0	0	0.0%	0.00
Attained secondary school diploma	0	0	0	0.0%	0.00
Attained a secondary school equivalency	0	0	0	0.0%	0.00
Completed one of more years of postsecondary education	0	0	0	0.0%	0.00
Attained a postsecondary technical or vocational certificate (non-degree)	0	0	0	0.0%	0.00
Attained an Associate's degree	0	0	0	0.0%	0.00
Attained a Bachelor's degree	0	0	0	0.0%	0.00
Attained a degree beyond a Bachelor's degree	0	0	0	0.0%	0.00
No Educational Level Completed	0	0	0	0.0%	0.00

Sheet 6: Goals v. Actual

Goals vs. Actuals Table


Performance Measures	Total_Planned	Total_Actual	Total_Deviation
# of Participants Enrolled	Err:520	Err:520	Err:520
# Placed into Employment	Err:520	Err:520	Err:520
Average Hourly Wage at Placement	Err:520	Err:520	Err:520
Placement Rate Overall (rate = employed/exited)	Err:520	Err:520	Err:520
# Exited	Err:520	0	Err:520
Employment Rate in the 2nd Quarter After Exit	Err:520	Err:520	Err:520
Median Quarterly Earnings in the 2nd Qtr. After Exit	Err:520	Err:520	Err:520
Employment Rate in the 4th Quarter After Exit	Err:520	Err:520	Err:520
Cost Per Placement (PoP Year 1 grantees only)	Err:520	Err:520	Err:520
Episodic Homeless - Placement Rate (PoP Year 2 and Year 3 grantees only)	Err:520	Err:520	Err:520
Participant Support Costs	$0	$0	0.0%
Indirect Costs	$0	$0	0.0%
Direct Costs	$0	$0	0.0%
Subtotal, Indirect and Direct Costs	$0	$0	0.0%
Total Expenditures	$0	$0	0.0%

File Type	application/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified	0000-00-00
File Created	0000-00-00