4 Workplan Worksheet RSVP

AmeriCorps Seniors Grant Applications, Progress Reporting, Independent Living and Respite Surveys

Work Plan Worksheets RSVP_Version 09032012

Senior Corps Application

OMB: 3045-0035

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Overview and Instructions

RSVP Work Plan Development Worksheets

Overview: The summary sheets below, along with the pre-formatted Work Plan Development Worksheets, are optional tools to help you plan placement of your volunteers in the Focus Areas and Performance Measures for the three-year performance period, as specified in the Grant Application Instructions. By using these templates to pre-plan how your volunteers will be placed in service opportunities and activities, you can plot the scope of your RSVP project, and use each completed sheet to calculate your percentages in each type of Performance Measure. Additionally, the completed Worksheets can be used as reference when you enter your Work Plan data into the eGrants System.





Instructions:

  1. As you complete these worksheets, we encourage you to reference the following resources:


  1. Use the following definitions when calculating “Total Number of Unduplicated Volunteers” and “Total Number of Volunteers”:

  • Number of Unduplicated Volunteers: This is the proposed number of volunteers who will be performing each service activity. Each volunteer can only be counted once when assigned to a service activity. The volunteer should be counted in the area where he/she will make the most impact- in terms of the type of service or in terms of the scope of service, such as the most number of hours served.

  • Total Number of Volunteers: The total number of volunteers engaged in the activities, if you were to assign all of them according to each activity, will be entered in this section. In this way, volunteers can be counted more than once- for example, if the same volunteer does two different types of activities such as meal delivery AND companionship, you can account for all assignments in this field.

TIP: When completing these worksheets and entering your volunteer numbers into the eGrants System, remember that the sum of the Number of Unduplicated Volunteers from each work plan must equal the Total Number of Unduplicated Volunteers for the project.















Volunteer Calculations:

  1. The total number of unduplicated volunteers in your proposed project: ______

    1. Calculate 25% of your total unduplicated volunteers = ________ volunteers

This is the minimum number of unduplicated volunteers to be placed in the Primary Focus Area (see Step 2 below)

    1. Calculate 30% of your total unduplicated volunteers = ________ volunteers

This is the maximum number of unduplicated volunteers to be placed in Community Priorities (see Step 3 below)

    1. Any remaining unduplicated volunteers will be placed in Other Focus Areas (see Step 4 below)

    2. Calculate 10% of your total unduplicated volunteers = _____ volunteers

This is the minimum number of unduplicated volunteers to be assigned to activities with Outcomes (see Step 5 below)



  1. Select the Primary Focus Area

Education Healthy Futures Economic Opportunity

Veterans and Military Families Environmental Stewardship Disaster Services

Use the relevant Focus Area Worksheet(s) (following on pages 3 to 27) to plan placement of volunteers in performance measures in the Primary Focus Area selected.


  1. Use the Community Priority Worksheet (following on page 31) to plan placement of a maximum of 30% of your unduplicated volunteers.



  1. Use the Focus Area Worksheets (following on pages 3 to 30) as needed to plan placement for the remainder of your unduplicated volunteers.

Note that the work plans for these volunteer placements will fall under Other Focus Areas (rather than Primary Focus Area) in eGrants.



  1. Ensure that 10% of your total unduplicated volunteers are in assignments that produce Outcomes.

When you create performance measures, you are required to select “Outputs” but “Outcomes” are only required for 10% of unduplicated volunteers. Review your completed worksheets and select Outcomes for the minimum of 10% of unduplicated volunteers. These Outcomes can be in any Focus Area (Primary or Other).



  1. Once you have completed these worksheets and you are ready to enter Work Plan data into the eGrants System you may want to review the online course “How to Represent Performance Measures in eGrants”, located in the Main Conference Hall section of the Senior Corps Virtual Conference (http://www.nationalserviceresources.org/scvirtualconference).







­­­­Work Plan Development Worksheet Focus Area: Education Objective: School Readiness

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED21. Number of children that completed participation in CNCS-supported early childhood education programs


http://www.nationalserviceresources.org/npm/ed21

Attendance Log; Activity Log; Other

Assisting in Classroom





ED23. Number of children demonstrating gains in school readiness in terms of social and/or emotional development


http://www.nationalserviceresources.org/npm/ed23

Observation Tool; Teacher Survey; Teacher Pre/Post Survey; Other


Assisting in Classroom – Head Start






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______

















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED21. Number of children that completed participation in CNCS-supported early childhood education programs


http://www.nationalserviceresources.org/npm/ed21

Attendance Log; Activity Log; Other

Assisting in Classroom





ED24. Number of children demonstrating gains in school readiness in terms of literacy skills.


http://www.nationalserviceresources.org/npm/ed24

Standardized Test; Standardized Pre/Post Test; Literacy Assessment Tool; Senior Corps Teacher Survey; Other


Assisting in Classroom – Head Start










Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED21. Number of children that completed participation in CNCS-supported early childhood education programs


http://www.nationalserviceresources.org/npm/ed21

Attendance Log; Activity Log; Other

Assisting in Classroom





ED25. Number of children demonstrating gains in school readiness in terms of numeracy (math) skills


http://www.nationalserviceresources.org/npm/ed25

Standardized Test; Standardized Pre/Post Test; Literacy Assessment Tool; Senior Corps Teacher Survey; Other


Assisting in Classroom – Head Start






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

ED29. Number of children served in child safety, welfare, and health programs

Other

Comforting Children






Caring for Infants





Helping Young Mothers





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



Work Plan Development Worksheet Focus Area: Education Objective: K-12 Success

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED2. Number of students that completed participation in CNCS-supported K-12 education Programs


http://www.nationalserviceresources.org/npm/ed2

Attendance Log; Activity Log; Other

Tutoring—Public Schools





ED5. Number of students with improved academic performance in literacy and/or math


http://www.nationalserviceresources.org/npm/ed5

Standardized Pre/Post Test; Standardized Test


Tutoring—Faith-Based School






Tutoring - Other






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED2. Number of students that completed participation in CNCS-supported K-12 education Programs


http://www.nationalserviceresources.org/npm/ed2

Attendance Log; Activity Log; Other

Tutoring—Public Schools





ED27. Number of students in grades K-12 that participated in the mentoring or tutoring or other education program, including CNCS-supported service-learning, who demonstrated improved academic engagement



School Records; Teacher Pre/Post Survey; Student Pre/Post Survey


Tutoring—Faith-Based School






Tutoring - Other
















Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______





















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED2. Number of students that completed participation in CNCS-supported K-12 education Programs


http://www.nationalserviceresources.org/npm/ed2

Attendance Log; Activity Log; Other

Tutoring—Public Schools





ED6. Number of youth that have improved their school attendance over the course of the CNCS-supported program’s involvement with the student


http://www.nationalserviceresources.org/npm/ed6

Attendance Log; Other


Tutoring—Faith-Based School






Tutoring - Other






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______





















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED2. Number of students that completed participation in CNCS-supported K-12 education Programs


http://www.nationalserviceresources.org/npm/ed2

Attendance Log; Activity Log; Other

Tutoring—Public Schools





ED26. Number of students acquiring a GED

GED Completion Record



Tutoring—Faith-Based School






Tutoring - Other






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______





















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period


http://www.nationalserviceresources.org/npm/ed4a

Attendance Log; Activity Log; Other

School-based Mentoring





ED5. Number of students with improved academic performance in literacy and/or math



Standardized Pre/Post Test; Standardized Test


Community-based Mentoring






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______

















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period


http://www.nationalserviceresources.org/npm/ed4a

Attendance Log; Activity Log; Other

School-based Mentoring





ED27. Number of students in grades K-12 that participated in the mentoring or tutoring or other education program, including CNCS-supported learning, who demonstrated improved academic engagement

School Records; Teacher Pre/Post Survey; Student Pre/Post Survey


Community-based Mentoring






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period


http://www.nationalserviceresources.org/npm/ed4a

Attendance Log; Activity Log; Other

School-based Mentoring





ED6. Number of youth that have improved their school attendance over the course of the CNCS-supported program’s involvement with the student


http://www.nationalserviceresources.org/npm/ed6

Attendance Log; Other


Community-based Mentoring






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______

















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

ED4A. Number of disadvantaged youth/mentor matches that were sustained by the CNCS-supported program for at least the required time period


http://www.nationalserviceresources.org/npm/ed4a

Attendance Log; Activity Log; Other

School-based Mentoring





ED26. Number of students acquiring a GED

GED Completion Record


Community-based Mentoring






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______

















Work Plan Development Worksheet Focus Area: Healthy Futures Objective: Aging in Place

Community Need:




Output

Output Instrument

Service Activity (each will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output

Target

Outcome (optional)

Outcome Instrument

Outcome Target

H8. Number of homebound OR older adults and individuals with disabilities receiving food, transportation, or other services that allow them to live independently


http://www.nationalserviceresources.org/npm/h8

Activity Logs; Client Tracking Database;

Survey; Other


Food Delivery





H9. Number of homebound OR older adults and individuals with disabilities who reported having increased social ties/perceived social support

Survey


Transportation






Companionship






Companionship—Dept. of Veterans Affairs






Providing Financial Literacy or Housing Services






Preventing Elder Abuse






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

H13. Number of caregivers of homebound OR older adults and individuals with disabilities receiving respite services

Activity Log; Client Tracking Database; Survey

Food Delivery





H14. Number of caregivers of homebound OR older adults and individuals with disabilities who reported having increased social ties/perceived social support

http://www.nationalserviceresources.org/npm/h14

Survey


Transportation






Companionship






Companionship – Dept. of Veterans of Affairs






Preventing Elder Abuse






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______





















Work Plan Development Worksheet Focus Area: Healthy Futures Objective: Obesity and Food

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

H10. Number of individuals receiving emergency food from food banks, food pantries, or other nonprofit organizations


http://www.nationalserviceresources.org/npm/h10

Tracking Form; Client Database; Other

Food Distribution





H12. Number of individuals that reported increased food security of themselves and their children (household food security) as a result of CNCS-supported services

Pre/Post Survey; Survey


Food Collection






Food Pantry Support







Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______

















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

H11. Number of individuals receiving support, services, education and/or referrals to alleviate long-term hunger


http://www.nationalserviceresources.org/npm/h11

Attendance Log; Activity Log; Client Tracking Database; Tracking Form/Log; Other

Developing/

Maintaining Community Gardens





H12. Number of individuals that reported increased food security of themselves and their children (household food security) as a result of CNCS-supported services

Pre/Post Survey; Survey


Educating






Providing Services






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______





















Work Plan Development Worksheet Focus Area: Healthy Futures Objective: Access to Care

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

H2. Number of clients to whom information on health insurance, health care access and health benefits programs is delivered

Attendance Log; Activity Log; Other

Staffing Hotline





Developing Materials





Distributing Information





Preventing Elder Abuse





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

H4. Number of clients participating in health education programs

Attendance Log; Activity Log; Other

Training





Coaching





Leading or Assisting Bone Builders





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______













Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

H7. Number of clients receiving language translation services at clinics and in emergency rooms

Program Records; Log; Case Management System; Other

Translating





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



­­­­Work Plan Development Worksheet Focus Area: Economic Opportunity Objective: Housing

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

O5. Number of economically disadvantaged individuals, including homeless individuals, receiving housing services


http://www.nationalserviceresources.org/npm/o5

Inspection Report; Certificate of Occupancy; Activity Log; Client Tracking Database; Attendance Log; Other

Building Homes





O11. Number of economically disadvantaged individuals, including homeless individuals, transitioned into safe, healthy affordable housing.


http://www.nationalserviceresources.org/npm/o11

Inspection Report; Certificate of Occupancy; Proof of Residence; Other


Repairing Homes






Assisting with Housing Search






Building or Assisting Homes – Habitat for Humanity






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______

­­­­

Work Plan Development Worksheet Focus Area: Economic Opportunity Objective: Employment

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

O2. Number of economically disadvantaged individuals receiving job training and other skill development services

Attendance Log; Activity Log; Other

Adult Basic Education





O10. Number of economically disadvantaged individuals placed in jobs

Acceptance Letter from Employer; Copy of Pay Stub; Program Records; Other


Helping with GED






Adult ESOL/ESL






Other






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



­­­­Work Plan Development Worksheet Focus Area: Economic Opportunity Objective: Financial Literacy

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

O1. Number of economically disadvantaged individuals receiving financial literacy services

Attendance Log; Activity Log; Other

Assisting VITA





Income Tax Tutoring





Preventing Elder Abuse





Providing Financial Literacy Education





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______

­­­

­­­­Work Plan Development Worksheet Focus Area: Veterans and Military Families Objective: Veterans and Military Families Served

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

V1. Number of veterans that received CNCS-supported assistance


http://www.nationalserviceresources.org/npm/v1

Activity Log; Other

Assistance a DOL VETS Program





Assisting a Dept. of Veterans Affairs Program





Healthy Futures Activity





Economic Opportunity Activity





Food Delivery – VA HBPC





Companionship – VA HBPC





Work with VA VAVS or VAMC





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

V8. Number of veteran’s family members that received CNCS-supported assistance

Activity Log; Attendance Log; Tracking System; Other

Healthy Futures Activity





Economic Opportunity Activity





Assisting a Dept. of Veterans Affairs Program





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______







Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

V7. Number of family members of active duty military service members that received CNCS-supported assistance


http://www.nationalserviceresources.org/npm/v7

Activity Log; Attendance Log; Tracking System; Other

Healthy Futures Activity





Economic Opportunity Activity





National Guard Volunteer Services





Assisting a Dept. of Veterans Affairs Program





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

V9. Number of military service members that received CNCS-supported assistance


http://www.nationalserviceresources.org/npm/v9

Activity Log; Attendance Log; Tracking System; Other

Healthy Futures Activity





Economic Opportunity Activity





National Guard Volunteer Services





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______









Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

V3. Number of veterans assisted in pursuing educational opportunities


http://www.nationalserviceresources.org/npm/v3

Proof of School enrollment; Tracking Systems; Other

Coaching/Counseling





Referring to Services





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______





­­­­Work Plan Development Worksheet Focus Area: Environmental Stewardship Objective: At-risk Ecosystems

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

EN4. Number of acres of national parks, state parks, city parks, county parks, or other public and tribal lands that are improves


http://www.nationalserviceresources.org/npm/en4

Activity Logs; Survey; Acknowledgement of Receipt of Services; Tracking Database; Other

Plant establishment or removal





Debris (not basic trash) removal





Land Restoration





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______







Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

EN5. Number of miles of trails or waterways (owned/maintained by national, state, county, city or tribal governments) that are improved and/or created


http://www.nationalserviceresources.org/npm/en5

Activity Logs; Survey; Acknowledgment of Receipt of Services; Other

Creating Trails





Improving Trails





Improving Waterways





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

EN6. Number of tons of materials collected and recycled

Tracking Form; Weight Receipt from Recycling Center or Buyer; Tracking Database; Other

Collecting and Recycling Materials





Composting





Reusing Materials





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______









Work Plan Development Worksheet Focus Area: Disaster Services Objective: Assistance Provided

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

D1. Number of individuals that received CNCS-supported services in disaster preparedness

Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other

Training





Creating Disaster Kits





Performing Outreach





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

D2. Number of individuals that received CNCS-supported services in disaster response

Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other

Setting Up Call Centers





Staffing Call Centers





Transporting Victims





Setting Up Shelter





Staffing Shelter





Proving Health/ First Aid Services





Distributing Meals





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______







Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

D3. Number of individuals that received CNCS-supported services in disaster recovery

Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other

Clearing Debris





Renovating Housing





Providing Housing Transition Support





Counseling





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

D4. Number of individuals that received CNCS-supported services in disaster mitigation

Call Center Records; Referral Logs; Attendance Sheet; Tracking System; Other

Fire Mitigation





Tornado/Hurricane Mitigation





Other Disaster Mitigation





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______











Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

D6. Number of RSVP volunteer service hours in disaster preparedness, mitigation, response, and recovery.

Attendance Sheet; Tracking System

Assisting with Preparation





Assisting with Mitigation





Responding





Assisting with Recovery

Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______































Work Plan Development Worksheet Focus Area: Capacity Building Objective: Capacity Building and Leverage

Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

G3-3.1. Number of community volunteers recruited by CNCS-supported organizations or National Service Participants

Attendance Sheet; Activity Log; Volunteer Management System; Other

Recruiting Volunteers







G3-3.3. Number of organizations implementing three or more effective volunteer management practices as a result of capacity building services provided by CNCS-supported organizations or national service participants

Pre/Post Organizational Assessment Tool


Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



















Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

Outcome (optional)

Outcome Instrument

Outcome Target

G3-3.2 Number of community volunteers managed by CNCS-supported organizations or National Service Participants

Attendance Sheet; Activity Log; Volunteer management System; Other

Managing Volunteers





G3-3.3. Number of organizations implementing three or more effective volunteer management practices as a result of capacity building services provided by CNCS-supported organizations or national service participants

Pre/Post Organizational Assessment Tool


Training Volunteers






Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______

Total number of unduplicated volunteers in Outcome: _______


Percentage of total unduplicated volunteers in Outcome: _______



Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

G3-3.16. Dollar value of cash resources leveraged by CNCS-supported organizations or national service participants

Financial Management System; Other

Garnering Donations





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______





Community Need:




Output

Output Instrument

Service Activity (each selected will generate a separate work plan)

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Output Target

G3-3.17. Dollar value of in-kind resources leveraged by CNCS-supported organizations or national service participants

Program Records; Financial Management System; Other

Garnering Donations





Supporting Blood Drives





Food Collection





Food Pantry Support





Other





Total number of unduplicated volunteers in Output: ______ Percentage of total unduplicated volunteers in Output: ______





























Work Plan Development Worksheet for Community Priorities Focus Area: Other Community Priorities Objective: Other Community Priorities

For all “Community Priorities” measures and activities, there is one standard output: “Grantee met its target for community priority activity (Yes/No).”

Use the worksheets below to develop one work plan that includes all volunteers (no more than 30% of the total unduplicated volunteers) in the Community Priorities Focus Area.

Community Need:




Output

# of Unduplicated Volunteers

# of Total Volunteers

# of Volunteer Stations

Grantee met its target for community priority activity




Total number of unduplicated volunteers in Output: ______


Percentage of total unduplicated volunteers in Output: ______



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File Typeapplication/msword
AuthorRoberts, Angela
Last Modified ByCannady, Laurie
File Modified2012-09-03
File Created2012-09-03

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