Form 1122-0023 Semi-Annual Performance Report for Sexual Assault Servic

Date Posted: 6-11-2025

U.S. Department of Justice Office on Violence Against Women
Semi-Annual Performance Report for
Sexual Assault Services Culturally Specific Program
Brief Instructions
This reporting tool details the Semi-Annual Performance Report questions for the Sexual Assault
Services Culturally Specific Program (SASP-CS). A report must be completed for each grant received.
Grant partners may complete sections relevant to their portion of the grant. Grant administrators and
coordinators are responsible for compiling and submitting a single report that reflects all information
collected from grant partners.
All grantees must complete the required sections. Required questions are marked with an asterisk (*).
For all other sections, grantees must answer an initial question about whether they used SASP-CS
Program funds to support certain activities during the current reporting period. If the response is yes,
then the grantee must complete that section. If the response is no, the rest of that section is skipped.
The activities of volunteers or interns should be reported if they were coordinated or supervised by
SASP-CS Program-funded staff or if SASP-CS Program funds substantially supported their activities.
For further information on filling out this report, refer to the separate instructions, which contain
detailed definitions and examples.

Public Reporting Burden
Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to
respond to a collection of information unless it displays a currently valid OMB control number. We try
to create forms and instructions that are accurate, can be easily understood, and which impose the
least possible burden on you to provide us with information. The estimated average time to complete
and file this form is 60 minutes per form. If you have comments regarding the accuracy of this
estimate, or suggestions for making this form simpler, you can write to the Office on Violence Against
Women, U.S. Department of Justice, 145 N Street NE, Washington, DC 20530.

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General Information

All grantees must complete the General Information section.
1. Date of report
2. Current reporting period (6-month)
•
•

January to June
July to December

Current reporting period (4-digit year)
3. Grantee name
4. Grant number
The federal grant number assigned to your SASP-CS Program grant.
This number, also called your Award Number, can be found at the top of your JustGrants
Funded Award Page. Please enter the grant number exactly as it appears, including dashes.
Examples: 15JOVW-12-GG-12345-PROG or 2000-XX-ZZ-1234
If you have multiple active OVW program grants, please enter the grant number associated
with the SASP-CS Program grant you are reporting on in this form.
5. Type of performance report
Indicate if this is a regular performance report or the final performance report for the grant
award being reported on.
•
•

Final
Regular

6. Point of contact
Provide information for the person responsible for the day-to-day coordination of the grant.
•
•
•
•
•
•
•
•
•

First name
Last name
Agency/organization name
Address
City
State
Zip code
Telephone
Email

7. Is this a faith-based organization?
•
•

Yes
No

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8. Is this a culturally-specific community-based organization?
•
•

Yes
No

9. Does this grant specifically address and focus on Tribal populations?
•
•

Yes
o
No

If yes, which tribes/nations?

10. Does your grant support the creation of products in languages other than English or
provide services in languages other than English?
•
•

Yes
o
No

If yes, what languages?

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Staff
1. Were SASP-CS Program grant funds used to fund staff time (at your agency, at a
partner agency, contractors, or stipends) during the current reporting period?
•
•

Yes
No

2. Staff
Report the total number of full-time equivalent (FTE) staff funded by the SASP-CS Program
grant during the current reporting period.
 Reporting 1.00 FTEs means a staff person worked full-time and was 100% funded by
the grant for the entire reporting period. Typically, one FTE is equal to 1,040 hours (40
hours per week multiplied by 26 weeks).
 FTEs should be prorated to reflect when a staff person did not work-full time and/or
when was not 100% funded by the SASP-CS Program grant for the entire reporting
period.
 Report staff by the function(s) they performed, not by title.
 Round and report FTEs to the second decimal place. For example, if you calculate an
FTE to be 0.66667, then rounding to the second decimal would mean this FTE would
be reported as 0.67 FTE.
Staff Function

FTE(s)

Administrator
Attorney (does not include prosecutor)
Counselor
Information technology staff
Legal advocate (does not include attorney or paralegal)
Outreach worker
Paralegal
Program coordinator
Support staff
Translator/interpreter
Victim advocate (non-governmental)
Other (specify):
Total

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3. Please describe how staffing impacted your ability to implement your grant-funded
activities.

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Coordinated Community Response
1. Coordinated community response activities
This question is required. Select all agencies/organizations that you provided SASP-CS
Program-funded referrals to/received from, met with, or engaged in consultation with during
the current reporting period. If SASP-CS Program-funded staff participated in a task force or
work group, check all attendees. If applicable, indicate the agencies or organizations with
which you have a mandatory collaboration for purposes of your grant (MOU partner).
Agency/organization

Provided referrals
to/received referrals from,
met with, or engaged in
consultation with

MOU Partner

Advocacy organization
Abuser intervention program
Corrections (probation, parole, and
correctional facility staff)
Court
Dual sexual assault and domestic
violence program
Domestic violence organization
Educational institutions/organizations
Faith-based organization
Governmental agency
Health/mental health organization
Law enforcement
Legal organization
Prosecutor’s office
Sex offender management/sex
offender treatment provider
Sexual assault organization
Social service organization (nongovernmental)
Tribal government/Tribal
governmental agency
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Other (specify): __________
2. Discuss the effectiveness of CCR activities funded or supported by your SASP-CS
Program grant and provide any additional information you would like to share about
your CCR activities.

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Policies
1. Were SASP-CS Program funds used to develop, substantially revise, or implement
policies or protocols during the current reporting period?
•
•

Yes
No

2. Type of organizations/agencies in which policies or protocols were developed,
substantially revised, or implemented
Indicate the organizations/agencies in which policies or protocols were developed,
substantially revised, or implemented using SASP-CS Program funds during the current
reporting period. Check all that apply.
o
o
o

o
o

o
o
o

o
o

Courts
Healthcare
Law enforcement
Legal services
Probation, parole, or another correctional agency
Prosecution
Supervised visitation
Transitional housing
Victim services
Other (specify)

3. Describe the protocols and/or policies developed, substantially revised, or implemented
with SASP-CS Program funds during the current reporting period.

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Products
1. Were SASP-CS Program funds used to develop or substantially revise products during
the current reporting period?
Select yes if SASP-CS Program-funded staff developed or revised products or if SASP-CS
Program funds directly supported the development or revision of products.
•
•

Yes
No

2. Describe the products developed or substantially revised with SASP-CS Program funds
during the current reporting period.
Describe what type of product it was, the title/topic of the product, as well as its intended
audience. Also provide information on if the product was translated into a language other than
English (including Braille).

3. Were products mentioned in the narrative above reviewed and approved by OVW?
•
•

Yes
No

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Victim Services
1. Were SASP-CS Program funds used to provide victim services (including legal services
provided by an attorney or paralegal) during the current reporting period?
Select yes if SASP-CS Program funds were used to support victim services during the current
reporting period. Report all victims served and victim services provided with SASP-CS
Program funds, whether by a victim services agency or victim services within law enforcement,
prosecution, or the court system in this section. If the grantee is funding a victim assistant or
victim-witness coordinator within law enforcement, prosecution, or the court system, they
should complete the victim services section to capture that staff’s grant-funded work.
•
•

Yes
No

2. Number of victims/survivors who were fully served, partially served, and not served
Report the following, to the best of your ability, as an unduplicated count for each category
during the current reporting period. This means that each victim/survivor who requested or
accepted SASP-CS Program-funded services during the current reporting period should be
counted only once in that reporting period. Do not report secondary victims here.
Served: A victim/survivor should be reported as served if they requested and/or accepted
grant-funded services and the program was able to provide all of those services.
Partially Served: A victim/survivor should be reported as partially served if they accepted
and/or requested grant-funded services and the program was able to provide some, but not all,
of those services.
Not Served: A victim/survivor should be reported as not served if the program could not
provide any of the grant-funded services that the victim accepted and/or requested.
Served
Partially served
Total Served & Partially Served
Not served

Number of primary victims/survivors

3. Number of victims/survivors who received SASP-CS Program-funded services for
multiple victimizations
Report an unduplicated count of victims/survivors reported in the previous question who
received SASP-CS Program-funded support for more than one victimization.

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4. Select all the additional victimization types, including specific forms of abuse, for which
these victims/survivors received SASP-CS Program-funded services:
Check all that apply. If you have reported at least one victim in Question 3, you must check at
least one box in Question 4. This applies regardless of when the additional victimization
happened, so long as the victim received grant-funded services for it during the current
reporting period.
o
o
o
o
o
o
o
o
o

Domestic/dating violence
Stalking
Female genital mutilation/cutting
Adult survivor of child sexual abuse
Sex trafficking
Labor trafficking
Economic abuse
Technological abuse
Forced marriage

5. Describe how SASP-CS Program funds were used to serve victims/survivors who
received grant-funded services for multiple victimizations.
6. Number of secondary victims served
Secondary victims must have received SASP-CS Program-funded services in order to be
reported in this question. They may be children, siblings, spouses or intimate partners,
parents, grandparents, and other affected relatives.
7. Select all of the reasons primary victims/survivors who requested SASP-CS Programfunded services were partially or not served:
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o

Conflict of interest
Did not meet statutory requirements
Hours of operation
Insufficient or lack of culturally specific services
Insufficient or lack of agency capacity to provide language access (including sign
language or assistive communication devices)
Insufficient or lack of services for people with disabilities
Insufficient or lack of services for people who are D/deaf or hard of hearing
Lack of childcare
Program reached capacity
Program rules not acceptable to victim/survivor
Program unable to provide service due to limited resources
Services inappropriate or inadequate for victims/survivors with mental health issues
Services inappropriate or inadequate for victims/survivors with substance abuse issues
Services otherwise not appropriate for victim/survivor
Transportation
Other (specify)

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8. Describe why grant-funded services were not provided, including barriers/challenges
your agency faced when providing SASP-CS Program-funded services, and how those
barriers impacted victims/survivors.
9. Race/ethnicity
Report the demographic information for the victims/survivors reported as served and partially
served with SASP-CS Program funds. Do not report demographics for secondary victims.
Report victims/survivors in each category they identify as. At least one race/ethnicity must be
reported for each victim/survivor reported as fully served and partially served. Those victims
for whom the race/ethnicity is not known should be reported in the “unknown” category.
Race/ethnicity
American Indian or Alaska Native
Asian
Black or African American
Hispanic, Latino, or Spanish origin
Middle Eastern or North African
Native Hawaiian or other Pacific Islander
White
People of a race or origin not listed
(specify):
Unknown
Total

Number of victims/survivors

10. Sex
Report victims/survivors in each category that applies.
Due to Presidential Executive Order 14168 and accompanying guidance from the Office on
Management and Budget, OVW amended demographic questions as follows. The term
“gender” was changed to “sex,” and the available responsive categories were limited to “male”
and “female.” Grantees should report the data that is relevant to those categories in those
categories. Grantees should not report data for victims for whom sex is unknown. The total
number of victims reported in this section must be less than or equal to the total number of
victims served and partially served. As always, victims do not have to share their demographic
information to obtain services. Please direct any questions to [email protected].
Female
Male
Total

Sex

Number of victims/survivors

11. Age
Report the age of each victim/survivor reported as fully and partially served. Exactly one age
must be reported for each victim/survivor reported as fully and partially served. Those victims
for whom the age is not known should be reported in the “unknown” category.
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0-6
7-10
11-17
18-24
25-59
60+
Unknown
Total

Age

Number of victims/survivors

12. Victim services
Report the SASP-CS Program-funded services provided to the victims/survivors reported fully
and partially served. Do not capture legal assistance provided by grant-funded attorneys or
paralegals in this question, as that information will be asked for in future questions. Refer to
the separate instructions document for service definitions.
The first column “Number of victims/survivors served” is an unduplicated count of the number
of victims/survivors who received each type of grant-funded service. No individual service
category should have a number of victims served greater than the total number of victims
served and partially served.
The second column “Number of times service was provided” is a total of the number of times
each victim in the first column received that services type during the 6-month reporting period.

Type of Service

Number of
victims/survivors
served

Number of times
service was
provided

Civil legal advocacy/court accompaniment
Counseling/support group
Criminal justice advocacy/court
accompaniment
Crisis intervention
Culturally specific services
Employment counseling
Information provided on economic matters
Hospital/clinic/other medical response
Job training
Language services

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Type of Service

Number of
victims/survivors
served

Number of times
service was
provided

Economic or material assistance
Transportation
Victim/survivor advocacy
Other (specify): ____________

13. Hotline support, information, and referral requests
Report the number of hotline requests received from primary victims and the total number of
hotline requests received on phone lines, text lines, or web-based communication paid for with
SASP-CS funds or answered by SASP-CS-funded staff, during the current reporting period. If
grant funds are supporting a portion or percentage of the hotline budget, prorate the total
hotline requests to reflect only what percentage of the budget is supported by the SASP-CS
grant. Hotline requests should not be reported as victims/survivors served or partially served
unless they also received at least one of the services reported in Victim Services questions.
Number of requests from
primary victims

Total number of
requests

Hotline support, information
and referral requests

14. Victim witness notification/unsolicited outreach activities to victims
Report the number of grant-funded victim witness notification activities and unsolicited
outreach activities. Victims/survivors who are the recipients of these notification/outreach
activities should not be reported as victims/survivors served or partially served unless they
also received at least one of the services reported in Victim Services questions.
15. Victim services staff assistance with protection orders
Report the total number of temporary and/or final protection orders granted that SASP-CS
Program-funded victim services staff helped with obtaining. These orders may also be referred
to as restraining orders, anti-harassment orders, no contact orders, or stay-away orders.
Temporary

Final

Protection orders granted

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16. Discuss the effectiveness of victim services supported by your SASP-CS Program grant
and to provide any additional information you would like to share.

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Narrative
1. Report on your SASP-CS Program grant goals, objectives, and activities as of the end
of the current reporting period.
This question is required. Report on the status of the goals and objectives as they were
identified in your grant proposal or as they have been added or revised. A goal or objective’s
status may be reported as "on hold," "not started, “pending," "ongoing," "complete," or any
other descriptor as appropriate.
2. What do you see as the most significant areas of remaining need, with regard to
improving services to victims/survivors, increasing victims/survivors’ safety, and
enhancing community response? (Maximum-8,000 characters)
This question is required for the January-June reporting period. Consider geographic regions,
underserved populations, service delivery systems, types of victimization, and challenges and
barriers unique to your jurisdiction.
3. What has SASP-CS Program funding allowed you to do that you could not do prior to
receiving this funding? (Maximum-8,000 characters)
This question is required for the January-June reporting period.
4. As you finalize your OVW award, please describe any lessons learned regarding the
most effective approaches in implementing your project. (Maximum-8,000 characters)
This question is required if this is your final report.
5. Provide additional information regarding the effectiveness of your grant-funded
program. (Maximum-8,000 characters)
If you have any other data or information that you have not already reported that demonstrate
the effectiveness of your SASP-CS Program grant, please provide it below.
6. Provide additional information to explain the data submitted on this form. (Maximum8,000 characters)
If you have any information that could be helpful in understanding the data you have submitted
in this report, please answer this question. For example, if you submitted two different
performance reports for the same reporting period, you may explain how the data was
apportioned to each report; if you reported staff but did not report any corresponding activities,
you may explain why; or if you did not use SASP-CS Program funds to support either staff or
activities during the reporting period, please explain how program funds were used.

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