Document
Beneficiary Report - Beneficiaries
ICR 202509-0970-010 · OMB 0970-0642 · Object 163015901.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | Beneficiary Report - Beneficiaries |
| Author | Wills, Benjamin (ACF) |
| Last Modified By | Calc |
| File Modified | 2025-09-09 |
| File Created | 2026-10-12 |
| Conversion State | complete |
Extracted Text
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 4 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. OMB Approval Number: 0970-0642 Expiration Date: 04/30/2028 An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Instructions The DDDRP Beneficiary Report is a semi-annual supplement to the quarterly PPR. This is a report of beneficiary characteristics and outcomes. The child, caregiver, and family characteristics tab should include unduplicated counts of beneficiaries who have enrolled since the start of the reporting period. The outcomes tab should include unduplicated counts of beneficiaries for whom outcomes have been measured at six months after program enrollment. Cover Page Please enter your grant recipient name, grant number, and project period start date as identified in your Notice of Award. Please enter the final day of the reporting period for this report. Child Characteristics Tab This tab only includes information on children receiving diapers through DDDRP. Please do not include characteristics of other children in the household. Please enter the number of children receiving diapers in cell B4. Next, please enter the number of children receiving diapers that fall into each category. The totals for each category, except race and ethnicity, will automatically calculate and should match the total number entered at the top of the sheet. For the race and ethnicity item, your data collection instruments should permit participants to select all races and ethnicities that apply. Because each individual may select multiple races and ethnicities, the total does not automatically sum for this question, and we ask you to confirm the number of individuals who provided this information in the total row. For more information on structuring race and ethnicity questions for your collection of information from participants, please see https://spd15revision.gov/content/spd15revision/en/2024spd15/question-format.html. Caregiver Characteristics Tab Please enter the number of caregivers reporting for the enrolled children in cell B4. Next, please enter the number of caregivers that fall into each category. The totals for each category, except the race and ethnicity category, will automatically calculate and should match the total number entered at the top of the sheet. For the race and ethnicity item, your data collection instruments should permit participants to select all races and ethnicities that apply. Because each individual may select multiple races and ethnicities, the total does not automatically sum for this question, and we ask you to confirm the number of individuals who provided this information in the total row. For more information on structuring race and ethnicity questions for your collection of information from participants, please see https://spd15revision.gov/content/spd15revision/en/2024-spd15/question-format.html. Family Characteristics Tab Please enter the number of families receiving diapers in cell B4. Next, please enter the number of families that fall into each category. The totals for each category will automatically calculate and should match the total number entered at the top of the sheet. Outcomes Tab Please fill out each section and appropriately enter the number of children, caregivers, or families that fall into each category. Please note that each section asks for different units, so pay attention to this. The outcomes tab should record outcomes at 6 months for enrolled families. Outcomes should be unduplicated and only recorded once for a family, caregiver, or child during the course of the program. ort of ould g period. ve been ed in your include ng diapers ory. The ch the tion ach his in the of n/2024- se enter ace and he top of ticipants to d he n ease see r of nd should lies that o this. The rogram. Name of Grant Recipient Grant Number Reporting Period 90EDA____ Number of Children Newly Enrolled During This Reporting Period Item Description CT Total Number of Children Receiving Diapers: Item Age at Enrollment for Children Receiving Diapers Number of Children Newly Enrolled During This Reporting Period CA1 CA2 CA3 CA4 CA5 CA6 CA7 CA8 CA9 CA10 CA11 CA12 CA13 CA14 CA15 CAU CAT Not yet born Newborn - 3 months 4 - 6 months 7 - 9 months 10 - 12 months 13 - 15 months 16 - 18 months 19 - 23 months 2 years 3 years 4 years 5 - 7 years 8 - 11 years 12 - 14 years 15+ years Unknown TOTAL (automatically sums) 0 Item Race or Ethnicity for Children Receiving Number of Children Newly Enrolled Diapers During This Reporting Period CR1 CR2 CR3 CR4 CR5 CR7 American Indian or Alaskan Native Asian Black or African American Hispanic or Latino Middle Eastern or North African Native Hawaiian or Other Pacific Islander White CRU Unknown CR6 CRT TOTAL KNOWN (cell does not autosum because caregivers can select multiple race and ethnicity options.) Item DDDRP Children Enrolled in Early Head Number of Children Newly Enrolled Start or Head Start During This Reporting Period CE1 CE2 CEU Yes No Unknown CET TOTAL (automatically sums) Item Children Under-Age for Kindergarten Receiving Diapers that Attend Childcare CC1 CC2 CC3 CCU CCT Yes No Other Unknown TOTAL (automatically sums) 0 Number of Children Newly Enrolled During This Reporting Period 0 Notes Notes Notes Notes Notes Item Description GT Total Number of Caregivers: Item Age GA1 GA2 GA3 GA4 GA6 GA7 GAU GAT Under 18 18 - 24 25 - 34 35 - 44 45 - 64 65 + Unknown TOTAL (automatically sums) Item Sex GG1 GG2 GGU GGT Female Male Unknown TOTAL (automatically sums) Item Race or Ethnicity GR1 GR2 GR3 GR4 GR5 American Indian or Alaskan Native Asian Black or African American Hispanic or Latino Middle Eastern or North African Native Hawaiian or Other Pacific Islander White Unknown GR6 GR7 GRU GRT TOTAL KNOWN (cell does not autosum because caregivers can select multiple race and ethnicity options.) Item Education Levels GE1 Grades 0-8 Number of Caregivers Newly Enrolled During This Reporting Period Number of Caregivers Newly Enrolled During This Reporting Period 0 Number of Caregivers Newly Enrolled During This Reporting Period 0 Number of Caregivers Newly Enrolled During This Reporting Period Number of Caregivers Newly Enrolled During This Reporting Period GE2 GE3 GE4 GE5 GE6 GEU GET Grades 9-12 or Non-Graduate High School Graduate, GED, or Equivalency Diploma 12th Grade + Some Post-Secondary 2 or 4 Years College Graduate Graduate or Other Post-Secondary School Unknown TOTAL (automatically sums) 0 Notes Notes Notes Notes Notes Number of Families Newly Enrolled During This Reporting Period Item Description FT Total Number of Families: Item Number of Adults in Family Household Number of Families Newly Enrolled During This Reporting Period FA1 FA2 FA3 FA4 FA5 FAU FAT 0 1 2 3 4+ Unknown TOTAL (automatically sums) 0 Item Number of Children Under 18 in Family Household FC1 FC2 FC3 FC4 FC5 FC6 FC7 FCU FCT 0 1 2 3 4 5 6+ Unknown TOTAL (automatically sums) Item Household Size FH1 FH2 FH3 FH4 FH5 FH6 FHU FHT 1 2 3 4 5 6+ Unknown TOTAL (automatically sums) Item Federal Poverty level FP1 Up to 50% Number of Families Newly Enrolled During This Reporting Period 0 Number of Families Newly Enrolled During This Reporting Period 0 Number of Families Newly Enrolled During This Reporting Period FP2 FP3 FP4 FP5 FP6 FP7 FP8 FP9 FPU FPT 51% - 75% 76% - 100% 101% - 125% 126% - 150% 151% - 175% 176% - 200% 201% - 250% 251% and over Unknown TOTAL (automatically sums) 0 Notes Notes Notes Notes Notes Item Total Enrollment Indicators OT1 Total Families Reporting Diaper Need at Baseline Reaching 6-Month Enrollment Milestone This Reporting Period Item Family Diaper Need ON1 Number of families with diaper need at baseline who do not have diaper need during the outcomes reporting period ON2 ONT Number of families with diaper need at baseline who continue to have diaper need during the outcomes reporting period TOTAL Item Total Enrollment Indicators OT2 Total Caregivers With Employment Needs at Baseline Reaching 6-Month Enrollment Milestone This Reporting Period Item Caregiver Education, Training and Employment Activities OE1 Number of caregivers with employment needs at baseline preparing for employment or training activities this reporting period OE2 Number of caregivers with employment needs at baseline enrolling in education or training activities this reporting period OE3 Number of caregivers with employment needs at baseline obtaining employment this reporting period OE4 Number of caregivers with employment needs at baseline who have not prepared for employment or training, enrolled in education or training, or obtained employment this reporting period OET TOTAL Item Total Enrollment Indicators Number of Families Eligible for Outcomes Reporting During This Reporting Period Number of Families This Reporting Period 0 Number of Caregivers Eligible for Outcomes Reporting This Reporting Period Number of Caregivers This Reporting Period 0 Number of Children Eligible for Outcomes Reporting This Reporting Period OT3 Total Children with Diaper Health Issues at Baseline Reaching 6-Month Enrollment Milestone This Reporting Period Item Child Diaper Health Issues OH1 Number of children with diaper health issues at baseline who did not have diaper health issues at follow up OH2 Number of children with diaper health issues at baseline who had diaper health issues at follow up OHT TOTAL Item Total Enrollment Indicators OT4 Total Families with Childcare Needs at Baseline Reaching 6-Month Enrollment Milestone This Reporting Period Item Childcare Access OC1 OC2 OCT Total families with childcare need at baseline who have obtained childcare Total families with childcare need at baseline who have not obtained childcare Total Number of Children This Reporting Period 0 Number of Families Eligible for Outcomes Reporting This Reporting Period Number of Families This Reporting Period 0 Notes Notes Notes Notes Notes Notes Notes Notes