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FVPSA Performance Report
FVPSA Performance Report
Page Content
WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES
BUREAU FOR CHILDREN AND FAMILIES
OFFICE OF FINANCE AND ADMINISTRATION
DIVISION OF GRANTS & CONTRACTS
Organization Name:
Report Period:
Section A - People Served (Unduplicated)
Indicate the number of all clients served by gender, ethnicity, and age. Do not include clients served only in Batters Intervention Services; count them in Section E.)
Unduplicated Count of Clients Served (Residential)
Women
Men
Children
Youth IPV Victim
Unduplicated Count of Clients Served (Non-Residential)
Women
Men
Children
Youth IPV Victim
Number of Clients (By Race)
Black or African-American
American Indian/Alaska Native
Asian
Hispanic or Latino
Native Hawaiian/Other Pacific Islander
White
Unknown/Other
Number of Clients (By Gender)
Female
Male
Not Specified
Number of Clients (By Age)
Age 0-17
Age 18-24
Age 25-59
Age 60 or Older
Unknown
Number of Clients (By Physical Characteristics)
Mental Disability
Physical Disability
Pregnant
Section B - Residential Services
Indicate the number of shelter nights for each person that arrives and is provided a shelter bed.
Count the # of people housed x (times) the number of nights.
Shelter Nights
Unmet Requests for Shelter
Section C - Related Services and Assistance for Adults
Indicate the number of service contacts and/or hours provided regardless of length. For states using time increments, report total hours in "Number of Hours" column provided.
Crisis Hotline Calls
Adult Spportive Counseling & Advocacy
Number of Hours (Individual)
Number of Contacts (Individual)
Number of Hours (Group)
Number of Contacts (Group)
Section D - Related Services and Assistance for Children
Indicate the number of service contacts and/or hours provided regardless of length. For states using time increments, report total hours in "Number of Hours" column provided.
Child Spportive Counseling & Advocacy
Number of Hours (Individual)
Number of Contacts (Individual)
Number of Hours (Group)
Number of Contacts (Group)
Activities for Children & Youth
Number of Hours (Individual Activities)
Number of Service Contacts (Individual Activities)
Number of Hours (Group Activities)
Number of Service Contacts (Group Activities)
Section E - Batter Intervention Services
Indicate the number of service contacts and/or hours provided.
Report ONLY if these services are funded by FVPSA.
Intervention/Counseling Services
Number of Clients (Individual Counseling)
Number of Service Contacts (Individual Counseling)
Number of Hours (Individual Counseling)
Number of Clients (Group Counseling)
Number of Service Contacts (Group Counseling)
Number of Hours (Group Counseling)
Section F - Community Education and Public Awareness
Community Education
Number of Presentations (Adults/General Population)
Number of Participants (Adults/General Population)
Number of Presentations (Youth Targeted)
Number of Particpants (Youth Targeted)
Community Awareness Activities
Section G - Service Outcome DATA
For each program area from which you collected outcome data, indicate how many surveys were completed and how many YES responses you received to each of the outcome questions (resources and safety).
Report ONLY if these services are funded by FVPSA.
Survey Type
Number of Surveys Completed (Shelter Survey)
Number of YES Responses to Resource Outcome (Shelter Survey)
Number of YES Responses to Safety Outcome (Shelter Survey)
Number of Surveys Completed (Support Services and Advocacy Survey)
Number of YES Responses to Resource Outcome (Support Services and Advocacy Survey)
Number of YES Responses to Safety Outcome (Support Services and Advocacy Survey)
Number of Surveys Completed (Counseling Survey)
Number of YES Responses to Resource Outcome (Counseling Survey)
Number of YES Responses to Safety Outcome (Counseling Survey)
Number of Surveys Completed (Support Group Survey)
Number of YES Responses to Resource Outcome (Support Group Survey)
Number of YES Responses to Safety Outcome (Support Group Survey)
Attachments