FVPSA Performance Report

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
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