Recipient: Enter the recipient name as it appears on (section 1) of the Grant Award Face Sheet.
Grant Award Number: Enter the grant number as it appears on the Grant Award Face Sheet.
Project Title: Enter the complete title of the project as it appears on (section 3) or the Grant Award Face Sheet
Grant Period: Enter the beginning and ending dates of the grant award period.
Address: Enter the address of the recipient.
Report Period: Enter the beginning and ending dates of the period reported.
Prepared By: Enter the name of the individual preparing the progress report.
Title: Enter the title of the individual preparing the progress report.
Phone Number: Enter the phone number of the individual preparing the progress report.
E-mail Address:Enter the e-mail address of the individual preparing the progress report.
Technical Assistance: Please indicate whether technical assistance is needed or requested. If so, please indicate specific areas or needs for technical assistance.
Project DirectorPlease indicate whether or not the PROJECT DIRECTOR (include name of current project
Review:director) has reviewed the progress report prior to submission.
REPORT PERIOD: Check the appropriate progress report period.
Enter the TOTAL PROJECT COST (including Match) as it appears on the Grant Award Face Sheet
Enter the TOTAL AMOUNT OF FUNDS EXPENDED to date. This equals the sum of funds claimed on all Report of Expenditures/Request for Funds (Cal OES 2-201) claims submitted to date.
Enter the TOTAL MATCH REPORTED to date. This equals the sum of match reported on all Report of Expenditures/Request for Funds (Cal OES 2-201) claims submitted to date.
Enter the current balance of the grant, as of the date of submission.
SECTION I: PERSONNEL Enter the name, position, and percent grant funded for all positions authorized in the Grant Award Agreement. Please check the Grant Award Agreement and Grant Award Modifications to ensure accurate reporting.
SECTION II: PROGRAMMATIC OBJECTIVES – DOMESTIC VIOLENCE PROGRAM (DVP0) REQUIREMENTS Provide statistical data by quarter and “Total to Date” for each objective.
PROGRAM OBJECTIVE DEFINITIONS (Directly from the DV Program Request for Application)
For the purposes of this section:
“UNDUPLICATED” refers to the number of NEW clients during the reporting period
“DUPLICATED” refers to the total number of services provided to all clients during the reporting period.
TwentyFour Hour Crisis Hotline
The agency must provide a 24-hour crisis hotline; 7-days per week. Immediate crisis intervention and assistance to survivors of domestic violence and their children must be provided through this telephone response by agency staff and/or volunteers who are trained domestic violence counselors pursuant to Evidence Code §1037.1. NOTE: Agencies may collaborate to provide this service.
Counseling (Individual and Group)
Individual – The project must provide a means for victims of domestic violence and their children to obtain individual counseling, when it is requested. Paid or volunteer staff may provide this service as per Evidence Code §1037.1. The counseling requirement may also be met by the development and implementation of written procedures for referrals to qualified professional counselors and/or counseling agencies.
Group Counseling – The project must provide interactive group counseling services, with staff or appropriately trained volunteer facilitators (pursuant to Evidence Code §1037.1).
The project must have at least one established, well publicized, business center (office) location. This office will be utilized to provide information, referral and overall assistance to survivors of domestic violence and their children. This business center must be accessible to all survivors (NOT just those survivors in need of shelter). At a minimum, business centers must be open during routine business hours (i.e., Monday through Friday, 9:00 a.m. - 5:00 p.m.).
NOTE: Business centers can be closed for holidays designated in the agency’s Holiday Policy.
Emergency Shelter for Victims and Their Children
The project must provide staffed confidential emergency shelter services for domestic violence survivors and their children/dependants. Pursuant to Penal Code §13823.15(f)(15)(B) emergency shelter services for domestic violence survivors and their children/dependants are defined as: (B) “…safe and confidential emergency housing on a 24-hour basis for survivors of domestic violence and their children, including but not limited to, hotel or motel arrangements, havens, and safe houses.”
Interim shelter provisions must be provided when there is no availability at the designated shelter.
Emergency Food and Clothing
The grantee must provide a means for responding to the immediate food and clothing needs of survivors of domestic violence and their children. This requirement may be met by the development and implementation of written Operational Agreements, for referrals, with appropriate community organizations.
Emergency Response to Calls from Law Enforcement
The project must provide 24-hour telephone response to law enforcement agencies (in the service area) seeking emergency services for survivors of domestic violence and their children/dependents. Written Operational Agreements (OAs) must be in place and include the types of emergency services available (e.g. shelter, clothing, food, and counseling); and protocols concerning how the law enforcement agency and the service provider will coordinate the provision of services to the survivors and their children/ dependents (e.g.: procedures regarding field response, and inter-agency communication protocols).
A list of agency services, including shelter and all supportive services will be provided to all local law enforcement agencies and updated regularly.
Emergency Response to Victims in Hospital Emergency Rooms, Medical Clinics, and/or Medical Offices
The project must provide 24-hour telephone response to local hospital emergency rooms, medical clinics and/or offices within the service area to establish and/or maintain a plan for the treatment and assistance of domestic violence survivors. Written operational agreements must be in place and include a description of how services are coordinated with local hospital emergency rooms (e.g., how referrals are made by emergency rooms to the project; the procedure for how such referrals are responded to; and, whether or not there is a system for follow-up by the project).
The project must provide a means for emergency transportation to shelters or other places of safety as appropriate for survivors of domestic violence and their children. The project should also provide a means for survivors to receive non-emergency transportation. This can be met by providing vouchers, direct cash, and/or by transporting the victim.
Counseling for Children
The project must provide a means for children of survivors of domestic violence to obtain counseling. The counseling must be goal-oriented, topic-focused and age appropriate. Paid or volunteer staff may provide this service. These structured and facilitated services should be provided at the shelter and/or business center. This requirement may be met through referral by developing and implementing Operational Agreements with qualified counselors and/or counseling agencies.
Court and Social Service Advocacy
The project must provide a means of advocacy to domestic violence survivors when necessary to intervene on their behalf with the courts and social services agencies (e.g., district attorney’s offices, Victim/Witness Programs, social service agencies, Cal WORKS, schools, county offices, non-governmental social service providers, etc.). Advocacy includes accompanying survivors to court and social service providers.
The project must have qualified staff to provide information and assistance to survivors of domestic violence in understanding, preparing, and processing the legal documents necessary to obtain temporary restraining orders and other protective orders and/or custody orders. This requirement may be met by developing Operational Agreements with an appropriate referral agency.
Establish, Maintain, and Participate in the Local Community Service Network to Ensure Appropriate Response to Victims’ Needs
The project must establish itself as an active participant in the local public and private social services network, (i.e., the local DV Council and any other collaborative DV partnerships, advocating for the timely and comprehensive response to DV survivors’ needs). Projects must maintain contact with all local agencies that are available to assist survivors of domestic violence, and, when appropriate, must refer clients to those agencies.
Information and referral calls may generate from the business center, administration office, outreach center, etc. The project must maintain a daily, 24-hour hotline. Information and referrals must be provided through this telephone response.
A referral resources list must be developed, maintained, regularly updated and include the following: law enforcement agencies, district and city attorney’s offices, medical care providers, mental health treatment facilities, county social services and child protective services agencies, other domestic violence centers, rape crisis centers, victim/witness assistance centers, family justice centers, etc.
Household Establishment Assistance
Upon request by the client, the project must assist survivors of domestic violence in establishing a new residence (e.g., furniture, food, transportation, cash donations, etc.).
SECTION III: VICTIMS OF CRIME ACT (VOCA) REQUIRED INFORMATION VOCA SERVICE DESCRIPTIONS (As defined by the U.S. Office of Justice Programs)
Counseling refers to in-person crisis intervention, emotional support, and guidance and counseling provided by advocates, counselors, mental health professionals, or peers. Such counseling may occur at the scene of the crime, immediately after a crime, or be provided on an ongoing basis.
Follow up refers to in-person contacts, telephone contacts, and written communications with victims to offer emotional support, provide empathetic listening, check on a victim's progress, etc.
Therapy refers to intensive professional psychological and/or psychiatric treatment for individuals, couples, and family members related to counseling to provide emotional support in crisis arising from the occurrence of crime. This includes the evaluation of mental health needs.
Group Treatment/Support refers to the coordination and provision of supportive group activities and includes self-help, peer, social support, etc.
Shelter/Safe House refers to offering short- and long-term housing and related support services to victims and families following victimization.
Information/Referral (in-person) refers to in-person contacts with victims during which time, services, and available support are identified.
Criminal Justice Support/Advocacy refers to support, assistance, and advocacy provided to victims at any stage of the criminal justice process, to include post-sentencing services and support.
Emergency Financial Assistance refers to cash outlays for transportation, food, clothing, emergency housing, etc.
Emergency Legal Advocacy refers to filing temporary restraining orders, injunctions, and other protective orders, elder abuse petitions, and child abuse petitions but does not include criminal prosecution or the employment of attorneys for non-emergency purposes, such as custody disputes, civil suits, etc.
Assistance in Filing Compensation Claims includes making the victim aware of the availability of crime victim compensation, assisting the victim in completing the required forms, gathering the needed documentation, etc. It also may include follow-up contact with the victim compensation agency on behalf of the victim.
Personal Advocacy refers to assisting victims in securing rights, remedies, and services from other agencies; locating emergency financial assistance, intervening with employers, creditors, and others on behalf of the victim; assisting in filing for losses covered by public and private insurance programs including workman's compensation, unemployment benefits, welfare, etc.; accompanying the victim to the hospital; etc.
Telephone Contact refers to contacts with victims during which time services and available support are identified. This does not include calls during which counseling is the primary function of the telephone call.
Other refers to other VOCA allowable services and activities not listed.
SECTION IV: FAMILY VIOLENCE PREVENTION AND SERVICES ACT (FVPSA) REQUIRED INFORMATION FVPSA DEFINITIONS (As defined by the Administration on Children and Families, US Department of Health and Human Services)
Residential – Number of new domestic violence victims/survivors seen for the first time during this reporting period who received shelter services (See shelter definition under FV-B-100). Clients should be counted once regardless of the number of times served during the fiscal year. Count should be within program only and not unduplicated across programs statewide. Clients who received shelter (residential services) should be counted in this category of people served only.
Non-Residential – Clients who received only non-residential services should be counted in this category. Specify the numbers who were women, men and children under the age of 18. Exclude clients served only by Batterer Intervention Programs (they are counted in Sec. E). Count should be within program only and not unduplicated across programs statewide.
Youth Interpersonal Violence Victim – Where youth under the age of 18 identified as victims of intimate partner violence (IPV), count in subset “Youth IPV Victims.” For example, a program served 100 children and youth, 8 identified as IPV victims. Report as Children and Youth – 100; Youth IPV Victim – 8.
Shelter Nights – Shelter includes onsite shelter managed by the domestic violence program, program-sponsored hotel rooms, and safe houses – residences of volunteers who offer their private homes for short-term crisis situations, or other temporary housing that your program arranges. Include victims of domestic violence and their dependents only. A night should be counted for each person that arrives and is provided a shelter bed. Count the # of people housed multiplied by the # nights. For example, a victim/survivor and her 3 children stay in the shelter or safe house for 5 nights – 4 people x 5 nights = 20 shelter nights.
Unmet Requests for Shelter – Unmet requests for shelter due to program being at capacity. Count the adult victims of domestic violence only. This count should not include individuals who were not served because their needs were inappropriate for the services of your program, e.g. homelessness not related to domestic violence. Count the total number of times requests for shelter were declined.
Related Services and Assistance for Adults and Children/Youth
Crisis Calls – Calls received on any agency line that relate to an individual or family in need of some kind of service. Count all calls including repeat callers and calls from third parties. Do not count: donations; general information about program or violence issues unrelated to a specific individual or family; calls from the media; etc.
Individual Supportive Counseling and Advocacy – Supportive services provided to adults which extend beyond a brief, isolated contact; e.g. crisis intervention, safety planning, individual counseling, peer counseling, educational services, legal advocacy, personal advocacy, housing advocacy, medical advocacy, information/referral, transportation, home visits, etc. Count total number of service contacts provided regardless of length. A contact could be a brief advocacy session in shelter or several hours to accompany a survivor to court. Do not count brief encounters such as distribution of tokens, supplies, toiletries, etc.
Group Supportive Counseling and Advocacy – Supportive services to adult victims in a group setting such as victims’ support group. Report the total number of sessions for each individual in attendance. E.g. 5 hour long support groups with 10 individuals at each = 50 service contacts.
Individual Supportive Counseling/Advocacy for Children & Youth – Supportive services provided to children which extend beyond a brief, isolated contact, e.g. crisis intervention, safety planning, individual counseling, peer counseling, educational services.
Children include anyone under the age of 18, unless legally emancipated. Count total number of service contacts.
Group Supportive Counseling/Advocacy for Children & Youth – Supportive services provided to children in a group setting, such as child-witness support groups. Total number of sessions for each individual in attendance, e.g. 4 hour long support groups with 8 individuals at each = 32 service contacts and/or 32 hours.
Individual Activities for Youth & Children – All activities that fall outside of child advocacy including unplanned/unstructured contacts such as mentoring opportunities. Count total number of service contacts.
Group Activities for Youth & Children – All activities that fall outside of child advocacy including recreational activities, child care, etc. Count total number of service contacts.
Community Education and Public Awareness
Adult Participants – all presentations of information or training about domestic violence and/or services related to victims of domestic violence and their children, such as training for health professionals. Include all presentations for a mix-age audience.
Youth Targeted – presentations that are specifically targeted for audiences of children and youth, such as school-based prevention programs (related to domestic violence, stalking and/or dating violence), should be included under the Youth Targeted section.
Community Awareness Activities – all domestic violence focused information forums where domestic violence information is distributed and an exact count of audience cannot be obtained, such as press conferences, booths at health fairs, etc. Count the number of such activities.
Service Outcome Data – describe resource outcome and Safety Outcome. 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.
SECTION V: PROJECT NARRATIVE AND OUTREACH INFORMATION