CALIFORNIA GOVERNOR’S OFFICE OF EMERGENCY SERVICES (Cal OES)

VICTIM SERVICES DIVISION

DOMESTIC VIOLENCE UNIT

STATE COALITIONAL TECHINCAL ASSISTANCE & TRAINING (BW) PROGRAM

PROGRESS REPORT

1. / Recipient / 2. / Grant Award #
State Coalition Technical Assistance &
3. / Project Title / Training (BW) Program / 4. / Grant Period
5. / Address / 6. / Report Period
7. / Prepared by / 8. / Title
9. / Telephone / 10. / Email Address

11. YES NO Does the project need/request any technical assistance from Cal OES?

If so, please specify areas/needs:

12. YES NO Project Director (insert name here →) has reviewed this report.

REPORT PERIOD

1st Progress Report: Covers July 1, 2016 – September 30, 2016 (due October 30)

Final Progress Report: Covers January 1, 2017 – June 30, 2017 (due July 31)

BUDGET

1. / Total Project Cost (including match): / $
2. / Total funds expended to date: / $
3. / Total match reported to date: / $
4. / Total Grant Award (including match) balance to date: / $
5. / Most recent Request for Funds (Cal OES 2-201) submitted (month):

YES NO Are grant funds being expended in accordance with the Grant Award?

If no, explain in the narrative section of this report.

YES NO Has the project added any line items to the budget during this report period?

If yes, describe each line item added and the relationship to the Grant Award objectives in the narrative section of this report.

REVIEWERS COMMENTS (For Cal OES use only)

Approved ______

Program Specialist Date

SECTION I. PERSONNEL

Positions Authorized in Grant Award Agreement:
All data must be supported by source documentation that is retained by the recipient and made available to Cal OES upon request. The information provided below must match the approved Grant Award or most-currently approved grant (Personal Services) budget.
Name of Staff / Position / FTE Grant Funded
1. 
2. 
3. 
4. 
5. 
6. 
7. 
8. 
9. 
10. 
11. 
12. 
13. 
14. 
15. 

Yes

/

No

/

Have any problems/delays occurred in the hiring/retention of personnel positions identified in the Grant Award? If yes, please explain below.

Yes / No / Have any of the job duties or grant-funded percentages, as detailed in the most current Grant Award budget, changed? If yes, please explain below. [Please note, a Grant Award Modification (Cal OES 2-223) is required if personnel percentages have been changed.]

If necessary, please explain any of the items noted above. Please attach an additional page if additional space is needed.

SECTION II: PROGRAMMATIC OBJECTIVES

Instructions: Report statistical data for the programmatic objectives listed below. The projected numbers must match what was submitted in the Grant Award Agreement or any subsequently approved Grant Award Modification(s).

TECHNICAL ASSISTANCE/TRAINING / July – September / October – December / January – March / April – June / Total
Total TAT Requests
Telephone/Email TAT Requests
Total TA Provided
On-Site TA
TAT Provided to Agencies Referred by Cal OES
Total number of Action Plans Successfully Implemented
Referrals Made to Victims/Survivors
Specialized Trainings/
Informational Webinars
(if applicable) / /
Date(s)/
Subject(s) / /
Date(s)/
Subject(s) / /
Date(s)/
Subject(s) / /
Date(s)/
Subject(s)
Required Collaborative Meetings / July – September / October – December / January – March / April – June / Total
Quarterly Meetings
with Cal OES / date / date / date / date / date
Attendance at statewide Domestic Violence Advisory Council (DVAC) meetings / date / date / date / date / date
Regional Networking Meetings / July – September / October – December / January – March / April – June / Total
North
Far North
Bay Area
Central Coast
Central Valley
Los Angeles
South
Annual Membership Meeting and Statewide Leadership Conference / (dates)
Total Number of Participants at the Annual Conference: / Total Number of Travel Stipends provided to the Annual Conference:
Conference Learning Tracks (titles):
Conference Workshops Conducted (titles):
Regional WorkSHOpS/Trainings
Location/Date: / / / Number of Attendees:
Location/Date: / / / Number of Attendees:
Location/Date: / / / Number of Attendees:
Location/Date: / / / Number of Attendees:
Location/Date: / / / Number of Attendees:
Location/Date: / / / Number of Attendees:
other projects
Training Module Developed/Revised: / Date Developed/Revised:
Training Module Developed/Revised: / Date Developed/Revised:
Training Module Developed/Revised: / Date Developed/Revised:

SECTION III: PROJECT NARRATIVE AND OUTREACH

Discuss applicable information:
·  Any delays and/or problems in implementation of program, or specific project objectives.
·  Those activities supporting each objective which are not currently operational or in place.
·  Any additional special projects or activities conducted under this program, not delineated in Section II.
·  Any accomplishments, community involvement, media events, awards, etc.

SECTION IV: FAMILY VIOLENCE PREVENTION & SERVICES ACT (FVPSA) - REQUIRED INFORMATION

To be completed on 12-month (Final) Progress Report only.

1.  Subgrantee (Agency) Data:

Total Agency Budget for (all) Domestic Violence Programs / $
(Cal OES grant) FVPSA Funding Amount / $
Total Number of Shelter Facilities
Total Number of Non-Residential Service Sites
Number of Volunteers
Number of Volunteer Hours

2.  Performance Narrative Questions:

·  Share a success story about a client, service, or community initiative.

·  Describe any efforts to meet the needs of underserved populations in your community.

·  Describe any prevention and outreach activities.

·  Describe any emerging issues or notable trends affecting crime victim services in your service area.

·  What does FVPSA allow you to do that you would not be able to do without funding? (Please, write N/A if you do not receive funding for the report period).

SECTION V: VICTIMS OF CRIME ACT (VOCA) – SPECIFIC NARRATIVE QUESTION

·  Please describe how VOCA funds have assisted the project?

BW15 Progress Report / 7 / Rev. Feb 2016