FORM #6: FOLLOW UP AND SMALL BUSINESS ASSESSMENT
Filled in by: / SBH name:SBH code: / Sex: / Female Male / Age: / IGA title:
SBH Address:
1.Follow up planning
Date of IGA start-up: / Date of IGA enhancement:Estimated closure date:
Estimated frequency of the LFO follow up per month:
2.Trainings
Business management training: □ Individual □ Group Realized on: ...... /...... /...... Refreshment: ...... /...... /......Hygiene and sanitation training: □ Individual □ Group Realized on: ...... /...... /...... Refreshment: ...... /...... /......
Other (Technical Training, sharing experience and refreshment session):
Date / Training provided / Progress / LFO actions / Next step
3.SBH situation progress
Date / DESCRIPTION / Situation of SBH assessed by the SBH? / LFO actions / Next StepSituation / Explanation
Access to loan / / /
Household support / / /
/ /
/ /
/ /
/ /
/ /
/ /
/ /
/ /
/ /
TIGA-Form#06 Follow up and Small business Assessment 6/6 / 1/6
4.Evaluation/Satisfaction of the service
Date / Description including name of service provider/ organization / Evaluation/ satisfaction / ExplanationsHealth / Project support to access services / / /
Services received from service provider / / /
Rehabilitation / Project support to access services / / /
Services received from service provider / / /
5.Small business analysis
All the calculations are done in riel.
Step 1: Determine the total production costs of the IGA
These costs refer to raw materials, labor costs and other expenses. They are calculated on a monthly base.
Write down the raw materials needed and their costs per month. Then, write down the costs for rent, labor, transportation, marketing and tax. Labor costs mean wages for any possible employees.
Month / Description / Production cost1 / Raw material
Labor
Transportation
Rent
Tax payment
Marketing
Others
TOTAL production cost (1)
Month / Description / Production cost
2 / Raw material
Labor
Transportation
Rent
Tax payment
Marketing
Others
TOTAL production cost (2)
Month / Description / Production cost
3 / Raw material
Labor
Transportation
Rent
Tax payment
Marketing
Others
TOTAL production cost (3)
Month / Description / Production cost
4 / Raw material
Labor
Transportation
Rent
Tax payment
Marketing
Others
TOTAL production cost (4)
Month / Description / Production cost
5 / Raw material
Labor
Transportation
Rent
Tax payment
Marketing
Others
TOTAL production cost (5)
Month / Description / Production cost
6 / Raw material
Labor
Transportation
Rent
Tax payment
Marketing
Others
TOTAL production cost (6)
(A) TOTAL PRODUCTION COST FOR SIX MONTHS (1+2+3+4+5+6)
Step 2: Determine the total revenues per month
According to the record of the SBH, please write down the revenue in each month from the IGA. Describe eachrevenue (example 15 chicken, 1 pig, etc…). If rows are not enough, please add.
Month / Description / Revenue1
TOTAL revenue (1)
Month / Description / Revenue
2
TOTAL revenue (2)
Month / Description / Revenue
3
TOTAL revenue (3)
Month / Description / Revenue
4
TOTAL revenue (4)
Month / Description / Revenue
5
TOTAL revenue (5)
Month / Description / Revenue
6
TOTAL revenue (6)
(B) TOTAL REVENUE FOR SIX MONTHS (1+2+3+4+5+6)
Step 3: Calculate the gross profit for six months
This is done by extracting the total production costs (step 1) from the total revenue (step 2):
Total revenue for six months (B) / - / Total production costs for six months (A) / = / (C) Gross profit per six months- / =
Is the profit satisfactory? / □ NO / □ YES
6.Conclusions
Comments from the SBH:Overall LFO comments:
Is the household economic situation better? / □ YES / □ NO
Has SBH’s household assets improved? / □ YES / □ NO
Has the SBH reached his/her goals identified? / □ YES / □ NO
Is the IGA profitable? / □ YES / □ NO
Has the SBH level of social participation improved? (ref form 2 section 4) / □ YES / □ NO
Were barriers associated with disability situation reduced? (ref form 3 section II) / □ YES / □ NO
According the answers, does the SBH consider his/her conditions of life have improved?
□ YES / □ NO
According the answer above, how can we describe the small business?
□Successful / □ Unsuccessful
Globally, did the SBH reach his/her objectives?
□ YES / □ NO, why? / □ Unemployment / □ Illness / □ Dead
□ Natural disaster / □ Change address / □ Debt
□ Others, precise:
Decision after six months providing services:
□Close the case / Reasons:
□ Provide additional support for □ 3 months □ 6 months
Reasons:
Date:……………………...………………….
Signature