McDowellCounty Partnership for Children & Families, Inc.

COUNTS & OUTCOMES QUARTERLY REPORT

CONTRACT YEAR 2009-2010

Instruction Section:Counts and Outcomes deal with only children age birth to five years old. Please fill in current progress toward meeting yearly outcomes and counts with year to date numbers for FY 09-10. Back up documentation should also be provided for information reported.

Additional reports must be submitted with the counts & outcomes report each quarter for a complete quarterly report package. These reports are: Family Support Surveys (Parenting Skills Enhancement and FRP: Family Support activities only), Cash & In-Kind, and Program Narratives. Information about the quarterly report and forms are located at Providers > Forms for DSPs> Quarterly Report.

Deadline for receipt of Quarterly Reports

First Quarter: October 7, 2009

Second Quarter: January 7, 2010

Third Quarter: April 7, 2010

Fourth Quarter: July 7, 2010

Counts & Outcomes Report, FY 2009-2010

Direct Service Provider/Activity: The McDowell Hospital/Healthy Start

Quarter: (Please Circle)One Two Three Four

Outcomes: Fill in current progress toward meeting yearly outcomes. Back-up documentation should be provided for the final fourth quarter report.

1. By June 30, 2010, 70% of active participants will be current with ASQ screening.
Actual Outcome:As of ______, 20__, ___% (___/___)of active participants are current with ASQ screening.
2. By June 30, 2010, of the participants with a demonstrated need for improvements in home safety, 90% will show improvements based upon the initial home assessment survey and rechecks of the environment on subsequent home visits or by telephone follow-up.
Actual Outcome:As of ______, 20__, of the participants with a demonstrated need for improvements in home safety, ___% (___/___) have shown improvements based upon the initial home assessment survey and rechecks of the environment on subsequent home visits or by telephone follow-up.
3. By June 30, 2010, 70% of parents/caretakers will maintain or increase the number of times that they read to their baby/child on a monthly basis.
Actual Outcome:As of ______, 20__,___% (___/___) of parents/caretakers maintained or increased the number of times that they read to their baby/child on a monthly basis.
4. By June 30, 2009, 90%of participants will be able to identify three parenting skills they have learned as reported on the Healthy Start Parenting Skills Survey.
Actual Outcome:As of______, 20__,___% (___/___) of participants are able to identify three parenting skills they have learned as reported on the Healthy Start Parenting Skills Survey.

Counts:Quarter one numbers should include all participants served during the quarter. Include only new numbers in the quarterly outputs for quarters two, three, and four.

QUESTION / Quarter One
(Jul, Aug, Sep) / Quarter Two
(Oct, Nov, Dec) / Quarter Three
(Jan, Feb, Mar) / Quarter Four
(Apr, May, Jun) / Year to Date
LPC1 / 35 Families will be served / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
LPC2 / 230 home visits will be made / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
LPC3 / 100 Moms will be screened / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
LPC4 / 35 Families will be instructed on fever in children and taught how to take child’s temperature. / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
LPC5 / 35 Home Safety Assessments will be made. / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date

Direct Service Provider/Activity: The McDowell Hospital/Healthy Start

Question / Quarter One
(Jul, Aug, Sep) / Quarter Two
(Oct, Nov, Dec) / Quarter Three
(Jan, Feb, Mar) / Quarter Four
(Apr, May, Jun) / Year to Date
FS1 / Number of parents/guardians who participate in home visits as part of a Smart Start funded activity. (Not PAT)
Typically activities with PSC5525 Intensive Home Visiting; PSC5505 Count ONLY the parents/guardians who are active participants in the home visit.
May include other adults (e.g. grandparents, aunts/uncles) who have care giving responsibility for the child AND who are active participants in the home visit.
Do NOT Count:
  • A parent/guardian or other individual who may be in the home during the home visit but does NOT participate in the home visit activities.
  • Family child care providers or child care center staff.
  • PSC5509 Parents as Teachers counts that are reported into the PAT Visit Tracker System
/ ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP1 / Number of families screened and found eligible for the Healthy Start program / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP2 / Number of families that screened positive for the Healthy Start program who declined services / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP3 / Number of eligible families that were denied services. Why? (i.e. translation availability, travel distance, staff shortages) / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP4 / Number currently on the waiting list / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP5 / Number of families served by this activity that gave birth in hospitals other than the McDowellHospital. / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP6 / Number of participants discharged from program during the quarter. / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP7 / (Additional Data for Annual Report – OPTIONAL) / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP8 / (Additional Data for Annual Report – OPTIONAL) / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP9 / (Additional Data for Annual Report – OPTIONAL) / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date
DSP10 / (Additional Data for Annual Report – OPTIONAL) / ___ / ___
*New Only / ___
*New Only / ___
*New Only / ___
Year to Date

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