OHIO DEVELOPMENTAL DISABILITIES COUNCIL

QUARTERLY PROGRAM REPORT

Project Title: ___________________________________________________

Project Number: ________________________________________________

Project Began: ______________________________

Project Completion Date: ____________________

Agency __________________________________________________________

Please be advised that a quarterly Program Report is required for any Federal Fiscal Year Quarter during which your grant has been active, e.g., October-December, January-March, April-June, and July-September.

This report is for the Quarter beginning ____________________ and ending _____________.

Quarterly Program Reports previously submitted:

For Quarter beginning ___________________and ending ______________

For Quarter beginning ___________________ and ending _______________

For Quarter beginning ___________________ and ending ________________

I certify that the activities related in this document have occurred and were performed in accordance with stipulation under which the grant funds were received.

__________________________________

Agency Director

___________________

Date

FFY 2007

SECTION I: PROGRESS TOWARD PERFORMANCE TARGETS

· SECTION II: OUTREACH TO THE UNSERVED AND UNDERSERVED

SECTION III: INVOLVEMENT OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES AND/OR THEIR FAMILIES

SECTION IV – REFLECTION AND EVALUATION

SECTION V: PERFORMANCE TARGETS

Area of Emphasis - Child Care

CH01 _____ Goal per proposal

CH01 _____ Children in inclusive child care settings through Council efforts.

Narrative –

CH02 _____ Goal per proposal

CH02 _____ Dollars leveraged for childcare programs.

Narrative –

CH03 _____ Goal per proposal

CH03 _____ Child care programs/policies created/improved.

Narrative-

CH04 _____ Goal per proposal

CH04 _____ People facilitated inclusive childcare.

Narrative-

CH05 _____ Goal per proposal

CH05 _____ People trained in childcare.

Narrative-

CH06 _____ Goal per proposal

CH06 _____ People active in systems advocacy about childcare.

Narrative-

Breakout number by category

1) _____ Self-advocates

2) _____ Family members

3) _____ Others

CH07 _____ Goal per proposal

CH07 _____ People trained in systems advocacy about childcare.

Narrative-

Breakout number by category

1) _____ Self-advocates

2) _____ Family members

3) _____ Others

SECTION V: PERFORMANCE TARGETS

Area of emphasis - Cross Cutting

CR1 _____ Goal per proposal

CR1. _____ Public Policymakers educated by council about issues related to Council initiatives.

Narrative-

CR2 _____ Goal per proposal

CR2. _____ Copies of products distributed to policymakers about issues related to Council Initiatives.

Narrative-

CR3 _____ Goal per proposal

CR3. _____ Members of the general public estimated to have been reached by Council public education, awareness, and media initiatives.

Narrative-

SECTION V: PERFORMANCE TARGETS

Area of Emphasis - formal and Informal Community Supports

CS01 _____ Goal per proposal

CS01 _____People receive formal/informal community supports through Council efforts.

Narrative-

CS02 _____ Goal per proposal

CS02 _____Dollars leveraged for formal/informal community supports.

Narrative-

CS03 _____ Goal per proposal

CS03 _____ Programs/policies created/improved formal/informal community supports

Narrative-

CS04 _____ Goal per proposal

CS04 _____People facilitated formal/informal community supports.

Narrative-

CS05 _____ Goal per proposal

CS05 _____People trained in formal/informal community supports.

Narrative-

CS06 _____ Goal per proposal

CS06 _____People active in systems advocacy about formal/informal community supports.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

CS01 _____ Goal per proposal

CS07 _____People trained in systems advocacy about formal/informal community supports.

Narrative-

Breakout number by category

1) _____ Self-advocates

2) _____Family members

3) _____Others

CS08 _____ Goal per proposal

CS08 _____Buildings/public accommodations became accessible.

Narrative-

SECTION V: PERFORMANCE TARGETS

Area of Emphasis - Education and Early Intervention

ED01 _____ Goal per proposal

ED01 _____Students have the education and support needed to reach their educational goals through Council efforts:

Narrative-

ED02 _____ Goal per proposal

ED02 _____Infants and young children have the services/supports needed to reach developmental goals through Council efforts.

Narrative-

ED03 _____ Goal per proposal

ED03 _____Students transitioned from school to community and jobs.

Narrative-

ED04 _____ Goal per proposal

ED04 _____Children transitioned from early intervention and pre-school to inclusive school/classrooms.

Narrative-

ED05 _____ Goal per proposal

ED05 _____Dollars leveraged for education.

Narrative-

ED06 _____ Goal per proposal

ED06 _____Education programs/policies created/improved.

Narrative-

ED07 _____ Goal per proposal

ED07 _____Post-secondary institutions improved inclusive education.

Narrative-

ED08 _____ Goal per proposal

ED08 _____Schools improved IEP practices.

Narrative-

ED09 _____ Goal per proposal

ED09 _____People facilitated inclusive education.

Narrative-

ED10 _____ Goal per proposal

ED10 _____People trained in inclusive education.

Narrative-

ED11 _____ Goal per proposal

ED11 _____People active in systems advocacy about inclusive education.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

ED12 _____ Goal per proposal

ED12 _____Parents or guardians trained regarding their child's educational rights.

Narrative-

SECTION V: PERFORMANCE TARGETS

Area of Emphasis: Employment

EM01 _____ Goal per proposal

EM01 _____Adults have jobs of their choice through Council efforts.

Narrative-

EM02 _____ Goal per proposal

EM02 _____Dollars leveraged for employment programs.

Narrative-

EM03 _____ Goal per proposal

EM03 _____Employers provided vocational supports to students on the job.

Narrative-

EM04 _____ Goal per proposal

EM04 _____Businesses/employers employed adults.

Narrative-

EM05 _____ Goal per proposal

EM05 _____Employment programs/policies created/improved.

Narrative-

EM06 _____ Goal per proposal

EM06 _____People facilitated employment.

Narrative-

EM07 _____ Goal per proposal

EM07 _____People trained in employment.

Narrative-

EM08 _____ Goal per proposal

EM08 _____People active in systems advocacy about employment.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

EM09 _____ Goal per proposal

EM09 _____People trained in systems advocacy about employment.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

SECTION V: PERFORMANCE TARGETS

Area of Emphasis - Health

HE01 _____ Goal per proposal

HE01 _____People have needed health services through Council efforts.

Narrative-

HE02 _____ Goal per proposal

HE02 _____Dollars leveraged for health services.

Narrative-

HE03 _____ Goal per proposal

HE03 _____Health care programs/policies created/improved.

Narrative-

HE04 _____Goal per proposal

HE04 _____People improved health services.

Narrative-

HE05 _____Goal per proposal

HE05 _____People trained in health care services.

Narrative-

HE06 _____Goal per proposal

HE06 _____People involved in systems advocacy on health care.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others:

HE07 _____Goal per proposal

HE07 _____People trained in systems advocacy about health care

Narrative-

Breakout number by category

1) _____Self-advocates

2) _____Family members

3) _____Others

SECTION V: PERFORMANCE TARGETS

Area of Emphasis - Housing

HO01 _____Goal per proposal

HO01 _____Individuals have homes of their choice through Council efforts.

Narrative-

HO02 _____Goal per proposal

HO02 _____People moved from congregate settings to homes in community.

Narrative-

HO03 _____Goal per proposal

HO03 _____Dollars leveraged for housing.

Narrative-

HO04 _____Goal per proposal

HO04 _____Banks made mortgage funds available to enable people to own homes.

Narrative-

HO05 _____Goal per proposal

HO05 _____Housing programs/policies created/improved.

Narrative-

HO026_____Goal per proposal

HO06 _____Units of affordable, accessible housing made available.

Narrative-

HO07 _____Goal per proposal

HO07 _____People facilitated home ownership/rental.

Narrative-

HO08 _____Goal per proposal

HO08 _____People trained in housing.

Narrative-

HO09 _____Goal per proposal

HO09 _____People active in systems advocacy about housing.

Narrative-

Breakout number by category

1) _____Self-advocates

2) _____Family members

3) _____Others

HO10_____Goal per proposal

HO10 _____People trained in systems advocacy about housing.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

SECTION V: PERFORMANCE TARGETS

Area of Emphasis: Quality Assurance

QA01 _____Goal per proposal

QA01 _____People benefiting from quality assurance efforts of the Council.

Narrative-

QA02 _____Goal per proposal

QA02 _____Dollars leveraged for quality assurance programs

Narrative-

QA03 _____Goal per proposal

QA03 _____Quality assurance programs/policies created/improved.

Narrative-

QA04 _____Goal per proposal

QA04 _____People facilitated quality assurance.

Narrative-

QA05_____Goal per proposal

QA05_____People trained in quality assurance.

Narrative-

QA06 _____Goal per proposal

QA06 _____People active in systems advocacy about quality assurance.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

QA07 _____Goal per proposal

QA07 _____People trained in systems advocacy about quality assurance.

Narrative-

Breakout number by category

1) _____Self-advocates

2) _____Family members

3) _____Others

QA08 _____Goal per proposal

QA08 _____People trained in leadership, self-advocacy and self-determination.

Narrative-

QA09 _____Goal per proposal

QA09 _____People attained membership on public and private bodies and other leadership coalitions.

Narrative-

QA10 _____Goal per proposal

QA10 _____Number of entities participating in partnerships or coalitions created or sustained as a result of Councils efforts.

Narrative-

SECTION V: PERFORMANCE TARGETS

Area of Emphasis - Recreation

RE01 _____Goal per proposal

RE01 _____People active in recreational activities through Council efforts.

Narrative-

RE02 _____Goal per proposal

RE02 _____Dollars leveraged for recreation.

Narrative-

RE03 _____Goal per proposal

RE03 _____Recreation programs/policies created/improved.

Narrative-

RE04 _____Goal per proposal

RE04 _____People facilitated recreation.

Narrative-

RE05 _____Goal per proposal

RE05 _____People trained in recreation.

Narrative-

RE06 _____Goal per proposal

RE06 _____People active in systems advocacy about recreation.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

RE07 _____Goal per proposal

RE07 _____People trained in systems advocacy about recreation.

Narrative-

Breakout number by category

1) _____Self-advocates

2) _____Family members

3) _____Others

SECTION V: PERFORMANCE TARGETS

Area of Emphasis - Transportation

TR01 _____Goal per proposal

TR01 _____People have transportation services through Council efforts.

Narrative-

TR02 _____Goal per proposal

TR02 _____Dollars leveraged for transportation.

Narrative-

TR03 _____Goal per proposal

TR03 _____Transportation programs/policies created/improved.

Narrative-

TR04 _____Goal per proposal

TR04 _____People facilitated transportation.

Narrative-

TR05 _____Goal per proposal

TR05 _____People trained in transportation.

Narrative-

TR06_____Goal per proposal

TR06 _____People active in systems advocacy about transportation.

Narrative-

Breakout number by category

1) _____Self -advocates

2) _____Family members

3) _____Others

TR07 _____Goal per proposal

TR07 _____People trained in systems advocacy about transportation.

Narrative-

Breakout number by category

1) _____ Self-advocates

2) _____Family members

3) _____Others