10-Exhibit 2 - Activities Report.pdf

Exhibit 2

City of Dallas Activities Report

Name of staff completing the report: __________________________________________ Date: _______________ (By writing your name you confirm the report is complete and correct)

Recipient’s Name ___________ Report Period ______________

Current Month Unduplicated Monthly Unduplicated Unduplicated Cumulative Total YTD

Section I. Total number of persons/households assisted

Section II. Total number of persons/households assisted (from Section I) who are:

Part A. Financial Status *

1. Extremely Low Income (Up to 30% AMI)

2. Very Low Income (More than 30 and less than 50% AMI)

3. Low Income (More than 50 and less than 80% AMI) Total

* See Federal Income Eligibility Guidelines

Part B. Family Status

1. Total Female Headed Households

Part C. Demographics Data (self-report)

Single Race

Current Month Undupl

Total

Current Month Undupl Total (Hispanic or

Latino)

Undupl.

Cumulative YTD

Undupl.

Cumulative YTD

(Hispanic or Latino)

1. White ________ ________ __________ ___________

2. Black/African American ________ ________ __________ ___________

3. Asian

4. American Indian/Alaskan Native ________ ________ __________ ___________

5. Native Hawaiian or Other Pacific Islander

Multi-Race

1. American Indian/Alaskan Native & White

2. Asian & White ________ ________ __________ ___________

3. Black/African American & White ________ ________ __________ ___________

4. American Indian or Alaskan Native & Black & African American

5. Other Multi-Racial ________ ________ __________ ___________

Total ________ ________ __________ ___________

Section III. Council District (List the Council District information for facility)

FACILITY LOCATION(S)

SERVICE AREA

(List the Council District and zip code information for the individuals shown in Section I, Column I.)

I certify that 100% of the clients receiving services are eligible in accordance with the appropriate income limits as specified by the City of Dallas Program Guidelines.

Category Population Number of

NEW

Individuals

Number of

CUMULATIVE

Individuals YTD

D. GENDER

(self-reported) Male

Female

Other

Not Reported

Not Tracked

Total (Must equal number reported in Question 4)

Age

(self-reported)

Report the age of the victim at the time of the victimization.

0-12

13-17

18-24

25-59

60 and Older

Not reported

Not tracked

Total (Must equal number reported unduplicated) survivors/victims served)

Types of Victimizations (for ALL individuals identified in Question 1)

If no data is collected for a category, enter the number of new individuals as Not Tracked or Not Reported (see Question 5 for definitions).

E. Individuals who received services by victimization type

Victimization Type

A. Number of individuals who received services based on the presenting victimization during the reporting period

Number of CUMULATIVE

Individuals YTD

Human Trafficking: Labor

Human Trafficking: Sex

Human Trafficking: Other

INSTRUCTIONS:

Enter the count of individuals who received services based on each presenting victimization type during the reporting period.

• An individual MAY be counted in more than one victimization type.

• An individual MAY NOT be counted more than once within the same victimization type.

• See Definitions RFP for Human Trafficking definition type.

Section III. Direct Services - Total number of persons/households assisted (from Section I)

Select the types of services provided by your organization during the reporting period:

INSTRUCTIONS: “Use of City of Dallas and Match Funds,” of your Grant Award Report (SAR).

1. Support for Wrap-Around Social Services for Survivors on the Road to Economic Empowerment

2. Implementing Focused Economic Empowerment Strategies for Survivors to Secure Paid Employment

3. Ensuring Survivors Maintain Employment through Ongoing Services and Barrier Mitigation

G. Direct Services

1. Support for Wrap-Around Social Services for Survivors on the Road to Economic Empowerment

a. Wrap-around social services Number of NEW Individuals Number of CUMULATIVE

Individuals YTD

Emergency Shelter

Housing

Trauma-Informed Counseling

Support Group (s)

Medical Care

Legal Assistance

Food & Basic Necessities

b. Comprehensive Case Management Number of NEW Individuals Number of CUMULATIVE

Individuals YTD

Continuing Education

Vocational Resources

Securing Identity Documents

Job Readiness Training

Scheduling and connecting with mental health counseling services

Scheduling and connecting with physical health counseling services

F. Of the individuals who received services, how many presented with more than one type of victimization during the reporting period?

Number of NEW Individuals

Number of

CUMULATIVE

Individuals YTD

Special classifications of individuals

(self-reported)

INSTRUCTIONS:

Enter the number of individuals who self-identify in one or more of these categories.

Deaf/Hard of Hearing

Homeless

Immigrants/Refugees/Asylum

Seekers

LGBTQ

Veterans

Victims with Disabilities:

Cognitive/ Physical /Mental

Victims with Limited English

Proficiency

Other

If other, please explain

2. Implementing Focused Economic Empowerment Strategies for Survivors to Secure Paid

Employment

a. Eligible Activities (Note: For activities involving money, no money should be given to survivors directly and it should be paid directly by the agency to the provider).

Number of NEW Individuals Number of CUMULATIVE

Individuals YTD

i. Financial Advocacy and Literacy

ii. Workforce Readiness

iii. Access to a Phone and/or internet

iv. Resume Development

v. Professional Headshots

vi. Innovative Approaches to Job

Matching

vii. Interview Preparedness

viii. Transportation

ix. Work Clothes

x. Peer-to-Peer Learning

xi. Developing Corporate Partnerships

3. Ensuring Survivors Maintain Employment through Ongoing Services and Barrier Mitigation

Ongoing Services and Barrier Mitigation Number of NEW Individuals Number of CUMULATIVE

Individuals YTD

a. Economic Empowerment for Survivors

b. Ongoing Comprehensive Case

Management

c. Day Care/Childcare

d. Leveraging Resources for Professional

Development

e. Leveraging Resources for Continuing

Education

Trauma-Informed Care: well-rounded economic empowerment

Number or percentage of participants completing GED completing vocational Training completing Business Training

Number or percentage of participants starting business

Number or percentage of participants starting business

Average monthly income of participants before participation

Average monthly income of participants after participation

Number or percentage of participants able to secure employment and a living, including for each position secured: Amount of hourly wages secure employment and a living, including for each position secured: If applicable, amount and type of fringe benefits secure employment and a living, including for each position secured: Amount of months employed

Exhibit 6

DEFINITIONS

The five racial categories are defined as follows:

a) American Indian or Alaska Native. A person having origins in any of the original peoples of

North and South America (including Central America), and who maintains tribal affiliation or community attachment.

b) Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent including, for example, Cambodia, China, Japan, Malaysia, Pakistan, the Philippines Islands, Thailand, and Vietnam.

c) Black or African American. A person having origins in any of the black racial groups of Africa.

d) Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

e) White. A person having origins in any of the original peoples of Europe, the Middle East, or

North Africa.

The two ethnic categories are defined as follows:

a) Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish culture or origin, regardless of race. The term, "Spanish origin," can be used in addition to "Hispanic or Latino."

b) Not Hispanic or Latino. A person not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Victimization type:

Human Trafficking: The use of force, fraud, or coercion to compel a commercial sex or labor act, or in which the person induced into commercial sex is a minor. The Trafficking Victims Protection Act of 2000 and its subsequent reauthorizations recognize and define two primary forms of human trafficking (U.S. Department of Justice):

a) Sex trafficking is the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age. (22 U.S.C. § 7102(11)(A)).

b) Forced labor is the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. (22 U.S.C. § 7102(11)(B)).

c) While the above are the legally recognized definitions of human trafficking, the City recognizes not all cases of victimization rise to the level where it is prosecuted as such. Accordingly, for this RFP, eligible survivors include adults (18 and up) who are high-risk, those who are past or current victims (based on the agency’s individual assessment), and those who the agency suspects are victims but no outcry by the victim has been made.