CTR075474_Exhibit_F_Monthly_Navigation_Report.pdf
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- Attached to
- Master Agreement AZ|CTR075474
- Contract number
- CTR075474
- Issued by
- Arizona
About this file
This document is an Exhibit F PBI (Performance-Based Indicator) Reporting Template, designed as a navigation and reporting tool for social service agencies. The template appears to be a standardized reporting form for tracking client interactions and service delivery across various assistance programs including LIHEAP (Low Income Home Energy Assistance Program), LIHWAP, ERAP (Emergency Rental Assistance Program), SSBG (Social Services Block Grant), TANF (Temporary Assistance for Needy Families), and other social service initiatives.
The template provides a comprehensive grid for documenting method of contact (in-person, phone, email/text, kiosk/tablet), client service requests, and service outcomes across multiple categories such as households in crisis, utility assistance, housing assistance, special needs, food, transportation, and case management. It includes columns for tracking approved, denied, unserved, and self-served interactions, as well as sections for portal navigation, eviction prevention, agency internal resources, and external referrals. The form is designed to capture granular data about social service interventions, allowing agencies to quantify and report on their service delivery and client engagement.
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Text version
Exhibit F
1. Agency Name 2. Report Month 3. Report Year
4. METHOD OF CONTACT 5. IN PERSON 6. PHONE 7. EMAIL/TEXT 8. KIOSK/TABLET TOTAL PBI Reporting Template
9. APPROVED 0
10. DENIED 0
11. UNSERVED 0
12. SELF SERVED 0
13. SERVICE REQUESTED -> 14. HOUSEHOLDS IN CRISIS 15. UTILITY ASSISTANCE 16. HOUSING ASSISTANCE 17. SPECIAL NEEDS 18. FOOD 19. IN-KIND SERVICE / INCIDENTAL 20. TRANSPORTATION 21. CASE MANAGEMENT 22. WEATHERIZATION 23. Energy Education 24. Energy Advocacy 25. Energy Kit 26.Monthly number of applications received
27.Monthly number of HH served
28. Monthly average benefit
PORTAL NAVIGATION (LIHEAP/LIHWAP/ERAP)
SSBG
STCS/TANF
NHN
CSBG
LIHEAP ASSURANCE 16
EVICTION PREVENTION
AGENCY INTERNAL RESOURCES
EXTERNAL REFERRAL
TOTALS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Eviction Prevention
NAVIGATOR REPORT TEMPLATE
Assurance 16
File details come from the government source that posted it. Updated .