CTR075474_Exhibit_F_Monthly_Navigation_Report.pdf

PDF 64 KB Posted

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.

View the file

Other files

Show all 17

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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 .