CTR075477_Exhibit_F_Monthly_Navigation_Report.pdf
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- Attached to
- Master Agreement AZ|CTR075477
- Contract number
- CTR075477
- Issued by
- Arizona
About this file
This document is an Exhibit F PBI (Performance-Based Indicator) Reporting Template, which appears to be a standardized reporting form for tracking social service interactions and assistance programs. The template is designed for documenting various methods of contact, service requests, and program interventions across multiple assistance categories including utility assistance, housing assistance, special needs, food support, transportation, and case management.
The reporting template provides a comprehensive grid for agencies to record detailed metrics across different service channels such as in-person, phone, email/text, and kiosk/tablet interactions. It covers portal navigation for programs like LIHEAP (Low Income Home Energy Assistance Program), LIHWAP, ERAP, SSBG, TANF, and other social service initiatives. The form allows tracking of approved, denied, unserved, and self-served requests, with columns for documenting specific intervention types like households in crisis, eviction prevention, and external referrals. Currently, the template appears to be blank, with no specific data entered.
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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 .