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 .