Exhibit_G_-_Monthly_CCSD_Community_Action_Inquire_Tracking_Sheet.xlsx

XLSX spreadsheet 18 KB Posted

Attached to
Master Agreement AZ|CTR075474
Contract number
CTR075474
Issued by
Arizona

About this file

The document is an Arizona Department of Economic Security (DES) Community Action Inquiry Tracking Sheet (Exhibit G), designed as a standardized tracking form for recording community service inquiries and requests. The form is specifically associated with the CCSD (Child Care Services Division) Community Action program and is used to document various types of service inquiries across different communication channels.

The tracking sheet captures detailed information about service requests, including inquiry types such as housing, utility assistance, case management, and other support services like food boxes or gas cards. The form allows for tracking inquiry methods (in-person, phone, email, agency portal) and outcomes, including service denials and withdrawals. While the document does not specify precise contract terms, it appears to be an administrative tool for monitoring and reporting community action service interactions, potentially used for state-level social service program management and performance tracking.

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Text version

SERVICES REQUESTED SHEET

Exhibit G
Arizona Department of Economic Security
CCSD COMMUNITY ACTION INQUIRY TRACKING SHEET
DATEIN PERSONPHONEEMAILHOUSINGUTILITYCASE MGMENTOTHERDeniedWithdrawn

DCAD COMMUNITY ACTION INQUIRY TRACKING SHEET

SERVICES REQUESTED SHEET (rev.

Exhibit G
Arizona Department of Economic Security

CCSD COMMUNITY ACTION INQUIRY TRACKING SHEET

Instructions: List the number of households inquiries.

Agency Name:
Month/Year:
INQUIRYTYPEOUTCOME
IN PERSONPHONEEMAILAGENCY PORTALHOUSINGUTILITYCASE MANAGEMENTOTHER
(i.e., food boxes, gas card, etc.)DENIALWITHDRAWN

DCAD COMMUNITY ACTION INQUIRY TRACKING SHEET

File details come from the government source that posted it. Updated .