Exhibit I Quarterly Data Report.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- Master Agreement AZ|CTR064216
- Contract number
- CTR064216
- Issued by
- Arizona
About this file
This document is a Quarterly Data Report template (Exhibit I) designed for tracking performance metrics across a service contract. The template appears to be a standardized reporting form for an unspecified agency, with detailed sections for tracking quarterly and annual data points related to client services, staffing, appointments, reports, court testimony, and incident reporting. While the specific agency and contract number are not filled in, the document is dated 9/22/2015 and provides a comprehensive framework for monitoring service delivery and operational performance.
The reporting template includes extensive quantitative tracking across multiple operational categories, with spaces to record monthly and quarterly totals for metrics such as number of clients served, staffing changes, appointment schedules, report completions, court testimonies, and unusual incident reports. The form is structured to capture zero values in this instance, suggesting it is a blank template awaiting actual data entry. Key reporting areas include client referrals, staff licensing, appointment tracking, treatment plan management, and incident reporting, indicating this is likely a service contract for a human services, healthcare, or social services organization with rigorous performance monitoring requirements.
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Text version
Quarterly Data Report
| EXHIBIT D | ||||||||||||||||
| QUARTERLY DATA REPORT | Contract Year | |||||||||||||||
| AGENCY NAME: | ||||||||||||||||
| CONTRACT #: | ||||||||||||||||
| CONTACT NAME AND INFO: | ||||||||||||||||
| January | February | March | EOQ Totals | April | May | June | EOQ Totals | July | August | September | EOQ Totals | October | November | December | EOY Totals | |
| INQUIRIES AND ORIENTATIONS | ||||||||||||||||
| Number of clients referred | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of clients served | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of clients provided culturally relevant, gender responsive and linguistically appropriate service. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| STAFFING | ||||||||||||||||
| Beginning Number of staff | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| New staff licensed each month (+) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Specialists/Consultants utlized (+) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Staff Terminated (voluntary or involuntary) (-) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Total Case Files | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| APPOINTMENTS | ||||||||||||||||
| Number of Scheduled appointments | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of No Contact (referrals) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of completed appointments | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| REPORTS | ||||||||||||||||
| Number of Reports completed | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of written reports submitted within fifteen (15) days | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of new individual treatment plans within 30 day | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of Treatment Plans updated | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Court Testimony | ||||||||||||||||
| Number of Court Testimony request | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of Court Testimony attended | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of Court Testimony attended on time | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| UNUSUAL INCIDENTS | ||||||||||||||||
| Number of Unusual Incident Reports (UIR) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Number of Unusual Incident reports submitted to appropriate Department within 24 hours of incident | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
9/22/2015
File details come from the government source that posted it. Updated .