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 REPORTContract Year
AGENCY NAME:
CONTRACT #:
CONTACT NAME AND INFO:
JanuaryFebruaryMarchEOQ TotalsAprilMayJuneEOQ TotalsJulyAugustSeptemberEOQ TotalsOctoberNovemberDecemberEOY Totals
INQUIRIES AND ORIENTATIONS
Number of clients referred0000000000000000
Number of clients served0000000000000000
Number of clients provided culturally relevant, gender responsive and linguistically appropriate service.0000000000000000
STAFFING
Beginning Number of staff0000000000000000
New staff licensed each month (+)0000000000000000
Specialists/Consultants utlized (+)0000000000000000
Staff Terminated (voluntary or involuntary) (-)0000000000000000
Total Case Files0000000000000000
APPOINTMENTS
Number of Scheduled appointments0000000000000000
Number of No Contact (referrals)0000000000000000
Number of completed appointments0000000000000000
REPORTS
Number of Reports completed0000000000000000
Number of written reports submitted within fifteen (15) days0000000000000000
Number of new individual treatment plans within 30 day0000000000000000
Number of Treatment Plans updated0000000000000000
Court Testimony
Number of Court Testimony request0000000000000000
Number of Court Testimony attended0000000000000000
Number of Court Testimony attended on time0000000000000000
UNUSUAL INCIDENTS
Number of Unusual Incident Reports (UIR)0000000000000000
Number of Unusual Incident reports submitted to appropriate Department within 24 hours of incident0000000000000000

9/22/2015

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