RFP 6124 Att I - Quarterly Report.xlsx

XLSX spreadsheet 22 KB Posted

Attached to
Microfilm Imaging Services for Marion County Clerk's Office
Solicitation number
S-C25102-00013756
Issued by
Marion County, Oregon

About this file

This is a Quarterly Report form (Attachment I) designed for Agency with Choice (AwC) programs to report operational metrics on a quarterly basis in March, June, September, and December. The form requires administrators to document key performance indicators including the number of new and current individuals served, the number of new and current Direct Support Workers (DSWs) employed, and the number of DSWs capable of speaking each individual's primary language. The form mandates submission of supporting individual records with each quarterly report, including Medicaid IDs, complaints, inspections, improvement plans, and contact logs. The document indicates approval by the Oregon Department of Justice as of May 25 and references RFP 5340 concerning acquisition and renovation of licensed residential facilities and homes.

The form provides a standardized template for consistent data collection across reporting periods with designated fields for notes and additional documentation. No specific pricing terms, budget amounts, or contract renewal options are detailed within this reporting instrument, as it functions primarily as a compliance and operational tracking document rather than a procurement specification. The quarterly reporting requirement ensures ongoing oversight of services provided to individuals and the workforce capacity supporting those services within the Agency with Choice program structure.

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Text version

Sheet1

ATTACHMENT I - Agency with Choice Quarterly Report

INSTRUCTION:

Please complete this form for each Quarter of each year:March, June, Sept,December

Agency with Choice Name:
Name of Administrator :
Indicate what Quarter:
DataNumber of IndividualsNotes (as necessary)
Number of new Individuals this quarter
Number of current Individuals this quarter
Number of new DSW working for AwC Individual
Number of current DSW working for AwC Individuals
Number of DSW that speak Individual's primary language
TOTAL Number of DSW0
TOTAL Number of Indiviudals0
Is it attached to this form?Notes (as necessary)
Quarterly reporting
Individual records that include but not limited to:
Individual Medicaid ID
Complaints
Inspections
improvement plans
Contact Logs
Other:
Number of Individual records attached
Additional Notes:
May-25
Approved by OR DOJ on _/__/__

RFP 5340 ACQUISITION / RENOVATION OF LICENSED RESIDENTIAL FACILITIES AND HOMES

&P of &N

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