RFP 6124 Att I - Quarterly Report.xlsx
XLSX spreadsheet 22 KB Posted
- 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.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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: |
| Data | Number of Individuals | Notes (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 DSW | 0 | |
| TOTAL Number of Indiviudals | 0 |
| 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 .