CalVIP Quarterly Progress Report

Baseline Report Survey

You will only be required to complete this form once!


Please submit this form by February 15, 2023.

 

SECTION 1 - GRANTEE INFORMATION

 
 

Please select the name of the city/organization that received funding from the BSCC.

 
 
 
Phone
 
 
 

SECTION 2 - PROJECT ACTIVITIES/PARTICIPANTS

 
 

2.1 - Project Activities

 

Please describe any project activity that occurred during the 12 months prior to the grant period (ex: hiring/training staff, securing facilities, etc.).

 
 

2.2 - Participants

 

Does your project formally enroll participants?

 

Has your project informally served any participants during the 12 months prior to the grant period?

 
 

SECTION 3 - PROJECT GOALS - BASELINE DATA

 
 

3.1 - Crime, Criminogenic Behaviors, and/or Recidivism Reduction Goals:

 

Does your project's target population include youth under age 18?

 

Do any of your project’s goals include detecting/interrupting cycles of violence?

 
 

3.2 - Service/Work Goals


1.

During the 12 months prior to the grant, approximately how many hours of service were provided for each of the following project activities (estimates are okay):


Note: if a service listed below was not provided by your project in the last 12 months, leave those items blank.

 
 
 

(street outreach, hospital-based, crisis, gang, etc.)

 
 
 
 

(tutoring, after-school programs, etc.)

 
 
 

3.3 - Positive Participant Outcomes

 

Do any of the project's goals focus on improving participant outcomes (ex: reducing risk factors, improving education/employment status, increasing protective factors, etc.)?

 
 

3.4 - Community Outcomes

 

Is your project measuring outcomes that will affect the community (ex: building community efficacy, promoting community safety, strengthening relationships between the community and law enforcement, etc.)?

 
 

SECTION 4 - PROJECT PLANS

 
 

4.1 - Planned Project Activities

Please select any and all activities that are/will be elements of your project.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

4.2 - Risk/Needs Assessment

 
 
 

4.3 - How do you define "successful completion"?

 

(e.g., case management, mentoring, school/student services).


Note: you will use this definition for identifying those participants who are "successfully completing" your project when you report exiting participants.


This definition could be an amount of time engaged in activities, a dosage of services received, improvement in an outcome measure, or other definition specific to your project.