ARSI-S2S & URSISemi-Annual/Quarterly Progress Report & InvoiceSubmission Form

ARSI-S2S & URSI

Semi-Annual/Quarterly

Progress Report & Invoice

Submission Form

PUBLIC HEALTH INSTITUTE (PHI) -

CENTER FOR IMMIGRANT AND REFUGEE HEALTH (CIRH)

Afghan Refugee School Impact-Support to Schools (ARSI—S2S) and Ukrainian Refugee School Impact (URSI) Programs

Semi-Annual/Quarterly Progress Report & Invoice Submission Form

Introduction

The Public Health Institute (PHI)/Center for Immigrant and Refugee Health (CIRH) appreciates your collaboration in implementing the ARS—S2S/URSI programs. This progress report is designed to capture how the ARSI—S2S/URSI program has impacted school districts, youth, and families for the current reporting period of [April 1, 2025 - June 30, 2025]. For funding purposes only, results will be aggregated anonymously and delivered to our funder the California Department of Social Services (CDSS) by PHI/CIRH.

Assistance

For report planning and preparation, download the following forms. These documents will help you compile the required reporting information in advance of entering this information online. For further assistance, please contact Debbie de Sagun at (323) 317-3819 or e-mail the "Monitoring, Evaluation, and Reporting" (MER) team at CIRHmer@phi.org. Please note that these 4 forms are to assist with tracking progress of planned activities; they do not need to be submitted.

FORM 1. ARSI—S2S/URSI Semi-Annual Progress Report Template

FORM 2. ARSI—S2S/URSI Quarterly Progress Report Template

FORM 3. Key Terms, Definitions, & Progress Report Due Dates

FORM 4. Progress Report Submission Checklist

Important Reminder

ALL required information must be entered in one sitting to successfully submit the progress report online. Your responses are not saved until you hit “Submit”. So, we advise that you have all required information ready to be entered and stable internet to prevent disruptions in the submission process.

3 Clicks To Start!

To start, first choose "Semi-Annual" or "Quarterly" below, based on which report is due. Then, choose which funds, "ARSI—S2S" or "URSI", that your school district/CBO is receiving. If you are receiving both types of funding, a separate report submission is required for each program (one for ARSI—S2S and one for URSI). Finally, choose the reporting period.

Once these 3 steps are done, all the questions for the specificed report submission will appear for your completion.

Is this for Semi-Annual or Quarterly?*

Semi-Annual

Quarterly

Reporting Period*

Select or enter value

(Semi-Annual) What Funds is Your School District/CBO Receiving?*

ARSI-S2S

URSI

(Quarterly) What Funds is Your School District/CBO Receiving?*

ARSI-S2S

URSI

School District/CBO Name*

Select

School District/CBO Representative or Other Authorized Designee*

(Name, Title, & Contact Information)

Accounting/Invoice Personnel*

(Name, Title, & Contact Information)

School District/CBO Break Dates*

(If not applicable, enter "N/A")

Date Administrators/Coordinators Return*

(If not applicable, enter "N/A")

Administrators/Coordinators Available During Break*

(Name, Title, & Contact Information; If not applicable, enter "N/A")

Signature*

(Please Type in your Full Name)

Today's Date*

OVERVIEW OF SEMI-ANNUAL PROGRESS REPORT

A. Program Staff During this Reporting Period

B. Program Implementation Progress, Learnings, and Success Stories During this Reporting Period

C. Eligibility Verification and Documentation Management During this Reporting Period

D. Participant Data Attestation During this Reporting Period

E. (Section E. is no longer applicable)

F. Program Participation TOTALS During this Reporting Period

G. Program Participation TOTALS By Service/Activity Category and Demographics During this Reporting Period

H. Invoice and Other Attachment Uploads

OVERVIEW OF QUARTERLY PROGRESS REPORT

This progress report only requires the following five sections:

**NEW -- Required Equipment Inventory Question**

B. Program Implementation Progress During this Reporting Period

D. Participant Data Attestation During this Reporting Period

F. Program Participation TOTALS

G. Program Participation TOTALS By Served Service/Activity Category & Other Demographics

H. Invoice and Other Attachment Uploads

REQUIRED EQUIPMENT INVENTORY QUESTION

Has your organization purchased grant-funded equipment during this reporting period April 1, 2025 - June 30, 2025?

Yes

Please complete the following online form.*

Use this link to complete your equipment inventory for this reporting period April 1, 2025 - June 30, 2025. Approval of this Quarterly Report + Invoice submission is contingent on completion and submission of this separate online form:

https://bit.ly/arsiursiequipment

Please check this box to attest that the above form has been completed and submitted.

A. Program Staff During this Reporting Period

Instructions: Please answer the question below about staff during this reporting period. Include staff changes that were either funded in part or fully with funds.

1. List the existing personnel supporting the program. If personnel were hired using funding, list their names, titles, roles, and dates of hire.*

(619 Word limit; if you need need more space and/or you prefer to respond to this question via a document, you are welcome to attach a document in section H.)

B. Program Implementation Progress, Learnings, and Success Stories During this Reporting Period

Instructions: Please answer the questions below about workplan implementation progress, challenges, learning experiences, and success stories.

1. Based on your workplan, summarize the services/activities implemented during this reporting period. Please summarize these services/activities by the categories outlined below (as applicable to your workplan).*

(619 Word limit; if you need more space and/or you prefer to respond to this question via a Word document, you are welcome to attach a document in section H.)

Connection for Basic Needs Support
Family Engagement and Empowerment
Youth Engagement and Development
School Enrollment Support
Service Provider Capacity Support

2. Based on your workplan, summarize the services/activities implemented with sub-contractors and/or other key highlights and progress updates with external organizations you have collaborative partnerships with during this reporting period (as applicable).*

(619 Word limit; if you need more space and/or you prefer to respond to this question via a Word document, you are welcome to attach a document in section H.)

3. Discuss the greatest challenges or learning experiences encountered implementing the program during this reporting period.*

(619 Word limit; if you need need more space and/or you prefer to repsond to this question via a Word document, you are welcome to attach a document in section H.)

4. Share success stories or any other positive narratives during this reporting period. We encourage you to attach pictures (attachments can be made at the end of this online form in section H.) and hyperlinks if available.*

(619 Word limit; if you need need more space and/or you prefer to repsond to this question via a Word document, you are welcome to attach a document in section H.)

C. Eligibility Verification & Documentation Management During this Reporting Period

Instructions: Please answer the questions below about eligibility verification and documentation management for this program during this reporting period.

1. What is your process for determining eligibility verification for the program AND how do you manage documentation records?*

(619 Word limit; if you need need more space and/or you prefer to repsond to this questions via a Word document, you are welcome to attach a document in section H.)

D. Participant Data Attestation During this Reporting Period

Instructions: Please check the box below about individual-level participant data attestation during this reporting period.

*A reminder that school districts/CBOs are required to use the provided Smartsheet participant data platform which adheres to individual-level data governance requirements (and/or other approved and agreed upon data management system).

1. I am attesting that our school district/CBO is securely collecting and storing participants' individual-level data for the program.*

F. Program Participation TOTALS During Federal Fiscal Year

Instructions: Please answer the questions below about program participation TOTALS during this reporting period (April 1, 2025 - June 30, 2025).

Include only the number of student and immediate family member participants who have been verified for ARSI—S2S/URSI eligibility AND whose verification documentation has been collected.

Include only the number of non-duplicated participants (students and immediate family members). This means that you can only count a participant once regardless of how many times AND types of service/activity categories they accessed throughout the program timeframe.

1. From April 1, 2025 - June 30, 2025: What is the TOTAL # of non-duplicated, ORR-eligibility-verified STUDENTS who participated in program services/activities?*

*This includes all students served during this reporting period regardless of their participation start date.

2. From April 1, 2025 - June 30, 2025: What is the TOTAL # of non-duplicated immediate FAMILY MEMBERS (e.g., parents, grandparents, legal guardians, primary caregivers, spouses, siblings) who participated in program services/activities?*

*This includes all immediate family members served during this reporting period regardless of their participation start date.

ONLY family member participants whose eligibility has been verified AND documentation has been collected can be counted. If you have eligible family participants who you served already, BUT have not yet collected their eligibility documentation or unable to collect the documents/other reasons - DO NOT COUNT THEM HERE- instead, please enter/explain this separate # and other details above in section B., Question 1. (open text part).

3. From April 1, 2025 - June 30, 2025: What is the TOTAL # of non-duplicated immediate FAMILY MEMBER ADULTS (e.g., parents, grandparents, legal guardians, primary caregivers) who participated in program services/activities?*

*Of the total # of immediate family members noted above in question 2.,the # who are ONLY ADULTS such as parents/grandparents/legal guardians/primary caregivers:

4. The number of ORR-eligibility-verified STUDENTS who have a participation start date from April 1, 2025 - June 30, 2025.*

These are newly enrolled student participants who started receiving services from April 1, 2025 - June 30, 2025 of this year.

5. The number of immediate FAMILY MEMBERS (e.g., parents, grandparents, legal guardians, primary caregivers, spouses, siblings) who have a participation start date from April 1, 2025 - June 30, 2025.*

These are newly enrolled immediate family member participants who started receiving services from April 1, 2025 - June 30, 2025 of this year.

6. I am attesting that the participant numbers (BOTH STUDENT & FAMILY MEMBERS) that my organization has reported on are ONLY for participants whose eligibility has been verified and documentation has been collected.*

Reminder: Eligibility verification and storage of these documents are required for both student/youth AND family member participants.

7. I am attesting that the participant numbers that my organization has reported on are ONLY for non-duplicated participants.*

G. Program Participation TOTALS By Service Category & Demographics During this Reporting Period

Instructions: Please answer the questions below about program participation by service/activity category, demographics, and other characteristics during the reporting period, April 1, 2025 - June 30, 2025.

Include only the number of student and family member participants who have been verified for ARSI—S2S/URSI eligibility AND whose verification documentation has been collected.

If a participant (student, family member, staff) received multiple ARSI—S2S/URSI services across 5 categories, please count that participant in each category that they received services.

For partnerships with other ARSI-S2S-/URSI-funded organizations, each organization can report on/count the participant as long each agency provided a distinct service/activity for that participant.

What services does your district have?*

1. Connections For Basic Needs Support

2. Family Engagement and Empowerment

3. Youth Engagement and Development

4. School Enrollment Support

5. Service Provider Capacity Support

1. Connections for Basic Needs Support

1a. # of Non-Duplicated, ORR-Eligibility-Verified Student Participants Served (Total) **This number should be equal to or lower than the number reported in section F. Question 1.***

(Connections for Basic Needs Support)

1b. # of Non-Duplicated Immediate Family Member Participants Served (who are connected to an ORR-eligibility-verified student) (Total) **This number should be equal to or lower than the number reported in section F. Question 2.***

(Connections for Basic Needs Support)

1c. # of Non-Duplicated Staff/Volunteers (Total)*

*Only for Service Provider Capacity Support*

2. Family Engagement and Empowerment

2a. # of Non-Duplicated, ORR-Eligibility-Verified Student Participants (Total) **This number should be equal to or lower than the number reported in section F. Question 1.***

(Family Engagement and Empowerment)

2b. # of Non-Duplicated Immediate Family Member Participants Served (who are connected to an ORR-eligibility-verified student) (Total) **This number should be equal to or lower than the number reported in section F. Question 2.***

(Family Engagement and Empowerment)

2c. # of Non-Duplicated Staff/Volunteers (Total)*

*Only for Service Provider Capacity Support*

3. Youth Engagement and Development

3a. # of Non-Duplicated, ORR-Eligibility-Verified Student Participants (Total) **This number should be equal to or lower than the number reported in section F. Question 1.***

(Youth Engagement and Development)

3b. # of Non-Duplicated Immediate Family Member Participants Served (who are connected to an ORR-eligibility-verified student) (Total) **This number should be equal to or lower than the number reported in section F. Question 2.***

(Youth Engagement and Development)

3c. # of Non-Duplicated Staff/Volunteers (Total)*

*Only for Service Provider Capacity Support*

4. School Enrollment Support

4a. # of Non-Duplicated, ORR-Eligibility-Verified Student Participants (Total) **This number should be equal to or lower than the number reported in section F. Question 1.***

(School Enrollment Support)

4b. # of Non-Duplicated Immediate Family Member Participants Served (who are connected to an ORR-eligibility-verified student) (Total) **This number should be equal to or lower than the number reported in section F. Question 2.***

(School Enrollment Support)

4c. # of Non-Duplicated Staff/Volunteers (Total)*

*Only for Service Provider Capacity Support*

5. Service Provider Capacity Support

5a. # of Non-Duplicated, ORR-Eligibility-Verified Student Participants (Total)*

(Service Provider Capacity Support)

5b. # of Non-Duplicated Immediate Family Member Participants Served (who are connected to an ORR-eligibility-verified student) (Total)*

(Service Provider Capacity Support)

5c. # of Non-Duplicated Staff/Volunteers (Total)*

*Only for Service Provider Capacity Support*

If your ARSI—S2S/URSI team (staff, volunteers, etc.) participated in PHI/CIRH-led cohort meetings and trainings (e.g., Technical Assistance, Webinars, Communities of Practice, Office Hours, Conference, and Other Informational Meetings) as well as additional external capacity building-related activities with other collaboratives or knowledge-/practice-sharing forums, please enter the TOTAL number of staff who participated in these efforts:

1. From April 1, 2025 - June30, 2025, how many non-duplicated, ORR-eligibility-verified students participated in the program services/activities described in section F.?

Please separate by students’ preferred gender identity.

# of Non-Duplicated, ORR-Eligibility-Verified Students:

1a. Males*

1b. Females*

1c. Non-Binary*

1d. Other*

1e. Total Number of Non-Duplicated, ORR-Eligibility-Verified Students (All Gender Identities).*

2. From April 1, 2025 - June 30, 2025, how many non-duplicated, ORR-eligibility-verified students participated in the program services/activities described in section F.?

Please separate by students’ grade level.

# of Non-Duplicated, ORR Eligibility-Verified Students:

2a. Grades PreK-5*

2b. Grades 6-8*

2c. Grades 9-12*

2d. Grades- Not Applicable/Other*

2e. Total Number of Non-Duplicated, ORR-Eligibility-Verified Students (All Grades)*

3. From April 1, 2025 - June 30, 2025, how many non-duplicated, ORR-eligibility-verified students participated in the program services/activities described in section B.?

Please separate by the number of months since arrival to the US.

# of Non-Duplicated, ORR-Eligibility-Verified Students:

3a. 0-12 Months Since Arrival to US*

3b. More than 12 Months Since Arrival to US*

3c. Total Number of Non-Duplicated, ORR-Eligibility-Verified Students (All Months)*

4. From April 1, 2025 - June 30, 2025, of the number of non-duplicated, ORR-eligibility-verified students who participated in the program services/activities described in section F., how many were successfully promoted to the next grade level (if applicable)? Please answer with a number, not a percentage.

This question applies to ORR-eligibility-verified students who were promoted to the next grade level from the Spring/Summer academic calendar to the Fall academic calendar. So we anticipate the highest numbers of student grade level promotion to be reported during the "September Semi-Annual Report/Invoice" due date. However, if there ANY mid-year promotions that occurred during this reporting period (April 1, 2025 - June 30, 2025), please report them here now. If there are no grade level promotions during this reporting period, please enter "0".

# of Non-Duplicated, ORR-Eligibility-Verified Students Successfully Promoted to the Next Grade Level*

5. Enter the number of non-duplicated, ORR-eligibility-verified students and/or their parents/legal guardians/primary caregivers who completed a formal orientation during the reporting period. This item should include those who successfully completed the orientation and not those that registered but did not attend or did not complete the orientation from October 1, 2024 - March 31, 2025. Report both students and parents/legal guardians/primary caregivers.

# of Non-duplicated, ORR-Eligibility-Verified Students and/or their Parents/Legal Guardians/Primary Caregivers Who Completed a Formal Orientation*

6. From April 1, 2025 - June 30, 2025, please list the top five preferred languages for youth and families who participated in the program services/activities described in section F.*

7. Were there any differences in service availability compared to the last Federal Fiscal Year, October 1, 2023 - September 30, 2024 (if applicable)?*

(619 Word limit; if you need more space and/or you prefer to respond to this question via a Word document, you are welcome to attach a document in section H.)

8. Explain noticeable (±10%) changes in the number of non-duplicated, ORR-eligibility-verified students and families participating in services as compared to the last Federal Fiscal Year, October 1, 2023 - September 30, 2024 (if applicable). Have any trends emerged? Please list any contributing factors.*

(619 Word limit; if you need more space and/or you prefer to respond to this question via a Word document, you are welcome to attach a document in section H.)

H. Invoice and Other Attachment Uploads

Instructions: Upload your invoice and ad-hoc attachment(s) for this reporting period.

Upload Files Here*

Drag and drop files here or

Check this box once the invoice is uploaded*

Send me a copy of my responses

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