Staffing Level Report Form

Staffing Level Report Form

The Staffing Level Report is to notify The Community Partnership for the Prevention of Homelessness (TCP) of your organization's current staff numbers and information on position vacancies.

The Staffing Level Report Form is to be submitted on the 10th of each month for the preceding month. (Ex. The Staffing Level Report for November is to be submitted no later than 5pm on December 10). Failure to submit the Staffing Level Report by the aforementioned deadline may result in the issuance of a Deficiency Notice and the withholding of contract paymnent.

Provider Name*

Please provide your organization's name.

Select or enter value

Program Name*

Please provide the program name.

Select or enter value

Contract Number

Please provide your current contract number.

Month of Report*

Please include for which month this report is being completed.

Select or enter value

Year of Report*

Select or enter value

Name of Staff Member Submitting Report*

Email of Staff Member Submitting Report*

Number of Full Time Staff*

Number of Part Time Staff*

Number of Case Managers*

Please provide the number of case managers.

N/A - Not Applicable

Number of Program Managers*

Please provide the number of program managers.

N/A - Not Applicable

Number of Licensed Social Workers*

Number of licensed social workers or authorized staff to provide clinical supervision

N/A - Not Applicable

Number of Support Staff*

Number of support staff (i.e. residential monitors, engagement specialists, residential advocates, program assistants, etc.)

N/A - Not Applicable

Number of Certified Food Handlers*

*All sites that receive meals are required to have certified food handlers*

Number of Bilingual Staff*

Please provide the number of bilingual staff members.

Number of Security Officers*

(Security Vendors Only)

Please provide the number of security or special police officers (SPOs).

N/A - Not Applicable

Number of Cooks*

(Meal Vendors Only)

Please provide the number of cooks.

N/A - Not Applicable

Number of Drivers*

(Meal Vendors Only)

Please Provide the number of drivers.

N/A - Not Applicable

Number of Janitors*

(Janitorial Vendors Only)

Please provide the number of janitors.

N/A - Not Applicable

Staff Vacancies

Number of Vacancies*

Please indicate below the positions that your program currently has vacant as well as the number of vacancies for each position.*

Example:

Case Manager: 3 vacancies

Program Director: 1 vacancy

Residential Aid: 4 vacancies

Position of Longest Vacancy*

Length of Longest Vacancy*

Expected Date(s) Vacant Positions Will Be Filled*

Example:

2 Case Manager vacancies: expected to be filled 8/30/2024

1 Program Director vacancy: expected to be filled 9/1/2024.

Hiring Updates in Detail*

If you are reporting staff vacancies, please provide a summary of hiring efforts to fill these positions (i.e. has the agency participated in job fairs? Where have these positions been posted? Have the postings been updated? Is the agency working with a recruiter? etc). If there are prospective candidates that are in the hiring process (i.e. in the process of obtaining background clearances, candidates that have received offer letters..etc.) please indicate in detail how many candidates are in each phase. Example: 4 candidates have been extended offer letters for the vacant case manager positions, 2 candidates for the Shelter Monitor positions are in the process of being fingerprinted...etc).

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