Program Administration - Questions: (0/9) - Not Started ** The sub-grantee will provide an organizational description of staff paid by 21st CCLC funds to support the 21st CCLC program; and, names and job titles of volunteers from the sub-grantee and partner organization(s). Supporting Documentation will include names and job titles of staff members and volunteers of both sub grant partners supporting the 21st CCLC program. (Choose at least one): [ ] Table of Organization [ ] Roster Spreadsheet [ ] Written Description [ ] Volunteer Roster [ ] Other ** The subgrantee conducts outreach to eligible students as described in the original grant application or subsequent amendments. [ ] Fliers (including distribution information) [ ] School staff Meeting Agenda and Minutes [ ] Assessment data related to outreach activities to identified students [ ] Recommendation forms [ ] ** The subgrantee provides the minimum number of hours per week required for the grade span. [ ] Calendar [ ] Staff Handbook [ ] Parent Handbook ** The subgrantee is using research- based reading and mathematics activities as described in the original grant application or subsequent amendments. [ ] Lesson Plan [ ] Curriculum description from publisher Page 1 of 9
Question 5 ** The subgrantee implements positive youth development activities/programming as described in the original grant application or subsequent amendments. [ ] Lesson Plan [ ] Curriculum description from publisher Question 6 ** The subgrantee implements parent/family programming or activities. [ ] Fliers (including distribution information) [ ] Sign In Sheets [ ] Program Calendar Question 7 ** The subgrantee implements an attendance policy and procedures to ensure accurate reporting and the safety of eligible students. [ ] Program Roster [ ] Attendance Policy [ ] Written Procedures [ ] Sign In Sheets Question 8 ** Consultation between 21st CCLC program and nonpublic officials shall occur before the program makes any decisions that affect the opportunities of nonpublic students to participate in programs. The consultation should be ongoing. [ ] Documentation of nonpublic meetings including agendas, meeting notes, sign-in sheets, e-mails [ ] Documentation of nonpublic schools declining services, if applicable [ ] Not applicable Question 9 ** At minimum, the program consults with the non-public school on the following: [ ] The method (or sources of data) the program will use to determine the number of nonpublic school students from lowincome families residing in participating public school attendance areas (usually this is the free and reduced-price meal application or the student income form [found in CCIP Doc Library]) Page 2 of 9
[ ] How the program will identify the needs of academically eligible (failing or at risk of failing reading and/or mathematics) nonpublic school children [ ] What services the program will offer to eligible nonpublic school children [ ] How and when the program will make decisions about the delivery of services [ ] How, where, and from whom the program will provide services to eligible nonpublic school children [ ] How the program will academically assess the services to eligible nonpublic school children and how it will use those results to improve 21st CCLC services [ ] Not applicable Program Management - Questions: (0/7) - Not Started ** The program is licensed. [ ] Ohio Department of Job and Family Services Childcare License [ ] ODJFS License Number: [ ] Ohio Department of Education School Age Childcare License [ ] ODE SACC License Number: [ ] Proof of Exemption ** The program implements policies and procedures to ensure students participate. [ ] Attendance Policy [ ] Incentive policy ** The program manager communicates with the school administrator(s) regarding linkages between day and before and/or after- school program. [ ] Progress reports ** The program seeks parent input regarding programming and activities. Page 3 of 9
[ ] Assessment data [ ] Advisory group representation [ ] Completed parent survey Question 5 ** The program holds staff and partnership meetings that engage staff and partners in collaboration and sharing promising practices. Question 6 ** The program addresses the transportation needs of children in the program. [ ] Transportation policy [ ] Transportation logs [ ] Permission slips [ ] Parent handbook [ ] Completed needs survey Question 7 ** The program has a system that demonstrates how students are safely transported to and from the program site. [ ] Policy and/or procedure [ ] Sign-in/out forms [ ] Parent handbook [ ] School/site transportation agreement Staffing and Professional Development - Questions: (0/7) - Not Started ** The program implements a standard hiring process ensuring staff and volunteers have professional qualifications for their positions. [ ] Hiring policy [ ] Sample application [ ] Job descriptions [ ] Interview questions Page 4 of 9
** The program has a certified teacher that oversees the program's academic content. [ ] Contract or memorandum of understanding/agreement [ ] Job description with certification requirements [ ] Current, unexpired teacher certification ** The program staff receives training in program policies and procedures. [ ] Orientation schedule [ ] Training agendas [ ] Staff handbook ** The program staff participates in ongoing and data-based professional development, including topics that address the diverse needs of students and families. [ ] Professional development agendas with learning objectives [ ] Individualized professional development plans [ ] Certificates of completion or sign-in sheets Question 5 ** The program implements a personnel evaluation process. [ ] Performance review policy [ ] Observation form [ ] Individualized professional development plans Question 6 ** The program makes efforts to retain quality staff. Page 5 of 9
[ ] Recognition plan [ ] Appreciation events [ ] Staff Survey Question 7 ** A subgrantee representative has attended all mandatory trainings outlined by the Ohio Department of Education 21st Century team. [ ] Staff Rosters [ ] Certificates of participation [ ] Purchase orders [ ] Individualized professional development plans Programming - Questions: (0/4) - Not Started ** There is evidence of students' choices and voices in program planning and implementation. [ ] Advisory group representation [ ] Completed Student Survey ** Academic activities are based on students' differentiated instructional needs. [ ] Publisher curriculum description with differentiated instructional methods [ ] Lesson plans addressing differentiated instruction ** The program addresses positive youth development by providing diverse recreational, cultural and resiliency-building activities. [ ] Program calendar with program description [ ] Lesson plans [ ] Publisher Curriculum Description Page 6 of 9
** The program enables students to explore community resources and issues in real world contexts. [ ] Lesson plans [ ] Program calendar with program description [ ] Service learning program/project description Sustainability - Questions: (0/5) - Not Started ** The subgrantee collaborates with at least one partner (other than the grant partner) in support of the program goals and objectives. ** The program seeks additional collaborators to address unmet needs and/or to expand and enhance program services. [ ] Memorandum of understanding/agreement ** The program establishes linkages among other federal, state and/or local agencies to connect community resources to the students and families. [ ] Memorandum of understanding/agreement [ ] Parent handbook and community resources [ ] Counseling services and referral forms [ ] Lesson plans connected to resources ** The grantee has a sustainability plan or process in place and efforts support progress towards maintaining and expanding the program and services when 21st CCLC funds expire. Page 7 of 9
[ ] Sustainability plan [ ] MOU/MOA or Board Resolution [ ] In-kind contribution tracking records Question 5 ** The program demonstrates progress toward achieving the goals set out in the formal, written sustainability report. [ ] Progress reports [ ] Achievement data [ ] Completed evaluations (parent, teacher, student) Evaluation and Outcomes - Questions: (0/4) - Not Started ** The program has an internal evaluation process to monitor progress and measure achievement of Program Performance Objectives as written in the grant. The evaluation includes qualitative and quantitative program data. [ ] Plan for evaluating program effectiveness [ ] Evaluation Calendar [ ] Project Timeline ** The program has a comprehensive evaluation report that includes qualitative and quantitative program data. [ ] Analysis of assessment data [ ] Annual report [ ] Evaluation Report ** The program is making progress toward meeting the Program Performance Objectives (including performance benchmarks/indicators) set out in the grant application. [ ] Assessment data and calendar Page 8 of 9
** Program outcomes are shared with program stakeholders, including, but not limited to, parents, students, community and business members. [ ] Annual report Fiscal Component - Questions: (0/4) - Not Started ** The subgrantee has a mechanism in place to review the budget monthly, track expenses and adjust the approved budget, as needed. [ ] Copy of award letter/ccip note from the Ohio Department of Education [ ] Copy of approved budget and any budget revisions from the department. ** The subgrantee submits FERs as appropriate to the department of education by due dates. [ ] Copy of Final Expenditure Report (FER) approved by the department. ** The subgrantee has a current, accurate physical inventory and policy in place. [ ] Current inventory policy (if purchased with 21st Century grant funds) ** The subgrantee has accounting records that are complete and accurate and include Uniform Statewide Accounting System coding. Also must include a report that identifies all grant expenditures that tie back to accountability reports for purposes 21st Century program activities. [ ] Report of all year-end expenditures and Fund 599 USAS Coded Accounting Records [ ] Budget account information (budget ledger) [ ] Detailed financial report sorted by object code [ ] Purchase orders, invoices and cancelled checks for specific transactions [ ] Bank statements for the grant period being reviewed Page 9 of 9