U. S.

Department of Housing and Urban Development Offi ce of Comnruniryplamrlg and Deveiopment

OMB Approvat 2506_0145 No. (exp.

I I /30/2009)

G@FV
Annuatr Frogress Report(ApR)
for SupportiveHousingprogram Shelterplus Care
and Section8 Moderate Rehabilitation for Single Room O..upancy Dwellings (SRO) prolram

estimated 33 toavsr4gg hoursper incrudins response, *^"_,1T: ;:?:'j;:i,'iffiifffi',""T'.?i1*Xi,':"_r#ffitX"r"r' ror revieu.ing d,; insrucrions, peisis on o.,ui,*n

Public reporting burden for this collection ofinformatior

gii. ;ii # ";,* ;;; ;, ;;; ::: fi :i i::i.11 :#ffi,:ti,n ,,ii,,,"i*l#:,il;:ji::1"ffi:,;i"fr.8"^irffi "il;

:ilX:i#A
H{lD-40118

Instrucfions General
Report (APR) is a reporling tool that I{LID usesto track program progressand Furpose. The Annual Progress f,ndilg. and inform the Deparhnent's conpetitive processfor homelessassistance accomplls,hn-rents grants must subrnit 2 APR'S to IIUD within 90 davs after Filing R.efiuirerrlents.Recipientsof IftID's homeiessassistance the end o't'each operating vear. One copy of the report must be submittedto the Community Planning and Development (CPD) Division Director ia the local IIIID Fieid Office responsible managing grant. The other copy must be subimtted for the to lfUD Headquarters, Departmentof Housing and Urban Development, Atfn: APR Data Editor, Room 7262, 45 I 7ft Sfreet, SW, Washington, DC. 20410. Failure to submit an APR will delay receiving grant fimds and may result in a detennination of lack of capacify for future funding. Ax APR must be submifted for each operatingyear in which HUD fi.mdingis provided. Granteesthat received SHP funding for new construction, acquisition, or rehabilitation are required to operatetheu facilities for 20 years. They must submrt an APR 90 days after the end of the fust operatingyear and every year throughout the 20 years. A separatereport must be submitted for each lfUD grant received. For ShelterPIus Care (S+C), a separate ApR must be submitted for each SfC component. For thosegrantees receivingan extension, separate a report coveringthat period must be submitted(seeExtension below). Recordkeeping. Grantees must coliect and maintain hformation on eachparlicipantin order to completean ApR. Optional worksheetsare altached. The worksheetsmay be used to record information manually or to design a computerizedsyslemto store and tabulate the information. The worksheets should not be submifted to HLID with the ApR. Organization of the Report. The APR is organized in the following m;!nner: Fart I: Project Progress.This porlion of the report describes progress moving homelesspersonsto self-sufficiency, the in documenting servicesreceived, listing project goals, and accounting for beds/units. Part II: Financial Information. and SRO. This portion of the report is completedby all granteesreceiving fu"diog under SHp, S+C,

Final Assembly of Report. After the entire report is assembled, nurnber every page sequentialiy. Mark any questionsthat do not apply to your program qrith "N/A" for not applicable. (See Special Instructions for SSO Projects below.) Definitions of Client/I{ousehold Types. Each clienr4rouseholdflpe is defined below. Note that a client's client&ousehold flpe should be basedon the client's age and,/orhousehold composition at theprogratn entrV date closest to the start of the operating year. Families - A family is a householdcomposedof two or more relatedpersons, least one of who is a cluld accompanied at by an aduit or a juvenile parent. Singles not in Families - Personsnot accompaniedby children, including pregnant women not accompaniedby other children and unaccompanied youth, are shgles not in families. When two adults or two unaccompaniedyouth present togetherfor services, eachpersonshouldbe countedin singiesnot in famiiies.. Clients' householdstafusshoul,C be determined basedon their householdcomposition at the program enfry date closestto the start of the operatingyear. This meansthat pregnantwomen expectedto give birth during their program stay should still be counted as sineles not in families. Adults in Families - Within a family, an adult is any person 18 yearsof age or older. For the purposes ApR reporting, of the determiaation of whether a person is an adult in family should be made based on ther age and householdcomposition at the program entry date closestto the start ofthe operating year. Children in Families - Children in Families are defiaedas childrenuaderthe age of 18 accompanied one or more by adults (parent, relative or guardian). Children in families also include both a juvenile parent and the parent's child(ren). For the purposesof APR reporling, the determination of whether a person is a child in family should be mad.ebasedon their age and householdcomposifion at the program enfry date closestto the start of the operating year. For example, clients who are iess than 18 years 0f age on the frst day of the operating year or at program enfi-y(if they enteredd*r.tg the operating year) should be counted as children even ifthey tum 18 durrng the course ofthe operatingyear.
H UD - 4 0 1 1 8

Fersons in Fainilies - Personsin famrlies includes adults tn famrlies and children rn famthes.

Other Key Definitions. The following terms are used in the APR. As indicated, in some cases,terms are applied differently dependingon whether the funding is from SHP, S+C, or SRO. person - HLID definesa chronicailyhomeless Chronicaily hometress personas "an unacconrpanied homeless individual with a disabling condition u'ho has either been conthuously homelessfor a year or more OR has had at least four (4) episodes homelessness the past three(3) years." To be considered of il chronicallyhomeless, personmust havebeen on a the streets in an emergency or shelter(i.e., not in transitionalhousing)during thesestays. HUD's definition of a cluonically homeless personis basedon the following components: Unaccompanied homelessindividual: an unaccompanied homeless individual has the samecharacteristics of a Srnglenot in a Family (described above). Disabling condition: seethe instructions under disablingcondition (below) to determinewhethera client is disabied. Did not leave the program - This term refersto clientswho were in the programon the last day of the operatingyear. Disabling condition - HIID definesa disablingcondition as: (1) A disability as defired in Section223 of the Social Security Act; (2) a physical, mental, or emotional rmpairment ufuch is (a) expectedto be of long-continued and indefinite duration, (b) substantially impedes an individual's ability to live independently,and (c) of such a nahue that such abilitv could be improved by more suitable housing condifions; (3) a developmentaldisability as defured in section 102 of the Developmental Disabilities Assistanceand Bill of Rights Act; (4) the diseaseof acquired immunodeficiency syndrome or any conditions arising from the etiological agencyfOr acquired immunodeficiency sy.ndrome; (5) a diagnosable or substance abusedisorder. Entered the program - Entered the program refers to the frst day a client receivesservices. For a residential prograrq this date would representthe first day of residencein the program's housing. For services,this date may representthe day of program enrollment, the day a service was provided, or the fust date of a period of continuous participation in a service (e.g., daily, weekly, or montlily). For S+C and SRO programs, the program entry date is the date that the participant starts to receive rental assistance.For S*C, servicesprovided prior to this point are recognizedas necessaryfor outreach/enrollmentand are elieible to count as match. An Extension APR applies to SHP and S+C granteesthat requestedand received an extension of their grant term from the HLD freld office. The only difference between an APR for the extensionperiod and the regular APR (besidesthe amount of time covered) is the signaturepage. Granteesshould circle "yes" to indicate the APR is for an extension penod and circle the operating year for which the report is an extension.For example,if the granteeis extending year 3, the granteeshould submit an APR as usual for year 3 and submit anotherAPR for the extension period, indicating the secondis an extension and also circling year 3 on the signaturepage. Grantee meansa direct recipient of th:HLD award. Left the program - Left the program refers to the last day a client receives services. For a residential prograr4 this date would representthe last day of residencein the program's housing. For services,the exit date may representthe last day a servicewas provided or the last dateof a period of continuousservice. If a client leavesthe program temporarily(e.g., for a hospitaluanon) but is expectedto retum within 30 days, do not count that ciient as having left the program. For S+C programs, the program exit date refers to the date the participant stopsreceiving rental assistance and is not expectedto return to S+C assistedhousing. If the participant returns to S+C assistedhousing within 90 days, the person should not be considered as exithg from the program. If the person returns to S+C assistedhousing after 90 days, that person is considered a new parficipant. The worksheetis designedto captwe this information, Match for S+C is the value of supporlive servicesreceived by participants ia the S+C project which, in the aggregate, must at leastequal the value of the S+C rentalassistance provided over the life of the proj ect. For SIIP, matchis cash
HUD-401 18

rehabilitation,new conshuction,operationsand suppodiveser-vices usedto provide the grantee'sportion of acquisition, expenses. Operating year - For SHP prograrns, fust operatingyear beginsafter development the activitiesfor acquisition, rchahili+qtinn"nd new constructionare complete,after a copy of the Certihcateof Occupancyis sentto the local HIJD nffi.o va've, o-,.{.'.h.' o.u *-..r the first participant is acceptedinto the project. For projects wrthout acquisition, rehabilitation, or new ennqrntetinnthe operatingstart datebegurswhen the granteeaccepts first participant. For dedicated the HMIS projects, rho ^-o-'+i'- "'ar begins when any eligible cost included in the approvedproject budget is incurred. For S+C (SRA, PRA and TRA components),the first operating year begins on the date HUD signs the grant agreement. For S+CISRO and for Sec. 8 SRO, the first operafing year begins with the effective date of the Housing AssistancePa).nnents (HAP) Contract. To determine which operating year to circle on the APR cover page, begin counting from the initial grant operathg start date and include reneq'al grants. For example, a project receiviag an initial grant for three years and a renewal grant for fwo years would circle years 1, 2, and 3 respectively on the APR cover sheetfor the irritial $ant and would circle 4 and 5 respectively for the renewal grant. For any future reneu'al grants, the granteewould begin by circlurg 6 on the ApR cover sheet. Participants - The term participant refers to Singles not in Families and Adults in Famrlies as defined above. participant does not include children or caregiverswho live with the adults assisted. Project Sponsor means the organizationresponsible for carrying out the daily operation of the project, if the organization is an entify other than the grantee. Special Instructions for Supportive Service Onlv (SSO) Programs. SSO grantees should completeall questions, unless a wriften agreementhas been reachedwrth the field office concerning which questionscan be answeredusing estimates, oi in rare instances,skipped. Below is an example of how information could be derived in a large, single-serviceSSO project: A grantee/sponsorstaff member could be assignedto collect hformation from the organizationshousing the participants. The staff person would contact these individual organizationsto request information regarding the persons in that facility that use the service. For participants living on the street,the grantee/projectsponsormay provide estimates. Information could be coilected for eachparticipant or for participants receiviag servicesat a point-in-time. If estimatesor point-in-time counts are used, the method used must be described in the APR and the document'ation kept on f,rle. As with all projects funded under HLID's homelessness grants, granteesoperating SSO projects are expectedto assistance complete alt APR questionsthat are applicable to them. Note that ali projects have been awarded funds as a r.rult of responding to the program goals of assistinghomelesspersonsobtafu/remail in permanenthousing and increasetheu skills and income. The APR documentstheir progress ia meeting thesegoals. In some circumstancesfield offices and granteesmay sign a written agreementconceming questionsthat can be answeredusing estimates,or in rare instances,skipped. Seethe special instructions below for reporting on special types of projects, such as outreach only projects, projects providing servicesto children only, and transportation,medical, dental, and other single, shortdurationserviceprojects. SSO programs are a third priority for local HMIS implementation, following emergencyshelters,transitional housingprogra116, outreachprograms, and permanent supportive housing programs. Once SSO prografirsare included rn the HMIS, SSO grantees will be able to answer all APR questionsusing their HMIS data. SSO granteesthat are not yet parhcipating in HMIS wili need to collect data to answer the APR questionsusing the speciai inshuctions provided above. Outreach Only Projects. Projectswhich are solely devotedto sheet oufreachand comection to housingand services are not required to frack parlicipants beyond their contact u.ith persons on the sfreet. It is sufficient for theseprojects to enter idormafion on questions1-10 (skipping questionsi 1-i3 and 17). Estimatesfor questions 5-9 are a1lowed, given that parlicipants may be reluctant to answerpersonal questions.

HUD-10118

number of people, providing basic Answering the questlonswill demonstratethat the granteeis sewing the appropriate the personsare beirig sewed, demonstrati-ng tipes of demograplic information for Congress,demonstratingthat homeless to, ale ho,rsingparticipants connected and the type ofservices they areleceivulg' are Elotline Projects. Hotlhe services similar to outreach only projects, but contactbetweengranteeand participantis often of very short duration- people enterand leavethe program nearly simuitaneously.It is sufficientfor theseprojectsto answer 4), questions (skipping 10,and 14-19(skipping17). 1-5 Frojects Froviding Services To Children Only. Projectsthatprovide child care,after schoolcare,counselingfor Whilethemainfocusoftheproject children,etc.makeanimportantconhibutiontowardmovingafamtlyoutofhomelessness. is providing servicesto the children, it is the adults who are repofied on in questions 6- I 6 of the APR. Like ail other proj ects, this fype is also targetedtoward getting the families into housing and increasiagthe families' incomes. Granteesmay skip (except 17). question9; all other questions shouldbe answered Transportation, Medical, Dental, and Other Single, Short-Duration Service Projects. Somegrantees provide a single service of fairly short duration focused ONLY indirectly on assistinghomelesspersons to obtail/remain in permanent housing and increasetheir skilis and incomes. It is sufficient for theseprojects to enter fuformation on questions 1-10 and 1419 (question 17 may be skipped). However, with transportation services,it is unreasonableto think that someonervouid have to give their age,race, and ethnicify to a bus driver to get a ride a few blocks. For these services,provide a narrative, which gives the number of rides given during the operating year, and provides estimates on the above statisticsbased on the population that utilZes the service. Special Instr]rctions For Safe l{aven (SH) Proiects. Granteesshould report on all participantsservedduring the operating year. Note: this is a changefrom prior instructions where granteeswere instructed to report on the first 25 participantsserved.

Special Instructions for HomelessManagement trnformation $vstern (HMIS) Proiects. HMISgranrees

should fill out the cover sheetof the APR, Part II Financial Information, and the HMIS Activities section.

HUD-40118

THIS PAGE. TO BE COMPLETED BY ALL GRANTEES

Grantee: City& Countyof San Francisco ProjectSponsor IIUD Grant or ProjectNumber: cAO I c501039 ProjectName:

C'Gptr
07 tat/06- 06t30il07

GP/TODCO-A, Inc.
opet;iing
(mondi/day/year)

KnoxSRO

nl u2 t r 3 D 4 [s n 6 g z x s n e n ro f lll ! 12 nl3 n i 4 l l s n l 6 [1 7 n l 8 D te n 2 0
I n d i ca te xte n sio n : ife from: Indicate ifrenewal: ! ye s M No ro: M Yes I No

Previous GrantNumben for this oroiect

cAO1 040 c301

Checkthe component the programon which you arereportlng. for SupportiveHousingProgram (SHP) LJ I r a n sr u o n a lo u sln g n ShelterPlus Care (S+C) E S f] U Tenant-based (TRA) RentalAssistance (SRA) Sponsor-based RentalAssistance Project-based (PRA) RentalAssistance (S S i ngl e oomOccupancy R O) R Section8 Moderate Rehabilitation tr SingleRoomOccupancy (S ec. S R O) 8

Permanent Housing for n Homeless Persons with Disabilities SateHaven L-l Innovative Supportive Housing n n N Supportive SewicesOnty HMIS

Summary of the project: (One or two sentences with a descriptionof population,number servedand accomplishments operatingyear) this The Knox SRO provides safe permanent housing linked with supportive case management services to homelessindividualswith multiple problems, including serious mental illness.

Name Tjtleof thePerson cananswer & who questions about report: this Marsha Jackson, M. Regional Manager TheJohnStew?4Company Address; 230Fourth Street SanFrancisco, 94103 CA Address rsha@todco.org ma E-mail

Phone: (include areacode) 415-869-141 6 FaxNumber:(includearea code) 41 5-896-0358

I h ere byce rtif y t hat all t he inf or m at ion s t at e dh e r e i n i s t r u e a n d a c c u r a t e . Warningr HUD will prosecutefalse claims and slatements.Convictionmay result in cri U.S.C.l00 l,1010, l0l21 3l U. S. C. 3729. 3802 Name& Title of Authorized GranteeOfficial:

penalties. (18 ature& Date: Signature &Date:

Steohen Adviento. Shelter PlusCareProoram Grants &

NameandTitle of Authorized ProiectSponsorOfficiai: John Elberling, President

GPTODCO, A-lnc.

PART I. TO BE COMPLETED BY ALL GRANTEES(EXCEPT

I{MIS)

SSOGKANTEES, PLEASE SEE SPECIAL INSTRUCTIANS ON PAGE 3 OF THE APR

Part I: Project Progress

roiectedLevel of Personsto be sen ed at a nt in time.
Number of Sing'les Not in Families

a.

Proiected Level Personsto be servedat a given point in time

Numberof Adultsin Families

Number of Children in Families

Number of Families

'18

2.

PersonsServedduring the operating year.

Number of SinglesNot in Families

Number of Adultsin Families

Number of Children in Families

Number of Families

Number on the first day of the operatingyear

14
4

b.

Number entering program during the operating year Number who left the program during the operating year

0 0 0 0

0
U

0
0 0

5
IJ

0 0

d.

Number in the program on the last day of the operating year (a+f-s):6

3.

Project Capacity.
Number of SingiesNot in Families

Number of Adultsin Families

Number of Children in Families

Number of Families

Numberon the lastday (from 2d, columns1 and4) b.

Number proposedin application(from 1a,colunms 1 and 4) Capacity Rate (divide a by b) = %

13 18 '72%

. : ,,ir,i,,., , j -

-, . 1

4.

Non-homelesspersons. This questionis to be completedfor Section8 SRO projects. I ruln

How manyincome-eligible persons non-homeless werehoused theSROprogram by duringtheoperating year?

5. Age and Gender. Of those who entered the project durrng the operating year, how many people are in the following age and gender categories? (fiom 2b. column1 SinelePersons
a.

Aqe 62 and over

lvlale

Female I

b,
d Personsin Families(from 2b. columns 2 & 3) f,
g

51-61 3 1-50

2 1

18-30
17 and under 62 and over

h.
l.
L

k. l. m.

51-61 31-50 18- 30 t3-1-7 6-12 1-5 Under 1

6a,

status' Veterans status. A veteranis anyonewho has ever been on activemilitary dufy f0 |

How many partlcipantswere veterans?

homelessindividual with a disabling condition who has either been 6b. Chronically homelessperson. An unaccompanied in continuouslyhomelessfor a year or more OR has had at least four (4) episodesofhomelessness the past three (3) years. To be consideredchronically homeless a person must have been on the streets or in an emergency shelter (i.e. not transitionalhousing)during thesestays.

individuals? were How manyparticipants chronicallyhomeless

lJ-l

7.

Ethnicity. How many participants are in the following ethnic categories? Hispanic or Latino Non-Hispanicor Non-Latino

b.

8.

Race. How many participants are in the following racial categories? American Indian/Alaskan Native Asian

b.
d. f.
tt.

American Black/African
Native Hawaiian/Other Pacihc Islander

0 0 0
U

White Native& White American lndian/Alaskan Asian& White & Black/AfiicanAmerican White
American Indian/Alaskan Native & BlacVAfrican American

0
0 0 0

OtherMulti-Racial

9a. Special Needs. How many participants have the following? Participantsmay have more than one If so, count them in all applicable categories. For each condition, also indicate the number that were chronically homeless. All b. d. Mental illness Alcohol abuse Chronic

3
I

Drueabuse
HIV/AIDS and related diseases Develoomental disabiliw

Physical disability
b.
L

Domesticviolence

Other(please specify)

0 0

0 0

are 9b. How many of the participants disabled? 4

project? prior Living Situation. How many parlicipantsslept in the foilowing placesin the week prior to entering.the 10. (For each participant, gn*t*shaqig-one plaie. the iotal nun-iberof p pu.ti"irrunisin questior,2b. .olumns 1 and 2). Also, indicatehow many chronically homelesspartlcipantssleptin the following places. (Chooseone) All b. c. d. f
g

Chronic

Non-housing(street.park, car, bus station,etc.) Emergency shelter persons Transitional housinefor homeless

2 1
: t: . -l

Psvchiatric facilitv*
Substanceabusetreatment facility* Hosoital* Jaillnrison* Domestic violence situation

h.
l

:,.L:, ,.
j.ll-

..' i '. i
t

.,, .:';,,

Livins with relatives/friends

Rentalhousine Other (pleasespecify)

"'l i:: i

*If a participantcamefrom an institution (psvchiatricfacility. substance abusetreafmentfacilit],, hospital.or jail). but was there less than 30 days and was living on the street or in emergency shelter before entering the treatment facility, he/she should as be counted in either the street or shelter_category, appropriate.

Completequestions11 - 15 for all participants who left during the operating year (from 2c, columns 1 and 2). The term participant means single personsand adults in famihes. It does not include children or caregivers. The homelessindividual with a disabiingcondition who term chronically homelessperson meansan unaccompanied in has either been continuously homelessfor a year or more OR has had at least four (4) episodesof homelessness chronicallyhomelessa personmust havebeen on the streets in an or the past three(3) years.To be considered emergency shelter (i.e. not transitional housing) during these stays. participants left duringtheoperating of who 11. Amount and Source Monthly Incomeat Entry and at Exit. Of those of year,how manyparticipants wereat eachmonthlyincomelevel andwith eachsource income? Aiso, please placethe monthly personsin the second columnof eachchart. Thenumberof of incomelevel andeachsource incomefor chronicallyhomeless participants ChartA andB shouldbe the same. in AII Chrcnic
A. Monthly Income at AII

C. Income Sources Entry At

I
2

Entry
4..

::'li.: :
3 0 3 0
I

Chronic

No income

Supplemental Security Income

b.

$t - 150

b c d
A A

Social Security Disability Income

Social Security

s15r $250
.l

1$25 $50 0

General PublicAssistance
Temporary Aid to Needy Families State Children's Heaith Insurance Veterans Benefits Employment Income B Unempl orrynent enefits

f
o

s50l- s1,000 $1001s1500 $2000 s1501+ 52001

f
b

h.

h
I

Veterans HealthCare
Medicaid Food Stamps

k
m

Other(please specify) No Financial Resources 1 1

AII B. MonthiyIncome at Exit

No income b d f. h

Chrcnic at Sources Exit D. Jncome . 1

a.

All

Chronic

t'

,!$j";
3 3

Supplemental Security Income

$1-150 $151 S 2 5 0 1 $25 - $ 5 0 0 $501 S 1 ,0 0 0 -

b.
c.

d.
4

Disability SocialSecurity SocialSecurity PublicAssistance General

Temporary Aid to Needy

4 f.
g

$1500 s1001$150 15 2 0 0 0 + $2001

State Children's Health

Veterans Benefits Employrnent Income Unemplo;.rnent Benefits Veterans Health Care Medicaid Food Stamps Other (pleasespecify) No FinancialResources 1
1

h.
j
1,

l.
m. n.

12a. Of those participants who left during the operating year (from 2c, colurnns I and 2), how many were in_theproject for the following lengthsof time? Also, pleaseplacethe length of stay for chronically homelesspersonswho left durins the operating:r'ear in the secondcolumn' A,, chronic
a.

Less than 1 month

b.
d. f.
o

I to 2 months 3 - 6 months
7 months - 12 months l3 months - 24 months

1
z

2
1 1

25 m o n th s -3 y e a rs
4 v ear s - 5v ear s 6 y ear s - Ty ear s

h.
I

8 vears- 10 vears Over 10vears

12b. Length of Stay in Program. For those participants tha+wlq did not leave during the operating year (from 2d, columns 1 and 2), how-long have they beenin the project? Also, pleaseplace the iength of stay for chronically homelesspersons who did not leave during the operatinevear in the secondcolumn. All Less than 1 month Chronic

b.
d. e.

t
g

h.

1 to 2 months 3 - 6 months 7 months- 12months 13months 24 months 25 mo n th s -3 v e a rs 4v e a rs -5 v e a rs 6v e a rs -T v e a rs

8 vears- l0 years Over 10 vears

2
7

2 2
I

t
2
6

2
o

1 year the during operating (from2c,columns and2),how participants lgft theproject who for 13. Reasons Leaving. Of those includeq1!2theprimaryrcdson.Thetotal left If reasons? a participant for multiplereasons, left rnany for thefollowing I ("A11') 2c. in of the should equal number pafiicipants question columns and2. in numterof oarticipants ihe firstcolurrur duringtheoperating -in persons who left theproject vear for place primary reason chronicallyhomeless the Also,please the second column.

Atl Chronic
Left for a housing opportuniry before completing program 1 1

b.

Completed program Non-pay.rnentof rent/occupancy charge

d.

Non-compliance project with

Criminal activity /destruction of property / violence

f.
o

Reachedmaximum time allowed in project

Needs couldnot be metby project

Disagreementwith rules/persons Death

h.

J
t.

Other (please specify) return to family/home of origin, out of state Unkno*m,/disappeared

1

year(from 2c, columnsi and2), how manyleft for-the 14. Destination. Of thoseparticipants who left duringthe operating place destination chronically persons following destination? Also,please the of homeless who left duringtheoperating yearin thesecond column.

AII PERMANENT(a-h)
b. Rental house or apartment (no subsidy)

Chronic

PublicHousing
Section8

d.

Shelter PlusCare HOME subsidized house aDartment or

Other subsidizedhouse oi aDartinent
t

Homeownership

h.

Moved in with family or liiends Transitionai persons housingfor homeless

Moved in with family or friends

(i-j) TRANSTTTONAL INSTITUTION(k-m)

J
L

Psychiatric hospital
Inpatient alcohol or other drue treafinent facilitv

I m EMERGENCYSHELTER(n) OTI{ER (o-q) p'

i

Jail/prison
Emergency shelter

n.

Othersupportive housing (e.g.street) Places meantfor human not habitation Other(please specify)
Unknown

LN{KNOWN

participants left duringtheoperating (from2, columns and2), how many who year 15. Supportive Of 1 Serviees. those place supportive the services duringtheirtimein theproject? Also,please services received following the supportive year participants !g[t duringtheoperating in the second u,ho homeless column.Participants received chronically for nay havereceived and should reported thetable. multiple services all services be in All Chronic Outreach 5 5 Case management 3 3 Life skills(outside case of management)
Alcohol or drue abuse services I

I I

Mentalhealth services
f.
g

HIV/AIDS-related services
Other health care services Education Housingplacement

h.

J
l,

Employrnentassistance Child care

t.
m.
n.

Transportation
Legal

specify) Other(please

I 6. Overall Prosram Goals. Under objectives, list your measurableobjectives for this operating year (from your application, Technical Submission, oi APR) for each of the three goals listed below. Under Progress,describe your progress in meeting the ' objectives. Under Next Operating Year's Objectives, specify the measurableobjectives for the next operating year.

L.

Residential Stabilitv

Objectives: Aftachmeut 16 See Progress: NextOperating Year's Objectives:

b.

Increased Skillsor Income Objectives: SeeAttachment 16 Progress: Next OperatingYear's Objectives:

c.

GreaterSelf-determination Objectives: Attachment16 See Progtess: NextYearOperating Year'sObjectives:

answer (SHPl1c. recipients 17b. answer SRO recipients 17a. answer S+C 17. Beds. SHprecipients SSOprojects do not complete tltis question)
a. SHP. How many beds were included in the application approved for tfils project under 'Current Levei' and undet 'New Effort'? How many of these New Effort beds were actually in place at the end of the operating year'! Current Level Number of Beds: b. S+C. How many beds and dwelling units were being assistedwith project funds at the end of the operating year? (Include beds for all participants, other family members, and care givers.) Number of Beds: Number of Dwelling Units: c. 13 13 New Effort New Effort in Place

SRO. How many dwelling units were being assistedat the end of the operating year? (Include units occupiedby "in place" non-homeless personswho qualify for assistance.) Number of Dwelling Units:

Fart IX: Financial Information

18. Supporlive Services. For Supporlive (SHP), exhibit Housing this provides information HUD on how SHPfundingfor supportive to services spent was during the operating year. Enter amount SHPfunding the of spent these on supportive services. Include HMIS costs undei "Other". For Shelter PlusCare(S+C), exhibit this tracks supportive the services match requirement. Specify valueof supportive the services ftom all sources canbe counted matchthatall homeless that as persons received during the operating year. 1S+C grantees should keepdocumentation file, including on source, amount, q,peofsupportive and services.) For Section SRO, exhibitprovides 8 this information HUD on thevalueof supportive to services received homeless by persons year. during the operating Supporlive Services
Outreach b. Case management Life skills (outsideof casemanagement)
d.

Dollars

$8,357.14 s2,824.r7 s91,493.07

Alcohol and drue abuseservrces Mental heaith services

f.
g

AIDS-relatedservices Other healthcare services Education Housing placement

h.
I

J.
1.

Employment assistance Child care Transportation

m. n o.

Legal Other (pleasespecify) TOTAL (Sum of a through n)

$102,674.38
r,):.',:

Cumulative amount of match provided to date for the Shelter Plus Care Program under this crant

8102,674.38

19. Supportive Housing Frogram: Leasing, Supportive Services, Operating Costs, HMIS Activities and Administration All grantees receivingfunding under the SupportiveHousing Programmust completethesechartseach operatingyear.For expansion projects: IfSHP grant funds are for the expansionofa pre-existing homelessfaciiity, only the people and expenditures the additionalexpansion for may be included,as in the original applicationor any grant amendments. Documentationof resources usedis not requiredto be submittedwith this report but shouldbe kept on file for possibleinspection by HUD and Auditors. Do not include any expenditures madebefore the SHP grant was executed. Summary of Expenditures. Enter the amount of SHP grant funds and cashmatch expendedduring the operating year for each activity. This table should add up both horizontally and vertically. The SHP supportiveservices total shouid be the sameas the SHP supportiveservices in

TotalExpenditures

SupportiveServices

HMIS Activities
Administration

Note: Pa;'rnents of principal and interest on any loan or mortgage may not be shown as an operating expense.

Sources of Cash Match. Enter the sourcesof cash identified in the Cash Match column, above, in the following categories. Use additional sheets, necessary. as Amount Grantee/project sponsor cash

b.

(please Local government specify)

State govemment (pleasespecify)

d.

Federal government (pleasespecify) Community DevelopmentBlock Grant (CDBG)

Foundations(pleasespecify)

Privatecashresources (please specify)

Occupancycharge/ fees Total

h.

t0

20. Supportive l{ousing Frogram:

Acquisition, Rehabilitation,

and New Construction

must completethesechartsin the year or that receivedSHP funds for acquisition,rehabilitation, new construction A11grantees one APR has contributedenoughcashto at leastequally match the amountof only. This exhibit will demonskateto HtiD that the grantee that matchingfunds were provided is not SHP funds spentfor acquisition,rehabilitation,or new construction. Documentation but shouldbe kept on fi1efor possibleinspectionby HL]D and Auditors. ired to be submittedwith this during the operatingyear for each Summary of Expenditures. Enter the amountof SHP grant funds and cashmatch expended activity.

SHPFunds
a.

Cash Match

TotalExpenditures

Acquisition Rehabilitation New construction

b.

d.

Total

Cash Match. Enter the sourcesof cashidentified in the CashMatch column, above,in the following categories. Use additional sheets. necessarv. as

Amount
a. b. Granteeiproject sponsor cash Locai government (pleasespecify)

State govemment (please specify)

u.

Federal govemment (please specify)

Development Block Grant(CDBG) Community

(please specify) Foundations

f.

Private cashresources(pleasespecify)

Occupancycharge/fees

h.

Total

ll

FOR HMIS ACTIWTIES O]YLY

21. For Supportive llousins (SHP) - HMIS Activities This exhibit providesinformation to HUD on how SHP-HMiS funding for supportiveservices was spentduring the operating year. Enter the amount of SHP-HMIS funding spenton theseactivities.

HMIS Activities Onl Cenhal Server(s) PersonalComouters and Printers

Software/ User Licensins Software Installation Support and Maintenance

Supporting Tools Software

Training by Third Parties i Technical Services Programming: Customization Programming: System Interface Programming: Data Conversron

Security Assessment Setup and

On-line Connectivitv flnternet Access Disasterand Recoverv

Project Managementi Coordhation Data Analvsis Technical Assistanceand Trainins

Administrative Support Staff

Subtotal

OperationalCosts

l2

year. implemented Describe problems any and/orchanges during the operating

Technical Assistanceand Recommendations Basedon your experience during the last year, are there any areasin which you needtechnicaladviceor assistance? Ifso, please describe.

IJ

SPCRKnox cAO1csO1039 ReportingPeriod: 7 ll/06-6130107 Residential Stability :

Objective: 70%of parlicipants remain S+Chousing at least year. will in for one Progress: Exceeded.13 out of 14participants 92%o or ofparticipants remained S+Chousing at leastoneyear. in for Next Operating Year'sObjective: 70Yo participants remainin S+Chousingfor at leastoneyear. of will objective: 35%of participants remainin S+c housing at leasttwo years. will for Progress: Exceeded. out of 13participants 610/o S or ofparticipants remained S+Chousingfor at leasttwo year. in Next Operating Year'sObjective: 35"/,of puticipantswill remainin S+Chousingfor at leasttwo yeai objective: 100%of participants pay somerent duringthe operating will year. Progress: Achieved.l2out of I3 participantsor 92%o ofparticipants paid somerent duringthe operating year. Next Operating Year'sObjective: 100%of participants paysomerent duringthe operating will year. Increased Skills or Income: Objective: Progress:
25Yoof participants will enter or continue part- or full-time employment or vocational training program during the operatingyear. Not achieved: I out of 13 participantsot 7.60/o ofthe participantsenteredor continuedpart- or full+ime employment or vocational training program during the operating year.

NextOperating Year'sObjective:

25Yo participants enteror continue of will part- or full-time employment vocational or hainingprogram duringthe operating year.

15%wlll eitherenteror continue an educational in program duringthe operafing year. Objective achieved.No participants not deemed ableto enteror continue educational an program were successful obtainingsuchresources. in Next Operating Year'sObjective: 15%wllleither enteror continue an educational in program duringthe operating year. 50%will obtain/sustain 5% will obtain/sustain benefits, SSI, VA 15%will obtain/sustain CAAp. and5%wiil obtain/sustain employment. Progress: Exceeded Objective: 12 out of 13participants 92o/o or obtained,/sustained ofthosehoused theendof SSI at theoperating year, NextOperating Year'sObjective: 50%will obtain/sustain 5% will obtain/sustain benefits, SSI, VA l5% will obtain/sustain CAAP, andSYo obtain/sustain will employment. 50Yo participants GA at their dateof entryinto theprogramwill havemovedon to of on SSI/VAISSDVSS/SSA,eligible,or obtainemplolnnent if incomeby the endof the operating year. Progress: Exceeded. out of 13participants 100%o 13 or ofparticipants GA at their dateofen1ryinto ihe program on havemoveon to SSI/VA/SSDVSS/SSA,eligible,or obtained if employment incomeUyttreenaof tn'e year. operatmg Next Operating Year'sObjective: 50% of participants GA at their dateof entryinto theprogram on wili havemoved to on SSIA/A/SSDVSS/SSA, if eligible, obtainemployment or income theendof the by year. operating
Objective: Progress:

Objective: Progress:

Objective:

Objective:

80%will either secure representative services, payrenton time on theirown. payee or Exceeded.13 out of l3 participants 100%eithersecured or representative payeeservices, paidrenton or time on their own.

Next OperatingYear's Objective: 80% will either securerepresentatlve payeeservices,or pay rent on time on their own.

ATTACHMENT

L4

Gr eater Self-deter minatio n : 35% of residentswill participatein residentmeetingduring the operatingyear. Not achieved.4 out of 13participants 30Yo residents-.s or of partlcipated resident in meetings duringthe operating year. Supportive services continue to,encourage risidentsto participate suchmeetingsl in Next operatingYear'sobjective: 35% of residents participate risident meetings will in Jurillih" op.."tir,g y.2,.. Objective: 65%will participate peer/social in actiyities. Progress: Exceeded.13out of 13participants l}}Toparticipated peer/social or in activities. Next operatingYear'sobjective: 65%will participate peir/social in activiries. 75% vnll sustain renewcommunications friendsand/orfamily members. or with Not achieved'7 out of l3 participants 53Yo or sustained renewed or communications friendsand./or with familymembers. Next Operating Year'sObjective: 7i%willsustain or renewcommunications friendsand,/or with family members. 20%will engage volunteer in activities. Exceeded" out of 13participants 23o/oengagedvolunteer 3 or in activities.Supportive Services continues to encourage participationin suchactivities. Next operatingYear'sobjective: 20%willengagein volunteer activities. Objective: Progress:
Objective: Progress:

objective; Progress:

ATTACIIMENT

15