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<br />Place an <br />"X" next to <br />one Activity/ <br />Activity Program City Outcome Tracking Goal HUD Outcome Tracking HUD Goal <br /> Youth Services 1. Track improvement in 1. For education-based Number of persons assisted: Accessibility for the <br /> pre-test, post-test scores. programs, improve pre-test -with new access to a service purpose of creating <br /> post-test scores by 50% -with improved access to a service Suitable Living <br /> -where activity was used to meet a quality Environments <br /> standard or measurably improved quality, <br /> report the number that no longer only <br /> have access to substandard service <br /> 2. Track number of 2. Provide opportunities for Number of persons assisted: Accessibility for the <br /> individuals exposed to the exposure to the fine arts. -with new access to a service purpose of creating <br /> fine arts. -with improved access to a service Suitable Living <br /> -where activity was used to meet a quality Environments <br /> standard or measurably improved quality, <br /> report the number that no longer only <br /> have access to substandard service <br /> 3. Track children/youth 3. 90% of children/youth Number of persons assisted: Accessibility for the <br /> seeking referrals that were seeking referra Is will be -with new access to a service purpose of creating <br /> linked to the services linked to the services -with improved access to a service Suitable Living <br /> sought. sought. -where activity was used to meet a quality Environments <br /> standard or measurably improved quality, <br /> report the number that no longer only <br /> have access to substandard service <br /> Low- and Track program participants 90% of program Number of persons assisted: Accessibility for the <br /> Moderate- that were linked to services participants will be linked to -with new access to a service purpose of creating <br />X Income sought. services sought. -with improved access to a service Suitable Living <br />Services -where activity was used to meet a quality Environments <br /> standard or measurably improved quality, <br /> report the number that no longer only <br /> have access to substandard service <br /> <br />Describe how you will gather the tracking information, noted above, for that activity. <br /> <br />Each client is referred to Women Helping Women by an organization or agency with whom we have established a <br />working relationship. All clients must bring a client referral form (created by Women Helping Women) completed and <br />signed by a case manager or other qualified individual from the referring agency. The referring agency has the <br />responsibility to verify/qualify the client as to income prior to making the referral to WHW. <br /> <br />Prior to receiving services, each client must complete a Client Intake Form (attached) and provide appropriate photo <br />identification. Clients complete demographic information relative to their permanent street address, age, social security <br />number, driver's license or 1.0. number, race and ethnicity, income, number of dependents, household size and other <br />information relevant to service needs and our established requirements for service. Clients must sign as to the accuracy <br />of the information they provide, and the form informs them of the requirements of Title 18, Section 1001 of the U.S. Code <br />regarding making false or fraudulent statements. <br /> <br />Each client served fills out an evaluation form to measure quality of service as well as satisfaction. <br /> <br />Exhibit A-1 <br />Page 3 of 3 <br /> <br />- <br />