Parent Name: Student Name: Parent Name: Student Name: Parent Name: Student Name: 21st Century Community Learning Centers Program Compliance Assessment Area of Compliance Examples of Supporting Documentation Implementation Status Comments Program Management Separate accounting of funds for 21st CCLC Financial reports WVEIS financial reports Yes No In Progress The fiscal agent draws and expends 21st Century funds according to OMB-A-21 or Federal funds may not be maintained as “cash on hand”. Financial records Budget revisions Reimbursement request financial report Yes No In Progress Materials and equipment purchased with 21st Century funds must have description, serial or ID number, acquisition date and cost, percent of federal funding used, location, use and condition of property, ultimate disposition date/date of disposal/sale price. Physical inventory of property must be taken at least once every 2 years. Must have a checkout process. POs/Invoices Inventory kept according to EDGAR 80.32 Yes No In Progress Supplies, materials and equipment purchased with 21st Century funds are used for the intended purposes. Requisitions of purchases Schedule of activities listed in grant Teacher Lesson/Activity Plans Yes No In Progress
Program is meeting the needs of low socio-economic students. Data needs assessment Activity log/lesson plans Data tracking student progress Student or parent survey or focus group interview Yes No In Progress Program accommodates children with special needs and encourages their participation in the program. Special accommodation information Specially trained staff Student data Special Ed. correspondence Yes No In Progress The approach and entrance to the program site is safe and accessible for everyone. American with Disabilities Act certification (ADA) Pre-site observation checklist Program director confirmation (verified on monitoring visit) Yes No In Progress The layout of the building allows people with disabilities to obtain materials and services without assistance. American with Disabilities Act certification (ADA) Pre-site observation checklist Program director confirmation (verified on monitoring visit) Yes No In Progress Restrooms are accessible to all participants. American with Disabilities Act certification (ADA) Pre-site observation checklist Program director confirmation (verified on monitoring visit) Yes No In Progress Program attendance is monitored. Data system Parent/student handbook policy Attendance policy Yes No In Progress Provide documentation of how many students are currently enrolled in program. Master list of students enrolled Data system Yes No In Progress Appropriate staff-to-student ratio exists for activities? Student daily attendance roster Staff daily attendance roster Program schedule Yes No In Progress
Participation of youth/family members involvement in program planning. Parent surveys Student surveys Parents serving on Advisory Council Other: please explain Yes No In Progress Provide documentation on how parents of participating students are notified of experiences, achievement and behaviors in the program. Correspondence Parent Meetings Phone logs progress reports Other: please explain Yes No In Progress Area of Compliance Supporting Documentation Compliance Status Comments Plan Management structure supports the achievement of the approved objectives within the approved timelines and budget. Program schedule Grant application Staffing Budget narrative Yes No In Progress Plans for staff development and staff input. Training agenda Professional dev. plan Staff sign in sheet Handouts/materials Description of the training Staff meeting minutes Yes No In Progress Volunteers are recruited and trained to work in the program. Volunteer sign in/timesheets Advertisement/PR Volunteer training agendas/plan Volunteer Handbook Yes No In Progress Communication is established between program and school day staff to supplement regular school day activities Faculty meetings minutes Correspondence Staff Surveys Student Data Collaborative meetings Advisory council meetings Descriptions of program activities Yes No In Progress
Verifies that center staff is aware of program goals and can explain the relationship of the day to day activities to program goals. posted in center handbook Program brochures/newsletters Advisory Council minutes Staff training agenda Yes No In Progress Process used to evaluate program staff. Evaluation instrument Completed evaluations Yes No In Progress Area of Compliance Supporting Documentation Compliance Status Comments Project Evaluation Evaluation measures have been collected related to the project outcomes. WV Data system Surveys Continuous improvement Student data Parent data Other: please explain Yes No In Progress Changes in program design have been made based on feedback given. Peer learning teams Continuous improvement action plan Continuation report Monitoring tool Teacher survey Advisory council Student/parent surveys Other: please explain Yes No In Progress Sustainability The program has made efforts to gain other sources of funding or in-kind resources for program sustainability Description of grant Applications/awards In kind resources pursued Advisory council minutes Partnerships Yes No In Progress Supports a plan for sustaining the program after the funding ends. Updated strategic/sustainability Plan Advisory council minutes Yes No In Progress Partnerships and Collaboration
The programs mission, activities and services have been advertised in the community using a variety of techniques Newspaper articles/Newsletters Special events/programs School postings Other: please explain Yes No In Progress Partner/contractors are aware of the program goals of the center. Meetings Communication Program brochure MOUs/Agreements/contracts Other: please explain Yes No In Progress Area of Compliance Supporting Documentation Compliance Status Comments Collaborative partners have provided programs and services in accordance with the application. Partners agreements/contracts MOUs/program activity schedule WVEIS /financial reports Presentation evaluation Yes No In Progress Center staff continues to develop and enhanced relationships with new and/or current community partners. Program schedule Program correspondence Partners agreements/contracts WVEIS /financial reports Meeting minutes/agendas Other: please explain Yes No In Progress Safety, Health, and Nutrition Vehicles used for transportation have been inspected for safety on a regular basis. Transportation logs Inspection information please explain Yes No In Progress The program provides nutritional snacks/supper during program operation. Records of USDA snacks/supper implementation Yes No In Progress The program emergency contact information for students and staff is maintained in a central location. Staff emergency contact information Student emergency contact information Yes No In Progress
Parental consent is required for student surveys, student records/ information, pictures, Internet usage and field trips Teacher survey consent forms Permission Other consent forms Yes No In Progress The program has established procedures for authorized student and communicated these to staff and families. Parental release forms Parent/student handbook Registration form Sign-in/Sign out Other, please explain Yes No In Progress The staff, students, and parents are informed of the program’s emergency readiness plan. Emergency Exit Plan Snow Closing Plan Staff meeting minutes Program handbook Parent/Student handbook Correspondence Handouts Evacuation and relocation plan Disaster plan Other, please explain Yes No In Progress Addendum Site Monitor’s Form INSTRUCTION DOCUMENTATION COMMENTS CORRECTIVE ACTIVE REQUIRED Purchased Professional & Technical Services Contracts/Invoices, specific dates and rates of product or service. Other Purchased Services Contracts/Invoices, specific dates and rates of product or services. Supplies & Materials Purchase orders, invoices specific costs, tied to application time lines and activities. SUPPORT SERVICES DOCUMENTATION COMMENTS CORRECTIVE ACTION REQUIRED Purchased Professional & Technical Services Specific dates, rates, salary and product/service. Date of hire consistent with approved application. Purchased Professional Education Services (Subgrant Cost Summary) Documentation for Sub grant budgets is the same as Lead agency.