Client Categories Biological Parents Wards Unity Housing Clients AIDS Housing Clients Other Client or Community Population Gender Males Females Client or Community Population Age Under 12 O 12 - 17 18 - 29 30 - 49 50 - 64 Over 64 Client or Community Population Major Religious Groups Catholic Jewish Islamic/Muslim O Protestant None Other (please specify) Client or Community Population Annual Family Income $13,000 $13,001 - $20,000 $20,001 - $30,000 Over $30,000 Client or Community Population Racial/Ethnic Composition Hispanic/Latino American American Indian/Alaskan Native Pacific Islander (non-Pacific Islander White Race (please specify) Client or Community Population Major Language Groups English Spanish Other (please specify)
C. Counseling Program 1. % achieve successful termination outcomes D. Focus Hope I, II, III, UMOJA, Ignite 1. ? % remain drug free or are involved in recovery services 2. ? % obtain employment 3. ? % participate in educational services 4. ? % of school age children participate in educational services 6. ? % participate in medical services 7. ? % participate in psycho/social services 8. ? % remain in permanent housing E. Harmony Village 1. ? % obtain employment 2. ? % participate in educational services 3. ? % achieve permanent housing 4. ? % remain drug free 3. Personnel A. Total Employees 1. B. Turnover 1. % 4. Tactical/Strategic Planning Update Status of each goal 5. Community Relations & Program/Resource Development, A. Grants/RFP’s submitted B. New Programs Started C. Fund raising events that took place and amounts collected Net gain D. Speeches/presentations given E. Focus Groups held F. Other notable/newsworthy Events; e.g. awards received G. News Articles submitted. Risk Management A. Grievances 1. Staff % resolved to the employee’s satisfaction 2. Consumers % resolved to the consumer’s satisfaction 3. Foster parents % resolved to the employee’s satisfaction B. UIR.s 1 Foster Care 1. # 2. CAP created CAP completed 2. Harmony 1. # 2. CAP created CAP completed 3. Focus Hope II 1. #
The R/QM Team will prepare a Corrective Action Plan whenever deficits violate agency thresholds. REPORTS REVIEWED ANNUALLY BY THE R/QM TEAM: ANNUAL CONSUMER PROFILE REPORT (ALL PROGRAMS) The Consumer Profile Report isolates the reasons for service, analyzes this data to improve service planning for different categories of clients, adjusts to changing circumstances when new trends surface and plans for offering new services. If trends are noted, the R/QM Team may make recommendations to the Executive Team to expand services or implement new approaches to service delivery. The Facilitator of the R/QM Team will report its findings and recommendation to the Administrative Assistant (R/QM). ANNUAL SURVEY DATA REPORTS A. The Consumer Service Experience and Satisfaction Survey is an aggregate measure of critical questions associated with client services and satisfaction. The R/QM and Executive Teams analyze this data to strengthen Unity’s service provision. B. The Employee Employment Experience Survey is an aggregate measure of critical questions associated with employee morale and stability. The R/QM and Executive Teams analyze this data to strengthen its employee developmental opportunities. The Survey also aggregates the measure of the employees’ satisfaction with leadership, the workload and/or caseload, their physical environment, communications, professional development and training, potential for advancement within the agency. The R/QM and Executive Teams analyze this data to strengthen its employee productivity. D. The Foster Parent Service Experience Survey is an aggregate measure of Unity’s level of recognition by agencies in the community. The R/QM and Executive Teams analyze this data to strengthen Unity’s role in the community. ANNUAL PERFORMANCE ANALYSIS AND TACTICAL PLANNING REPORT The Performance Analysis and Tactical Planning Report analyses the agency’s performance and its ability to carry out functions to meet its goals in the past year. The report then goes on to project goals for the coming years. This report incorporates Quality and Risk Management and includes the status of achievement of strategic goals, changes in those goals and new or revised contract outcomes. REVIEW BY EXECUTIVE TEAM The Executive Team reviews recommendations from the Cross-Program R/QM Team meetings as well as Quarterly Financial Reports. When reviewing R/QM data the Executive Team may request the attendance of the following: Facilitator of the Cross-Program R/QM Team Member of the Board of Directors A Consumer Advisory Committee Member A Foster Parent Advisory Committee Member
his/her vulnerability to maltreatment Yes No condition contribute to current report of maltreatment? Yes No become significant to the ongoing safety of the child? Yes No Describe child’s emotional/mental health condition: has a developmental condition that increases his/her vulnerability to maltreatment Yes No If yes, did the child’s developmental condition contribute to current report of maltreatment? Yes No Is the child’s developmental condition likely to become significant to the ongoing safety of the child? Yes No Describe the Child’s developmental condition: behavior increases his/her vulnerability to maltreatment Yes No If yes, did the behavior contribute to current report of maltreatment? Yes No Is the behavior likely to become significant to the ongoing safety of the child? Yes No Describe the pattern of child’s behavior: Child’s lack of an adequate support system increases his/her vulnerability to maltreatment Yes No If yes, did the lack of an adequate support system contribute to current report of maltreatment? Yes No Is the lack of an adequate support system likely to become significant to the ongoing safety of the Yes No Describe the Child’s support system: and caretaker interactions are generally negative or conflictual. Yes No If yes, did the child/caretaker interactions contribute to current report of maltreatment? Yes No Is this dysfunctional child/caretaker interaction likely to become significant to the ongoing safety of the child? Yes No Describe the pattern of Child/Caretaker interaction:
Caretaker Factors Caretaker demonstrates lack of impulse and anger control. Yes No If yes, did the caretaker’s inability to control their anger contribute to current report of maltreatment? Yes No Is this inability to control anger or impulsivity likely to become significant to the ongoing safety of the child? Yes No Describe the caretakers impulsivity/anger control: Paramour has a negative or conflictual relationship with the children in the family? Yes No N/A If yes, did the actions of the paramour contribute to current report of maltreatment? Yes No Is the paramour’s presence/actions likely to become significant to the ongoing safety of the Yes No Describe the paramour’s relationship to other family members: Caretakers lack an adequate support system. Yes No If yes, did the caretaker’s lack of an adequate support system contribute to current report of maltreatment? Yes No Is this lack of an adequate support system likely to become significant to the ongoing safety of the child? Yes No Describe the caretaker’s support system: Caretaker’s/paramour’s physical interferes with the provision of adequate child care or supervision Yes No If yes, did the caretaker’s/paramour’s physical condition contribute to current report of maltreatment? Yes No Is the caretaker’s/paramour’s physical condition likely to become significant to the ongoing safety of the Yes No Describe the caretaker’s/paramour’s physical condition: Caretaker’s/paramour’s emotional/mental health interferes If yes, did the alleged or observed mental illness contribute to the current report of maltreatment? Is the alleged mental illness likely to become significant to the ongoing safety of the child?
with provision of adequate child care or supervision. Yes No Yes No Yes No Describe the caretaker’s alleged or observed emotional/mental illness: Caretaker’s/paramour’s developmental disabilities interferes with provision of adequate child care or supervision. Yes No If yes, did the caretaker’s paramour’s developmental disabilities contribute to current report of maltreatment? Yes No Is the caretaker’s/ paramour’s developmental disabilities likely to become significant to the ongoing safety of the child? Yes No Describe the caretaker’s/paramour’s developmental disabilities: Caretaker’s/paramour’s use or misuse of alcohol and/or drugs interferes with provision of adequate child care or supervision. Yes No If yes, did alleged or observed substance abuse problem contribute to current report of maltreatment? Yes No Is the alleged substance abuse problem likely to become significant to the ongoing safety of the child? Yes No Describe the caretaker’s alleged or observed substance abuse problem: In allegations of sexual abuse, the caretaker/paramour demonstrate an inability to believe and support child victim of sexual abuse Yes No If yes, did the caretaker’s inability to believe and support child victim contribute to current report of maltreatment? Yes No Is the caretaker’s/paramour’s inability to believe and support child victim likely to become significant to the ongoing safety of the child? Yes No Describe the caretaker’s/paramour’s level of support to the child victim: Caretaker/paramour has a history of perpetrating sexual Yes No If yes, did the caretaker’s or paramour’s history as perpetrator of sexual abuse contribute to current report of maltreatment? Yes No Is the caretaker’s or paramour’s history as a perpetrator of sexual abuse likely to become significant to the ongoing safety of the child? Yes No Describe the past history of sexual abuse
Caretaker’s/paramour’s criminal behavior or background poses immediate or continuing threat to child Yes No If yes, did the caretaker’s criminal behavior and background contribute to current report of maltreatment? Yes No Is this criminal behavior and background likely to become significant to the ongoing safety of the child? Yes No Describe the caretaker’s/perpetrator’s criminal behavior and history (include LEADS results if available): Perpetrator’s access to the child poses immediate or continuing threat to the child Yes No If yes, did the caretaker’s ability to access the child contribute to current report of maltreatment? Yes No Is the caretaker’s ability to access the likely to become significant to the ongoing safety of the child? Yes No Describe the caretaker’s level of access: PARENTING FACTORS Caretaker’s lack of capacity to parent poses immediate or continuing threat to child Yes No If yes, did the caretaker’s inability to parent contribute to current report of maltreatment? Yes No Is this inability to parent likely to become significant to the ongoing safety of the child? Yes No Describe the caretaker’s capacity to parent: Caretaker’s interactions with child are negative or conflictual Yes No If no, did the caretaker’s inability to control their anger contribute to current report of maltreatment? Yes No Is this inability to control or impulsivity likely to become significant to the ongoing safety of the child? Yes No Describe the caretakers level impulsivity/anger control: FAMILY FUNCTIONING History of abuse or neglect in the family increases risk of harm to child Yes No If yes, did the prior history contribute to an escalated level of risk in the current report of maltreatment? Yes No Is the prior history likely to become significant to the ongoing safety of the child? Yes No Describe the history of abuse or neglect in the family: