{"text_format":"1","workbook":"xlsx","n_sheets":6,"sheets":["Instructions","Certification and Evaluation","Tenant Survey","Performance Measures","Operating Budget","Lists"],"not_rendered":{"charts":0,"images":1,"macros":0,"external_links":3,"defined_names":103,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Instructions","index":0,"n_rows":37,"n_cols":1,"rows_kept":37,"cut":false,"hidden":false,"merged":[[36,0,52,8],[2,0,6,8],[0,0,1,8],[7,0,13,8],[14,0,21,8],[22,0,35,8]]}
["INSTRUCTIONS"]
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["Pursuant to the Budget Act of 2019 as amended by Section 16 of Senate Bill 109. \nThe Department may implement the activities described in this provision through the issuance of forms, guidelines, and one or more notices of funding availability or requests for proposals, as the Department deems necessary."]
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["Bi-Annual Reporting \nis due to be submitted to the Department no later than 30 days after the reporting period.  For example, a reporting period of July 1, 2020 to December 31, 2020 would have a due date of January 31, 2021 and a reporting period of January 1, 2021 to June 30, 2021, would have a due date of July 31, 2021. All reports must be submitted to: PAS@HCD.CA.GOV.  Please include in your email subject line: Bi-Annual Report, project name and contract number."]
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["Completion of the Reporting Workbook:\nAll fields in which information is requested must be completed by the grantee within the 4 tabs of the reporting workbook.  Reporting workbooks which contain blank information will be considered incomplete and will be returned to the grantee for completion.  Any questions pertaining to the grantees reporting requirements should be directed to the Grant Management Representative assigned to their project. Or submit your email inquiry at PAS@HCD.CA.GOV, if, you do not have your Grant Management Representative information."]
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["Pursuant to Exhibit D, Section 5 of the Standard Agreement as stated under Reporting/Audits, it reads:   \nCommencing with the Effective Date of this Agreement and continuing through the Expiration Date, the Contractor shall submit a biannual report to the Department as follows:  1) If applicable, no later than one hundred and eighty (180) days after the Standard Agreement expires; the applicant shall submit the data as required by the Department to measure the costs and outcomes for each of the beds assisted pursuant to the Program. The Contractor shall work with service providers or other sub-recipients to gather any applicable data.\n2) The Contractor shall report on the sources of participant referrals to the shelter and submit both client data and performance outcome data to the Department. Performance outcome data shall include, but is not limited to, number of participants provided shelter, number assisted by the program, reason for exit, and satisfaction as measured in a survey, length of stay, and locating permanent housing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            \nB.  The Department reserves the right to monitor the expenditures and activities of the Contractor, at the Departments discretion, to ensure compliance with Program requirements   \n"]
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["Pursuant to Section II E 5 & 6 of the Departments PAS Notice of Funding Availability (NOFA) dated December 31, 2019 reads:\nPerformance Measures: Projected measurable outcomes, including the number of participants, reported every six-months through June 30, 2022, that:\n a. Are assisted by the shelter in general;\n b. Are assisted by the PAS program specifically;\n c. Show increased residential stability;\n d. Show increased skills and/or income; \n e. A measurable outcome from a tenant satisfaction survey, as determined by the applicant    (for example does the tenant feel more self-sufficient); and \n f. An additional measurable outcome from a tenant satisfaction survey, as determined by the applicant.\n\nPerformance Measures: An evaluation plan that describes how data will be collected, tracked and analyzed in order to determine the effectiveness of the project. The evaluation plan should include the measurable outcomes, as well as indicate who will analyze the data and perform the PAS program evaluation."]

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["DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT"]
["STATE GRANT MANAGEMENT"]
["2020 West El Camino, 4th Floor"]
["Sacramento, CA  95833"]
["PAS@HCD.CA.GOV "]
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["PET ASSISTANCE AND SUPPORT (PAS) PROGRAM\nBI-ANNUAL REPORTING\nCERTIFICATION AND EVALUATION "]
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["HCD Contract Number:",null,null,null,null,"Reporting Period","Select Reporting Period"]
["Project Name:",null,null,null,null,"Contractor Name:"]
["Project Address (Address, City, State, Zip):",null,null,null,null,"Preparer Name:"]
["Total # of PAS Assisted Beds Available:",null,null,null,null,"Preparer Email:"]
["Total # of Shelter Beds\nAvailable:",null,null,null,null,"Preparer Phone Number:"]
["Certification"]
["On behalf of the entity identified above, I certify that:  The information, statements and attachments included in this report are, to the best of my knowledge and belief, true and correct and I possess the legal authority to submit this report on behalf of the entity identified in the signature block."]
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["Authorized Representative Printed Name and Title",null,null,null,null,"Signature (electronic signature accepted)",null,null,null,"Date"]
["Describe your evaluation plan. Include how you have been collecting, tracking, and analyzing the data (including the data from the measurable outcome category's listed within the Performance Measures Report) on the effectiveness of your project.  Include who is analyzing the data and performing the program evaluation (e.g. staff, consultant, etc.). What are any outcomes of the analysis?"]

{"sheet":"Tenant Survey","index":2,"n_rows":31,"n_cols":4,"rows_kept":31,"cut":false,"hidden":false,"merged":[[0,0,1,10],[30,0,30,10],[3,0,3,10],[31,0,56,10],[4,0,29,10],[2,3,2,10],[2,0,2,2]]}
["PET ASSISTANCE AND SUPPORT (PAS) PROGRAM\nTENANT SURVEY  "]
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["Reporting Period: ",null,null,{"$f":"IF('Certification and Evaluation'!G11=\"\",\"\",'Certification and Evaluation'!G11)","v":"Select Reporting Period"}]
["Tenant Satisfaction Survey - Describe the type of questions asked, which should also include PAS or pet-specific questions. How are the questions reviewed, what do you do with the results, and how often do you conduct the survey. Please submit a copy of your actual Satisfaction Survey. (The results of the survey may be incorporated as part of the other category's under Measurable Outcomes, i.e., satisfaction measured in a survey that would reveal the length of stay and locating permanent housing.)"]
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["Tenant Exit Survey - Describe the questions asked to determine the reason(s) for exiting the shelter. Also provide the reason(s) given for tenants exiting the shelter. Additionally, please submit a copy of your actual Exit Survey. "]

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["PET ASSISTANCE AND SUPPORT (PAS) PROGRAM\nPERFORMANCE MEASURES "]
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["Reporting Period:",null,{"$f":"IF('Certification and Evaluation'!G11=\"\",\"\",'Certification and Evaluation'!G11)","v":"Select Reporting Period"}]
["Number of Participants Assisted by the PAS Program",null,null,null,"Participant's Average Length of Stay (in days)"]
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["Please provide details of participant referrals to your facility, which should include name of referring entity, their address, contact name and phone number and the numer of referrals per entity during the 6 month reporting period. "]
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["Eligible Activity",null,null,null,"Average Cost Per Participant Bed By Activity"]
["Crates and Kennels"]
["Animal Food"]
["Staff for PAS"]
["Veterinarian Services"]
["PAS Liability Insurance"]
["PAS Independent Audit"]
["Comments:  Please provide any additional information describing how PAS funds were expended."]
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["Measurable Outcomes: "]
["Category",null,null,null,"Numerical Outcomes","Participant Outcome Objectives for the next 6 month reporting period"]
["Assisted by the Shelter: Participants assisted by the Shelter in General"]
["Assisted by the PAS Program: Participants assisted specifically by the PAS Program"]
["Total Number of Pets Receiving Behavioral Support Training from Veterinary Services"]
["Total Number of Pets Receiving  Spay/Neuter Veterinary Services"]
["Total Number of Pets Receiving Vaccination Veterinary Services"]
["Residential Stability: Participants that moved to permanent housing"]
["Increased Skills and/or Income: Participants gain job-related skills, job-related training and/or education, gain stipend part-time or full-time supported employment, and access to mainstream service/income support programs for which they are eligible"]
["Other Category: Measurable Outcome as determined from tenant satisfaction surveys"]
["Other Category: Additional Measurable Outcome as determined from tenant satisfaction surveys"]

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["PET ASSISTANCE AND SUPPORT (PAS) PROGRAM\nOPERATING BUDGET"]
[null,null,null,null,null,null,null,null,null,null,null,"Please Select"]
["Reporting Period:",null,null,null,null,null,null,{"$f":"IF('Certification and Evaluation'!G11=\"\",\"\",'Certification and Evaluation'!G11)","v":"Select Reporting Period"},null,null,null,"Yes"]
["Actual Revenues",null,null,null,null,null,null,null,null,null,null,"No"]
["Are the grant funds in an interest-bearing checking or savings account insured by the federal or state government and all interest earned from the deposit of grant funds used for eligible Program activities and accounted for?",null,null,null,null,null,null,null,"Please Select"]
["REVENUE SOURCES:",null,null,null,null,null,null,null,{"$f":"H3","v":"Select Reporting Period"}]
["Private Donations ",null,null,null,null,null,null,null,0]
["Local Government:",null,null,null,null,null,null,null,0]
["State  ",null,null,null,null,null,null,null,0]
["FEMA",null,null,null,null,null,null,null,0]
["Federal (define here)",null,null,null,null,null,null,null,0]
["Rental Income",null,null,null,null,null,null,null,0]
["Fees",null,null,null,null,null,null,null,0]
["Fundraising",null,null,null,null,null,null,null,0]
["PAS Funding",null,null,null,null,null,null,null,0]
["Other (define here)",null,null,null,null,null,null,null,0]
["Other (define here)",null,null,null,null,null,null,null,0]
["Other (define here)",null,null,null,null,null,null,null,0]
["TOTAL REVENUE",null,null,null,null,null,null,null,{"$f":"SUM($I7:$I18)","v":0}]
["Actual Expenses"]
["EXPENSES:",null,null,null,null,null,null,null,{"$f":"I6","v":"Select Reporting Period"}]
["Administration (including admin staff)",null,null,null,null,null,null,null,0]
["Staff (for direct client services)",null,null,null,null,null,null,null,0]
["Accounting & Legal",null,null,null,null,null,null,null,0]
["Rent/Lease",null,null,null,null,null,null,null,0]
["Debt Service (Principal & Interest)",null,null,null,null,null,null,null,0]
["Taxes",null,null,null,null,null,null,null,0]
["Utilities",null,null,null,null,null,null,null,0]
["Insurance",null,null,null,null,null,null,null,0]
["Food-Residents",null,null,null,null,null,null,null,0]
["Crates and Kennels",null,null,null,null,null,null,null,0]
["Food-Animals",null,null,null,null,null,null,null,0]
["Veterinarian Services",null,null,null,null,null,null,null,0]
["Staff (for assisting Pets)",null,null,null,null,null,null,null,0]
["Independent Audit",null,null,null,null,null,null,null,0]
["Liability Insurance",null,null,null,null,null,null,null,0]
["Other (define here)",null,null,null,null,null,null,null,0]
["Other (define here)",null,null,null,null,null,null,null,0]
["Other (define here)",null,null,null,null,null,null,null,0]
["Other (define here)",null,null,null,null,null,null,null,0]
["TOTAL EXPENSES",null,null,null,null,null,null,null,{"$f":"SUM(I22:I40)","v":0}]
["NET OPERATING INCOME",null,null,null,null,null,null,null,{"$f":"I19-I41","v":0}]
["Additional Notes"]
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["Note: if you need to customize this form, please contact your PAS HCD Representative. "]

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[null,"Select Activity"]
[null,"Crates and Kennels"]
[null,"Animal Food"]
[null,"Staff for PAS"]
[null,"Veterinarian Services"]
[null,"PAS Liability Insurance"]
[null,"PAS Independent Audit"]
[]
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[null,"Select Reporting Period"]
[null,"July 1, 2020 to December 31, 2020"]
[null,"January 1, 2021 to June 30, 2021"]
[null,"July 1, 2021 to December 31, 2021"]
[null,"January 1, 2022 to June 30, 2022"]