Survey of Faith-based and Community Organizations

OMB No. xxxx-xxxx

Expiration Date: xx/xx/xxxx

Compassion Capital Fund Evaluation

Targeted Capacity Building Program

Survey of Faith-based and Community Organizations

The Office of Community Services, Administration for Children and Families (ACF) within the Department of Health and Human Services is conducting a study to examine the benefits of the Targeted Capacity Building (Mini-Grant) Program funded through the Compassion Capital Fund (CCF). ACF has contracted with Branch Associates, Inc., and their sub-contractor, Abt Associates, Inc., to carry out the study.

As part of a larger study of the CCF program, we are surveying organizations that received a CCF Mini-Grant in 2003, 2004, and/or 2005. Our records indicate that your organization received a Mini Grant in 2003 [2004 or 2005]. Your participation in completing this survey will greatly benefit the Compassion Capital Fund program. Information you provide will assist the Administration for Children and Families in assessing and improving the CCF program in general and the Targeted Capacity Building Program specifically.

Please note that responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across organizations and will not associate responses with a specific organization or individual. We will not provide information that identifies you or your organization to anyone outside the study team, except as required by law. Completing this survey is voluntary.

Instructions:

Please complete the following questions to help us evaluate the CCF Mini-Grant program. Please answer each of the questions in this survey about the primary recipient of the Mini-Grant award. Throughout this questionnaire, the primary recipient will be referred to as “your organization.”

Please make a copy of the completed survey for your records prior to sending the completed document back to Branch Associates. Research staff may contact you if clarification is needed for any of your responses.

Please return this survey in the enclosed pre-stamped envelope by (to be inserted: 30 days). Thank you for your time in completing this survey!

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this data collection instrument is xxxx-xxxx. The time required to complete these worksheets is estimated to average 30 minutes per response, including the time to review instructions, search existing data sources, gather the data needed, and fill in the survey

1. Name of the organization that was the recipient of the CCF Targeted Capacity Building Program Grant (Mini- Grant):

2. Street Address

City:_____________________________________ State: ________________Zipcode_____________________

3. Name of the individual primarily responsible for completing this survey:

____________

4. Title: __________________________________________________________

5. How long have you been with the organization?

• 1 year

• 2 years

• 3 years

• 4 years

• Over 4 years

6. Phone number:__________________________________________

7. Email address: __________________________________________

8. Check the box that best describes your Organization: (check one)

₁ Faith-based organization ₂ Secular organization

9. What is/are your Organization’s current primary programmatic area(s)? (Check all that apply)

1	Abstinence	8	Homelessness/housing assistance
2	At-risk youth/children and youth services	9	Hunger
3	Drug and alcohol rehabilitation	10	Job training/welfare-to-work
4	Economic/community development	11	Marriage/relationships
5	Education/training	12	Prison services or prisoner reentry services
6	Elderly/disabled services	14	Rural community services
7	Health Services (including HIV/AIDS/pregnancy)	13	Services to immigrants (including ESL)
		15	Other (Specify:) _________________________

10. Is your organization currently:

₁ Unincorporated

₂ Incorporated, but hosted by a 501 (c) (3) organization that serves as a fiscal agent

₃ In process of obtaining 501(c) (3) status

₄ 501(c) (3) organization Date received 501(c) (3 ) ___________

₅ Other (specify)________________________________________________

11. In what year was your organization formed? _______________________

12. In the last completed fiscal year, what were your organization’s total expenditures? _________________

13. Please indicate the current number of staff in your organization

Paid staff

Full-time (30 or more hours per week) #

Part-time (Less than 30 hours per week) #

Unpaid Staff/Volunteers

Full-time (30 or more hours per week) #

Part-time (Less than 30 hours per week) #

14. Is the head of your organization (e.g., the executive director) a paid position?

₁ Yes, paid full-time salary

₂ Yes, paid part-time salary

₃ No, not a paid position

15. We would like to know about the number of people your organization serves. Please give your best estimate of the total number of individuals and/or families your organization served in the most recent month of full service delivery:

____________# served

• We do not provide services to individuals or families

16. How did your organization learn about the availability of the CCF Mini-Grant Program? (check all that apply)

₁ Notice from a mailing list (or email list)

₂ Conference or other gathering of faith-based and community organizations

₃ General web search for possible funding sources

₄ Personal/professional network (word of mouth)

₅ Other (please specify)___________________________________________

17. Use the table below to indicate any other organizational capacity building assistance your organization received from 2003-2006 (in addition to the CCF Mini-Grant).

Year	Received financial assistance (sub-award or direct grant) in addition to the CCF Mini-Grant	Received customized one-on-one technical assistance	Received training (i.e. classes, workshops)	Was any of this assistance provided by a CCF-funded Intermediary?
2003	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	1 Yes; Name_______________________ 2 No 3 Don’t Know
2004	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	1 Yes; Name_______________________ 2 No 3 Don’t Know
2005	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	1 Yes; Name_______________________ 2 No 2 Don’t Know
2006	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	1 Yes; Name_______________________ 2 No 2 Don’t Know

The rest of this survey is focused on learning how the CCF Mini-Grant affected your organization.

18. Did the Mini-Grant enable your Organization to start a new program?

₁ Yes (Proceed to Question #18a)

₂ No (Proceed to Question #19)

18a. If yes, was your Organization able to sustain this new program after the Mini-Grant funds ran out?

₁ Yes  Please explain how your organization sustained the new program: (check all that apply)

₁ New funding source

₂ Replaced paid staff with volunteers

₃ New partnership with another organization

₄ More efficient use of existing resources; describe __________________

₅ Other (please explain) __________________________________

₂ No

19. Did the Mini-Grant enable your Organization to serve more clients (families or individuals)? (check all that apply)

₁ Yes, we expanded an existing program or service  Indicate the number of additional clients: #______

₂ Yes, we started a new program  Indicate the number of additional clients: #_____

(If yes to either above, proceed to #19a and 19b)

₃ No (Proceed to Question #20)

19a. Was your Organization able to sustain this number of clients after the Mini-Grant funds ran out?

₁ Yes (If yes, proceed to question #19b)

₂ No (If no, proceed to question #20)

19b. Please explain how your organization sustained the increased number of clients: (check all that apply)

₁ New funding source

₂ Replaced paid staff with volunteers

₃ More effective outreach

₄ Higher quality services attracts more clients

₅ New partnership with another organization

₆ More efficient use of existing resources; describe __________________

₇ Other (please explain)________________________________________

20. Did the Mini Grant enable your Organization to hire more staff?

₁ Yes  Indicate the total number of additional staff: #____part-time and/or #___ full-time

(If yes, proceed to Question #20a)

₂ No (Proceed to Question #21)

20a. If yes, was your Organization able to sustain this increase in staffing levels after the Mini-Grant funds ran out? (check all that apply)

₁ Yes, staff are paid through other funding sources

₂ Yes, staff work on volunteer basis

₃ Yes, other means (please explain)__________________________________________________

₄ No

21. Organizations used CCF Mini-Grant funds in many different ways. Please indicate the specific ways that your organization used the CCF Mini-Grant to strengthen your organization.

1. Increased Access to Technology
Obtained computers and related hardware and software necessary to manage the organization		1 Yes 2 No
Obtained access to high-speed Internet		1 Yes 2 No
Trained staff in use of technology (e.g., spreadsheet skills)		1 Yes 2 No
Developed individual email/voicemail accounts for staff		1 Yes 2 No
2. Improved Facilities or Equipment
Purchased equipment		1 Yes 2 No
Purchased supplies		1 Yes 2 No
3. Improved Organization’s Governance
Established Board of Directors		1 Yes 2 No
Defined roles and responsibilities for Board members		1 Yes 2 No
Recruited new Board members to increase diversity and effectiveness of Board		1 Yes 2 No
Established Board committees to accomplish goals		1 Yes 2 No
Developed formal orientation for new Board members		1 Yes 2 No
4. Improved Organization’s Ability to Manage its Finances
Developed systems for recording financial transactions and generating regular (monthly, quarterly) budgets		1 Yes 2 No
Developed systems for tracking income and expenses		1 Yes 2 No
Developed systems for managing cash flow		1 Yes 2 No
Adopted a computerized bookkeeping system		1 Yes 2 No
Began using new financial software (e.g., Quickbooks)		1 Yes 2 No
Instituted internal controls to improve oversight of finances		1 Yes 2 No
Hired CPA to conduct independent audit		1 Yes 2 No
5. Increased ability to seek/diversify funding sources or resources
Obtained 501(c)(3) status		1 Yes 2 No
Hired grant writer		1 Yes 2 No
Developed fund-development plan		1 Yes 2 No
Applied for the first time for funding from a new funding source		1 Yes 2 No
Obtained in-kind donations from new source		1 Yes 2 No
6. Increased ability to do effective long-term planning
Developed or refined a written mission statement		1 Yes 2 No
Gathered information from constituents to inform strategic decisions		1 Yes 2 No
Developed a written workplan for implementing long-range and annual goals and objectives		1 Yes 2 No
Created or updated a written strategic plan		1 Yes 2 No
7. Developed system for tracking outcomes
Began collecting basic information about program clients		1 Yes 2 No
Developed an automated system for tracking information about clients and program services		1 Yes 2 No
Identified specific key outcomes for program and began collecting outcome data on an ongoing basis		1 Yes 2 No
Began tracking long-term outcomes		1 Yes 2 No
8. Expanded awareness of the organization and/or developed community linkages
Created or updated website		1 Yes 2 No
Developed or distributed written materials (such as brochure or newsletter)		1 Yes 2 No
Made presentations to faith-based or other community groups		1 Yes 2 No
Developed a new partnership arrangement with other organization(s)	1 Yes 2 No
Other Uses of the Mini-Grant? If yes, please describe:		1 Yes 2 No

22. Use the chart below to describe your Organization’s grant writing and fundraising activities related to each of the funding sources listed in the first column prior to the receipt of the CCF Mini-Grant and since the receipt of the Mini-Grant.

	Prior to September 2003 [change for ’04, ’05 grantees] Award of CCF Mini Grant		Since Receipt of CCF Mini Grant in 2003 [change for 2004 and 2005 grantees]
Funding Sources	Had your Organization applied for funding to this source?	Had your Organization obtained funds from this source?	Has your Organization applied for funding from this source?	How many applications has your Organization submitted to this source?	Has your Organization obtained funds from this source?	How many applications have been funded by this source?	What was the total amount of funding from this source?
1. Federal government agencies (other than OCS/ACF CCF Mini Grant)	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	#: ________	1 Yes 2 No	#: ______	$_______
2. State or local government agencies	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	#: ________	1 Yes 2 No	#: ______	$_______
3. Foundations	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	#: ________	1 Yes 2 No	#: ______	$_______
4. Federated giving groups (e.g., United Way)	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	#: ________	1 Yes 2 No	#: ______	$_______
5. Other Funding Sources (Specify:)	1 Yes 2 No	1 Yes 2 No	1 Yes 2 No	#: ________	1 Yes 2 No	#: ______	$_______

23. Think about the changes that your organization has undergone since the receipt of CCF Mini-Grant and select a response category for each of the following questions.

In addition, in order to assist us in improving the Targeted Capacity Building program, we are interested in better understanding any barriers or problems that may have lead to a “not at all” or “very little” response as well as what activities/factors lead to “to a great extent” or “somewhat” response. Please provide a brief explanation for your response to each question.

	Not at all	Very little	Somewhat	To a great extent
a. To what extent did the Mini-Grant make a positive difference in your Organization’s overall organizational development?	1	2	3	4

Please provide a brief explanation for the response you chose:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

	Not at all	Very little	Somewhat	To a great extent
b. To what extent did the Mini-Grant make a positive difference in leadership development within your Organization?	1	2	3	4

Please provide a brief explanation for the response you chose:

__________________________________________________________________________________________________________________________________________________________________________________________________________________

	Not at all	Very little	Somewhat	To a great extent
c. To what extent did the Mini-Grant make a positive difference in your Organization’s overall revenue development strategy?	1	2	3	4

Please provide a brief explanation for the response you chose:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

	Not at all	Very little	Somewhat	To a great extent
d. To what extent did the Mini-Grant make a positive difference in the level or quality of your Organization’s services to individuals/families?	1	2	3	4

Please provide a brief explanation for the response you chose:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

	Not at all	Very little	Somewhat	To a great extent
e. To what extent did the Mini-Grant contribute to improved outcomes for the participants your Organization serves?	1	2	3	4

Please provide a brief explanation for the response you chose:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

	Not at all	Very little	Somewhat	To a great extent
f. To what extend did the Mini-Grant contribute to improved community linkages or partnerships?	1	2	3	4

Please provide a brief explanation for the response you chose:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________