Form 1 Refugee Agricultural Partnership Program (RAPP) Indicato

RAPP Indicators
GRANTEE NAME:			Reporting Period
GRANT NUMBER:			Budget Period
Program Activities	First Reporting Period	Second Reporting Period	Cumulative Fiscal Year	Cumulative Project Period
Number of participants enrolled:
Number of participants enrolled identifying as "Male" excluding minor dependents:
Number of Participants enrolled indentifying as "Female" excluding minior dependents:
Number of Participants enrolled identifying as "Unspecified" or another gender identity excluding minor dependents:
Acres of land provided for RAPP activities:
Number of training hours provided in nutrition and/or food safety for personal consumption:
Number of training hours provided in farming production techniques (e.g., agricultural produce selection, proper irrigation, harvesting, extending growing seasons, etc.)
Amount of produce cultivated (lbs.):
Gross sales of produce sold by all participants ($):
Number of participants and family members accessing healthy and nutritious foods through farming:
Number of activities aimed towards increasing psychosocial development of refugees:
Number of types of services received by the participants, not provided by RAPP grantee:
Personal and Psychosocial Development Assessment
	At Enrollment	End-of-Year Assessment
Number of Individuals Asessed:
Using the scoring scale below, provide a mean assessment score of all clients enrolled in RAPP.
1 - Not At All - Client cannot complete activites in this area without assistance from the grantee.
2 - Sometimes - Clients can complete some activities on their own, but still require assistance from the grantee for related tasks.
3 - Most Of The Time - Clients are able to complete most tasks in this area on their own, but may request occasional assistance from the grantee.
4 - All The Time - Clients are able to complete all activities in this area without any assistance from the grantee.
	At Enrollment	End-of-Year Assessment
Client has access to healthy food:
Client understands what a healthy diet is:
Clients are engaged in physically activity:
Client has sufficient income to cover needs (e.g., housing, food, transportation, etc.)
Client is engaged in the community:
Client knows how to find answers for questions about nutrition and health:
Client knows how to find answers for questions about gardening/farming (e.g., leasing land, zoning laws, pesticides, organic production, etc.):
Client can navigate relevant systems (e.g., local governments, business development process, accessing benefits, etc.) without grantee intervention:
Logic Model Outputs Progress	Semi-Annual Results				Cumulative Fiscal Year	Cumulative Project Period
	Months 1-6		Months 7-12
Please list all planned Outputs from the Logic Model in the following spaces. Add more spaces as necessary.	Identify progress towards each Output for Months 1-6		Identify progress towards each Output for Months 7-12.		Describe progress towards Outputs for the current fiscal year.	Describe progress towards Outputs for the project period.
Logic Model Outcomes Progress	Semi-Annual Results				Cumulative Fiscal Year	Cumulative Project Period
	Months 1-6		Months 7-12
Please list all planned Outcomes from the Logic Model in the following spaces. Add more spaces as necessary.	Identify progress towards each Outcomes for Months 1-6		Identify progress towards each Outcomes for Months 7-12.		Describe progress towards each Outcome for the current fiscal year.	Describe progress towards each Outcome for the project period.
OMB Control Number: 0970-0490; Expiration date: 1/31/2023
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is gathering data on your grant program to understand the design and effectiveness of the program and to inform technical assistance needs. Public reporting burden for this collection of information is estimated to average 2.3 hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is required to retain a benefit (Pub. L. 105-285, section 680(b) as amended). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information, please contact Yimeem Vu at Yimeem.Vu@acf.hhs.gov