PROGRAM LOGIC MODEL and ANNUAL EVALUATION REPORT (Sample) ITEM # 29a A B C C1 D E F G H For For evaluation report evaluation Projected Processes/Program report Inputs Outputs Expected Outcomes Indicators level of Activities Actual level Actual of Description achievement of achievement of changes achievement Staff establish sites for Number and percent community activities. of clients who 24 (75%) of Staff demonstrate an Outcome 1:Clientsincrease clients will Staff and clients increase in awareness awareness of community identify community of community achieve the Clients resources. 32 interests. resources, as outcome measured by pre and clients Staff post test scores sites (list will arrange/coordinate Number and percent major participate transportation to/from of clients who Outcome 2: Clients increase 24 (75%) of ones) community activities. in 500 demonstrate an utilization of public and clients will community increase in utilization private services in their achieve the Staff facilitate of public and private living example community. outcome living community activities. services in their curriculum community Staff conduct pre and Number and percent post activity Outcome 3: Clients 24 (75%) of of clients who (vans) workshops to teach generalize acquired skills to clients will generalize acquired and support clients’ other home and community skills to other home achieve the involvement in and community living living situations outcome community life situations
PROGRAM LOGIC MODEL and ANNUAL EVALUATION REPORT (Sample) ITEM # 29a A B C C1 D E F G H Inputs Processes/Program Activities Outputs For evaluation report Expected Outcomes Indicators Projected level of achievement For evaluation report Actual level of achievement Actual of achievement Description of changes example Staff Clients sites (list major ones) living curriculum (vans) Staff establish sites for community activities. Staff and clients identify community interests. Staff arrange/coordinate transportation to/from community activities. Staff facilitate community activities. Staff conduct pre and post activity workshops to teach and support clients’ involvement in community life 32 clients will participate in 500 community living Outcome 1:Clientsincrease awareness of community resources. Number and percent of clients who demonstrate an increase in awareness of community resources, as measured by pre and post test scores 24 (75%) of clients will achieve the outcome Outcome 2: Clients increase utilization of public and private services in their community. Number and percent of clients who demonstrate an increase in utilization of public and private services in their community 24 (75%) of clients will achieve the outcome Outcome 3: Clients generalize acquired skills to other home and community living situations Number and percent of clients who generalize acquired skills to other home and community living situations 24 (75%) of clients will achieve the outcome
2014GroupCareRFPTechnicalandPr.docx