Section A Description: Need for Program High Score High-Middle Score Low-Middle Score Low Score 20 points Describe the needs of the populations to be served by the grant program. Tell how the proposed program will help meet these needs by providing services and opportunities not currently available. It is vital that the applicant clearly show specific, identified needs that connect to the goals and measurable objectives of the application, the proposed activities and services, and the program evaluation. Data-based needs of the community in which the students and families to be served by the grant reside are identified, including data from a community needs assessment conducted in the last three years .Explanation is given as to why this community was selected and how the program to be provided will be of value. (4 pts.) Important data-based community needs have been clearly described in detail, including data from a community needs assessment conducted in the last three years. A connection has been effectively made to show how the program will benefit the community by impacting the identified needs and providing services not currently available. 4 pts. Needs of students to be served by the grant program are defined by subgroup, using current, specific data to document those needs. (4 pts.) Specific needs of students to be served are defined by subgroup. A broad-base of current data is used to correctly document these needs. Student achievement data is included to show need for program.4 pts. Data-based needs of parents and families clearly and correctly support all critical factors as to why the community was selected for this program. 4 pts Data-based needs of the community to be served by the grant program, focusing on parents and families, are identified. (4 pts.) Community data-based needs have been described in some detail, including data from a community needs assessment conducted in the last three years. A connection has been made in general terms as to how the program will benefit the community by impacting needs and providing services not currently available. 3 pts. General needs of students to be served are defined by subgroup. Current data is used to correctly document these needs. 3 pts. Community needs have been minimally described. It is not entirely clear how the program will benefit the community by impacting needs and providing services not currently available. 2 pts. Community needs have been minimally described. There is no clear connection between the program proposed and how it will benefit the needs of the community. A community needs assessment conducted within the past 3 years is not included.1 pt. General needs of students to be served are defined by subgroup. Data used to document these needs may not be current or correct. 2 pts. Needs of students may not be defined by subgroup. Data to document these needs may be missing, incorrect or not current. 1 pt. Data-based needs of parents and families correctly support most of the critical factors as to why the community was selected for this program. 3 pts. Little data on parents and families is used support critical factors as to why the community was selected for this program. Data may not be current. 2 pts. Minimal data are shared on parents and families to support critical factors as to why the community was selected for this program. Data may not be current. 1 pt. Gaps in community services and opportunities for those living in the area included in the proposed program are described. How the grant will help provide services and activities not available at this time for participants in the program is clear. (4 pts.) Gaps in community services and opportunities have been clearly and completely described. Important details show how the grant will effectively close these gaps by providing services and activities not currently available. 4 pts. Research information shared in this section is supported by APA citation of the data source. (2 pts.) Correct APA citations are used for all research shared. 2 pts. Applicant consultation with private school officials during the design and development of the application as to the needs to be addressed and the services to be offered, are described. If there is no private school within the applicant’s attendance area, this is stated by the applicant.(2 pts.) Strong efforts have been described to engage private schools in the design and development of the application. Details are provided about how the needs of the private school were determined and the services to be offered address those needs. Gaps in community services and opportunities have been described. Details describe how the grant will provide services and activities not currently available, however there is not a strong connection as to how they will close gaps. 3 pts. Correct APA citations are used for most research shared.1.5 pts. A description of the effort to engage private schools in the design and development of the application is provided. Some detail is provided about how the needs of the private school were determined and the services to be offered address those needs. OR 1.5 pts A statement is correctly made claiming there is no private school within the applicant’s attendance areas. 2 pts. Gaps in community services and opportunities are stated. There is a lack of detail about providing services and activities not currently available and no strong connection as to how gaps will be closed. 2 pts. APA citations are used for most research shared but may not be correct.1 pt. A description of the effort to engage private schools in the design and development of the application is provided. Information about how the needs of the private school were determined and the services to be offered address those needs is minimal. 1 pt. Gaps in community services and opportunities are mentioned in a minimal way. There is a lack of detail about providing services not currently available and no connection as to how gaps will be closed. 1 pt. Few correct APA citations are given for research shared. .5 pt. Minimal effort has been given to described consultation with private schools. Only generally information is provided about addressing needs and services. .5 pt. Section B Description: Goals and Objectives High Score High-Middle Score Low-Middle Score Low Score 15 points Develop broad program goals that address identified needs from section A. One goal must address raising academic achievement for students with a second goal addressing raising the education or skill levels of adults. Other goals may be added if needed. List the measurable objective(s) the proposed program will use to remedy the risk factors (needs) described for the target populations in the goals identified. Each objective must include all parts of a well-written measurable objective: population, outcome, measure, target and time frame. A program goal is included that addresses raising academic achievement for students. (3 pts.) The goal is well-written and addresses an important academic achievement need for students as defined in Section A. 3 pts. The goal is well-written and addresses an important academic achievement need of students. The link to student needs in Section A is not clear or strong. 2.25 pts. A program goal is included that addresses raising the education or skill level of adults. (3 pts.) The goal is well-written and addresses an important need of adults in the community as defined in Section A. 3 pts. The goal is well-written and addresses an important need of adults. The link to needs of adults in the community in Section A is not clear or strong. 2.25 pts. A measurable objective(s) is defined for each goal. (7 pts.) The measurable objective is correctly written, including the population, outcome, measure, target and time frame. The objectives are all clearly connected to a grant goal(s) and are likely to impact goal achievement. Data measures that can be analyzed prior to June 1 are included. 7 pts. The measurable objective is correctly written, including the population, outcome, measure, target and time frame. The objectives are all connected to a grant goal(s) and may have the potential to impact goal achievement. Data measures that can be analyzed prior to June 1 are included. 5.25 pts. The goal addresses an academic achievement need of students but may not be well written. The link to student needs in Section A is not clear or strong. 1.5 pt. The goal addresses a need of adults but may not be well written. The link to needs of adults in the community in Section A is not clear or strong. 1.5 pt. The measurable objectives may not all be correctly written, including the population, outcome, measure, target and time frame. The objectives are all connected to a grant goal(s) but their potential to impact goal achievement is not clear. Data measures that can be The goal is poorly written and does not connect to student needs identified in Section A. .75 pt. The goal is poorly written and does not connect to adult needs identified in Section A. .75 pt. The measurable objectives are not correctly written, missing the population, outcome, measure, target and/or time frame. The objectives may be connected to a grant goal(s), but they do not seem to have the potential to impact goal achievement. Data measures that can be analyzed prior to June 1 Grant goals and objectives have been created to sufficiently meet the critical data-based needs of the students, parents and families in the community. (2 pts.) All grant goals and objectives clearly relate to data-based needs from Section A, with the most critical areas of need for the community, parents, families and students addressed. Achievement of grant goals will likely have a positive impact on the community. 2 pts. Grant goals and objectives relate to data-based needs from Section A, with the most critical areas of need for the community, parents, families and students addressed. Achievement of grant goals has the potential to have a positive impact on the community. 1.5 pts. analyzed prior to June 1 may not be included. 3.5 pts. Some grant goals and objectives relate to data-based needs from Section A, with areas of need for the community, parents, families and students addressed. Achievement of grant goals may or may not have a positive impact on the community. 1 pt. may not be included. 1.75 pts. Grant goals and objectives are not clearly related to data-based needs from Section A. The most critical areas of need for the community, parents, families and students are not addressed. It is unclear if achievement of grant goals will have a positive impact on the community. .5 pt. Section C Description: Student Program High Score High-Middle Score Low-Middle Score Low Score Activities & Implementation (20 points) Describe how the program designed connects activities and implementation to the goals and measurable objectives established and to the identified needs of the students. Explain the relationship of major cost items to program activities/components. Components and related activities that the program will offer to students to meet the needs previously identified are described. Information on the time allotted to components and activities described is included, as well as partner involvement. Scientifically-based research that provides evidence that the programs or activities included in this section will help students meet state and local student academic achievement standards is included and citations made in correct APA style citations. A description is also given, if optional summer programs are being implemented. (Programs will not receive credit for having a summer program if sufficient funds are not included in the budgets for years 1-3 and in the budget narrative.)(9 pts.) The method(s) for recruiting and retaining students in the program is explained. (2 pt.) Detailed description of program components and activities is given, including time allotment and partner involvement. Program components and activities offered to students clearly meet the student needs identified in Section A and the goals and measurable objectives for students in Section B. Scientifically-based research is included with correct APA style citations. Components and activities are ageappropriate, and it is likely that they will appeal to interests of students. 9 pts. Description of program components and activities is given, including time allotment and partner involvement. Program components and activities offered to students may help meet the student needs identified in Section A and the goals and measurable objectives for students in Section B. Scientifically-based research is included but citations may not be provided correctly. Components and activities are age-appropriate, and they may appeal to interests of the students. 6.75 pts. Description of program components and activities is vague and may not include time allotment or partner involvement. More details are needed for clarity and questions may remain. It is not clear how program components and activities offered to students will help meet the student needs identified in Section A and the goals and measurable objectives for students in Section B. Components and scientifically based research is not provided. Activities may not be ageappropriate and may not appeal to the interests of students. 4.5 pts. Description of program components and activities is incomplete. Details are needed for better understanding and questions remain. It is not clear how program components and activities offered to students will help meet the student needs identified in Section A and the goals and measurable objectives for students in Section B. A clear, detailed explanation of the method(s) used for A detailed explanation of the method(s) used for recruiting and retaining students in the An explanation of the method(s) used for recruiting and A vague explanation of the method(s) used for recruiting and retaining 2.25 pts. ongoing recruiting and retaining students in the program is given. The method(s) has a high probability for success with attendance. Creativity is evident. 2 pts. program is given. The method(s) has a high probability for success with attendance. 1.5 pts. retaining students in the program is given, however questions may remain. The method(s) may contribute to success with attendance. 1 pt. students in the program is given. Questions remain and it is unclear whether the method(s) will be successful with attendance. .5 pt. How program services in centers will be available to any participating student a minimum of three days for high school programs and four days per week for elementary and middle school students is defined. (All programs must begin by October 15 and meet a minimum of 25 weeks during the regular school year.) (2 pt.) The program will be open to any participating student beyond the minimum number of days per week or weeks per year for the programmatic level they serve. The program will be open by the required October 15 start date. A summer program will be offered. 2 pts. The program will be open to any participating student beyond the minimum number of days per week or weeks per year for the programmatic level they serve. The program will be open by the required October 15 start date. 1.5 pts. A statement is provided that the program will be open to any participating student, at a minimum, the number of days and weeks required by the RFP for the programmatic level they will serve. The program will be open by the required October 15 start date. 1 pt. A statement that the program will be open to any participating student. The number of days and weeks required by the RFP for the programmatic level they will serve is not provided. The program does not assure an October 15 start date. .5 pt. How project staff will vary their approaches to help meet the individual needs of students and improve their achievement in core academic areas to meet or exceed local and state standards is explained. Steps proposed to ensure equitable access to, and participation by, students and program personnel with special needs are included. (3 pts.) A clear, detailed explanation of how staff will vary approaches to meet individual student needs to improve core academic achievement is given. Steps to ensure equitable access and inclusion of special needs individuals in the program are clearly outlined. The A detailed explanation of how staff will vary approaches to meet individual student needs to improve core academic achievement is given. Steps to ensure equitable access and inclusion of special needs individuals in the program are provided. The plan has the An explanation of how staff will vary approaches to meet individual student needs to improve core academic achievement is given. Steps to ensure equitable access and inclusion of special needs individuals in the A vague explanation of how staff will vary approaches to meet individual student needs is given. Steps to ensure equitable access and inclusion of special needs individuals in the program may not be provided. Questions remain and without more clarity it is plan is likely to lead to greater individual student success. 3 pts. potential to lead to greater individual student success. 2.25 pts. program are provided. However, questions may remain, and it is not clear if the plan has the potential to lead to greater individual student success. 1.5 pts. not evident that the plan will lead to greater individual student success. .75 pt. How the program will provide hands-on, problem-based or project-based learning activities that support state learning standards and contribute to academic performance for all students is described. (3 pts.) A clear description of plans to include realworld, hands-on, problem- or project-based learning activities that support state learning standards is given. It is clear that the activities described have the likelihood of appealing to the age-group served and impacting academic performance for all students. Creativity and innovation are evident. 3 pts. A description of plans to include real-world, hands-on, problem- or project-based learning activities that support state learning standards is given but lacks important details. The activities described may or may not have the potential to impact academic performance for all students, and may or may not be age-appropriate or appealing to the age-group served. 2.25 pts. A description of plans may include realworld, hands-on, problem- or projectbased learning activities that support state learning standards, however questions remain. It is unclear if the activities described have the potential of appealing to the age-group served or impacting academic performance for all students. 1.5 pts. A minimal description of plans that may include real-world, hands-on, problem- or project-based learning activities that support state learning standards is given. Questions remain and without more clarity it is not evident that the activities described have the likelihood of appealing to the agegroup served or impacting academic performance for all students. .75 pt. Plans to provide supper for participating students each day the program meets are stated. ( A snack may also be offered.) (1 pt.) Plans to provide supper are stated. 1 pt. - - - Section D Description: Collaboration High Score High-Middle Score Low-Middle Score Low Score 15 points Explain how the program was developed, and will be implemented, in collaboration with the schools the students attend and with partners submitting MOUs. Include collaboration with your co-applicant partner(s), if submitting jointly. Describe the capacity of the lead organization (and partner, if submitting jointly) to implement the proposed grant program. How the program was developed and will be carried out in active collaboration with the schools the students attend and with partners submitting MOUs is explained. How joint planning time and professional development opportunities will be available for school staff, program staff and partners that will help meet both program goals and objectives, as well as school and district goals and objectives, are described. (5 pts.) A specific, detailed plan for active collaboration with the schools the students attend and with program partners is given. Joint planning time and professional development opportunities are clearly explained. The plan increases the likelihood that goals and measurable objectives of both the program and the school will be achieved. 5 pts. A general plan for active collaboration with the schools the students attend and with program partners is given, however some important details may be missing. Joint planning time and professional development opportunities are explained. The plan increases the potential that goals and measurable objectives of both the program and/or the school will be achieved. 3.75 pts. Collaboration between afterschool staff and regular school day teachers and administrators in order to identify areas for individualized student assistance in academic subjects, is described. The datasharing plan is explained: how student records and individual and aggregate achievement data will be accessed for use in program planning, implementation and evaluation; as well as how afterschool program data will be shared with the schools served. The process used to gain individual parent consent to access and use an individual student’s data is explained. (7 pts.) A detailed plan is provided that describes how the program staff will collaborate with regular school day teachers and administrators to identify areas for individualized student assistance in academic areas. Data sharing includes both student records and individual and aggregate A plan is provided that describes how the program staff will collaborate with regular school day teachers to identify areas for individualized student assistance in academic areas. Data sharing includes both student records and individual and aggregate achievement data. The plan includes data-sharing, however details are not A vague outline of a plan for active collaboration with the schools the students attend and with program partners is given. Joint planning time and professional development opportunities are not clearly explained. Questions may remain unanswered. It is not clear if the plan will help meet the goals and measurable objectives of both the program and the school. 2.5 pts. A plan is provided that describes how the program staff will collaborate with regular school day teachers to identify areas for general student assistance in academic areas. Specific types of data may not be identified. Questions may remain. The plan may include data- A minimal description of active collaboration with the schools the students attend and with program partners is given, leaving many important details unanswered. Joint planning time and professional development opportunities are not explained. Questions remain unanswered. The plan does not appear to help meet the goals and measurable objectives of both the program and the school. 1.25 pts. A vague plan is provided that describes how the program staff will collaborate with regular school day teachers to identify areas for general student assistance in academic areas. The plan does not include datasharing. 1.75 pts. Prior experience and/or capacity of the lead organization and co-applicant partner, if applicable, to provide educational and related activities that will complement and enhance the academic performance, achievement, and positive youth development of students is described. (3 pts.) achievement data. The plan includes a clear explanation of ongoing data-sharing between both school and afterschool for the purpose of program planning, implementation and evaluation and has the likelihood of positively impacting student success. 7 pts. Both prior experience and capacity of the lead organization (and coapplicant partner, if applicable) to provide educational and related activities that will complement and enhance the academic performance, achievement and positive youth development of students are clearly described. Information explaining the kinds of activities provided and the areas of academic achievement and youth development impacted is shared. 3 pts. clearly explained. The plan appears to have the potential to positively impact student success. 5.25 pts. sharing, however it is not clear how it will positively impact student success. 3.5 pts. Both prior experience and capacity of the lead organization (and coapplicant partner, if applicable) to provide educational and related activities that will complement and enhance the academic performance, achievement and positive youth development of students are described. Some information is given explaining the kinds of activities provided and the areas of academic achievement and youth development impacted. 2.25 pts. Both prior experience and capacity of the lead organization (and coapplicant partner, if applicable) to provide educational and related activities that will complement and enhance the academic performance, achievement and positive youth development of students are described vaguely. There is little information explaining the kinds of activities provided and the areas of academic achievement and youth development impacted. 1.5 pts. Prior experience and/or capacity of the lead organization (and coapplicant partner, if applicable) to provide educational and related activities that will complement and enhance the academic performance, achievement and positive youth development of students may or may not be mentioned. There is no information explaining the kinds of activities provided or the areas of academic achievement and youth development impacted. .75 pt. Section E Description: Facility Plan 10 points High Score High-Middle Score Low-Middle Score Low Score Describe the facility where the program will be located. Include details on how the students will travel safely to the 21st CCLC and home from school–based and/or off- site programs. State the number of buses needed to adequately serve the target participants, based on data provided by the county board of education and/or principal. Provide information on emergency exit and readiness procedures. The safe environment the program will provide for participants is described. (5 pts.) A thorough description of the facility is provided, including: interior and exterior environment, condition of the building, furniture and equipment to be used by participants; capacity of service, storage of materials and overall cleanliness. Required agency inspections are described. Assurance is given that no safety hazards exist. 5 pts. A description of the facility is provided, including all or some of the following: interior and exterior environment, condition of the building, furniture and equipment to be used by participants; capacity of service, storage of materials and overall cleanliness. Required agency inspections are described. Assurance is given that no safety hazards exist. 3.75 pts. How the program will ensure that the students will travel safely to the 21st CCLC and home from school–based and/or offsite programs is explained, along with the number of buses needed to adequately serve the target participants, based on data provided by the county board of education and/or principal. Support for transportation must be included as an expense and/or inkind in the budget and budget narrative. (3 pts.) A plan for student transportation has been clearly outlined. The specific number of buses needed to adequately serve target participants has been defined based on data provided by school or district administrators. Daily student transportation is included in the budget and a clear, A plan for student transportation has been outlined. The specific number of buses needed to adequately serve target participants has been defined. Daily student transportation is included in the budget and a mathematical explanation is given in the budget narrative. 2.25 pts. A general description of the facility is provided. Only some of the following indicators are mentioned: interior and exterior environment, condition of the building, furniture and equipment to be used by participants; capacity of service, storage of materials and overall cleanliness. Required agency inspections may not be described. Assurance is given that no safety hazards exist. 2.5 pts. A plan for student transportation has been outlined, however questions may remain. The specific number of buses needed to adequately serve target participants has been defined, however no data from the school or district was used in determining the A minimal, vague description of the facility is provided. Few of the following indicators are mentioned: interior and exterior environment, condition of the building, furniture and equipment to be used by participants; capacity of service, storage of materials and overall cleanliness. Required agency inspections are not described. Assurance may or may not be given that no safety hazards exist. 1.25 pts. The plan for student transportation has been minimally outlined. The specific number of buses needed to adequately serve target participants is not defined. Daily student transportation is included in the budget, however the mathematical explanation in the budget narrative does not clearly mathematical explanation is given in the budget narrative. 3 pts. The procedure for communicating the emergency exit plan and emergency readiness plan to the staff, students and parents is described. (2 pts.) Specific procedures for how emergency exit and readiness plans will be communicated to staff, students and parents are clearly described. Fire drill procedures are practiced during afterschool time. 2 pts. General procedures for how emergency exit and readiness plans will be communicated to staff, students and/or parents are described. Fire drill procedures are practiced during afterschool time. 1.5 pts. number. Daily student transportation is included in the budget however the mathematical explanation in the budget narrative does not clearly or correctly explain the expense. 1.5 pts. General procedures for how emergency exit and/or readiness plans will be communicated are described. There is no mention of specific audiences, such as staff, student and parents. Plans for practicing fire drills are not stated. 1 pt. or correctly explain the expense. .75 pt. No procedures for how emergency exit or readiness plans will be communicated are described. There is no mention of specific audiences, such as staff, student and parents. Plans for practicing fire drills are not stated. .5 pt. Section F Description: Program Personnel 15 points High Score High-Middle Score Low-Middle Score Low Score Describe the procedures for managing the program. Include a chart that shows the staff structure, along with job descriptions for key community and school staff. Assure that the program director will spend at least 10 hours per week carrying out grant responsibilities and that all program staff and regular volunteers have passed an approved state-level background check prior to working in the program. Describe the plans and the budget for staff training, and assure that one full-time staff member per site will be certified in CPR and First Aid within a month of employment. Tell how volunteers will be used, and describe the work of a program Advisory Council. A chart that describes the staff structure (roles and responsibilities), including the position descriptions of both key community and school staff, is included. (4 pts.) Procedures for managing the program are provided, along with a clear, concise chart describing the staff roles and responsibilities. Thorough descriptions of key community and school staff positions are included. It is evident that the level of staff assures participant safety and high-quality program delivery, based on the activities included and age of participants. 4 pts. Procedures for managing the program are provided, along with a chart describing the staff roles and responsibilities. Descriptions of key community and school staff positions are included. It is evident that the level of staff assures participant safety and high-quality program delivery, based on the activities included and age of participants. 3 pts. Plans for on-going staff training for the program are described and included in the budget and budget narrative, along with required state and regional trainings. (Expenses may include payment of staff for time to plan and attend the training.) (3 pts) A plan for specific staff training is described that will help assure staff the ability to successfully implement the 21st CCLC program proposed in the A general staff training plan is described, with few specifics. Topics for the focus of year-one training are included. Ongoing training and selection of future Basic procedures for managing the program are provided. A chart describing the staff roles and responsibilities is provided, but it is not clear or complete. Descriptions of some key community and school staff positions may be missing. There is not enough information to claim that the level of staff assures participant safety and high-quality program delivery, based on the activities included and age of participants. 2 pts. Staff training is vaguely described. Topics for the focus of year-one training may not be given. Ongoing training and selection of future Procedures for managing the program are minimally provided. A chart describing the staff roles and responsibilities may be provided, but it is incomplete and/or inaccurate. Descriptions of key community and school staff positions are minimal or missing. It is not evident that the level of staff assures participant safety and high-quality program delivery, based on the activities included and age of participant. 1 pt. Staff training is minimally described. Topics for year-one training are not given. Both ongoing training and selection of future training topics are The use of qualified volunteers to support proposed activities is explained. (2 pt.) grant application. Topics for the focus of year-one training are included. How training will be ongoing and how future topics of training will be decided is thoroughly described. Required state and regional trainings are included. The budget includes a line-item for staff training and the budget narrative clearly explains the mathematical determination of costs. 3 pts. A volunteer plan is thoroughly explained. Information provided includes: source(s) of volunteers, realistic numbers of volunteers, duties of volunteers and training of volunteers. It is highly likely that the use of volunteers will make a positive impact on the program. 2 pts. training topics are explained. Required state and regional trainings are included. The budget and budget narrative include a line item for staff training and the mathematical determination of costs. 2.25 pts. training topics are not completely addressed. Required state and regional trainings are included. The budget and budget narrative include a line item for staff training and the mathematical determination of costs. However, the calculation may not be accurate. 1.5 pts. not addressed. Required state and regional trainings may not be included. The budget includes a line-item for staff training, but the budget narrative may be incomplete or inaccurate. .75 pt. A volunteer plan is generally explained. Information provided includes: source(s) of volunteers, realistic numbers of volunteers, duties of volunteers and training of volunteers. There is potential for the use of volunteers to make a positive impact on the program. 1.5 pts. Volunteer use is vaguely explained, and an intentional plan is lacking. Some key information is missing, making program’s plans for source(s) of volunteers, realistic numbers of volunteers, duties of volunteers and training of volunteers unclear. Questions remain and the positive impact of volunteers on the program may not be projected. 1 pt. Volunteer use is minimally explained and no plan is evident. Much key information is missing, making source(s) of volunteers, realistic numbers of volunteers, duties of volunteers and training of volunteers unclear. There does not seem to be a potential for volunteers to make a positive impact on the program. .5 pt. The requirement for the Program Director to allocate a minimum of 10 hours per week to carry out grant responsibilities is assured, along with the requirement for at least one full-time staff member per site to be certified in both CPR and first aid (within one month of employment). (1 pt.) It is ensured that all out-of-school-time staff and regular volunteers will have passed an approved state-level background check prior to working in the program. The budget and budget narrative includes funding for this expense. (1 pt.) A program Advisory Council that will meet at least quarterly and consist of program staff, co-applicant partner, school/district administrative staff if applicable, parents, students (for secondary programs) and community members has been described. (4 pts.) A statement is given that the Program Director will allocate, at a minimum, 10 hours per week to carry out grant responsibilities. Also, having one full-time staff member per site certified in CPR and First Aid within one month of employment is assured. 1 pt. A statement is given that all out-of-school-time staff and regular volunteers will have passed an approved statelevel background check prior to working in the program. Funding is included in the budget and budget narrative. 1 pt. A well-structured program Advisory Council is clearly defined, including member positions from all key stakeholder groups. The purpose and leadership of the Council, as well as the frequency of meetings is provided in detail. The valued role of the Council in the success of the program is clearly Only one of the two stated requirements is assured: either the Program Director will allocate, at a minimum, 10 hours per week to carry out grant responsibilities; or one full-time staff member per site will be certified in CPR and First Aid within one month of employment. .5 pt. - - - - - A program Advisory Council is defined, including member positions from all key stakeholder groups. The purpose and leadership of the Council, as well as the frequency of meetings is provided. The valued role of the Council in the success of the program is described. 3 pts. A program Advisory Council is generally defined, including member positions from all key stakeholder groups. The purpose and leadership of the Council, as well as the frequency of meetings is provided, however questions may remain. The valued role of the Council in the success A program Advisory Council is minimally defined, including member positions from most key stakeholder groups. The purpose and leadership of the Council, as well as the frequency of meetings is provided but questions remain. The valued role of the Council in the success of the program is not described. described. It is evident that the council will have the capacity to positively impact the program success. 4 pts. of the program is not clear. 2 pts. 1 pt. Section G Description: Sustainability High Score High-Middle Score Low-Middle Score Low Score 15 points Explain how the costs of the proposed program are reasonable, based on the number of average daily attendees, the services to be provided and the anticipated benefits. Describe how other sources of funding will be leveraged to supplement the grant program. If a fee-structure is used, it may not impact program participation. Procedures for administering and managing the funds must be described. Include a plan that details how the program will be sustained after the grant period ends. An explanation of how the budget is reasonable in relation to the number of average daily attendees to be served, services to be provided and anticipated results and benefits is provided. (The budget and budget narrative will be judged against the scope of the program and its anticipated benefits.) (4 pts.) A description of how other sources of funding will be leveraged to supplement the grant award and to support services is given, including how other federal, state and local programs with compatible/complementary services (i.e. Title I, Adult Basic Education, etc.) will be coordinated with the grant program. An explanation that the program will ensure that funds will not be used to supplant federal, state, local or non-federal funds is given. If the applicant chooses to establish a fee structure, a narrative is provided that explains that fee structure and it is assured that income and or ability to pay will not deter families from enrolling their children in the program. Additionally, a description of how the funds will be administered and managed is included. (Anticipated income The reasonableness of the budget is clearly explained in terms of the number of average daily attendees to be served and services provided. Also stressed is the reasonableness related to the positive results and benefits anticipated for the students and community; a thorough explanation is given. 4 pts. A thorough description of how other sources of funding will be leveraged to supplement the grant award and support services is given. How other federal, state, and local programs with complementary services will be coordinated with the grant is explained clearly. The program ensures that funds will not be used to supplant other funds. A fee structure, if used, is thoroughly The reasonableness of the budget is explained in terms of the number of average daily attendees to be served and services provided. A general statement is used to stress the reasonableness related to the positive results and benefits anticipated for the students and community. 3 pts. The reasonableness of the budget may not be explained in terms of the number of attendees to be served and/or services provided. Reasonableness related to the positive results and benefits anticipated for the students and community is vaguely explained. 2 pts. The reasonableness of the budget is not explained in terms of the number of attendees to be served and/or services provided. The reasonableness related to the positive results and benefits anticipated for the students and community is not described. 1 pt. A description of how other sources of funding will be leveraged to supplement the grant award and support services is given. How other federal, state, and local programs with complementary services will be coordinated with the grant is explained. The program ensures that funds will not be used to supplant other funds. If a fee structure is used, a narrative is provided that explains the structure, assures it will not prevent students A general statement that other sources of funding will be leveraged to supplement the grant award and support services is given, however, coordination of the grant with other federal, state, and local programs with complementary services is not explained clearly. Questions may remain. The program ensures funds will not be used A general statement that other sources of funding will be leveraged to supplement the grant award and support services is given, however, coordination of the grant with other federal, state, and local programs with complementary services is not explained. Questions remain. The program neglects to ensure that funds will not be used to supplant other funds. If a from collection of fees should be reported in the budget as an additional source of revenue.) (4 pts.) explained. An assurance is given that the fee will not prevent students from attending, and explains the administration and management of the funds. Anticipated income from a fee structure is reported in the budget and budget narrative as an additional source of income 4 pts. from attending, and explains the administration and management of the funds. Questions may remain, however. Anticipated income from a fee structure is reported in the budget and budget narrative as an additional source of income.. 3 pts. A reasonable plan for sustaining the community learning center(s) after grant funding ends is detailed. (7 pts.) A well-thought out plan is clearly explained for sustaining the program after grant funding ends, including a thorough explanation as to how the program will build sustainability through: A plan is explained for sustaining the program after grant funding ends; however some key information is missing, leading to a lack of clarity. Sustainability components described include most or all of the following: working effectively with schools, school district support services, parents, community organizations, and other partners participating in strategic planning with the district working with schools, school district support services, parents, community organizations and other partners to supplant other funds. If a fee structure is used, a narrative is provided but is vague in explaining the structure, assuring it will not prevent students from attending, and explaining the administration and management of the funds. Anticipated income from a fee structure is not reported in the budget and budget narrative as an additional source of income. 2pts. A plan is vaguely explained for sustaining the program after grant funding ends, however questions may remain. An explanation as to how the program will build sustainability may include some of the following: fee structure is used, a minimal narrative is provided that does not clearly explain the structure, assure it will not prevent students from attending, and explain the administration and management of the funds. Anticipated income from a fee structure is not reported in the budget and budget narrative as an additional source of income. 1 pt. working with schools, school district support services, parents, community organizations and other partners working with schools, school district support services, parents, community organizations and other partners A plan for sustaining the program after grant funding ends is minimally described. Information is incomplete and questions remain. An explanation as to how the program will build sustainability includes few, if any, of the following: and schools served by the grant using data to inform others gathering evidence of parent and student satisfaction with the program, building capacity to meet goals and objectives leveraging other sources of funding accessing external planning support and technical assistance in sustainability planning showing program results through a positive impact on youth development and achievement, as well as parent/adult education and skill levels. 7 pts. participating in strategic planning with the district and schools served by the grant using data to inform others gathering evidence of parent and student satisfaction with the program, building capacity to meet goals/objectives leveraging other sources of funding accessing external planning support and technical assistance in sustainability planning showing program results through a positive impact on youth development and achievement, as well as parent/adult education and skill levels. 5.25 pts. participating in strategic planning with the district and schools served by the grant using data to inform others gathering evidence of parent and student satisfaction with the program, building capacity to meet goals/objectives leveraging other sources of funding accessing external planning support and technical assistance in sustainability planning showing program results through a positive impact on youth development and achievement, as well as parent/adult education and skill levels. 3.5 pts. participating in strategic planning with the district and schools served by the grant using data to inform others gathering evidence of parent and student satisfaction with the program, building capacity to meet goals/objectives leveraging other sources of funding accessing external planning support and technical assistance in sustainability planning showing program results through a positive impact on youth development and achievement, as well as parent/adult education and skill levels.. 1.75 pts. Section H Description: Parents, Family, & High Score High-Middle Score Low-Middle Score Low Score Community Involvement 15 points Describe the components and related activities that your program will offer to parents, families and community members to meet the needs previously identified, including how equitable access and participation will be ensured for family members and other program beneficiaries with special needs and how center information will be disseminated to them. Include an explanation of how parents and community members will be involved in program planning, implementation, evaluation and decision making. The components and related activities the program will offer to parents, families and community members to meet the needs previously identified are described. (These activities MUST be aimed at improving the education or skill level of adults or at involving parents in their children’s learning, either at home, at programs sponsored by the center, or elsewhere.) Steps are proposed to ensure equitable access to, and participation by, family members and other program beneficiaries with special needs. The budget and budget narrative includes provision for these activities. (8 pts.) Detailed description of program components and activities for parents, families and community members, is given. Databased information is shared on how these components and activities were selected. Both components and activities are aimed at improving the education or skill level of adults or at involving parents in their children’s learning. These components clearly help meet the needs identified in Section A and the goals and measurable objectives in Section B. Funds are included in the budget and a clear, mathematical explanation is given in the budget narrative. Thought and creativity are evident. 8 pts. Description of program components and activities for parents, families and community members is given. Information is shared on how these components and activities were selected. Both components and activities are aimed at improving the education or skill level of adults or at involving parents in their children’s learning. These components help meet the needs identified in Section A and the goals and measurable objectives in Section B. Funds are included in the budget and a clear, mathematical explanation is given in the budget narrative. 6 pts. A description of program components and activities for parents, families and community members is given, however it may vague or unclear. How the components and activities were selected is not stated. Both components and activities may not be aimed at improving the education or skill level of adults or at involving parents in their children’s learning. It is unclear whether these components will help meet the needs identified in Section A and the goals and measurable objectives in Section B. Funds are included in the budget and a mathematical explanation is given in the budget narrative. 4 pts. A minimal description of program components and activities for parents, families and community members is given. How the components and activities were selected is not stated. Components and activities are not aimed at improving the education or skill level of adults or at involving parents in their children’s learning. These components do not seem to have the potential to help meet the needs identified in Section A and the goals and measurable objectives in Section B. Funds are included in the budget and budget narrative, however information is incomplete or inaccurate. 2 pts. How parents and community members will be involved in planning, implementation of services, program evaluation and decisionmaking in the program is described. (5 pts.) Parent and community member involvement in planning, implementation of services, program evaluation and decisionmaking is thoroughly described. The stakeholders involvement described is ongoing and meaningful and has the likelihood of helping build capacity for the program’s success. 5 pts. Parent and community member involvement in planning, implementation of services, program evaluation and decision-making is described. The stakeholder involvement described is meaningful and may have the potential of helping build capacity for the program’s success. 3.75 pts. How the program will disseminate information about the center(s) to the community in a manner that is understandable and accessible is explained. (2 pts.) A plan to disseminate center information to the community in an understandable, accessible way is described clearly and specifically. Communication is ongoing, throughout the year and is disseminated through various media or formats. 2 pts. A plan to disseminate center information to the community in an understandable, accessible way is described. Communication is ongoing, throughout the year and may be disseminated through various media or formats. 1.5 pts. Parent and/or community member involvement in planning, implementation of services, program evaluation and decision-making is described, however important information is missing and questions remain. It is not clear, from the stakeholder involvement described, whether it will help build capacity for the program’s success. 2.5 pts. A plan to disseminate center information to the community in an understandable, accessible way is briefly described and questions may remain. Communication may not be ongoing, throughout the year nor disseminated through various media or formats. 1 pt. Parent and/or community member involvement in planning, implementation of services, program evaluation and decisionmaking is minimally described. Important information is missing and questions remain. The stakeholder involvement described will do little to build capacity for the program’s success. 1.25 pts. A plan to disseminate center information to the community in an understandable, accessible way is minimally described. Questions remain. Communication is neither ongoing, throughout the year nor disseminated through various media or formats. .5 pt. Section I Description: Program Monitoring and Evaluation 20 points High Score High-Middle Score Low-Middle Score Low Score Each applicant will submit a logic model and an Internal Monitoring Plan narrative. The logic model depicts the logical relationships that exist among project goals, objectives, activities, inputs, and outputs/outcomes. It also describes the data-based indicators that will be used to provide evidence of the project’s effectiveness. A clear relationship must be made between the goals and objectives of the plan, the activities to be implemented and the outcomes anticipated. The internal monitoring plan is a narrative that describes the methods that will be used throughout the program to monitor accomplishment of the objectives included in the logic model. This narrative must include a description of: (a) the applicant’s capacity to access, collect, and analyze the data necessary to effectively document program objectives and outcomes; (b) the specific action steps that will be taken to monitor the activities included in the logic model, including a time line for completion of these activities; (c) assurances that monitoring results will be documented quarterly; and (d) how monitoring results will be continuously reviewed and used to inform program decision-making. Applicants must also assure that they will participate meaningfully in all mandated state and federal program evaluations of the CCLC program. The logic model template provided, including areas for goals, objectives, activities, inputs, outputs, outcomes and indicators is included. (10 pts.) The logic model is thoroughly completed for each program goal. The template shows a clear, effective relationship connecting goals and objectives, activities and outcomes. Process and outcome measures are included. The logic model is clearly aligned with the rest of the application. 10 pts. The logic model is complete for each program goal. The template shows a relationship connecting goals and objectives, activities and outcomes. Process and outcome measures are included. The logic model generally makes sense in the context of the rest of the application. 7.5 pts. Internal Monitoring Plan narrative including descriptions of: (a) the applicant’s capacity to access, collect, and analyze the data necessary to effectively document program objectives and outcomes; (b) the specific action steps that will be taken to monitor the activities included in the logic model, The Internal Monitoring Plan narrative is thoroughly completed. The narrative excels in describing all four components: The Internal Monitoring Plan narrative is complete. The narrative contains adequate descriptions of the four components: a) capacity to access, collect, and analyze data The logic model is completed poorly and may prompt questions. There is not a clear link between the logic model and the rest of the application. The template shows a minimal relationship connecting goals and objectives, activities and outcomes. Process or outcome measures are included. 5 pts. The Internal Monitoring Plan narrative is completed poorly and may prompt questions. The narrative may not fully address the four components: The logic model is poorly completed or incomplete, leaving obvious questions unanswered. There is little or no connection between the logic model and the rest of the application. The template fails to show a relationship connecting goals and objectives, activities and outcomes. Process or outcome measures are included. 2.5 pts. The Internal Monitoring Plan narrative is poorly completed or incomplete, leaving obvious questions unanswered. One or more of the four components may be missing: including a time line for completion of these activities; (c) assurances that monitoring results will be documented quarterly; and (d) how monitoring results will be continuously reviewed and used to inform program decision-making (8 pts.) a) capacity to access, collect, and analyze data b) time bound action steps for monitoring activities c) quarterly documentation of monitoring results d) explanation of how monitoring results will be continuously reviewed to inform program decision making 8 pts. Program participation in state and federal mandated annual evaluation, consisting of the following, is assured: 1. Collection of Annual Performance Report (APR) data through a WVDE data system 2. Completion of the USDOE 21 APR data collection system 3. Completion of the annual Teacher Survey by the regular classroom reading/language arts or mathematics teacher of regular attendees of the program. 4. Submission of the annual Program Director Survey (1 pt.) Program participation in state and federal mandated annual evaluation, consisting of the following, is assured: Collection of Annual Performance Report (APR) data through a WVDE data system Completion of the USDOE 21 APR data collection system Completion of the annual Teacher Survey by the regular classroom reading/language arts or b) time bound action steps for monitoring activities c) quarterly documentation of monitoring results d) explanation of how monitoring results will be continuously reviewed and inform project decision making 6 pts. a) capacity to access, collect, and analyze data b) time bound action steps for monitoring activities c) quarterly documentation of monitoring results d) explanation of how monitoring results will be continuously reviewed and inform project decision making 4 pts. a) capacity to access, collect, and analyze data b) time bound action steps for monitoring activities c) quarterly documentation of monitoring results d) explanation of how monitoring results will be continuously reviewed and inform project decision making 2 pts. mathematics teacher of regular attendees of the program. Participation in program monitoring, conducted by WVDE 21st CCLC staff, requiring submission of required documentation and arrangement of focus group interviews with key stakeholders is assured. (1 pt.) Submission of the annual Program Director Survey 1 pt. Participation in program monitoring, conducted by WVDE 21st CCLC staff, requiring submission of required documentation and arrangement of focus group interviews with key stakeholders is assured. 1 pt. - - - Section J Description: Budget and Budget High Score High-Middle Score Low-Middle Score Low Score Narrative 10 points A West Virginia Department of Education Budget Form must be completed for the first three years of the project. A mathematical narrative must be submitted detailing how funds will be expended in year one. All program components requiring grant funds must be included in the budget and narrative. Provide a detailed description explaining in-kind support and/or funding provided by co-applicant partners (if applicable) and other collaborating partners. WVDE Budget Forms for the first three years of grant funding are attached. Any support from other sources that will be used to fund the proposal, both revenue and inkind sources, is documented. (4pts) WVDE Budget Forms are correctly and completely filled-out for the first three years of the grant. Any revenue and/or inkind source used to fund the proposal is documented. 4 pts. WVDE Budget Forms are completely filled-out for the first three years of the grant but may contain an error. All revenue and/or in-kind sources used to fund the proposal may not documented. 3 pts. The budget narrative for year one includes a complete, mathematical basis for estimating the costs of personnel salaries, fringe benefits, project staff travel, student transportation, training, materials and supplies, equipment, evaluation, facility rental, background checks, indirect costs and other project expenditures is provided. (Each staff position is identified and the formula for rate of pay and the duration of services is provided, along with specifics on fringe benefits.) (5 pts.) The complete, correct mathematical basis for line-item estimations in the grant budget is provided in a clear, understandable manner. Each staff position is identified and the formula for rate of pay and duration of services is provided, along with specifics on fringe benefits. Line items for staff travel, student transportation, staff training, materials and supplies, equipment, evaluation, facility rental, background checks and The mathematical basis for line-item estimations in the grant budget is provided but is not clearly understood. Not all staff positions described in the grant are identified with the formula for rate of pay and duration of services, along with specifics on fringe benefits. Line items for staff travel, student transportation, staff training, materials and supplies, equipment, evaluation, facility rental, background checks and indirect costs, if these costs are associated with the proposal, are included, along WVDE Budget Forms are filled-out but may not be complete or correct. The first three years of the grant may not all be represented. All revenue and/or inkind sources used to fund the proposal may not be documented. 2 pts. The mathematical basis for line-item estimations in the grant budget is provided but is not clearly understood. Budget items may be incomplete or incorrect. Lack of information may raise questions. Not all staff positions described in the grant are identified with the formula for rate of pay and duration of services, along with specifics on fringe benefits. Line items for staff travel, student WVDE Budget Forms are neither correctly nor completely filled-out for the first three years of the grant. Any revenue and/or in-kind source used to fund the proposal is not documented. 1 pt. The mathematical basis for line-item estimations in the grant budget is provided, however there are numerous mistakes and oversights. Questions remain. Not all staff positions described in the grant are identified with the formula for rate of pay and duration of services, along with specifics on fringe benefits. Line items for staff travel, student transportation, staff training, materials and supplies, equipment, evaluation, facility rental, background checks and Indirect costs align with the school board rate or a maximum of six percent. (1 pt.) indirect costs, if these costs are associated with the proposal, are included, along with other project expenditures. 5 pts. with other project expenditures. 3.75 pts. Indirect costs align with approved school board rates. Community- and faith-based organizations have used a rate that is no more than six percent. 1 pt. - transportation, staff training, materials and supplies, equipment, evaluation, facility rental, background checks and indirect costs, if these costs are associated with the proposal, are included, along with other project expenditures. 2.5 pts. - indirect costs, if these costs are associated with the proposal, and other project expenditures, may be missing. 1.25 pts. -