e l /2 N O M B A p p r o v a l o . 2 5 0 6 - 01 4(5 xp .

0 7 /3 0 0 0 )

U. S. Department of Housing and Urban Development Office of CommunityPlaruring and Develooment

iF,6.

JFLTr..a tvullF"L?

Report (APR) Annual Progress

for SupportiveHousing Program ShelterPlus Care and Section8 Moderate Rehabilitation for Single Room Occupancy Dwellings (SRO) Program

Public reporting burden for this collection ofinformation is estimatedto average33 hours per response, including the time for reviewing instructions, s earc h i n g e x i s t i n g d a t a so u r ce s,g a th e r in g a n d m a in ta in in g thedataneeded,andcompl eti ngandrevi ew i ngthecol l ecti onofi nformati on genc y may Thi sa . not conduct or sponsor, and a personis not required to respondto, a collection ofinformation unlessthat collectiondisplaysa valid OMB control number.

General Instructions Purpose' The Armual Progress Report (APR) tracksprogramprogressand accomplishments the Deparfment'scompetitive in homeless assistance prograrru. Filing Requirements. Recipientsof HUD's homeless assistance Erants must submit 2 APR'S to HUD within 90 days after the end of each operating year. One copy of the report must be submittedto the CpD Division Director in the local HUD Field Office responsiblefor managing the grant. The other copy must be submitted to HUD Headquarters,Department of Housing and Urban Development,At|l1: APR Data Editor, F(oom7262,45l'7th Street,SW. Washington,DC. 20410. Failure to submit an APR will delay receiving grant funds and may result in a determination of lack of capacity for future funding. An APR must be submitted for each operating year in which HUD funding is provided. Granteesthat received SHP funding for new construction, acquisition, or rehabilitation are required to operatetheir facilities for 20 years. They must submit an APR 90 days after the end of the first operating year and any year in which they use SHp funding for leasing, supporlive services,or operations. For years in which they do not receive SHP funding, they must submit an Amual Certification of Continued Project Operation throughout the 20 years. The certification can be found at the back of this APR. A separatereport must be submitted for eachHUD grant received. For Shelter Plus Care, a separate APR must be submitted for each Shelter Plus Care component. For those granteesreceiving an extension,a separate report covering that period must be submitted (seeExtension below). Recordkeeping. Granteesmust collect and maintain information on eachparlicipant in order to complete an ApR. Optional worksheetsare attached. The worksheetsmay be used to record information manually or to design a computerized systemto store and tabulate the information. The worksheetsshould not be submitted to HUD with the ApR. Organization of the Report. The APR is organizedin the following manner: Part I: Project Progress. This portion of the report describes progress moving homeless the in personsto self-sufficrency, services received, project goals,and beds created. Part II: Financial Information. This portion of the report is completedby all grantees receivingfunding under SHp, S+C and SRO. Final Assembly of Report. After the entire report is assembled,number every page sequentially. Mark any questionsthat do not apply to your program with "N/A" for not applicable. (SeeSpecialInshuctionsfor SSOProjectsbelow.) Definitions. The following terms are used in the APR. As indicated, in some cases,terms are applied differently dependingon whether the funding is from SHP, S+C, or SRO. Chronically homelessperson - HIiD definesa chronicallyhomeless personas "an unaccompanied homelessindividual with a disabling condition who has either been continuously homelessfor a year or more OR has had at leastfour (4) episodes ofhomelessness the past three (3) years." To be considered in chronicallyhomeless a person must have been on the streetsor in an emergencyshelter (i.e.not transitional housing) during these stays. Disabling condition - HUD defines"disabling condition" as "a diagnosable substance disorder,seriousmental use ilLness,developmental disability, or chronic physicai illness or disability, including the co-occurrenceof two or more of theseconditions. A disablingcondition limits an individual's ability to work or perform one or more activitiesof rleikz living." Entered the program for S+C and SRO projectsmeanswhen the participantstartsto receiverental assistance. For S*C, services provided prior to this point are recognizedas necessary outreach/enrollment are eligible to count as for and match.

HUD-401 18

from An Extension ApR applies to SHP and S+C granteesthat requestedand received an extension of their grant term the HUD held office. the only difference between an APR for the extensionpenod and the regular APR (besidesthe amount of time covered) is the signaturepage. Granteesshould circle "yes" to indicate the APR is for an extension nerind and circle fhs operatingyear for which the report is an extension. For example,if the granteeis extendingyear 3, the granteeshould submit an APR as usual for year 3 and submit anotherAPR for the extension period, indicating the secondis an extension and also circiing year 3 on the signaturepage. F amily meansa householdcomposed two or more relatedpersons,at leastone of whom is an adu1t.Caregiversare of not reporled on in the APR. Grantee meansa direct recipient of the HUD award. Left the program for S+C projectsmeanswhen the participantstopsreceivingrental assistance is not expectedto and return to S+C assistedhousing. If the participant returns to S+C assistedhousing within 90 days, the person should not be consideredas exiting from the program. If the person returns to S+C assistedhousing after 90 days, that person is considereda new participant. The worksheetis designedto capture this information. Match for S+C meansthe value of supportive servicesreceived by participants in the S+C project which, in the provided over the life of the project. For SHP, match aggregate,must at least equal the value of the S+C rental assistance means cashused to provide the grantee'sportion of acquisition, rehabilitation, new construction, operationsand supportiveser.lices expenses. Operating year for SHP meansthe date when parlicipants begin to receive housing and/or services. The fust operating year begins after developmentactivities for acquisition, rehabilitation, and new construction are complete, after a copy of the Cefiificate of Occupancy is sentto the local HUD office, and when the first participant is acceptedinto the project. For projects without acquisition, rehabilitation, or new construction, the operating start date begins when the grantee acceptsthe first participant. For S+C (SRA, PRA and TRA components),the first operating year begins on the date HUD signs the grant agreement. For S+C/SRO and for Sec. 8 SRO, the first operating year begins with the effective date of the Housing AssistancePalments (HAP) Contract. To determine which operating year to circle on the APR cover page, begin counting from the initial grant operating start date and include renewals grants. For example, a project receiving an initial grant for three years and a renewal grant for two years would circle years 1, 2, and3 respectively on the APR cover sheetfor the initial grant and would circle 4 and 5 respectively for the renewal grant. For any future renewal grants, the granteewould begin by circling 6 on the APR cover sheet. during the operating year. Participant Participant means single personsand adults in families who received assistance does not include children or caregiverswho live with the adults assisted. Project Sponsor meansthe organizationresponsible for carrying out the daily operation of the project, if the organization is an entity other than the grantee. SSO grantees shouldcompleteall questions, Special Instructions For Supportive Service Onlv Proiects. unlessa written agreementhas been reachedwith the freld office concerning which questionscan be answeredusing estimates,or in rare instances, skipped. SSOproject: Below is an exampleof how informationcould be derived in a large, single-service A grantee/sponsor staff member could be assignedto collect information from the organizationshousing the parlicipants. The staff person would contact these individual organizationsto request information regarding the persons in that facility that use sponsormay provide estimates. the service"For participantsliving on the sffeet,the grantee/project Inforrnation could be collected for eachparticipant or for parlicipants receiving servicesat a point-in-time. If estimatesor point-in-time counts are used, the method used must be described in the APR and the documentationkept on hle. grants,grantees As with all projectsfunded underHUD's homelessness assistance operatingSSO projects are expectedto compieteall APR questions that are applicableto them. Note that all projectshavebeen awardedfunds as a result of
HUD-40118

and respondingto the program goals of assistinghomelesspersonsobtain/remain in permanenthousing and increasetheir skills income. The APR documentstheir progressin meeting these goals. In some circumstances fie1d ofhces and granteesmay sign a written agreementconcerning questionswhich can be answered Belowaresomeconsiderationsforreportingonparticulartlpesofprojects: usingestimates,orinrareinstances,skipped. Outreach Only Proiects. - Projectslvhich are so1ely devotedto streetoutreachand connectionto housingand servicesare not required to track participants beyond their contact with persons on the street. It is sufficient for theseproj ects to enter informationon questions1-10 (skipping questions11-13and 17). Estimatesfor questions 5-9 are aliowed, given that participants may be reluctant to answerpersonal questions. Answering the questionswill demonstratethat the granteeis serving the appropriate nr.rmber people, providing basic of demographicinformation for Congress,demonstratingthat homelesspersonsare behg served,demonstratingthe types of housing parlicipants are connectedto, and the type ofservices they are receiving. Hotline Proiects. - Hotline servicesare similar to outreach projects,but contactbetweengranteeand participantis often of very short duration - people enter and leave the program nearly simultaneously. It is sufficient for theseprojects to answer questions (skipping 1-5 4),10, and 14-19(skipping17). Proiects Providing Sgrvices To Children Only. - Projectsthat provide child care,after schoolcare,counselingfor children, etc. make an important contribution toward moving a famrly out of homelessness.While the main focus of the project is providing servicesto the children, it is the adults who are reported on in questions6-16 of the APR. Like al1other projects, this b.?e is also targetedtoward getting the families into housing and increasingthe families' incomes. Granteesmay skip question 9; all other questionsshould be answered(except 17). Transportation. Medical. Dental. and Other Single. Short-Duration Service Proiects. - Somegrantees provide a single service of fairly short duration focused ONLY indirectly on assistinghomelesspersonsto obtain/remain in permanent housing and increasetheir skills and incomes. It is suff,rcient theseprojects to enter information on questions 1-10 and 14for 19 (question l7 may be skipped). However, with transportationservices,it is urueasonableto think that someonewould have to give their age,race, and ethnicity to a bus driver to get a ride a few blocks. For theseservices,provide a narrative, which gives the number of rides given during the operating year, and provides estimates on the above statisticsbased on the population that utilizes the service. Special Instructions For Safe Haven (SH) Proiects. - Granteesare remindedthat they are to report ONLY on the number of participants the application was approved for (cannot exceed25 participants). Homeless Management Information System (HMIS) Proiects. - HMIS grantees shouldfrll out the cover sheet of the APR (marking HMIS at the bottom) and Part II Financial Information. The APR also has a sheetthat lists HMIS activities.

HUD-40118

THIS PAGE - TO BE COMPLETED BY ALL GRANTEES

urantee: Cit y and Count y o f Sa n F ra n c i s c o :D e p a rl mentof H uman S ervi ces
Project Sponsor:

HUD Grantor ProjectNumber:

cAO'1850102s
D .n i o n f \T"'.-

Northern California ServiceLeaoue

Operating Year: (Circle the operatingyear being reportedon)

CameoHouse
Reporting Period: (monrlr/d,ay I year)

lr J z t r : l + n s !o Z t l s@ l ro nll [ 1 2 [ r : n r + l i s n ro n rz Irs n rs l zo
Indicateif extension: I Yes x No Indicateif renewal: xYes fl No PreviousGrant Numbers for this proiect:

ftom:1102106 to 1101107

c AO1 8 0 0 1 0 2 4
cA3989601 30

cA018401011

cAO1 8201 007 cAO 1 01007 83

Check the componentfor the programon which you arereporting.

SupportiveHousing Pro gram (SHP) 6 I

Ll

Shelter Plus Care (S+C)

Section ModerateRehabilitation 8 n Single RoomOccupancy (Sec. SRO) 8

T.ansitional Housing Permanent Housing for Homeless Persons with Disabilities

)ale llaven

n tr n r

Tenant-based Rental Assistance(TRA) Sponsor-based RentalAssistance (SRA) (PRA) Project-based Rental Assistance (SRO) SingleRoom Occupancy

I I f]

Innovative Supportive Housing SupporliveServicesOnly HMIS

Summary of the project: (One or two sentences with a descriptionof population,number servedand accomplishments operatingyear) this CameoHouseis a transitionalhousefor homelessex-offender women with children ages0-6 years. The approximatelength of stay is 6 to 12rronths. Thisyear,thehousewasfilledtocapacityfromFebruarythroughtheendofthecalendaryear. Attheendofthecalendaryear
there were approximately i0 clients on the waiting list. Name & Title ofthe Personwho can answerquestionsabout this report: Stephanie Hall Director Address: 424 Guerrero Street San Francisco,CA 941 l0 Phone: (include area code)

(415) 703-0600
Fax Number: (include area code)

(415) 703-0s50
E-mailAddressstephani_hall@sbcglobal.net

I herebycertify that all the informationstatedherein is true and accurate.

Warning: HUD will prosecutefalseclaims and statements. Conviction may result in

(18U .S .C

1 0 1 0, 1012; 31U. S . C3 7 2 9 ,3 8 0 2 ) .
Name & Title of Authorized Grantee Olficial Signature & Date:

Mik

tN ADViruTv ['nace,a"ra lk
Signafure &

Kim-Molina. GrantsManaoer

6p.Mryru

o7
-MounA

Name and Title of Authorized Proiect Sp<insor Official

Shirley Melnicoe Executive Director

,$i\o\.oi* e/a+/m\
HUD-40118

(EXCEPT HMIS) BY PARTI. TOBE COMPLETED ALL GRANTEES

SSO PLEASE INSTRI]CTIONS PAGE3 OF THEAPR GRANTEES, SEESPECIAL ON Part I: Project Progress
1. ProjectedLevel of Personsto be served at a given point in time. (from the application, SHP-Sec. SpC-Sec, F; D; SRO- Sec.D)
Number of Singles Not in Families Numberof Adultsin Families
Number of Children in Families

Numberof Families

Proiected Level a.

Persons be served a givenpointin time to at PersonsServed during the operating year.

++New Director took over on 1/15/07. After review, pleasenote the accurate numbersof families enrolled in oroeram. Number of SinglesNot in Families

11

11

2.

Number of Adults in Families 4

Number of Children in Families

Number of Families

a.

Number on the first day ofthe operatingyear(January 1) Number enteringprogram during the operatingyear Number who left the program during the operating year

II

b.

23
lo

30

23
16 lt

d.

Number in the program on the last day of the operating year (a+ b-c):d

11

20

3.

Project Capacity.
Numberof Singles in Not Families Numberof Adultsin Families Numberof Childrenin Families

Numberon the lastday (from 2d, columns1 and4)

Number proposedin application(from 1a, columns 1 and 4) CapacityRate (divide aby b) -- %

4.

Non-homeless persons. This questionis to be completedfor Section8 SRO projects.

ila

How many income-eligibie non-homeless personswere housedby the SRO programduring the operatingyear?

5.

Age and Gender. Of thosewho entered the project during the operatingyear, how many people are in the following age and gender categories?
(from 2b. column 1) Single Persons a. b.
c

Ase
62 and over

Male

Female

51-61

31-50 I 8-30
I 7 and under

(from 2b. columns & 3) Persons Families in 2

f.

62 and over

s.
h.
L t.

51 -61

31-50 18- 30 t3-17

6-12 Under 1 6 5

8 l5

k. I
m.

10 8
HUD-40118

Answer questions - 10 oniy for participants who entered the project during the operating year (from 2b, columns | &2). 6 The tenn participant meanssinglepersonsand adultsin families. It doesnot include children or caregivers.NOTE: The total for questions, 8 and 10 below shouldbe the same;respondto eachof thosequestions all participants. Someof the for 7, questionslisted throughout the APR will be asking information for individuals who are chronically homeless.
6a. Veterans Status. A veteranis anyonewho has ever been on active military duty status. How many participants were veterans? 6b. Chronically homelessperson. An unaccompanied homelessindividual with a disabling condition who has either been continuously homelessfor a year or more OR has had at leastfour (4) episodes ofhomelessness the pastthree (3) years. To be considered in chronically homeless a person must have been on the streets or in an emergency shelter (i.e. not transitional housing) ring these stays. How many participantswere chronically homelessindividuals? 7.
a.

| +

Ethnicity. How many participantsare in the following ethnic categories? Hispanic or Latino Non-Hisoanicor Non-Latino Race. How many participantsare in the following racial categories?
a.
tc A

b. 8,

10

d.

f h.
I

American Indian/Alaskan Native Asran Black/African American Native Hawaiian/Other Pacific Islander White American Indian/AlaskanNative & White Black/African American & White American Indian/AlaskanNative & Black/Afiican Amencan Other Multi-Racial

0
16
I

2
A

s. Asian& White

0 0 0 0

9a. Special Needs. How many participantshave the following? Partic:ipants may have more than one Ifso, count them in all applicablecategories.For eachcondition, also indicatethe number that were chronically homeless. All Chronic

Mentalillness
b.

5
LJ

c. d.

Alcohol abuse Drus abuse HIV/AIDS and relateddiseases Developmentaldisabilitv

z)

I
g.

Phvsical disabilitv
Domestic violence Other (oleasesoecifv)

l0

h.

9b. How many of the participantsare disabled? 1l--l

HUD-40118

10. Prior Living Situation. How many participantsslept in the following placesin the week prior to enteringthe project? (For each participant, Chooseone place). Also, indicatehow many chronically homelessparticipantsslept in the following places. (Chooseone) All b.
c.

Chronic
A
I

(street, park,car,bus station, Non-housine etc.) Emergencv shelter persons Transitional housinsfor homeless Psvchiatric facilitv* Substance lacilitv* abuse treatment
Hosoitalx

d. f. h.
I

8 2 4

t.

Jail/orison* Domesticviolence situation Livins with relatives/friends Rentalhousins Other (pleasespecify)

*lf a participant came froman institution wasthereless but than30 daysandrvasliving on thestreet ln or emergency shelter before entering treatment facility, he/she should counted either street shelter be in the the or category, appropnate. as

Completequestions1I - l5 for all participants who lgft during the operating year (from 2c, columns 1 and 2). The term participantmeanssinglepersonsand adultsin families.It doesnot include children or caregivers.The term chronically homelessperson meansan unaccompanied homeless individual with a disablingconditionwho has eitherbeen continuously homeless a year or more OR hashad at leastfour (4) episodes homelessness the past three (3) years.To be considered for in of shelter(i.e. not transitionalhousing)during chronicallyhomeless personmust have been on the streets in an emergency a or thesestays. participants left duringtheoperating year, who how many I 1. Amountand Source Monthly Incorire Entry and at Exit. Of those of at place monthlyincome participants at each of the levelandeach were monthly income levelandwith each source income? Also,please persons thesecond of in source income chronically of for homeless in column each of chart.Thenumber participants ChartA and B should thesame. be
All A, Monthlv Income at Entrv No income b. c. d. Chmnic C. Income SourcesAt Entrv Supplemental SecurityIncome (SSI) b. Social SecurityDisability Income (SSDI) Social Security
A

All

Chmnic

S 1 50 $15 - s250

s25 - $500
$50 - $ 1, 00 0

d.

General Public Assistance TemporaryAid to Needy Families(TANF)

l0 z
f.
a

t0

f.

sr001$1500 s150152000
+ $2001

(SCHIP) Program Children's HealthInsurance State Veterans Benefits

EmployrnentIncome Benefits Unemplo;,nrent I

h.

h.

J
L

VeteransHealth Care Medicaid

FoodStamps m
n. Other (pleasespecify) No FinancialResources

l3

HUD-4018 I

All B. Mon thly I nc om eat Er it

a.

Chmnic
::j.-::.:;:;i

AII
at D. IncomeSources Exit SecurityIncome (SSI) Supplemental

Chmnic

....
2

No income

b c. d
E.

s1150
$151 5250

b.
d.

Social SecurityDisability Income (SSDI) Social Security GeneralPublic Assistance (TANF) Aid to NeedyFamilies Temporary

r
g

s251- $500 s501 $1,000 s1001s1500

$1501$20 0 0 + $2001

6 1 i
o

(SCHIP) Program Health Insurance State Children's Benefits Veterans

Emplol,rnent Income Unemplovment Benefits

n.

J
1.

Veterans Health Care Medicaid Food Stamps

t4

m n

specify) Other(please
No FinancialResoutces

tZa. t-engttr of Stay in Program. Of those participants who left during the operating year (from 2c, columns I and 2), how many were in the project for the following lengthsof time? Also, pleaseplace the length of stay for chronically homelesspersonsin the second column. All 4 Chronic

b.
u
C. I

Lessthan 1 month I to 2 months

3 - 6 months
7 months - 12 months l3 months - 24 months

2 7 2 1

i
g

25m ont h s -3 v e a rs
4vea rs-5 y ear s 6yea rs-T y ear s 8 vears- 10 vears

h.
t.

t.

Over10vears

that did not leave during the operatingyear (from 2d, columns 1 and 2), how l2b. Length of Stay in Program. For those participants place the length ofstay for chronically homelesspersonsin the secondcolumn. long have they been in the project? Also, please All Lessthan 1 month b. d. f. h. Chronic

I to 2 months
3 - 6 months 7 months - l2 months l3 months - 24 months 2 5mo nth s - 3v ear s 4 ve ars-5v ear s

J J

6v ear s -T y e a rs
8 vears- l0 vears

Over10vears

HUD-40118

13.Reasons Leaving. Of those for participants left theproject year who duringtheoperating (from2c,columns and2), how many 1 left for thefollowing reasons? a participant for multiple If left reasons, includeonlv theprimary reason.Also,please place the primary reason chronically for homeless persons thesecond in column.
All
a.

Chronic

Left for a housing opportunitybefore completingprogam Completed program Non-pa;nnent of rent/occupancycharge Non-compliance with project Criminal aclivity I destruction of property / violence 1i

b. c. d.

f
o

Reached maximum time allowed in oroiect Needscould not be met by project Disrgreement with rules/persons Death Other (pleasespecify) Unknown/disappeared

h.
1

J.
t.

l4'

Destination. Of those participants who !g[ during the operating year (from 2c, columns 1 and2), how many left for the following destination?Also, pleaseplace the destinationof chronically homelesspersons in the secondcolumn All PERMANENT (a-h) Rentalhouseor apartment(no subsidy) Chronic

b.
d.

PublicHousing
Section8 ShelterPlus Care HOME subsidizedhouse or apartment

f.
b.

Other subsidizedhouse or aoartment Homeownership

h.

Movedin with family or friends Transitional persons housing homeless for

Moved in with family or friends Psychiatrichospital Inpatient alcohol or other drus treatment facilitv Jail/prison Emergency shelter Other supportivehousing Places not meantfor human habitation(e.g. street) Other (pleasespecify) Unknown

-7

TRANSTTTONAL (i-j) INSTITUTION(k-m)

l.

J.
1K.

t.
m.

I I

(n) EMERGENCY SHELTER OTHER(o-q)

n. o
Y'

Y.

LINKNOWN

10

HUD-40118

year 1 the who 15. Supportive Services. Ofthoseparticipants left duringtheoperating (from2, columns and2), how manyreceived place supportive the services received chronically for duringtheirtimein theproject? Also,please followingsupportive services year column participants left duringtheoperating in thesecond homeless who

a.

Outreach Case management Life skills (outsideof casemanagement)

AII 6 6 6
o

Chronic

b.
d.

Alcohol or drug abuseservrces Mental health services

6 6 6 6 6
6

f
g

HIViAIDS-related services Other health care services Education Housing placement EmPloYT nent assistance

h.

1.

Child care Transportation

6 6 6

m. n.

Legal

specify) Other(please

l1

HUD-401l8

16. Overall Program Goals. Under objectives, your measurable iist objectivesfor this operatingyear (from your application,Technical Submission, APR) for eachof the three goalslisted below. Under Progress, or describeyour progress meetingthe objectives. in Under Next OperatingYear's Objectives,specifythe measurable objectivesfor the next operatingyear.

a.

ResidentialStability Objective:65% will transition to permanent housing within six to twelve months Sevenfy-five percent(12 out of 16) of our CameoHousewomen transitionedinto permanent housingwithin six to twelve months during the nine month period beginning Janurary | , 2006 - January 1, 2001.----NextOperating Year'sObjectives: 65oh will transition to permanent housing within six to twelve months

Objective: 600/o program graduates who securehousing will remain in permanent housing at least one year. of 68% ofprogram graduateswho securedhousing have remained in perrnanenthousing for at least one year. (1 1 out of 16 participants) Next OperatingYear's Objectives: 60'h of program graduates who secure housing will remain in permanent
h n r r s i n o e t l pr sf n n p vp e r

b.

Increased skillsand income based clientscompletion Cameo on of House Objective: 607o will enter employment or further education within 6 to 14 months. 8'7.5Yoof ow women entered either emploltnent or further education within six to fourteen months during this operatingyear.(14 of 16 participants) Next Year's Objective: 607o wilt enter employment or further education within 6 to 14 months Objective: 40oh of program participants who enter vocational training or seek further education will complete the vocational or educational program Progress: 25%oof participants (4 out of 16) enrolled have completed their progarn, however this number does not reflect those pafticipants who are still enrolled in a vocational or educational program with the expectation of completing. Next year's goal: 40o/, of program participants who enter vocational training or seek further education will complete the vocational or educational program.

Objective: 1007o of residents will completeNCSL's Life Skill Program

93o% our residents of completedNCSL's Life Skill Program( 15 out of 16 women). One woman left the program prror to enrollment in the Lifeskills workshop. Next Year's Objective: 100% of residentswill complete NCSL's Life Skill Program Objective: 95o/oof program participants who enter the program without TANF, Food Stamps or SSI will be enrolled in these benefits within the first 30 days of the program. Progress:100% of Cameoparticipants have achievedthis goal. (16 out of 16 women) Next year's objective:95% of program participants who enter into the program without TANF, Food Stamps or SSI will be enrolled in these benefits within the first 30 days.

1,2

HUD-401 18

Greater Self Determination Objective: 100% of residentswill participate in structured activities such as support groups, parenting and money management; NA/A{, etc. Progress: 100o/o CameoHouseparticipantshave achievedthis goal. ( 16 out of 16 women) of Next year's goal: 1007o of residentswill participate in structured activities such as support grgups,parenting and money management; NA./AA, etc.

Objective: 807o will reunite with their youngest child. Progress: 100% of our women obtainedor retainedcustodyof a minimum of one child while at CameoHouse. (16 out of 16 women) Next year's goal:807o will reunite with their youngest child. Goal: 1007' of babies and children will have up-to-date immunizations and will baby/child check-ups. attend all scheduled

Progress: 100% of our Cameo House babies and children had up-to-dateimmunizationsand attendedall scheduled baby/child check-ups. (16 families out of 16 families) Next year's goal:1007o of babies and children will have up-to-date immunizations and will scheduledbaby/child check-ups. attend all

Goal: 1007o of residents will develop a written plan outlining their educational, vocational. Life skills. and housing goals within 30 days of entering the program. l00Yo of our residents completed written plans outlining their educational, vocational. life skills and housinggoals within thirty days of entering CameoHouse. (16 out of 16 women) Next year's goal: 100o/oof residents will develop a written plan outlining their educational, vocational. Life skills, and housing goals within 30 days of entering the program.

Goal: 507o will continue participation in recovery groups and counseling services for six months after leaving the program Progress: 81% ofresidents have continued to participate in aftercareservicesas well as outpatient support durtng this operating year. (13 of 16 women) 50% of graduating clients that remain in contact with Cameo House participite rn recoverygroupson a regularbasis.(8 out of 16 women) Nextyear's goal:50o/owill continue participation in recovery groups and counseling services for six months after leaving the program

13

HUD-401 l8

answer 17c. (,S/IP-SSO projects do answer17b. SROrecipients 17. Beds. SHPrecipients answer17a. S+Crecipients

not completethis question)

a. SHP. How manybedswereincluded the application in for approved this projectunder'CurrentLevel' andunder'New Effort'? How manyof these New Effort bedswereactuallyin placeat the endof the operatingyear?

Current Level New Effort New Effort in Place Numberof Beds: 22 b. S+C. How manybedsanddwellingunitswerebeingassisted with projectfundsat the endof the operatin year? g (Includebedsfor all participants, otherfamilymembers, caregivers.) and Numberof Beds: Numberof Dwelling Units: c. SRO. How manydwellingunitswerebeingassisted the endof the operatingyear'! at (Includeunitsoccupied "in place"non-homeless persons by who qualiff for assistance.) Numberof Dwellins Units:

t4

HUD-401 l8

Part II: Financial Information

18. Supportive Services. For SupportiveHousing (SHP), this exhibit provides information to HUD on how SHP funding for supportiveserviceswas spentduring the operating year. Enter the amount of SHP funding spent on thesesupportiveservices. Include HMIS costsunder "Other". For ShelterPlus Care(S+C), this exhibit tracksthe supportiveservices match requirement. Specify the value of supportiveservicesfrom all sources that can be countedas match that all homelesspersonsreceivedduring the operating year. (S+C grantees should keep documentationon file, including source,amount,and type of supportiveservices.) For Section 8 SRO, this exhibit provides information to HUD on the value of supportiveservicesreceivedby homelesspersonsduring the

SupporliveServices
a,

Dollars 2,382.17
36,875.98

Outreach Casemanagement Life skills (outsideof casemanagement) Alcohol and drug abuse services Mental healthservices

b. c. d.

23,821.69
R 795 qc)
4 41R q)

f.
g

AIDS-relatedservices Other health care services Education Housing placement Employrnent assistance Child care Transportation Legal Other (pleasespecify Recreation/ArtEducation Residential lvlanagement Servrce

8,385.24

h.
I

r7,866.27
.42 5,955 11,910.85 25,08.8I 1

k. I
m.
n.

r0,610.92

8,996.20 23,028.54 187,630.00

o.

TOTAL (Sum of a through n)

Cumulative amountof match provided to date for the Shelter PIus Care Program under this grant

15

HUD-40118

19. Supportive Housing Program: Leasing, Supportive Services, Operating Costs, HMIS Activities and Administration All grantees receivingfunding underthe SupportiveHousing Programmust completethesechartseachoperatingyear.For expansion projects: IfSHP grant funds are for the expansionofa pre-existinghomelessfacility, only the peopleand expenditures the additional for expansion may be included,as in the original applicationor any grant amendments.Documentationof resources usedis not requiredto be submittedwith this report but shouldbe kept on file for possibleinspectionby HUD and Auditors. Do not include any expenditures made beforethe SHP grant was executed. Summary of Expenditures. Enter the amountof SHP grant funds and cashmatch expended during the operatingyear for eachactivity. This table should add up both horizontallyand vertically. The SHP supportiveservices total shouldbe the sameas the SHP supportive servrces Questlon18. rn SHP Funds Leasing b.
c. d

CashMatch

Total Expenditures

SupportiveServices OperatingCosts HMIS Activities Administration Total

1 8 7 ,6 3 0.00 1 0 1 87.00 .4

62,465.69 3E ,015.55

250,095.69 139,502.5s

7,228.00 296,345.00

0.00 t00,48t.24

7,228.00 396,826.24

Note: Palments of principal and interest on any loan or mofigage may not be shown as an operating expense

Sourcesof Cash Match. Enter the sources cashidentified in the Cash Match column, above,in the followine of categories.. Use additionalsheets, necessary. as Amount Grantee/project sponsor cash b Local government (please specify)

85,8 8 02.0

Stategovemment (pleasespecify)

d.

Federalgovernment(pleasespecify) Community DevelopmentBlock Grant (CDBG)

E.

Foundations(pleasespecify)

f.

Private cash resources (please specify)

Occupancy charge / fees

14.679.16 100,481 .24

Total

16

HUD-401t 8

20. Supportive Housing Program:Acquisition, Rehabilitation, New Construction and

All grantees that receivedSHP funds for acquisition,rehabilitation,or new constructionmust completethesecharls in the year one APR oniy. This exhibit will ciemonstrate HUD that the granteehas contributedenoughcashto at leastequally match the amount of SHP funds to spentfor acquisition, rehabilitation, new construction. Documentation or that matching funds were provided is not requiredto be submitted with this report but shouid be kept on file for oossiblei ion bv HUD and Auditors. Summary of Expenditures. Enter the amountof SHP grant funds and cashmatch expendedduring the operatingyear for eachactrvity

SHPFunds
a. b

Cash Match

Total Expenditures

Acquisition Rehabilitation New construction Total

c. d.

Cash Match. Enter the sourcesof cashidentified in the CashMatch column, above,in the following categories. Use additional sheets, necessary. as

Amount
a

Grantee/proj sponsorcash ect Local government(pleasespecify)

b.

c.

Stategovemment(pleasespecify)

d.

Federalgovernment(pleasespecify) Community DevelopmentBlock Grant (CDBG)

Foundations(pleasespecify)

Privatecashresources (pleasespecify)

Occupancycharge/fees Total

h.

l1

HUD-401 18

FOR HMIS ACTIWTIES ONLY

2l . For Supportive Housine (SHP) - H1VIISActivities This exhibit providesinformation to HUD on how SHP-HMIS funding for supportrveservrces was spentduring the operating year. Enter the amount of SHP-HMIS funding spenton theseactivities.

HMIS Activities Onlt

Dollsrs

E,
CentralServer(s) PersonalComputers and Prhters Networking Security Subtotul Software/ User Licensins SoftwareInstallation Support and Maintenance SupportingSoftwareTools Subtotal

,Se rvices
Trainins bv Third Parties Hosting/ Technical Services Programming: Customization Programming: SystemInterface Programming: D ata Conversron SecurityAssessment and Setup On-lineConnectiviry(Internet Access) Facilitation Disasterand Recovery Subtotal

Personnel
Project Management / Coordination Data Analysis Programming Technical Assistanceand Trainine Administrative Support Staff Subtotal HMIS SpaceCosts OperationalCosts Total

18

HUD-40118

Describe any problems and/or changesimplemented during the operating year. On January 21,2006, Cameo House brought on a new Program Director, Stephanie Hall to replace outgoing Director, Deborah Yarock. Cameo House was filled to capacity within thirty days of Ms. Hall's hire date and remained so throughout the calendar year. Case management staff was also changed in mid-Fetrruary, when outgoing Case Manager Leona Lewis was replaced with monitor Yvondalee Davis. In early June, Cameo House's therapy intern, Susan Matsumura completed her internship which left several of clients without an individual therapist as Carol Norris, current therapist was unable to absorb all clients. This problem was complicated by the fact that many clients did not have proper insurance that would cover the cost of individual therapy sessions.Cameo House was able to recruit one pro-bono therapist to refer our clients to and Carol Norris was able to extend her hours to accommodatethree additional clients. All clients were receiving therapy on a weekly basis by the end of July. Cameo House brought on a new Art Director, Yustenov Smith to facilitate both a weekly group with the women as well as the designing of a sculpture garden that will be displayed in the back yard of Cameo House. The participants in the program have named this garden "Maternity" to reflect the bond between mother and child. In late October, Cameo House graduated 12 successfulparticipants with a lovely ceremony that reflected their accomplishments. Many outside agencieswere in attendance. During the holiday period, clients received many donations that allowed them to give a beautiful Christmas to their children. The main concern that is noted by both staff and clients is the lack of permanent housing in the Bay Area. Many clients completed their requirements of the program but had nowhere to transition to becauseof their housing needs. Some transitioned to family members but by the end of the calendar year were still unable to obtain their own housing units. Cameo House did not move up on the list with Shelter Plus Care and no Section 8 vouchers were issuedin San Francisco.

Technical Assistanceand Recommendations Based on your experience during the last year,are there any areasin which you needtechnicaladviceor assistance? Ifso, pleasedescribe

technical supportand assistance whenever needed. No, I feel that we havegottenexcellent

19

HUD-40118

Annusl CertiJication of Continued Project Operation

Supportive HousingProgram
ProjectNumber: ProjectName: OperatingStartDate:
Grantees that receivedSupportiveHousing Programfunding for new construction, acquisition,or rehabilitationarerequiredto operate their facilities for 20 years.

, certify that the facility that receivedassistance acquisition,rehabilitation,or new constructionfrom the for SupportiveHousing Programhas operatedas a facility to assisthomeless personsfrom * I also certify that the grantis still serving to _. number of

I,

(mo/yr)

(mo/yr)

persons at

(site address) and all the requirements the grant agreement being satisfied. of are

(Signature) (Title) (Dateof Certification)

*Current Year 20

HUD-40118

PersonsServed Worksheet - IIUD Annual Progress Report

This workheet is optional andis intndedto help collet infomation neededto complteth Annual Progrss Report. lnstrrlctionsdd Codesfo low. Do not subdt th IIL'D. 'ou
Number of Months in Project (calculate) 12a Number of Months in Project-Participant did not leave (calculate) t2b New Participant (Y /N )

2l

HUD-40118

Persons Served Worksheet (continued)

Do not submit this worksheet to HUD
No. Veterans Status(Y/N) 6a Chronically Homeless ( Y n J) 6b Ethnicity (code) 1 Race (code) 8 Spccial Needs (code) 9a SpecialNeeds (code) 9b Prior Living Sitr"ration (code ) l0 Monthly lncome At Project Ilntry l la Monthly lncome At ProjectExit llb Income Sources At Entry (code) l lc IncomeSources At Exit (code) l ld

22

tIU D -401 l 8

Persons Served Worksheet (continued) Donotsubmit worksheet HUD this to

No. Reasonfor Leaving Program (code) l3 Destination (code)
t4

Supportive Sewices (code) 15

Notes

L)

Instructions and Codes for PersonsServedWorksheet T he use o f this wor k s heet is opt ional. I t was des i g n e d to he lp you co llect inf or m at ion on par t ic ipant s ne e d e d to comple te the An nual Pr ogr es s Repor t . I f t he work sh ee t is u pd ate d as par t ic ipant s m ov e in and m o v e out o f you r pro ject, m os t of t he inf or m at ion r equi r e d f or comp letio n will be c ont ained in t he wor k s hee t . D o not s ub mit th is wo rk s heet wit h t he ApR. F or pro jects tha t ser v e f am ilies , HUD only r equir e s repo rting o n th e n um ber of c hildr en s er v ed, and t h e age and ge nd er of thes e c hildr en. O nly nam e, relation sh ip, d ate o f bir t h, and age on t he wor k s h e e t need to b e comp lete d f or c hildr en. As s ign t he ad u l t s a numbe r, bu t n ot ea c h f am ily m em ber . Us e t his nu m b e r t o tra nsfer to th e other pages of t he wor k s heet . B eginn ing with n um ber 4, t he num ber s in t he c olu m n s ref er to the qu estion s on t he APR f or m . I f any ques tron s a re an swe r ed wit h "O t her , " pleas e ent er t h e specific "Othe r" a ns wer f or inc lus ion in t he ApR. P art icipa nt Nu mLre r . This c olum n allows y ou to eithe r n umb er pa r t ic ipant s c ons ec ut iv ely or t o assign a case nu mbe r . O ne num ber s hould be assig ne d to e ach a du 1t . Name. Na mes of p er s ons will not be r epor t ed t o HU D. Th e u se o f na m es is f or y our r ec or d k eepr ng conven I en ce . Relatio nship . En ter t he appr opr iat e r elat ions hip. E xam p les in clu de : S elf , Head of hous ehold, Spou s e , child. E ntry Da te. Ente r d at e par t ic ipant ent er ed t he proiect. Usua lly th is will be t he dat e of ac t ual physical move-in for a hous ing pr ojec t . E xit Da te. Ente r d at e par t ic ipant lef t t he pr ojec t . U sually th is will be t he dat e t he par t ic ipant physica lly moved o ut f or a hous ing pr ojec t . Do n o t includ e a p articipa nt who t em por ar ily lef t t he pr oj e c t and is e xp ected to ret ur n in les s t han 90 day s ( e. g . hospita liza tion y. 4. In co me-e ligib le Non- hom eles s in SRO . The S R O pr o gra m a llows as s is t anc e t o unit s oc c upied b y Se ctio n 8 in co me- eligible per s ons r es iding at t h e SRO p rior to re habilit at ion. For SRO pr ojec t s only, in dicate whet her t he par t ic ipant is an in co me-e ligib le, non- hom eles s per s on ( y ) or n o t (N). SHP an d S+ C pr ojec t s s hould s k ip t his it e m .

6a. Veterans Status. Indicate if the participant is a veteran. Please nole; A veteran is anyone who h a s e v e r b e e n o n a c t i v e n t i l i t a r y d u t y s t atu s fo r the United States 6b. Chroncally homeless person. Indicate the number of participants that are chronically homeless. 7. E t h n i c i t y . E n t e r a p p r o p r i a t e l e t t e r f o r eth n i c group. a. Hispanic or Latino b. Non-Hispanic or Non-Latino Race. Enter appropriate letter for race. a. American Indian or Alaskan Native b. Asian c. Black or African-American d. Native Hawaiian or Other pacific Islander e . Wh i t e f . A m e r i c a n I n d i a n / A l a s k a n N a t i v e & Whi te g . A s i a n & Wh i t e h . B l a c k / A f r i c a n A m e r i c a n & Wh i t e i. American Indian/Alaskan Native & Black/A frican American j. Other Multi-Racial

8.

9a. Special Needs. Enter the letter(s) for the c a t e g o r y ( i e s ) t h a t d e s c r i b e t h e p a r t i c i p a n t,s disability(ies). (You may double count). a. Mental illness b. Alcohol abuse c. Drug abuse d. HIV/AIDS and related diseases e. Developmental disability f. Physical disabilities g. Domestic violence h. Other (please specify) 9 b . E n t e r t h e n u m b e r o f p a r t i c i p a n t s w i t h a di sa b i l i ty 1 0 . P r i o r L i v i n g S i t u a t i o n . E n t e r t h e l e t t e r th a t b e st d e s c r i b e s w h e r e t h e p a r t i c i p a n t s l e p t i n t he w e e k prlor to entering the project. Do not double count. a . N o n - h o u s i n g ( s t r e e t , p a r k , c a r , b u s s t a t i o n , e tc.) b. Emergency shelter c. Transitional housing for homeless persons d. Psychiatric faciliry* e. Substance abuse treatment facilityx f. Hospital * g. Jail/prison* h. Domestic violence situation i. Living with relatives/friends j. Rental housing k. Other (please specify) *I f a p a r t i c i p a n t c a m e f r o m a n i n s t i t u t i o n but w a s t h e r e l e s s t h a n 3 0 d a y s a n d w a s l i v i n g o n th e s t r e e t o r i n a n e m e r g e n c y s h e l t e r b e f o r e e n t e ri n g th e f a c i l i t y , h e / s h e s h o u l d b e c o u n t e d i n e i t h e r t he str e e t or shelter category, as appropriate.

5a. Date o f Birth . E nt er dat e of bir t h inc ludr ne m o nth , da y, an d y ear . 5b. Ag e. En ter ag e at ent r y . 5c. Ge nd er. En ter appr opr iat e let t er f or gender . M-Ma le F- Fem ale.
) /1

HU D - 4 0 1 1 8

I nstru ctio n Co de s for Per s ons Ser v ed \ Y ork sh ee t (co ntin ue d)

14. Destination.
l a o r /i - d tl '-

E n t e r t h e d e s t i n a t i o n o f t h ose

.,,.

i l a .Gr os s M ont hly In c o me a t Pro j e c t En try . E nt er t he am oun to f g ro s s mo n th l y i n c o m e th e p ar t ic ipantis r ec e i v i n ga t e n try i n to th e p ro j e ct

lb. Gro ss Mon thly I nc om e at Pr ojec t Ex it . Ent e r the gro ss mon thl y inc om e t he par t ic ipant is re ce ivin g wh en ex it ing t he pr ojec t . l c.In co me Sou rce s Rec eiv ed at Pr ojec t Ent r y . Ente r all type s of as s is t anc e t he par t ic ipant is receiving a t en tr y t o t he pr ojec t . a. Su pp leme nta l Sec ur it y I nc om e ( SSI ) b. Social Security Dis abilit y I ns ur anc e ( SSDI ) c. So cia l Se cu rit y d. Gen era l Pu blic As s is t anc e e. Te mpo rary Aid Needy Fam ilies ( TANF) f. StateChildren's Health InsuranceProgram(SCHIP) g. Ve tera ns b en ef it s h. Emplo yme nt inc om e i. Un emp loymen t benef it s j. Ve tera ns Hea lt h Car e k. Me dicaid 1. Foo d Stamp s m . Oth er (p lea se s pec if y ) n. No Fin an cia l R es our c es I d.Income Sou rce s Rec eiv ed at Pr ojec t Ex it . E nte r all typ es of inc om e t he par t ic ipant is rece ivin g a t pro jec t ex it . ( Us e c odes as in 1 1c . )

Permanent: a . R e n t a l h o u s e o r a p a r t m e n t ( n o s u b si d y) b. Public Housing c. Section 8 d. Shelter Plus Care e. HOME subsidized house or apartment f. Other subsidized house or apartment g. Homeownership h. Moved in with family or friends Transition al: i . T r a n s i t i o n a l h o u s i n g f o r h o m e l e s s p e r so n s j. Moved in with family or friends Institution: k. Psychiatric hospital. l . I n p a t i e n t a l c o h o l o r d r u g t r e a t m e n t fa ci l i ty m. Jail/prison Emergency: F " - - *- ^ ^ ^ . , s h e l t e r Other: o. Other supportive housing. p . P l a c e s n o t m e a n t f o r h u m a n h a b i t a ti o n (e.g., street) q. Other (please specify) Unknown: r. Unknown 15. Supportive Services. Enter all types of s u p p o r t i v e s e r v i c e s t h e p a r t i c i p a n t r e c e i ve d d u r i n g the time in the project. a. Outreach b. Case management c . L i f e s k i l l s ( o u t s i d e o f c a s e m a n a g em e n t) d. Alcohol or drug abuse services e. Mental health services f. HIV/AIDS-related services g. Other health care services h. Education i. Housing placement j. Employrnent assistance k. Child care L Transportation m. Legal n. Other (please specify)

^ '^ ;1,. ^ .. t ' -J

2 a L engt h in S t ay i n P ro g ra m . C a l c u l a te di te m. (S ee E nt r y Dat e a n d Ex i t D a te a b o v e .)
2b. L en gth of Stay in Pr ogr am . ( Par t ic ipant did not lea ve d urin g t he oper at ing y ear . How long h ave the y b ee n in t he pr ojec t ?) 3. Re ason fo r L ea v ing Pr ojec t . Ent er t he pr im a r y reason wh y th e p ar t ic ipant lef t t he pr ojec t . (Co mple te on ly for par t ic ipant s who lef t t he pr oje ct a nd are n ot ex pec t ed t o r et ur n wit hin 9 0 d ays. a. L eft for a h ou s ing oppor t unit y bef or e comple ting th e p r ogr am b. Comp lete d p rogr am c. No n-p aymen t of r ent / oc c upanc y c har ge d. No n-comp lian c e wit h pr ojec t e. Crimin al a ctiv it y / des t r uc t ion of pr oper t y / vio I e nce f . Re ache d ma xim um t im e allowed in pr ojec t g. Ne ed s co uld n ot be m et by pr ojec t h. Disa gre eme nt wit h r uies / per s ons i. De ath j. Oth er (p lea se s pec if y ) k. Un kn own /disappear ed

25

HUD-40118