Nutrition Services Reporting Forms « Area Agency on Aging 1-B

1020Y Reporting Form Instructions
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These are the instructions on how to complete the 1020Y Reporting Form.

1020Y Reporting Form
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This report is used to report actual year to date nutrition units and expenditures. Nutrition service providers must submit a separate report for each service, one for congregate, and one for home delivered meals.

1020M Reporting Form Instructions
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These are the instructions on how to complete the 1020M Reporting Form.

1020M Reporting Form
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This report is used to report actual expenditures and units to date. This report is due on the 10th of every month.

Universal Intake
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he Universal Intake Form is a tool to foster communication among providers and shall be used by nutrition contractors, resource advocates and any other service providers who wish to refer clients to the AAA 1-B Information and Assistance (I&A) Resource Center, Community Support Services (CSS) or to other contracted providers.

Nutrition Services Fiscal Assessment Guide
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This document gives an overview of the process used during the fiscal on site assessment.

Equipment Inventory Form
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Nutrition Services Budget
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ARRA Nutrition Budget Worksheet
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Congregate Meal Site Survey
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Required 4th quarter only, due October 10th. This report provides details regarding congregate meal sites both contract and NSIP.

Subcontracting Request Form
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This form should be completed by all Contractors that plan to utilize subcontractors (i.e. Service Contracts) through their AAA 1-B Contract. This form must be submitted to the AAA 1-B Contract Manager for approval prior to entering into an agreement with a subcontractor.

Program Goals and Objectives
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This form is to be updated quarterly and submitted with your other quarterly reports.

Targeting Plan
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This form is to be updated quarterly and submitted with your other quarterly reports.

Targeting Plan Goals and Objectives
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This form is to be updated quarterly and submitted with your other quarterly reports.

FY 2010 Assessment Instructions
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To be used for your programmatic assessment.

Nutrition Services Quarterly Programmatic Report Guidelines (Revised: 2/25/2010)
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This document contains instructions for Programmatic Quarterly Reports. These reports are due to the Nutrition Contracts Manager by the 10th of the month following the close of each quarter: January, April, July and October. They can be submitted electronically to NDreports@aaa1b.com.

All Services Quarterly Programmatic Narrative and Waiting List Report (Revised: 2-25-2010)
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This report outlines new developments in the contracted congregate and home delivered services, problems or barriers affecting the contract, milestones in meeting goals/obligation and progress in reaching and serving groups indicated in your target plan, in addition to indentifying religious, cultural or ethnic minority populations and barriers to service. It is important that the extent of the unmet need for locations and time waiting for service is documented. This data is required by the OSA and used by the AAA1-B to advocate for additional funds and/or against cuts in service dollars.

Nutrition Education Plan
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Required 4th quarter only. Due October 10th. Submit this report electronically listing nutrition education and dates for fiscal year and plan for next year. Can be submitted electronically to NDreports@aaa1b.com.

Nutrition Site Change Request Form Instructions
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Nutrition Site Change Request Form
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Complete the form electronically and submit to the Nutrition Contracts Manager at least six weeks prior to action for approval.

New OSA Waiting List Instructions
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Holiday Meals on Wheels Standards and Procedures
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Nutrition Provider Supplement for Eldercare Funding: Holiday Meals on Wheels
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FY 2011 Nutrition Fund Increase Form
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