DAAS Programmatic Monitoring Tools The Division of Aging and Adult Services (DAAS) provides the following monitoring instruments to be utilized by AAAs when monitoring service delivery for home and community-based services for older adults. For questions please contact your DAAS subject matter staff person. Files FY21_ADC-ADH_HCCBG-CARES_monitoringtool_3-10-21.docx Microsoft Word • 86.13 KB - June 25, 2021 FY21_ADC-ADH_FiscalVerification-CARES_Non-Unit.docx Microsoft Word • 16.41 KB - January 22, 2021 FY21_CareMgnt-HCCBG-CARES_clientrecordreview.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 25.89 KB - January 25, 2021 FY21_consumer_contributions_monitoring_tool.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 82.75 KB - January 28, 2021 FY21_FCSP-CARES-Monitoring Tool.docx Microsoft Word • 64.28 KB - January 25, 2021 FY21_Care Mgnt-HCCBG-CARES_monitoring_tool.docx Microsoft Word • 55.72 KB - June 25, 2021 FY21_FCSP-Contract Review Form_.docx Microsoft Word • 40.3 KB - January 29, 2021 FY21_FCSP_Instruction_and_Attestation_Form_March_2021 .docx Microsoft Word • 46.27 KB - June 25, 2021 FY21_FCSP-NonUnit Tracking Worksheet_Working Papers.docx Microsoft Word • 30.29 KB - January 26, 2021 FY21_FCSP-OAA-MonitoringTool.docx Microsoft Word • 61.45 KB - January 26, 2021 FY21_FCSP-Unit Verification Client Review Form.docx Microsoft Word • 64.61 KB - January 29, 2021 FY21_IHA_HCCBG-CARES_Client_Review.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 225.13 KB - January 27, 2021 FY21_GroupRespiteService_HCCBG-CARES_monitoringtool_updated_3-8-21.docx Microsoft Word • 77.44 KB - June 25, 2021 FY21_HCI_HCCBG_CARES_ MonitoringAdmin.docx Microsoft Word • 21.11 KB - June 25, 2021 FY21_IHA_HCCBG-CARES_ProgramAdmin_AttachA-C.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 380.5 KB - January 28, 2021 FY21_SeniorCenterOperations-HCCBG-CARES-Final.docx Microsoft Word • 39.64 KB - January 27, 2021 FY21_HCI_HCCBG_CARES_ MonitoringPart.docx Microsoft Word • 21.94 KB - June 25, 2021 HealthScreening-i.doc Health Screening application/msword • 59.5 KB - July 28, 2015 FY21_HHI-HCCBG-CARES_monitoring tool 3-8-21.docx Microsoft Word • 80.76 KB - June 25, 2021 FY21_IHA_HCCBG-CARES_Program_Admin_3-24-21.docx Microsoft Word • 67.58 KB - June 25, 2021 Health Promotion III-D Monitoring Tool 2018.pdf Health Promotion Monitoring Tool PDF • 50.31 KB - August 27, 2018 AAA LTO Monitoring Tool.pdf Senior Center LTO Monitoring Tool PDF • 96.02 KB - January 03, 2020 Health Promotion-Disease Prevention III-B Programmatic Monitoring Tool.pdf Health Promotion/Disease Prevention PDF • 98.06 KB - August 27, 2018 HomeHealthServices-i.doc Home Health Services application/msword • 120 KB - July 28, 2015 IHA_contract_example.pdf In-Home Aide Contract Example PDF • 26.83 KB - July 28, 2015 IHA_county_general_contract.doc In-Home Aide County General Contract application/msword • 67 KB - July 28, 2015 IHA_contract_attachment_B.doc In-Home Aide Contract Attachment B application/msword • 39 KB - July 28, 2015 InstitutionalRespite-i.doc Institutional Respite Care application/msword • 152 KB - July 28, 2015 FY21_IandOC-HCCBG-CARES_monitoringtool.docx Microsoft Word • 66.52 KB - June 25, 2021 Legal Monitoring Tool.doc application/msword • 84 KB - June 25, 2021 Legal Services Covid Instr Sheet and Monitoring Documents B for 2020-21.docx Microsoft Word • 26.27 KB - June 25, 2021 mental_health_counseling_sample_client_log.pdf Mental Health Counseling Sample Client Log PDF • 35.18 KB - July 28, 2015 FINAL v20_3-7-2011_MHC_Monitoring_tool-i (2).doc application/msword • 130.5 KB - February 01, 2021 FY21_Nutrition tool Att. C-Cong_Liq_Nut_Supp.docx Microsoft Word • 45.22 KB - June 25, 2021 FY21_Nutrition tool Att. C-Cong_NSIP_Only.docx Microsoft Word • 44.36 KB - June 25, 2021 FY21_Nutrition tool Att. C-Cong_Thera_Diet_Meals.docx Microsoft Word • 44.94 KB - June 25, 2021 FY21_Nutrition tool Att. C-Congregate.docx Microsoft Word • 45.54 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM.docx Microsoft Word • 45 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM_Liq_Nut_Supp.docx Microsoft Word • 44.85 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM_NSIP_Only.docx Microsoft Word • 44.52 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM_Thera_Diet_Meals.docx Microsoft Word • 45.43 KB - June 25, 2021 FY21_Nutrition-HCCBG-FFRCA-CARES monitoringtool_updated_3-9-21.docx Microsoft Word • 182.84 KB - June 25, 2021 FY21_OvernightRespiteService-HCCBG-CARES_monitoringtool_updated_3-5-21.docx Microsoft Word • 34.25 KB - June 25, 2021 SeniorCompanion-i.doc Senior Companion application/msword • 89 KB - July 28, 2015 FY21_Transportation-HCCBG-CARES_updated_3-8-21.docx Microsoft Word • 55.48 KB - June 25, 2021 FY21_VolunteerProgramDevelopment-HCCBG-CARES_monitoringtool updated 3-4-21.docx Microsoft Word • 38.92 KB - June 25, 2021 doa710.rtf DOA-710 - Verification of Compliance application/rtf • 6.25 KB - July 28, 2015 doa711.rtf DOA-711 - Notice of Record (Reversionary Interest Unit of Local Governments) application/rtf • 6.85 KB - July 28, 2015 doa712.rtf DOA-712 - Notice of Record (Reversionary Interest Private Non-Profit Corporations) application/rtf • 6.12 KB - July 28, 2015
DAAS Programmatic Monitoring Tools The Division of Aging and Adult Services (DAAS) provides the following monitoring instruments to be utilized by AAAs when monitoring service delivery for home and community-based services for older adults. For questions please contact your DAAS subject matter staff person. Files FY21_ADC-ADH_HCCBG-CARES_monitoringtool_3-10-21.docx Microsoft Word • 86.13 KB - June 25, 2021 FY21_ADC-ADH_FiscalVerification-CARES_Non-Unit.docx Microsoft Word • 16.41 KB - January 22, 2021 FY21_CareMgnt-HCCBG-CARES_clientrecordreview.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 25.89 KB - January 25, 2021 FY21_consumer_contributions_monitoring_tool.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 82.75 KB - January 28, 2021 FY21_FCSP-CARES-Monitoring Tool.docx Microsoft Word • 64.28 KB - January 25, 2021 FY21_Care Mgnt-HCCBG-CARES_monitoring_tool.docx Microsoft Word • 55.72 KB - June 25, 2021 FY21_FCSP-Contract Review Form_.docx Microsoft Word • 40.3 KB - January 29, 2021 FY21_FCSP_Instruction_and_Attestation_Form_March_2021 .docx Microsoft Word • 46.27 KB - June 25, 2021 FY21_FCSP-NonUnit Tracking Worksheet_Working Papers.docx Microsoft Word • 30.29 KB - January 26, 2021 FY21_FCSP-OAA-MonitoringTool.docx Microsoft Word • 61.45 KB - January 26, 2021 FY21_FCSP-Unit Verification Client Review Form.docx Microsoft Word • 64.61 KB - January 29, 2021 FY21_IHA_HCCBG-CARES_Client_Review.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 225.13 KB - January 27, 2021 FY21_GroupRespiteService_HCCBG-CARES_monitoringtool_updated_3-8-21.docx Microsoft Word • 77.44 KB - June 25, 2021 FY21_HCI_HCCBG_CARES_ MonitoringAdmin.docx Microsoft Word • 21.11 KB - June 25, 2021 FY21_IHA_HCCBG-CARES_ProgramAdmin_AttachA-C.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 380.5 KB - January 28, 2021 FY21_SeniorCenterOperations-HCCBG-CARES-Final.docx Microsoft Word • 39.64 KB - January 27, 2021 FY21_HCI_HCCBG_CARES_ MonitoringPart.docx Microsoft Word • 21.94 KB - June 25, 2021 HealthScreening-i.doc Health Screening application/msword • 59.5 KB - July 28, 2015 FY21_HHI-HCCBG-CARES_monitoring tool 3-8-21.docx Microsoft Word • 80.76 KB - June 25, 2021 FY21_IHA_HCCBG-CARES_Program_Admin_3-24-21.docx Microsoft Word • 67.58 KB - June 25, 2021 Health Promotion III-D Monitoring Tool 2018.pdf Health Promotion Monitoring Tool PDF • 50.31 KB - August 27, 2018 AAA LTO Monitoring Tool.pdf Senior Center LTO Monitoring Tool PDF • 96.02 KB - January 03, 2020 Health Promotion-Disease Prevention III-B Programmatic Monitoring Tool.pdf Health Promotion/Disease Prevention PDF • 98.06 KB - August 27, 2018 HomeHealthServices-i.doc Home Health Services application/msword • 120 KB - July 28, 2015 IHA_contract_example.pdf In-Home Aide Contract Example PDF • 26.83 KB - July 28, 2015 IHA_county_general_contract.doc In-Home Aide County General Contract application/msword • 67 KB - July 28, 2015 IHA_contract_attachment_B.doc In-Home Aide Contract Attachment B application/msword • 39 KB - July 28, 2015 InstitutionalRespite-i.doc Institutional Respite Care application/msword • 152 KB - July 28, 2015 FY21_IandOC-HCCBG-CARES_monitoringtool.docx Microsoft Word • 66.52 KB - June 25, 2021 Legal Monitoring Tool.doc application/msword • 84 KB - June 25, 2021 Legal Services Covid Instr Sheet and Monitoring Documents B for 2020-21.docx Microsoft Word • 26.27 KB - June 25, 2021 mental_health_counseling_sample_client_log.pdf Mental Health Counseling Sample Client Log PDF • 35.18 KB - July 28, 2015 FINAL v20_3-7-2011_MHC_Monitoring_tool-i (2).doc application/msword • 130.5 KB - February 01, 2021 FY21_Nutrition tool Att. C-Cong_Liq_Nut_Supp.docx Microsoft Word • 45.22 KB - June 25, 2021 FY21_Nutrition tool Att. C-Cong_NSIP_Only.docx Microsoft Word • 44.36 KB - June 25, 2021 FY21_Nutrition tool Att. C-Cong_Thera_Diet_Meals.docx Microsoft Word • 44.94 KB - June 25, 2021 FY21_Nutrition tool Att. C-Congregate.docx Microsoft Word • 45.54 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM.docx Microsoft Word • 45 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM_Liq_Nut_Supp.docx Microsoft Word • 44.85 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM_NSIP_Only.docx Microsoft Word • 44.52 KB - June 25, 2021 FY21_Nutrition tool Att. C-HDM_Thera_Diet_Meals.docx Microsoft Word • 45.43 KB - June 25, 2021 FY21_Nutrition-HCCBG-FFRCA-CARES monitoringtool_updated_3-9-21.docx Microsoft Word • 182.84 KB - June 25, 2021 FY21_OvernightRespiteService-HCCBG-CARES_monitoringtool_updated_3-5-21.docx Microsoft Word • 34.25 KB - June 25, 2021 SeniorCompanion-i.doc Senior Companion application/msword • 89 KB - July 28, 2015 FY21_Transportation-HCCBG-CARES_updated_3-8-21.docx Microsoft Word • 55.48 KB - June 25, 2021 FY21_VolunteerProgramDevelopment-HCCBG-CARES_monitoringtool updated 3-4-21.docx Microsoft Word • 38.92 KB - June 25, 2021 doa710.rtf DOA-710 - Verification of Compliance application/rtf • 6.25 KB - July 28, 2015 doa711.rtf DOA-711 - Notice of Record (Reversionary Interest Unit of Local Governments) application/rtf • 6.85 KB - July 28, 2015 doa712.rtf DOA-712 - Notice of Record (Reversionary Interest Private Non-Profit Corporations) application/rtf • 6.12 KB - July 28, 2015
FY21_CareMgnt-HCCBG-CARES_clientrecordreview.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 25.89 KB - January 25, 2021
FY21_consumer_contributions_monitoring_tool.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 82.75 KB - January 28, 2021
FY21_FCSP_Instruction_and_Attestation_Form_March_2021 .docx Microsoft Word • 46.27 KB - June 25, 2021
FY21_FCSP-NonUnit Tracking Worksheet_Working Papers.docx Microsoft Word • 30.29 KB - January 26, 2021
FY21_IHA_HCCBG-CARES_Client_Review.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 225.13 KB - January 27, 2021
FY21_GroupRespiteService_HCCBG-CARES_monitoringtool_updated_3-8-21.docx Microsoft Word • 77.44 KB - June 25, 2021
FY21_IHA_HCCBG-CARES_ProgramAdmin_AttachA-C.xlsx application/vnd.openxmlformats-officedocument.spreadsheetml.sheet • 380.5 KB - January 28, 2021
Health Promotion III-D Monitoring Tool 2018.pdf Health Promotion Monitoring Tool PDF • 50.31 KB - August 27, 2018
Health Promotion-Disease Prevention III-B Programmatic Monitoring Tool.pdf Health Promotion/Disease Prevention PDF • 98.06 KB - August 27, 2018
IHA_county_general_contract.doc In-Home Aide County General Contract application/msword • 67 KB - July 28, 2015
IHA_contract_attachment_B.doc In-Home Aide Contract Attachment B application/msword • 39 KB - July 28, 2015
Legal Services Covid Instr Sheet and Monitoring Documents B for 2020-21.docx Microsoft Word • 26.27 KB - June 25, 2021
mental_health_counseling_sample_client_log.pdf Mental Health Counseling Sample Client Log PDF • 35.18 KB - July 28, 2015
FY21_Nutrition-HCCBG-FFRCA-CARES monitoringtool_updated_3-9-21.docx Microsoft Word • 182.84 KB - June 25, 2021
FY21_OvernightRespiteService-HCCBG-CARES_monitoringtool_updated_3-5-21.docx Microsoft Word • 34.25 KB - June 25, 2021
FY21_VolunteerProgramDevelopment-HCCBG-CARES_monitoringtool updated 3-4-21.docx Microsoft Word • 38.92 KB - June 25, 2021
doa711.rtf DOA-711 - Notice of Record (Reversionary Interest Unit of Local Governments) application/rtf • 6.85 KB - July 28, 2015
doa712.rtf DOA-712 - Notice of Record (Reversionary Interest Private Non-Profit Corporations) application/rtf • 6.12 KB - July 28, 2015
