Community Partnership Reporting / Evaluation Form

Name of CPPC Site: Indianola DCAT Cluster	County(ies): Madison, Marion and Warren

Reporting Period: July 1, 2014-June 30, 2015	Check the Following: Propose Plan ☐ Year-End☒

(Please click inside of the box for desired answer).

Highlighted areas should be filled out at the beginning of the year. Dark Highlighted areas should be filled out at the end of the year.

Community Partnership Involvement Community Partnership Involvement

Partner (Categories)	# of professionals involved	FTDM (ICA)*	Shared Decision Making *	Neighborhood Networking	Policy and Practice Change	# of Comm. members involved*	FTDM (ICA)	Shared Decision-Making *	Neighborhood Networking	Policy and Practice Change	Comments
DHS	☐	☐	☐	☐	☐	☐	☐	☐
Decat	2	☒	☐	☒	☒	☐	☐	☐	☐
Empowerment	2	☒	☒	☒	☒	☐	☐	☐	☐
Neighborhood/Comm. Members*	☐	☐	☐	☐	☐	☐	☐	☐
Domestic Violence	2	☐	☐	☒	☐	☐	☐	☐	☐
Substance Abuse	4	☒	☐	☒	☐	☐	☐	☐	☐
Mental Health	3	☒	☒	☒	☒	☐	☐	☐	☐
Faith-based groups	1	☐	☒	☒	☒	☐	☐	☐	☐
Health Care	1	☐	☐	☒	☐	☐	☐	☐	☐
Education	2	☒	☒	☒	☐	☐	☐	☐	☐
Business	☐	☐	☐	☐	☐	☐	☐	☐
Legal System (Court)	1	☒	☒	☒	☒	☐	☐	☐	☐
Law Enforcement	☐	☐	☐	☐	☐	☐	☐	☐
Government (i.e. City, Co.)	☐	☐	☐	☐	☐	☐	☐	☐
Practice Partners*	6	☒	☒	☒	☒	☐	☐	☐	☐	Job search center, CRISP, etc.
Economic Supports	☐	☐	☐	☐	☐	☐	☐	☐
Prevention Councils	1	☒	☒	☒	☒	☐	☐	☐	☐
Youth	☐	☐	☐	☐	☐	☐	☐	☐
Former Clients of DHS	☐	☐	☐	☐	☐	☐	☐	☐
Parent Partners	4	☒	☐	☒	☐	☐	☐	☐	☐
Other	☐	☐	☐	☐	☐	☐	☐	☐
Total	29	0

(To compile the TOTAL: highlight the number “0”, click the “Layout” tab and then click “Formula” [located to the upper right of the screen] and then click “OK”. This section can be manually calculated if needed.)

Total % of Professionals involved in the initiative	100%	Total % of Community Members Involved in the initiative	Select

Instructions & Definitions

In the gray columns put the number of professional and the number of community members who are associated with the respective category.

In the FTDM (ICA), Shared Decision-Making, Neighborhood Networking and Policy & Practice column put a check mark if there are professionals and/or

community members participating in these activities.

Please do not duplicate numbers. Select one primary category for each person. The comment section may be useful to explain

when more than one category applies to one person. If a person represents two or more categories, include the person in the number count of the

primary role and check mark the gray column for the other categories and explain in the comment section.

Provide a total count and % for both the professional and community members involved.

# of Community Members – This number count is for those who are involved as volunteer community members and are associated with one of the categories

listed. Examples: faith-based members can be volunteers if they are not being paid to attend, professional who is volunteers but is not serving/participating as a

representative in their official/professional capacity, substance abuse sponsor who is not being paid, volunteer advocate for domestic violence.

# of Neighborhood/Community Members – these are individuals who are neighborhood/community residents or parents and are not associated with any of the

other categories.

FTDM (ICA) - those who are facilitators conducting FTDM defined by Iowa’s Standards

Shared Decision Making- those who are involved on the CPPC leadership committee(s)

Practice Partners- includes social service agencies that do not fall under another category (i.e. in-home workers, early childhood programs,

Community Action Agency when applicable)

Economic Supports – includes social service agencies that provide financial and basic-need supports (FaDSS's workers, Income Maintenance

Community Action Agency when applicable)

Shared Decision-Making Shared Decision-Making

Describe your community partnership shared decision-making leadership group and oversight role. Who coordinates? How it is structured? How it is linked to Decat? Are there task teams or subcommittees? (Please click inside of the box for your desired answer.) Our shared decision-making (SDM) group is called the DCAT Steering Committee. The CPPC coordinator sends out agendas, records the minutes, and facilitates the meetings. The committee is designed to have four voting members per county, a total of 12 members. Currently, we have 2 members from Madison County, 2 members from Marion County, & 3 members from Warren County totaling 7 voting members. Guests are always encouraged to attend, but have no voting power. Each proposal that comes in for DCAT funds, first comes through the Steering Committee. The committee members give recommendations on how they would like to see the funding spent to the executive DCAT Board. Subcommittees are formed from the SDM team when necessary.
How often does this group meet?	Once per month on the first Tuesday. Usually taking the summer off.
Attach meeting agendas.	Are meeting agenda's attached?	Yes: ☒ No: ☐
Identify Goal(s) for engaging new members:	Fill voting slots for each county due to resignations. Seek out potential voting members at local provider meetings.
Was your goal met? If no, please explain.	Yes: ☒ No:☐
State Goal(s) for identifying, and/or planning and/or addressing an unmet need(s)	Incorporate community member input into SDM team process by filling all four voting slots in each county. Identify, through SDM, the unmet needs of families in our communities. Promote awareness of various programs/agencies through presentations at SDM team meetings.
Was your goal met? If no, please explain.	Yes: ☒ No: ☐
Have you identified the goal for the % of community membership on the SDM committee?	Yes: ☒ No: ☐ If yes, what %: 25% because community membership is on a completely voluntary basis, it has been difficult to engage community members to volunteer their time.
Was your goal met? If no, please explain.	Yes: ☐ No: ☒ We are still having difficulty getting community members to volunteer their time to attend meetings.
Describe how your SDM group has diverse representation.	Our SDM group has representation in nearly all of the categories listed at the start of this report. Over the last several years, we have been able to maintain consistent attendance by members in nearly all of the categories. We also have several men that attend this meeting which has been huge for our area.
Is there a community member in the leadership SDM role?	Yes: ☐ No: ☒ Please explain this leadership role. The CPPC Coordinator serves in our leadership role. She prepares for, facilitates and takes the minutes for each SDM meeting.

Based on your activities, select the level* for Shared Decision-Making that best fits your site: 2

Describe strategies to advance to the next level: Click here to enter text.

Based on your activities, circle the level* for Shared Decision-Making that best fits your site: 3

Please have each committee member on the leadership/steering committee fill out the Shared Decision Making form, compile the average response for each question, and report the average response below.
*Instructions: Baseline=1st year at the beginning of year on proposed plan (Yellow). Previous Year=Previous year on progress report (Green). Current Year: Current year on progress report (Green)	Baseline Year 2010	Previous Year 2014	Current Year 2015
Shared Decision Making Survey “1” disagree, "2" mildly disagree, "3" neutral "4"mildly agree "5" agree

Shared Decision Making	Description	Baseline Year:	Previous Year:	Current Year:
1. Common Vision:	Members have a shared common vision.	4.38	4.27	4.4
2. Understanding and Agreement Goals:	Members understand and agree on goals and proposed outcomes/objectives.	4.13	4.27	4.4
3. Clear Roles & Responsibilities:	Roles & responsibilities of Members are clear.	3.88	4.09	4.3
4. Shared Decision Making:	All members have a voice and are engaged in the decision making process.	4.38	4.45	4.4
5. Conflict Management:	We are able to successfully manage conflict.	4.25	4.64	4.5
6. Shared Leadership:	Leadership is effective and shared when appropriate.	4.5	4.45	4.6
7. Well Developed Work Plans:	Work Plans are well developed and followed.	4	4.18	4.5
8. Relationships/Trust	Members trust each other.	2.88	4.55	4.3
9. Internal Communication:	Members communicate well with each other.	3.88	4.55	4.1
10. External Communication:	Our external communication is open and timely within the broader community and partners.	4	4.55	4.5
11. Evaluation:	We have built evaluation performance into our activities.	2.5	3.8	4.3
12. Understanding of CPPC:	Members have a clear understanding of the Community Partnerships Four Strategies.	3.13	3.8	4.0
TOTAL:	(To compile the TOTAL highlight the number, click the “Layout” tab and then click “Formula” [located to the upper right of the screen] and then click “OK”) Total # of Participants:	46	51.6	52.3

Community / Neighborhood Networking Community / Neighborhood Networking	Level #	Network Activity	Description (include what was goal, what was invested and what was done)	# of Participants	Outcome(s)
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Total # of Activities:	Click here to enter text.	Total # of Participants:	0
Community / Neighborhood Networking Community / Neighborhood Networking

Activities may overlap and meet several goals, or one activity may meet only one goal.	Goals
Please list goal(s) for level 1 Neighborhood/ Community Networking Activities:	1. Maintain website (www.cppconline.com) 2. Participate in a local event 3. Gather input from users of services by attending community meetings
Was your goal met? If yes, include this information in prior section. If no, please explain.	Yes: ☒ No: ☐ Click here to enter text.
Please list goal(s) for level 2 Neighborhood/ Community Networking Activities:	1. Provide access to community service brochures 2. Maintain website (www.cppconline.com) 3. Provide resource information to providers through local presentations 4. Continue provide assistance in sending requests out to mailing lists for family needs.
Was your goal met? If yes, include this information in prior section. If no, please explain.	Yes: ☒ No: ☐ Click here to enter text.
Please list goal(s) for level 3 Neighborhood/ Community Networking Activities:	1. Continue to maintain website (www.cppconline.com) as a “hub” for local events, resources, job openings, etc. 2. Work with local mental health, domestic violence, etc. providers to establish a network of individuals to be called on if those supports are needed for a family (especially for a family team meeting)
Was your goal met? If yes, include this information in prior section. If no, please explain.	Yes: ☒ No: ☐ Click here to enter text.
Please list goal(s) for level 4 Neighborhood/ Community Networking Activities:	Continue to utilize DHS involved Family Team meetings as well as Community Based Family Team meetings. 2. Continue to collaborate with mental health, domestic violence, substance abuse, etc. agencies to provide the best possible supports for families involved with DHS and/or the Family Team Meeting process.
Was your goal met? If yes, include this information in prior section. If no, please explain.	Yes: ☒ No: ☐

Based on your activities, select the level* for Community / Neighborhood Networking that best fits your site: 4

Describe strategies to advance to the next level: Click here to enter text.

Based on your activities, circle the level* for Community / Neighborhood Networking that best fits your site: 4

Level #	Network Activity	Description (include what was goal, what was invested and what was done)	# of Participants	Outcome(s)
2	Distributing Madison & Warren County Resource Directories	To distribute the Madison and Warren County Resource Directories. CPPC Coordinator networked with local businesses and agencies at provider meetings, local events, etc. to ensure each had enough resource directories throughout the year to meet their and their client’s needs.	200+	Directories were supplied to all those who indicated a need.
2	Distributing CPPC brochure.	To distribute the CPPC brochure to local businesses, families and to providers. Brochure was handed out at local events and meetings.	100+	Brochures were given to participants in local events and meetings to educate on the purpose and goals of CPPC.
3	CPPC Website Event Calendar	To provide one location for all community members to find events taking place in Madison, Marion and Warren Counties. CPPC Coordinator posted on and maintained the event calendar at www.cppconline1.com.	30+ ** this number includes those that submit information to be posted on the CPPC website by the CPPC Coordinator, NOT all those that view the website.	CPPC Events Calendar contains the most up-to-date, accurate information of events happening in our three county area.
3	General needs met for Madison County families.	To meet the basic needs of Madison County families working with CRISP. CPPC Coordinator worked with CRISP Coordinator, Lynette Judd, and local providers to help families obtain needed supplies such as: dressers, beds, washing machines, etc.	50+	CPPC Coordinator worked with CRISP to send out needs lists to CPPC Coordinator’s mailing lists and coordinate donation and pick up of needed items. As a result, many Madison County families’ needs were met.
4	Assisted Boone/Dallas/Story CPPC sites in setting up their own websites.	To discuss steps needed to develop a CPPC website. CPPC Coordinator participated in a meeting (via Skype) and a phone conversation to discuss options for setting up a successful website.	3	Website was created by site and is currently being utilized.
3	Madison County Cares Secretary	To provide support to a local provider group. CPPC Coordinator created the meeting agendas, sent meeting reminders and took meeting minutes when needed.	1	CPPC Coordinator continued filled in as the Madison County Cares (MCC) secretary as needed in FY15. CPPC Coordinator wrote minutes, and distributed them to the appropriate mailing list. Agenda ideas were generated in collaboration with meeting attendees and the MCC Executive Team (President, Vice President and Secretary).
3	Maintained CPPC website	To increase awareness of CPPC and advertise local events and job postings. CPPC Coordinator updated the website daily to maintain accurate and up-to-date information.	1+	CPPC Coordinator networked with local providers, community members and agencies to receive up to date information on events, job openings, etc. which are necessary for the upkeep and purpose of the CPPC website. CPPC Coordinator also promoted the website and discussed its usefulness at each of the three county provider groups.
3	Madison County Cares	To attend Madison County Cares meeting to assist in planning community events and learn of community needs. CPPC Coordinator attended 10, one and a half hour monthly meetings.	50+ *This number only includes those who attend the meetings, NOT those who participated in the events.	Successful spring community events were planned and implemented for families in Madison County. CPPC Coordinator learned of needs and reported back to Shared Decision Making Team/Steering Committee.
3	Warren County Providers	To attend Warren County Provider/Family Care Team meeting to learn of needs in the community and help address needs within the schools in Warren County. CPPC Coordinator attended 7, one hour monthly meetings.	20+	CPPC Coordinator learned of needs and reported back to Shared Decision Making Team/Steering Committee.
3	Marion County Providers	To attend Marion County Provider meeting to learn of needs in the community. CPPC Coordinator presented at the April meeting to educate attendees about CPPC, FTMs, DCAT, etc. CPPC Coordinator attended 10, one and a half hour monthly meetings.	20+	CPPC Coordinator learned of needs and reported back to Shared Decision Making Team/Steering Committee. Providers had a better understanding of CPPC/DCAT.
4	CPPC Steering Committee	To work with local providers and community members in Madison, Marion and Warren Counties to learn of community needs and address the four strategies of CPPC in a way that best fits the needs. CPPC Coordinator facilitated each meeting and recorded meeting minutes.	25+	Providers and community members were made aware of community needs. Many needs were met.
3	CPPC Newsletter	To distribute information and updates on the Indianola DCAT Cluster to our three county area. CPPC Coordinator gathered information and data and compiled it into a newsletter to be disseminated to mailing lists and posted on the website.	150+	Semi-Annual and Year-End Newsletters were completed and distributed.
2	Presentations at CPPC Steering Committee Meetings	To invite local agencies to present information pertaining to the services they offer to the Steering Committee. CPPC Coordinator worked with local agencies to schedule presentations.	25+	Employee and Family Resources (EFR) and Prevent Child Abuse Iowa were able to present information to our Steering Committee (SDMT).
2	Al’s Pals	To provide the evidence based Al’s Pals curriculum to all interested schools/daycare centers in Madison, Marion and Warren Counties. CPPC Coordinator made connections with area schools/centers to promote Al’s Pals and work with those who were interested in becoming or remaining a DCAT/CPPC sponsored Al’s Pals school/center.	1,000+ *this number includes students receiving the curriculum and teachers trained to facilitate Al’s Pals.	All interested schools/centers in our three county area were trained in Al’s Pals and provided their supplies free of charge.
4	FreeStore Planning Group	To work with community members to brainstorm ways to store and distribute donated items in Madison County. CPPC Coordinator attended several meetings, contributing ideas/suggestions, in FY15.	15+	The group decided to table this discussion as funding was problematic.
3	Carlisle Resource Fair	To educate community members on CPPC and its initiatives in Warren County. CPPC Coordinator distributed information, spoke with community members and networked with other providers.	50+	CPPC Coordinator distributed CPPC information and educated community members on CPPC initiatives in our area.
2	Warren County Health and Safety Fair	To educate community members on CPPC and its initiatives in Warren County. CPPC Coordinator distributed information, spoke with community members and networked with other providers	100+	CPPC Coordinator distributed CPPC information and educated community members on CPPC initiatives in our area.
4	Tri County Collaborative Conference	To provide a learning environment for community members and providers to gain information on Adverse Childhood Experiences (ACEs) as well as network to learn of community needs and resources. CPPC Coordinator and Conference Planning Committee met 5+ times for approximately 1 hour each time to plan all aspects of the conference. DCAT/CPPC provided funding for the conference.	50+	The Indianola DCAT Cluster hosted a successful conference on May 14th.
2	Warren County Necessity Pantry Open House	To provide information on programming and resources available to families through CPPC. To educate community members/families on CPPC initiatives. CPPC Coordinator planned for and participated in this event.	50+	CPPC Coordinator distributed CPPC information and educated community members on CPPC initiatives in our area.
4	PCA Iowa Conference	To participate in PCA Iowa conference, network with other providers and gain knowledge on preventing child abuse in our three county area. CPPC Coordinator’s time to participate in 2 day conference.	50+	CPPC Coordinator participated in both days of the conference.
3	1st Five Coalition Meetings	To participate in meetings to learn of new resources/services in Madison and Warren Counties. CPPC Coordinator’s time to participate in monthly meetings.	20+	CPPC Coordinator learned of resources/services in Madison and Warren Counties.
3	Hosted Stewards of Children Training	To hold a Stewards of Children Sexual Abuse Prevention training in places of our January Steering Committee (SDMT) meeting. CPPC Coordinator’s time to organize and advertise training. Participants time to participate in the 2 hour training (vs. our normal 1 hour meeting).	15	Approximately 15 people participated in the Stewards of Children Training.
3	Aaron Thomas Presentation	To learn ways to create resiliency and address mental health concerns in our communities. CPPC Coordinator’s time to participate in discussions and attendance at the event.	100+	CPPC Coordinator assisted in planning Aaron’s presentation. CPPC Coordinator and community members attended the event.
2	EFR Town Hall Meetings	To work with EFR employees through the Madison County Cares and WCSTOP groups, to create and advertise town hall meeting discussions that address community concerns. CPPC Coordinator’s time to participate in discussions and publicize meetings on the CPPC website.	50+	Two successful town hall meetings were held (one in Warren and one in Madison County) in June 2015.
4	Mobilizing Conference	To participate in Mobilizing Conference in order to learn more about human trafficking across the country and in Iowa. CPPC Coordinator’s time to attend the conference.	150+	CPPC Coordinator gained knowledge to disseminate in Madison, Marion and Warren Counties.
3	Warren County Standing Together On Prevention (WCSTOP)	To work with other local providers to reinstate the WCSTOP coalition in Warren County. CPPC Coordinator’s time to attend meetings.	10+	WCSTOP coalition was reinstated and now meets monthly on the 2nd Friday of each month.
3	Regional and Statewide CPPC Meetings	To learn about changes within CPPC and network with other coordinators, DHS staff, etc. to learn of events and programming happening across the state. CPPC and DCAT Coordinators’ time to attend meetings.	100+	DCAT and CPPC Coordinator networked with CPPC Coordinators, DCAT Coordinators, and DHS staff from across the state.
3	Technology Booklet	To partner with Employee and Family Resources to create a booklet with information regarding children and technology use. CPPC Coordinator’s time to look up technology free activities for families and proof read the booklet.	3	A booklet which gives information about technology use among children and activities that are technology free. The booklet is now ready for distribution in FY16.
3	Here, Now and Down the Road	To provide Here, Now and Down the Road in Madison, Marion and Warren Counties. CPPC and DCAT Coordinators’ time to monitor the program which was subcontracted through Partners in Family Development. DCAT funding to support the program.	22	Here, Now and Down the Road was provided through 11 sessions to 18 individuals in Madison, Marion and Warren Counties.
3	DCAT Mini Projects	To provide funding for local programming in the Indianola DCAT Cluster. DCAT and CPPC Coordinators’ time to set up new scoring process, disseminate application process information and field questions related to the application process. Steering Committee Voting Members’ time to read and score proposals.	500+	The Indianola DCAT Cluster funded 12 projects ranging from Cowboy Up to 24/7 Dads and School Based Mental Health.
Total # of Activities: 30	Total # of Participants: 2,960+

Individualized Course of Action/Family Team &Youth Transition (Dream Team) Decision Making Individualized Course of Action

Please describe how Family Team Meetings are implemented in your area. Who facilitates? How are referrals made? What funding is used? Family Team Meetings are referred by the Department of Human Services for DHS clients. Our area has one full time Family Team Meeting Coordinator/Facilitator. She completes all DHS involved Family Team Meetings throughout the year. In addition, our CPPC Coordinator completes all Community-Based Family Team Meetings for clients who do not have an open DHS case as a prevention strategy. The CPPC Coordinator has completed the below mentioned trainings for this purpose. Referrals come from community agencies, schools, churches and private providers. Should the referrals become too numerous for the two to handle, we have back up facilitators who have completed 3 days of facilitator training and field application training with an approved facilitator. They have also passed the field application training in order to become a facilitator. DCAT funds the Family Team Meetings with a separate budget but is part of the CPPC process. The CPPC Coordinator has completed the previously mentioned trainings for this purpose. Referrals come from community agencies, schools, churches and private providers.
Please list goal(s) for Level 1 Individualized Course of Action:	1. Continue current efforts of training, monitoring, tracking for quality assurance and effectiveness. 2. Promote community-based FTM’s through schools, provider meetings, churches and daycares (who we will be working with through Al’s Pals). 3. Continue to work with DHS to provide FTMs to all DHS involved families who would like one. 4. FTM Coordinator will continue to track and report FTM numbers monthly and quarterly to the DCAT Governance Board and the CPPC Steering Committee.
Was your goal met? If no, please explain.	Yes: ☒ No: ☐
Please list goal(s) for Level 2 Individualized Course of Action:	Continue current efforts of training, monitoring, tracking for quality assurance and effectiveness. 2. Continue to administer the FTM Customer Evaluation.
Was your goal met? If no, please explain.	Yes: ☒ No: ☐
Please list goal(s) for Level 3 Individualized Course of Action:	Continue providing education for facilitators on various topics relating to family dynamics. Continue with reporting, evaluations, networking, etc. to ensure quality assurance.
Was your goal met? If no, please explain.	Yes: ☒ No: ☐
Please list goal(s) for Level 4 Individualized Course of Action:	Continue providing FTMs and CBFTMs as common practice in Madison, Marion and Warren Counties. Complete FTM Coordinator and CPPC Coordinator’s field experience for Iowa Youth Dream Team facilitator’s number.
Was your goal met? If no, please explain.	Yes: ☐ No: ☒ The Indianola DCAT Cluster decided to have FTM Coordinator facilitate all YTDM meetings. CPPC Coordinator has completed training and one observation, but has not received her number.
# of state approved facilitators	Goal (# value) N/A	Current # of FTM: 241	Goal Met (Y/N): Yes
# of Community education activities about CBFTDM and CBYTDM	Goal (# value) N/A	Current # of FTM: N/A	Goal Met (Y/N): Choose an item.
# of CBFTDM held annually for families Not involved with child protection service	Goal (# value) 12	Current # CBFTDM: 18	Goal Met (Y/N): Yes
# of CBYTDM held annually for families Not involved with child protection service	Goal (# value) 1	Current # YTDM: 1	Goal Met (Y/N): Yes

Based on your activities, select the level* for Individualized Course of Action that best fits your site: 3

Describe strategies to advance to the next level: Complete field experience for CPPC Coordinator to be certified as a YTDM facilitator.

Based on your activities, select the level* for Individualized Course of Action that best fits your site: 3

Policy and Practice Change Policy and Practice Changes Policy and Practice Changes Policy and Practice Changes

Please list goal(s) for Level 1 Policy and Practice Change:	1. Work with families/agencies involved with Al’s Pals and SDM team to determine needs relating to policy and practice change. 2. Attend local and regional meetings to learn of needs 3. Engage SDM team in discussions that identify needs 4. Create and utilize informal surveys to gather data from parents and youth impacted by policy and practice change to investigate needs
Was your goal met? If no, please explain.	Yes: ☒ No: ☐
Please list goal(s) for Level 2 Policy and Practice Change:	1. Establish a plan with objectives and dates for completion once a need is identified 2. Identify partners to engage to accomplish change
Was your goal met? If no, please explain.	Yes: ☒ No: ☐
Please list goal(s) for Level 3 Policy and Practice Change:	1. Carry out and monitor plan developed in level 2 for completion and effectiveness 2. Evaluate effectiveness based upon end-user input
Was your goal met?	Yes: ☒ No: ☐
Please list goal(s) for Level 4 Policy and Practice Change:	1. Ensure that SDM team and other service providers are aware that needs for policy and practice change is a priority of CPPC- invite and encourage participation at monthly CPPC steering committee meetings 2. Regularly evaluate surveys and feedback from families/community members.
Identify training/technical assistance goal(s) that will assist in the development and/or implementation of CPPC and the four strategies: Examples: Regional 101 Attend 201 One on one Technical Assistance with state CPPC consultant	The CPPC Coordinator will continue to attend trainings on various topics relating to family safety, assessment, and prevention when appropriate.
List Trainings/Technical Assistance sponsored and/or attended that assisted in the development and/or implementation of CPPC and the four strategies	8/6/14: Carlisle Resource Fair 8/21/14: Madison County FreeStore Meeting 9/11/14: Warren County Health Fair 9/11/14: CPPC Regional Meeting (Joe) 9/22/14: Madison County FreeStore Meeting 11/4/14: Immersion 201 (Presenter) 11/5/14: Statewide CPPC (Presenter) 12/9/14: Warren County Pantry Open House 12/9/14: Meeting with Americorps (Ames) representatives regarding website 12/18/14: PCA Iowa Webinar 1/6/15: Stewards of Children training 3/26/15: Meeting with Deb Fertal (EAGALA) 4/3/15: Aaron Thomas presentation (initiated by MCC) 4/14/15 & 4/15/15: Prevent Child Abuse Conference 5/5/15: Statewide CPPC 5/7/15: Conference call with Brian (EFR)- Town hall meeting 5/14/15: Tri-County Collaborative Conference 5/19/15: Mobilizing Conference 6/9/15: CPPC Regional 6/23/15: Health & Safety Fair (Warren)
Was your goal met?	Yes: ☒ No: ☐

Based on your activities, select the level* for Policy and Practice that best fits your site: 4

Describe strategies to advance to the next level: Maintain all current strategies for advancing policy and practice change in Madison, Marion and Warren

Based on your activities, select the level* for Policy and Practice that best fits your site: 3

Name: Sarah Hohanshelt Title: CPPC Coordinator

Site: Indianola DCAT Cluster	Address: 200 S Howard Stret, Indianola 50125 Phone: 515.468.8181

Please return this completed form to both Sandy Lint and Shelby Zirbel:

Sandy Lint, DHS-CFS

1305 E Walnut

Des Moines, Iowa 50319-0114

Email: slint@dhs.state.ia.us

Phone: (515) 242-5319

Fax: (515) 281-4597

Shelby Zirbel, DHS-CFS

1305 E Walnut

Des Moines, Iowa 50319-0114

Email: szirbel@dhs.state.ia.us

Phone: (641) 330-4828

Fax: (515) 281-4597