Post on 06-Jun-2020
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2019 CCUSA Annual Survey Core
Start of Block: Annual Survey Core
Q1
Thank you for participating in the 2019 CCUSA Annual Survey. Data collected is used to
illustrate the size, scope, and impact of the Catholic Charities ministry. Any data reported may
be used and disseminated by CCUSA.
Select your Agency Code, Agency Name, and Diocese Name for calendar year 2019. Please
ensure you select the correct agency.
▼ 101 Karidat Chalan Kanoa (669) ... 394 Catholic Charities of New Hampshire Manchester (835)
Q2 We want to ensure we have your latest information. Please provide contact information for
the person completing the survey.
o Your Name (1) ________________________________________________
o Your Phone Number (2) ________________________________________________
o Your E-mail (3) ________________________________________________
o Title (4) ________________________________________________
o Agency/Location (5) ________________________________________________
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Q3 How many unduplicated clients did your agency serve in 2019?
________________________________________________________________
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Q4 You've indicated that you served ${Q3/ChoiceTextEntryValue} unduplicated clients in 2019.
Please provide unduplicated client counts by age. To get the total to add up
to ${Q3/ChoiceTextEntryValue}, count clients for which you don't have this information as
Unknown.
# of clients (1)
Children / Adolescents (Under 18) (1)
Adults (18 - 64) (2)
Seniors (65+) (3)
Unknown (4)
Total
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Q7
You've indicated that you served ${Q3/ChoiceTextEntryValue} unduplicated clients in 2019.
Please provide unduplicated client counts by race and ethnicity. To get the total to add up
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to ${Q3/ChoiceTextEntryValue}, count clients for which you don't have this information as
Unknown.
# of clients (1)
Asian/Pacific Islander (1)
American Indian/Alaska Native (2)
Non-Hispanic Black/African American (3)
Non-Hispanic White (4)
Hispanic/Latino (all races) (5)
Multiple Races (6)
Other/Unknown (7)
Total
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Q4 How many people did you help in pursuing each of the following primary aims in 2019?
(Note: Because clients can be counted more than once in each category, your total will exceed
your unduplicated client count).
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# of clients (1)
Meet basic needs and close emergency financial gaps (191)
Increase access to nutritious food (192)
Increase income and financial self-sufficiency (193)
Increase access to stable, affordable housing (194)
Recovery from natural or man-made disasters (195)
Prevent/end homelessness or reduce harm for people experiencing homelessness (196)
Increase access to healthcare and improve physical and mental well-being (197)
Welcome and integrate immigrants, refugees, and asylees (198)
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Facilitate recovery or reduce harm from addiction and serious mental illness (205)
Cultivate children's emotional and intellectual development (200)
Promote strong family functioning (201)
Improve quality of life for individuals with physical and neurodevelopmental disabilities
(202)
Develop and promote Catholic identity and strategic engagement with parishes (203)
Other (Please specify) (204)
Total
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Q5 Does your agency provide any of the following case management services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (83)
▢ Brokerage/generalist case management (84)
▢ Intensive case management (85)
▢ Clinical case management (86)
▢ Other (Please specify) (87) ________________________________________________
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Q6 Does your agency provide any of the following counseling/mental health services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (249)
▢ Youth or adolescent counseling/therapy (250)
▢ Adult counseling/therapy (262)
▢ Family counseling/therapy (251)
▢ Group counseling/therapy (263)
▢ Prevention services (254)
▢ Trauma-informed care (252)
▢ Psychiatric medication (256)
▢ Case management for persistent mental illness (257)
▢ Residential treatment program(s) (258)
▢ Partial hospitalization/day treatment (259)
▢ Assertive community treatment (ACT) (260)
▢ Other (Please specify) (261) ________________________________________________
Q7 Does your agency provide any of the following addiction services?
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Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (416)
▢ Individual counseling (417)
▢ Group counseling (418)
▢ Case management (419)
▢ Care management (420)
▢ Peer support/lived experience (421)
▢ Recovery support services (422)
▢ Prevention services (423)
▢ Medication management (424)
▢ Medication-assisted treatment (431)
▢ 12-step fellowship (425)
▢ Toxicology screening (426)
▢ Intensive outpatient treatment (427)
▢ Inpatient residential treatment (428)
▢ Naloxone distribution (i.e. Narcan) (429)
▢ Other (Please specify) (430) ________________________________________________
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Q8
Does your agency provide any of the following pregnancy and parenting services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (467)
▢ Parenting education for new parents (468)
▢ Counseling (469)
▢ Support services for adolescent parents and families (470)
▢ Maternity assistance (471)
▢ Pregnancy prevention services (472)
▢ Abstinence education promotion (473)
▢ Prenatal care (474)
▢ Post-partum care (475)
▢ Post-natal care (476)
▢ Father involvement programs (477)
▢ Housing for pregnant women (478)
▢ Pregnancy testing (479)
▢ Project Rachel or other post-abortion ministry (480)
▢ Alternative high school for pregnant teens (481)
▢ Other (Please specify) (482) ________________________________________________
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Q9
Does your agency provide any of the following adoption services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (333)
▢ Home studies (334)
▢ Post-adoption services (335)
▢ Adoption search and reunion (336)
▢ Adoption registry (337)
▢ Orientation and information about adoption (338)
▢ Counseling for birth parents (339)
▢ Services to adult adoptees and birth parents (340)
▢ Domestic infant adoption (341)
▢ Recruitment and counseling for prospective adoptive families (342)
▢ Pre-adoptive infant foster care placement (343)
▢ Special needs adoption (344)
▢ Intercountry adoption (345)
▢ Other (Please specify) (346) ________________________________________________
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Q10 Does your agency provide any of the following child and transition-age youth services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (175)
▢ Group homes (176)
▢ Therapeutic foster care (177)
▢ Youth mentoring (178)
▢ Qualified residential treatment (187)
▢ Family preservation and reunification (188)
▢ Childcare (179)
▢ Summer camps (180)
▢ Out of school time (OST) programming (181)
▢ Child welfare services (182)
▢ Adolescent aftercare services (183)
▢ Adolescent independent living (184)
▢ Adolescent life skills classes (185)
▢ Other (Please specify) (186) ________________________________________________
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Q11 Does your agency provide any of the following services to immigrants, refugees, or
asylees?
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Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (2345)
▢ Citizenship education services (2346)
▢ Community education and outreach (2347)
▢ Counseling and mental health services (2348)
▢ Health or medical services (2367)
▢ Cultural adaptation and social adjustment (2349)
▢ Employment training (2350)
▢ ESL Services (2351)
▢ Family tracing and reunification (2352)
▢ Financial literacy services (2353)
▢ Immigration legal services (2354)
▢ Life skills education (2355)
▢ Matched savings program (2356)
▢ Other legal services (2357)
▢ Parish-based services (2358)
▢ Preservation of cultural and religious heritage (2360)
▢ Resettlement and placement (2361)
▢ Sponsorship development (2362)
▢ Tangible assistance (2363)
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▢ Translation/Interpreter services (2364)
▢ Transportation (2365)
▢ Other (Please specify) (2366) ________________________________________________
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Q12 Does your agency provide any of the following education & enrichment services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (562)
▢ Adult education (563)
▢ Tutoring (564)
▢ Family life education (565)
▢ Conflict-resolution education (566)
▢ Literacy (567)
▢ Head Start or similar (569)
▢ Special education (570)
▢ Social justice education (571)
▢ GED programs (572)
▢ Abstinence education (573)
▢ Marriage preparation (574)
▢ Values clarification (575)
▢ Alternative schools (576)
▢ Other (Please specify) (577) ________________________________________________
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Q13 Does your agency provide any of the following asset development services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (109)
▢ Financial education/literacy (110)
▢ Financial coaching (111)
▢ Debt counseling (112)
▢ Matched savings programs (IDA) (113)
▢ Tax assistance (EITC/VITA) (114)
▢ Micro loan programs (115)
▢ Lending circles (116)
▢ Partnerships with financial institutions (117)
▢ Other (Please specify) (118) ________________________________________________
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Q14 Does your agency provide any of the following community services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (113)
▢ Community-based service programs (114)
▢ Neighborhood/community centers (115)
▢ Community organizing activities (116)
▢ Catholic Youth Organizations (117)
▢ Dispute mediation (118)
▢ Restorative justice (119)
▢ Other (Please specify) (120) ________________________________________________
Q15 Does your agency provide any of the following employment services?
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Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (224)
▢ Issuing industry-recognized certificates (227)
▢ Job placement (228)
▢ Job readiness (i.e. interview and resume training and other soft skills) (229)
▢ Job search (230)
▢ Mentoring programs (231)
▢ Social enterprise(s) (232)
▢ Senior employment programs (233)
▢ Disability employment programs (234)
▢ Veteran employment programs (235)
▢ Youth job programs (236)
▢ Vocational training (e.g apprenticeship, on-the-job training) (237)
▢ Other (Please specify) (238) ________________________________________________
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Q16 Does your agency provide any of the following health-related services?
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Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (274)
▢ Physician referrals (275)
▢ Health insurance enrollment assistance (276)
▢ Health fairs (277)
▢ Health clinics (278)
▢ Dental clinics (279)
▢ Prescription services (280)
▢ Community pharmacy (281)
▢ Caregiver support (282)
▢ Home health services (283)
▢ Visiting nurses (284)
▢ HIV/AIDS services (285)
▢ Personal care homes (286)
▢ Skilled/intermediate care facilities (287)
▢ Parish nurse (288)
▢ Hospice services (289)
▢ Needle exchange services (290)
▢ Speech and hearing services (291)
▢ Other (Please specify) (292) ________________________________________________
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Q17 Does your agency provide services to any of the following at-risk and other specific
populations?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (110)
▢ Services to domestic violence/intimate partner violence survivors (112)
▢ Services to human trafficking survivors (113)
▢ Other (Please specify) (115) ________________________________________________
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Q18
Does your agency provide any of the following services for seniors?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (246)
▢ Services for seniors who are homebound (247)
▢ Case management (248)
▢ Transportation (249)
▢ Respite care (250)
▢ Senior centers (251)
▢ Adult day care (252)
▢ Counseling (253)
▢ Chore services (254)
▢ Services to victims of elder abuse (255)
▢ Home repair (256)
▢ Guardianship (257)
▢ Legal services (258)
▢ Ombudsman (259)
▢ Other (Please specify) (260) ________________________________________________
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Q19 Does your agency provide any of the following prepared food services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (105)
▢ Meals served at emergency and transitional housing facilities (106)
▢ Soup kitchens (107)
▢ Meals served at senior citizen centers (108)
▢ Meals served at adult and child day care (110)
▢ After-school meals (109)
▢ Meals on Wheels (111)
▢ Other home delivered meals (112)
▢ Summer meal programs (114)
▢ Other (Please specify) (115) ________________________________________________
Q20 Does your agency provide any of the following food distribution services?
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Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (157)
▢ Food bank (158)
▢ Traditional food pantry (159)
▢ Client-choice food pantry (160)
▢ Donated food (161)
▢ SNAP enrollment (162)
▢ Nutrition education programs (e.g. Cooking Matters) (164)
▢ Government bulk food distribution (166)
▢ Community gardens, greenhouses, or farms (167)
▢ Special Supplemental Nutrition Program or Women, Infants, and Children (WIC) (168)
▢ Medically-tailored food packages/meals (169)
▢ Food co-ops (i.e. SHARE, etc.) (170)
▢ Other (Please specify) (171) ________________________________________________
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Q21 Does your agency provide any of the following housing services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (108)
▢ Weatherization projects (109)
▢ Project-based subsidized housing (110)
▢ Housing vouchers (111)
▢ Energy conservation (112)
▢ Home repair (113)
▢ Home loan assistance (114)
▢ Housing counseling (115)
▢ Housing search and information (116)
▢ Subsidized home purchase (117)
▢ Emergency rental assistance (119)
▢ Shared senior housing (120)
▢ Other (Please specify) (121) ________________________________________________
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Q22 Does your agency provide any of the following shelter and transitional housing for
individuals and families experiencing homelessness?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (9)
▢ Homelessness prevention (10)
▢ Emergency Shelter (11)
▢ Transitional Housing (12)
▢ Other (Please specify) (13) ________________________________________________
Q23 Does your agency provide permanent supportive housing and rapid re-housing for formerly
homeless individuals?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (7)
▢ Permanent supportive housing (8)
▢ Rapid rehousing (9)
▢ Other (Please specify) (10) ________________________________________________
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Q24 Does your agency provide any of the following basic needs services?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (64)
▢ Transportation (65)
▢ Toiletries (66)
▢ Household items (67)
▢ Utility assistance (68)
▢ Clothing items (69)
▢ Diaper bank (70)
▢ Prescription assistance (71)
▢ Funeral expenses (72)
▢ Other (Please specify) (73) ________________________________________________
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Q25 Does your agency provide any of the following disaster preparedness, response, and
recovery services?
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Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (25)
▢ Temporary housing (26)
▢ Points of distribution (38)
▢ Immediate casework (39)
▢ Feeding (40)
▢ Childcare (41)
▢ Legal assistance (42)
▢ Laundry services (43)
▢ Home repair (44)
▢ Financial assistance (45)
▢ Counseling (27)
▢ Mass care (29)
▢ Transportation (30)
▢ Food Subsidies (31)
▢ Client advocacy (33)
▢ Grants (34)
▢ Loans (35)
▢ Hazard Mitigation services (36)
▢ Other (Please specify) (37) ________________________________________________
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Q26
Does your agency provide any of the following Parish Social Ministry services?
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Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (440)
▢ Engagement with school groups (e.g. local Catholic schools, collegiate groups) (459)
▢ Coordinating volunteer opportunities for parishioners or parish groups (441)
▢ Development (i.e. soliciting funds from parishes) (442)
▢ Parish social ministry (443)
▢ Prison ministry (460)
▢ Collaborating with the St. Vincent De Paul Society (444)
▢ Educating parish leaders on parish social ministry and its importance (445)
▢ Educating on Catholic social teaching and current social justice issues (446)
▢ Facilitating networking between parish-based social ministry staff and volunteers for best practices sharing and problem solving (447)
▢ Coordinating a referral line specifically for people seeking services from parishes (448)
▢ Designating individuals/ “Ambassadors” at parishes to serve as agency representatives (449)
▢ Dispersing emergency assistance through parishes (450)
▢ Providing leadership development training for parish-based social ministers (451)
▢ Coordinating Catholic Campaign for Human Development Efforts (452)
▢ Coordinating legislative advocacy (453)
▢ Promoting global solidarity, potentially through Catholic Relief Services (454)
▢ Promoting community organizing and economic development (455)
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▢ Coordinating pro-life/respect life ministries (456)
▢ Coordinating parish involvement in formation activities (i.e. JustFaith, Salt and Light, etc.) (457)
▢ Conducting trainings or formation opportunities for seminarians or diaconate candidates (461)
▢ Coordinate regional or diocesan meetings of parish-based social ministry leaders (462)
▢ Other (Please specify) (458) ________________________________________________
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Q27 Does your agency provide any of the following services for individuals or families affected
by incarceration?
Please select all that apply.
▢ ⊗We did not provide any of these services in 2019 (1)
▢ Services for returning citizens (2)
▢ Services for victims of crime (3)
▢ Services for families of incarcerated (4)
▢ Violence prevention services (5)
▢ Other (Please specify) (6) ________________________________________________
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Q28 How much of your agency's resources were spent in providing services for following
primary aims in 2019?
(Note: Please provide employee and volunteer counts as full time equivalents (FTEs). A full time
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employee or volunteer counts as a single FTE. If you have part time employees and volunteers,
calculate FTEs by adding up total annual hours and divide by 2080)
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Annual Expenses
(Dollars) (1) Employees (FTE) (2) Volunteers (FTE) (3)
Meet basic needs and close emergency
financial gaps (13)
Increase access to nutritious food (14)
Increase income and financial self-
sufficiency (15)
Increase access to stable, affordable
housing (16)
Recovery from natural or man-made
disasters (17)
Prevent/end homelessness or reduce harm for
people experiencing homelessness (18)
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Increase access to healthcare and
improve physical and mental well-being
(19)
Welcome and integrate immigrants, refugees, and asylees
(20)
Facilitate recovery or reduce harm from
addiction and serious mental illness (21)
Cultivate children's emotional and
intellectual development (22)
Promote strong family functioning (23)
Improve quality of life for individuals with
physical and neurodevelopmental
disabilities (24)
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Develop and promote Catholic identity and
strategic engagement with parishes (25)
Other (Please specify) (26)
Total
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Q29
What is the total dollar amount in diocesan and church support that your agency received in
2019?
o Dollar amount (1) ________________________________________________
o Unsure / We do not track this (2)
o My agency did not receive any diocesan and church funds in 2019 (3)
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Q30 Does your agency file an IRS Form 990 or multiple 990s for the corporation(s) that make
up your agency?
If you answer yes, we will get your financial information from a trusted supplier of nonprofit 990
data and you will not need to provide any additional financial information in this survey. If you
answer no, you will be prompted for you organization's financial information.
o Yes (1)
o No (2)
Skip To: Q31 If Does your agency file an IRS Form 990 or multiple 990s for the corporation(s) that make up your a... = Yes
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QF1 Below is part of an IRS FORM 990. Please record your revenue as presented in the
agency's most recent financial statement(s), combining all information applicable to the entities
included in the annual survey. Round your figures to the nearest dollar. Record each dollar
received (Revenue)
QF2 1a Federated campaigns (PART VIII, Line 1a of the Federal 990)
Dollar amount (1)
(A) United Way support (1)
(B) Combined Federal Campaign (CFC) (2)
QF3
Dollar amount (1)
1b Membership dues (PART VIII, LINE 1b of the Federal 990) (1)
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QF4
Dollar amount (1)
1c Fundraising events (PART VIII, LINE 1c of the Federal 990) (1)
QF5
Dollar amount (1)
1d. Related organizations (PART VIII, LINE 1d of the Federal 990) (1)
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QF6 Total government revenue (Part VIII, 1e of the Federal 990)
Dollar amount (1)
(A) Funds received from federal grants, contributions (includes funds passed through
a state/county etc.) (1)
(B) Funds received from state or local governments (not pass-through from federal)
(2)
QF7 All other contributions, gifts, grants, and similar amounts not included above, formerly
Community Support (Part VIII, LINE 1f of the Federal 990)
Dollar amount (1)
(A) Corporate contributions (1)
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QF8 (B) Individual contributions (Part VIII, Line 1f of the Federal 990)
Dollar amount (1)
i. Bequests (1)
ii. Charitable gift annuities (2)
iii. Other individual contributions (3)
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QF9 2. PROGRAM SERVICE REVENUE (PART VIII, LINE 2g of the Federal 990)
Dollar amount (1)
(A) Direct client fees (fees for service) (1)
(B) Government contracts (2)
(C) Other third-party payments (3)
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QF10 3. OTHER REVENUE NOT CAPTURED ABOVE (Sum of A, B, C, and D should tie-out to
Part 1, Line 10 of the Federal 990)
Dollar amount (1)
(A) Investment income (including Dividends and Interest, Part VIII, Line 3 of the Federal
990) (1)
(B) Investment Income (Capital Gains/Losses, Part VIII, Line 7d of the
Federal 990) (2)
(C) Unrelated business income (Part VIII, Lines 5, 6d, 8c, 9c, 10c of the Federal 990)
(4)
(D) Other revenue (Part VIII, Line 11d of the Federal 990) (5)
Total
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QF11 TOTAL IN-KIND CONTRIBUTIONS (Sum of A, B, and C) (Part VIII, Line 1g of the
Federal 990)
Dollar amount (1)
(A) In-Kind (Such as volunteer services and the difference (1)
(B) Unrelated business income (2)
(C) Other revenue (3)
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QF12 Please refer to the following definitions to guide your responses as you complete the
following questions.
Program costs are those that can be identified specifically for a particular program, service, or
activity.
Fundraising costs include financial campaigns, endowment drives, solicitation of gifts and
bequests, etc.
Management and General costs are those that cannot be readily identified with a particular
service activity administrative time not directly related to oversight of program operations and
costs, as well as depreciation of facilities and salaries and expenses of executive, accounting,
and personnel staff.
* This includes the portion of your budget that is spent directly on behalf of clients for food,
clothing, transportation, rent, utilities, medical/dental services, etc. (non-donated goods).
** Pass-Through Funds are funds that flow through the agency, but are not considered part of
the operating budget.
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QF13 Please fill out the table below:
Program (1) Fundraising (2) Management and
General (3)
Salaries and Wages (1)
Benefits and Payroll Taxes (2)
Direct Client Assistance* (3)
Pass-Through Funds** (4)
All Other Expenses (5)
Total Expenses (Part IX, Line 25 of the Federal 990) (6)
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QF14 Please provide the following information:
o Unrestricted net assets as of the beginning of the most recent fiscal year (1) ________________________________________________
QF15 Please provide the following information:
o Unrestricted net assets as of the end of the most recent fiscal year (1) ________________________________________________
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Q31 Please refer to the following definitions as you answer the question below:
Executive Level Positions include: Diocesan Director/Chief Executive
Officer/President/Executive Director/Administrator/ Chief Operating Officer/Vice-
President/Assistant Executive Director/Chief Financial Officer/Chief Program Officer
Director Level Positions include: Controller/Director of Communications/Public
Relations/Marketing/Director of Development/ Director of Diversity/Racial Equality/Director of
Quality Improvement/Evaluation/Research/ Director of Human Resources/Director of
Management Information Services/Systems Administrator/Directors of Parish Social
Ministry/Regional and Divisional Directors/Program/Department/District Directors
Program Level Positions include: Program Supervisors/Program Professional and
Paraprofessional Staff. Also include in this category professional Consultants/Contractors
Administrative Support Positions include: Administrative Staff (Finance, Human
Resources, Technical Support, etc.)/Executive Assistants, Secretaries and Clerical Staff
Support Service Staff include: Drivers, Cooks, Custodial, etc.
Q32 In FTEs (full-time equivalent staff people), how many total staff does your agency employ?
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(Note: A full time employee or volunteer counts as a single FTE. If you have part time
employees, calculate FTEs by adding up total annual hours and divide by 2080)
Employees (FTE) (1)
Executive Level Positions (1)
Director Level Positions (2)
Program Level Positions (3)
Administrative Support Position (4)
Other Paid Staff (5)
Total
Q33 What is the total number of service sites at your agency?
________________________________________________________________
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Q34 Please list all of the accreditations your agency holds (e.g. COA, CARF, NACC, etc.)
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
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Q35 If you have a person in your agency responsible for any of the following functions, please
provide their name and contact information. Indicate 'None' where applicable.
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First Name (1) Last Name (2) Title (3) E-Mail Address
(4)
Advocacy (385)
Affordable Housing (386)
Disaster Relief (395)
Evaluation, Research, or
Data Analytics (387)
Immigration and Refugee
Services (397)
Integrated Health (388)
Nutrition and Feeding (389)
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Workforce Development
(390)
Parish Social Ministry (391)
Volunteer Management
(393)
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Q36
You have reached the end of the survey. When you click the right arrow, your responses will be
submitted and you will receive an e-mail with all of your responses.
Is there someone in your agency that should review or approve this submission?
Note: They will receive an automatically generated report.
o No (1)
o Yes (please provide their e-mail address) (2) ________________________________________________
End of Block: Annual Survey Core