Write in the total number of trainings/workshops here. This will equal the number of PARENT/PROVIDER TRAININGS & WORKSHOP forms that have been filled out during the month.

Training/Workshop hours

PARENT/PROVIDER TRAINING OR WORKSHOP Training/Workshop hours 4 + PARENT/PROVIDER TRAINING OR WORKSHOP Training/Workshop hours 6 + PARENT/PROVIDER TRAINING OR WORKSHOP Training/Workshop hours 2 = PARENT/PROVIDER TRAININGS & WORKSHOPS Total number of Trainings/Workshops 3 Total number of Training/Workshop hours 12

NUMBER OF PARTICIPANTS (Do not double count individuals) Center Based Staff Children Exempt Provider Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee

NUMBER OF PARTICIPANTS (Do not double count individuals) Center Based Staff 12 Children Exempt Provider Licensed FCCH Provider 20 Parent/Relative/Guardian Prospective Licensee + NUMBER OF PARTICIPANTS (Do not double count individuals) Center Based Staff Children Exempt Provider Licensed FCCH Provider 5 Parent/Relative/Guardian 14 Prospective Licensee = Center Based Staff 12 NUMBER OF PARTICIPANTS (Totals) Children Exempt Provider Licensed FCCH Provider 25 Parent/Relative/Guardian 14 Prospective Licensee

FUNDING SOURCE (Totals) First 5 R&R/APP contract from CDD R&R contract from CDD R&R/CCIP

.

FUNDING SOURCE (Check all that apply) First 5 R&R/APP contract from CDD R&R contract from CDD R&R/CCIP Foundation Grant + First 5 R&R/APP contract from CDD FUNDING SOURCE R&R contract from CDD (Check all that apply) R&R/CCIP = FUNDING SOURCE (Totals) First 5 2 R&R/APP contract from CDD 1 R&R contract from CDD R&R/CCIP Foundation Grant 1

LANGUAGE OF TRAINING (Check all that apply) English Spanish Chinese Korean Tagalog Vietnamese

LANGUAGE OF TRAINING (Check all that apply) English Spanish Chinese Korean Tagalog Vietnamese Russian + LANGUAGE OF TRAINING (Check all that apply) English Spanish Chinese Korean Tagalog Vietnamese Farsi = LANGUAGE OF TRAINING (Totals) English 2 Spanish 1 Chinese 1 Korean Tagalog Vietnamese Russian, Farsi 2

PROVIDER TOPIC (Check all that apply) Administration and Supervision Child Development and Learning Culture, Diversity, and Equity Dual-Language Development Family and Community Engagement Health, Safety, and Nutrition Leadership in ECE Learning Environments and Curriculum Observation, Screening, and Assessment Professionalism Relationships, Interactions, and Guidance Special Needs and Inclusion + Administration and Supervision Child Development and Learning Culture, Diversity, and Equity Dual-Language Development Family and Community Engagement PROVIDER Health, Safety, and Nutrition TOPIC Leadership in ECE (Check all that apply) Learning Environments and Curriculum Observation, Screening, and Assessment Professionalism Relationships, Interactions, and Guidance Special Needs and Inclusion =

PROVIDER TOPIC (Check all that apply) Administration and Supervision Child Development and Learning Culture, Diversity, and Equity 1 Dual-Language Development Family and Community Engagement Health, Safety, and Nutrition Leadership in ECE Learning Environments and Curriculum Observation, Screening, and Assessment Professionalism 1 Relationships, Interactions, and Guidance 1 Special Needs and Inclusion

Child Development and Learning Choosing Child Care Family Activity Health, Safety, and Nutrition PARENT TOPIC Parenting Skills (Check all that apply) School Readiness/Early Literacy Special Needs and Inclusion Support Groups/Networks + Child Development and Learning Choosing Child Care Family Activity Health, Safety, and Nutrition PARENT TOPIC Parenting Skills (Check all that apply) School Readiness/Early Literacy Special Needs and Inclusion Support Groups/Networks = PARENT TOPIC (Check all that apply) Child Development and Learning Choosing Child Care 2 Family Activity Health, Safety, and Nutrition Parenting Skills School Readiness/Early Literacy 2 Special Needs and Inclusion Support Groups/Networks

ROLE OF AGENCY (Check all that apply) Host/Coordinate and support Trainer/Speaker/Workshop leader

Host/Coordinate and support ROLE OF AGENCY (Check all that apply) Trainer/Speaker/Workshop leader + ROLE OF AGENCY (Check all that apply) Host/Coordinate and support Trainer/Speaker/Workshop leader = ROLE OF AGENCY (Totals) Host/Coordinate and support 2 Trainer/Speaker/Workshop leader 1

COMMUNITY COLLABORATIONS OR SERVICES Total number of Collaborations/Services First 5 FUNDING SOURCE (Totals) R&R/APP contract from CDD R&R contract from CDD TYPE OF ACTIVITY (Totals) Advocacy activity with media Advocacy activity without media CCL orientation Child Care Planning Council meeting Community workshop/training First 5 meeting Media event only Other regularly scheduled meeting R&R Network meeting Special project/event meeting Attend/Participate Committee member ROLE OF AGENCY (Totals) Coordinate & Support Lead agency Presenter/Invited speaker

FUNDING SOURCE (Totals) First 5 R&R/APP contract from CDD R&R contract from CDD

COMMUNITY COLLABORATION OR SERVICE FUNDING SOURCE (Check all that apply) First 5 R&R/APP contract from CDD R&R contract from CDD Foundation Grant + COMMUNITY COLLABORATION OR SERVICE FUNDING SOURCE (Check all that apply) First 5 R&R/APP contract from CDD R&R contract from CDD =

TYPE OF ACTIVITY (Check one activity per collaboration) Advocacy activity with media Advocacy activity without media CCL orientation Child Care Planning Council meeting Community workshop/training First 5 meeting Media event only Other regularly scheduled meeting R&R Network meeting Special project/event meeting

TYPE OF ACTIVITY (Totals) Advocacy activity with media Advocacy activity without media CCL orientation Child Care Planning Council meeting Community workshop/training First 5 meeting Media event only Other regularly scheduled meeting R&R Network meeting Special project/event meeting + TYPE OF ACTIVITY (Totals) Advocacy activity with media Advocacy activity without media CCL orientation Child Care Planning Council meeting Community workshop/training First 5 meeting Media event only Other regularly scheduled meeting R&R Network meeting Special project/event meeting =

Advocacy activity with media 1 Advocacy activity without media CCL orientation TYPE OF ACTIVITY (Totals) Child Care Planning Council meeting Community workshop/training First 5 meeting 1 Media event only Other regularly scheduled meeting R&R Network meeting Special project/event meeting

Attend/Participate ROLE OF AGENCY (Check all that apply) Committee member Coordinate & Support Lead agency Presenter/Invited speaker

ROLE OF AGENCY (Check all that apply) Attend/Participate Committee member Coordinate & Support Lead agency Presenter/Invited speaker + ROLE OF AGENCY (Check all that apply) Attend/Participate Committee member Coordinate & Support Lead agency Presenter/Invited speaker = Attend/Participate ROLE OF AGENCY (Totals) Committee member Coordinate & Support 1 Lead agency 1 Presenter/Invited speaker 1

Total number of Site Visits RECIPIENT (Totals) FUNDING SOURCE (Totals) SITE VISITS Center Based Staff Children Exempt Provider Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee First 5 R&R/APP contract from CDD R&R contract from CDD Write in the total number of site visits here. This will equal the number of SITE VISITS forms that have been filled out during the month. English Spanish Chinese LANGUAGE (Totals) Korean Tagalog Vietnamese

Center Based Staff Children NUMBER OF RECIPIENTS (Do not double count) Exempt Provider Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee

NUMBER OF RECIPIENTS (Do not double count) SITE VISITS Center Based Staff Children Exempt Provider Licensed FCCH Provider 2 Parent/Relative/Guardian Prospective Licensee + NUMBER OF RECIPIENTS (Do not double count) SITE VISITS Center Based Staff Children Exempt Provider 1 Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee = SITE VISITS Total number of Site Visits 2 Center Based Staff Children RECIPIENT (Totals) Exempt Provider Licensed FCCH Provider 2 Prospective Licensee 1 Parent/Relative/Guardian

FUNDING SOURCE (Totals) First 5 R&R/APP contract from CDD R&R contract from CDD

FUNDING SOURCE (Check all that apply) First 5 R&R/APP contract from CDD R&R contract from CDD + FUNDING SOURCE (Check all that apply) First 5 R&R/APP contract from CDD R&R contract from CDD = First 5 2 FUNDING SOURCE (Totals) R&R/APP contract from CDD R&R contract from CDD 1

LANGUAGE (Check all that apply) English Spanish Chinese Korean Tagalog Vietnamese

LANGUAGE (Check all that apply) English Spanish Chinese Korean Tagalog Vietnamese Arabic + LANGUAGE (Check all that apply) English Spanish Chinese Korean Tagalog Vietnamese = English 2 Spanish 1 LANGUAGE (Totals) Chinese Korean Tagalog Vietnamese 1 Arabic 1

RECIPIENT OF LIBRARY SERVICES Onsite Library Visits Mobile Library Center Based Staff Community Organization Exempt Provider Instructor/Trainer Licensed FCCH Provider Parent/Relative/ Guardian Prospective Licensee

RESOURCE LIBRARY Onsite Library Mobile Library RECIPIENT (Totals) Center Based Staff Community Member/Organization Exempt Provider Instructor/Trainer Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee Totals

Center Based Staff Community Organization Exempt Provider Instructor/Trainer Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee Student III Onsite Library Visits Mobile Library IIII I IIII III IIII IIII II II III RECIPIENT (Totals) RESOURCE LIBRARY Onsite Library Mobile Library Center Based Staff 3 Community Organization 6 Exempt Provider 8 Instructor/Trainer Licensed FCCH Provider 9 Parent/Relative/Guardian 2 Prospective Licensee 2 Student 3 Totals 25 8

Messages Recipient Blog Posts Email Blasts Mass Mailings Outreach Events Robo-Calls Website Visits

OUTREACH Messages Recipient TYPE (Totals) Blog Posts Email Blasts Mass Mailings Outreach Events Robo-Calls Website Visits Totals

Message Type Blog Posts III Email Blasts II III Mass Mailings III IIII III Outreach Events II IIII IIII Robo-Calls IIII IIII IIII Website Visits IIII IIII IIII Recipient OUTREACH Message Blog Posts 3 Recipient Email Blasts 2 3 Mass Mailings 3 8 TYPE (Totals) Outreach Events 2 10 Robo-Calls 9 4 Website Visits 4 10 Totals 23 35

RECIPIENT OF TECHNICAL ASSISTANCE Center Based Staff Community Organization Exempt Provider Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee TECHNICAL ASSISTANCE TOPICS Child Care Data Child Development Child Care Licensing Community Resource/Referral to Outside Agency R&R Program Information Subsidy

RECIPIENT (Totals) TECHNICAL ASSISTANCE Center Based Staff Community Member/Organization Exempt Provider Licensed FCCH Provider Parent/Relative/Guardian Prospective Licensee

RECIPIENT OF TECHNICAL ASSISTANCE (Do not count child care referrals or updating of parent/provider database) Center Based Staff Community Organization Exempt Provider Licensed FCCH Provider Parent/Relative/ Guardian Prospective Licensee Reporter, Legislative Staff, Planning Council IIII IIII I III III IIII IIII IIII IIII IIII IIII II RECIPIENT (Totals) TECHNICAL ASSISTANCE Center Based Staff 11 Community Member/Organization 3 Exempt Provider 3 Licensed FCCH Provider 5 Parent/Relative/Guardian 10 Prospective Licensee 10 7 Totals 49

TOPICS (Totals) TECHNICAL ASSISTANCE Child Care Data Child Development Child Care Licensing Community Resource/Referral to Outside Agency R&R Program Information Subsidy

TECHNICAL ASSISTANCE TOPICS Child Care Data Child Development Child Care Licensing Community Resource/Referral to Outside Agency R&R Program Information Subsidy III IIII IIII IIII IIII IIII IIII IIII IIII IIII TOPICS (Totals) TECHNICAL ASSISTANCE Child Care Data 3 Child Development 4 Child Care Licensing Community Resource/Referral to Outside Agency 15 R&R Program Information 20 Subsidy 4 Totals 46