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OMB Approval No.2506_0 i 45 (exp. /31 07 /200

Annualprogress Report(ApR)
for Supporfivel{ousing prograrn Shelferplus Care and Section Mod g

for^:3 Rehabilitarion --'"r^oor)T.#;l:,

H uD 40 l8 t

public reporting burden for this collectjon of information is estimatedto average33 hours per response, including the time for reviewing instructions, Tl i on. s earc hin g e x i s t i n g d a t a s o u r ce s,g a th e r in g a n d m a in ta in in g th e dataneeded,andcompl eti ngandrevi ew i ngthecol l ecti onofi nformatisagen c y may

numbel displays validOMB control a that un'less collection ofinlormatjon to, to is and sponsor, a person not required respond a collection oondqglor

Genei*i tdstrucffius r.._ r' .; ! I


programs. homeless assistance

(APR)tracks program progress accomplishments Deparfment's and in the competitive Report

grants must submit 2 APR'S to HUD within 90 days after Filing Requirements. Recipientsof HUD's homeless assistance year. One copy of the report must be submittedto the CPD Division Director in the local HUD the end of each operating Field Office responsible for managing the grant. The other copy must be submrftedto HUD Headquarters,Deparlment of Housing and Urban Development,Attn: APR Data Editor, Room7262,451 76 Street,SW, Washington, DC. 20410. Failure to submit an APR will delay receiving grant funds and may result in a determination of lack of capacity for funue funding. An APR must be submitted for each operating year in which HUD funding is provided. Grantees acquisition,or rehabilitationare requiredto operatetlieir facilities for that receivedSHP funding for new construction, 20 years. They must submit an APR 90 days after the end of the fust operating year and any year in which they use SHP funding for ieasing,supportiveservices, operations.For yearsin which they do not receiveSHP funding,they must submit or an Amual Certificationof ContinuedProject Operationthroughoutthe 20 years. The certificationcan be found at the back of this APR. A separate report must be submittedfor eachHUD grant received. For ShelterPlus Care,a separate APR must be submrtted for eachShelterPlus Care component. For thosegrantees reporl covering that period must be submitted(seeExtensionbelow). receiving an extension,a separate Recordkeeping. Granteesmust collect and maintain information on each participant in order to complete an APR. Optional worksheetsare attached. The worksheetsmay be used to record information manually or to design a computerizedsystem to store and tabulate the information. The worksheetsshould not be submitted to HLID with the APR. Organization of the Report. The APR is organized in the following manner; Part I: Project Progress. This portion of the report describes progressin moving homeless the persons self-sufficiency, to services received, project goals,and beds created. Part II: Financial Information. This portion of the repod is completedby all grantees receivingfunding under SHP, S+C and SRO. Final Assembly of Report. After the entire report is assembled,nurnber every page sequentially. Mark any questionsthat do not apply to your program with "N/A" for not applicable. (SeeSpecialInstructionsfor SSOProjectsbelow.) Definitions. The foilowing tern'lsare used in the APR. As indicated,in somecases, terms are applied differently dependingon whetherthe funding is from SHP, S+C, or SRO. personas "an unaccompanied Chronically homelessperson - HUD definesa chronicallyhomeless homelessindividual with a disablingconditionwho has either been continuousiyhomeless a year or more OR has for had at leastfour (4) episodes homelessness the past three (3) years." To be considered of in chronicallyhomeiess a personmust have been on the streets in an emergency or shelter(i.e.not fransitionalhousing)during thesestays. Disabling condition - HUD deltnes"disablingcondition" as "a diagnosable substance disorder,seriousmental use illness,developmental disabiiify, or chronic physicalillnessor disabiiity, including the co-occurrence two or more of of theseconditions. A disablingcondition limits an individual's ability to work or perform one or more activitiesof daily living." Entered the program for S+C and SRO projectsmeanswhen the participantstartsto receiverental assistance. For S+C, servicesprovided prior to this point are recognized as necessaryfor outreach,/enrollment are eligible to count as and match.


and receivedan extensionoftheir grant term lrom that requested An Extension APR appliesto SHP and S+C grantees the HUD field office. The only difference betweenan APR for the extensionperiod and the regularAPR (besides the page. Grantees should circle "yes" to indicatethe APR is for an extension amountof time covered)is the signarure npr i^/ l ' n^^i ' ^ l e th e o p e ra ti n g y e a rfo rw h i chthereporl i sanextensi on.Forexampl e,i fthegranteei se xt endingyear 3, thc oranree chnrtldsubmit an APR as usualfor year 3 and submrtanotherAPR for the extensionperiod, indicatingthe secondis an extensionand also circling year 3 on the signature page. Family meansa householdcomposed fwo or more reiatedpersons,at leastone of whom is an adult. Caregiversare of not reported on in the APR. Grantee meansa direct recipientof the HIID award. Left the program for S+C projectsmeanswhen the participantstopsreceivingrental assistance is not expectedto and return to S+C assisted housing. If the participantreturnsto S+C assisted housingwithin 90 days, the personihoutd not be considered exiting from the program. Ifthe personreturnsto S+C assisted as housingafter 90 days,that personis considereda new participant. The worksheet is designedto capture this information. Match for S+C meansthe value of supportive servicesreceived by participants in the S+C project which, in the mrtcrat leastequalthe value of the S+C rental assistance provided over the life of the project. For SHp, match ^osrPo're meanscashused to provide the grantee's portion of acquisition,rehabilitation,new construction, operations and supportiveservicesexpenses. Operating year for SHP meansthe datewhen participants begin to receivehousingand/or services. The first operating year beginsafter development activitiesfor acquisition,rehabilitation,. new consfructionare complete,after a copy of and the Certificateof Occupancy sentto the local lfLlD offrce, and when the first parlicipantis accepted is into the proieit. For projectswithout acquisition, rehabilitation,or new consfruction, operatingstartdatebeginswhen the grantee the acceptsthe first participant. For S+C (SRA, PRA and TRA components), lust operatingyear begins on the date HUD the signsthe grant agreement.For S+C/SROand for Sec.8 SRO, the first operatingyearbegins with the effective date of the Housing Assistance (IIAP) Contract. Payments To determinewhich operating year to circle on the APR cover page, begin counting flom the initial grant operating sran date and include renewalsgrants. For example, a project receiving an initial grant for tluee years u.rd u r"r,"-ul grant for two years would circie years 1, 2, and3 respectively on the APR cover sheetfor the initial grant and would circle 4 and 5 respectively for the renewal grant. For any fuhre renewal grants, the granteewould begin by circling 6 on the ApR cover sheet. Participant means single personsand adults in families who received assistance during the operating year. participant does not include children or caregiverswho live with the adults assisted. Project Sponsor meansthe organizationresponsiblefor carrying out the daily operation of the project, if the organization is an entity other than the grantee. Special Jnstructions For Supportive Service Only Proiects. SSO grantees shouldcompleteall questions, unlessa written agreementhas been reachedwith the field office concerning w'hich questionscan be answeredusing estimates,or in rare instances, skipped. Beiow is an exampleof how informationcould be.derivedin a large, single-service SSOproject: A grantee/sponsor staff membercould be assigned collect information from the organizations to housingthe participants.The staff personwould contacttheseindividual organizations requestinformationregardingthe personsin that lacility that use to the service.For participantsIiviag on the sfreet,the grantee/project sponsormay provide estimates. Information could be collected for eachparticipant or for participants receiving servicesat a point-in-time. If estirnatesor point-in-time counts are used, the method used must be described in the APR and the documentationkept on file. As with all projectsfunded under HIID's homelessness assistance grants,grantees operatingSSO projects are expectedto completeall APR questions that are applicableto them. Note that all projectshavebeenawardedfunds as u ,.r.ult of
H U D - 4 0 1 t8

responding to the program goals of assistinghomelesspersons obtain/remain in permanenthousing and increasetheir skills and income. The APR documentstheir progress in meeting these goals. In some circumstancesfield offices and granteesmay sign a written agreementconcernhg questionswhich can be answered for skipped. Below are some considerations reportingonparticularfypes of projects: using estimates, inrare instances, or to are Outreach Onlv Proiects. - Projectswhich are solely devotedto streetoutreachand conriection housingand servrces not requiredto hack participantsbeyond their contactwith personson the sfreet. It is sufficient for theseprojectsto enter E 'in fo rrrlat iononques t i o n s l -1 0 (s k i p p i n g q u e s ti o n s l l -i 3and17).sti matesforquesti ons5-9areal l ow ed,gi venthat participantsmay be reluctantto answerpersonalquestions. Answering the questionswill demonstratethat the granteeis serving the appropriate number of people, providing basic demographic information for Congress,demonstratingthat homelesspersons are befurgserved,demonslratingthe fypes of housing parlicipants are connectedto, and the tlpe of servicesthey are receiving. Hotline Proiects. - Hotline servicesare similar to oufreachprojects,but contactbetweengranteeand participantis often of very short dwation - people enter and leave the program nearly simultaneously. It is sufficient for theseprojects to answer questions1-5 (skipping4), I0, and 14-19 (skipping 17). Proiects Providing Services To Children Onlv. - Projectsthat provide child care,after school care,counselingfor children, etc. make an important conhibution toward moving a family out of homelessness.While the main focus of the project is providing servicesto the children, it is the adults who are reported on il questions6-16 of the APR. Like all otherprojects, this type is also targeted toward getting the families into housing and increasing the families' ilcomes. (except 17). shouldbe answered Grantees may skip question9; all other questions provide a Transportation. Medical, Dental. and Other Single. Short-Duration Service Proiects. - Somegrantees personsto obtain/remain perrnanent homeless in single serviceof fairly short dwation focusedONLY indirectly on assisting housingand increase their skills and incomes. It is sufficientfor theseprojectsto enterinformation on questions1-10 and 14it to 19 (question17 may be skipped). However, with transportation services, is unreasonable think that someonewould have to give their age,race, and ethnicity to a bus driver to get a ride a few blocks. provide a narrative,which gives the number of rides given during the operatingyear,and provides estimates For theseservices, on the abovestatistics basedon the population that utilizes the service. For Safe Haven (SH) Proiects. - Gantees are remindedthat they are to repofi ONLY on the Special Instructions number of participants the application was approved for (cannot exceed 25 participants).

HomelessManagement Information Svstem(HMIS) Proiects. - HMISgrantees should fillout thecover sheet HMISatthebottom) PartII Financial and Information. APRalso a sheet listsHMIS The has of theAPR(marking that activities.




HUD Grantor ProjectNumber:

Hamilton Family Center

Project Sponsor:


San Francisco HumanServices Agency

year OperatingYear: (Circle operating beingreported the on)

Hamilton Family Transitional Program

ReportingPeriod: (month/daylyear)

n t J z n : Aq n s !o X z tra !s Er o n t t l r z [ r : D r +E rs l ro n rz l ra n rs E zo
Indicateif extension: I Yes X No Indicateif renewal: X Yes n No PreviousGrantNumbersfor this oroiect:



cA0'1 8 2 01016

8 cA 0 1 1 0 1 0 0 7


Checkthe componentfor the program on which you are reporting.

Supportive Housing Program (SHP)

Shelter Plus Care (S+C)

Section8 Moderate Rehabilitation tl Single Room Occupancy (Sec.8 SRO)

TransitionalHousing Petmanent Housing for Homeless Persons rvith Disabilities SafeHaven Innovative Supportive Housing SupportiveServices Only HMIS


n n x n

Tenant-basedRental Assistance(TRA) (SRA) Sponsor-based RentalAssistance (PRA) Project-based RentalAssistance (SRO) Single Room Occupancy

(One twosentences a descriptionpopulation, with Summary theproject: of or of number served accomplishments and year) thisoperating Hamilton FamilyCenter's Transitional HousingProgramprovides transitional housingand supportservices for including homeless families who face a complexity challenges familystability, of to histories mentalhealthissues, of addiction, domestic immigration fostercare,amongothers.Duringthe past year,the programworked and violence, housinguponexitingthe program. with a totalof 45 families 76% of whom obtainedpermanent
Name & Title of the Personwho can answer questions about this report Phone: (include area code)

Devra Edelman, M. Program Director


(415)409-2'100 x107

'1631 Hayes SanFrancisco, St.; CA94117 dedelman i orq E-mait Address @hamltonfamilycenter.


I hereby certify tliat all the information stated herein is true and accurate.
false claims and statements.Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, Warning: HUD will prosecute

1 0 1 0. 10l2: 3l U. S . C3 7 2 9 3 8 0 2 . .
Name& Title of Authorized Official Grantee


5 : rlv a c ( o c} 4 u n ti v& r-,E ra c"0 l re

Project Sponsor Officiai: NameandTitleof Authorized

2,-15 -O
Signature X

Director Menjivar, Executive Salvador


A4i r F-vur,tq Grq,ttr; MenAqr Kivn,

--i --l



1. Projected Level of Persons to be served at a given point in time. (from the application,SHP-Sec. SPC-Sec. F; D; SRO- Sec.D)
Number of S i ngl es ot N in Families

ProiectedLevel Persons be served a given point in time to at

Number of Adults in Families

Number of Children in Families

Number of Families






PersonsServedduring the operating year.

Number of S i ngl es ot i n N Fami l i es

Number on the first day of the operatingyear b.



Number of Adults in Families z3

N umberof C hi l dreni n Fami l i es

N umberof Fami l i es

49 44

19 26 25

Number enteringprogramduring the operatingyear Number who left the program during the operatingyear

38 33 28


year Number theprogram the lastdayof the operating in on (a + b- c ) = d Project Capacity.


Number of SinglesNot in Families


Number of Adults in Families

' . .::. :lr 1".....i

Number of Children in Families

Number of Famil i es

Number on the last day (from 2d, columns I and 4) Number proposedin application(fiom 1a, columns I and 4) CapacityRate (divide abyb): %

N/A %

t ''tt" .. tt:

." .



: '', *, t l - , ', , ]




j' , r

i 100 %


Non-homeless persons. This questionis to be completedfor Section8 SRO projects. I ruln

How manyincome-eligible persons non-homeless werehoused theSROprogram by year? duringtheoperating 5.

Age and Gender. Of thosewho entered the project during the operatingyear, how many peopleare in the following age and gendercategories?
SinglePersons(from 2b. column I

62 and over





5 1-61


31-50 I 8-30
17 andunder



N/A N/A 0 0

Personsin Families (from2b, columns 2 & 3)


62 and over




51 - 6l 3l -50 18- 30 l3-17 6-12 l -5 Under1

7 .)


z HUD-4018 I

year (from2b,columns e.4. I the who entered project during the operating questions - 10 only for participants 6 Answer children caregivers, or NOTE: Thetotal not persons adults famiiies.It does include and in single Thetermparticipantmeans questions all participants. to for Some the of be respond each those of for questions, 8 andi0 beiowshould thesame; 7, questions information rndividuals for who areehrSnisaly hA4eles!. listedthroughout APR will be asking the
6a. Veterans Status. A veteranis anyonewho has ever beenon active militarv dutv status. How many participantswere veterans? 6b. Chronically homelessperson. An unaccompanied homeless individual with a disablingconditionwho has either been continuously homeless a year or more OR has had at leastfour (4) episodes for ofhomelessness the pastthree(3) years. To be considered in chronically homeless a person must have been on the streets or in an emergency shelter (i.e. not transitional housing) during these stays.

How manyparticipants werechronically homeless individuals?

7. a. b. 8,


Ethnicify. How many participantsare in the following ethnic categories? Hispanic or Latino Non-Hispanic Non-Latino or Race. How many participantsare in the following racial categories? American Indian/Alaskan Native Asian Black/African American Native Hawaiian/Other Pacific Islander White American Indian/AlaskanNative & White


d. f. h.

I 12

Asian& White
Black/Afiican American & White American Indian/Alaskan Native & Black/African American Other Multi-Racial

9 0 0

9a. Special Needs. How many participantshavethe following? Participantsmay have more than one. Ifso, count them in all applicablecategories.For eachcondition, also indicatethe number that were chronically homeless. All Chronic


Mental illness Alcohol abuse Drugabuse

HIV/AIDS and relateddiseases Developmental disabilitv




Physical disability
Domestic violence Other (pleasespecify) Recent Immigrant


9b. How many of the participantsare disabled? 4

H U D - 4 0 1 t8

theproject? (Foreach in slept 10. prior Living Situation.How manyparticipants in the followingplaces theweekpriorto entering one) sleptin thefoilowingplaces.(Choose participants how manychronicallyhomeless one participant, Choose place). Also,indicate
All b.


Non-housing(street,park, car, bus station,etc.) Emergencyshelter persons housingfor homeless Transitional Psvchiatricfacilitv*


. t:.


d. f.

facilitv* abuse treatment Substance

Hosoital* Jailiorison* Domestic violencesituation Livin s with relatives/fi-iends Rental housine specifu):Transitional/ Mental Health Facilitl Other (please


';'"-- . -'-.,';.. ,
t,:. : ,:

': - : '" '. i


xlf a participantcamefrom an institution but was there lessthan 30 days and was living on the streetor in emergencyshelterbeforeenteringthe treatmentfacility, heisheshould be countedin either the streetor shelter caregory. appropriate. as

Completequestions11 - 15 for all participants who left during the operating year (from 2c, colurnns 1 and2). The term padicipant meanssinglepersonsand adultsin families.It doesnot include children or caregivers.The term chronically individual with a disablingcondition who has either been continuously homeless homelessperson meansan unaccompanied in of homelessfor a year or more OR hashad at leastfour (4) episodes homelessness the past three (3) years.To be considered a chronically homeless personmust havebeen on the sfreetsor in an emergencyshelter(i.e. not transitionalhousing)during thesestays. year, participants left duringtheoperating who how manlof I 1. Amount and Source Monthly Incomeat Entry and at Exit. Of those place monthlyincome the levelandeach of income levelandwith eachsource income? Also,please participants monthly wereat each chart.Thenumber participants ChartA andB of in persons the second column each of in for homeless of source income chronically should thesame. be
A. Monthly Incomeat Entrv No income All Chrcnic 1- i ::-.+l a. All C. Income SourcesAt Entrv Chronic
I t: .:.j l

(SSI) Income Suppiemental Security (SSDI) Securiry Disability Income Social Security Social PublicAssistance General
TemporaryAid to Needy Families (TANF)

,,,': 1

c. d.

$1- 150


c, d.

s15i- $2s0
$251- S500


$s01 s1,000 f.

1 0 0 25

$1001$150 0


s2000 sr501+ s2001

1 0


(SCHIP) Health Insurance Program State Children's

VeteransBenefits EmployrnentIncome Benefits Unemplo;,rnent VeteransHealth Care Medicaid Food Stamps Other (pleasespecify): Child Support No Financial Resources




k. I
m n.


HU D - 4 0 1 1 8

a. b.


All at D. Income Sources Exit



B. Mo nthlyI nc om eat Ex it No income

S u p p l e m e n t a l e c u r i t yI n c o m e( S S I ) S SocialSecurityDisabilityIncome(SSDI) SocialSecurity General Public Assistance




sr 5r- s250

I $25 - $500 $501 $1, 0 0 0 s i00l- $15 0 0 $1501- 0 0 $20 + $2001



Temporary to Needy (TANF) Aid Families



t. 1

StateChildren's Health InsuranceProgram(SCHIP) VeteransBenefits Emplol'rnent Income Unemployrnent Benefits Veterans Health Care Medicaid Food Stamps



1 0 11


26 20 1


(please Other specify): ChildSupport

No FinancialResources

l2a. Length of Stay in Program. Of those participantswho left during the operatingyear (from 2c, columns I and 2), how manywere in for the following lengthsof time? Also, pleaseplacethe Iengthof stay for chronically homeless personsin the second :::J#j:" All


Lessthan I month

1i ta


1 to 2 months 3 - 6 months
7 months- 12 months

13months 24 months 2 5mo nth s - 3v ear s



4y ear s -5 y e a rs 6y ear s -T y e a rs
8 vears- 10 vears Over l0 years

0 0 0 0 0

participants did not leave year l2b. Length ofStay in Program. For those that duringthe operating (from2d,columns and2), how I place length stayfor chronicallyhomeless longhavetheybeen theproject?Also,please in persons thesecond the of in column. All
Lessthan 1 month


d. f

I to 2 months
3 - 6 months 7 months- l2 months

6 6

13months 24 months 25 mon ths - 3y ear s

4y ear s - 5 y e a rs
6yea rs-T y ear s


8 years 10years Over10years

0 0 0

HUD-401 l8

1 year duringtheoperating (from2c,columns and2), how many who participants left theproject for 13.Reasons Leaving. Of those place the includeq2futheprimary redso'|' Also,please tet li left for thefollowingreasons? a participant for mutiipiereasons, column. persons the second in homeless for primary reason chronically All
Left for a housing opportunitybefore completingprogram


c. d.

Completedprogram charge Non-paymentof renVoccupancy Non-compliancewith project



/ of Criminalactivityldestruction property violence

f. Reachedmaximum time allowed in proiect Needscould not be met by project (Active DV) with ruleslpersons Disagteement Death J





due speciff):Ineligibility to CPSRemoval Other(please


14. Destination. Of those participants who left during the operating year (from 2c, columns 1 and 2), how many left for the following destination?Also, pleaseplacethe destinationof chronically homelesspersons in the secondcolumn. All Chronic


(no houseor aparfment subsidy) Rental Housing Public

8 Section


Plus Shelter Care

HOME subsidizedhouseor apadment Other subsidizedhouseor apartment Homeownership Moved in with family or friends persons housingfor homeless Transitional

10 0 0
4 1





Movedin with family or friends Psychiatric hospital facility Inpatient alcoholor otherdrugtreatment Jail/prison shelter Emergency MH/DD Facility) housing(Transitional Othersupportive (e.g.street) habitation not for Places meant human specify): DV Shelter Other(please


OTHER (o-q)

n. o.

0 1 2 1


1 2



HUD-4018 r

the received I year who Ofthoseparticipants left duringtheoperating (from2, columns and2),how many Services. 15. Supportive for received chronically services place supportive the project? Also,please theirtime in the during services followingsupportive column. yearin the second the participants left during operating who homeless






management Case
management) Life skills (outsideof case servtces Alcohol or drug abuse Mental health services

8 17



services H lV/AIDS-related Other health care services Education Housing placement assistance Employ'rnent Child care Transportation Legal




23 30


DV specify): or CPSAssistance Other(please


HUD-401 I8

Technical year for objectives thisoperating (fromyourapplication, list 16. overall prosram Goats.Underobjectives, yourmeasurable in the yourprogress meeting objectives describe Progress, listedbelow. Under of ApR) for each thethreegoals SuU-lrrion,or year. for objectives thenextoperatlng the specify measurable Year'sObjectives, UnderNextOperating
a. ResidentialStabilify Objectives:


housingwith the complete programwill move into permanent who successfully 85% of the participants theirhousing. incometo maintain sufficient


for housing at least will the complete program remainin permanent successfully 85% of participants aftertheirexit

Progress: (22 the t. 90% of families(18 out of 20) and 92% of adultsparticipants outof 24) who completed program Two theirhousing. incometo maintain housingwith sufficient during2006 movedinto permanent incomeat the time to exit into the completed programbut did not have sufficient familiessuccessfully facility and has sinceobtained housing transitional to One familyexited a dual-diagnosis housing. afterbeingin exitedto shelter voluntarily One family PlusCare program. the through Shelter housing year. laterin the was housed Thisfamily for the program 1Bmonths. ll. the completed programduring2005 and were 100% ofthefamilies(21 outof21) who successfully housingfor at leastonq yeara er theirexi in permanent housedremained

Year's Objectives: NextOperating housing the complete programwill move into permllnent who successfully families l. 85% of participating their housing. incometo maintain with sufficient ll. housing the complete programwill remainin permanent who successfully families 85o/o participating af year aftertheirexit for at leastone

Increased Skillsor Income Objectives: '100o/o all eligible participantswill apply to obtain TANF, WlC, food stamps, and Medicaid benefits of


within30 daysof programentry. ll. and familyactivities life participants take partin a variety skillworkshops will 90% of all adultprogram training conflicts withthe meetings. or unless theiremployment school/vocational whilein the program, in or or school, enrolled an employment vocational attending will 85%of adultparticipants be working, program substance and/ormental use addressing in program, enrolled a day treatment or training issues. health will theirincomeas and of 80o/o familieswho completeprogramrequirements graduate increase to compared incomeat programentry. program will or in schoolor enrolled an employment vocationaltraining who attended 80% of residents by the time ihey graduate' obtainfull time employment





Frogress: aid participants who were not receiving appliedfor aid within30 daysof programentry. 100%of eligible employment school or who An overallaverageof 95% of all adultparticipants, did not have a disability, offeredduring2006. and familyactivities participated the varietyof life skillsworkshops in conflicts, in school,involved an attending were eitheremployed, An overallaverageof 94% of adultparticipants programaddressing program, enrolled a day treatment in training or or employment vocational substance abuseand/ormentalhealthissues. I2
H UD - 4 0l1 8




iheir income the completed programin 2006 increased who successfully 70%,or 14 out of 20 families and exitedto completed who successfully as compareoto incomeat programentry.5 families did the permanent housingexitedwithinfour monthsof entering programand therefore not have income.Thesefamiliesall exitedto viablehousingand successfully time to increase sufficient the completed program. program, and attended employment vocational an or 83%,or 5 out of the 6 adultswho graduated the by obtained employment the time theycompleted program.


Next Operating Year's Objectives:


participants 100o/o alleligible willapplytoobiainTANF,WlC, foodstamps, of and Medicaid benefits within30 days of programentry. will 90% of all adultprogramparticipants take part in a varietylife skillworkshops and familyactivities whilein the program, unless disability, a theiremployment school/vocational or training conflicts withthe meetings. 85%of adultparticipants be working, will attending school, enrolled an employment vocational or in or programaddressing program,or enrolledin a day treatment training substance use and/ormental health issues. 80% of familieswho successfullycompletethe program and are in the program for at least 6 months theirincomeas compared incomeat programentry. to will increase graduate who successfully 80% of residents from a schoolor an employment vocational or training whilein the programwill obtainfull time employment the time they exit. by



lV. V.


Greater Self-determination Objectives:

l. ll.

100%of familieswill establish Family a ActionPlan,to be reviewquarterly. will 95% of adultparticipants attendweeklyresident meetings, unlesstheirschooland/orernployment schedule conflicts with meetinotimes.

l. ll.

Progress: 100%(61outof 61)adultparticipantsin2006have,orhaddeveloped,afamilyactionplanthatis reviewed weeklyand quarterly with the participant's case manager. An overallaverageof 95o/o adultparticipants 2006,who do not have employment in of schoolconflicts, or physical healthproblems, attended CommuniiyMeetings twice a month.

Next Operating Year's Objectives:

l. ll.

ActionPlan,to be reviewquarterly. 100%of familieswill establish Family a will 95% of adult participants attendweeklyresident meetings, unlesstheirschooland/orernployment schedule conflicts with meetinotimes.


HUD-401 l8

recipients answer c. (SHP-SSOprojects do 17 recipients answer SRO 17b. tr7. Beds. SHP recipients answer S+C 17a. rtot complete tltis questiott)
a. SHP. Howma ny beds wer einc ludedint heappli c a t i o n a p p r o v e d f o r t h i s p r o j e c t u n d e r 'C u r r e n t L e v e l 'a n d u n d e r 'Ne w Effo r t'? How many of theseNew Effort bedswere actually in place at the end of the operatingyear? New Effort New Efforl in Place Cunent Level q N/A Number of Beds: 80 with project funds at the end of the operatin year? g S+C. How many beds and dwelling units were being assisted (Include beds for all participants, other family members, and care givers.) Number of Beds: Number of Dwelling Units: c. SRO. How many dwelling units were being assisted the end of the operatingyear? at (Include units occupiedby "in place" non-homeless personswho qualify for assistance.) Number of Dwellins Units:




H UD - 4 0 1 1 8

MAR-1 5- 2O O 7 1422 7

D H S' C ' .C ' M

415 65? trJ679

P . 002



Part IL Financisl Irtforrnation
18. Supportive Serrylces,

' nv

For $upoortive ll,qu[itr-(SHP). thi.scxhibit providcs information to Hl]D on how SHP f+nding for supportivc scn iccs wqs spsfltduring thc opentitrg year, Entcrthe amouht ofSHP funding SPent lhesc supportivc scrviccs. tnclude on FMIS costsundcr "Other" For ShelterPlus Care(S+C),this exhibit trackst}c supportivcssrviccsma.tch rcquircment,Specity the virluc of supportivc scrviccs fiom all sources thot con be countcd 0.smutch thst $ll homclcss pcrsons reccived durlng thc shouldkccp documcntationon frle, including source,afiount, nnd typc of supportive opcratilrg ycar, (S+C grantccs senrices.) rcccivcd by horneless For SectiOn SRO, ttris ofiibit providcsinformation to HUD on the value of nupportivcscr'vices E pcrsorls during the operating yeor.

Supportivc Scrviccs

Dollars 93,435



cosc m*nugcmcnt
Lifc skills (outside of casc management) Alcohol slld druRabuscscrviccs M cnt{rl hcglth scrviccs

AlDS-rclatcd scn iccs Other healthcsresefficcs Education Housirtg placcmcnt Employnlcnt tssistancc




Child carc Trrursportution


Residential $259,331 Oth* (plc*sc spccify)

268,1 50

(indirect) 8,E19 Administration $

TOT,\L (Sum of + through n)

rilii;r]fiiiilifriiiitiiiiltlflflttlHlil llillli!lLlr!rilillllll{lirirrlrrrliiitiiriii{iillilrjlil'llilljilliiliiiiiiliiltliiiililii;iiliillfltiiifiiiii liliiiliiilliHllfif ilfrP*iliflifl*ffiF'iillilifililftJlrruu lllll1ilttlr1llll

of Cumulotivc u.mount match providcd to dutc for thc Shcltcr Plus Carc Program undcr this Erunt

M AR-1 5 * 2007

t 4: 27

D H S,

O . C, M

4t6 667 5679

P. 003

19. Supporiive Hou--ing Progrom: Administrstion

Lcasing, Supportive Services, Operating

Costs, IIMIS

Activitie.c and

All grontces rccciving funding undcr the SupportiveHousing Progr*mftust complstcthcsc chans each operatirg yem, For cxprnsiotr projcct$: If SHP grant fund.s for the expansionof s prc-existinghomclcssfacility, only the peoplc rmd are cxpcnditurcs for rhc additional expan.5iqn moy be included. as in thc originul upplication or any grtnt arr1fid111snts, Documcntationof resoure-q rrsedis not rcquircd to bc submittcdwith this rcport but should be kept on filc for possiblc inspection by HUD_qqd,Audi1o1s-Do no[ iticludc uny cxpcnditurcs mudc bcforc t]4 SHP lrant was executed-

Summrry of Expcn<litures, Enrcrrhcamount SHPgrantfunds andcash of matchcxpendcd duringthe aperating yenrfor cuch This tablcshould up bothhorizontally v*tictlly, Thc SHPsupportivc add and scrvices totalshould thc samc thc be as -rctivity. SHP vc scrytccstn E. 'foral Expenditurcs SHPFunds CashMalch



194,048' 110,308 45,553

490,1?7 166,995

c d.

Operating Costo
HMIS Acriviries


f. Total




Notc; Plymcnls of principal rnd intcrcst on any loan or rnotlgoge tm:y not bc shown as un opanting crpcnsc, Sources ot Cash Mntclr. Enter the sources of crrsh idcntificd in thc Cash Match column, above, in thc followinc

s. Use additional sheets, a.q

of SanFrancisco Department Human Services

Strtc govcmmcnt (plcasc specify)

Federal governrnent (ples8c spccify) Community Dcvelopmtrlt Block Grunt (CDBG)

(plcasespecify) Foundarions

Privatc ccsh rcsourccs (plcasc spccify)

Occuprurcychargc / fccs


and Rehabilitation, New Construction 20. Supportive }lousingProgram: Acquisition,

or All grantees that receivedSHP funds for acquisition,rehabilitation, new constructionmust completethesechartsin the year one APR has contributedenoughcashto at leastequally match the amount of SHP funds to only. This exhibit will demonstrate HLID that the grantee that matching funds were provided is not requiredto be submitted rehabilitation,or new construction. Documentation spentfor acquisition, by with this report but should be kept on file for possibleinspection HUD and Auditors. Summary of Expenditures. Enter the amount of SHP grant funds and cashmatch expendedduring the operatingyear for eachactivity SHP Funds Acquisition b. c.

Cash Match

Total Expenditures

Rehabilitation New construction Total

Cash Match. Enter the sourcesof cashidentified in the CashMatch column, above,in the following categories. Use additionalsheets, necessary. as


Grantee/projectsponsor cash Local government(pleasespecify)



State government (pleasespecify)


Federalgovernment(pleasespecify) Community DevelopmentBlock Grant (CDBG)

(please specifl) Foundations


(please cash resources specify) Private

o 5'

fees Occupancy charge/




HUD- 40r t8


21. For SupportiveHousine (SHP) - HMIS Activities This exhibit providesinformation to HUD on how SHP-HMIS funding for supportiveserviceswas spentduring the operating year. Enter the amountof SHP-HMIS funding spenton theseactivities.

Cenhal Server(s) PersonalComputers and Printers Networking

': - ,.:. .
Software/ User Licensi Software Installation Support and Maintenance

Software Tools

Hosting/ Technical Services

Security Assessmentand Setup On-line Connectivity (Internet Access) Facilitation Disasterand Recovery

ProjectManagement Coordination / Data Analysis TechnicalAssistance and Tra Administrative Support Staff

Operational Costs


HUD-401 l8

year. duringthe operating implemented Describe problems and/orchanges any

Technical Assistaice and Recommendations Based on your experienceduring the last year, are there any areasin which you need technical advice or assistance?Ifso, pleasedescribe.



Annuul certification of continuedProjectoperution

Supportive Housing Program

ProjectNumber:CAO18501 13 0

ProjectName: HamiltonFa Operating Start Date: February 2000

Grantees that receivedSupportiveHousing Programfunding for new construction,acquisition,or rehabilitationare requiredto operatetheir facilities for'20 years.

I, SalvadorMenjivar,certi$rthat the facilify thatreceivedassistance acquisition, for rehabilitation,or new constructionfrom the SupportiveHousing Programhas operatedas a facility to assisthomeless personsfrom February2000 to February 2007. * I also certi$r that the grantis still serving20 families at:

1631 Haves Street: Franci San (siteaddress)

CA 94117

andail therequirements the grantagreement beingsatisfied. of are

(Title) (Dateof Certification)

*Current Year


HUD-401 18

Persons ServedWorksheet- HIID Annualprogress Report

Thisworksheet optional is intended helpyou collect is and to information needed complete Annualprogress to the Report Instructions Codes and follow. Do not submitthisworksheet to HUD.
Number of Months in Project(calculate) 12a Number of Months in Project-Participant did not leave (calculate) l2b New Participant (Y i N )


H U D - 4 0 18 l

PersonsServedWorksheet (continued)
Do not submitthis worksheet HUD to
No. Veterans Status (Y,A{) 6a Chronically Homeless (Y/N) 6b Ethnicity (code) 7 Race (code) 8 SpecialNeeds (code) 9a SpecialNeeds (code) 9b Prior Living Situation (code ) Monthly Income At Project Entry lla Monthly Income At Project Exit 1l b

Income Sources At Entry

(code) Ilc

Income Sources At Exit (code) I ld



1 r'ru D-4018

Persons Served Worksheet (continued) Do notsubmit worksheet HUD this to

No Reason for Leaving Program (code)

Destination t4

Supportive Services (code) 15



I [{uD-401 8

lnstructions and Codes Persons for Worksheet Served

T he use o f th is wo rk s heet is opt ional. I t was des i g n e d t o he lp you colle ct inf or m at ion on par t ic ipant s ne e d e d t o comple te the Ann ual Pr ogr es s Repor t . I f t he works he et is up da ted as par t ic ipant s m ov e in and m o v e out of yo ur pro ject, m os t of t he inf or m at ion r equi r e d f or comp letio n will be c ont ained in t he wor k s heet . D o not su bmit this wo rk s heet wit h t he APR. F or p roje cts th at ser v e f am ilies , HUD only r equir e s reportin g o n th e nu m ber of c hildr en s er v ed, and t h e age a n d g en de r o f th es e c hildr en. O nly nam e, relat ion sh ip, da te of bir t h, and age on t he wor k s he e t need to be comp lete d f or c hildr en. As s ign t he adu l t s a number, bu t no t e ach f am ily m em ber . Us e t his nu m b e r t o tra nsfer to the o ther pages of t he wor k s heet . B egin nin g with n umb er 4, t he num ber s in t he c olu m n s ref er to the q ue stio ns on t he APR f or m . I f any questio ns a re an swe r ed wit h "O t her , " pleas e ent er t h e specific "Othe r" a nswer f or inc lus ion in t he ApR. P artic ipa nt Numb er. This c olum n allows y ou t o eit her n umb er pa rt ic ipant s c ons ec ut iv ely or t o assign a ca se nu mbe r . O ne num ber s houid be assigne d to e ach a du lt . N ame. Na mes of p er s ons will not be r epor t ed t o H UD . Th e use o f na m es is f or y our r ec or d k eeping conve nie n ce. R elationship . Ente r t he appr opr iat e r elat ions hip. E xamp les in clu de : Se lf , Head of hous ehold, Spous e , child. E ntry Da te. En ter dat e par t ic ipant ent er ed t he pro-iec t. Usua lly th is will be t he dat e of ac t ual physica l move-in for a hous ing pr ojec t . B xit Da te. Ente r da t e par r ic ipant lef t t he pr oiec t . Usually th is will b e the dat e t he par t ic ipant physica lly mo ve d o ut f or a hous ing pr ojec t . Do no t include a p articipa nt who t em por ar ily lef t t he pr oje c t and is expe cte d to retur n in les s t han 90 day s ( e. g. ho spitalizatio n). 4. I nco me-e ligib le N on- hom eles s in SRO . The S R O pro gra m a llows as s is t anc e t o unit s oc c upied by S e ctio n 8 income - eligible per s ons r es iding at t h e S RO p rior to re ha bilit at ion. For SRO pr ojec t s on ly, in dicate wh et her t he par t ic ipant is an inc ome -elig ible , n on- hom eles s per s on ( Y) or n o t (N). SHP an d S+C pr ojec t s s hould s k ip t his it e m .

6 a . V e t e r a n s S t a t u s . I n d i c a t e i f t h e p a r t i c i pa n t i s a veteran. Please note: A veteran is anyone who h a s e v e r b e e n o n a c t i v e m i l i t a r y d u t y s t attts fo r the United States. 6 b . C h r o n i c a l l y h o m e l e s s p e r s o n . I n d j c a t e th e n u m b e r o f p a r t i c i p a n t s t h a t a r e c h r o n i c a il y h o m e l es s . 7. E t h n i c i t y . E n t e r a p p r o p r i a t e l e t t e r f o r e th n i c group. a. Hispanic or Latjno b. Non-Hispanic or Non-Latino Race. Enter appropriate letter for race. a. American Indian or Alaskan Native b. Asian c. Black or African-American d . N a t i v e H a w a i i a n o r O t h e r p a c i f i c I s l a nd e r e . Wh i t e f . A m e r i c a n I n d i a n / A l a s k a n N a t i v e & Whi te g . A s i a n & Wh i r e h . B l a c k / A f r i c a n A m e r i c a n & Wh i t e i. American Indian/Alaskan Native & B lack/African American j. Other Multi-Racial


9a. Special Needs. Enter the letter(s) for the c a t e g o r y ( i e s ) t h a t d e s c r i b e t h e p a r t i c i p a n t,s disability(ies). (You may double count). a. Mental illness b. Alcohol abuse c. Drug abuse d. HIV/AIDS and related diseases e. Developmental disability f. Physical. disabilities g. Domestic violence h. Other (please specify) 9 b . E n t e r t h e n u m b e r o f p a r t i c i p a n t s w i t h a d i sa b i l i ty 1 0 . P r i o r L i v i n g S i t u a t i o n . E n t e r t h e l e t t e r th a t b e st d e s c r i b e s w h e r e t h e p a r t i c i p a n t s l e p t i n t he w e .e k prior to entering the project. Do not double count. a . N o n - h o u s i n g ( s t r e e t , p a r k , c a r , b u s s t a t i o n , e tc.) b. Emergency shelter c. Transitional housing for homeless persons d. Psychiatric facil ity* e. Substance abuse treatment facility* f. Hospital* g. Jail/prison* h. Domestic violence situation i. Living with relatives/friends j. Rental housing k. Other (please specify) *I f a p a r t i c i p a n t c a m e f r o m a n i n s t i t u t i o n but w a s t h e r e l e s s t h a n 3 0 d a y s a n d w a s l i v i n g o n th e s t r e e t o r i n a n e m e r g e n c y s h e l t e r b e f o r e e n t e r i n g th e f a c i l i t y , h e / s h e s h o u l d b e c o u n t e d i n e i t h e r t h e str e e t or shelter category, as appropriate.

5a. D ate o f Birth . Ent er dat e of bir t h inc ludine mo nth , da y, a nd y ear . 5b. A g e, Ente r a ge a t ent r y . 5c. G end er. En ter ap pr opr iat e let t er f or gender . M-M a le F- Fe male.

HU D - 4 0 1 l 8

In s t r uc t ion Code sfo r P e rs o n sS e rv e d Wo r k s heet ( c ont in u e d ) I l a. G r os s M ont h l y In c o m e a t Pro j e c t E n try . E nt er t he am o u n to f g ro s smo n th l y i n c o m e t he par t ic ipantis r e c e i v i n ga t e n try i n to th e p ro j ect l 1 b . G r os s M ont hl y In c o m e a t Pro j e c t E x i t. Enter t he gr os s m on th l y i n c o meth e p a rti c i p a n ti s
r enei' , i. a . ' , he. ..itinc flre nrnipnt

I I c .In co me So urces Rec eiv ed at Pr ojec t Ent r y . Ente r all type s of as s is t anc e t he par t ic ipant i s receiving at en t r y t o t he pr ojec t . a. Sup ple men tal Sec ur it y I nc om e ( SSI ) b. So cia l Secur it y Dis abilit y I ns ur anc e ( SSD I )
n Snnial Qpnrrrifrr

d. Gen era l Pub lic As s is t anc e e. Te mpo rary A id Needy Fam ilies ( TANF) f. StateChildren's Health Insurance Program(SCHIP) g. Ve tera ns b enef it s h. Emp loymen t inc om e i. Une mplo yme nt benef it s j. Vete ran s He alt h Car e k. Me dicaid l. Foo d Sta mps m. Oth er (ple as e s pec if y ) n . No Fin an cia l Res our c es 1 I d.In co me So urces Rec eiv ed at Pr ojec t Ex it . En ter all typ es of inc om e t he par t ic ipant r s , re ce ivin g a t p rojec t ex it . ( Us e c odes as in 1 1 c . ) 12a L en gth in Stay in Piogr am . Calc ulat ed it em . (Se e Entry Date and Ex it Dat e abov e. ) l2b. L en gth o f Stay in Pr ogr am . ( Par t ic ipant di d no t le ave du ring t he oper at ing y ear . How lon g ha ve th ey be en in t he pr ojec t ?) 13. Re ason fo r L ea v ing Pr ojec t . Ent er t he pr im a r y re ason why th e par t ic ipant lef t t he pr ojec t . (Co mple te o nly f or par t ic ipant s who lef t t he p roje ct an d are not ex pec t ed t o r et ur n wit hin 9 0 d ays. a . Le ft for a ho us ing oppor t unit y bef or e comp letin g th e pr ogr am b. Co mple ted pr ogr am c. No n-p aymen t of r ent / oc c upanc y c har ge d. Non -co mplia nc e wit h pr ojec t e. Crimin al act iv it y / des t r uc t ion of pr oper t y / vi o len ce f. Re ache d maxim um t im e allowed in pr ojec t g . Ne ed s cou ld not be m et by pr ojec t h. Disag ree men t wit h r ules / per s ons i. De ath j. Oth er (p lea se s pec if y ) k . Unkno wn/d is appear ed

1 4 . D e s t i n a t i o n . E n t e r t h e d e s t i n a t i o n o f th o se leaving the project. Perman ent: a . R e n t a l h o u s e o r a p a r t m e n t ( n o s u b si d y) b. Public Housing c. Section 8 d. Shelter Plus Care e . H O M E s u b s i d i z e d h o u s e o r a p a rtm e n t f. Other subsidized house or apartment g. Homeownership h. Moved in with family or friends T ran siti on al: i . T r a n s i t i o n a l h o u s i n g f o r h o m e l e ss p e r so n s j. Moved in with family or friends Institution: k. Psychiatric hospital. l . I n p a t i e n t a l c o h o l o r d r u g t r e a t m en t fa ci l i ty m. Jail/prison Emergency: n. Emergency shelter O t h er : o. Other supportive housing. p . P l a c e s n o t m e a n t f o r h u m a n h a b i ta ti o n (e.9., street) q. Other (please specify) Unknown: r. Unknown l5.Supportive Services. Enter all types of s u p p o r t i v e s e r v i c e s t h e p a r t i c i p a n t r e c e ive d d u r i n g the time in the project. a. Outreach b. Case management c . L i f e s k i l l s ( o u t s i d e o f c a s e m a n a ge m e n t) d. Alcohol or drug abuse services e. Mentai health services f. HIV/AIDS-related services g. Other health care services h. Education i. Housing placement i Fmnlnvment aSsiStance k. Child care
I T-^--.^^*^.:^r. rr4lrJPUrt4rlull

m. Legal n. Other (pleasespecify)


HUD-401 18