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EMERGENCY SHELTER GRANTS PROGRAM <br /> OPERATIONS ACTIVITIES FORM <br /> A separate form should be filled out for each subrecipient. Directions for <br /> filling out this form are found on pages 7 and 8 of the guidelines. <br /> A. Name of Applicant: county of Orate (Local Government) <br /> B. Name of Shelter: r_$i h Cosimm ty Shelter <br /> 1. What is the overnight lodging capacity of the shelter now? 33 Persons <br /> 2. For what kind of operating costs are ESGP funds to be used? <br /> Rent? Utilities? <br /> Maintenance? g_ Furnishings? <br /> Blankets/Cots? Maintenance Supplies? x <br /> Insurance? -A— Telephone? <br /> Appliances? Other? Tenant Suc1ies _(Specify) <br /> 3. How long has the shelter been providing assistance to the homeless? <br /> (Present Shelter) 3 Years 4 Months <br /> 4. Is the shelter to be assisted with ESGP funds currently occupied by the <br /> subrecipient agency? <br /> Yeses No <br /> 5. Is the shelter a soup kitchen, day shelter, or other non-lodging facility? <br /> Yes Nom <br /> 6. How many different persons use the shelter per day, on average? <br /> Peak Season: 25 Persons Off-Peak Season: 15 Persons <br /> 7. Estimate the number of persons who use the shelter or services each day during <br /> peak and off-peak seasons of shelter operation. <br /> Peak Season Off-Peak Season <br /> Lodging: 25 Persons Lodging: 15 Persons <br /> Served Meals: 25 Persons Served Meals: 15 Persons <br /> Other Rpthrra7 s — cey 25 Persons Other Referral Seryi 15 Persons <br /> 8. Describe the types and circumstances of the shelter's average clients. <br /> Among those requiring urgency services at the Caiuity Shelter are <br /> families temporarily homeless. Women with children/ teenagers who are <br /> pregnant or who are having disputes with their families/ dei.nstutionaliz- <br /> ed pens, chronic street people. alcoholics, eu-offerers and transients. <br /> ESGP #112-1 (Revised 3/88) <br />