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DocuSign Envelope ID:78F84828-4CC5-4A5B-B256-33C571A84687 t A- continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> The Charles House program thrives to <br /> Program Goal Same Same <br /> enhance the functioning and quality of <br /> life for participants. <br /> Over 50%of families will report in the <br /> annual evaluation survey satisfaction <br /> with the Charles House program and <br /> Performance will report positive effects of the <br /> program for their enrolled family Same Same <br /> Measures members, such as improvement in their <br /> participant/enrollee's behavior, <br /> emotional status, physical and/or <br /> cognitive functioning. <br /> It is projected that the <br /> annual Caregiver Survey <br /> In the 2015 Caregiver in 2016 will show a high <br /> Survey' of percentage,>85%,of <br /> Program Results <br /> respondent families respondent families will <br /> In the 2014 Caregiver Survey, 100%of reported improved report improvement in <br /> respondent families reported improved functioning in their family family member <br /> functioning in their family members members functioning. <br /> Program administration assures that all <br /> aspects of the program are in <br /> Program Activity 3 <br /> compliance with the state rules for <br /> annual certification <br /> The program strives for a level of <br /> Program Goal excellence and maintains standards same same <br /> required by the State Division of Aging <br /> and Adult Services <br /> Charles House Association will <br /> Performance continue to surpass the NC Standards <br /> same same <br /> Measures and maintain state certification to <br /> operate as an adult day program. <br /> Charles House received Charles House will <br /> recertification by the State maintain certification by <br /> Program Results Charles House received recertification Division of Aging and the State Division of <br /> by the State Division of Aging and Adult Services in July, Aging and Adult Services <br /> Adult Services in May,2014 2015 for the new center. in 2016. <br /> Main Application 1/25/2016 11:54:37 AM Page 16 of 21 <br />