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DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A <br />PROVIDER'S OUTSIDE AGENCY APPLICATION <br />Work Statement <br />aa) Complete the Work Statement Chart to describe the work to be performed. <br />This chart is used to document program activities, program goals, performance measures, <br />and actual results. (Add more rows as needed) If this is a new program, you will only <br />document the projected information. Every program is required to have AT LEAST 1 <br />Program Activity, which should be SMART (,2pecific, Measurable, Achievable, Relevant, and <br />Time - bound. Click on SMART Goals to learn more. <br />• Program Activitiesshould outline major activities the agency implements to accomplish its <br />program goals. (i.e. Deliver meals to elderly /disabled residents.) <br />• Program Goal should explain what the program is trying to achieve /accomplish. Goals are <br />statements about what the program should accomplish. (i.e. Deliver 100 meals per day, <br />Monday - Friday.) <br />• Performance Measuresdescribe how you will evaluate the degree in which you achieved <br />the stated goals. (i.e. Will track the number of meals delivered each day.) <br />• Actual Program Results use program results to indicate the actual measureable <br />achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of <br />105 meals per day.) <br />Work Statement Chart for Program - Family Reading Partners - Orange County Literacy Council <br />5. Program Activity Name <br />Model for parents how to have good conversations around books <br />with their children <br />Program Goal <br />Increase children's exposure to books; practice school readiness <br />skills: have fun with books <br />Performance Measures <br /># of sessions /attendees <br />Previous Year Program Results <br />NA <br />Current Year Estimated Results <br />18 sessions /25 attendees <br />Next Year Projected Results <br />25 sessions /70 attendees <br />6. Program Activity Name <br />Model for parents a variety of books, both fiction and nonfiction, <br />from multiple genres <br />Expand children's knowledge of the world through exploration of <br />books; expand children's vocabulary <br /># and types of books read <br />Program Goal <br />Performance Measures <br />Previous Year Program Results <br />NA <br />Current Year Estimated Results <br />Over 50 books shared; over 50% nonfiction <br />Next Year Projected Results <br />Over 70 books shared; at least 25% nonfiction <br />7. Program Activity Name <br />Parents and children read and enjoy together <br />Provide opportunities for quality parent -child interaction; parents <br />are more empowered and see themselves as child's most <br />important teacher <br />Program Goal <br />Performance Measures <br />Parents answer survey about what they have learned from <br />modeling sessions <br />Previous Year Program Results <br />NA <br />Current Year Estimated Results <br />100% of parents say they have learned better how to share books <br />with their children and have quality conversations around books <br />with their child <br />Next Year Projected Results <br />100% of parents say they have learned better how to share books <br />with their children and have quality conversations around books <br />with their child <br />PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 22 of 26 <br />