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DocuSign Envelope ID: E7F88FC1-7C61-4E68-8AF9-5870F711DEBC it A continued <br /> Provider's Outside Agency Application <br /> Provide companionship,escorted Provide companionship,escorted Provide companionship,escorted <br /> "door-through-door" "door-through-door" "cloor-through-door" <br /> transportation,in-home transportation,in-home transportation,in-home <br /> assistance including light assistance including light assistance including light <br /> Program housekeeping and meal housekeeping and meal housekeeping and meal <br /> Activity 3 preparation,and respite care. preparation,and respite care. preparation,and respite care. <br /> 90%of program participants will 80'/of program participants will 80%of program participants will <br /> Program Goal remain in their homes or active in remain in their homes or active in remain in their homes or active in <br /> assisted living. assisted living. assisted living. <br /> Performance Regular recording and tracking of Regular recording and tracking of Regular recording and tracking of <br /> Measures service delivery. service delivery. service delivery. <br /> Provide companionship,escorted Provide companionship,escorted Provide companionship,escorted <br /> "door-through-door" "cloor-through-door" "door-through-door" <br /> transportation,in-home transportation,in-home transportation,in-home <br /> assistance including light assistance including light assistance including light <br /> Program housekeeping and meal housekeeping and meal housekeeping and meal <br /> Results preparation,and respite care. preparation,and respite care. preparation,and respite care. <br /> Program <br /> Activity 4 <br /> Program Goal <br /> Performanceii <br /> Measures <br /> Program <br /> Results <br /> Program <br /> Activity 5 <br /> Program Goal <br /> Performance <br /> Measures <br /> Program <br /> Results <br />