Arizona Department of Education s1

ARIZONA DEPARTMENT OF EDUCATION 21st Century Community Learning Center Program Planning Tool (Example) - Year 1 21st CCLC Grant Application Site Number / Entity ID of the School: Site 2 / 0000 Do not identify schools, districts, or fiscal agents by name in this section of the application. Instead, use a descriptor such as Site 1, Site 2, the school, etc.

Measurable Objectives Activities Timeline Evaluation Plan Budget Alignment (Items 46-48) (Items 49-51) (Item 76) (Items 85-87) (Budget Detail Narrative) Program Need List the program’s measurable Describe specific activities to be Provide a list of tentative dates Clearly identify the instruments Clearly identify expenses that are objectives in the three program used to progress towards the (beginning and end dates) in and method(s) that will be used to needed to implement activities to (Items 40-43) areas. stated objectives. which the activities will be assess each objective. Also achieve objectives. implemented. indicate when and how often the Identified Needs: The assessment will take place. needs assessment conducted 1. Academics 1. Academics 1. Academics 1. Academics 1. Academics indicates that there are several Objectives: Activities: Timeline: Evaluation: Budgeted items: factors that contribute to the risk of academic failure for our 1.1 80% of the students 1.1 Intensive Reading 1.1 Session 1: 1.1 -Pre-, Mid, and Post- 1.1 students including low regularly attending the 21st tutoring (based on specific September 15 – Formative Assessment for -6 Academic Instruction achievement scores, percentage of CCLC program in grades 3- standards) December 15 each class session. Teachers (2 per grade) students who qualify for ELL 5 will advance one level in -3rd grade 1.2 Session 2: -DIBELS Data -Instruction software (XYZ services, school characteristics, Reading Proficiency as -4th grade January 5 – May 20 -Quarterly District Reading) low parent involvement and measured by AIMS-DPA by -5th grade Benchmark Reading -2 Enrichment teachers safety. June 1 of each year. proficiency data (Cook to Read) Reading enrichment- -Progress monitoring of -Cooking to Read booklets Data compiled shows that many cooking class (standards after-school students. -Cooking supplies, utensils, of our students are at risk for based) -Teacher observations will cook vessels, recipe academic failure. 43% of 3-5th be evaluated as well. products, etc. grade students either fall far -After-school teachers will -Pencils, paper and printing below or approach the standards be invited to attend regular in math. 48% of 3-5th grade school day grade level data students either fall far below or meetings where the regular approach the standards in reading. school day teachers will be sharing data about the students. 36% of our students qualify for ELL and the population continues to grow. Test results for these 2. Youth Development 2. Youth Development 2. Youth Development 2. Youth Development 2. Youth Development students are below that of the Objective(s): Activities: Timeline: Evaluation: Budgeted items: native English Speakers. 2.1 90% of the students 2.1 Regarding these four 2.1 September 15 – June 20 2.1 2.1 regularly attending the 21st selected assets: 75% of our students qualify for CCLC program will report 2 External-Family/School -Student records his/her -Site Coordinator -Youth free/reduced lunch. growth on at least three of and Adult Relationships; & self-perception of the 4 Development assignments four assets of “Search 2 Internal-Reading for selected assets on a 1-4 -Pencils and printing Youth Teacher and parent surveys Institute’s 40 Pleasure and Optimism) Likert Scale at the time Development forms indicate that parent involvement Developmental Assets®” by enrollment. is limited. 40% of our parents do June 20. Students’ Pre-assessment to -Periodic self-assessment not attend parent teacher determine baseline at with staff monitoring. conferences. enrollment, progress at 15 -Observation that student’s and 30 days, and Post- instruction plan Target Population: 3-5 assessment. modifications for Youth grade students who are at risk for Development are followed. Modify student youth academic failure including ELL -Change in students’ self- development plan if needed. and SPED students perceptions noted for year- end reporting. Measurable Objectives Activities Timeline Evaluation Plan Budget Alignment (Items 46-48) (Items 49-51) (Item 76) (Items 85-87) (Budget Detail Narrative) 3. Family Engagement 3. Family Engagement 3. Family Engagement 3. Family Engagement 3. Family Engagement Objective(s): Activities: Timeline: Evaluation: Budgeted items: 3.1 3.1 25 family members 3.1 3.1 3.1 Total Center who have students attending st Services the 21 CCLC will increase Two After School class October 15-April 15 Completed observation form their support of their (Items 69-74) visits per family member: signed by teacher -Site Coordinator-Family child/ren’s reading progress Observe child’s reading Engagement assignments as documented on instruction Provide Quarterly District Hours per week: 12 attendance logs for at least 3 Benchmark Reading Days per week: 4 school-based family Four Workshops: October 15-April 15 proficiency data to families engagement activities by Weeks per yr: 30 Parenting for Student and compare to their -1 Family Literacy teacher June 20. Success, includes data on student/s. Record -Resources (English & student/s reading status and attendance. Days per yr: 120 Spanish) training supplies related Reading Homework Log. Projected # of regular -BEST Test booklets attendees: 150 Once per week: Literacy for November 15-June 15 Pre- and post- BEST -Pencils, paper Adult Language Learners Literacy “Reading and which includes conversation writing skills in authentic Projected # of family with teachers regarding situations for Adult members: 75 student/s’ academic success language learners.” - and at-home support.

3.2 60 family members Instruction for family October 15-April 1 Record family member who have students attending members on how to use attendance at Reading the 21st CCLC will increase Reading Homework Logs or Homework Log training. their at home support of equivalent processes their child/ren’s reading progress as documented by Collection of Reading October 21-April 8 Compile a) number of 90% completion of Reading Homework Logs or family’s completion of Homework Logs by June equivalent forms (weekly) Logs; b) percent of the Logs 20. completed by family

V 2.10.11 mln