Survey 4: CSBG Expenditures and Resources Administered by the CSBG Network
This survey will focus on the domains for reporting on CSBG expenditures, agency capacity, and agency
level resources.
Please reference the following documents when completing this survey:
o Proposed CSBG Expenditures and Agency Capacity Report (Excel and PDF)
o Proposed Resources of the CSBG Network Report (Excel and PDF)
* Questions marked with an asterisk are required.
Important Reminders:
 As you complete the online survey, do not use the browser “back” button to return to previous
screens. You can use the “previous” button within the survey.
 You may begin any survey and complete that survey at a later time, as long as you continue to
complete the survey using the same computer on which you began. Existing responses will be
captured.
 This document is for reference only, please complete this survey online at:
https://www.surveymonkey.com/r/T2BL57W.
 This document contains all possible options of questions, numbered consecutively. However,
the online survey contains skip patterns to customize questions based on previous answers, and
therefore does not contain corresponding question numbering.
1. Please select an organization type. (check one)
 CSBG Eligible Entity or Community Action Agency (if selected, answer Questions 2, 3, then
skip to 5)
 State CSBG Lead Agency (if selected, skip to question 4)
 State Association (if selected, skip to question 4)
 National Partner (if selected, skip to question 4)
 Other (please describe), (if selected, skip to question 4)
[If respondent’s answer to question 1 is CSBG Eligible Entity or Community Action Agency, answer
questions 2 and 3, then skip to question 5.]
2. In what state are you located? (drop down listing each state)*
3. What is the name of your organization? (drop down listing each organization by state for CSBG
Eligible Entity or Community Action Agency)
[If respondent’s answer to question 1 is State CSBG Lead Agency, State Association, National Partner,
or Other, skip to question 4]
4. In what state are you located? (drop down listing each state)
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5. What role do you play in your organization?
 State Administrator
 Executive Director – CSBG Eligible Entity or Community Action Agency
 Planning Director - CSBG Eligible Entity or Community Action Agency
 Data manager or data systems staff - CSBG Eligible Entity or Community Action Agency
 Program Director or Senior Staff- CSBG Eligible Entity or Community Action Agency
 Executive Director – State Association
 Program Director – State Association
 Other (if selected, please describe)
State Administrators, State Associations and RPIC Leads may respond to the survey in one of two ways:
You may respond as one entity, based on your understanding of the needs of the agencies you represent
from a state or regional perspective. In this case, the response to the question, "How many agencies are
represented by your response to this survey?" is one (1) and will be included in the final report as any
CSBG Eligible Entity or Community Action Agency.
Alternatively, you may gather multiple responses in an organized fashion (host a webinar, meeting or
other virtual or face to face meeting) and create a single response to the surveys that represents the
input of the different local agencies. In this case, you can respond based on the number of agencies
providing input. The number of agencies should be reported in the question, "How many agencies are
represented by your response to this survey?" This value will be used as a multiplier as if those
organizations had each responded directly by themselves. Please note that in this case you may have
some of your agencies responding in favor of an item and some who want to provide suggested
changes. You will reflect these kinds of differences in the comment boxes provided.
6. How many agencies are represented by your response to this survey? _______ (enter number)
7. Are the agencies represented by your response to this survey from: (drop down with options: “from
my state only” or “from across my region?)
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CSBG Expenditures and Agency Capacity
Please refer to the Proposed CSBG Expenditures and Agency Capacity Report Excel and PDF to complete
this section of the survey.
Below is an image of Table 1, where you will be asked to provide information describing how CSBG funds
are expended.
8. How well do the domains for reporting expenditures in Table
1: CSBG Expenditures allow you to describe your
expenditures?*
Very Well  Not Well At All
5
4
3
2
1
NA
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9. Provide any follow-up comments you have about Table 1: CSBG Expenditures, and the domains for
reporting expenditures. Indicate how you would modify this table, if applicable. If you selected a 3
or lower on the scale above, please explain why.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
10. If you described changes that you would like to see, rate how
important it is that these changes be made.
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Critical  Not Necessary
5
4
3
2
1
NA
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Below is an image of Table 2, where you will be asked to provide information describing how CSBG funds
are expended to build agency capacity.
How well does:
11. The list of activities in Table 2, number one identify your
agency capacity building activities?*
12. The identification of hours in Table 2, question 2 demonstrate
your support for board members, staff, and volunteers?*
13. The list of credentials and certifications in Table 2, question 3
reflect staff qualifications that demonstrate agency capacity?*
Very Well  Not Well At All
5
4
3
2
1
NA
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14. Provide any follow-up comments you have about the elements in Table 2: Details on Agency
Capacity Expenditures. Indicate how you would modify this table, if applicable. If you selected a 3 or
lower on the scale above, please explain why.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
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15. If you described changes that you would like to see, rate how
important it is that these changes be made.
Critical  Not Necessary
5
4
3
2
1
NA
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Resources Administered and Generated by the CSBG Network
Please refer to the Proposed Resources of the CSBG Network Report Excel and PDF to complete this
section of the survey.
16. How well do the categories for recording resources allow you
to describe your resources?*
Very Well  Not Well At All
5
4
3
2
1
NA
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17. Provide any follow-up comments you have about the categories for recording resources. Indicate
how you would modify the categories, if applicable. If you selected a 3 or lower on the scale above,
please explain why.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
18. If you described changes that you would like to see, rate how
important it is that these changes be made.
Critical  Not Necessary
5
4
3
2
1
NA
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Thank you for completing Survey 4: CSBG Expenditures and Resources Administered by the CSBG
Network.
Your input is critical as we work to build a system to enable states and agencies to better understand
what services provide the best outcomes for which families and communities by building the capacity
for robust data analysis.
Which Survey would you like to answer next?
High Level Survey
 Survey 1: Theory of Change and National Goals
Mid-Level Surveys
 Survey 2: Community Level Work
 Survey 3: Individual and Family Level Work
High Level Survey
 Survey 5: Tying it Together
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Remember you can find all the supporting documents at: http://www.nascsp.org/ROMA/919/ROMANext-Generation.aspx?iHt=17
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