NEW YORK STATE



NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICESBUREAU OF TRAININGBureau of Training INDIVIDUAL Field Staff QUARTERLY ReportFORM OCFS 4797CONTRACT/WORK PLAN INFORMATIONContract/Work Plan PeriodVendorProject CodeContact PersonContract NumberBT Training Manager Reporting PeriodBT SupervisorContract/Work Plan TitleOn-Site OCFS SupervisorDate This Report Reviewed By On-Site OCFS SupervisorSUMMARY OF STAFF ACTIVITIESField Staff Member NameField Staff Member LocationTraining Activities completedBrief Narrative Summary of Training – Related ActivitiesEstimated percent of time devoted to training activitiesAdministrative Activities completedBrief Narrative Summary of Quarterly Administrative – Related ActivitiesEstimated percent of time devoted to administrative activities*Additional Information: INSTRUCTIONS FOR COMPLETING FORM OCFS-4797Purpose of Form: To thoroughly and consistently document the individual field staff activities supported through contracts/work plans during the delivery year, and create a historical record. Item HeadingInstructionI. CONTRACT/WORK PLAN IDENTIFYING INFORMATIONVendorProvide the full official name of vendor organization (i.e., the contractor, training provider, etc.).Contact PersonProvide the full name of the individual representing the vendor organization for the purposes of this report.BT Training ManagerProvide the name OCFS BT Training Manager assigned to this contract/work plan.BT SupervisorProvide the name of the person supervising the Training Manager.Contract/Work Plan PeriodProvide the period covered by the contract/work plan (e.g., 1/1/14 – 12/31/14).Project Code Provide the identifying code (formerly Training Project Code).associated with the current work plan.Contract NumberProvide the contract number Reporting PeriodProvide the quarter covered by this report (i.e., choose 1, 2, 3, or 4 for standard contract/work plans).Contract/Work Plan TitleProvide the title of this contract/work plan.II. Summary of Staff ActivitiesField Staff Member NameProvide the name of the staff member who is the subject of this report.Field Staff Member LocationProvide the location of the staff member who is the subject of this report.Training Activities completedProvide a list of the training activities (for example training classes conducted) completed by this staff member. Brief Narrative Summary of Training – Related ActivitiesProvide a brief summary of training activities.Estimated percent of time devoted to training activitiesProvide an estimate of the percent of the staff member’s time devoted to training activities relative to the time worked on the project. Any percentage change from the work plan must have prior approval. If the percentage is different than noted under this component, please attach approval documentation for the change (Form OCFS-4789).Administrative Activities completedProvide a brief summary of completed Administrative Activities.Brief Narrative Summary of Quarterly Administrative – Related ActivitiesProvide a brief summary of Administrative – Related Activities.Estimated percent of time devoted to administrative activitiesProvide an estimate of the percent of the staff member’s time devoted to administrative activities relative to the time worked on the project. Any percentage change from the work plan must have prior approval. If the percentage is different than noted under this component, please attach approval documentation for the change (Form OCFS-4789).Additional informationProvide any additional information relevant to the staff member’s contribution to the contract/work plan. ................
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