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DIVISION OF YOUTH SERVICES - CBA <br />PROGRAM AGREEMENT <br /> <br />Name of Program Uwharrie Group Home <br /> <br />County's Federal I.D. Number ~6000281E <br />Sponsoring Agency Uwharr~ Homes, Inc. <br /> <br />ConmctPerson(name & address) <br /> <br /> Jerry garnhardt <br /> <br /> PO Box ]026 <br /> <br /> Albemarle, NC ~i~ 28002 <br /> <br />Phone#(70~ 983-1808 Fax#(70) 983-1808 <br /> <br />Re~alSources Juvenile Courts, Schools <br />Department of Social Services <br /> <br />Piedmont Area Mental Health <br /> <br />County <br /> <br /> CABARRUS <br />Program Type <br /> <br /> Group Home <br />Funding Period <br /> <br /> ?/I/96 thru <br />CBA Assigned I.D. # <br /> <br /> 213013 <br /> <br />New Program <br /> <br />Continuation X <br /> <br />*Client Capacity 2 . Anticipated average length of stay <br /> <br /> Estimated number of youth to be served during funding period '4 <br /> *Counting only Cabarrus County Youth <br /> <br /> *Actual number of youth admitted last fiscal year: <br /> <br />6/30/97 <br /> <br />.Reported using Client Tracking Forms <br /> <br />_Reported using Annual Program Review <br /> <br /> # Juvenile Court or law enforcement referred <br /> <br />180 (days). <br /> <br />33 % <br /> <br /> Date received in Regional Office <br /> <br /> Please submit 4 copies with original signatures. <br /> <br /> *If the funds being requested will be used for more than one program component please provide this information for each <br /> component on a separate sheet. <br /> <br />DYS (REV. 10-95) <br /> <br /> <br />