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Name of Program <br /> <br /> DIVISION OF YOUTH SERVICES - CBA <br /> PROGRAM AGREEMENT <br /> <br />Home-Based Services <br /> <br />SponsoffngAgen~y Cabarrus County Department of <br /> Social Services <br /> <br />ContactPemon Game & ad.ess) <br /> <br /> Yvette Murphy, MSW, Intensive Family Services <br /> <br /> P.O. Box 668 <br /> <br /> Concord, North Carolina ZiE28026-0668 <br />Phone#(70~ 786-7141 Fax# 7~Z~ '788-8420 <br />Re~rr~Sources District Court Judses <br /> <br /> Juvenile Court Counselors, Parents/Caretaker, <br /> <br />School Personnel, Department of Social Services <br /> <br />County <br /> <br /> Cabarrus <br /> <br />Program Type <br /> <br /> Non-Residential <br /> <br />Funding PeHod <br /> <br /> 7/I/95 thru 6/30/96 <br /> <br />CBA Assignedl. D.# <br /> <br /> 213005 <br /> <br />New Program <br />Continuation X <br /> <br />*Client Capacity 20 . Anticipated average length of stay 120 <br /> <br /> Estimated number of youth to be served during funding period 40 <br /> <br />.(days). <br /> <br />*Actual number of youth admitted last fiscal year: <br /> <br />NA <br /> <br />Reported using Client Tracking Forms <br /> <br />Reported using Annual Program Review <br /> <br /># Juvenile Court or law enforcement referred <br /> <br />100 % <br /> <br />Date received in Regional Office <br /> <br /> Please submit 4 copies with original si_~natures. <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. 1-95) <br /> <br /> <br />