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Name of Program <br /> <br /> DIVISION OF YOUTH SERVICES - CBA <br /> <br /> PROGRAM AGREEMENT <br />Temporary Shelter Care Project <br /> <br />County's Federal I.D. Number 566000281E <br />Sponsoring Agency Cabarrus County <br /> <br /> Department of Social Services <br /> <br />Contact Person (name & address) <br /> Ms. Deedee Wright <br /> <br />Cabarrus County Department of Social Services <br /> <br />P.O. Box 668, Concord, NC .Zip. 28026-0668 <br /> <br />Phone# Q04)786-7141 Fax #(704. 788-8420 <br /> <br />Referral Sources Juvenile Court, Family Court <br />Counselors, Mental Health Center, Schools, <br /> <br />Department of Social Services, Family, Law Enf. <br /> <br />County <br /> <br /> CABARRUS <br /> <br />Program Type <br /> <br /> Temporary Shelter Care <br /> <br />FundingPefiod <br /> <br /> 7/1/96 thru6~30~97 <br /> <br />CBA AssignedI.D.# <br /> 213011 <br /> <br />New Program <br />Continuation X <br /> <br />*Client Capacity 5 . Anticipated average length of stay 90 <br /> <br /> Estimated humber of youth to be served during funding period 20 <br /> <br />(days). <br /> <br />*Actual number of youth admitted last fiscal year: <br /> <br />20 _Reported using Client Tracking Forms <br /> <br />0 Reported using Annual Program Review <br /> <br />16 # Juvenile Court or law enforcement referred <br /> <br />8O % <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 /> <br /> component on a separate sheet. <br />(REV. 10o95) <br /> <br /> <br />