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Caseworker Daily Time Sheet (tracked in ¼ hour segments) ASSURANCE 16 ADMINISTRATIVE/ PROGRAM COST Taking application for energy assistance (DHHS)

3:30 Determining household’s crisis status (DHHS)

0:30 Calculating the household’s benefit amounts (DHHS)

1:00 Intervening with an energy company to maintain service 0:15

Assisting in setting up utility payment arrangements (including APPs) 0:30

Referring family to other sources of assistance 0:15

Assessing the family’s need for Weatherization 0:15

Educating family on use of energy kit materials 0:00

Delivering energy education to the family 0:00

Counseling family on energy cost budgeting 1:00

Providing program brochures, outreach materials

0:15 Staffing an outreach application site

0:00 TOTAL 2:15 5:15