anglo american chairman’s fund reporting form sustainable...

1 of 19 | Anglo American Chairman’s Fund | Reporting Form Sustainable Community Development 2017

Anglo American Chairman’s Fund | Reporting Form Sustainable Community Development 2017 • Capacity Building • Community Development/Youth Development • Livelihoods • Thought Leadership • Welfare Support

The Anglo American Chairman’s Fund is administered by Tshikululu Social Investments NPC


Please use the reporting form provided on the following pages. Using another reporting form and / or template is not acceptable and will negatively impact your opportunity to receive further funding.

All sections of the reporting form need to be completed.

Please note that Tshikululu Social Investments holds the Directors or Trustees or Members of the organisation responsible for the preparation of this report and the integrity of the documents submitted with it.

The Anglo American Chairman’s Fund is required by the BEE Codes of Good Practice No. 29617 of 2007, statement 700, section 3 (3.2)

(3.2.2) and (3.2.3) to provide the ethnic and gender breakdown of all the beneficiaries of its corporate social investment.

Send your reporting form together with the attachments to the email address below. Do not forget to keep a copy of your report.

Should you have any queries, please contact Tshikululu Social Investments, administrators of the Anglo American Chairman’s Fund,

on 011 544 0300.

By email: [email protected]

Date of submission:

Name of organisation:

Name of funded project:

Grant amount in Rands:

Project reference number:

Reporting period: (from receipt of grant to report due-date) (month) (year) to (month) (year)

Is this a multi-year grant? yes no

If yes, on which year are you reporting? year out of years

This form is an editable pdf form. Please complete all fields, then save your file.

Submission is by email only, but ensure that the total size of the email including attachments is no more than 5 MB.

Please note: the ‘save’ functionality is only enabled in later versions of Adobe Acrobat Reader. If you cannot save your form, visit http://get.adobe.com/reader to upgrade to the latest version.

Anglo American Chairman’s Fund Reporting Form 2017


Section 1 – Organisation overview

Name of organisation:

1. Details of contact person for this report

Full name and designation: (Miss , Mrs, Mr , Dr, Prof.)

Direct tel. & cell no.: Direct email:

2. Details of alternate contact person

Full name and designation: (Miss , Mrs, Mr , Dr, Prof.)

Direct tel. & cell no.: Direct email:






Please provide information below for the specific project for which your organisation received funding as per your original application

and signed grant letter.

This section is vital to your opportunity of receiving future funding so please ensure that the information you provide is as complete and as detailed as possible within the space provided.

Section 2 - Narrative report on your grant

Name of project:

Actual project start date:

If the project was delayed, provide reasons:

1. Project outcomes

Primary project objectives:

Activities completed using this grant:






Section 2 - Narrative report on your grant continued

If you made any changes to the original project plan, please describe them:

What were the highlights of the project during the reporting period?:

What challenges did the project face during the reporting period?:







2. Project impact

What was the impact of this grant?

3. Project impact – beneficiaries

Total Female Male African ColouredIndian /

Asian WhiteOther/

Unknown Disability

Direct

Indirect

Numbers should only refer to beneficiaries of activities completed with funding from the Anglo American Chairman’s Fund.

“Direct beneficiary” refers to a person, group of persons or organisation that has direct contact with the intervention or project.

“Indirect beneficiary” refers to a person, group of persons or organisation that has no direct contact with an intervention or pro-

ject but which is affected by it via a direct beneficiary.











4. Project impact - employment

Total Female Male African Coloured Indian / Asian White Other/

Unknown Disability

Permanent jobs created

Permanent jobs

supported

Temporary jobs created /

supported

Partner staff trained

Community members

trained

Numbers should only refer to activities completed with Anglo American Chairman’s Fund monies.

“Jobs created” refer to permanent full-time and part time (not less than 20 hours per week) jobs created as a result of your organisation’s activities. For example if an entrepreneur trained by your organisation is able to successfully start a business and employs 3 people then your organisation has created 4 jobs for the reporting period.“Jobs supported” refer to permanent full time and part-time jobs that may have already existed that were supported (salaries continued to be paid etc) as a result of grant funding.“Temporary jobs supported or created” by your organisation does not include permanent employees on a part-time basis but rather employees hired for a limited period (less than one year).

“Partner staff trained” and “Community members trained” may be a subset of the number of people reported as “direct beneficiaries”.

5. Project impact - infrastructure

Number of facilities (or sites) improved/maintained:

Number of facilities built:



6. Case study and / or success story from the reporting period describing how an individual, organisation or community has changed as a result of this project

7. Please list any lessons learnt during the implementation of this project





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Females

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African

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White

Other

People with disabilities

Rural

Urban

1. Livelihoods

1.1.

Num

ber o

f peo

ple

rece

ivin

g sk

ills t

rain

ing

(e.g

. bus

ines

s ski

lls,

agric

ultu

ral s

kills

etc

.) an

d jo

b pl

acem

ent a

ssist

ance

1.2.

Num

ber o

f exi

stin

g en

terp

rises

(a

cros

s sec

tors

) re

ceiv

ing

train

ing

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

1.3.

Num

ber o

f tra

ined

ben

efici

arie

s em

ploy

ed in

per

man

ent j

obs p

ost

skill

s tra

inin

g

1.4.

Num

ber o

f tra

ined

ben

efici

arie

s em

ploy

ed in

tem

pora

ry jo

bs p

ost

skill

s tra

inin

g

1.5.

Num

ber o

f hou

seho

lds n

ewly

su

ppor

ted

with

food

as a

dire

ct

resu

lt of

agr

icul

tura

l ski

lls tr

aini

ng

for a

per

iod

of 6

mon

ths o

r mor

e

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

1.6.

Num

ber o

f new

ent

erpr

ises

crea

ted

post

skill

s tra

inin

g N/

AN/

AN/

AN/

AN/

AN/

AN/

AN/

A

Plea

se re

port

on

the

indi

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rs th

at y

ou h

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2. Community development

2.1.

Num

ber o

f peo

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train

ed

on in

itiat

ives

to st

reng

then

soci

al

cohe

sion

2.2.

Num

ber o

f peo

ple

acce

ssin

g ps

ycho

soci

al se

rvic

es (c

ouns

ellin

g,

lega

l or r

ehab

ilita

tive

serv

ices

)

2.3.

Num

ber o

f peo

ple

refe

rred

to

psyc

hoso

cial

/ leg

al/ r

ehab

ilita

tive

serv

ices

2.4.

Num

ber o

f com

mun

ity

enga

gem

ent s

essio

ns, p

rior t

o im

plem

enta

tion,

to

esta

blish

co

mm

unity

buy

-in

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

2.5.

Num

ber o

f aw

aren

ess

prog

ram

mes

/wor

ksho

ps/e

vent

s co

nduc

ted

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

2.6.

Num

ber o

f peo

ple

part

icip

atin

g in

aw

aren

ess r

aisin

g pr

ogra

mm

es

2.7.

Num

ber o

f peo

ple

trai

ned

to b

e vo

lunt

eers

or c

omm

unity

wor

kers

2.8.

Num

ber o

f com

mun

ity

mem

bers

invo

lved

in a

ctiv

ities

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2. Community development

2.9.

Num

ber o

f ind

ivid

uals

from

m

argi

nalis

ed g

roup

s (pe

ople

with

di

sabi

lity,

refu

gees

) in

clud

ed in

to

mai

nstre

am so

ciet

y in

the

targ

eted

co

mm

uniti

es

2.10

. Num

ber o

f peo

ple

in a

re

habi

litat

ion

prog

ram

me

2.11

. Num

ber o

f com

mun

ity

initi

ativ

es th

at a

re p

rom

otin

g po

sitiv

e va

lues

and

figh

ting

agai

nst

issue

s tha

t thr

eate

n so

cial

cohe

sion

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

2.12

. Num

ber o

f div

erte

d pe

ople

/ yo

uth

who

re-o

ffend

afte

r div

ersio

n is

com

plet

ed

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Indian

White

Other


Rural

Urban

3. Youth development

3.1.

Num

ber o

f you

th w

ho a

ttend

ed

train

ing

wor

ksho

p (e

.g. le

ader

ship

, lif

e sk

ills,

entre

pren

eurs

hip)

3.2.

Num

ber o

f tra

ined

you

th w

ho

rece

ived

pos

t-tra

inin

g su

ppor

t

3.3.

Num

ber o

f tra

ined

you

th

assis

ted

with

care

er g

uida

nce

3.4.

Num

ber o

f tra

ined

you

th

initi

atin

g co

mm

unity

act

iviti

es p

ost

train

ing

inte

rven

tion

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e to

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achm

ents

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ore

than

5 M

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se n

ote:

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nalit

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Reas

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evin

g or

un

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chie

ving

Females

Males

African

Coloured

Indian

White

Other


Rural

Urban

4. Capacity building

4.1.

Num

ber o

f non

-pro

fit

orga

nisa

tions

sele

cted

to p

artic

ipat

e in

par

ticul

ar p

rogr

amm

eN/

AN/

AN/

AN/

AN/

AN/

AN/

AN/

A

4.2.

Num

ber o

f tra

inin

g w

orks

hops

he

ld

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

4.3.

Num

ber o

f par

ticip

ants

in

train

ing

wor

ksho

p

4.4.

Num

ber o

f ind

ivid

ual s

ite v

isits

/m

ento

ring

sess

ions

cond

ucte

d w

ith

part

icip

atin

g or

gani

satio

ns

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

4.5.

Num

ber o

f par

ticip

atin

g no

n-pr

ofit o

rgan

isatio

ns th

at re

port

di

vers

ified

fund

ing

sour

ces

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

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se n

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onit

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alua

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mun

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Dev

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men

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area

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for

over

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evin

g or

un

dera

chie

ving

Females

Males

African

Coloured

Indian

White

Other


Rural

Urban

5. Welfare support

5.1.

Num

ber o

f peo

ple

(com

mun

ity

prac

titio

ners

) tra

ined

in th

e pr

ovisi

on

of q

ualit

y ho

me/

com

mun

ity b

ased

ca

re

5.2.

Num

ber o

f pro

ject

s im

plem

entin

g th

e ‘as

set b

ased

ap

proa

ch’ (c

omm

unity

care

mod

el

whi

ch u

ses c

omm

unity

bas

ed

initi

ativ

es.)

5.3.

Num

ber o

f peo

ple

acce

ssin

g w

elfa

re se

rvic

es (

e.g.

coun

selli

ng,

drop

-in ce

ntre

s)

5.4.

Num

ber o

f car

egiv

ers o

r fam

ily

units

stre

ngth

ened

to ca

re fo

r vu

lner

able

peo

ple.

5.5.

Num

ber o

f res

iden

ts a

cces

sing

qual

ity ca

re (a

s defi

ned

belo

w)*

*

5.6.

Num

ber o

f peo

ple

rece

ivin

g re

gula

r sup

port

in a

hom

e se

tting

(p

leas

e in

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16 of 15 | Anglo Amer ican Chairman’s Fund | R e p o r t in g f o r m Edu c at i o n

Section 3 - Monitoring and Evaluation

Any additional comments on M&E table and/or indicators:





** Residents participate in their daily activities and decision-making, are safe (fire extinguishers in place etc., good policies regarding safety in place e.g. visitors must sign in, in some instances cameras in place to monitor safety),enjoy good hygiene, healthy (good nutrition plan in place, physical exercise plan in place), happy, engaging in activities (must be programmes in place), are confident to engage with outsiders (appropriately), relate well to their care workers and environment (emotional and psychosocial needs are met). Ratio of Caregiver to benefi-ciary relevant to the needs of the beneficiary , time spent with the beneficiary and model of care ( service packaged)

WHO Quality Rights Tool Kit - key quality standards for all facilities• livingconditionstobesafeandhygienicandthesocialenvironmenttobeconducivetorecovery;• theprovisionofevidence-basedcarefortheirmentalandphysicalhealthcondition,onthebasisoffreeandinformedconsent;• gearingservicestowardsenhancingpeople’sautonomyenablingthemtoengageintheirownrecoveryplans;• reportingandhaltingallinhumantreatment;and• linkinghealthserviceswithemployment,education,socialandhousingservicesinordertopromoteindependentlivinginthecommunityfor

mental health service users.


Section 4 - Your organisation

1. Please indicate any changes to your board as per the table below

Full name Role Race GenderDisability

Y/NResigned or Appointed

2. Please indicate any changes to your management as per the table below

Full name Role Race GenderDisability

Y/NResigned or Appointed

3. Please provide further information in the event of high management turnover or key resignations from the board






Section 4 - Your organisation continued

4. More about you organisation

Have there been any changes to your organisation in the reporting period? For example:

•newfundersorfewerfunders•newstrategy/businessplan•projectsclosingornewonesopening•provincialspreadchanging

What have been the organisation’s key achievements during the reporting period?

Excluding fundraising, what have been your organisation’s key challenges during the reporting period?






Section 5 - Attachments

DocumentCheck if

attached Provide reason if not attached

Latest annual report

Latest set of unabridged, signed audited financial statements

If your organisation has an associated Trust or any other body that contributes to the finances of the organisation, please submit the audited financial statements of this body

Financial report for the grant, including original planned budget and actual expenditure

The most up-to-date Management Accounts for the current financial year

Photographs of your work

(NB: the Fund assumes that we have permission to use any photographs submitted for the purpose of our own reporting and publicity unless the photograph is clearly marked to the contrary.)

Any new internal or external evaluations of the impact of the work of your organisation





anglo american chairman’s fund reporting form sustainable...

Documents