General Administration Monitoring Form

Grantee:  	

Grant Number:  	

Prepared by:  	

Date Prepared:  	

Project Name:  	

Administrative Structure	

1.	What is the grantee’s administrative structure for the
CDBG program? List staff, consultants and their areas of responsibility.		

2.	If a consultant is used, how many hours per week are
they in the community on average?		

3.	What is the grantee’s procedure for the supervision of
consultant provided services?		

4.	Are the program files maintained in the grantee’s
office?  Check the location.	Yes	No		

Citizen Participation Plan	
5.	Checklist for required provisions of plan:	

What is the date the plan was adopted:		
Provision for and encouragement of citizen participation,
especially LMI residents of slum/blighted areas and project areas	
Yes	No	
Provision of access to local meetings, information, and records
relating to use of funds	
Yes	No	
Provision of technical assistance to groups representative of LMI
persons that request such assistance	
Yes	No	
Provision for public hearings at all stages of the program
(applications, amendments, and closeout)	
Yes	No	
Complaint procedure specifying a response within 10 calendar
days	
Yes	No	
Identification of means to meet needs of non-English speaking
residents, where a significant number of non-English speaking residents can be reasonably expected to participate	
Yes	No	

Anti-Displacement and Relocation Assistance Plan	
6.	What was the date the plan was adopted? Does the plan include:	

A commitment to replace all occupied or vacant and occupiable
LMI housing units demolished or converted to another use within
3 years of the commencement of demolition or rehabilitation?		

To publish a description of the activity and replacement plans?

To provide relocation assistance as described in 570.606(b)(2) to each displaced household?		

List steps to minimize the displacement of persons from their homes?		

Complaints and Reports	

7.	
How many complaints has the grantee received? (If none go on to question 8; otherwise sample one complaint for compliance with the complaint procedure).		
Name of complainant:		
Describe the complaint:		
Date complaint received:		
Date response mailed to complainant:		
Date complaint resolved:		
Was the complaint handled in accordance with the grantee’s
adopted procedure and does the resolution appear to be satisfactory?		

8.	
Are internal status reports, with financial data and program accomplishments, provided to the governing body at least quarterly? What documentation verifies this?	

Yes	No	

9.	
Is the grantee current with the submission of Quarterly Progress
Reports to REDD?		

10.	

Who gives reports to the Board? What documentation verifies this?		

_________________________________________	        _______________________
Grantee Representative				                    Date

____________________________________	          ___________________
Grant Management Representative				  Date