SOP_NUMBER: 214.04-att-5
TITLE: Evidence Based Program Weekly Report
DIVISION: Facilities
TOPIC_AREA: 214 Policy-Facilities Programs
EFFECTIVE_DATE: 2025-02-20
WORD_COUNT: 345
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/1214530
URL: https://gps.press/sop-data/214.04-att-5/

SUMMARY:
This is a weekly reporting form used to track Evidence Based Program (EBP) activities at GDC facilities. The form captures data on program proposals, mentor involvement across multiple program phases, participant graduation rates, elective course enrollment, family day events, and disciplinary referrals. Facilities submit this report on a weekly basis covering the previous week's activities, and completed forms are retained by the Statewide EBP Coordinator for two years.

KEY_TOPICS: Evidence Based Program, EBP, weekly reporting, program phases, mentors, Pathfinders, Identity Reformation, graduation rates, electives, family day, disciplinary referrals, offender programs, facilities programs, program tracking

ATTACHMENTS:
  1. Participation Agreement
     URL: https://gps.press/sop-data/214.04-att-1/
  2. TCU CTSFORM – Criminal Thinking Scales: Scales and Item Scoring Guide
     URL: https://gps.press/sop-data/214.04-att-2/
  3. TCU CTS Form (Attachment 3) - Thinking Style and Criminal Thinking Patterns Assessment
     URL: https://gps.press/sop-data/214.04-att-3/
  4. EBP Elective Proposal
     URL: https://gps.press/sop-data/214.04-att-4/
  5. Evidence Based Program Weekly Report
     URL: https://gps.press/sop-data/214.04-att-5/

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SOP 214.04
Attachment 5

02/20/25
Page 1 of 4
## Evidence Based Program Weekly Report Facility Name Submitted By

|Facility Name|Col2|Week-of|Col4|
|---|---|---|---|
|**Submitted by**||**Date**||
|_This is one week retroactive of report due date_<br>_(Example: report due Wednesday May 31st is for activities from Wednesday May 24-May_<br>_Tuesday May 30th) _|_This is one week retroactive of report due date_<br>_(Example: report due Wednesday May 31st is for activities from Wednesday May 24-May_<br>_Tuesday May 30th) _|_This is one week retroactive of report due date_<br>_(Example: report due Wednesday May 31st is for activities from Wednesday May 24-May_<br>_Tuesday May 30th) _|_This is one week retroactive of report due date_<br>_(Example: report due Wednesday May 31st is for activities from Wednesday May 24-May_<br>_Tuesday May 30th) _|


# **Weekly Activities**





Retention Schedule: Upon completion this form shall be maintained by the Statewide EBP Coordinator for two (2)
years.


SOP 214.04
Attachment 5

02/20/25
Page 2 of 4
# **Proposal**

|Ideas presented that further the goals and mission of EPB that establish a positive forward<br>momentum. This is required on a minimum monthly basis|Col2|
|---|---|
|**Proposal**<br>**Name/Idea**||
|**Result**| Approved by _______________ Denied BY_________________<br>|


|Mentors|Col2|Col3|Col4|Col5|
|---|---|---|---|---|
||**Completed**|**Enrolled**|**Start Date**|**End Date**|
|**Total Number of**<br>**Mentors:**|||||
|**Pathfinders:**|||||
|**Identity**<br>**Reformation**|||||
|**Mentor Meeting**<br>**Date and take ways**<br>**from meeting**|||||


# **Phase Numbers:**

|Pre-Phase|Col2|Phase 1|Col4|
|---|---|---|---|
|**Phase 2**|<br>|**Phase 3**||
|**Phase 4**|<br>|**Graduates Phase**||
|**Mentors**|<br>|**Fire Station**||
|**Total Offenders**||||



**Start and end Date of any EBP Training: __________________________________________**
**Graduation Date: ______________________________________________________________**

# **Graduation Rates**

|Year|Col2|
|---|---|
|**2023**||
|**2024**||
|**Total**||



Retention Schedule: Upon completion this form shall be maintained by the Statewide EBP Coordinator for two (2)
years.


SOP 214.04
Attachment 5

02/20/25
Page 3 of 4
# **Electives**

_(use additional sheets as needed)_

|Col1|Elective|Number of Offenders|
|---|---|---|
|**1 **|||
|**2 **|||
|**3 **|||
|**4 **|||
|**5 **|||
|**6 **|||
|**7 **|||
|**8 **|||
|**9 **|||
|**10**|||
|**11**|||
|**12**|||
|**13**|||
|**14**|||
|**15**|||
|**16**|||
|**17**|||
|**18**|||
|**19**|||
|**20**|||
|**21**|||
|**22**|||
|**23**|||
|**24**|||
|**25**|||
|**26**|||
|**27**|||
|**28**|||
|**29**|||
|**30**|||
|**31**|||
|**32**|||
|**33**|||
|**34**|||
||**_Total_**||


# **Family Day**


Retention Schedule: Upon completion this form shall be maintained by the Statewide EBP Coordinator for two (2)
years.


SOP 214.04
Attachment 5

02/20/25
Page 4 of 4

|Date:|Col2|
|---|---|
|**Family Day Goals/Accomplishments:**||
|**Family Day Goals/Accomplishments:**||
|**Family Day Goals/Accomplishments:**||


# **Disciplinary Referrals**


Retention Schedule: Upon completion this form shall be maintained by the Statewide EBP Coordinator for two (2)
years.