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Title V: Community Prevention Grants Program
Community Self-Evaluation Workbook

FORM 1-7: PPB MEETINGS, ACTIONS, AND ACTIVITIES
WHEN TO USE: DURING EACH MEETING OF THE PPB OR ITS COMMITTEES
KEY FEATURES: RECORD OF PPB MEETINGS AND DECISIONS

This Form will serve as a log of the issues discussed and decisions made at Prevention Policy Board (PPB) meetings. Planned actions will be recorded at each meeting and then the status of each action will be reviewed at the next meeting(s). Consider using Form 1-7 for recording the minutes of all PPB meetings!
- Do not write on this Form
. Make additional copies of both pages of Form 1-7. You will need one copy of the Form to document each PPB meeting.
- Sections 1 through 4 are to be completed during each PPB meeting.
Section 5 will be completed at the following meeting(s). |
1. Meeting Information
- Date:
Provide the date of the meeting.
- Time:
Provide the time the meeting started and the time it ended.
- Location:
Provide the meeting site.
2. Participants
- Meeting Group:
Indicate whether the meeting was held for the entire PPB or a committee, subcommittee, task force, or working group of the PPB. If applicable, specify the name of the sub-group.
- Names of Participants:
Record the names of all persons attending the meeting.
3. Major Issues Discussed or Activities Conducted
Briefly summarize the principal topics discussed, activities conducted, or problems addressed during the meeting. If additional space is necessary, attach a separate sheet.
4. Key Decisions Made at Today's Meeting
- Action to be Taken:
List the actions and activities that board members have agreed to undertake based on the issues discussed. Be specific. Try to link the actions to the issues and topics listed in section 3. Examples of possible actions: Contact the local radio station to schedule dates for upcoming media campaign; Hold a sub-committee meeting to assess the progress of a parenting education class; Collect current risk indicator data from the District Attorney's Office; Establish a task force to organize a community forum on youth violence.
- Who is Responsible:
Name the person(s) who will be responsible for completing the action.
- Target Date:
List the date by which the action is intended to be completed.
- At your next meeting, complete section 5 of Form 1-7 for the previous meeting(s). This is similar to addressing "old business."
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5. Progress Since the Last Meeting
| | D. | Status Code: From the box below, choose and enter the appropriate status code to indicate whether the action was completed by the target date, was completed behind schedule, is in progress, or was never initiated. Change status codes as necessary to reflect progress. Incorporate the status of actions from previous meetings into the agenda for the current meeting. |
| Status
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Code
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| Completed by target date
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C
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| Completed behind schedule
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CB
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| In progress, not yet complete
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IP
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| No action taken
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NA |
| | E. | Actual Completion Date: Enter the date the action was actually completed. If no action has been taken (NA) or the activity is still in progress (IP), then leave the box blank until completion. |
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Things to Think About When Completing Form 1-7:
- Are PPB meetings being held on a regular basis?
- Are most PPB members attending meetings regularly and actively participating?
- In general, is the level of participation balanced among the members? (That is, are one or two people doing all the work or is the level of participation distributed fairly evenly among the members?)
- Do PPB members regularly receive meeting minutes, notices, and other communications?
- Are there appropriate rules and procedures to facilitate smooth meeting dynamics?
- Are there adequate decision-making and conflict resolution processes in place?
- Are actions and activities generally completed as planned? If not, what needs to be done?
- Are realistic schedules being set?
- Is adequate time being spent by the PPB in oversight of the Title V Initiative?
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FORM 1-7 (Wordperfect Format)
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