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2020-2021 Annual Data Collection for ESSER and ESSER

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1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 1/12
1.
2.
ESSER SPED
3.
Mark only one oval.
Students and teachers both in Title I and non-Title I schools
Students and teachers in Title I schools
4.
2020-2021 Annual Data Collection for
ESSER and ESSER SPED
On April 23, 2020 the U.S. Department of Education (USED) was granted approval for this
information collection that solicited from State educational agencies (SEAs) applications for
funding under section 18003 of the Coronavirus Aid, Relief, and Economic Security Act (CARES
Act), the Elementary and Secondary School Emergency Relief Fund (ESSER Fund). The ESSER
Fund awards grants to State educational agencies (SEAs) for the purpose of providing local
educational agencies (LEAs) with emergency relief funds to address the impact that Novel
Coronavirus Disease 2019 (COVID-19) has had, and continues to have, on elementary and
secondary schools across the nation.
* Required
District or Interlocal Number (Example: 500 if USD 500). *
District Name *
Who is the LEA serving with ESSER SPED (SEA Reserve)? *
What was the total amount awarded to the LEA for ESSER SPED (SEA Reserve)?
(Example: 100000- no dollar sign or comma) *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 2/12
5.
6.
7.
Mark only one oval per row.
8.
For ESSER SPED (SEA Reserve), what was the amount expended by the LEA for
public schools? (Example: 100000- no dollar sign or comma) *
For ESSER SPED (SEA Reserve), what was the total amount expended for equitable
services for non-public school students and teachers? (Example: 100000 - no dollar
sign or comma) *
Did your LEA use ESSER SPED (SEA Reserve) funds to provide home internet access
for any students? Please answer yes or no to each of the options below. *
Yes No
Mobile Hotspots with paid data plans
Internet connected devices with paid data
plans
LEA pays for the cost of home internet
subscription for student
District provides home internet access
through a district-managed wireless network
Other, if Yes, please specify in next question
Mobile Hotspots with paid data plans
Internet connected devices with paid data
plans
LEA pays for the cost of home internet
subscription for student
District provides home internet access
through a district-managed wireless network
Other, if Yes, please specify in next question
If you chose "Other" in the prior question, please specify
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 3/12
9.
Mark only one oval.
Yes
No
10.
11.
12.
13.
ESSER
Did your LEA use ESSER SPED (SEA Reserve) funds to provide dedicated learning
devices to any students? *
If you provided dedicated learning devices using ESSER SPED (SEA Reserve) funds
to students, how many elementary students received devices? *
How many elementary students were enrolled on September 30, 2020?
(Enrollment should match for both ESSER SPED and ESSER). *
If you provided dedicated learning devices using ESSER SPED (SEA Reserve) funds
to students, how many secondary students received devices?
How many secondary students were enrolled on September 30, 2020? (Enrollment
should match for both ESSER SPED and ESSER). *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 4/12
14.
Mark only one oval.
Students and teachers both in Title I and non-Title I schools
Students and teachers in Title I schools
15.
16.
17.
Who is the LEA serving with ESSER funds? *
What was the total amount awarded to the LEA for ESSER funds? (Example:
100000.00 - no dollar sign or comma) *
For ESSER funds, what was the amount expended by the LEA for public schools?
(Example: 100000 - no dollar sign or comma) *
For ESSER funds, what was the total amount expended for equitable services for
non-public school students and teachers? (Example: 100000.00 - no dollar sign or
comma) *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 5/12
18.
Mark only one oval per row.
19.
20.
Mark only one oval.
Yes
No
Did your LEA use ESSER funds to provide home internet access for any students?
Please answer yes or no to each of the options below. *
Yes No
Mobile Hotspots with paid data plans
Internet connected devices with paid data
plans
LEA pays for the cost of home internet
subscription for student
District provides home internet access
through a district-managed wireless network
Other, if Yes, please specify in next question
Mobile Hotspots with paid data plans
Internet connected devices with paid data
plans
LEA pays for the cost of home internet
subscription for student
District provides home internet access
through a district-managed wireless network
Other, if Yes, please specify in next question
If you chose "Other" in the prior question, please specify
Did your LEA use ESSER funds to provide dedicated learning devices to any
students? *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 6/12
21.
22.
23.
24.
Student Participation
If you provided dedicated learning devices using ESSER funds to students, how
many learning devices did you provide to elementary students? *
How many elementary students were enrolled on September 30, 2020?
(Enrollment should match for both ESSER SPED and ESSER). *
If you provided dedicated learning devices using ESSER funds to students, how
many learning devices did you provide to secondary students?
How many secondary students were enrolled on September 30, 2020? (Enrollment
should match for both ESSER SPED and ESSER). *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 7/12
25.
Mark only one oval per row.
Please mark all methods used to document elementary student participation and
engagement during remote learning: (Mark yes for methods used for 50% or more
of the students within the grade level in the LEA). *
Yes No
Submission of assignments
Participation of assessments
Tracking student logins to online learning
platform
Participation in individual coaching or check-
ins
Participation in email, text or other electronic
communication
Participation in help lines or hot lines for
help with remote learning
Participation in synchronous online classes
Submission of assignments
Participation of assessments
Tracking student logins to online learning
platform
Participation in individual coaching or check-
ins
Participation in email, text or other electronic
communication
Participation in help lines or hot lines for
help with remote learning
Participation in synchronous online classes
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 8/12
26.
Mark only one oval per row.
Full-Time
Equivalent
(FTE)
Positions
Provide the number of full-time equivalent (FTE) positions for the LEA, or non-LEA Entity
as of the listed reporting dates. (The number of FTE positions includes all staff
regardless of whether the position is funded by Federal, State, local, or other funds—and
equals the sum of the number of full-time positions plus the full-time equivalent of the
number of part-time positions.)
27.
28.
Please mark all methods used to document secondary student participation and
engagement during remote learning: (Mark yes for methods used for 50% or more
of the students within the grade level in the LEA). *
Yes No
Submission of assignments
Participation of assessments
Tracking student logins to online learning
platform
Participation in individual coaching or check-
ins
Participation in email, text or other electronic
communication
Participation in help lines or hot lines for
help with remote learning
Participation in synchronous online classes
Submission of assignments
Participation of assessments
Tracking student logins to online learning
platform
Participation in individual coaching or check-
ins
Participation in email, text or other electronic
communication
Participation in help lines or hot lines for
help with remote learning
Participation in synchronous online classes
Please provide the number of full-time equivalent positions for the LEA as of
September 30, 2018 *
Please provide the number of full-time equivalent positions for the LEA as of
September 30, 2019 *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 9/12
29.
30.
Allowable Uses - ESSER SPED
Please provide the number of full-time equivalent positions for the LEA as of
March 13, 2020. *
Please provide the number of full-time equivalent positions for the LEA as of
September 30, 2020 *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 10/12
31.
Mark only one oval per row.
32.
*
Yes No
Purchasing educational technology
(including hardware, software, and
connectivity), which may include assistive
technology or adaptive equipment.
Activities focused specifically to addressing
the unique needs of low-income children or
students, children with disabilities, English
learners, racial and ethnic minorities,
students experiencing homelessness, and
foster care youth
Providing mental health services and
supports.
Sanitization and minimizing the spread of
infectious diseases, including cleaning
supplies and staff training to address
sanitization and minimizing the spread of
infectious diseases.
Summer learning and supplemental
afterschool programs.
Other (uses of funds not included above). If
yes, please describe.
Purchasing educational technology
(including hardware, software, and
connectivity), which may include assistive
technology or adaptive equipment.
Activities focused specifically to addressing
the unique needs of low-income children or
students, children with disabilities, English
learners, racial and ethnic minorities,
students experiencing homelessness, and
foster care youth
Providing mental health services and
supports.
Sanitization and minimizing the spread of
infectious diseases, including cleaning
supplies and staff training to address
sanitization and minimizing the spread of
infectious diseases.
Summer learning and supplemental
afterschool programs.
Other (uses of funds not included above). If
yes, please describe.
Other (uses of funds not included above). If yes, please describe
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 11/12
Allowable Uses - ESSER
Provide the amount of LEA expenditures of ESSER subgrant funds.
33.
34.
35.
36.
37.
38.
Purchasing educational technology (including hardware, software, and
connectivity), which may include assistive technology or adaptive equipment. *
Activities focused specifically to addressing the unique needs of low-income
children or students, children with disabilities, English learners, racial and ethnic
minorities, students experiencing homelessness, and foster care youth *
Providing mental health services and supports. *
Sanitization and minimizing the spread of infectious diseases, including cleaning
supplies and staff training to address sanitization and minimizing the spread of
infectious diseases. *
Summer learning and supplemental afterschool programs. *
Other (uses of funds not included above). If yes, please describe *
1/4/2021 2020-2021 Annual Data Collection for ESSER and ESSER SPED
https://docs.google.com/forms/d/14pXZ6FDUksVCkCOgZ8B1WYt2X1qXy48di-pKa48yfWs/edit 12/12
Certifications
By signing this report, I certify to the best of my knowledge and belief that the report
is true, complete, and accurate, and the expenditures, disbursements and cash
receipts are for the purposes and objectives set forth in the terms and conditions of
the Federal award. I am aware that any false, fictitious, or fraudulent information, or
the omission of any material fact, may subject me to criminal, civil or administrative
penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18,
Section 1001 and Title 31, Sections 3729-3730 and 3801-3812).
39.
40.
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2020-2021 Annual Data Collection for ESSER and ESSER

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Completed 7 January 2021

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