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Health Center Program Site Visit Guide
For HRSA Health Center Program Grantees and Look-Alikes

Health Center Program - Site Visit Report Template
For HRSA Health Center Program Grantees and Look-Alikes

*** WARNING ***

  • You are accessing a U.S. Government information system, which includes (1) this computer, (2) this computer network, (3) all computers connected to this network, and (4) all devices and storage media attached to this network or to a computer on this network. This information system is provided for U.S. Government-authorized use only.
  • Unauthorized or improper use of this system is prohibited and may result in disciplinary action, as well as civil and criminal penalties. Personal use of social media on this system may result in disciplinary action unless otherwise authorized.
  • By using this information system, you understand and consent to the following:
    • You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system. At any time, and for any lawful Government purpose, the government may monitor, intercept, and search and seize any communication or data transiting or stored on this information system.
    • The government may record and audit your information system usage, including usage of personal email systems to conduct HHS businesses.
    • Any communication or data transiting or stored on this information system may be disclosed or used for any lawful Government purpose.
Rules of Behavior
To browse through our web site, you need to agree to the following:
a. I understand that I have been given the user id and password to use on a system owned by the U.S. Government, and I am responsible for actions taken with that user id and password.
b. I will not share my password with others.
c. If I suspect that the security of my password is compromised, I will change it immediately and notify the System Owner.
d. I will use the system to carry out only those procedures which form a part of my job function.
e. I will not share any information about the data that I have access to through this system with anyone outside of HRSA, or anyone within HRSA who does not need to know this information as part of their job in the Government.
f. I will not try to upload any infected software programs that will damage this Government system. 
In the event it is suspected that you do not comply with these rules of behavior your account will be frozen and you will be denied access to the site. Suitable disciplinary action, including termination, might be taken.

Intrusion Detection
This site is maintained for the U.S. Government. It is protected by various provisions of Title 18, U.S. Code. Violations of Title 18 are subject to criminal prosecution in federal court.
For site security purposes and to ensure that this service remains available for legitimate use by authorized users, we will collect information concerning your use of this system, such as the data you view and alter. We employ software programs to monitor traffic to identify unauthorized attempts to view or change information, or otherwise cause damage. In the event of authorized law enforcement investigations, and pursuant to any required legal process, information from these sources may be used to help identify unauthorized activities.


Health Center Program Site Visit Report General Instructions

Reports for Operational Site Visits: Please ensure all sections of the online report are completed:

  • Sections I-IV: Compliance Assessment of all 19 Program Requirements across Need, Services, Management and Finance, Governance
  • Section V: Clinical and Financial Performance Analysis
  • Section VI: Capital and Other Grant Progress Review (if applicable)
  • Section VII: Best Practices Documentation (if appropriate)

Reports for Program Requirement Verification Site Visits and Targeted Program Requirement Assessment Site Visits: Complete only applicable sections (I-IV) of the online report based on the program requirement(s) reviewed.


Program Requirement Assistance Site Visits and Performance Improvement Site Visits: : Please ensure all sections of the generic online report are completed.


Generic Report: Please ensure all sections of the generic online report are completed.


FTCA Report: Click here to download the FTCA report template.
PCA Site Visits: Click here to download the PCA Site Visits template.
HCCN Site Visits: Click here to download the HCCN Site Visits template.


Report Completion:


Contact Information: For assistance with this system, contact HRSA Contact Center, http://www.hrsa.gov/about/contact/ehbhelp.aspx.

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