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{"sheet":"申請書","index":0,"n_rows":35,"n_cols":42,"rows_kept":35,"cut":false,"hidden":false,"merged":[[27,19,28,29],[34,28,34,37],[33,28,33,37],[32,28,32,37],[31,28,31,37],[30,28,30,37],[29,29,29,37],[31,20,31,26],[32,20,32,26],[33,20,34,22],[33,24,33,27],[34,24,34,27],[28,2,28,14],[29,20,30,27],[2,35,2,36],[2,32,2,33],[2,29,2,30],[7,22,7,36],[8,22,8,36],[15,1,15,9],[15,10,15,17],[4,0,4,9],[6,22,6,36],[12,1,12,37],[10,0,10,38],[17,4,17,22],[18,4,18,27],[18,28,18,32]]}
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（様式２７）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　令和",null,null,"年",null,null,"月",null,null,"日"]
[]
["福井県知事　杉本　達治",null,null,null,null,null,null,null,null,null,"様"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（所在地）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（法人名）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（役職・代表者名）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
[]
["令和２年度福井県新型コロナウイルス感染症緊急包括支援事業補助金\n（福祉サービス従事者（障がい）慰労金事業）実績報告書"]
[]
[null,"　令和　年　　月　　日付け福井県指令障第　　　号で交付決定を受けた令和２年度福井県新型コロナウイルス感染症緊急包括支援事業（障がい分）のうち、福祉サービス従事者への慰労金支給事業が完了したので、関係書類を添えて、下記のとおり報告します。"]
[]
[]
[null,"　　実　績　額　：　",null,null,null,null,null,null,null,null,{"$f":"SUM(別添!N5:N19)","v":0},null,null,null,null,null,null,null,"千円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(K16=SUM(別添!$N$5:$N$29),\"○\",\"! 別添(事業所一覧)の合計額と一致しません\")","v":"○"}]
[]
[null,"（内訳）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(#REF!=#REF!,\"○\",\"! 職員表の合計人数と個票の合計人数が一致しません\")","v":{"$error":"#REF!"}}]
[null,null,1,null,"福祉サービス従事者（障がい）慰労金事業",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(別添!$H$5:$H$19)","v":0},null,null,null,null,"千円"]
[]
[null,"（添付書類）（該当がないものについては、取り消し線を記載すること）"]
[null,"１　（様式28）事業所・施設別実績額一覧"]
[null,"２　（様式29）新型コロナウイルス感染症緊急包括支援事業補助金（障がい分）事業実施報告書（事業所単位）"]
[null,"３　（様式30）障がい福祉慰労金受給職員表（法人単位）"]
[null,"４　慰労金を支給した職員の受領書（様式12）の写し"]
[null,"５　従事者への慰労金交付の際の振込手数料を証明する書類（法人単位）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【報告内容に関する連絡先】"]
[null,null,"受付欄（記入不要）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 申請法人住所",null,null,null,null,null,null,null,"〒"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 部署名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 担当者氏名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 連絡先",null,null,null,"電話番号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"e-mail"]

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["（様式28）事業所・施設別実績額一覧"]
[]
["No.","事業所・施設名","事業所番号","サービス種別","電話番号","住所","代表となる\n法人名","補助実績額（千円）",null,null,null,null,null,null,"審査\n結果"]
[null,null,null,null,null,null,null,"障がい福祉\n慰労金","20万円\n対象者の\n有無","感染対策費用\n助成事業\n（多機能型居室を除く。）","感染対策費用\n助成事業\n（多機能型居室に限る。）","個別再開支援\n助成事業","再開環境整備\n助成事業","合計"]
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[10,"","","","","",{"$f":"IF(N14>0,申請書!$W$8,\"\")","v":""},"","","","","","",0,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"",""]
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["（注）行が不足する場合には適宜行を追加して差し支えないが、列の挿入は絶対に行わないこと。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"",""]
[null,"　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"",""]
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["（様式29）"]
[]
["福井県新型コロナウイルス感染症緊急包括支援事業補助金（障がい分）に関する事業実施報告書（事業所単位）"]
[]
["施設概要"]
[]
["事業所番号",null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所名称"]
["所在地",null,null,"都道府県名",null,null,null,"住所",null,null,null,null,null,null,null,null,null,null,null,"連絡先",null,null,"電話番号",null,null,null,null,null,null,null,null,null,"担当部署名"]
[null,null,null,"福井県"]
["提供サービス（プルダウンから選択）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"定員",null,null,null,null,"人",null,"職員数\n(派遣含む)",null,null,null,null,"人"]
["事業区分",null,null,null,null,null,null,null,null,null,null,"障がい福祉慰労金事業"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"訪問介護事業所",534,"/事業所",null,200,"/事業所"]
["交付等に関する確認",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"短期入所療養介護事業所",{"$f":"CD14*[1]個票1!$AC$10","v":0},"/定員",44,200,"/事業所"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"訪問介護事業所",534,"/事業所",null,200,"/事業所"]
["県から交付された慰労金は、障がい福祉サービス事業所・施設等職員個人へ確実に支払いました",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"訪問入浴介護事業所",564,"/事業所",null,200,"/事業所"]
["障がい福祉サービス事業所・施設等職員個人から取得した代理受任委任状等は、適切に保管します",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"＊左欄両方に〇を記載してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"訪問看護事業所",518,"/事業所",null,200,"/事業所"]
[]
["支出実績額"]
[]
["１．障がい福祉慰労金事業",null,null,null,null,null,null,null,null,null,null," ※対象職員の氏名等について、様式30を作成すること。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"実績額①",null,null,null,{"$f":"(20*M22+5*V22)*10+AE22","v":0},null,null,"千円"]
["慰労金の区分・人数",null,null,null,null,null,null,"20万円対象",null,null,null,null,null,null,null,"人","5万円対象",null,null,null,null,null,null,null,"人","振込手数料",null,null,null,null,null,null,null,"千円",null,"（千円未満切捨）",null,null,null,null,{"$f":"IF(M22=0,,\"有\")","v":0}]

{"sheet":"職員表","index":3,"n_rows":86,"n_cols":22,"rows_kept":86,"cut":false,"hidden":false,"merged":[[3,19,3,21],[3,15,3,18],[3,0,4,0],[3,6,4,6],[3,7,3,9],[3,14,4,14],[3,1,4,1],[3,2,4,2],[3,3,4,3],[3,10,3,13]]}
["（様式30）障がい福祉慰労金受給職員表（法人単位）"]
[]
["※　本表は法人単位でまとめて記載すること。法人一括申請を行わずに事業所ごとに申請する場合も同様の取扱いとします。（本表の記載内容は、同一法人であれば同一となります。）"]
[null,"氏名（漢字）","氏名（全角カナ）","生年月日（西暦）",null,null,"本人の住所","主たる勤務先",null,null,"分類",null,null,null,"慰労金\n(万円)","確認事項",null,null,null,"支払実績"]
[null,null,null,null,"（確認用）","（確認用）",null,"事業所番号","提供サービス","事業所・施設の名称","施設区分","対応区分","(計算用)","他の施設等との期間通算がある場合その施設名",null,"委任状の有無","他法人での慰労金の申請の有無","業務委託による\n従事者","重複\n申請者\n確認用","支払年月日\n（西暦）","慰労金\n支払金額\n（円）","振込手数料\n（円）"]
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[{"$f":"A6+1","v":2},null,null,null,{"$f":"B7&C7&D7","v":""},{"$f":"IF(E7=\"\",\"\",COUNTIF($E$6:$E$85,E7))","v":""},null,null,null,null,null,null,"",null,{"$f":"IFERROR(VLOOKUP(M7,計算用!$A$56:$B$63,2,FALSE),\"\")","v":""},null,null,null,{"$f":"IF(F7>=2,\"\",\"可\")","v":""}]
[{"$f":"A7+1","v":3},null,null,null,"","",null,null,null,null,null,null,"",null,{"$f":"IFERROR(VLOOKUP(M8,計算用!$A$56:$B$63,2,FALSE),\"\")","v":""},null,null,null,""]
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[10,null,null,null,"","",null,null,null,null,null,null,{"$f":"K15&L15","v":""},null,{"$f":"IFERROR(VLOOKUP(M15,計算用!$A$56:$B$63,2,FALSE),\"\")","v":""},null,null,null,""]
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["（注）記入欄が不足する場合は、6行目～85行目を行ごとコピーし、86行目に右クリック→「コピーしたセルの挿入」で挿入してください"]

{"sheet":"計算用","index":4,"n_rows":115,"n_cols":12,"rows_kept":115,"cut":false,"hidden":true,"merged":[]}
[null,"（１）①　",null,null,null,"（２）②",null,null,null,null,null,"※本シートは絶対に編集しないこと。"]
[null,"共通",null,"単価","多機能型居室","共通"]
["療養介護",2374,"/事業所",null,null,200,"/事業所"]
["生活介護",757,"/事業所",null,null,200,"/事業所"]
["自立訓練（機能訓練）",346,"/事業所",null,null,200,"/事業所"]
["自立訓練（生活訓練）",273,"/事業所",null,null,200,"/事業所"]
["宿泊型自立訓練",273,"/事業所",null,3000,200,"/事業所"]
["就労移行支援",265,"/事業所",null,null,200,"/事業所"]
["就労移行支援（養成施設）",265,"/事業所",null,null,200,"/事業所"]
["就労継続支援Ａ型",335,"/事業所",null,null,200,"/事業所"]
["就労継続支援Ｂ型",353,"/事業所",null,null,200,"/事業所"]
["就労定着支援",52,"/事業所",null,null,200,"/事業所"]
["自立生活援助",27,"/事業所",null,null,200,"/事業所"]
["児童発達支援",380,"/事業所",null,null,200,"/事業所"]
["医療型児童発達支援",240,"/事業所",null,null,200,"/事業所"]
["放課後等デイサービス",360,"/事業所",null,null,200,"/事業所"]
["短期入所",204,"/事業所",null,3000,200,"/事業所"]
["施設入所支援",1215,"/施設",null,3000]
["共同生活援助（介護サービス包括型）",402,"/事業所",null,3000]
["共同生活援助（日中サービス支援型）",358,"/事業所",null,3000]
["共同生活援助（外部サービス利用型）",180,"/事業所",null,3000]
["福祉型障害児入所施設",1182,"/施設"]
["医療型障害児入所施設",635,"/施設"]
["居宅介護",115,"/事業所",null,null,200,"/事業所"]
["重度訪問介護",188,"/事業所",null,null,200,"/事業所"]
["同行援護",65,"/事業所",null,null,200,"/事業所"]
["行動援護",115,"/事業所",null,null,200,"/事業所"]
["居宅訪問型児童発達支援",46,"/事業所",null,null,200,"/事業所"]
["保育所等訪問支援",38,"/事業所",null,null,200,"/事業所"]
["計画相談支援",60,"/事業所",null,null,200,"/事業所"]
["地域移行支援",44,"/事業所",null,null,200,"/事業所"]
["地域定着支援",46,"/事業所"]
["障がい児相談支援",44,"/事業所",null,null,200,"/事業所"]
["重度障害者包括支援"]
["地域活動支援センター"]
["日中一時支援"]
["盲人ホーム"]
["福祉ホーム"]
["移動支援事業"]
["訪問入浴サービス"]
["障害者相談支援事業"]
["基幹相談支援"]
["盲ろう者向け通訳・介助員派遣事業"]
[]
["①"]
["②"]
["③"]
["④"]
[]
["施設区分"]
["陽性者(濃厚接触者)発生施設","訪問系で陽性者等に1日以上対応又は訪問系以外で1日以上勤務","訪問系で陽性者等への対応はないが対象期間に10日以上勤務","対象期間の勤務が9日以下"]
["その他の施設","対象期間に10日以上勤務","対象期間の勤務が9日以下"]
[]
[]
["慰労金単価"]
[{"$f":"A51&B51","v":"陽性者(濃厚接触者)発生施設訪問系で陽性者等に1日以上対応又は訪問系以外で1日以上勤務"},20]
[{"$f":"A51&C51","v":"陽性者(濃厚接触者)発生施設訪問系で陽性者等への対応はないが対象期間に10日以上勤務"},5]
[{"$f":"A51&D51","v":"陽性者(濃厚接触者)発生施設対象期間の勤務が9日以下"},0]
[{"$f":"A52&B52","v":"その他の施設対象期間に10日以上勤務"},5]
[{"$f":"A52&C52","v":"その他の施設対象期間の勤務が9日以下"},0]
[]
[]
[]
[]
["なし"]
["あり"]
[]
[]
["北海道 "]
["青森県 "]
["岩手県 "]
["宮城県 "]
["秋田県 "]
["山形県 "]
["福島県 "]
["茨城県 "]
["栃木県 "]
["群馬県 "]
["埼玉県 "]
["千葉県 "]
["東京都 "]
["神奈川県 "]
["新潟県 "]
["富山県 "]
["石川県 "]
["福井県 "]
["山梨県 "]
["長野県 "]
["岐阜県"]
["静岡県"]
["愛知県"]
["三重県"]
["滋賀県"]
["京都府"]
["大阪府"]
["兵庫県"]
["奈良県"]
["和歌山県"]
["鳥取県"]
["島根県"]
["岡山県"]
["広島県"]
["山口県"]
["徳島県"]
["香川県"]
["愛媛県"]
["高知県"]
["福岡県"]
["佐賀県"]
["長崎県"]
["熊本県"]
["大分県"]
["宮崎県"]
["鹿児島県"]
["沖縄県"]