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2014-03-11 Item 10 - Federal Grant Entitlement Programs
FEDERAL GRANT ENTITLEMENT PROGRAMS 0.. 1»,1 B G HOME E00..0 HE Oj��jj J� �o ��l�ll j �� »��� f FUNDIN APPLI ATI N AND RECOMMENDATIONS The Funding Applications and Recommendations Notebook is a compilation of the funding applications CITY OF and recommendations for use of the City's Federal CHUIAVISTA Entitlement Grant Funds (Community Development Block ...................... Grant, Home Investment Partnerships Act, and Emergency HOUSING DIVISION Solutions Grant). ATTACHMENT NO. 1 U.S. Department of Housing and Urban Development Grants CDBG I HOME I ESG FY 2014-2015 Grant Entitlements COMMUNITY • • • D: Available Funds Entitlement Amount $1,746,692 Program Income/Prior Year Unencumbered Funds $404,216 Total CDBG Available $2,150,908 Spending Plan Planning and Administration (20%of entitlement) $349,338 Public Services (15%of Entitlement) $255,762 Section 108 Debt Service Payment $756,175 Capital Improvement and Community Enhancement $789,633 Total CDBG Allocations $2,150,908 HOME INVESTMENT PARTNERSHIPS ACT HOME Available Funds 2014/2015 HOME Entitlement $598,807 Spending Plan Administration (10%of Entitlement) $59,881 Affordable Housing Projects/Programs $538,926 Total HOME Allocations $598,807 EMERGENCY SOLUTIONS Available Funds 2014/2015 Entitlement $119,795 Spending Plan Administration (7.5%of Entitlement) $8,985 Shelter Services $68,277 H PRP $42,533 Total ESG Allocations $119,795 TOTAL COMBINED GRANT ENTITLEMENT AMOUNTS(Estimated) $2,869,510 2014/2015 Federal Grant (CDBG I HOME I ESG) Funding Application Requests and Recomendations RecommendedNo. Applicant Project/Program Funding 2013/2014 Funding Request Funding Meals-on-Wheels Greater San 1 Diego,Inc. Meals on Wheels $ 12,000 $ 12,000 $ 12,000 Interfaith Shelter Network of 2 San Diego Rotational Shelter Network $ 11,000 $ 11,000 $ 11,000 3 Lutheran Social Services Project Hand $ 20,400 $ - $ 12,200 4 South Bay Community Services South Bay Food Program $ 15,000 $ 10,000 $ 10,000 Jacobs&Cushman San Diego 5 Food Bank Food 4 Kids Backpack Program $ 20,000 $ - $ 15,000 v� Family Violence Treatment 6 South Bay Community Services Program $ 39,000 $ 39,000 $ 39,000 •i Services for High Risk and N 7 South Bay Community Services Homeless Youth $ 39,550 $ 34,550 $ 39,550 v Chula Vista Elementary Schools aDistrict for the Chula Vista Family Resource Center (g 8 Community Collaborative Emergency and Basic Services $ 69,945 $ 39,312 $ 39,312 m City of Chula Vista Recreation Therapeutic Recreation U 9 Department Programs $ 22,516 $ 20,100 $ 20,100 Center for Employment Employment Reentry for At- 10 Opportunities Risk Young Adults(18-25) $ 30,000 $ 14,000 $ 14,000 Family Health Centers of San 11 Diego KidCare Mobile Medical Unit#3 $ 30,000 $ 13,600 $ 13,600 City of Chula Vista Recreation Norman Park Center Senior& 12 Department Disabled Services $ 41,013 $ 30,000 $ 30,000 City of Chula Vista Housing 13 Division Fair Housing Services $ 32,000 $ 35,000 $ 32,000 Total $ 255,762 City of Chula Vista Finance 14 Department Section 108 Loan Repayment $ 756,715 $ 756,756 $ 756,715 03 T c City of Chula Vista Housing �n *= ai 15 Division Housing Services $ 50,000 $ 54,705 $ 50,000 v £ c 16 Urban Corps of San Diego Green Streets $ 76,138 $ - $ 150,000 p O >> 17 South Bay Community Services Landis Studios $ 450,000 $ - $ 450,000 v u D City of Chula Vista Housing Production of Affordable 18 Division Housing Projects/Programs $ 139,093 $ - $ 139,093 Total $ 1,545,808 c m E City of Chula Vista Housing CDBG Grant Q 19 Division Administration/Planning $ 349,338 Total $ 349,338 City of Chula Vista Housing Homeless Prevention and 20 Division Rapid ReHousing $ 42,533 $ 42,533 $ 42,533 City of Chula Vista Housing ESG Grant N 21 Division Administration/Planning $ 8,985 $ 8,985 $ 8,985 W 22 South Bay Community Services ESG-Casa Nueva Vida $ 68,277 $ 68,277 $ 68,277 Total $ 119,795 City of Chula Vista Housing HOME Grant UJ 23 Division Administration/Planning $ 59,881 $ 59,881 $ 59,881 � City of Chula Vista Housing Production of Affordable = 24 Division Housing Projects/Programs $ 538,926 $ 538,926 $ 538,926 Total $ 598,807 TOTAL GRANTS $ 2,869,510 Application No. CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Meals-'dn-Wheels Greater San Diego, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Meals on Wheels Project Description: Meals-an-Wheels will deliver meals to h6meboun'd Chula Vista,seniors. wals�will be deli I vered for 365 days a year,, including, holidays;,by volunteers who not only deliver a rneal, but, provide social contact to, homebound seniors,to,combat isolation'. Type of Program/Project: Public Services [(§570.201(e)] Target Popullatloh:' OSA-Senior Services Proposed Number; 220 to Serve: (subject to change &R§'570''208(a)(2)'Lo' w depending on funding Moderate Income recommendation) Limited Clientele Program Total Budget: $346,920 C. V. Cost per Client: $54 (Based on funding recommendation) Funding Request: Prior Year,Fundin,g: $121000, Specific Use of Chula Vista Food and packaging FUNDING $12,000 Funding: expenses RECOMENDED Staff Notes:: " COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fiscal Year 2014-2015 Ua �ir� Application Number: Project category ® Public service (cDaG Program office use Only) (check oneonlyJ ❑:Capital improvement Applicant Agency Information Appl1ca07ega!name 1Meals-on-Wheels Greater San Diego, Inc. Type:of agency ® 501(c)(3) ❑ Gov't./Public j❑ Fvr Profit ❑ Faith-Based �❑ Other: AgericyAddress 12254 San Diego Avenue#200 San Diego CA 92110 Date of.incorpordtran July 7, 1970 Tax!D number:'' 95-2660509 Agency DU[V5 number 020210332 Annual a" eratin. g budget' x$4,223,541 illum ber of paid staff 78 € Numberaf volunteers: 2,700 'A ..gency mission statement.`.., The mission of Meals-on-Wheels Greater San Diego is to support the independence and well-being of seniors. We fulfill our mission through delivering healthy daily meals to seniors throughout San Diego County. Project Title: Meals-on-Wheels Chula Vista '"Brief project,descrrptian Meals-on-Wheels will deliver meals to homebound Chula Vista seniors. Meals will be delivered for 365 days a year, including Holidays, by volunteers who not only deliver a meal, but provide social contact many homebound seniors need to combat Funding Request Tota!funding requested rn,'thts app lrcatlan Other funds alread y secured or 1$12,000 I$0.00 (you viii!!provide a detailed budget rn Appendix C project. Total cos('to complete project $346,920 Otherfunds not yetsecured.far.' $334,920 Project Information 4. row is a publrc:Servlce, uvr11$ervrcebe site,spec¢!e? I❑Yes ;.IAN if your onswer is yes,please provide: Addresses)below Census tract Target Clientele ,(Homeless, Youth, Elderly residents of Chula Vista. Elderly, disabled, Other/General); Then nsving quest{oan individual clients and households:to be serve only.to Public5er0ce,and Minor. Residential Rehabiiitatron.`projects Wtl!the project serve individual clients(lC)or households(HN)? ® Individual clients [ Households Total.unduplicated 1C/HH served: 1220 Annual cast;per client/household: � Page 1 of 9 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 GDBG FUNDING APPLICATION Section 1; Project Details (Max Score: 25 Points) 'Provide a concise description of the proposed proj'e'ct"(this description must match.the one provided on"the cover page) Space for a fuller narrative is provided in Appendix A. ;Meals-on-Wheels will deliver meals to homebound Chula Vista seniors. Meals will be delivered for 365 days a year, including Holidays by volunteers who not only deliver a meal, but provide social contact many seniors need to combat isolation. 1 2 Pet start date July 1, 2014 ,4rtficrpafed erid.;clate June 30, 2015 1 3 Profect:'s""days%hours`nf operat(on M-F 8:30 a.m.to 5:00 p.m.Sat: 8:30 a.m.to 2:00 P.M. 14 Project' ®�Public service 1 5 Prafect ® Suitable living environment category objective:, ❑ Decent housing �cneckoreonlyj El`Capital improvement {checkoneaRryx ❑E Economic opportunity 1 fi Project ® Availability/accessibility outcome: ❑ Affordability (check oneonlyi ,❑ Sustainability 17 CDBG Criterid: Which CDBG,criterion below does your proposed project meet ❑� (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income(LMI). Please provide a map identifying the Census Tracts designated as LMI. ® (2) Limited clientele(selects ubpart below): ,❑ (a) Special needs group (select benefit group from the list below): (i) Abused children ® (ii) Elderly persons 62 years or older ❑, (iii) Battered spouses (iv) Severely disabled adults(not children)--Census definition;documentation required ❑, (v) Illiterate adults ❑ (vi) Persons living with HIV/AIDS ❑ (vii) Migrant farm workers ❑' (viii) Homeless persons 10 (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? (3) Housing(select subpart below): ❑� (a) Single family(must be 100%LMI) (b) Multi-unit(must be 51%LMI) 1.$. Th.e:2010a-2015 cohsolidated Noll goals are listed below Select the goal appropriate"to your project:. ❑ Affordable Rental Housing Opportunities ❑ Maintenance and Preservation of Housing(rehabilitation activities) ❑ Homeownership Opportunities (homebuyer programs) ❑� community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 1.10 t® 1.15: 2 Pages) 1 10 Explain;how the proposed project addresses the goal selected;: . Meals-on-Wheels Greater San Diego is committed to ensuring that homebound seniors have the living environment necessary to support their daily nutrition and their ability to age in place.We do this by providing them access to daily meals they might not otherwise receive, by delivering those meals directly to their residence, and by assuring that they are receiving healthy daily nutrition. In addition,we improve their living environment through contact with our specially trained volunteers during the meal delivery.At this time, the volunteer conducts a wellness check to assure that the senior is not in need of additional help and provides the social contact needed to reduce isolation and loneliness for homebound seniors. 1;11: Summarrze,anystdtistres and othersupportrng documentation that.demorts rare the importance Oaddressing this creed or problem Senior hunger is an often hidden,yet rapidly growing, problem throughout the United States, including San Diego. In addition, the senior population is not only increasing exponentially as the Baby Boomer generation retires, seniors are living longer with the greatest increase in those age 85 and over, placing increased demands on senior services to provide support. Cost of living continues to increase,yet the vast majority of seniors live on fixed incomes with minor, if any, cost of living adjustments.Add to this the of the 2008 recession and we are seeing a growing number of seniors who are struggling to make ends meet and are faced with difficult decisions between paying for food or other necessities, such as medications and housing. When they are homebound,these problems are compounded and often they go without adequate nutrition.Though there are organizations that may be able to help,there are more seniors in need than services to support them. A few facts to support the case for providing homebound seniors with daily meals: • There are an estimated 24,376 seniors age 62 and over residing in the City of Chula Vista (SAINDAG), 10%of the total population of the City. • 1 in 6 seniors faces the threat of hunger(Hunger in America:An Annual Report 2012, MOWAA Research Institute)— for Chula Vista this translates to over 4,000 seniors threatened with hunger. • Of the 2,700 seniors we deliver meals to annually,90%are low-moderate income, the majority live alone, the average age is 82 and 49%are 85 or older. (Meals-on-Wheels Greater San Diego annual statistics.) • While HUD uses the poverty threshold ($11,490/yr/individual) as an index of need,the Elder Index---San Diego County(UCLA Policy Institute),which has been accepted by California as a measure of poverty among the elderly established that the poverty threshold for San Diego seniors as$24,377/yr/individual, more than twice that of the federal threshold based on San Diego cost of living.The consequence is that many more seniors than accounted for in the census data fall into a service gap—too much income to qualify for low-income services and meals and too little income to adequately meet their basic daily needs for nutrition. • Poor nutrition plays a major role in falls among seniors and falls is one of the leading causes of hospitalization for seniors (U.S. Centers for Disease Control). Poor nutrition in the senior population, including dehydration, contributes to decreased mental status and poor healing and recovering from injury and disease (multiple scientific studies of nutrition in the elderly). List each service provided:fay thh . e project.'`For each service, indicate whether it is o new service or.an expansion;of air: existing service The project will provide the following service: home delivery of up to two meals a day for every day of the week with Sunday's meals delivered on Saturday. Meals are delivered to each client by a volunteer. During the meal delivery, these specially trained volunteers conduct a wellness check, listening to and observing the client and their surroundings to ascertain if there are changes that indicate the client is depressed or having problems that need attention. If this is the case, Meals-on-Wheels conducts further assessment and makes appropriate referrals as needed.This program is an expansion of an existing service. Page 3 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION In addition to our meal service, we provide special touches for our seniors. In collaboration the Helen Woodward Center, through our Animeals program,we deliver free dog and cat food to our seniors who need help providing for their loved animal companions. With our Waggin' Wheels program we have teamed up with the San Diego Humane Society to offer free in-home visits to seniors by pet therapy dogs. Every senior receives a special package on their Birthday and on Holidays, or when they need a little extra attention. 1 13 `Haw.does your agency plan;.to tell the target populatrorr about,the project/servicesi. We inform our target population about our services through a wide variety of methods including brochures,talks, our presence at health fairs and other public events through door hanger campaigns,through our website and social media such as Facebook as well as responding to telephone inquiries. We are also listed in a variety of different directories of elder/senior services as well as with 2-1-1.To make information accessible to Latino elders and their families, our service brochures, website, and volunteer information is all available in Spanish as well as English. i.14.;[' t Pt three outcomes of the project(at least one is required). For;each.outcome listed; provide the number of P articipants uiho wr1l benefit and.the way data will be collected to track or verify the outcome 1) 220 low-moderate income elder persons age 62 and over residing in the City of Chula Vista will receive up to two meals a day(including sides and beverage). Outcome measurement: Number of unduplicated CDBG clients served. Data to verify this outcome will be collected by our Service Center and Meal Center Staff, entered into our database-, SERVtracker, reported on monthly and aggregated in the final report. 2) 220 low-moderate income elder persons age 62 and over residing in the City of Chula Vista will receive a wellness check at the time of meal delivery. Outcome measurement: Number of unduplicated CDBG clients served. Data to verify this outcome will be collected by our Service Center and Meal Center Staff, entered into our database, SERVtracker, reported on monthly and aggregated in the final report. 1.15., Will the project collaborate wrth other servrce provrders!n the corrmmunrty?If yes,list them dbdescribe the collaboratarr:. Q Yes ® No Though we do not have a formai collaboration related to this project, we collaborate with a large number of other senior service providers to help meet the nutrition needs of homebound seniors.These providers include ElderHelp, St. Paul's Senior Community Centers, Glenner Memory Care Centers,Jewish Family Services, various hospitals and health care systems such as Sharp Healthcare and UCSD Healthcare, as well as various homecare agencies.These providers often help us identify seniors in need or our services and/or refer these seniors to us for meals. In addition,we collaborate with over 60 organizations, including the Navy, who "Adopt A Route" and provide us volunteers to help deliver meals. Page 4 of 9 (Revised.1.2/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBGi FUNDING APPLICATION Section 2: Agency Capacity (Max Score: 10 Points) 2.1: Who:will be alae person responsible for.the overall oversight of the proposed project.. Name of person: (Debbie Case Title of person President &CEO Relevant education: (Bachelor of Science-Pre-med studies,Cert. of Strategic Planning, USD & Haines Ctr. 2010 Telephone;number 619-260-6110 X 4006 Date,first employed:` 12/01/08 2 2" 1Nho vvili be"the"alternate person responsible for the overall ai a sight of the;proposed project? Name of person•`; Matt Tapper True of person:I ;CFO Relevant"educatiortBachelor of Science in Accountancy, Licensed CPA since 2001 Telephone number: 619-260-6110 X 4007 Date first em played: 01/24/07 2.3Who +null be the person responsible far the day to ddy`operations.'and management of the proposed projectir Provide na more than two4ndi„1dui s Name of person ` ;Chequita Falls :Title of person:, South County Service Center Manager Relevant education: M.A. in Community Counseling, Adams State College and B.A. with major in Psychology Telephone'number :61.9-420-2782 i Date irsf emla ed ' f pv J.ame.`af person 7"rtle"of person ;: Relevantweducationall Telephane;number•.: Date frst"enap!oyed. 2 4 . 'Who will be"the.person responsible for the finai cial oversightiof the CDBG expenditures and fiscal.compliance. Pravide"no more.. 'two individuals. Name,of person (Matt Topper Title of person::; ,CFO Relevant°educatio.n Bachelor of Science in Accountancy, Licensed CPA since 2001 Telephone:number ;619-260-6110 X 4007 Date first employed` 1 ;01/24/07 Name of person: 'Title of person: Relevant education: Telephone.number Date'first employed•< Page 5 of 9 (Revised 1214120.13) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to 2.8: 1 Page) L2.5." .:L&the evaluation tools your agency"plans"to employ to track. ,and monitor the progress of the.protect Meals-on-Wheels Greater San Diego will evaluate the success of this project using three metrics: the number of ILMI seniors served, the number of meals delivered, and the grant dollars expended. We will use our SERVtracker database, which captures all our client and meal data, to track and report on the number of clients and meals. Reports are generated monthly and compared against the total to be served in order to assure the project is on track.A combination of SERVtracker and our financial system, QuickBooks,will be used to track funds expended. Reports as well as invoices will be generated and submitted monthly, or as required, in addition to any final reports required. 2 6 " Houv does your agency pldn.`to ensure.campliance uvith applicable policy and procedure!requirements(including those listed'ihHUDs<""Plain b t" ��� - he Rule " •�" Y 9 Y ; " s" andbookf Meals-on-Wheels Greater San Diego has an organizational chart setting forth lines of responsibility and a full finance department with separation of duties. We maintain a Financial Management Procedures designed to assure proper handling of all funds and compliance with generally accepted accounting principles, as well as set of Fiscal Management Procedures pertaining specifically to CDBG funds. We maintain a copy of HUD's"Playing by the Rules" Handbook in our files for reference if needed, as well as copies of other guidance documents such as 24 CFI; Par 82 and OMB Circular A- 122 "Cost Principles for Non-profit organizations. Our financial systems and records, as well as other records pertaining to use of CDBG funds are safeguarded and all electronic systems are backed up nightly to an outside server.All source documentation is maintained within our Finance Department. Our QuickBooks system provides extensive budget reporting, cash management and financial reporting capabilities. Financial and budget reports are reviewed by executive staff on a monthly basis. In addition,we conduct an independent annual audit or our systems to assure compliance. 2 7 Describe any rnresalved ADA issues"in the pro�e.ct or project office and ho►nc your dyency pins::to'atldress them (!f. the objective of the,project is ADA.rehabilitatron, do not repeat the project description here.J. There are no unresolved ADA issues in the project or project office. 2.8'. ow,many does'your Board ofDrrectors haves 120 How.many Boardmembers are also members of the profect's:aarget`population or resrdO. the.project`s,target area?Indicate'"which%ones rrt Appendix F. 1 Page 6 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3.1. Briefly;descrr"6e your agency's payrrment and disbursement procedures, wrth`relevance�to the proposed project: General Payment and Disbursement Procedures: Incoming invoices area opened by the Payroll and Administrative Manager and stamped with approval/coding stamp. Invoices are approved by the CFO. Every Friday, cash disbursements are prepared by the Accountant for signature by an authorized Meals-on-Wheels Greater San Diego official for expense, debts and liabilities of the organization. All disbursements are made by check. All checks of$5,000 or more require two authorized signatures. Checks are mailed by the Accounts Receivable Clerk. Supporting documentation is filed by the Accountant in the Vendor Files. Bank reconciliation is conducted by the CFO and Accountant on a monthly basis as are Cash Flow forecasts. CDBG Specific Payment and Disbursement Procedures: Meals-on-Wheels Greater San Diego's Finance Department is responsible for fiscal management of CDBG funds and to assure compliance with Federal Regulations. Fiscal management system and policies and procedures comply with generally accepted accounting principles. Meals-on- Wheels maintains a written manual of policies and procedures governing fiscal management. Meals-on-Wheels conducts an independent annual audit. 1) CDBG contractual information is entered into the Financial Management system once the final CDBG agreement is fully executed. 2) Client and meal delivery information is reported to the Finance Department on a quarterly basis 3) A unique identifier is established to track CDBG funds from each City 4) The CDBG city is invoiced on a quarterly basis Payments are entered into the Financial Management system. 3"2. ,:,'Descrbe.how your agency's Board of Directors exercises programmatic and fiscal oversight The Board of Trustees' Finance Committee meets monthly to review all financial statements.The Services Committee of the Board also meets monthly to review program reports and assure that programmatic goals are met.The full Board meets monthly(except December) and reviews reports from both the Finance and Services Committees.These reports include oversight of all CDBG projects. 3 3 Brrefly'descrle your agency's financial repartrng system/accounting procedures, vilfh relevanre''to the'propased Project Meals-on-Wheels employs QuickBooks Premier Nonprofit as its primary financial system. Private funding is identified separately from public funding and each CDBG funding source is assigned a unique identifier making it possible to track all invoices and payments by type and source. Invoices are generated quarterly based on monthly program reports of services rendered. All fiscal procedures are governed by the Accounting Department Standard Operating Procedures. 3 4 Briefly describe.your.agency.'s record keeping system, with relevance to the:proposed project: We maintain a permanent record of CDBG projects. Proposal and Agreement: We maintain both a hard copy of the original proposal and fully executed agreement, as well as an electronic copy. Fiscal:A copy of all invoices, payments and receipts relevant to CDBG projects are maintained in both hardcopy and electronic format. Client information: Most client information is entered into SERVtracker(client and meals database).A small hard copy client record is maintained that includes such items as the intake form, verifications and Service Center staff notes. Page 7 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-20 .5 CDBG FUNDING APPLICATION 1.35. . Briefly;describe your'agency's auditing requirements, including those forme.proposed rbject: Meals-on-Wheels Greater San Diego conducts monthly fiscal reconciliations and reviews as well as an annual independent audit. In addition, client and meal statistics are reviewed monthly by both Service Center as well as Executive staff.This includes review of all CDBG clients. Finally, a monthly CDBG report is generated as required as well as a final year-end report. 3 6.. 'Br.iefly.tlescribe yaur'agency's.internal controls to minimize op.p .t t.ies,far fraud, waste; and mismanagement . Meals-on-Wheels Greater San Diego conducts monthly fiscal reconciliations and reviews as well as an annual independent audit. In addition, client and meal statistics are reviewed monthly by both Service Center as well as Executive staff.This includes review of all CDBG clients. Finally, a monthly CDBG report is generated as required as well as a final year-end report. 3 7 Flow does your agency plart;;to segregate CDBG funds frotri otfier agency funds for purposes of rrlentrficat.ion, cracking, arnd�reportng� [CDBG funds are assigned a unique identifier delineating source and type.Thus, City of Chula Vista CDBG funds are tracked separately from those from Vista or El Cajon, and from non-public funding sources.This assures that we are able to produce accurate accounting of these funds Page g of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) 4.1. . Briefly highlight.yaur agency s experience.`and mciior accompl5hrnents rn providing services to LMt residents and/or; communities .:.You may expand in,4ppendixA Meals-on-Wheels Greater San Diego has been home-delivering meals to seniors since 1960. In that time, we have delivered almost 17 million meals to seniors who might otherwise have gone hungry. We have grown from an organization that served only a portion of the City of San Diego, to an organization that delivers meals throughout the entire City as well as the County—reaching more than 950 seniors a day—even in remote, rural areas. Over the past 10 years,we have received CDBG funding from 11 cities in the County, helping to reach thousands of additional seniors. We deliver meals for every day of the week, including Holidays, something no other meal delivery agency does, and we not only provide a meal, but our more than 2,600 specially trained volunteers provide the social contact and warm smile that many of our homebound seniors need to remain independent in their homes and age with dignity. Though Meals-on-Wheels Greater San Diego is a local, independent non-profit,we do belong to the Meals On Wheels Association of America (MOWAA) and are accredited by them. Meals-on-Wheels Greater San Diego is regarded as one of the top Meals on Wheels organizations in the country and is accredited by the MOWAA at the highest level,a level awarded to only a handful of Meals on Wheels organizations. In the past four years some of our signature accomplishments include annually increasing the number of seniors we serve and meals we deliver,creating a Healthy Latino Menu to better serve our Latino seniors, and the increased use of farm-and ocean-to-table produce in the preparation of our Meals. Our remodeled our Meal Center, where our meals are prepared and individually packaged for delivery, includes a full commercial kitchen, now produces, on average, 900 meals a day. 4 2 Has y6ur agency received CDBG or other federalfund in,any 6fthe past"three fiscal years (Fiscal Years..2011 2012,2612 2013,-through 2.013 2Q14J?!f yes,"complete"Appendix G for ® "Yes ❑ No each of the grants received for,the;"three Fiscal Years 2(111,2012, areal 2013.: Section 5: Back-Up Plan (Max Score: 5 Points;) 5 1 MI..your agencystrll implement this protect should CDBG funds not"be awarded?!f yes, how ® Ys No will the":implementation be:achieveda Meals-on-Wheels Greater San Diego is dedicated to serving San Diego's seniors,yet our ability to serve additional seniors is limited by the funds that we can raise to support our daily home-delivered meals. If these funds are not awarded,we will continue to make every effort to raise the funds we need to continue to support our current level of service. However, City of Chula Vista CDBG funds will help us expand our services more quickly as we continue to grow our other sources. 5 2 " iffunded,ho.w will your agency continuethrs protect if CDBG funds are not available rn future years? Meals-on-Wheels has a robust development department that conducts ongoing fundraising efforts through donations, grants, our annual Gala, and planned giving. We work hard to use a funding opportunity to leverage additional funds that continue to support our ability to deliver daily meals to seniors. Page 9 of 9 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix A: Narrative of Project (Max Length: 2 Pages) In two pages:or less,explain beCd vyour proposed project and make the case w�iy it should be award d fun jng Meals-on-Wheels Greater San Diego plays a unique role in the fabric of services that support low- moderate income seniors' ability to age in place with dignity and receive the daily nutrition they need. In particular, we serve seniors age who are homebound and typically have very limited ability to prepare meals for themselves. There are no other guidelines—no need to have a particular disease or disability, just a need for daily meals. Without Meals-on-Wheels' service many seniors would not eat regular or nutritious meals. We are the only agency that home delivers prepared meals to seniors for all seven days of the week,year round, including Holidays,throughout the City of Chula Vista as well as the County. Let us tell you about our clients--including those living in Chula Vista. Fifty-seven percent are women, 43% men. The average age is 82 and 45% of our clients are over 85, the fastest growing age demographic of those we serve. Currently, we have a client who is 110! We not only serve increasing numbers of seniors, we are serving them for a longer time. The majority of our clients live alone, frequently isolated and lonely. Ninety percent are low to moderate income, often living on fixed incomes that do not keep up with the cost of living. Many fall into a service gap, too much money to qualify for free services, but too little to meet their basic needs often forcing them to make difficult decisions between food and other necessities such as medications and rent. In the City of Chula Vista alone, an average 300 Meals-on-Wheels volunteers deliver along 14 weekday and 5 weekend routes. In 2013, we delivered 36.170 meals to 200 unduplicated Chula Vista clients—a 9° increase over last year. This is a vulnerable population who need our support to help them age in place with dignity. There is a tremendous need for home-delivered meals for seniors. AARP, Feeding America and Meals On Wheels Association of America all agree that 1 in 6 seniors in"face the threat of hunger"; the majority have incomes over the poverty line. There are an estimated 24,376 seniors age 62 and over in the City of Chula Vista. Of those, almost 6,492 are age 80 or older (SANDAG). By 2030, a projected 1 in 5 citizens will be 65 and over. Simple math tells us that there are a potential 3,400 seniors at risk of hunger in the City of Chula Vista. While there are services that provide meals or boxes of food if you have the mobility or means to reach a meal center, or distribution center, there are few that home-deliver pre-prepared meals to seniors city-wide, and none, other than Meals-on-Wheels Greater San Diego, that regularly delivers up to two meals a day for every day of the week, including Holidays. When seniors have poor nutrition they can suffer from poor health, poor recovery from illness or injury, decreased mental status, and decreased ability to care for themselves in their residence (Journal of Nutrition 2001: Nutritional and Health Consequences Are Associated with Food Insecurity among U.S. Elderly Persons Jung Sun Lee and Edward A. Frongillo, Jr.) In addition, many seniors who are homebound suffer from isolation, lack of contact with others and depression. If they are injured or ill, no one may be aware of it until the senior needs immediate hospitalization or they have died. Meals-on-Wheels is not alone in providing meals for seniors in the City of Chula Vista. However, each agency/program is different in what they provide, how often they provide it, and how many seniors they serve. Some have a congregate site where seniors can come for meals, others distribute emergency meals and food, some have income guidelines, and others don't. The reality is that we are all critical to supporting seniors, each in our own way--the need is simply greater than the services available. Appendix"A"–Narrative Page 1 of 2 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION What do we do? Meals-on-Wheels, as noted earlier, delivers up to two meals a day for every day of the week, including Holidays, with Sunday's meals delivered on Saturday. Meals are pre-prepared so our seniors don't have to cook or prepare any food. All of our meals and menus are developed to the senior nutrition guidelines issued by the USDA. All of our meals are reduced sodium, reduced fat, and reduced sodium, making them heart and diabetic friendly. They also come in an easy chew option. Lunches come prepared fresh each day and dinners are prepared and delivered either frozen or preheated, as the client wishes. We offer substantial variety in our meals so that seniors are not eating the same meals over and over and are introduced to new items on a regular basis. This assures that we are meeting both the needs and the varying tastes and preferences of our seniors.We fail in our job if a meal goes uneaten. Last year we developed our Healthy Latino Menu in conjunction with two local chefs.We are pleased to be in the process of piloting the meals on two of our Chula Vista routes and it is our hope to roll out the menu to all clients in 2014. Our Meal Center, where meals are prepared and packaged for delivery, has a full commercial kitchen which allows us to prepare most meal items in-house. We are dedicated to using fresh, local ingredients whenever possible, providing our seniors with fresh vegetables, fruit and salads, as well as locally caught fish. Since our volunteer delivering the meals may be the only person a senior sees all day, our daily contact also provides a safety net for our senior clients. Our Meals-on-Wheels volunteers are specially trained not only deliver a friendly greeting and smile along with the meal, but to conduct a wellness check—looking for signs of changes in health or mental status (including depression), or conditions in the house, that may indicate that a senior is in need of additional services. if additional services are needed, Meals-on-Wheels makes the appropriate referrals. Volunteers are also trained in how to deal with emergencies, for example if a client has fallen, calling 911 and staying with the client until help arrives. Meals-on-Wheels also provides clients with the added extra touches that make a difference in their lives. Partnering with the Helen Woodward Center, through our AniMeals program, we deliver dog and cat food to our seniors who have these pets so that their beloved companions are assured meals as well. For Birthdays, Holidays and other special occasions, or when a client needs a little extra attention,we deliver a We Care package, a gift bag with various sundries and other non-food items. These gift bags for our clients are donated by volunteers. How do we sustain our services? We are a local, independent non-profit and, aside from CDBG funds, do not receive any federal or state funding. We subsidize every meal we deliver and depend primarily on private donations and grants to make this possible. For a lunch and dinner (including sides and beverage) our direct cost is approximately $14.20 yet we ask our client to pay the low fee of only $7.00 for both meals and, if they are unable to pay, we lower their fee. Similar organizations, such as Senior Community Centers also ask a similar fee but, because they receive Federal funding, may offer more reduced-fees or free meals to very-low income seniors. The funding we receive through CDBG helps us to expand our services to more clients as well as to reduce feesfor clients who cannot afford to pay the$7. Chula Vista can be proud of Meals-on-Wheels Greater San Diego. Regarded as one of the top Meals on Wheels in the country, we have received the highest level of accreditation from MOWAA, which only a handful of Meals on Wheels have been awarded. We are honored to serve the seniors of Chula Vista and if awarded a grant through the CDBG program, we will steward it with the greatest care to assure that the City's seniors receive the meals they need to remain independent and live with dignity. Appendix"A"—Narrative Page 2 of 2 (Revised 121412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM MEALS-ON-WHEELS GREATER SAN DIEGO FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step(1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step (3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista(Step 1) $12,000 3.46% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOP WA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds 0.00% Private Funds 0.00% Agency Funds $334,920 96.54% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTAL $0 $346,920 100% TOTAL PROJECT BUDGET $346,920 APPENDIX C-2: THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM MEALS-ON-WHEELS GREATER SAN DIEGO FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three(3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes. Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements. FY 2012 CY Page# 7 Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 29,208 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 116,832 List the amount of FY 2014-2015 CDBG funding applied for this application. 12,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. - List the amount of FY 2014-2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 12,000 Compare Agency Cash Balance Available(Item A)with Total FY 201.4-2015 CDBG Funding Request(Item B): Item Al116,832 Item B 12,000 Difference 104,832 Analyze Results I- If difference is a positive amount or equals $0,the Agency is eligible to apply. 2- If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance, as long as: A)EACH PROJECT MEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATIONS, AND B)CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX C-3: PUBLIC SERVICE SCHEDULE 1 - BUDGET EXHIBIT AGENCY Meals-on-Wheels Greater San Diego, Inc. i i PROJECT Meals-on-Wheels Chula Vista CDBG Percentage SALARIES &WAGES (Schedule 2) 0 FRINGE BENEFITS (Schedule 3) 0 TOTAL PERSONNEL 0 SUPPLIES (Schedule 5) POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPECIFY): Food &Packing (Schedule 5) 12,000 (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 12,000 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD (IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 12,000 Page 1 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2 -PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct project/client services. Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO) line item. The Total CDBG Salary &Wages must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Meals-on-Wheels Greater San Diego, Inc. PROJECT Meals-on-Wheels Chula Vista (1) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES NOT APPLICABLE TOTAL CDBG SALARY&WAGES 11. Liositions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule_(Check One) Monthly Biweekly Twice a Month Page 2 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3 -PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Meals-on-Wheels Greater San Diego,Inc. PROJECT Meals-on-Whects Chula Vista (1) (2) (3) (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT NOT APPLICABLE - TOTAL CDBG FRINGE BENEFIT - 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4. Use gross pay for project/total all wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule (Check One) Monthly Biweekly Twice a Month Page 3 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD (IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Meals-on-Wheels Greater San Diego,Inc. PROJECT Meals-on-Wheels Chula Vista (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD NOT APPLICABLE - TOTAL CDBG INDIRECT COST/ADMINISTRATWE OVERHEAD - (5) Total CDBG Budget 12,000 Percentage 0.00% (Must be equal or less than 15%) - _ ............ - 1.Leis at ll personnel or nonpersonnel(NPE) charged against CDBG funding-include detailed description of indirect use. 2. List total Agency budget for positon and/or NPE line item. 3. List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5 Enter the Total FY13 CDBG Budget; percentage will be AUTOMATICALLY calculated. Pqy Schedule Check One Monthly Biweekly Twice a Month Page 4 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET J[JSTIFICATION* AGENCY Meals-on-Wheels Greater San Diego, Inc. PROJECT Meals-on-Wheels Chula Vista LINE ITEM Other Expenses:Food&Packaging AMOUNT Detailed Explanation: Food for meals(protein,vegetables,fruit, beverages, etc.)and 12,000 containers (boxes,plastic container cups,plastic wrap, etc.)for individually packaging meals for each client prior to delivery. Estimated @$3.56/meal unit. Meal unit consists of a lunch, dinner and accompanying beverage and sides) TOTAL $ 12,000 LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - *All line items must bejustified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 5 of 5 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix De Implementation (Max Length; 1 Page; Max Score; S Points) Provide a listing beIoui of the specilfrc tasks or activities needed to-mplernent the proposed project and a theline for their.tompletron Number each task or activity,describe it, andgive the projected date of completion Add additional rows as needed Meals bA Wheels Greater.San Diego,'Inc # Task/Activity Description Completion ; <, Date 1,1E :Recruit clients for the program Conduct outreach and other activities for the 106/30/2015 purpose of recruiting clients.Ongoing throughout the project. 71— lEnroll clients in the program Complete intake and other forms to assure that 1,06/30/2015 client is correctly enrolled in the program.Ongoing throughout the project. 'I 1,3 j ;Prepare meals j All meals will be prepared and individually packaged 106/30/2015 for delivery to the client.Ongoing throughout the project. 1, i4 ;Deliver meals ' (Meals will be delivered to the client on a daily basis (06/30/2015 with Sunday's meals delivered on Saturday.Ongoing throughout the project. 1, �5jConduct Wellness Check 1, Wellness checks will be conducted for all clients at 06/30/2015 the time of each meal delivery.Ongoing throughout the project. 1,6 lComplete and submit reports Reports will be created and submitted on a monthly 106/30/2015 basis or as required. Ongoing throughout the project. 7 ,Submit invoices and process payments j (Invoices will be prepared and payments processed 06/30/2015 as required by CDBG. Ongoing throughout the project. 8 1, (Project Completion :Final report and invoices have been submitted and 1,06/30/2015 all CDBG funding payments received. I I i 1, ! i I i 1 Appendix"D"–Implementation Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix E: foster of Bard Members & Professions Provlde a roster of the members ofyour agency's Board of Drrectors arzd,thelr professions by filling out the;table below: eas-on7W. .. eeEi Greatear'Saia Diiego,Inc Member Resides in of Target Name%Board Position ProfessYori/Affiliation rarger ,Populatio Areae Lauren Abrams j Retired Healthcare Professional ; ❑ ❑, jDaralyne Baddour:Audit Committee Chair ;CPA Ryan Belmer: Secretary i !First VP Investments,UBS Financial Service ❑ Clara Browning-Baity Retired Registered Dietician ❑ Stephanie Dathe Event Planner, Compass 1❑ ❑ (Tyson Dethloff Vice President,Allenbrooke Ins.Services j ;❑ ❑ Gary Gramling iPresident, Gramling Construction ❑ ❑ jGail Ives Sr,.Vice President, Union Bank j❑ ❑ Jason Levin: Finance Committee Chair Founder&President,Dos Gringos ) ❑ Noah Katsell: Board Chair Partner,DLA Piper 1❑; E) Kevin McMahon Vice President/CFO McMahon Steel ❑ ❑ Eric Pannese VP Product Management,Kyriba ❑', I❑I Peter Pavao Technical Analyst Manager,SDG&E ❑ ❑ Kristi Pieper-Rossbacher: Board Dev.Chair jProperty Manager, Five K Family Trust ; I❑ Nanci Porter I iconsultant Diana Ramirez ! Marketing Brand Manager,AMN Healthcare ❑ I❑ Joan Richardson ; ;Owner, Richardson Insurance Agency ❑ ❑ �om Rodriguez ' General Manager,The Men's Wearhouse []. Maria Stanley Philanthropist I j❑ I❑ (Hon. Margie G.Woods ,San Diego Superior Court Judge IF ❑ Appendix"E"—Roster of Board Members and Professions Page 1 of 1 (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix F: Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests, payments, and campaign contributions must be filed.The following information must be disclosed: 1. List the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e.g.,owner,applicant,contractor,subcontractor, material supplier). Meals-on-Wheels Greater San Diego, Inc. 2. If any person* identified in section 1 above is a corporation or partnership,list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership) entity. Not applicable. 3. If any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee, beneficiary and trustor of the trust. Debbie Case, President&CEO 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. (Debbie Case, President&CEO;Jane Howell, Development Manager 5. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official**of the City of Chula Vista as it relates to this contract, project or application within the past 12 months?Yes :❑1No® If yes,briefly describe the nature of the financial interest the official may have in this contract. !Not applicable. 5. Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than $250 within the past twelve(12) months to a current member of the Chula Vista City Council? No'❑Yes® If yes,which Council member(s)? Not applicable.'1 7. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value, money to retire a legal debt,gift, loan,etc.)Yes;❑=No® If Yes, list official and what was the nature of item provided? E ot applicable.; 8. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of income of$500 or more to an official** of the City of Chula Vista in the past twelve(12)months?Yes[] 'No® If Yes, identify the official and the nature of the income provided? Not applicable. 'December 23, 2013 .Debbie Case, President&CEO', Signature: * Person is defined as:any individual,firm,co-partnership,joint venture,ass ciation,social club,fraternal organization,corporation, estate,trust,receiver,syndicate,any other county,city,municipality,district,or other political subdivision,or any other group or combination acting as a unit. ** official includes,but is not limited to: Mayor,Council member, Planning Commissioner, Member of a board,commission,or committee of the City,and City employees or staff members. Appendix"F"v Disclosure Statement Page 1 of 1 (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identification of Prior Year C®BG and/®r Federal Funds G.1. 'Agency. I EMeals-on-Wheels Greater San Diego, Inc. G 2 iTroject name: Meals-on-Wheels Chula Vista G 3 - Year of funding: ❑ Fiscal Year 2011 ❑ Fiscal Year 2012 1 ZI Fiscal Year 2013 ndicate.the source of the federal funding'awarded to the prior project: ® CDBG ❑ HOPWA ❑ ESG ❑ HOME ❑ CDBG-R ❑ HPRP ❑ IVSP ❑ Other(rndicateberow); i I G.5.. Amount awarded. ',$12,000 G 6 Arnount;spent to date: ' $6,000 G7. 'Amount reprogrammed to date: G:S:-' Indicate below the outcomes anticrpated.(rgferto the`original applrcatron.for the project,:'if possible): (Meals-on-Wheels Chula Vista will deliver two meals and a beverage, for seven days a week,to approximately 210 (1), Chula Vista seniors during the 2014-15 funding period. (2): Meals-on-Wheels will subsidize meals for 100%of low to moderate income seniors in the City of Chula Vista. (3) [Meals-on-Wheels will continue to accommodate Chula Vista seniors 62 and over who seek our services. G.9. Indicate bel6w the outcomes achieved.. . : To date we have delivered meals to 100 unduplicated Chula Vista clients (2j' [To date, we have subsidized meals for all 100 (100%) unduplicated Chula Vista clients (3). To date, we continue to accommodate Chula Vista seniors 62 and over who seek our services G.10: !f any anticipated outcomes were NOT achieved, specify which ones'and exp in below. ,[Type response here.] Page 1 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION G 1 Agency name: Meals-on-Wheels Greater San Diego, Inc. G 2 Proiect name: Meals-on-Wheels Chula Vista G 3 ='Year.of funding ❑ Fiscal Year 2011 ® Fiscal Year 2012 ❑ Fiscal Year 2013 G 4 7n icate the`source:6f the federal funding awarded toahe prior project. ® CDBG ❑ HOPWA IEF ESG ❑ HOME 10 CDBG-R ❑ HPRP ❑ NSP ❑ other(lndimtebel..): 11EE G 5 Amount a+niarded: 1$12,000 G.6.. Amount to date.`'; ($12,000 G 7. 'Amount reprogrammed to date:. G.8..`lridicate..:belaw the outcomes ant cipated'(refb.er the original application for the project;:if possibleJ:. Meals-on-Wheels Chula Vista will deliver two meals and a beverage,for seven days a week,to approximately 210 (1J Chula Vista seniors during the 2012-2013 funding period. (2): 'Meals-on-Wheels will subsidize meals for 100%of low to moderate income seniors in the City of Chula Vista. (Meals-on-Wheels will continue to accommodate Chula Vista seniors 60 and over who seek our services. G.9. '1hdicate.below the autcomes.achieved:. fIj.. EWe delivered meals to 219 unduplicated Chula Vista clients (2). ilWe subsidized meals for all 100%of the 219 Chula Vista clients (3).`: ! e continued to accommodate Chula Vista seniors 60 and over who seek our services AID. If any anticipated outcomes were NOT achieved,specify,which ones and explain vs hy:below :[Type response herG.] Page 2 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G.1. Agenmy name: Meals-on-Wheels Greater San Diego, Inc. G.2.':'Project name; I 'Meals-on-Wheels Chula Vista G 3 ':Year,of funding: ® Fiscal Year 2011 ❑ Fiscal Year 2012 ❑ Fiscal Year 2013 G 4. <'lndicate the,:soerrce`of the:federal funding awarded to the,prior project: ® CDBG ❑] HOPWA ❑ ESG ❑' HOME CDBG-R ❑ HPRP ❑ NSP ❑' other(fnyicwe below): G.5..'::Amount aW''arded ;$12,000 G.'6 A' ount:spent:to date' $12,000 F G.7. Amount reprogrammed to.'date: $0 G.8...'Indicate below the outcomes anticlpated:(refer:to the original applrtation:`for the:'project,`{if possible) (1) ;Meals-on-Wheels Chula Vista will deliver up to two meals a day to an estimated 205 Chula Vista Senios W ;Meals-on-Wheels will subsidize meals for 100%of low to moderate income seniors in the City of Chula Vista. ;Meals-on-Wheels will continue to accommodate all Chula Vista seniors 60 and over who seek our services (looking (3J to increase the number of clients we serve in the area). j G:9: Indicate beiolti the outcomes achieved: (s) Meals-on-Wheels Chula Vista deliver up to two meals a day to 219 Chula Vista Seniors (2J: ',Meals-on-Wheels will subsidize meals for 100%of low to moderate income seniors in the City of Chula Vista. ,Meals-on-Wheels will continued to accommodate all Chula Vista seniors 60 and over who seek our services. G.10. If any'anticrpated.`outcomes were NOT achieved,specify which ones:and,eXplain >ti>,y below: :[Type response herG.] Page 3 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CABG FUNDING APPLICATION (Max Length per Project: 1 Page) G 1 (Agency name: G.2. ""Project name: I.G,.,3:;. ,Year,af funding "s ❑ Fiscal Year 2010 E Fiscal Year 2011 Fiscal Year 2012 G.*." ';Indicate the source of the federal funding.awarded to the prior project " [� CD—BG iQ HOPWA Q'', ESG HOME. ❑I' CDBG-R !Q HPRP Q''..... NSP �.. Otherllndkatebelowl: G.5. >Amount awarded G. Amountspent'to date:. Amount reprograrnmed"to date G.S. . Indicate below the outcomes anticipated'(refer_to the'orrginal application forthe.`praject,;if possible) 11) , f2) 6.9, Indicate below the:'outcomes::ach eved ._.. 11) ' lZ) (3) G:10.',!f any anticipate d outcomes were NOT achieved, specify which ones;and explain'why tielow.: [T'ype response herG.] Page 4 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) I .G.1. ''Ageircy name ' G.2. Pra1ect naive: i I G 3. Year of funding E] fiscal Year 20.10 � Fiscal Year 2011 [� Fiscal Year 2D12 G.4. ,1ndk6te the'sourc0 of the federal funding awarded to the prior project ,Q CDBG C]I HOPWA �' ESG Q' HOME ❑j CDBG-R HPRP 0 NSP Q' other(Indicate berow}: ount awarded: G 6 Amount spent to date: G 7 Amount reprogrammed to'.date -' G S : Indicate.below the`outcomes anticippted(refer to the original appl cation: or the project,'if possible] (2)' (3)is G.9: Indicate below the outcomes achieved W 42).: (3J G.10. tf any anticipated outcomes were"NOT achieved,specify which ones and explairr why below '[Type response herG.] Page 5 of 5--Supplement to Appendix E Application No. 2 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Interfaith Shelter Network of San Diego . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Rotational Shelter Network Project Descr'lp'tioh: The''pro'Ject will provide seasonal, higbt-tim6 emergency shel'ter' to, homeless low-to-mod,6ra' te income, families' ,and individuals and services toyassist'moving individuals and families towards transitional orpormanent housing. Shelter gpests'are referred tosub'-contracted social service agencies for"' intake, screening, and on,-going, case management and then vouthered' into facilities at, churtkes and �synagogues for shelter, meals and support I Type of Program/Project: Public Services [(§570.201(e)] Target Population:' 03C-,'Ho' m'61ess, Proposed Number 30 F6cilities to Serve: (subject to chonge depending,on funding &R§ 510.208(a)(2) Low rec6mmenddtibn): Mod erate Income, Lim' ited Clientele Program Total Budget: $336,645 C. V. Cost per Client: $366 (Based on funding recommendation) Funding Reiqu6st: $11,104o, Prior Year,Fundin,g: $111,000, Specific Use of Chula Vista Personnel Costs FUNDING $10,000 Funding: ($8,600) and Consultant RECOMENDED Services ($2,400) Staff Notes-. , COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fiscal Year 2014-2015 HUbl k"SIA Application Number: Project category ® Public service (CDBG Program Office Use Only) (check oneoniy) ❑I Capital improvement Applicant Agency Information A;bplicarit legal`name Interfaith Shelter Network of San Diego Type of agency ® 501(c)(3) J 101 Gov't./Public j❑ For Profit ® Faith-Based ❑ Other: Agencymdres ..- 3530 Camino Del Rio N Suite 301 San Diego CA 92108 Date of rrcorporatron"' /24/1970 Tax 1D number":` 95-2630300 Agency.DUNS number ` 964841621 Annual operatingbudgef:; $566,860 Number of pard staff= 7 Number of volunteers ': 4400 gencymrssion s aement At t iv CQUordinate the efforts of participati�1g congregations, social service agencies,and governental programs in order til provide shelter and other resources to homeless individuals and families and enable those we serve to move toward self-sufficiency while respecting their dignity as children of God. Project Title: Rotational Shelter Program Brief project"description:' The project will provide seasonal night-time emergency shelter to homeless low-to-moderate"income families and individuals and services to assist moving individuals and families towards transitional or permanent housing.Shelter guests are referred to sub-contracted social service agencies for intake,screening, and on-going case management, and then vouchered into facilities at area churches and synagogues for shelter, meals and support. Funding Request Total funding requested in this application Other funds already secured far 11,000 {191,654 (yau wdl provide a detailed budget rn Appendix C protect: Total cost to complete protect 336,645 Other funds not yet secured for'. 144,991 Project Information Public Service will se.rvice;be sites ecl rca f .r p f' !f your answer is yes,"please provide "Add ress(esJ,below Census tract IE Target C1lentele (Homeless, Youth, lHomeless men,women and children, including families and couples without Elderly, Disabled,""other/General) children. Thefollowing questions on individual clients and households to be,served apply only to public 5ervrce,"and Minor Residentral Rehabjlrtatron projects 4Wthe"protect r seve individual clients(1C),or;households (FIHJ? ® Individual clients E] Households Total ur?duplrcatel lC/HH served 30 Annual cost per client/household $367.00/client Page 1 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Project Details (Max Score: 25 Pints) 1 1 Provide a concise description of the proposed project(this description must"match the one provided an the cover page) Space for,a fuller narrative is pr„ovrded in Appendix A he project will provide seasonal, night-time emergency shelter to homeless low-to-moderate income families and individuals and services to assist moving individuals and families towards transitional or permanent housing.Shelter guests are referred to sub-contracted social service agencies for intake,screening, and on-going case management, and then vouchered into facilities at area churches and synagogues for shelter, meals and support. Project start date 7/1/2014 Anticipated end date 6/30/2015 i 1.3.': Project's days/hours,of operation. 1'I IM-F 8:30--5:00 for office.Shelters operate 5:30 p.m.—7:00 a.m. Dec-April 14: Project ®�Public service ;1 5 Project ® Suitable living environment category objective �E] Decent housing ❑ (check'one only}. Capital improvement (check oneoniyJ ❑ Economic opportunity 1 6 ,Project ® Availability/access!bilIty -outcome ❑ Affordability (heckIF Sustainability i.7.` CDBG Criteria, Which CDBG criterion below does your proposed project meeta (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income (LMI). ❑ Please provide a map identifying the Census Tracts designated as LMI. ® (2) Limited clientele(select subpart below): ® (a) Special needs group (select benefit group from the list below): F I (i) Abused children ❑� (ii) Elderly persons 62 years or older EJ (iii) Battered spouses ❑ (iv) Severely disabled adults (not children)--Census definition;documentation required El (v) Illiterate adults ❑ (vi) Persons living with HIV/AIDS ❑ (vii) Migrant farm workers ® (viii)Homeless persons ❑ (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? ❑ (3) Housing(select subpart below): ❑ (a) Single family(must be 100°o LMI) ❑ (b) Multi-unit(must be 51%LM!) J.&.. The 2010 2015 Consohclated Plarj goals.are listed below. Select the goal appropriate to your project Affordable Renta!Housing Opportunities ❑ Maintenance and Preservation of Housing(rehabilitation activities) ❑ Homeownership Opportunities (homebuyer programs) ❑ Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 1.10 to 1.15: 2 Pages) 1 10. Explain how the proposed'protectaddresses the.ggal selected; The Interfaith Shelter Network (ISN) Rotational Shelter program provides up to 12 shelter beds in the City(84 extra shelter beds county-wide) for up to seven (7) months during cold-weather season,from December through March or April,without building new shelters or hiring staff. ISN provides training and technical assistance to the 10+ congregations that provide shelter, meals and support using volunteers and the 1-2 case management agencies that provide the screening and follow through to the Network's shelter guests. ISN staff coordinates the efforts of participating congregations, social services agencies and governmental programs,to provide shelter and food, case management and the supportive services needed to move toward self-sufficiency to homeless low to moderate income families and individuals.The program has received national recognition as a cost effective and innovative public-private partnership. 1 11 Summarize 6nystatrstics and othersupportriig documentation that demonstrate the importance of addressing this need or prob:Ietn. , Statistics from the Regional Task f=orce on the Homeless point-in-time count tell us that at least 8,879 people are homeless throughout the San Diego Region,with an enumerated homeless population in the City of Chula Vista of 495, 301 unsheltered in the City.The point-in-time count offers a "snapshot" of homelessness on a single night only and includes estimates of the number of homeless persons within particular subpopulations,such as persons who are chronically homeless, severely mentally ill,substance users,veterans, and unaccompanied homeless youth. Based on the point-in-time count,only 39%of the City's homeless population will be housed in a given night in temporary shelters or transitional housing programs. Hundreds of homeless persons throughout San Diego County Region are unable to secure shelter each night which leads to higher rates of physical and mental health problems that city facilities and programs must deal with, as well as enforcement issues for area police and over-utilization of area hospital emergency rooms. 1 12 List each service provided by the protect For each service, indicate whether it is a new service or an expansion'of.an existing service �his project shall provide emergency night-time shelter at various locations, utilizing congregational facilities located throughout the South Bay.A cumulative total of 1,000 bed nights of shelter(1 person in a shelter for 1 night equals 1 bed night) shall be provided to clients. Showers and other support shall also be provided to clients. In addition, case management services shall be provided,which consists of: 1) intake screeningprocess; 2) establishing and evaluating client case plans that are designed to move them into a more permanent housing situation; 3) providing assistance to clients with obtaining permanent ortransitional housing; and 4)assistance with obtaining employment and public cash benefits(i.e.CalWORKS,Supplemental Social Security income).Workshops in career planning and fiscal budgeting shall be conducted for the clients. Project services shall be provided to 30-40 unduplicated homeless persons. Each client served shall be provided with up to 8 weeks of nightly shelter,as determined by progress on a mutually agreed case plan. Case management services are provided to clients weekly. Subcontracted social service agencies shall provide intake screenings and then refer clients to the shelter sites.Shelters are staffed by volunteers who provide meals, shelter set-up, conduct workshops, and serve as overnight hosts. Case Managers from subcontracted social services agencies and community organizations shall provide clients with transportation, public assistance appointments, help obtaining identification cards and birth certificates. In addition,the subcontracted agencies shall provide follow-up case management to clients beyond the required eight-week stay. Additionally,the Rotational Shelter Coordinator works with area congregations to coordinate client meals (at least one hot meal, continental breakfast and a sack lunch) beyond the City's funding as in-kind services. As these services are provided seasonally, operating December through March or April,they are considered new access to services not otherwise provided. Page 3 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 1 13: How does your agency plan to tel!the tgget population about the project/services?„ )Interfaith Shelter Network coordinates with 2-1-1 regarding available shelter beds and the appropriate referral methods. Additionally, ISN maintains a web-site that ranks highly under the search terms"homeless" and "San Diego".Also, program staff networks with area social service collaboratives, including the South Bay Homeless Advocacy Coalition, Emergency Resources Group, Regional Continuum of Care Council, Metropolitan Area Providers of Social Services, Regional Task Force on the Homeless,and Alliance for Regional Solutions, as well as the County's Community Action Partnership and Housing and Community Development offices,and uses those networks to let agencies who may receive walk-ins know about the availability of services 1 14> Lrst up to three outcomes of the project(at least ane rs required) For each outcome fisted;provide the dumber:of participants nrha will berie it and;the way data vrll be collected to track or verify the outcome. 25-35 new and unduplicated homeless persons (10 from the City of Chula Vista) shall have access to emergency shelter for up to 8 weeks for the purpose of enhancing their suitable living environment. Data is collected and transmitted by case managers submitting monthly reports to Rotational Shelter coordinator including number of shelter guests who are entered into the program, and their length of stay. Case management reports entered into an automated database for tracking and analysis of performance measures by Network staff. At least 40%of shelter guests will leave the program for more permanent housing(transitional housing, shared housing, re-united with family, or permanent housing). At least 25%of the adults in the shelter will leave with some sort of income (employment or approved benefits). L15 Will the prayed c0llaborat1 with�otherservice providers rn the commurnty�;lf yes, lr'st there and b ® Yi=s �❑ N o . __riefly desc?ibe,' the collaborairan. Interfaith Shelter Network will sub-contract with one to two social service agencies in South Bay to provide intake, screening, referrals and on-going case management.We anticipate them to be South Bay Community Services and METRO Good Neighbor Center.Additionally,five to six agencies outside of the city provide similar services in our collaboration, including Community Resource Center, Encinitas; Interfaith Community Services;Volunteers of America; Crisis House, EI Cajon; Catholic Charities, Social Advocates for Youth (SAY San Diego),and Presbyterian Urban Ministries. ISN also collaborates with up to 10 congregations in the South Bay and an additional 30 in the county to provide shelter sites and volunteer staffing.These are scattered throughout the South Bay area, including Chula Vista, Imperial Beach, National City, South San Diego, and Nestor. Further, ISN works with 2-1-1 San Diego to coordinate information about available shelter beds.Additionally, ISN staff works with the South Bay Homeless Advocacy Coalition, the Regional Continuum of Care Council and the Emergency Resources Group to coordinate region-wide services Page 4 of 9 (Revised.12/4/2013) CITY OF CHULA VISTA FY 2014.-2015 CDBG FUNDING APPLICATION Section 2: Agency Capacity (Max Score: 10 Points) 2 1 Who;;wr!!be the person resports�b7e for the averp!!oversrgh.-.o fthe proposed protecta Name,of personJoe Zilvinskis Trtle of person'' Rotational Shelter Manager/Director of Operations Relevant education MS Systems Management, Navy Drug&Alcohol Counselor Program Telephone number .'- 619-702-5399 Date first&mployed 1 November, 1995 2.2. Who`wrll he`the dlferrate personresponsrble for the overall oversrgftt,of the-proposed protect? Name:'of person risha Brereton Trtl&'of person•; Executive Director Relevant education Frmr CEO, Paradise Valley Hospital Foundation .1 7 Telephone number, 619-702-5399 Date first employed:; 10 ctober, 2013 Wha;;wrll 6ethe person responsible for the day to day,vperatlons acid management of tiie proposed protect? Provide no,more than two mdrviduals Name of person: oe Zilvinskis Trtle:of.person:, Rotational Shelter Manager/Director of Operations Relevant education: IMS Systems Management, Navy Drug&Alcohol Counselor Program Telephone number 619-702-5399 Date frrst`employed: 1 November, 1995 Nameof person any? Roome Title`of p lRotational Shelter Coordinator Relevant;educaton BA Human Services, SD County Public Health Trainer Tel-e ph- 6h... A0,mber 619-702-5399 Date frrsC employed 6 lune, 2012 Who:will be:the person respvnsif le for the finioncra!oversight of the:CDBG'expend►tures and fiscal compkance? Arovtde n..more than two individuals . Name:;of personoe Zilvinskis Trtle:'of person: lRotational Shelter Manager/Director of Operations Relevant education- MS Systems Management, Navy Drug&Alcohol Counselor Program Telephone number, 1619-702-5399 Date first employed 1 November, 1995 Name.of person ` risha Brereton Title;of person,: Executive Director Relevant,educd6 IFrmr CEO, Paradise Valley Hospital Foundation Telephone number: 619-702-5399 Date firsf:employed 11 October, 2013 Page 5 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 t® 2.8: 1 Page) 2 S Lrst the evaluatron;tools your agency plans to employ to"track and monrtor"the progress of the project"" [The Rotational Shelter Manager monitors project progress and is also responsible for submission of regular reports to the funder as well as required annual reports. As clients' intake and case management are subcontracted,those contractors maintain client files on their premises in accordance with their agency policies,which are generally stricter than administrative records.The Rotational Shelter Coordinator tasks subcontractors with the minimum required data collection that should appear in the client files, and includes client demographics, head of household information, household size, income level, race and ethnicity, as well as covered expenses,client progress towards goals,and client prior living situation. Network staff monitors subcontractor compliance through regular interface, Monthly case management reports are entered into an automated database for tracking and analysis of performance measures. 1. Case managers submit monthly reports to Rotational Shelter coordinator including number of shelter guests who are entered into the program,their length of stay, and their outcomes if they leave with a job or income and more permanent housing. 2.Weekly meetings of shelter guests with case manager during which progress toward increased income and more perrnarient<<ousIng is docurrnented. 3. Congregational coordinators report daily to case managers regarding behavior, progress, and challenges they observe while guests are in the shelter. 4. Agency staff communicates regularly with case managers(usually daily) and Congregational Coordinators(usually bi- weekly)and conducts site visits of both agency facilities and shelter sites to track progress and receive feedback from constituents. 2.6.' How'does your agency plan to ensure compliance with applicable policy and procedural requirements(including those Irstecl in HUD`s "Playing b h. Rules"HdhdbootCJ he Rotational Shelter Manager and Coordinator monitor project compliance, including record retention required by 24 CFR 85.42, 24 CFR 570.503 (b)(2), and others listed in the Handbook.The Agency will subcontract with area case ` management agencies to enter and maintain electronic logs,and all applicable services and client demographic data on ServicePoint to provide HUD Annual Progress Report (APR) data on all unduplicated homeless persons complete with demographic, income, disability, and supportive services information as applicable.The Shelter Coordinator and/or the Outreach Coordinator perform site visits to the sub-contracted agencies to ensure record keeping is being done in an accurate and timely manner. 27. Describe any unresolved ADA issues in the project or protect office and hobo your agencyplans t0 address them (If the ob ective o the ro ect rs AD4 rehabrktatron do n'ot repeat the project:description here J " J f.. p 1. No unresolved ADA issues noted. Interfaith Shelter Network offices are ADA compliant. 2.8.' How many'members does your eodrd of Directors have? How many"Board members are also nieinbers of the project's target population or reside in' �2 the "ro ect's target area Indicate which ones. n.A en, r F ' p" j. .. g �.. pp.. Page 6 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) WOW"8rrefly describe your a9e>yty's payrrrentrnd disbursement procedures, with relevance ta;_the proposedprafect, fhe general procedures for financial management are set forth in the Interfaith Shelter Network Accounting and Procurement Policies.The following steps apply specifically to CDBG contracts: Program Coordinator will generate check requests based on expenditures or claims from subcontractors based on contracted activities. Only eligible activities as laid out by the CDBG contract are allowable to be charged to the contract. Back-up documentation, such as a claim or receipts, accompanies the check request.The Coordinator will verify activities have taken place that were claimed, and will ensure the accuracy of the claim, making corrections as needed. Coordinator is also responsible for disbursement of payments to any subcontractors involved. Coordinator also prepares the claim for reimbursement for the CDBG contract payment based on the above expenditures. Claims are submitted based on the schedule set forth in the CDBG contract. The Executive Director will authorize payments based on the submitted check request, checking it for accuracy and eligibility. The Interfaith Shelter Network Director of Operations(DOO) will produce payments and code the charges to the appropriate fiscal activity for the grant program from which the funds are derived.The D00 receives payment from CDBG funders, codes it to the appropriate source, and deposits the funds to the appropriate account. Payroll is submitted to an outside firm,and is based on bi-weekly time sheets,with activity attributed to appropriate cost centers to track billing accuracy of claims. 3 2' Describe how your ogeney s Board of Drectorsexercises programmatic and fiscdl:oversr'ght Regular financial reports are distributed and summarized at monthly board meetings by the Treasurer of the Board. Board President and/or Treasurer is a signatory on both the Federal form 900 and State form 199.The Treasurer is a member of the finance committee,which meets monthly 10 times a year and reviews regular financial reports. Program oversight occurs through monthly reports by the Executive Director at the same monthly board meetings. 3 3 8rrefly describeyour agency's finanaa!reporting system/accounting procedures, with relevance p,t,"i r osed project . �he Interfaith Shelter Network operates on an accrual basis, and uses Quickbooks to track income and expenses for the agency. Separate accounts are set up for CDBG funds within the Chart of Accounts. All check requests pertaining to the project are generated by the Program Coordinator/Manager responsible for the project and tied to the Chart of Accounts. All requests for payment require the approval of the Executive Director to safeguard all such assets and assure they are used solely for authorized purposes. All checks for this project require two signatures regardless of the amount. Financial reports are generated each month and reviewed monthly. Accounting records including cost accounting records,are supported by source documentation. 3,.4 Briefly describe your agency's record keeping system,:with relevance to the proposed pro1ect. �he Program Coordinator maintains the master contract file. Records for all agency expenses and deposits are maintained in a locked cabinet in the finance office. Financial records are maintained electronically with hard copy backup kept according to agency file retention policy in locked filing cabinet. Financial records are maintained for at least 7 years. 3:5 Briefly describe your agency s auditing requirements, including chose for the proposed pragct JPer OMB Circular A-133 (Audits of State, Local Governments, and Nonprofit Organizations), a single audit is not required by the agency. However,the Interfaith Shelter Network of San Diego has a full and complete financial audit conducted Page 7 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION each year by an outside accounting firm. As a public benefit corporation,the ISN is also required to submit a Form 990 to the IRS. Additionally, a Form 199 is prepared and submitted to the State of California. PP f f 3 6 Briefly describe yoar agency s internal , -controls to minimize a ortunrtres or rautl waste, and rrirsmanugement IAII expenses require a check request and a vendor invoice if applicable. The check request must be signed by the requesting staff and approved by the Executive Director before payment is processed by the Director of Operations. All checks over$1,000 require two signatures, and in the case of the Rotational Shelter program, all checks regardless of amount must have two signatures. Credit cards are not used except for one specific to an office supply vendor. Petty Cash requires submission of invoice/receipt, and two signatures on the request(person submitting/person authorizing). There is no bill pay using online banking 3 7 Haw clues your agency plan to segregate C[78G funds from other agency funds for purposes of,identification, tracking, and reporting? I[The interfaith Shelter program uses specific account numbers in the Chart of Accounts to designate CDBG funds. Requests for payment must cite the Chart of Accounts per line item in the approved CDBG budget. Income and expenses that pertain to the CDBG funds are clearly noted on check requests, deposits, and financial reports, and are differentiated from expenses charged to other funders or to Agency funds. Monthly financial reports are prepared by an independently contracted bookkeeper.There is a monthly review of financial reports generated each month by Agency staff, the Executive Director,and a member of the Board, usually the Board Treasurer.11 Page 8 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max length: 1 Page for Section 4/5 Combined) 41 Briefly hrghl ghf your agency's eXperfence and mayor accomplishmentsJ.rn pravrdrng services to LMl residents and/or communities You rrrayeXpand rnAppendrxA 'hroughout its 27 years of providing the above services, the program has sheltered 8,500 homeless people for 218,000 bed nights County-wide using the model above. In the South Bay area, more than 330 homeless people were sheltered for over 13,000 in the last 10 years through this program. Over that time, more than 56% left our program for transitional or permanent housing County-wide. Over that time, more than 58%of the adults left with a job or income to which they were entitled County-wide. 4 2 Has your agency received CDBG or other federal funds in anyof the past three fiscal years (Fiscal Years 2011 2012, 2012 2013, through 2013 2014)?!f yes, complete Appendix G for ® Yes 101 No eachaf the'grants.received for the three Frscal::Years 2011,2012, and 2011 Section 5: Back-Up Pian (Max Score: 5 Points;) 5 1 Will your,agencysfr!!implement this protect should C0BG funds not be awarded if yes, hove wr!!the rrr►plemeritation,be achieved Yes ❑ iVa: lif unable to secure funding to meet the basic operating costs,service levels will decrease commensurate with the level of funding.As the program is County-wide,services that would have been provided in the city may be diminished. how will;"your agency continue this pro�ect'if CnBG funds are-not available in future years? �he Rotational Shelter Program secures financial support from various sources that include the County of San Diego, City of Chula Vista, County ESG, private grants,Cities of San Diego, Oceanside, and San Marcos,foundations, and individual donations to meet operating costs. if funded and future funding to meet the basic operating costs is not available,service levels will decrease commensurate with the level of funding. Depending on the level of support from non-governmental sources,this may mean a decrease in the length or amount of shelter provided in the City of Chula Vista,thus increasing the need for such services throughout the City from other programs. Page 9 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-201.5 CDBG FUNDING APPLICATION Appendix A; Narrative of Project (Max Length: 2 Pages) In two pages or less,exptarn belowyaur proposed pr oJect and make the case why>!tshould be awarded funding IThe Interfaith Shelter Network Rotational Shelter Program is an emergency winter shelter program operated at congregational shelter sites located throughout the urban county from Oceanside to El Cajon to Nestor and Imperial Beach inclusive. It addresses lack of support services,insufficient income,and lack of affordable housing by providing case management,transportation,training in career planning and budgeting,overnight shelter for up to eight weeks,showers,meals,and other essential needs. More than half of those we serve leave for more permanent housing,and more than half of the adults leave with a job or income to which they are entitled. The Rotational Shelter operates in seven areas or branches of the county.In the South Bay,congregations host the program in Chula Vista,Nestor,Imperial Beach, National City and South San Diego. How long the program is open in each branch depends on how many congregations are willing to permit use of their facilities and provide 50-150 volunteers to prepare meals,provide overnight supervision,and complete other tasks as needed. In the past several years,we have consistently served 240-285 county-wide (25-3S in the City of Chula Vista) shelter guests each season,between October and May. Bed nights vary between 6,800 and 8,000 (1,000- 1,400 in the City of Chula Vista),again depending on how many congregational host sites are available. CDBG Funds help provide the staff support,case management services,and shelter guest transportation that allows for the coordination of more than 10 congregations and social service agencies scattered to achieve these results.Experience has shown the program more successful, in that it keeps people in/near their neighborhood of choice where existing support systems may exist. Clients are referred to the program via 2-1-1 or as walk-ins to area agencies.Guests are pre-screened and monitored by local social service agencies with whom we contract. Each week,they must meet with a case manager at the contracted agency for that branch.The case manager decides,based on each guest's progress toward goals, whether or not they will be issued a voucher for an additional weep of shelter.Congregational coordinators,all of whom are volunteers,are strongly encouraged to be in daily contact with each guest's case manager.Guests arrive each evening,are served dinner,provided showers on or off site,and sleep on donated cots or air mattresses. In the morning,they are given breakfast and a sack lunch before leaving for the day.School-age children are expected to remain enrolled and in attendance at the school they were at when the family became homeless.Volunteers also provide career planning and budgeting workshops on alternate Saturday mornings in most branches. Further,each congregation is provided a resource book with information regarding library hours; local community clinic location, services,and hours of operation; and information about major employer/human resource contacts in the San Diego region. Guests may stay in the program for up to eight(8)weeks,with an option to stay longer on a case by case basis. The Rotational Shelter serves a distinctive niche in the continuum of care and is the only Emergency Shelter in Chula Vista.We serve the situationally homeless,those who are willing and able to move toward self-sufficiency within eight weeks.There are very few winter shelter beds available region-wide that provide case management for shelter guests,and there are few shelter beds available for those who are most able to help themselves, especially single men looking for work.It is difficult to verify residency for most of the participants,as they are homeless,and . many do not report their prior zip-code as part of their intake procedures ® For families,there is often a month or Longer wait to be admitted to family programs locally or at the YWCA Cortez Hill program.The Rescue Mission's emergency nighttime shelter does not accept adult men including single Appendix"A"—Narrative Page 1 of 2 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION fathers,fathers with custodial responsibilities,or couples without children.Some families must therefore choose between shelter for the mother and children and staying together. Despite the vagaries of the economy,the Rotational Shelter has been consistent in its positive outcomes for those whom it serves. Now in its 281h season,the shelter,thanks to the work of our case managers and our shelter volunteers,has been able to move the majority of shelter guests into more permanent housing.The majority of the adults served leave with a job or income to which they are entitled. • Rotational Shelter staff,which includes one full-time shelter manager, one full-time shelter coordinator, one outreach coordinator,and the executive director who is also responsible for program development,resource development, and staff supervision of a transitional housing program for homeless battered women and children located in the City of San Diego,have taken leadership roles in the region-wide continuum of care.The Rotational Shelter Manager is chair of the Metropolitan Area Providers of Social Services (MAPSS).The Rotational Shelter Coordinator participates in the region-wide Emergency Resource Group (ERG) and the South Bay Homeless Advocacy Coalition.The ISN Executive Director serves on the Regional Continuum of Care. Our Rotational Shelter Manager/Director of Operations has been in this position for 18 years and has a background in Navy housing administration.Together with the Rotational Shelter Coordinator,who has been with the program for 2 years,the staff schedules,trains,and monitors all participating congregations and case management agencies as well as supervises. The Rotational Shelter Coordinator was a Health Information Specialist with the County of San Diego for 9 years providing on-site disease education for public and private organizations including outreach to specific populations such as homeless service providers,drug and alcohol recovery programs and HIV/AIDS service providers. Additionally,she spent 2 years at the San Diego Rescue Mission Family Crisis Shelter as a Resident Manager.There she coordinated homeless services for women and children in emergency crisis situations providing screening and assistance with intake case management for up 60 residents per night,directing clients to necessary resources or social service provides and documenting activities and incident reports. Our Outreach Coordinator is an AmeriCorps member,and has been with the agency since September 2013. Previously,she was a CalFresh Summer Associate at Feeding America San Diego. Appendix"A"--Narrative Page 2 of 2 (Revised 12/412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all fiends to be made available for the project. There are 3 steps to the completion of this table: Step (1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step (2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step (3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista (Step 1) $11,000 3.27% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds $33,337 $56,215 26.60% San Diego Housing Commission $97,648 29.01% State Funds 0.00% County Funds $25,000 7.43% Local Funds $22,900 6.80% Private Funds $29,876 8.87% Agency Funds $60,669 18.02% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTAL $191,654 $144,991 100% TOTAL PROJECT BUDGET $336,645 APPENDIX C-2: THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three (3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes. I Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements. FY 2012 CY 2012 Page# 3 Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 141,875 A. Multiply Agency Cash Balance by 4 Cash available for project(s) 567,500 List the amount of FY 2014-2015 CDBG funding applied for this application. 11,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. List the amount of FY 2014-2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 11,000 Compare Agency Cash Balance Available(Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item A 567,5001 Item B 11,000 Differencel 556,500 Analyze Results 1-If difference is a positive amount or equals$0,the Agency is eligible to apply. 2-If difference is a negative amount, the Agency has the options below; The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance,as long as: A)EACH PROJECTMEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATISAND B)CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQ. APPENDIX C-3: PUBLIC SERVICE SCHEDULE I -BUDGET EXHIBIT AGENCY Interfaith Shelter Network PROJECT Rotational Shelter Program CDBG Percentage SALARIES &WAGES (Schedule 2) 7,225 FRINGE BENEFITS (Schedule 3) 1,375 TOTAL PERSONNEL 8,600 SUPPLIES (Schedule 5) POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) 2,400 MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES Schedule 5 TELEPHONE (Schedule 5) OTHER EXPENSES (SPECIFY): (Schedule 5) (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 2,400 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD (IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15%of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 11,000 Page 1 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct project/client services.Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO)line item. The Total CDBG Salary&Wages must match the Budget Exhibit farm.Round off totals to whole dollars. AGENCY Interfaith Shelter Network PROJECT Rotational Shelter Program (1) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES Rotational Shelter Manager/Director of Operations 49,345 7.13% 3,520.3 Rotational Shelter Coordinator 37,050 10.00% 3,705.0 TOTAL CDBG SALARY&WAGES 7,225 1.List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 2 of 5 APPENDIX C-3; PUBLIC SERVICE SCHEDULE 3 - PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Interfaith Shelter Network PROJECT Rotational Shelter Program {1} {2) (3) (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Rotational Shelter Manager/DOO Health/Dental 8,040.00 49,345 7.13% 573 Rotational Shelter Manager/DOO Social Security 2,750.00 49,345 7.13% 196 Rotational Shelter Manager/DOO Medicare 1,080.00 49,345 7.13% 77 Rotational Shelter Coordinator Health/Dental 2,150.00 37,050 10.00% 215 Rotational Shelter Coordinator Social Security 2,250.00 37,050 10.00% 225 Rotational Shelter Coordinator Medicare 885.00 37,050 10.00% 89 TOTAL CDBG FRINGE BENEFIT 1,375 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. '2, List Fringe Benefit title FOR EACH POSITION charged to CDBG finds. 3. List the amount of insurance for each position charged against CDBG funds. 4. Use gross pay for project/total al I wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 3 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COSTIADMINISTRATIVE OVERHEAD(IC/AO)CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY Interfaith Shelter Network PROJECT Rotational Shelter Program (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD I i `i TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 11,000 Percentage 0.00% (Must be equal or less than 15%) 1. List all personnel or nonpersonnel(NPE)charged against CDBG funding-include detailed description of indirect use. 2. List total Agency budget for positon and/or NPE line item. 3. List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5. Enter the Total FYI CDBG Budget;percentage will be AUTOMATICALLY calculated. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 4 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Interfaith Shelter Network PROJECT Rotational Shelter Program LINE ITEM Consultant Service AMOUNT Detailed Explanation: Case Management Services 1,200 Client Transportation 1,200 TOTAL $ 2,400 LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 5 of 5 CITY OF CHULAVISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identification of Prior Year CDBG and/or Federal Funds G 1 "°Agency name Interfaith Shelter Network of San Diego G 2 Project Warne Rotational Shelter Program G 3 Year.of funding ® Fiscal Year 2011 I JE]I Fiscal Year 2012 ❑ I Fiscal Year 2013 G 4; . lndreat1.e the'source of fhe fed6b funding awarded t 't he prigr pro1ect ® CDBG �0� HOPWA 'JEJJ ESG ❑ HOME; ❑ CDBG-R JEJ NSP ❑ OthEr(lndicatebelow): .11 Amount d.Warded" 10,350 G 6 Amount spent to d. at e..Id 110,350 G 7.i Amount reprograrrimed to date G:S.'; Indicate below,the outcomes on Jgrpatecl(refer;to the orlglna!applrcatiori"for the profect;if possible) Provide shelter, case management,transportation to 30-40 people total homeless (10 Chula Vista residents), with (1); more than 50%of guests leaving for more permanent housing. (2}' lProvide 16 weeks of shelter utilizing congregational volunteers and facilities. 13J Improve access to case management services with regular follow-up. G.9.': Indicate below the:;;outcones.acHreved Provided shelter, case management,transportation to 30 people total homeless (17 Chula Vista residents),with (1J more than 55%of guests leaving for more permanent housing. (2). Provided 19 weeks of shelter utilizing congregational volunteers and facilities. (3J wo area social service agencies provided case management with weekly follow-up. G:10 !f Qr;y anticipated outcomes were NOT achreveci,specify Uiihich ,ones;and explainvhy below IN/A Page 1 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION G 1 Agency name Interfaith Shelter Network of San Diego G 2" Project name Rotational Shelter Program G 3 Year of funding. ,!� ❑ Fiscal Year 2011 ® Fiscal Year 2012 ❑� Fiscal Year 2023 G 4 Indicate the,source of the federal funding awarded to the pr►or project"" CDBG ❑ HOPWA ❑ ESG ❑ HOME ❑ CDBG-R ❑ HPRP ❑ NSP ❑I other(1nd;catebelow): G 5." Amount awarded 10,350 G 6. pmountspent to date,` 10,350 G.7: ,4mdun' t reprogram med to'cd 0 G:S. lndfcate below the outcomes aiiticrpatec((refer.to the original application`for the project; f possr.'6!e). Provide shelter, case management,transportation to 30-40 people total homeless(10 Chula Vista residents); with more than 50%of guests leaving for more permanent housing. (2),; Provide 16 weeks of shelter utilizing congregational volunteers and facilities. (3J Improve access to case management services with regular follow-up. G.91 indicate belo'ry"the"outcomes achieved " Provided shelter,case management,transportation to 28 people total homeless X22 Chula Vista residents), with (1J; 50%of guests leaving for more permanent housing. (ZJ; Provided 16 weeks of shelter utilizing congregational volunteers and facilities. n area social service agency provided case management with weekly follow-up. 6.10.: ! an ",antici aced outcomes were�NO;T"achieved s ecl f Y p p fy which ones and eXpiatn,why below. �N?A Page 2 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G 1 Agency name Interfaith Shelter Network of San Diego G 2" Prooectndrt�e Rotational Shelter Program G 3.` Yearof funafrng ❑ Fiscal Year 2011 ❑ Fiscal Year 2012 ® Fiscal Year 2013 Indicate the.'sourceof the`federal:fundirg avi!arded.,to'the prior protect ® CDBG ❑ HOPWA ESG ❑ HOME ❑ CDBG-li LJJ HPRP E] NSP I L] other(Indicate berow): G.S." Amount awarded 10,350 G 6. Amount spent'to date: 10,350 Amount repr"ogrammed to date G 8.. Indicate below thebutco''.. anfrcrpated(refer to th"e original application for the:'project rf possible).":::.,:::; Provide shelter, case management,transportation to 25 LMI total homeless people (10 from the City of Chula Vista), with 50%of guests leaving for more permanent housing. (2J Provide 16 weeks of shelter utilizing congregational volunteers and facilities. (3J n area social service agency will provide case management with weekly follow-up. G 9' , Ind cpte below"the;'outcomes achieved. .. .... . . ........................... ... .... ... . Provided shelter,case management,transportation to 35 people total homeless (20 Chula Vista residents),with (1J 85%of guests leaving for more permanent housing. (2J' Provided 18 weeks of shelter utilizing congregational volunteers and facilities. (3),. n area social service agency provided case management with weekly follow-up. 7777777777771 G 10 If ary anticipated outcomes were NOT"achreved,specify which ones and explarri why.below INCA I Page 3 of 5—Supplement to Appendix E Application No. 3 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Lutheran Social,Se''rvices- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Project Hand project roject Detcripildw Project, Hand is''a food pantryin Chula Vi I sta located at $t. Mark's Church, distributing" emergency food supplies to hungry I families, throughout,the South'Bay. Hours of operation are Monday'through, Friday from 9.00'am until 2:40 pm. Type of Program/Project: Public Services [(§570.201(e)] Target Populatloh:' 05W'- Food Banks, Proposed Number; 5,100, to Serve: (subject to change &R§'570''208(a)(2)'Lo' w depending on funding Moderate Income recommendation) Limited Clientele Program Total Budget: $40,800 C. V. Cost per Client: $4 (Based on funding recommendation) Funding Request: $20,400 Prior Year,Funding: $0 Specific Use of Chula Vista Personnel Costs FUNDING $12,200 Funding: RECOMENDED Staff Notes:: COMMUNiTy DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fiscal Year 201442015 UUk VISTA Pro ect cafe o Application Number j 9 rY ® Public service ;case arogrnm offr[e Use only) (che[koneonryi ❑ Capital improvement Applicant Agency Information Appliccrratlegai name. Lutheran Social Services of Southern California (LSSSC),San Diego Area Office I Type of agency': ® 501(c)(3) ❑j Gov't,/Public ❑i Far Profit ® Faith-Based !❑i Other: AgecyAddress. 14271 Clairemont Mesa Blvd. San Diego CA 92117 Date ofincorporado. �4pril8, 1946 j fax1©.number,? 95-2225798 Agency D(lN5 nurr�ber 198953929 Annual operating'biadget: �972,413 1 Number of paid staff.• 11 Number of volunteers: 100 Ageiacy rriissron statement Lutheran Social Services of Southern California celebrates the love of Christ for all people through acts of service. We strive to walk with those in need in Southern California by embracing those in crisis,equipping individuals and families, and empowering them to live with integrity,dignity,and self-sufficiency. Project Title: ;Project Hand Brief Orojct descrlptron Project Mand is one of the oldest food pantries in Chula Vista located at St. Mark's Church,distributing emergency food supplies to hungry families throughout the Southbay. We operate Monday through Friday from 9:00am until 2:00pm. 1 Funding Request Total jFundrrg requested in this apphCation Dfiher funds already Secured for 1$20,400 J x$20,400 (you will providaadetailed budget in append&C: prb;ect, Total cost to`cpmplete Praject: 40,800 Other funds not yet secured for: 0 Project Information 'I pre ct l ` P blit Service evil!service be"site s i iso ,®Yes If your ans+ner is yes,please provide ,Address(esJ below Census Tract St. Mark's Lutheran Church, 580 Hilltop Drive,Chula Vista,CA 91910 Target Glre>?tele (Hotrieless, Youth, ILow income families and individuals who need food without regard to age, race, Elderly, Disabled,"other/General) address or any other discriminating factor. 1 The f01lpW'jng::qtjesVo0.dti individual diems acid households to be"served apply only 46 Publlc service, and Minor Residential Rehabilitation projects. Wil!the roject serve individual ehents"`(IC)orhouseholds o"1 .�T.. lq individual clients ® Households Tata!unduplicated`iQHHserved; 5,100 Annual cost per client/h"ousehold $8.00 Page 1 of 8 (Revised 12/4/2013) cif Y OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Pr®ject-Details (Max Score: 25 Points) 11. ;Provl e a concise description of the proposed project(this deseriptib must match:(he one provided on the cover. page).Space forahiller narrative;'is provided irn Appendix A. Project Hand distributes emergency food to thousands of hungry families in Chula Vista and other Southbay i communities annually. Each client must register with valid identification and complete intake documents. Each client is allowed to visit one time per month, per regulations. However, no one is ever turned away. Project Hand also participates in The Emergency Food Assistance Program,facilitated by the Jacobs&Cushman San Diego Food Bank. For a more complete picture of our mission,vision,operation policies and programs and our vision for moving forward, please see Appendix A of this application. Inventory controls and required reporting is kept current. 12.. .Pr oleetstartdate: i Ongoing program Antrcipa.ted.end`:date: n/a I 1.3. Project's drryrs/hours of operation; Monday through Friday 9:00am—2:00pm 1.4. AraJect Q Public service 1.5 Project ® Suitable living environment category: objective: ❑I Decent housing (check oneonry) ❑Capital improvement icheckorteonly) ❑I Economic opportunity 1.6, Protech :, ❑'� Availability/accessibility outcome: Affordability (ton ® Sustainability 1.7... CDBG Criteria: Which CDBG criterion below does your proposed project rrieet? (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income(LMI). Please provide a map identifying the Census Tracts designated as LMI. I (2) Limited clientele(select subpart below): (a) Special needs group(select benefit group from the list below): ❑', (i) Abused children r (ii) Elderly persons 62 years or older ❑ (iii) Battered spouses i❑ (iv) Severely disabled adults(not children)—Census definition;documentation required ❑1 (v) Illiterate adults (vi) Persons living with HIV/AIDS ❑! (vii) Migrant farm workers ❑' (viii)Homeless persons ® (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics?THROUGH INTAKE RECORDS AND PERSONAL INTERVIEWS AT CHECK IN ❑ (3) Housing(select subpart below): (a) Single family(must be 100%LMI) (b) Multi-unit(must be 51%LMI) A. The 201042015 Consolidated Plart goals are listed below Select the goal appropripte ta,your project: [] Affordable Rental Housing Opportunities ❑ Maintenance and Preservation of Housing(rehabilitation activities) Homeownership Opportunities(homebuyer programs) trtj Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of B (Revised 12141201.0 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max length for Questions 1.10 to 1.15: 2 Pages) 1.10. Explain how'the proposed project addresses the goal selected: We address the goal by providing emergency food through our food pantry, Monday through Friday 9:00am to 2:00pm to low and moderate income families. Summarize anystatlstie. and other supporting documentati.an that demonstrate:the importance of adq'ressirig this need or problem ..: In the City of Chula Vista alone,9.7%of the population lives below the poverty line, according to figures provided by QuickFacts from the U.S. Census Bureau in 2010. That equates to nearly 25,000 Chula Vistans that suffer from hunger anxiety. That does not count the families that live paycheck to paycheck that visit Project Hand. 1 12s List each service provided by the:pro1ect For each servrce; indicate whether it Is-a:ne servrce nr an.expansrgr of an existing servrce Food bag distribution Referrals to other services within the community that our clients can benefit from Distribution of hygiene items, when available Diapers,formula 1.13: How'does your agency plan to tell the.target population about the project/services? [1. Through personal visits to churches, other pantries and agencies in the immediate area. 2. On our website,www.lsssc.org 3. Through additional programs operated by LSS in San Diego area. 4. Word of mouth 1.14. List up to three outcomes of the project(at least one is required): For each outcairie listed, provide the number of participants who will benefit anti'the wary data wVr!!be.collectea'to track or`verrfy;the outcome [1. To distribute emergency food to a minimum of 4,500 unduplicated low income families in Chula Vista. 2. Participate in a weekly Emergency Food Assistance Program through the Jacobs & Cushman San Diego Food Bank serving an additional 600 unduplicated LMI families in Chula Vista and the surrounding communities. 3. Create a minimum of 50 monthly outsourced referrals to meet additional client needs. 1.15. Will the project collaborate With other service providers in the comrriunity 'If yes, list theirs ❑x Yes ❑ No'. and briefly describe,the coYaboratran Yes, we established collaboration with the Jacobs& Cushman San Diego Food Bank, EFAP program that allows us to serve an additional 600 families per month. They deliver 6 palettes of canned food once monthly for us to distribute. We are in the development stages of collaboration with the Third Avenue Charitable Organization (TACO) to provide case management for clients of Project Hand as well of their own clients.] Page 3 of (Revised.121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Slecti®n : A ertc Ca acit (Max Score: 10 Points) 2 1,4, Who uvrll be.:the person resp sible for the averpli 000600flMe proposegl project ome of person: John Taylor .;Trtle of person: rea Director lielevant education BS- Business Administration-SDSU Telephone number:' 858-483-4007 Date;fast ernpiayed ;' 7/1/2011 2 2 Wha irvrlC be.the altr?rnate.person,resparlsrble foe the overall aversrgh;t of the proposed prn1ect? j Name of person : Darlene Mees ; r Trtle trf person dministrative Assistant Relevant education BA-Sociology-Cal State San Bernardino Telephone'number: 858-483-4007 Date first enapiayed: 2/1/1999 2 3 Wha wrll be the person responsible far the day-ta ddy operations on. management of the proposed pro�eet?. Provide no irrore than two'indIVA Uals. Name f person:. Johnny Viloria 71tie,of 046n " Program Manager Relevant education• Prior work related experience(3 years) I TOpp hon number: 619-425-4061 Date first employed 7/1/2010 Name of person: Trtle of person Relevant eduedtion: 7elephane';num ber Date fast employed: 2 4. ,Who will be=the person responsible for the financial oversight of the CDBG expenditures and fiscal campiiance Provide no more than twondividdals: Nome of perAmy Fawcett Title:vf person: Controller Relevant educati6n.' BA-Communications-Pepperdine University Telephone number: 714-244-4271 Date fast employed:' 10/1/2009 1Vame of 00s6h, John Taylor Title of person,: Area Director Relevant education BS-Business Administration-SM Tekohane number 858-483-4007 Dpte first employed: 7/1/2011 Page 4 of 8 (Revised 1 21412 0 1 3) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION ax Length for Questions 2.5 t® 2-8: 1 Page) [4,5".;:'List the evaluation to your a envy plans to errtplvy to track and monytor`the progress of the project. 1. j[Intake Form 2. Client Services Ledger 3. Statistical Database--Daily Input 4. Statistical Reports-Monthly, Quarterly and annually 5. Quarterly Compliance Reports 2<f, Flow daes your agency plan to ensure compliance with,app!lcable policy and procetlura1 requirements(including those listed in HUD". "Playing by the Rules"Harrrlboolc)� 3A"Policy and Procedure Manual" has been adopted for operational guidance. Monthly staff meetings are conducted to address relevant policy and procedure issues.Additionally the HUD"playing by the Rules" (March 2005 version) manual is downloaded and available to be used as a reference guide. i 2.7. `Describe any unresolved ApA issues in tie projector protect office and haw}rouragericy plans to address therlt (!f the o6jec>tiive':of the project is ADA rehab l t tion, do not repeat the project description there.} [NA 2;8. How many members daes:yaur Board of;Directvrs have?- 15with 13 filled- Howmany Board members are also members of this project's target population orreside in I1 the project's target areas indicate uvhlch ones inAppendix F. Page 5 of 8 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section a Auditing Control (Max Score: 15 Points, Max Length: 2 Pages) 3.1. Briefly descrr'be your agency's payment and drsbursement procedures, with reievonce to the proposed project: !Expenses incurred for the program must be pre-approved. A"Check Request form" is submitted to the Area Director" for payment to be rendered. The Area Director maintains a local Imprest Account and makes payments from this account directly if$150.00 or less. The form,original invoice,and any relating paperwork are sent to the agency Central Support office in Orange and copies are maintained in the San Diego administrative office for dual recording keeping. For expenditures above$150.00 the Area Director does not render payment locally but still submits the same original paperwork to Central Support for payment at that level. Copies are maintained in the local office in the same manner. Grant billing is done quarterly by using the general ledger and the board approved budget.The full year grant is divided into quarters and billed accordingly for the allowable costs incurred during that quarter. 'I 3.2., Describehal+ your Agency's Board df Directors!exercises pragromrr►atic.and:fiscaF ov�rsigftt f Expenses incurred for the program must be pre-approved. A"Check Request form" is submitted to the Area Director" for payment to be rendered. The Area Director maintains a local Imprest Account and makes payments from this account directly if$150.00 or less. The form,original invoice,and any relating paperwork are sent to the agency Central Support office in Orange and copies are maintained in the San Diego administrative office for dual recording keeping. For expenditures above$150.00 the Area Director does not render payment locally but still submits the same original paperwork to Central Support for payment at that level. These copies are maintained in the local office in the same manner. Grant billing is done quarterly by using the general ledger and the board approved budget. The full year grant is divided into quarters and billed accordingly. The final year end billing is for the balance remaining for the full grant amount. 3 3 BPiefiy describe yatr agendy'sfnanciai reporting systern/accounring procedures, wrth.reievance•.to the<proposed - project Accounting procedures for the prosed project would follow guidelines stated in 3.1-3.7 and will be assigned an independent cost center for budgeting and tracking purposes upon acknowledgement of grant award. 3.4. Briefly describe your agency's recprd keeping system, with relevance to the'propased project, I Client Files: Housed at program site,filed in alphabetical order, maintained by program manager. Statistical data: Data entry into a spreadsheet designed for accurate reporting is computer generated, maintained by the program manager, reviewed monthly by the Area Director and housed both at the program site and the local Administrative office and turned in Quarterly to Central Support to be reviewed by the agency Compliance Department and reported to the Board of Directors. All original grant applications,awards letters and reports are maintained at Central Support with The Agency Compliance Department and copies are kept at the local area office. Page 6 of B (Revised.12/4/20.13) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 3.5. Briefly,descrr'be your agency's auditing requirements,including those for ttre proposed protect. JLSS is audited annually by an independent auditing firm in accordance with generally accepted auditing standards in the U.S. and the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of The United States. The financial statements present a Schedule of Expenditures of Federal Awards and Schedules of Findings and Questioned Costs for purposes of additional analysis as required by U.S.Office of Management and Budget Circular A-133,Audits of States, Local Governments,and Non-Profit Organizations. 3:6. ;Briefly describe your agency`s internat°eoOrols'tominimize dppgrtui rhes for frucrd,was>`e, and m►srridn rgement jPrior to all operating years the agency prepares a budget which is Board Approved. This becomes the blueprint for fiscal operations for every program operated by the agency. Area Directors are required to monitor the financial variance of each program in their respective area on a monthly basis. Any line item that has a variance of at least 5%or$2,000.00 must be justified. All requests for payments must be submitted to the Area Director for approval. Once approved the request is submitted to our Central Accounting office where payment is rendered. All checks written for reimbursement require 2 signatures. Expenses that are routine(rent,telephone, utilities,etc.)do not require prior approval. One-time or periodic irregular expenses must have prior approval from the Area Director before engaging services if$150.00 or under and from our Central Support office if over$150.00. Dual exposure at the area level and then the central support level serve to minimize fraud, inaccuracies, and misuse within the agency. 3.7. Haw'cloes your agency plan to segregate CDBG funds tram other agency funds for purposes of identification,, tracking, and.,ieportrnga , Our agency accounting system is set up on a cost center basis. All CDBG funding is assigned a cost center code that separates it by the funding source,the specific program it funds and the program location. in our"Audited Financial Statement"there is a "Schedule of Expenditures for Federal Awards"that identifies: Federal Grantor/Pass-Through Grantor/Program Title, Federal CFDA#, Funding Period,Agency or Pass-Through#, and Federal Expenditure Amount, Page 7 of 8 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Ex erience (Max Score: 10 Points, Max Length: 1 Page for Section 4/5 Combined) 4.1. Briefly highlight your agency's experience and malar accomplishments in providing services to LMi residents and/vr; cammunrtres You rray expand hOAppenclrx A. ., IFor over 65 years LSS has provided services to LMI clients throughout Southern California. Since 2010 we have managed over 50 programs annually.Of those 50+programs, 22 per year were funded by federal dollars amounting to above 4,000,000. In 2014 again we operate over 22 federally funded programs within the agency. Specifically in San Diego we have operated our Senior Companion Program for more than 14 years. It requires complex record keeping and stringent reporting to our funding source. it utilizes the services of over 40 LMI seniors annually who provide better than 44,000 hours of service to frail seniors throughout San Diego county. We have been routinely monitored by our funding source and are in good standing E 4 2 Has your agency received CDB G or other federal funds in any of the past three fiscal years: (Frsca!bears 201.2-2022,2022 2019. through 2013 2024)?if yes, complete Appendix G far ® Yes . �I No each of the grants received far the three Fiscal Years 2013,2012,and 2013. SectionBack-Up Plan (Max Score: 5 Points,) 5 Wrl1 your agency still implement this project should CDBG funds Trot he alniarded;'If yes, how ! Yes i0 No'; will th-e implementation he..achioued? LSS has been operating this program without CDBG funds for 2 consecutive years and will continue to do so if funding is not awarded. Staff hours were initially cut back when CDBG funds were no longer available to us. We have gone from 2 part time employees to 1 part time employee. With increase funds available we will be able to add another 2" part time employee. This was a growing period for us. During that time we improved our record keeping methods tremendously which has not only allowed us to better track outcomes but also to work more efficiently. We continue to seek support for the financial needs of the program. Each partner is an integral part of providing this safety net how.In!lll your agenr~y continue this protect if:(I)BGfunds die not'availaole in.future years? LSS has demonstrated that it has the capacity to continue to operate without federal funding as it has done so for the past 2 years. In 2013 LSS began a "Sustainable Funding Campaign"throughout its Southern California service areas. Management level personnel attended a 2 day training program put on by Benevon. The first phase of this fund raising system has been implemented in North Los Angeles County. During 2014 they will implement it in San Diego County. A Central Support staff person has already begun working 1 day per week out of the local area office to lay the ground work. The system is designed to bring a higher level of awareness to the community of our organization,to strengthen our donor base,and to engage more community partners to support our efforts. Page 8 of B (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix A: Narrative ®f Project (Max Length: 2 Pages) In two pales or less, explain belowyour proposed.&r feat and make the case why it s '60d,be awarded furz,ding ;! Project Hand has been part of the Chula Vista charitable community for decades, dispensing emergency food bags to the needy of Chula Vista and surrounding communities in the Southbay. Project Hand is located on the campus of St. Mark's Lutheran Church, 580 Hilltop Drive, Chula Vista, CA 91909. We occupy office,reception and storage space within the church that has grown over the years to include a new and necessary storage room for our canned goods. Recently,we were awarded a new commercial freezer donated to the Jacobs&Cushman San Diego Food Bank by Jenny Craig. We participated in a modified grant process by the food bank and were awarded one of several that were given to area food pantries. Additionally,we purchased a new Frigidaire refrigerator to replace one that had finally given up. Project Hand shares and supports our agency mission of non-discrimination to any person or family that is in need of food. We solicit as many volunteers as possible from the clients and offer them an opportunity to work for us and themselves by helping others in our distribution in exchange for additional food. OUR MISSION, OUR VISION Lutheran Social Services of Southern California (LSS) through all its programs celebrates the love of Christ for all people through acts of service. Our vision is that all people will have the opportunity to live and work in a community in safety, dignity and with hope. HISTORY AND EXPERIENCE LSS was founded in 1946 to provide aid and comfort to persons and families in Los Angeles and San Diego. Since those early days,we have grown to manage more than 50 programs throughout Southern California. We Embrace Equip and Empower through emergency services,program resources and circles of support. NON-DISCRIMINATION POLICY LSS Community Care as an agency maintains a firm policy of non-discrimination in its practices toward employees and those served by the agency. As an equal opportunity employer and service provider LSS serves all persons, regardless of religious affiliation, race, national origin,age,gender, sexual orientation, disability or economic status. OPERATION To become a client of Project Hand, one need only to present themselves to the window with valid identification. They are required to complete an intake form that asks for their address,level of income and number within their household. Other demographic data,such as head of household are logged on a special Excel worksheet kept on the pantry manager computer,with hard files maintained out of contact with any client or volunteer. Demographic information is totaled at the end of each month and emailed to the Area Office for approval by the area director and reporting to our Central Support office. The Excel worksheets include all information that was most recently required by the City of Chula Vista in their quarterly reports. NEW PROGRAMS ADDED IN 2013 In addition to our in-house clients,we also participate in 2 additional USDA programs offered by the Jacobs& Cushman San Diego Food Bank. As a participant in the Emergency Food Assistance Program (EFAP), Project Hand receives monthly 6 additional palettes of canned food and frozen protein product(chicken,ham,pork,etc.) to feed more than 500 families. As part of their Flex-site program,we agree to expand our distribution days and times for this USDA program. Previously,we had this mass distribution one day per month. Now we distribute this special and separate food on Monday,Wednesday and Friday each week. This food is stored separately and accounted for Appendix"A"—Narrative Page 1 of 2 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION specifically to the food bank with special reports generated following delivery and distribution for gross numbers as well as number of food bags handed out. LOOKING FORWARD LSS is planning to hire a case manager to work with selected clients at Project Hand, 20 hours per week to begin. Our goal is to counsel as many as realistically possible in a private setting on the church grounds to help them move out of poverty and get them back on the road to financial and emotional security. We will teach them how better to manage their money,their time and their families,and regain their dignity and ambition. With 25,000 persons living below the poverty line in Chula Vista and countless more living paycheck to paycheck, there is a tremendous need for programs like Project Hand to continue. Through the "Circles" initiative, a program we are implementing in 2014,in Chula Vista,our goal is to move people out of poverty, one person, one family at a 3 time. Appendix"A"--Narrative Page 2 of 2 (Revised 121412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step(1): Enter the FY 20142015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project;and Step(3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE:Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT %OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Nista(Step 1) $20,400 50.00% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds 0.00% Private Funds 0.00% Agency Funds 0.00% $20,400 50.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTAL, $20,400 $20,400 100% TOTAL PROJECT BUDGET $40,8001 APPENDIX C-2: THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL,YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three(3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes. Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements. FY 30-Jun-13 CY Page# 3 Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 299,198 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 1.,196,792 List the amount of FY 2014-2015 CDBG funding applied for this application. 20,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. 100,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 201.4-2015 CABG funding request(s) 120,000 Compare Agency Cash Balance Available(Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item Al1,196,792 Item B�-120,000 Difference) 1,076,792 Analyze Results 1-If difference is a positive amount or equals$0,the Agency is eligible to apply. 2-If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance,as long as: A)EACH PROJECT MEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE A_PPLIC_ATIONS, AND B)CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN OR EQUAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX G3:PUBLIC SERVICE SCHEDULE 1 -BUDGET EXHIBIT AGENCY Lutheran Social Services PROJECT Project Hand CDBG Percentage SALARIES& WAGES (Schedule 2) 27,720 FRINGE BENEFITS (Schedule 3) 3,594 TOTAL PERSONNEL 31,314 SUPPLIES (Schedule 5) 1,000 POSTAGE (Schedule 5) 94 CONSULTANT SERVICES (Schedule 5) 0 MAINTENANCE/REPAIR (Schedule 5) 420 PUBLICATIONS/PRINTING (Schedule 5) 100 TRANSPORTATION (Schedule 5) 780 RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) 0 INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) 1,200 OTHER EXPENSES(SPECIFY): Food/Groceries (Schedule 5) 1,200 Internet Tech Support (Schedule 5) 420 (Schedule 5) TOTAL NON-PERSONNEL 5,214 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD(IC/AO) (Schedule 4) 4,272 11.7 [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 40,800 Page 1 of APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct projecticlient services,.Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO)line item. The Total CDBG Salary&Wages must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY Lutheran Social Services PROJECT Project Hand (1) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES John Taylor-Area Director 45,000 20.00% 4,000.0 Johnny Viloria-Program.Manager 18,720 100.00% 18,720.0 TOTAL CDBG SALARY&WAGES 27,720 _.........._.._.. 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3.List percent of gross pay to be charged against CDBG funding. Pay Schedule(Check One) Monthly Biweekly x Twice a Month Page of APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3-PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY Lutheran Social Services PROJECT Project Hand (1) (2) (3) (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT John Taylor-Area Director Payroll Tax 881 20.00% 1.76 John Taylor-Area Director Workers Comp 81 20.00% 16 John Taylor-Area Director Health Benefits 1,107 20.00% 221 John Taylor-Area Director Pension 270 20.00% 54 Johnny Vitoria-Program Manager Payroll Tax 2,396 100.00% 2,396 Johnny Vitoria-Program Manager Workers Comp 168 100.00% 168 Johnny Viloria-Program Manager Pension 562 100.00% 562 TOTAL CDBG FRINGE BENEFIT 1 3,594 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2.List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3.List the amount of insurance for each position charged against CDBG fiends. 4.Use gross pay for project/total all wages of agency.Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pgy Schedule Check One Monthly Biweekly x Twice a Month Page of C APPENDIX C-3: PUIRLIC SERVICE SCHEDULE 4-INDIRECT COST/ADAIMSTRATIVE OVERHEAD(IC/AO)CALCULAT10N The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO trust match the Budget Exhibit form.Round off totals to whole dollars. AGENCY Lutheran Social Services PROJECT Project Hand (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLEILINE ITEM AMOUNT CHARGED OVERHEAD Area Director 9,000 11.70% 1,053 Program. Manager 18,720 11.70% 2,190 Fringe Benefits 3,594 11.70% 420 Supplies 1,000 11.70% 117 Postage 94 11.70% 11 Maintenance 420 11.70% 49 Publications/Printing 100 11.70% 12 Transportation 780 11.70% 91 Rent Insurance Telephone 1,200 11.70% 140 Groceries 1,200 11.70% 140 Internet Tech Support 420 11.70% 49 TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD 4,272 (5)Total CDBG Budget 36,528 Percentage 11.70% (Must be equal or less than 15%) 1.List all personnel or nonpersonnel(NPE)charged against CDBG funding-include detailed description of indirect use. 2.List total Agency budget for positon and/or NPE line item. 3. List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5. Enter the Total FYI CDBG Budget; percentage will be AUTOMATICALLY calculated. Pay Schedule(Check One) Monthly Biweekly X Twice a Month Page of APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Lutheran Social Services PROJECT Project Hand LINE ITEM Salaries AMOUNT Detailed Explanation: Program Manager-Responsible for operating program,statistical data 21,846 collection,reporting to Area Director, Overseeing volunteers Area Director-Program Oversight, Submitting complaince reports to City of 9,468 Chula Vista,Reporting to LSS Central Support TOTAL $ 31,314 LINE ITEM Supplies AMOUNT Detailed Explanation: Purchase necessary paper,pens,file folders,ink, grocery bags and other office supplies to operate program. 1,000 .i :I TOTAL $ 1,000 LINE ITEM Postage AMOUNT Detailed Explanation: Stamps(2 rolls)Correspondence between central support and local office, 94 betwe ocasl o Tice and the City of Chula Vista. Mailing thank you to volun ee nors and supporters of program. TOTAL $ 94 *All line items must be justified in relation to CDBG-funded activities to be completed.Add pages as needed. Page of •� APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Lutheran Social Services PROJECT Project Hand LINE ITEM Maintenance/Repair AMOUNT Detailed Explanation: Pest Control monthly service @$35 per month 420 TOTAL $ 420 LINE ITEM Publications/Printing AMOUNT Detailed Explanation: , Marketing flyers for progran - andouts to clients for referrals 100 TOTAL $ 100 LINE ITEM Telephone AMOUNT Detailed Explanation: Phone/IT service at program site$100/month 1,200 TOTAL $ 1,200 *All line items must be justified in relation to CDBG-funded activities to be completed.Add pages as needed. Page of APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET RJSTIFICATION* AGENCY Lutheran Social Services PROJECT Project Hand LINE ITEM Food/Groceries AMOUNT Detailed Explanation: Supplement food items in pantry when low due to donation fall off 1,200 TOTAL $ 1,200 LINE ITEM Internet Tech Support AMOUNT Detailed Explanation: Program share of charges to LSS for technical support with all IT issues 420 i TOTAL $ 420 LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - `All line items must be justified in relation to CDBG-funded activities to be completed.Add pages as needed. Page of CITY OF CHULA VISTA FY 2014-203.5 CDBG FUNDING APPLICATION .Appendix D: Implementati®n (Max Length. 1 Page; Max Score: 5 Points) Provide a listing below of the specific tusks or activities needed to to the proposed pt oJect and a timeline for -their`comp letion.Number each task ar activity,describe it,and glue the pra�ected d ate'of campletior Add addr"tional rowsas needed i Completion' : # Task/Activr Description Date ITis is not a new project and functions I as such. I , 3 1 E 44 E 1 i i1 717— TF-- I 1 I 3 if I I i 71— 1 TIF E H 7F - I � i E I i Appendix"D"—Implementation Page I of 2 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix E, Roster ®f Bard Members & Professions Provide a roster of the members'ofyour agency's Board of Irrectors and their professions by f llrrry aut the table below., Member afTarget Resides to Name .. BodrdPosr` ioa Profession/A "alaation target Popalato Arep Sharon Grady Retired Physical Therapist ❑1 ;❑ ITempie Beaman ;Seminar Facilitator ❑; El Gloria Espeseth I Pastor �QI El ,Kristine Anderson j JCPA I ❑ ❑J Barbara Kokkinakis ; I,Civil Litigation Attorney I ❑ ❑, Gary Norton JDistrict Staff Lutheran Church Missouri Synod X X Sheila Wenzel Retired Admin Secretary ❑' i Kristal Shipp Marketing/Communications Specialist David M Burtch VP Ameritel,Inc �❑ ❑' Karen Althaus Thrivent Financial Representative ❑ ❑ i Rev Larry Stoterau President Lutheran Church Missouri Synod ❑J ❑ Rev Murray Finck Bishop Evangelical Lutheran Church-Pacifica ❑' 01 Rev Dean Nelson Bishop Evangelical Lutheran Church-SWI ❑I ❑' 10 ❑; I❑i _7071 - IE I - E i I❑ 0,11 IED 7017 Appendix"E"--Roster of Board Members and Professions Page 1 of 1 (Revised 1 2/412 0 1 3) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix F: Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests,payments,and campaign contributions must be filed.The following information must be disclosed: 1. List the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e.g.,owner,applicant,contractor,subcontractor,material supplier). 10A] 1 2. If any person*identified in section.1 above is a corporation or partnership,list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership)entity. [[NA.]1 3. If any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee,beneficiary and trustor of the trust. JJ[NA.]J 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. 1[NA.] S. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official**of the City of Chula Vista as it relates to this contract, project or application within the past 12 months?Yesj❑1No® If yes, briefly describe the nature of the financial interest the official may have in this contract. 6. Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than$250 within the past twelve (12) months to a current member of the Chula Vista City Council?No;®Iles;❑1 If yes,which Council member(s)? 7. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value,money to retire a legal debt,gift, loan,etc.)Yes[_]jNo® If Yes,list official and what was the nature of item provided? 11(i 8. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of income of$500 or more to an official**of the City of Chula Vista in the past twelve(12)months?Yes,,❑ 1No® If Yes, identify the official and the nature of the income provided? 1 4[1/28/2014 ;[John Taylo> Signature: ' Person is defined as:any individual,firm,co-partnership,joint venture,association,social club,fraternal organization,corporation, estate,trust,receiver,syndicate,any other county,city,municipality,district,or other political subdivision,or any other group or combination acting as a unit. ** Official includes,but is not limited to: Mayor,Council member, Planning Commissioner,Member of a board,commission,or committee of the City,and City employees or staff members. Appendix"F"--Disclosure Statement Page 1 of 1 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix Ge Identification ®f Pri®r Year CDBG and/®r Federal Funds G 1 i4gency name: Lutheran Social Services G 2 Project name., Project Hand G 3 Year of funding ® Fiscal Year 2010 ❑I Fiscal Year 2011 Fiscal Year 2012 G.4. :indicate the source o the ederal.`,undin ' marded to the prior ro gct. f _ g p p J., ® CDBG ❑ HOPWA ❑ ESG 101 HOME ❑� CDBG-R HPRP NP (indicate l G.S. Amount awarded. 18,530 G.6. Amount spent;to date: : 18,530 G 7 'Amount reprogrammed to``date:, 0 G 8 lndlcote belo t+the outcomes anticipated{refer to the original;application for the project, if pass$le): (1)< lProvide Emergency Food Pantry Services to 4,500 LM clients in Chula Vista and surrounding are {2j G.9. `lndledte b66W the outcomes achieved: 3 of 4 quarterly reports show 2,855 clients were served. The first quarterly report is missing from our documents (zJ; and therefore not included in this number, G 10.j!f any anticipated autcames were:V0T achieved;specify which �e 1 In elow: Although it is believed the full outcomes were realized LSS struggled with maintaining accurate records to reflect this outcome. We have implemented a very effective procedure which has been utilized for over 1 program year now which demonstrates our increase in capacity in grant compliance measures.] j ;Agency name Lutheran Social Services of Southern California G,2. Project name: Project Hand G:3. Year of funding ? Fiscal Year 2010 Fiscal Year 2011 ❑. Fiscal Year 2012 G.40, Indicate the source of the federal funding awarded to the prior project.... ® CDBG ❑, HOPWA ❑I ESG HOME l CDBG-R HPRP ❑ NSP ❑i Other(lndicate below): G.S. .' Amaun awarded., ,20,000 G,6. ,Arriount;spent to date: : 20,000 G 7 Amount reprograminm to date: 0 f G 8. indicate below the outcomes anticipated{refer:to the original applleatton for the project, if passible): {1) I JProvide Emergency Food Pantry Services to 4,500 LMI clients in Chula Vista and surrounding areas Page 1 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013.2014 CDBG FUNDING APPLICATION lel: G.9. Indicate beio>'theoutcories achieved: (1); 6,033 clients were served during the program year. any'anUclputed,a rtcomes were NOT achrevecl specify which ones rind explain why below ![Type response herG.) Page 2 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G Agency name, Lutheran Social Services of Southern California G.2. Project name: Project Hand I G.3. Year of funding: fiscal Year 2010 ❑ Fiscal Year 2011 ® Fiscal Year 2012 i G.4., lndico..te the source of the federal funding awarded to the prior project. ® CDBG ❑ HOPWA ❑ ESG ❑i HOME ❑; CDBG-R ❑ HPRP 'QI MSP Other pndic&,bo..): Amount awarded: 27,830 1 G.6. Amount 5petit'to date.. 27,830 G.7. <Amount reprogronnined to date: 10 G.8. 'indicate belouv the outcornes anticipated(refer',ta the originaL,applicatrorr for the proleCt, if possible) (1):` Provide Emergency Food Pantry serves to 4,500 LME clients in Chula Vista and surrounding area G,9: Indicate below the outcornes achieved: 15,828 clients were served during the program year G.10. if any anticipated outcomes were:?NOT dchreved;specify which ones'and explain why below: [Type response herG.] Page 3 of 5—Supplement to Appendix E Application No. 4 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant-." South Bay Community Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: South Bay Food Program Project Description: The''Sou'th Bay Food Program includes,Thu'rsdaV's Meals (weekly hot meals), F6eding,America's, Metro Mobile, Pantry, Which has paned to a second Chula'Vista'location, and SECS` in-house Emergency Food Program for, Homeless and Chula Vista residents/famil'i0s,in need of ,food services and support.. Type of Program/Project: Public Services [(§570.201(e)] Target Population: 05W'- Food Banks, Proposed Number; 300 to Serve: {,subject to change &R§'570'208(a,)(2)'Lo' w depending,onfunding Moderate Income recommendation) Limited Clientele, Program Total Budget: $40,500 C. V. Cost per Client: $50 (Based on funding recommendation) Funding Request: Prior Year,Fundin,g: $10'000 Specific Use of Chula Vista Personnel Costs FUNDING $10,000 Funding: ($5,940) and Supplies RECOMENDED ($9,060) Staff Notes:: ORIGIN46MUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fiscal Year 2014-2015 Or CHUiAsm Application Number: Project.Category. ® Public service (CDBGFrogromOfficeUseOnly) (check one only) :`' ❑ Capital improvement Applicant Agency Information Applicant legal`name: South Bay Community Services Type of agency;: ® 501(c)(3) I ❑ Gov't./Public ❑ For Profit ❑ Faith-Based ❑I Other: Agency Address` 430 F Street, Chula Vista 91910 Date of incorporation: September 1972 T.ax!D number: 95-2693142 AgencyDUNS number: 1 1134077791 Annual operating budget: $26,601,738 Number of Paid staff: 500 Number of volunteers: 750 Agency`mission"statement: SBCS' mission is to provide children,youth, and families with services that reinforce the family's role in our community and assist individuals to aspire realistically to lives of self-fulfillment. Project Title: South Bay Food Program Brief project description: he South Bay Food Program includes Thursday's Meals (weekly hot meals), Feeding America's Metro Mobile Pantry program which has expanded to a second Chula Vista location, and SBCS'in-house Emergency Food Program for Homelps.q and nppdv Chula Vista residents/families in need of food cprvirps and sunnort. Funding Request Tota!funding requested in this application other funds already secures!for 1$15,000 x$25,500 (you:will provide a detailed budget in Appendix C. project: Total cost to complete project: 71$40,500 Other funds not yet secured for 1$15,000 Project Information If Project is a Public Service; will service be site specific? ZYes ❑Nb.: If your answer is yes, please provide:'Address(es)below. Census tract: '. 30 F Street,Chula Vista 12402/12700 160 Quintard Street, Chula Vista 13203 707 F Street, Chula Vista - 1500 Target Clientele: (Homeless, Youth, Homeless and/or low-income Chula Vista residents/families Elderly, Disabled,:Other/General) The following questions on individual clients and households to be served apply only to Public Service,and Minor Residential Rehabilitation projects: Will the project serve.individual clients(IC)or households(HH)?;j ® Individual clients I 1E] Households Total unduplicated IC/HH served: 5,100* (Duplicative—clients may be served by multiple program components) Annual cost per client%household: $2.94 Page 1 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Project Details (Max Score: 25 Points) 1.1. Provide a concisedescription`of the proposed project(this description must match the one provided on the cover. page). Space for a fuller narrative is provided in Appendix A. he South Bay Food Program includes Thursday's Meals (weekly hot meals), Feeding America's Metro Mobile Pantry program which has expanded to a second Chula Vista location, and SBCS'in-house Emergency Food Program for Homeless and needy Chula Vista residents/families in need of food services and support. Project start date: my 172014 Anticipated end date: une 30, 2015 j 1.3: Project's`days/hours of operation: oo many to list here—see 1.12 below. 1.4. Project I®I Public service 1.5 Project: ® Suitable living environment category:` objective: Decent housing g ❑ capital improvement(checkorieonly) I❑� p p (check one only)' ❑I Economic opportunity 1.6 Project ® Availability/accessibility outcome ❑ Affordability (check one only)' ❑ Sustainability 1.7. CDBG Criteria: Which CDBG criterion below does your proposed project meet? ® (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income (LMI). Please provide a map identifying the Census Tracts designated as LMI. ❑ (2) Limited clientele(select subpart below): ❑ (a) Special needs group (select benefit group from the list below): ❑ (i) Abused children ❑ (ii) Elderly persons 62 years or older ❑ (iii) Battered spouses 04 (iv) Severely disabled adults(not children)--Census definition;documentation required (v) Illiterate adults (vi) Persons living with HIV/AIDS ❑ (vii) Migrant farm workers ❑ I (viii)Homeless persons I❑ (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? _FET] (3) Housing(select subpart below): ❑ I (a) Single family(must be 100%LMI) ❑ (b) Multi-unit(must be 51%LMI) 1.8.: The 2010.2015 Consolidated Plan.goals are listed below. Select the goal appropriate to your project ❑ Affordable Rental Housing Opportunities ❑ Maintenance and Preservation of Housing(rehabilitation activities) ❑ Homeownership Opportunities (homebuyer programs) El Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 20142015 CDBG FUNDING APPLICATION (Max Length for Questions 1.10 t® 1.15: 2 Pages) 1.10. Explain how the proposed project addresses the goal selected: The South Bay Food Program is designed to benefit the Chula Vista community, including low income families, and individuals by addressing issues in their living environment. The Food Program helps to make one of the basics of living, food, available and accessible to low- and moderate-income people where they live. 1.11.:Summarize anystatistics and other supporting documentation that demonstrate the importance of addressing this . need or problem: to increase with " rs in Chula Vista continues including seniors,T tuber of homeless and need families and individuals, , he nu Y � , dwindling food resources. Homeless and low income families struggle to feed themselves and their children with healthy and nourishing meals. The South Bay Food Program helps to provide families with food, education and resources that they need to develop healthy, self-sufficient lifestyles. 1.12. List each service provided by the project. For each service,indicate whether it is a new service or an expansion of an existing service: Services coordinated through the South Bay Food Program include the following: Thursday's Meals provides homeless and needy families with hot and nourishing foods on a weekly basis (Mondays at 12 pm, Wednesdays at 5 pm, Fridays at 4 pm and Sundays at 5 pm); Feeding America's Metro Mobile Pantry provides 30-40 pounds of food including dry food , produce, and non food items (such as cleaning supplies, diapers and other home use items)twice per month (The second Tuesday of the month from 5-7 pm and the 3rd Wednesday of the month from 4-6 pm); and SBCS' In-House Emergency Food Program, provides those in need with both non-perishable food items and fresh produce on an as- needed basis. All programs are existing services; however, SBCS has added the second distribution site (Castle Park Middle School) and time (3rd Wednesday of the month from 4-6 pm)for the Metro Mobile Pantry to serve additional families in need. All of these services are on-going, and will be sustained with CDBG funding. 1.13. How does your agency plan to tell the target population about the project/services? . Information about the South Bay Food Program is advertised at the SBCS main agency,through flyers distributed to local Family Resource Centers, schools,the Chula Vista Community Collaborative and through local partners including churches and other community service providers. 1.14:`List up to three outcomes of the project(at least one is required). For each outcome listed;provide the number of participants who will benefit and the way data will be collected to track or verify the outcome: �he overall program goal is to provide food to low-income and homeless families in Chula Vista, allowing them the opportunity to lead healthy and self-sufficiency lives,free from hunger. The program will be evaluated based on the successful completion of the following objectives: ® Provide low-income-and homeless families with access to hot, prepared meals; 300 of whom will visit one of the four Thursday's Meals distributions, as measured by program surveys; ® Provide low-income and homeless families with monthly access to non-perishable food items and fresh produce; 300 of whom will be served by the Metro Mobile Pantry, as measured by program records; and ® Provide 100%of food program participants with access to educational materials related to healthy eating, as well as access to agency-run self-sufficiency programs. Page 3 of 9 (Revised 121412013) CITY OF CHULA V18TA FY 2014-2015 CDBG FUNDING APPLICATION 1.15. Will the project collaborate with other service providers in the community?If yes, list them ® Yes ❑� 1Vo and briefly describe the collaboration: SECS works closely with the Ecumenical Council (18 congregations in the South Bay) as well as Feeding America, the San Diego Food Bank, and the Chula Vista Community Collaborative to cater to the food needs of low income and homeless families and individuals in the Chula Vista Community. Page 4 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Secti®n 2: Agency Ca acit (Max Score: 10 Pints) 2.1. : Who Will be the person responsible for the overall oversight of the proposed project? Name of person: Don Hunter Title of person: IFamily Wellness and Self-Sufficiency Department Director Relevant education: B.S. Psychology Telephone number (619)420-3620 Date firstemployed' 1997 2.2.' Who will be the alternate person responsible for the overall oversight of the proposed project? Name of person: Dina Chavez Title of person; 'Associate Director Relevant education::` B.S. Business Administration Telephone number. (619)420-3620 Date first`employed: 1989 2.3: . Who will be the person responsible for the day to-day operations and management of the proposed project? . Provide no more than two individuals: Name of person: Amaris Sanchez Title of person: Program Director Relevant'education: B.A. English, Women's Studies Telephone number: .(619)420-3620 Date first employed: 12003 Name of person Title of person: Relevant education: Telephonenurn.ber' Date first employed: 2.4. Who will be'the'person responsible for the financial oversight of the CDBG expenditures and fiscal compliance? Provide no more than two individuals Name.of person: Elizabethlniguez Title of person: CFO Relevant education: B.S. Business Administration Telephone number: (619)420-3620 Date first employed. 1993 Name Of person: Title of person: Relevant education: Telephone number: Date:first employed. Page 5 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to 2.8: 1 Page) 2.5... List:the evaluation tools your agency plans to employ to track and monitor the progress of the project. Clients receiving services and support through the South Bay Food Program are tracked and monitored in the following ways: ® Thursday's Meals:via sign-in sheets and demographic surveys; ® Metro Mobile Pantry: via sign in sheets; and ® In-House Emergency Food Program:via sign-in sheets. Client information is then entered into the agency database and maintained by the Contract Compliance and Quality Assurance Staff. 2 6. How does:your agency plan to ensure compliance with applicable policy and procedural requirements (including „ those listed in HUD' "Playing rlaying by`the RulesU..:.Handbook)?_ l SBCS receives multiple types of HUD funding, and as such has aligned its financial management policies, methods of procurement and contracting, property management, record-keeping and reporting policies,administration and program requirements, and required financial audits in compliance with HUD's "Playing by the Rules" Handbook. 2.7 Describe any unresolved ADA issues in the project or project office and how your agency plans.to address them. (if the objective of the project is ADArehabilitation,do not repeat the project description here.) Not applicable. 2.8. How many members does your Board of Directors have? 9 How many Board members are also members of the project's'target`population or reside in. ,5 the project's target area?Indicate which ones in Appendix F. Page 5 of 9 (Revised.12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3.1: Briefly describe your agency's payment and disbursement procedures, with relevance to the proposed project All funds are managed by SBCS' Fiscal Department. The Fiscal staff includes the Chief Financial Officer (CFO): Elizabeth Iniguez, 3 Accounting Associates, 1 Accounts Payable Clerk, and 1 Fiscal Aide. The following are SBCS' fiscal procedures: Cash Disbursements: cash disbursements are prepared twice a month by our computerized accounts payable program. Payment is done for all authorized check requests. Where warranted, due to the significant amount of the purchase, approval from the Board of Directors is needed. Original supporting documents must be attached to all check request forms. After payment, all supporting invoices are stamped "paid" to avoid duplication of payment. All checks over $1,000.00 require two signatures, the CEO and a member of the Board of Directors. Pre-numbered checks are used on all disbursements. Numerical and physical control is maintained over blank checks as well as issued checks. Void checks are adequately mutilated and filed in numerical order with canceled checks. Cash Receipts: cash receiving is handled by the receptionist. She is in charge of opening all mail and logging in all checks received.The receptionist is not involved in any fiscal duties. Incoming cash receipts, primarily in the form of checks, are locked in a file cabinet until accumulation merits a deposit. The collection of cash is maintained by a separate cash receipt log. The Deposit is prepared by an Accounting Associate and posted to the general ledger by the Lead Accountant, maintaining discrete accounts for different funding sources. Periodic reconciliation of detailed cash receipt records to duplicate deposit slips, accounts receivables, and cash control accounts are prepared by personnel independent of cash functions. Payroll and Personnel: New employees are investigated before being hired. Wage and personnel policies are current and in writing. Current and complete personnel files are maintained. An adequate system is used to insure proper recording of hours and time. All salary and wage payments are made by check. An outside payroll company is responsible for processing payroll and printing appropriate payroll checks. All payroll checks are delivered to our office for review, and distribution to employees. The payroll account is reconciled by someone other than the person preparing the payroll and signing checks. Revenue, Billing, and Receivables:The CFO prepares all grant billings. Billings are done under reimbursement basis once a month and journalized as a receivable until the proper payment is made. The billings are done either on a preprinted form provided by the grantor or in-house prepared form. The CFO is in charge of monitoring the year-to-date expenses and comparing them to the annual budget. Under no circumstances will billings for a particular expense exceed the annual authorized budget.The fiscal department does a periodic analysis of receivables. Petty Cash and Cash On Hand: Petty cash funds are maintained on an imprest basis, with one individual responsible for the fund. They are not combined with other receipts. Responsibility for petty cash is separate from cash disbursements, receipts, and receivables functions. Limits exist on the amount for reimbursements out of petty cash. Supporting documents are checked and canceled at the time the fund is replenished. The fiscal department makes periodic and surprise counts of funds. 3.2.':. Describe how your agency's Board of Directors exercises programmatic and fiscal oversight: South Bay Community Services' Board of Directors meets every other month, during which they receive programmatic updates, and are advised on other significant agency business. The Board of Director's reviews and approves all funding requests, quarterly budget updates and the annual report. The Board is comprised of a number of sub-committees including the Executive Committee and Audit Committee,whose members attend to agency policies, procedures and financial management. The Board also directly oversees the President and CEO,who has the authority to act on the agency's behalf. 3.3;: Briefly describe your agency's financial reporting system/accounting procedures, with relevance to the proposed project: The Chief Financial Officer and Fiscal Staff utilize generally accepted accounting procedures in handling disbursement of funds and maintaining fiscal records. SBCS successfully manages more than 60 Federal, State, County, and city grants, as Page 7 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION well as Private Foundation funding.The agency is audited by an independent auditor on an annual basis, and has a history of clean financial audits. 3.4. `Brieflydescribe your agency's record keeping system;with relevance to the proposed project, Program Evaluation and Quality Management is an integrated process facilitated by the SBCS' Contract Compliance and Quality Assurance Department. The CCQA staff possess extensive experience with monitoring and evaluating service delivery, and they regularly review the conditions of each contract to ensure these conditions are being met correctly and with high quality. SBCS has written policies that address Privacy and Confidentiality and the Release of Information, and all program procedures are HIPAA compliant. Direct service staff will use various tools to measure program success including contact logs, sign-in sheets, client surveys and case notes.All confidential files are transported in confidential lock boxes from program sites to the main agency, and are maintained in locked secure file cabinets when not in use. 3.5. Briefly describeyour agency's auditing requirements,including those for the proposed project. South Bay Community Services is audited by an independent auditor on an annual basis, and has a history of clean financial audits. 16. ''Briefly describe your agency's`internal controls to minimize opportunities for fraud; waste, and mismanagement.- In ismanagement.In addition to the Fiscal Policies listed above in 3.1, the CFO monitors the budget on a daily basis as receipts and debits are posted, as new grants come in, and as expenses and invoices are paid.There are regular meetings with the President and CEO to make sure funding streams are adequate for programs, and strategies are developed to apply for and acquire more funds as programs expand. 3.7. . How does your agency plan to segregate CDBG funds from other agency funds for purposes of identification, tracking, and reporting? Contracts, grants, and other major funding sources are accounted in separate departments to prevent overlap of expenses and maintain separate general ledgers for each funding source. This system facilitates the monthly monitoring of year-to-date expenses by funding source, and accounting for expenses to any particular funding source. CDBG funds will be managed in accordance with this agency policy. Page 8 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) Briefly highlight your agency's experience and major accomplishments in providing services to LMi residents and/or communities. You may expand in`Appendix A. South Bay Community Services (SBCS) is a dynamic 501(c)(3) organization and is the largest provider of social service and community development programs in San Diego County's South Bay. SECS serves San Diego County's Southern Region, an area with a diverse population that is greatly affected by immigration, characterized by transience, low socioeconomic expectancy, high crime rates, intense gang activity, and substance abuse, making it difficult for them to find employment, affordable housing, and access community resources and services. SECS was created by dedicated community members in 1971 as a drop-in center for drug abusing teens. Responding to evolving community needs and concerns, we have developed a wide range of integrated, bilingual, prevention, intervention,and treatment options for youth and families, including mental health counseling; the region's only permanent shelter and support services for homeless families,youth,and domestic violence victims and their children; transitional and affordable housing; drug&alcohol prevention and intervention; domestic violence prevention and intervention; community development; child abuse prevention and intervention; and extensive youth programming. SBCS is an experienced operator of food programs,and has been receiving CV CDBG funds and operating Thursday's Meals since July of 2003; Our Feeding America program has been in existence since August of 2010; and SBCS' In-House Emergency Food Program has been in operation since we began sheltering homeless families in 1993 and has become a larger and more formally entrenched program every year since. 4.2. Has your agency received CDBG or other federal funds in any of the past three fiscal years (Fiscal Years 2011-2012, 2012-2013, through 2013-2014)?If yes, complete Appendix G for ® Yes No each of the grants received for the three Fiscal Years 2011,2012, and 2013. Section 5: Back-Up Plan (Max Score: 5 Points;) 5.1. Will your agency still implement this project should CDBG funds not be awarded?if yes,how ® Yes EllNo will the implementation be achieved? The need for food and food services has increased at a time when funding has decreased, so CDBG support of the South Bay Food Program is essential to sustain this much needed service within the community. If funded at an amount less than requested, we will continue to provide Food Distribution, but will be forced to serve fewer families and individuals. 5.2. If funded; how will your agency continue this project if CDBG funds are not available in future years? Funding support for the South Bay Food Program is spread over a wide base of local, county, state, and federal agencies as well as individual donors, local corporations, and private foundations, to guard against program closure because of the loss of a funding source.This strategic formula will create sustainability over time through the leveraging of diverse funding sources, and limits liability and dependence upon one type of support. Page 9 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix A: Narrative of Project (Max Length: 2 Pages) In two pages or less, explainbelowyour proposed project and make the case why it should be awarded funding The South Bay Food Program is the largest in Chula Vista, and currently coordinates a number of food distribution efforts: • Thursday's Meals, are weekly prepared,hot meals available for homeless and needy individuals and families. Meals are prepared four times a week: Mondays at 12pm,Wednesdays at 5 pm,Fridays and 5 pm and Sundays at 5 pm; and served by staff and volunteers including those from the International Christian Center, Chula Vista Church of God and Most Precious Blood. • Feeding America's Metro Mobile Pantry, provides over 10,000 pounds of food/household items to homeless and low income individuals and families each month. Staff and volunteers break down pallets of food and I create 30-40 pound packages which include dry food, fresh produce,and non-food items like cleaning supplies, diapers and other household items. This program operates at 707 F Street, on the second Tuesday of the month from 5-7 pm; and at 160 Quintard Steet on the third Wednesday of the month from 5-7 pm. • SBCS'In-House Emergency Food Program, is comprised of food from public and private drives as well as community donations, and allows those in need to receive both non-perishable food items and fresh produce an an as-needed basis. The South Bay Food Program serves low income families in predominately Western Chula Vista,including children, adults and senior citizens,many of whom are homeless or at-risk of homelessness. In addition to food,Food Program participants are provided with nutrition information, education and resources. They also have access to SBCS'wraparound continuum of services including emergency shelter,transitional housing and affordable housing; the Family Self-Sufficiency Program; as well as crisis intervention, employment assistance, children's services and assistance applying for benefits.The South Bay Food Program is more than just food-it provides families with the ingredients to prepare healthy and nourishing meals,along with the education and resources that they need to develop healthy,self-sufficient lifestyles. Appendix "A"-Narrative Page 1 of 1 (Revised 121412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step (1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step (2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step(3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista (Step 1) $15,000 37.04% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% Hpgp 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds $10,500 25.93% Private Funds 0.00% Agency Funds 0.00% In-Kind $15,000 37.04% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTAL $25,500 $15,000 l00% TOTAL PROJECT BUDGET $40,500 APPENDIX C-2: THREE-MONTH CASH RULE TEST" CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three (3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes. i Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements. FY 6/30/2013 CY Page# Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 1,220,960 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 4,883,840 List the amount of FY 2014-2015 CDBG funding applied for this application. 15,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. 78,550 List the amount of FY 2014-2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 93,550 Compare Agency Cash Balance Available (Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item Al4,883,840 Item B 93,550 Differencel 4,790,290 Analyze Results 1- If difference is a positive amount or equals $0, the Agency is eligible to apply. 2-If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance, as long as: A)EACH PROJECT MEETS THE MINIMUM REQUIRED.AMOUNT FOR EACH OF THE.APPLICATIONS, AND B) CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX C-3: PUBLIC SERVICE SCHEDULE I -BUDGET EXHIBIT AGENCY South Bay Community Services PROJECT South Bay Food Program CDBG Percentage SALARIES & WAGES (Schedule 2) 4,680 FRINGE BENEFITS (Schedule 3) 1,260 I i TOTAL PERSONNEL 5,940 SUPPLIES (Schedule 5) 9,060 POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE Schedule ) ( 5 OTHER EXPENSES (SPECIFY): (Schedule 5) (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 9,060 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD (IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 15,000 Page 1 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2 -PERSONNEL SCHEDULE; GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct project/client services. Positions providing non-direct services must be included in the indirect costs/administrative overhead (IC/AO) line item. The Total CDBG Salary &Wages must match the Budget Exhibit form. Round off totals to whole dollars, AGENCY South Bay Community Services PROJECT South Bay food Program ` (1) (2) (3) (`t) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY& WAGES Youth and Family Associate 39,000 12.00% 4,680.0 TOTAL CDBG SALARY & WAGES 4,680 11. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule (Check One) Monthly Biweekly X Twice a Month Page 2 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3 -PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT South Bay Food Program (1) (2) (3) (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Youth and Family Associate Fica 4,680 7.65% 358 Youth and Family Associate sui 850 2.00% 17 Youth and Family Associate Pension - 0.00% - Youth and Family Associate Health 6,800.00 12.00% 816 Youth and Family Associate W/Comp 4,680 1.47% 69 TOTAL CDBG FRINGE BENEFITI 1,260 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4. Use gross pay for project/total all wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance - Pa Schedule Check One Monthly Biweekly X Twice a Month Page 3 of 5 APPENDIX C-3; PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD (IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT South Bay Food Program {1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5) Total CDBG Budget 15,000 Percentage 0.00% (Must be equal or less than 15%) 1. List all personnel or nonpersonnel (NPE)charged against CDBG funding-include detailed description of indirect use. 2. List total Agency budget for positon and/or NPE line item. 13. List PERCENT of total budget to be charged against CDBG funding. I4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5. Enter the Total FY 13 CDBG Budget; percentage will be AUTOMATICALLY calculated. Pay Schedule(Check One) Monthly Biweekly X Twice a Month Page 4 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY South Bay Community Services PROJECT South Bay Food Program LINE ITEM AMOUNT Detailed Explanation: TOTAL, LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 5 of 5 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length: 1 Page; Max Score: 5 Points) Provide a listing below of the specific tasks or activities needed to implement the proposed prolect':and'a timeline for their completion.Number each task or activity, describe it, and give the projected date of completion Add.:additional rows as needed. ## Tdsk/Activity. Description Completion Date 1. Coordinate volunteersVolunteers are utilized to serve weekly hot meals :On-going through Thursday's Meals,and to assist with the creation and distribution of food packages for the Metro Mobile Pantry 2. ,Serve Hot Meals I :Coordinate and serve hot meals to individuals and On-going families every Monday at 12 pm,Wednesday at 5 pm, Friday at 4 pm and Sundays at 5 pm 4. :Provide access to healthy (Coordinate and distribute food/produce/household On-going food/recipes/education items/recipes and nutrition information to families and individuals bi-monthly through the Metro Mobile Pantry on the Second Tuesday of the month from 5- 7pm and the 3rd Wednesday of the month from 4- 6pm I ' Appendix"D"—Implementation Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identification of Prior Year C®BG and/®r Federal Funds G.I. Agency no South Bay Community Services G.2: Project name: FSouth Bay Food Program G.3. Year of funding: ❑; Fiscal Year 2011 ❑ Fiscal Year 2012 ® Fiscal Year 2013 G.4. Indicate the source of the federal funding awarded to the prior project: ® CDBG ❑' HOPWA !Ell ESG ❑ HOME ❑'' CDBG-R ❑ HPRP ❑ NSP ❑ Other(,dicateberow): G..5. Amount awarded $10,000 G.G. Amount spent'to date ;$10,000 G.7 Amount reprogrammed to date: G.8: Indicate below the outcomes anticipated(refer to the.ori'gindl application for the project; if possible): Provide nutritious and nourishing meals to 300 unduplicated low/moderate income homeless and needy people in (1) the City of Chula Vista at various sites throughout the City. ; (2) At least 51%of those served are at or below 80%of the Area Median income. (3) G.9.' Indicate below the outcomes achieved: As of December 2013, 169 clients (both Chula Vista and non-Chula Vista residents) were surveyed and received (1) nutritious and nourishing meals (2) 1As of December 2013, 100% of those served were below 80%AMI (3) G.10. If any anticipated outcomes were NOT achieved;specify which ones and explain Why below: (Type response herG.) G.L. Agency name: South Bay Community Services G.2 Project name: South Bay Food Program G.3: Year of funding:. ❑ Fiscal Year 2011 ® Fiscal Year 2012 [], Flscal Year 2013 G.4. Indicate the source of the federal funding awarded tot he prior project: ® CQBG ❑I HOPWA [❑ E5G ❑ HOME ❑ CDBG-R ❑ HPRP ❑', NSP ❑ Other(Indicate below)*. G.5.; Amount awarded: ;$10,000 G.6. 'Amountspenttodate: 1$10,000 Amount reprogrammed to date G.8. Indicate below the outcomes anticipated(refer to the original application for theproject, if possible): Provide nutritious and nourishing meals to 300 unduplicated low/moderate income homeless and needy people in {�J the City of Chula Vista at various sites throughout the City. Page 1 of 3—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (2J At least 51%of those served are at or below 80%of the Area Median Income. G.9. Indicate below the outcomesachieved: 683 clients (both Chula Vista and non-Chula Vista residents)were surveyed and received nutritious and nourishing (1) meals (2) :99.7%of those served were below 80%AMI 0 G.10: If any anticipated'outcomes were IVOTachieved,specify which ones and explain why below, [Not applicable. Page 2 of 3—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G.1. Agency name: South Bay Community Services G.2. . Project name:.:: Food Program—Thursday's Meals G.3:.. Year offunding: I ® I Fiscal Year 2011 1 1E] I Fiscal Yeor 2012 ❑' Fiscal Year 2013 G.4: Indicate the source of the federal funding awarded to the prior project: ® CDBG ❑I HOPWA 01 ESG ❑', HOME ❑ CDBG-R ❑ HPRP EJ NSP I❑' Other(lndicatebelow): i i i I GS: Amount awarded: $10,000 G.6.:.Amount.spent to date %0,000 G.7. Amount reprograrnmed to date: G.B Indicate below the'autcomes anticipated(refer to the:origirial application forthe project, if possible). !Provide nutritious and nourishing meals to 300 unduplicated low/moderate income homeless and needy people in (1) the City of Chula Vista at various sites throughout the City. (2) At least 51%of those served are at or below 80%of the Area Median Income. (3) G.9.. indicate below the outcomes achieved: 396 clients (both Chula Vista and non-Chula Vista residents)were surveyed and received nutritious and nourishing (.1) meals (2) 100%of those served were below 80%AMI (3) G.10. If any anticipated outcomes were LVOT achieved,specify which ones and explain why below: [Not applicable: Page 3 of 3—Supplement to Appendix E Application No. 5 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Jacobs &Cushrhan'san Diego Food Bank,, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Food 4 Kids Backpack Program Project Description: The Food 4 Kids Backpack,Program provides food to people in need and connects the 1people served to'a range of health and hum'a' n'services , 'providers. The program'advocates',for the hungry and I educate the , 'public about hunger in the community. Type of Program/Project: Public Services [(§570.201(e)] Target Populatloh:' 05W'- Food Banks, Proposed Number; 100 to Serve: (subject to cho'n'g6 &R§'570''208(a)(2)'Lo' w depending on funding Moderate Income recommendation) Limited Clientele Program Total Budget: $300,000 C. V. Cost per Client: $200 (Based on funding recommendation) Funding Request: $20,0100 Prior Year,Funding: $0 Specific Use of Chula Vista Personnel Costs FUNDING $15,000 Funding: ($2,309) and Supplies RECOMENDED ($17,721) Staff Notes:: COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM - Application for Funding for Fiscal Year 2014-2015 CHUIAVISTA Application Number: Project category: X Public service (CDBG Program Office use Only] (check one only) Capital improvement Applicant Agency Information Applicant legal name: Jacobs &Cushman San Diego Food Bank I Type of agency: X 501(c)(3) ❑ Gov't./Public ❑ For Profit ❑ Faith-Based ❑;Other: Agency Address: 9850 Distribution Avenue San Diego CA 92121 Date of incorporation: May 2006 'Tax ID number. 120-4374795 Agency DUNS number: 101-573-5903 '. Annualoperating budget: ;$7,700,00 Number of paid staff: 41 Number of volunteers: 121,000 Agency mission statement: The Jacobs &Cushman San Diego Food Bank provides food to people in need and connects the people we serve to a range of health and human service providers. We advocate for the hungry and educate the public about hunger in our community. Project Title: jFood 4 Kids Backpack Program Brief project description: The Food 4 Kids Backpack Program provides food to elementary school children who receive free/reduced price school meals during the week, but risk hunger during weekends when school meals are unavailable. Funding Request Total funding requested in this application Other funds already secured for (you will provide a detailed budget inAppendix C. $20'000 project. $50,000 Total cost to complete project: 4$300,000 , ` Other funds not yet securedfor $250,000 Project Information If Project is a Public Service, will service be site specific? X Yes No •; If your answer is yes, please provide:.,Address(es)below:::. Census tract. John montgomery Elementary, 1601 Fourth Ave.,Chula Vista, CA 91911 :13204 :Harborside Elementary,681 Naples St., Chula Vista,CA 91911 113309 ;Calvin J. Lauderbach Elementary, 390 Palomar St., Chula Vista, CA 91911 13203 Target Clientele:(Homeless, Youth; Youth Elderly, Disabled, Other/General) The following questions on individual clients and households to be served apply only to Public Service, and Minor Residential Rehabilitation projects: Will the project serve individual clients(IC) or households(HH)?-T X Individual clients ❑ Households Total unduplicated IC/HH served: 100 Annual cost per client/household: $200 per student; $0 cost to participants or schools Page 1 of 8 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Project_Details (Max Score: 25 Points) 1.1. Provide a concise description of the proposed project(this description must match the one provided on the cover page). Space for a fuller narrative is provided in Appendix A. The Food 4 Kids Backpack Program provides food to elementary school children who receive free/reduced price school meals during the week, but risk hunger during weekends when school meals are unavailable. 3 1.2. Project start date: ;September 2014 Anticipated end date: June 2015 1.3. Project's days/hours of operation: Weekly for 36 weeks 1.4. Project X Public service 1.5 Project X Suitable living environment category: objective ❑ Decent housing (check one only) ❑;Capital improvement (check one only) ❑'' Economic opportunity 1.6 Project X Availability/accessibility outcome: 1 :E] Affordability (check one only) ❑ Sustainability 1.7. CDBG Criteria: Which CDBG criterion below does your proposed project meet? ❑ (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income(LMI). Please provide a map identifying the Census Tracts designated as LMI. X (2) Limited clientele(select subpart below): (a) Special needs group (select benefit group from the list below): rE (i) Abused children (ii) Elderly persons 62 years or older (iii) Battered spouses (iv) Severely disabled adults (not children)—Census definition,documentation required (v) illiterate adults (vi) Persons living with HiV/AIDS (vii) Migrant farm workers ❑ (viii)Homeless persons X (b) At feast 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics?--Free and reduced price school meal participants. ® (3) Housing(select subpart below): :❑ I (a) Single family(must be 100%LMI) ❑ (b) Multi-unit(must be 51%LMI) 1.8. The 2010-2015 Consolidated Plan goals are listed below. Select the goal appropriate to your project: ❑ Affordable Rental Housing Opportunities ❑ Maintenance and Preservation of Housing (rehabilitation activities) ❑ Homeownership Opportunities (homebuyer programs) ❑ Community Enhancement(public facilities/spaces) X Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 8 {Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length f®r Questions 1.10 to 1.15: 2 Pages) 1.10. Explain how the proposed project addresses the goal selected: ;The Food 4 Kids Backpack Program addresses the "Special Needs and Homeless Priorities Including Public Services. . objective by providing basic and essential services—weekly food bags, information on nutrition and social service programs and assistance with gaining Cal Fresh benefits—to local students and their low-income families. 1.11. Summarize any statistics and other supporting documentation that demonstrate the importance of addressing this need or problem: The Food Bank's stakeholders are particularly concerned by the increasing problems of childhood hunger. The 446,000 human beings who live in poverty in San Diego County include 137,000 children under the age of 18. Poverty is a i condition that almost always equates to poor school performance, missed meals and chronic illness. Nutrition affects a child's cognitive, social, and emotional development. Hungry children have enormous problems in school. Children who do not get the nutritious food their bodies need are more likely to have problems learning, growing, and interacting with their teachers and peers.Signs of chronic hunger can be short attention spans; inability to concentrate; excessive absences; hyperactive, aggressive, irritable, anxious,withdrawn, distressed,or passive/aggressive behaviors; difficulty in forming friendships and getting along with others; and/or frequent sickness,such as sore throat, the common cold, stomach ache, ear infection, and fatigue. While tens of thousands of families are receiving meals through the Food Bank's huge warehouse distribution programs, we are painfully aware that too many of the poorest and most hungry children either"slip through the cracks" or do not receive enough personal food once it is distributed through our existing food programs. When it comes to childhood hunger,we have only one goal:to eliminate it-completely. We realize such a goal demands the creation of powerful programs, and our Food 4 Kids Backpack Program is exactly that! 1.12. List each service provided by the project. For each service, indicate whether it is a new service or an expansion of an existing service: ;The Food 4 Kids Backpack Program targets chronically hungry children in San Diego County by working in select public schools where large percentages of the children receive government-sponsored free meals during the school week, but have no such provisions over weekends. All children who receive free/reduced price lunches through government programs are eligible to receive Food Bank backpacks. Chronically hungry children are identified by teachers and school staff using a referral form that provides guidelines and warning signs for program eligibility.These children are provided new backpacks each school year. Every Friday,the backpacks are filled with food that is nutritious, nonperishable, and easily-consumed. Confidentiality and discretion are always a priority and parents of participating children are requested to sign approval forms for participation. In Chula Vista specifically,the Food 4 Kids Backpack Program assists 25 students at Calvin J. Lauderbach Elementary, 25 students at Harborside Elementary and 50 students at John Montgomery Elementary. If possible,we will look to expand on the existing levels of service to these schools. 1.13. How does your agency plan to tell the target population about the project/services? ;Working with principals, counselors,school nurses,teachers and parents,the Food Bank has several means to promote the Food 4 Kids Backpack Program to the target population and to identify potential participants. Confidentiality and discretion are important considerations for everyone involved, so more personal and targeted communication are key to the program's success and growth. Page 3 of 8 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 1.14. List up to three outcomes of the project(at least one is required). For each outcome listed, provide the number of participants who will benefit and the way data will be collected to track or verify the outcome: 1. 50 students at John Montgomery Elementary, 25 students at Harborside Elementary and 25 students at Calvin J. Lauderbach Elementary School will receive a backpack full of child-friendly, nutritious food every Friday during the school year. 2. The Jacobs &Cushman San Diego Food Bank will send home in backpacks information about nutrition,food distributions and other social services available to low-income households. 3. The Jacobs&Cushman San Diego Food Bank will offer assistance in prescreening and qualifying Montgomery, Harborside and Lauderbach families to receive CalFresh benefits (formally Food Stamps). For the first outcome,the Food Bank maintains records of the number and weight of the bags of food delivered to each school each week. Regular reports from school personnel provide additional information on the program's reach and impact. For the second and third outcomes,the Food Bank's Direct Services Manager, Daniela Solano oversees the availability of these additional services. 1.15. Will the project collaborate with other service providers in the community?If yes, list them X Yes ❑ Na and briefly describe the collaboration: The Food Bank is proud of its strong, working relationship with the Chula Vista schools participating in the Food 4 Kids Backpack Program. For this particular project, the Food Bank will continue to collaborate with John Montgomery Elementary, Harborside Elementary and Calvin J. Lauderbach Elementary.At each school, key school administrators work with teachers to identify and enroll eligible students.The Food Bank delivers weekly packs of food which are then distributed by the individual school sites to participating students. Page 4 of 8 (Revised.121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 2: Agency Capacity (Max Score: 10 Points) 2.1. Who will be the person responsible for the overall oversight of the proposed project? Name of person: :Vanessa Franco Title of person: Vice President, Operations Relevant education: Some college coursework, LEAD San Diego graduate and Fieldstone Foundation graduate. Telephone number: 858-863-5114 Date first employed; ,11/2003 2.2. Who will be the alternate person responsible for the overall oversight of the proposed project? i Name of person: :Casey Castillo Title of person: :Vice President, Finance 'I Relevant education: :MBA from Cal State, San Bernardino Telephone number: 858-863-5116 Date first employed: 03/2008 2.3 Who will be the person responsible for the day-to-day operations and management of the proposed project? Provide no more than two individuals: Name of person: Daniela Solano Title of person: 'Direct Services Manager Relevant education: Degree in Psychology from San Diego State University Telephone number; $58-863-5143 Date first employed; 12/2008 Name of person: Vanessa Franco Title of person: :Vice President, Operations Relevant education: :Some college coursework, LEAD San Diego graduate and Fieldstone Foundation graduate. Telephone number: 858-863-5114 Date first employed: 11/2003 2.4. Who will be the person responsible for the financial oversight of the CDBG expenditures and fiscal compliance? Provide no more than two individuals: Name of person: Casey Castillo Title of person: Vice President, Finance Relevant education: MBA from Cal State San Bernardino Telephone number: 858-863-5116 Date first employed: 03/2008 Name of person: Title of person; Relevant education: Telephone number: Date first employed: Page 5 of 8 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to 2.8: 1 Page) 2.5. List the evaluation tools your agency plans to employ to track and monitor the progress of the project. ;Reports from school personnel experienced with the program assure us that the Food 4 Kids Backpack Program has a significant positive effect on student attendance, attention in the classroom,grades, social interactions, personal hygiene and overall health of the student. The following program control documents guarantee the program is consistently evaluated and outcomes measured: Parent Permission Slip in English and Spanish, Memorandum of Understanding with host school, "Identifying Chronically j Hungry Children" handout,Student Referral Form, School Program Coordinator Responsibilities, Coordinator Evaluation Form, Monthly and Year-end Report forms. The Food Bank evaluates progress toward goals by using straightforward benchmarks that relate to themes of reliability, sensitivity, and quality nutrition. Our benchmarks to measure effectiveness for both programs are responsible and adequate and will continue to include the questions: o Did all participating children receive a quality backpack that week? ® Are sensitive issues involving human dignity handled quickly and effectively? ® Are adequate food records and interactions with children reported? ® Has the school Program Coordinator filed a monthly report to the Food Bank? These records and reports—the raw material for evaluating the program—will continue to be collected and reviewed by the Direct Services Manager or Vice President of Operations. The data is used to identify necessary program changes or even to modify tactics if data merits such change. 2.6. How does your agency plan to ensure compliance with applicable policy and procedural requirements(including those listed in HUD's "Playing by the Rules"Handbook)? The Food Bank has years of experience successfully managing projects and programs supported with CDBG funding from cities throughout San Diego County. Through the concentrated efforts of key Food Bank personnel—including the Vice President of Finance,the Vice President of Operations,the Risk Management Manger and the Direct Services Manager— the Food Bank plans to continue to strictly follow the applicable policy and procedural requirements as outlined. In addition, the Food Bank monitors the activities of Backpack Program schools by conducting full site visits at least once a year. 2.7. Describe any unresolved ADA issues in the project or project office and how your agency plans to address them. (if the objective of the project is ADA rehabilitation, do not repeat the project description here.) ;[There are no unresolved ADA issues in the project or project office that the Jacobs& Cushman San Diego Food Bank is aware of at this time.] 2.8. How many members does your Board of Directors have? 18 How many Board members are also members of the project's target population or reside in 3 the project's target area?Indicate which ones in Appendix F. Page 6 of 8 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3.1. Briefly describe your agency's payment and disbursement procedures, with relevance to the proposed project: ;Invoices are received by the Accounts Payable department and are approved by the CFO before processing. Once checks are processed,they are approved and signed by the CFO and President before disbursement. 3.2. Describe how your agency's Board of Directors exercises programmatic and fiscal oversight: The Board of Directors approve any significant program changes or any fiscal expenses more than $25,000 (not included in the budget). The Board is updated regularly on the status of all projects. 3.3. Briefly describe your agency's financial reporting system/accounting procedures, with relevance to the proposed project:. !The Food Bank prepares its financial statements in accordance with General Accepted Accounting Principles(GAAP), and identifies costs associated with the CDBG Project in QuickBooks accounting software. 3.4. Briefly describe your agency's record keeping system, with relevance to the proposed project: The Food Bank uses QuickBooks accounting software and records revenue and expenses related to the CDBG Project with a special CDBG classification. 3.5. Briefly describe your agency's auditing requirements, including those for the proposed project. :The Food Bank uses QuickBooks accounting software and records revenue and expenses related to the CDBG Project with a special CDBG classification. 3.6. Briefly describe your agency's internal controls to minimize opportunities for fraud, waste, and mismanagement: 'The Food Bank uses segregation of duties, supervisory and Board review,and purchase authorization guidelines to help minimize risk. An annual audit and review is conducted to further ensure minimum risk. 3.7. How does your agency plan to segregate CDBG funds from other agency funds for purposes of identification, tracking, and reporting? ;CDBG revenue and expenses are recorded using a unique class, identifying these transactions to the CDBG project. In turn,funds and expenses are separated from others. Page 7 of 8 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agenicy Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) 4.1. Briefly highlight your agency's experience and major accomplishments in providing services to LMI residents and/or communities. You may expand in Appendix A. [The Food Bank was founded in 1977, making it one of the oldest food banks in the U.S. Since then,we have grown steadily, servicing a growing population of more than 3 million people in San Diego County. As our community's#1 safety net for hungry people,we have a proven ability to recover fresh,frozen, canned and boxed food and redistribute it quickly to those who are in need. We provide food to people in need and connect the people we serve to a wide range of health and human service providers. Through a combination of government programs and partnerships with 330 San Diego County non-profit allies, the Food Bank acts as a central repository and distribution point for government and donated food. Funded by foundations, corporations, the USDA and individual donors,the Food Bank distributed nearly 20 million pounds of food last year to impoverished individuals, families and our network of non-profit partners that work with us to alleviate hunger throughout San Diego County. Of that, more than 7 million pounds of food distributed was in the form of fresh produce. Together with its community allies,the Food Bank serves 320,000 San Diegans every month, including more than 1,400 students through the Food 4 Kids Backpack Program. 4.2. Has your agency received CDBG or other federal funds in any of the past three fiscal years (Fiscal Years 2011-2012,2012-2013, through 2013-2014)?If yes, complete Appendix G for X Yes [� No each of the grants received far the three Fiscal Years 2011,2012, and 2013. Section 5: Back-Up Plan, (Max Score: 5 Points;) 5.1. Will your agency still implement this project should CDBG funds not be awarded?If yes, how X Yes jEJ No will the implementation be achieved? ,[The Food Bank is committed to addressing the negative impacts poverty and food insecurity have on local residents, especially the 137,000 children living at or below the poverty line. The Food 4 Kids Backpack Program provides an effective avenue for getting healthy, nutritious food in the hands of needy students who may not find enough food to eat at home. Should the Food Bank not receive CDBG funding,the program would continue with private individual, corporate and foundation support, but growth in the number of participants would likely stall. 5.2. If funded, how will your agency continue this project if CDBG funds are not available in future years? ,,[Recently, the Food Bank has taken steps to ensure the Food 4 Kids Backpack Program can continue into the future by being able to withstand potentially reduced funding in future years. An endowment is being built to provide a reserve source of funding should the need arise. In addition,we continue to ramp up our fundraising efforts to solicit support from a wider range of potential funders. As the program grows to meet increasing need,the Food Bank will not fund a school one year then pull the program because of insufficient funds. Page 8 of 8 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix A: Narrative of Project (Max Length: Z Pages) In tvv0 pages or less, explain belowyour proposed project and make Che case why iGshould be a>niarded funding. IThe mission of the Jacobs and Cushman San Diego Food Bank(Food Bank) is to provide food to people in need in San Diego County and connect the people we serve to a range of health and human service providers.We are advocates for the hungry and strive to educate the public about hunger in our community. Now in our 371h year,the Food Bank is presently operating at the absolute zenith of effort in our fight to solve skyrocketing childhood hunger; reduce barriers faced by poor families to fresh and nutritious Foods;improve poor participation rates by this same population in such programs as CalFresh,WIC,and FITC; and other comparatively new initiatives targeting tens of thousands of poor seniors and,surprisingly,military dependents. The Food Bank, in partnership with 330 local nonprofit human services agencies,is now providing emergency food to 320,000 people every month.That is nearly 10%of the entire population in San Diego County! In our last full year,the Food : Bank distributed nearly 20 million pounds of food-equal to 15.7 million meals.This is remarkable since just 5 years ago we were distributing 9 million pounds,or 7 million meals.This doubling of scope combined with our proven fiscal responsibility has earned the Food Bank the top 4-Star rating from Charity Navigator.We've also been awarded the prestigious California Award for Performance Excellence (CAPE),the criteria for which is defined by the Baldrige National Quality Program. Both awards recognize the Food Bank's innovative programs,operational efficiency, and organizational leadership. Without doubt, one of our most popular and effective programs targeted at an especially vulnerable segment of our population is the Food Bank's Food 4 Kids Backpack Program (F4KBP). F4KBP provides backpacks full of nutritious,child-friendly food to elementary school children who are receiving free breakfast or lunch at school during the week,but are lacking adequate food at home over the weekend. Backpacks are filled with kid-friendly food every Friday to ensure these children do not go hungry while away from school. The Food Bank's stakeholders are particularly concerned by the increasing problems of childhood hunger.The 446,000 human beings who live in poverty in San Diego County include 137,000 children under the age of 18. Poverty is a condition that almost always equates to poor school performance,missed meals and chronic illness. Nutrition affects a child's cognitive,social,and emotional development. Children who do not get the nutritious food their bodies need are more likely to have problems learning,growing,and interacting with their teachers and peers. Hungry children have enormous problems in school.Signs of chronic hunger can be short attention spans; inability to concentrate; excessive absences; hyperactive,aggressive,irritable, anxious,withdrawn,distressed,or passive/aggressive behaviors; difficulty in forming friendships and getting along with others; and/or sickness,such as sore throat,the common cold,stomach ache, ear infection,and fatigue. While tens of thousands of families are receiving meals through the Food Bank's huge food distribution programs, we are painfully aware that too many of the poorest and most hungry children either"slip through the cracks"or do not receive enough personal food once it is distributed through our existing food programs. When it comes to childhood hunger,we have only one goal:to eliminate it-completely. We realize such a goal demands the creation of powerful programs, and the F4KBP is exactly that! The F4KBP targets chronically hungry children in San Diego County by working in 31 select public schools where large percentages of the children receive government-sponsored free meals during the school week,but have no such provisions over weekends. All children who receive free lunches through government programs are eligible to Appendix"A"-Narrative Page 1 of 2 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION receive Food Bank backpacks.Working with school principals, counselors,teachers,parents,and dedicated volunteer leaders,the Food Bank initiated our Food 4 Kids Backpack Program in 2006 by targeting 75 needy children in 2 of our poorest institutions. Presently,we are operating the program for a staggering 1,400 children--a remarkable 1,700%increase in program scope over the last seven years! The Food Bank is requesting$20,000 for support of the Food Bank's Food 4 Kids Backpack childhood hunger program at three Chula Vista elementary schools.As the cost per child is$200 for the entire school year,this grant will cover the full costs for 100 chronically hungry children in the 2014-2015 school year at John Montgomery(50), Harborside (25) and Calvin J. Lauderbach (25) elementary schools. Participating children,who are always extremely low-income,receive backpacks of healthy, child-friendly foods to help them through long weekends at home where too often there is little or no food available. The Food Bank carefully plans to ensure that only nutritious,child-friendly foods are stocked in our backpacks. These items may include: Breakfast Items-granola bars,cereal, oatmeal,graham cracker snacks. Lunch/Dinner Items-peanut butter,macaroni and cheese,soups, pop-top beans and franks,chicken/tuna"to go." Snack Items- fruit cups,fruit roll-ups,pudding cups,applesauce cups,mini raisin boxes, and shelf stable milk and juices. The F4KBP accomplishes the following goals; ® Removes the barrier of hunger that contributes to poor school performance. ® Increases nutritional intake of participating students by providing healthy food in backpacks,limiting sugars and"empty" calories. ® Increases awareness among parents and guardians about resources available to low-income families in their community by including handouts about nutrition and other social service resources in backpacks. With funding support from the City of Chula Vista,the Food Bank can continue to provide critically needed and highly nutritious weekly meals to 100 of Chula Vista's most food insecure children.These meals will assist these students in making the most of their educational opportunities by seeing that one of their most basic needs-food-- is being met every week. Appendix"A"-Narrative Page 2 of 2 (Revised 121412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 201.4-201.5 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step(1): Enter the FY 2011-2015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step (3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL TY 2014-2015 CDBG Application Request from City of Chula Vista(Step 1) $20,000 6.67% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds 0.00% Private Funds $50,000 $205,000 85.00% Agency Funds $25,000 8.33% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% /0.00% 0.00% TOTALI $75,000 $225,000 100% TOTAL PROJECT BUDGETI $300,000 APPENDIX C-2: THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three (3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both puiposes. Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements. FY 2012/2013 CY Page# 4 Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 1,007,0$6 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 4,028,344 List the amount of FY 2014-2015 CDBG funding applied for this application. 25,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. 1,000,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 1,025,000 Compare Agency Cash Balance Available(Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item A 4,028,344 Item B 1,025,000 Difference 3,003,344 Analyze Results 1-If difference is a positive amount or equals $0,the Agency is eligible to apply. 2-If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance,as long as: A) EACH PROJECT MEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATIONS, AND B)CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX C-3: PUBLIC SERVICE SCHEDULE I -BUDGET EXHIBIT AGENCY Jacobs&Cushman San Diego Food Bank PROJECT Food 4 Kids Backpack Program E CDBG Percentage SALARIES &WAGES (Schedule 2) 2,309 FRINGE BENEFITS (Schedule 3) TOTAL PERSONNEL 2,309 SUPPLIES (Schedule 5) 825 POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) 99 PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) 297 RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPECIFY): Food Purchases (Schedule 5) 16,500 (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 17,721 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD (IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 20,030 Page I of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAS' The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct proj ecticlient services.Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO) line item. The Total CDBG Salary&Wages must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Jacobs &Cushman San Diego Food Bank PROJECT Food 4 Kids Backpack Program (1) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES Project Coordinator 36,000 1.32% 475.2 Program.Coordinator 45,000 3.30% 1,485.0 Driver 33,000 1.06% 348.5 TOTAL CDBG SALARY&WAGES 21309 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 2 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3 - PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount.The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Jacobs &Cushman San Diego Food Bank PROJECT Food 4 Kids Backpack Program (I) (2) (3) (4) (5) (6) i AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT TOTAL CDBG FRINGE BENEFIT - 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4.Use gross pay for project/total all wages of agency.Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule (Check Ong Monthly Biweekly Twice a Month Page 3 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD (IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Jacobs & Cushman San Diego Food Bank PROJECT Food 4 Kids Backpack Program (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 20,030 Percentage 0.00% (Must be equal or less than 15%) 1.List all personnel or nonperson el (NPE)charged against CDBG funding-include detailed description of indirect use. 2. List total Agency budget for positon and/or NPE line item. 3. List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5. Enter the Total FY13 CDBG Budget; percentage will be AUTOMATICALLY calculated. Pgy Schedule(Check One) Monthly Biweekly Twice a Month Page 4 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Jacobs &Cushman San Diego Food Bank PROJECT Food 4 Kids Backpack Program i LINE ITEM Transportation AMOUNT Detailed Explanation: Cost to transport product to Backpack schools. This includes vehicle insurance 297 and fuel costs. Food Bank uses the IRS standard of 56 cents per mile. TOTAL $ 297 LINE ITEM Supplies AMOUNT Detailed Explanation: This includes general office supplies and storage containers to cover staff 825 directly related to the program. Includes backpacks and plastic bags used to house food that is inserted into each backpack. TOTAL $ 825 LINE ITEM Food Purchases AMOUNT Detailed Explanation: Includes food purchases to support the program. 16,500 TOTAL $ 16,500 *All line items must be justified in relation to CDBG-fiinded activities to be completed. Add pages as needed. Page 5 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Jacobs&Cushman San Diego Food Bank PROJECT Food 4 Kids Backpack Program LINE ITEM Maintenance/Repairs AMOUNT Detailed Explanation: This includes maintenance repairs for Food Bank fleet. 99 TOTAL $ 99 LINE ITEM Salaries &Wages AMOUNT Detailed Explanation: Includes salary and wage allocation for all employees directly associated 2,309 with backpack program. TOTAL $ 2,309 LINE ITEM Food Purchases AMOUNT Detailed Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 6 of 6 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length: 1 Page; Max Score: 5 Points) Provide a listing'below'of the specific tasks or activities needed to implement the proposed.project and a timeline for their:completion.Number each'task or activity, describe it;.andgive the projected date of completion.Add`additional rows`as needed. . . '.. # Task/Activity Description Completion Date n supplies Back acks bags food u 2014 food and s 1 purchase ( pp 1 p � g � g� 12 Create calendar of deliveries; share (Schools receive calendar with delivery schedule (Aug. 2014 with schools -F37 11dentify and enroll students Staff at school identify"at risk" students to Sept. 2014 participate 1 and ongoing I ;4 Begin backpack distribution I JDelivery of backpacks to school and distribution to (Sept. 2014 I students 5 ssemble and deliver bags of food 1 Child's bags of food are assembled at Food Bank and ISept. 2014 delivered as scheduled I and ongoing 16 (Conduct CalFresh Outreach lPrescreen interested families for CalFresh eligibility Ongoing 7 I jReceive referrals and record data Schools submit referral forms for students in 1,Sept. 2014 program I and ongoing I 8 I lReceive monthly reports I (Schools submit monthly progress reports Oct. 2Q14 and ongoing 19 F (Conduct annual site visits with schools isit schools to monitor program annually I Nov.2014 and ongoing I i iI 3 II 11 it Appendix"D"--Implementation Page 1 of 1 (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix E: Roster of Board Members & Professions Provide a roster of the members ofyour agency's Board of Directors arid.their professions by filling`out the table ... below: Member. of Target Resides in Name%Board Position Profession/Affiliation Target Populaho Area Larry Cleary/Chairman Vice President, Sales Indyme ❑ ❑ Steve Berstein/Vice Chairman J Business Banking President/Wells Fargo 1 ❑ 1Dan Devine/Secretary Executive Vice President/CFO/Bridgepoint Ed 10 ❑ Sheldon Derezin/'T'reasurer Consultant/Wazie Sanitary Supply I El 171 Bruce Hollingsworth/Past Chairman Retired I ❑I ❑1 David Bejarano Chief of Police, Chula Vista 1 101 X 'Bob Bolinger Sr.Vice President/Marketing Manager/KYXY I1❑ ❑i Aimee Fawcett I 'Executive VP Public Policy&Member Services j ❑ ❑, 1Anne M. Goshert I ISr. Customer Marketing Mngr/Coca-Cola ❑ 10 Once Kasperick I IFounder&President/AimLoan.com I TE1F 10 ames A. Floros President&CEO Jacobs&Cushman San Diego ❑I X Food Bank I ISteve Hoffman Consultant/Energy Industry 101 ;❑ 1Carlos Illingworth 1Director, Public Affairs&Gov't Relations 1 101 Richard Kelley jPresident&GM/NBC San Diego ❑ ❑, Kimberly Layton _ 'Director of Public Affairs/San Diego Chargers ❑ ❑ erry Swain Founder&CEO/Jer's Chocolates 1❑ ❑i (Erica Fessia Independent Consultant/Qualcomm Demise Durkin I 1Product Dev. Mgr./Jenny Craig I1❑ ❑� i 1❑I ❑ Appendix"E"—Roster of Board Members and Professions Page 1 of 2 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix F: Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests, payments,and campaign contributions must be filed.The following information must be disclosed: 1. List the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e.g.,owner,applicant,contractor,subcontractor, material supplier). [[None I 2. If any person* identified in section 1 above is a corporation or partnership, list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership) entity. [[N/A]l 3. If any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee, beneficiary and trustor of the trust. I[N/A]l 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. [James A. Floras, Casey Castillo,Vanessa Franco, Kaye de Lancey Hentschke, Daniela Solanoll 5. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official**of the City of Chula Vista as it relates to this contract, project or application within the past 12 months?Yes❑JNoX If yes, briefly describe the nature of the financial interest the official may have in this contract. [EN/Ali 6. Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than $250 within the past twelve(12) months to a current member of the Chula Vista City Council?No,X es❑l If yes,which Council member(s)? IN/All 7. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value, money to retire a legal debt,gift, loan,etc.)Yes❑INoX if Yes, list official and what was the nature of item provided? [N/All 8. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of Income of$500 or more to an official**of the City of Chula Vista in the past twelve(12)months?Yes!❑ INoX If Yes,identify the official and the nature of the income provided? 11[N/All ,[January 27, 2014-1 e. James A. Floro Signature: * Person is defined as:any individual,firm,co-partnership,joint ve ture�s dation,social club,fraternal organization,corporation, estate,trust, receiver,syndicate,any other county,city, municipa'iy�distric,,or other political subdivision,or any other group or combination acting as a unit. ** official includes,but is not limited to: Mayor,Council member,Planning Commissioner, Member of a board,commission,or committee of the City,and City employees or staff members. Appendix"F"--Disclosure Statement Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identification of Prior Year CDBG and/or Federal Funds 0.1.;;!Agency name: ) acobs&Cushman San Diego Food Bank G.2. Project name. Tood 4 Kids Backpack Program G.3. Year of funding I ❑I I Fiscal Year 2010 1 �❑I Fiscal Year 2011 X Fiscal Year 2012 G.4. Indicate the`Ource'of the federal funding awarded to the prior project: X CDBG ❑' HOPWA '❑ ESG ❑ HOME CDBG-R ❑ HPRP ❑ NSP I LJ1 Other(indicate6elowJ: I .G.5 Amount awarded: $15,500 G.6. •Amount.spent:to date::';1 J$15,500 G T to Amount reprogrammed date: D G.8. Indicate below the:'outcomes anticrpated(refer to the original application for the:project'rf possible) A total of 100 students at Montgomery, Harborside and Lauderbach elementary schools would receive a backpack (�) full of child-friendly, nutritious food every Friday during the school year. he Food Bank will send home in backpacks information about nutrition,food distributions and other social (2)' services available to low-income households. Food Bank staff will offer assistance to pre-screening and qualify Montgomery, Harborside and Lauderbach families (31 for CalFresh benefits. 6.9:.` Indicate below the outcomes achieved: lA total of 100 students at Montgomery, Harborside and Lauderbach elementary schools received a backpack full of (1): child-friendly, nutritious food every Friday during the school year. j he Food Bank sent home in backpacks information about nutrition,food distributions and other social services (2). available to low-income households. Food Bank staff completed pre-screening for Montgomery, Harborside and Lauderbach famifies for CalFresh (3) benefits. G.10.:If any anticipated outcomes were NOT achieved,specify which ones and explain 'why below: [Ali anticipated outcomes were achieved for this project in this school year. Page 1 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION G.1. 'Agency name; San Diego Food Bank Corporation G.2..; Project name Warehouse Docks, Roadway Improvements; Sorting Room/Clean Repack Room &Addition G.3. Year offuriding: ❑I Fiscal Year 2010 ❑', Fiscal Year 2011 X Fiscal Year 2012 G.4.'> Indicate the source'ofthe federal funding awarded to the prior project: X CDBG ❑ HOPWA ❑ ESG ❑ HOME j❑ CDBG-R ❑ HPRP ❑' NSP I ❑ Other flndicatebefo.): 6.5. ! Amount awarded: $620,000 G.6. 4mount.spent:to date. 11$620,000 G.7. Amount reprogrammed to date: 0 G.S., .indicate below the outcomes anticipated(refer to the original application for the'proiect if possible): (1): Docks and roadway renovation and improvement will result in utilization of 9 docks to deliver food faster. Sorting/repack room completion will result in daily repacking and salvage sorting, increasing the quantities (2); purchased and delivered. `'(3): New racks will increase capacity for food acquisition and safe storage of emergency food. G.9 Indicate below the outcomes achieved: ( ) Renovation and improvement completed; 9 docks now used and food delivery is quicker. Sorting/repack room completed; bulk foods repacked daily while salvage is sorted, increasing the quantities of low- (2), cost bulk food purchased and delivered to the hungry. New racks have been installed, resulting in increased capacity for food acquisition and safe storage of emergency (3) food. G':10. if any anticipated outcomes.were NOT'achieved,specify Which ones;and explain why below: J[N/A I Page 2 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G.L. Agency name San Diego Food Bank Corporation G.2. Project name Warehouse Roof Repair G.3.':> Year of funding ❑ Fiscal Year 2010 X Fiscal Year 2011 ❑! Fiscal Year 2012 G.4. Indicate the sourceof the'federal funding awarded to.the prior project: X CDBG ❑ HOPWA ❑ BSG HOME ❑ CDBG-R ❑! HPRP ❑', NSP ❑ Other(tndicatebelow): i G.5. ' Arno' d:Unt awarde $140,134 6.6. Amount'spent to date: $140,134 G'.7 Amount reprogrammed to date 10 G.9L Indicate below the outcomes anticipated(refer;to the:originalapplication far the project;;if possible) (1) !As a result of warehouse roof repair, 2.5 million pounds of food will be safe from water damage. lAs a result of warehouse roof repair,the inventory of emergency food for 480,000 San Diegans at risk for hunger (2) will be safeguarded. IAs a result of warehouse roof repair,supplies of nutritious emergency food will be available for distribution to (3) food-insecure San Diegans. G.9:. Indicote below the'outcomes achieved: Roof repair was completed, eliminating leaks and ensuring that 2.5 million pounds of food are protected from (1) water damage. iRoof repair was completed, eliminating leaks and ensuring that the emergency food for 480,000 San Diegans at risk (2),,. for hunger is safeguarded. Roof repair was completed,eliminating leaks and ensuring that nutritious emergency food is available for (3) distribution to food-insecure San Diegans. if any anticipated outcomes were NOT achieved,specify which ones:and explain why below: �N/A Page 3 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G 1. `Agency name San Diego Food Bank G 2.: Project name: Food Assistance Program/CA Dept of Social Services/Emergency Food Asst Program (EFAP) G.3. Year bffunding !Ell Fiscal Year 2010 1 Ell I Fiscal Year 2011 X Fiscal Year 2012 6.4. :: Indicate:the source of the federal funding awarded to;the prior project. ❑ CDBG ❑ HOPWA ❑ ESG ❑I HOME ❑i X Other CDBG-R ❑ HPRP L] NSP Pass-through-CA Dept Social Services-Cash Assistance G.S. ';Amount awarded: $315,855 G.6. .Amount spent to date. $316,855 63. Amount reprogrammed to date: 0 G.8. 'Indicate below the outcomes anticipated(refer to the original applicationfor the project,.if possible): Food Assistance Program food will be accepted, received, stored,transported, and distributed to all eligible agencies and families/persons within the service area as approved by the County Board of Supervisors and CA (1) Dept. of Social Services(CDSS). All program-related requirements in accordance with federal and/or state laws, policies, rules, and regulations will (2) be complied with. (3) 1 JEvery effort will be made to maintain the integrity of the food products. G.9.;.Indicate below the outcomes achieved: food Assistance Program food was accepted, received, stored,transported, and distributed to all eligible agencies and families/persons within the service area as approved by the County Board of Supervisors and CA Dept. of (1):' Social Services (CDSS). All program-related requirements in accordance with federal and/or state laws, policies, rules, and regulations `(2)` were complied with. (3). lEvery effort was made to maintain the integrity of the food products. G.10 If any anticipated outcomes were NQT achieved,specify Which ones and explain Why below: I[N/A Page 4 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max length per Project: 1 Page) GA.`; Agencyname Jacobs &Cushman San Diego Food Bank G.I . Project name lCommodity Supplemental Food Program (CSFP)/CA Dept. of Education Nutrition Services G.3. Year`of funding ❑! Fiscal Year 2010 ❑' Fiscal Year 2011 X Fiscal Year 2012 G.4. Indicate the:source of the federal funding oworded to the prior project: ❑i CDBG ❑ HOPWA ❑' ESG ❑ HOME I❑ CDBG-R ❑ HPRP ❑'' NSP I X Oth e r Ondicate below): Pass-through-CA Dept. of Education-Cash Assistance G.5. Amount awarded: $588,808 G.G. . Amount spent to date $588,808 G.T Amount reprogrammed to date 0 G.B. Indicate below the outcomes anticipated(refer to the'orlg nal appiicatiorr`for the project,if passible): Distribution of supplemental food to women, infants and children will be made only to eligible recipients, (1) parents/legal guardians, or proxies. (2) ISupplemental foods will not be issued to persons participating in the WIC program. Distribution to the elderly will be made only to recipients, or their proxies,who have eligibility certification forms (3); completed and signed by authorized personnel. GA:: Indicate below the outcomes achieved: (1) Supplemental foods were distributed only to eligible recipients, parents/legal guardians, or proxies. I (2) INo supplemental foods were issued to persons participating in the WIC program. Distribution to the elderly was made only to recipients, or their proxies, who had eligibility certification forms (3) completed and signed by authorized personnel. alp. if any anticipated outcomes were NOT achieved,specify which ones and explain why below: �N/A Page 5 of 5—Supplement to Appendix E Application No. 6 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" South Bay Community Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Family Violence Treatment Program Project Description: The... Family Violence' Treatment Program provides therapeutic counseling services and crisis, intervention services to 'a'dult, and ou ,children,victims Of Whily violence,, as well 'as treatment and court_ mandated groups for perpetrators'. Type of Program/Project: Public Services [(§570.201(e)] Target Popullatloh:' 05G-Battered and, Proposed Number; . . . . . .. 389 Abused to Serve:, (subject'to cha' nge depending,on funding CFR§'570'.208('a)(2)'Lo' w recommendation) Moderate I'nc'ome Limited Clientele, Program Total Budget: $494,000 C. V. Cost per Client: $100 (Based on funding recommendation) PUricling Request: $39,0140 Prior Year,Funding: $39,000, Specific Use of Chula Vista Personnel Costs FUNDING $39,000 Funding: RECOMENDED Staff Notes:: ORIGINAL COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fiscal Year 2014-2015 C11ULA WSW Application Number: Project category: ® Public service (CABG Program Office Use Only) (cfieckone only) ❑:Capital improvement Applicant A Information pp Agency Y Applicant legal name: South Bay Community Services Type of agency ® 501(c)(3) ❑ Gov't./Public ❑' For Profit I ❑ Faith-Based I IE] Other: AgencyAddressf 430 F Street, Chula Vista 91910 `I Date of incorporation September 1972 Tax ID number: 95-2693142 Agency DUNS number:; 1113407779 Annual operating budget. ;$26,601,738 ;staff. : Number of volunteers: 750 Number of paid staf. Agency mission statement: SECS' mission is to provide children,youth, and families with services that reinforce the family's role in our community and assist individuals to aspire realistically to lives of self-fulfillment. Project Title: Family Violence Treatment Program Brief project description::: The Family Violence Treatment Program provides therapeutic counseling services and crisis intervention services to adult and children victims of family violence, as well as treatment and court-mandated groups for perpetrators. Funding Request Tata!funding requested in this application Other funds already secured for (you will provide a detailed budget in Appendix C; $39,000 ' project: $455,000 Total cost to complete project;. ($494,000 Other funds not yet secured for. $39,000 j Project Information !f Project is a Public Service, w!1l service be site.specific? ❑yes ®No If your answer rs yes, please provide: Addresses)below: Census tract Target Clientele: (Homeless, Youth, Adult and Child Victims of Domestic Violence Elderly,Disabled,Other/General) The following questions on individual clients and households to be served apply only to Publrc'Service,.and Minor Residential Rehabilitation projects: Will the project serve individual clients (IC) or.households'(HHJ? ® Individual clients ❑ Households Total unduplicated!C/HH served:: 389 Annual cost per client/household::.:... $87.40 Page 1 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CABG FUNDING APPLICATION Section 1: Project Details (Max Score: 25 Points) 1.1. Provide a concise description of the proposed project(this description must match the one provlded on.the cover page). Space for a fuller narrative is provided in Appendix A The Family Violence Treatment Program provides therapeutic counseling services and crisis intervention services to adult and children victims of family violence, as well as treatment and court-mandated groups for perpetrators. 1.2: : Project start date.,, . July 1, 2014 1 Anticipated end date' lune 30, 2015 1.3: Project's days/hoursof operation. Crisis intervention is provided 24 hours a day/7days a week. 1.4 Project ®1 Public service 1 5 Protect.. ® Suitable living environment category Objective: 'Decent housing ❑ Capital improvement (rheckone:'only) (check one only) ❑ Economic opportunity 16 Project: ® Availabiiity/accessibility outcome. ❑, Affordability (check oneoniyl ❑'; Sustainability 13; CDBG Criteria: Which CbBG criterion below does your proposed project meet? (1) Area benefit:At least 51% of residents within the targeted activity area are low to moderate income(LMI). Please provide a map identifying the Census Tracts designated as LMI. ® (2) Limited clientele (select subpart below): ® (a) Special needs group (select benefit group from the list below): ❑ (i) used children ❑ (ii) Elderly persons 62 years or older ® (iii) Battered spouses (iv) Severely disabled adults (not children)—Census definition; documentation required ❑ (v) Illiterate adults ❑ (vi) Persons living with HIVIAIDS ❑, (vii) Migrant farm workers ❑ (viii) Homeless persons ❑., (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? ❑; (3) Housing(select subpart below): ❑ (a) Single family(must be 100%LMI) ❑ (b) Multi-unit(must be 51%LMI) 1.8. The 2010-2015 Consolidated Plan goals are listed below. Select the goal appropriate to your project: ❑'' Affordable Rental Housing Opportunities ❑', Maintenance and Preservation of Housing (rehabilitation activities) ❑'' Homeownership Opportunities (homebuyer programs) ❑` Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 1.10 to 1.15: 2 Pages) 1,10`. Explain how the proposed project addresses the goal selected. The Family Violence Treatment Program is designed to benefit the Chula Vista community by providing crisis intervention and support services for those experiencing family violence. The Family Violence Treatment Program assists low and moderate-income persons to overcome the trauma associated with violence, and rebuild safe, healthy lives for themselves and their children, 1.11. Summarize any statistics and other supporting documentation that demonstrate the importance of addressing this need or problem: The current economic climate has created high unemployment coupled with an increased risk of homelessness, placing tremendous stress on families that has resulted in increased demand for domestic violence (DV) and shelter services. This past year, SBCS has responded to a high number of calls to the Domestic Violence Response Team (DVRT) and the emergency hotline, and has noticed a clear increase in the severity of DV incidences.This has created an overwhelming need for both supportive services and emergency shelter for victims and their families. SBCS' priority is to be able to continue providing high-quality core services to as many victims of DV as possible. 1:12: List each service provided by the project. For each service, indicate whether it is a`new service or an expansion of an: existing service The Family Violence Treatment Program includes the following services and activities: ® DVRT for emergency responses, 24 hr. hotline assistance for DV victims, and 24 hr. access to emergency shelter; ® Strengths-based Assessments and Safety Planning for DV victims and their children; ® individual and group counseling for children, and support groups for adults; ® Unique therapeutic pre-school, Mi Escuelita,for child victims of family violence; r On-going case management and support for victims; ® Court-mandated perpetrators' groups; and ® Access to other SBCS programs including emergency and transitional housing,financial self-sufficiency services, and job development services. All of these services are on-going and CDBG funds will assist SBCS in responding to more calls through the DVRT—the entry point for many victims to get the assistance they need to re-build safe, stable and healthy lives for themselves and their children. 1.13. How does your agency plan to tell the target population'about the:project/services? Information about the Family Violence Treatment Program is advertised at the SBCS main agency, through flyers distributed to local Family Resource Centers, schools, the Chula Vista Community Collaborative and through local law enforcement partners. DVRT is also accessed through 211 San Diego and SBCS' emergency hotline. 1.14. List up to three outcomes of the project(at least one is required). For each outcome listed, provide the:number of. participants who will benefit and the way data will be collected to track or verlfylhe outcome _ The overall program goal is to break the cycle of family violence by promoting physical, mental, social and economic health of families within the Chula Vista Community. The program will be evaluated based on the successful completion of the following objectives: ® Provide 389 persons with improved public services; ® 200 victims of family violence will participate in a range of individual, family or group counseling; and ® 165 court-ordered batterers will participate in weekly counseling in the Domestic Violence Intervention Program. Page 3 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 1.15. Will the project collaborate with other service providers in the community?If yes,list them ® Yes No and briefly describe the collaboration: SBCS works closely with the Chula Vista Police Department,the District Attorney's Office, Child Welfare Services, the region's hospitals and clinics, Family Resource Centers operated by the Community Collaboratives, school districts, Legal Aid of San Diego, Family Health Centers, and other local organizations in order to respond effectively to the needs of victims and their families. Y Page 4 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 2: Agency Capacity (Max Score: 10 Points) 2.1.;:: Who will be the person responsible for the overall'oversightof the proposed project? Name of person: Don Hunter Title of person Family Wellness and Self-Sufficiency Department Director Relevant education: B.S. Business Administration Telephone number: (619) 420-3620 Date first employed: 2010 2.2. Who will be:the alternate person responsible for the overall oversight of the proposed project? Name of person:.: :Amaris Sanchez Title of person Program Director Relevant education: 113,A.Women's Studies Telephone number. '(619) 420-3620 Date first employed; 2003 2.3. Who will be the personresponsible for the day-to.-day operations and management of the proposed project? Provide no more than two individuals: Name of person: Don Hunter Title of person: Family Wellness and Self-Sufficiency Department Director Relevant education: B.S. Business Administration Telephone number: ;(619)420-3620 Date first employed: 2010 Name of person: Amaris Sanchez Title of person: Program Director !, Relevant education: B.A. Women's Studies Telephone number: (619)420-3620 Date first employed: 2003 2.4, Who will be the person responsible for the financial oversighrof the CDBG expenditures and fiscal compliance? Provide no more than two individuals Name of person: Elizabeth Iniguez Title of person: CFO Relevant education: B.S. Business Administration Telephone number. :(619) 420-3620 Date first employed. 1993 Name of person: Title of person; Relevant education: Telephone number: Date first employed: Page 5 of 9 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to 2.8: 1 Page) 2.51. List the evaluation tools your agency plans to erriployto track and monitor the progress of the project. Upon entrance into the program, each Victim/family is assessed utilizing the Family Well-Being Assessment, which gauges a victim/family's strengths and barriers. A Family Violence Associate reviews the assessment with the victim/family, and based on its results, work together to create an Individualized Service Plan. As a victim/family progress toward her/their goals, the Family Violence Associate will document client progress in case notes, re-assess her needs and assist in amending the Service Plan relative thereto. 2.6. ' How does your agency plan to:ensure compliance.with applicable policy and procedural:'requirements(including, those listed in HUD's "Playing by Rules.Handbook)?. SBCS receives multiple types of HUD funding, and as such has aligned its financial management policies, methods of procurement and contracting, property management, record-keeping and reporting policies, administration and program requirements, and required financial audits in compliance with HUD's "Playing by the Rules" Handbook. 2.7. Describe any unresolved ADA issues in the project or project office and hour your agency plans to address them. (If the objective of the project is ADA rehabilitation; do not repeat the project description here.) Not applicable. 2.8: :. Now many members does your Board of Directors have? 9 How many Board members are also members of the project's target population or reside rn l5 the project's target area?Indicate which ones in Appendix F. Page 6 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3.1. Briefly describe your agency's payment and disbursement procedures, with relevance to the proposed project, All funds are managed by SECS' Fiscal Department. The Fiscal staff includes the Chief Financial Officer (CFO): Elizabeth Iniguez, 3 Accounting Associates, 1 Accounts Payable Clerk, and 1 Fiscal Aide. The following are SECS' fiscal procedures: Cash Disbursements: cash disbursements are prepared twice a month by our computerized accounts payable program. Payment is done for all authorized check requests. Where warranted, due to the significant amount of the purchase, approval from the Board of Directors is needed. Original supporting documents must be attached to all check request forms. After payment, all supporting invoices are stamped "paid" to avoid duplication of payment. All checks over $1,000.00 require two signatures, the CEO and a member of the Board of Directors. Pre-numbered checks are used on all disbursements. Numerical and physical control is maintained over blank checks as well as issued checks. !Void checks are adequately mutilated and filed in numerical order with canceled checks. Cash Receipts: cash receiving is handled by the receptionist. She is in charge of opening all mail and logging in all checks received.The receptionist is not involved in any fiscal duties. Incoming cash receipts, primarily in the form of checks, are locked in a file cabinet until accumulation merits a deposit. The collection of cash is maintained by a separate cash receipt log. The Deposit is prepared by an Accounting Associate and posted to the general ledger by the Lead Accountant, maintaining discrete accounts for different funding sources. Periodic reconciliation of detailed cash receipt records to duplicate deposit slips, accounts receivables, and cash control accounts are prepared by personnel independent of cash functions. Payroll and Personnel: New employees are investigated before being hired. Wage and personnel policies are current and in writing. Current and complete personnel files are maintained. An adequate system is used to insure proper recording of hours and time. All salary and wage payments are made by check. An outside payroll company is responsible for processing payroll and printing appropriate payroll checks. All payroll checks are delivered to our office for review, and distribution to employees. The payroll account is reconciled by someone other than the person preparing the payroll and signing checks. Revenue, Billing, and Receivables:The CFO prepares all grant billings. Billings are done under reimbursement basis once a month and journalized as a receivable until the proper payment is made. The billings are done either on a preprinted form provided by the grantor or in-house prepared form. The CFO is in charge of monitoring the year-to-date expenses and comparing them to the annual budget. Under no circumstances will billings for a particular expense exceed the annual authorized budget.The fiscal department does a periodic analysis of receivables. Petty Cash and Cash On Hand: Petty cash funds are maintained on an imprest basis, with one individual responsible for the fund. They are not combined with other receipts. Responsibility for petty cash is separate from cash disbursements, receipts, and receivables functions. Limits exist on the amount for reimbursements out of petty cash. Supporting documents are checked and canceled at the time the fund is replenished. The fiscal department makes periodic and surprise counts of funds. 3.2. . Describe ho your agency's Board of Directors exercises programmatic and fiscal oversight South Bay Community Services' Board of Directors meets every other month, during which they receive programmatic updates, and are advised on other significant agency business. The Board of Director's reviews and approves all funding requests, quarterly budget updates and the annual report. The Board is comprised of a number of sub-committees including the Executive Committee and Audit Committee, whose members attend to agency policies, procedures and financial management. The Board also directly oversees the President and CEO, who has the authority to act on the agency's behalf. 3.3. Briefly describe your agency's financial reporting system/accounting procedures, with relevance to the proposed project: The Chief Financial Officer and Fiscal Staff utilize generally accepted accounting procedures in handling disbursement of funds and maintaining fiscal records. SBCS successfully manages more than 60 Federal,State, County, and city grants, as Page 7 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION well as Private Foundation funding. The agency is audited by an independent auditor on an annual basis, and has a history of clean financial audits. 3.4...; Briefly describe your agency's record keeping system; with relevance to the proposed project; Program Evaluation and Quality Management is an integrated process facilitated by the SBCS' Contract Compliance and Quality Assurance Department. The CCQA staff possess extensive experience with monitoring and evaluating service delivery, and they regularly review the conditions of each contract to ensure these conditions are being met correctly and with high quality. SBCS has written policies that address Privacy and Confidentiality and the Release of Information, and all program procedures are HIPAA compliant. Direct service staff will use various tools to measure program success including contact logs, sign-in sheets, client surveys and case notes. All confidential files are transported in confidential lock boxes from program sites to the main agency, and are maintained in locked secure file cabinets when not in use. 3.5. Briefly describe your agency's auditing requirements, including those for the proposed project: South Bay Community Services is audited by an independent auditor on an annual basis, and has a history of clean financial audits. 3.6. Briefly describe your agency's internalcontrols to minimize opportunities for fraud, waste; and mismanagement: In addition to the Fiscal Policies listed above in 3.1, the CFO monitors the budget on a daily basis as receipts and debits are posted, as new grants come in, and as expenses and invoices are paid. There are regular meetings with the President and CEO to make sure funding streams are adequate for programs, and strategies are developed to apply for and acquire more funds as programs expand. 3.7. How does your agency plan to segregate CDBG funds from other agency funds for purposes of identification, tracking, and reporting? Contracts, grants, and other major funding sources are accounted in separate departments to prevent overlap of expenses and maintain separate general ledgers for each funding source. This system facilitates the monthly monitoring of year-to-date expenses by funding source, and accounting for expenses to any particular funding source. CDBG funds will be managed in accordance with this agency policy. Page 8 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-201S CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) 4.1...: Briefly highlight your agency's'experience and major accomplishments in:providing services to LMl residents and/or; communities. You mayexpand in ppendixA. South Bay Community Services (SECS) is a dynamic 501(c)(3) organization and is the largest provider of social service and community development programs in San Diego County's South Bay. SECS serves San Diego County's Southern Region, an area with a diverse population that is greatly affected by immigration, characterized by transience, low socioeconomic expectancy, high crime rates, intense gang activity, and substance abuse, making it difficult for them to find employment, affordable housing, and access community resources and services. SBCS was created by dedicated community members in 1971 as a drop-in center for drug abusing teens. Responding to evolving community needs and concerns, we have developed a wide range of integrated, bilingual, prevention, intervention, and treatment options for youth and families, including mental health counseling; the region's only permanent shelter and support services for homeless families, youth, and domestic violence victims and their children; transitional and affordable housing; drug&alcohol prevention and intervention; domestic violence prevention and intervention; community development; child abuse prevention and intervention; and extensive youth programming. SBCS is the sole provider of comprehensive Domestic Violence services in the South Bay region. Since 1991,SBCS has provided comprehensive, culturally appropriate, integrated prevention and intervention services to victims of domestic violence that promote integrity and self-sufficiency, improve their access to resources, and increase their safety and the safety of their children. On their way to becoming self-sufficient, SBCS' clients achieve major successes with the help of the program, such as learning English,getting a job, saving money, reuniting with their children after completing a drug rehabilitation program, overcoming depression, or getting a home of their own. SBCS is the leader in the state in emergency response to DV victims. SBCS is also the regional leader in providing trauma informed best practices for victims, to the extent that the agency trains other providers throughout the county and the state. 4.2. Has your agency received CDBG or other federal funds in any of the past three fiscal years (Fiscal Years 2011-20.12,2012-2013, through 2013-2014)?If yes, complete Appendix G for ® Yes 0 No each of the grants received for the three Fiscal Years 2011,2012;.and 2013 Section 5: Back-Up Plan (Max Score: 5 Points;) 5.1. Will your agency still implement this project should CDBG funds not awarded?if yes, how ® yes El. No will the implementation be achieved? The need for Domestic Violence Services has increased at a time when funding has decreased significantly, so CDBG support of the Family Violence Treatment Program is essential to sustain this much needed service within the community. If funded at an amount less than requested, we will continue to provide Domestic Violence Services, but will be forced to serve fewer victims and children. 5.2. If funded, how will your agency continue this project if CDBG funds are not available in future years? Funding support for the Family Violence Treatment Program is spread over a wide base of local, county, state, and federal agencies as well as individual donors, local corporations, and private foundations,to guard against program closure because of the loss of a funding source.The Board of Directors works hard each year to put together our annual fundraiser, "Change Their Lives" with all proceeds benefitting Mi Escuelita and our children's domestic violence services. We have also begun a social enterprise, East Side Sequel, an upscale resale boutique which not only provides jobs for our community members, but profits benefit our domestic violence programs.This strategic formula will create sustainability over time through the leveraging of diverse funding sources, and limits liability and dependence upon one type of support. Page 9 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix A. Narrative of Project (Max Length: 2 Pages) In two pages or less, explain below your proposedproject and make the case Why itshould be awarded funding.. , Since 1991, SBCS has provided the South Bay's only comprehensive Domestic Violence services,including a 24/7 Domestic Violence Response Team (DVRT), emergency shelter and transitional housing, counseling, children's services, and a wide array of other support services.The Family Violence Treatment Program coordinates the following therapeutic services and crisis intervention activities: • Domestic Violence Response Team (DVRT), responds with law enforcement to 911 calls involving domestic violence,provides 24 hour hotline assistance for DV victims,and 24 hour access to emergency shelter; • Strengths-based Assessments and Safety Planning for DV victims and their children; • Individual and group counseling for children,and support groups for adults; • Unique therapeutic pre-school,Mi Escuelita, for child victims of family violence; • On-going Case Management and support for victims; • Court-mandated perpetrators' groups; and ® Access to other SBCS programs including emergency and transitional housing, financial self-sufficiency services, and job development services. The Family Violence Program serves low and moderate income families, including victims and their children,in Chula Vista, predominately on the Western side of the City. The Family Violence Treatment Program has inspired many success stories over the years,much like this one. Carolina is the mother of three children, and became a victim of DV by her husband. She separated from him and obtained a Temporary Restraining Order,which her husband repeatedly violated for six months. Carolina was told to call the police each time her husband violated the conditions of the TRO; she did this,and each time she called the police, DVRT responded. As a result of the DVRT responses Carolina received: • Advocacy with police detectives resulting in the arrest and conviction of the abuser; • Placement in secure, confidential shelter and transitional housing; • Counseling services for herself and her children. As a result of these services Carolina was able to find safe housing for herself and her children. She resurrected a business her husband had previously forced her to close. She now makes enough from her business to support herself and her children,who are now not only more respectful toward Carolina,but happier in general. CDBG funds will enable SBCS to sustain the DVRT and respond to and assist more victims and children affected by family violence. Together SBCS, law enforcement and local partners can inspire more stories like that of Carolina. Appendix "A"—Narrative Page 1 of 1 (Revised 12/412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step (1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step (2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step(3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista (Step 1) $39,000 7.90% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% 14OPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds $250,000 50.59% Local Funds $110,000 2.2.27% Private Funds $95,000 19.23% Agency Funds 0.00% . 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00°x° 0.00% 0.00% 0.00% TOTAL $455,000 $39,000 100 TOTAL PROJECT BUDGETI $494,000 APPENDIX C-2: THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three (3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes. Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. i Balance Sheet-Audited Financial Statements. FY 6/30/2013 CY Page# Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 1,220,960 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 4,883,840 List the amount of FY 2014-2015 CDBG funding applied for this application. 39,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. 54,550 List the amount of FY 2014-2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 93,550 Compare Agency Cash Balance Available (Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item Al4,853,840 Item B 93,550 Differencel 4,790,290 Analyze Results 1- If difference is a positive amount or equals $0,the Agency is eligible to apply. 2- If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance, as long as: A) EACH PROJECT MEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATIONS, AND B)CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX C-3: PUBLIC SERVICE SCHEDULE I -BUDGET EXHIBIT AGENCY South Bay Community Services PROJECT Family Violence Treatment Program CDBG Percentage SALARIES & WAGES (Schedule 2) 31,200 FRINGE BENEFITS (Schedule 3) 7,800 TOTAL PERSONNEL 39,000 SUPPLIES (Schedule 5) POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPECIFY): (Schedule 5) (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 0 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD (IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 39,000 Page 1 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct project/client services. Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO) line item. The Total CDBG Salary & Wages must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT Family Violence Treatment Program (1) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY& WAGES Youth and Family Associate 39,410 67.00% 31,200.0 TOTAL CDBG SALARY&WAGES 31,200 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule (Check One) Monthly Biweekly X Twice a Month Page 2 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3 -PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT Family Violence Treatment Program (1) (2) (3) (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Youth and Family Associate Fica 31,200 7.65% 2,387 Youth and Family Associate sui 4,000 2.00% 80 Youth and Family Associate Pension 31,200 5.00% 1,560 Youth and Family Associate Health 6,800.00 50.00% 3,392 Youth and Family Associate W/Comp 31,200 1.22% 381 TOTAL CDBG FRINGE BENEFIT 7,800 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4. Use gross pay for project 1 total all wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule (Check One_ Monthly Biweekly X Twice a Month Page 3 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD (IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT Family Violence Treatment Program (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 39,000 Percentage 0.00% (Must be equal or less than 15%) 1. List all personnel or nonpersonnel (NPE)charged against CDBG funding-include detailed description of indirect use. 2. List total Agency budget for positon and/or NPE line item. 3. List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5. Enter the Total FYI CDBG Budget; percentage will be AUTOMATICALLY calculated. Pay Schedule(Check One) Monthly Biweekly X Twice a Month Page 4 of 5 APPENDIX C-3; PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY South Bay Community Services PROJECT Family Violence Treatment Program LINE ITEM AMOUNT Detailed Explanation: TOTAL LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - LINE ITEM AMOUNT Detailed .Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 5 of 5 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length: 1 Page, Max Score: 5 Points) Provide'a listing below of the specific tasks or activities needed to implement the proposed project and a timeline for their completion. Number each task or activity, describe it, andgive the projected date of completion Add additional rows as needed. # Task%Activity Description Completion Date 1. 'Domestic Violence Response Team 'Employ staff 24 hours/day, 7 days/week to respond On-going to police calls involving DV 2. Provide follow-up Crisis Intervention . DVRT Staff provide follow-up crisis intervention On-going services for Victims visited on emergency calls 3. Case Management Victims are assigned to a Case Manager to coordinate ion-going referrals and access needed services 4. Emergency Shelter/Transitional `Victims and their children have access to SBCS' :On-going Housing Transitional Housing and Emergency Shelter Programs 5. Mi Escuelita ISBCS operates Mi Escuelita,a therapeutic preschool On-going program for children ages 3-5 who have been exposed to family violence 6. Counseling Weekly group counseling sessions for children and On-going Victim Support Groups are available for DV victims and their children 7. `DVIP (Domestic Violence Intervention and Counseling On-going sessions are held weekly for court-ordered DV offenders 8. Client assessment and follow-up :Clients in the Family Violence Treatment Program On-going are assessed utilizing the Family Well-being and as Assessment upon entrance into the program,and needed Case Managers follow-up regarding client progress/needs/services Appendix"D"—Implementation Page 1 of 1 (Revised 121412013) Application No. 7 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" South Bay Community Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Services for High Risk and Homeless Youth Project Descirilltiori: SECS will provide services;support and opportunities for high-risk,and homeless youth" in order to assist, them to build' healthy, stable and productive lives,' , avoid(iig' first-time or' repeat, contact, with, law' enforcement, homelessness, substance abuse, and/or' gang, ,involvement. Type of Program/Project: Public Services [(§570.201(e)] Target Populafloh:' 05D,-Youth Services' Proposed Number; 240 to Serve: {,subject to change CFR§'570'.208('a)(2)'Lo' w depending,onfunding Moderate I'nc'orne recommendation) Limited Clientele, Program Total Budget: $2,037,561 C. V. Cost per Client: $164 (Based on funding recommendation) Funding Request: Prior Year,Funding: $34i550, Specific Use of Chula Vista Personnel Costs FUNDING $39,550 Funding: ($38,050) and Program RECOMENDED Expenses ($1,500) Staff Notes:: Historically,furidink for,this program has been $39,550; however, clue'to,a funding: deficit,in 2013/2014 the program was reduced by$5,000., For 2014/15,it is,proposed to restore prior year funding leiVels., COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Applicati®n f®r Funding for Fiscal Year 2014-2015 (ITY Of CHINA VSA Application Number. 'Oct.category: ® public service fCORG Program Office Use Only) (check o.ne only) In Capital improvement Applicant Agency Information A,vplicant legal name South Bay Community Services Type of a"gericy: ® 501(c)(3) ❑ Gov't./public ❑ For Profit ❑ Faith-Based ❑ Other: Agency"Address:; 430 F Street,Chula Vista 91910 Date,of incorporation: September 1972 Tax 10 number: 95-2693142 Agency DUNS nam.'bet..: 113407779 Annual operating budgets:' $26,601,738 E� Number of paid staff.' 500 Number Of volunteers' 750 Agency mission statement SECS' mission is to provide children, youth, and families with services that reinforce the family's role in our community and assist individuals to aspire realistically to lives of self-fulfillment. Project Title: [FSer\rtces for Nigh Risl<and Homeless Youth Brief project description: BCS will provide services,support and opportunities for high-risk and homeless youth in order to assist them to build healthy, stable and productive lives, avoiding first-time or repeat contact with law enforcement, homelessness, substance abuse- and/or ganLy involvement Funding Request Total funding requested in this application Other funds already secured for 11,997,611 ($39,550 $ (you will provide a detailerJ budget in AppendixC.' project. Tota!cost to complete project: 2,037,561 Other funds not yet secured for. 39,55{# Project Information if project is a Public Service,,will service be site specific?. ❑Yes No !f your answer is yes,please provide: Address(es)beloui: Census tract: Target Clientele: (Nameless,.Youth, Nigh-risk and Nameless Youth Blder ly, Disabled, Other/General) The following questions on individual clients and households to be served apply only to.Public Service,and Minor Residential Rehabilitation projects Will fhe project serve individual clients:(!c)or households(H1W ® Individual clients I❑ Households Total`un duplcated::!C/HH served::: 240 Annual cost per chenC/household. $164.79 Page 1 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Project Details (Max Scree 25 Pints) 1.1. Provide a concise description of the proposed project(this description must match the one provided on the cover Page).Space fora fuller narrative is provided in Appendix A. BCS will provide services,support and opportunities for high-risk and homeless youth in order to assist them to build healthy, stable and productive lives, avoiding first-time or repeat contact with law enforcement, homelessness, substance abuse, and/or gang involvement 1 2 ,.; Project start date. my 1, 2014 Anticipated end date: une 30, 2015 1.3. Project's days/hours of operation M- h:8:3Qarn-7:30pm, F: 8:30am—5pm, Weel<ends as necessary 1.4. Project ❑ Public service 1.5 Project ® Suitable living environment category: objective ❑ Decent housing {c heck 6neony) ❑I capital improvement (check oneoriry) ❑ Economic opportunity 1.6 Project ® Availability/accessibility outcome: JFJJ Affordability {check one only): ❑ $ustainablllty 1.7. .CDBG'Criteria Which,CDBG criterion below does your proposed project meet? ® (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income (LMI). Please provide a map identifying the Census Tracts designated as LMI. ❑ (2) Limited clientele(select subpart below): ❑ (a) Special needs group(select benefit group from the list below): ❑ (i) Abused children ❑ (ii) Elderly persons 52 years or older ❑ (iii) Battered spouses ❑ (iv) Severely disabled adults (not children)—Census definition;documentation required ❑ (v) Illiterate adults ❑ (vi) Persons living with HIV/AIDS ❑ (vii) Migrant farm workers ❑ (viii)Homeless persons ❑ (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? ❑ (3) Housing(select subpart below): ❑ (a) Single family(must be 10096M) ❑ I (b) Multi-unit(must be 51%LMI) 1.8 The 2010-2015 Consolidated Plan goals are listed below.'Select the goal appropriate to your project:: . ❑ I Affordable Rental Housing Opportunities IF-11 I Maintenance and Preservation of Housing (rehabilitation activities) ❑ Homeownership Opportunities(homebuyer programs) ❑ Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION ax Length for Questions 1010 to 1.15: Z Pages) 1.10' Explain how the proposed project addresses the goal selected' Services for high-risk and homeless youth are designed to benefit the Chula Vista community by providing support, services and opportunities for low and moderate-income youth who otherwise would exhibit risk factors and barriers including homelessness, substance abuse and gang involvement, which stand in their way of positive youth development and self-sufficiency. 1.1.1:.Sumrrrarize any statistics and other supporting documentation that demonstrate the importance of addressing this: need.or problem. Youth in Chula Vista experience a high rate of exposure to violence in the home combined with conditions of high unemployment, transience, high drop-out and truancy rates, substance abuse,teen pregnancy, lack of educational ties, gang involvement,family disintegration and homelessness. SBCS' proposed program aims to provide support and prevention/intervention services to youth experiencing any number of these issues. 1.12: List each service provided by the.project. For each service,indicate whether it is a new service or an exponsion of on "existing service: Activities provided for high-risk and homeless youth include the following: ® Assessment, individual case plan creation,and on-going support and case management; ® Individual,group and/or family counseling; ® Community Service activities and gang prevention; a Monitoring of school attendance and access to academic tutoring and after-school programs; ® Referral to substance abuse prevention/intervention programs; ® Parenting classes and teen relationship violence prevention groups; and 0 Access to SBCS'transitional housing programs, independent living skills training, workforce readiness, and any other programs necessary or deemed appropriate by a youth's case plan. All of these services are on-going, and will be sustained with CDBG funding. 1.11.How does your agencyplan to tell the target population:about the project/services. Information about the Services for At-Risk and Homeless Youth are advertised at the SBCS main agency,through flyers distributed to local Family Resource Centers, schools,the Chula Vista Community Collaborative and through local law enforcement and community service partners. 1.14. List up to three outcomes of the project(at least one is required). For each outcome listed,provide the number of participants who will benefit and the way data will be collected to track or verify the outcome: The overall program goal is to provide bilingual, culturally appropriate services to high-risk and homeless youth within the Chula Vista community, allowing them the opportunity to lead healthy, productive lives,free from law enforcement contact, homelessness, substance abuse and gang involvement. The program will be evaluated based on the successful completion of the following objectives: a 240 youth will have access to services,as measured by case files and program statistics; 0 75%of youth referred will complete the program successfully, as measured on service plans; ® 85%of youth will have no further contact with law enforcement while engaged in services, as noted in case files; and 85%of youth will report satisfaction with program participation as evidenced by client satisfaction questionnaires. Page 3 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 20 .4-2015 CDBG FUNDING APPLICATION 1.15. Will the project collaborate With other service providers in the community?If yes, list them: @rYe s ❑j No and briefly describe the collaboration: SBCS receives referrals from and works closely with the Chula Vista Police Department, County Probation Department, Child Welfare Services,School Attendance Review Boards,School Districts, Family Resource Centers operated by the Chula Vista Community Collaborative,other homeless providers, and many other local agencies to carry out program activities, and cater to the needs of each individual youth. Page 4 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section : Agency Capac (MaxScore: 10 Pints) .2.1. Who will be:the person responsible for the overall oversight of the proposed project? Name of person; Mauricio Torre Title of person:' outh and Family Development Department Director Relevant education.: B.S. Psychology Telephone number: (619)420-3620 Date`frrst ernployedc I 1997 2.2. Who will be the alternate person responsible for the overall oversight Of the proposedproject? Name of person:: Dina Chavez Title of person; Associate Director Relevant education:' B.S. Criminal Justice Administration Telephone number:. (619)420-3620 Date first employee: 111989 2.3 : : Who will be. the person responsible for the day-to-day operations and management of the proposed project? Provide no more:than two individuals: Name of person;. Amanda Miscevic Title of person: Program Director Relevant education: B.S. Psychology Telephone number: (619)420-3620 Date first employed: October 2004 Name;of person: Title of person. Relevant edbCation Telephone number: Date first employed: 2.4. •' Who will be the person responsible for the financial'oversight of the CDBG expenditures. and fiscal compliance? Provide no more than tufo individuals: ::. Name of person: Elizabeth lniguez Title of person: CFO Relevant educations B.S. 6.usiness Administration Tele.phone`number (619)420-3620 Date:first employed. 1993 Name:of person. Title 4f person: Relevant education: Telephone number: Date'first employed:, Page 5 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION ax Length for Questions 2.5 t® 2.8: 1 Page) 2.5.'. List the evaluation tools your agency plans to employ to track and monitor the progress of the project. Upon entrance into the program, each youth is assessed utilizing the Family Well-Being Assessment,which gauges a youth/family's strengths and barriers. A Youth and Family Development Associate reviews the assessment with the youth,and based on its results,the two work together to create an Individualized Service Plan. As a youth progress toward his/her goals,the YFDA will document client progress in case notes, re-assess his/her needs and assist in amending the Service Plan relative thereto. 2.6. ; How does your agency pian to ensure compliance with applicable policy and proceduralrequirements (including those listed in HUD's:"Playing by the Rules"Handbook)? SBCS receives multiple types of HUD funding, and as such has aligned its financial management policies, methods of procurement and contracting, property management, record-keeping and reporting policies, administration and program requirements, and required financial audits in compliance with HUD's"Playing by the Rules" Handbook. 2.7. Describe any unresolved ADA issues in the projector project office and how your agency plans to address them. (if the objective of the project is ADA rehabilitation; do not repeat the Project description here.) Not applicable. 2.8. How many members does your Board of Directors have? 9 How many Board members are also members of the project's target population or reside in I5 the project's target area?Indicate which ones in Appendix F. Page 6 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section a Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3 1. 8rieflydescribe your agency's payment and disbursement`procedures, with relevance to the proposed project: All funds are managed by SBCS' Fiscal Department. The Fiscal staff includes the Chief Financial Officer (CFO): Elizabeth Iniguez, 3 Accounting Associates, 1 Accounts Payable Clerk, and 1 Fiscal Aide. The following are SBCS' fiscal procedures: Cash Disbursements: cash disbursements are prepared twice a month by our computerized accounts payable program. Payment is done for all authorized check requests. Where warranted, due to the significant amount of the purchase, approval from the Board of Directors is needed. Original supporting documents must be attached to all check request forms. After payment, all supporting invoices are stamped "paid" to avoid duplication of payment. All checks over $1,000.00 require two signatures, the CEO and a member of the Board of Directors. Pre-numbered checks are used on all disbursements. Numerical and physical control is maintained over blank checks as well as issued checks. Void checks are adequately mutilated and filed in numerical order with canceled checks. Cash Receipts: cash receiving is handled by the receptionist. She is in charge of opening all mail and logging in all checks received.The receptionist is not involved in any fiscal duties. Incoming cash receipts, primarily in the form of checks, are locked in a file cabinet until accumulation merits a deposit. The collection of cash is maintained by a separate cash receipt log. The Deposit is prepared by an Accounting Associate and posted to the general ledger by the Lead Accountant, maintaining discrete accounts for different funding sources. Periodic reconciliation of detailed cash receipt records to duplicate deposit slips, accounts receivables, and cash control accounts are prepared by personnel independent of cash functions. Payroll and Personnel: New employees are investigated before being hired. Wage and personnel policies are current and in writing. Current and complete personnel files are maintained. An adequate system is used to insure proper recording of hours and time. All salary and wage payments are made by check. An outside payroll company is responsible for processing payroll and printing appropriate payroll checks. All payroll checks are delivered to our office for review, and distribution to employees. The payroll account is reconciled by someone other than the person preparing the payroll and signing checks. Revenue Billing, and Receivables:The CFO prepares all grant billings. Billings are done under reimbursement basis once a month and journalized as a receivable until the proper payment is made. The billings are done either on a preprinted form provided by the grantor or in-house prepared form. The CFO is in charge of monitoring the year-to-date expenses and comparing them to the annual budget. Under no circumstances will billings for a particular expense exceed the annual authorized budget.The fiscal department does a periodic analysis of receivables. Petty Cash and Cash On Hand: Petty cash funds are maintained on an imprest basis, with one individual responsible for the fund. They are not combined with other receipts. Responsibility for petty cash is separate from cash disbursements, receipts, and receivables functions. Limits exist on the amount for reimbursements out of petty cash. Supporting documents are checked and canceled at the time the fund is replenished. The fiscal department makes periodic and surprise counts of funds. L:3._2.; Describehow your agency's Board of Directors exercises programmatic and fiscal oversight: South Bay Community Services' Board of Directors meets every other month, during which they receive programmatic updates, and are advised on other significant agency business. The Board of Director's reviews and approves all funding requests, quarterly budget updates and the annual report. The Board is comprised of a number of sub-committees including the Executive Committee and Audit Committee,whose members attend to agency policies, procedures and financial management. The Board also directly oversees the President and CEO,who has the authority to act on the agency's behalf. 3.3 ` Briefly describe your agency's financial reporting system/accounting procedures, with relevance to the proposed `project. The Chief Financial Officer and Fiscal Staff utilize generally accepted accounting procedures in handling disbursement of funds and maintaining fiscal records. SBCS successfully manages more than 60 Federal, State,County,and city grants, as Page 7 of 9 (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION well as Private Foundation funding.The agency is audited by an independent auditor on an annual basis, and has a history of clean financial audits. 3.4. Briefly describe your agency's record keeping system,with relevance to the proposed project: Program Evaluation and Quality Management is an integrated process facilitated by the SECS' Contract Compliance and Quality Assurance Department. The CCQA staff possess extensive experience with monitoring and evaluating service delivery, and they regularly review the conditions of each contract to ensure these conditions are being met correctly and with high quality. SECS has written policies that address Privacy and Confidentiality and the Release of Information, and all program procedures are HIPAA compliant. i Direct service staff will use various tools to measure program success including contact logs, sign-in sheets, client surveys and case notes.All confidential files are transported in confidential lock boxes from program sites to the main agency, and are maintained in locked secure file cabinets when not in use. 3.5. Briefly describe your agency's auditing requirements, including those for the proposed project: South Bay Community Services is audited by an independent auditor on an annual basis, and has a history of clean financial audits. 1:6,:.`Briefly describe your agency's internal controls to minimize opportunities for fraud; waste, and mismanagement: In addition to the Fiscal Policies listed above in 3.1, the CFO monitors the budget on a daily basis as receipts and debits are posted, as new grants come in, and as expenses and invoices are paid.There are regular meetings with the President and CEO to make sure funding streams are adequate for programs, and strategies are developed to apply for and acquire more funds as programs expand. 33. How does your agency plan to segregate CDBG funds from other agency funds for purposes of identification,. tracking,and reporting? Contracts, grants, and other major funding sources are accounted in separate departments to prevent overlap of expenses and maintain separate general ledgers for each funding source. This system facilitates the monthly monitoring of year-to-date expenses by funding source, and accounting for expenses to any particular funding source. CDBG funds will be managed in accordance with this agency policy. Page 8 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points, Max Length: 1 Page for Section 4/5 Combined) 4.1. :. Briefly highlight.your agency's experience and major accomplishments in providing services to LMl residents and/or `communities:.You may expand in A endix A. South Bay Community Services (SECS) is a dynamic 501(c)(3) organization and is the largest provider of social service and community development programs in San Diego County's South Bay.SBCS serves San Diego County's Southern Region, an area with a diverse population that is greatly affected by immigration, characterized by transience, low socioeconomic expectancy, high crime rates, intense gang activity, and substance abuse, making it difficult for them to find employment, affordable housing, and access community resources and services. SBCS was created by dedicated community members in 1971 as a drop-in center for drug abusing teens. Responding to evolving community needs and concerns, we have developed a wide range of integrated, bilingual, prevention, intervention, and treatment options for youth and families, including mental health counseling;the region's only permanent shelter and support services for homeless families,youth, and domestic violence victims and their children;transitional and affordable housing; drug&alcohol prevention and intervention; domestic violence prevention and intervention; community development; child abuse prevention and intervention; and extensive youth programming. The Youth Services Department, under which the At-Risk and Homeless Youth Program falls, has been serving youth since 1971, and currently provides youth with a full spectrum of services designed to offer families the resources and skills they need to reach their full potential and give their best to not only themselves but their community as well. From youth in need to peer mentors, all youth in the South Bay benefit from our services. Our programs reach more than 7,000 youth annually,the majority of whom are from low to moderate income families. 4.2. ` Has your agency received CDBG or other federal funds in any of the post three fiscal years (Fiscal Years 2011-2012.2012.-2013, through 2013-2014)?if yes; complete Appendix G for ® Yes ❑I No each of the grants received for the three Fiscal Years 2011,2012,and 2013. Section ack®Up_Plan Score. 5 Points,) 5..1.:. Will.your agency still implement this project should CDBG funds not be awarded?if yes,how ® y�a Will the implementation be achieved? If funded at an amount less than requested, we will continue to provide services for at-risk and homeless youth, but will be forced to serve fewer youth. [5.2.. if funded, how will your agencycontinue this project if CDBG funds are not available in future years? Funding support for Services for At-risk Youth is spread over a wide base of local,county,state, and federal agencies as well as individual donors, local corporations, and private foundations,to guard against program closure because of the loss of a funding source.This strategic formula creates sustainability over time through the leveraging of diverse funding sources, and limits liability and dependence upon one type of support. Page 9 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix Ao Narrative of Project (Max Length: Z Pages) In two pages or less, explain belowyour proposed project and make the case why it should be awarded funding: The goal of the At-Risk Youth Services Program is to provide bilingual,culturally appropriate services to high-risk and homeless youth within the Chula Vista community, allowing them the opportunity to lead healthy,productive lives,free from law enforcement contact,homelessness,substance abuse and gang involvement. This is achieved by by providing support,services and opportunities for low and moderate-income youth who otherwise would exhibit risk factors and barriers which stand in their way of positive youth development and self-sufficiency. i This Program is especially important because youth in Chula Vista experience a high rate of exposure to violence in the home combined with conditions of high unemployment, transience,high drop-out and truancy rates,substance abuse,teen pregnancy, lack of educational ties,gang involvement,family disintegration and homelessness. SBCS' proposed program aims to provide support and prevention/intervention services to youth experiencing any number of these issues. SBCS'At-Risk Youth Services Program aims to provide support and prevention and/or intervention services to youth experiencing any number of these issues. Activities provided for high-risk and homeless youth include the following- 0 Assessment,individual case plan creation,and on-going support and case management; ® Individual,group and/or family counseling; 0 Community Service activities and gang prevention; 0 Monitoring of school attendance and access to academic tutoring and after-school programs; 0 Referral to substance abuse prevention/intervention programs; s Parenting classes and teen relationship violence prevention groups; and ® Access to SBCS'transitional housing programs,independent living skills training,workforce readiness, and any other programs necessary or deemed appropriate by a youth's case plan. Upon entrance into the program, each youth is assessed utilizing the Family Well-Being Assessment,which gauges a youth/family's strengths and barriers. A Youth and Family Development Associate (YFDA) reviews the assessment with the youth, and based on its results,the two work together to create an Individualized Service Plan,which may include any of the above mentioned services and supports,as needed and appropriate. Together the youth,family and YFDA work to overcome barriers and attain both positive youth development and self-sufficiency. Appendix"A"—Narrative Page 1 of I (Revised 121412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK.GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step (1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step (2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step (3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL Y 2014-2015 CDBG Application Request from City of Chula Vista.(Step 1) $39,550 190% F List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds $350,000 16.85% San Diego Housing Commission 0.00% State Funds 0.00% County Funds $1,547,561 74.51% Local Funds $140,000 6.74% Private Funds 0.00% Agency Funds 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTALI $2,037,561 $39,550 100% TOTAL PROJECT BUDGET $2,077,111 APPENDIX C-2: THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three (3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to tape a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes, Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements, FY 6/30/2013 CY Page# Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 1,220,460 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 4,853,�40 List the amount of FY 2014-2015 CDBG funding applied for this application. 39,550 List the amount of FY 2014-2015 CDBG funding applied for any other application. 54,000 List the amount of FY 2014.2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 201.4-2015 CDBG funding request(s) 93,550 Compare Agency Cash Balance Available(Item A)with Total FY 2014-2015 CDBG Funding Request(Items B): Item A 4,883,840 Item B 93,550 Difference 4,790,290 Analyze Results I- If difference is a positive amount or equals $0,the Agency is eligible to apply. 2- If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance, as long as: A)EACH PROJECT MEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATIONS, AND B)CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX C-3: PUBLIC SERVICE SCHEDULE ] -BUDGET EXHIBIT AGENCY South Bay Community Services PROJECT At-Risk Youth Services CDBG Percentage SALARIES &WAGES (Schedule 2) 29,558 FRINGE BENEFITS (Schedule 3) 9,492 TOTAL PERSONNEL 38,050 SUPPLIES (Schedule 5) POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPECIFY): Program Expenses (Schedule 5) 1,500 (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 1,500 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD (IC/AO) (Schedule 4) [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 39,550 Page I of S APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct project/client services, Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO)line item. The Total CDBG Salary& Wages must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT At-Risk Youth Services (1) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY &WAGES Youth and Family Associate 39,410 75.00% 29,558.0 TOTAL CDBG SALARY&WAGES 29,555 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule(Check One) Monthly Biweekly X Twice a Month Page 2 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3 -PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT At-Risk Youth Services (1) (2) (3) (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Youth and Family Associate Fica 29,558 7.65% 2,261 Youth and Family Associate sui 5,250 2.00% 105 Youth and Family Associate Pension 29,558 2.00% 591 Youth and Family Associate Health 6,800.00 75.00% 5,100 Youth and Family Associate W/Comp 29,558 1.47% 435 TOTAL CDBG FRINGE BENEFIT 8,492 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOREACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4. Use gross pay for project/total all wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule(Check One) Monthly Biweekly X Twice a Month Page 3 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD (IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY South Bay Community Services PROJECT At-Risk Youth Services (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERELEAD TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 39,550 Percentage 0.00% (Must be equal or less than 15%) 1. List all personnel or nonpersonnel (NPE)charged against CDBG funding-include detailed description of indirect use. 2. List total Agency budget for positon and/or NPE line item. 3. List PERCENT of total budget to be charged against CDBG finding. 4. Total indirect cost/adininistrative overhead to be charged against CDBG funding. 5. Enter the Total FY13 CDBG Budget; percentage will be AUTOMATICALLY calculated. PaSc�(Check One_ Monthly Biweekly Twice a Month Page 4 of 5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE S-BUDGET 3-USTIFICATION* AGENCY South Bay Community Services PROJECT At-Risk Youth Services LINE ITEM Program►Expenses AMOUNT Detailed Explanation: Storage fee to Iron Mountaing to mainta.ing closed files.Monthly Fee$125/mth 1,500 TOTAL $ 1,500 LINE ITEM AMOUNT Detailed Explanation: i TOTAL $ LINE ITEM AMOUNT Detailed Explanation: TOTAL $ *All line items must be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 5 of 5 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length. 1 Page, Max Score: 5 Points) Provide a listing below of the specific tasks or activities needed to'implement the proposed project and a timeline for:' their completion.Number each task or activity, describe it, rand give the projected date of completion:Add additional rows as needed. Completion j # Task/Activity Description Date 1. 'Accept/Screen Referrals '; !Accept and screen referrals for eligible youth On-going 2. Assess Youth �ssess youth using Family Well-Being Assessment On-going 3, Assign Case Manager ':Assign youth to Youth and Family Development On-going Associate (YFDA) 4. ICreate Individualized Service Plan i ,Together Youth and YFDA discuss strengths/barriers 'On-going and create Service Plan 5, (Provide adequate services/referrals j 11,ink youth to services based on Individualized On-going Service Plan , 6. Follow-up on Youth Progress I iYFDA follows up with youth regarding program Quarterly progress and re-assesses needs ' or more frequently as needed i - I 4 I � I Appendix "D"--Implementation Page IofI (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix E. Roster of Board Members & Professions Provide a roster of the members ofyour agency's Board of Directors and their,professions by filling out the table below: Member Resides in of Target get Name/Board Position Profession/Affiliation Tar P00U1&i6 Area n. Anthony Perez, Board Chair Union Bank, SVP/Region Manager I ❑' Ceanne Guerra,Vice Chair j !Cox Communications j ❑. David D.Rowlands,Jr.,.Past Chair Retired ; ❑ ❑ Sue Belmonte,Audit Committee Chair ' SD Daily Transcript I E] 01 Charles Moore ;Retired i ® 011 ,Nancy Kerwin Chula Vista Elementary School District ❑ Fran Muncey .The Galley at the Marina I I❑ ',❑ John Nelson ;Chula Vista Elementary School District '❑ Diane Rose 'ResCare Workforce Services ® 6❑ ED ❑I ❑I 7011 i 10: 01— 017. - ❑i ❑I ❑ ❑I ❑: ❑j ❑ ❑3 Appendix"E"—Roster of Board Members and Professions Page 1 of 1 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix Fo Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests, payments,and campaign contributions must be filed.The following information must be disclosed: 1. List the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e.g.,owner,applicant, contractor,subcontractor, material supplier). [South Bay Community Services, Kathryn Lembo,Roger Dinsmore 2. If any person* identified in section 1 above is a corporation or partnership, list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership) entity. [Type response here.] 3. If any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee, beneficiary and trustor of the trust. ;[Kathryn Lembo]; 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. ;[Kathryn Lembo,Dina Chavez, Mauricio Torre, Don Hunted 5. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official** of the City of Chula Vista as it relates to this contract, project or application within the past 12 months?Yes;ONo® if yes,briefly describe the nature of the financial interest the official may have in this contract. `[Not applicable..]', 5. Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than $250 within the past twelve(12) months to a current member of the Chula Vista City Council?No!,Q iYesD If yes,which Council member(s)? ;[Type response here.] 7. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value, money to retire a legal debt,gift, loan, etc.)YesO 1Na® If Yes, list official and what was the nature of item provided? I[Not applicable.]) S. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of income of$500 or more to an official**of the City of Chula Vista in the past twelve(12)months?Yes,❑ INo® If Yes,identify the official and the nature of the income provided? ;[Not appliacableJ January 15, 2014 [Kathryn Lembo; Signature: * Person is defined as:any individual,firm,co-partnership,joint venture,association,social club,fraternal organization, corporation, estate,trust, receiver,syndicate,any other county,city, municipality,district,or other political subdivision,or any other group or combination acting as a unit. ** Official includes,but is not limited to: Mayor,Council member, Planning Commissioner, Member of a board,commission,or committee of the City,and City employees or staff members. Appendix"F"--Disclosure Statement Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identification of Prior Year CDBG and/®r Federal Funds G.I. Agency name: South Bay Community Services G.2 Project name: 'At-Risk Youth Services ' G.3. Year of funding: ❑ Fiscal Year 2011 ❑ Fiscal Year 2012 ® Fiscal Year 2013 G.4. Indicate the source of the feder�ai funding`awarded to the pnor project ® CDBG ❑; HOPWA ❑ ESG ❑', HOME ❑' CDBG R ❑i HPRP NSP ❑ Other(lndicatebefow): G.S. Amount awarded: $39,550 G.6... Amount spent to date: 11$39,550 G.7. Amount reprogrammed to date: - G.8. Indicate below the outcomes anticipated(refer to the original application for the project, if possible) iProvide 240 youth with the services,support, and opportunities they need to lead healthy and productive lives, (1) avoiding further contact with law enforcement and gang involvement. 75%of youth referred will complete the program successfully, as measured on service plans; 85%of youth will (2) have no further contact with law enforcement as noted in case files {3J X85% of you will report satisfaction with program participation �, 6.9. . Indicate below the outcomes'achieved: (1) 369 have completed the At-Risl<Youth Program (2) '94%completed the program successfully; 95% had no further contact with law enforcement (3) 95% reported satisfaction with program participation G.10. If any anticipated outcomes were NOT achieved;specify which ones and explain why below: lNot applicable.' G.I. Agency name: South Bay Community Services G.2. Project name At-Risk Youth Services G.3. Year of funding: ❑ Fiscal Year 2011. ® Fiscal Year 2012 ❑ Fiscal Year 2013 G.4. Indicate the source of the federal funding awarded to the prior project: ® CDBG ❑ HOPWA ❑I ESG ❑ HOME �. CDBG-R ❑` HPRP ❑I NSP ❑ Other(lndicatebefow): G.5_ Amount awarded $39,550 G.6. Amount spent to date: ;$39,550 G7.: Amount reprogrammed to date: I G.8. Indicate below the outcomes anticipated(refer to the original application for the project; if possible).. 'Provide a bilingual, culturally appropriate Youth services program to 240 high-risk children,youth and families in (1) the community, which includes prevention, intervention, and supportive services,giving them the opportunities Page 1 of 2--Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION T(2) e y need to lead healthy and productive lives and avoid law enforcement contact and gang involvement. % of youth referred will complete the program successfully; 85%will have no further contact with law forcement. (3) 85%of you will report satisfaction with program participation. G.9. Indicate below the outcomes achieved; (1) 340 have completed the At-Risk Youth Program (2) 96% completed the program successfully; 95% had no further contact with law enforcement . (3) 95% reported satisfaction with program participation G.10. If any anticipated outcomes were NOT achieved,specify which ones and explain why below... [Not applicable. G.1. Agency name: South Bay Community Services G.2. Project name: At-risk Youth Services G.3. Year of funding: ® Fiscal Year 2011 ❑ Fiscal Year 2012 ❑! Fiscal Year 2013 G.4. Indicate the source of the federal funding awarded to the prior project: ® CDBG ❑', HOPWA ❑ ESG ❑ HOME ❑, CDBG-R ❑' HPRP ❑ NSP E] Other(lrrditate6elow): G.5. Amount awarded. $39,550 G.6. Amount spent to date: $39,550 G.7. Amount reprogrammed to date' G.8. Indicate below the outcomes anticipated(refer to the original applicationfor the project; if possibleJ: Provide a bilingual, culturally appropriate Youth services program to 240 high-risk children, youth and families in the community, which includes prevention, intervention, and supportive services,giving them the opportunities (1) they need to lead healthy and productive lives and avoid law enforcement contact and gang involvement. 75%of youth referred will complete the program successfully; 85%will have no further contact with law (2J enforcement. } (3J 85% of you will report satisfaction with program participation. j G.9. Indicate below the outcomes achieved: (1) 300 youth have completed the program (2) 93% completed the program successfully; 97% had no further contact with law enforcement (3) 90% reported satisfaction with program participation. G.10. If any anticipated outcomes were NOT achieved,specify which ones and explain why below Not applicable. Page 2 of 2—Supplement to Appendix E Application No. 8 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Chula Vista Elementary School's District for the, Chula Vista Com munity Collaborative' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Family Resource Center Emergency and Basic Services Project Description: Low'income and, vulnerable, families in Chula, Vista will be provided etnotgphty and basic, needs services; Families in crisis or' emergency situations, will I be ,provided with, emergency, food boxes, clothing, ancill6ry, and transportation services as well as assessed for additional ongoing services, Type of Program/Project: Public Services [(§570.201(e)] Target Population:' OS'= Pub]k Services, Proposed,Number 415 General to Serve:, (subject to change depending on funding CFR§'570'.208('zi)(2)'Lo' w recommendation) Moderate Income, Limited Clientele Program Total Budget: $222,031 C. V. Cost per Client: $147 (Based on funding recommendation) Funding Request: $69,945 Prior Year,Funding: $39,312 Specific Use of Chula Vista Personnel Costs FUNDING $39,312 Funding: RECOMENDED Staff Notes:: COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fiscal Year 2014-2015 CHWWWA Ado ect cite: Application Number: y ® Public service (cagc Program Office use Only) 0!�' .'4"o01yi Capital improvement Applicant Agency Information 4 . 3icantMOW h6mo. JChula Vista Elementary School District for Chula Vista Community Collaborative pe pf.tx enc ! 501(c)(3) GoVtJPublic i For Profit Faith-Rased Other: ,AgenWAddress (Type response here.J Date pf incorporation:; Established 1892 Tax number;' 5-6000613 A ency DUNS number:' 66156274 Annual operating budget. ;$832,912 iVumbcr of paid stcr 15 ' Number a �raluneers: 10+ Agency mission statement: I'Enhancing community partnerships to develop and implement coordinated strategies and systems for future generations j Project Title. Family Resource center Emergency and Basic Services Brief project description: 11-ow income and vulnerable families in Chula Vista will be provided emergency and basic needs services. Families in crisis or emergency situations will be provided with emergency flood boxes, clothing, ancillary, and transportation services as well as assessed for additional and ongoing.services Funding Request Total funding requested in this application �69,�5 other funds already secured for ; i (you will provide a detailed budget in Appendix C: project: Total cost to complete prcject: I other funds not yet secured for 1 Project Information if Project is a Public Service,.will service be site specific? Yes OW !f your answer is yes,&ase provide: Addresses)below: Census tract: f Totget Clientele:(Homeless, Youth, �1_ow Income Chula Vista residents and families ! Elderly, disabled, tither/General) The.following questions on individual clients and households to be served apply only to Public Service, and Minor Residential Rehabllitation pro ects: Will the P2,Lectserve individual clients 00 or households HN)? I ' individual clients ! Households Tptal.unduplicated!C/HH served: j E Annual cost per clienVhousehold. Page 1 of 9 (Revised 1214/2013) CITY OF CHUiA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Pr®"ect Details (Max Score: 25 Points) 1.1. Provide.a concise description Of the proposed project(this description must match the one provided on the cover page). Space for a fuller narrative is provided in Appendix A. ?Low income and vulnerable families in Chula Vista will be provided emergency and basic needs services. Families in crisis or emergency situations will be provided with emergency food boxes, clothing, ancillary, and transportation services as well as assessed for additional and ongoing services. 1.2. . 'Project start date: J 17/1/14 Antrci aced end date: /30/15 3 1.3. Project's 4ays1hours of operation: Monday—Friday 8 am to 4pm 1.4. Project Public service 1,5 Project ® Suitable living environment category: objective: Decent housing (check one only) capital improvement (checkooeonly) Economic opportunity 1.6 project ® Availability/accessibility outcome: Affordability (check one only) Sustainability 1.7. CDBG Criteria:Which C086 criterion below does your proposed project.meet? ® {1) Area benefit:At least 5196 of residents within the targeted activity area are low to moderate income(LMI). Please provide a map identifying the Census Tracts designated as LMI. (2) Limited clientele(select subpart below): U (a) Special needs group(select benefit group from the list below): (i) Abused children (ii) ,Elderly persons 62 years or older (iii) Battered spouses (iv) Severely disabled adults(not children)—Census definition;documentation required (v) illiterate adults ! (vi) Persons living with HIV/AIDS ❑' (vii) Migrant farm workers {viii)Homeless persons (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? (3) Housing(select subpart below): (a) Single family(must be 100%LMI) LEJ (b) Multi-unit(must be 51%LMI) 1.$. The 2o10-2015 Consolidated Plan goals are listed below. Select the goal appropriate to your project: Affordable Rental Housing Opportunities Maintenance and Preservation of Housing(rehabilitation activities) ❑ Homeownership Opportunities(homebuyer programs) Community Enhancement(public facilities/spaces) Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 9 (Revised 1 21412 0 1 3) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION ax Length for Questions 1.10 to 1.156 2 Pages) 1.10. &plaln how the proposed gest addresses the 9oal selected: I[The proposed program will provide a safety net for families in Chula Vista who are facing poverty and food insecurity. The program addresses the priorities of Tier 1 by providing emergency and basic needs services for low income Chula Vista residents. The program also improves access to needed services for vulnerable and disengaged families in Chula Vista. Low income families will be able to access services through five conveniently located community sites in Chula Vista. In addition to emergency and basic services,families will be screened and assisted to access immediate social and health needs and will be referred to additional services as needed. Low income families in Chula Vista will be assisted to connect to support services for their children and adults. CVCC is currently facing a major financial risk as we have been notified by one of our primary funding sources(Sweetwater Union High School District)that funding will end June 30, 2014. This represents a major loss of funding and the closing of one FRC as of 6/30/14,which represent a major decrease in services to Chula Vista families. Therefore funding of safety net and emergency services is even more critical. I 1.11. Summarize any statistics and other wpporting.documentation that demonstrate the importance of addressing this need or problem: )[Western Chula Vista is home to a disproportionate rate of families who are experiencing socioeconomic disparities. According to SANDAG,the population in Chula Vista is 51% Hispanic, but the population in Western Chula Vista is 63°x6 Hispanic. Western Chula Vista has a disproportionate number of residents who are Hispanic,poor, lack health insurance, and lack knowledge about where and how to access services,creating a hub of vulnerable and underserved population. According to the US Department of Agriculture's report on "Household Food Security in the United States in 2012'. low income households,single women households,and Hispanic households have a substantially higher food insecurity than other households. It goes on to state that these families can experience food insecurity up to 7 months of the year. The economic disparity of Chula Vista families is evident in western Chula Vista,were the median income in the 91911 zip code is only$39,167,compared to the citywide median income of$43,712. According to the World Health Organization, "poor people have worse health outcomes than better-off people. Poverty and low income also cause ill-health ... poor people suffer from a multiplicity of deprivations that translate into high levels of ill-health. Poor people are thus caught in a vicious circle:poverty breeds ill health, ill-health maintains poverty." Bulletin of the World Health Organization 20(12,80(2)#World Health Organization 2002. 11 1.12. List each service provided by the project. For each.service;indicate whether it is a new service or an expansivrl of an existin service: ([Bilingual and culturally appropriate Emergency and basic services will be provided to at-risk/low income families in the community. Services will include: Exner enc Food Boxes: Families in need will be provided with an emergency food box to meet their families need. Grocery Store Gift Card:. Families in food insecurity situations will be provided with a$25 gift card to purchase perishable food items for their family. Eme rgency Clothin : Families and individuals will be provided with clothing for all members of their family through the CVCC's community closet. Anci!lary Services: Family and individuals will be provided with emergency ancillary support such as shoes,diapers, uniforms,glasses, prescriptions costs,etc. EmeMency Transportation Costs: Family and individuals will be provided with emergency transportation costs to include bus tokens or bus passes to be able to go to needed appointments,school, or job. Page 3 of 9 (Revised 1 21412 0 1 3) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION ].1 . Haw does yvuragency plan to tell the target population about the project/services? services will be available through five conveniently located and community based Family Resource Centers located in western Chula Vista. Outreach will be conducted through schools, school events,community events,community presentations,website,and email announcements. CVCC will leverage community education opportunities where Promotoras are already in the community and will spread the word(flyers and brochures)about services available at Family Resource Centers. In addition Promotoras are able to speak one-on-one to individuals in the community and readily share about services available through Family Resource Centers 1. t,rstup to three putcomes'6 the:pr6jecr(at least erne is required).For each oui cO ne listed,provide the number a,f . pardelo6pts who will benefit and the way data will be collected to track or verify the outcome: 1. I[The project will provide a safety net for low income families in Chula Vista 2. The project will increase availability and accessibility of needed services to the most vulnerable and needy population in Chula Vista (low income individuals and families). 3. The project will offer families needed emergency services such as food boxes,clothing, diapers, uniforms,etc. Families will be provided with immediate needs but will also be connected to ongoing services to ensure family strengthening and sustainability by assisting families to eliminate barriers to self sufficiency 1.15. Will the project collaborate with ether service providers In the community?If yes,list them ® Yes [Q No and briefly describe the collaboration: i[The proposed activity will be conducted by CVCC staff only. As part of our partnerships,CVCC will collaborate with the Chula Vista Welfare Council and other donors to secure food boxes,gift cards,clothing donations,etc. As part of our services, referrals will be made to other agencies stationed within the Family Resource Centers and outside agencies. These agencies include;the Chula Vista Elementary School District, Home Start,South Bay Community Services,San Diego Adolescent Pregnant and Parenting Program (SDCOE)San Ysidro Health Center, Family Health Center and the County of San Diego Health and Human Services. CVCC has over 250 partner agencies and many have a reciprocal relationship with CVCC to refer clients to the most appropriate services j Page 4 of 9 (Revised 1 21412 0 1 3) CIN OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 2: Agency_Capaci (Max Score: 10 Points) 2.1. Who will be the person responsible for the overall oversight oJ the proposed project? Name pf person. IMargarita Holguin ; Title,of erson: Director-CV CC Relevant educdtF in. lOver 25 years of public service administration-Masters in Public Administration i Telephone number:` 619409-9412 j toprst em toyed: une 2007 2.1. Who will be the alternate peaon responsible for the overall oversi ht of the proposed pLo ect? Name person: Heather Nemour of Title of person: JFRC Coordinator Relevont education: ver 16 years of experience in FRC Operations-MA in Sociological Practice Telephone number: 19498-8042 Date first employed. eptember 1997 2.3 Who will be the person responsible for the day-to-day operations and management of the proposed project? Provide no more than two individuals: Name of person: Heather Nemour Title of pLrsow., FRC Coordinator Relevant education: See above Telephone number: Dare f7rst etn Toyed: j Name o person: Marvin Roxas ' Title 9f person: IFRC Coordinator Relevant education: M.A. in Counseling psychology,over 3 years of experience managing social service programs. Tele hone number: Date first em toyed 2.4. Who will be the person responsible for the financial oversight of the CDBG expenditures and fiscal compliance? Provide no more than two individuals: Name of person: IMargarita Holguin Title of Person: Director Relevant education: See above Telephone number: _ Date Eat em toyed: Name of person: hristina Ross Title of person: Office Manager ; Relevant education: 118+years in the position with oversight for CVCC financial duties-prior experience in banking E Telephone number: 1619 498-8044 Date first employed: �my 1995 Page 5 of 9 (Revised 121412013) CITY OF CHUTA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 #® 2.8: 1 Page) 2.5. last the evaluation.tools your agency plans to employ to track and monitor the progress of the project. 3 I(The program will be reviewed and monitored on a regular basis as follows: Monthly—the number of clients and services provided in reviewed monthly and monthly statistical reports are completed to demonstrate outcomes Quarterly—the number of clients served and services provided is monitored to ensure compliance and that all goals of the program will be met Quarterly—Complete and submit quarterly report to City staff Ongoing-customer satisfaction surveys provided to all customers 2.6. How does your agency plan to ensure compliance with applicable policy and procedural requirements(including those listed in HUD's "Playing by the Rules"Handbook)? j[CVCC has written policies and procedures in place. These policies and procedures are reviewed with staff and are part of new employee orientation. A copy of our policies and procedures are available upon request. 2.7. Describe any unresolved ADA Issues in the projector project office and how your agency plans to address them. (if the objective of the project is ADA rehabilitation,do not repeat the project description here.) None 2.8. How many members does your Board of Directors have? 9 How many Board members are also members of the project's target population or reside in ,6 the project's target area?indicate which ones in Appendix F. Page 6 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score. 15 Points; flax Length: 2 Pages) 3:1. Brle y describe your agency's payment and disbursement procedures, with relevance to the proposed pro ect: The proposed project covers personnel costs only. Our fiscal agent(Chula Vista Elementary School District,CVESD) receives a Personnel Action Form from CVCC detailing the funding breakdown. Payroll costs are updated monthly by CVESD in their Business Pius system. Any changes to funding require a new Personal Action Form to be generated by CVCC and submitted to CVESD Human Resources and Budget departments. Staff timecards are completed monthly and approved by immediate supervisor and site supervisor. Timecards are submitted to CVESD. The school district processes and cuts all checks and disbursements. 3.2. Describe how your p engy's'Board of Directors exercises programmatic and rscal oversight: The CVCC's Steering Committee has oversight for the CVCC and its Director. The Director is directly responsible for program operations and has collaborative oversight. The Steering Committee approves program direction and annual budget. Steering Committee approved new initiatives and grants/grant applications. Steering Committee meets monthly and reviews programs and plans and takes action on application items. Minutes of Steering Committee meetings are kept and clearly outline actions approved by the committee. Minutes are available upon request. The Steering Committee approved a five year strategic plan for the CVCC and as such, received regular updates to ensure all actions and programs are within the mission and vision of the CVCC. 3.3. Briefly describe your agency's flnoncial reporting system/accounting procedures, with relevance to the proposed project. All fiscal matters for CVCC as handled by the CVESD. The school district's systems and procedures are applicable to CVCC. CVCC works closely with the CVESD budget department and submits all payables and receivable through the CVESD. CVCC has access to the District's Business Plus system to check expenses and revenue. Quarterly reports are generated from the Business Plus system and reviewed by the CVCC Director,CVCC Clerk and CVESD financial department 3.4. Brle y describe your agency's record keeping system, with relevance to the proposed project: The CVCC maintains a detailed Excel Spreadsheet to monitor expenses and quarterly CDBG payments. Payments are sent to the CVESD Accounting Department for deposit. Deposits are made to the San Diego County Treasurer or local banks on a regular basis and a receipt is returned to CVCC verifying the deposit. Quarterly the revenue is posted to the Business Plus system. Working closely with the CVESD budget department the CVCC spreadsheets and Business Plus postings are reviewed to be sure the project remains within budget. 3.5. Briefly describe your agency's t�uditin requirements, including these for the proposed project: CVESD Board Policy AR3460 states that by April 1St of each year the Board shall supply the districts books and accounts for audit by a certified public accountant or a public accountant licensed by the State Board of Accountancy as deemed qualified by the State Controller. Prior to the audit,and on a regular basis,the CVESD budget department and the CVCC staff review the projects fund. CVCC works closely with the CVESD budget office and provides all necessary information and documentation. The school district audit includes the CVCC funds. Page 7 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION .3.6. Briefly describe your.agency's internal controls to minimize opportunities for fraud, waste, and mismanagement: There is adequate separation of duties so no one individual has authority over the entire project. The CVCC Administration Handbook has a written policy on"Specific Funding Requirement"stating CVCC staff responsibilities on authorization of contract signing,financial transactions and staff training to meet specific outcomes and reporting criteria of the project. In addition,as the fiscal agent for CVCC,the School District reviews and approves all expenditures and disbursements for CVCC. 3.7. How does your agency plan to segregate.CM funds from other agency funds for purposes of identification, trackin , and reporting? CVESD,as the fiscal agent, uses the state standardized account code structure(SACS). CDBG funds and individual classifications(salary, FICA,SSI, etc.) have specific numbers assigned to them. CVCC Clerk uses the SACS numbers designated to the CDBG funds. Page 8 of 9 (Revised.1 21412 0 1 3) CITY OF CHULA VISTA FY 2014.2015 CDBG FUNDING APPLICATION Section 4: Agent Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) 4J. viiefly highlight your agency's experience and malar accomplishments In providing services to LMI residents and/or:. communities. You may expand in Append&A. �he CVCC is celebrating its 2&anniversary in 2013. CVCC has an established reputation for collaboration within the Chula Vista Community. CVCC consists of over 250 partner agencies and we work to enhance and improve the lives of Chula Vista residents. Through facilitation of issue specific coalitions,we strive to identify issues that affect our community and seek out and leverage resources for Chula Vista residents. CVCC operates five Family Resource Centers in Chula Vista.All of the Centers provide an access venue for families to receive an array of services including; Emergency food and clothing, Parenting classes/support groups, Health insurance enrollment assistance(0-18), Employment preparation and search, Kinship services, Family advocacy, Linking to extracurricular activities, Referrals for counseling, Pregnant/parenting teen support, Information and referral, Energy assistance,CalFresh(Food Stamps) screening assistance,Adult education classes with free childcare, Paperwork assistance/workshops, Volunteer/community service opportunities, and Health and Nutrition classes. Through its FRCS,CVCC served 12,999 individuals in 2011-2012. Families are assisted with basic and emergency services, and assisted in connecting to other programs and services. FRGS serve as a hub for services. Service providers outstation staff at the FRCs to provide services in the community. The CVCC FRCS conduct outreach efforts to ensure more families are made aware of community resources and have a venue to access services. The FRCs provides ancillary services for families including: Bread distribution,food baskets,toys, uniforms,clothing, etc. These services assist families in immediate situations and also connect them to additional services and programs aimed at increasing family self- sufficiency.) 4.2. Has your agency received CDBG or other federal funds in any of the past three fiscal years (Fiscal Years 2011-2012,2012-2013, through 2013-2014)7 If yes,complete Appendix G for ® Yes �. No each of the grants received for the three Fiscal Years 2011,2012,and 201.3. Section 5: Back-Up Plan (Max Score: 5 Points;) 5.1. will your agency still implement this project should CDBG funds not be awarded?if yes, how ® Yes No will the implementation be achieved? CVCC will implement this project even if funding is not received. This project is leveraged through other funding sources. if funding is not received we will significantly scale down the project and will not be able to assist the same number of families and individuals. CVCC is currently facing a major risk as we have been notified by one of our primary funding sources(Sweetwater Union High School District—SUHSD)that funding will end lune 30,2024. This represents a major loss of funding and the closing of one FRC as of 6/30/14. Therefore funding of safety net and emergency services is even more critical. 5.2. l funded, how vsrlll your p envy continue this roJect if CDBG funds are not available in future years? CVCC will continue services through leveraging partnerships and funding. The vision of the CVCC is to ensure"A healthy community of Chula Vista residents." In accordance with our vision,we will continue to provide as many services as we are able to sustain to our families. Page 9 of 9 (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix A: narrative of Project (Max Length: 2 Pages) in two pages or less,explain below your proposed project and make the case why it should be awarded funding. The Chula Vista Community Collaborative (CVCC)through its network of five Family Resource Centers (FRCs) in Chula Vista provides a broad array of family support and wrap around services for families. This network of FRCS is a safety net to help the most vulnerable families in Chula Vista. Families can access services at any of the five locations, all of which are easily accessible through public transportation. Low income and vulnerable families often faces crisis situations and suffer from hunger and food insecurity. CVCC's proposed program will provide emergency and basic needs services to families in Chula Vista. Every family that has an identified need for food will be provided with an immediate box of food to meet their families' emergency food needs along with a $25 grocery store gift card for perishable items. At the same time, families will be prescreened for CalFresh benefits and if eligible, will be assisted with the application process for ongoing food support. Additionally, families that need to complete their CalFresh quarterly reporting or renew their applications will be assisted. The FRC's maintain a current list of other food resources available in the community. Families in unstable financial situation are concerned with their primary needs and often cannot afford clothing for their children or for themselves. The programs will provide families with emergency clothing for all members of the family through our newly created community closet at Rayo de Esperanza FRC. The closet is consistently supplied with newer and gently used clothing for babies, children, youth and adults. The closet also has shoes and school uniforms. The CVCC has created a smooth process for each FRC to provide personalized clothing voucher for each family to take to the closet. Many families face situations in which their emergency needs cannot be met by various programs. Many times they cannot purchase a pair of shoes, diapers, uniforms, glasses or even pay for prescriptions or other critical needs_ CVCC will provide families with ancillary services and/or will assist to pay for these types of unique and critical needs. Another unmet need for this population is often transportation needs. CVCC will provide families with basic transportation assistance such as bus tokens or a bus pass to ensure they are able to get to a job, school, medical, or needed appointments. The program will improve access to needed services for low income and disengaged families in Chula Vista. Families will be able to access services through five conveniently located community sites in Chula Vista. All FRCS are located on school campuses and are open and accessible to the entire community(see below for list of FRCs). The CVCC has the ability to leverage resources and offer a comprehensive service delivery model that ensures non duplication of services and collective action to strengthen families. As families access FRC services or as they are referred for services to the FRC, they will be assessed to determine the family's needs. All services will be provided in English or Spanish by bilingual and bicultural staff. All services are free of charge. Families typically enter the FRC with a crisis or with emergency needs. In order to strengthen and support families, to goal is to link them to a CVCC's social worker or other FRC staff to address other social issues that lead to the emergency situation. Some of the services they may be linked to are. employment services, CalFresh, family or individual counseling, teen parent case management, health clinics, kinship services, child care, health insurance, youth services, support groups, parenting classes, etc. The project will increase availability and accessibility of needed services to the most vulnerable and needy population in Chula Vista (low income individuals and families). Though a comprehensive assessment, families Appendix"A"_Narrative Page 1 of 2 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDINo APPLICATION will be linked to needed and ongoing services to ensure family strengthening and sustainability by assisting families to eliminate barriers to self-sufficiency services. Families in Western Chula Vista are challenged with a disproportionate rate of socioeconomic disparities. According to SANDAG, the population in Chula Vista is 51% Hispanic, but the population in Western Chula Vista is 63% Hispanic. Western Chula Vista has a disproportionate number of residents who are Hispanic, poor, lack health insurance, and lack knowledge about where and how to access services, creating a hub of vulnerable and underserved population. According to the US Department of Agriculture's report on "Household Food Security in the United States in 2012", low income households, single women households, and Hispanic households have a substantially higher food insecurity than other households. It goes on to state that these families can experience food insecurity up to 7 months of the year. The economic disparity of Chula Vista families is evident in western Chula Vista, were the median income in the 91911 zip code is only $39,167, compared to the citywide median income of$43,712. According to the World Health Organization, "poor people have worse health outcomes than better-off people. Poverty and low income also cause ill-health ... poor people suffer from a multiplicity of deprivations that translate into high levels of ill-health. Poor people are thus caught in a vicious circle: poverty breeds ill health, ill-health maintains poverty." Bulletin of the World Health Organization 2002, 80 (2) #World Health Organization 2002. By working together with Community partners, the CVCC seeks to provide wrap around services at each of the FRCS. As families request assistance, CVCC/FRC staff serve as advocates for families and assist families navigate the the various complex systems such as education, legal, health and mental health. FRC staff builds constructive and ongoing relationships with families. Once families are stabilized from their crisis or emergency situation, they tend to return for ongoing support and other resources. Through these services, we ensure a smoother continuum of services, avoid duplication, and increase access to resources and opportunities to assist Chula Vista families. To ensure Chula Vista residents are aware of these services, CVCC will routinely advertise these services and will conduct outreach on a regular basis through school events, community events/fairs, community presentations, website, and email announcements. List of CVCC Family Resource Centers: Beacon FRC Rayo de Esperanza FRC Campus of Vista Square Elementary Campus of Otay Elementary 540 G Street 1671 Albany Ave. Chula Vista, CA 91910 Chula Vista, CA 91911 Open Door FRC New Directions FRC Campus of Palomar High School Campus of Rice Elementary 480 Palomar St. 915 Fourth Ave Chula Vista, CA 91919 Chula Vista, CA 91911 (This FRC may close effective July/August 2014) Fair Winds FRC Campus of Loma Verde Elementary 1450 Loma Lane Chula Vista, CA 91911 Appendix"A"—Narrative Page 2 of 2 (Revised 12/4/2013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK.GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step(1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step (2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step (3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista (Step 1) $69,945 31.50% List Other Sources Below: (Step 2) H 0.00% HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP �� 0.00% 0'00©/° Other Federal Stimulus Funds Other Federal Funds (School Medi-Cal LEA&Title 1) $125,000 56.30% San Diego Housing Commission 0'00% State Funds 0.00% County Funds 0.00% LocalFunds 0.00% Private Funds $27,086 12.20% Agency Funds 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTAL $152,086 $69,945 100% TOTAL PROJECT BUDGET $222,031 APPENDIX C-3: PUBLIC SERVICE SCHEDULE I -BUDGET EXHIBIT AGENCY Chula Vista Community Collaborative PROJECT Family Resource Center Emergency and Basic Services CDBG Percentage SALARIES &WAGES (Schedule 2) 48,919 FRINGE BENEFITS (Schedule 3) 21,026 .;I TOTAL PERSONNEL 69,945 SUPPLIES (Schedule 5) POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPECIFY): (Schedule 5) (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL, 0 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD(IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 69,945 Page 1 of 6 APPENDIX C-3:PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount.The positions listed below must provide direct project/client services. Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO)line item. The Total CDBG Salary&Wages must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY Chula Vista Community Collaborative PROJECT Family Resource Center Emergency and Basic Services (i) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES Community Referral Specialist(Enriquez) 44,238 40.00% 17,695.3 Community Referral Specialist(Orozco) 44,283 40,00% 17,713.3 Community Referral Specialist(Servin) 41,692 40.00% 16,676.8 Community Referral Specialist(Ramirez-Denis) 37,915 40.00% 15,165.8 Office Manager(Ross) 53,876 5.00% 2,693.8 TOTAL CDBG SALARY &WAGES 69,945 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. PAy Schedule Check One X Monthly Biweekly Twice a Month Page 2 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3 -PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount.The Total Fringe must :match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Chula Vista Community Collaborative PROJECT Family Resource Center Emergency and Basic Services (1) (2) (3) (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Community Referral Specialist(Enriquez) Statutory/Health/Life 13,705.64 30,533 40.00% 17,595 Community Referral Specialist(Orozco) StatutorylHealth/Life 13,504.65 30,779 40.00% 17,713 Community Referral Specialist(Servin) Statutory/Health/Life 10,748.16 30,944 40.00% 16,677 Community Referral Specialist(Ramirez-Dei Statutory/Health/Life 12,543.10 25,371 40.00% 15,166 Office Manager(Ross) Statutory/Health/Life 16,516.30 37,360 5.00% 2,694 TOTAL CDBG FRINGE BENEFIT 69,945 1.List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4.Use gross pay for project/totaI all wages of agency.Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule LCheck One x Monthly Biweekly Twice a Month Page 3 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD (IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Chula Vista Community Collaborative PROJECT Family Resource Center Emergency and Basic Services (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD IAIAO is not being charged against CDBG TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 69,945 Percentage 0.00% (Must be equal or less than 15%) 1. List all personnel or nonpersonnel (NPE)charged against CDBG'funding-include detailed description of indirect use. 2.List total Agency budget for positon and/or NPE line item. 3.List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5. Enter the Total FYI CDBG Budget; percentage will be AUTOMATICALLY calculated. Pay Schedule(Check Ong X Monthly Biweekly Twice a Month Page 4 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Chula Vista Community Collaborative PROJECT Family Resource Center Emergency and Basic Services LINE ITEM Personnel AMOUNT i Detailed Explanation: Community Referral Specialist(CRS),Enriquez 17,695 TOTAL $ 17,695 LINE ITEM Personnel AMOUNT Detailed Explanation: 17,713 Community Referral Specialist(CRS), Orozco TOTAL $ - LINE ITEM Personnel AMOUNT Detailed Explanation: Community Referral Specialist(CRS), Servin 16,677 TOTAL $ 16,677 *All line items must be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 5 of 6 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Chula Vista.Community ColIaborative PROJECT Family Resource Center Emergency and Basic Services ;E LINE ITEM Personnel AMOUNT Detailed Explanation: Community Referral Specialist(CRS),Ramirez-Denis 15,166 TOTAL $ 15,166 LINE ITEM Personnel AMOUNT Detailed Explanation: Office Manager,Ross 2,694 TOTAL $ 2,694 LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 6 of 6 CITY OF CHUL4 VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length: 1 Page, Max Score: 5 Points) Provide a listing below of the specifrc tasks or activities needed to implement the pr nposed profect and atimeline far their completion,Number each task or activity,describe it and give the projected date of completion:Add additianal rows as needed. # T arsklActft4o Description Completion Date TT JEmergencvFood Boxes: Families in need 1300 Families or individuals will be provided a food 16/30/15 i will be provided with an emergency food box.Families will also receive a grocery store gift box to meet their families need_ card } Grocery Store _Gift Card: Families in food insecurity situations will be provided with a $25 gift card to purchase perishable food items for their family. 12 Emergency Clothing: Families and X150 Families or individuals will be provided with :6/30/15 individuals will be provided with clothing emergency clothing for all members of their family through the CVCC's community closet. j 5 n ills Services: Family and individuals 150 Families or individuals will be provided with X6/30/15 will be provided with emergency ancillary ancillary support support such as shoes, diapers, uniforms, glasses,prescriptions costs, etc. i 4 IEmeMency Transportation Costs: Family �20 Families or individuals will be provided a ;6/30/15 and individuals will be provided with transportation support j emergency transportation costs to include bus tokens or bus passes to be able to go to needed appointments, school,or job. 71 TF I E I Iii I 4 1 17 Appendix"D"_implementation Page 1 of 1 (Revised 1 2/412 0 1 3) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix Ee Roster of Board Members & Professions Provide a roster of the members ofyour agency's Board of Directors and their professions by filling out the table below. ldl�m�er Resides In Name/Board Position Profession lAf liadon of�ar�Populado Target Area a 1Kendra Brandstein ; Scripps Mercy Hospital Chula Vista ❑ ony Delos Santos Family Health Centers of San Diego ❑i iPaula Guerra 3 ;Horne Start Nancy Kerwin 1 ;Chula Vista Elementary School District I 1E] El Victor Tapia Sanchez G weetwater Union High School District Jessica Newmyer ;Health&Human.Services Agency-Co of SD `❑ ,Mauricio Torre ;South Bay Community Services ;Krish McClure I ;City of Chula Vista-Recreation Dept Tina Williams South Bay Family YMCA [l ! i i❑: ❑. i f❑ 1❑ i II {{ ! 1 1❑,E . ❑; i Appendix"E"-Roster of Board Members and Professions Page 1 of 1 (Revised 1214/2013) CITY Of CHULA VISTA FY 2014-2015 CABG FUNDING APPLICATION Appendix F. Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, j Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests,payments,and campaign contributions must be filed.The following information must be disclosed: i 1. List the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e.g.,owner, applicant,contractor,subcontractor, material supplier). [N/A 2. If any person* identified in section 1 above is a corporation or partnership, list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership)entity. N/A 3. if any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee, beneficiary and trustor of the trust. [N/A] 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. [Margarita Holguin] 5. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official**of the City of Chula Vista as it relates to this contract,project or application within the past 12 months?YesFI]hIoN If yes,briefly describe the nature of the financial interest the official may have in this contract. [N/A] 6. Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than $250 within the past twelve (12) months to a current member of the Chula Vista City Council? NOE esn If yes,which Council member(s)? 7. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value, money to retire a legal debt,gift,loan, etc.)YeslINo® If Yes,list official and what was the nature of item provided? 8. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of income of$500 or more to an official** of the City of Chula Vista in the past twelve(12)months?Yes[ ]No® If Yes, identify the official and the nature of the income provided? [N/� #anuary 1.0, 2014 - [Francisco Escobedo,Ed.D.Superintendent signature: * Person is defined as: any individual,firm,co-partnership,joint venture,association,social club,fraternal organization,corporation, estate,trust, receiver,syndicate,any other county,city,municipality,district,or other political subdivision,or any other group or combination acting as a unit. ** Official includes,but is not limited to: Mayor,Council member, Planning Commissioner, Member of a board,commission,or committee of the City,and City employees or staff members. Appendix"F"—Disclosure Statement Page 1 of 1 (Revised 11/412013) CITY OF CHULA VISTA FY 2014-2015 CD BG FUNDING APPLICATION Appendix F. Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests,payments,and campaign contributions must be filed.The following information must be disclosed: 1. List the names of all persons having a financial interest in the project that is the subject of the application,project or contract (e.g.,owner,applicant,contractor,subcontractor,material supplier). 2. If any person* identified in section 1 above is a corporation or partnership, list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership)entity. N/A 3. If any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee,beneficiary and trustor of the trust. FIN 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. N/A 5. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official**of the City of Chula Vista as it relates to this contract, project or application within the past 12 months?Yes❑�No® If yes,briefly describe the nature of the financial interest the official may have in this contract. 6. Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than$250 within the past twelve(12) months to a current member of the Chula Vista City Council?NOM+Yes❑ If yes,which Council member(s)? 7. Has any person* identified in 1, 2, 3, or 4,above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value, money to retire a legal debt,gift, loan,etc.)Yes❑'No® If Yes,list official and what was the nature of item provided? =�I/A 8. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of income of$500 or more to an official**of the City of Chula Vista in the past twelve(12)months?YeJIF INo® If Yes, identify the official and the nature of the income provided? 'N/A January 10,2014 (Margarita Holguin Signature: i i * Person is defined as:any individual,firm,co-partnership,joint venture,association,social club,fraternal organization,corporation, estate,trust,receiver,syndicate,any other county,city, municipality,district,or other political subdivision,or any other group or combination acting as a unit. ** Official includes,but is not limited to:Mayor,Council member,Planning Commissioner,Member of a board,commission,or committee of the City,and City employees or staff members. Appendix"F"—Disclosure Statement Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identification of Prior Year C®BG ander Federal Funds G. .,4 ency name: Chula Vista Elementary School District for Chula Vista Community Collaborative G.2. Project name: family Resource Center Assessment and Referral Services f G.3. )eor of funding: Fiscal Year 2010 Fiscal Year 2011 1 Q1 Fiscal Year 2012 G.4, lndicate the source of,the federal funding awarded to the prirar project: ® CDBG 1 HOPWA ❑' ESG i HOME CDBG-R HPRP ❑ NSP ❑ Other()ndicatebelow): 1 � 3 G.S. Amount awarded: $35,524 G.S. Amount spent to date: 11$39,312 1 G.7. Amount reprogrammed to date. I IN/A G.8. Indicate below the outcomes anticipated(refer to the original application for the project, if possible): LI) . ;Created economic opportunities (Z) Provided supportive services 11 (3) G.9. Indicate below the outcomes achieved. (1) rincreases access to services for low income families (2) Allow at risk families to achieve stability 11 (3) G.10. If any anticipated outcomes were NOT achieved,specify which ones and explain why below: !All objectives achieved and exceeded G.1. Agency name: I JChula Vista Elementary School District for Chula Vista Community Collaborative G.2. Protect name: Family Resource Center Assessment and Referral Services G.3. Year of funding: Fiscal Year 2010 ® I Fiscal Year 2011 Fiscal Year 2012 G.4. indicate the source of the federal funding awarded to the prior project: CDBG HOPWA ESG HOME CDBG-R 'U. HPRP NSP ❑: Other(indicate beiow): G.S. Amount awarded. 39,312 G:6. Amounts ent to date: $39,312 G.7. Amount reprogrammed to date: I IN/A G.8. Indicate below the outcomes anticipated(refer to the original application for the project, if possible): (1) ;Create a suitable living environment (2J E Page 1 of 5—Supplement to Appendix E CITY OF CHUTA VISTA FY 2013-2014 CDBG FUNDING APPLICATION G.9. indicate below the outcomes achieved: I) jincreased availability of services for low income families {2) 5ricreased access to needed services for low income families (3) 'increase access to emergency services for at risk families G.ao. It any anticipated outcomes were NOT achieved,specify which ones and explain why below: All objectives achieved and exceeded Page 2 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CD BG FUNDING APPLICA'T'ION (Max Length per Project; 1 Page) GA.. Agency name:' ;Chula Vista Elementary School District for Chula Vista Community Collaborative G.2. .Project name: Family Resource Center Assessment and Referral Services ' G.3. Year of funding:. Fiscal Year 2010 1 € instal Year 2011 ® Fiscal Year 2012 G.4. Indicate the source of the federal funding awarded to the rior project; CDBG HOPWA ❑ ESG i HOME CDBG-R ❑ IiPRP ❑ NSP Other(indicate below): G.5. Amount awarded: 1 J$39,312 G.6. Amount spent to date: $39,312 6.7.. Amount reprogrammed to date; N/A G.8. indicate below the outcomes anticipated(refer to the original application for the project,if possible): A) Create a suitable living environment (2) G.9. Indicate below the outcomes achieved: (1) ;Increased availability of services for low income families (2), lincreased access to needed services for low income families (3) lincrease access to emergency services for at risk families G.10. If any anticipated outcomes were NOT achieved,specify which ones and explain why below: ;All objectives achieved and exceeded Page 3 of 5—Supplement to Appendix E CITY OF CHULA VISTA EY 2016-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G.1, Agency name: G.2. Project name: G.3. fear of funding: Fiscal Year 2010 Fiscal Year 2011 Fiscal Year 2012 G.4. Indicate the source of the federal funding awarded to the prior project: CbBG HOPWA ESG HOME [� CDBG-R iEJ HPRP rMsp 0 Other(Indicatebelouv): G71117-.5. Amount awarded., G.6. Amountspent to date: G,7. Amount reprogrammed to date: G.8. indicate below the outcomes anticipated(refer to the original application for the project,if possible): (1) (a) (3) . G.9. indicate below the outcomes achieved: (1) (2) (3) G.10. If any anticipated outcomes were NOT achieved,specify which ones and explain why below: _ IType response herG.) Page 4 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project; 1 Page) G.I. Agency name: G.2. Project name: G.3. .,Year offunding., 1 JE1 I Fiscal Year 2010 1 ! Fiscal Year 2011 Fiscal Year 2012 G.4. indicate the source of the federal funding awarded to the prior project. CDBG I ❑j HOPWA a,❑ ESG HOME ❑ CDBG-R ❑ HPRP ❑ NSP Other(indicate below): i G.5. Amount awarded: i G.6. Amount spent to date: G.7. Amount reprogrammed to date; I G.8. Indicate below the outcomes anticipated(refer to the original application for the project, if possible): I1) 3 (2) (3) I G.9. Indicate below the outcomes achieved. (2) (3) G.10. if any anticipated outcomes were NOT achieved,specify which ones and explain why below: '[Type response herG.] Page 5 of 5—Supplement to Appendix E Application No. 9 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" City of Chula'Vista Recreation Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Therapeutic Recreation Programs Project Description: The...Therapeutic Recreation' orb'' , gramming, provides, persons with disabilities the opportunity to' participate in 'recreation: programs, speciftal,ly designed for persons with developmental, or physical disabilities. , Programs are,designed for ages six through adult, and occur, on a weekly' basis,year round. , The,programs include sports programs, dance classes., creative and Onrithment activities, exercise and fithess, tlasses, special events, and Learn to Swim,programs all �offered in a fun supportive environment, Type of Program/Project: Public Services [(§570.201(e)] Target Populatloh:' OSB'- Handicapped Proposed Number 100, Services, to Serve:, (subject to change depending 6n,funding &R§ 510.208(a)(2) Low rec6mmenddtibn): Moderate Income, Limited Clientele Program Total Budget: $22,516 C. V. Cost per Client: $225 (Based on funding recommendation) Funding Request: Prior Year,Funding: $20,100, Specific Use of Chula Vista Personnel Costs FUNDING $20,100 Funding: ($18,516) and RECOMENDED Supplies/Printing ($4,000) Staff Notes-. COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fiscal Year 2014-2015 clAffi Pra1ect catepublic service gory Application Number: {CORG Program Office Use Only} (cn&xoneon�y} ❑ Capital improvement Applicant Agency Information Applicant legal n'an?e: City of Chula Vista Recreation Department Type of agency:"; ;❑ 501(c)(3) ®Govt./Public ❑' For Profit I Faith-Based ❑ Other: AgercyAddress:' 276 Fourth Avenue, Bldg C Chula Vista CA 91910 Date of incorporption: 1911 Tax 1D number 95-6000-690 Agency DUN S.nurnber: N/A Annual operating;bucfget. 1$22,516 Number of paid staff.' ;5 PT Number of volunteers. 10 .... ....... ... ............................................. ... . Agency mission'statement: e enrich our community through recreational opportunities and services Project Title: Therapeutic Recreation Programs&Classes Briefproject;description: he Therapeutic Recreation programming provides persons with disabilities the opportunity to participate in recreation programs specifically designed for persons with developmental or physical disabilities. Programs are designed forages six through adult and occur on a weekly basis year round. These programs include sports programs, dance classes, creative and enrichment activities, exercise and fitness classes, special events, and Learn to Swim programs all offered in a fun and supportive environment. Funding Request Tota!funding requested in this application Other funds already secured for i $22,516 None , (You will provide a"ciefailed budget rn Appendix C project.. ' Total cost to complete project::: $22,516 Other funds not yet secured jor. None Project Information !f Project is d Public Service;;vvi11 servlce'be.site specific? ❑Yes" Na !f your answer is yes,please provide: Add res s(es)"belaw. . CehStis'tract Various City Recreation Facilities and Swimming Pools. Target Clientele: (Homeless, Youth, (Children,teens and adults with disabilities, Elderly;Disabled, Other/General) The following questions on individual clients and househaidsta be served apply only to Public Service,and Minor Resiclentlal 4e hdbilitation;projecu Page 1 of 9 (Revised 12/4/1013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION W11I.the protect serve individual clients{1C) orf ouseholds (Hlo h+)? ® individual clients �' i useholds Tota!unduplWcated'1C/HHserved 100 Aualnncostper client/hdusehold $225 Page 2 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Pro'ect Details (Max Score: 25 Points) 1.1. Pravrde a concise description of the proposed project(this description must match the one provided on the cower page) Space for a fuller narrative is provided in Appendix A. . he CDBG funds will be used for direct service delivery to community members who have a developmental or physical disability. These Therapeutic Recreation programs will operate at city recreation facilities within the City of Chula Vista. The program sites will operate year round to accommodate all levels and interests of those with special needs, in addition, it will allow parents some respite time while their child enjoys a community recreation experience. The program will offer scheduled and supervised activities designed to be educational, healthy, and recreational rased. Activities are designed to build social skills, self-esteem, independence and sportsmanship. The programs anticipate having a core group of participants. All funds will benefit children,teens and adults with developmental and physical disabilities. (See Appendix A) 1.2. .:Prajectstart dot eJuly 2014 Anticipated enddate::' I une 2©15 1.3. Pro1ect'S days/hours of operation: arious daytime and evening hours, Monday-Saturday 1.4. ':Protect ®I Public service 1.5 Project x Suitable living environment category oblectrve: ❑ Decent housing (check Dire onr)1 I❑I Ca pita l improvement (check one oiafyl [] Economic opportunity 16 Protect ;® Availability/accessibility outcorrte ❑' Affordability lcP:eckpap:R.yl ❑ Sustainability 1.7. CDBG Criteria: Which CDBG criterion below does your proposed project meet? (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income(LMI). ❑� Please provide a map identifying the Census Tracts designated as LMI. ® (2) Limited clientele(select subpart below): ® (a) Special needs group (select benefit group from the list below): ❑` (i) Abused children ❑ I (ii) Elderly persons 62 years or older ❑ (iii) Battered spouses ® (iv) Severely disabled adults (not children)—Census definition; documentation required ❑� (v) Illiterate adults ❑ (vi) Persons living with HIV/AIDS (vii) Migrant farm workers ❑ (viii)Homeless persons in (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? -TET] (3) Housing(select subpart below): ❑ (a) Single family(must be 100%LMI) ❑ (b) Multi-unit(must be 51%LMI) !'A The 2010 2015 Consolidated Plari:goals are listed below Select the goal appropriate to,your prq�ect ❑ Affordable Rental Housing Opportunities ❑ Maintenance and Preservation of Housing (rehabilitation activities) ❑ Homeownership Opportunities(homebuyer programs) Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 3 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Page 4 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 1.10 t® 1.15: 2 Pages) 1'1 Q. 'explain how the proposed project;addresses file goa!selected? I[The South Bay area currently does not have any agencies providing Therapeutic Recreation programs specifically designed for children, teens and adults with disabilities. Our programs and classes would provide recreational opportunities and experiences for those persons with special needs. 1.11. Summarize ariy statistics and other supporting documentation that demonstrate the importance of addressing.this need.or problem I[The Sweetwater Union High School District has 796 students with Moderate & Moderate-Severe disabilities in the current 2013-2014 school year. The Chula Vista Elementary School District has 867 with Mild-Mod and Mod-Severe students in the 2013-2014 school year who are currently receiving special education services. I 1 12. list each service provided by the project. For each service, indicate whether it is a new service or,an expansion-of an existing service I[We will provide recreational classes, activities and programs such as theme dances, 2umba, Hip Hop Dance, basketball, fitness and exercise, Legos,special events and Parent's Nights Out that showed great success and popularity in the past. We also stay current with trends and interest to provide new activities throughout the Chula Vista community. I 1.13. How does your agency plan to tell the targetpopulation about the project/services? ([We would advertise via email, Nixel, Facebook, our website, monthly citywide newsletters and press releases. Additionally we will distribute flyers throughout the school districts, all City of Chula Vista recreation centers, Southwestern College, and other organizations that support or serve persons with disabilities. I 1.14. List up to three outcomes of the pralect{at least one is required). Far each outcome listed,prourde the number pf participants inrho wr."ri benefit and the way data.will be collected to track"oryerify,the-,outcome I[The most important outcome for these programs would be to improve and enhance participants quality of life by increasing self-esteem,social skills, independence, and encouraging a healthy lifestyle for all participants. The number of participants will vary depending on their interest, but these were popular programs and we are rebuilding,so we would expect 30-50 participants. We will collect data by parental surveys,the number of registrations, staff feedback and supervisor observation. I .. .. 1 15 Wr1I the project collaborate with,other service,providers in the'community?If.yes, list them and$riefly describe=the collaboration: IQ, Yes ® No I[The project will not formally collaborate with other services providers in the community. However,we will target specific schools and other organizations who serve children, teens, and adults with disabilities to inform them about the programs and events we will be offering. We will encourage them to inform their participants and refer them to our programs. Page 5 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 2: Agency Capacity (Max Scree 10 Pints) 2 1 Who vvrl!be the person responsible for the overall oversight of the propose project? i Wendi Garrison, Sr. Recreation Manager. !Name of person:' Wendi Garrison T[tleof per'sgn ' Senior Recreation Manager Relevant elu`cation: iBachelor of Arts in Recreation Administration, minors in Health &Special Education ,Telephone=number'..'' (619)585-5617 Date frrstetnployed ' August 2012 2 2 Who`wr!!be'the alternate person;'responsrblefoi the overall oversight of the proposed protect?, Jllame of person Anthony Ramos ,,`Title of person:';', Recreation Supervisor III Relevant erlucatfon:`'; Bachelor's Degree in Recreation Administration Telephone-numb2r: (619) 691-5266 Date first employed February 8, 2002 2 3 Who irvrll be the person responsr6Je for the day"to day operations and management of the proposed protect? Provide na more than tw, b lndrvrduafs Name.'of person: ICarmel Wilson, CTRS Trtle'of person Recreation Supervisor 11, CTRS Relevant e'ducabon -: Bachelor's Degree in Recreation Administration, Emphasis in Recreation Therapy Certified Telephone n6ti& (619) 421-3859 bate first employed my 28, 2000 :Name of pers_on ' Anthony Ramos ;'„Title;of person:'; Recreation Supervisor Ill . Relevant education. Bachelor's Degree in Recreation Administration Telephone number (619) 691-5266 Date fihtf6 ployed February S, 2002 2 4 Wha will be the person respansrtile for the financial oversight of the CDBG expenditures acrd fiscal corriplrancea Provrcle no more t .an two mdivrefuals' . F Name of person Wend i Garrison Title of person Senior Recreation Manager Releo t'educatron ? Bachelor of Arts in recreation Administration, minors in Health &Special Education Telephone number',; (6191585-5617 Date first employed August 2012 Name,of person ,;: Brian Cox Title'of person Principle Manager Relevant education Bachelor of Arts in recreation & Leisure Studies, Master's Degree in Recreation Administration Telephone numb ,- (691) 585-5619 flute first`;emoyed ', 1987 pi Page 6 of 9 (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to 2.8: 1 Page) 2 5 Lis(the evaluation tools your agency plans to emwoy to track and monitor the progress of the project. 11. Quarterly surveys 2. Health Forms 3. Liability Waivers 4. Rosters 2.6. How does your agency plan to ensure compliance iniith';applicable pd1* J. and procedural requirements (including those luted!r HUD's "Playing by the Rules Handbook)2 IWe would maintain and implement City Of Chula Vista standards that we hold every employee to and report accountability through appropriate CDBG documentation. E 2.7. Describe.any unresolved ADA issues in the project or project office acid how'your agency plans to address therm (lf the objective of the prn}ect is ADA'rehabilitation, do not repept the project description here) ; I[None] I 2 8 How many members does your Board of pirectors have? N/A How many Board members. are also members of the,project's target papulation or reside in IN/A theproject`s target area?Indicate.whrchones ria Appendix! Page 7 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3.1 .. Briefly describe your agency's payment and disbursement procedu .roposed protect [Payment and disbursement is completed by providing the appropriate documentation and staff timesheets each quarter to Community Development. 3.2. ._;Descrbe how your agey's BoarcJ,of Directors=exercises pro ncgram matic oval fiscaloversight f[H/A] 33 --Briefly describe, Ur agency`s frnanc�al reporting system/accounting procedures, >Nrth relevance to the`proposed project [[The Recreation Department utilizes the City's financial system (IFAS). Hourly wages spent will be tracked through time sheets,which will be verified by Recreation Supervisor II, Carmel Wilson.The Department's Fiscal Office Specialist will submit all hours and expenditures for tracking in IFAS.] 3,4. Brie l describe„ aura enc 's'record kee in system, urlth relevance to thee: ro osetl ro ect fY Y g Y p g -y p p .1 All expenditures will be tracked though the City's accounting system (IFAS). Hourly wages spent will be tracked through time sheets,which will be verified by Recreation Supervisor II, Carmel Wilson.The Department's Fiscal Office Specialist will submit all hours and expenditures for tracking IFAS.] . 3.5. Briefly describe:yaur agency's auditing requirements, including those far the proposeci,project: Recreation Supervisor II, Carmel Wilson will directly oversee the project and provide all necessary documentation. Recreation Supervisor III Anthony Ramos and Sr. Recreation Manager Wendi Garrison will verify all documentation submitted by Carmel Wilson. Principle Manager, Brian Cox will review all final documentation for final submittal.] 3 6 Brie 1 describe our a enc 's,internal controls to minimize opportunities_far fraud,s,vgste, and;mismanagement fY Y 9 Y I[All hourly wages submitted by staff will be verified by Recreation Supervisor Il,Carmel Wilson and reviewed by Recreation Supervisor III, Anthony Ramos and Sr. Recreation Manager, Wendi Garrison on a bi-weekly basis. No supplies or services will be purchased without authorization by a Recreation Supervisor III or above.] I 33 Hovu:aloes your agency pldn to segregla ate CDBG funds from other agen,11 cy funds for purposes of rdentrfrcatron, tracking, ai.d reporting? - I[Funds will be put into a separate account with a specific account number(17530) and those funds will only be utilized for CDBG programs, classes, recreation supplies and materials. Page R of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) 4.1. ;Briefly highlight your agency's experience and major accomplishments in providing services to LM!residents and/or;. communities" You naayexpand in Appendix A. [The City of Chula Vista Recreation Department previously had great success serving children,teens, and adults with disabilities through our Therapeutics Section of programming.This section of programming began in the Recreation Department in 1969 and provided programs and services for children,teens,and adults with developmental and or physical disabilities.An array of classes, special events and day camps were offered year round and Chula Vista was the only organization providing recreational programs strictly for those with special needs in the South Bay area.] 42' ..:'Has your agency received CDBG or other federal funds in any of the post three fiscal years „(Fiscal Years 2011-2012,2012 2013, through�2013-2014)?If yes, complete;4ppendrx G far ® Yes ❑ No each of the grants received for the three:H cal.Years 2011,2012, and 2013.. Section 5: Hack-Up Plan (Max Score: 5 Points;) . . 5 1 Will your,aaency still rmple 7?ent this project should CDBG funds not be awarded if yes, hpw will the implementation be achieved?, ❑ Yes ® No I[No Therapeutic programming will be administered. Participants will be encouraged to seek Inclusion services. 5.2. If funded, how wIlf your agency continue this project!f CDBG funds are not available in future years? I[If CBDG funds are not available in the future,Therapeutics Programming would cease until a new funding source is found. New funding sources may include grant by other government agencies or allocation of funds through City Council.] Page 9 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix A: Narrative of Project (Max Length: Z Pages) In two pages ar less,explain belq�iyairr proposed project aid make the""ease why it should be awarded funding. [[The Therapeutic Section of recreation programming began in the City of Chula Vista Recreation Department in 1969. It provided specifically designed programming for individual's ages six to adult with developmental and/or physical disabilities the opportunity to enjoy year round recreational activities in their community. The department has offered a variety of classes such as bowling, day camp, dances,hip hop dance,cooking class,aqua exercise, basketball,Saturday morning special events,field trips,wheelchair sports,hand cycling,wheelchair sports tournaments and specialty classes. The City also collaborated with other organizations such as the Chula Vista Elementary School District and the City of San Diego Therapeutic Services Department to offer joint programs and special events. In 2008,due to city-wide budget reductions the Therapeutic Recreation program was eliminated. The therapeutic programs eliminated were very low cost or no cost to the consumers leaving a large void of programming for our community with disabilities. To date,there is no other organization offering programs or classes like these in the City of Chula Vista. The CDBG Funds will be used for direct service delivery to community residents and non-residents who have a developmental or physical disability. Funds will cover staff costs,trainings,supplies, and materials. The program will offer scheduled and supervised activities designed to be recreational, educational and healthy. Activities are designed to build social skills, increase self-esteem,independence,activities of daily living and sportsmanship. All of our programs would be offered in a fun,safe and supportive environment. The program anticipates having a core group of participants who in turn gain social skills,new friends and community support. All Funds will benefit children, teens and adults with developmental or physical disabilities. The requested CDBG funds would enable us to meet a community need that is not being met. It will allow us to continue to meet the Citywide strategic goal of connected community,by promoting diverse opportunities that connects every community member and fosters civic pride through comprehensive communication strategies and cultural, educational, and recreational programming. All of the funds requested would be used to cover staffing, supplies and materials. Without the requested CDBG funding,the Recreation Department would not be able to offer Therapeutic Recreation programs to our community of people with disabilities. Appendix"A"—Narrative Page 1 of 1 (Revised 121412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION for the project. There are 3 steps to the completion of This table serves to provide the listing of all funds to be made availablep J p p this table: Step(1): Eater the FY 2014-2015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step (3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista (Step 1) #DIV/O! List Other Sources Below: (Step 2) HOME #DIV/0! ESG #DTV/O! HOPWA #DIV/O! CDBG-R #DIV/0! NSP #DIV/0! HPRP #DIV/0! Other Federal Stimulus Funds #DIV/0! Other Federal Funds #DIV/0! San Diego Housing Commission #DIV/0! State Funds #DIV/0! County Funds #DN/O! Local Funds #DIV/O! Private Funds #DIV/01 Agency Funds #DN/01 #DIV/O! #DTV/O! #DIV/O! #DN/O! #DIV/O! #DIV/O! #DIV/0! #DIV/O! #DIV/O! #DIV/0! #DTV/0! TOTAL $0 $01 #DN/O! TOTAL PROJECT BUDGET $0 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 1 -BUDGET EXHIBIT AGENCY City of Chula Vista Recreation Department PROJECT Therapeutic Recreation Programs &Classes CDBG Percentage SALARIES &WAGES (Sehedule 2) 15,734 FRINGE BENEFITS (Schedule 3) 2,782 TOTAL PERSONNEL 18,516 SUPPLIES (Schedule 5) 2,000 POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) 2,000 TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPEC]EY): (Schedule 5) (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 4,000 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD(IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15%of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 22,516 Page 1 of 1 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct project/client services. Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO)lige item. The Total CDBG Salary&Wages must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY City of Chula Vista Recreation Department PROJECT Therapeutic Recreation Programs &Classes (1} (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES Recreation Specialist 9,859 100.00% 9,859.0 Recreation Aide 5,440 100.00% 5,440.0 Aquatic LDR 435 1.00.00% 435.0 TOTAL CDBG SALARY&WAGES 15,734 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3.List percent of gross pay to be charged against CDBG funding. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 1 of 1 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3 -PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. i AGENCY City of Chula Vista Recreation Department PROJECT Therapeutic Recreation Programs &Classes (1} (2) (3) (4) 5 (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Recreation Specialist PERS/PARS/Medicare 2,477 100.00% 2,477 Recreation Aide PERS/PARS/Medicare 283 100.00% 283 Aquatic LDR PERS/PARS/Medicare 22 100.00% 22 TOTAL CDBG FRINGE BENEFIT 2,782 1.List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4.Use gross pay for project/total all wages of agency. Then muliply by required percent for each fringe. 5.List percent of gross pay to be multiplied for insurance. Pay Schedule(Check One Monthly X Biweekly Twice a Month Page 1 of 1 APPENDIX C-3:PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD (IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY City of Chula Vista Recreation Department PROJECT Therapeutic Recreation Programs&Classes i (1) (2) (3) (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD NIA i .. f TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 22,516 Percentage 0.00% (Must be equal or less than 15%) 1. List all personnel or nonpersonnel (NPE) charged against CDBG funding-include detailed description of indirect use. 2. List total Agency budget for positon and/or NPE line item. 3.List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5.Enter the Total FYI CDBG Budget;percentage will be AUTOMATICALLY calculated. Pay Schedule Check One Monthly X Biweekly Twice a Month Page I of 1 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY City of Chula Vista Recreation Department PROJECT Therapeutic Recreation Programs &Classes LINE ITEM SUPPLIES AMOUNT Detailed Explanation: Splash-N-Groove=decorations, prizes,untensils,plates,refresments 1,200 Monthly dances=decorations,prizes,refreshements 400 Fitness Classes=Fitness Equipment(weights,rubber bands,therapy balls) 400 TOTAL $ 2,000 LINE ITEM PUBLICATIONS/PRINTING AMOUNT Detailed Explanation: Splash-N-Groove=Tickets,Flyers 500 Monthly Dances=Tickets Flyers 500 Fitness Classes=Tickets,Flyers 500 Wearing Apparel 500 TOTAL $ 2,000 LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed.Add pages as needed. Page I of 1 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length: 1 Page; Max Score: 5 Points) Provide a lrstzng below of the specific tasks oractivit es needed to mpierr ent the proposed project and a timeline far their completlO:A umber each task or activity,describe it, and giv.,e the projected date of completiota.Add additional, rows as needed. . ..'' I # Task/Activity Description Completion Date . 1 JMonthly Promotions of programs JFlyers and schedules will be distributed,website 7/2014- updates,to inform the public 6/2015 Z ; Development and implementation of JSurvey participants at activities 7/2014- programs that are popular, new and 6/2015 successful -F3T JDances, Fitness Classes, Sports, Learn Monthly activities will be set up and offered 1x a 7/2014- To Swim, Exercise Classes week I 6/2015 -477 Ispecial Events, Parent's Night Out I Quarterly events to bring in new participants and [9/30/2014, increase awarenessI 12/31/2014, 3/31/2015, 6/30/2015 5 uarterl reporting uarterl reports due 4x 9/30/2014, lQ Y p g l lQ Y P 12/31/2014, 3/31/2015, 6/30/20151 6 I JPurchase Supplies and Materials On-going supplies and materials to support classes, 7/2014- special events, Learn to Swim I 6/2015 7I Maintain registrations,health forms, On-going collection of participant and parental waiver liabilities liabilities I information,health info,waivers 6/2015 E TF- 11 TF i EE li E ITFi II 1 II Appendix"0"-Implementation Page 1 of 2 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identificati®n ®f Pri®r Year C®BG and/®r Federal Funds G 1 Agency name City of Chula Vista, Recreation Department G.2. Protect name: herapeutic Recreation Programs&Classes G.3. Year of funding: ❑' Fiscal Year 2011 ❑ Fiscal Year 2012 ® Fiscal Year 2013 G.4. Indicate"the source;df thefederal funding,awarded to the prlgr.protect ® CDBG I JLJ HOPWA ❑' ESG I �Fj HOME ❑j CDBG-R I IE] HPRP ❑' NSP I ❑ Other(i,dicat,ioaw): i G.5. Amount awarded $20,000 G.6. Amount'spentta date: : $9,031 G.7. Amount reprogrammed to date: $0 G.8, Indicate hel6W....he outcomes anticipated(refer`to the.original application (or"the project, if possible): (1J. Provide Therapeutic Recreation activities to a population not being served in Chula Vista and the South Bay areas. (2) Increase independence,self-esteem,and a healthy lifestyle to persons with disabilities. (3)i 11 G 9. ',"Indicate belauv the outcomes achieved (1) jProvided a variety of classes, special events,and dances. (2) 1programs were offered at various Recreation facilities and swimming pools throughout Chula Vista. (3). Participants learned new skills, enhanced activities of daily living and made new friends. G.10♦ If any anticipated outcomes were.NOT achieved, specify which ones`and eXplain s by below [Nonei Page 1 of 1---Supplement to Appendix E Application No. 10 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Center'for Employment Opportuaitie' s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Employment Reentry for At-Risk Young Adults (18-25) Project Description: CEO will provide 28 people,,including 15,at-risk yciung,,6clufts (118`25) tefurning,horne from prison with"life'skills, eclucafion, paid transitional work,, full time, job placement and ,I)-mon'th of retention, services'. ' 'Those served will have limited employment histlori0s;'lowe' ducational, ,attainment,levels and no source of legitimate' income. Type of Program/Project: Public Services [(§570.201(e)] Target Popullatloh:' 05H -;,Employment Proposed Number; 28' training', to Serve:, (subject to change depending on funding &R§,570.208(�)(2)10' w recommendation) Moderate Income, Limited Clientele Program Total Budget: $67,674 C. V. Cost per Client: $1,071 (Based on funding recommendation) Funding Request: $30,0140 Prior Year,Funding: $14,000, Specific Use of Chula Vista Personnel Costs FUNDING $14,000 Funding: RECOMENDED Staff Notes:: COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM 0*7 Application for Funding for Fisca I Yea r 2014-2015 Prp�ei � y Application Number r ® Public service (CDBG Program Office Use Only) (thckar�e ❑`Capital improvement Applicant Agency Information jprtrp>.lat.rrrr»a Center for Employment Opportunities 501(c)(3) ❑ Gov't./Public 101 for Profit I [ll Faith-Based ❑ Other. �� �9rMA�dt1350 6t�'Avenue,Suite 180 San Diego CA 92101 1' t [1 'D71� 12pC1'eai ,., 4/06/1995 _`. a � M iftFl :; 13-3843322 Agerrr�r L7LJNSlurn6er r_ 88-470-3257 �lnriva(ojt? rrt� td� 20,142,465.78 t�urrrberrtl t 192 ^` cmber ovclteer x AglPitcy miss�rirt�tatement� - _ The Center for Employment Opportunities(CEO)is dedicated _...... .; _ ._., ; ._. to providing immediate,effective and comprehensive employment services to men and women with recent criminal convictions.Our highly structured and tightly supervised programs help participants regain the skills and confidence needed for a successful transition to a stableproductive life. Project Title: Employment Reentry for At-Risk Young Adults (18-25) Brief prdjrectds?sr► t » .: ,. „ [CEO will provide 28 people,including 15 at-risk young adults(18-25)returning home from prison with life skills education,paid transitional wont, full time job placement and 12-months of retention services.Those served will have limited employment histories,low educational attainment levels and no source of legitimate income. More than 70%of participants will reside in Chula Vista census tracts with a majority of LMl residents. Funding Request r� � ��u�d�rt�t'�c;Fu�s��d �'�t.�apjQllca�rrn ~�£ � reiw�i�nd�a�ready.�ec�red��t� 2. f1rlde ar dr�ltritr�rr Aer� liX 30,000 I $37,674 a ,t1rztE ; � 1 €s1cjfi£; $67,674 F ( h ►€� Z , rare lac:; Project Information tf PraJeot rs Puiteruic ,w1►Jervrce b spec>flh ., . x - gs if your ansu%er rs ye, ,�letx�f��r'r�.►rrA�� Address(�s- Unemployed, at-risk LMI adults and young adults (18-25) on parole and BtdC�[� zild, fJk� r/�en�ralJ probation currently residing in the City of Chula Vista RUM.R ftslavllzus Ga ct rhr !# lien and bcusehaldso ire e plfo Fub1c Stvtae,'r�n�#lvlttir �teIet► tlr[dr - b )t�rh6u � if ® Individual clients Households Tatrx!'Urt1f .red Anrii�r[ o -der � t _ s 1107 Page 1 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Project Details (Max Score: 25 Points) 1 Prord a cQnctse descrrpttotr cif tfe prapsed project(this descrvtian mPte ani ptoVttied an theoUe CEO will provide 28 people (15 at-risk young adults aged 18-25) returning home from prison and jail with life skills education, paid transitional work,full time job placement and 12-months of job retention services.These individuals will ave invited employment istories, 167w leveFs of educational attainment and no source of legitimate income. More than 70%of participants will reside in census tracts within the City of Chula Vista with a majority of LMI residents. et start date, 7/1/2014 Akttc►paecf enrl nate 6/30/2©15 lro e 13,. Pxol!et� dayshoul°s of dperattdri<: => Monday-Friday;lam-spm 1 Public service pro eft ® Suitable living environment ,� f® categc�t ' oblectru ❑ Decent housing (ck,fne aril ❑I Capital improvement Idherlror�e erty ❑ Economic opportunity 1 1a�ect ® Availability/accessibility outcox»e ❑ Affordability eckQnen[yl ❑ Sustainability ODBC Criteria Wh►ch GpOG crrterron ie(ouv doffs yc.ur prc oto ed Coject►rreet� ❑ (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income(LM1). Please provide a map identifying the Census Tracts designated as LMI. ® (2) Limited clientele(select subpart below): ❑ (a} Special needs group(select benefit group from the list below): ❑` (i) Abused children ❑ (ii) Elderly persons 62 years or older ❑� (iii) Battered spouses ❑ (iv) Severely disabled adults(not children)—Census definition; documentation required 0! (v) Illiterate adults ❑ (vi) Persons living with HIV/AIDS ❑' (vii) Migrant farm workers ❑ (viii) Homeless persons ® (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? ❑ (3) Housing)(select subpart below): BF Single family(must be 1009'1 LMI)Multi-unit(must be 51%LM!) 18 ,TFr0t1�2U5 Cofrst�lydated_P1Qn goals alr IFsted777777777-7777&leJaw 5elec „ e g .u1 apl+apF<ate to'frou► p,(ect� !❑ Affordable Renta!Housing Opportunities ❑ Maintenance and Preservation of Housing (rehabilitation activities) ❑ Homeownership Opportunities (homebuyer programs) Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate income Persons Page 2 of 9 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 CABG FUNDING APPLICATION (Max Length for Questions 1.10 to 1.15: 2 Pages) J. 10`,ExpluFrt haw fhe�tt�ciposed prodee�q�i�r �es;the goy[seleetetl� ...., `' This project will create a better living environment for those directly served, and for other members of their communities, by providing residents of Chula Vista with immediate income and a pathway to permanent unsubsidized employment upon their re ease rom prison or jai .Those serve irect y wi e unemp aye , hig y concentrated within Chula Vista's most poverty-stricken neighborhoods and likely come from families that face similar economic circumstances.This project ensures that the labor market is accessible to these participants, many of whom are at risk of spending their entire lives in poverty, or worse, incarcerated for a new crime. This opportunity is extended to participants at a significant point in time--immediately after their release from incarceration- when participants face tremendous difficulties but are also highly motivated to change. In this moment, CEO offers the structure,stability and income people need to successfully reenter society. Expected benefits include: increased individual and household recidivism; and fewer children at risk of criminal stability; neater public safet throu h reduced recld , income;greater family stabs y, g p Y g justice system involvement in the future. 2.��,, Sumr�r�rrrze any sta��st�cs and pt'het'supportrng doeurri�ntc��tt�n tf�€rt der�c�ns�'rr�te fhe rm�ortanee oj�addressrng this The City of Chula Vista has over 840 people under criminal justice supervision, nearly all of whom return to low-income neighborhoods. This is a population that often has low levels of education and little (if any)experience in the workforce. For example, last year,46%of CEO participants had no HS Diploma or GED and 42% had no previous work experience. These individuals come home from incarceration disconnected from the labor market and,without services like the ones offered in this project, are likely to remain disconnected. Research has shown that incarceration creates"stickiness" at the bottom rung of the economic ladder. One study found that after twenty years, 67%of formerly incarcerated people were still living at or below poverty levels. By providing formerly incarcerated people with an immediate connection to income and employment,this project would seek to prevent this sustained poverty, placing participants on a pathway towards greater self-sufficiency and enhanced opportunity. Many at-risk young adults in Chula Vista returning home from incarceration do not receive the services and supports that they need to be successful upon release. The consequences of this are severe. San Diego County has the third highest recidivism rate in California as nearly 70%of parolees return to state prison within three years. Not only does -income communities, it also means that more and more public this recidivism correspond with high crime rates in low resources must be spent on corrections agencies rather than invested into communities. Investing in programs like CEO that are proven to reduce recidivism is an effective use of public resources as the costs associated with incarceration are significant, especially in a time of constrained public sector budgets. ach srutce pt�v�dea by the'project jar epch servicer In ►rcat a weth ► rs a new setvrce ar an exp�rnsrc�t ap ., 1.��� This project will assist 13 at-risk adults and 15 young adults(ages 18-25)on parole and/or probation residing in Chula Vista to secure full-time employment through the provision of the following services (all are expanded services): 1) Life Skills Education (expansion)-a one-week job readiness training course that offers basic "soft skills"training on job interviewing, addressing one's conviction and employer expectations.The course also assists participants in securing all documents necessary in order to work; 2)Transitional job (expansion)-all participants are immediately employed by CEO as staff members for our work crew business which provides general labor services to a variety of paying customers. Participants are paid daily for this work. 3)Full-Time Job Placement(expansion)-While employed by CEO, participants are also required to work closely with employment specialists to secure a full-time job outside of CEO; 4)Job Retention services (expansion)-After placement outside of CEO, participants receive 12 months of retention services, including financial incentives to motivate their progress and help CEO stay in touch with them as their jobs progress. In addition, if individuals lose their jobs, they can return to CEO and rejoin a work crew to ensure income and steady work while they pursue another placement with the help of CEO vocational staff. Page 3 of 9 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 1.1 . Now does your ttetcfr plan to tell;the target populatrarr abrin#the prr�jeei%s�rvrces? CEO exclusively serves people on parole and probation and all referrals to CEO are made directly through a parole agent or probation officer. In just over a year of operation in San Diego County, CEO has already been able to establish solid partnerships with these agencies helping to ensure that our services are reaching those who can benefit from them F---most Based-owtk-results of ndom-assigntent eve4u-atkDrn-of-EE&and its e#fieaey-in addressing#h"eeds-offiigh— risk clients, Parole and Probation selects individuals with similar profiles: those who were released within the past 90 days and those at high risk of recidivism. Further, by working closely with these agencies, CEO is able to target additional high-impact sub groups, such as young adults ages 18-25, and people from specific high-need communities. Other community organizations may refer participants into the program so long as the parole or probation officer submits the official referral documentation. Rather than employ generalized outreach efforts, CEO's recruitment of participants is conducted in concert with the parole and probation officers supervising them, ensuring a streamlined selection process and that those referred are likely to benefit from CEO's program. Once referred, participants are typically contacted by CEO staff within 1-3 weeks to begin the enrollment process. CEO staff members call participants directly, inviting them into the program and giving them all the necessary information about their first week in the job-readiness training. By relying on parole for the initial referral, CEO staff already have critical documentation on each participant,which includes demographic information, conviction history,address, marital status, and contact information, allowing the staff to begin building individualized case management plans immediately upon enrollment. All information from these referrals is entered into CEO's secure, customized cloud-based data system in Salesforce.com. 14 Irst up to three outcomes of the prafect(at leapt ane rs regulred)„, r each outcpm lrted,provide the nurrrl�er of parfrs~pants rrvha vrrif!bene`it and the way data null be+rallecdp track crr uerifY.tfte outcome Outcome Statement Outcome Data Sources Data Collection measurement A total of 28 formerly incarcerated at-risk LMI #of unique CEO work CEO administrative and vocational adults(15 young adults)will be employed in a individuals crew site logs staff will collect and track all work transitional job with CEO, increasing their employed on and payroll crew attendance data through CEO's access to immediate income and work CEO work crew records customized system in opportunity for improved quality of life. Salesforce.com,which also tracks all relevant demographic data At least 15 formerly incarcerated,at-risk LMI # of full-time Participant CEO job developers will enter all adults will be placed into full-time jobs at job placements pay stubs placement data into Salesforce.com local businesses, providing increased access as well as collect and store copies of to income,greater self-sufficiency and a more paystubs; CEO follow-up unit will suitable living environment for clients and independently verify placements their families 1�11r1f tare project=:allabnrc�te."i, zithers rvlce rovrders rn the comm trdity� fres,Yrst them E y d bieflfr dscrrbe the cQfabcrirtart. - ® v Parole and Probation-CEO works in close collaboration with these agencies building partnerships through steady communication and a mutual understanding of one another's roles. CEO staff maintains regular communication with their supervising officers and report both positive and negative aspects of a participant's performance. Local Community Providers—CEO also works closely with a variety of local community providers that can supplement CEO's vocational services and respond to the multiple needs of.the reentry population (e.g. drug treatment, housing). with Metro United Methodist Urban Ministry,the local EDD and One-Stop Career Centers, as well as a variety of other community organizations associated with the Reentry Roundtable. Page 4 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 2: Agency Ca acit (Max Score: 10 Points) . 2:1:"_Who:virrll b�the person respons�6le or the overs!!oversight of the propiised prajecta lameaf Person,'; Bill Heiser Director of California Operations `, eua t crn: BA, Hampshire College; MA, University of Chicago .. ; phare number,..;: 510-251-2240 ext 613 j E ®ate first employed 2010 2 2„ U4/hc�uurl!be the alternate perse Namef persaam Schaeffer �`itle of person thief Executive Officer and Executive Director,CEO AucBA, Reed College Tetphon-'ttiirbr: 212-422-4430 ext 259 mate first exnployei:; 2009 2 VVhv will he the person responsrh[e for the slay tip dayiperaoas cnd management of the prrosed projet Prairie-tit more thorn t�nrt�7rtdtvrduals - 1►lame,cf person : Keiara Auzenne i Title„uf pershia: San Diego County Director Reluantecucatrrl: BA, UC Santa Barbara; MBA, Monterey Institute;JD, UCLA School of Law lel, phon znumker” '619-6844810 ext 650 Uoe firstrrployed 2011 11lame f persanr Pablo Ramirez Titlef s'rst� ; ,lob Coach/Life Skills Educator Rf �ranf educatrn s 'BS,San Diego State University Telephort rturtthe`rr 619-684-4810 ext 654 tpt ; tst ernplr�yeds 2011 . s p Pravrde rto more tFi"np�>nro r�adru%r"duals, - Name of erson !Hilda Romero Tilte ti person , Comptroller t7 [ uar< e'IuCarc ?,_, BA, Universidad Francisco Marroquin 7`ephor�e pure , 212-422-4430 ext 454 aat ►rsternployecl, 2006 NA)��WW JBrad Dudding �XmTitle 4f pron< Chief Operating Officer leanterrtaktir:v BA, University of Missouri; MA, Rutgers University Teephr�ne nunlrx,; 212-422-4430 ext 211 afrseipe' ,- 1994 Page 5 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to 2.8: 1 Page) 2 5. ,Lrst the eur�luarrr�rr tools.your'agency plar7s to em to„#o frack;and t�onrtor fhe"progress,.�af tlxe�rafect Salesforce.com-CEO's program model depends on extensive data tracking across a variety of measures, using an in- house adaptation of Salesforce.com's online customer relationship management(CRM) database.This program data allows us to eta ermine whether our Theory of Change is working as expected and whether we are having an impact in the communities that we serve.We collect extensive data on participant's demographics and also all individual events in the program (e.g. transitional work site attendance,job start readiness assessments, interview feedback, etc.) as they occur.This information allows CEO to chart progress against near-, mid-and long-term goals, such as job placement and retention, in real time.These tools are used by management and staff every day and they are essential to achieving organizational excellence.All participant and program related data is aggregated and displayed on a set of Dashboards that allow management,job developers and job coaches to have a real time feedback loop on progress towards outcomes. Furthermore, Salesforce.com allows CEO to easily create new reports and dashboards based on the specific needs of a project allowing us to track performance simultaneously for multiple projects. Follow-up Unit-CEO holds itself to the highest standard of outcome verification and reporting. As one of our primary outcomes is the full-time employment of participants,CEO has an independent"follow-up" unit separate from job developers who are making these placements. Only those participants that the follow-up unit has independently verified as employed—via paystub, written confirmation by a parole/probation officer,or direct contact with an employer—are counted as working. CEO does not accept self-reported information on employment status to count against outcomes. 2 Haw daes yQ tr agency pian o en ure camplrar re Wrttt 0PPlr0able laalrcy a 7 r,099:dural r equiireMents(�»c(ut rtrg those;lrsted in FIUll'Sfire Rrales Ham _06�, yy CEO is currently the recipient of two federal Social Innovation Fund awards which require CEO to meet fiscal and administrative requirements comparable to those that will be expected for CDBG. CEO has consistently been assessed as "low-risk"for non-compliance by our SIF grantors during regular internal audits. This includes thorough documentation of participant demographics, strong fiscal oversight and a management team that is fully committed to supporting all project staff and progress towards outcomes. Furthermore, CEO will be leveraging existing resources to ensure that all project activities are fully staffed and supported. 7 UeCrrbe airy unrest tive�l ADA 1s ues lfi tie Prr�ject or pra�eCt ince and h� yaur zfgency plans to rrdress t17 elf .:.,_fhb r�blect(v�of the�pm�ec��s,,�;�A rehdrlltafian,���r��r<ep�art the pro�e�t;�escrrptlar�hers� .` _ CEO does not have any unresolved ADA issues at this time. 2 S Hvw many rrrert�,��rs does +atrr�o�rd of fllrec�o�`s have' � How ratty Bvgd rnembrs ares cttsriemlrr of the prdjec target papula€ran resrde rn the p_.`ljet's tcrrgetaraa�ndretruFzrch vrtes rn�4PpeadrF I Page 6 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3 1 �a"refl y a'�scribe your agency's pay�ez�t,��d clisbursetri�ni'pr�cedw�`�s, vrrrth,re�eva�ac�to the propasect.pr`o1ecf: CEO's policies for purchasing/payroll are as follows: 1. A purchase requisition is required for all purchases of$25(3 or more.Three bids are required for all purchases of 1amishings Supplies or equIpmenttMting$1000 or mom. 2. Every position is supported by a job description. Full-time permanent employees have offers of employment or employment agreement. 3. All deductions from employee pay are supported by appropriate documentation to authorize each deduction. 4. Upon hiring, CEO examines and maintains all required information regarding employment eligibility under immigration laws(1-9). 5. All employees are required to prepare time sheets and sign attendance forms(time sheets). 6. Additional procurement requirements for specific government contracts are followed and procedures are modified as needed. CEO procedures for payroll include the following: 1. HR Director assigns ID numbers to new employees, prepares Personnel Action form,obtains labor distribution and approvals from the COO, Executive Directors and CEO. 2. Once employees are entered into the payroll system, it is modified only after receipt of authorized notification of changes on a Personnel Action Form, approved by the appropriate level of management. 3. All regular CEO employees complete time sheets on a biweekly basis.Time sheets are reviewed and approved by the immediate supervisor. 4. After reviewing and approving employee time sheets,the supervisor releases the timesheets for payroll processing. 5. At the end of each pay period,the Payroll Manager resolves discrepancies with the supervisor, reviews information for accuracy and prepares export data to payroll system. 6. The Controller reviews and approves the payroll prior to payroll processing. 7. The Payroll Manager reviews the payroll for accuracy and completeness and forwards paychecks and paystubs to the HR Director for distribution. CEO's policies for disbursement as follows: 1. All complete expense voucher packages are reviewed and approved by the Chief Financial Officer. 2. Only original documents with original request and original approval signatures will be processed for payment. Disbursement Procedures are follows: 1. All invoices delivered to the Fiscal Office are stamped with a "received date" upon receipt. 2. A check request voucher is required for each approved invoice.The voucher package includes:purchase request and purchase order(if applicable); invoice and packing slip (if applicable)—original only;check request form with original signatures 3. The voucher package is reviewed by the CFO for documentation that is incomplete or missing. Authorized check signers are the Executive Director,the Chief Operating Officer, the Chief of External and Legislative Affairs,the Board Treasurer, and the CFO. Checks over$3,000 require two signatures. � .: L7escrb�how your agency�s Board�f t�t�'�c�lnr�exer�t�es p�c3�rammir�rc t�nd�sca�auer�►gh� ., .. CEO's Board of Directors meets fourtimes a year. At each board meeting CEO's program and fiscal performance is reviewed. Programmatically,CEO Management presents key performance indicators(KPIs)to the Board which summarizes program activities and outcomes related to CEO's mission. In addition, at CEO's Annual Meeting in January, CEO Management presents an annual performance review report for the previous fiscal year. This report provides data on outcomes and suggestions for process and program improvements. Financially,CEO updates the board at each meeting on CEO's financial condition and identifies financial risks to the organization. CEO Management meets with the Executive Committee, including the Treasurer, before each board meeting,to review financial projections in detail before reporting out to the full board. The CEO Board is also required to approve the organization's annual budget each year at the June board meeting. CEO also has an Audit Committee comprised of three board members. The Audit Committee coordinates CEO's independent annual audit held in the fall of each year after the June NII fiscal year close. The Audit Committee meets with the independent auditor after the audit and reports on the results of the audit to the board at the annual board meeting. The audit is approved by the full board at this meeting. Finally, CEO Management provides interim financial statements to the Audit Committee one month after the close of each fiscal quarter. Page 7 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 3 3 Brrefly c�escrrbe your agency s financrat reporting 77 sytemlaecvuntrng procedures, wrth reteUance to the propostl project = CEO's accounting system is comprised of the methods and records used to identify, assemble, classify, record, and report accounting transactions. It is set up to: a. Identify and record all of CEO's transactions; b. Describe the transactions in enough detail to allow classification for financial reporting; c. Indicate the time period in which transactions occurred in order to record them in the proper period. CEO has a computerized financial accounting system using Blackbaud Financial Edge software. When CEO gets a new funding source it assigns the grant a new fund number so that all transactions can be recorded and reported on. r4rreffy deser►`be yoir agency's rer and(cipng system,tivith retuance to the prcr{iosed project CEO Record Policies: 1) Records will be maintained for the periods sufficient to satisfy IRS regulations,federal grant requirements,req OMB A133 audit requirements,if applicable, and other legal needs as may be determined; 2) Record retention requirements are reviewed annually with legal counsel and independent auditors to determine any necessary changes. For a full listing of CEO's retention schedule see the included CEO Fiscal Policies and Procedures Manual. 3 rtefly t<escr be yat r ager��y's Oditrng requlreMgnts,-nclutll g these fur tete prop s tl project CEO's financial statements and internal controls are audited by the organization's independent auditor once a year. The audit is overseen by CEO's Audit Committee. CEO's independent auditor also performs an A-133 audit each year because CEO receives federal funds. CEO also works with funding agencies when conducting their program and financial audits. l rrefly tlescr�be ya rr ag cy s rnr`erna!ca roll ttt m►r itntze apportunrtaes torfraudr waste,and tntsm nt ge ent CEO's internal control structure consists of policies and procedures that have been established to achieve CEO's objectives. This structure is established and maintained to reduce the potential unauthorized use of CEO's assets or misstatement of account balances. CEO's internal control structure is composed of the following basic elements: The Control Environment-The control environment reflects the importance CEO places on internal controls as part of its day today activities. 1. The Accounting System-The accounting system comprises the methods and records used to identify, assemble, classify, record, and report accounting transactions. 2. Control Procedures-Control procedures are the procedures set up to strengthen CEO's internal control structure and thus safeguard the agency assets. They are divided into the following:Segregation of Duties; Restricted Access to valuable and movable assets is restricted to authorized personnel; Document Controls; Processing Control; Reconciliation Controls 3, The Accounting Cycle-The overall purpose of an accounting system is to accurately process, record,summarize, and report transactions of CEO.The component bookkeeping cycles fall into one of four primary functions: (1) Revenue, accounts receivable, and cash receipts, (2) Purchases, accounts payable, and cash disbursements, (3) Payroll, (4) General Ledger and Financial Statements. fiouu does your agency play to segregcite Ct�BG fctncls from other raeny funtls forurpses otlerrtlfctro �ru�krng,arraf r�par�r��? ,; F (CEO's accounting system allows for a separate set of books and records for each restricted grant/contract received. Hence each grant/contract has a standalone, detailed accounting of revenues and expenditures attributable to it during the life of the grant/contract. This accounting is based on the life of the grant and is irrespective of CEO's fiscal year.All charges to the grant are based on direct costs incurred or costs allocated on a consistent,verifiable basis following the a enc 's cost allocation Ian. - Page 8 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) rrefly hrgttttfi your agency`s exprn+e r rnd m�rlor ricampfr'shrren �nravrd�ng servfc+? fa Ln/!f dent pndJ�r i cantniunites YaU rriay extend rn Ape�rlrx A CEO has a long track record of providing paid transitional work and full time job placement to men and women recently released from incarceration who face steep barriers to finding and maintaining employment. Last year, CEO served 3,078 participants across the country who had limited, if any, sources of legitimate income. Further,these individuals were likely to return home to neighborhoods with pockets of deep and persistent poverty. The combination of CEO's highly-structured program and staff who are trained specifically to work with the formerly incarcerated population helps . the organization effectively address the immediate need of clients, while also helping to achieve long-term impacts in support of their families and communities at large. CEO's experience is marked by accomplishments; over 10,000 participants have been placed into full time jobs within the past ten years. in the past year alone, CEO San Diego provided paid transitional jobs to 157 people and helped SO individuals secure full-time employment. in addition to providing jobs for a highly vulnerable LMI population, CEO has been shown to keep communities safer.The results of a three-year randomized control trial showed that CEO made statistically significant impacts on all measures of recidivism, including arrests,convictions and incarceration. CEO San Diego is backed by the Center for Employment Opportunities,which operates in ten (10)jurisdictions and three (3) states across the country. CEO has replicated its proven model with fidelity in each state and as a result,the organization has been awarded CDBG funds in three localities, including Chula Vista.CEO's fiscal department has extensive experience in the oversight of CDBG funding allocations and ensuring that all expenses are allowable under HIED guidelines. In addition, CEO is currently the recipient of two Federal Social Innovation Fund awards supporting the expansion into CA through FY 2014.These awards require stringent fiscal accounting procedures, all of which have undergone recent federal A-133 audits. This experience ensures that CEO is capable of addressing all federal audit requirements. �2 Hai ya�r encs re�e�ved Co�C or rlth�r'�ederal ft�r�ds�n trny'o,�;~�e pr�.�t fhree,�r�ca!years ( Q � 2Q1�, � � 2hrgh1s4) T��s, ta►npe� � ertdfG sok ® ydsI N a1ch of the grants raerved�f�t the the ;�iscal Years Q �tt 2A1 ,otlt13_ Section 5: Back-Up Plan (Max Score: 5 Points;) 1 W�fl y+ tr agencyf►Il trn�lrert thrs pra�ectf�rLu1dIG furttls nat beIrctc[e�►?1 yes, hc�t�r -.E aay:aaa3.. !Waft Impt�r»et�t�rjr�r��e�lchrev�d� W This application is in support of increased vocational services to expand CEO's program capacity in Chula Vista. CEO intends to move forward with implementing this project if CDBG funds are not awarded. Failure to receive funding may reduce some of the vocational support offered to new participants,though the organization will look to other revenue sources to fund these services. 5 2 !f fttrrded� hvw�vrll your agency an ,nue fhr3 prv1ect if CtCrnds are rlat a►rarlal �n uue years„ CEO has a long track record of operating a financially sustainable organization that effectively leverages public and private sector support. To launch operations in San Diego County, CEO secured multi-year investments from two federal Social Innovation Fund awards that will extend through the current and next fiscal year. In the San Diego County office's first year of operation, CEO secured paying work crew customers and private foundation support that has begun to anticipated that CEO will be able to attract additional earned revenue from paying work crew customers,government grants and philanthropic investments that decrease the dependence on any single revenue source. Page 9 of 9 (Revised 12/412013) FY 2014-2015 CDBG FUNDING APPLICATION CITY OF CHULA VISTA Appendix A: Narrative Of Project (Max Length: 2 Pages) EaQ9QSr, ;ss,eplri1 ' 9 ]� l 1 s DRAFT:ADD UPDATED STATS FOR CURRENT CDBG&OTHER CDBG AWARDS,ACCOMPLISHMENTS,ETC... The Center for Employment Opportunities [CEO)has offered immediate, effective and comprehensive employment services exclusively to men and women under criminal justice supervision for over 30 years.Created as a pilot cadent non-profit in 1996.CEO's vision is that s own independent protect of the Vera Institute of justice,CEO became rt P anyone returning from prison who wants to work has the preparation and support needed to find a job and stay 3,CEO helped 168 San Diego County residents (21 from the City of attached to the labor force.In Fiscal Year 201 Chula Vista) to build the workplace skills and confidence needed for a successful transition to a stable,productive life.CEO's program model is specifically designed to help those participants most in need of a job, many of whom .At a time when few other options exist,CEO intervenes,offering the are returning to impoverished communities opportunity to work and earn a paycheck within one week of enrallnnent.Through its unique program,CEO enables the experience,skills and confidence that will participants to earn.vital income in the short-term while also building help them secure long-terra employment. The CEO model consists of four phases specifically designed to assist people under community supervision in securing full-time employment.The Program begins with a one week Life Skills Education course that quickly prepares participants to reenter the workforce.Immediately after completing the course all participants are placed into a paid transitional job on one of CEO's supervised work crews,where they receive a daily paycheck.This allows participants,none of whom have a source of income,to begin earning an income within 7 clays of enrolling at CEO.The crews also provide an employment"laboratory"where participants can build the work experience that most are lacking four days a week,7 hours a day.On the fifth day,participants work closely with employment specialists to secure full-time job placements outside of CEO.This approach enables those who are ready for ition opening space for new participants and permanent employment to move quickly 0'stservices.te sector Qn average,people spend bout three months engaged with enabling more people to benefit from CE CEO an a daily basis before being placed into full-time jobs.More than just the income and work experience,the at a time when participants'lives are often in a program serves as a stabilizing force,offering structure and routine state of a tremendous flux.After placement CEO supports them by providing 12 months of retention services, including financial incentives that help motivate their progress and helps CEO stay in touch with participants as their jobs progress. In addition,if individuals lose their jobs they can return to CEO and rejoin a work crew to ensure income and steady work while they pursue another placement with CEO vocational staff. �l�.es; eats o u a ista w o are on parole"or pro ation are ig y concentrateTffi some o t e ci s most power - stricken communities. CEO's participants reflect this concentration in economically depressed communities:last year,two-thirds of CEO participants in San Diego came from census tracts where more than 70% of residents were LMI,a trend that is likely mirrored in Chula Vista.These are communities where,in many cases,nearly a third of residents are living at or below federal poverty levels,placing them on the very/extremely low-income end of the economic spectrum.Further adding to their burdens,many CEO participants are parents and have a responsibility to provide for their children upon release.In the)ast fiscal year, 69 of the participants served in San Diego County had children.Research indicates that the incarceration of a parent depresses household income by 22%in their absence.Thus,the prospect of reliable employment upon release from prison or jail is of critical importance to both participants and their families, and to the communities to which they return. en arrive lacking the knowledge and experience to successfully navigate The men and women who come to CEO oft the labor market.just over half(54%) of participants served in San Diego last year had a High School Diploma or 42% of CEO participants had no work experience at all..Thus,for many, CEO is a first GED.Perhaps more startling, P P experience with legitimate employment.Connecting participants to the labor market is particularly critical to their long-term success given their relative youth; nearly 65%of CEO Participants from Chula Vista are under 35 years Appendix A —Narrative Page 1 of 2 FY 2014-2015 CDBG FUNDING APPLICATION CITY OF CHULA V&A old,and 45%are under 2S.In a typical career trajectory,most people spend their 20s and early 30s in jobs with progressively increasing levels of responsibility and pay.During this time,most will learn the skills necessary for their profession,establishing professional networks and laying the foundation upon which their career will be built. CEO participants too frequently spend these years incarcerated,excluded from even entry-level jobs and often faced with tremendous debt from fines,restitution,and unpaid child support. Research has clearly shown that the effect on economic mobility,with nearly 67%of formerly incarcerated consequences of incarceration have a lifelong men remaining on the bottom rung of the economic ladder 20 years after serving their sentence. By targeting a marginalized population highly concentrated in low-income neighborhoods,CEO stems the persistence of poverty in underserved communities, in the last fiscal year,CEO served 21 people from the City of Chula Vista,11 of whom were young adults.In the upcoming year,CEO seeks CDBG funding to serve an additional 28 people from Chula Vista, 15 of which will be young adult participants.Despite the barriers discussed above,CEO was able to place over half of San Diego County participants into full-time jobs. What's more,CEO's employment reentry intervention has been proven, ear independent random assignment evaluation conducted by MDRC,to increase public safety and through athree-y yield up to$3.30 in taxpayer savings for every dollar invested.The study found that for those recently released,CEO made statistically significant impacts on all measures of recidivism,including arrests,convictions and incarceration. As the first reentry service provider nationally to submit to a random assignment evaluation,CEO offers an effective program model whose impact has met the highest possible standard of evidence. While many organizations--in San Diego and national--serve formerly incarcerated clients, CEO's services are distinguished from other workforce development providers in several ways:the organization exclusively serves individuals with criminal convictions; all participants are guaranteed immediate paid transitional work up to four days per week; and every participant placed in full-time employment is given one year of retention services that combines intensive case management with work-related financial incentives. Several other components of the CEO model such as Life Skills Education,job Coaching and Job Development are utilized by other local providers,but CEO links these services in a unique manner that allows participants to build basic work skills and earn immediate income while getting the support they need to secure full-time, permanent employment. Over the next six months, CEO anticipates doubling its capacity in San Diego to serve 375 people with histories of incarceration. For this grant,CEO is requesting support for a portion of the vocational services to be provided to 28 at-risk adults residing in the City of Chula Vista.CEO is aiming to leverage monies from a variety of government and private sources for this project. Of note,if received,this funding will leverage dollars through two federal Social Innovation Funds that require a match source such as CDBG funding in order to be drawn down. Overall, CEO is asking for less than 45 percent of the project's total$67,674 cost.The proportion of requested funding translates to a cost of$1,071 per participant served--a modest investment,especially with consideration to the financial benefits — that t e CE program-has een emons ra ed o prov. �t'a�cp�yer�" This project offers a cost-effective solution for improving public safety and connecting formerly incarcerated people to the labor market.CEO intervenes in our participants' lives at a time when they are highly motivated to find employment(recently after release)but are the least likely to be able to secure a job. By offering services at this critical juncture, CEO has proven that it can significantly reduce recidivism among participants and generate substantial cost savings to taxpayers. In times of strained state and municipal budgets,less spending on incarceration means more resources are available for other critical issues and population.needs. Appendix"A!'–Narrative Page 2 of 2 Revise APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step (1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step(3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista(Step 1) $30,000 44.33% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds $37,674 55.67% .Private Funds 0.00% Agency Funds 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTAL $37,674 $30,000 100% TOTAL PROJECT BUDGET1 $67,674 APPENDIX C-2: THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three (3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds trust be available for both purposes. �I I Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements. FY 2013 CY Page# 3 Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 2,491,637 A. Multiply Agency Cash Balance by 4-Cash available for project(s) 9,966,548 i List the amount of FY 2014-2015 CDBG funding applied for this application. 30,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. 95,810 List the amount of FY 2014-2015 CDBG funding applied for any other application. 20,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. 150,000 B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 295,810 Compare Agency Cash Balance Available(Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item A 9,966,548 Item B 295,810 Difference 9,670,738 Analyze Results I-If difference is a positive amount or equals$0,the Agency is eligible to apply. 2-If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance,as long as: A) EACH PROJECT MEET'S THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATIONS, AND B)CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX C-3: PUBLIC SERVICE SCHEDULE 1 -BUDGET EXHIBIT AGENCY Center for Employment Opportunities PROJECT Employment Reentry for At-Risk Young Adults(18-25) CDBG Percentage SALARIES &WAGES (Schedule 2) 20,500 FRINGE BENEFITS (Schedule 3) 5,482 TOTAL PERSONNEL 25,982 SUPPLIES (Schedule 5) POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCE/REPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPECIFY): (Schedule 5) (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 0 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD(IC/AO) (Schedule 4) 4,018 0.1339333 [IC/AO Expenses limited to 15%of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 30,000 Page of CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length. 1 Page, Max Score: 5 Points) P�'o�td�a li��rng below ►; the specr�il+�tasks ter�ct�yctres neede��'����ater��n�lb��ar�r�nsed prrr,�ect�ztzd�t�%r��l�rte fps their�ornpl�tror� 1Vumbe��a�h>Cosk oructzt�rtjr,d�scr`1be rte andgi�e the prn�eotea�date cif�r�rnp[et�on Add addrtian�ri h 'ask, it� ascf : On : j Project Ramp-up CEO will establish all data tracking, 1 asking, fiscal and 8/1/2014 administrative,programmatic procedures for operations and reporting on CDBG grant. 2 Participant Recruitment CEO will recruit 8 eligible at-risk LMI young adults 9/30/2014 from Probation and Parole Offices per quarter to start the program. 12/31/2014 3/31/2015 6/30/2015 3 Life Skills Education ICEO will conduct at least one Life Skills Education last class per month to accommodate program calendar participants,graduating an average of 6 day of each participants per quarter. month [Transitional Work CEO will run a transitional work crew offering ILast participants 650 hours of paid transitional work per calendar month where they learn basic skills and are day of each evaluated daily by their supervisor. month I5 ob Development I JCE0 will place 8 participants in full time jobs, 12/31/2014 approx.3 per quarter,for the last three quarters of t 3/31/2015 he year. 6/30/2015 ,6T Employer Outreach ICEO Job Development staff work with the business 9/30/2014 community to expand the number of employers CEO work with thereby increasing the amount of full- 12/31/2014 time job available to CEO clients.Progress will be 3/31/2015 tracked on a quarterly basis. 6/30/20151 Appendix"D" Implementation Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-20115 CDBG FUNDING APPLICATION Appendix E: Roster of Board Members & Professions Praride a roster of tfteml�erfYr a�erty' Board o11rcvs ar�d r herr proessztsiyZltrrg oto the ta,bte elaw. ` ! c 4 1N it eP f NNO hfamea�ardc�sftron :Poen f AfIrt �►nr �A��r►�ec Popu ut ori Dav id Moskovitz, Chair Chief Executive,Accenture ❑ Steven Fishner,Treasurer IDir. Foreign Practice,KMPG ❑ ❑ �0.Peter Sherwood, Sec. judge,Supreme Court NY ❑ ❑ Joel Hornstein,Audit Chair M.D.,American Dream Fund ❑ ❑ Emary Aronson,Trustee M.D., Robin.Hood Foundation ❑ ❑ Elizabeth Balfour,Trustee Partner, SMR&Hampton, LLP ❑j ❑ Cristine S. DeBerry,Trustee Chief of Staff,DA George Gascon ❑ IF]—I Kathryn Jo Mannes,Trustee Senior VP,AACC ❑ ❑ William J.Snipes,Trustee Partner, Sullivan&Cromwell ❑� ❑ Credit Suisse Securities ❑ Andrew van der Vord,Trustee VP, �❑ Ellen V. Holloman,Trustee Partner, 01shan Frome Wolosky ❑, ❑ Jonathan D. Miller,Trustee JDM Associates I ❑ ❑ ❑ 101 ❑ 'Ell I❑ ❑ ❑ 101 E❑ Appendix"E"—Roster of Board Members and Professions Page 1 of 1 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix F: Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests, payments,and campaign contributions must be filed.The following information must be disclosed: 1. list the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e.g.,owner,applicant,contractor,subcontractor,material supplier). iN/A j 2. If any person* identified in section 1 above is a corporation or partnership, list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership)entity. N/A 3. If any person* identified in section 1 above is a noxi-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee, beneficiary and trustor of the trust. N/A 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. Sam Schaeffer (CEO/Executive Director), Brad Dudding(Chief Operating Officer), Keiara Auzenne (San Diego County Director) 5. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official**of the City of Chula Vista as it relates to this contract, project or application within the past 12 months?Yes❑JNoZ If yes, briefly describe the nature of the financial interest the official may have in this contract. N/A 6. Has any person* anyone identified in 1, 20 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than $250 within the past twelve(12) months to a current member of the Chula Vista City Council?Noes❑ If yes,which Council member(s)? N/A 7. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value, money to retire a legal debt,gift, loan,etc.)Yes❑JNo® If Yes, list official and what was the nature of item provided? N/A 8. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of income of$500 or more to an official** of the City of Chula Vista in the past twelve(12)months?Yes❑ JNo® If Yes, identify the official and the nature of the income provided? N/A :[January 23, 2014 :1 Sam Schaeffer I Signat�ep, * Person is defined as:any individual,firm,co-par joint ve ,association,social club,fraternal organization,corporation, estate,trust, receiver,syndicate, any other county,city, municipality,district,or other political subdivision,or any other group or combination acting as a unit. ** official includes,but is not limited to: Mayor,Council member,Planning Commissioner, Member of a board,commission,or committee of the City,and City employees or staff members. Appendix'T'—Disclosure Statement Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: identification of Prior Year CDBG and/or Federal Funds 1 Agerl; rrame City of Tulsa C Wra�rx nrrnI JNorth Tulsa Employment Reentry Project '� G Yed .a + ttrn�l ❑ Fiscal Year 2010 ❑ I Fiscal Year 2011 ® Fiscal Year 2014 f G 4 MOO the snCr of the federal fndrtwurcleda the prrcx► project a ® CDBG ❑ HOPWA ❑ ESG ❑; HOME ❑ CDBG-R ❑ HPRP JLJJ NSP ❑ Other(lndkatebelaw): I I A dct� 3,771 17.34 G 7 ��Irh�t�nt tepr'pgrarr�m�d,ta-�#afes�W 8F, indre�t����orly the�utcort�� �rrr�reapat� (refertcr th�.�r'Igirt�l appl��txtrvn fit th , raject, �f pr��slble);,,:' ... ; Provide life skills education and job coaching to 120 new North Tulsa participants between 7/1/13 and 6/30/14 Place at least 70 individuals in full-time private sector employment Provide at least 70 individuals with retention services post-placement lr�drexttow ,acicahr �rt ' ` ' = z I, N/A E ! � N/A :''. N/A , ?!�Tr Wr'� rM,�jtteotn�� �his contract is currently being executed during this year, Fiscal Year 2014. G1 `d�`grrtaity of Chula Vista 2 Prajam. � ` I Employment Reentry for at At-Risk Young Adults Fiscal Year 2010 `❑ Fiscal Year 2011 ® Fiscal Year 2014 #�ar�rcate theMst~urc 'af the fdc;l " rtdrr% ® CDBG JHJ HOPWA ❑ ESG ❑ HOME ❑ CDBG-R ❑ HPRP ❑ NSP ❑ Other(lndleatebelow): 14,000 ,.,` iitb/t1 �pelllU, t : Provide life skills education and job coaching to 15 new Chula Vista participants Place at least 8 individuals in full-time private sector employment Provide at least 8 individuals with retention services post-placement Page 1 of 5 —Supplement to Appendix E CITY OF CHULAVWA FY 2013-2014 CDBG FUNDING APPLICATION G9. 'Inrlrca b�1w tie outcor�ars uhieved" N/A N/A N/A G��} tf rzr�y;ci"nt[c,p�t�d.�tutcr��es wereNQF achr�ved,�p�rify whrcH Anes and e�cplarrr ul/hy br'lvw = �his contract is currently being executed during this year, Fiscal Year 2014. Page 2 of 5 —Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) O 1 , agencj�� City of Buffalo Department of Community Services G,2, 'Prbjectt�prr� City of Buffalo Community Development Block Grant Entitlement Program Yetr>afutdl»� ;; ❑� Fiscal Year 2010 Fiscal Year 2011 ® Fiscal Year 2013 G lndrptehe,s�riar�e of the ferferrlc(rtdrrig a +arded to the Pprvjecd , ® CDBG ❑ HOPWA [-] ESG ❑ HOME y a ❑ CDBG-R ;❑ HPRP ❑ NSP ® other(Indicate below): US HUD + 5 `.'EltYtoun ,trwr id` v 194,313 a►tunsrerrtr�datr;:,� 188,798.27 8.'„lrrdicrf�beCc rhe outcorles arircrpai�re,>~ertcz therrgrtct[ rpl�err for , e°protpassrZl 1..,. Provide life skills education and job coaching to 75 new City of Buffalo participants v Place at least 50 individuals in full-time private sector employment , 3jProvide at least 50 individuals with retention services post-placement lnd�carte i m if lv the aut atr e a hlev t CEO provided life skills education and job coaching to approximately 196 participants between 5/1/12 and 4/30/13 CEO placed approximately 198 City of Buffalo residents into full-time private sector employment ; (3� CEO provided retention services to 122 City of Buffalo residents placed in full time employment anrelpatedOatcorres were Nf�7 dhreuecf,specif j wh7eh©ries endxfa77777777r7-7777lr #r why1r�v Page 3 of 5—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) 1 <ggericy G:�: _�rofec#name _, ._. 9, ❑ Fiscal Year 2010 raF6mar 2011 ❑ � fiscal Year 2012 J G 4 lndreate the source o the e erdt furrdrng rw d�*d to"t_fre prior pr"j .. ❑ CDBG ❑ HOPWA ❑' ESG ❑ HOW ❑ CDBG-R ❑ HPIRP ❑ NSP ❑ Other(Indicate below): eta � !nd►Gte helauuhe' ratarr aapatec prefer:to the WulWatFrn for th :pr©�ecf rpar61 W 9 Ind►ctxte befog the arrcatt18M,c�cl'evecl:' _ G 1 ani trntfrrpaed.otttaakmes wre,NOTrchved,saeejfy uvhich tines pnd e�p[arn'why befouu. (Type response herG.] Page 4 of 5 —Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project: 1 Page) G �.„ ;Agency nark � 2 Pio}e��name: � � i� _ T � �F sca!Year 2010 Ffsca Year 2011 �� FisCa!Year 2012 �F .._Ihdtateho source ah .federrf�fundtn arnardd tothe ptr pro}ect, CDBG ❑ HOPwA ❑ ESG [ �ion� . ❑ CD$G-ft '❑ HPRP NSP other(indicate betow): ecpsstble �,8. Indre�te bel©w t`��outc�rr���r�rrttcrpr�ted�re�e��o the,t�rr�r►n�r��pp��cat'tr��fpr the prt�} tf rf p. 15� G � ' [nd{cite b�{ow the utcpmes a�hleved<::. . . 77 ` p . . ;. . 10 !f any ontrcrpo ed,vutcprnes t�vere Nd7 achroued,sp et y-kh ones and ex lc�lrt inrh be dint [Type response herG.] Page 5 of 5—Supplement to Appendix E Application No. CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Family Health Centers of San I)iegp, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: KidCare Mobile Medical Unit#3 Project Descr'ip'tioh: The''Mbbile Medical Units (MMU) proviclehigh quality, healthcare to , low-income, and medically underserved peirso'ns, including horneless children, youth, and adults, The MMU is a licensed icensed rnodical I tl in lcthat provides irnimuniiatioris, illness management,, and health screeningsAo, patients; thereby eliminating, ffn'ancial, cultural, linguistic, and, transportation ba' rriers;to care. Type of Program/Project: Public Services [(§570.201(e)] Target Populatloh:' OSM - Health Services Proposed Number; 1'500 to Serve: (su'biect'to change &R§'570'.208(a)(2)'Lo' w depending on funding Moderate Income, recommendation) Lim' ited Clientele Program Total Budget: $326,963 C. V. Cost per Client: $20 (Based on funding recommendation) Funding Request: $3Q,000 Prior Year,Funding: $13,600, Specific Use of Chula Vista Personnel Costs FUNDING $13,600 Funding: RECOMENDED Staff Notes:: COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM .. Application for Funding for Fiscal Year 2014-2015 CH Application Number: Project category: ® public service (CDBGProgram Office Use Only) fcnrcrOne-onry) ;Capital improvement Applicant Agency Information Applicant legal name. il=amily Health Centers of San Diego(FHCSD) Type of agency: 501(c)(3) I Gov't./Public For Profit El Faith-Based I El Other: A encu Address- ,823 Gateway Center Way Date of incorporation- ;1970 Tax IU number:. '95-2833205 AgenDUNS number' c+ 02053-1893 ' Annual operating budget., $111,642,770 Number o aid staff., ;1074 Number of volunteers, 75 .4-eng mission statement. Our mission is to provide caring,affordable,high quality healthcare and supportive services to everyone,with a special commitment to uninsured,low income and medically underserved persons. Project Tale. Kidcare Express Mobile Medical Unit#3 (MMU) . Brief project description: .Our MMUs provide high quality healthcare to low-income and medically underserved persons, including homeless children,youth,and adults.The MMU is a licensed medical clinic that provides immunizations,illness management,and health rrrppnj im.to natients-thereby eliminating financial,cultural, l6nPifl_qt6r__ and tranennrtation barx'ers to Funding Request Total funding requested in this application $30000 Other funds already secured for $0 (you will provide a detailed budget in.Appendix C, , project: Total cost to complete project. $326,963 Other funds not yet secured for X326,963 Project Information rf Project is a Public Service,will service be site specific? ; Yes ZIVB if our answer is yes,please provide. Address(es)below' Census tract.. Our MMU serves multiple sites in the City of Chula Nista and the greater South Bay region 127, 131.02, 132.03 Including schools,social service sites,community centers,and public gathering sites. 133.03,134.19 3 Target Clientele.(Homeless, Youth. l.ow-income,medically underserved people in Chula Vista including homeless Elderly,Disabled,OtherlGeneral) ` individuals,children,youth, and adults The fallowing questions on individual clients and households to be served apply only to public Service,and Minor. Residential Rehabilitation projects: Will the projectserve individual clients lc or households(HH)� individual clients L1 Households Total uni ulicated lC/1lHservec=,. '1500 I Annual cost per clientlhtlusehold; $20 I Pale i of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CABG FUNDING APPLICATION Section 1: Project Details (Max Score: 25 Points) 11. Provide.a concise description of the proposed;project(this description must match the one provide d ori the cover page) Space for a fuller narrative is provided irr Appendix "A Our MMUs provide high quality healthcare to low-income and medically underserved persons, including homeless children,youth,and adults.The MMU is a licensed medical clinic thatrovides immunizations illness management,an p g d health screenings to patients,thereby eliminating financial,cultural, linguistic, and transportation barriers to care. In addition,the MMU serves as a conduit to a primary care medical home for those who do not have ane. 1:2..:. Project start date my 1, 2014 ; at�d Antklp `end date: dune 30,2015 1,3. Prrjer-C-s days/hi)urs of operotrorr: Monday through Friday,8a+m to 5 m but varies by location and day. 1.4, Project �I j Public service 15 Project Suitable living environment Category.. objedi Decent housing (Cha�(meonly). di O' fchecl,vn��nry) Economic opportunity 1.6 project: ® Availability/accessibility outcotne Affordability (rheck.vnr:aiuy) Sustainability 1..7., CDBG Criteria: Which CDBG criterion below does your proposed projects meet? ❑ (1) Area benefift:At least 51%of residents within the targeted activity area are low to moderate Income(LMI), Please provide a map identifying the Census Tracts designated as LMI, (2) Limited clientele(select subpart below): ❑ (a) Special needs group(select benefit group from the list below): (i) Abused children (ii) Elderly persons 62 years or older j (iii) Battered spouses (iv) Severely disabled adults(not children)—Census definition;documentation required (v) Illiterate adults (vi) Persons living with HIVIAIDS (vii) Migrant form workers (viii)Homeless persons (b) At least 5196 of clientele to be served will be documented as LML How does your agency track and ® record client demographics?We use our electronic health records and internal systems to track demographics. (3) dousing(select subpart below): (a) Single family(must be 100%LMI) (b) Multi-unit(must be,51%LMI) 1 The 102c7-2015 Cmsolidd6ed Plan goals.are fisted b iora:r.SeYect the`gaol apirrP,vrrate io ypur project Affordable Rental Housing Opportunities Maintenance and Preservation of Housing(rehabilitation activities) Homeownership Opportunities(homebuyer programs) Community Enhancement(public facilities/spoces) Public Services to Special!Needs Population and/or Law Moderate Income Persons 139je 2 of 9 (Revised 12141201.3) CITY OF CHULA WSTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 1®10 to 1015: Z Pages) 1.10, Explain how.the prowled:project addresses the goatselected. lour MMU program is designed to increase access to health care for low-income and medically underserved people by eliminating financial,cultural and linguistic, and transportation barriers often associated with primary medical care services. By bringing the MMU to local schools,social service agencies,and store parking lots,we are helping vulnerable populations receive vital health care services. Many of these patients,especially homeless individuals,Often rank health care concerns secondary to more immediate subsistence needs such as food and shelter.MMU services enable low to moderate income (LMI)patients to get health care in a timely manner when serious conditions are still preventable. We have been providing mobile medical care onboard our MMUs throughout San Diego County since 1998. MMU services are provided to low-income and medically underserved patients in Chula Vista and non-Chula Vista residents in the South Bay approximately 32 hours per week in convenient,easily recognizable locations like school campuses and store parking lots. For the 2014-2015 fiscal year,we anticipate serving 1500 people, including homeless persons, individuals with substance abuse or mental health issues, public housing residents,children,youth,and adults. T 1 ; Summarize on-y statistics and other supporthig documentation that demonstrate the importance cif addressina this need or problem. 'According to the 2012 San Diego County Health Status Report,the South Region,which includes Chula Vista,leads the county in some troubling health statistics for both chronic and infectious diseases.The South Bay has the highest rate of female breast cancer,and Chula Vista had the highest rate of prostate cancer and overall cancer death in the region.The South Region has a coronary heart disease(CND)hospitalization rate 32.3%higher than the county overall,with Chula Vista having the highest rates of death, hospitalization,and emergency department(ED)discharge for both CHD and stroke.The rate of diabetes hospitalization in the South Region is over 50%greater than the county overall,with Chula Vista having the highest rates of death, hospitalization,and ED discharge due to diabetes.The incidence rate for tuberculosis is 95.7%higher,and the rate of chronic hepatitis C is 170.7%higher in the South Region than the county overall.The South Region also had an incidence rate for chlamydia that is 15.4%higher than the county overall,with Chula Vista having the highest rate in the area.Though the infant mortality rate in the South Region is generally lower than the county overall,Chula Vista has the highest percentage of very low birth weights among the communities within the South Region.Chula Vista also had the highest rate of hospitalization due to assault,suicide,self-inflicted medical encounter,and fall-related deaths, hospitalizations,and ED discharges in the South Region.These health disparities are even more pronounced among the nearly 500 homeless individuals in Chula Vista,as homelessness is linked with greater need for mental health and supportive services,as well as increased use of paramedic health services and emergency hospital care. These statistics and the fact that San Diego is one of the few large counties in California without a county hospital equates to a large need for health care services. FHCSD helps fill gaps by providing critical care on the MMU to vulnerable individuals who face significant barriers accessing healthcare. Despite the passage of the Affordable Care Act, it is estimated that 3 million Californians will still be uninsured or underinsured.As the largest provider of safety net health care in San Diego County, FHCSD serves the highest-risk and most vulnerable people.80%of MMU patients typically have neither health insurance nor the means to pay for their visit.Compared with other County Regions,South Region residents are more likely to use public services(such as community clinics like FHCSD)as their usual source of care, it is therefore more important than ever to ensure that we continue providing services through our MMU. 1;=Ustch service provided 6y the projectn,For ear h ser lice,indreate uvhether'it is u newrserviceof an ser, C►ur MMU program will continue to provide high quality, culturally competent health care services like immunizations, well check-ups, preventive care, illness management,and health screenings to LMI patients in the City of Chula Vista. In addition,we will expand our program using a targeted approach to ensure that we reach a significant portion of the homeless population in Chula Vista,including individuals who may not readily identify as homeless but meet the federal definition of homelessness(e.g., couch surfers and unstably housed individuals).We will continue to care for patients onboard the MMU and link them to FHCSD's larger system of care, helping them establish medical homes and referring Pave 3 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION them to other services.This is even more critical for homeless individuals who not only need a primary medical home but would benefit from additional resources available through our federally funded Health Care for the Homeless Project(e.g.,mental health services,vision care, restorative dental care,case management,transportation assistance, etc.). We will continue to collaborate with existing partners like the Chula Vista Elementary School District and Sweetwater Union High School District,and explore partnerships with other social services agencies to promote and deliver MMU services to ILMI residents in Chula Vista. MMU staff and agency outreach workers will also promote MMU services.A monthly schedule of MMU clinic sessions will be created,published,and provided to all partners. Individual patients will be encouraged to contact FHCSD directly to schedule an appointment or identify where the closest MMU clinic session will be held.Clinic sessions will be held in half day blocks of time,four hours each,four days a week. Patients will be registered at the point of services and then receive the health care that they need and/or request. Referrals to specialty care will be provided when needed. Patients will receive assistance in enrolling in public health benefit programs if they qualify. Patient data will be collected daily and will include the total number of patients and health care encounters for analysis and reporting purposes as required, j 143, How cines your agency pla>i!to.tell the target population.about the prOjim-t/services? 1FHCSD has a long history of working with over 400 other service agencies throughout the county to promote our programs and services.We work with our community partners to reach the target population for our MMU program.In addition,we actively go out to the community conducting outreach activities to ensure that people know about the services available aboard the MMU.The quality of care we provide keeps our patients coming and encourages word of mouth advertising.The same holds true for MMU patients who are impressed with the high quality,culturally competent services we provide.They often refer other family members,friends,neighbors,and colleagues to FHCSD. We also have an Outreach Workers Network that promotes the MMU program to clients and helps us identify needs in the community to determine where to deploy the MMU. Our talented marketing team creates interesting promotional materials and helps us promote the MMU online via our website, Facebook page, and at community events. 1,14, List up to three outcomes of the project(at least one is required) For Each outcome listed,provide the number of participants who will benefit and the Way data will be collected to track or verify the outcome. :FHCSD will track the following measurable outcomes far the project: 1)the total number of unduplicated patients receiving care onboard the MMU;2)the total number of MMU patients who meet the federal definition of homelessness;and 3)the total number of encounters/visits to the MMU.For fiscal year 2014-2015,we anticipate that we will serve 1500 unduplicated patients,through 1875 encounters.300 of the total number of patients we serve during the fiscal year will meet the federal definition of homelessness.We will expand MMU services to reach a significant portion of the homeless population in Chula Vista through a concentrated effort involving targeted outreach and working closely with existing and new partners. Data will be collected through the use of our fully deployed electronic health records(EMR),our proprietary Clinical Management Information System (CMTS), clinic logs,daily productivity sheets,and other internal documents within our system. 1115 Will the project collaborate e��rrh'atherservice providers in,the community?if yes;list them andbriefly deseribe#ne coilrxboratrcmn '; ® Yes FHCSD collaborates with over 400 other service agencies to deliver primary healthcare to medically underserved persons including homeless individuals, people with substance abuse and mental health issues,public housing residents,at-risk children,youth,and adults,and other low-income individuals. For example,we partner with local non-profit homeless shelters and public housing sites to deliver primary healthcare to people without transportation or insurance.We also partner with non-profit mental health and substance abuse recovery agencies such as Vista Hill, Mental Health Systems, and McAlister Institute to deliver care to their residential clients.Our MMU program has a strong partnership with the Chula Vista Elementary School District,the Sweetwater Union High School District,community centers,and other local places of gathering(e.g.,store parking lots)to deliver mobile healthcare to those who need it.E Paje 4 of g (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION SectionLAgenpy apacitA (Max Score: 10 Pointe 241. Whet will be the person res mible or:the overall ouersr ht o the IqMvsed ra-ect? Nairne Ofpersari (Fran Butler-Cohen Tkk of person; JCEO relevant education Masters in Business Administration Telephone number, 519-515-2301 Date fiat errrployed. 11985 ? 21. Who will be the alternate person responsible for.the overall oversight of the`pro useo ro'ect? Name o 6.rson- Robert Lewis Title of persons` Director of Special Populations Relevant en"` Bachelors in Business Administration,20+years experience in healthcare Tete hone number: 615-515-2586 , Date nst em 7vverl. 11997 23 Who will-be the person responsible for the do' day operatiurts'and management of the proposed'project ; ProWde`no mole than two individuals dame of persona' , om Stubberud Title of person' iManager of Homeless Services and Mobile Medical Services Relevant education., ;Masters in Public Health Tek hone number-, 1619-515-2372 1. Date.'first.emplp edf ;2005 Name of person-• � rtle o Relevant education:: Telephone number;- 1. Date first erptq ed-" 1I i 214, Who Will be the person responsible for the financial oversight of the CDBG expenditures'ond fiscal compliance? Provide riomore than iwo rndrvidur�ls Naive o `erson:1 Ricardo Roman Tlt1e aersan ; FO Refevcint edu+ctrorr.; Masters'rn Taxation, Bachelors in Accounting TTeWhope number, 19-906-4603 'Date rst erri'1� ed - 010 f+loroe personFran Butler-Cohen Title a erson''' CEO f� AL educaOah. Masters in Business Administration Telephone number:; 619-515-2307 I Date first employed 1986 Page5of9 (Rev(sed 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Max Length for Questions 2.5 to 2.8e 1 Page) 2.5. List the evaiuotion tools your agency plans to eraplgy to track and monitor the:progress of the project. �FHCSD has a robust infrastructure which includes EHR and CMIS, both of which are available and accessible aboard our MMU fleet. Bath EHR and CMIS are vital evaluation tools that help us to track and monitor the progress of the project. Patient demographics and other relevant data will be collected onboard the MMU vehicle during each encounter using EHR and CM IS,which will allow us to generate reports for continuous program improvement and for submission to funders as required. one measure of success is the ability to provide services to new patients who are not currently established with a primary care provider.This indicates that the program is reaching additional individuals who can benefit from health services provided. Some specific mechanisms for monitoring and tracking the program include: 1) A monthly MMU schedule of all clinic locations,which will be created and distributed to all project partners, 2)Daily clinic productivity sheets,which will be maintained for each clinic session;and 3) Individual patient registration information,which will be collected and entered into CMIS. By using electronic systems and CMIS data,we will track the number of unduplicated patients as a measure against established goals and objectives by June 30,2015. MMU staff will also use clinic logs and CMIS data to track the number of patient encounters during the 2014-2015 fiscal year. In addition, MMU staff will maintain regular contact via phone, email, and in-person,with key partner agencies(e.g.,Chula Vista Elementary School District and Sweetwater Union High School District)and site contacts to ensure the project is successfully providing high-quality health care services through June 30,2015. I 2.6: How does your agency plan to ensure.compliance with applicable policy and procedural requirements ftncludin those listed irr.HOD's''flaying by the Rules--Handbook).?..'. 'FHCSD has decades of experience receiving and successfully managing federal,state,and local government funding for the provision of primary health care.This includes funding as a result of our status as a Federally Qualified Health Center from the U.S. Department of Health and Human Services Bureau of Primary Health Care, Medi-Cal funding,State Office of Family Planning,and others.over the years,we have built a successful history of receiving and managing CDBG funds from multiple sources including the County of San Diego and several cities(San Diego,Chula Vista, EI Cajon,and Lemon Grove). FHCSD is familiar with all policies and procedural requirements pertaining to CDBG funds, including those listed in the HUD's Playing by the Rules Handbook. .2,77: Describe.any unresolved'ADA iisares r'n the project or`project office and h6iw your agency plows tv wd►ess therm;;(If the ob1ec:tive i)f the project rs A"DA rehabJllt xt ren,da rant repeat the` ro�ect rles�rrptran here J - . Our KidCare Express MMU is fully ADA compliant and does not have any unresolved issues in the project or project office. 2&r How many M,embesl doesoW.Board of f3lrettors-have' 15 How many Bol ardrnern ers ate`also'merrr6ers`of the prvlect's tatddt p .0 ation orresrde in the pr©sect's targe€area?ftidicate which ones rn; pP �c F endr . P$ge 6 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 34 Auditing Control (Max Score: 15 Paints; Max Length: 2 Pages) 3.1: Briefly describe your agency's payment and disbursement:procedures,.with relevance to the proposed project jFHCSD utilizes state-of-the-art information systems,accounting software,and automated billing processes to collect, organize,and track key performance data and to report on the organization's financial status.We operate an extensive management information system coordinated through our Information Technology(IT) Department. FHCSD has an accounting system whereby costs are recorded by site, by department or program,and by object code or expense type. This system is in accordance with Generally Accepted Accounting Principles and applicable Office of Management Circulars(e.g.,OMB A-122 Cost Principles for Non-Profit Organizations).The chart of accounts and the general ledger are structured by embedding the site, department,program or grant Into the full account number.For service budgeting, expenditures,and reporting,a separate fund number is assigned for each grant.This separate fund number enables FHCSD to keep a clean accounting of the services provided and expenditures related to them. Budget modifications are submitted for approval when necessary. .Describe how your agenWs Board ofDirectors exercises pfpgrammatic and fiscal oversight Our Governing Board of Directors meets monthly for oversight and governance,as codified in the organization's Amended and Restated Bylaws.The CEO and CFO provide monthly reports to the Board and FHCSD directors provide scheduled reports in accordance with an annual board calendar of topics,such as patient satisfaction,clinical outcomes, environment of care,and compliance measures.The Board approves all major grant applications,as well as FHCSD's annual budget.The Board provides direct oversight and evaluation of FHCSD's progress in meeting its annual and long- term programmatic and financial goals. The Board requests presentations over the course of each year that include annual reports on Quality Assurance activities,service area environment of care/emergency, UDS clinic reports, Ryan White Care Act Program (Part C: HIV Early intervention Services), and patient satisfaction. In addition to specific reports,periodic presentations are provided on key areas, including IT, budgets, sliding scale and fees,Healthcare for the Homeless and Public Housing activities,and the emergency management plan.The CEO and the CFO provide monthly financial and clinical performance progress reports to the Board.The Board uses this ongoing reporting and exchange of information to support strategic planning and continuous review of FHCSD's bylaws,policies,and procedures, patient satisfaction,and effectiveness in fulfilling our mission. I 3..3.:.. Briefly describe your agenry`5Pnoncial reporting systemlaccoun.ting.procedures.:with relevance' 'to the proposed, project. iA monthly financial report is prepared for every grant or contract,summarizing the revenue recognized and the expenses incurred for the month and year-to-date compared to the grant budget. FHCSD also utilizes the Serenic Navigator accounting software to track the organization's financial status, including revenues,funds and expenses by grantor and other funding source,by site/location, by department/cost center,and by any combination of those parameters.We maintain detailed policies and procedures that govern processes for approval of all purchasing,cash receipts,cash disbursement, payroll, investment, patient/third party billing and revenue-related activities and transactions.A strong system of internal control is structured through implementation and oversight of these procedures. FHCSD receives an annual external audit under requirements of the U.S.OMB Circuler A-133(Audits of States, local Governments and Non-Profit Organizations), performed in compliance with federal audit requirements. 3A, Briefly describe your aglency'.s record* eprrig'systeM,wifh relewrice to the°proposed project.` FHCSD has a robust infrastructure which includes a fully deployed EHR and our proprietary CMIS that allow us to manage bath patient and financial records.Our Accounting Department maintains financial records for a minimum of seven years. 3:5r Brleflyciescrib `our age►tcy's'auditing requlrerrteribs,:ins ludin biose fnr the rnposed}rofect In accordance with U.S.OMB Circular A-133,Audits of States,Local Governments and Non-Profit Organizations, FHCSD receives an annual external audit performed in compliance with federal audit requirements.Our latest audit covers the period July 1,2011 to June 30,2012.There have been no major findings or questioned costs in any recent or near-recent Page 7 of 9 (Revised 1214120.13) CITY of CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION year. FHC5D's Accounting Department closely tracks grant expenditures. Expenditure reports for the MMU program are reviewed regularly by the Director of Special Populations. 116. ::.`Briefly dekribe your agency's internal controls to minimrie opportanitres for Froud, waste, and r.tr'smanagementr FHCSD, by virtue of being a non-profit organization,has established and continues to maintain effective internal Financial and Accounting controls in compliance with the strict requirements of the laws, regulations,contracts and grants applicable to federal, state, and county grants,among others.These internal controls,enforced by written policies and procedures,are designed to promote and achieve the following objectives: 1) Proper validation of documentation for evidence that a recorded transaction actually took place and that it occurred in accordance with the prescribed policies and procedures. 2) Ensuring accuracy of amounts and account classification. 3) Completeness of control processes to ensure that all transactions are initially recorded on a control document and accepted for processing only once recorded. 4) Appropriate maintenance control to keep track of accounting records after the entry of transactions to make certain that they continue to reflect the operations of the organization accurately.This involves procedures, decisions,documentation,and subsequent review by a responsible authorized individual. It also includes proper supervision and segregation of duties, 5) Physical security of assets to ensure adequate protection of the same. These internal controls govern and provide clear distinction and separation of duties in processing transaction as opposed to approval and authorization; handling of cash against recording in the books;writing checks away from those who authorize; reconciliation process separate from those who record the transaction; policies on conflict of interest;to name a few. f 17. . How dries your,agency plan to segregate CABG funds from other agency funds for purposes of identification, tracking,and reporting? IFHC5D employs a methodology whereby costs are recorded by site,by department or program and by object code or expense type.The chart of accounts and the general ledger are structured by embedding the site,department,program or grant into the full account number. For service budgeting,expenditures,and reporting,a separate fund number is assigned for each grant.This separate fund number enables us to keep a clean accounting of the services provided and expenditures related to them. FHCSD is experienced in establishing and maintaining systems for the provision of claims data and information for billing purposes.A monthly financial report is prepared forevery grant or contract, summarizing the revenue recognized and expenses incurred for the month and year-to-date compared to the grant budget. Depending upon the grant requirement for claims submission,claims are prepared monthly,quarterly,or per requested frequency,with the necessary expenditures information/details.when claim payments are received,funds are deposited and recorded in the general ledger Under the appropriate grant. FHCSD's system is in accordance with generally accepted accounting principles and all applicable Office of Management Circulars,and we have not received a management letter related to our external independent audit for the last two decades. PaWe g of 9 (Revised 12/41201.3) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max Length: I Page for Section 4/5 Combined) 4.1, Briefly highlight your agency's experience qnd major accornpfi�hments in providing services ttt LMi residents pndlnr communities(Yogi may expand in Appendix A ;FHCSD has a proven track record of serving very low-income residents of San Diego County for over 44 years.In 2012, we cared for over 173,000 clients in more than 650,000 encounters through our 34 sites, including 17 primary care clinics,5 dental clinics,4 behavioral health centers,and 3 MMUs.A significant majority of the people we cared for in 2012 were impoverished:86%of FHCSD's patients lived at or below 200%of the Federal Poverty Level(FPQ,and 76% live below 100% FPL.58%of our patients we served in 2012 were uninsured. We operate health centers that serve LMI residents in communities including Barrio Logan,City Heights,Diamond Neighborhoods, Lemon Grove, El Cajon,Spring Valley,and Chula Vista.Our fleet of MMUs provide vital healthcare services to LMI residents at over 30 community locations, including homeless shelters, public housing sites, schools,and local community centers. FHCSD is the largest provider of school-based health services and HIV prevention and care services in San Diego County,We are the lead agency for the federal Health Care for the Homeless funding in San Diego and the coordinator of developmental and behavioral services for low-income children, aged birth to 5 in two County regions. FHCSD's recent accomplishments in providing services to LMI residents include the addition of radiology and physical therapy services at our newly expanded City Heights Family Health Center,the change in status of Rice Family Health Center from part-time to a full-time school based health center,and our soon to open new Diamond Heights Family Health Center,which will greatly expand our ability to serve patients in Southeast San Diego. FHCSD was the second health center in the nation to receive The Joint Commission's designation as a Primary Care Medical Home and we are recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance.We are deeply committed to continuous program improvement and ensuring that we provide the highest quality care to our patients. FHCSD is a 2013 Eureka Silver California Award for Performance Excellence winner awarded by the California Council for Performance Excellence. 4,2;. Has your oge'ncy receive'CDBG or other federat.fund{in any of the pest three fiscal years (Fiscal Years 20112012,2012= 013,through-2013-2014; if yes,eoinplete Appendix G for ® Yes �Q No each of the grunts received for the three Fiscal years 2011,201?and 201_:? Section 5: Back-Up Plan (Max Score: 5 Points;) 5;1 Irbill your age" lvlement this project shoId CABG funds nat be awarded?!f vet,how will the implementation oe achieved? ® No Yes In the event that FHCSD does not receive CDBG funds for this project,we will work to raise funds from local charitable organizations and foundations that fund health care services for low-income, uninsured,and underserved people in the City of Chula Vista. In the past,we have committed agency funds as well, but this is not a long-term sustainable model. 5 2. if;unded :houir will yourar :hot available iii future year FHCSD maintains a diversified funding stream from partners at the federal,state,and local levels to facilitate continued operations during financially challenging times. j Pge9of9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 1-Wendix A: Narrative of Project (Max Length: 2 Pages) In two paries orless,explain belowyour propoaed project and make the corse whys itshould be awar+fed funding. Jur KldCare Express Mobile Medical Unit(MMU)program proposes to continue providing needed high quality, culturally competent primary health care services to low to moderate income(LMI)and medically underserved people in Chula Vista,including homeless persons,public housing residents,people with mental health and substance abuse issues,and at-risk children,youth,and adults.We have been providing healthcare aboard our MMUs throughout San Diego County since 1498. Our MMUs are 40 foot long converted buses that operate as fully-licensed medical clinics on wheels.The goal of the MMU program is to increase access to primary health care.We eliminate financial,cultural, linguistic,and transportation barriers to care by bringing much needed medical services to low-income and medically underserved people where and when they need them.The services offered aboard the MMU include immunizations, well check-ups,preventive care,illness management,health screenings,and referrals to other services. Family Health Centers of San Diego(FHCSD)collaborates with over 400 other service agencies to deliver primary healthcare to low-income and medically underserved people,including homeless individuals,children,youth,and adults.According to the 2013 Point In Time Count conducted by the Regional Task Force on the Homeless,there were 715 individuals who were homeless in the South Region,a majority of whom were found in Chula Vista(495). These homeless individuals Include military veterans,people with severe mental illness,chronic substance abusers, people living with HIV/AIDS,and victims of domestic violence.At FHCSD's two fixed-site clinics, Rice Family Health Center and Chula Nista Family Health Center,we served 1,130 individuals who met the federal definition of homelessness through 4,056 encounters in 2013.As the lead agency for the federal Health Care for the Homeless funding in San Diego,we know that homeless children and adults are among the most underserved by the health care community.Our agency collaborates with community partners throughout the county like South Bay Community Services,the South Bay Homeless Advocacy Coalition,and the Regional Task Force on the Homeless to provide respectful,culturally competent,and high duality services to homeless persons. We also work with both the Chula Vista Elementary School District and the Sweetwater Union High School District to provide MMU services to students and their families on campus.We currently provide mobile health care on a regular basis throughout the school year at Castle Park Elementary,Castle Park Middle School,Lauderbach Elementary,Silverwing Elementary,Vista Square Elementary,and feaster Charter School.FHCSD also works with nonprofit mental health and substance abuse recovery agencies to deliver much needed medical services to their clients via the MMU.In Chula Vista,we partner with the McAlister Institute's South Bay Regional Recovery Center to deliver healthcare to residential clients. In addition to being a vital community program that provides medical services to people in Chula Vista where and when they need them,our MMU also serves as a conduit to the broader system of care.Staff aboard the MMU routinely assist patients in-establishing a primary medical care home at Rice Family Health Center,Chula Vista Family Health Center,or other clinics in the area.By linking MMU patients to a medical home they experience better health benefits due to the increased continuity of care. As the largest Federally Qualified Health Center in the county,a critical provider of safety net health care in San Diego,and one of the first clinics in the state to provide mobile medical care to low-income people,FHCSD has a proven track record of providing MMU services to vulnerable populations.Through our skilled staff,well cultivated partnerships,effective approaches,and a robust infrastructure,our program is able to demonstrate success through measurable outcomes.Our MMU has been credited with community accomplishments like improving attendance at elementary schools, delivering life-saving care,and reducing inappropriate use of local emergency rooms.Every Appendix"A"—Narrative Page 1 of 2 (Revised 12/4/2013) CITY OF CHULA VISTA FY 20142015 CDBG FUNDING APPLICATION time an indigent San Diegan receives care at a local emergency room,the hospital loses at least$45 S.That amount is just$42 shy of FHCSD's cast of caring for the same patient for an entire year! Mary(name changed)is a mother of four who is currently homeless and staying in a shelter.She came into a local community center for emergency food and employment assistance,and found out that health services were also available onsite through FHCSD's MMU program.Thanks to our MMU,Mary's children all received annual checkups and required vaccinations.All four of her children are healthy,up to date on their immunizations,and are now all enrolled in school.Mary continues to turn to the community center for fellowship and assistance,including healthcare,which our MMU provides, Norman(name changed)was a 16 year old patient who came in to the MMU with his mother for a physical, He appeared weak,pale,and was not talkative.During the assessment,his mother informed the provider that Norman was newly diagnosed with Type 1 diabetes but did not have any medication.He also did not want to drink water because he was urinating frequently.The provider performed a glucose check and discovered that Norman had seriously high blood sugar levels(over 900 mg/dL).The provider immediately referred.Norman to Children's Hospital where he was admitted for two weeks due to his uncontrolled glucose levels.The provider's assessment and quick action saved Norman's life,as very high blood sugar levels(600 mg/dL or higher)can lead to a coma or death if not addressed promptly. These two stories are prime examples of how FHCSD's MMU program benefits the communities it serves.Many more stories like these happen every day as we continue to Improve the health and quality of life of our patients in Chula Vista and the South Bay. Appendix"A"—Narrative Page 2of2 (Revised 1 21412 0 1 3) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project.There are 3 steps to the completion of this table: Step(1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project;and Step(3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE:Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project, Howevor supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista(Step 1) $30,000 9.29% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds $180,474 55,91% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds 0.00% Private Funds $36,866i 11.42% Agency Funds 0.00% 3rd Party Payment(Medi-Cal,LIHP, etc.) $75,433 23.37% 0,00% 0.00% 0.00% 0.00% 0.00% 0.00% . 0.00% 0,00% 0.00% 0.00% TOTAL $0 $322,773 100% TOTAL PROJECT BUDGET1 $322,773 20 APPENDIX C-2:THREE-MONTH CASH RULE TEST CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION THREE-MONTH CASH RULE TEST The three(3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes. Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet Audited Financial Statements. FY 2012-2013 CY Page# 9 Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 21,217,118 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 84,868,472 List the amount of FY 2014-2015 CDBG funding applied for this application. 30,000 List the amount of FY 2014-2015 CDBG funding applied for any other application. - List the amount of FY 2014-2015 CDBG funding applied for any other application. B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 30,000 Compare Agency Cash Balance Available(Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item Al84,868,472 1 Item B1 30,000 1 Difference 84,838,472 Analyze Results I-If difference is a positive amount or equals$0,the Agency is eligible to apply. 2-If difference is a negative amount,the Agency has the options below; The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in a positive or$0 balance,as long as: A)EACH PROJECT MEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATIONS, AND B)CASH AVAILABLE FOR PROJECTS 1S NOW GREATER THAN ORE UAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. 21 APPENDIX C-3.PUBLIC SERVICE SCHEDULE 1 -BUDGET EXHIBIT AGENCY Family Health Centers of San Diego PROJECT KidCare Express Mobile Medical Unit CDBG Percentage SALARIES &WAGES (Schedule 2) 22,800 FRINGE BENEFITS (Schedule 3) 7,200 TOTAL PERSONNEL 30,000 SUPPLIES (Schedule 5) POSTAGE (Schedule 5) CONSULTANT SERVICES (Schedule 5) MAINTENANCEIREPAIR (Schedule 5) PUBLICATIONS/PRINTING (Schedule 5) TRANSPORTATION (Schedule 5) RENT (Schedule 5) EQUIPMENT RENTAL (Schedule 5) INSURANCE (Schedule 5) UTILITIES (Schedule 5) TELEPHONE (Schedule 5) OTHER EXPENSES (SPECHIY): (Schedule 5) (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 0 TOTAL INDIRECT COSTSIADMMSTRATIVE OVERHEAD(IC/AO) (Schedule 4) 0 [IC/AO Expenses limited to 15%of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 30,000 Page 1 of 5 22 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE; GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount.The positions listed below must provide direct project/client services.Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO)line item.The Total CDBG Salary&Wages must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY Family Health Centers of San Diego PROJECT KidCare Express Mobile Medical Unit (1) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES Lead Medical Assistant $ 38,113.90 59.82% 22,800.0 TOTAL CDB,G SALARY&WAGES 22,800 ....--. - 1.List all positions charged against CDBG funding providing direct CDBG project/client activity. `2.List gross pay for each position listed. 3,List percent of gross pay to be charged against CDBG fending. Pay Schedule(Check One Monthly X Biweekly Twice a Month Page 2 of 5 23 APPENDIX C-3:PUBLIC SERVICE SCHEDULE 3-PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount.The Total Fringe must match the Budget Exhibit farm.Round off totals to whole dollars. AGENCY Family Health Centers of San Diego PROJECT KidCare Express Mobile Medical Unit (1) (2) (3) (4) 5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Lead Medical Assistant FICA 7.65% $ 38,113.90 78.71% 2,295 Lead Medical Assistant Worker's Comp 1.78% $ 38,11390 78.71% 534 Lead Medical Assistant Health Insurance 10.32% $ 38,113.90 78.71% 3,096 Lead Medical Assistant Retirement 2.41% $ 38,113.90 78.71% 723 Lead Medical Assistant Others(Life, SUI,CME) 1.84% $ 38,113.90 78.71% 552 TOTAL CDBG FRINGE BENEFIT 7,200 1.List all POSITIONS charged against CDBG funding providing direct CABG projeeVelient activity. :2.List Fringe Benefit title FOR EACH POSITION charged to CDBG funds, '3.List the amount of insurance for each position charged against CDBG funds. 4.Use gross pay for project/total all wages of agency.Then muliply by required percent for each fringe. 5.List percent of gross pay to be multiplied for insurance. Pay Schedule LQheck One Monthly X Biweekly Twice a Month Mage 3 of 5 24 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COSTIADMINISTRATIVE OVERHEAD(IC/AO)CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested.The Total IC/AO must match the Budget Exhibit form..Round off totals to whole dollars. AGENCY Family Health Centers of San Diego PROJECT KidCare Express Mobile Medical Unit (1) (2) (3) (4 AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD NIA _ TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 30,000 Percentage 0.00% (Must be equal or less than 15%) 1.List all personnel or nonpersonnel(NPI )charged against CDBG funding-include detailed description of indirect use. 2.List total Agency budget for positon and/or NPE line item. 1`3.List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. IS.Enter the Total FYI CDBG Budget;percentage will be AUTOMATICALLY calculated. Pay Schedule(Check Ones Monthly X Biweekly Twice a Month Page 4 Af --5 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET"JUSTIFICATION* AGENCY family Health Centers of San Diego PROJECT KidCare Express Mobile Medical Unit LINE ITEM Lead Medical Assistant AMOUNT Detailed Explanation: Salary for Lead Medical Assistant providing ease aboard KidCare Express 22,800 TOTAL $ 22,800 LINE rTEM Lead Medical Assistant AMOUNT Detailed Explanation: Fringe benefits for Lead Medical Assistant providing care aboard KidCare 7,200 Express TOTAL $ 7,200 LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed.Add pages as needed. Page 5 of 5 26 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length: 1 page; Max Score: 5 Points) Prow. a Irstr"n heloiv of the spec ic.tasks or act vrties'rJeeded to jmgentent"the proposed project and a tiinelrni for their,coniplet on.Number each task or activity,destr7be iry and give the prajpcted date of rompletib. Add additional rowsds needed' # Task/Actrvl<ty '6eseripfianl Cvr*nletf®h -FIT ontract Award I City Council Awards Funds , ay 2{314 2 1 Contract Agreement , 1ContractAgreement between FHCSD and City une 2014 -731— IFreparations j rogram Manager meets with staff to plan for une 2014 1 upcoming year;sites of service confirmed;MOUS are secured as appropriate 4 ; 'Services Initiated and Continue Services covered by CDBG grant begin ; ;July 2014- Throughout Fiscal Year 2414-2015 June 2015 5 ; ;Internal Monthly Reports ; 'Program Manager reviews program data for quality !Monthly assurance and continuous program improvement TF Pirst Quarter Report I ;Program Manager prepares and ensures the 1St 10ctober Quarter Report is submitted to the City i 2014 7 'Second Quarter Report i Program Manager prepares and ensures the 2nd .January Quarter Report is submitted to the City ; 2015 hird Quarter Report program Manager prepares and ensures the 3rd 4Apri12015 Quarter Report is submitted to the City Fourth Quarter Report Program Manager prepares and ensures the 4th my 2015 i Quarter Report is submitted to the City ; -17 kmual Report Program Manager prepares and ensures the annual my 207.5 report for fiscal year 2014-2015 is submitted to the City 1. . I , ? � 1 ,appendix"D"-Implementation @pgeIofI (Revised 1 21412 0 1 3) CITY OF CHULA VISTA FY 2014-20115 CDBG FUNDING APPLICATION Appendix E: Mosier of Board Members & Professions Provide a roster of the members of your agency's Board of Dirwors,and their professions kir filling out the table below. Member` of Target Resrdc��n. N(111Ie l�DATL�PD3I#IUn Pmfessio n l AfflU d Uon Target !►opurgfia Area n Wayne Anderson,Board Member Physician,Scripps Clinic Margarita Carmona,Board Member 11 Icommunity Representative 19 Barbara Carr,Board Chair lCommunity Representative ose de la Garza,Board Member I lcoinmunity Representative Frank Espinoza,Board Member I lCommunity Representative Bertha Garcia,Board Member ; Paralegal,Mexican-American Paralegal& Translation I ID 10 anice Gilmore-See,Board Member ,Librarian,La Mesa-Spring Valley School District 1 ❑, 1®, Daniel Guillen,Board Member I lCommunity Representative j 23 1EI Sean Mathews,Board Member I lCommunity Representative Steve Olson,Board Member ommunity Representative tephanie Perez,Board Member lCommunity Representative fID Walter Scott,Board Vice-Chair I 1community Representative Mary Sesson,Board Member Mayor,City of Lemon Grove Cesar Solis,Board Member ssistant Chief,San Diego Police Department ❑ anus Thomas,Board Secretary/Treasurer I PA,ShoeBox Accounting I ❑ 10 Appendix"E"—Roster of Hoard Members and Professions @@ge I of 1 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix F: Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests,payments,and campaign contributions must be filed.The following information must be disclosed: 1. List the names of all persons having a financial Interest In the project that is the subject of the application,projector contract (e.g.,owner,applicant,contractor,subcontractor,material supplier). ;Family Health Centers of San Diego 2. if any person*identified in section 1 above is a corporation or partnership,list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership)entity. N/N 3. If any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee,beneficiary and trustor of the trust. Oran Butler-Cohen 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent ou before the City In this matter. Ben Avey and Robert LevviA� S. Has any person* identified in 1, 2,3, or 4,above,or otherwise associated with this contract, project or application, had any financial dealings with an official*"of the City of Chula Vista as it relates to this contract,project or application within the past 12 months?Ye1No® If yes,briefly describe the nature of the financial interest the official may have in this contract. 6, Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than$250 within the past twelve(12)months to a current member of the Chula Vista City Council?NON 1 res If yes,which Council member(s)? N/A 7. Has any person* Identified In 1,2, 3, or 4, above, or otherwise associated with this contract,project or application,provided more than $420 (or an Item of equivalent value) to an official** of the City of Chula Vista In the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value,money to retire a legal debt,gift,loan,etc.)Yes❑;No®if Yes,list official and what was the nature of Item provided? N/A 8. Has any person* Identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of Income of$500 or more to an official"of the City of Chula Vista in the past twelve(12)months?YesE] No® If Yes,Identify the official and the nature of the income provided? N/A �anuary28, 2014 :Fran Butler-Cohen Signato4pI Person is defined as:any individual,firm,ca-partnre,association,social club,fraternal organization,corporation, estate,trust,receiver,syndicate,any ,other county,city,municipality,district,or other political subdivision,or anyother group or combination acting as a unit. ** Official includes,but Is not limited to:Mayor,Council member,Planning Commissloner,Member of a board,commission,or committee of the City,and City employees or staff members. Appendix"F'—disclosure Statement 139ge 1 of 1 (Revised 121412013) CITY OF CHLILA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G. Identification of Prior Year CDBG and/or Federal Finds G,L ;Agencnam e Farnil Health Centers of Son Diego G.21 Prbji?ethaim I IKidCare Express Mobile Medical Unit#3(MMU) G,3F Yearo#,Nnding" Fiscal Year 2011 fiscal Year 2012 1 Z I Fiscul Year 2013 GA., jnditate the source,ut theederul funr3ingW(trdi?d to Me.priorproject CDBG HOPWA ESG HOME CDBG-R HPRP NSP I JLJ Other(indimte berpw): G.S. Amaant dwarded 17,000 G..li. Amount spent'to date; 1.7,000 G.7. 4rxlaunt r"epr fammed''tu date:: G.8.s lrdicrte below the'oufcorres artr'rpaced(refer ia the orrg anal application for tre project,.rf p ossr6le).' (:t) To provide 1,040 individuals with culturally competent health care services aboard the MMU. (2) To improve access to comprehensive health care services for low-income residents. (3) G,0, Odlcate below the dr&bmes achieved; , (1) a provided 1,880 individuals with culturally competent health care services aboard the MMU. 3 (2) 1 Low-income residents experienced increased access to comprehensive healthcare services. Y any ontrzr`pr#ted outcomes were MOTArNeved;'specify which rites and exvldih Why,bdow. J[N/� 30 Page 1 of 1—Supplement to Appendix E Application No. 12 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" City of Chula'Vista Recreation Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Norman Park Center Senior & Disabled Services Project Descr'ip'tioh: Provide a, multitude, of, unique, services, and support programs to seniors including those'with clisabilities. Program examples amo!es include: free cohiputer"and fitness classes, conversational Spanish, 65sistance in, completing Christmas in July paperwork;,blood' pressure screenings,, health workshops, informatioh/referral services, RUOK phone calls, m6de to those,homeb6luhd, ehrichmebt classes, social events, support groups and low cost/free, meetIng,,spoce for hon-profit groups to provide a one-stop shop serving seniors. Type of Program/Project: Public Services [(§570.201(e)] Target Popull6tloh:' 05A-Senior,Services Proposed Number 400 to Serve:, fsu'bject to change &R§ 510.208(a)(2) Low depending 6n,funding Moderate Income, recommenddtibn) Limited Clientele Program Total Budget: $168,295 C. V. Cost per Client: $102 (Based on funding recommendation) Funding Request: $41,013, Prior Year,Fundin,g: $30,000, Specific Use of Chula Vista Personnel Costs FUNDING $30,000 Funding: RECOMENDED Staff Notes-. COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Funding for Fisca l Yea r 2014-2015 Project tate or Application plumber 1 9 Y ® Public service (CDBGProgramOfceUse Only) (check one only) ;Capital improvement Applicant Agency Information Applicant legal name ;City of Chula Vista Recreation Type,of agency.,` ❑ 501(c}(3) ® Gov't./Public ❑ For Profit ❑ Faith-Based ❑ Other: Agelcy Address 276 Fourth Ave Bldg C,Chula Vista Date o54.6eorporation: 1911 I Tax!b hLi mber, 95-60000690 Agency RUNS number: N/A Annual operating budget':; $122,540 Number of paid staff. 9 Number of volunteers; 84 Agency mis§ibhn,statement: We enrich our community through recreational opportunities and services. Project Title: Norman Park Center Senior& Disabled Services Brief project descrrptlon.... Provide a multitude of unique services and support programs to seniors including those with disabilities.Program examples include: free computer and fitness classes,conversational Spanish, assistance in completing Christmas in July paperwork,blood pressure screenings, health workshops,information/referral services,"RUOK"phone calls made to those homebound,enrichment classes,social events, support groups and low cost/free meeting space for non-profit groups to provide a one-stop shop serving seniors. Funding Request Total funding requested in this application 1 Other funds already secured for (you will provide a detailed budget rn Appendix C: I$41,013 1 project I$0 Total cost to complete project: $168,295 Dtherfunds riot yiet"secuie for; $1.27,282 Project Information !f Project is a Public Service, will service be site specrfica, Yes ❑too; if your ansuver is yes,please provide: Address(QsJ below Census tract Norman Park Center 270 F St Chula Vista,CA 91.910 1302 1 Target Clre►r,tele: (Homeless, Youth, 00 Elderly and disabled elderly, homeless Elderly, Disabled, Other/ eneral) The follovmirng questions ora individual clients and households`to be'served apply only to Public Service, and Minor Residential:Rehabrlltatran'projects: WiII the project serge�ndrvrdual clients (!C)or households(hfHJ? ® Individual clients LoHouseholds Total unduplicated.lC/HH served400 Page 1 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Annvpl costper client%household, 1$138.47 Page 2 of 9 (Revised 12/4/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 1: Project Details (Max Score: 25 Points) 1 1 Provtd..e a concise description of tl?e proposed project(this descrlpti'on must:match the one provided on the cover page) .',Space,for a fuller narrative is provide d in 4ppenclrxA Provide a multitude of unique services and support programs to the elderly including those with disabilities.Program examples include: summer cool zone,low cost meals,assistance in completing Christmas in July paperwork,free computer and fitness classes, conversational Spanish blood pressure screenings, health workshops,information and referral services,"are you okay"phone calls made to those homebound/medically fragile,enrichment classes,social events,support groups,low cost/free meeting space for non- profit groups to provide a one-stop shop serving seniors including partnerships with RlderLaw,AARP(American Association of Retired Persons)for tax assistance,Health&Human Services Agency(HHSA),Aging&Independence Services(AIS)and Meals on Wheels. Project start date. July 1, 2014 Anticipated end date: lune 30, 2015 1.3:. :Project's days/hours of operation Monday through Thursday 8am-7pm, Fridays$am-spm 1 4 Project ®�Public service 1,5 ® Suitable living environment category: objective: ❑'Decent housing (check one only) Capital improvement (,heck one ohly) ❑ Economic opportunity .:......... : 1.6 Project ® Availability/accessibility outcome.... ;❑ Affordability (check one only) ❑ Sustainability 17. CDBG Criterip: Which CDBG criterion below does your.proposed proiect meet? (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income (LMI). ❑' Please provide a map identifying the Census Tracts designated as LMI. ® (2) Limited clientele(select subpart below): ® (a) Special needs group (select benefit group from the list below): (i) Abused children '! ® (ii) Elderly persons 62 years or older ❑' (iii) Battered spouses ❑' (iv) Severely disabled adults (not children)--Census definition;documentation required ❑' (v) 11!lterate adults 10 (vi) Persons living with HIV/AIDS _OL (vii) Migrant form workers ® (viii) Homeless persons (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and 'El record client demographics? (3) Housing(select subpart below): ❑ I (a) Single family(must be 100%LMI) (b) Multi-unit(must be 51%LMI) 1.8, The 20.10=2015 Consolidated Plan goirls are listed below, Selectihe goal.appropriate to your project: ❑I Affordable Rental Housing Opportunities Maintenance and Preservation of Housing (rehabilitation activities) Homeownership Opportunities(homebuyer programs) ® Community Enhancement(public facilities/spaces) ® Public Services to Special Needs Population and/or Low Moderate Income Persons Page 3 of 9 (Revised 12/412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 1.10 t® 1.15: 2 Pages) 1 10: Explar_'n how;the proposed'protect addresses: e`goa[selected Norman Park Senior Center has been an integral part of the City of Chula Vista for over 50 years. It is the only designated senior center in the City of Chula Vista that welcomes all seniors regardless of disability, income levels or ability to pay for direct services. Without Norman Park many of our elderly residents would have nowhere to go since there are no other designated senior centers in Chula Vista. Norman Park Senior Center is a unique one-stop shop which houses not only its own senior services, but also various non-profit organizations that provide valuable services to seniors,low income families and those with disabilities. Organizations housed at Norman Park Senior Center include: Meals-on-Wheels,Southern Caregivers, and Parkinson's disease Foundation. HomeStart Inc.is another organization at Norman Park which oversees a number of services including assisting seniors and those with disabilities in signing up for health care as well as providing mental health and emergency services. Norman Park also partners with several local senior clubs including the Korean Club(Korean speaking), Filipino-American Club, Chula Vista Senior Club, Parkinson's Disease Foundation,Chula Vista Garden Club and Club Amistad (Spanish speaking)to provide free space for meetings in a variety of languages for those in our community who have ESL or are non-English speaking. Norman Park's one-stop shop also includes partnerships with AARP for free income tax assistance and Driver Safety Courses;Scripps Health for free monthly health talks; HHSA and AIS for workshops on safety,fall prevention, healthy living,chronic conditions and fraud and scam prevention; Elder Law which provides free legal advice and assistance;a Bereavement Group led by San Diego Hospice;and Men's Health Discussion group led by a volunteer MD. In addition to all of the essential services listed above, Norman Park Senior Center also provides over 50 health,fitness,educational and enrichment classes and programs every month with an attendance of approximately 6,000 per month. 1.11;: Suirimarrze any statistics and othersupportrna documentation that'.rAemo strate the+mportance of addressing this need_�or problem — �tarting in January 2011 the Chula Vista Recreation Department along with a number of other departments went through drastic budget cuts. The recreation department was forced to cut its budget in half,including laying off nearly 50%of its staff with significantly reduced hours of operations at most community/recreation centers. Norman Park Senior Center was severely impacted by the layoffs of most of its staff,greatly reducing operating hours and eliminating senior programs.As a result of the limited operating hours of 8am—12pm Monday through Thursday, many seniors were displaced,and clubs, organizations and partnered services had nowhere to go.The public outcry was immediate with several seniors voicing their concerns and needs at public forums including to the city council. Additionally,through a needs assessment survey, public forums and program feedback,it was clearly demonstrated that the reduced operating hours of 16 per week were woefully inadequate to service the needs of our growing aging population. The funds provided through the grant would allow us to continue operations and service levels nearly consistent with the demands of the ever increasing senior community. j 1 12'.- Wt each service provided by the protect: Far each service, indicate whether rt&whew service or an expansion of an eXlstlnC_t service = x' i Current: ROUK phone calls to check on homebound seniors to make sure they"are okay." Low cost office space for other non-profit organizations that serve seniors(Meals on Wheels,Southern Caregivers, Parkinson's Foundation, Home Start Inc.) Free meeting space for civic groups serving seniors leisure, education and health and wellbeing,such as the CV Garden Club,Club Amistad (Spanish speaking), CV Senior Citizen's Club, Filipino-American Club, Korean Club.Safe place to be during the day. Provide a recognized "Cool zone"during-hot summer months. Provide free and low-cost computer classes led by senior volunteers. Provide community engagement through a multitude of volunteer opportunities offered.. Expansion:Twelve free fitness classes,4 low cost($1/class)fitness classes including Zumba gold. Free monthly"hot topic"seminars put on by unique partnerships with other community service or non-profit organizations to meet the needs of the senior community. Monthly seminars,workshops and classes include:living with Chronic Conditions, Fraud and Scam Prevention & Awareness, Health Fair,healthy cooking classes,history talks,etc. Information and referral services and partnerships to meet the needs of our growing elderly and disabled population. Free educational,social,enrichment and active daily drop-in classes to provide essential services along with quality of life. Monthly special events such as a Health Fair, Holiday Brunch,Valentines Dinner and Movie and Summer BBQ to provide a healthy meal and educate our seniors about ways to stay healthy while providing for social opportunities and celebrating their active lifestyles.) Page 4 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 'How does your.agen.. plan to tell;the target population about the project/services? IWe market our programs by providing a quarterly newsletter with all of our events, classes and activities that is posted on the Norman Park section of the city's webpage,which is also mailed out and provided in person at our volunteer run hostess) desk. We post monthly"hot topics"seminars on our outdoor two-sided marquee. Programs are also promoted through our Facebook page, Nixel, press releases,and are also sent out through the city's monthly newsletter and Commission on Aging meetings.Additionally Norman Park staff serves in SoCAN (South County Action Network serving older adults and adults with disabilities)as well as attending outreach events and presentations such as Kiwanis Club and senior services meetings. 1.14, Lrst up to three outcomes of the project(at least one is,required). For each outcome listed,provide the number of partrc pants who will benefit and the way data will be collected to track or verify the outcome: 1) Continue to partner with local non-profit organizations and clubs,to meet the city's operational excellence goal,in an effort to provide an increased variety of senior services and programs to meet the exponential growth in our aging community.— Track the number of unique partnerships created and the number of increased programs and participants through those partnerships.—Anticipate over 800 participants will be served along with connecting to at least 10 local senior organizations 2) increase the number of low cost activities being offered in order to meet the communities' needs while working toward increasing revenue and therefore less dependence on grant and general fund monies.-Anticipate over 2,000 in attendance in new and expanded low cost opportunities tracked through attendance records. 3) Increase attendance at Norman Park Center by at least 10%to serve over 57,000/year.—Anticipate an additional 5,000 will be served.Staff will keep daily attendance sheets,tracking attendance .. .... ......... ......... ........ . 1.15. Will the'project collaborate with other service providers m the community?If yes,list them and briefly describe the collaboration ® Yes j❑ No • Meals on Wheels Chula Vista headquarters, meeting&training space as well as a location for food q g pick up and drop off is hosted through a partnership with Norman Park Center. Expansion plans include utilizing Norman Park as an actual meal site, meaning NP participants could purchase a meal to eat at Norman Park or to have delivered to Norman Park for them to pick up and take home. ® Parkinson's Foundation:Through a partnership with Norman Park, Parkinson's has an office space on site as well as hosting two support groups each month,one in Spanish and one in English. ® Scripps Wellness Center:Through a partnership with Norman Park,Scripps offers a variety of free health talks and workshops led by medical professionals and doctors. • Southern Caregivers:Southern Caregivers Resource Center not only has their Chula Vista headquarters and meeting space on site but also hosts two support groups each month,one in Spanish and one in English. • Chula Vista Senior Citizen's Club: Provides opportunities for seniors to get involved and connected to their community by providing a variety of volunteer opportunities from manning the hostess)desk and answering phones to setting up and breaking down rooms for various functions.Additionally,the senior club volunteers,along with Norman Park staff, plan and host a variety of weekly and monthly events such as bingo, potlucks,special events,trips and dances. • Chula Vista Garden Club:We provide free meeting and event space on a monthly basis,during normal business hours,as well as space for promoting their upcoming events in our newsletter. • Chula Vista American/Korean Club:We provide free meeting and event space on a monthly basis,during normal business hours,as well as space to promote their upcoming events in our newsletter. • AARP:We provide registration, marketing and meeting space for AARP's driver's safety courses and Car-Fit for Seniors as well as their free tax assistance program. • HHSA/AIS:We provide registration, promotion and meeting space for a variety of free workshops,classes and seminars such as Fraud and Scam Prevention,Tai Chi classes and Healthy Living with Chronic Conditions. • HomeStart Inc.:HomeStart Inc. not only has an office and meeting space on site but also hosts meetings and provides one- on-one assistance in Spanish and English on the California Care and First 5 programs. • Club Amistad:We provide free meeting and event space on a monthly basis,during normal business hours,for this Spanish speaking club.We also provide space in our newsletter for promoting their upcoming events and meetings. • ElderLaw:We provide a free private meeting space twice a month,during normal business hours,for Elder Law to offer free legal advice or assistance to seniors in need.Services provided include creating wills, assisting with senior fraud, etc. } Page 5 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Secti®n 2: Agency Capacity (Max Score: 10 P®ilhts) 2.1. Who,v'rll be the,person responsrtile for the overall oversight of the proposed project? . ;, Name of person endi Garrison Title of persdn ' Senior Recreation Manager Relevant educdtror? -= Bachelor of Arts in Recreation Administration, minors in Health &Special Education Telephone number 619-585.5617 Date fast employed ugust 2012 2 2 Whoryill be;-.the olternate..person responsible for the opera!!oversrgt of the proposed protect? to (.qnw 1person'. Brian Cox Title of person:`: Principal Recreation Manager Relevant education: Bachelor of Arts in Recreation & Leisure Studies, Masters in Recreation Administration Telephone,number:;: 619-585-5619 Dote first employed:> 1987 2.3 - Who will be the person responsible for the day-to day operations and management of the proposed protect? Provide no more-than two;individuals: - A. Name of person_ Shannon Bullock Title rsoe lRecreation Supervisor 1 (hourly) Relevant education: Bachelor of Arts in Recreation Administration Telephone number: 619-409-1931 Date first.. irst employed::; 2002 rrre'of personI Wendi Garrison Title'of person:' Senior Recreation Manager Relevant.education: lBachelor of Arts in Recreation Administration, minors in Health &Special Education Telephone number ` 619-585-5617 Date frrst,employed August 2012 2 4'", Who fir!!be'the person responsible for t_iae financial oversight of the; COB expenditures and fiscal compliance? Provide no more than tiro individuals Name of person". Wendi Garrison Title.of person 3; Senior Recreation Manager Relevant education Bachelor of Arts in Recreation Administration, minors in Health &Special Education Telep wn—e`h ember 67 9 585-5617 Date first employed: August 2012 Narneof person Brian Cox Trtle'of person:, Principal Recreation Manager Relevant education: Bachelor of Arts in Recreation & Leisure Studies, Masters in Recreation Administration Telephone`numier: 61.9-585-5619 Date first employed:; 1987 Page 6 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to 2.8: 1 Page) 2 5. ;.J9 the evaluation toois your agency plans to employto track and monitor the progress of the project. s Staff perform hourly counts at all programs throughout the facility. Additionally we create and distribute surveys, hold public forums and work with the Commission on Aging to assist in understanding and staying current with trending needs of the senior population.We also use the provided intake forms to ensure we are gathering data correctly. 2.6. How does, agency plan to ensure compliance with applicable policy and procedure!requirements (in(ludrrg those listed in HUD's "Playing;by the Rules"Handbaakj? Iwe provide copies of the city payroll journals that model the "Playing by the Rules" handbook. Additionally as a city agency,we follow city and department policies and procedures that also follow the Playing by the Rules" handbook. 2.7. Describe any unresoived ADA issues rn the project or project office and haw your agent,-plans.ta address then? (!f the objective of the pro�ect;rs ADA:rehabffitqfion.:! indt repeat the prajett description here J I[None 2 S How many members does your Bogrd of;©irectors have? ;N/A How many Board members are also members of the project's'target'populatian or reside in rN/A the project's target area?Indicate which'ones iii Appendix F. i Page 7 of 9 (Revised 121412013) CITY OF CHULA V&A FY 2014-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control (Max Score: 15 Points; Max Length: 2 Pages) 3 1 „Briefly describe your agency's paymenfand disbursement procedures,.wrth relevance to the proposed protect: Payment and disbursement is done by providing the appropriate documentation and staff timesheets each quarter to Community Development. 3 2 „ Describe haw,your,;agency's Board,of Directors'exercrses programmatic and fiscal'aversight INCA B 3 Briefly describe your agency's financial reporting system/accounting procedures, with relevance to the proposed -,project = - I i '? The Recreation Department utilizes the City's financial system (IFAS). Hourly wages spent will be tracked through time sheets,which will be verified by Shannon Bullock.The Department's Senior Fiscal Office Specialist will submit all hours and expenditures for tracking in IFAS.1. 114..,;'_ Briefly describe your:agency's record keeping system, ,vrth relevance to the`prop'osed project: IAII expenditures will be tracked though the City's accounting system (IFAS). Hourly wages spent will be tracked through time sheets,which will be verified by Recreation Supervisor I (hourly), Shannon Bullock and then Wendi Garrison, Senior Recreation Manager.The Department's Senior Fiscal Office Specialist, Cathy Martin,will then submit all hours and expenditures for tracking to IFAS. 3S.- Briefly describe your agency's aWclrting requirements,including those for the proposed protect:..' Recreation Supervisor I (hourly),Shannon Bullock,will directly oversee the project and provide all necessary documentation. Senior Recreation Manager, Wendi Garrison, will verify all documentation submitted to Senior Fiscal Office Specialist for final approval ensuring meeting auditing standards held by the City. 3.6. Briefly describe your agency's interna!controls tt6 mir irriize,opportunrties far fraud, waste, and,rrrismanagement, Payroll is first completed by the onsite supervisor,then submitted to the Senior Recreation Manager for approval then finally to the Senior Fiscal Office Specialist for review and submittal. Ha>,v does your agency plan to segregate CDBG funds;fram other agency funds for purposes of rdentrfrcatron,. tracking, aril repoftrng? - _— _- Ijsince we are only requesting salary and fringe benefits from CDBG funds,we will track hours on the individual day to day time sheets. Only the hours associated with the grant funds will be billed.This can be back tracked by looking at copies of the time sheets per pay period. We will ensure tracking and reporting are accurate by providing staff costing worksheets each quarter which show the precise names, hours, positions and pay rates being billed to allocated CDBG funds. - Page 8 of 9 (Revised 12/4/2013) C[TY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 4: Agency Experience (Max Score: 10 Points; Max Length: 1 Page for Section 4/5 Combined) 4.1: Brlefly highlight your agency's experience and rrra�or accompltshmerts in providing services to LfVil residents and/or` . camm;unities: You may expand in Appendix A. The City of Chula Vista's has managed the only senior center in all of Chula Vista for over 50 years, Norman Park Senior Center. A large majority,approximately 60%,of our senior population who attend are on a fixed income that falls into the LMI categories as demonstrated through our onsite participant intake forms. For the last 50+years Norman Park has provided a wealth of free and low cost programs to meet the needs of our LMI seniors. Currently Norman Park is offering over 60 free or low cost programs, activities,classes, clubs,workshops and seminars every month which include: low cost computer classes led solely by senior volunteers,free blood pressure screenings,vision support groups,Singing Seniors,six different free bridge groups,free drop in pinochle,watercolor,free craft and art classes, book club,two bunco game nights,free computer and camera club,creative writers group,four social dancing classes,chess club, 12 free exercise classes,4 low fee fitness classes($1 per class), knitting and crocheting, quilting,scrabble,free shuffleboard,free billiards,world affairs discussion group,Spanish conversation group, monthly special events,free movie days, out 2 lunch bunch,community trips,free special interest talks,a fitness center and much more. Additionally,we have provided RUOK and information and referral services specifically targeting low-income seniors for over 11 years. The RUOK services have helped secure the safety of many seniors unable to leave their house due to health,illness or limited mobility. We place dozens of calls throughout the day to seniors signed up for the service. If they don't answer or they are not okay,we call either one of their emergency contact persons or the RSVP(Reserve Senior Volunteer Patrol)to go check on them at home.This provides safety and security for seniors who may be living alone and have no one to call on for help. In an effort to continue to meet our aging communities needs while being fiscally responsible,in addition to the variety of services and activities we provide,we also partner with local non-profit agencies such as ElderLAw to provide free legal advice onsite two days a month;Southern Caregivers Resource Center,whose offices are located within Norman Park Center to provides free services &counseling in Spanish and English to caregivers of aging&frail adults or adults affected by a chronic illness or brain impairment; and AARP who provides free tax assistance and low cost driver's safety courses both held at Norman Park. We are also currently working with Meals on Wheels,whose headquarters are at Norman Park Senior Center,to provide low cost healthy meals onsite at least one day a week. In total,we partner with over 30 local organizations,agencies and clubs every year to expand our programming and provide additional services to seniors to provide that one stop shopping experience. One of our greatest accomplishments is our ability to create unique partnerships to leverage our limited funding. E 4.2. Has your agency received CDBG or other federa[funds in any of the past three fiscal years (Fiscal Years 2011,2012, 2012-2013,through 201.x=2014)?If yes, complete Appendix G for ® Yes �❑, No each of the,grants received for the three'Fiscal-Years 2011,2612, and 2013. Section 5: Back-Up Plan (Max Score: 5 Points;) 5.1. Will your,agency st!!!Implement this project should CDBG funds not be awarded?!f yes, how wi11 the rmplementdtran be achieved? I❑r Yes lif funds are not awarded the city will need to drastically cut the senior services being provided at Norman Park,likely by approximately 55%,due to limited funding.This in turn would affect six non-profit agencies that have offices located within Norman Park,as well as over 30 other clubs,groups and partnerships,affecting about 40,000 seniors in attendance. 5.2. !ffunded, how will.your agency continue this project if CDBG funds are not available in future years *e are currently working with our senior population and our Commission on Aging to research alternative funding sources.Sources we are examining include grants,cost recovery classes and activities, new partnerships,sponsorships and paid advertising.Our goal is to find new long term funding options that will help us meet the needs of our exponentially growing senior population and reduce our needs for CDBG funds.) Page 9 of 9 (Revised 121412013) CITY OF CHULA VISTA FY 201.4-2015 CDBG FUNDING APPLICATION Appendix A.: Narrative of Project (Max Lengthy 2 Pages) I n two a es or'less, ex Iain belaui out ro osed ro ectdnd make the case wh- it should be awarded undin -P. 9 p Y F A P 1 Y f 9 1P, = Norman Park Senior Center has been an integral part of the City of Chula Vista for over 50 years.It is the only designated senior center in the City of Chula Vista that welcomes all seniors regardless of disability, income levels or ability to pay for direct services.Without Norman Park many of our elderly residents would have nowhere to go since there are no other designated senior centers in Chula Vista; nor are there any provided by other public agencies or private and non-profit organizations. With the failure of Prop H in November 2010,the City of Chula Vista was forced to eliminate many of its core services in order to continue to provide some level of restructured services to the community. During this time,the City of Chula Vista's Recreation Department budget was cut by more than 50%,which resulted in layoffs of 50%of its full time staff. Norman Park Senior Center was severely impacted by these cuts,resulting in drastically reduced hours of service to only 16 per week,which caused a tremendous uproar in the senior community. Additionally, several non-profit organizations that are housed at Norman Park Senior Center were also severely affected by the limited hours of operation to the public. The enormous outcry from our senior population was the impetus for our department to seek unused CDBG funds in March 2011 so we could expand the hours and services to meet the unmet needs of our senior and disabled community. Norman Park Senior Center is a unique, one-stop shop which houses not only its own senior services,but also various non-profit organizations that provide valuable services to seniors,low income families and those with disabilities. Organizations housed at Norman Park Senior Center include: Meals-on-Wheels,Southern Caregivers, and Parkinson's Disease Foundation. HomeStart Inc. is another organization at Norman Park which oversees a number of services including assisting seniors and those with disabilities in signing up for health care as well as providing mental health and emergency services. Norman Park also partners with several local senior clubs including the Korean Club (Korean speaking), Filipino- American Club,Chula Vista Senior Club, Parkinson's Disease support group, Chula Vista Garden Club and Club Amistad (Spanish speaking)to provide free space for meetings in a variety of languages for those in our community who have ESL or are non-English speaking. Norman Park's one-stop shop also includes partnerships with AARP for free income tax assistance and Driver Safety Courses; Scripps Health for free monthly health talks; HHSA and AIS for workshops on safety, fall prevention, healthy living, chronic conditions and fraud and scam prevention; Elder Law which provides free legal advice and assistance; a Bereavement Group led by San Diego Hospice; and Men's Health Discussion group led by a volunteer MD. In addition to our vast community,as well as public and private partnerships,which provide for a connected and healthy community and ensure fiscal responsibility,the staff at Norman Park also provide extensive information and referral services which vary from meeting with seniors one-on-one to help complete their government applications or Christmas in October forms for housing rehabilitation,to referring them to a local public or private it of Chula ices the are in immediate need of. There is no other lace in the city agency that directly provides the services P g Y Yp Y Vista that brings all of these services together under one roof for our seniors and those with disabilities. g g In addition to all of the essential services listed above, Norman Park Senior Center also provides low cost computer classes taught solely by volunteers,blood pressure screenings,vision support groups, Singing Seniors (come by any Tuesday to hear their joyfulness),six different bridge groups,drop in pinochle,watercolor,craft and art classes, book club,two bunco game nights, computer and camera club,creative writers group,four social dancing classes, chess club, 12 free exercise classes,4 low fee fitness classes ($1 per class),knitting and crocheting,quilting, Appendix"A"--Narrative Page 1 of 2 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION scrabble, shuffleboard,billiards,world affairs discussion group, Spanish conversation group,monthly special events,movie days, out 2 lunch bunch,community trips,special interest talks and a fitness center. Research has shown that our aging population will grow exponentially in the next several years and for the first time in history we are expected to have more people entering the senior population than we will have children being born. As we look to the future to serve the GI Generation,Silent Generation and our Baby Boomers,we will have an even larger senior population to serve each year,requiring additional efforts and resources to meet the needs of this expanding segment of our population. Additionally,recent data shows 50%of all seniors 65 and up have a disability.This is substantially more than the 20%mark of the general population. Due to our increasing disabled population, Norman Parr staff must constantly evaluate the services and make adjustments and adaptations to activities and programs that are provided to ensure we are meeting all seniors'needs,and particularly the needs of that 50%of the senior population with disabilities. Without funding for Norman Park Center,this often overlooked population of seniors with disabilities will not be served. The$41,013 in requested CDBG funds would enable us to continue to meet the City's strategic goals of providing a safe and secure neighborhood facility that engages and connects the community to City services,while promoting civic pride through extensive volunteerism with a focus on fostering a healthy aging population while creating unique partnerships to provide operational excellence and fiscal responsibility. All of the funds requested would go to the direct staff costs associated with operating Norman Park Senior Services for the hours requested and expected by our community and our non-profit partners housed within the building. None of the funds would be used to cover administrative or overhead costs associated with providing the services.The$41,013 grant would allow us to continue to operate 53 hours per week and to continue to accommodate the 52,000 a year attendance supported by the facility. Without the requested CDBG funds,Norman Park would have to significantly reduce its operating hours and the above services provided to our senior and disabled population.This in turn would displace or severely impact the operations of the other non-profit agencies (Meals-on-Wheels,Southern Caregivers,Home Start Inc. and Parkinson's Foundation) also housed in our facility. Appendix"A"—Narrative Page 2 of 2 (Revised 12/4/2013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CIIULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICATION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step (1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step(3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE: Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista(Step 1) $41,013 24.37% List Other Sources Below: (Step 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% BTRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds $121,282 72.07% Private Funds 0.00% Agency Funds $6,000 3.57% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TOTAL $0 $168,295 100% TOTAL PROJECT BUDGET $168,295 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 1 -BUDGET EXHIBIT AGENCY Chula Vista Recreation Department PROJECT Norman Park Senior&Disabled Services CDBG Percentage SALARIES &WAGES (Schedule 2) 38,985 FRINGE BENEFITS (Schedule 3) 2,028 TOTAL PERSONNEL 41,013 SUPPLIES (Schedule 5) 0 POSTAGE (Schedule 5) 0 CONSULTANT SERVICES (Schedule 5) 0 MAINTENANCE/REPAIR (Schedule 5) 0 PUBLICATIONS/PRINTING (Schedule 5) 0 TRANSPORTATION (Schedule 5) 0 RENT (Schedule 5) 0 EQUIPMENT RENTAL (Schedule 5) 0 INSURANCE (Schedule 5) 0 UTILITIES (Schedule 5) 0 TELEPHONE (Schedule 5) 0 OTHER EXPENSES (SPECIFY): (Schedule 5) 0 (Schedule 5) (Schedule 5) TOTAL NON-PERSONNEL 0 TOTAL INDIRECT COSTS/ADMINISTRATIVE OVERHEAD(IC/AO) (Schedule 4) - 0 [IC/AO Expenses limited to 15% of Total CDBG Project Budget] TOTAL CDBG PROJECT BUDGET 41,013 Page 1 of 1 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 2-PERSONNEL SCHEDULE: GROSS PAY The purpose of this form is to list the positions being claimed against the CDBG funding request amount. The positions listed below must provide direct project/client services.Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO) line item. The Total CDBG Salary&Wages must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Chula Vista Recreation Department PROJECT Norman Park Senior&Disabled Services (1) (2) (3) (4) i PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY &WAGES Recreation Specialist 42,744 60.00% 25,646.4 Rec Leader 29,641 45.00% 13,338.5 TOTAL CDBG SALARY&WAGES 38,985 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3.List percent of gross pay to be charged against CDBG funding. Pay Schedule (CheckOne) Monthly X Biweekly Twice a Month Page I of 1 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 3-PERSONNEL SCHEDULE: FRINGE BENEFITS The purpose of this form is to list the fringe benefits being claimed against CDBG funding request amount. The Total Fringe must match the Budget Exhibit form.Round off totals to whole dollars. AGENCY Chula Vista Recreation Department PROJECT Norman Park Senior&Disabled Services (1) (2) (3) (4) (5) (6) AMT OF PERCENT POSI'T'ION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT Recreation Specialist PARS 1,603 60.00% 962 Recreation Specialist Medicare 620 60.00% 372 Recreation Leader PARS 1,112 45.00% 500 Recreation Leader Medicare 430 45.00% 194 TOTAL CDBG FRINGE BENEFITJ 2,028 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2.List Fringe Benefit title FOR EACH POSITION charged to CDBG fimds. 3.List the amount of insurance for each position charged against CDBG funds. 4. Use gross pay for project/total all wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule(Check One) Monthly x Biweekly Twice a Month Page 1 of I APPENDIX C-3: PUBLIC SERVICE SCHEDULE 4-INDIRECT COST/ADMINISTRATIVE OVERHEAD(IC/AO) CALCULATION The purpose of this form is to list the IC/AO being claimed against CDBG funding amount requested. The Total IC/AO must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Chula Vista Recreation Department PROJECT Norman Park Senior&Disabled Services (1) (2) {3} (4) AGENCY TOTAL INDIRECT BUDGET PERCENT COST/ADMINISTRATIVE POSITION TITLE/LINE ITEM AMOUNT CHARGED OVERHEAD TOTAL CDBG INDIRECT COST/ADMINISTRATIVE OVERHEAD - (5)Total CDBG Budget 41,013 Percentage 0.00% (Must be equal or less than 15%) 1.List all personnel or nonpersonneI (NPE)charged against CDBG funding-include detailed description of indirect use. 2.List total Agency budget for positon and/or NPE line item. 3. List PERCENT of total budget to be charged against CDBG funding. 4. Total indirect cost/administrative overhead to be charged against CDBG funding. 5.Enter the Total FYI CDBG Budget; percentage will be AUTOMATICALLY calculated. Pay Schedule(Check One) Monthly x Biweekly Twice a Month Page 1 of 1 APPENDIX C-3: PUBLIC SERVICE SCHEDULE 5-BUDGET JUSTIFICATION* AGENCY Chula Vista Recreation Department PROJECT Norman Park Senior&Disabled Services LINE ITEM N/A AMOUNT Detailed Explanation: TOTAL $ - LINE ITEM NIA AMOUNT Detailed Explanation: TOTAL $ - LINE ITEM AMOUNT Detailed Explanation: TOTAL $ - *All line items must be justified in relation to CDBG-funded activities to be completed.Add pages as needed. Page 1 of 1 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix D: Implementation (Max Length: 1 Page, Max Score: 5 Pints) Provide a listing below of the specific tasks or aetivit es needed to implement the proposed prolect.and a timeline for their completion Numbe: each task or'activity,describe it,andgive the projected date of coirm I tr Add additional rows as needed mplet # Task/Actrvity Description C� Dame ion .: 1 Expand the number enrolled in the ROUK ;Revise existing enrollment forms to be more user friendly 06/30/15 phone program and in a format that can be submitted online for seniors who may not be able to come to the center to complete them 12 Expand programming to meet the needs to ork with the Commission on Aging to find out what 06/30/15 our new ever expanding"baby boomer" needs we are not currently meeting for the baby boomer seniors generation. 3 Increase the number of classes,programs ;Seep out new partnerships to expand facility offerings 06/30/15 and activities being offered = without having a fiscal impact on the city's budget 14 Provide a welcoming"cool zone"during hot Offer a variety of free drop in programs that seniors can 09/30/14 summer months participate in during the hot summer months when they need a place to cool off i5 :Provide meeting space for civic groups and :Coordinate the reservation of meeting rooms and facilities 06/30/15 clubs serving seniors for civic groups and clubs through our new online software program,ActiveNet 6 Improve marketing and customer service jlmplement online registration through ActiveNet for 12/30/14 by increasing the ways for seniors to find classes and special events and enroll in our classes and special events 7 1 JProvide for a safe and secure neighborhood The center provides a safe,secure and supervised place 06/30/15 facility for those displaced or seeking security 8 :Information&Referral Services :Continue to attend collaborative meetings in our 06/30/15 community to increase our knowledge of potential services for LMI seniors to access 19 1 ;Provide low cost office space for non- ;Meals on Wheels,Southern Caregivers Resource Center, 106/30/15 1 profits serving seniors HomeStart and Parkinson's Foundation all have offices within Norman Park for a one stop shop _F16T IPartner with local non-profit agencies for ;Coordinate with E1derLaw,AARP,Scripps,HHSA,AIS,and 06/30/15 free/low cost programs and services more to provide meeting or class space to offer free provided onsiteservices such as legal advice,nutrition classes,fraud and scam prevention,health fairs,blood pressure screenings, bereavement support groups and more. I Appendix"D"—Implementation Page 1 of 2 (Revised.12/4/2013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix G: Identification of Prior Year C®BG and/or Federal Funds G 1 :;Rgency i&e: ,_Jj ICity of Chula Vista Recreation Department G.2. Project name Norman Park Afternoon and Friday Operations G 3: Year.of funding i[j I Fisca!Year 2011 I [:] I Fiscal Year 2012 ® I Fiscal Year 2013 G 4 Indicate ~he.source`of the.federa!funding awarded to the error project ® CDBG ❑[ HOPWA ES G HOME. ❑I CDBG-R ❑; HPRP NSP ❑ Other(lradtcat,below): i G 5 =Rrriount awarded „ • $30,00 =G 6 `Arriount spent:=to date $18,360 G 7 _;=Amount reprogrammed to;date $0 G 8'-indtcate below"the`outcomes anticipated,(refer.to the,';orrgtna!application for g..pr !f possrbleJ (1J: Provide free monthly computer classes,free fitness classes,free monthly seminars. (zJ- Enable the City to provide a safe and healthy supervised venue for activities for the elderly. (3). Provide a one stop shop for seniors for information and referral Indicate belov4r the outcomes gch)eved We now provide 12 free fitness classes per week along with 4 low cost ($1./class)classes,for a total of over 736 free or low cost fitness classes a year,serving nearly 2,000 seniors in attendance per quarter.We offer 12 free intro to computer classes per year along with over 80 low cost classes($26 for a month of classes)serving 275 seniors. We partner with AARP, Scripps Wellness Center, HHSA,AIS, CV Historical Society, Buffalo Soldiers and the CV Police department to offer over 30 seminars and/or workshops throughout the year.This increases our programming on (1J_" site by over 30%, now serving over 18,500 per quarter in attendance. Provided a recognized "cool zone"for the hot summer month, including movie marathon days every Monday -_- during those hat months. Held 23 weekly free, drop-in activities such as bridge, bunco,scrabble, world affairs discussion, knitting&quilting, book club, crafts, billiards, computer&camera club, singing seniors,Spanish conversation, chess club, bereavement support group, shuffleboard, pinochle, art and much more for seniors (2) needing a safe and supervised place to be during the day. Partnered with over 30 organizations to provide a variety of services onsite for seniors including Meals on Wheels, _--_..... Southern Caregivers, Parkinson's f=oundation, HomeStart Inc., ElderLaw, AARP, Scripps,Sharp, HHSA,AIS, CCA, CV -_ = Senior Club, CV Garden Club, Korean Club, Club Amistad, Filipino-American Club,the VA and many more. Also -' assisted seniors in filling out forms for low income housing, emergency medical care,disability, and providing them with useful information or referral to local agencies to meet their immediate needs. G:1Q If any-anticipated outcomes were NDT achreved,spec fy,whrch ohes.idnd•explatn why None Page 1 of 3—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION i. F. G 1 Agen I JCity of Chula Vista Recreation Department G 2 Aroect name Norman Park Operations i G I.." Year of funding ❑ Fiscal Year 2011 ® Fiscal Year 2012 ❑ Fiscal Year 2033 GA,,"Indicate the source,of the federal.furadingowarded tot ' he prior project ® CDBG HOPWA Q ESG ❑ HOME ❑ CDBG-R ❑ HPRP ❑' N5P j❑ Other(Indicate below): G.5. Amount awarded $37,500 G 6 - 4mount spent to date: $37,500 G.7. 'Amount reprogrammed to date: 0 .. ........ . ........... . . . . G.S. Indicate belo.yv the outcomes anticipated(refer to the grigrnal application for the:project.,if possible): Maintained increased hours of operation to provide unique social, educational and recreational opportunities to (1;)i seniors (2);'. Enable the City to provide a safe and healthy supervised venue for activities for the elderly. „(3) jProvide a one stop shop for seniors for information and referral G.9.,. Indicate below tiie outcomes achieved: Provided 53 hours of programmed enrichment, recreational and educational activities,classes and events for 1...... seniors Provided a recognized "cool zone"for the hot summer months. Held numerous drop-in activities for seniors ( J.;; needing a safe and supervised place to be during the day. Partnered with over 20 organizations to provide a variety of services onsite for seniors.Also, assisted seniors in filling out forms for low income housing, emergency medical care, disability, and providing them with useful (3): information or referral to agency's to meet their immediate needs. G.10! !f any anticipated autcot»es were NOT achieved, specify rivhr`ch ones and explain w...y below None I Page of 3—Supplement to Appendix E CITY OF CHULA VISTA FY 2013-2014 CABG FUNDENG APPLICATION (Max Length per Project: 1 Page) G 1 gent name: I JCity of Chula Vista Recreation Department G.2. Projectname . .. Norman Park Operations G'3 Year of funding: ® Fiscal Year 2011 ❑ Fiscal Year 2012 ❑I Fiscal Year 2013 Indicate the source of the federal funding awarded to the prior project: ® CABG ❑ HOPWA ❑ ESG ❑ HOME CABG-R LJ HPRP ❑' NSP ❑ Other(indicate below): G.S: Amount awarded: $50,000 1 G 6inaunt spent to date: $50,000 G:7. amount reprogrammed to'date: $0 Indicate below the outcomes anticipated.(refer to the original application for the project, if possible): (1) Expand hours of operation in order to provide unique social, educational and recreational opportunities to seniors (2) Enable the City to provide a safe and healthy supervised venue for activities for the elderly. (3), Provide a one stop shop for seniors for information and referral ..... ........ . G.9. indicate beloiw the outcomes achieved: Increased hours of operation by 87%, allowing for restoration of approximately 75%of the pre-reduction (1); operations. Additional hours and associated programming bolstered the existing limited activities. Numerous programs that had been canceled were revived and activities held at less desirable venues were brought (2) back to the facility providing a noteworthy increase (or rather restoration) in attendance. Activities and requests for information and referrals picked up very quickly once hours were expanded, emphasizing the importance of the center to the community. Partnerships quickly picked up and services were able j (3) to grow substantially in a relatively short amount of time. G.10. ! .ahi anticipated outcomes Were NOT achieved,specify which ones'and explain why below None :i Page 3 of 3—Supplement to Appendix E Application No. 13 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" City of Chula'Vista Housing Division, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Fair Housing Services Project Description: Ci I ties receiving CDBG,,fund funds have the obligation to affirmatively further urther fair, housJng, by" providing fair housing,,related services' ,which include , ,anti-hbusing discrimination acid tenant-landl',ord education services to advise persb'ns,of their,rights'under the Fair Hou' stng,Act. Type of Program/Project: General Program Administration (570.206) Target Populatloh:' 216- Fair Housing, Proposed Nutriber N/A Activity(subject to to Serve:, Admin. Cop) N/A Program Total Budget: $35,000 C. V. Cost per Client: N/A Funding Request: Prior Year ftjndirig: $35,000, Specific Use of Chula Vista Staff Costs and/or FUNDING $32,000 Funding: Consultant Costs RECOMENDED Staff Notes:: Application No. i CITY OF CHUdAVISTA HOUSING DIVISION CDBG Application Summary Applicant: City of Chula'Vista Finance Department Program/Project: Section 108 Loan Repayment Project Description: Funds will be used for the debt,"service' payment of the $9. million Section 108 Loan` hick' as received ih 2007. The funds were used for the Castlepark :Infrastructure Program which consisted of the completion of 11 new streets; including:, sidewalks", curbs, gutters, lighting and signage; Type of Program/Project: N/A Target Population:' 19F- Planned Proposed Number N/A Repayments of Sec. 108 to Serve:, Loans N/A Program Total Budget: $756,715 C. V. Cost per Client: N/A Finding Request: Prior Year Funding: $756,756 Specific Use of Chula Vista Debt repayment FUNDING $756,715 Funding: RECOMENDED Staff Notes: 09/29/2008 10:25 212-815-0162 BhIY PAGE 021132 HUD 108 CONSOI.tOATED AMORTIZATION SCHEDULE FOR SEFttES: 2008-A BORROWER; CHULA VISTA,CA NbTE NUMBER: 5-06-MC-06-0540 NOTE DATE; 611212008 AMOUNT OF NOTE- $x,500,000 r^.Un'::.r�.:rrzs7;• ti,'f.+•c,`. 2.+ri=se t, ;�c,f,Li{-"F' WU4U4S.:lf 'c d��:•.'.rem""-..-w✓•?s'ir7'r �"i t.•... w7' M 5 a:• 1':=r"'31 Jnt _ h• r^4'ci$r 1G"%tt -.fir.`w'^—^�",r_: `''n'. '"g r,r .";i�Li+r"�+; ��.-tk"�'?'R r� `",,'•'� 1�•1'�j-�t'r•4'a'ia =:-"3�-'4;-•• 'ms# . xx.�^ � �Y.•. ��:t-G'i; :i`-:� ° �;4"N �ilt#[7A,�itl,-�.-�� (�q� �.'„x•_f" s.Y. (;rfy.�t3:v Y.,'(/t�F�-" rLy,..,�,t,��r, ;�-4 `.'7�r r?h'=tr.1>•ti .Iu..�,: �`� L ,cy_�w) ,; "'"c. re.`{r��•_ �..�Ca.:l F r 55.;;�r•'•���,.y_4V •�\'k..�. iL V"�iy...�Cu;`r ^��Ju� '� S.ti.:3�ri.3 �. Hja^'�'aj� `r=..'.S`L.' �'h`•:Gt�y� '�� Z rY+�l �.� "J.=aS`,(sE;�llz_��,•,'_"rr+"`-!k S'•.��'' �s�#T11.��.�'efji �e�_. e�� �. ,1�'Y,�: �1 s•._1t.i 4 I'"ii�%'.'k ,'" � !„h"Y•'C f,!'f�<«iinii.... - nA5 rt.4��er..�,::!:�. l:ui3'.fYJ ar*o,�:. ��riT_sa.:Sr• ,; `-..n'..tfS� x�!i-'2.ye.�.wrynk!f��,�-�,«.»rl'�e.°�,.G*�,.,.•s,?iLS�_�,`,�� :•�.nn�:t>_ 21il2009 $ 287,032.73 $...' - S 287,032.73~ 5 9,5DO,ODO 81112009 $ 225,61.5.25 / 287 000.00-- -- S . 512,615,25 s9,213,000 2/112010 _S 221,855.58 5 _ $ 221,$55.55 $ .�.... 9,213,ODpy 8.1112010 $ 221.855,55 $ 302,000.00 $ 523.855,55 $ r 8,911,000 w 2/112011 _ 217,159.45 �. $. . . . 5 217J69,45 � 8,919,000 1311/2011 ~ 5 217.159.:5_ S wT_ 317,004,00 $ 534,159AS S�; 8,594.000 21112012. . .. 211,707.05 $ .7.11,707.05 $ .6.594,0QQ 011120/2 S 211,707.05 . ..332,000.00 $ 543,707.05 $ 8,262,000 .21112013 $T 205,365.85 S 20�:• _-.. ...� . r,385.85 8,?6...x.,1000 $. $.. 81'112013 $ 205,365.85 _ 349,000.00 M_ S_ 554,365.85 $ 7,913,000 7.!112014 $ 198385.85 � $ . . .. _ 8 1913,385.85 � $- 7,913,000 81112014 $ w 196,385.85. $ 367,000.00 S 565,385.86 $. _7,546,000 100,788.95___ s _ S 790,788.96 $ 7,546,000 817/2015_M 5 190,788,95 $ 385.000,00 S 575,788.95 $ 7.161,000 2/112018 182,453.70 $ $ 162,453.70 _ 5 7,161,000 81112016 182,453.70 S. 404,000,00 $.. 586,43.70 S $,757000 _ 21112017 173,404.10 S - $ 173,404.10 $ .. 6,757,000 811/2017 S 173,404.10 $ 425,000.00 $. . .$95,404,10 $ 6,332.000 211/2018 S . . 163,714.10W^ $ $ .. 163,714.10 $ 6,332,000 81112018- $ 163,714.iD S .. 446,000.00 $ .609,714.10 $ 51886.001) 21112019 $ 153,411.50 $ - $. .153.411.50 811/2019 S -- 153,411.50 $ 468,000.00 $. 621,411,50 $.. 5,498,000 211/2020 - _ S 142.015,70 $ . - S. 142,015,70 $ ,. .5,418,000 8/1/2020 S 142015.70 S ..492,000.00 S 634,015.70 $ 4,926,000 2/112021 $ 129,814,10 - $ $ 129,814.10 5 4,926,000 81912021 $ 129 814.10 $w .578 OQ0.00 �$ �645,61410 S ::::4,410000 _-_ _ 211/2022 S 116785.10 5 S. ..116,785.10 $ - X4,410,000 8/1/2022 715,785.10 Si . . 542,000.00 S 658,785.10 $ 3,168,000 2/1/2023 _5 102,8617.80 . $ $ 102,882.80 S , 3,868.004 $1112023 -�__102,882.80 $ 569,000.00 S 671.882.80 $ 3,299,fl00 211!2024 S 88,117.25 $ $ 88 9, k7 25 __ $ ., 3,289,000 8/1/2024 S 88,117.25 $ 697,000.00 $ -. 685J17.25 S 2,702,000 21112025 S 72446.00 5 - S 72,/146.00 $ 2,702,000 ,.._ 8/112025 __ w�S 72,446.00 $ 627,000.00 S 699,446.04 21112026 $ $M30.50 $ - S _ 55.830.50 _ S 2,075,1104 81112426 $ 55 830.50 S 659 000.00 $ 714,830.50' 4 1.415,000 21112027 S38,235.20 - $ 38,235.20 .... _.W 9.476,000 8/112027 a_ X8,235.20 5 592,000-OD S 730,236,20 S 724.000 211/2028 TS 19,620.40 S u $ . 18.620.40 $ 724 000 8/112028 $ 19,620.40 $ 724 000.00 8 743.620.�D $ TOTAL: 40 S 5,880,634.28 $ 91500.000.00 $ 15,380,634.28 Application No. 15 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" City of Chula'Vista Housing Divi'sion, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Housing Services Project Description: Funds are used to, cover staff,costs associated with 'ptojects, and peogr'ams,fund'ed'through the,HOME program., Examples of,services, provided include the following: Energy auditing, preparation of work, specifications, reviewing of applications, loan processing, inspections, tenant,selection, and assisting owners, tenants', contractors',:and'other entities, participating, or seeking, to 'participate in, housing, 'projects �assisted with the HOME program. Type of Program/Project: General Program Administration (570.206) Target Popullatloh:' 141- Housing Services Proposed Number; N/A HoMtOriogram to Serve:, &R§ 510.208(a)(3) Low Moderate Income, Housing, Program Total Budget: $50,000 C. V. Cost per Client: N/A Funding Request: Prior Year,Funding: $54i705 Specific Use of Chula Vista Personnel Costs and FUNDING $50,000 Funding: Program Administration RECOMENDED Expenses Staff Notes-. , Application No. 16 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Appficaht-." Urban torps,of San Diego' Program/Project: Green Streets Project Des;crtpt1ion: Urban Corps of San Diego proposes a "'Gireen' Streets" project that provides interior and exterior home, irnproveimenits, basic Weatheriz'at,ion, minor rehabilitation,, and minor homei security y improv&nentsto"10,Low M6detat6,lrc6me,(LMI) householdsinChula Vista and,distribute "do-it-yourself"Water'and energy conservation kits to an additional 20 LMI' households. The'applic'an't requests $76,138. , An additional $76,862is recommended to cover'City staff costs and to cover'a portion,of additional health and safety related repairs that,may be'identified by City or Urban Corps staff. Total recommended funding is'$150,0004 Type of Program/Project: Low/Mod Housing [570.208(a)(3)] Target Populatio' n.4, 14A-Single Unit, Proposed Nuriiber 30 Residentia f,Rehab to S6rve:, (Subject to chonge depending dn'funding CFR§ 570,208(p)(3)'Low recommendation) Moderate Income Housing Program Total Budget: $84,620 C. V. Cost per Client: $2,537 (Based on funding recommendation) Fthiding kequ6st: $16,138, Prior Y06r Funding: $0 Specific Use of Chula Vista Urban Corps: Personnel FUNDING $150,000 Funding: Costs ($36,108) and RECOMENDED Construction Costs ($40,030) City Personnel Costs ($73,862) Staff Notes: Funding for the Orbari,Corp will be up to the amount requested ($16,188) The remainder of the,recommended I amount will I b,6 Utiliz, ed f6rCity services". 1COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Application for Fending for Fiscal Year 2014-2015 Application Number: Project category Public service El; (CDBG Program Ofj"rce Use Only) (check one'onlo Capital improvement Applicant Agency Information Applicant legal'name '`Urban Corps of San Diego County Type of agency:; ® 501(c)(3) F]J Gov't./Public E] For Profit Ei Faith-Based ];Other: .E Agency Address: 8127 Jefferson St., San Diego,CA Date of incorporation:; !4/25/89 Tax ID:number.*. 30352148 ::::A ncy DUNS number: 05017888 Annual operating budget. $7,490,000 IVumber'0 paid staff.• 66 Number of volunteers: 10 ', Agency mission statement: The Urban Corps of San Diego County is a certified local conservation corps and charter school whose mission is to provide young adults with a high school education combined with job training and community service. Project Title: Green Streets 11 Brief project description:' The Green Streets project will provide interior and exterior home improvements, basic weatherization, minor rehabilitation,and minor home security improvements to 10 LMI households in Chula Vista and distribute do-it-yourself water and energy conservation kits to an additional 20 LMI households. Funding Request Total funding requested in this opplication Otherfiunds already secured for $76,138 1 x$8,482 + (youiwill provide a'detalled budget In Appendr'x C project: Total`cost to complete project: $84,620 t Qtherfunds not yet secureal for; .. Project Information !f Prefect is:a Public Service, will servicebe site specific? QYesiVa If your answer is yes,please provide: Address.(esJ below: Census:traet: 3arget Clreoa#e!e (Nameless, Youth, X111 beneficiaries would be verified as LMI. We have completed similar projects serving LMI clients, and program applicants included elderly and disabled Elderly, Disabled, Other/Genera!) individuals. We expect a similar mix of applicants for the proposed project. The following questions on individual clients and households to be served apply only to PublicServlce and Minor Residential Rehabilitation projects:. Will the project serve individual.clients(IC)or households(HH)? E Individual clients ® [households Total unduplicated IC/HH served: 30 Annual cost per client/household. $2,820.67 Pagel of 9 Ion;..,-tea z�iR/�nza� CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section a Prpj_ t Details (MaxScree 25 Points) 1.1. Provide a concise description of the proposed project(this descriptionmust match the one provided on the cover page). Space for a fuller narrative is provided in Appendix A. The Green Streets project will provide interior and exterior home improvements, basic weatherization, minor rehabilitation, and minor home security improvements to 10 LMI households in Chula Vista and distribute do-it-yourself water and energy conservation kits to an additional 20 LMI households. j 1.2 : Project start date: 7/1/14 a Anticipated end date.:: 6/30/15 f 1.3 Project's days/hours of onerativh M- 7:30 a.m.-4:30 p.m. l 1,4,` Project [] public service 1.5 Project: ] Suitable living environment category oblectrve ®;Decent housing (check one only)': 0 Capital improvement (eherkane'on1y1 17 Economic opportunity 16 P.90ct. ® Availability/accessibility outcome. F1Affordability (checkoneonly) ❑ Sustainability I.T. CDBG Criteria: Which CDRG criterion below does your proposed project meet? (1) Area benefit:At least 51%of residents within the targeted activity area are low to moderate income(LMI). Please provide a map identifying the Census Tracts designated as LMi. ❑ (2) Limited clientele(select subpart below): []? (a) Special needs group(select benefit group from the list below): (1) Abused children ❑ (ii) Elderly persons 62 years or older ❑' (iii) Battered spouses ❑' (iv) Severely disabled adults(not children)—Census definition;documentation required ❑ (v) Illiterate adults ]' (vi) Persons living with HIV/.41DS (vii) Migrant farm workers (viii)Homeless persons ❑ (b) At least 51%of clientele to be served will be documented as LMI. How does your agency track and record client demographics? ® (3) Housing(select subpart below): ® (a) Single family(must be 100%LMI) ❑` (b) Multi-unit(must be 51%LMI) 1.8, The 2010-20.15 Consolidated Plan goals are listed below. Select the'goal`appropriate to:your project: ❑° Affordable Rental Housing Opportunities ® Maintenance and Preservation of Housing(rehabilitation activities) ❑ Homeownership Opportunities(homebuyer programs) E. Community Enhancement(public facilities/spaces) ❑ Public Services to Special Needs Population and/or Low Moderate Income Persons Page 2 of 9 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Length for Questions 1.10 to 1.15: 2 Pages) 1.10. Explain how the proposed project addresses the goal selected Urban Corps'Green Streets project will support the continued revitalization of Chula Vista's most underserved neighborhoods by providing basic weatherization, minor interior and exterior rehabilitation, and home security improvements to LMI residents at no charge to the homeowner.Through the project, low-income qualifying homeowners will benefit from a variety of residential rehabilitation services geared toward improving the livability, sustainability, safety,and security of homes. The primary goal of the Green Streets program is to revitalize LMI neighborhoods by making minor home improvements and addressing safety concerns while creating long-term energy efficiency benefits for LMI residents. Improvements will assist in securing the safety and health of residents, while offering them more efficient use of energy and water and correcting minor defects due to deferred maintenance. In many cases, residents will also see improved curb appeal.Site visits will assess the needs of the home, and improvements will be performed on an "as-needed" basis.All homeowners receiving services will undergo an application and income verification process to qualify them as an LMI household. Urban Corps will make every effort to employ green building methods and install improvements which will lower the cost of utilities for residents, using durable, non-toxic, and renewable materials to promote a healthy living environment.As an added benefit, the program will develop S LMI Chula Vista youth through paid job skills training and education at Urban Corps'onsite charter school,which will have the long-term effect of uplifting LMI communities by increasing the education level and economic opportunity of these LMI Chula Vista residents. Additionally, Urban Corps will distribute 20 "do-it-yourself" (DIY)weatherization kits to eligible LMI residences.These kits will be provided free-of-charge to residents and are designed for easy use on minor repairs and upgrades such as caulking, insulation, and waterproofing.All residents receiving these kits will also undergo an application process proving their qualification as Low-to Moderate-income.The DIY kits are intended to create a low-cost solution to energy efficiency issues for the greatest possible number of homeowners in these underserved neighborhoods. It is expected that as these 30 LMI residents participating in the Green Streets project experience a_healthier living environment and decreased energy bills,they will also take more pride in their homes and neighborhoods, inspiring them and their neighbors to take better care of their community. Summan,w any statistics and other supporUng documentatlan thar d6h7onstrate the importance of ad lressing this need or problem: ;According to a 2009 report by the White House's Council on Environmental Quality, homes in the U.S. generate more than 20 percent of the nation's carbon dioxide emissions,.making them a significant contributor to climate change. Existing techniques and technologies in energy efficiency retrofitting--such as those used by Green Streets—can reduce home energy use by up to 40 percent per home and lower associated greenhouse gas emissions by up to 160 million metric tons annually by 2020. Home energy efficiency retrofits have the potential to reduce horde energy bills by$21 billion annually, paying for themselves over time.These savings are particularly relevant for LMI residents and communities, especially as the US economy attempts to recover from a deep recession. Meanwhile, 100%of Urban Corps participants (Corpsmembers)are from LMI areas throughout San Diego County. Some are parentless; some are homeless; others are young single parents. Many are refugees from war-torn countries referred to Urban Corps by Catholic Charities or the International Refugee Committee.This project has the double benefit of not only serving LMI homeowners, but providing jobs and education to the LMI youth employed by Urban Corps. Urban Corps is committed to reversing the cycles of poverty that have kept these LMI residents from living productive, healthy lives. Urban Corps' dynamic work/learn program addresses the issues of youth poverty and lack of education. We are committed to employing 8 LMI Chula Vista youth for the proposed project. By providing jobs for LMI young adults to make minor home improvements for other LMI residents, we expand our impact into the homes of Chula Vista's most needy and underserved neighborhoods. Page 3 of 9 fer....r...,.1.1 a fn/�n l�% CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION 1.12. List each service provided by the project. For each service, indicate whether it is a new service or an expansion of an existing service: 'Urban Corps will have two crews of four Corpsmembers and one Supervisor conduct home improvement work at 10 homes.Services may include, but are not limited to, caulking; weather stripping; repair, replacement, and/or installation of security doors and/or security screens; installation of smoke alarms; water heater blanket replacement or installation; window replacement;exterior rodent and vermin protection; low-flow shower head and faucet aerator installation; low- flow toilet installation; replacement and/or installation of electrical outlets,switch covers, and gaskets;washing down of mold and mildew and repainting with matching color; debris hauling; and window and door replacement.Additionally, crews will canvass, income-qualify, and distribute conservation kits at an additional 20 homes.The program is new for the City of Chula Vista, but it is an expansion of our existing Green Street program in other areas of San Diego County. 1.13`. How:doesour agency.Plan.to_tell the tar et_population.abo"uthe project/evcs? .. ;Urban Corps will canvass in underserved neighborhoods throughout the City of Chula Vista to gather applications to provide services and do-it-yourself home improvement kits to residents whose homes qualify.This process will be accomplished through door-to-door visits. In addition,services offered will be posted on the Urban Corps website and promoted in outreach materials, social media, and in the Urban Corps newsletter which goes to a wide variety of community partners in a position to refer qualifying homeowners. All homeowners who apply to receive services will have their LMI status verified through our application process.The Project Manager will visually assess potential work to be done,approach homeowners about the services offered, and follow-up throughout the income verification process. 1.14: List up to three outeames of the project(at least one is required). For each;outcor>ne listed,provide the:number of participants who will benefit and the way data''will be collected to track or;verify the auteome: Outcome 1: Completion of minor home improvements for 10 LMI-qualifying households, providing affordable decent housing opportunities. Data will be collected through applications, before and after construction photos,approvals for scopes of work, initial and final inspection reports, and project status reports, Outcome 2: Distribution of Do-It-Yourself water and energy efficiency kits to 20 LMI.households. Data will be collected through initial applications and signatures acknowledging delivery. Outcome 3:Job training and education provided to 8 LMI Chula Vista residents participating in the Urban.Corps program. Data will be collected through participant enrollment records and daily rosters showing work accomplished in the Green Streets program. 1.15. Will the project collaborate with other service providers in the community?;lf yes, 11st thein and.briefly describe the collaboration: 0 Yes ® No N/A Page 4 of 9 fo.,144Tl/R/^rn771 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Section 2: Lale icy Capacity (Max Score: 10 Points) 2.1. Who will be the person responsible for the overall oversight of the proposed project? Name of person ,Robert Chavez j Title of person;: Chief Executive Officer Relevanteducaton: B.S. Criminal Justice Administration; M.B.A. Telephone number:' '(619)235-6884 Date first employed. /15/12 2.2. Who`will be:the alternafe.person responsible for the`overall'oveOyht Of.the proposed project?.. Name of person- �Yolanda Maeder ` Th)e;of person: ;Senior Operations Manager/Contracts Compliance Officer Relevant education :Paralegal Certificate Telephone number:. ,(619)235-6884 Date first employed: ;9/1/08 2.3 Who will be the person responsible for the day<to-day operations and managerr►ent of the proposed project?'' Provide na more than two individuals: ' No the: person:: !Daniel Perez Title of person:: reenBuild Manager Relevant education ;Responsible Managing Employee—State Contractors License Telephone number.*. ;(619)235-6884 j date first employed: 1 4/1/11 Name of person: John Reynolds Title of person: GreenBuild Coordinator Relevant education B.A. History,Spanish Minor Telephone number (619) 235-6884 Date first employed:', j1/14/13 2.4. Who will be:the person responsible for the financial oversight of the CDRG'expend.itures'and fiscal compliance? Prauide no more than two individuals: Name:Of person: kyle Kennedy Title of person.. Chief Financial Officer Relevanteducation: B.S. Accounting,Certified Public Accountant Telephone number: (619) 235-6884 Date first employed•: .12/16/13 Name of person: Douglas Burns Title of person: Staff Accountant Relevant education: B.B.A..Accounting Telephone number. (619) 235-6884 Date first employed: 7/8/13 Page 5 of 9 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION (Max Length for Questions 2.5 to a 1 Page) 2.S. List the evoluation tools your agency plans to employ to track and monitor the progress of the project. `.Urban Corps employs a full-time Senior Operations Manager/Contracts Compliance Officer who maintains all reports and documentation relating to CDBG and other federal funds, making regular site visits to ensure projects progress according to schedule.She has six years of experience handling successful CDBG projects and is familiar with the HUD Playing by the Rules handbook, using that information as a guide to assist her in complying with applicable regulations and documentation.The Contracts Compliance Officer works with the Project Managers to ensure that all progress reports are completed in a timely, efficient manner. 2.6 How does your agency plan to ensure compliance with applicable policy and procedural:requirements'{includi6g those listed'ih HUD's "Playing by the Rules"Handbook)? Our Senior Operations Manager/Contracts Compliance Officer is responsible for researching policy and procedural requirements and ensuring that project activities are in compliance with these regulations. Urban Corps' Board of Directors also provides programmatic and fiscal oversight to ensure compliance with federal and state requirements. 2.71. Describe any unresolved ADA issues rn the project or project office and howl your agency plans to address thein. Of. the objective of the project is ADA rehabilitation, do not repeat the project:description Frere.J There are no unresolved ADA issues in the project.The project will be reviewed for compliance with federal and state laws as they relate to accessibility. if the home assessment identifies ADA health and safety needs,the project scope can include accessibility improvements such as grab bars and ADA-accessible ramps. 2.8.. How:manymembers does.your Board of Directors have? 12 j How:many Board members are also members of the project's target papulation or reside in 0 the project's.target:area?lndica.te which ones in�ippend' F.' Page 6 of 9 CITY OF CHULA VISTA FY 201.4-2015 CDBG FUNDING APPLICATION Section 3: Auditing Control Score: 15 Points, Max Length` 2 Pages) 3.1. Briefly describe your agency's payment and disbursement procedures, with relevance to the proposed project: All required payments, disbursements,tax forms and schedules will be made in a timely, accurate and complete manner without exception.The Controller approves all Federal and State tax returns, as well as approving all employment- related tax forms. All disbursements are accompanied by a completed and approved requisition form or petty cash form. Invoices must be stamped with the date received prior to processing. Only original invoices are processed. Urban Corps does not pay from statement. Payment discount terms are used whenever possible.All check disbursements are prepared by the Controller. Checks are preprinted in numeric sequence and kept in a locked file.All checks require two (2) authorized signatures.As a general rule, checks are prepared on a weekly basis, usually on a Thursday. Prior to signatures and distribution,checks are compared with accompanying vouchers. Distribution of checks is by mailing or direct delivery to payee.The Controller maintains the disbursement register. 1. 3..2. Describe how your agency's Board of airectorsexercises proagramrr atic aria)fiscai:;oversight: One of the functions of the Urban Corps Board of Directors is to oversee the integrity of the organization's financial management systems, risk and controls related to financial reporting and compliance with laws, program regulations and our internal ethics policy.The Board of Directors also ensures the budget process is conducted in an accurate and timely manner by staff with a review of the preliminary upcoming annual budget in April of each year and approval of the final operating budget no later than July 31..Additionally, monthly financial statements are approved by the Board of Directors or executive staff. Lastly, written approval from the Board of Directors is required to open, modify or close any accounts within the Agency's primary banking institution. 3.3. Briefly describe your agency's financial reporting system/accounting procedure.,Wlth relevance to the proposed project Monthly financial statements are to be prepared in a timely and accurate manner on a monthly accrual basis and presented to the Board of Directors as a standing report. General standards include fairness of presentation, compliance with all prescribed requirements,timeliness, and usefulness. "Full disclosure" is the primary principle by which reports are made and presented.All significant costs are to be included. Form, content and arrangement of each financial statement should be as simple as possible. Detailed but brief explanation should be made for any items significantly different to budget. Reports are to be consistent in format from period to period. 3.4. : Briefly describe your ageney's record keeping system,'with relevance to the.proposedprofect: Urban Corps ensures that all of its transactions are properly controlled and safeguarded.All income expenses are coded by project number to track direct costs.The Accounting Department holds primary responsibility, with the exception of limited involvement from the Chief Executive Officer.All receipts are recorded immediately in a receipts log, including the date of receipt, payer name, check number and the amount received. Receipts are stamped for deposit without delay, and deposited into an Urban Corps bank account intact.A copy of each item received is made and filed in chronological order. No cash receipts will be cashed and no substitution of monies, checks or other documents will be made for the actual receipts officially received. Full compliance within all federal, state and local laws and regulations that apply to public corporations are maintained at all times. 3.5. Briefly describe your agency's auditing requirements, including those far the proposed project: An independent audit by a qualified outside audit firm of all agency financial operations and procedures is conducted on an annual basis approximately three (3) months after the end of each fiscal year.The audit is submitted to the Audit Committee of the Board of Directors for approval and presentation to the Board of Directors.The Controller initiates contact with the outside audit firm in the May/June timeframe each year and arranges a preliminary meeting where the dates and timeline for the audit are discussed and set.The Controller receives a list of required tasks, information and Page 7 of 9 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION schedules and ensures that everything is completed prior to the first day of audit fieldwork.The Controller and the Accounting Staff work as a team to prepare all required documents.The Controller and the Accounting Staff give the audit field team their first priority during the field team's time on site.The Controller briefs the Chief Executive Officer (CEO)on any matter pertaining to policy issues that may need to be addressed during the course of the audit. At the CEO's discretion, either the Controller or the audit team presents the results to the Audit Committee of the Board of Directors.The Audit Committee prepares and presents the audit report to the Board of Directors for final approval. Briefly describe your agency's interna(controls to minimize opportunities far fraud, wiaste, and mismanagement 'Fiscal oversight for the organization is provided by the Board of Directors' Audit Committee,which ensures that all financial processes are conducted in an accurate and timely manner by Staff with a review of the preliminary upcoming annual budget in April of each year and approval of the final operating budget no later than July 31 each year.The budget may be revised if and when necessary and only with the approval of the Board of Directors. 3.7' ..:> Howr`does your agency plan to segregate CDBG funds from other agency funds far purposes of dentrficatron, tracking, and reporting? Strict adherence to restricted funding such as that of CDBG is of utmost importance for Urban Corps'Accounting Staff. All restricted funds are subject to audit by Urban Corps'external auditor for restriction compliance.When services are specifically dedicated to CDBG, valid receipts of dollar value and/or description of services provided to Urban Corps with monetary value must be submitted from the applicable company, institution or employer.These receipts are then filed with the appropriate project file. Urban Corps'accounting systems are fully automated utilizing Sage accounting software (MAS 200) including General Ledger, Accounts Payable,Accounts Receivable,Job Cost, Payroll, Inventory Management, Warehouse Management, Purchase Order, Bank Reconciliation, Fixed Assets and Time Card. Projects such as CDBG are assigned a unique identifier so that project associated costs can be tracked and reported correctly.] Page g of 9 (U-1111,.1r Il/aMni 2$ CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION ecti®n 4: Agency Experience (Max Score: 10 Pints; Max Length: 1 Page for Section 4/5 Combined) 4.1. Briefly highlight your agency's experience and major accomplishments in providing services to LMI residents acid/or communities. You.may expand in Appen.dixA. ;Urban Corps has an excellent 25-year track record in meeting its contractual obligations from a wide variety of funding sources. We have received CDBG funding since 2005 and have successfully completed these projects without any negative project audits, resulting in improvements to many of San Diego County's most underserved neighborhoods. In addition to CDBG funds,we have received federal funding through the San Diego Workforce Partnership, successfully implementing and meeting the goals for the Workforce's Hire-A-Youth 2009, 2010 and 2011 programs. Regardless of where they take place, 100%of Urban Corps'work projects serve LMI youth and LMI communities in San Diego County. Urban Corps provides high school education, paid job training, career counseling, life skills training, and job and higher education placement services to unemployed youth around San Diego County.We enroll approximately 180 young adults in our program at a time, some of whom reside in the City of Chula Vista.The young people we serve face many barriers to success. Nearly 100%of our Corpsmembers meet Federal Poverty levels, and over 80% have additional barriers to employment such as lack of transportation, need for child-care, language barriers, court and gang involvement, past substance abuse, and limited social skills.Through the job training program,these young people are able to gain transferable job skills while giving back to the community by planting trees, improving homes, painting out graffiti, restoring native habitat, and more.These services benefit thousands of residents, businesses, and visitors around the county. 4.2. Has your agency rece.ived;CDBG or other federal funds in any;af the`past three fiscal years (Fiscal Years 2011-2012,1012-2013 through 2013-2014)?if yes,complete Rpperrdix G for ® Yes Na' �' each of the grants received far th three Fiscal.Years 2011,2...012, and 2013: Section aBack-Up Plan (MaxScore: 5Points;) 5.1. Will your agency still.implement this project should 058G funds not be awarded If yes;how will the Implementation be achieved? ® Yes; ❑ No' Orban Corps is 85 percent funded by fee-for-service projects contracted by staff and undertaken by Corpsmembers, and the organization seeks additional funding through private donations,foundation grants, and other funding opportunities on the local, state,and federal levels. If this proposal is not funded by CDBG, we will pursue funding through all of these other avenues. 5 2. If funded, how will.:your agency continue this project if CDBG funds.are not available in f4tl1re years? If the Green Streets project is funded through CDBG in FY 2014-15 and further funding is not available, Urban Corps will seek assistance through work projects,other grant applications, and private donations as described above. Page 9 of 9 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix Ao Narrative of Project (Max Length: 2 Pages) Ire two pages or less,explain belowyour proposed project aM make the case why rt should be awarded funding. The ultimate mission of Urban Corps' Green Streets project is to support the continued revitalization of Chula Vista's most disadvantaged neighborhoods by providing basic weatherization, minor interior and exterior rehabilitation, and minor home security improvements to LMI residents across the city. Urban Corps requests $76,138 to complete the proposed Green Streets project, matched with $8,482 in educational costs from our onsite charter school. The project will provide these small-scale home and community improvements free of charge to LMI residents. The improvements are intended to conserve resources, help beautify neighborhoods, and enhance living conditions in LMI communities.The work undertaken in Green Streets projects promotes sustainable, healthy living environments while developing job skills for LMI young adults, which increases residents' connection to—and ownership of—their neighborhoods. Since many of our program participants, or Corpsmembers, reside in the communities in which Green Streets operates, it also gives them a chance to give back to their disadvantaged neighborhoods while receiving paid work training and education in the process. This project combines many of Urban Corps' diverse and dynamic GreenBuild program services into one community-driven package which includes home Weatherization and minor residential rehabilitation aimed at safety, curb appeal, and broader community revitalization. Past Green Streets projects have been uniformly successful from the perspective of both community members and Urban Corps' LMI youth population, as these projects have presented a unique opportunity to train and educate youth while improving neighborhoods. Green Streets was specifically designed to target Low- to Moderate-Income communities, addressing multiple issues under one comprehensive project banner. Emphasis is placed on providing free renovation services to LMI-qualified households via an application and income verification process, as many homeowners in these neighborhoods cannot afford to provide improvements to their homes without financial assistance.This process proves that residents who will receive free services are LMI through paystub verification and a household survey. Urban Corps will also distribute 20 "do-it-yourself" energy and water efficiency kits to LMI residences. These kits are provided free-of-charge to residents and are designed for easy use on minor repairs such as caulking, insulation and waterproofing. All residents receiving these kits will undergo the same application process proving their qualification as Low-to Moderate-Income. Weatherization retrofits are of key importance among the many home improvement services offered by Green Streets. These improvements help properly seal and insulate homes, which helps lower energy bills for residents,especially in the summer and winter months when weather is at its most extreme and use of heating and/or air conditioning is at a premium. Weatherization includes the use of caulking and weather stripping to prevent moisture damage to property, which would otherwise lead to mold and/or rot. The ability to live in a healthy, safe environment is something that every resident should have, regardless of socio- economic status. Nevertheless, socioeconomic issues are what result in LMI neighborhoods becoming dilapidated and rundown, with individual homes often becoming infested with vermin or insects. In response, Green Streets provides key improvements like exterior rodent and vermin protection that prevents entry for pests into the home. As these pests can spread disease, create unpleasant living conditions, and further contribute to decline of property values, it is important for the homeowner's most basic standards of living to ensure they are kept out. Green Streets can also install battery-operated smoke alarms for the safety of residents, as many don't even have the most minor defenses to alert them in case of a fire. Particularly relevant for the safety of children, the project also replaces and installs electrical outlet covers and gaskets that may be exposed, as toddlers can be susceptible to electrocution if outlets are left unprotected. Appendix"A"_Narrative Page 1 of 2 (Revised 1214120131 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Security is also a crucial issue, especially in LMI communities. These neighborhoods often have higher crime rates than those with higher incomes, and homeowners may need assistance in keeping their families and property safe and free from intruders. Green Streets offers repairs, replacement, and installation of security doors and security screens, as well as window replacement to keep residents secure in their homes. In many cases, LMi homeowners are forced to neglect home repairs for so long that even the most minor fixes can make a large difference. Following water heater blanket replacement or installation, residents see more efficient hot water results, while electricity bills go down. Likewise, with simple installation of low-flow shower heads, less water is wasted and more money stays in the homeowners' pockets. Green Streets can also install water-efficient, drought-tolerant landscaping for some homeowners, as residential lawn care is often the first area of home upkeep to be neglected when finances are at a minimum. e=xterior and interior painting is also offered by the project. Both of these not only beautify the residences and enhance curb appeal, but contribute to the overall livability and revitalization of the neighborhood, which is the broader goal of Green Streets. In addition to accomplishing residential rehabilitation on 10 Domes, the project will distribute 20 "DIY" weatherization/conservation kits to qualifying LMI homeowners, enabling them to make minor home improvements on their own. Each kit may include such items as compact fluorescent light bulbs, faucet aerators, low-flow showerheads, energy-efficient nighttime lights, caulk, toilet kits (consisting of a wax ring and leak testing material), refrigerator bulbs and, most importantly, educational material explaining to residents how to accomplish these improvements. By putting these basic improvements in the hands of the homeowners themselves, Green Streets also gives them the opportunity to teach friends and neighbors how to improve their own houses.This creates a very affordable solution to promote decent housing, which ultimately results in the uplift of entire LMI communities. When it comes to uplifting entire communities, little else compares to the impact of affecting a community's young people. Through Green Streets, a total of eight LMI youth Corpsmembers will gain real-world job experience and hands- on home improvement skills that they will take with them into the mainstream workforce.The paycheck they earn will go back into their LMI communities; the skills they acquire will help them attain future employment, benefitting them and their families well into the future. Most importantly, the Green Streets project supports these 18- to 25-year-old young adults in attaining a high school diploma, something most thought they would never get a second chance to earn. The costs related to educational services for this program are offered as a match and are not requested from CDBG. Through earning their diploma, and bettering their chances at future employment, they gain the confidence, life skills, and momentum needed to transition into self-reliant, productive members of the Chula!lista community. Appendix"A"—Narrative Page 2 of 2 (Revised 121412013) APPENDIX C-1: LIST OF ALL FUNDING SOURCES FOR THE PROJECT CITY OF CHULA VISTA COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR 2014-2015 APPLICAI`ION This table serves to provide the listing of all funds to be made available for the project. There are 3 steps to the completion of this table: Step (1): Enter the FY 2014-2015 CDBG application funding request amount for this application; Step(2): Complete the following table with the amounts of other funding sources that have been secured or funding sources that are unsecured for the implementation of the project; and Step(3): Attach any supporting documentation that verifies the secured funding sources and amounts for the project. NOTE:Amounts Unsecured should be funding sources that the Agency is reasonably sure will be available for the project. However supporting documentation is not yet available. AMOUNT AMOUNT" % OF SECURED UNSECURED TOTAL FY 2014-2015 CDBG Application Request from City of Chula Vista (Step 1) $76,138 89.98% List Other Sources Below: (Ste 2) HOME 0.00% ESG 0.00% HOPWA 0.00% CDBG-R 0.00% NSP 0.00% HPRP 0.00% Other Federal Stimulus Funds 0.00% Other Federal)Funds 0.00% San Diego Housing Commission 0.00% State Funds 0.00% County Funds 0.00% Local Funds. 0.00% Private Funds 0.00% Agency Funds $8,482 10.02% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% TO'T'AL $8,482 $76,13$ 100% TOTAL PROJECT BUDGET $84,620 URBAN (ORPS January 29, 2014 Angelica Davis Housing Project Coordinator City of Chula Vista SAN DIEGO COUNTY1 276 Fourth Avenue Chula Vista, CA 91910 BOARD OF DIRECTORS Dear nils. Davis: WIL WILLIAMS,President Past Vice President The Urban Corps Charter School (UCCS) is pleased to submit this letter of Corporate Communications,Titan Corporation commitment in reference to Urban Corps of San Diego County's proposal to the CHRISTINE Nt;MQQRE,1st Vice AT&Tsident City of Chula Vista CDBG Program for its Green Streets program which will help Director of External Affairs,AT&T CaliforniaCmia � INGRID NIELSt:N,2,1 Vice President 30 low- to moderate-income Chula Vista households maintain safe, secure, healthy Commercial Property Manager housing while employing eight disadvantaged young adults ages 18 to 25. Nielsen Properties DANIEL MORALES,Secretary UCCS will provide classroom education to the eight youth participants while they Community Services Liaison San Diego Housing Commission are enrolled in the Green Streets program. This education will be financed by non- TRACEY WILLIAMS,Treasurer federal Average Daily Attendance (ADA) funds. A match of$8,482 will be provided Senior paLftegy to Urban Corps for facilities use to support the educational component of the RICHARD BARRERA Green Streets program. Board Member Ex-officio Secretary Treasurer andof the Labor ow Follin the Green Streets program, UCCS commits to enrollingthese young San Diego-Imperial Counties Labor Council � p � r BOB BENSON people on a full-time basis while they are simultaneously engaged in Urban Corps' President work programs, helping them to earn their high school diplomas. We offer our full National Universityinternationai support of Urban Corps' mission to positively affect out-of-school youth and their LEON BROOKS Principal communities. We have every program g confidence that the Green Streets oafs of Leon Brooks and Associates providing workforce training and education to out-of-school youth will benefit each DIANECHALMERS individual's future job prospects and/or post-secondary education goals. Board Member,ARCS Foundation,Inc. RICHARD J.FREEMAN Shouldy ou have any questions about this partnershipor our commitment, please Past President&COQ San Diego Padres,Petco Park do not hesitate to contact me. GINO V.MAZZANTI Board Member Ex-QfPlclo Sincerely, , GAIL WEED Personal Banking Officer Torrey Pines bank \, Robert Chavez Dan Thomas Chief Executive Officer Doan of Education Urban Corps Charter School &Ftffjed Law &Rservationschool "Learning,Earning,&Conserving" 3127 Jefferson Street,San Diego,CA 92110:Mailing Address:P.O.Box 80156,San Diego,CA 92138-0155 Telephone(619)235-6884:Fax(619)235-5425:Tall Free(855)SD-CORPS:www.urbancorpssd.org APPENDIX C-2a TREE-MONTH CASH RULE'PEST CITY OF CHULA VIS'T'A COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM FISCAL YEAR.2014-2015 APPLICATION THREE-MONTH CASH RULE'PEST The three (3)-month rule is used as a guideline to determine whether an Agency is solvent and has enough available cash to take a CDBG project from beginning to end during the 12-month allowed to complete the project. CDBG projects should not harm the day-to-day operations of the Agency, so enough funds must be available for both purposes. Provide the information requested below to demonstrate that the agency has enough cash on hand to operate the proposed project on a reimbursement basis. Balance Sheet-Audited Financial Statements. FY 2013 CY Page# 1 Document must be attached to Application Enter Agency Cash Balance (Cash cannot include Investments or Receivables) 542,935 A. Multiply Agency Cash Balance by 4=Cash available for project(s) 2,171,740 List the amount of FY 2014-2015 CDBG funding applied for this application. 76,138 List the amount of FY 2014-2015 CDBG funding applied.for any other application. 558,675 List the amount of FY 2014-2015 CDBG funding applied for any other application. 73,174 B. Sum all the amounts for FY 2014-2015 CDBG funding request(s) 707,987 Compare Agency Cash Balance Available (Item A)with Total FY 2014-2015 CDBG Funding Request(Item B): Item A 2,171,740 Item.B 707,987 Differencel 1,463,753 Analyze Results 1- If difference is a positive amount or equals $0,the Agency is eligible to apply. 2-If difference is a negative amount,the Agency has the options below: The Agency can adjust any of the FY 2014-2015 CDBG requested amount(s)to result in.a positive or$0 balance, as long as: A)EACH PROJECT MEETS THE MINIMUM REQUIRED AMOUNT FOR EACH OF THE APPLICATIONS, AND B) CASH AVAILABLE FOR PROJECTS IS NOW GREATER THAN OR EQUAL TO THE TOTAL FY 2014 CDBG FUNDING REQUEST. APPENDIX C-5< MINOR RESIDENTIAL REHABILITATION(MRk2) SCHEDULE I.--BUDGET EXHIBIT AGENCY Urban Corps of San Diego County .PROJECT Green Streets CDBG Percentage SALARIES & WAGES -PROJECT MGMT (Schedule 2) 4,473 FRINGE BENEFITS-PROJECT MGMT (Schedule 3) 1,383 [Project mgmt PE&NPE are limited to 15%of Total CDBG Project Budget] SALARIES &WAGES-CONST/RENOV (Schedule 4) 23,320 FRINGE BENEFITS-CONST RENOV (Schedule 5) 6,932 TOTAL PERSONNEL 36,108 PROJECT MANAGEMENT SERVICES (Schedule 6) 0 7.69% [Project mgmt PE&NPE are limited to 15%of Total CDBG Project Budget] LEAD-BASED PAINT ASSESSMENT/ABATEMENT (Schedule 6) 0 CONSTRUCTION/RENOVATION (Schedule 6) 40,030 CONSULTANTIPROFESSIONAL SERVICES (Schedule 6) 0 OTHER EXPENSES (SPECIFY): (Schedule 6) (Schedule 6) (Schedule 6) (Schedule 6) TOTAL NONPERSONNEL 40,030 TOTAL CDBG PROJECT BUDGET 76,138 Page of APPENDIX C-5: MINOR RESIDENTIAL,REHABILITATION(MRR) SCHEDULE 2-PERSONNEL GLOSS PAY, PROJECT MANAGEMENT [Project MGMT Expenses are Limited to 15% of CDBG Project Budget] The purpose of this form is to list the positions being claimed against the CDBG funding request amount.FOR PROJECT MANAGEMENT PURPOSES. The positions listed below must be providing direct project/client services. Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO) line item. The Total CDBG Salary& Wages must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Urban Corps of San Diego County PROJECT Green Streets (I) (2) (3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES GreenBuild Manager 3,360 100.0% 3,360 GreenBuild Coordinator 1,113 100.0% 1,113 TOTAL CDBG SALARY&WAGES 4,473 1. List all positions charged against CDBG funding providing direct CDBG project/client activoty. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 2 of 7 APPENDIX C-5: MINOR RESIDENTIAL REHABILITATION(MRR) SCHEDULE 3-PERSONNEL GLOSS PAY: ]FRINGE BENEFITS [Project.MGMT'Expenses are Limited to 15% of CDBG Project Budget] The purpose of this form is to list the fringe benefits being claimed against the CDBG funding funding request FOR PROJECT MANAGEMENT PURPOSES. The Total Fringe must match the Budget Exhibit form:. Round off totals to whole doRlars. AGENCY Urban.Corps of.San Diego County PROJECT Green Streets (1 (2) 3 (4) (5) (6) AMT OF PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT GreenBuild Manager Payroll Taxes 437 100.0% 437 GreenBuild Manager WIC Insurance 672 100.0% 672 GreenBuild Coordinator Payroll Taxes 107 100.0% 107 GreenBuild Coordinator W/C Insurance 167 100.0% 167 TOTAL CDBG FRINGE BENEFIT 1. List all POSITIONS charged against CDBG funding providing direct CDBG pro,ect/cheat activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds. 3. List the amount of insurance for each position charged against CDBG funds. 4.Use gross pay for project/total all wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 3 of 7 APPENDIX C-5o MINOR RESIDENTIAL REHABILITATION ) The purpose of this form is to list the positions being claimed against the CDBG funding request amount FOR CONSTRUCTION.PURPOSES. The positions listed below must be providing direct project/client services. Positions providing non-direct services must be included in the indirect costs/administrative overhead(IC/AO)line item. The Total CDBG Salary& 'Mages must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Urban Corps of San Diego County PROJECT Green Streets (1) (2) 3) (4) PERCENT TOTAL POSITION TITLE GROSS PAY CHARGED SALARY&WAGES 4 Corpsmembers 15,264 100.0% 15,264 Supervisor 8,056 100.0% 8,056 TOTAL CDBG SALARY& WAGES 23,320 1. List all positions charged against CDBG funding providing direct CDBG project/client activity. 2. List gross pay for each position listed. 3. List percent of gross pay to be charged against CDBG funding. Pay Schedule(Check Ones Monthly X Biweekly Twice a Month Page 4 of 7 APPENDIX C-5: MINOR RESIDENTIAL REHABILITATION(MRR) SCHEDULE 5-FRINGE BENEFITS: CONSTRUCTION MANAGEMENT The purpose of this form is to list the fringe benefits being claimed against the CDBG funding request amount FOR CONSTRUCTION PURPOSES. The Total Fringe must match the Budget Exhibit form. Round off totals to whole dollars. AGENCY Urban Corps of San Diego County PROJECT Green Streets (1) (2) (3) (4) (5) (6) AMT OF .PERCENT POSITION TITLE FRINGE TITLE INSURANCE GROSS PAY CHARGED AMOUNT 4 Corpsmembers Payroll Taxes 1,221 100.0% 1,221 4 Corpsmembers WIC Insurance 3,053 100.0% 3,053 Supervisor Payroll Taxes 1,047 100.0% 1,047 Supervisor WIC Insurance 1,611 100.0% 1,611 TOTAL CDBG FRINGE BENEFIT 6,932 1. List all POSITIONS charged against CDBG funding providing direct CDBG project/client activity. 2. List Fringe Benefit title FOR EACH POSITION charged to CDBG funds, 3. List the amount of insurance for each position charged against CDBG funds. 4. Use gross pay for project/total all wages of agency. Then muliply by required percent for each fringe. 5. List percent of gross pay to be multiplied for insurance. Pay Schedule(Check One) Monthly X Biweekly Twice a Month Page 5 of 7 APPENDIX C-5: MINOR RESIDENTIAL,REHABILITATION(MRR) SCHEDULE S FY 2014 BUDGET J fJSTIFICATIONY i AGENCY: Urban Corps of San Diego County PROJECT. Green Streets LINE ITEM Minor Residential Rehabilitation Materials AMOUNT Detailed Explanation: Minor Residential Rehabilitation for 10 homes cr, $3,000 per home consisting 30,000 of low-flow toilets, water heaters, sinks,faucets w/aerators, low-flow showerheads,tile,paint, caulking, security doors, screens, smoke alarms, etc. Cost per home varies based on prescribed work to be completed; estimated cost per home is $3,000 x 10 homes=$30,000 TOTAL $ 30,000 LINE ITEM DIY Kits AMOUNT Detailed Explanation: DIY(Do-It-Yourself)kits will be distributed to 20 LMI homes. 3,000 Kits will include supplies for minor weatherization and home repairs such as caulking, insulation, waterproofing, and water and energy efficiency upgrades. Instructions for use will be included. 20 kits x$150/kit=$3,000 TOTAL $ 3,000 LINE ITEM Fuel Costs AMOUNT Detailed Explanation: Duel Costs: 5 days of rehab per home @ 10 homes = 50 days 3,180 5 days of assessments; 3 days of DIY Kit distribution Total of 58 days Mileage ,$60/day x 58 days - $3,480 TOTAL $ 3,480 *All line items must be justified in relation.to CDBG-funded activities to be completed. Add pages as needed.. Page 6 of 7 APPENDIX C-5e MINOR RESIDENTIAL REHABILITATION (MIR) SCHEDULE 6- FY 2014 BUDGET JUSTIFICATION* AGENCY: Urban Corps of San Diego County PR®JEC I o Green Streets LINE ITEM Dumpster Rental AMOUNT Detailed Explanation: Rental of 5 dumpsters for waste disposal @$350/dumpster $1,750 1,750 TOTAL $ 1,750 LINE ITEM Safety Equipment and Uniforms AMOUNT Detailed Explanation: Purchase of safety equipment(goggles, steel-toed boots, reflective vests, 1,500 earplugs,hard hats, etc.) and uniforms for 4 Corpsmembers and 1 Supervisor @$300/person= $1,500 TOTAL $ 1,500 LINE ITEM Outreach Materials AMOUNT Detailed Explanation: Printing costs and advertising for informing homeowners about services 300 available, income qualification information, applications, etc. @ $300 TO1AL $ 300 *All line items trust be justified in relation to CDBG-funded activities to be completed. Add pages as needed. Page 7 of 7 CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix Do Implementation (Max Length® I Page, Max core: 5 Pints) Provide a listing below of the spectfic'tasks or activities needed to implement the proposed project and a timeline for . . their completion. Number each task a activq`t describe it and give the prajecterl date of completion.Add additional rous.as needed . GO.MP etion. # Task/Activity Desggptton Date Recruitment l Canvass LMI neighborhoods throughout the City of 9/2014 Chula Vista to locate qualifying homeowners. 2 !Assessment/Approval ssess needs of homes,compiling documentation of 11/2014 workto be completed at each home.Meet with homeowners to acquire signatures of approval for scopes of work.Obtain approval of scopes of work from CDBG staff. 3 ! Minor Home Rehab Provide interior and exterior home improvements, {5/2015 basic weatherization,minor rehabilitation,and minor home security enhancements to 10 homes according to approved scopes of work. ?4 Distribution of DIY kits Iffistribute 20 do-it-yourself weatherization and 5/2015 home repair kits to qualifying LMI residents.Acquire signatures of receipt. 5 j I inal documentation and closeout ; Document and review completed work with ;5/2015 homeowner.Acquire signatures of completion. Submit final documentation and reports to CDBG staff. l ii y , ; I i I Appendix"D"_Implementation Page 1 of 1 (Revised 121412013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix Ed Roster of BoardMembers & Professions Provide a roster of the members ofyo.ur agency's Board of Directors ands by nung:out the table..... below. Member of Target Resides in Alae/Baar;:-d Position d'rofass&an/Afrlir�tian Target Poprilado n Area. Ralph Ralph Williams, President Titan Corporation ❑ I❑! ;Christine Moore, lstV.P. IAT&T California ❑'i ❑! Ingrid Nielsen, 2nd V.P. Nielsen Properties 1 ❑ ❑! Tracey Williams,Treasurer ISempra Energy ❑ D (Daniel Morales,Secretary I San Diego Housing Commission ❑ j❑ :Leon Brooks ILeon Brooks&Associates I ❑ ❑' ;Bob Benson National University international ❑ '❑ '[Diane Chalmers (Retired, Non Profit Executive 1E11 Dick Freeman San Diego Padres ❑' E ;Gail Weed ;Torrey Pines Bank f ❑' °❑ Gino Mazzanti, Esq. (Ex-Officio) Attorney-at-Law ❑' ❑E Richard Barrera (Ex-Officio) (San Diego-Imperial Counties Labor Council ❑ ❑ ! I 0 '❑ I❑ [1 'El 0: I❑I Appendix"E"—Roster of Board Members and Professions Page I of I (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 CDBG FUNDING APPLICATION Appendix F.- Disclosure Statement Pursuant to City Council Policy 101-01, prior to any action on a matter that requires discretionary action by the City Council, Planning Commission or other official legislative body of the City, a statement of disclosure of certain ownerships, financial interests, payments,and campaign contributions must be filed.The following information must be disclosed: 1. List the names of all persons having a financial interest in the project that is the subject of the application, project or contract (e.g., owner,applicant,contractor,subcontractor, material supplier). ;Urban Corps of San Diego County 2. if any person* identified in section 1 above is a corporation or partnership,list the names of all individuals with an investment of$2000 or more in the business(corporation/partnership)entity. N/A 3. If any person* identified in section 1 above is a non-profit organization or trust, list the names of any person who is the director of the non-profit organization or the names of the trustee,beneficiary and trustor of the trust. ;Robert Chavez. 4. Please identify every person, including any agents, employees, consultants, or independent contractors, whom you have authorized to represent you before the City in this matter. Robert Chavez,Anne Bernstein,Yolanda Maeder 5. Has any person` identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, had any financial dealings with an official**of the City of Chula Vista as it relates to this contract, project or application within the past 12 months?Yes❑ No® if yes, briefly describe the nature of the financial interest the official may have in this contract. IN/A 6. Has any person* anyone identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, made a campaign contribution of more than $250 within the past twelve(12) months to a current member of the Chula Vista City Council?Nolo Yes,❑ If yes,which Council member(s)? F97 7. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, provided more than $420 (or an item of equivalent value) to an official** of the City of Chula Vista in the past twelve (12) months? (This includes any payment that confers a personal benefit on the recipient, a rebate or discount in the price of anything of value, money to retire a legal debt,gift, loan, etc.)Yes,❑!No® If Yes, list official and what was the nature of item provided? [N/A. 8. Has any person* identified in 1, 2, 3, or 4, above, or otherwise associated with this contract, project or application, been a source of income of$500 or more to an official**of the City of Chula Vista in the past twelve(12)months?Yes❑ No® if Yes, identify the official and the nature of the income provided? N/A. :January 28, 2014 jjfE :Anne Bernstein, C06 Signature:--- Person i nature�Person is defined as:any individual,firm,co-partnership,joint venture,association,social club,fraternal organization,corporation, estate,trust, receiver,syndicate,any other county,city, municipality,district,or other political subdivision,or any other group or combination acting as a unit. ** Official includes,but is not limited to: Mayor,Council member, Planning Commissioner, Member of a board,commission,or committee ## of the City,and City employees or staff members. I Appendix"F"—Disclosure Statement Page I of 1 (Revised 1214/2013) CITY OF CHULA VISTA FY 2014-2015 FUNDING APPLICATION Appendix o Wentificati®n of Pri®r Year CDBG and/®r Federal Funds G:1 = Agency name: 'Urban Corps of San Diego County (i.2.: Project name.'. .Weatherization, Energy Efficiency, and Rehab (WEER) Program G.I. Year.of funding: ® Fiscal Year 2011 ❑ Fiscal Year 2012 ❑ Fiscal Year 2013 G.4. lndicate thesource`of the federal funding awarded to:the prior project: ® CDBG ❑I HO ❑ ESG �❑ HOME CDBG-R HPRP RESP Ej other o dicatebelow): G.5.:. Amount awarded: ;$185,651 G.6. Amount spent fo date: $185,651 6.7. Amount reprograrnned to $0 G.8.: lndicgte below the'outcomes anfigp.ate f(refer:to fhe::orlginal application for the project;:ifpossible). Send out Corpsmember Recruitment Teams to target districts and census tracts to disseminate program information and recruit residence owners. Meet with residence owners to go over agreement for services and (1); acquire signature. (Complete assessments on all participant residences and have written documentation of the scope of work to be completed at each specific site. Meet with residence owner to go over assessment and scope of work to be (2);; completed and acquire approval signature. !Complete scope of work. Document work completed and review completed work with home/property owner, (3)! going over final checklist and acquiring signature of completion. G.9.' indicate.below the outcomes achieved: Sent out Corpsmember Recruitment Teams to target districts and census tracts to disseminate program information and recruit residence owners. Met with residence owners to go over agreement for services and (1J' acquire signature. 'Completed assessments on all participant residences and have written documentation of the scope of work to be completed at each specific site. Met with residence owner to go over assessment and scope of work to be { ) completed and acquire approval signature. 'Completed scope of work. Documented work completed and reviewed completed work with home/property (3) owner,going over final checklist and acquiring signature of completion. G.10< if any anticipated outcomes were NOT achieved,specify which ones and explain rtihy below: N/A # GA.: Agency narneIUrban Corps of San Diego County G 2. ' Project name Green Streets G.3. Year offiinding: I ;❑ I Fiscal Year 2011 ® Fiscal Year 2012 1 'E]'j Fiscal Year 2013 G.4. Indicate the source of the federal funding awarded to the prior project:, ® CDBG ❑ HOPWA ❑` ESG I ❑ HOME ❑ CDBG-R ❑ tfPRP E] NSP ❑ Other(fndicatebelaw): —Ci inninmont to Annnnrsiv F CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION i G5. AmountaiNarded:`;; $115,037 G.6. Amourifspenttadate ,$110,455 G.T. ,Amount eeprograriimed to date:: $4582 i G.$ . Indicate below the'.`outcomes anticipated(refer to the'orlgrrra/application for the prajeet; if possible) Recruit property owners in target districts and census tracts; Meet with home/property owners to go over (I) agreement for services and acquire signature. ';Complete assessments on all participant sites and have written documentation of work to be completed at a specific site. Meet with home/property owner to go over assessment and scope of work to be completed and .(2).... acquire approval signature. ;Complete scope of work. Document work completed and review completed work with property owner, going over {3) final checklist and acquiring signature of completion. G.9:':' :lndicate below the`'outcomes achieved:':' ;Recruited property owners in target districts census tracts. Met with home/property owners to go over agreement (j)! for services and acquire signature. ' (Distributed 40 Do-It-Yourself Weatherization Kits to owner-occupied l.MI residences within target Districts and (2). eligible census tracts ,Completed scope of work. Documented and reviewed completed work with property owner, going over final {3� checklist and acquiring signature of completion. , G.10:. If any anticipated outcomes were IUOT achieved,specify which ones and explain irvhy below IN/A _f C ,Ca nnlAnP%nnf4iv P CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION (Max Length per Project.- I Page) I .G.I. Agency name: ;Urban Corps of San Diego County G.2; Project name' ;Weatherization, Energy Efficiency,and Rehab (WEI=R) Program G.3 s Year of funa'rng ❑j Fiscal Year 2031 ® Fiscal Year 2012 € Fiscal Year 2013 G.4. lndieate the:source of the federal funding awarded to'.the prior project: ® CDBG k NOPWA ❑ ESG HOME_ ❑ CDBG-R ❑' HPRP ❑ NSP ❑: Other(Indicate Mo.): E E G 5. Amount aWarded:. ;$114,953 G 6. Amount spent to date: i$109,268 G.7. Amount reprogrammed to date:' !$5,685 G.8. Indicate below the outcomes anticipated(refer to the original application for the project rf possible (1} Complete minor repairs and Weatherization on 60 residences. j Distribute 40 Do-it-Yourself Weatherization Kits to owner-occupied LMI residences within target districts and (2) eligible census tracts. G.9..> Indicate below the'outcom&5 achieved::` (1} ,Completed minor repairs and weatherization on 60 residences. ,Distributed 40 Do-it-Yourself Weatherization Kits to owner-occupied LMI residences within target districts and (2) eligible census tracts. IF G.10 !f any anticipated outcomes were NOT achieved,specify which ones and explain viihy below I N/A I Paaa of s„—Ci onnlc%mPn4 to Annondiv F CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION Length per Project: 1 Page) I.G.I. Agency name: .!Urban Corps of San Diego County 1 G.2 Project name ;Campus Safety and Security Enhancement G.3 Year;of funding ❑ Fiscal Year 2011 ❑ Fisca!Year 2012 ® Fiscal Year 2013 G.4lndieate the source of the federal funding awarded to the prior project: ffCD"G ❑ HOPVIIA ❑ ESG ❑' HOME CDBG-R ❑ HPRP ❑ IVSP ❑'� Other(Indicate below): G.5 Amo`unt awarded ,$352,901 3.6. Amauntspenttadate. $352,901 G.7. Amount reprogrammed to date `$0 G.8. Indicate below the;outco nes anticipated(refer to the;original application for the project, if;nossibleJ: (1) Create a safe and secure enclosed campus and obstruction-free parking lot to enhance safety. (2J'. . G.9.` .Indicate below the outcomes achieved::;' 'Created a safe and secure campus by installing fencing, security cameras, and exterior lighting;completed parking (1J; lot improvements. (2) (3)ti' G.lq, ff any anticipated outcomes were NOT achieved,specify which ones:and explain why below: ;NSA Pave!JI of r,—CoinnlamPnt to AnnPndiv F CITY OF CHULA VISTA FY 2013-2014 CDBG FUNDING APPLICATION Length per Project: I Page) G1 . Ageriey name: G 2 Project name G.3: Year of funding: I ❑ I Fiscal Year 2011 1,❑ Fiscal Year 2012 ❑ Fiscal Year 2013 G.4 ' Indicate the source..of the:federal.funding awarded to.'"the prior project: ❑ CDBG ❑I HOPWA ❑ ESG 10. HOME ❑I CDBG-R HPRP ❑ NSP ❑ Other(Indicate below): II urrt awarded: j 'G.6. Airrount spent'i6 date: l G.7. Amount reprograirmed to date: G.B. Indicate below theoutcomes anticipated{refer to the original application jor t..e'project if possible): (2) IE {3) F G9. . lndicate below the;outcorries achFeved: {2) GA !f any anticipated o:.utcomes were NOT achieved,specify which ones.:and explain vt by beCgw '[Type response herG.] j Paan r,nf K;—SiinnlPmPnf to AnnQndix F Application No. 17 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant-." South Bay Community Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Landis Studios Project Description: The-projectcohsists ,of therehabilitatfon and creation of 1 affordable, housing, unitsin the, existing, structure, located at 192-196 Landis, Avenue. , The units will be used for housing, opportunities,forr`the, 'homeless. Type of Program/Project: Capital Improvement (§570.202) Conditions of Funding • Secure other funding sources to,fund the'project ' • Complkearchitectural plans, Obtain necessary,building permits Finalize Or of'or m 0 Funding Recommendation Conditionally approving financial assistance in the form of a residual receipts loan in an amount not to exceed $450,000. Target Population.4, 14B MUlti-Uhit Proposed Wilts Residential Rehabilitation, CFR§ 570.208(6)(3) Low Moderate Income, Housing Estimated Development $1,271,905 Budget Application No. 18 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" City of Chula'Vista Housing Division, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Production of Affordable Housing Projects/Programs Project Descirilltioin: Funds will be used for affordabl,6 ho'using dev' elo' pm' eht, housing, site improvements and other activities',,to stiriiulafe,housing, for lower, income,persons in"the'City. The accomplishments will fulfull the City's Five-year,Affordable Housing Boas., Once a firm affordable housing project is identified, staff,will return to City,Council for review and �ap,proval of the specific project, Type of Program/Project: Low/Mod Housing [570.208(a)(3)] Target Populatloh:' Unknown at this time. Proposed Number; N/A to Serve: &R§,570'.208(zi)(3)'Lo' w Moderate Income, Housing, Program Total Budget: $139,093 C. V. Cost per Client: N/A Funding Request: $139,093 Prior Year,Fundin,g: N/A Specific Use of Chula Vista Unknown at this time. FUNDING $139,093 Funding: RECOMENDED Staff Notes:: Application No. 19 CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" City of Chula'Vista Housing Division, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: CDBG Grant Administration/Planning Project Description: Adr6inistrat,ion funds will be'utilized f6r'the staffcosts,assodiate'd with the management and,administration of, Chula Vista's CDBG pr6graft this, includes, preparation of the: required planning documents, regulatory'compliance; contract oversight of the partn erihg ag6nctes, ,environmental reviews and fiscal management., Type of Program/Project: General Program Administration (570.206) Target Popullatloh:' 21A-General Program Proposed Number; N/A Administration to Serve:, N/A Program Total Budget: $349,338 C. V. Cost per Client: N/A Funding Request: $349,338 Prior Year,Funding: $273,997 Specific Use of Chula Vista Personnel Costs and FUNDING $349,338 Funding: Program Administration RECOMENDED Expenses Staff Notes:: Application No. 20 CITY OF CHULAVISTA HOUSING DIVISION ESG Application Summary Applicant:" City of Chula'Vista Housing Divi'sion, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Homeless Prevention and Rapid ReHousing Project Description: HP'RP is'a rental' assistance,program designed to help prevent and end , homelesshess-by paying a,portion a participants,rent;up to''a,maximum of $1,000 per month a'nd up to'a maximum of $1,000 for the security, deposit. the tenant's,pottion of the rent is'-flexible based on their current, income. QUOlifying,apartmen'ts must'b in the City of Chula Vista,and,under Fair Market, Rent. Apartment size is determined by family size'. Type of Program/Project: Public Services [(§570.201(e)] Target PopullatloM' 055 Renta l'H busing Proposed Number 5. Subsidies and/or' to Serve:, (subject to change 05T,Se' c'urity Deposits, depending,on funding recommendation) C]FR§ 510.208fa)(3) LbW Mod erate Income, Housing, Program Total Budget: $42,533 C. V. Cost per Client: $8,506 (Based on funding recommendation) Funding Request: Prior Year,Fundin,g: $42,533 Specific Use of Chula Vista Direct Financial FUNDING $42,533 Funding: Assistance RECOMENDED Staff Notes-. , Application No. 21 CITY OF CHULAVISTA HOUSING DIVISION ESG Application Summary Applicant:" City of Chula'Vista Housing Division, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: ESG Grant Administration/Planning Project Descirip'tiori: AdIrriinistrat,ion,funds will be'utilized for the staff costs associated with the management and administration' of thula Vista's, tS(5 program,., This, includes, preparation of the: required planning dotuments, tegulatory'compliance; contract oversight of the partn6ring,,agendes I, ,environmental reviews and fiscal management. Type of Program/Project: General Program Administration (570.206) Target Popullatloh:' 21A-General Program Proposed Number; N/A Administration to Serve:, N/A Program Total Budget: $8,985 C. V. Cost per Client: N/A Funding Request: $81'985 Prior Year,Funding: $8,985, Specific Use of Chula Vista Personnel Costs and FUNDING $8,985 Funding: Program Administration RECOMENDED Expenses Staff Notes:: Application No. 22 CITY OF CHULAVISTA HOUSING DIVISION ESG Application Summary Applicant:" South Bay Community Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: ESG - Casa Nueva Vida Project Description: Sks' Casa Nueva, Vida I' offers the;bnly, permanent short-term shelter/housirig program for'homeless farhilies�(which children) in the South Bay region, includingvictimsof domestic violence. Staff utike a, comprehensive strengths-based assessment, afterw' hich together With clients, they develop an individua' ,lized treatment,ptan, to include'any' number of services include case management,,counseling, 'employment, assistance,',chilcltare, etc'., This helps each client work to re-establisha self-sufficient lifestyle free from ho'rqel'es�sness,., With he current, economy there, has been, an,increase in housing needs and over,the: past, year, S8CS' Was, forced to refuse, 1,631,,indiv''iduals in need of' shelter because, 'Casa Nueva Vida'da 1, was full. Withoutsupportive, housing programs like this, more individuals Would be forced to live on the streets. Type of Program/Project: Public Services [(§570.201(e)] Target Population. Of-Operating Casts Proposed Number 140 Homelessubiect to chon'ge' td'Serve., depending on fuhdihg, CFR§ 570:208(x)(2) Low recommendation) Moderate Income Orbited Clientele Program Total Budget: $443,277 C. V. Cost per Client: $487 (Based on funding recommendation) FundingRequest: $68,277 Prior Year Funding: $68,217' Specific Use of Chula Vista Personnel Costs FUNDING $68,277 Funding: ($33,807), Consultant RECOMENDED ($4,500), Program Expenses ($29,970) Staff,Notes.— KI A will 'K DUE DATE: January 30, 2014 RAc E® BY CITY ®N: BY (CITY STAFF NAME): EMERGENCY SOLUTIONS ' carr O-- F GRANT APPLICATION CH UTA VISFA INTRODUCTION: This application will help City staff and officials make a decision regarding the funding of your project through the Emergency Solutions Grant (ESG) program. It will be used for the preliminary review of your funding request only. Completion and submission of this application does not obligate the City of Chula Vista to allocate ESG funds to your activity. FINAL ALLOCATION OF ESG FUNDS IS BY CITY COUNCIL ACTION ONLY. Please be advised that ESG Contracts allow for a one-year contract term and are subject to City Council approval. NOTE: Please keep your answers brief and contained within the space provided. In the event that additional information is needed, you will be contacted by ESG program staff. Unsolicited information will not be forwarded to the City Council. Seco©n 1. General pp PC n,1nf0rrnatiora . Project Name: Casa Nueva Vida I Applicant Name South Bay Community Services Applicant Contact: Kathryn Lembo, President and CEO Applicant Address: 430 F Street, Chula Vista,CA 91910 Phone Number: (619)420-3620 Fax Number: (619)420-8722 E-Mail Address: 141echc'r,c 51�s.o1' Federal Tax ID: 95-2693142 Business License No.: 068557 DUNS#: 113407779 Business licenses are available at no cost to non-profit agencies The location of the facility where this program is operated requires a Conditional Use Permit (CUP) ❑ if the facility is located in an area that requires a Conditional Use Permit(CUP),please attach a copy. Application will not be considered complete without including a copy. ESG Funds Requested: $68,277 For assistance with this application, please call (619)476-5375 2013-2014 ESG Application-- Page 1 Due January 31, 2013 1 Type of Organization Other Organization Characteristics (please check one) (check all that apply) 501(c)(3) registered non-profit ® Faith-Based Organization ❑ Date of certificate: September 1972 Requested for HUD statistical purposes only. Response does not affect funding decision. Not currently registered as non-profit ❑ Institution of higher education ❑ Government Entity ❑ Have you previously received ESG funding Non-profit status applied for E] from the City of Chula Vista? For-Profit Organization ❑ Is the primary purpose of your proposed program any of the following? (Please check all that apply). Help prevent Homelessness ® Help those with HIV/AIDS ❑ Help the homeless Primarily help persons with disabilities ❑ For assistance with this application,please call (619)476-5375 2013-2014 ESG Application- Page 2 Due January 31,2013 2 Section . ;Proposed Protect Summary a s - e e e e v e • - s e s • a a a o a - a s^ a • o- -a .aa s v a a a ,eo 0 0 0 SBCS' Casa Nueva Vida I offers the only permanent short-term shelter/housing program for homeless families (with children) in the South Bay region, including victims of domestic violence. Staff utilize a comprehensive strengths-based assessment, after which together with clients they develop an individualized treatment plan, to include any number of services including case management, counseling, employment assistance, childcare, etc. so each client can work to reestablish a self-sufficient lifestyle free from homelessness. With the current economy we have seen an increase in housing needs and over the past year, SBCS was forced to refuse 1,631 individuals in need of shelter because Casa Nueva Vida I was full. Without supportive housing programs like Casa Nueva Vida, more individuals would be forced to live on the streets. - a a a- a v - e • a- -e o o a o- e e a-a o -o -a e Casa Nueva Vida emergency shelter program includes the following services and activities: Emergency housing for homeless families; 0 Strengths-based assessments and treatment plan development; 0 On-going case management and support for homeless families; 0 Access to emergency food, clothing, and transportation support; a Individual and group counseling; 0 Substance abuse prevention and intervention services; a Employment assistance and financial literacy classes and services; 0 Connection to advocacy and community resources; 0 Childcare while participating in services; and 0 Specialized preschool and school readiness services for children 0-5 in SBCS' Mi Escuelita Preschool. a - s - e e s e o n s a s e • s - - e a o 0 Casa Nueva Vida I responds to the needs of homeless families in the community. These needs are increasing due to the current economic climate and lack of affordable housing in the area: in FY 12-13 1,631 individuals were turned away from the shelter because we were full. Without programs like Casa Nueva Vida I these families would be forced to live on the streets. SBCS has successfully operated the Casa Nueva Vida I Shelter Program since 1993. The most frequent reasons cited by those seeking shelter include domestic violence, lack of affordable housing, exacerbation of other problems due to substance abuse, job loss, loss of home and lack of income and job skills. We address these issues with the families in our program, and in FY 12-13 had 80% of our clients graduate to safe, stable housing (compared to the 30%National Average). a- o- av a e e• -a e o The Casa Nueva Vida I Shelter Program focuses on homeless families in the South Bay with the majority within the City of Chula Vista. For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 3 Due January 31, 2013 3 Sectran 3 Organization Euperience and In ormat on SBCS has received CDBG funding from the City since 1999, and currently manages over 60 different Federal, State and local contracts, all of which are operating successfully without any findings or default. SBCS has an excellent track record of developing, implementing, and sustaining programming in response to community needs, and with continued ESG funding Casa Nueva Vida I will continue to touch the lives of the homeless within Chula Vista. • ' s - o o a - • • � o e - a - o e a ` s o • •- -e s a • _ SBCS has received CDBG funding from the City of Chula Vista since 1999, and leverages funding from a variety of sources, and utilizes volunteers for program support. The ESG funding is only 14% of the total cost of operating the shelter—other funds come from the federal government, State and private donations. o e o e o a • - e e • - • e e o - o o v SBCS works closely with the Chula Vista Police Department, the District Attorney's Office, Child Welfare Services, the region's hospitals and clinics, family Resource Centers operated by the Community Collaboratives, school districts, Legal Aid of San Diego and other local organizations like the Regional Taskforce on the Homeless and the Homeless Advocacy Coalition in order to respond to the needs of homeless families. a e e- • e- s o • a• a s ••e -• a o- STQFF MEMBER'S NAIr/IE POSITION TITLE EXPERIENCE Kathryn Lembo President and CEO BA in Psychology/Sociology, CEO of SBCS for 32 years Pam Wright Clinical Director MSW,20+years experience with SBCS Don Hunter FWSS Department Director BS in Business Admin, Co-creator of DV Response Team Dina Chavez Associate Director BS in CJA,20+years experience with SBCS Amaris Sanchez Program Director BA in Women's Studies, 10+years experience wl SBCS o . o e ® e •777 M;EMBEOCCUPATION YEARS ON BOARDAnthony Perez nion Bank 3 David D.Rowlands,Jr. Retired 5 Ceanne Guerra Cox Communications 5 Fran Muncey The Galley at the Marina 8 Charles Moore Retired 20 John Nelson CVESD 6 Nancy Kerwin LVESD 5 Sue Belmonte San Diego Daily Transcript 16 Diane Rose ResCare Workforce Services 1 For assistance with this application,please call (619)476-5375 2013-2014 ESG Application- Page 4 Due January 31, 2013 4 Section 4. Project Activity • • s • Street Outreach ❑ Emergency Shelter HMIS ❑ Rapid Re-Housing ❑ Homeless Prevention 1 ® ' - o • - e s • • s • o a n a s o • o e 1OBJECTIVE (check one) OUTCOME (check one)Create a suit. able living environment ® 1. Availability/Accessibility ❑ 2. Provide decent affordable housing ❑ 2. Affordability ❑ 3. Create economic opportunity ❑ 3. Sustainability Objectives: Outcomes: 1. Creating suitable living environments relates to activities 1. Availability/Accessibility applies to activities that make that are designed to benefit communities,families,or services, infrastructure,public services,public facilities, individuals by addressing issues in their living environment housing,or shelter available or accessible to low-and (i.e.,crime prevention,literacy, child care,elderly services). moderate-income people, including persons with 2. Providing decent housing focuses on housing activities disabilities. whose purpose is to meet individual family or community 2. Affordability applies to activities that provide affordability housing needs. in a variety of ways to low-and moderate-income people. 3. Creating economic opportunities applies to activities Affordability is an appropriate objective whenever an activity is Powering the cost, improving the quality,or related to economic development commercial revitalization, or job creation. increasing the affordability of a product or service to benefit a low-income household. 3. Sustainability applies to activities that are aimed at improving communities or neighborhoods, helping to make them viable by providing benefit to persons of low and moderate-income or by removing or eliminating slums or blighted areas. For assistance with this application, please call (619)476-5375 2013-2014 ESG Application- Page 5 Due January 31, 2013 5 s e ' o • s o • e e e ' a • • o J; • 2012 2013 2011]201 20112012 20 ,3=2014 2013 2014 2012/2013 %Low incorne Type of clients #of clients %Low Income. #of clients' %Lnw Income served to Date (servedao (Actual} (Actual} (Estimate} ( strmate date}'; Chula Vista 106 100% 47 100% 60 80% Non-residents 125 100% 130 98% 80 80% Total 231 100%. 187 99% 140 80% D - a - e o s s e e • s a s - e e a • a - a - a The overall program goal is to provide emergency housing with supportive services to low-income, homeless families so that each client can work toward self-sufficiency and transition to safe and stable housing. The program will be evaluated based on the successful completion of the following objectives: e Provide emergency shelter for 140 persons/families while they work toward self-sufficiency; (CDBG funds pay for 14% of shelter services to persons/families, or 14% of the total 87 beds (12 beds)); a Provide babysitting for homeless clients participating in groups, employment development and other program activities; a Provide homeless families with food, clothing, and other items necessary for programa success; and a Provide 100% of clients with access to case management and mental health/counseling services. For assistance with this application, please call(619)476-5375 2013-2014 E5G Application- Page 6 Due January 31, 2013 6 ?SeCVO 5.; Program Financia[ to orrna.ion.; A Most:Recent Fiscal B F 1��n1� Curren Fiscal Year7777 Year %Change Total . 2012/ 013 PRIVATE SUPPORT Contributions $0.00 $0.00 $0.00 Grants $17,000 $30,000 $30,000 0% 6% Fundraising $71,225 $58,700 $109,000 85% 25% Other $0.00 $0.00 $0.00 Subtotal $ 88,225 $ 88,700 $ 139,000 57% 31% GOVERNMENT Federal $120,496 $121,400 $104,277 -14% 24% State $200,000 $200,000 $200,000 0% 45% Local $0.00 $0.00 $0.00 Subtotal $ 320,496 $ 321,400 $ 304,277 -5% 69% OTHER REVENUE Membership Dues $0.00 $0.00 $0.00 Program Fees $0.00 $0.00 $0.00 Other $0.00 $0.00 $0.00 Subtotal $ 0.00 $ 0.00 $ 0.00 TOTAL REVENUE $'. 408,721 $410,100 $443,277 8% 100% Column A is the Audited,or most recently completed 12-month period. Column D represents the percent change from Column B to Column C((C-B)/B). Explain changes greater than 15%under comments. Column E represents the percent of total budgeted for Column C. A MastRecentF'scal C` © . EX �11S�S Curren#Fiscai.Year Proposed.Budget o Year .- to Change %Tota 2012/2013 20I3f 2014 Fuiy 1,2014 , June 30,'2015 Personnel (salaries, $224,013 $238,574 $294,003 23% 66% benefits,taxes, etc.) Capital (equipment, supplies, services, $58,450 $51,509 $48,976 -5% 11% utilities etc. Other(insurance, audits, $126,258 $120,017 $100,298 -16% 23% etc.) TOTAL EXPENSES $ 408,721 $410,100: $443,277 : . . . 8% 100% Surplus (or Deficit) of Total Support& Revenue $ 0.00 $ 0.00 $ 0.00 Other Expenses $0.00 $0.00 $0.00 Column A is the Audited,or most recently completed 12-month period. Column D represents the percent change from Column B to Column C((C-B)/B). Explain changes greater than 15%under comments. Column E represents the percent of total budgeted for Column C. For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 7 Due January 31, 2013 7 0 • • I I - e a B B e • • '� a f - -B B B • B 0 f' Fundraising efforts were increased to cover government funding reductions and increased staff costs due to cost of living increases and staff raises/merit increases. • 0 " • I ! 8 I 1 / f ! ! I I '1 '1 1 / 1 1 I 9 1 1 1' 8 / '1 ' D; Funding Source ,4�rioulnt Fundraising $109,000 Grants from Foundations $30,000 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 T®TAI. $139000 For assistance with this application, please call (619)476-5375 2013-2014 ESG Application- Page 8 Due January 31, 2013 8 Section �.1 Protect Spec rc Financial-In Qrma ion request vr. undtng . • . • . o . . . e e . - . • • . . . . a + • s• o- -• -• o •-• o e o a Budget line item Proposed Chula Vista Other Sources Total Costs ESG Share Salaries $24,101 $200,150 $224,251 Fringe benefits (FICA,SUI, etc.) $9,706 $60,046 $69,752 Space Rental $0.00 $0.00 $ 0.00 Utilities $10,773 $7,853 $18,626 Insurance (general liability,directors and $3,596 $3,850 $7,446 officers,worker's comp.,automotive, etc.) Consultant Services: Sub-contract (RTFH) $4,500 $0.00 $4,500 Travel $0.00 $1,800 $1.,800 Supplies $0.00 $7,700 $7,700 Equipment $0.00 $0.00 $ 0.00 Client Services (describe under comments) $6,000 $10,350 $16,350 Other Expenses (describe under comments) $9,601 $83,251 $92,852 Total Expenses $68,277 $375,000 $443,277 o r e o o e • aOEM Client Services include bus vouchers/tokens, motel vouchers, translator services, emergency food vouchers Other expenses include telephone, repairs and maintenance, food, administrative cost. e • . ' • • a e ' e a • o • s • - s e e - • 0 0 e o e a e• s-• o - •. a o- .e Funding Source Award Date Qate A ilab Amount Cal EMA TBD TBD $200,000 FEMA 711114 $36,000 Fundraising _ 711114 $109,000 Grants from Foundations 7/1114 $30,000 $0.00 $0.00 $0.00 $0.00 $0.00 Total Cipher Sources $ 375,000 For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 9 Due January 31, 2013 9 o o a .o a- e s e e• -o -s o s• o • SEES= WE -s .a Activit Services essential Operations Operations Homeless; YI Services (excIutling.Staff) (Staff Gusts} Preuentiort . Resident Manager $0.00 $0.00 $6,636 $6,636 Maintenance $0.00 $27,171 $0.00 $27,171 Insurance $0.00 $3,596 $0.00 $3,596 Utilities $0.00 $10,773 $0.00 $10,773 Telephone $0.00 $2,101 $0.00 $2,101 Repairs and Maintenance Supplies $0.00 $7,500 $0.00 $7,500 Food $0.00 $6,000 $0.00 $6,000 Sub-contract: RTFH $0.00 $4,500 $0.00 $4,500 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL REQUEST $ 0.00 $61,641 $6,636 $65,277 =Sktl;on 7. Insurance Requ%rem nts s s a •a e-s } e e e- } s s s � s • a •• a e • s . o e -s .•a s -• •a • •a a• -4 i e -} s -} 0 .} • IN 1,1l,111, .- . o�� eea •- . . i "Na'; x iv Insurance Cornparty .e. ct yye dates s ofDeduciesper of Policy Liability'. ©ccurrence General Liability Insurance Zenith Insurance Company 07/08/2013 $3,000,000 $1,000 Automobile Liability Zenith Insurance Company 07/08/2013 $1,000,000 $500 Worker's Compensation' Zenith Insurance Company 01/01/2014 $1,000,000 $0 For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 10 Due January 31, 2013 10 Sectron 8 Cer#rficatarxs The undersigned certifies that: (a) The information contained in this document is complete and accurate; (b) The proposed program described in this application meets one of the Eligible Activities governing the use of Emergency Solution Grant (ESG) funds; (c) The applicant shall comply with all Federal and City policies and requirements affecting the ESG program; (d) If the project is a facility, the sponsor shall maintain and operate the facility for its approved use throughout its economic life. (e) Sufficient funds are available from non-ESG sources to complete the project as described, if ESG funds are allocated to the applicant; and (f) The applicant has review the Subrecipient Contract and is able to comply with the Contract if funds are awarded, including he insurance requirements. ZZ Signo6re o Autho��d Applicant Representative Date Kathryn Lembo, President and CEO Print Name and Title of Authorized Applicant Representative Section 9. Application Submittal PLEASE SUBMIT THIS APPLICATION AND ALL REQUIRED DOCUMENTS(SEE ATTACHED CHECKLIST)TO: City of Chula Vista, Redevelopment and Housing, 276 Fourth Avenue Building 300, Chula Vista, CA 91910, Attn: Jose Dorado, Project Coordinator You will be contacted, by the Project Coordinator regarding the receipt and status of your grant application. if you have any questions regarding your grant application, or the ESG program in general, please contact Jose Dorado, Project Coordinator at(619) 476-5375. Applications must be received by JANUARY 30, 2014,4:00 PM NO LATE OR FAXED APPLICATIONS WILL BE ACCEPTED Thank you for your interest Please submit applications to the following address no later than January 30, 2014 at 4:00 PM - City of Chula Vista, Redevelopment and Housing 276 Fourth Avenue Building 300 Chula Vista, CA 91910 Attn: Jose Dorado, Project Coordinator If you have any questions regarding the required documents to be submitted or need assistance with this application, please contact Jose Dorado, Project Coordinator, at (619) 476-5375 For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 11 Due January 31, 2013 11 N/ 31 RECEIVED BY CITY N: DUE DATE: January 30, 2014 0Y (CITY STAFF DAME): EMERGENCY SOLUTIONS GRANT (ESG) PROGRAM GRANT APPLICATION CHUTA VISTA INTRODUCTION: This application will help City staff and officials make a decision regarding the funding of your project through the Emergency Solutions Grant (ESG) program. It will be used for the preliminary review of your funding request only. Completion and submission of this application does not obligate the City of Chula Vista to allocate ESG funds to your activity. FINAL ALLOCATION OF ESG FUNDS IS BY CITY COUNCIL ACTION ONLY. Please be advised that ESG Contracts allow far a one-year contract term and are subject to City Council approval. NOTE: Please keep your answers brief and contained within the space provided. In the event that additional information is needed, you will be contacted by ESG program staff. Unsolicited information will not he forwarded to the City Council. Se�taon 1„ (�enral Apllcatl®n Inf®rrr>iatl�ll Project Name: Casa Nueva Vida I Applicant Name South Bay Community Services Applicant Contact: Kathryn Lembo,President and CEO Applicant Address; 430 P Street, Chula Vista,CA 91910 Phone Number: (619)420-3620 Fax Number: {619}420-8722 E-Mail Address: klembo cr,csbcs.org Federal Tax ID: 95-2693142 Business License No.: 068557 DUNS#: 113407779 Business licenses are available at no cost to non-profit agencies The location of the facility where this program is operated requires a Conditional Use Permit (CUP) ❑ if the facility is located in an area that requires a Conditional Use Permit(CUP),please attach a copy. Application-will not be considered complete without including a copy. ESG Funds Requested: $68,277 For assistance with this application, please call (619)476-5375 2013-2014 ESG Application- Page 1 Due January 31, 2013 Type of Organization Other Organization Characteristics (please check one) (check all that apply) 501(c)(3) registered non-profit ® Faith-Based Organization ❑ Date of certificate: September 1972 Requested for HUD statistical purposes only. Response does not affect fundinq decision. Not currently registered as non-profit ❑ Institution of higher education ❑ Government Entity ❑ Have you previously received ESG funding Non-profit status applied for ❑ from the City of Chula Vista? For-Profit Organization ❑ Is the primary purpose of your proposed program any of the following? (Please check all that apply). Help prevent Homelessness ® Help those with HIV/AIDS ❑ Help the homeless Primarily help persons with disabilities ❑ For assistance with this application, please call(619)476-5375 2.013-2014 ESG Application- Page 2 Due January 31, 2013 S� t>lon 2 prop®fed PrQect Statuary s s - � s e a s a s - a • a ' • s • s s • s SBCS' Casa Nueva Vida I offers the only permanent short-term shelter/housing program for homeless families (with children) in the South Bay region, including victims of domestic violence. Staff utilize a comprehensive strengths-based assessment, after which together with clients they develop an individualized treatment plan, to include any number of services including case management, counseling, employment assistance, childcare, etc. so each client can work to re-establish a self sufficient lifestyle free from homelessness. With the current economy we have seen an increase-in housing needs and over the past year, SBCS was forced to refuse 1,631 individuals in need of shelter because Casa Nueva Vida I was full. Without supportive housing programs like Casa Nueva Vida, more individuals would be forced to live on the streets. a • - .e• s -• • • m^ s•e m Casa Nueva Vida emergency shelter program includes the following services and activities: ® Emergency housing for homeless families; a Strengths-based assessments and treatment plan development; a On-going case management and support for homeless families; ® Access to emergency food, clothing, and transportation support; ® Individual and group counseling; ® Substance abuse prevention and intervention services; a Employment assistance and financial literacy classes and services; a Connection to advocacy and community resources; Childcare while participating in services; and ® Specialized reschool and school readiness services for children 0-5 in SBCS' Mi Escuelita Preschool. • - s - e • s • • • • - • • ® • a - - • e • a MM Casa Nueva Vida I responds to the needs of homeless families in the community. These needs are increasing due to the current economic climate and lack of affordable housing in the area: in FY 12-13 1,631 individuals were turned away from the shelter because we were full. Without programs like Casa Nueva Vida I these families would be forced to live on the streets. SBCS has successfully operated the Casa Nueva Vida I Shelter Program since 1993. The most frequent reasons cited by those seeking shelter include domestic violence, lack of affordable housing, exacerbation of other problems due to substance abuse, job loss, loss of home and lack of income and job skills. We address these issues with the families in our program, and in FY 12-13 had 80% of our clients graduate to safe, stable housing (compared to the 30%National Average). e - a sea - a • The Casa Nueva Vida I Shelter Program focuses on homeless families in the South Bay with the majority within the City of Chula Vista. For assistance with this application, please call (619)476-5375 2013-2014 ESG Application- Page 3 DueJanuary3l, 2013 3 Se� �on 3. rganizat�on Exeri�ne and Inforrntli®n SBCS has received CDBG funding from the City since 1999, and currently manages over 60 different Federal, State and local contracts, all of which are operating successfully without any findings or default. SBCS has an excellent track record of developing, implementing, and sustaining programming in response to community needs, and with continued ESG funding Casa Nueva Vida I will continue to touch the laves of the homeless within Chula Vista. • ' m • • m - • • e s e • - ® a • SBCS has received CDBG funding from the City of OChula Vista since 1999, and leverages funding from a variety of sources, and utilizes volunteers for program support. The ESG funding is only 14% of the total cost of operating the shelter—other funds come from the federal government, State and private donations. SBCS works closely with the Chula Vista Police Department, the District Attorney's Office, Child Welfare Services, the region's hospitals and clinics, Family Resource Centers operated by the Community Collahoratives, school districts, Legal Aid of San Diego and other local organizatiozas like the Regional Taskforce on the Homeless and the Homeless Advocacy Coalition in order to respond to the needs of homeless families. • • s a s a e • • a e• a - • r•s -a a •r STAFF MEMBER'S N��/iE f�OS9TION/TITLE EXPERIENCE Kathryn Lembo President and CEO BA in Psychology/Sociology, CEO of SBCS for 32 years Pam Wright Clinical Director MSW,20+years experience with SBCS Don Hunter FWSS Department Director BS in Business Admin, Co-creator of DV Response Team Dina Chavez Associate Director BS in CJA,20+years experience with SBCS Amaris Sanchez Program Director BA in Women's Studies, 10+years experience w/SBCS IE30AtD tVIEMPR'S NAME ®CUPATI®1V YENS ®AIRD ,.Anthony Perez Union Bank 3 David D.Rowlands,Jr. _ Retired 5 Ceanne Guerra Cox Communications 5 Fran Muncey The Galley at the Marina 8 Charles Moore Retired 20 John Nelson CVESD 6 Nancy Kerwin CVESD 5 Sue Belanonte San Diego Daily Transcript 16 Diane Rose ResCare Workforce Services 1 For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 4 Due January 31, 2013 Sects n 4 Pt A�tp�ity i o a e Street Outreach ❑ Emergency Shelter i I HMIS ❑ Rapid Re-Housing ❑ Homeless Prevention • • •- • •ji or ®• ®• ® ! • OBJECTIVE (check one) . OUTCOME (check one) 1. Create a suitable living environment ® 1. Availability/Accessibility ❑ 2. Provide decent affordable housing ❑ 2. Affordability ❑ 3. Create economic opportunity ❑ 3. Sustainability Objectives: outcomes: 1. Creating suitable living environments relates to activities 1. Availability/Accessibility applies to activities that make that are designed to benefit communities,families,or services, infrastructure,public services,public facilities, individuals by addressing issues in their living environment housing,orshelter available or accessible to low-and (i.e.,crime prevention, literacy,child care, elderly services). moderate-income people,including persons with 2. Providing decent housing focuses on housing activities disabilities. whose purpose is to meet individual family or community 2. Affordability applies to activities that provide affordability housing needs. in a variety of ways to low-and moderate-income people. 3. Creating economic opportunities applies to activities Affordability is an appropriate objective whenever an related to economic development,commercial activity is lowering the cost,improving the quality,or revitalization, or job creation. increasing the affordability of a product or service to benefit a low-income household. 3. Sustainability applies to activities that are aimed at improving communities or neighborhoods, helping to make them viable by providing benefit to persons of low- and moderate-income or by rem-o ing or eliminating slums or blighted areas. For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 5 Due January 31, 2013 C 212 2013 2013 2414 2013 2014 2411/2012 ' 2011/2012 2012/2Q13 %Law Income #of clients 9e Louv Ir�corrie T e of clients #of clients %I ow Income Yp Served 4a Date, [served to [Actual) [Est[Actual) [Est ate) lrn: irnate, 'date) Chula Vista 106 100% 47 100% 60 80% Non-residents 125 100% 130 98% 80 80% Total, 231 100% 187 99% 140 80% • e - • e a ' • a The overall program goal is to provide emergency housing with supportive services to low-income, homeless families so that each client can work toward self-sufficiency and transition to safe and stable housing. The program will be evaluated based on the successful completion of the following objectives: a Provide emergency shelter for 140 persons/families while they work toward self-sufficiency; (CDBG funds pay for 14% of shelter services to persons/families, or 14% of the total 87 beds (12 beds)); a Provide babysitting for homeless clients participating in groups, employment development and other program activities; ® Provide homeless families with food, clothing, and other items necessary for program success; and a Provide 100% of clients with access to case management and mental health/counseling services. For assistance with this application, please call (619)475-5375 2013-2014 ESG Application- Page 6 Due January 31, 2013 r,Sect>lan 5 Pro�,ram t=�nancaal Informati®n A � ; ` Most Recent Frscal B � E Current Frscal Year Proposed Butlget ZU13f 2014 July 1,2014 June 30,2015 %Change °Y lota_l za PRIVATE SUPPORT Contributions $0.00 $0.00 $0.00 Grants $17,000 $30,000 $30,000 0% 6% Fundraising $71,225 $58,700 $109,000 85% 25% Other $0.00 $0.00 $0.00 Subtotal $ 88,225 88,700 $ 139,000 57% 31% GOVERNMENT Federal $120,496 $121,400 $104,277 -14% 24% State $200,000 $200,000 $200,000 0% 45% Loca l $0.00 $0.00 $0,00 Subtotal $ 320,496 $ 321,400 $ 304,277 -5% 69% OTHERREVENUE . Membership Dues $0.00 $0.00 $0.00 Program Fees $0.00 $0.00 $0.00 Other $0.00 $0.00 $0.00 Subtotal $ 0.00 $ 0.00 $ 0.00 TOTAL REVENUE $ 408,721 $410,100 $443,277 8% 100% Column A is the Audited,or most recently completed 12-month period. Column D represents the percent change from Column B to Column C((C-B)/B). Explain changes greater than 15%under comments. Column E represents the percent of total budgeted for Column C. A B C Most Recent Frscal D` E E�p�11SeS Y77',ear Current Frscal Year Proposed,BudBet %Change %Total 2013�2014�: July 1,2014 June 30,2015 20122013 Personnel (salaries, $224,013 $238,574 $294,003 23% 66% benefits,taxes, etc.) Capital (equipment, supplies, services, $58,450 $51,509 $48,976 -5% 11% utilities, etc. Other(insurance, audits, $126,258 $120,017 $100,298 -16% 23% etc.) 70TAL EXPENSES` $ 408,721 $410,100 $4439277 8% 100% Surplus (or Deficit) of $ 0.00 $ 0.00 $ 0.00 Total Support& Revenue Other Expenses $0.00 $0.00 $0.00 Column A is the Audited,or most recently completed 12-month period. Column D represents the percent change from Column B to Column C((C-B)/B). Explain changes greater than 15%under comments. Column E represents the percent of total budgeted for Column C. For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 7 Due January 31,2013 a a + + e ® a ® ® e e ^ Fundraising efforts were increased to cover government funding reductions and increased staff costs due to cost of living increases and staff raises/merit increases. i i i i i I I 'i s 1. Funding Source -A Lint: Fundraising $109,000 Grants from Foundations $30,000 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL $139,000 For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page S Due January 31, 2013 a Secvon;6 Protect Spec� ec Fina nPal 8nf®rmatn' Request fir Fund�n e e ' Budget line Item Proposed Chula Vista Other Sources Total Costs ESG Share Salaries $24,101 $200,150 $224,251 Fringe benefits (FICA,SUI,etc.) $9,706 $60,046 $69,752 Space Rental $0.00 $0.00 $ 0.00 Utilities $10,773 $7,853 $18,626 Insurance (general liability,directors and $3,596 $3,850 $7,446 officers,worker's comp., automotive,etc.) Consultant Services:Sub-contract (RTFH) $4,500 $0.00 $4,500 Travel $0.00 $1,800 $1,800 Supplies $0.00 $7,700 $7,700 Equipment $0.00 $0.00 $ 0.00 Client Services (describe under comments) $6,000 $10,350 $16,350 Other Expenses (describe under comments) $9,601 $83,251 $92,852 Total Expenses $65,277 $375,000 $443,277 s • • e • • • • , • 0 Client Services include bus vouchers/tokens, motel vouchers, translator services, emergency food vouchers Other expenses include telephone, repairs and maintenance, food, administrative cost. Cal E Fund r9g S® rce Arn�ard ®ate ®ate Ay""64 ble Arnoi nt Mp, TBD TBD $200,000 FEMA 711114 $36,000 Fundraising - 711114 $109,000 Grants from Foundations 711114 $30,000 $0.00 $0.00 $0.00 $0.00 $0.00 Total Other Sources $ 375,000 For assistance with this application, please call(619)476-5375 2013-2014 ESG Application- Page 9 Due January 31, 2013 n s • e s y Essential ®pest ons ®perattons homeless ActsVity/SerVoce§ 5eru�ces excludin StafF Staff Costs) Prevention`_ t i Resident Manager $0.00 $0.00 $6,636 $6,636 Maintenance $0.00 $27,171 $0.00 $27,171 Insurance $0.00 $3596 $0.00 $3,596 Utilities $0.00 $10,773 $0.00 $10,773 Telephone $0.00 $2,101 $0.00 $2,101 Repairs and Maintenance Supplies $0.00 $7,500 $0.00 $7,500 Food $0.00 $6,000 $0.00 $6,000 Sub-contract: RTFH $0.00 $4,500 $0.00 $4,500 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL:REQUEST $. Oa00 $61,641 $6,636 $68,277 Sea~tt®n �, ;Insuran� Re I upre�nents Marne of InsranceCornpany Effective ®aces Lirnots of Deductibles per of Policy Liab�l'ty- ; ®cc�; rence General:Liability Insurance Zenith Insurance Company 07/08/2013 $3,000,000 $1,000 Automobile Liability` Zenith Insurance Company 07108!2013 $1,000,000 $500 Worker's Compensation Zenith Insurance Company 01/01/2fl14 $1,000,004 $0 For assistance with this application, please call (619)476-5375 2013-2014 ESG Application- Page 10 Due January 31, 2013 1 Cf Sectgorll S Cert�f�caipns The undersigned certifies that: (a) The information contained in this document is complete and accurate; (b) The proposed program described in this application meets one of the Eligible Activities governing the use of Emergency Solution Grant (ESG) funds; (c) The applicant shall comply with all Federal and City policies and requirements affecting the ESG program; (d) If the project is a facility,the sponsor shall maintain and operate the facility for its approved use throughout its economic life. (e) Sufficient funds are available from non-ESG sources to complete the project as described, if ESG funds are allocated to the applicant; and (f) The applicant has review the Subrecipient Contract and is able to comply with the Contract if funds are awarded, including he insurance requirements. Signa6re o Authori Applicant Representative Date Kathryn Lembo, President and CEO Print Name and Title of Authorized Applicant Representative ectior:9 ,4ppl��aion 5brniftai PLEASE SUBMIT THIS APPLICATION AND ALL REQUIRED DOCUMENTS(SEE ATTACHED CHECKLIST)TO: City of Chula!lista, Redevelopment and Housing, 276 Fourth Avenue Building 300, Chula nista, CA 91910, Attn: Jose Dorado, Project Coordinator You will be contacted, by the Project Coordinator regarding the receipt and status of your grant application. If you have any questions regarding your grant application, or the ESG program in general, please contact Jose Dorado, Project Coordinator at(619) 476-5375. Applications must be received by JANUARY 30, 2014, 4:00 PM NO LATE OR FAXED APPLICATIONS WILL BE ACCEPTED Thank you for your interest Please submit applications to the following address no later than January 30, 2014 at 4:00 PM City of Chula !lista, Redevelopment and Housing 276 Fourth Avenue Building 300 Chula Vista, CA 91910 Attn: Jose Dorado, Project Coordinator If you have any questions regarding the required documents to be submitted or need assistance with this application, please contact Jose Dorado, Project Coordinator, at (619) 476-5375 For assistance with this application, please call (619)476-5375 2013-2014 ESG Application- Page 11 Due January 31, 2013 11 Application No. 23 CITY OF CHULAVISTA HOUSING DIVISION HOME Application Summary Applicant:" City of Chula'Vista Housing Division, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: HOME Grant Administration/Planning Project Descirip'tiori: Adr6inistrat,ion funds will be'utilized for the staff 'costs associated With the management;and,administration,of Chula,Vista's,HOME,, program. This, includes, preparation of the: required planning dotuments',' regulatory'compliante; contract, oversight of the partn6ring ag6ncies, ,environmental reviews and fiscal managerrlient. Type of Program/Project: General Program Administration (570.206) Target Populatloh:' 21A-General Program Proposed Number N/A Admin'Istratioh' to Serve:, Program Total Budget: $59,881 C. V. Cost per Client: N/A Funding Request: $59,881 Prior Year,Funding: $59,881 Specific Use of Chula Vista Personnel Costs and FUNDING $59,881 Funding: Program Administration RECOMENDED Expenses Staff Notes:: Application No. CITY OF CHULAVISTA HOUSING DIVISION CDBG Application Summary Applicant:" Meals-'dn-Wheels Greater San Diego, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Program/Project: Meals on Wheels Project Description: Meals-an-Wheels will deliver meals to h6meboun'd Chula Vista,seniors. wals�will be deli I vered for 365 days a year,, including, holidays;,by volunteers who not only deliver a rneal, but, provide social contact to, homebound seniors,to,combat isolation'. Type of Program/Project: Public Services [(§570.201(e)] Target Popullatloh:' OSA-Senior Services Proposed Number; 220 to Serve: (subject to change &R§'570''208(a)(2)'Lo' w depending on funding Moderate Income recommendation) Limited Clientele Program Total Budget: $346,920 C. V. Cost per Client: $54 (Based on funding recommendation) Funding Request: Prior Year,Fundin,g: $121000, Specific Use of Chula Vista Food and packaging FUNDING $12,000 Funding: expenses RECOMENDED Staff Notes::