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02-22-2011 CC Rpt C01 COUNCIL AGENDA STAFF REPORT CITY CLERK USE ONLY Meeting Date: February 79 9011 RECEIVED 3 L"` Public Hearin Cdr g� 2011 FEB 14 PM 3: 27 'S: Discussion Item: o.aw Consent Item: ❑ OFFICE OF CITY CLERIC CHIN0 HMIS DATE: February 15, 2011 TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS FROM: CITY MANAGER SUBJECT: PRIORITIZATION AND ALLOCATION OF ELIGIBLE PUBLIC SERVICE PROJECTS FOR FISCAL YEAR 2011-2012 COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS RECOMMENDATION: 1) Conduct a Public Hearing, review, and provide policy direction regarding allocating a percentage of Community Development Block Grant funds to public service projects; and 2) Choose public service projects in which to allocate Community Development Block Grant funds. BACKGROUND/ANALYSIS: The United States Department of Housing and Urban Development (HUD) annually allocates funds to the City of Chino Hills through the Community Development Block Grant (CDBG) program. Due to budget delays, HUD has not been able to provide the City with its expected allocation at this time. As a result of information provided by the White House Office of Management and Budget Director, staff currently estimates a 7.5% reduction of last year's allocation thus estimating a $422,700 appropriation. The allocation estimate may either increase or decrease based upon the official allocation from HUD. Prior to receiving CDBG funds, the City is required to develop and submit to HUD an annual Action Plan, which identifies the City's goals and objectives for utilizing CDBG funds to benefit low and moderate-income families, and further fair housing practices. There are several ways in which this can be accomplished and these have been categorized into different eligible activities. Public service is one eligible activity. Only 15%, or $63,400, of the grant can be allocated to public service projects. Council has the ability to allocate no funds, a portion of the funds, or the full amount to public service projects. If no funds or only a portion of the funds are allocated to public service projects, then the remaining funds could be programmed into other CDBG projects (i.e. Los Serranos Infrastructure Project, Home Improvement Grant Program, land acquisition for low income housing). r AGENDA DATE: February 22, 2011 PAGE TWO SUBJECT: PRIORITIZATION AND ALLOCATION OF ELIGIBLE PUBLIC SERVICE PROJECTS FOR FISCAL YEAR 2011-2012 COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS As the City enters the fourth year of the five-year Consolidated Plan, it is important for the City to continuously review and reevaluate all programs. CDBG regulations encourage cities to utilize CDBG funds for public services provided that the service is a new service or there is a quantifiable increase in the level of an existing service that has been provided by the City in the 12 months preceding the Annual Action Plan. Staff was recently advised by HUD that the City is not in compliance with HUD's minimum funding requirement of $5,000 for all public service contracts receiving funds from the CDBG program. HUD considers grant awards below $5,000 to be a misuse of the limited public funds that are available. Although the City has not received an official finding for this, HUD strongly recommends a $5,000 minimum funding requirement be instituted for the 2011-12 program year. As a result of this recommendation, Staff instituted a minimum $5,000 funding level for the 2011-12 program year. Based upon suggestions the City received from HUD during a monitoring of the City's program, staff has also revised the City's application process. As part of the application process, a publically noticed, mandatory, CDBG workshop was held to provide information to all current and potential applicants and a rating system for each application was implemented. The rating criteria is also attached. Each application includes an evaluation sheet and score. In November 2010, staff sent 40 project proposal applications to various organizations throughout the area and placed advertisements in the Chino Hills Champion Newspaper on November 13, 2010 and November 20, 2010. The mandatory workshop was held December 1, 2010. Staff received eight proposals totaling $87,760. Attachment A summarizes the public service project proposals received, a description of each project, and the amount of funding requested. The full applications and evaluations are attached for your review and consideration. All public service proposals submitted meet CDBG objectives. Program proposals submitted by House of Ruth and the YMCA meet the City's objectives for utilizing CDBG funds and do not require additional resources or staff costs to facilitate such programs. For the 2010-2011 CDBG program year, Council allocated the entire estimated 15% cap ($60,600) for public service programs. In prior years, any remaining balance was used to fund the City's Home Improvement Program and/or reprogrammed into the Los Serranos Infrastructure Project. The City allocated funds to the San Bernardino County Library Literacy Program ($21,000), House of Ruth ($4,000), Chino Hills Recreation Division ($18,100), West End YMCA ($7,500), and Together We Rise ($10,000). Current Programs The James S. Thalman Chino Hills Branch Library has reported 55 residents taking advantage of the Literacy program, through assessment or student/tutor matches, AGENDA DATE: February 22, 2011 PAGE THREE SUBJECT: PRIORITIZATION AND ALLOCATION OF ELIGIBLE PUBLIC SERVICE PROJECTS FOR FISCAL YEAR 2011-2012 COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS mature driver education classes, senior computing classes, adult basic computing classes, and grammar courses. Currently, House of Ruth has provided counseling services to 49 individuals and provides many referrals through the 24-hour hotline and local workshops. The YMCA has currently provided childcare subsidies to 10 families. The Recreation Division gave 16 qualified residents scholarships to attend nine weeks of the Summer Day Camp program. There has been no reportable progress from Together We Rise. New Proposals For FY 11/12, Staff received four new proposals for funding under the CDBG program. Caring for the Hills is a Chino Hills non-profit organization committed to providing low- moderate income residents the opportunity to receive sustaining food to enhance the quality of life. Through their Feeding Program, Caring for the Hills addresses the needs of homeless families, seniors, and low-income residents specifically in the Los Serranos area and through-out the City. Food is provided on a daily basis. Emergency food boxes are delivered to individuals and families when necessary and holiday food baskets are arranged and provided for Thanksgiving and Christmas. Caring for the Hills also facilitates a Senior Citizen Meal Program, in conjunction with Oldtimers Foundation, that delivers hot meals on weekdays to seniors in the City. This proposal is from an organization servicing low-moderate income residents and meets basic eligibility standards set forth by HUD. A more detailed description of the project can be found in the application, which has been included for your reference. Oldtimers Foundation works to provide comprehensive, supportive services, and volunteer activities to seniors in the community to help maximize their levels of personal dignity and independence. The home delivery meal program provides weekday hot meals to frail, shut-in seniors. The congregate meal program provides socialization opportunities with a wide array of recreational events and special activities. This proposal is from an organization servicing low-moderate income residents and meets basic eligibility standards set forth by HUD. A more detailed description of the project can be found in the application, which has been included for your reference. Legal Aid Society of San Bernardino provides legal services to low income residents throughout the County. Qualified residents participating in the program receive free legal consultation on a broad spectrum of legal issues as well as affordable access to the legal system. Through legal and support staff, residents receive document preparation and step-by-step instructions to facilitate requests for court orders. This proposal is from an organization servicing low-moderate income residents and meets AGENDA DATE: February 22, 2011 PAGE Four SUBJECT: PRIORITIZATION AND ALLOCATION OF ELIGIBLE PUBLIC SERVICE PROJECTS FOR FISCAL YEAR 2011-2012 COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS basic eligibility standards set forth by HUD. A more detailed description of the project can be found in the application, which has been included for your reference. Nevelle is an organization providing college and work preparation for youth in the community. The mission is to prepare students to excel in the workforce by providing career related workshops, information, and resources to improve professional skills. Though this project may meet basic CDBG eligibility requirements, the ability to track and income qualify participants may prove overly burdensome to the organization. As a recently formed non-profit this organization may lack the capacity and experience necessary to implement and comply with Federal regulations. Based on the application submittal, there is no clear evidence of use of leveraged funds or other resources and program sustainability. A more detailed description of the project can be found in the application, which has been included for your reference. All applicants have been notified of this public hearing and have been encouraged to briefly highlight their program and proposal. Following Council's action on this item, staff will incorporate the recommendations into the City's Annual Action Plan. The Action Plan will come before Council again in May for final approval. Due to the unavailability of the City's actual allocation, if there is any variance from the estimated HUD allocation, Council may then readjust the public service project funding at that time. REVIEWED BY: This item has been reviewed by the Finance Director. FISCAL IMPACT: CDBG funds are federal funds and the allocation has no impact on the City's General Fund. Respectfully submitted, Reco ended 11/..% Michael S. Fleagef Qify Manager Jo 'than Marshall / C mmunity Services Director MSF:JM:lc:cfc Attachments CDBG Proposal Evaluation Criteria FY2011 Maximum Points Possible: 64 Quality of Program Design 16 Points Does the proposal demonstrate an unmet community need? Is the program consistent with needs and priorities of the Consolidated Plan? Does the program coordinate with existing services arid show evidence of community support Overall program merit Quality of Proposal Elements 16 Points Does the proposal include a realistic timeline of project milestones and drawdown schedule (benchmarks;? Are objectives and outcomes clearly stated and measurable? Are the performance measurements a good indication of success of the project? Capacity and Experience 16 Points Has the organization undertaken this activity in the past? If yes,with what results? Does the organization have experience with CDBG funding? Does the organization employ sufficient,qualified staff to undertake the proposed activity? Funding Request 16 Points Is the budget realistic for this project? Are other funds listed in the budget for this project? Includes use of leveraged funds or other resources and program sustainability The following worksheet is the form that will be used in the review of all applications submitted for funding. This is offered only for information purposes and requires no action on your part, Attachment A Summary of Public Service Project Proposals Organization Log Public Service Project 10-11 11-12 Number Allocation Request House of Ruth provides 24-hour emergency shelter, transitional living, and walk-in services for battered women and their children. Prevention education is $4,000 $5,000 House of Ruth 11-01 also provided to the community. House of Ruth operates a 24-hour emergency hotline. San Bernardino County Library, Chino Hills branch, provides direct service to illiterate adults in the Chino Hills community by continuing a specially designated one-day per week "Literacy Day". The Library also San Bernardino 11-02 provides an introductory class in basic computing to $21,000 $10,000 County Library assist adult learners with attaining computer skills, a grammar course, senior computing classes, and a weekly driver education study group targeted to elderly residents and those with limited literacy skills. Recreation staff reports that inquiries are received annually for financial assistance to attend summer programming like Day Camp where the fee is much higher than other programs during the rest of the $18,100 $9,765 Recreation Division 11-03 year. A scholarship program is proposed to enable 10 qualified residents to attend 9 weeks of Summer Day Camp. The Chino Valley YMCA Childcare subsidy program provides financial subsidy to poverty, low and moderate income families from Chino Hills to attend West End YMCA 11-04 YMCA licensed Childcare. This will provide $7,500 $10,000 assistance to CVUSD schools located in Chino Hills and to children from Chino Hills who attend other CVUSD schools. The feeding program feeds needy individuals in the Caring for the Hills 11-05 community by providing daily food distribution, $0 $15,000 emergency food boxes, and holiday food baskets. The Nutrition Program is designed to provide a nutritious meal and an opportunity for socialization Oldtimers Foundation 11-06 and involvement in the community. The home- $0 $7,000 delivery program enables frail, homebound seniors the opportunity to maintain their independence and receive social interaction. Provide free legal consultations to low-moderate Legal Aid Society 11-07 income residents and affordable access to the $0 $10,000 judicial system to resolve disputes. The mission is to prepare students to excel in the Nevelle 11-08 workforce by providing career related workshops, $0 $19,960 information, and resources to improve professional skills. Together We Rise i Did not submit application for FY 2011-2012 I $10,000 ( $0 TOTAL I $60,600 $86,725 Estimated Available $63,400 Allocation Applicant: House of Ruth 01 CDBG Proposal Application Evaluation Worksheet Scoring: 0=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors I I I I I Quality of Program Design 1 Does the proposed program/project comply with the overall 0 1 2 3 kim regulations, goals and objectives of the CDBG program? Does the application include a demonstration of unmet 2 0 1 2 4 need? Is the application proposal consistent with the needs and 3 0 1 2 (FED 4 priorities of the Consolidated Plan? Overall program merit including coordination with existing 4 services [non-duplication) and evidence of community 0 1 2 3 4 support Quality of Proposal Elements 5 I Are the Program activities and goals clearly defined? I 0 1 1 2 I 3 4 1) Are there measurable outcomes and outputs for the 6 0 1 2 3 I proposed program activities? Does the proposed program/project take into consideration 7 the collaboration of resources with other public and/or private 0 1 2 3 development efforts to be more effective and efficient? Are the eligibility standards for low/mod and limited clientele 8 0 1 2 4 met, as set forth by the numbers, set forth in the application? pacify and Experience Does the organization have the experience and staff 90 1 2 3 )6) qualifications to meet their intended program goals? Has the organization demonstrated past experience in 100 1 2 3 F) implementing and complying with federal regulations? Has the organization demonstrated an ability to deliver their 11 0 1 2 3 services? 12 Has proof of non-profit status been submitted? I 0 1 1 1 2 1 3 14 ) I Funding Request Will the proposed activity require additional funding to fully 13 correct the conditions and/or meet the needs that exist? If so, 0 1 2 3 el) is this funding available? Does the operating budget seem adequate for the 14 0 1 2 3 organizational structure and proposed project/activity? Does the proposed cost of the project/activity justify the 15 number of persons who will directly benefit from the 0 1 2 3 project/activity? Has the organization demonstrated an ability to leverage and 16 raise other funds? Are there other financial resources available beyond CDBG funds that could be used to fund the ? 0 1 2 3 (9 proposal? Total Points Received: 'Q Lout of 64 Applicant: SBC Library H-02 CDBG Proposal Application Evaluation Worksheet Scoring: 0=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors Quality of Program Design Does the proposed program/project comply with the overall 1 0 1 2 3 (411' regulations, goals and objectives of the CDBG program? Does the application include a demonstration of unmet 2 0 1 2 3 4 need? Is the application proposal consistent with the needs and 30 1 2 A73 4 priorities of the Consolidated Plan? Overall program merit including coordination with existing 4 services [non-duplication] and evidence of community 0 1 2 3 4 support I Quality of Proposal Elements 5 I Are the program activities and goals clearly defined? I 0 I 1 2 1 3 (4 )I Are there measurable outcomes and outputs for the 6 0 1 2 3 —1proposed program activities? Does the proposed program/project take into consideration 7 the collaboration of resources with other public and/or private 0 1 2 3 development efforts to be more effective and efficient? Are the eligibility standards for low/mod and limited clientele 8 0 1 2 3 4 met, as set forth by the numbers, set forth in the application? Capacity and Experience Does the organization have the experience and staff 9 0 1 2 3 O. qualifications to meet their intended program goals? 10 Has the organization demonstrated past experience in 1 2 3 0 h4Di implementing and complying with federal regulations? ( Has the organization demonstrated an ability to deliver their 11 0 1 2 3 EP services? 12 j Has proof of non-profit status been submitted? Nik 3-t4 I Funding Request Will the proposed activity require additional funding to fully 13 correct the conditions and/or meet the needs that exist? If so, 0 1 2 3 is this funding available? Does the operating budget seem adequate for the 14 0 1 2 3 10 organizational structure and proposed project/activity? 4 Does the proposed cost of the project/activity justify the 15 number of persons who will directly benefit from the 0 1 2 Fop 4 project/activity? Has the organization demonstrated an ability to leverage and raise other funds? Are there other financial resources "Th 1 6 0 1 2 3 ( available beyond CDBG funds that could be used to fund the Proposal? Total Points Received: 51 out o_fie1,0 Applicant: Recreation Il-03 CDBG Proposal Application Evaluation Worksheet Scoring: 0=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors Quality of Program Design Does the proposed program/project comply with the overall 1 0 1 2 3 4 regulations, goals and objectives of the CDBG program? Does the application include a demonstration of unmet 2 0 1 2 3 0 need? Is the application proposal consistent with the needs and 3 0 1 2 3 4 priorities of the Consolidated Plan? Overall program merit including coordination with existing 4 services [non-duplication] and evidence of community 0 1 2 3 support I Quality of Proposal Elements 5 Are the program activities and goals clearly defined? I 0 1 1 2 I 3 (4) Are there measurable outcomes and outputs for the 6 0 1 2 3 rzap proposed program activities? Does the proposed program/project take into consideration 7 the collaboration of resources with other public and/or private 0 1 2 3 4 development efforts to be more effective and efficient? Are the eligibility standards for low/mod and limited clientele 8 0 1 2 3 9 met, as set forth by the numbers, set forth in the application? Capacity and Experience Does the organization have the experience and staff 9 0 1 2 3 riCI) qualifications to meet their intended program goals? Has the organization demonstrated past experience in 10 0 1 2 3 if9 implementing and complying with federal regulations? Has the organization demonstrated an ability to deliver their 11 0 1 2 3 services? 12 1 Has proof of non-profit status been submitted? 0 11 1 2 1 3 (4 ) I Funding Request L./ I Will the proposed activity require additional funding to fully 13 correct the conditions and/or meet the needs that exist? If so, 0 1 2 3 4 is this funding available? Does the operating budget seem adequate for the 14 0 1 2 3 p organizational structure and proposed project/activity? Does the proposed cost of the project/activity justify the 15 number of persons who will directly benefit from the 0 1 2 3 rip project/activity? Has the organization demonstrated an ability to leverage and raise other funds? Are there other financial resources 16 0 1 2 3 C9 available beyond CDBG funds that could be used to fund the Proposal? Total Points Received: ki9":out of 64 Project: YMCA CDBG Proposal Application Evaluation Worksheet Scoring: O=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors I I I Quality of Program Design Does the proposed program/project comply with the overall 1 0 1 2 4 regulations, goals and objectives of the CDBG program? Does the application include a demonstration of unmet 2 0 1 2 6) 4 need? Is the application proposal consistent with the needs and 3 0 1 21-P' 4 priorities of the Consolidated Plan? Overall program merit including coordination with existing 4 services [non-duplication] and evidence of community 0 1 2 3 (2 support Quality of Proposal Elements , 5 Are the program activities and goals clearly defined? 0 11 2 3 14) Are there measurable outcomes and outputs for the 6 0 1 2. 3 61 proposed program activities? Does the proposed program/project take into consideration 7 the collaboration of resources with other public and/or private 0 1 2 3 development efforts to be more effective and efficient? Are the eligibility standards for low/mod and limited clientele 8 0 1 2 3 bi) met, as set forth by the numbers, set forth in the application? Capacity and Experience Does the organization have the experience and staff 9 0 1 2 3 4 qualifications to meet their intended program goals? Has the organization demonstrated past experience in 10 0 1 2 3 implementing and complying with federal regulations? Has the organization demonstrated an ability to deliver their 11 0 1 2 3 4 services? 12 1 Has proof of non-profit status been submitted? I 0 1 1 I 2 3 (4) I Funding Request Will the proposed activity require additional funding to fully 13 correct the conditions and/or meet the needs that exist? If so, 0 1 2 3 4 is this funding available? Does the operating budget seem adequate for the 14 0 1 2 3 organizational structure and proposed proiect/activity? Does the proposed cost of the project/activity justify the 15 number of persons who will directly benefit from the 0 1 2 3 project/activity? Has the organization demonstrated an ability to leverage and raise other funds? Are there other financial resources 16 0 1 2 3 available beyond CDBG funds that could be used to fund the proposal? Total Points Received: (Si_ out of 64 Applicant: Caring for the Hills CDBG Proposal Application Evaluation Worksheet II-U5 I Scoring: 0=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors I I I I I I Quality of Program Design 1 Does the proposed program/project comply with the overall 0 1 03 4 regulations, goals and objectives of the CDBG program? 2 Does the application include a demonstration of unmet 0 1 2 3�� need? 3 Is the application proposal consistent with the needs and 0 1 24 priorities of the Consolidated Plan? t Overall program merit including coordination with existing 4 services [non-duplication] and evidence of community 0 1 2 3 support Quality of Proposal Elements - I 5 I Are the program activities and goals clearly defined? I 0 I 1 12 /3) 4 6 Are there measurable outcomes and outputs for the 0 1 2 3 proposed program activities? Does the proposed program/project take into consideration r , 7 the collaboration of resources with other public and/or private 0 1 2 3 4 development efforts to be more effective and efficient? 8 Are the eligibility standards for low/mod and limited clientele 0 1 i / 3 4 met, as set forth by the numbers, set forth in the application? I Capacity and Experience 9 Does the organization have the experience and staff 0 1 2 3 di--) qualifications to meet their intended program goals? _ 10 Has the organization demonstrated past experience in U1%I 0 1 2 3 4 implementing and complying with federal regulations? 11 Has the organization demonstrated an ability to deliver their 0 1 2 3 go services? 12 I Has proof of non-profit status been submitted? I 0 I 1 12 ( 3 (4 )I Funding Request V Will the proposed activity require additional funding to fully /� 13 correct the conditions and/or meet the needs that exist? If so, 0 1 2 3 I is this funding available? 14 Does the operating budget seem adequate for the 0 1 2 () 4 organizational structure and proposed project/activity? Does the proposed cost of the project/activity justify the 15 number of persons who will directly benefit from the 0 1 2 (3) 4 project/activity? Has the organization demonstrated an ability to leverage and j1 16 raise other funds? Are there other financial resources 0 1 2 3 l4 ` available beyond CDBG funds that could be used to fund the l✓ proposal? • Total Points Received:152-out of 64 Applicant: Oldtimer's Foundation CDBG Proposal Application Evaluation Worksheet if-00 I Scoring: O=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors I I I Quality of Program Design 1 1 Does the proposed program/project comply with the overall 0 1 2 7.3) 4 regulations, goals and objectives of the CDBG program? 2 Does the application include a demonstration of unmet 0 1 2 3 4 need? 3 Is the application proposal consistent with the needs and 0 1 2 33 4 priorities of the Consolidated Plan? Overall program merit including coordination with existing 4 services [non-duplication] and evidence of community 0 1 2 3 support I Quality of Proposal Elements 2 1 5 ( Are the program activities and goals clearly defined? I 0 I 1 V2 )1 3 14 6 Are there measurable outcomes and outputs for the 0 1 goo3 4 proposed program activities? Does the proposed program/project take into consideration 7 the collaboration of resources with other public and/or private 0 1 2 3 r4 ') development efforts to be more effective and efficient? }}✓✓ 8 Are the eligibility standards for low/mod and limited clientele met, as set forth by the numbers, set forth in the application? 0 1 2 3 Capacity and Experience 9 Does the organization have the experience and staff 0 1 2 3 (41 qualifications to meet their intended program goals? 10 Has the organization demonstrated past experience in 0 1 2 3 (41 implementing and complying with federal regulations? 11 Has the organization demonstrated an ability to deliver their 0 1 2 3 services? 12 I Has proof of non-profit status been submitted? I 0 11 12 1 3 14 )� I Funding Request Will the proposed activity require additional funding to fully 13 correct the conditions and/or meet the needs that exist? If so, 0 1 2 3 4 is this funding available? 14 Does the operating budget seem adequate for the 0 1 2 3 (/1 organizational structure and proposed proiect/activity? Does the proposed cost of the project/activity justify the I�� 15 number of persons who will directly benefit from the 0 1 2 3 d project/activity? ��� Has the organization demonstrated an ability to leverage and 16 raise other funds? Are there other financial resources 0 1 2 34 available beyond CDBG funds that could be used to fund the �� proposal? Total Points Received: 51 out of 64 Applicant: Legal Aid )1-0 CDBG Proposal Application Evaluation Worksheet Scoring: o=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors I I I j Quality of Program Design 1 Does the proposed program/project comply with the overall 0 1 2 IN 4 regulations, goals and objectives of the CDBG program? 2 Does the application include a demonstration of unmet 0 1 2 3 4 need? % { 3 Is the application proposal consistent with the needs and 0 1 2 3 4 priorities of the Consolidated Plan? Overall program merit including coordination with existing 4 services [non-duplication] and evidence of community 0 1 2 3 4 support I Quality of Proposal Elements 5 I Are the program activities and goals clearly defined? 1 0 11 1 2 1 3 A'4 X 6 Are there measurable outcomes and outputs for the 0 1 2 3 0 proposed program activities? Does the proposed program/project take into consideration 7 the collaboration of resources with other public and/or private 0 1 2 3 4 development efforts to be more effective and efficient? 8 Are the eligibility standards for low/mod and limited clientele 0 1 2 3 4Th met, as set forth by the numbers, set forth in the application? L 1 Capacity and Experience �/ 9 Does the organization have the experience and staff 0 1 2 3 ' " " qualifications to meet their intended program goals? (� �� 10 Has the organization demonstrated past experience in 0 1 2 3 4l implementing and complying with federal regulations? 11 Has the organization demonstrated an ability to deliver their 0 1 2 3 0 services? 12 I Has proof of non-profit status been submitted? 1 0 1 1 12 1 3 fl I Funding Request Will the proposed activity require additional funding to fully 13 correct the conditions and/or meet the needs that exist? If so, 0 1 2 3 0 is this funding available? 14 Does the operating budget seem adequate for the , organizational structure and proposed project/activity? 0 1 2 3 � Does the proposed cost of the project/activity justify the 15 number of persons who will directly benefit from the 0 1 2 3 �0 proiect/activitv? Has the organization demonstrated an ability to leverage and 16 raise other funds? Are there other financial resources 0 1 2 3 010 available beyond CDBG funds that could be used to fund the proposal? PP�� Total Points Received: 120 out of 64 Applicant:Nevelle CDBG Proposal Application Evaluation Worksheet I Scoring: 0=Unacceptable 1= Poor 2 = Fair 3 = Good 4 = Excellent Evaluation Factors I I II I I Quality of Program Design 1 Does the proposed program/project comply with the overall 0 2 3 4 regulations, goals and objectives of the CDBG program? Does the application include a demonstration of unmet 2 need? 0 1 2 #p 4 3 Is the application proposal consistent with the needs and 0 1 24 priorities of the Consolidated Plan? �© Overall program merit including coordination with existing 4 services [non-duplication] and evidence of community 0 1 2 3 4 support I Quality of Proposal Elements 15 i Are the program activities and goals clearly defined? I 0 i'l� ( 2 ( 3 ( 4 6 Are there measurable outcomes and outputs for the 0 l / 2 3 4 proposed program activities? Does the proposed program/project take into consideration 7 the collaboration of resources with other public and/or private 0 1 2 3 4 development efforts to be more effective and efficient? (` 8 Are the eligibility standards for low/mod and limited clientele 0 111, 2 3 4 met, as set forth by the numbers, set forth in the application? Capacity and Experience I 9 Does the organization have the experience and staff 0 1 2 3 4 qualifications to meet their intended program goals? 10 Has the organization demonstrated past experience in � 1 2 3 4 implementing and complying with federal regulations? Q 1 1 Has the organization demonstrated an ability to deliver their 2 3 4 services? (I 9 112 I Has proof of non-profit status been submitted? J 0 ( 1 12 ( 3 f14-) I Funding Request Will the proposed activity require additional funding to fully 13 correct the conditions and/or meet the needs that exist? If so, 9 1 2 3 4 is this funding available? 14 Does the operating budget seem adequate for the i1 2 3 4 organizational structure and proposed proiect/activity? (� J Does the proposed cost of the project/activity justify the 15 number of persons who will directly benefit from the l: 1 2 3 4 project/activity? Has the organization demonstrated an ability to leverage and 16 raise other funds? Are there other financial resources 0 1 2 3 4 available beyond CDBG funds that could be used to fund the proposal? Total Points Received: lib_ out of 64 House of Ruth 11-01 tr- House of Ruth { A Assisting Families lrictimized 9 A riA 4 4 !ORM i Ey Domenic 4bolence December 21, 2010 City of Chino Hills Lara Christensen Community Services Department 14000 City Center Drive Chino Hills, CA 91709 BOARD OF Dear Ms.Christensen: DIRECTORS ROBIN LEONHARD House of Ruth is submitting an application for 2011-2012 Community Development Block President Grant funds. We have been privileged to serve the residents of Chino Hills for many years LESLIE PEARCE and appreciate your consideration in previous funding cycles. Vice President ARLENEANDREW Thousands of women each year are victims of domestic violence.Almost one-third of .Secretory female homicide victims that are reported in police records are killed by an intimate partner. THOMAS K.CARR,JR.CFP Domestic Violence has a profound and lasting impact on the children who witness it or who Treasurer themselves are victims of the abuse. Statistics rarely tell the story since most cases of Inge domestic violence go unreported. House of Ruth will continue to provide domestic violence . .Der at Large services for battered women and their children in the City of Chino Hills through our MEMBERS Shirleyirley Abrams bmms residential and non-residential programs. Our goal is to serve 255 residents of Chino Hills Karen Taylor Herring during the 2011-2012 fiscal year. Services to participants will include case management, Bridger Healy Christine F.Kenmore counseling, support groups, self-sufficiency workshops, housing and employment assistance, Valerie E.Martinez and legal and social services advocacy. A Child Abuse Treatment Program provides Rhonda Proul Carol Tanenbaum therapeutic counseling to children who have been impacted by violence in their homes, Richard\VatkinsIan Brown schools,or communities. Our residential programs include a 45 dayemergency shelter and a P g g Y Margaret Latimer 2-year transitional living program. We have also begun a program of subsidized scattered Julianne Baumann Linda Gladson site housing through partnerships with a local housing developer,the City of Rancho Cucamonga and the City of Fontana. Prevention education presentations are focused on Ex Officio education, safety, and the reduction of domestic violence in our communities. SUZANNE AEBISCHER Executive Director House of Ruth programs and services are funded through 22 local, State, and Federal grants and by a number of private foundations and donors. Our funding request of$5,000 represents only a portion of the cost of services to Chino Hills residents. Remaining costs are covered by State and Federal grants and private funding sources. We look forward to a continuing partnership with the City of Chino Hills as we work to eliminate domestic violence in our communities. Sincerely, A/UKL, ati5 s c L Suzann ebischer Executive Director A NONWRROrfTAX E%LMPT ORGANIZATION Tek(909)623-4364 Fax:(909)629-9581 24 hour Hotline(909)988-5559 n n R,.450 (7nrnnnnr.California 91711 y rTh Project Name: SeMceo(ciBallere0WomenandlFnrcniaren Page: 1_ 'q'I EXHIBIT F m CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG) • i APPLICAT • ION h`:n17<`Li TIEDJI. APPLICATION DEADLINE: 5:00 PM. on WEDNESDAY. JANUARY 5, 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please type or use a computer-generated form. Handwritten applications will not be accepted. 1) Name of Agency: House of Ruth, Inc. 2) Name/Title of Workshop Attendee: Jean Leavy, Grant Writer 3) Mailing Address where correspondence about this application is to be sent: P.O. Box 457 Claremont CA 91711 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: 522 N. Fern Avenue Ontario CA 91762 Street City State Zip 5) Physical Address where project records will be kept for monitoring purposes. Add additional lines if there is more than one location: 522 N. Fern Avenue Ontario CA 91762 Street City State Zip 6) Federal Tax I.D. No,: 95-3276033 7) CA Franchise Tax Board I.D. No.: C0836819 8) Contact Person's Information: Jean Leavy, Grant Writer jleavy@houseofruthinc.org Name/Title Email Address (909)868-8006 (909)623-8584 Phone Number Fax Number 9) Authorized Person's Information (if same as Contact Person, note "same'below): Suzanne Aebischer, Executive Director saebischer@houseofruthinc.org Name/Title Email Address (909)868-8008 saebischer@houseofruthinc.org Phone Number Fax Number , w�,w�����w��� 2 Project Name: Page: _ 10) Project Name: ServiCesfmr Battered Women and their Children 11) Briefly describe the proposed project and whatqoal(s) it is intended to achieve: House of Ruth provides supportive services and residential programs for battered women and their children. Safety and Self-sufficiency are the primary focus of our domestic violence services.The agency maintains a 24-hour Crisis Hotline, 24-hour Emergency Shelter for up to 45 days, Transitional Shelter for up to two years, Walk-in Service Centers in San Bernardino County and Los Angeles County, Temporary Restraining Order Clinics in two courts, and Prevention Education programs for children, youth and adults in local communities. House of Ruth also provides a therapeutic counseling program for children who have been exposed to violence in their homes, schools, or communities. House of Ruth services are free and flexible. Our facilities are accessible for persons with disabilities. Program materials are provided in English and Spanish. Chino Hills residents make up approximately 2.7%of all San Bernardino County persons served by House of Ruth. All House of Ruth programs and services are available to residents in the City of Chino Hills. House of Ruth's overall goal is to provide a place of safety where battered women can receive quality domestic violence services that will help to improve their lives. Program goals for Chino Hills residents include increased safety through education and planning, and increased understanding of domestic violence and its impact on women and children. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. /lvai|Uhiliiv//\ccessibi|itv This category applies to proposals that make services, infrastructure, housing, shelter or jobs availabie or accessible to low and moderate-income persons, including persons with disabilities. Enhances the living environment through new/improved availability | Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Affordability This ThiscategVry applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. I | / | Enhances the living environment through new/improved availability | Creates decent housing with new/improved availability l | Promotes economjc opportunity through new/improved availability Page 15 of 24 Project Name: Services tar 3aIlr,cd Women and ctLdrar. Page: 3 Promoting Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping to make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. J Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category. Describe the anticipated quantifiable results of your proposal for the selected category. Availability/Accessibility: Domestic Violence impacts the living environments of battered women and their children in a number of ways, primarily affecting their safety arid creating emotional and health issues. Domestic Violence also impacts many facets of our society including the economy, the health care system, the welfare system, immigration, and housing, often translating to an undue fiscal burden such as health care costs, lost wages and expenses related to the child welfare system. House of Ruth provides options to living with domestic violence, including emergency shelter, transitional shelter, and assistance with finding affordable housing. Counseling and support groups address the emotional issues, while other supportive service are in place to address health, income, immigration, safety, legal, and children's issues. Continued on attachment: 14) Please check one that best identifies the nature of the Project in Chino Hills': LJStart-Up j One-Time I,� Continuing I I Expansion 15) Project/Activity Type: I VI Public Service I I Capital Improvement (Requires cost estimate) 16) If"Capital Improvement" is selected, provide the location of the project by census tract and block group number. Census Tract Block Group NOTE; Most construction projects (other than some residential rehabilitation) will be required to meet HUD labor requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. During the five year period 2005 through 2009,law enforcement received 517 domestic violence related calls for assistance from the City of Chino Hits.During that same time period,House of Ruth received 188 calls from Chino Hills residents cn our 24-hour crisis hotline.Last year,House of Ruth provided services to 44 Chino Mills women on the agency's emergency hotline,17 Chino Hills women and children at the walk-in centers,1 Chino Hills woman in the emergency shelter,and 2 Chino Hills children in House of Ruth's'Child Abuse Treatment Program.175 children and adults were provided with domestic violence and teen dating violence prevention education programs. Continued on Attachment 1 Start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that is expanded in scope, not just that more people are,served. Page 16 of 24 Continued from application: Page 3(a) 13. The availability of our services has increased over the past years as we continue to serve battered women at a variety of locations. In addition to the shelter and walk-in centers in Pomona and Ontario, House of Ruth staff are co-located at the TAD and GAIN offices in Pomona, Ontario, and Rancho Cucamonga where we provide supportive services to battered women in the CaIWORKs program. Staff are also in the East Valley Superior Court in Pomona and the Foothill Law and Justice Center in Rancho Cucamonga where we staff two temporary restraining order clinics. We have staff at the Rancho Cucamonga Family Resource Center, and will have a case manager at the Montclair Family Resource Center which is scheduled to open by the end of December. Help is available on our crisis hotline 24 hours a day, 365 days a year. House of Ruth will serve an estimated 255 persons from the City of Chino Hills through the following programs: 9 24-Hour Hotline:40 battered women O Emergency Shelter: 1 family e Walk-in Centers: 12 Families e Child Abuse Treatment Program: 2 Children e Community Education: 200 As in past years, House of Ruth will use a Program Logic Model to track and measure outcomes for Chino Hills residents.The Logic Model will measure the number of Chino Hills residents who: 1) Increase their safety through education and planning 2) Increase their understanding of domestic violence and the impact on themselves and their children 17. Thousands of women each year are victims of domestic violence.Almost one-third of female homicide victims that are reported in police records are killed by an intimate partner, Domestic Violence has a profound and lasting impact on the children who witness it or who themselves are victims of the abuse. Statistics rarely tell the story since most cases of domestic violence go unreported. Teen dating violence is an issue that has come to the forefront in recent years. Statistics from the Center for Disease Control state that in a nationwide survey, 9.8 percent of high school students report being hit, slapped, or physically hurt on purpose by their boyfriend or girlfriend in the 12 months prior to the survey in 2009. Other statistics from the CDC state that 1 in 4 adolescents report verbal, physical, emotional, or sexual abuse from a dating partner each year. About 10% of students nationwide report being physically hurt by a boyfriend or girlfriend in the past 12 months, Dating violence often starts with teasing and name calling. These behaviors can lead to more serious violence like physical assault and rape. Victims of teen dating violence are more likely to do poorly in school, and report binge drinking, suicide attempts, and physical fighting. Victims may carry the patterns of violence into future relationships. Our services to Chino Hills residents will include Teen Dating Violence Prevention programs in local middle and high schools. Project Name: services tor[tailored Women and their Children Page: 4 *Is the purpose of this project activity to: Help prevent homelessness? ✓ Yes 1.J No Help the homeless? ✓ Yes No Help those with HIV/AIDS? Yes ,/ No Primarily help persons with disabilities? Yes ✓ No 18) Identify the specific need being addressed by the proposed project in the 2010-2015 City of Chino Hills Consolidated Plan (see Exhibit D, page 13). City of Chino Hills Consolidated Plan CDBG Program Priorities: House of Ruth addresses the needs of battered and abused spouses/children's services which is an activity listed under 7)Provide Needed Community Services. House of Ruth provides walk-in center services and emergency shelter for battered women and their children.Agency services include therapeutic counseling for abused children.Our food pantry provides emergency food for walk-in center clients. Case managers assist with housing and employment.According to HUD regulations, battered women are presumed low income.Our own intake data indicates that approximately 95%of our clients are in the low/very low income range. Many families are at poverty level. 19) Please identify unduplicated (new clients) persons/households: Check One: 7 Persons Households Total number of persons or households to be served by the proposed project: 14,000 a) Of the total number to be served, how many are Chino Hills residents: 255 b) Of the total number to he served, how many are low/moderate-income: 95% 20) Was this project previously funded with Chino Hills or other CDBG funds? jI Yes No If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. A list of CDBG grant sources for the past 5 years are attached, All funds were expended within the program year. In addition to local CDBG funding, House of Ruth also receives support each year from other Cities in our service area. The Cities of Claremont and Montclair provide funding through City general funds. The City of Ontario provides an Emergency Shelter grant. ' Continued on Attachment 21) It your organization is a non-profit organization, provide and/or attach the following documentation as applicable: 1. Copies of both State and Federal tax exemption determination letters; 2. List of organization's board of directors, board members, and titles, 3. Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; 5. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed project or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed project; if applicable. Page 17 of 24 Page 4(a) 20. CDBG Grant Funds—Five Years Source 12010/11 12009/10 12008/09 12007/08 12006/07 Chino 14,025 14,600 14,600 14,600 14,600 I Chino Hills 14,000 I 4,000 ( 4,000 14,000 14,000 Pomona 110,886 19,000 18,796 110,000 110,000 Rancho 7,400 7,400 7,400 7,600 7,600 Cucamonga San Bernardino 25,000 20,000 20,000 10,000 10,000 County Project Name: Services for liallcied women end their Children Page: 5 22) Is your organization considered a faith-based organization? Yes I✓I No 23) Describe organization's mission and goals. House of Ruth's mission is twofold:to advocate for and assist women victimized by domestic violence and children exposed to violence in transforming their lives by providing culturally competent shelter, programs, opportunities and education: and to contribute to social change through intervention, education, prevention programs and community awareness. In addition working directly with domestic violence victims, House of Ruth works within the community to foster system change and assist other agencies in the community as they work with battered and homeless women and children,We partner with coalition groups and other community service providers to enhance and increase services to victims of domestic violence. Training is provided to hospital and law enforcement personnel, social services agencies, and other groups in the community,A program of prevention education provides vital information to the community in an effort to create awareness of this continuing problem. The overall goal of House of Ruth is to provide a place of safety where battered women and their children will receive quality services. Each year this goal is accomplished through our many programs for women and children who seek our services. 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. History: House of Ruth is a non-profit agency that has served the City of Chino Hills and neighboring communities for 32 years, providing comprehensive programs and services for victims of domestic violence. House of Ruth's history includes the opening of an emergency shelter in 1981, followed by the establishment of an outreach office in the City of Pomona. The West End outreach office was opened in 1988 and is now located in Ontario. What began in 1977 as a hotline with referral services has grown to include residential programs and services, a children's program at the shelter, and self-sufficiency programs and outreach services in two counties. Last year House of Ruth provided direct services to more than 1,400 persons. In addition, more than 200 calls a month were received on our 24-hour hotline. Each year, prevention education is provided for approximately 10,000 persons in local communities. The agency's comprehensive approach to domestic violence programming extends beyond short-term emergency needs.A two-year Transitional Living Program bridges the gap between emergency shelter and permanent housing. Families exiting from emergency shelter can apply for residency in House of Ruth's transitional shelter. House of Ruth began transitional living in 1993 as a six-month program in a rented three-bedroom house. In 1999, the agency purchased and renovated an 18,000 square foot facility for its residential programs. Transitional living is now provided for women and their children for up to two years in completely furnished one-bedroom suites, providing 25 beds for transitional residents. Support and services in the Transitional Program help to insure the maximum degree of success for participating families. No rent is charged for transitional shelter. The women are required to save 30% of any income they earn while they are in the program.The money is returned to them when they leave, and may be used for housing, a car, education or job training. Continued on attachment Page 18 of 24 Page 5(a) 24. Programs and Services: For battered women seeking support in an outreach setting, services are provided at two conveniently located walk-in centers. House of Ruth's west-end outreach office is located in the City of Ontario. Supportive services at the walk-in centers include case management, counseling, parenting classes, housing and employment assistance, and legal and social services advocacy. Childcare is provided during a mother's program participation. Safety measures for battered women and their children may include obtaining a temporary restraining order (TRO). For residents of San Bernardino County, assistance is provided at House of Ruth's TRO Clinic at the Foothill Law and Justice Center in Rancho Cucamonga. Women are helped with the paperwork and process of filing a restraining order. House of Ruth also provides a supportive services program that helps women participating in CaIWORKs to overcome domestic violence barriers to self-sufficiency. Services at our emergency shelter include case management, counseling, support groups, workshops, legal and social services advocacy, job search, and finding a safe place to go when leaving shelter. A children's program provides a safe place for children to talk about the violence they've witnessed. A doctor from a local medical clinic visits the shelter several times a month and provides assistance with medical assessments and prescription medicines. Staffing: The Agency is headed by an 18 member Board of Directors and Executive Director Suzanne Aebischer who has a BA in Social Welfare, 30 years experience in the field of domestic violence and shelter management, and who has been with the agency for 19 years. CFO Sharon McGrath-Gold has a BA in Psychology, MA in Business Administration, 24 years contract administration experience and has been with the Agency for 9 years. Program Director, Michelle Roberts, has 8 years prior experience as the Executive Director of a rape crisis/domestic violence agency, 10 years experience developing program evaluation, and has been with the Agency for 5 years. Current staffing includes 44 full time and part time program and administrative personnel. Key management staff have degrees in the field of Social Services. Counseling staff have Masters degrees, two staff are licensed. Many of our direct service staff have Bachelor's degrees. Several have advanced degrees. One third of all staff are bilingual English/Spanish. All House of Ruth staff are required to have 40 hours of domestic violence training. Accounting/Financial: House of Ruth is a well-run,fiscally efficient agency. Our most recent fiscal audit supports the fact that 77 cents of every dollar spent by House of Ruth went directly to client services,with 23 cents spent on administrative costs and fundraising. House of Ruth programs are supported by 22 Federal, State and local government grants, a variety of foundation grants, community donors, and agency events. Most of our government grants have been in place for more than 15 years and continue to be funded. House of Ruth has developed policies and procedures that insure the integrity of and accountability for agency funds.All policies and procedures are documented in the Agency's "Accounting & Financial Policies and Procedures Manual".A Fraud Hotline has been established through which staff may call, either anonymously or by name,to leave an information message if they think fraud has been committed. Messages from the hotline are retrieved by a Board member and are kept in strict confidentiality. The following are House of Ruth's current accounting procedures: a The Staff Accountant maintains a computerized accounting system, with Accounts Payable and General Ledger.The system is designed to allocate expenditures and funds received by fund source designation, and produces reports in the same format. Income and expense accounts in the General Ledger are maintained by the Staff Accountant. a Incoming checks and cash from government grants are received by the Grants Analyst. Foundation and private donor cash and checks are received by the Administrative Assistant. Page 5(b) • The Grants Analyst posts the amounts of incoming checks and cash to the Accounts Receivable Spreadsheet, Amounts received are compared to the correlating reimbursement requests. If discrepancies are found, the Grants Analyst follows up with the funding source from whom the check was received. • Checks and cash are given to the Staff Accountant who logs them into a cash receipts journal and posts the incoming revenue to the General Ledger. • Bank deposits are prepared and made by the Staff Accountant. Deposits are reviewed and approved by the Chief Financial Officer. Bank accounts are reconciled monthly by the Staff Accountant and reviewed by the Chief Financial Officer. • Requisition requests and vendor invoices are approved for payment by the Chief Financial Officer. Checks are drawn by the Staff Accountant with two signatures required on checks over$2,500. Checks are signed by the Executive Director. • Monthly/quarterly reimbursement requests to funding sources are completed by the Grants Analyst, signed and approved for mailing by the Executive Director and/or the Chief Financial Officer, • Payroll is processed by the Staff Accountant through a payroll service. Payroll information is uploaded online. Payroll is generated by-monthly.The Grants Analyst is the alternate for processing payroll. • Monthly financial statements are prepared for the Board Finance Committee by the Staff Accountant. Statements are reviewed and approved by the Executive Director, the Chief Financial Officer, and the Board Finance Committee. Statements are presented to the full Board of Directors quarterly. SoMcas'.or H2Oa,S Woman and,tch Chian Project Name: Page: 6_ EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is$5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of any proposed increase in services, and estimate costs accordingly. 1111 11:111'10 1 ' ,_ VOLUNTEER HOURLY - HRS.` MONTHS -'` POSTTIOMjTX'1`,LE ` PER. TOTAL COST CDBG SHARE,iN` - ,jN} EMPLOYED , Prevention Coordinator1 N $ 18.381 30 12 ( $28,688 $2,795 Grants Analyst N I $20.381 4Q 12 $43,390 $500 Community services word,I N 1 $20.251 40 12 l $42,120 $759 Additional Staffing! $ l $ $ Residential Staffl N 1 $Variedl Varied 12 $515,109 $0 Community Services Staff I N I $Variedl Varied 12 $313,719 $0 Housing Assistance Staff N $Varied! 40 12 $ 131,472 $0 Counseling Staff N $VariedIvariedl 12 $289,867 $0 Administrative Staff N $ Varied 40 l 12 15372,635 l $0 I $ I I IS 1 $ WAG SUBTOTAL FOR 1 $1 ,737,000 1 $4,054 FRINGE BENEFITS: TYPE OF COSTS 4 PERCENT OF SALARY j TOTAL COST I CDBG SHARE FICA 1 7.65% $ 132,880 $310 sui l 5.68% 1 $98,661 $230 I OTHER l 10% $172,937 $406 SUBTOTAL FOR FRINGE BENEFITS $404,478 $946 I TOTAL COST I GUBG ¶ARE TOTAL PERSONNEL/STAFF COSTS $2,141 ,478 $5,000' Page 19 of 24 Services Fnr Bahered Women and Children 7 Project Name: Page: _ (B) PROPOSED PROGRAM BUDGET OVERVIEW: Include all costs associated with the proposed program A) COST CATEGORY B,) TOTAL COST C) CDBG SHARE SPACE RENTAL I $ 15,480 $0 UTILIl1ES $224,015 $0 GENERAL LIABILITY INSURANCE 1 $42,500 $0 AUTOMOBILE LIABILITY INSURANCE $Included in General Liability $0 WORKER'S COMPENSATION INSURANCE $Included in Benefits $0 OTHER INSURANCE:All insurances are included in General Liability $ $0 CONSULTANT SERVICES $103,300 $0 TRAVEL $22,680 $0 SUPPLIES 1 $36,550 $0 EQUIPMENT $34,000 $0 OTHER: Client Assistance $ 196,619 $0 OTHER: Postage, Printing I $31 ,250 I $0 OTHER: Conferences, Miscellaneous $51 ,920 $0 TOTAL SUPPLIES AND SERVICES I $758,314 $0 Page 20 of 24 Services for Battered Women end Children 8 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate. 2, Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4. Sufficient funds are available to complete the project as described, if CDBG funds are approved. House of Ruth, Inc. Organization Services for Battered Women and their Children Project Name Suzanne Aebischer, Executive Director Print Name and Title of Authorized Person \Ati /1-A.J14.412_0-(jAs /02h-9f/10 Signatuth of Authorized Person Date Signed Page 22 of 24 City of Chino Hills Page 9 CDBG Application Exhibit F Project/Program Work Schedule Time Frame Task/Deliverable Person Responsible Quarter 1 Respond to 10 Hotline Calls House of Ruth staff on duty Provide Services to 3 families at Community Services Coordinator the Walk-in Ctr. Case Manager/Counselor Quarter 2 Respond to 10 Hotline Calls House of Ruth staff on duty Provide Services to 3 families at Community Services Coordinator the Walk-in Ctr. Case Manager/Counselor Provide domestic violence Prevention Coordinator prevention presentations to 50 persons Quarter 3 Respond to 10 Hotline Calls House of Ruth staff on duty Provide Services to 3 families at Community Services Coordinator the Walk-in Ctr. Case manager/Counselor Provide therapeutic counseling Children's Therapist to 2 children Provide domestic violence Prevention Coordinator prevention presentations to 50 persons Quarter 4 Respond to 10 Hotline Calls House of Ruth staff on duty Provide Services to 3 families at Community Services Coordinator the Walk-in Ctr. Case manager/Counselor Provide emergency shelter to 1 Shelter Case Manager/Advocates family Provide domestic violence Prevention Coordinator prevention presentations to 100 persons. The schedule is a projection. Work to be accomplished is dependent upon the needs and requests of Chino Hills residents. Senfes for flattered Women and their t,hUdren 1 0 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Submittal Checklist IV( Completed and signed application (including Attachment A); and the following mandatory attachments: MI Copies of both State and Federal tax exemption determination letters; [ List of organization's board of directors, board members, and titles; [12/ Copy of organization's articles of incorporation and bylaws; [s/ Copy of organization's conflict of interest policy; [ / Copy of most recent annual audit or current balance sheet; ❑ Copy of lease (if CDBG funding request involves the reimbursement of rental N//t expenses to conduct proposed project or make improvements to property not owned by applicant); For donated space: A letter from outside organization detailing terms of N/A donated space to conduct the proposed project, if applicable; Submit the original and one additional complete copy of the application, including Attachment A. Submissions should be unbound on white paper with the name of the applying organization and the project name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the meetings. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717, or by e-mail at Ichristensen(achinohills.oro. Page 24 of 24 San Bernardino County Library 11-02 COUNTY or SAN BERNARDINO Sara: r N BERNARDINO COUNTY LIBRARY 4` Ar SAN BERNARD • 104 W.4th Street•San Bernardino,CA 92495-0035 • (909)387.5720 5 LEONARD X.HERNANDEZ Fax(909)387-5724 -��" County Librarian January 3, 2011 '114A14 4 1147AH Michael S.Fleager,City Manager City of Chino Hills 14000 City Center Drive Chino Hills,CA 91709 Dear Mr.Fleager, Thank you for allocating$21,000 during Fiscal Year 2010-11 in Community Development Block Grant(CDBG) funding for library literacy service at the San Bernardino County lames S.Thalman Chino Hills Branch Library. Enclosed is a CDBG 2011-12 application,which I am submitting for your perusal.This grant application will allow the continuance of successful literacy services in your cormmn nity,by helping to maintain current service hours at your local branch library. While the County Library provides a County-wide Literacy Program through ten literacy coalitions; this grant proposal seeks to provide increased Literacy services. CDBG funding is also used as a funding/dollar match for California Literacy Campaign funds from the California State Library. As a result,both funding sources combine to provide and expand the literacy programming in your community each year. The Chino Hills Branch Library Adult Literacy Program services include a Literacy Specialist on site who is available for student interviews, assessment,student/tutor matching,reporting,tutor training and volunteer recruitment. Specially trained library staff members are also "able to assist people in their quest to become literate,as well provide Mature Driver Education and Basic Computer Literacy instruction. :assists learners with selection of literacy materials that include; English Language improvement materials,reading and writing workbooks,career materials,computer and math books,parenting and children's materials.Preschool story hours where families receive information about literacy events,training and services are offered.Additionally,the Literacy Specialist and library staff assist with reference and library orientation of resources and services in general. Literacy Services are provided to program participants at no charge. Individual student goals include but are not limited to reading,writing,spelling and math improvement,employment or career advancement, computer literacy and parenting assistance. Special displays,a designated area for literacy materials and one-on-one free tutoring will be provided.This grant seeks funds for personnel costs for Literacy Services in the amount of$10,000. All materials,books and other operational costs such as utilities continue to bo provided by the County Library. • While no one can dispute the economic value of a functionally literate populace the byproduct of this program is that the library will continue to be open additional hours. Adult Literacy Services are available to all Chino Hills residents who seek to take advantage of these no-cost services provide by their community library. While block grant funds may be targeted for other uses in your community, this program would provide a viable community service to a significant portion of your community,as statistics indicate that 1 in 7 American Adults is functionally illiterate. Should you have any questions regarding this proposal,please do not hesitate to contact me. Thank you for your consideration in tins matter and,Hook forward to a successful collaborative effort. Sincerely yours, Leonard Hernandez rnty Librarian cc: Supervisor Ovitt County Administiative Officer Board of Supervisors Gregory C. Devereaux BRAD NIITZELFELT . First District NEIL DERRY. . . .. . . . . . .. . . . Third District JANICE RUTHERFORD Second District GARY C.OVII T.. . ........ . Fourth District JOSIE GONZALES Fifth District '1' -1 /� Project Name: Adult Literacy Services Page: 1 =r / EXHIBIT F Q CITY OF CHINO HILLS ^; COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG) APPLICATION APPLICATION DEADLINE: 5:00 P.M. on WEDNESDAY. JANUARY 5. 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please type or use a computer-generated form. Handwritten applications will not be accepted. 1) Name of Agency: San Bernardino County Library, James S. Thalman Chino Hills Branch 2) Name/Title of Workshop Attendee: Lisa Llewellyn, Literacy Services Coordinator 3) Mailing Address where correspondence about this application is to be sent: 104 West 4th Street San Bernardino CA 92415-0035 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: 14020 City Center Drive Chino Hills CA 91709 Street City State Zip 5) Physical Address where project records will be kept for monitoring purposes. Add additional lines if there is more than one location: 14020 City Center Drive Chino Hills CA 91709 Street City State Zip 6) Federal Tax I.D. No.: 95-6002748 7) CA Franchise Tax Board I.D. No.: 8) Contact Person's Information: Lisa Llewellyn, Literacy Services Coordinator Illewellyn@lib.sbcounty.gov Name/Title Email Address (909) 574-4561 (909) 574-4566 Phone Number Fax Number 9) Authorized Person's Information (if same as Contact Person, note "same"below): Leonard Hernandez, County Librarian Ihernandez©lib.sbcounty.gov Name/Title Email Address (909) 387-5721 (909) 387-5724 Phone Number Fax Number Project Name: Adult Literacy Services Page: 2 10) Project Name: Adult Literacy Services, James S. Thalman Chino Hills Branch Library 11) Briefly describe the proposed project and what goal(s) it is intended to achieve: The Adult Literacy Program provides free tutoring services to illiterate adults in reading and writing. These English-speaking adults are assessed and matched with trained tutors. The tutor and adult learner meet one to two times per week at the library for individualized instruction in reading and writing. According to the 2009 U.S. National Assessment of Adult Literacy, one in seven adults have difficulty reading anything more challenging than a children's picture book. A previous national assessment indicated that 14 million Californians are at the "below basic" literacy level. In San Bernardino County alone it is estimated that 350,000 cannot read or write. The goal of the Adult Literacy Program is to equip adult participants with life-long learning sills and prepare them for personal, family, career and community success. Learning to read has a great impact upon a person's life, and the benefits extend far beyond the ability to open a book and read. Great employment opportunities, higher wages, school involvement and voting are some the benefits of the ability to read and write. The Adult Literacy Program will also provide services targeted to the needs of senior residents of Chino Hills by offering free weekly Mature Driver Education and Basic Computer Skills for Seniors Classes. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. Availability/Accessibility This category applies to proposals that make services, infrastructure, housing, shelter or jobs available or accessible to low and moderate-income persons, including persons with disabilities. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Affordability This category applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. II Enhances the living environment through new/improved availability 1 Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Page 15 of 24 • Project Name: Adult Literacy Services page: _.3 Promoting Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping to make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability ✓1 Promotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category. Describe the anticipated quantifiable results of your proposal for the selected category. The Adult Literacy Program meets the first CDBG National Objective set forth by HUD by benefitting low and moderate income individuals. the income level of program participants will be obtained by utilizing the City of Chino Hills CDBG Beneficiary Qualification Statement. The adult participant will document his/her address, family income level,ethnicity, and female head of household status. Additionally, illiterate adults fall within HUD's Presumed Benefit criteria. All client/participant documentation will be kept in a locking cabinet within the Chino Hills Library. Program staff will submit Quarterly Reports to the City of Chino Hills. Program staff will provide Literacy services to 48 low and moderate income Chino Hills residents. 14) Please check one that best identifies the nature of the Project in Chino Hills': Start-Up I I One-Time I✓I Continuing I I Expansion 15) Project/Activity Type: III Public Service Li Capital Improvement (Requires cost estimate) 16) If"Capital Improvement" is selected, provide the location of the project by census tract and block group number. Census Tract Block Group NOTE: Most construction projects (other than some residential rehabilitation) will be required to meet HUD labor requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. The Adult Literacy Program serves a great need by helping Chino Hills residents reach their individual learning goals such as: obtaining a driver's license,preparing a resume', finding a job, helping children with school work, passing the GED, using the Internet, etc. By achieving individual goals, the success of the adult participant resonates throughout the family and community at large, Increased literacy skills often lead to greater employment opportunities and increased Family Median Income level for participants. 1 start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that is expanded In scope, not just that more people are served. Page 16 of 24 Project Name: Adult Literacy Services page: 4___ *TstbepUrpore. ofth/sp ject ato: Help prevent homelessness? �~ Yes I No Help the homeless? Yes 10 No Help those with HIV/AIDS? Yes I No Primarily help persons with disabilities? Yes SI No 18) Identify the specific need being addressed by the proposed project in the 2010-2015 City of Chino Hills Consolidated Plan (see Exhibit D, page 13). As identified in the 2010-2016City 0fChino Hills Consolidated Plan, Exhibit D # 7' The Adult Literacy Services provides needed community services to "other low and moderate incOnA8." The Adult Literacy Program specificaHy targets illiterate adult learners, a presumed class within the category of Low and Moderate Income Individuals. Services are also provided to Seniors, a presumed class, via the Mature Driver Education Course. 19) Please identify unduolicated (new clients) persons/households: ^�| Check One: Persons | Households � | Total number of persons or households to be served by the proposed project: Ufthe total number tnheSo[ved, huw/ ooanyare Chino HUls a) 4� residents: b) Of the total number to be served, how many are low/moderate-income: 48 20) Was this project previously funded with Chino Hills nrother CDBGfunds? Yes No |� If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. The James S. Thalman Chino Hills Branch Library has previously received CDBG funding from the City of Chino Hill, with record of funding going back to 2003. For Fiscal Year 20OR-10. approximately $11000fCDBGwere not expended, For current Fiscal Year 2010-11, the Adult Literacy Services Program is receiving CDBG funding from City of Chino Hills and is on track to have all funds expended by June 30th. 21) It your organization is a nnn'pro|i[ organiz3bOn/ provide and/or attach the following documentation as applicable: 1. Copies of both State and Federal tax exemption determination letters; 2. Ust of organization's board of directors, board members, and titles. 3. Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; 5. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed project or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed project; if applicable. Page 17 of 24 Project Name: Adult Literacy Services Page: 5 22) Is your organization considered a faith-based organization? Yes I No 23) Describe organization's mission and goals. The San Bernardino County Library is the community's resource for access to information to promote knowledge, education, lifelong learning, leisure and cultural enrichment for the people of the County of San Bernardino. The Mission of the San Bernardino County Library's Literacy Program is to support the San Bernardino County Library. This is accomplished by providing, free, individualized Literacy Services and materials to our patrons, community members and their families in a confidential, non-threatening, and learner-centered environment, in order to equip participants with lifelong learning skills and prepare them for personal, family, career and community success. • 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. The San Bernardino County Library System has provided Adult Literacy Services throughout the County since 1984. Over the past 27 years the SBCL Adult Literacy Program has seen continuous expansion;growing from an initial start-up with 4 library-based Literacy sites, to a total of 13 such sites providing Literacy services in 2011.SBCL Adult Literacy Services expanded to the Chino Branch Library in 1994. Each of the 13 Literacy sites has a dedicated staff Literacy Specialist,who reports to the SBCL Literacy Coordinator as well as their respective Library Branch Managers. Current James S.Thalman Chino Hills Branch Library Literacy Specialist,Anne Fine,works part-time and provides 19 hours of Adult Literacy Services programming per week. Literacy Specialist duties include: community outreach and Adult Literacy Services Program promotion, intake and assessment of new adult learners, recruitment and training of tutors, instruction of weekly Mature Driver Education Class, maintenance of program files per Federal, State and local government guidelines, assisting clients with mandatory Beneficiary Qualification Statements,and submission of required CDBG Quarterly Reports. The Chino Hills Library Branch Manager provides additional support to the Adult Literacy Program through Instruction of weekly Basic Computer Literacy Classes, new client referrals, and assistance with participants's CDBG paperwork. Each Literacy site tracks participant statistics as well as accrued instructional/tutoring hours in the online centralized database, LiteracyPro Systems, for required reporting to the California State Library Literacy Services and other local government agencies. Maintenance and submission of CDBG billing is provided by SBCL Administrative Fiscal Analyst and Assistant Fiscal Clerk. Payroll records indicating labor hours spent on the program are provided as well as other documentation as to what public interaction activities occurred during those labor hours. Funds are received on reimbursement (by agency warrant) process. Revenues and expenditures are tracked in FM, Revenues are tracked by org code denoting the branch that funds are applicable to, a GRC code is used to denote funds that are specifically for a CDBG Grant Program. Expenditures on the program are for salary and detailed in the invoicing process using EMACS Reports. Page 18 of 24 Adult Literacy Services Project Name: Page: 6 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is $5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of any proposed increase in services, and estimate costs accordingly. HRS. VOLUNTEER HOURLY MONTHS POSITION/TITLE PER EMPLOYED TOTAL COST CDBG SHARE (Y/N) RATE WK. Literacy Specialist N $ 13.47 19 12 h3,308.36 j s 8,000.00 Librarian II N $28.04 3 12 $4,430.40 $2,000.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ SUBTOTAL FOR WAGES $ 17,738.76 $ 10,000.00 FRINGE BENEFITS: TYPE OF COSTS PERCENT OF SALARY TOTAL COST CDBG SHARE FICA H SUI OTHER SUBTOTAL FOR FRINGE BENEFITS $ $ I TOTAL COST CDBG SHARE TOTAL PERSONNEL/STAFF COSTS $ 17,738.76 $ 10,000 00 Page 19 of 24 Project Name: Adult Literacy Services Page: 7 (B) PROPOSED PROGRAM BUDGET OVERVIEW; Include all costs associated with the proposed program A) COST CATEGORY I B) TOTAL COST C) CDBG SHARE SPACE RENTAL $ I $ UTILITIES S $ 1111 GENERAL LIABILITY INSURANCE $ $ AUTOMOBILE LIABILITY INSURANCE WORKER'S COMPENSATION INSURANCE I $ $ OTHER INSURANCE: $ $ CONSULTANT SERVICES $ $ TRAVEL $ $ SUPPLIES $ 500 $ EQUIPMENT $ $ OTHER:Consumable student workbooks,GED study guidestlest prop&Dictionaries $4,500 $ OTHER: $ j $ OTHER: $ $ TOTAL SUPPLIES AND SERVICES $5,000 $0 Page 20 of 24 Not Applicable NIA Project Name: Page: _ EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Capital Improvement Budget You must submit one or more written cost estimates from a licensed and insured contractor with this aoolication. Guidance: Please use the following to present your CDBG request for funding. In column A, list budgeted items for your project/activity. In Column 13, provide the projected amount and calculation for each budgeted item. In Column C, provide the calculation and projected amount for CDBG request of funds. A) COST CATEGORY B) TOTAL COST C) CDBG SHARE PERSONNEL EXPENSES TOTAL PERSONNEL $ DELIVERY COSTS ACQUISITION SITE DEVELOPMENT MATERIALS PHYSICAL INSPEL i IONS ARCHITECTURAL. ENGINEERING REHAB LOAN COSTS $ PERMITS AND FEES $ INSURANCE $ LEGAL FEES I $ FINANCING APPRAISAL COSTS $ TOTAL DELIVERY COSTS $ CONTRACT SERVICES js $ $ TOTAL CONTRACT SERVICES $ BUDGET TOTAL $ $ Page 21 of 24 Project Name; Adult Literacy Services Page: 8 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate. 2. Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4. Sufficient funds are available to complete the project as described, if CDBG funds are approved. San Bernardino County Library, James S. Thalman Chino Hills Branch Organization Adult Literacy Services Project Name Leonard Hernandez, County Librarian Print Name and Title of Authorized Person January 3, 2011 Sigfi-iture of Authorized Person C) Date Signed Page 22 of 24 Project Name: Adult Literacy Services. Chino Hills Branch Library Page: 10. Attachment A EXHIBIT F City of Chino Hills Community Development Block Grant Program APPLICATION -Attachment A PROJECT/PROGRAM WORK SCHEDULE Time Frame Task/Deliverable Person Responsible 1st Quarter (July-Sept) Advertise/publicize program Chino Hills Literacy Specialist in Chino Champion, PSAs in area newspapers, post flyers throughout community & in library, promote on library homepage. Assist 12 low/mod clients through: a.) One-one-one basic literacy tutoring b.) Mature Driver Education Class c.) Basic Computer Skills Chino Hills Library Branch for Seniors Manager 2nd Quarter (Oct— Dec) Continue to promote Chino Hills Literacy Specialist program via newspaper, flyers, homepage, etc. Provide Literacy Services to Chino Hills Library Branch 12 low/mod clients. Manager 3rd Quarter (Jan— Mar) Continue to program via Chino Hills Literacy Specialist print materials & online. Provide Literacy Services to Chino Hills Library Branch 12 low/mod clients. Manager 4r° Quarter (Apr—June) Provide Literacy Services to Chino Hills Literacy Specialist 12 low/mod clients. ServicesAdult Literacy 0 �� Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Submittal Checklist V Completed and signed application (including Attachment A); and the following mandatory attachments: Ll Copies of both State and Federal tax exemption determination letters; • F- List of organization's board of directors, board members, and titles; [— Copy of organization's articles of incorporation and bylaws; | | Copy of organization's conflict of interest policy; | � Copy of most recent annual audit or current balance sheet; Li Copy of lease (if CDBG funding request involves the reimbursement of rental expenses to conduct proposed project or make improvements to property not owned by applicant); | | For donated space: A letter from outside organization detailing terms of donated space to conduct the proposed project, if applicable; Submit the original and one additional complete copy of the application, including Attachment A. Submissions should be unbound on white paper with the name of the applying organization and the pject name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the nneeOnqs. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717, or by e-mail at |ch|iSiensen(aChiUohi||s.oro. Recreation Division 11-03 c"`"-"`"u"—"'"`""Ps""-14"'" rrm M..Nu.summm o.v Cnmps""-1pp. ',m 1 Project Name: Page: HIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBGEX) APPLICATION APPLICATION DEADLINE: 5:00 P.M. on WEDNESDAY. JANUARY 5. 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please type or use a computer-generated form. Handwritten applications will not be accepted. 1) Name of Agency: City of Chino Hills 2) Name/Title of Workshop Attendee: Christine Martinez/Recreation Supervisor 3) Mailing Address where correspondence about this application is to be sent: 14000 City Center Drive Chino Hills CA 91709 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: Street City State Zip 5) Physical Address where project records will be kept for monitoring purposes. Add additional lines if there is more than one location: 14000 City Center Drive Chino Hills CA 91709 Street City State Zip 6) Federal Tax I.D. No.: 330-490-245 7) CA Franchise Tax Board I.D. No.: 8) Contact Person's Information: Christine Martinez cmartinez@chinohills.org Name/Title Email Address (909) 364-2702 (909) 364-2735 Phone Number Fax Number 9) Authorized Person's Information (if same as Contact Person, note "same"below): Same Name/Title Email Address Phone Number Fax Number [Ay va CIJ.a NW Eunow Day Cart,6Alm1/4p,mpen Project Name: Page: 10) Project Name: City of Chino Hills Summer Day Camp Scholarship Program 11) Briefly describe the proposed project and what goal(s) it is intended to achieve: A 10 week Summer Day Camp program offered at Grand Avenue Park and Mystic Canyon Park from June-August. Both Summer Day Camp locations host 50 campers each. The program will be offered Monday-Friday from 7:00 a.m.-6:00 p.m. Children participate in a variety of camp activities including arts and crafts, games, sports, movie days,"Party Friday's", two field trips a week, educational activities, and all receive a camp T-shirt. City staff coordinate the program with assistance from the Volunteens. The cost of the program is$108 per camper per week for a total of$972 per camper for the entire 9 week program. Staff receive inquiries annually regarding financial assistance for residents unable to afford the cost of camp. Those residents that have been awarded scholarships in the past have thanked the City for its generosity and commented on the positive Impact it has had on their children. The program has promoted self-esteem and allows these children a safe and fun environment to socialize with other children and not have a economical barrier. Many have made lasting friendships and have been able to fully embrace what recreation Is all about. This would not be possible without this assistance. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. Availability/Accessibility This category applies to proposals that make services, infrastructure, housing, shelter or jobs available or accessible to low and moderate-income persons, including persons with disabilities. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Affordability This category applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. II Enhances the living environment through new/improved availability Creates decent housing with new/improved availability II Promotes economic opportunity through new/improved availability Page 15 of 24 Project Name: "'""°"—"""`'"•'"'"'"' Page: 3 Promoting Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping to make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability LiPromotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category, Describe the anticipated quantifiable results of your proposal for the selected category. The locations in which camp is held are located in one of the lower income areas of Chino Hills, Many of the neighborhood children participate in the City's free Mobile Recreation Program. Most do not have access to the funding necessary to register for the Summer Day Camp program and have had little participation in Recreation. 14) Please check one that best identifies the nature of the Project in Chino Hills': Start-Up I I One-Time ISI Continuing ri Expansion 15) Project/Activity Type: �/ Public Service I I Capital Improvement (Requires cost estimate) 16) If "Capital Improvement" is selected, provide the location of the project by census tract and block group number, Census Tract Block Group NOTE: Most construction projects (other than some residential rehabilitation) will be required to meet HUD labor requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. Participants engaged in recreational activities have an increased sense of social well-being, self esteem, and belonging. Through activities at Day Camp they are able to socialize with many other children making friends of all ethnicities, ages, and financial background without being singled out. 1 Start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request Is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that is expanded in scope, not just that more people are served, Page 16 of 24 Project Name: c"`"'"'"'4"'"`"'`"*"5"°"°— Page: 4 *Is the purpose of this project activity to: Help prevent homelessness? Yes 171 No Help the homeless? Yes [I] No Help those with HIV/AIDS? Yes Ea No Primarily help persons with disabilities? Yes No 18) Identify the specific need being addressed by the proposed project in the 2010-2015 City of Chino Hills Consolidated Plan (see Exhibit D, page 13). Provide Needed Community Services: Child Care Services 19) Please identify unduplicated (new clients) persons/households: Check One: it Persons I I Households Total number of persons or households to be served by the proposed project: Of the total number to be served, how many are Chino Hills a) 10 residents: b) Of the total number to be served, how many are low/moderate-income: 10 20) Was this project previously funded with Chino Hills or other CDBG funds? j Yes I I No If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. 2008, 2009, & 2010 21) It your organization is a non-profit organization, provide and/or attach the following documentation as applicable: 1. Copies of both State and Federal tax exemption determination letters; 2. List of organization's board of directors, board members, and titles. 3, Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; 5. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed project or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed project; If applicable. Page 17 of 24 Project Name: C"Mfsv "a—""°%C, "'""' Page: 5 22) Is your organization considered a faith-based organization? LJ Yes WI No 23) Describe organization's mission and goals. The goals of the Recreation Division are to provide a fun, safe, and active teaming environment for residents in Chino Hills through youth and adult programming in the areas of camps, classes,workshops, sports,tiny tots, trips, and special events. 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. Day Camp has been operating for 19 Years. Page 18 of 24 City of Olin*MI.Summer Day Gmp SdSarsN4 P.R., . 6 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is$5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of anv proposed increase in services. and estimate costs accordingly. VOLONTEER HOURLY HRS. MONHS '�' ( POSITION/TITLE � � PER TOTAL COST ��' CDBG SHARE ,' •&: IY/N) ,. � I I I I $ I $ $ $ I $ $ _ I $ $ $ $ I I $ V I $ $ $ I $ I $ $ $ I $ I $ I $ $ $ I $ I I $ I $ SUBTOTAL FOR $ $O WAGES FRINGE BENEFITS: TYPE OF COSTS OSTS I PERCENT OF SALARY I TOTAL COST 1 CDBG SHARE FICA $ $. , 1 SUI $ $ 1 OTHER I $ I $ 1 SUBTOTAL FOR FRINGE BENEFITS $ $ 1 TOTAL COST 104G_00'4,4, RE TOTAL PERSONNEL/STAFF COSTS $ $0 Page 19 of 24 sbaaum iuirt wm,e ow c..msma.waavAvnm 7 Project Name: Page: (B) PROPOSED PROGRAM BUDGET OVERVIEW: Include all costs associated with the proposed program A) COST CATEGORY B) TOTAL COST I C) CDBG SHARE { SPACE RENTAL $ I $ UTILITIES $ I $ GENERAL LIABILITY INSURANCE $ $ AUTOMOBILE LIABILITY INSURANCE $ I $ WORKER'S COMPENSATION INSURANCE $ I $ OTHER INSURANCE: $ I $ CONSULTANT SERVICES $ I $ TRAVEL $ I $ SUPPLIES $ I $ EQUIPMENT $ I $ OTHER: Scholarships for participants $ s$9,765 OTHER: $ I $ OTHER: $ I $ TOTAL SUPPLIES AND SERVICES I $ S$9,765 Page 20 of 24 uy&Chtr.wAa Summed Day comp Sdide.NPPrwmr, �Q Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate. 2. Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4. Sufficient funds are available to complete the project as described, if CDBG funds are approved. City of Chino Hills Organization City of Chino Hills Summer Day Camp Scholarship Program Project Name Christine Martinez, Recreation Supervisor Print Name and T - of Authorized Person / � 1/4/2011 Signature of Atithorized1 erson Date Signed Page 22 of 24 r�y.r OJ,o Hu,s.,s wr�mp sa,a,ma�rr wm 9 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Submittal Checklist n Completed and signed application (including Attachment A); and the following mandatory attachments: n Copies of both State and Federal tax exemption determination letters; I List of organization's board of directors, board members, and titles; Fl Copy of organization's articles of incorporation and bylaws; n Copy of organization's conflict of interest policy; 11 Copy of most recent annual audit or current balance sheet; n Copy of lease (if CDBG funding request involves the reimbursement of rental expenses to conduct proposed project or make improvements to property not owned by applicant); D For donated space: A letter from outside organization detailing terms of donated space to conduct the proposed project, if applicable; Submit the original and one additional complete copy of the application, including Attachment A. Submissions should be unbound on white paper with the name of the applying organization and the project name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the meetings. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717, or by e-mail at Ichristensen(achinohills.oro. Page 24 of 24 Summer Day Camp A ten-week Summer Day Camp program is offered at Grand Avenue Park Community Building and Mystic Canyon Community Building from June to August with 50 campers at Grand Avenue Park and 50 campers at Mystic Canyon. The program is offered from 7:00 a.m.to 6:00 p.m., Monday through Friday. Children participate in a variety of activities including arts &crafts, indoor games, and outdoor education. Camp includes a two weekly field trip on Tuesdays&Thursdays, a"Party Friday,"and a camp T-shirt. Camper to staff ratios; Daily: 10 to I Field trips: 6 to 1. Number of Participants: 100 Expenses 001-0900-888-4445 Supplies General Supplies (board games, decorations, crafts, toys, etc.) $7,450 $4,967 Party Day Supplies ($100 x 10 days x 3 camps) $3,000 $0 Party Day Supplies($100 x 10 days x 2 camps) $0 $2,000 $6 per shirt x 250 shirts $1,500 $1,500 Beach trip supplies ($100 x 3 camps) $300 $0 Beach trip supplies ($100 x 2 camps) $0 $200 Total Supplies $12,250 $8,667 Trio Tickets 001-0900-888-3190 125 tickets (100 campers, 17 staff, 8 volunteens) Disneyland (10:1 free$54 per person x 138 participants) $7,452. $0 Disneyland (10:1 free $54 per person x 115 participants) $0 $6,210 Lazer Tag ($12 per child x 120 children) $1,440 $0 Lazer Tag ($12 per child x 108 campers and volunteens) $0 $1,296 Movies (1 trip, $9.45 per person x 150 participants) $1,418 $0 Movies (2 trips x$1,200 theater rental at Harkin's Theatre) $0 $2,400 Roller Skating($8.50 per child x 129 children) $1,097 $0 Roller Skating($8.50 per child x 108 children) $0 $918 Bowling ($14 per hour per lane x 30 lanes x 2 hours) $840 $0 Bowling($14 per hour per lane x 20 lanes x 2 hours) $0 $560 Knott's Soak City(15:1 free $15.99 per person x 140 participants) $2,239 $0 Knott's Soak City(15:1 free $18.99 per person x 117 participants) $0 $2,222 El Capitan Theatre ($11 per participant x 150 participants) $1,650 $0 Knott's Berry Farm (15:1 free$19.99 per person x 140 participants) $2,799 $0 Knott's Berry Farm (15:1 free$21.99 per person x 117 participants) $0 $2,573 Wild Rivers (10:1 free $14.50 child $20.50 adult) $2,444 $0 Wild Rivers (10:1 free/$15 child/$22 adult) $0 $2,486 Reptile Show($150 per hour x 3 shows) $450 $0 Reptile Show ($150 per hour x 2 shows) $0 $300 California Adventure(10:1 free$50 per person x 138 participants) $6,900 $0 La Mirada Splash($13 adult&$9 child) $1,470 $0 La Mirada Splash ($14 adult&$10 child) $0 $1,318 Magic Show $350 $0 John's Incredible Pizza($5.99 per person x 150 participants) $899 $0 John's Incredible Pizza($9.00 per person x 125 participants) $0 $1,125 Rock City Climbing Center($15 per participant x 129) $1,935 $0 Jumping Jacks Bounce House(flat fee for all participants for 3 hours) $0 $600 Glen Helen Water Park($5 per participant x 125 participants) $0 $625 Summer's Last Blast $0 $500 Scandia($13.50 x 125 participants) $0 $1,688 Quakes Game($7 x 125 participants) $1) $875 Total Trip Tickets $33,383 $25,696 Transportation 001-0900-888-3190 13 trips with 3 buses $17,500 $0 7 trips with 2 buses $0 $8,500 Alliance Bus for local trips $5,959 $0 Alliance Bus for 10 local trips $0 $7,000 Bus Parking $375 $0 Bus Parking $0 $250 Total Transportation $23,834 $15,750 Contractual 001-0900-888-5610 Water and electricity costs to CVUSD $3,640 $0 Total Contractual $3,640 $0 Staff Recreation Specialist(day camp pre-season preparation) $12.80 per hour x 40 hrs $512 $0 $11.61 per hour x 60 hrs x 1 staff $0 $697 $11.06 per hour x 40 hrs x 2 staff $885 $0 $11.06 per hour x 60 hrs x 1 staff $0 $664 Senior Recreation Leader(day camp pre-season preparation) $10.02 per hour x 20 hrs x 2 staff $401 $0 $10.02 per hour x 40 hours x 1 staff $0 $401 $10.52 per hour x 20 hrs $210 $0 $10.52 per hour x 40 hrs x 1 staff $0 $421 Recreation Specialist(2 staff total) $12.80 per hour x 40 hrs per week x 10 weeks $5,120 $0 $11.61 per hour x 40 hrs per week x 10 weeks $0 $4,644 $11.06 per hour x 40 hrs per week x 10 weeks x 2 staff $8,848 $0 $11.06 per hour x 40 hrs per week x 10 weeks $0 $4,424 Senior Recreation Leader(2 staff total) $10.02 per hour x 35 hrs per week x 2 staff x 10 weeks $7,014 $0 $10.02 per hour x 35 hrs per week x 10 weeks $0 $3,507 $10.52 per hour x 35 hrs per week x 10 weeks $3,682 $3,682 Recreation Leader $9.76 per hour x 21 staff x 22 hrs per week x 10 wks $45,091 $0 $9.29 per hour x 20 staff x 21 hours per week x 10 weeks $0 $39,018 Extended Camp Hours $9.29 per hour x 2 staff x 5 hours per week x 10 weeks $0 $929 Total Staff $71,763 $58,387 Total Expenses $144,870 $108,500 1681g0 2r1C0 = 10 = 108.W x9 = q-1141.D A to =gmv5 West End YMCA 11-04 IJ- m In YMCA :z; We build strong kids, strong families,strong communities. Lara Christensen January 5, 2011 City of Chino Hills CDBG Dear Ms Christensen, Please find enclosed an application for CDBG funding for the Chino Valley YMCA Childcare Subsidy, The YMCA Childcare Subsidy program will provide financial subsidy to poverty, low and moderate income families from Chino Hills to attend YMCA Licensed Childcare. This includes before school, after school and summer care. In providing reduced fee childcare to low and moderate income families, this gives these participants access to a safe, nurturing environment for children to learn, grow and develop social skills and eases the burden of care for working families. This access will help families be healthy, confident and secure and strengthen the Chino Hills community. The YMCA is a powerful association of men, women and children joined together by a shared commitment to nurturing the potential of kids, promoting healthy living and fostering a sense of social responsibility. We believe that lasting personal and social change can only come about when we all work together to invest in our kids, our health and our neighbors. That is why, at the Y, strengthening community is our cause. Every day, we work side-by-side with our neighbors in our community to make sure that everyone, regardless of age, income or background, has the opportunity to learn, grow and thrive. Thank you for your work in strengthening our community. As partners and neighbors, we will continue to strive to enhance opportunities for our residents. Sincerely, Debra C. Anderson President/CEO Chino Valley YMCA• 5665 Edison Avenue • Chino, California 91710-9051 909-597-7445 •Fax: 909-597-2072 A Branch of the West End YMCA e1 /— Project Name: YMCA Childcare Subsidy Page: 1 i.rr / \` EXHIBIT F CITY OF CHINO HILLS , COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG) ::"' APPLICATION Cirl E0121810=LS APPLICATION DEADLINE: 5:00 P.M. on WEDNESDAY. JANUARY 5. 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please type or use a computer-generated form. Handwritten applications will not be accepted. 1) Name of Agency: West End YMCA/Chino Valley YMCA 2) Name/Title of Workshop Attendee: Debra Anderson / President & CEO 3) Mailing Address where correspondence about this application is to be sent: 5665 Edison Ave Chino CA 91710 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: 4980 Riverside Dr Chino CA 91710 Street City State Zip 5) Physical Address where project records will be kept for monitoring purposes. Add additional lines if there is more than one location: 5665 Edison Ave Chino CA 91710 Street City State Zip 6) Federal Tax I.D. No.: 95-1727678 7) CA Franchise Tax Board I.D. No.: 128326 8) Contact Person's Information: Debra Anderson / President & CEO deb@weymca.org Name/Title Email Address 909-597-7445 909-597-2072 Phone Number Fax Number 9) Authorized Person's Information (if same as Contact Person, note "same"below): same Name/Title Email Address Phone Number Fax Number . Y��CAChi|�omSubs�y � ProjectName: Page: _~ 10) Project Name: YM/~& Childcare Subsidy 11) Briefly describe the proposed pject and what goal(s) it is intended to achieve: The YMCA Childcare Subsidy program will provide financial subsidy to poverty, low and - moderate income families from Chino Hills to attend YMCA Licensed Childcare. This includes before school, after school and summer care. In providing reduced fee childcare- to low and moderate income families, this gives these participants access to a safe, nurturing environment for children to learn, grow and develop social skills and eases the burden of care for working families. This access will help families be healthy, confident and secure and strengthen the Chino Hills community. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. Avai|abi|itv/Accessibi|iLv This category applies to proposals that make services, infrastructure, housing, shelter or jobs available or accessible to low and moderate-income persons, including persons with disabilities. ) Enhances the living environment through new/improved availability Creates decent housing with new/improved availability | | / | Promotes economic opportunity through newYinnprnvedavai|abi|ity Affordability This category applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. |^�| Enhances the living environment through new/improved availability Creates decent housing with new/improved availability / Promotes economic opportunity through new/improved availability Page 15 of 24 Project Name: YMCA Childcare Subsidy page. 3 Promoting Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping to make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category. Describe the anticipated quantifiable results of your proposal for the selected category. This program meets the affordability category/enhancing the living environment through new/improved affordability, by providing reduced fee childcare to low and moderate income families. This improves the living environment for these families by providing a safe haven for their children while they are working and - provides the children access to a nurturing environment for children to learn,grow and develop social skills. _ This access will help families be healthy,confident and secure and strengthen the Chino Hills community. If fully funded,this program would assist 15-30 families with sliding scale childcare fees. Families could - receive up to 100%assistance with their childcare fees. The average assistance on this program is 40%of the fee. 14) Please check one that best identifies the nature of the Project in Chino Hills': Start-Up One-Time ��/� Continuing Expansion 15) Project/Activity Type: t/ Public Service Capital Improvement (Requires cost estimate) 16) If"Capital Improvement" is selected, provide the location of the project by census tract and block group number. Census Tract Block Group NOTE: Most construction projects (other than some residential rehabilitation) will be required to meet HUD labor requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. There is a lack of access to affordable,quality Childcare. This program addresses this need by providing financial assistance to improve and increase the access. During this economic downturn, the need for childcare still exists, but families are stretched financially. This program helps to ease the financial concern, while providing a high quality enriching experience for the children. This allows the parents to go to school or work with a peace of mind regarding their children's activities. 1 Start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request Is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that is expanded in scope, not just that more people are served. Page 16 of 24 Project Name: YMCA Childcare Subsidy page: 4 *15 the purpose of this project activity to: Help prevent homelessness? Yes H No Help the homeless? Yes III No Help those with HIV/AIDS? Yes pi No Primarily help persons with disabilities? 1 | Yes |/| No 18) Identify the specific need being addressed by the proposed project in the 2010-2015 City of Chirto Hills Consolidated Plan (see Exhibit D, page 13). This addresses the need in the community for affordable quality childcare. This will increase the access to childeare by low and moderate Chino Hills residents. 19) Please identify unduolicated (new clients) persons/households: Check One: ��� Persons Households Total number of persons or households to be served by the proposed project: | 20 (p) | a) Of the total nonnbertnboserved, huxvroanyare Chino Hills residents: 20 b) Of the total number to be served, how many are low/moderate-income: 20 Z0) Was this prect previously funded with Chino Hills or other CDBG funds? |v |�� Yes } |i Nu � If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. 2010-2011. City of Chino Hills funded $7,500 and we anticipate expending all funds. 2010-2011. City of Chino funded $2,100 and we anticipate expending all funds. The City of Chino has funded this program for the past 20 years at difFerent amounts, All Funds were expended. 21) Dynornrganizabonisaoon'prof|torganizahon, prnvideand/urattach [he [o||ow|ng documentation as applicable: 1. Copies of both State and Federal tax exemption determination letters; Z. Ust of organization's board of directors, board members, and tides. 3. Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; S. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed pject or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed pject; if applicable. Project Name: YMCA Childcare Subsidy page: 5 22) Is your organization considered a faith-based organization? I I Yes No 23) Describe organization's mission and goals. We are a powerful association of men, women and children joined together by a shared commitment to nurturing the potential of kids, promoting healthy living and fostering a sense of social responsibility. We believe that lasting personal and social change can only come about when we all work together to invest in our kids, our health and our neighbors.That's why,at the Y, strengthening community is our cause, Every day, we work side-by-side with our neighbors in our community to make sure that everyone, regardless of age, income or background, has the opportunity to learn, grow and thrive. Our mission is to put Judeo-Christian principles into practice to enrich the quality of spiritual, mental, physical and social life for our families, our communities and ourselves. The Y makes accessible the support and opportunities that empower people and communities to learn, grow and thrive, With a focus on youth development,healthy living and social responsibility, the Y nurtures the potential of every youth and teen, improves the nation's health and well-being, and provides opportunities to give back and support neighbors. An integral part of the YMCA is to provide access to programs for all people, We offer financial assistance with dollars raised in annual fund-raising campaigns. In addition to CDBG funds,the Y provides over $75,000 of financial assistance to families in the Chino Valley. 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. The Chino Valley YMCA, a branch of the West End YMCA, has been in existence as a certified YMCA since 1985. We have been a provider of quality childcare for over 25 years. In addition to Childcare, the YMCA provides many programs that focus on youth development, healthy living and social responsibility. We provide programs that nurture the potential of children and teens including childcare, preschool, swimming, sports and camp. We provide programs that improve health and well-being for all ages including fitness, swimming, sports and recreation. We provide programs that give back to our communities including opportunities for volunteering, contributing, collaborating and providing needed social services. Our YMCA staff is comprised of 5 full-time directors and approximately 50 part-time program staff.The full-time staff combined have over 75 years of YMCA service. The Childcare staff is a full-time director and approximately 10 part-time teachers and aides. The full-time staff are responsible for the overall supervision and design of the programs. All of the full-time staff are intricately involved in the program delivery and each brings a minimum of 10 years of program related experience, The part-time staff are responsible for active program delivery and each brings education and training to their respective programs. As a branch of a larger corporation,the Chino Valley YMCA follows a strict accounting and financial system monitored by corporate office and meeting all of the mandated requirements. The specific program, YMCA Childcare Subsidy, is part of the overall system. Briefly the program works like this. A prospective YMCA childcare participant applies for financial assistance. The application process is overseen by a Program Director and amount of the subsidy is set by a sliding scale based on County income levels. The Program Director has the discretion to increase the assistance based on special circumstances like unemployment, housing issues or other financial challenges. The overall application and suggested amount of the subsidy is approved by the President/CEO. All monies are given as a discounted rate to the participant and applied through our financial computer system. In addition to the computer system,the Program Director keeps detailed records on the attendance and payment of the fees, including the applied financial assistance. Overall the finances/accounting is monitored monthly by the President/CEO and the CFO. For this grant,the Program Director reports the total dollar amount of the assistance, the unduplicated number of children receiving assistance and a duplicated number of children (monthly attendance). Only Chino Hills residents are reported for this grant. Page 18 of 24 YMCA Childcare Subsidy 6 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is $5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of any proposed increase in services, and estimate costs accordingly. VOLUNTEER HOURLY HRS' MONTHS POSITION/TITLE (Y/N) RATE PER EMPLOYED TOTAL COST CDBG SHARE Site Director I N I $ 19.54) 40 I 12 1 $40,643 1 $ 10,000 11 Teacher(5 FTE, 51 wks)I N $ 9.50 1200 I 12 $96,900 $ 0 Aides (4 FTE, 51 wks) N $ 8.50 150 12 j $65,025 1 $ 0 $ $ I $ $ I I I $ $ $ $ 1 $ $ I I $ 1 $ $ I I $ V $ I I $ 1 $ 1 $ I I $ I $ SUBTOTAL FOR WAGES $202,568 $ 10,000 FRINGE BENEFITS: TYPE OF COSTS I PERCENT OF SALARY I TOTAL COST I CDBG SHARE 1I FICA 6.2% $ 12,559 $0 1I I sui 10% $20,256 $0 1I1 OTHER 15% $30,385 $0 SUBTOTAL FOR FRINGE BENEFITS $63,200 1 $0 I TOTAL COST I CDBG SHARE TOTAL PERSONNEL/STAFF COSTS $265,768 $ 10,000 Page 19 of 24 YMCA Childcare Subsidy 7 Project Name: Page: (B) PROPOSED PROGRAM BUDGET OVERVIEW: Include all costs associated with the proposed program A) COST CATEGORY B) TOTAL COST C) CDBG SHARE SPACE RENTAL $ 15,000 $0 UTILI T IES $7,500 $0 GENERAL LIABILITY INSURANCE $ 15,0Q0 $0 AUTOMOBILE LIABILITY INSURANCE $Inc. above 1 $0 WORKER'S COMPENSATION INSURANCE $Inc. in Benefits $0 OTHER INSURANCE: $Inc. above $0 CONSULTANT SERVICES $0 $0 TRAVEL $32,000 $0 SUPPLIES $15,000 $0 EQUIPMENT $0 $0 OTHER:Vehicle Purchase $ 14,000 $0 OTHER: $ $ OTHER: $ $ TOTAL SUPPLIES AND SERVICES $98,500 $0 Page 20 of 24 YMCA Childcare Subsidy 8 Project Name: Page: _ EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Capital Improvement Budget You must submit one or more written cost estimates from a licensed and insured contractor with this application. Guidance: Please use the following to present your CDBG request for funding. In column A, list budgeted items for your project/activity. In Column B, provide the projected amount and calculation for each budgeted item. In Column C, provide the calculation and projected amount for CDBG request of funds. A) !CPO' 'PATSPilt B) TOTAL COST C) CDBG SHARE PERSONNEL EXPENSES TOTAL PERSONNEL $ DELIVERY COSTS ACQUISITION SITE DEVELOPMENT MATERIALS PHYSICAL INSPECTIONS ARCHITECTURAL ENGINEERING REHAB LOAN COSTS PERMITS AND FEES $ INSURANCE LEGAL FEES FINANCING APPRAISAL COSTS TOTAL DELIVERY COSTS $ CONTRACT SERVICES $ $ $ $ TOTAL CONTRACT SERVICES $ BUDGET TOTAL $ NA $ NA Page 21 of 24 YMCA Childcare Subsidy 9 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate, 2. Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4. Sufficient funds are available to complete the project as described, if CDBG funds are approved. West End YMCA/Chino Valley YMCA Organization YMCA Childcare Subsidy Project Name Debra C. Anderson / President & CEO Print Name and Title of Authorized Person I ' e, ' I 1/4/2011 Signature of Authorized Person Date Signed Page 22 of 24 Project Name: YMCA Childcare Subsidy Page: 1 O Attachment A PROJECT/ PROGRAM WORK SCHEDULE Time Frame I Task/Deliverable { Person Responsible Financial Assistance awarded Childcare Staff to qualified participants$2,500 July- September Number of Qualified Children Childcare Staff served -5 (Unduplicated) Units of Service-total monthly Childcare Staff participants—25 (duplicated) Financial Assistance awarded Childcare Staff to qualified participants$2,500 Number of Qualified Children October—December served - 5 (Unduplicated) Childcare Staff Units of Service-total monthly I Childcare Staff participants—25 (duplicated) Financial Assistance awarded Childcare Staff to qualified participants $2,500 Number of Qualified Children January— March served -5 (Unduplicated) Childcare Staff Units of Service-total monthly Childcare Staff participants—25 (duplicated) Financial Assistance awarded Childcare Staff to qualified participants$2,500 Number of Qualified Children April — June served-5 (Unduplicated) Childcare Staff Units of Service-total monthly Childcare Staff participants—25 (duplicated) YMCA Childcare Subsidy 11 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION /� Submittal Checklist ��I Completed and signed application (including Attachment A); and the following mandatory attachments: Copies of both State and Federal tax exemption determination letters; IX List of organization's board of directors, board members, and titles; Copy of organization's articles of incorporation and bylaws; til, Copy of organization's conflict of interest policy; I Copy of most recent annual audit or current balance sheet; Copy of lease (if CDBG funding request involves the reimbursement of rental expenses to conduct proposed project or make improvements to property not owned by applicant); W I I For donated space: A letter from outside organization detailipg terms of donated space to conduct the proposed project, if applicable; IV pt Submit the original and one additional complete copy of the application, including Attachment A. Submissions should be unbound on white paper with the name of the applying organization and the project name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the meetings. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717, or by e-mail at Ichristensen(Dchinohills.oro. Page 24 of 24 Caring for the Hills 11-05 u. 15,5 Project Name: Feeding Program page: EXHIBIT F CITY OF CHINO HILLS • COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG) APPLICATION iliTtraMeal APPLICATION DEADLINE: 5:00 P.M. on WEDNESDAY. JANUARY 5, 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please type or use a computer-generated form. Handwritten applications will not be accepted. 1) Name of Agency: Caring for the Hills 2) Name/Title of Workshop Attendee: Judith Rogers - Director 3) Mailing Address where correspondence about this application is to be sent: 15554 Cecelia Street. Chino Hills CA 91709 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: Same Street City State Zip 5) Physical Address where project records will be kept for monitoring purposes. Add additional lines if there is more than one location: Same Street City State Zip 6) Federal Tax I.D. No.: 33-0762884 7) CA Franchise Tax Board I.D. No.: 2058314 8) Contact Person's Information: Judith Rogers judycares4you@yahoo.com Name/Title Email Address 909-597-1454 none Phone Number Fax Number February 16, 2011 City of Chino Hills CDBG PROGRAM RE: Letter of Introduction Caring for the Hills To Whom It May Concern: Caring for the Hills has been in existence for 13 years,helping the needy in the Los Serranos area and extending to all of Chino Hills. Our programs are tailored to meet the needs of families and seniors that are far below the poverty level. We are applying for grant assistance this year for our feeding program. In the past we relied on individual donations and corporate food sponsors. Caring for the Hills feeds on the average 700 individuals weekly and supplies 10— 14 emergency food boxes per month. We have been blessed with fresh produce, dairy products,bakery items and meat on a daily basis but with the need so great. The grant monies will be utilized to cover the costs of running the charity as well as the Thanksgiving and Christmas turkey dinner giveaways. We have a number of other programs that we are currently running, such as: Senior Citizen Meal Program, Backpack & School Supply Giveaways, and Holiday Toy Giveaways. We appreciate the opportunity to continue being of service to Chino Hills and the possibility that we may receive financial assistance. Thank you, Judy Rogers Executive Director Project Name: Feeding Program page: 2 10) Project Name: Caring for the Hills Feeding Program 11) Briefly describe the proposed project and what goal(s) it is intended to achieve: The feeding program goals are to continue to feed needy individuals and their families through our daily food distribution and emergency food boxes. We are currently feeding 300+individuals per week. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. Availability/Accessibility This category applies to proposals that make services, infrastructure, housing, shelter or jobs available or accessible to low and moderate-income persons, including persons with disabilities. WIEnhances the living environment through new/improved availability Creates decent housing with new/improved availability II Promotes economic opportunity through new/improved availability Affordability This category applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. Enhances the living environment through new/improved availability piCreates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Page 15 of 24 Project Name: Feeding Program Page: 3 Promoting Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping to make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability IPromotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category. Describe the anticipated quantifiable results of your proposal for the selected category. Through our feeding program, low-moderate income persons have the opportunity to receive sustaining food to enhance their quality of life. Each person served is the quantifiable result. 14) Please check one that best identifies the nature of the Project in Chino Hills1: Start-Up One-Time ri Continuing Expansion 15) Project/Activity Type: �/ Public Service Capital Improvement (Requires cost estimate) 16) If"Capital Improvement" is selected, provide the location of the project by census tract and block group number. Census Tract Block Group NOTE: Most construction projects (other than some residential rehabilitation) will be required to meet HUD labor requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. In an already low income neighborhood, the economy has hit the residents of Chino Hills hard. With only enough finances to provide shelter, medication, utilities and the like, it seems that food is put on the back burner. This is the need that our program can fulfill. 1 Start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request Is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that is expanded in scope, not just that more people are served. Page 16 of 24 Project Name: Feeding Program Page: 4 *Is the purpose of this project activity to: Help prevent homelessness? Yes No Help the homeless? Yes I I No Help those with HIV/AIDS? Yes No Primarily help persons with disabilities? Yes No 18) Identify the specific need being addressed by the proposed project in the 2010-2015 City of Chino Hills Consolidated Plan (see Exhibit D, page 13). Addresses the needs of homeless families with children; homeless individuals. Support public services funding for. Seniors Other low and moderate-income services. 19) Please identify unduplicated (new clients) persons/households: Check One: IV Persons Households Total number of persons or households to be served by the proposed project: Of the total number to be served, how many are Chino Hills a) 300 residents: b) Of the total number to be served, how many are low/moderate-income: 250 20) Was this project previously funded with Chino Hills or other CDBG funds? IYes WI No If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. 21) It your organization is a non-pront organization, provide and/or attach the tollowing documentation as applicable: 1. Copies of both State and Federal tax exemption determination letters; 2. List of organization's board of directors, board members, and tides. 3. Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; 5. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed project or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed project; if applicable. Page 17 of 24 Project Name: Feeding Program Page: 5 22) Is your organization considered a faith-based organization? Yes No 23) Describe organization's mission and goals. Caring for the Hills is a non-prom organization that is totally volunteer, operated and funded by donations. Since 1997, Caring for the Hills has reached out to individuals and families who are in need. Our goal is to provide food for needy individuals and seniors on a daily basis through our feeding program. 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. )ease Sem A 110.e—kvvr2r l B 6 Project Name: Feeding Program Page: _ EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is$5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of any proposed increase in services, and estimate costs accordingly. VOLUNTEER HOURLY HRS, MONTHS POSITION/TITLE (Y/N) RATE PER WK. TOTAL COST CMG SHARE EMPLOYED CEO Y $0 84 168 S0 I So V. President Y so 49 24 $0 I $0 Treasurer Y so 2 6 $0 $0 Pantry Manager Y so 40 72 $0 I $0 $ Is$ $ $ Is $ $ I $ $ I $ $ Is SUBTOTAL FOR WAGES $0 I $0 FRINGE BENEFIIS: TYPE OF COSTS I PERCENT OF SALARY I TOTAL COST I CDBG SHARE I FICA I SUI I I $ Feeding Program 7 Project Name: Page: (B) PROPOSED PROGRAM BUDGET OVERVIEW: Include all costs associated with the proposed program A) COST CATEGORY B) TOTAL COST C) CDBG SHARE SPACE RENTAL $5000 $0 UTILITIES $3000 $0 GENERAL LIABILITY INSURANCE $1100 $1100 AUTOMOBILE LIABILITY INSURANCE $1500 $0 I WORKER'S COMPENSATION INSURANCE $0 $0 OTHER INSURANCE: $0 $0 CONSULTANT SERVICES $0 $0 i ,RAVEL $2000 $2000 SUPPLIES $15000. $10436 EQUIPMENT $500 $ I OTHER:Trash $1464 $1464 I OTHER: $ $ OTHER: I TOTAL SUPPLIES AND SERVICES $29,564. $15,000. I Project Name: Feeding Program Page: 8 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Capital Improvement Budget You must submit one or more written cost estimates from a licensed and insured contractor with this aoolication. Guidance: Please use the following to present your CDBG request for funding. In column A, list budgeted items for your project/activity. In Column B, provide the projected amount and calculation for each budgeted item. In Column C, provide the calculation and projected amount for CDBG request of funds. A) COST CATEGORY B) TOTAL COST C) CDBG SHARE PERSONNEL EXPENSES $ $ TOTAL PERSONNEL $ $ DELIVERY COSTS ACQUISI I ION $ $ SITE DEVELOPMENT $ $ MATERIALS $ $ f PHYSICAL INSPEL I IONS $ $ ARCHITELIURALENGINEERING $ $ REHAB LOAN COSTS $ $ PERMITS AND FEES $ $ INSURANCE $ $ LEGAL FEES $ $ FINANCING $ $ APPRAISAL COSTS $ $ TOTAL DELIVERY COSTS $ $ Project Name: Feeding Program Page: 9 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate. 2.. Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4. Sufficient funds are available to complete the project as described, if CDBG funds are approved. Caring for the Hills Organization Feeding Program Project Name Judith Rogers CEO Print Name and Title of Authorized Person January 4, 2011 fiif nature of Aitfh%rized Person Date Signed ATTACHMENT A Project Name: Feeding Program Page: 9 TIME FRAME TASK DELIVERABLE PERSON RESPONSIBLE IST Quarter: Assist 100 low/mod clients CEO July— September 2"d Quarter Assist 100 low/mod clients CEO October—December 3rd Quarter Assist 50 low/mod clients CEO January—March 4`h Quarter Assist 50 low/mod clients CEO April - June Project Name: Feeding Program Page: _1_1 _ EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Submittal Checklist Fl Completed and signed application (including Attachment A); and the following mandatory attachments: Fr Copies of both State and Federal tax exemption determination letters; VList of organization's board of directors, board members, and titles; VCopy of organization's articles of incorporation and bylaws; [it Copy of organization's conflict of interest policy; VCopy of most recent annual audit or current balance sheet; El Copy of lease (if CDBG funding request involves the reimbursement of rental expenses to conduct proposed project or make improvements to property not owned by applicant); n For donated space: A letter from outside organization detailing terms of donated space to conduct the proposed project, if applicable; Submit the original and one additional complete copy of the application, including Attachment A. Submissions should be unbound on white paper with the name of the applying organization and the project name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the meetings. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717, or by e-mail at Ichristensen(chinohills.ora. A l 1 ACHMENT B Project Name: Feeding Program Page 5_ Item 24 Caring for the Hills has been in existence for 13 Years. Programs and Services: 1. Food on an emergency basis to feed individuals or families for a few days until they can obtain permanent or long-term help. In 2010, Caring for the Hills has provided over 200food boxes to needy individuals and families. 2. Holiday food baskets were provided to 135 families at Thanksgiving in 2010., At Christmas 197 food baskets were provided complete with turkeys or hams, fresh fruit, vegetables, bread and all the trimmings. 3. Holiday toys were provided to over 357 children in Chino Hills and surrounding areas in 2010. Churches, schools and social service agencies qualify children, Our children range from birth to 16years old. 4. Senior Citizen Meal Program: Hot meals are delivered weekdays to 21 seniors through our meal delivery program. These meals are delivered by all volunteer staff This staff receives no compensation for their time, vehicle use or gas. Volunteers average about 10,000 miles altogether a year. 5. Backpacks & Supplies; In 2010 we were able to provide over 75 backpacks to children in need in Chino Hills, thanks to our many volunteers. Many school items were donated to the Parks and Recreations Mobile Units. Our Staff is a volunteer staff. We have a CEO, President, Vice President, Treasurer and a Pantry Manager. Also we have a fluctuating volunteer staff of 5 — 10 community services workers who unload, sort, pack and giveaway food items as well as clean up. Our financial reporting is on,the Cash system and in compliance with all governmental agencies. Oldtimers Foundation 11-06 0LDTI MERS FOUNDATION (Founded 1964) Dino Papavero-Founder A Charitable and Educational Organization Serving the Needs of Senior Citizens 8572 Sierra Avenue • Fontana, California 92335 • (909) 829-0384 • Fax: (909) 829-0313 January 26,2011 City of Chino Hills Ms.Lara Christensen' Administrative Analyst II 14000 City center Drive Chino Hills, CA 91709 Dear Ms. Christensen: For over forty years,the Oldtimers Foundation has directed its purpose and dedicated its efforts toward comprehensive, supportive services, and volunteer activities that enable senior citizens to maximize their levels of personal dignity and independence. Oldtimers Foundation serves over 500,000 congregate and home delivered meals to frail,shut-in seniors every year by way of 17 nutrition sites. The congregate sites provide vital socialization opportunities with a wide array of recreational events and special activities. In the County of San Bernardino,our Home Maintenance Program provides smoke detector installation, carpentry, electrical and plumbing services,and minor roof repairs for little or no costs to low-income senior citizen homeowners, In the County of Los Angeles, our Dial-A-Ride service is a door-to-door, shared ride service for seniors and eligible disabled persons. Each year the senior population continues to grow; each year the challenges we face are substantially greater than those of the past. Many people depend on our services and programs to sustain their independence and their well-being. We are requesting support from the City of Chino Hills with our Home Delivered Meal Program. We continue to see an increase of 5%of frail low income seniors who have very little resources available to them. We appreciate the opportunity to apply for CDBG funding and we count on the city of Chino Hills to he a partner with us in this effort. We look forward to hearing from you soon. Si icerely, i�1 Gregory Alvarado Director `SEMPRE AVANTI' CO N 1.76 rTh Project Name; Senior Nutrition Program Page: 1 u . EXHIBIT F ;,a; CITY OF CHINO HILLS •ai COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG) 7-A APPLICATION mm `l APPLICATION DEADLINE: 5:00 P.M. on WEDNESDAY, JANUARY 5, 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED, Please type or use a computer-generated form. Handwritten applications will not be accepted. 1) Name of Agency: Oldtimers Foundation 2) Name/Title of Workshop Attendee: Greg Alvarado, Regional Director 3) Mailing Address where correspondence about this application is to be sent: 8572 Sierra Ave. Fontana CA 92335 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: 13170 Central Ave. Chino CA 91710 Street City State Zip 5) Physical Address where project records will be kept for monitoring purposes. Add additional lines if there is more than one location: 8572 Sierra Ave. Fontana CA 92335 Street City State Zip 6) Federal Tax I.D. No.: 95-6126109 7) CA Franchise Tax Board I.D. No.: 220-69983 g) Contact Person's Information: Greg Alvarado, Regional Director gaalvarado@yahoo.com Name/Title Email Address (909) 829-0384 (909) 829-0313 Phone Number Fax Number 9) Authorized Person's Information (if same as Contact Person, note "same'below): same as above Name/Title Email Address Phone Number Fax Number Project Name: Senior Nutrition Program Page: 2 10) Project Name: Senior Nutrition Program 11) Briefly describe the proposed project and what goal(s) it is intended to achieve: The Oldtimers Foundation Nutrition Program Is designed to provide a nutritious meal and an opportunity for socialization and involvement in the community. The home-delivered meal program enables frail, homebound seniors the opportunity to maintain their independence. Often the person who delivers the meal is the only social contact the senior may have that day, and this provides a vital link for a person who needs care and is all alone. In 2011-2012 Oldtimers Foundation is planning to serve approximately 7,000 meals to residents in the City of Chino Hills. Meals for home delivery will be packed and sent out from the site daily for approximately 30 homebound seniors. The Home Delivered Meals are prepared at the senior center in the City of Chino. Opportunities to volunteer and become involved in the program and with other community affairs give meaning to many seniors. Funding for the program has been cut and costs continue to rise, the CDBG funding is vital to maintain current levels of service. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. Availability/Accessibility This category applies to proposals that make services, infrastructure, housing, shelter or jobs available or accessible to low and moderate-income persons, including persons with disabilities. ,/ Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Affordability This category applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. ✓J Enhances the living environment through new/improved availability JI Creates decent housing with new/improved availability IPromotes economic opportunity through new/improved availability Page 15 of 24 Project Name: Senior Nutrition Program Page: 3 Promotina Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping to make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category. Describe the anticipated quantifiable results of your proposal for the selected category. The Oldtimers Foundation is a non-profit, community based social service agency. it was established in 1964 with the purpose of maintaining and improving the physical, psychological and social well being of senior citizens age sixty and over in San Bernardino and Los Angeles Counties through varied, comprehensive, and coordinated programs. The West Valley Senior Concern Nutrition Program serves meals at eight senior centers from Rialto,to Chino; provides home-delivered meals to shut-in seniors:provides socialization, recreation, community involvement, and volunteer opportunities. Seniors who participate in the Home Delivered Meal Program will have the opportunity to maintain independency. We will use intake forms to enroll and monitor clients. Our intakes forms will collect relevant information from new prospective clients. Re-assessments will be conducted three times a year. 14) Please check one that best identifies the nature of the Project in Chino Hills1: riStart-Up One-Time IV Continuing I I Expansion 15) Project/Activity Type: t/ Public Service I I Capital Improvement (Requires cost estimate) 16) If`Capital Improvement" is selected, provide the location of the project by census tract and block group number. Census Tract Block Group NOTE: Most construction projects (other than some residential rehabilitation) will be required to meet HUD labor requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. The Home Delivered Meal Program assists seniors that qualify with maintaining a higher quality of life. The program is based on donations from seniors which makes it very affordable while assisting in sustaining a higher quality of living with a well balanced nutritious meal daily. 1 start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that Is expanded in scope, not just that more people are served. Page 16 of 24 Project Name: Senior Nutrition Program Page: 4 *Is the purpose of this project activity to: Help prevent homelessness? Yes [1 No Help the homeless? Yes [1 No Help those with HIV/AIDS? Yes No Primarily help persons with disabilities? Yes No 18) Identify the specific need being addressed by the proposed project in the 2010-2015 City of Chino Hills Consolidated Plan (see Exhibit D, page 13). Primarily help senior citizens with disabilities. 19) Please identify unduplicated (new clients) persons/households: Check One: Persons Households Total number of persons or households to be served by the proposed project: Of the total number to be served, how many are Chino Hills a) 30 residents: b) Of the total number to be served, how many are low/moderate-income: 30 20) Was this project previously funded with Chino Hills or other CDBG funds? ri Yes v No If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. Chino 2009-2011 $ 5,800 Rancho Cucamonga 2004-2011 11,000 Rialto 2004-2011 21,000 Upland 2010-2011 5,000 Colton 2010-2011 7,000 All allocated monies were expanded within the program year. 21) If your organization is a non-protit organization, provide and/or attach the following documentation as applicable: 1. Copies of both State and Federal tax exemption determination letters; 2. List of organization's board of directors, board members, and titles. 3. Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; 5. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed project or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed project; if applicable. Page 17 of 24 Project Name: Senior Nutrition Program Page: 5 22) Is your organization considered a faith-based organization? Yes No � 23) Describe organizauon's mission and goals. The Oldtimers Foundation is a non-profit, community based social service agency. It was established in 1964 with the purpose of maintaining and improving the physical, psychological and social well being senior citizens age sixty and over in San Bernardino and Los Angeles counties through varied, comprehensive,end coordinated programs. Responding to the needs of senior,the Oldtimers Foundation developed a nutrition program that encompasses meals that addresses the senior's daily nutritional needs. This program is carried out at 11 nutritional sites and through our home delivery meal routes to the frail and homebound. The programs service the areas of Chino, Chino Hills, Ontario, Upland, Rancho Cucamonga, Fontana, Rialto, Bloomington, Colton,Loma Linda and the surrounding county areas. 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. The Oldfimers Foundation is a non-profit, community based social service agency. It was in 1964 with the purpose of maintaining and improving the physical, psychological and social well being senior citizens age sixty and over in San Bernardino and Los Angeles counties through varied, comprehensive, and coordinated programs. For 46 years The Oldtimers Foundation focuses on providing seniors with basic human and social services through its programs as Nutrifion, Minor Home Repair Program, Health, Case Management and Advocacy and Affordable Housing. Program Activity 2008/2009 Meals served at Sites (Congregate) 151,444 Home Delivered Meals 146,892 Total /95,644 Minor Home Repair Total number of homes repaired 854 Health Services Total number of seniors served 6'176 Page 1Vof24 Senior Nutrition Program Project Name: Page: _ 6 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is $5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of any proposed increase in services, and estimate costs accordingly. HRS. VOLUNTEER HOURLY MONTHS POSITION/TITLE PER EMPLOYED TOTAL COST CDBG SHARE (Y/N) RATE wK. Cook N $ 9.30 30 12 14,508 $ 7,000 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ SUBTOTAL FOR WAGES $ 14,508 1 $ 7,000 FRINGE BENEFITS: TYPE OF COSTS PERCENT OF SALARY TOTAL COST CDBG SHARE FICA 7.65 1 $ 1,109.00 $ 0 sui 4.7 1 $ 682.00 $ 0 OTHER 116% Workmen Comp. 1 $ 2,321 .00 j $ 0 SUBTOTAL FOR FRINGE BENEFITS $ 4,112.00 $ 0 TOTAL COST I CDBG SHARE TOTAL PERSONNEL/STAFF COSTS $ 18,620 $ 7,000 Page 19 of 24 Project Name: Senior Nutrition Program Page: 7 (B) PROPOSED PROGRAM BUDGET OVERVIEW: Include all costs associated with the proposed program A) COST CATEGORY B) TOTAL COST C) CDBG SHARE SPACE RENTAL $ 0 $ 0 UTILITIES $ 0 $ 0 GENERAL LIABILITY INSURANCE $ $ 0 AUTOMOBILE LIABILITY INSURANCE $ 0 $ 0 WORKER'S COMPENSATION INSURANCE $ $ 0 OTHER INSURANCE: All insurance $ 65,000 $ 0 CONSULTANT SERVICES $ 10,000 $ 0 TRAVEL $ $ 0 SUPPLIES $ $ 0 EQUIPMENT $ $ 0 OTHER: Consumable Supplies $ 91 ,000 $ 0 OTHER: Food $ 675,000 $ 0 OTHER: $ $ 0 TOTAL SUPPLIES AND SERVICES I $ 841 ,000 $ 0 Page 20 of 24 Senior Nutrition Program Project Name: 8 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate. 2. Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4. Sufficient funds are available to complete the project as described, if CDBG funds are approved. Oldtimers Founation Organization Senior Nutrition Program Project Name Greg Alvarado, Regional Director }E PC t Name and Title of Authorized Person (1 } ii 4,//-r.. )4/2 / / --.,,i .— 4/Signature of Ail hno eekii•rson Date Signed - Page 22 of 24 Attachment A OLDTIMERS FOUNDATION Time Frame Task/D'el�verable I Person ltespons�ble Advertise program in 1st Quarter Local newspaper Program Director Assist 40 low/mod clients ( Program Staff Advertise program in 2nd Quarter Local newspaper Program Director Assist 20 low/mod clients Program Staff Advertise program in 3rd Quarter Local newspaper Program Director Assist 10 low/mod clients J Program Staff 4th Quarter Assist 10 low/mod clients Program Staff Senior Nutrition Program 10 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Submittal Checklist I. Completed and signed application (including Attachment A); and the following mandatory attachments: Lvi Copies of both State and Federal tax exemption determination letters; IA List of organization's board of directors, board members, and titles; i2j Copy of organization's articles of incorporation and bylaws; [� Copy of organization's conflict of interest policy; Pr Copy of most recent annual audit or current balance sheet; LJ Copy of lease (if CDBG funding request involves the reimbursement of rental expenses to conduct proposed project or make improvements to property not owned by applicant); Li For donated space: A letter from outside organization detailing terms of donated space to conduct the proposed project, if applicable; Submit the original and one additional complete copy of the application, including Attachment A. Submissions should be unbound on white paper with the name of the applying organization and the project name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the meetings. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717, or by e-mail at IchristensenCachinohills.ora. Page 24 of 24 Legal Aid Society 11-07 CL t#? 4, LEGAL AID SOCIETY OF SAN BERNARllINO 588 W. Sixth Street, San Bernardino, CA 92410 •4 Telephone: (909) 889-7328 E-mail: leealaidofsbai.earth link.net December 30, 2010 City of Chino Hills Attn: Lam Christensen, Community Services Dept. —CDBG 14000 City Center Drive Chino Hills, CA 91709 Re: Application for CDBG Funding of Public Services Grant Year: July 1, 2011 —June 30, 2012 Dear Ms. Christensen: Our agency has been providing free legal services to low income residents of this County for the past 30 years. We conduct Most of our work through our San Bernardino office. However, we offer outreach clinics at several sites within the county, including a monthly clinic held at the Neighborhood Activity Center in Chino. During the past six months, the number of people from Chino Hills seeking our help has increased by 170%. In order to answer this increasing need, we enclose herein an Application for CDBG funding for the 2011-2012 grant term. With this funding, we would provide residents of Chino Hills with free attorney consultations on a broad spectrum of legal issues. Additionally, for those seeking to resolve disputes via the court system, we would prepare their documents and provide step-by-step instructions to facilitate their requests for court orders to establish parental rights, custody and visitation orders, child or family support orders, orders prohibiting domestic violence, civil harassment and elder abuse, and orders to allow caregivers to provide daily care and health care access for their dependant, disabled adults or for minor children of absent parents. Our agency has successfully used grant funds to extend this service to other regions of the county for many years. However, as you know, our county CDBG funding will not allow us to serve residents of Chino Hills. Should you need anything further at this time, please contact me. Sincerely, LhouF Executive Director DJAD/bs; Enclosures Fed. Exp. #872967088644 A(501(c)(3)Non-Profit Organization • Donations May Be Tax Exempt CL z LES LES Project Name: LEGAL AID Page: 1 ,j. EXHIBIT F CITY OF CHINO HILLScc COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG) —i APPLICATION =' �mmffiu APPLICATION DEADLINE: ' 5:00 P.M. on WEDNESDAY. JANUARY 5, 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please type or use a computer-generated form. Handwritten applications will riot be accepted. 1) Name of Agency: LEGAL AID SOCIETY OF SAN BERNARDINO 2) Name/Title of Workshop Attendee: Deborah Davis, Program Coordinator 3) Mailing Address where correspondence about this application is to be sent: 588 W. Sixth Street San Bernardino CA 92410 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: Neighborhood Activity Center, 5201 N. "D" Street Chino CA 91710 Street City State Zip 5) Physical Address where project records will be kept For monitoring purposes. Add additional lines if there is more than one location: 588 W. Sixth Street San Bernardino CA 92410 Street. City State Zip 6) Federal Tax I.D. No.: 95-1997024 7) CA Franchise Tax Board I.D. No.: 452-4515-0 8) Contact Person's Information: Deborah J. Davis, Program Coordinator ddavis_legalaidofsb2@verizon.net Name/Title Email Address (909) 889-4811; cell (909) 647-3045 (909) 889-6338 Phone Number Fax Number 9) Authorized Person's Information (if same as Contact Person, note "same"below): Roberta Shouse, Executive Director legalaidofsb@earthhnk.net,Roberla5@legalaidofsb.com Name/Title Email Address (909) 381-4633; cell (909) 553-0957 (909) 889-6338 Phone Number Fax Number Project Name: LEGAL AID Page: 2 10) Project Name: LEGAL AID 11) Briefly describe the proposed project and what goal(s) it is intended to achieve: Through this project, Legal Aid proposes to provide free legal services to 100 low and low-to-moderate income residents of the City of Chino Hills. The services to be provided include consultations with an lattorney on a broad spectrum of issues;and, for approximately 87 such clients, preparation of legal documents and provision of step-by-step procedural instructions to help the client navigate the court system. (Such access will allow these residents to secure lawful orders in parental nghts, child and tamily support, custody and visitation,freedom from domestic violence and civil harassment, prevention of elder abuse, 11 yuo uiaiiai up w p' Jviuc uctic al LLl a\,tC O w iica,ui umc 0V, ,un,v,o vi QLacna pc,cnm, w W,IOCI vaw,a ur, i provide care and access health care for dependant, disabled adults. Each client served will receive 2-20v Use of the iudicial system to resolve such sensitive issues is necessary to secure and maintain stable (homes,to stabilize family income, reduce dependency upon social and emergency rescue services and reduce the need for law enforcement involvement. Thus, by helping the residents improve and stabilize their name lite, tnls project will oenem inoivrouais, rnelr dependents,melt nelgnoornoods and the elty of Chino Hills. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. Availability/Accessibility This category applies to proposals that make services, infrastructure, housing, shelter or jobs available or accessible to low and moderate-income persons, including persons with disabilities. j Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Affordability This category applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. 1 Enhances the living environment through new/improved availability I- Creates decent housing with new/improved availability _j Promotes economic opportunity through new/improved availability Page 15 of 24 Project Name: LEGAL AID Page: 3 Promotina Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping tp make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. 111 Enhances the living environment through new/improved availability Creates decent housing with new/improved availability II Promotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category. Describe the anticipated quantifiable results of your proposal For the selected category. 'Data on all clients served will be captured in a secure data base,which allows Legal Aid to track the amount I 1enu exreiit oi selvu:es l euuerou anu lilt 114111oel UI nuuseuuws uet ienueu. i nwuyu Lida ueyel Aid pi ujeet, 100% of the clients served will attain improved knowledge as to their rights and responsibilities in legal disputes. Approximately 78% of the clients served will pursue lawful actions to seek court orders to e,Jjminale vinlenre eSfihli.sh naenefnl hnme life seek financial debility through viable al.lnnnrt nrdere nr access health care and needed services for dependent minors or disabled adults. By serving 100 ... _ of those households. 1 14) Please check one that best identifies the nature of the Project in Chino Hills1 : nStart-Up One-Time Continuing I I Expansion 15) Project/Activity Type: 1 Public Service Capital Improvement (Requires cost estimate) 16) If "Capital Improvement" is selected, provide the location of the project by census tract and block group number. Census Tract NOT APPLICABLE Block Group NOTE: Most construction projects (other than some residential rehabilitation) will be required to meet HUD labor requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. All residents need access to income, suitable housing, health care, and freedom from domestic strife. Chino I 1=iiiu pupuiaiivii ineiuues. (a) 3.4',o vi dii ianiiiies iiviiiy ueiuw puveliy level, i 6.5% ui wheal ale (eanaie heads of household with related minors under age 18; (b)4,7% unemployed and 27.7% not in the labor 38.5%who speak a language other than English in the home, and 29.8% of whom are grandparents reepnncihle for their nranrl '•' • -. •r•'. .a.s - ••- -• •• ' -. - r' d . FFa 7- 1-Searth&geo_idit&_ge). This project will afford these most under served residents access to curative orders 1 Start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that is expanded in scope, not just that more people are served. Page 16 of 24 Project Name: LEGAL AID Page: 4 *Is the purpose of this project activity to: Help prevent homelessness? L Yes n No Help the homeless? Yes No Help those with HIV/AIDS? Yes No Primarily help persons with disabilities? Yes No 18) Identify the specific need being addressed by the proposed project in the 2010-2015 City of Chino Hills Consolidated Plan (see Exhibit D, page 13). Thic Legal Aid rirnjent will rwvirle nppriprl rOmMIrnily ceatirne: i P lonal QPIA/Inesi V/h1rh will ael- qualifying adults of all ages, including seniors, disabled, female heads-of-houshold, victims of abuse, single ,capc.y;(c.; caloSLifi porenlo 19) Please identify unduplicated (new clients) persons/households: Check One: I I Persons 14 Households Total number of persons or households to be served by the proposed project: Of the total number to be served, how many are Chino Hills a) 100 residents: b) Of the total number to be served, how many are low/moderate-income: 100 20) Was this prot previously funded with Chino Hills or other CDBG funds? Yes If No If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. cApplilozIVIC 21) It your organization is a non-profit organization, provide and/or attach the following documentation as applicable: 1 . Copies of both State and Federal tax exemption determination letters; 2. List of organization's board of directors, board members, and titles. 3. Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; 5. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed project or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed project; if applicable. Page 17 of 24 Project Name: LEGAL AID Page: 5 22) Is your organization considered a faith-based organization? Yes I No 23) Describe organization's mission and goals. 'LEGAL AID'S Mission Statement is to "provide counseling and legal services to the indigent and needy and Ito ascertain that the rights and privileges ot the individual are recognized and protected regardless or their lability to oav". o_ .et e ••- ee, '.!.. e Lt.:— .- .0 offer 100 low and low te-ma4ieriate4riome rosidionta cf Chiaa Hi!!i with more accessible and affordable help to determine their legal rights and responsibilities; and, to lat,iiiicii 67 i.,-..;i I i ebiLiei IL s acid'ijoip;e al:LiCa LU li le jujiUcai ybic,iii IL) peoutruiiy I Cbuive ii4uieb itIIntltit"; rights, custody/visitation,family and child support, domestic violence or civil harassment, and to authorize care-givers to provide daily care and health care access for dependant minors ot absent parents or rienondant ilkololeri adults --- I I I . I 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. ILegal Aid has continually served this County since its inception in 1957. For the past 30 years, our service Inas included iegai consultations comoined wan preparation or all needed documents, and provision or 'procedural instructions, to allow clients to resolve legal disputes. Services are bundled and delivered to clients in structured units,to help clients navigate the legal process, step-by-step, to conclusion of their rag,. AlthnuGh mnct rlinnfq will nrrpcc up in 711 unitc nf Qartfirn nor nncp nnr nrnnl farm then/ arn rniintnri and reported only once. Legal Aid work is performed, county-wide,with a staff of 1.5 full-time attorneys and approximately 15 support stan memoers, augmented oy me neip or volunteer attorneys, students and interns, tour txecuuve Director has over 30 years of experience. our supervising staff attorney has over 30 years of experience. our bookkeeper has over 20 years of experience, and our support staff vary in experience from 2 to 30 years. We maintain a statistical database designed specifically for non-profit and legal services tracking. This LICItClIJCIJC CIIPOVVO LU LI[WI\ 1,11Clu cicywiliry. wuntuy OUVI lt.., kyr- vi vo wncur, nutwe. ln OCI vi,C; W r c.-11, c.1114 number, age and relationship of the clients served and their household members. - We maintain a fiscal database which allows us to identify, record and track the source and nature of funds received o ivved and expended. Legal Aid has received CDBG funds to provide services throughout thesirsuch county for w a-years, and-has-suc.,cessfullycomplated-agiscal and eernpliance auckterinvielved-la-u , funds. Legal Aid also conducts irs own fiscal audit, in compliance with the provisions of OMB-133a, each rCCII al 16 ilicake Li itnt." III IC1114,101 1cliel I ClIII . CU id IGtJUI t clValICAIJIC kJ ;VI RIC!Z) I I I I i I Page 18 of 24 Project Name: LEGAL AID Page: 6 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is $5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of any proposed increase in services, and estimate costs accordingly. HRS. VOLUNTEER HOURLY MONTHS (Y POSITION/TITLE ' / PER M EMPLOYED TOTAL COST CG SHARE N) RATE VVK. Case Worker I N Is 12 4 12 I $ 2,496 $ 1,025 Case Worker II N I $ 16 4 12 I $ 3,328 $ 1 ,365 Case Worker II N $ 15 4 12 $ 3,328 $ 1 ,365 Case Worker III N $ 18 4 12 I $ 3,744 $ 1 ,985 Attorney Y $ 275 3 12 I $42,900 $ Data Entry Clerk N $ 12 4 12 1 $ 2,496 $ 1,330 $ V $ $ I $ $ $ $ $ I $ $ SUBTOTAL FOR WAGES $58,292 $ 7,070 FRINGE BENEFITS: ITYPE OF COSTS • PERCENT OF SALARY 1 TOTAL COST CDBG SHARE F ICA 7.65 1 $ 1 ,154 $475 sui 3.55 I $ 546 $210 OTHER I 2.05 I $ 311 $ 140 SUBTOTAL FOR FRINGE BENEFITS $ 2,011 $825 TOTAL COST I CDBG SHARE ,I TOTAL PERSONNEL/STAFF COSTS $ 60,303 $7,895 Page 19 of 24 Project Name: LEGAL AIDPage: 7 (B) PROPOSED PROGRAM BUDGET OVERVIEW: Include all costs associated with the proposed program A)COST_,CATEGO;RXS . ' : „'.B) :TOTALCOST . - ::, C C• DBG,SHARE SPACE RENTAL H$ I $ UTILITIES I $ I $ GENERAL LIABILITY INSURANCE I $245 I $ 139 AUTOMOBILE LIABILITY INSURANCE I $310 I $ 180 WORKER'S COMPENSATION INSURANCE $215 I $ 110 OTHER INSURANCE: $ I $ CONSULTANT SERVICES $ 740 $425 TRAVEL $470 I $ 355 SUPPLIES $6 10 I $430 EQUIPMENT $ 685 I $475 OTHER: $ H $ OTHER: $ I $ OTHER: $ $ TOTAL SUPPLIES AND SERVICES $2,996 I $2,105 Page 20 of 24 Project Name: LEGAL AIDPage: 8 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Capital Improvement Budget You must submit one or more written cost estimates from a licensed and insured contractor with this anal/cation. Guidance: Please use the following to present your CDBG request for funding. In column A, list budgeted items for your project/activity. In Column B, provide the projected amount and calculation for each budgeted item. I n.Column C, provide the calculation and projected amount for CDBG request of funds. Cost:SATEpORY 13): TOT 4L,CoST -cOl3G•Sl4E. i PERSONNEL EXPENSES $ not applicable I $ not applicable TOTAL PERSONNEL $ DELIVERY COSTS ACQUISITION I $ SITE DEVELOPMENT MATERIALS $ • PHYSICAL INSPECTIONS $ ARCHITECTURAL ENGINEERING $ REHAB LOAN COSTS $ PERMITS AND FEES INSURANCE $ LEGAL FEES $ FINANCING $ APPRAISAL COSTS TOTAL DELIVERY COSTS $ $ CONTRACT SERVICES $ TOTAL CONTRACT SERVICES I $ not applicable $ not applicable BUDGET TOTAL $ Page 21 of 24 Project Name: LEGAL AID Page: 9 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate. 2. Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4, Sufficient funds are available to complete the project as described, if CDBG funds are approved. LEGAL AID SOCIETY OF SAN BERNARDINO Organization LEGAL AID Project Name ROBERTA SHOUSE, Executive Director PF'-it Name and Title of Authorized Person reab, 12-30-2010 Signature of Authorized Person Date Signed Page 22 of 24 Project Name: Legal Aid Page: 10 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Attachment A PROJECT/PROGRAM WORK SCHEDULE Include your Project Work Schedule as Attachment A. The information provided will be used to track project progress through Quarterly Project Progress Reports. The projected goal/outcome should be broken down at least by quarters (see example below), but may be broken down into smaller time frames: _ . ,. . T .,.. . . . . ...... ...... .. . .. . .. .. ... .. Time Frame .,",;Task/Deliverable Person Responsible. • Serve 25 new, unduplicated Administrator 1.s Quarter: clients: provide consultation and Attorneys July-September interview for document Caseworkers I, II or III preparation 2nd Quarter: Serve 25 new, unduplicated Administrator October - December clients: consultation and Attorneys interview for document Caseworkers I, II or III preparation; and, extend 80+ units of service to returning clients 3rd Quarter: Serve 25 new, unduplicated Administrator January-March clients: consultation and Attorneys interview for document Caseworkers I, II or III preparation; and,, extend 80+ units of service to returning clients 41h Quarter: Serve 25 new, unduplicated Administrator April-June clients: consultation and Attorneys interview for document Caseworkers I, II or III preparation; and, extend 80+ units of service to returning clients Page 23_ of 24__ LEGAL AID 1 � ������� | / Project0anme' Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Submittal Checklist IA Completed and signed application (including Attachment A): and the following mandatory attachments: Copies of both State and Federal tax exemption determination letters; tg List of organization's board of directors, board members, and titles; Copy of organization's articles of incorporation and bylaws; [9 Copy of organization's conflict of interest policy; IA Copy of most recent annual audit or current balance sheet; 11 Copy of lease (if CDBG funding request involves the reimbursement of rental expenses to conduct proposed project or make improvements to property not owned by applicant): � For donated space: A letter from outside organization detailing terms of • donated space to conduct the proposed project, if applicable; Submit the original and one additional complete copy of the application, including Attachment A, Submissions should be unbound on white paper with the name of the applying organization and the project name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the meetings. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717. or by e-mail at lchristensen@chinohills.org. Page 24 of 24 NeveIle 11-08 January 5, 2011 Dear Selection Committee: Nevelle was created in 2007 in response to the lack of college and work preparation of youth in the community. Nevelle is an organization born out of the experience of President and Founder, Dora Edney. Dora,dike many college students,contemplated about what direction to take her career.Not really knowing all the options available, she plowed her way through the educational system entering with one major exiting with another, working paid positions as well as multiple unpaid internships. Fortunately, her tenacity earned her a B.A. degree and an M.S. degree along with certificates in Education and Human Resources, but it was no easy task. Dora shared, "If there were more programs in place to expose students to the plethora of options there are in education and employment at a young age, students would then have more direction to make more informed decisions about their career endeavors and be "ahead of the game" due to the many experiences they would be exposed to. Simple exposure can make a difference in the lives of youth."After earning her degrees, she workedni management at top corporations, taught career services at Junior College and 4-year Universities, counseled students, and developed innovative career programs. While workiug in the college environment, she recalled the challenges she went through to accomplish her goals and recognized the challenges students were still going through today to achieve theirs. She decided to do something about it by forming Youth Work Prep. In order to combat this issue, Nevelle has participated in numerous Work Fairs, College Expos, and provided career workshops to expose youth to the world of work and increase their confidence and knowledge to be prepared to adequately compete for jobs/internships in the workforce. Our mission is to prepare students to excel in the workforce by providing career related workshops, information, and resources to improve their professional skills. The proposed project directly correlates with our goals in that we will prepare youth for tomorrow's workforce by equipping them with the knowledge necessary to present themselves in a professional manner by providing resume, interview, and dress for success workshops. We will also work with local employers to provide job shadow opportunities as well as internship/job listings. Our ability to carry out this type of project has been proven in our previously mentioned events and experience of our Director, Dora Edney. Dora has worked as the Director of Internships for Loyola Marymount University, Career Services Coordinator/Counselor and Professor at Whittier College, Internship Developer at American River College and has managed million dollar budgets with top corporations as well as smaller grant programs. I look forward to discussing the ways in which Nevelle will benefit the community. It is with much interest and anticipation that I await for the opportunity of meeting with you. Sincerely, L(/A-g,e(CA'Dora Edney,MS Executive Director Nevelle NEVELLE-YOUTH WORK PREP 13089 Peyton Dr.*Chino H81s,CA 91709 (9091 638-9431 Email:dedoev(alvoothworknren.ore Project Name: You CITY QF CHINOth HILLWorkS Prep Page: 1 ' ' COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM (CDBG)EXHIBIT F Lr;, APPLICATION ..-4 carrecwants APPLICATION DEADLINE: .' 5:00 P.M. on WEDNESDAY. JANUARY 5. 2011 APPLICATIONS SENT BY FAX OR E-MAIL WILL NOT BE ACCEPTED. LATE OR INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please type or use a computer-generated form. Handwritten applications will not be accepted. 1) Name of Agency: NeveIle 2) Name/Title of Workshop Attendee: Dora Edney/Director 3) Mailing Address where correspondence about this application is to be sent: 13089 Peyton Dr. #C321 Chino Hills CA 91709 Street City State Zip 4) Physical Address where proposed project is conducted (if different than mailing address). Add additional lines if there is more than one location: various campus sites + city hall Chino Hills/Chino CA 91709 Street City State Zip 5) Physical Address where project records will be kept for monitoring purposes. Add additional lines if there is more than one location: 15525 Oakdale Rd. Chino Hills CA 91709 Street City State Zip 6) Federal Tax I.D. No.: 80-0362953 7) CA Franchise Tax Board I.D. No.: 2923983 8) contact Person's Information: Dora Edney/Director dedney@youthworkprep.org Name/Title Email Address 909-638-9431 909-393-9772 Phone Number Fax Number 9) Authorized Person's Information (if same as Contact Person, note "same"below); same same Name/Title Email Address same same Phone Number Fax Number Project Name: Youth Work Prep Page: 2 10) Project Name: Youth Work Prep 11) Briefly describe the proposed project and what goal(s) it is intended to achieve: The Youth Work Prep Program is organized to prepare youth for work experience by providing resources, career workshops,job shadow opportunities,and internship listings to the local community of Chino Valley. The goal is to expose youth to the work world instilling confidence and experience to better compete for future career opportunities and simultaneously provide community employers with advertising and training opportunities that may lead to valuable assistance to increase productivity. 12) Performance Outcome Measurements The three program performance categories listed below are required under the CDBG program by the U.S. Department of Housing and Urban Development (HUD). Please check one or more boxes under the following program performance categories that apply to your proposal. Availability/Accessibility This category applies to proposals that make services, infrastructure, housing, shelter or jobs available or accessible to low and moderate-income persons, including persons with disabilities. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability WIPromotes economic opportunity through new/improved availability Affordability This category applies to proposals that provide affordability, through various means, to the lives of low and moderate-income persons. II Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability Page 15 of 24 Project Name: Youth Work Prep Page: 3 Promotino Livable or Viable Communities This category applies to proposals that are aimed at improving a community or neighborhood by helping to make it more livable or viable by providing a benefit to principally low and moderate-income persons or by removing or eliminating slums or blighted areas. Enhances the living environment through new/improved availability Creates decent housing with new/improved availability Promotes economic opportunity through new/improved availability 13) Please provide a brief explanation of how your proposal will address the selected program performance category. Describe the anticipated quantifiable results of your proposal for the selected category. The proposal will promote economic opportunity through new availability by effectively informing and preparing youth for the work world by sharing career resources and connecting youth with prospective trainers to expose them to work attire,etiquette,and possible work opportunities. 14) Please check one that best identifies the nature of the Project in Chino Hills1: (✓I Start-Up One-Time I I Continuing r Expansion 15) Project/Activity Type: ILI Public Service I I Capital Improvement (Requires cost estimate) • 16) If"Capital Improvement" is selected, provide the location of the project by census tract and block group number. Census Tract Block Group NOTE: Most construction projects(other than some residential rehabilitation) will be required to meet HUD labor,requirements, including competitive bidding of contracts, HUD approval of contractor prior to contract award, and payment of prevailing wages. 17) Describe the community need(s) or issue(s) the proposed project/activity will address. Employment in the Chino Valley for youth needs to be a priority because businesses and families financial planning are falling apart. In today's poor economic condition for families and businesses,this project will prepare youth to compete in the job market for economic opportunities in the community and provide increased economic stability for families and the community. Start-Up - New project/program; One-Time - funding request will fulfill a one-time expenditure need; Continuing - funding request is to continue a previously funded project/program; or Expansion - an existing or a previously-funded project/program that is expanded in scope,not just that more people are served. Page 16 of 24 Project Name: Youth Work Prep Page: 1- *Is the purpose of this project activity to: Help prevent homelessness? ✓ Yes n No Help the homeless? _ Yes n No Help those with HIV/AIDS? Yes No Primarily help persons with disabilities? Yes d No 18) Identify the specific need being addressed by the proposed project in the 2.010-2015 City of Chino Hills Consolidated Plan (see Exhibit D, page 13). Support public services funding for other low and moderate-income services. 19) Please identify unduplicated (new clients) persons/households: Check One: / Persons Households Total number of persons or households to be served by the proposed project: Of the total number to be served, how many are Chino Hills a) residents: 20 b) Of the total number to be served, how many are low/moderate-income: 20) Was this project previously funded with Chino Hills or other CDBG funds? 11 Yes I jl No If yes, indicate the year(s) in which CDBG funds were received; the granting agency; the amount of funding, and whether the allocation was expended within the program year. - 21) If your organization is a non-profit organization, provide and/or attach the tollowing documentation as applicable: 1. Copies of both State and Federal tax exemption determination letters; 2. List of organization's board of directors, board members, and titles. 3. Copy of organization's articles of incorporation and bylaws; 4. Copy of organizational chart; 5. Copy of organization's Conflict of Interest Policy; 6. Copy of most recent annual audit or current balance sheet; 7. Copy of lease (if CDBG funding request involves reimbursement of rental expenses to conduct proposed project or make improvements to the property not owned by applicant); 8. Letter from outside organization detailing terms of donated space to conduct the proposed project; if applicable. Page 17 of 24 Project Name: Youth Work Prep Page: 5 22) Is your organization considered a faith-based organization? Yes No 23) Describe organization's mission and goals. The mission of Youth Work Prep is to prepare students to excel in the workforce by providing career related workshops,information, and resources to improve their professional skills. The goal is that youth will leave this experience more confident,knowledgeable, and encouraged to become a productive member of society. 24 Provide number of years the organization has been in existence; describe number, type, and complexity of programs/services administered; provide number of staff and major kinds of responsibilities; and describe accounting and financial reporting system. Nevelle has been in existence for three and a half years and has multiple programs ranging from resume development to collaborations to produce career expos. Nevelle is comprised of a Director-responsible for overall management of program, Consultant-responsible for career workshops, and various volunteers promoting the organization, clerical tasks,and other duties as assigned.Accounting and financials are reported by the Director via spread sheet format, Page 18 of 24 Project Name: Youth Work Prep Page: 6 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Public Service Budget Minimum grant request is$5,000 (A) PERSONNEL/STAFF COSTS: Please complete the following tables WAGES: Please provide the following information for each member of your program's staff necessary to administer the proposed program for CDBG funding. If applicable, add additional positions needed as the result of any proposed increase in services, and estimate costs accordingly. POSITION/TITLE VOLUNTEER HOURLY PER' MONTHS TOTAL COST CDBG SHARE OVN) RATE WK. EMPLOYED Director 1 Y I $60.001 6 I 12 I $18720 1 $9360 Consultant I N 1550.001 3 9 6000 $6000 Consultant + N I $ 50.001 3 9 6000 6000 Volunteer I Y Is 0 6 12 $ $ Volunteer I Y is 0 ! 6 ! 12 $ $ Volunteer Y $0 6 12 $ $ Volunteer Y $0 3 9 $ $ Volunteer I Y I $ 0 ! 3 I 9 $ $ Volunteer I Y I $ 0 12 I 9 $ $ Volunteer I Y I $ 0 12 I 9 $ $ AL FOR WAGES $30720 $21360 WAGES FRINGE BENEI-I i S: TYPE OF COSTS I PERCENT OF SALARY I TOTAL COST CDBG SHARE I IFICA I Independent Contractor! $ $ Isur I Independent Contractor! $ $ IOTHER I I $ SUBTOTAL FOR FRINGE BENEFITS I $0 $0 TOTAL COST I CDBG SHARE TOTAL PERSONNEL/STAFF COSTS $30720 17360 Page 19 of 24 Project Name: Youth Work Prep Page: 7 (B) PROPOSED PROGRAM BUDGET OVERVIEW: Include all costs associated with the proposed program A) COST CATEGORY B) TOTAL COST C) CDBG SHARE SPACE RENTAL $0 $0 UTILITIES $0 $0 GENERAL LIABILITY INSURANCE $0 $0 AUTOMOBILE LIABILITY INSURANCE $0 $0 WORKER'S COMPENSATION INSURANCE $0 $0 OTHER INSURANCE: $0 $0 CONSULTANT SERVICES $0 $0 TRAVEL $200 $200 SUPPLIES $ 100 $ '100 EQUIPMENT $100 $ 100 OTHER: Marketing $200 $200 OTHER: gp{tware $2000 $2000 OTHER: $0 $0 TOTAL SUPPLIES AND SERVICES $2600 $2600 Page 20 of 24 Project Name: Youth Work Prep Page: 8 EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Capital Improvement Budget You must submit one or more written cost estimates from a licensed and insured contractor with this application. Guidance: Please use the following to present your CDBG request for funding. In column A, list budgeted items for your project/activity. In Column B, provide the projected amount and calculation for each budgeted item. In Column C, provide the calculation and projected amount for CDBG request of funds. A) COST CATEGORY B) TOTAL COST C) CDBG SHARE IPERSONNEL EXPENSES $ N/A $ N/A TOTAL PERSONNEL $ $ DELIVERY COSTS ACQUISITION $ $ SITE DEVELOPMENT $ $ IMAILRIALS $ $ 11 PHYSICAL INSPECIIONS $ $ IARCHITECTURAL ENGINEERING $ $ REHAB LOAN COSTS $ $ IPERMITS AND FEES $ $ INSURANCE $ $ ILEGAL FEES $ $ IFINANCING $ $ APPRAISAL COSTS $ $ TOTAL DELIVERY COSTS $ $ ICONTRACT SERVICES $ $ I I $ $ I TOTAL CONTRACT SERVICES $ $ I BUDGET TOTAL $ $ Page 21 of 24 Youth Work Prep 9 Project Name: Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Certification The undersigned hereby certifies that: 1. The information contained in the project proposal is complete and accurate. 2. Application has been duly authorized by the governing body of the applicant to act on its behalf. 3. The agency shall comply with all Federal, State, and City policies and requirements affecting the CDBG program. 4. Sufficient funds are available to complete the project as described, if CDBG funds are approved. Nevelle Organization Youth Work Prep Project Name Dora Edney, Director Print Name and Title of Authorized Person iqiilali in-6 of Authoriz-a-Person Date Signed Page 22 of 24 Attachment A Youth Work Prep 1Tirne Frame Task/Deliverable Person Responsible Program preparation, Research, 1st Quarter-July-September Advertising and Promotions Director/Volunteers Offer career workshops,attent PTA and pertinent meetings, Outreach,Set up job shadow and Director/Consultans/ 2nd Quarter-October-December presentations Volunteers Follow through on workshops and job shadow opportunities- set up additional opportunites, feed back,college programs introduced and information on colleges and their career centers, 3rd Quarter-January-March Develop internship listings Director/Volunteers Interview preparation, dress for success,contacting employers for opportunities, Post Director/Consultans/ 4th Quarter-April-June internship/job listings Volunteers Project Name: Youth Work Prep Page: EXHIBIT F CITY OF CHINO HILLS COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION Submittal Checklist I I Completed and signed application (including Attachment A); and the following mandatory attachments: Ii Copies of both State and Federal tax exemption determination letters; ❑ List of organization's board of directors, board members, and titles; ❑ Copy of organization's articles of incorporation and bylaws; ❑ Copy of organization's conflict of interest policy; Li Copy of most recent annual audit or current balance sheet; ❑ Copy of lease (if CDBG funding request involves the reimbursement of rental expenses to conduct proposed project or make improvements to property not owned by applicant); fI For donated space: A letter from outside organization detailing terms of donated space to conduct the proposed project, if applicable; Submit the original and one additional complete copy of the application, including Attachment A. Submissions should be unbound on white paper with the name of the applying organization and the project name printed in the upper right corner of each page. All pages should be sequentially page numbered. Do not include tabs or colored separation sheets. A person or persons very knowledgeable of all aspects of the proposed project should attend the meetings. Questions may be directed to Lara Christensen, Administrative Analyst II, at (909) 364-2717, or by e-mail at (Christensen@chinohills.oru. Page 24 of 24 NOTICE OF PUBLIC HEARING NOTICE IS HEREBY GIVEN that the City Council of the City of Chino Hills will hold a public hearing on February 22, 2011, 7:00 p.m., in the Council Chamber of the City Hall, 14000 City Center Drive, Chino Hills, regarding the proposed allocation of the Fiscal Year 2011.12 Community Development Block Grant (CDBG) entitlement funds in the approximate amount of$434,200 and provide recommendations for Public Service Projects. ALL INTERESTED PARTIES are invited and encouraged to attend the public hearing and to express their views. Due to time constraints and the number of persons who may wish to give oral testimony, time restrictions may be placed on oral testimony al the public hearing regarding this proposal. You may wish to make your comments in writing to insure that you are able to express yourself adequately. Please direct any correspondence to the City Clerk, City of Chino Hills, 14000 City Center Drive, Chino Hills,CA, 91709, ADDITIONAL INFORMATION regarding this project may be obtained from Lara Christensen, Administrative Analyst II, Community Services Department at(909)364- 2717, Monday through Thursday, 7:30 a.m.to 5:30 p.m.and Friday 7:30 a.m.to 4:30 p.m. DATED: February 08,2011 BY ORDER OF THE CITY COUNCIL OF THE CITY OF CHINO HILLS S/Mary M. McDuffee,City Clerk PUBLISH: Chino Hills Champion February 12,2011