HomeMy WebLinkAbout2003-101
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RESOLUTION NO. 2003-101
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AUTHORIZING THE MAYOR OF THE CITY OF SAN
BERNARDINO OR HER DESIGNEE TO APPLY FOR AND ADMINISTER A GRANT
IN THE AMOUNT OF $158,378.00 FROM CALIFORNIA DEPARTMENT OF
EDUCATION FOR THE ADMINISTRATION OF THE SUMMER FOOD SERVICE
PROGRAM FOR YOUTH.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
SECTION 1. The Mayor of the City of San Bernardino or her designee is hereby
authorized to apply for and administer on behalf of said City, a grant in the amount of
$158,378.00 from CDE for the administration of the Summer Food Service Program for
youth.
SECTION 2. The authorization granted hereunder shall expire and be void and of
no further effect if the agreement is not executed by both parties and returned to the
Office of the City Clerk within 120 days following effective date of the Resolution.
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2003-101
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20 2003.
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AUTHORIZING THE MAYOR OF THE CITY OF SAN
BERNARDINO OR HER DESIGNEE TO APPLY FOR AND ADMINISTER A GRANT
IN THE AMOUNT OF $158,378.00 FROM CALIFORNIA DEPARTMENT OF
EDUCATION FOR THE ADMINISTRATION OF THE SUMMER FOOD SERVICE
PROGRAM FOR YOUTH.
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
and Common Council of the City of San Bernardino at a j t. regular meeting thereof, held
,2003, by the following vote, to wit:
on the 5th day of May
Council Members: AYES
ESTRADA x
LIEN-LONGVILLE ------X-
MCGINNIS x
DERRY X
SUAREZ X
ANDERSON X
-
MCCAMMACK X
NAYS
ABSTAIN ABSENT
(--:'J . Le' L
,_Ac-(J.~l_.r,J ..t4lAJe_
RacfteJG. Clark, City Clerk
The foregoing resolution is hereby approved this '\nt day of May
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Approved as to
Form and legal content:
L {. Le--
A. Ith Valles, Mayor
C~y of San Bernardino
/
JAMES F. PENMAN,
City Alto
By"
Do ou wish to receive commodity
Ves
The California Department of Education (CDE) and the Agency whose name and address appear above renew their Agre
and to comply with 7 CFR Part 225. This includes all requirements developed pursuant to and imposed by those regulatio
original Agreement between CDE and the Agency, which incorporates all amendments, Schedule A, and the Meal Patter
Agency assures CDE it will continue to adhere to all of the requirements and responsibilities as agreed to in the original
follow all Nutrition Services Division policies and guidance. The agency will comply with Title VI of the Civil Rights Act of
Education Amendments of 1973, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and
concerning nondiscrimination (7 CRF Parts 159 and 15b). The agency will comply with applicable Office of Management a
A21, AB7, Al02, All0, A122 and A133. The agency will comply with Uniform Federal Assistance (7 CFR Part 3016)
Lobbying requirements (7 CFR Parts 3017 and 301 B). CDE will hold the agency responsible for all ofthe requirements an
agreed to in the original Agreement and as outlined in 7 CFR Part 225.
California Department of Education
Nutrition Services Division
SUMMER FOOD SERVICE PROGRAM
2003 RENEWAL APPLICATION/AGREEMENT
NSD 8041 (lt03)
PLEASE PRINT OR TYPE ALL INFORMA nON
1. Name of Sponsor:
San Bernardino, City Of
Address of Sponsor (include street, city, county, and zip plus four):
547 North Sierra Way - San Bernardino, CA 92410-4816
Name of Authorized Representative:
Lemuel P. Randolph
2. Method of meal service (check one or more):
Self-preparation No
Vended ~
3. If vended, provide name(s) and address of vendor and
attach a copy of the signed agreement/contract (attach list if
necessary):
San Bernardino Citv Unified School ni~trict
1257 North Park Boulevard
San Bernardino. Ca. 92407
If self-preparation, provide name(s) and address of central
kitchen (attach list if necessary):
4. Number and type of sites:
Rural #
Urban # 30
H133-02
36-8360-0V
Vendor Number
Agreement Number
RETURN TO:
Califomia Department of Education
Nutrition Services Division
P. O. Box 944272
Sacramento, CA 94244-2720
Attention: Resources and Information
Name of Contact Person:
OSCAR J. PERRIER
Telephone Number:
(909)384-5231
Fax Number:
(909)384-5160
5. Dates of operation:
From: 6-30-03
To: 8-2
6. Would you like to receive an:
Operational costs advance?
DYes [!] No
Administrative costs advance?
o Ves I!J No
7. Does the agency receive at least $
lunds? If yes, indicate your agency
(Private nonprofit and Indian Tribes
IiJ Yes 0 No 0 NIA
Fiscal Vear 07 /2002
SIGNA lURE OF AUTHORIZED REPRESENT AliVE:
I hereby certify all information contained in this document is true and correct to the best of my knowledge.
TITLE:
Oirector
Management Unit
9-03
300,000 in federal
's fiscal year.
only)
foods?
ement to Participate
ns as outlined in the
n (Schedule B). The
Agreement and will
1964, Title tX ofthe
USDA's regulations
nd Budget Circulars
and Debarment and
d responsibilities as
TE:
IBLE
- 9/30/03
ates
OA
CALIFORNIA DEPARTMENT OF EDUCATION USE ONL V
COMMODITY ELIG
Ves
APPROVAL BY NUTRITION SERVICES DIVISION
Manager
Field Services Unit
Nutrition Services Division
Approved
FROM:
I t
Effective D
:;alifomia Department of Education
"utrition Services Division
Program Resources. Education and Policy Unit
Renewal NSD 80408 (3103)
SUMMER FOOD SERVICE PROGRAM
MANAGEMENT PLAN
1. Staffing Pattern: List below all Summer Food Service Program (SFSP) personnel who will be
involved with management, food service operations, training, and monitorjng.
PRINT EMPLOYEE NAME AND
POSITION
Oscar Perrier-Senior Rec Supervisor Administer the SFSP 6/17
P'~~al~ appllcdLlon packeL. supervIse s~att & monl~ors.
Lynn Knutson-Recreation SUDerviso~versee ~ay tn ~ay nppratinn~. 4/1/n1
. ~SSlSt wIth offIce duties related' .
Betty Urlbes-Sr. Rec Leader ~n lUR'~ prg3ra~ 9~epati9ft3. 4/1/01. fi/l~ 6/11 &-e/l7
4 Monitors (Not yet identified) Monitor site oDeratinn~ fnr ~/ln. ~/]l & ~/17
campl iance.
By signing this Renewal Application/Agreement you agree to:
2. Conduct a preoperational visit at each new site, and sites that had problems during the previous
year to determine the adequacy and suitability for food service. All preoperational visits must be
documented and kept on file for California Department of Education (CDE) to review.
3. Visit all sites at least once during the first week of operation.
4. Review all sites at least once within four weeks of program operation. If a site operates less than
four weeks, conduct at least one review.
SPECIFIC DUTIES
SFSP TRAINING DATES
5. Conduct additional monitoring visits to sites as necessary to assure compliance with program
requirements. Documentation must be kept on file for CDE to review.
6 Accept final administrative and financial responsibilities for operations of the SFSP at each site.
7. Retain SFSP records for three (3) years after the end of the program fiscal year to which they
pertain.
8. Collect and maintain the income eligibility documentation of participants for any closed enrolled or
camp site. If you will not be using the Income Eligibility Form for Camps and Enrolled Sites form that
is provided in the renewal packet, please submit a copy of your proposed form for approval.
Program Resources. Education and Policy Unit
NSO 804Q-C (3103)
Vendor Number: H133-02
Agreement Number: 36-8360-0V
SUMMER FOOD SERVICE PROGRAM
2003 1.lWJ! BUDGET INFORMATION
Fiscal Year
California Department of Education
Nutrition Services Division
Federal regulations require Summer Food Service Program (SFSP) sponsors to submit a budget for California Department of
Education review and approval.
In the event that costs exceed anticipated revenue, sponsors should have other funding sources to pay the difference.
Sponsors may submit a revised budget for administrative costs as needed.
PROGRAM COSTS
The sponsor is reimbursed lesser of the two: actual cost or The sponsor is reimbursed least of the three: actual cost,
meals times the ODElratinll rate. meals times the administrative rate or the sponsor's budllet.
GENERAL OPERATING COSTS ADMINISTRATIVE COSTS
Food $147 782.80 Administrative personnel salaries/benefits $ R 711n IIn
Food service personnel salarieslbenefits $ 3,888.20 Office supplies $ 2,000.00
Facilities/utilities $ Facilities/utilities $
Food transportation to sites $ Transportation MILEAGE $1,800.00
Nonfood supplies $ 6 707_00 Other (specify): '" ~ '0.0/" $ 1,432.10
III
Other (specify): $ 'Indirect Cost %: $
'Indirect Cost %: $ $
TOTAL $158.::l7R_00 TOTAL $14 012.90
'NOTE: Attach Indirect cost documentation for costs that are associated with the above operating and administrative
budgets.
CONTRACTS
Is there a rental agreement, lease, or contract associated for any of tha costs listed above? D Ves OCJ No
If yes, list and attach a copy:
INCOME
Will meals be sold to adults? D Ves [!] No
If yes, list price to be charged for each meal:
Breakfast: Snack:
Lunch:
Dinner:
Will your SFSP receive income from other sources other than the SFSP reimbursement? NI A
If yes, list type and amount:
Donations/Grant: Unspecified Income:
Administration:
Operational:
Other:
REIMBURSEMENT RATES
Formula for rate projections:
Number of operating days (00) X average daily participation (AOP) X meal (MRl I administrative (ARl rates = totai
OPERATING RATES
00 X ADP X MR = TOTAL
Breakfast X X = $
Snack 44 X 990 X .55 = $ 23,958
Lunch 44 X 1300 X 2.35 =SJ.u a?n
Dinner X X =$
TOTAL $158,378
ADMINISTRATIVE RATES
00 X ADP X AR = TOTAL
Breakfast X X =$
Snack 44 X 990 X 0525 = $2 286.90
Lunch 44 X 1300 X ?n..n =$J.1726.0C
Dinner X X =$
TOTAL ~4 012.9C
California Department of Education
Nutrition Services Division
Program Resources, Education and Policy Unft
NSD 8050.C (3103)
SUMMER FOOD SERVICE PROGRAM
MEDIA RELEASE
Use the following format for your media/public release or send this form to announce
your site location(s):
Check the box(es) that apply and insert the name, address and meal service time(s) of
each site in the appropriate section. Attach an additional sheet of paper if necessary.
[X] OPEN SITES:
City of San Bernardino Parks. Recreation &
Agency name: COIIIDunity Services Department announces
the sponsorship of the Summer Food Service Program. To file a complaint of
discrimination, write United States Department of Agriculture, Director, Office of Civil
Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington,
D.C. 20250-9410 or call (202) 720-5964 (voice and TDD).
Site Name:
Address:
Meal Time:
Dates:
Enter site information below or attach a list.
See Attached Site Name:
Address:
Meal Time:
Dates:
.........................................................................................................
o RESTRICTED-OPEN SITES:
Agency name: announces
the sponsorship of the Summer Food Service Program. Due to: 0 safety 0 security
o control 0 capacity a limited number of meals will be made available to attending
children who are 18 years of age and younger at no cost on a first come, first serve
basis. In accordance with Federal law and United States Department of Agriculture
(USDA) policy, this institution is prohibited from discriminating on the basis of race,
color, national origin, sex, age, or disability. (Not all prohibited bases apply to all
programs.)
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room
326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, D.C. 20250-
9410 or call (202) 720-5964 (voice and TDD).
Site Name:
Address:
Meal Time:
Dates:
Enter site information below or attach a list.
Site Name:
Address:
Meal Time:
Dates:
California Department of Education
Nutrition Services Division
Program Resources, Education and POlicy Unit
NSD BOSO-C (3t03)
D ENROLLED SITES:
City of San Bernardino Parks, Recreation &
Agency name: COIIIIIunity Services Department announces
the sponsorship of the Summer Food Service Program. Free meals will be made
available to all eligible enrolled children who are 18 years of age and younger. In
accordance with Federal law and United States Department of Agriculture (USDA)
policy, this institution is prohibited from discriminating on the basis of race, color,
national origin, sex, age, or disability. (Not all prohibited bases apply to all programs.)
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room
326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, D.C. 20250-
9410 or call (202) 720-5964 (voice and TOO).
Children from households with incomes at or below the income eligibility guidelines are
eligible for free meal benefits. Children who are members of households receiving food
stamps or benefits from a food distribution program on an Indian reservation, Kinship
Guardian Assistance Payment (KinGAP), recipients of Califomia Work Opportunity and
Responsibility to Kids Act (CaIWORKs), or participants of the Workforce Investment Act
(WIA) are categorically eligible to receive free meal benefits.
Enter enrolled site name, address, meal service times and dates below, or attach a list.
Site Name: Site Name:
Address: Address:
Meal Time: Meal Time:
Dates: Dates:
Income Eligibility Guidelines
Effective July 1, 2002 through June 30, 2003
FAMILY SIZE YEAR MONTH WEEK
1 $16,391 $1,366 $316
2 22,089 1,841 425
3 27,787 2,316 535
4 33,485 2,791 644
5 39,183 3,266 754
6 44,881 3,741 864
7 50,579 4,215 973
8 56,277 4,690 1,083
For each additional + 5,698 +475 + 110
family member
add:
California Department of Education
Nutrition Services Division
Program Resources, Education and Policy Unit
Schedule 0, NSO 8050-0 (3103)
SUMMER FOOD SERVICE PROGRAM
FREE MEAL POLICY STATEMENT
The authorized representative certifies that all children at the sites described on the site information
sheets will be served the same meals at no separate charge regardless of race, color, national origin,
sex, age, or disability. (Not all prohibited bases apply to all programs.)
The free meal policy statement must be signed by all new sponsors and by any returning sponsors
who have substantive changes in their original site document(s) (e.g. changing from "open" to
"enrolled" site).
Signature of Authorized Representative Agency Name City of Date
San Bernardino Parks, Rec.
Comm. Services Dept.
California Department of Education
Nutrition Services Division
Program Resources, Education and Policy Unit
(3103)
SUMMER FOOD SERVICE PROGRAM
REIMBURSEMENT RATES
JANUARY 1, 2003, THROUGH DECEMBER 31, 2003
OPERATING COSTS
Operating costs are expenses incurred by the sponsor for preparing, delivering, and serving SFSP
meals. These costs include, but are not limited to:
Purchasing, Storing, and Obtaining Food
Food Service Personnel Salaries/Benefits
Utilities
Non-Food Supplies
Equipment and Facilities Rental
Food Preparation Equipment Repairs
The operating reimbursement rates are:
Breakfast
Lunch or Supper
Supplements
$1.35
$2.35
$0.55
ADMINISTRATIVE COSTS
Administrative costs are expenses incurred by the sponsor for administrative activities related to
planning, organizing, and monitoring the SFSP. These costs include, but are not limited to:
Administrative Personnel Salaries/Benefits
Office Supplies
Insurance
Audits
Equipment and Facilities Rental
Mileage and Parking
Communications
The administrative reimbursement rates for rural or self-preparation sites are:
Breakfast
Lunch or Supper
Supplement
$0.1350
$0.2475
$0.0675
The administrative reimbursement rates for urban sites that purchases meals from a food
service vendor are:
Breakfast
Lunch or Supper
Supplement
$0.1050
$0.2050
$0.0525
California Department of Education
Nutrition Services Division
Program Resources, Education and Policy Unit
NSO Schedule A Supplement (3/03)
Agreement Number ~~_~~tln nv
Vendor Number H1 -
SUMMER FOOD SERVICE PROGRAM
NON OPERATING DAYS
For returning sites only. Complete and submit this form with your Schedule A to report additional
days that you will not be operating, including holidays, that fall within your normal Summer Food
Service Program beginning and ending dates.
Example: The submitted Schedule A indicates the site will operate Monday through Friday. Report
only planned "close" days that occur within Monday through Friday.
Site #
Site Name
Date Closed
Boys & Girls Club
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
7/4/03
2
3
4
5
Brockton Complex
cm
Campfire Boys & Girls
7
Cesar Chavez Park
10
Delmann Heights Community Center
Hernandez Community Center
12
14
Home of Neighborly Services
17
21
Johnson Hall
23
Lytle Creek Community Center
Hill Community Center
Neighborhood Spirit Community Center
Nicholson Community Center
24
26
27
28
30
33
39
North Fontana Parks & Recreation
PAL Center
Ramona Drop In Center
Ruben Campos Community Center
Y.H.C.A
California Department of Education
Nutrition Services Division
Program Resources. Education and Policy Unit
NSD Schedule A Supplement (3/03)
Agreement Num""c 36-8360-0V
Vendor Number HlJiJi-U.l:
SUMMER FOOD SERVICE PROGRAM
NON OPERATING DAYS
For returning sites only. Complete and submit this form with your Schedule A to report additional
days that you will not be operating, including holidays, that fall within your normal Summer Food
Service Program beginning and ending dates.
Example: The submitted Schedule A indicates the site will operate Monday through Friday. Report
only planned "close" days that occur within Monday through Friday.
Site # Site Name Date Closed
43 United Pentacostal Church 7/4/03
48 Central City Lutheran Mission 7/4/03
62 Temple Community Outreach Center 7/4/03
67 Mentone Elementary School 7/4/03
78 Set Free Christian Fellowship 7/4/03
81 Rialto Community Center 7/4/n1
84 Little Zion Manor 7I41O?,
86 80ys & Girls Club of Fontana 7I4/0?'
Christ Temple Church 7/4/03
North Fontana Church of Christ
7/4/9J
Fontana Youth Center 714/03