HomeMy WebLinkAbout2000-121
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RESOLUTiON NO. 2000-121
RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
MAYOR OF THE CITY OF SAN BER~ARDINO OR HER DESIGNEE TO APPLY
FOR AND ADMINISTER A GRANT IN THE AMOUNT OF $178,104 FROM SAN
BERNARDINO COUNTY DEPARTMENT OF AGING AND ADULT SERVICES FOR
THE ADMINISTRATION OF THE SENIOR NUTRITION PROGRAM.
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 a grant in the amount of $178,104 from San Bernardino
County Department of Aging and Adult Services for the administration of the Senior Nutrition
Program.
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 City
Clerk within 60 days following effective date of the resolution.
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2000-121
.,
RESOLUTION 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 $178,104 FROM SAN
BERNARDINO COUNTY DEPARTMENT OF AGING AND ADULT SERVICES FOR
THE ADMINISTRATION OF THE SENIOR NUTRITION PROGRAM.
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5 I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
Joint
6 and Common Council of the City of San Bernardino at aRegular meeting thereof, held on the
7 5th day of
June
, 2000, by the following vote, to wit:
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NAYS
ABSTAIN
ABSENT
Council Members:
AYES
ESTRADA
x
LIEN
x
McGINNIS
x
SCHNETZ
x
SUAREZ
x
ANDERSON
x
McCAMMACK
x
Q."J.'1 h. ~
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The foregoing resolution is hereby approved this 7~ day of June ,2000.
Approved as to
Form and legal content:
JAMES F. PENMAN,
City Attorney
,L
..
REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY, CALIFORNIA
AND RECORD OF ACTION
t
Agreements 98-949
99-699
June 20, 2000
FROM: MIKE DECKER, Director
Department of Aging and Adult Services
SUBJECT: AMENDMENT NO. 2 TO CONTRACT NO. 98-949, AND AMENDMENT NO. 1 TO
CONTRACT 99-699 WITH THE CITY OF SAN BERNARDINO.
RECOMMENDATION:
1. Approve Amendment NO.2 to Contract 98-949 with the City Of San Bemardino to provide
nutrition services to seniors. Amendment NO.2 will:
a. Increase the amount of the contract by $12,965 for FY 99-00, from $181,360 to
$194,325.
b. Change the method of payment to the contractor, and
c. Extend the terms of the agreement through FY 00/01 for $178,104.
2. Approve Amendment NO.1 to Contract 99-699 with the City of San Bernardino to provide
Senior Companion Services to seniors. Amendment NO.1 will:
a. Increase the amount of the contract by $45,317 for FY 00/01 from $53,167 to $98,484.
b. Extend the terms of the agreement through FY 00/01 for $98,484.
BACKGROUND INFORMATION:
1. On November 10, 1998, the Board of Supervisors approved Contract No. 98-949 for $148,693
with the City of San Bernardino to provide congregate meals daily to 303 seniors for 212 days
from September 1, 1998 through June 30, 1999. The City of San Bernardino was one of the
agencies selected to provide nutrition services for seniors after a competitive award process
performed in July, 1998. This process is required every four years by the Older Americans Act
(OAA).
On August 17, 1999, the Board of Supervisors approved Amendment NO.1 to Contract No.
98-949 to extend the contract through FY 99/00 in the amount of $181 ,360.
Approval of Amendment NO.2 to Contract No. 98-949 will:
a. Increase the amount of the contract for FY 99/00 by $12,965, from $181,360 to $194,325.
The City of San Bernardino will use these funds to purchase an ice machine and to fund
an unanticipated shortfall in donation income. These types of expenditures and purchases
are permitted with One- Time-Only OAA funds.
b. Change the method of payment to the contractor to the same method used by the
California Department of Aging (CDA) in reimbursing the Department.
cc: DAAS-Mike Decker w/agree.
City of San Bernardino w/agree.
c/o DAAS
Auditor w/agreement
SBD w/agreement
Risk Management
CAO-Hughes
HSS
File w/agreement
Record of Action of the Board of Supervisors
Rev 07/97
mil
MOTION
MOVE
5
BY
ITEM 024
~
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AMENDMENT NO.2 TO CONTRACT NO. 98-949, AND AMENDMENT NO.1 TO CONTRACT
99-699 WITH THE CITY OF SAN BERNARDINO.
June 20, 2000
PAGE 2
c. Extend the term of the contract through FYOO/01 for $178,104. The City of San Bernardino has
met the goals of the prior contract. They qualify for a contract extension as allowed by the
Older Americans Act. The City of San Bernardino is expected to serve 261 seniors daily for
249 days.
2. On July 27, 1999, the Board of Supervisors approved Contract No. 99-699 for $53,167 with the
City of San Bernardino to provide Senior Companion Services to 40 seniors in FY 99/00 using
Community Based Services Program (CBSP) State funds. Services offered through the Senior
Companion Program by volunteers include friendly visitation of seniors, shut-ins, and those
individuals who may be cut off from the normal day to day activities of living because of a serious
illness. The funds are used to pay for stipends, meals, travel and facilities, and administrative
costs allowed by the program regulations. The City of San Bernardino was selected because the
State regulation requires that if there is an existing provider in San Bemardino County, that
provider must be given the opportunity to accept this State-funded program through a sole source
contract. The Senior Companion Program must meet specific performance criteria; services that
are accessible to the frail and elderly, services provided in a timely manner, services that provide
social intervention to shut-ins with serious or terminal illness, and the requirement to service 40
program participants. These performance standards were established by the Older Americans Act
and the Older Californian's Act. This program is required to be monitored routinely, and monitoring
is also conducted by the California Department of Aging in their annual County reviews.
Approval of Amendment No.1 to Contract No. 99-699 will:
a. Increase the amount of the contract for FY 99/00 by $45,317 from $53,167 to $98,484. The
City of San Bernardino will use $5,314 to increase Senior Companion services hours in the
Victor Valley area and use $40,003 to expand this program to the Morongo Basin area. An
additional 35 seniors will be served through the Senior Companion program through the
expansion
b. Extend the term of the contract through FY 00/01 for $98,484. The City of San Bernardino is
expected to serve 75 seniors.
REVIEW BY OTHERS: These contract amendments have been reviewed and recommended for
approval by the Senior Affairs Commission on April 12, 2000, Deputy County Counsel Fiona Luke on
May 15, 2000, and Deputy County Counsel Michael Sachs for Risk Management on May 15, 2000.
FINANCIAL IMPACT: Appropriations and revenues are included in the Fiscal Year 1999/2000
Budget and the Fiscal Year 2000-2001 Requested Budget and are adequate to cover these
expenditures. All costs are funded by State and Federal revenues. There is no additional local cost.
SUPERVISORIAL DISTRICT(S): First, Third and Fifth.
PRESENTER: Mike Decker, Director, Department of Aging and Adult Services
JUNE 20, 2000
ITEM 024
.
.
E New Vendor Code Dept. Contract Number
M Change SC A 98-949 A-2
X Cancel
County Department Dept. Orgn. Contractor's License No.
AGING AND ADULT SERVICES OOA OOA N/A
County Department Contract Representatille Ph. Ex!. Amount ri Contract
MIKE DECKER, DIRECTOR "'$521,122"'TOT AL
Fund Dept. OrganizaliOl'l Appr. ObjlRev Source Activity GRClPROJ/JOB Number
SSG OOA OOA 200 2445
Commodity Code Esijmated Payment Total by Fiscal Year
FY Amount VD FY Amount VD
Project Name - -
Nutrition for Seniors 98/99 $148,693 00/01 $178,104 I
- -
99/00 $181,360 I
- -
99/00 $ 12,965 I
FOR COUNTY USE ONLY
County of San Bemardino
FAS
STANDARD CONTRACT
THIS CONTRACT is entered into in the State of Califomia by and between the County of San Bemardino, hereinafter called
the County, and
Name
City of San Bernardino hereinafter called Contractor
Address
547N. Sierra Way
San Bernardino, CA 92401-1211
Phone Birth Date
(909) 384-5231
FederallD No. or Social Security No.
95-6000772
IT IS HEREBY AGREED AS FOllOWS:
(Use space below and additional bond shfl6ts. Set folth setvice to be rendered, amount to be paid, manner of payment,
time for petformance or completion, determination of satisfactory petformance and cause for termination, other terms and
conditions, and attach plan s, specifICations, and addenda, if any.)
WHEREAS, the County and City of San Bernardino entered into a contract on November 10,
1998, designated in County Records as Contract No. 98-949, and said Contract was amended on
August 17, 1999 for Amendment No.1; and
WHEREAS, the parties now desire to amend Contract No. 98-949 and Contract No. 98-949 A-I.
NOW, THEREFORE, it is mutually agreed that Contract No. 98-949 and Contract No. 98-949
Amendment No. 1 is amended as follows:
1) Delete existing Article II, and substitute therefore the following as a new Article II:
"The term of this Agreement will begin on the 1 Q day of September 1998 and terminate on
the 30th day of June 2001."
2) Delete existing Article III, Paragraph AI, and substitute therefore the following as a new
Article III, Paragraph Al :
The maximum amount of funds available under this Agreement shall be $521,122, and shall
be subject to availability offunds from CDA These funds are divided as follows:
-'
Fiscal Year 1998 - 1999
Fiscal Year 1999 - 2000
Fiscal Year 2000 - 2001
$ 148,693
$ 194,325
$ 178,104
The budget displays for the funds for FY 1999-2000 are attached as Fiscal Year 1999-2000
Revised Exhibit B, and Revised Exhibit B-1, and for FY 2000-2001 are attached as Fiscal
Year 2000-2001 Exhibit B, and Exhibit B-1.
3) Delete existing Article III, Paragraph A2, and substitute therefore the following as a new
Article III, Paragraph A2:
Schedule or Payments
Contractor may be provided a payment advance equal to 10% of the Title III portion of the
total funding for each fiscal year. This advance is to be recouped from reimbursements to
the Contractor within the fiscal year the advance is for. Contractor shall be reimbursed with
the remainder of the Title III funds monthly. The calculation of the monthly reimhursement
amount will be based on expenditures identified in the "Expenditure Report/Request For
Reimbursement Form" submitted by the Contractor compared to the year-to-date payments
made to the Contractor. USDA funds will be paid at the prevailing rate for each
reimhursable meal served, and reimbursed to contractor as funds become available.
4) Delete existing Article III, Paragraph C , and substitute therefore the following as a new
Article III, Paragraph C:
Matching Contnbutions
The Contractor will provide a minimum matching contribution of $45,343, allocated as
follows: $12,591 is for fiscal year 1998-1999, $16,791 is for fiscal year 1999-2000 and
$15,961 is for fiscal year 2000-2001. This is calculated by multiplying the Title III portion
of the contract amount by 11.11 %. Allowable match shall be in compliance with the
following CDA requirements:
1. Matching In-Kind contnbutions must be for allowable cost as determined by CDA policy
allowable cost include but are not limited to rent, utilitjes, supplies, personnel (volunteers).
2. To qualitY as a matching contributjon, indirect or contractor allocated overhead expenses
must be supported by a documented cost allocation plan.
3. Matching contributions in excess of the minimum required in one service component may
be used to match another service component within the Older Americans Act. As an
example, match exceeding the minimum requirement in Transportation program may be
used to offset an under match in In-Home Supportive Services.
4. Contractor will comply with the Budget In-Kind Narrative (EXHmIT Cot) for fiscal
year 2000-2001 identifying the type, rates applied and, if applicable, sourcellocation of in-
kind to be used as match for the period of the contract. The identified in-kind match will be
reported monthly on the "Monthly Expenditure I Reimbursement Report."
a Services of volunteers shall be valued at rates consistent with those ordinarily
paid for similar work by the contractor. If the contractor does not have similar
work, the rate shall be consistent with those in the labor market. In either case,
a reasonable amount of employee benefits may be included.
b. All other in-kind contributions shall be valued at current market value.
5) Article X, Paragraph B is amended to read, "Contractor shall provide all program services
and perform all activities identified in Attachment A and Exhibit A-I for Fiscal Year 1999
- 2000 and Fiscal Year 2000 - 2001."
Except as modified by tbis amendment, all provisions of Contract No. 98-949 as amended in
98-949 A-t, remain in full force and effect, and are incorporated by this reference.
This Amendment shall not be effective until approved in writing by both parties.
FOR THE DEPARTMENT OF AGING
AND ADULT SERVICES
FOR THE CONTRACTOR
.
~a:~f~
San Bernardino County
Board of Supervisors
JUN 2 0 2000
t- 7- 00
Date
Date
COUNTY OF SAN BERNARDINO
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Jon
CITY OF SAN BERNARDINO
(Print or COIpOIll~y, contracfor. e/c.)
By
Dated:
ikels, Chainnan, Board of Supervisors
JUN 2 0 2000
(Authorized sture - sjgn in blue ink)
Esther Estrada
(Print or type name of person sjgning contract)
Title Mayor Pro Tem
Name
SIGNED AND CERTIFll;OcrHAT J!\ COPY OF THIS
DOCUMENT HAS -' E!HI~~EO TO THE
CHAIRMAN OFT. ~ N~<<1,
O'tl k ll<9f pervisors
~ ardino.
By
Dated: ~/cP/~:ri'>D
\ l Er
Address 3.?"? 4/. 1> asI-
.>/11 6~;U7. ~
REl\IielNlld by Contract Compliance Reviewed for Processing
~~ O/2/c;,r.,t~'tL c(1,L-'77:>Ac ~
Agency AdministratorlCAO
Date r. /1. tJO
Date
Date
CITY OF SAN BERNARDINO
EXHIBIT B - REVISED
BUDGET SUMMARY
FY 1999 . 2000
FY 99/00
FUNDING
EXPENDITURES:
$194,325
REVENUES:
Title III, Older Americans Act
C-1
151,134
U. S. Department Of Agriculture
C-1
43,191
TOTAL REVENUES:
$194,325
SAN BERNARDINO COUNTY-DAAS Form 312A
02113/98
FY 99/00 EXHIBIT B-1
CO~REGATE SITES Cl 0 HOME DELIVERED.MEALS C2 D REVISED
EXPENDITURE CATEGORY Funding Match TOTAL
Less Match Cash In-Kind
1. PERSONNEL 129,145 30,000 159,145
2. STAFF TRAVEL 500 500
3. STAFF TRAINING 220 220
4. EQUIPMENT 7,300 7,300
5. CONSULTANTS 4,179 4,179
6. FOOD COSTS 111,580 700 112,280
7. CONSUMABLESUPPUES 13,500 13,500
8. INSURANCE 833 833
9. REPAIRS & MAINTENANCE 3,888 1,667 5,555
10. RENT/BUILDING SPACE 40,833 40,833
11. UTILITIES 18,333 18,333
12. VEHICLE OPERATIONS 7,999 7,999
13. VOLUNTEER EXPENSES 833 833
14. OTHER 13,657 6,584 20,241
Total Expenditure 291,968 99,783 391,751
Less Match
Match Cash
Match In-kind 99,783 99,783
Less Funding
Non Match USDA-78,529 43,191 43,191
Non Match Cash
Program Income 97,643 97,643
TOTAL FUNDING REQUEST 151,134 151,134
Date of Submission - APRIL 10, 2000 INITIAL BUDGET D
PROVIDER NAME - CITY OF SAN BERNARDINO REVISED BUDGET 0
SAN BERNARDINO COUNTY-DAAS FOIm 312A
02113198
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For FY 00/01 Attachment A is amended to read:
Attachment A
Page 1 of 5
WORK PLAN
City of San Bernardino
FY 00/01-
This work plan contains the measurable objectives mandated by DAAS of the Nutrition provider. The work plan
specifies and establishes time frames either on an annual basis or where required by state regulations on a quarterly
basis. The work plan constitutes the primary document for on-going monitoring, Annual Program Performance
ReviewlFiscal Audit and will be used to measure the provider's efforts towards providing quality Nutrition Services.
L Program Description
A. Geographic Area/Clientele and Eligibility Criteria
1. The geographic area served by this contractor covers the communities of San Bernardino and
Highland.
2. individuals eligible to receive a meal at a congregate nutrition site are:
a. Any person aged 60 or over; or
b. . The spouse of any person aged 60 or over; or
c. A disabled person as defined in OAA Sec. 102(8)(9) under age 60 who resides in housing facilities
occupied primarily by older persons at which congregate nutrition services are provided; or
d. A disabled individual who resides at home with and accompanies an older individual eligible
under the OM; or
e. Any volunteer regardless of age who volunteers hislher time at a meal preparation site at least
eight hours per month.
3. individuals eligible to receive a home-delivered meal are:
a. Any person aged 60 or over who is frail, homebound by reason of illness or incapacitating
disability as defined in OAA Sec. 102 (8)(9), or otherwise isolated, shall be given priority; or
b. A spouse of a person in b.c. above, regardless of age or condition, may receive a home-delivered
meal if the Area Agency on Aging (AAA) criteria conclude that it is in the best interest of the
homebound older person; or
c. A disabled individual who resides at home with older individuals eligible under t4e OAA; or
d. Any volunteer regardless of age who volunteers hislher time at a meal preparatioo site at least
eight hours per month.
B. Program Description
I. Purpose: Nutritioo services are provided to assist elderly or adult disabled individuals to live
independently by promoting better health through improved nutrition and reduced isolation through a
program coordinated with other supportive services.
2, Definition: Nutrition services include the procurement, preparation, transport, and service of meals to
older or adult disabled persons at congregate sites or in their homes.
C. intended Outcomes
1. Serve 261 (EXHIBIT A-i) Congregate meals per day that are nutritious, providing at least 1/3 of the
minimum daily requirements, served in an environment that is pleasant, safe and free from coercion at
least 249 (EXHIBIT A-i) days for a total of 64,989 meals per year at the sites listed in Exhibit A-I.
For FY 00/01 Attachment A is amended to read:
Attachment A
Page 2 of 5
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2. Provide Congregate meals to at least 800 unduplicated seniors of which 92 are minority low-income
seniors.
3. A Program Dietician, meeting the requirements set fqrth within PM 95 03(P), 145.3b, will provide a
minimum of 20 hours of activity to provide functions mandated by the State of California. Those
functions include approval of the con1ractors menus, staff training, nulrition education activities, and
monitoring.
At least one person in each facility shall be certified in food safety, a person who has passed, an
approved and accredited food safety examinations required by Assembly Bill 1978 (Campbell) which
is now included in the California Health and Safety Code.
Contractor's menus will be approved by the dietitian before submission to the AAA Dietitian for final
approval and certification prior to use as specified within PM 9503 (P), 143.3 a, 6, Staff training will
be provided as specified within PM 95 03 (P), 147.5. Nutrition education services shall be provided to
homebound and congregate sites as specified within PM 9503 (P), 145.13. Nutrition counseling shall
be provided to homebound and congregate participants as specified within PM 95 03 (P), 145.13.
The staff training, nutrition education and program monitoring activities shall be documented and
submitted to DAAS nutritionist for review.
Provide a nulrition risk assessment for both congregate and homebound participants and a report shall
be submitted to DAAS Nutritionist to be used in the preparation of Stale Program Reporting (SPR) per
PM 97-02.
4. Provide outreach in the community through a minimwn of 6 presentations to community groups,
organizations, etc., and through door-tCHioor contact to new seniors of at least 50 contacts which
represents at least 100 hours of outreach activity, and is exclusive of the periodic home visits
conducted by the provider to their current participants homes. All outreach will be documented and
kept on file for the Annual Program Performance Review.
5. Conduct a client satisfaction survey at least once a year if not more often. The survey instrument must
be approved by a designated DAAS staff prior to its use, and all findings from the surveys must be
used to improve services. The returned surveys and the tabulated results must be kept on file for review
by DAAS: A copy of the tabulated results must be sent to DAAS.
6. Prepare posters and signs in languages other than English, and post the signs in such locations as
churches, comnnmity service locations and small stores serving the minority communities.
II. Service Delivery Activities
A. Staffing and Volunteers
Sufficient personnel shall be available to carry out the needs of the program. This includes a Project
Director and additional personnel as determined by the size of the service area and the method and level of
service provision needed to fully comply with the terms of this work plan and agreemenl.
1. Paid Staff FTE %CI %C2
a. Food Supervisor II 1.00 100 0
b_ Food Supervisor I 1.00 100 0
c. Food Worker II 1.00 100 0
d. 2 Food Worker 1's 1.00 100 0
e. 3 Site Coordinators!
Recreation Leaders 1.13 100 0
For FY 00/01 Attachment A is amended to read:
.
Attachment A
Page 3 of 5
f. Senior Recreation Leader/
Accountant! Account Tecb/
Kitchen Helper 1.00 100 0
g. 2 Food Service!
Delivery Persons 1.00 100 0
h. Administrative Assistant!
Recreation Specialist .60 100 0
i. Senior Recreation Supervisor .25 100 0
j. 4 Kitchen Helpers 2.00 100 0
3 , Volunteer Staff
a. Volunteers Constitute individuals who work at least eight hours per-month without pay in the
performance of essential duties at a Congregate or Home-delivered kitchen.
b. Volunteers shall be recruited and used in all phases of services operations. Volunteers shall:
i. Be screened and selected through a formal process that assesses their capabilities, and;
ii. Not replace paid personnel.
c. Individuals who work at a meal preparation site for either Congregate or Home-delivered Meals
and are paid through Job Training and Partnership Act, Senior Employment, Work Study, or any
other job training program are not considered volunteers and must pay the agreed upon rate
charged for regular paid staff
B. Staffing Definitions-Nutrition Services Project Director: The minimum qualifications for a Nutrition
Project Director include individuals with an associate degree with emphasis in:
I. Minimum qualifications shall include applicants who have no less than an associates degree with
emphases in food service management, business administration, personnel and/or human resource
management or gerontology. Preferably, they shall have no less than 2 years experience with
increasing responsibility and an emphasis on management ability.
2. Preference shall be given to applicants possessing food service management skills. Persons with these
skills may include a dietitian, food service manager, or a home economist with education and
experience in food service management
C. Training Activities
I. Attend training events mandated by DAAS.
2. Provide training for one hour monthly, at a minimum, to improve the ability, knowledge, and skills of
paid and volunteer staff of the nutrition program. A written training plan shall be prepared as specified
within PM 9503 (P), 147.5, in order to comply with this requirement. The written staff training plan is
to be implemented and placed on file by July 1-, 2000, and be available for review by DAAS staff. A
copy of a training plan shall be submitted to DAAS nutritionist for review and approval.
In addition, annually evaluate the paid staff and volunteer's performance to determine hislher
effectiveness, skill development and understanding of the tasks they are assigned. Documentation of
the annual evaluations will be kept on file at the provider's main office for review by DAAS during the
Annual Program Performance Review.
3. All Project Directors and food service managers shall complete a minimum of 15 clock hours
specifically related to food service management, business administration, personnel, or personnel
For FY 00/01 Attachment A is amended to read:
Attachment A
Page 4 of 5
management Proof of completion will be documented and kept on file for review by the Department
during the Annual Program Performance Review.
4. All Project Directors and food service managers shall complete a minimum of 15 clock hours
specifically related to food sanitation and health. Proof of completion will be documented and kept on
file for review by the Department during the Annual Program Performance Review. This requirement
can be fulfilled by the Manager's Food Safety Certification Course.
D. Service Locations
Central Kitchens
I. 5th Street Senior Center Site
2. Hernandez Site
3. Lytle Creek Site
4. Highland Site
5. Nicholson Site
6. Perris Hill Senior Center Site
7. Enterprise Center Site
1. 5th Street Senior Center Site
2. Perris Hill Senior Center Site
E. Menu Planning
1. Coordinate with the Department's Nutritionist by providing monthly menus, No change to the menus
will occur without a two day prior notice to DAAS and proper documentation kept on file at the
provider's main office.
2. Develop menus that are reflective of the participants food eating habits. Particular attention shall be
paid to ethnic and regional foods which should be served at least once a week if not more often.
m. Other Service Requirements
A. Meal Site Physical Set-up
1. Provide an attractive environment including but not limited to table cloths, table decorations, bulletin
boards, wall decorations, matching dishes and utensils. Fwther, the provider will encourage creative,
appealing and innovative activities aimed at encouraging greater participation by the seniors.
2. Post floor plans identifying emergency exits, assembly areas, etc. and conduct evacuation drills at least
twice a year. Proof of evacuation drills will be kept on file duly signed by the Fire Marshall, or other
authorized agency within the community where the site or sites are located.
3. Post "No Soliciting" signs on the door leading into each Congregate site. No soliciting of any kind is
pennitted on the premises during the hmch hours for services or goods promoted by businesses.
B. Donations and Confidentiality
I. Maintain a written donation policy and appropriate procedures to safeguard and account for all contn'butions.
2. Encourage seniors to donate by posting motivational signs, and by verbally reminding the participants
about the importance of their contributions. The Contractor will not in any way employ tactics which
could be viewed as coercive, embarrassing and/or obligatory to the meal being provided to the senior
participant. Tactics such as placing volunteers to guard the collection boxes, having participants sign-
in and pay before a meal ticket is given, etc. are strictly prohibited by this work plan and contract.
Further, no exchange of money for the purpose of making change will be allowed at the collection box.
For FY 00/01 Attachment A is amended to read:
Attachment A
Page 5 of 5
3. All contributioos, including those for guest and staff meals, shall be used to increase the munber of
meals, to fucilitate access to nutrition services, and to provide other supportive services directly related
to nutrition.
C. Coordination Activities
I. If applicable, develop a :fair and equitable policy and procedure for referring elderly participants to the
appropriate transportation provider for securing public 1ransportation to and from nutrition sites and
have the policy fully in place by September 30.
2. Include the following statement on all advertising, brochures, posters, etc. "Funding for this service has
been provided by the San Bernardino County Department of Aging and Adult Services through a grant
award from the California Department of Aging",
3. Coordinate services with other county departments and local agencies by providing time for
presentations or special activities that promote a Community Based System of Care for the elderly
participants attending their sites. All such activities must be documented and kept on file for review by
DAAS.
D. Reporting Requirements
I. Report all knOWII or suspected cases of elderly or dependent adult abuse to DAAS Adult Protective
Services or law enforcement immediately or as soon as possible by telephone, and send a written
report within two (2) working days. Abuse of an elder or dependent adult means physical abuse,
neglect, intimidation, cruel punishment, fiduciary abuse, abandonment, isolation or other treatment
with resulting physical harm or pain or mental suffering or the deprivation by a care custodian of
goods or services which are necessary to avoid physical harm or mental suffering.
2_ Report accurate meal counts on CDA 187 & 188 forms which will be verified by DAAS during the
Annual Audit. Additionally, establish audit files which include but are not limited to a copy of the 187
report attached to the meal sign-in sheets supporting meals reported on the CDA 187 form, and a copy
of the 188 report attached to source documents, i.e. route sheets supporting meals reported on the CDA
188 form all of which will be kept on file by month for annual review.
3. Report monthly expenditures to DAAS by the 5'" working day of the month. Maintain support files
including but not limited to invoices, payron, and other supporting documents, all for which will be
attached to a copy of the expenditures report and kept on file by month for review during the Annual
Audit.
4. Maintain records, by month, that support claimed in-kind expenditures.
5. By September 30, report expenditures funded with Deferred Income,
6. Develop and have on hand, for review by DAAS, a cost allocation plan which explains the methods
used to allocate costs between Congregate and Home- Delivered Meals or any other program funded by
DAAS, such as Home Repair, etc.
In the event additional funds become available, the provider will use the funds to increase the number
of meals being provided to elderly participants by either increasing the number of individuals attending
its present sites, or by opening new sites in communities not already served by the provider.
Exceptions to this requirement, for instance the use of additional funds to purchase equipment, must be
fully documented in writing and submitted to the department for prior approval. Failure to abide by
this work plan will constitute just cause for sanctions being imposed.
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CITY OF SAN BERNARDINO
EXHIBIT "B"
BUDGET SUMMARY
FISCAL YEAR 2000 - 2001
FY 00/01
FUNDING
EXPENDITURES:
$178,104
REVENUES:
Title ill, Older Americans Act
C-1
143,660
U. S. Department Of Agriculture
C-1
34,444
TOTAL REVENUES:
$178,104
SAN BERNARDINO COUNTY-DAAS Form 312A
02113/98
FY 00/01 EXHIBIT B-1
COMjrREGATE SITES Cl 0 HOME DEUVERED MEALS Co2 D
EXPENDITURE CATEGORY Funding Match TOTAL
Less Match Cash In-Kind
1. PERSONNEL 111,000 26,262 137,262
2. STAFF TRAVEL 500 500
3. STAFF TRAINING 200 200
4. EQUIPMENT
5. CONSULTANTS 8,400 8,400
6. FOOD COSTS 102,630 624 103,254
7. CONSUMABLE SUPPLIES 8,000 8,000
8. INSURANCE 741 741
9. REPAIRS & MAINTENANCE 2,000 1,471 3,471
10. RENT/BUILDING SPACE 35,741 35,741
11. UTILITIES 16,053 16,053
12. VEHICLE OPERATIONS 6,000 6,000
13. VOLUNTEER EXPENSES 741 741
14. OTHER 6,364 5,773 12,137
Total Expenditure 245,094 87,406 332,500
Less Match
Match Cash
Match In-kind 87,406 87,406
Less Funding
Non Match USDA-64989 34,444 34,444
Non Match Cash
Program Income 66,990 66,990
TOTAL FUNDING REQUEST 143,660 143,660
Date of Submission - APRIL 18, 2000 INITIAL BUDGET 0
PROVIDER NAME - CITY OF SAN BERNARDINO REVISED BUDGET D
SAN BERNARDINO COUNTY-DAAS Form 312A
02113198
'.
Anachment B
PRINCIPAL OWNER INFORi\1ATION FORM
San Bernatdino County Code Section 110.0101 et seq. contains the San Bernardino County Child Support Compliance Program.
This Program requires the County' to provide certain information to the District Anomey concerning its employees and business
licenses. It further requires that bidders or proposers for County contracts provide, directly to the District Anorney, infom13tiol1
concerning their "Principal Owners," that is, those nahual persons who o\\'n an interest of 10% or more in the Contractor. For each
"Principal-O\mer," the information which must be provided to the Dis'trict Attorney is: 1) the Principal Owner's name; 2) his or her
title, and; 3) whether or not the Contractor has made a payment of any sort to the Principal Owner.
1:\ ORDER TO CQ:\IPL Y WITH THIS REQUlRBIE!\T, CQ:\IPLETE THIS FOR:'I ."'-''iD MAlL OR FA-X IT DIRECTLY
TO THE DISTRICT ATTOR:'iEY AT THE ADDRESS OR FAX 1\U:\IBER SHOW"" BELOW O:\' OR BEFORE THE DATE
YOU SUB:\IIT A BID OR PROPOSAL TO A COU1\TY DEPARBIE1\T.
"IAT:\TAI:\ DOCU:\IE1>'TATIO:\ OF SUB'IIISSIO:\.
In addition, bidders or proposers must certify to the soliciting County department that they are in full compliance with the Program
requirements by submining the Child Support Compli311ce Program Certification, along with the bid or proposal.
To:
Disrrict Anorney Child Support Division
Ombudsman Program
10417 n.'1ountain View Avenue
Loma Linda, CA 92354-2030
FAX: (909) 478-7470
PHOCiE: (909) 478-7300
Contractor Name as ShowTl on Bid or Proposal:
Contractor Address:
.
Contractor Phone:
County Department Receiving Bid or Proposal:
Type of Goods or Services to be Provided:
Contract or Purchase Order Number (if applicable):
Fax:
Principal Owners: Please check appropriate box. If Box I is checked, no further information is required. Please sign and date the
form belo\\'.
I. 0 1\0 natural person o\ms an interest of 10% or more in this Contractor.
II. 0 Required Principal Owner information is provided below. (Use a separate sheet, if necessary)
1>'A,,'IE OF PRT:\CIPAL OW1>'ER
TITLE
P A YJ\lE1\T
RECEI\"ED FRO'l1
CO:\TR.\CTOR
l"ES 1\0
l.
2.
3.
I DECLARE, Ul\'DER PPlALTY OF PERJURY, THAT THE FOREGOE\G Il\'FOR\IATlO:'\ IS TRUE A!\'D
CORRECT.
By: U.~ Date: C/.t/~
(Sign .!!Ire of r. Prillcipr.! Q;n;er. 1I1l OJ;icer, or Mar.r:.ger respol:sible for S:lbmissioll of the bid or propdslI! 10 the COllnt)}.
Prin.ed ~.1me
Mayor Pro Tem
Title / P05ition
Esther Estrada"
ATTACHMENT C
"
h
. ,Son Bernardino County
. CDA 217 (6/96)
Deportment of Aging and Adull Services
,
CERTIFICATION REG,A,RDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS tOAN5, AND COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief. thai:
(1) No federal appropriated funds hove been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress,
or on employee of a Member of Congress in connection wilh the awarding of any federal
contract, the breaking of any federol grant. the making of any federal loon, the entering
into .of any cooperative agreement. and the extension, continuation, renewal.
amendment, ar modification of any federal contract, grant. loon, or cooperative
agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence on officer or employee of any agency,
o Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection yvilh this federal contrad gran!. loon, or cooperative
agreement Ihe undersigned sholl complete and submit Standard Form-LLL. "Disclosure
Form to Report Lobbying," in accordonce with its instructions.
(3) The undersigned sholl require ihat the language of Ihis ceriification be included in Ihe
award documents for all subowards ot 011 tiers (including subcontracts. subgronts. and
contracts under grants, loons. and cooperative agreements) and Ihat all subreCipients
sholl certify and disclosure occordingly.
This ceriificalion is 0 malerial representolion of foct upon which reliance was ploced when Ihis
transaction was mode or enlered into. Submission oj Ihis certification is 0 prerequisite for moking
or enlering into this transaction imposed by Section 1352, Tille 31, U.S. Code. Any person who
fails to file the required ceriification sholl be subject to a civil penalty of not less than $10,000 and
not more than $100,000 for each such foi!uie,
..~ (!I/ Or '));J D:!(2;J/1I:Nll/0
CONTRACTOR
CA
5T AT E
ORIZED S!GNATURE Esther Estrada
Mayor Pro TPm
TITLE
C:IJ/~
DATE
A
,.
..
An;'C'lMFNT D
"
SOLICITIi'iG DEPART\IE:-;T: DEPARTMENT OF AGING & ADULT SERVICES
ADDRESS: 686 E. MILL STREET, SAN BERNARDINO, CA 92415-0640
CO:-O;TACT NA~IE & PHOi'iE 1\'0.: MIKE DECKER
CHILD SUPPOHT COMPLIANCE PROGRAM CERTIFICATION
San Bernardino County Code Section 110.0101 et seq, contains the San Bernardino County Child Support
Con.pliance Pi'ograr71. This Program requi;es the County to provide certain information to the District Attorney
concerning its employees and business licenses. It further requires that bidders or proposers for County contracts
submit certifications of Program compliance to the soliciting County dep8rt:::ent, 210"6 with their bids or
. proposals. (in an emergency procCirement, as detemlined by the soliciting County department, these cenific<.tio;-,s
may be provided immediately following the procurement).
Il\' ORDER TO CO\IPLY WITH THIS REQUIREMEl\'T, CO\IPLETE THIS FOR\I Al\'D SUB\IIT IT
DIRECTLY TO THE SOLICITI:-;G COUNTY DEPARTMENT, ALONG WITH YOUR BID OR
PROPOSAL. IN ADDITIOi'i, THE SOLICITIl\'G DEPARTi\IENT WILL PROVIDE A COpy TO THE
DISTRICT ATTOR1\'EY AT THE ADDRESS OR FAX NUMBER SHOW1\' BELOW.
I, (prillt Jl{Ime)
proposal)
at (COil tractor 's address)
is in compliance with San Bernardino County's Child Support Compliance Program ind has met the following
hereby certify that (contractor /lame as shown Oil bid or
, located
requirements:
]. Submitted a completed Principal Owner Infom1ation Form to the District Attorney, Child Support Division;
2. Fully complied with employment and wage reporting requirements (42 USC Section 653a and California
Unemployment Insurance Code Section IOSS.5), and will continue to comply with such reporting
requirements;
3. Fully complied with all lawfully-served Wage and Earnings Withholding Orders or District At10rney Notices
of Wage and Earnings Assignment, [Code of Civil Procedure Section 706.031 and Family Code Section
5246(b)), and will continue to comply with such Orders or Notices.
I declare, under penalty of perjury, that the foregoing is true and correct.
Executed this
d~y of
~~
- c:.vl)
(Month & Year)
;to 7-
3Fc/- S~~.P-
0'
,..
(Telephone 'Kumber)
By: 0 Tem
(Sigl:r:::lr~ of (/ Principal O....r..::r, GI: Q}7.:cr, O' ,\/(1Ilr:ger respollsi .e or submission olthe bid or proposal /0 the COUllr;.).
Soliciting Dept Send
Copy to: District Attorney, Child Support Division FAX: (909) 478-7470
Ombudsman Program
10417 Mountain Vie\\' Avenue PHO\'E: (909) 478-7300
Lorna Linda, CA 92354-2030
COUNTY COUNSEL
Fax:9093874068
i\'l"l'A.L.t1l""lJ~avl'l' E
May 12 '00 7:04 P.03 -
.'
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~
ASSURANCE OF COMPLIANCE WITH
THE SAN BERNARDINO COUNTY
WELFARE DEPARTMENT
NONDISCRIMINATION IN STATE
AND FEDERALL V-ASSISTED PROGRAMS
(1/ '11/ elr <:?~;I) hE rQ/lJI-I-I2.I>( ,/;)(.1
NAME OF VENDOR/RECIPIENT
HEREBY AGREES THAT it will comply with Title VI of the Civil Rights Act of 1964 as amended;
Section 504 of the Rehabilitation Act of 1973, as amended: the Age Discrimination Act of 1975, as
. amel1ded;.the Food Stamp Act of 1977, as amended, and in particular Section 272.6; Title II of the
Amencans with Disabilities Act of 1990; California Civil Code, Section 51 at seq., as amended;
California Government Code Section 11135-11139.5, as amended; Califomia Government Code
Section 12940 (c), (h) (1), (I), and 0); California Government Code, Section 4450; Title 22, California
Code of Regulations Section 98000-98413; the Dymally-A1atorre Bilingual Services Act; Section 1808
Removal of Barriers to Inter Ethnic Adoption Act of 1996 and other applicable federal and state laws,
as well as their implementing regulations [including 45 Code of Federal Regulations (CFR) Parts 80,
84, and 91; 7 CFR Part 15; and 28 CFR Part 35], by ensuring that employment practices and the
administration of public assistance and social services programs are nondiscriminatory, to the effect
that no person shall because of age, sex, color, disability, national origin, race, marital status, religion
or political affiliation be excluded from participation in or be denied the benefits of. or be otherwise
subject to discrimination under any program or activity receiving federal or state financial assistance;
and HEREBY GIVES ASSURANCE THAT it will immediately take any measures necessary to
effectuate this agreement.
THIS ASSURANCE is given in consideration of and for the, purpose of obtaining any and all federal
and state assistance; and THE VENDOR/RECIPIENT HEREBY GIVES ASSURANCE THAT
administrative methods/procedures which have the effect of subjecting individuals to discrimination or
defeating the objectives ofthe California Department of Social Services (CDSS) Manual of Policies
and Procedures (MPP) Chapter 21, will be prohibited.
BY ACCEPTING THIS ASSURANCE, the vendor/recipient agrees to compile data, maintain records
and submit reports as required. to permit effective enforcement of the aforementioned laws, rules and
regulations and permit authorized CDSS and/or federal govemment personnel, during normal working
hours, to review such records, books and accounts as needed to ascertain compliance. If there are
any violations of this assurance, CDSS shall have the right to invoke fiscal sanctions or other legal
remedies in accordance with Welfare and Institutions Code Section 10605. or Govemment Code
Section 11135-11139.5, or any other laws, or the issue may be referred to the appropriate federal
agency for further compliance action and enforcement of this assurance.
THIS ASSURANCE is binding on the vendorirecipient directly or through contract, license, or other
provider services, as long as it receives federal or state assistan~ Z-
~ ?? ~ ~,;;?-"-i!f;r ~
~ Datal" ,~ , Veo'",DI_"S1goo',,,
o AJ . 1.) c0<f--
t6~ ' Esther Estrada
A ress of vendor/recip~ . Kayor Pro Tem