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RESOLUTION NO.
2006-38
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF
SAN BERNARDINO AUTHORIZING THE MAYOR OR HER DESIGNEE TO RATIFY
THE SUBMITTAL OF A CONTRACT APPLICATION FOR A PROGRAM
CONTINUATION GRANT FROM THE EMERGENCY FOOD AND SHELTER
PROGRAM IN THE AMOUNT OF $101,000 FOR THE CONTINUED OPERATION OF
THE EMERGENCY FOOD AND SHELTER PROGRAM LOCAL BOARD FEMA XXIV
AND AUTHORIZATION TO ADMINISTER THE GRANT FUNDS IF AWARDED.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AS FOLLOWS:
10
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12 authorized to ratify a submittal of a federal grant application in the amount of $101,000 to
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SECTION 1. The Mayor of the City of San Bernardino or her designee is hereby
continue the Emergency Food and Shelter Program at the Westside Community Service Center
14 and to execute the Agreement for Delegation of Activities for the County of San Bernardino
15 Emergency Food and Shelter Program Local Board FEMA XXIV, a copy of which is attached
16 hereto, marked Exhibit ''1'' and incorporated herein by reference as fully as though set forth at
17
length.
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19
20 further effect if the Agreement is not executed by both parties and returned to the Office of the
21 City Clerk within one hundred twenty (120) days following the effective date of the resolution.
22 II
23 II
24 II
25 II
26 II
27 II
28 II
SECTION 2. The authorization granted hereunder shall expire and be void and of no
2006-38
1
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
2 OF SAN BERNARDINO AUTHORIZING THE MAYOR OR HER DESIGNEE TO
RATIFY THE SUBMITTAL OF A CONTRACT APPLICATION FOR A PROGRAM
3 CONTINUATION GRANT FROM THE EMERGENCY FOOD AND SHELTER
PROGRAM IN THE AMOUNT OF $101,000 FOR THE CONTINUED OPERATION OF
4 THE EMERGENCY FOOD AND SHELTER PROGRAM LOCAL BOARD FEMA XXIV
51 AND AUTHORIZATION TO ADMINISTER THE GRANT FUNDS IF AWARDED.
6111 HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor and
I
7 Common Council of the City of San Bernardino at a joint regular
Meeting, thereof,
, 2006 by the following vote, to wit:
NAYS
ABSTAIN ABSENT
x
~ ' ~
.(- t _ -0
. eoJ:.lu.z J. CtA k. C
Rac I Clark, City Clerk
20
The foregoing resolution is hereby approved this
day of February ,2006
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23 Approved as to form
and legal content:
24 James F. Penman
25 City Attorney
26 BY:~~~~~
\
-
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FFM^ XXIlI \Vestsidc
_ .-t'..~-4..----
.I H VALLES, MAYOR
it)) of San Bernardino
Exhibit "1"
Federal Emergency Food and Shelter Program
The Emergency Food and Shelter Program is a needs based program for which clients must qualify.
Client eligibility criteria for the year of 2005-2006 grant
All clients will have to attend a one-day class, regarding employment, nutrition, and self esteem
(The importance of getting back on track).
I. All adults in the home must have a California picture ID and a Social Security Card.
2. All children must have a Medi-Cal sticker or a Social Security Card.
3. Client must show written veri lication of current income.
4. When client is asking for rent or mortgage assistance, they must bring a lease agreement and
an eviction notice or 3-day quit.
5. Landlord or mortgage company will be called to verify that he/she will accept payment from
the City Program. (Landlord's name, address, and phone number must be furnished by
client.)
6. Client must furnish current copies of all utility bills, and past due notice.
7. As of December 2002, if any other FEMA agency has helped client pay for these bills, our
agency will not be able to help them.
If our department finds that the client application has been falsified in any way, the client and
any person listed on the application will not be allowed to apply for (2) years.
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
INSTRUCTIONS
1. All agencies must complete Sections 1 and 2.
2. For Section 3, complete the funding request matrix on page 8, AND submit ONLY the category or
categories in which you are applying for funding. Do not submit the blank categories.
3. Submit one (1) copy each of the required attachments: (without these, your application will be
incomplete, and will not be considered for funding)
. Current Board of Directors Roster
. IRS form 501 (c)(3) (new agencies only)
. Most recent financial report (monthly or quarterly)
. Independent annual audit for 2004 (if requesting $25,000 or more in EFSP funds; and/or an
annual budget greater than $100,000)
. Per diem or per meal sample schedule (if applicable)
4. No handwritten applications will be accepted. The application must be typewritten or computer-
generated.
5. Use only the space provided for narrative questions. Do not attach additional pages or alter the
pagination. Do not user anything smaller than 10 point font.
6. Submit one (1) original plus fifteen (15) copies of the completed application.
7. The application must be received by: Thursday, December 15, 2005 at 2:00 p.m.
OR postmarked not later than Thursday, December 15, 2005 at 2:00 p.m.
8. The application can be mailed or hand-delivered to:
San Bernardino County EFSP Local Board
clo Inland Empire United Way
9624 Hermosa Avenue
Rancho Cucamonga, CA 91730
9. If you need technical assistance or clarification, please contact:
a. Patricia Fuentes: 909-980-2857 ext. 213 or pfuentesCcil.ieuw.orQ
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
Section 1: General Agency Information
Legal Name of Agency:
City of San Bernardino, Parks, Recreation & Community Services, Westside
Community Services Center
Mailing Address:
1505 West Highland
San Bernardino
CA
92411
City
State
Zip
Agency Executive:
Lemuel Randolph
Title: Director of Parks, Recreation & Comm.
Services
Program Contact Person:
Aaliyah Harkley
Title: Senior Recreation Supervisor
Telephone Number:
909-384-5231
Fax Number:
909-384-5160
Alternate Phone Number:
Westside Community Services Center - Peggy James, Manager 909-384-5428
E-mail Address:
Harkley aa@sbcity.org
Agency Website:
www.sbcity.org
Year the agency was
incorporated:
1854
Year the agency began
delivering services:
1854
Has this agency ever received EFSP funds?
$ 211.477,600
~ Yes
D No (Explanation is attached.)
~ Yes
D No
Total operating budget for this aQencv:
Is your agency in good standing with the Secretary of State of
California and the IRS? If not, please attach an explanation.
If so, what is the last phase that funds were received?
Phase 23
The agency has received or is requesting EFSP funds from:
~ San Bernardino County
D Riverside County
D Los Angeles County
D Other:
Agency mission statement and brief description of how the agency achieves its mission:
Our mission is to provide quality and cost effective services to the people of San Bernardino. We will provide excellence in
leadership through the allocation of public resources to City programs that are responsive to community priorities and
maximize opportunities for economic and cultural viability. The City of San Bernardino achieves its mission through its
elected officials, divisions and departments. Through the General Fund and numerous grants the City of San Bernardino,
will offer a wide range of housing, recreation, cultural, educational and employment opportunities for all that come live and
work in our city.
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
Describe the agency's financial reporting ability and accountability procedures (software, staff, systems used):
The City of San Bernardino fiscai management procedures including budget control, accounting systems, cash
and banking procedures, payroll systems and internal auditing is operated, managed and controlled through the
City of San Bernardino, Finance Department. The budget process is facilitated and administered annually via the Mayor,
City Council and City Administration. The entire City of San Bernardino must maintain a satisfactory set of financial
records in each department. All departmental records are kept and audited by the Finance Department routinely. An
independent auditor reviews city financial records annually.
How do you fund the services you are requesting funding for when EFSP
funding is not available?
Through the general fund and various grant programs, departments and agencies such as the Economic Development
Agency, Attorney General's Office, City Parks and Recreation and Wests ide Community Services, provides financial
assistance to those in need.
These services are distributed directly or indirectly through city departments. Some of these departments
are; City Parks, Recreation & Community Services, Attorneys Office and Economic Development Agency, to name a few.
The EFSP fund enables the City to extend much needed services to the elderly, homeless and indigent population.
Please check if your agency's basic needs program(s) targets specific client populations by choosing up to three (3)
from the list below:
Ethnic Minorities
IZJ Families with Children
IZJ General Population
o General Homeless Population
o Mentally Disabled
o Persons with AIDS/HIV
Physically Disabled
o Seniors
o Single Men
o Single Adults
o Single Women
o Substance Abusers
Unaccompanied minors
o Veterans
o Victims of Domestic Violence
o Other (please list):
Describe the geographic region/boundaries your agency serves. For example, list the county(ies), city(ies), zip
code(s), neighborhood(s) served:
The EFSP funds are used to assist the County of San Bernardino. The cities that receives assistance are; San
Bernardino, Rialto, East Highland, Loma Linda, Mentone, Redlands, Yucaipa, Upland, Rancho Cucamonga and
Fontana. Victorville, Hesperia, Big Bear
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
Approximate the percentage of clients the agency serves from each of these geographic areas of San Bernardino
County. (Should equal 1 00%; Use statistics from the most recently completed fiscal year.)
Central Countv East Vallev Northern Desert Southern Desert West End
Big Bear East Highland Adelanto Johnson Valley Chino
Bloomington Loma Linda Apple Valley Joshua Tree Chino Hills
Blue Jay Mentone Baker Landers Fontana
Colton Redlands Barstow Morongo Valley Lytle Creek
Crestiine Yucaipa Helendale Pioneertown Montclair
Devore Hesperia Twentynine Palms Mt. Baldy
Grand Terrace Lucerne Wonder Valley Ontario
Highland Needles Yucca Valley Rancho Cucamonga
Lake Arrowhead Phelan Upland
Mountain Communities Pinon Hills
Rialto Victorville
San Bernardino Wrightwood
60% 17% 0% 0% 23%
Demonstrate the need for emergency/basic needs services in the area the agency serves (the basis for this
funding request). Include statistics, turn away rates, increases in the demand for agency's services, etc.
The Wests ide Community Services Center is located in the City of San Bernardino, west of Rialto, south of Colton, north
of Devore, east of Highland, and on Highland Avenue. The Westside Community Services Center has been in
existence since 1968. The Center is demographically positioned in an area where approximately 65% of its residents
have income below the poverty level. Since 1985, the Center has made a significant impact on the community and
the surrounding areas by providing food, clothing, shelter, utiiity, and other related services. The majority of residents
in need are single homeless mothers with children. Last fiscal year the Center received over 7,000 telephone calls,
3000 referrals from other agencies and over 3000 walk-ins for food shelter, utility and clothing assistance. The Center
provided financiai assistance to approximately fifty-nine (59) applicants available through EFSP. However, collaborative
efforts with New Hope Missionary Baptist and the City of San Bernardino's Low and Moderate Relocation Assistance City
Fund of $250,000, allowed the Center to provide assistance to over 500 households. These funds were dispersed as it
saw fit. On a daily basis, the Center turns away approximately two-thirds of the residents requesting help.
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Inland Empire United Way
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
Describe the agency's collaborative efforts (I.e. use of community volunteers. participation with coalition..
community projects. coordination of service dallvery with other providers):
The City of San Bernardino, Parks, Recreation & Community Services Department, Westside Community Services Center
collaborates with government and private agencies, nonprofit and for profit businesses. Because of Its unique strength,
the Center is well positioned to essist individuels and families with the most pressing needs. such as homeless. prisoners
ra- entering the community, children of prisoners, at-risk youlh, addicts, elders in need, at risk adults (HIV/AIDS
population, aging seniors, etc.), and families In transition from welfare to work. The Westside Community Services Center
has a long history of providing an array of Important services to people In need in Its community. Some of the previous
collaborative efforts were with New Hope Baptist Church, Catholic Charities, San Bernardino City Unified School District,
Concerned African American Parents Association (CAAPA), Department of Aging and Adult Services, HIV/AIDS (BASIA).
San Bernardino Retirement, Rlalto FamHy Medical Group, Inc., San Bernardino County Food Bank, Alzheimer's
Association, Retired Senior Volunteer Program (RSVP), Allstate Insurance. and SCAN Health Plan.
I am authorlZ8d to apply on behalf of
and attest that all Informe/Ion contained In this application is accurate and complate to the best of my knowledge. All
Information contained in this application is acknowledged to ba public information. I authorize the San Bernardino County
EFSP Local Board to contact any or all of the parties listed in this proposal.
zf:~/,f1 /~/;~/~
Signature 6f Agency ec ve Date
Lemuel P. Randolph
Printed Name
Director
Tille
Date
Signature of Board President
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
Title
Printed Name
6
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
Section 2: Certification Form
Please review the following Local Recipient Organization (LRO) Certification Form carefully. Check each item and fill in the
blanks at the end of this section. Note that is any agency meets all of the criteria except the annual audit and/or accounting
system, another agency that meets these requirements may be approved to serve as the fiscal agent. Signing this form
does not guarantee funding. The form is used only to certify to the Local Board and National Board that your agency is
eligible to receive Emergency Food and Shelter Program funds. Incompletely filling out this section will cause your
application to be denied.
As a recipient of Emergency Food and Shelter National Board Program (EFSP) funds made available for
Phase 24 and as the duly authorized representative of
by the checkmarks and my signature, I certify that my public or private organization:
1. [gJ
2. [gJ
3. [gJ
4. [gJ
5. [gJ
6. [gJ
7. [gJ
8. [gJ
9. [gJ
10. [gJ
11.0
12. [gJ
13. [gJ
Has the capability to provide emergency food andlor shelter services
Will use funds to supplement and extend existing resources and not to substitute or reimburse
ongoing programs and services
Is non-profit or an agency of the government
a. 0
Copy of 501 (C) (3) status is enclosed
Has an accounting system or fiscal agent approved by the Local Board;
Conducts an annual audit (auditor must not be affiliated with agency)
a. [gJ
Copy of most recent audit is enclosed
b. Date of most recent audit:
c. Audit prepared by:
Understands that cash payments are not eligible under EFSP
Understands that EFSP funds cannot be used for staff salaries
Understands that interest income must be reported on final report and used on allowable program
expenditures
Has or will secure a Federal Employee Identification Number
a. FEIN#:
Practices non-discrimination (if an agency with a religious affiliation, will not refuse service to an applicant
based on religion, or engage in religious proselytizing or religious counseling with federal funds)
If private, not-for-profit, has a voluntary board of directors/governors
a. [gJ
Board roster is enclosed
Will comply with the Phase 24 Responsibilities and Requirements Manual, particularly the Eligible and
Ineligible Costs section
Will provide required reports to the Local Board according to the requested timeframe
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JUN-21-2006 16:46
Inland Empire United Way
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Has no known Emergency Food and Sheller Program compliance exceptions in this, or any other jurisdiction
~.
Agency AulhclPlfed Sig ur
14. 121
15. 121
16. 121
17. 121
18. 121
19. 121
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
Will expend monies only on eligible costs and keep complete documentation (copies of canceled checks -
front and back - invoices, receipts, etc.) on all expenditures for a minimum of three years
Will spend all funds and close out the program by September 30, 2006 and return any unused funds to the
National Board ($5 or more)
Will provide complete documentation of expenses to the Local Board, if requested, no later than one month
following my jurisdiction's selected end-of-program
Will comply with the Office of Management and Budget Circular A-133 if receiving over $500,000 in Federal
funds
Will comply with lobbying prohibition certification and disclosure of lobbying activities (if applicable) if
receiving more than $100,000 in Emergency Food and Shelter program funds
Date
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
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Inland Empire United Way
9099802957
P.09
EMERGENCY FOOD AND 8HELTER PROGRAM
Pha.. 24 Appllcatloll
CATEGORY 3: OTHER 8HELTER (Motel Vouchers)
Dollar amount requested for Olh8r Shelter funde: $ 15,000
Whet .. the total anIIt:1DtDd budget for direct eervlcee for the Other Shelter program durlng $ 37,500
Phaee 24? Do not Include ....lie.. admlnletre1lve COe1e, overhead.
Whet wee IN total budget for direct eervlces for the Other Shelter program for tile moat $ 37,500
_fIIf conJIJIaflJd _l? Do not Include ..rlee. admlnle1ratlve co.... overtleed.
L1et IIfttIcIpeted eou_ of .upport for the Other SltelterlMotel Voucher program during Phue 24:
SPECIFIC SOURCES
(PIeeea 1Iet)
AMOUNT ~
EFSP Funds $ 15.000 IZI Pending
o Committed
Other Federal Funds $ o Pending
o Committed
Stale Funds $ o Pending
o Committed
Local Government Funds $ 37,500 o Pending
IZI Committed
United Way Funds $ o Pending
o Committed
Private $ o Pending
ContrlbutionslFundrals/ng o Committed
other $ o Pending
o Committed
Low/moderate Relocation Assistance Fund
New Hope Missionary Baptist Church
Program delIcrlptlon: The Westslde Community SllfVIces Center IlI'OVldes motel ass/stance through homeless
wuchersto persons In need of shelter. A few of the motels used are Central City and Colton Inn. Accordtng to the 2003
San Bernardino County Homeless Census and Survey, there are batween 5,270 and 8,351 homeless persons In San
Bamardlno County on any given day. Due to the devastating effects of hunioane season and the economy, the Center
has seen an influx In the need for seMoaS. Last year with the help of the City's fund, New Hope BaptISt Chun:h and
EFSP, approximately 550 households beneftted.
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Inland Empire United Way
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
list all voucher distribution Jocatlons and the dayslhours of operation.
Address, City, State. Zip Days & Hours of Service
Westside CommunKy Services Center 5 days/wk Monday-Friday 8:30 a.m. - 5:00 p.m.
1505 W. Highland Ave.
San Bernardino, CA 92411
# of cUenta agency anticipates serving WITHOUT EFSP funds:
Additional # of clients agency anticipates serving WITH EFSP funds:
# of bed nights agency anticipates providing WITHOUT EFSP funds:
Additional # of bed nights agency anticipates providing WITH EFSP funds:
130 clients
50 clients
Averaae # of motel
nights provided per
cUent:
30 nights
Maximum # of motel
nights provided per
client:
3,900 nights
1,500 nights
1992 (approximately)
30 nights
Year the agency began providing motel vouchers:
How often can the same cUent receive a motel voucher? 1
Describe ellgJblllty for clients receiving motel vouchers: Clients must be homeless and have not received EFSP
funding from another agency within the same fiscal year.
List any additional support services being provided to clients receiving motel vouchers, and by whom the service
Is being provided:
SERVICE
Resource Information/referral program
Counseling
Case Management I Financial Assistance
SERVICE PROVIDER
Westside Community Services
New Hope MiSSionary Baptist Church
Westside Community Services Center
Months of the year motel vouchers are provided:
VOUChers are provided all year when funds are available.
Is participation In any ~ or religious service required of clients?
181 Yes
ONo
If yes, please explain:
All clients go through a class called "Gelling Back on Track". This class give participant Information regarding nutrition,
employment, health. continuing education. and Informs participants of other agencies that assist In social and community
needs.
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Inland Empire United Way
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EMERGENCY FOOD AND SHELTER PROGRAM
"hsse 24 Applicatlon
Ust the facilities that provide lodging for this program:
Central City Motel and the Colton Inn.
What are the criteria for choosing these facilities?
rates on rooms.
Both facilities have egreed to -give us discounted
Has the agency negotiated rates and availability?
~ Yes
o No
If so, what are they?
$45.00 per night
What Is the expected impact of this program on Its participants? _
The program provides 30 days of motel assistance and aids the client in search for permenent housing. During
this time, Westslde assists with referrals and provides a list of other agencies.
How does the agency currently measure success for this program/How do you know this program ts effective?
The participant becoming self-sufficient by obtaining permanent housing within a 30-day period measures success.
through the case management process, all participants wera assisted in reaching this goal.
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Inland Empire United Way
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EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
CATEGORY 4: RENT/MORTGAGE ASSISTANCE
Dollar amount requested for Rent/Mortgage funds:
$
$
60,000
150,000
What is the total antle/Dated budget for direct services for the Rent/Mortgage program
during Phase 241 Do not Include salaries, administrative costs, overhead.
What was the total budget for direct services for the Rent/Mortgage program for the most
recentlv comDleted vear? Do not Include salaries, administrative costs, overhead.
$
150,000
List anticipated sources of support for the Rent/Mortgage program during Phase 24:
AMOUNT PENDING OR
COMMITTED
EFSP Funds $ 60,000 IZI Pending
o Committed
Other Federal Funds $ o Pending
o Committed
State Funds $ o Pending
o Commilled
Local Government Funds $ 150,000 o Pending
IZI Commilled
United Way Funds $ o Pending
o Commilled
Private $ o Pending
Contributions/Fundraising o Commilled
Other $ o Pending
o Committed
SPECIFIC SOURCES
(Please list)
Low/moderate Assistance Fund
New Hope Missionary Baptist Church
Program description: The program assists eligible applicants with one month's rent or mortgage assistance. All
applicants are required to attend a one-day workshop entitled, "Gelling Back On Track". The purpose of this workshop is
to infonm motivate and train individuals in the aspects of job development, nutrition, budgeting and health related issues.
19
JUN-21-2006 16:49
Inland Empire United Way
9099802957
P.13
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
List all rent/mortgage essistance locations and the days/hours of operation.
Address, City, state, Zip Days & Hours of Service
Westside Community Services 5 dayslwk Monday-Friday 8:30 a.m. 5:00 p.m.
1505 West Highland Ave.
San Bernardino. CA 92411
Percentage of EFSP funds the agency will use for first month rents/mortgages:
Percentage of EFSP funds the agency wUI use for Dast due rents/mortgages:
100%
II of cUents agency anticipates serving WITHOUT EFSP funds:
Additional II of clients agency anticipates serving WITH EFSP funds:
II of renl/mortgage bills agency anticipates paying WITHOUT EFSP funds:
Additional II of renl/mortgage bills agency anticipates paying WITH EFSP funds:
70
30
70
Year the agency began providing renl/mortgage assistance:
40
1986
How otten can the same client receive ranI/mortgage assistance?
1 X each year
Describe eligIbility for cUents receiving renl/mortgage assistance:
Eligible clients must attend a workshop
At the conclusion of the workshop, individuals are accepted by appointment for needs assessment. Once the needs are
assessed by a counselor, assistance will be provided accordingly. All clients are given a resource list.
Averaae amount of anlstance provided for $
first month's renl/mortgage:
Averaae amount of assIstance $ 700.00
provided for Dest due rent/mortgage:
Maximum amount of assistance provided $
for first month's renl/mortgage:
Months of the year renl/mortgage assistance Is provided:
Maximum amount of assistance $1,000.00
provided for Dast due renlJmortgage:
Assistance is provided alf year when funds are
available
Is participation In any class or reUglous service required of clients?
181 Yes
o No
If yes, pleese explain: All clients gO through an information and referral class ("Getting Back On Track"). This
class was established to share information and resources with clients for a broader help basa.
20
JUN-21-2006 16:50
Inland Empire United Way
9099802957
P.14
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
list any additional support services being provided to clients receiving rent/mortgege assistance, and by whom
the service Is being provided:
SERVICE
Rent/Mortgage Assistance, shelter, and food
Shelter, counseling, and legal assistance for eligible participants
Shelter, counseling, and legal assistance
Rent/Mortgage Assistance, utilities and food
SERVICE PROVIDER
Economic Development Agency
Department of Aging and Adult Services (OMS)
Child Protective Services (CPS)
New Hope Missionary Baptist Church
What Is the expected impact of this program on Its participants?
The impect of the program will give the participant a new beginning with increased knowledge of financial management
In addition, bUdget skills to aid the participant in the future.
How does the agency currently measure success for this program/How do you know this program Is effective?
The effectiveness of the program is meesured by the renter/owner keeping current with payments and other basic needs,
after they have received assistance from the Westslde Community Services. Success is measured through on going
assessments, questionnaires and telephone interviews.
21
JUN-21-2006 16:50
Inland Empire United Way
9099802957
P.15
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
CATEGORY 6: OTHER FOOD
(Food bag distribution, food gift cards and certificates)
Dollar amount requested for Other Food funds:
What Is the total antJclDated budget for direct servlc;es for the other Food program during
Phase 241 Do not Include salaries. adminlatratlve costa, overhead,
$10,000
$25,000
What was the total budget for direct aervlces for the Other Food progrem for the moat
recentJv comDleted vear? Do not Include aalarlea, admlnlatratlve costs, overheed.
List anticipated sources of support for the Other Food program during Phase 24:
AMOUNT PENDING OR
COMMITTED
EFSP Funds $ 10,000 181 Pending
o Committed
Other Federal Funds $ o Pending
o Committed
State Funds $ o Pending
o Committed
Local Government Funds $ 25,000 o Pending
181 Committed
United Way Funds $ o Pending
o Committed
Private $ o Pending
ContributionslFundraising o Committed
Other $ o Pending
o Committed
Program description:
$25,000
SPECIFIC SOURCES
(Please list)
Low/moderate Relocation Assislance Fund
New Hope Baptist Church
The Westside Community Services Center provides food and food vouchers 10 eligible participants. An assessment is
made on each participant and is evaiuated within three month after services are received. Continued food distribution is
on a biweekly basis. Identification and income source is required.
25
JUN-21-2006 16:61
Inland Empire United Way
9099802967
P.16
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
List all food distribution locations and the days/hours of operation.
Address, City, State, Zip Days & Hours of Service
Westside Community Services Center 8:30 a.m. - 5:00 p.m. Monday - Friday
1505 West Highland Ave.
San Bernardino, CA 91701
.. of clients agency anticipates serving WITHOUT EFSP funds:
7,347
Additional" of clients agency anticipates serving WITH EFSP funds
if. of meals agency anticIpates providing WITHOI{T EFSP funds:
Additional if. of meals agency anticipates providing WITH EFSP funds:
2,446
7,347
2,446
Average" of meals provided per day: 7 meals
Year the agency began providing "other food":
Average .. of meals provided per client:
Average .. of meals provided per week:
141 meals/wk
1986
2 meals per day
What Is the aVerage cost per meal?
$ 2.25
Describe eligibility for clients receiving food:
Eligible client must show proper idenllfication and proof of income. Client must be low income or currently at risk and in
need of services.
How often can the same client receive services?
Vouchers are provided all year when funds are available
I8l Grocery store gift card/gift certificate
o Meal voucher
I8l Bag/box of food
Method(s) of esslstance provided (check all that apply):
Months of the year food assistance Is provided:
Vouchers are provided all year when funds are available.
Does the agency charge a fee?
DYes
I8l No
if yes, please explain:
26
JUN-21-2006 16:51
Inland Empire United Way
9099802957
P.17
EMERGENCY FOOD AND 8HEL TER PROGRAM
Phase 24 Application
Is participation In any class or religious service required 0 Ves
of clients?
I8l No
If yes, please explaIn:
List any additional support service. being provided to clients receiving "other food" and by whom the service Is
being provIded:
SERVICE
SERVICE PROVIDER
Westside Community Services
New Hope Missionary Baptist Church
Westside Community Services Center
Resource Referral Program
Counseling
Case Managemenll Nutrition
What is the expected Impact of this program on Its participants?
This program assists participants with two weeks of groceries and gives the participant a resource list for assistance.
It Is our expected Intent to help the participant with enough food to feed themselves and their family until they are able to.
for themselves.
How does the agency currently measure success for this programlHow do you know this program Is effective?
Participants are seen on biweekly basis. As their living situation improves and the participants are able to meet their
activIties of daily living (ADl's) and instrumental activities (IADl's), they show evidence of improved nutritiOn and belter
health.
27
JUN-21-2006 16:62
Inland Empire United Way
9099802967
P.18
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
CATEGORY 7: UTILITY ASSISTANCE
Dollar amount requested for Utility Assistance funds: $ 7,500
Whst is the total ant/clDafad bUdgst for direct servlcsa for the Utility Asalstance $ 43,500
program during Phase 241 Do not include salaries. administrative coata, overhead.
What was the total budget for direct &8rvlces for the Utility Asalatance program fRL.1ll! $ 43,500
mosf t"8Centlv comD/efed vear? Do not Include aalarl86. administrative costs, overhead.
list anticipated sources of support for the Utility Assistance program during Phaae 24:
AMOUNT PENDING OR
COMMmED
EFSP Funds $ 7,500 I8l Pending
o Commilled
Other Federal Funds $ o Pending
o Committed
State Funds $ o Pending
o Committed
local Government Funds $ 37,500 o Pending
I8l Committed
United Way Funds $ o Pending
o Committed
Private $ o Pending
ContributionslFundraising o Committed
Other $ 6,000 o Pending
I8l Committed
SPECIFIC SOURCES
(PleBse list)
New Hope Missionary Baptist Church
Program deacrlpllon: This program provides utility (gas, electric, and water) assistance to low income
Eligible participants. To receive funding, all participants must attend an 8 hour class that wiilteach them sUlVlval
skill and give them other resources,
28
JUN-21-2006 16:53
Inland Empire United Way
9099802957
P.19
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
List all utility assistance locations and the days/hours 01 operation.
Address, City, Stale, Zip Days & Hours of Service
Westside Community Services Monday-Friday 9:00 a.m. to 5:00 p.m.
1505 W. Highland Avenue
San Bernardino, CA 92411
# of clients agency anticipates serving WITHOUT EFSP funds:
Additional # of clients agency anticipates serving WITH EFSP funds:
# of utility bills agency anticipates paying WITHOUT EFSP funds:
Additional # of utility bills agency anticipates paying WITH EFSP funds:
533
533
Year the agency began providing utility assistance:
1966
How often can the same client receive utility assistance?
Averaae amount of utility assistance provided:
One time per year
$ 60.00
$150.00
Maximum amount of utility assistance provided:
Describe eligibility for clients receiving utility assistance:
Participant must be low income, indigent and must be behind on his or her utility payment.
Months of the year utility assistance Is provided:
Is participation in any ciass or religious service
required of clients?
If yes, please explaIn: A resource and Information class called. Gelling Back on Track". Eligible participants
Must allend a workshop at the conclusion of the worl<shop, individuals are accepted by appointment and assessed. Once
A counselor assesses the needs, for assistance and provides assistance accordingly. All participants are given a resource
List.
All year, when funds are available
~ Yes
o No
29
JUN-21-2006 16:53
Inland EmpIre United Way
9099802957
P.20
EMERGENCY FOOD AND SHELTER PROGRAM
Phase 24 Application
List any additIOnal support services being provided to cllenta receiving utility assllltance, and by whom the
eervlce Is being provided:
SERVICE
Food, Clothing and Sheller
Utility Assistance
Counseling and other emergency services
SERVICE PROVIDER
Catholic Charities
San Bemardino County HEAP Program
What ill the expected Impact of this program on Its partlclpants?
Through the assistance of Westside Community Services, the participant is brought current on his or her utility
Bill. Additionally, the participant is given information on energy conservation.
How does the agency currently measure succees for this programlHow do you know thle program I. effectIVe?
Through a quarterly assessment process, Westside Community Services measures success and the programs
Effectiveness.
-END OF APPLICA TlON-
30
TOTAL P.20