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HomeMy WebLinkAbout20-Parks & Recreation - , Dept: Parks, Recreation & Community Services Dept. CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION Subject: 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 $185,700 FROM SAN BERNARDINO COUNTY DEPARTMENT OF AGING AND ADULT SERVICES FOR THE ADMINISTRATION OF THE SENIOR NUTRITION PROGRAM. OR ~'" , ~ , ~ L Ij~llijii From: Lemuel P. Randolph, Director Date: May 10, 2002 MICC Meeting Date: June 3, 2002 Synopsis of Previous Council Action: On May 7, 2000 the Council approved Resolution 2001-88 authorizing the Department to apply for and administer the grant. This program's operations have been approved by Council since 1977. Recommended Motion: ~~-- G/ ~oa~ Adopt Resolution Contact person: Tom Boggs Phone: 384-5031 Supporting data attached Staff Report, Reso., & contract Ward: City-wide FUNDING REQUIREMENTS: Amount: Source: (Acct. No.) (Arr.t n~c:,..rirtinn) Finance: Council Notes: 'l2b~) ~ aoo.;)-\S"d.- Agenda Item No. ~o (,13/0 z.. CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION Staff Report Subiect: 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$185,700 from San Bernardino County Department of Aging and Adult Services for the administration of the Senior Nutrition Program. Backl!round: The Parks, Recreation and Community Services Department has provided nutrition services to seniors for 24 years. During fiscal year 2001-02, the Senior Nutrition Program served over 60,000 total meals for a daily average of 250 meals to 7 nutrition sites. This program celebrated its twenty-fourth anniversary July 22-26, 2001. Financial ImDact: The Senior Nutrition Program is financially supported by a combination of grants, donations, and USDA reimbursements, and requires no direct support from the City's general fund. The 2002- 2003 Senior Nutrition grant is $185,700, which consists of $32,092 non-match USDA funds, $49,669 Realignment Funds (county grant), and $103,939 Federal Nutrition Funds (county grant). This entire nutrition service budget is derived from the following sources: $185,700 Grant/USDA Funds $ 93,970 Individual Meal Donations & Revenue from Community Adult Day Care Contract $ 83,662 In-kind match from the City of San Bernardino (includes space, utilities, Senior Supervisor & staff time) $363,332 Grand Total Revenue and Expenditures This program provides a vital service to Senior Citizens 60 years and over, and it is recommended that the Resolution be approved so that services may continue for fiscal year 2002- 2003. Recommendation: Adopt Resolution. c c c I-~~j /--:.~ :' 'l 'i , ~::J~. Ii '. RESOLUTION NO. 2 RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE MAYOR OF THE CITY OF SAN BERNARDINO OR HER DESIGNEE TO APPLY FOR 3 AND ADMINISTER A GRANT IN THE AMOUNT OF $185,700 FROM SAN BERNARDINO COUNTY DEPARTMENT OF AGING AND ADULT SERVICES FOR THE 4 ADMINISTRATION OF THE SENIOR NUTRITION PROGRAM. 5 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY 6 OF SAN BERNARDINO AS FOLLOWS: 7 SECTION 1. The Mayor of the City of San Bernardino or her designee is hereby 8 authorized to apply for and administer a grant in the amount of $185,700 from San Bernardino 9 County Department of Aging and Adult Services for the administration of the Senior Nutrition 10 Program. II SECTION 2. The authorization granted hereunder shall expire and be void and of no 12 further effect if the agreement is not executed by both parties and returned to the Office of the City 13 Clerk within one hundred twenty (120) days following effective date of the Resolution. 14 /1/ 15 /1/ 16 /1/ 17 /1/ 18 //1 19 /1/ 20 //1 21 /1/ 22 /1/ 23 /1/ 24 /1/ 25 /1/ 26 //1 27 /1/ 28 //1 c (- '- c 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 $185,700 FROM SAN BERNARDINO COUNTY DEPARTMENT OF AGING AND ADULT SERVICES FOR THE ADMINISTRATION OF THE SENIOR NUTRITION PROGRAM. I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor and Common Council of the City of San Bernardino at a meeting thereof, held on the , 2002, by the following vote, to wit: _ day of Council Members: AYES NAYS ABSTAIN ABSENT ESTRADA LIEN McGINNIS DERRY SUAREZ ANDERSON McCAMMACK Rachel G. Clark, City Clerk ,2002. The foregoing resolution is hereby approved this day of Judith Valles, Mayor City of San Bernardino Approved as to Form and legal content: JAMES F. PENMAN, City Attorney 1..1 . "1 Ie? IJ c -- - -.BudgetSummary FPR ."UTRITION SERVICES .. ....... - .. - .-- FISCAL YEAR 2002~003 . .. - - . __ . ,_. . .... --0' _.... _. .. ..._~ .-. -. CONGREGATE SITES C-1 r xx HOME D MEALS C.2 r 1 Funding Cash -=In-KInd ~lCIItln ~ MIIlch rcMI 1. PERSONNa 126.500 0 26"m 152~ 2. STAFFlRAVEl 500 0 0 500 3. STAFF TRAINING 500 0 0 soc: 4. EQUIPMENT 0 0 0 0 5. CONSUlTANTS 8400 0 0 8.400 8. FOOO COSlS 114000 0 1100 115.!2!! 7. CONSU SUPPLIES 11 870 0 0 11.8711 8. INSURANCE 0 0 800 800 9. REPAIRS 2000 0 1 l500 3m 10. RENTIBUILDfNG SPACE 0 0 38 000 ~ 11. UTILITIES 0 0 18000 12. VEHICLE OPERATIONS 8700 0 0 8~ 13. VOLUNTEER EXPENSES 0 0 0 14. OTHER 1.200 0 0 7~ roTAL EXPENDIlURE 279,810 0 83.1182 383:.!S . LESS FUNDING II.rch c.tI Milich In-KIncI 83.lI82 83,882 Non" I.A\ USDA 32,0V2 ..... ~ Non" II,c.h . NGt MRI I.ln-Kind CDBG RRI Fu... 49.869 ..... G~ ~"_ne 93.5170 93.9701 IToTAL fUNDING REQUEST 103,939 I...- 0 83.1162 1~ Date of Submill8ion - J- 9- (;7 h INITIAL BUDGET PROVIDER NAME aJsc.;J I< .::r:t?rH 'c~ REVISED BUDGET __CWOITToDMS.....317A Gill 0 F S"/-fAJ -;5ernc,.rc!..rto O2II:w1llll1 I {xx) [ ) c ,/-. L ..., t. i ~l!!f!l!l!.&~l!f!f!f! i ~...,I; .J:.-I:.S=I!!; \ ll~~~~~~~~& t\j /"'"'"' f\tN------~-- L I'J~R.J v..; '2 ~ ~ l-1 ...~...I~~II~ , w. lilD i t!@ ~~ll~~lla;D.~ b fJ 0 888888888 I .~ ....-'i' 0 ~ ...... '~S",~~c:i I- .. l::l2g ...~q,?-~ . N \.) . - 8 Q ......g> ..;i ,,0 () \.~ ......", -' - ~ ~. . ILl II . E ~ 0 z l:i . z Z - ~ ... ~ I N ~ 'S :I 0 ~ ~~aaaaa ~ 8 II. !~ClClClDClD" ~I' I&. Jt ......----- .... 0 I -g>..,"\"\~~ ... ................. ~ .. ~ II - r \...., S .." ~a8~~aaaaaa Wi. ~ 1:1 I '3!S~~~~~!!! ~JI ..,... . .. ... · z:. ~ 2 ~~~Iti~~~~~ UI.I;I~;~~~~~I= I%~. ~:;lilia"'" i !! ~I~ " - .. ~ I . f=- 5 )11 ! ~ I ~3:~~: I!~I ! lIS -I .. I .ill.. !6c 1J S I III II. I ll~llllli J :.fiJ ! r-- L c c o , . . .. . Budget In-lQnd', Narrative. ., - for . . , REQUES.T FOR.APPUCATION' . - .- Provka JnronnaIIon rapnllng a,..cHk IIHdnd eo be UMd _ matI:h. Include ...Io-r;.... if .ppIH.... Ii.. trlpllona, ,.... and ClIIher....'Mnt I..r...-.natlon. The ~ should.... the IIIIIOUftt oIln-1dnd ...porI8d _ mMch on your budget nmmIIry. o.crtption ..... T...1ft.fCInd ..... PersonMI 2, 1l18.5O IIlClIIIh -- c..... dh.ator r:A Senior Nutrftion p,ogr8l11 4O'M. of I8IlPyIbeneIIts Fooda Costa 81m montI1 1.1. t)onalions 1......- IlIO ,.., ~I,. 1.500 ,... 1. City S1alf RentI8uIIcIng Spece 3,000 month 31,_ 600 W. 5th S1reetf18O E. 21. StAIet Senior NutritiOn Center UtiIItlM 1.500 month 1Ul1O 600 W. 5th S1reetI780 E. 21. Street SenIor Nutrition Center 'tldentIIY type r:A In-ldnd: rwnt. YOIunlBer lI8l'Ilcea. etc.) DATE OF euBIIISSlON: :S" - q - 0 2- PROVIDERfWIE: Q<l:..f.J-/(. :;r. Cr-'I-'.'T,r' (;~ Dr-- Se:JtJ Rc,C\6fJ. ~ s.nIMl-A_~Famt_R1_01IDaW c c P'4 .-: d .. .... iJ!1 " .. : . .:: '5 . Ii: 1 ~ .. :l"':ll .. i :I .. " 1M.. l"Ph jU!.~~ & . Ll. jnJiJ: J 1.2 JNl,ii: "1,"0 IS " w E ,U i"J~I: U ,ala . .. : . " -- - Ii: _ Ii: ".I:, ! ~ : . I . .. &. !: .. ...~...~~~ .. 1 :I 1 ... .~IH!~1i:lcoccc 1(!'!iI:'" '~J1il~C;::!~~&!"" o G 1.. ~ . "w 15 · H ~ .&_)il~ocoocc 101110 .. ",I 1 ~ I -Ji lC;:~~~~I"" u ':1-= I) D ~ ~ ~ ~ Z LIJ ....I LU ~ L.I.I NLU I-l C,I) U LiJilX Q:c...... ., QU Z ..:: .t:: "::z ::5V'lQ.. = ;~~G~~ V~ LlJLlJ:;_LlJZ ... .::,<V'lI%o_iQ..LlJ Cl.. * W :W ...... .....? "... ."......:-7.':-:-: ".;.,.,...:-:.:., .. .. E .. a a i ; * ii .. ,. ~e : ill!.. o! i :h~!j := o I ~ ffi c "~8" h~; ; h~! ~ mr , I ..... N U '" .... '" ~ ~~ o e ~ II: III '" e" ~12 !! ; .1 II: l2 If II~i ..21=:2 ~;8" w; co '" '" . ... u i i I ~ f . . . 1 .. -I i Ii c " 1'1 i is I: w 'li I .. U . . c :i I I I ! i . I e . I : 1 ! .. .!i t ! If ... 3 .1 1! 1 I! . .:.. i 'I p ... I . I .I ~.: ~ . .. 0 - i ~ lu,l . . ~ . I. o! I W .. 10 .. i21J .. I Hi: .I .~J.I 1 ;;.I} i 58 e . " .I.r i lUl I K11 · hl!}1I. . " ,. I '" i ~~'li 1~ ;; 1- ~ 1 .! 5~1t.1 . . Ill'" 1~li~Jli .. ~ !. ...J9. -c hUII:1 "'~"'~Sf l:":C1! I- j21~.1.Ij!: HI51aJi .:.zy~ ... u. ll". t ... ". .. I 31 .. . q .. -.. .! I' III c c ,--- "- Scope of Work City of San Bernardino FY 2002-2003 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 monitoriI1& Annual Program Performance Review/Fiscal Audit and will be used to measure the providers efforts towards providing quality Nutrition Services. City of San Bernardinio I. Program Description A Geographic Area/Clientele & Eligibility Criteria 1. The geographic area served by this contractor covers the City of San Bernardino. B. Congregate Meals. Individuals eligible to receive a meal at a congregate nutrition site are: 1. Any older individual. 2. The spouse of any older individual. 3. A person with a disability, under age sixty (60) who resides in housing facilities occupied prImarily by older individuals at which congregate nutrition services are provided. 4. A disabled individual who resides at home with and accompanies an older individual who participates in the program. C. Volunteer Meals. 1. A volunteer under age sixty (60) may be offered a meal if doing so will not deprive an older individual of a meal. D. 2. A written policy for providing and accounting for volunteer meals shall be developed and implemented. Program Definition 1. The purpose of the Elderly Nuttition Program is to provide nutrition services as described in the Older Americans Act (OM) of 1965, as amended, and to assist older individuals in California to live independently, by promoting better health through improved nutrition, and reduced isolation through programs coordinated with nutrition- related supportive services. Page 1 of 7 c c ~ L E. 2. Definition: Nutrition Services means the procurement, preparation, transport, and service of meals, nutrition education, nutrition screening, and nutrition counseling, to eligible individuals at congregate sites or in their homes. Intended Outcomes 1. Meals Serve 238 Congregate meals per day that are nutritious, providing at least 113 of the minimum daily requirements, served in an environment that is pleasant, safe and free from coercion at least 254 days for a total of 60,550 meals per year at the sites listed in Exhibit A-I. 2. Individuals Provide Congregate meals to at least 1,279 unduplicated seniors of which 610 are minority seniors of which 25% are low-income. 3. A Program Dietitian, meeting the requirements set forth within Tide 22, will provide a minimum of 4 hours of activity per month to provide functions mandated by the State of California. Those functions include approval of the contractor menus, staff training, nutrition education activities, and monitoring. Contractor's menus will be planned to meet the nutritional requirements providing 113 of the Daily RDA's. The menus shall include a variety of ree:ular and ethnic foods and shall be prepared by personnel knowledgeable in food safety and the HACCP principles (Hazard Analysis, CrinCa! Control Point). The HACCP system includes mainly temperature (food, refrigeration, storage, delivety, etc.) and time control and documentation. The temperatures and holding times shall be monitored and records kept on file for DAAS audit. Menus shall be approved by the project dietitian before being submitted to the AM Dietitian for final approval and certification l'rior to use as specified within Tide 22. Staff training will be provided as specified withm Tide 22. Nutrition education services shall be provided to homebound and congregate sites as specified within Title 22. Nutrition counseling shall be provided to homebound and congregate participants as specified within Title 22 4. The project will assure that each participant shall fill out the Nutritional Risk Assessment form to determine his or her level of nutritional health risk. Forms will be filled out at the beginning of service for the home-delivered meal participants and once a year for congregate meal participants. These forms will be sent to the Area Agency on Aging Registered Dietitian on a monthly basis. 5. Provide outreach in the community through a minimum of 1 presentation to community groups, organizations, at least once a month and throul(h door-to-door contact to new seniors of at least 42 contacts which represents at least 27 hours of outreach activity. All outreach will be documented and kept on file for the Annual Program Perfurmance Review. 6. 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. Page 2 of 7 c c c 7. Prepare posters and signs in languages other than English, and post the signs in such lo~ti~ns as chur~es, community service locations and smaJI stores serving the nunonty commurunes. II. Service Delivery Activities A. Staffing and Voluntem Sufficient personnel shall be available to carty 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 contract. 1. Paid Staff FTE %C1 Food Service S~rvisor II 1 100% Pr~ Speci Sf .56 100% (2) ooks 1.75 100% Driver .81 100% (4) Kitchen Workers 2.19 100% 2. Volunteer Staff a. Volunteers constitute individuals who work without pay in the performance of essential duties in meal preparation, service, or delivery at either a Congregate or Home-delivered meal program and for which an agreement exists between them and the project. The agreement should cover at a minimum the number of hours that will be volunteered, and the type of work to be volunteered. b. Volunteers shall be recruited and used in all phases of services operations were qualified. Volunteers shall be screened and selected through a formal process that assesses their capabilities c. Individuals who work at a meal preparation site for either Congregate or Home- delivered Meals and are paid through Job Training and Partnersliip 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. Sraffin~ Definitions-Nutrition Services Project Director: The minimum qualifications for a Nutrition Project Director include under Tide 22 the following: 1. Possess an associate degree in institutional food service management, or a closely related field, such as, but not limited to, restaurant management, plus two (2) years experience as a food service supervisor, or, 2. Demonstrate experience in food service, such as, but not limited to, cooking at a restaurant, and within twelve (12) months of hire successfully complete a minimum of twenty (20) hours specifically related to food service management, business administration, or personnel management at a college level. Prior to completion of Page 3 of 7 c c .~ l..- c. meeting the hours, this individual's performance shall be evaluated through quarterly monitoring by a registered dietitian, or, 3. Two years experience managing food services. Such experience shall be verified and approved by a registered dietitian prior to hire. Training Activities 1. All staff, p'aid and volunteer, shall be oriented and trained to perform their assigned responsibilities and tasks. Training, at a minimum, shall include: a. Food safety, prevention of food-borne illness, and HACCP principles and have current Food Handlers Permits. b. Accident prevention, instruction on fire safety, first aid, choking, earthquake preparedness, and other emergency procedures. 2. A yearly written plan for staff training shall be developed, implemented, and maintained on file by the nutrition services provider, as reguirea in subsection 7636.7(c) below. The training plan shall identify who is to 6e trained, who will conduct the training, content of training, and when it is scheduled. The plan should be approved by the DAAS Nutritionist and be on me no later than September 1" of each contract year. 3. The nutrition services provider's registered dietitian shall review and approve the content of all staff training prior to presentation. 4. A minimum of four (4) hours of staff training shall be provided annually, by providers, for paid and volunteer food service staff, including congregate and home- aelivered meal staff. 5. 6. Training sessions shall be evaluated by those receiving the training. Documentation of training to include evaluations and attendance records shall be maintained, as required in subsection 7636.7(c) ofTicle 22. 7. Comply with the Division of Occupational Safety and Health (CaI/OSHA), California Department of Industrial Relations requirements regarding staff and participant safety and have at least one staff who is certified in the Manager's Food Safety Certification Program. D. Central Kitchens Service Locations 1. 2. 3. 4. 5. 6. Senior Center PerrisHiII Lytle Creek Highland Enterprise Hernandez ~ Page 4 of 7 Screening for Home-Delivered Meals 1. Eligibility for receiving a home-delivered meal will be based on a screening assessment of the potential client by phone or in-home verified by a home visit within two weeks of the beginning of me meal service. 2. Clients will be reassessed each quarter, by telephone andlor in-home visits. In-home visits shall be made evety other quarter. 3. The initial assessments and the quarterly reassessments shall be kept on file and monitor by DAAS. F. Menu Planning c E. 1. Coordinate with the Department's Nutritionist by providing monthly menus. Allow DAAS two weeks for me menu certification process. No change to the menus will occur after certification without a two-day prior notice to DAAS and proper documentation kept on me at the provider's mam office. 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. 2. C III. Other Service Requirements A Meal Site Physical Set-up 1. Provide an attractive environment and encourage creative, appealing, and innovative activities aimed at encouraging greater participation by the seniors. 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. 2. Post "NO SOLICITING" signs on the door leading into each Congregate site. No soliciting of any kind is permitted on the premises during the lunch hours for services or goodS promoted by businesses. B. Donations and Confidentiality c 3. 1. Maintain a written donation policy and appropriate procedures to safeguard and account for all contributions. 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 coercion, embarrassing andlor obligatory to me meal being provided to the senior participant. Page 5 of 7 c c c T acties such as placing volunreers 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. Encourage partiCipants to bring the correct change or make chan~ elsewhere (i.e. office). Allow participants to place their donation in the box by themselves in strict confidentiality. All conrributions, including those for guest and staff meals, shall be used to increase the number of meals, to facilitate access to nutrition services, and to provide other supportive services directly related to nutrition. C. Coordination Activities 3. 1. If applicable, develop a fair and equitable policy and procedure for referring elderly participants to the appropriate transportation provider for securing public transportation to and from nutrition sites and have the policy fully in place by September 30. 2. Include the following statemenr on all advertising, brochures, posters, etc. "Funding for this seroice hIlS been provided by the San Bernardino County Department of Aging and Adult Seroices through a grant award from the California Department of Aging". Coordinate service with other county departments and local agencies by providing time for presenrations 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 3. 1. Report all known or suspected cases of elderly abuse to DAAS Adult Protective Services or law enforcement immediately or as soon as possible by relephone, and send a written report within two (2) working days. Abuse of an elder or dependent adult means phYSical abuse, neglect, intimidation, cruel punishmenr, fiduciary abuse, abandonment, isolation or other treatrnenr with resultin~ physical harm or pain or mental suffering or the deprivation by a care custodian of goods or services wliich are necessary to avoid physical harm or mental suffering. 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 be 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. Report monthly expenditures to DAAS by the 5th working day of the month. Maintain support files including but not limited to invoices, payroll, and other supporting documents, all of wliich 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. 2. 3. Page 6 of 7 c\ By September 30, report expenditures funded with Deferred Income. Send all quarterly site monitorin~ reports to DAAS N urritionist within 30 days of completion fot on-going monitorIng and review. Provider must assure regular on- going monitoring of health and safety factors including but not limited to: a. Hazard Analysis Critical Control Point; b. Temperature monitoring and documentation; c. Proper food storage and food holding times. 7. 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. 6. 5. In the event additional funds become available, the provider will use the funds to increase the number of meals bein~ 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 bemg imposed. c Aging and Adult Services Director Contractor Designee, Title Date Date c Page 7 of 7 '. ATTACHMENT C Can Bernardino County 'DA217 (6/96) Department of Aging and Adult Services CERTIFICATION REGARDING WBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) (2) C3) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attemptinl; to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the breaking of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. If any funds other than federal appropriated funds have been paid or will be paid 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 an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclosure accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. c riry nf S~n Rprmrrlinn CONTRACTOR rA STATE AUTHORIZED SIGNATURE TITLE DATE ~ ATTACHMENT D (' \".,; ASSURANCE OF COMPLIANCE WITH THE SAN BERNARDINO COUNlY WELFARE DEPARTMENT NONDISCRIMINATION IN STATE AND FEDERALLY ASSISTED PROGRAMS r.iry nf Son R..rnortlinn NAME OF VENDOR/RECIPIENT HEREBY AGREES THAT it will comply with Title VI and VII of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1973, as amended; the Af,e Discrimination Act of 1975, as amended; the Food Stamp Act of 1977. as amended, and in particular Section 272.6; title II of the Americans with Disabilities Act of 1990; California Civil Code, Section 51 et seq., as amended; California Government Code Section 11135-11139.5, as amended; California Government Code Section 12940 (c), (h), (i), and (j); California Government code, Section 4450; Title 22, California Code of Regulations 98000-98413, and other applicable federal and state laws, as well as their implementing regulations (including 45 Code ofFederal Regulations (CFR) Parts 80, 94, and 91, 7 CFR Pan 15, and 28 CFR Pan 42), by ensuring.rhat employment practices and the administration of public assistance and social services programs are nondiscriminatory, to the effect that no person shall because of ethnic group identification, age, sex, color, disability, medical condition, national origin, race, ancestry, marital status, religion, religious creed or political belief be excluded from participation in or be denied the benefits of, or be otherwise subject to discrimination under any program or activity receivingfederal or state financial assistance; and HEREBY GIVE ASSURANCE THAT it will immediately take any measures necessary to effectuate this agreemenL .--THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all federal and state assistance; and THE t ENDOR/RECIPIENT HEREBY GIVES ASSURANCE THAT administrative methods/procedures which have the effect of "-s6bjecting individuals to discrimination or defeating the objectives of the California Depanment 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 government 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 Government 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 vendorlrecipient directly or through contract, license, or other provider services, as long as ir receives federal or state assistance. Date Director's Signature City of San Bernardino Parks, Recreation, and Community Services Senior Nutrition Program 547 North Sierra Way San Bernardino, CA 92410 C~- .ddress ofVendorlRecipient (6/119 . . CITY OF SAN BERNARDINO Interoffice Memorandum CITY CLERK'S OFFICE Records and Information Management (RIM) Program DATE: June 6, 2002 TO: Tom Boggs FROM: Michelle Taylor, Senior Secretary RE: Transmitting Documents for Signature - Resolution 2002-152 At the Mayor and Common Council meeting of June 3, 2002, the City of San Bernardino adopted Resolution 2002-152 - Resolution authorizing the Mayor of the City of San Bernardino or her designee to apply for and administer a grant in the Amount of $185,700 from San Bernardino County Department of Aging and Adult Services for the administration of the Senior Nutrition Program. Attached is one (I) original agreement. Please obtain signatures in the appropriate location and return one original agreement to the City Clerk's Office as soon as possible, to my attention. Please be advised that the resolution and authorization will be null and void if not executed with 120 days, or by October 1, 2002. If you have any questions, please do not hesitate to contact me at ext. 3206. Thank you. Michelle Taylor Senior Secretary I hereby acknowledge receipt of the above mentioned documents. Signed:C(J. Ccf6.~ Date: 6- (.;-08--' Please sign and return , ** FOR OFFICE USE ONLY - NOT A PUBLIC DOCUMENT ** RESOLUTION AGENDA ITEM TRACKING FORM Meeting Date (Date Adopted): U - 3 - () d- Vote: Ayes /,;) 5. I" 1 Nays , . . r Change to motion to amend original documents: Item # :;0 k Abstain Reso. # On Attachments: -L Contract tenn: Note on Resolution of Attachment stored separately: --=- Direct City Clerk to (circle I): PUBLISH, POST, RECORD W/COUNTY Date Sent to Mayor: (p ~ S ~ O~ Date of Mayor's Signature: I..t - (; - {)?-' Date of ClerklCDC Signature: (p - (p - 0 '/ Date MemolLetter Sen Signature: 60 Day Reminder Letter Sent on 90 Day Reminder Letter Sent on 45th day: See Attached: See Attached: See Attached: Request for Council Action & Staff Report Attached: Updated Prior Resolutions (Other Than Below): Updated CITY Personnel Folders (6413, 6429, 6433, 10584, 10585, 12634): Updated CDC Perso,nnel Folders (5557): Updated Traffic Folders (3985, 8234,655,92-389): Copies Distributed to:. City Attorney / . Parks & Rec. ,; Code Compliance Dev. Services Police Public Services Water Notes: Resolution # :J.O();;2 - /59- Absent 3 I 'f RY NulIIVoid After: /.10 dm-p IU- /-Od-' By: Reso. Log Updated: ;/' Seal Impressed: ,..-/ Date Returned: Yes L No By_ Yes NOf By_ Yes No By_ Yes No By_ Yes No By_ EDA Finance / MIS Others: BEFORE FILING. REVIEW FORM TO ENSURE ANY NOTATIONS MADE HERE ARE TRANSFERRED TO THE YEARLY RESOLUTION CHRONOLOGICAL LOG FOR FUTURE REFERENCE (Contract Term, etc.) Ready to File: m" Date: 0 -, ~~ Revised 01/12/01