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RESOLUTION NO. 2010-5
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO RATIFYING THE SUBMITTAL OF A SENIOR NUTRITION
PROGRAM GRANT APPLICATION THROUGH THE COUNTY OF SAN
BERNARDINO DEPARTMENT OF AGING AND ADULT SERVICES (DAAS) FOR
SENIOR NUTRITION SERVICES FOR THE PERIOD OF JULY 1, 2010 THROUGH
JUNE 30, 2011.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
SECTION 1. The Mayor and Common Council of the City of San Bernardino hereby
ratify submittal of a grant application to the County of San Bernardino for the Senior Nutrition
Program for the period of July 1, 2010 through June 30, 2011 and supporting application
documentation, a copy of which is attached hereto, marked as Attachment "c" showing amount
requested on the Budget Summary with the County of San Bernardino (DAAS).
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RESOLUTION NO. 2010-5
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN
BERNARDINO RATIFYING THE SUBMITfAL OF A SENIOR NUTRITION
PROGRAM GRANT APPLICATION THROUGH THE COUNTY OF SAN
BERNARDINO DEPARTMENT OF AGING AND ADULT SERVICES (DAAS) FOR
SENIOR NUTRITION SERVICES FOR THE PERIOD OF JULY 1, 2010 THROUGH
JUNE 30, 2011.
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
Joint
and Common Council of the City of San Bernardino at a Regular meeting thereof, held
, 2010, by the following vote, to wit:
on the 19th day of January
Council Members: AYES
ESTRADA x
BAXTER x
x
BRINKER
SHORETT x
KELLEY X
JOHNSON X
X
MCCAMMACK
NAYS
ABST AIN ABSENT
~~J ~C&Jc
City Clerk
The foregoing resolution is hereby approved this ().O -r t:!:-- day of January
,2010.
Approved as to form:
2010-5
, ,
APPLICATION
Elderly Nutrition Program
(Older Americans Act Title III C Funds)
INSTRUCTIONS: Please answer all questions and submit all requested documents.
Failure to do so may result in the application being rejected.
.,
1, Agency Name: CITY OF SAN BERNARDINO, PARKS, RECREATION & COMMUNITY SERVICES
Address: 1350 SOUTH "E" STREET, SAN BERNARDINO, CA. 92408
Telephone: (909) 384-5231
FAX: (909) 384-5160
3. Authorized Signature:
NamefTitle: KEVIN
2. Agency SSN# or FID#: 95-60
Telephone: (909) 384-5030
E-mail address: Hawkins_ke@sbcity.org
4. Agency Contact Person: AALIYAH HARKlEY
Title: HUMAN SERVICES PROGRAM MANAGER
Telephone: (909) 384-5231
E-mail address: Harkley-aa@sbcity.org
5. Type of Organization: x GovernmentIPublic Agency
0 Private Not-for-Profit
0 Private For-Profit
0 Other:
6. Type of Legal Entity: Corporation
0 Sole Proprietorship
0 Partnership
X Other: _Government
7,
Is the Agency in good standing with the Secretary of State of California? f. fI
111Tl1cH;.1~;J7 ~
No
o
Yes x
20lG-S
8. Does the Applicant agree to provide the services as described in the application for a
one-year period beginning no later than July 1, 2010, with an option to renew the
Contract for two additional one-year periods, if awarded a Contract?
Yes x No 0
9. Have all aspects of the application, including cost, been determined independently, without
consultation with any other prospective Applicant or competitor for the purpose of restricting
competition?
Yes x No 0
10.. Are all declarations in the application and attachments true?
Yes x No 0
11. Does the Applicant understand and agree that all aspects of the RFA and the application
submitted shall be binding if awarded a Contract?
Yes x No 0
12. Does the Applicant agree to provide the County with any other information that the County
determines is necessary for an accurate determination of the Applicant's ability to perform
services as proposed?
Yes x No 0
13. Does the Applicant agree to comply with all applicable local, State, and Federal rules, laws,
and regulations, if awarded a Contract?
Yes x No 0
13, Does the Applicant employ any former County of San Bemardino Administrative Officials
and/or do any former County of San Bemardino Administrative Officials represent the
Agency (See RFA, Section VII)?
14. Yes No X
If yes, list names and positions
15. Does the Applicant have an organization that is adequately staffed and trained to perform
the required services?
. Yes x No 0
If no, does the Applicant have the capability for recruiting sufficient staff?
Yes x No 0
16. Does the Applicant agree to obtain insurance in the amounts and coverages listed in
Section V, Paragraph B, Indemnification and Insurance Requirements, if awarded a
Contract, and submit proof prior to performing services?
Yes x No 0
17. Does the Applicant understand and accept the Client Complaint and Grievance
Procedures for Older Americans Act Programs, as defined in Section V, Paragraph A, Item
6 and Attachment B?
Yes x No 0
2010-5
18, Does the Applicant certify that all statements in Section V, Paragraph A, Item 14,
Debarment, Suspension, and Other Responsibility Matters are true?
Yes x No 0
If no, please explain:
19. Does the Applicant use subcontractors?
Yes x No 0
If yes, list subcontractor information, including name of each company, and type of work
to be performed. (Note: Any subcontractor shall be subject to the terms and conditions
.. of any resulting Contract, as defined in Section V, Paragraph A, Item 3.) All sub-
Contracts must be approved by DAAS before service Is Contracted.
Dietician
Consulting Health & Nutrition Services Inc.
28551 Oak Ridge Rd, Highland, CA. 92346
20, . The application package must include the following documents:
. Program Description-
. Budgetary Information-
. List of Assurances
. Audited Financial Statements (Most recent and complete)
-Program questions, Budget questions and budget forms\ List of Assurances and
Exceptions to Assurances follow this page.
I certify that the information contained in this application package is true to the best of my
knowledge.
Print Authorized Name: KEVIN HAWKI s
Title: DIRECTO
Signature:
Date: DECEMBER 7, 2009
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2010-5
ATTACHMENT C
25. Check the area(s) to be served:
, Service Area
.
Check Area(s) Service Areas
Served
Details
0 Colorado Needles, Havasu, Big River and surrounding areas
River
U North Desert Barstow, Newbeny Springs, Trona, Baker and surrounding areas
0 Morongo Joshua Tree, Landers, Morongo Valley, Wonder Valley, Yucca Valley, Twenty-
Basin Nine Palms and surrounding areas
0 Victor Valley Adelanto, Apple Valley, Hesperia, Lucerne Valley, Victorville and
surrounding areas
0 Mountains Crestline, Running Springs, Lake Arrowhead, Big Bear, Twin Peaks and
surrounding areas
X East Valley Rialto, Bloomington, Fontana, Colton, Redlands, Yucaipa, San Bernardino City,
Lorna Linda, Lytle Creek, Highland and surrounding areas
0 West Valley Chino, Chino Hills, Montclair, Ontario, Rancho Cucamonga, Upland and
surrounding areas
26. List any exceptions to the areas checked above:
East Valley: City of San Bernardino & City of Highland only
27. List additional funding sources for program operations for the last two (2) years, such
as fundraisers, grants, donations. !i
FY 07/08: Fund raisers (Trips and Tours, Special Events)
FY 08/09: SCAN Corporation, Fund raisers (Trips and Tours, Special Events)
28. Agency Description:
. Describe the mission and purpose of the Agency.
The City of San Bernardino operates under a Mayor, Council and City Manager form
of government. The Mayor and Council members serve four-year terms. Under the
supervision of the Mayor, the City Manager is the Chief Administrative Officer. The
City also has an elected City Attorney, City Treasurer and City Clerk.
It is the mission of the City of San Bernardino to govern with professional leadership,
vision and compassion to endeavor to:
6
2010-5
ATTACHMENT C
Provide safe neighborhoods for the preservation of life and property;
Improve and maintain a diversified ~nd successful economic base;
,
Foster a well-maintained and progressively designed infrastructure;
Enhance opportunities for quality education and leisure pursuits;
Advance regional cooperation and the city's leadership role within the Inland Empire.
The Parks, Recreation & Community Services Department, Senior Nutrition
Program's mission is to provide nutrition services as described in the older
Americans Act (OM) of 1965, as amended, and to assist older individuals in the City
of San Bemardino to live independently. It's primary goal is to promote better health
through improved nutrition and reduce isolation through senior programs coordinated
with nutrition-related supportive services.
. Describe the Agency's experience in providing services to older individuals
and individuals with a disability.
In 1854 the City of San Bernardino, was officially incorporated, The City of San
Bernardino has been a public organization for approximately two hundred-years and
I,
there are no related prior business names. Today the city houses 198,580 residents
and is the largest city inside the largest county in the state of Califomia. The City of
San Bernardino is celebrating 33 years of demonstrated services as a provider of
congregate nutritious meals to our low-income senior population, The City of San
Bernardino, Senior Nutrition Program, has served 125% more meals since 1980.
Through the collaborative efforts of the San Bernardino County Department of Aging
and Adult Services (DMS), and the City's Parks, Recreation & Community Services
Department, our Senior Nutrition Services Program has operated and served our
community with an excellent track record in providing the services as outlined in this
contract.
7
2010-5
ATTACHMENT C
. Describe the agency's relation~hips to other organizations that may provide
other services at the proposed site(s).
The City of San Bernardino collaborates with many agencies and organizations to
support our efforts in bring a well-rounded health program to our senior population.
Some of these agencies are staffed and housed inside our city departments, The
Retired & Senior Volunteer Program and the Senior Companion Program are both
financially part of the City of San Bernardino's general fund and both play major roles
in the mission of health and well being to our senior population.
Also, the San Bernardino Adult Education School operates many educational and
recreational programs from both our 5th Street and Perris Hill Senior Center sites.
Some of the classes offered are Computer training, Exercise classes, Fifty-Five and
A Live, and Ballroom Dancing. We also network with agencies and organizations
from both the private and public sector to assist us with program delivery and
financial donations. We recently received a $5,000 dollar donation from SCAN to
assist us in serving more senior meals.
. List applicable licenses and permits presently held.
The City of San Bernardino, Parks, Recreation & Community Services, Senior
Nutrition Program through the city's Facility Department holds the following
Licenses and Permits:
1, Building Permits for each site are listed below
a. 5th Street Senior Center
b, Perris Hill senior Center
c. Lytle Creek Community Center
d. Hernandez Community Center
2. Health Permits for all 0 sites
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2010-5
ATTACHMENT C
3. All servers have County of San Bernardino Certified Food Workers Permits
(Food Handlers cards).
If additional permits or licenses are required we will acquire upon request.
. List subcontractors, if applicable, and services they provide.
(See attachment 1)
The City of San Bernardino subcontracts with Consulting Health & Nutrition
Services to provide Registered Dietitian services in accordance with Section 339
of the OAA and follow the general requirements in Title 22, Division 1.8 and
Section 7500. The Dietitian provides;
a. Quarterly monitoring for safe food handling and sanitation practices of
food facilities.
b. Review and approve the content of staff training prior to presentation.
c. Develop, or review, and approve the monthly or cycle menus.
d, Develop, or review, and approve the nutrition education plan for
participants.
e. Nutrition education to seniors and lor staff training.
f. Technical support and assistance to the Provider as needed.
. List current and previous contracts completed during the past three (3)
years, including name of funding agencies, dates, and dollar amounts.
The City of San Bernardino, Parks, Recreation and Community Services
Department is constantly seeking alternative funding resources. This report details
the past three years of some of the grant funding received by our Department.
The Nutrition Network Program has received the following grants in the past three
years.
FY 2009-2010 FOCUS Project Grant County Public Health Services $ $55,000
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2010-5
ATTACHMENT C
FY 2008-2009 FOCUS Project Grant County Public Health Services $ $55,000
FY 2007-2008 FOCUS Project:Grant County Public Health Services $ $55,000
The Senior Nutrition Program has received the following grants within the last
three fiscal years.
FY 2009-2010 Senior Nutrition Program DAAS
$ 177,773
$ 231,807
$ 270,180
FY 2008-2009 Senior Nutrition Program DAAS
FY 2007-2008 Senior Nutrition Program DAAS
The Senior Companion Program has received the following grants in the past
three years.
FY 2009-2010 Senior Companion Program federally funded $ 295,349
FY 2008-2009 Senior Companion Program federally funded $ 295,349
FY 2007-2008 Senior Companion Program federally funded $ 300,600
The Retired & Senior Volunteer Program has received the following grants in the
past three years.
FY 2009-2010 Retired & Senior Volunteer Pro~. Federally funded $ 57,415
FY 2008-2009 Retired & Senior Volunteer Prog. Federally funded $ 57,415
FY 2007.2008 Retired & Senior Volunteer Prog. Federally funded $ 58,436
These are just a few of the many grants that the Parks, Recreation & Community
Services Department receives every year, All of the grants listed except for the
Focus Mentoring Grant have been awarded to the City of San Bernardino, Parks,
Recreation & Community Services Department for over thirty years.
. Describe how the Agency seeks other funding sources that provide
additional funding for the program (e.g. fundraising, donations, other grants,
etc.)
Through effective partnering with outside agencies the City of San Bernardino's
Senior Nutrition program is able to maintain it's operating budget. The Senior
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2010-5
ATTACHMENT C
Employment Agency, The National Indian Council on Aging Agency, The California
Indian Consortium and Community Options, helps the Senior Nutrition Program
,
,
with funding for temporary staffing. These agencies play an important role in
assisting the City of San Bernardino, Senior Nutrition Program, with funding for
hiring and training of prospective employees before they are placed on the City of
San Bernardino's payroll. The valuable revenue that these partnering agencies
give helps the City with thousands of dollars for senior nutrition staffing. Also
during each fiscal year the City of San Bernardino, Senior Nutrition Program looks
for sponsors and solicits donations for special occasions and holiday lunch meals.
29. Agency's plans to provide Elderly Nutrition Services:
. Describe the project objectives
The City of San Bernardino, Parks, Recreation & Community Services Department,
Senior Nutrition Program objective is to provide nutrition services as described in the
Older American Act (OM) of 1965, as amended, and to assist older individuals in
the City of San Bernardino to live independently. By promoting better health through
'I
improved nutrition, and reduce isolation through senior programs coordinated with
nutrition-related supportive services.
. Complete the charts below:
Projected # of Participants per year
Projected number of minority
participants
Projected # of low-income
participants
57,757
80%
98%
Total # of days meals are to
be served oer year
249
Projected number of meals
to be served each day
232
Projected number of meals
to be served oer vear
57,757
. List holidays that will be observed
11
2010-5
ATTACHMENT C
New Year's Eve, New Year's Day, Martin Luther King Jr. Day, All President's Day,
Memorial Day, Independence Day, Labor Day, Veteran's Day, Day After
Thanksgiving, Christmas Eve, CJ1ristmas Day. See (Attachment 6)
. Proposed sites: '
o List each proposed site.
5th Street Senior Center, 600 W. 5th Street, San Bernardino, Ca, 92410
Perris Hill Senior Center, 780 E. 21st Street, San Bernardino, Ca. 92404
Highland Senior Center, 3102 E. Highland, Highland, Ca. 92346
Lytle Creek Community Center, 380 "K" Street, San Bernardino, Ca. 92404
Hernandez Community Center, 222 Lugo, San Bernardino, Ca. 92408
New Hope Family Life Community Center, 1505 Highland, S. 6., Ca. 92411
Light House for the Blind, 762 N. Sierra Way, San Bernardino, Ca. 92410
o Describe how the Agency complies with the Americans with
Disabilities Act (ADA).
The City of San Bernardino, Senior Nutrition Program currently is using
facilities that are in compliance with the Americans with Disabilities Act. All
of the facilities used are existing buildings! none are new structures. It is the
responsibility of the city's Facilities Department to ensure that all city
buildings meet the ADA requirements. See (Attachment 2)
o Describe the physical characteristics of each proposed congregate
site and how accessibility for handicapped and disabled seniors will
be accommodated.
All facilities used for the Senior Nutrition Program are Senior or Community
Centers except for the Lighthouse for the Blind, which is a school facility for
senior disabled blind individuals. All sites have a kitchen area where the
senior lunch and dinner meals are prepared onto the senior's tray and
served to each senior. At each site all disabled and handicapped patrons
12
2010-5
ATTACHMENT C
are served first. Once the meal is consumed volunteers then pick up meal
trays, All staff persons and volunteers have a current Food Handlers Permit.
,
The senior dinner meal will only be served at the 5th Street Senior Center on
Tuesdays and Thursdays,
o State whether the sites are ADA compliant.
All of the Lunch Meal sites are in compliance with the Americans with
Disabilities Act (ADA). See (Attachment 2)
o If one (1) or more sites are not ADA compliant, provide a list of what
needs to be done to become ADA compliant and when and how those
needs will be met
N/A
. Outreach Plan - Describe how the Agency will conduct outreach to identify
potential participants who are low income minority seniors, seniors residing
in rural areas, seniors with limited English speaking ability, seniors with
severe disabilities, seniors with speech, visual or hearing impairments,
Alzheimer's, and related dementia disorders. Include number of proposed
hours of outreach that will be conducted each month.
I,
In order to increase the number of meals served, a 'h,inimum of two (2) canvassing
of the neighborhood within a one square mile radius of each of the seven (7)
senior nutrition sites will be conducted. Each canvassing will have a minimum of
two employees or volunteers visiting the neighborhoods and sharing information
about the Senior Nutrition Program to the senior residents as well as other family
members. Each team will complete a log, keeping track of all the residences that
were contacted and the results. Each team will receive training on the canvassing
procedures from the Food Service Supervisor II. After each canvassing, meal sites
will be monitored to gauge if there is an increase in the meal count. Also the
Senior Nutrition Program staff will have free informational fliers for seniors during
Senior Health Fairs and scheduled Special events: Promotional material is also
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2010-5
ATTACHMENT C
created in English and Spanish in order to communicate with a larger city
population. Lastly the Senior Nutrition Program will appear on Channel 3
throughout the year to talk about the senior meal program and give the addresses
and meal times for all (7) seven sites, This will help reach senior and their family
members, who have Alzheimer's, dementia disorders, and who are physically
impaired.
. Describe how meals will be served or delivered.
Senior Nutrition staff at each site will prepare and serve the senior nutrition meals,
All sites that receive delivered meals are delivered by the Senior Nutrition's staff.
Staffs are well trained and possess a valid Food Handler's Card. The senior
nutrition staff person at each site location will serve the meals to the senior
patrons.
Some of the supplies that will be used to serve the senior meal are 1-30z spoodle,
1-30z solid spoon, 1-20z ladle, 1-60z spoodle, 2 medium serving spoons, 1 small
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metal spatula, 1 medium metal spatula, 2 tongs, 1-30z disher, 1-4 disher, stove,
refrigerator and coffee maker. The disabled and handicapped patrons are
personally served by staff and given silverware and napkins at their arrival. A
professional trained volunteer seats the seniors. All disabled and handicapped
patrons are served first. Once the meal is consumed volunteers then pick up meal
trays and properly clean and store plates, utensils, and pots and pans for daily
use,
. Describe the Agency's proposed buying system, inventory control, and
dietitian services.
14
2010-5
ATTACHMENT C
The Food Service Supervisor II and the Program Specialist share the purchasing
and inventory duties, The Inventory is conducted every time items are taken for
,
use or new items are put in. The inventory method used is First in First out.
After the inventory is updated, the menu for the day is then broken into five
categories. These categories are meat, frozen items, raw food products, produce
and consumables. The components needed to prepare the menu items that are
not in inventory are placed on an items list to be ordered and the items on the
current inventory list are deducted from the list once used,
Dietician services are currently contracted out to Consulting Health and Nutrition
Services, to insure compliance with all contracted guidelines and dietician
regulations for the Senior Nutrition meal.
. Describe how volunteers will be recruited.
The recruitment process for any volunteer working for the City of San Bernardino,
Parks, Recreation & Community Services Department, Senior Nutrition Program,
begins with recruitment by either the Retired & Se~ior Volunteer Program or the
Food Service Supervisor II. At the conclusion of each interview I skills assessment
only the volunteers that show that they can meet average or better performance
objectives will be given the opportunity to assist with the senior lunch meal.
Volunteers are used in all phases of service operations in our Senior Nutrition
Program. Volunteers are screened and selected through a formal process,
Volunteers receive the same training as regular employee staff. All volunteers that
will be handling food must obtain a current Food Handlers Card issued by the
Professional Development Center and a current TB clearance.
. Describe personnel who will manage the site(s) and their experience with
maintaining the warm, caring environments, food service management, and
15
2010-5
ATTACHMENT C
training staff and volunteers. Ple,ase refer to Attachment A, Section V -
Staffing for requirements.
The City of San Bernardino is a municipal government corporation and is
adequately staffed with trained employees to perform the required services.
Sufficient personnel are available to carry out the needs of the Senior Nutrition
Program (attachment 7). The Human Services Program Manager (Aaliyah
Harkley) has the overall responsibility for compliance with the terms of the work
plan and contract. Duties are separated in the following order of command: Senior
Nutrition Program Dietitian (Maria Sauerwein), Food Service Supervisor II (Jerri
Calles), Program Specialist (Trudy Panowicz), Food Service Worker I (Lola
Calloway), Kitchen Helpers (Susan Kim and Ida Newell) and one Driver (Rod Mc
Dowell),
The Human Services Program Manager (Aaliyah Harkley) holds a Master Degree
in Business Administration and is the primary contact for the Senior Nutrition
Program for the City of San Bernardino, Parks & Recreation & Community
,
i
Services Department. The Food Service Supervisor II (Jerri Calles) has worked in
Food Management and Administration with the City of San Bernardino, Parks,
Recreation & Community Services Department, Senior Nutrition Program, for 19
years and was certified by Maria Sauerwein, the program's Registered Dietician
(see attachment 1). Program Specialist Trudy Panowicz has worked with the
Senior Nutrition Program for three years and is responsible for recording and
maintaining all records for the program, completing all month end reporting and
special projects. The Food Service Supervisor II is the primary operator of the
client tracking software (SAMS) that is licensed through OMS and directly
supervises the performance Senior Nutrition staff. Also all staff is knowledgeable
on the Client Complaint and Grievance Procedures fo'r Older Americans Act.
16
2010-5
ATTACHMENT C
. Describe how the Agency will internally monitor its performance and what
evaluation criteria will be used to gauge accomplishments.
,
A plus and minus report is completed each month which helps us in monitoring the
program's performance, This report has the meals served number from the current
month, the past month and last year same-month information. Daily reports show
how special meals are received and which days more meals are served in
comparison to which day more donations are received.
. Provide an example of the proposed Staff Training Plan. Please refer to
Attachment A, Section VI - Staff Training Activities for requirements.
Staff Training Plan See (Attachment 3)
. Provide a sample Nutrition Education Plan for seniors. Please refer to
Attachment A, Section VII - Senior Participation for requirements,
Nutrition Education Plan for seniors See (Attachment 4)
. Provide a sample one-month Menu. Please refer to Attachment A, Section
VIII- Menu Planning GuidelineslMenu Requirements for requirements.
One-Month Menu See (Attachment 5)
. Describe how donations are handled. Include ~ow participants attending a
congregate meal site will be provided the opportunity to donate
confidentially.
The secured donation boxes are placed behind a partition so that all donations are
confidential. Once the donation box has been placed behind the partition there will
be no monitoring to see how much each senior gives, and there will be no change
given from the donation box. All donations will be confidential.
Seniors are encouraged to donate by posting motivational signs and reminding
them of the importance of their contributions. Tactics such as placing someone to
guard the collection box or having participants sign in and pay before a meal is
strictly prohibited by the Work Plan and Contract with San Bernardino County
17
201Q-5
ATTACHMENT C
DAAS and the City of San Bernardino, Parks, Recreation & Community Services
Department, Senior Nutrition Proqram.
At the end of the lunch period, the donation boxes and sign in sheets are taken to
the Senior Nutrition office. Two employees will count the donations together and
complete a log before taking the deposit to Central Cashiering where they will
deposit the Program Income revenue and receive a cash receipt. Senior Nutrition
staff working the sign-in table will check employee's signature as well as check
daily Program Income totals. Random compliance inspections are conducted
periodically by the Human Services Program Manager. All sign in sheets are filed
and kept at the 5th Street Senior Center site.
30. For Home Delivered meal programs:
. Describe the knowledge, experience, ability, and skill of the individuals who will be
delivering home-delivered meals.
N/A
. Describe how assessments will be conducted, Please see Attachment A, Section
II - Eligibility for Nutrition Services for requirements.
N/A
. Describe how client participation is prioritized,
N/A
. Describe how participants will be given the opportunity to donate in a confidential
manner.
N/A
. Describe the management of the vehicles to be used to deliver homebound meals.
N/A
18
2010-5
ATTACHMENT C
NAME OF CONTRACTOR
BUDGET LINE ITEMS FOR NUTRITION SERVICES
Fiscal Year: 2010/2011
CONGREGATE SITES C-1 ~
HOME DELIVERED MEALS C-2 0
Section I: Prepare this section based on annual estimated cost to serve the meals.
a T b C=a+b
Cost to Provider for the year
Expenditure Cateaory: Cash In-Kind Annual Expense
1 Personnel 156,422,88 $39,600 $192,723
2 Staff Travel
3 Staff Trainino 1,000 1,000
4 Consultants 10,500 10,500
5 Food Cost 120,000 103,910
6 Consumable Supplies 20,000 11,889
7 Insurance
8 Reoair & Maintenance 9,500 9,500
9 Rent/Buildina Maintenance 2,000 2,00
10 Utilities $21,000 21,000
11 Vehicle Operations 8,591
12 Volunteer Expenses
13 Other Exoenses 4,000 4,000
14 Nutrition Education
Total Expenditures 332,014 60,600 392,614
County Contract Revenue Sources:
TlllelllC
NSIP
One Time Only
CDBG - DAAS
CDBG-ECD ;
Countv Fundino 'I
Nutrition Education
Total County Contract Revenue 282,014 282,014
Sources
other Revenue Sources:
Prooram Income 40,000 40,000
Deferred Income
Matchino Cash 10,000 10,000
, Matchino In-Kind 60,600 60,600
Non-Match Cash
Non-Match In-Kind
Total other Revenue Sources 110,600
Total Revenue 392,614 392,614
Section II: Prepare this 'Section based on estimated number of meals that will be served multiplied by meal
cost per unit.
d e f-d~e
Estimated annual number of meals ProDOsed meal cost nPr unit Annual Budaet
57,757 $5,56 $321,129
2010-5
ATTACHMENT C
NAME OF CONTRACTOR
BUDGET LINE ITEMS FOR NUTRITION SERVICES
Fiscal Year:
.
CONGREGATE SITES C-1 D
HOME DELIVERED MEALS C-2 [gJ
Section I: Prepare this section based on annual estimated cost to selVe the meals.
a I b C=a+b
Cost to Provider for the year
Exl enditure Category: Cash In-Kind Annual Expense
1 Personnel
2, Staff Travel
3 Staff Training
4 Consunants
5 Food Cost
6 Consumable Supplies
7 Insurance
8 Repair & Maintenance
9 Rent/Building Maintenance
10 Utilities
11 Vehicle Operations
12 Volunteer Expenses
13 Other Expenses
14 Nutrition Education
Total Expenditures
County Contract Revenue Sources:
TItle IIIC
NSIP
One Time Only
CDBG - DAAS
CDBG-ECD ~:
County Funding
Nutrition Education
Total County Contract Revenue
Sources
Other Revenue Sources:
Proaram Income
Deferred Income
Matching Cash
MatChing In-Kind
Non-Match Cash ,
Non-Match In-Kind
Total Other Revenue Sources
Total Revenue
Section II: Prepare this section based on estimated number of meals that will be selVed multiplied by meal
cost per unit.
0 e t-d~~
Estimated annual number of meals Proposed meal cost per unit Annual Budget
201Q-5
ATTACHMENT C
Provide justification, rates, comments, descriptions, etc. for line items on the Budget
Summary Form-DAAS 312,
3
$1,000
Manager Certification for Supervisor and Cook. Food Handlers Permits for
entire Senior Nutrition Program staff.
4
$40.50/258 hr.
$10,500
Nutrition Education C-1 7sites x 2,50 hours x 4 lectures = 70 hours, Site
Monitoring 6 sites x 3 hours each x 4 monitoring = 72 hours 1 kitchen x 4 hours
each x 4 monitoring = 16 hours. In-Service Training 4 classes x 8 hours each =
32 hours. Menu 4 cycles x 5 hours/cycle = 20 hours. Preparation of materials
for Nutrition Education, In-Service 4 hours/month x 12 =48 hours.
8
$9,500
$9,500/ by 12 = 791.67 per month for repair and maintenance cost, engine
tune ups, brakes, etc,
11
$8,591
$8,591/ by 12 = $716 per month for Vehicle Operation.
Prepared by: Aaliyah Harkley (909) 384-5231
Date Submitted:
San Bernardino County-OAAS 320
Revised 0310612001
Provider Name
City of San Bernardino
2010-5
ATTACHMENT C
Provide justification, rates, comments, descriptions, etc. for line items on the Budget
Summary Form-OMS 312.
1
$3,300 monthly
$39,600 annually
The In-Kind for Volunteer staff at $8,40 per hour averages around $3,300 each
month, The In-Kind volunteer monthly amount of $3,300 x 12 months= $39,600
of In-Kind revenue for the Senior Nutrition Program,
10
The FY 2009 / 2010
Cost $21 ,000
For rate determination used FY 2009 / 2010, In-Kind cost amount for FY 2010 /
2011 In-Kind cost. There will be no changes in the number of sites or sites used
during the FY 2010 /2011,
Prepared by: Aaliyah Harkley (909) 384-5231
Date Submitted:
San Bernardino County-OMS 322
Revised 0310612001
Provider Name
City of San Bernardino
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2010.-5
ATTACHMENT C
BUDGET SUMMARY
SCHEDULE OF EQUIPMENT
Item Budgeted Total
DescrlDtlon Quantity Cost Cost!
Provider Name:
San Bernardino County - OMS Form 316
Revised 0110812001
25
2010.-5
ATTACHMENT C
30. Does the Applicant agree to the Assuranpes listed below?
,
Yes X No 0
If no, provide explanation on Page 21.
List of Assurances
NOTE: All references given are for the Older Americans Act of 1965, as amended.
Thlt Applicant assures that it shall:
1, Set specific goals for providing services to older individuals with the greatest economic or
social needs, including specific objectives for providing services to low-income minority
individuals. (306 (a)(5}(A}(i})
2. Include in each agreement made with a subcontractor a requirement that such service
will-- (I) specify how the provider intends to satisfy the service needs of low-income
minority individuals in the area served by the provider; (II) to the maximum extent
feasible, provide services to low-income minority individuals in accordance with their
need for such services; and (III) meet specific objectives established by the area agency
on aging, for providing services to low-income minority individuals within the planning and
services areas. (306 (a)(5}(A}(ii})
3. Use outreach efforts that will- (i) identify individuals eligible for assistance under this Act,
with special emphasis on (I) individuals residing in rural areas; (II) older individuals with
greatest economic need (with particular attention to low-income minority individuals); (III)
older individuals with greatest social need (with particular "ttention to low-income minority
individuals); (IV) older individuals with severe disabilities; M older individuals with limited
English-speaking ability; and (VI) older individuals with Alzheimer's disease or related
disorders with neurological and organic brain dysfunction (and caretakers of such
individuals); and (ii) inform the older individuals referred to in subclauses (I) through (IV)
of clause (i), and the caretakers of such individuals, of the availability of such assistance,
(306 (a)(5}{B})
4. Assure that it will- (A) maintain the integrity and public purpose of services provided, and
service providers, under this title in all Contractual and commercial relationships; (B)
disclose to the Commissioner and the State agency - (i) the identity of each non
governmental entity with which such agency has Contract or commercial relationship
relating to providing any service to older individuals; and (ii) the nature of such Contract
or such relationship; (C) demonstrate that a loss or diminution in the quantity or quality of
the services provided, under this title by such agency has not resulted and will not result
from such Contract or such relationship; (D) demonstrate that the quantity or quality of
the services to be provided under this title by such agency will be enhanced as a result of
such Contract or such relationship; and (E) on the request of the Commissioner or the
State for the purpose of monitoring compliance with this Act (including conduct an audit),
disclose all sources and expenditures of funds such agency receives or expends to
provide services to older individuals, (306 {a}(14} {A} through (E))
201O~5
ATTACHMENT C
5. Assure that funds received under this title will not be used to pay any part of a cost
(including an administrative cost) incurr~d by the applicant to carry out a Contract or
commercial relationship that is not carried out to implement this title. (306 (a){15})
6. Assure that preference in receiving services under this title will not be given by the
applicant to particular older individuals as a result of a Contract or commercial
relationship that is not carried out to implement this title. (306 (a){16})
7. Assure that (A) the applicant will pursue activities to increase access by older individuals
who are Native Americans to all its programs under this title,
8. Assure that persons age 60 or over who are frail, homebound by reason of illness or
incapacitating disability, or otherwise isolated shall be given priority in the delivery of
services under this part. (91321,69 (a})
9. Such fiscal control and fund accounting procedures will be adopted as may be necessary
to assure proper disbursement of, and accounting for, Federal funds paid under this title
to the applicant. (307 (a}(7){A})
10. (i) No individual (appointed or otherwise) involved in the designation of the head of any
subdivision of an area agency on aging, is subject to a conflict of interest prohibited under
this Act; (ii) no officer, employee, or other representative of an area agency on aging is
subject to a conflict of interest prohibits under this Act; and (Hi) mechanisms are in place
to identify and remove conflicts of interest prohibited under this Act. (307 (a}(7){B})
11. (i) (It will) maintain the integrity and public purpose of services provided in all Contractual
and commercial relationships; (ii) Demonstrate that a loss or diminution in the quantity or
quality of the services provided, or to be provided, under~~his Act by such applicant has
not resulted and will not result from such Contract or such relationship; (iii) Demonstrate
that the quantity or quality of the services to be provided will be enhanced as a result of
such Contract or such relationship. (307 (a}(7){C})
12. Furnish assurances to the area agency that the applicant will maintain efforts to solicit
voluntary support and that the funds made available under this title to the applicant will
not be used to supplant funds from non-Federal sources. (307 (a){13){H})
13. It shall establish procedures that will allow the option to offer a meal, on the same basis
as meals are provided to elderly participants, to individuals providing volunteer services
during the meal hours, and to individuals with disabilities who reside at home with and/or
accompany to meal sites older individuals who are eligible for meals. (307 (a){13){/})
14, In the case of purchase or construction, that there are no existing facilities in the
community suitable for leasing as a multipurpose senior center, [and that the] plans and
specifications for the facility are in accordance with regulations relating to minimum
standards of construction promulgated with particular emphasis on securing compliance
with the requirements of the Act of August 12, 1968, commonly known as the
Architectural Barriers Act of 1968. (307 (a){14}{B){C})
2010.-5
ATTACHMENT C
15. Any laborer or mechanic employed by any applicant in the performance of work on the
[multipurpose senior center] facility wil~ be paid wages at rates not less than those
prevailing for similar work in the localitY as determined by the Secretary of labor in
accordance with the Act of March 3, 1931 (40 USC 276a-276a-5, commonly know as the
Davis-Bacon Act), and the Secretary of labor shall have, with respect to the labor
standards specified in this clause, the authority and functions set forth in reorganization
plan number 14 of 1950 (15 FR 3176; 64 Stat. 1267), and Section 2 of the Act of June 13,
1934 (40 U.S,C. 276c), (307 (a){14}{D})
16. If a substantial number of older individuals in the applicants service area are of limited
English-speaking ability, the applicant shall (A) utilize in the delivery of outreach services
under Sec. 306 (a) (2) (A) and 306 (a) (6) (P), the services of workers who are fluent in
the language spoken by a predominate number of elderly individuals who are of limited
English-speaking ability. (307 (a}{20})
17. All services provided under Title III meet all existing State and local licensing, health, and
safety requirements for the provision of those services.
18, All staff hired by the program will be required to attend appropriate training sessions and
workshops sponsored by the Department of Aging & Adult Services and the California
Department of Aging.
19, All materials, videotapes, and publicity will acknowledge the San Bernardino County
Department of Aging & Adult Services and indicate that the programs are made possible by Older
Americans Act funds.
201 0.-5
ATTACHMENT C
31, Please list exceptions to the List of Assurances and fully explain the exceptions.
.
,
Assurance #
Reason for Non-Compliance
29
2010-5
ATTACHMENT C
APPLICATION CHECKLIST
Proposer: City of San Bernardino, Parks, Recreation & Community Services
Department
ELDERLY NUTRITION SERVICES
Congregate Nutrition Services and/or Home Delivered Nutrition Services
and/or
Pilot Program for Nutrition Services
RFA HS 09-01
Applications submitted in response to RFA HS 09-01 for Elderly Nutrition
Services must be delivered to the following address no later than 4:00 p.m.,
Thursday, December 10, 2009
County of San Bemardino
Human Services
ATTN: Contract Administration RFA HS 09-01
150 South Lena Road
San Bemardino, CA 92415-0515
One original and five (5) unbound copies of the written Applications are required.
Each Application must include the following items, Detailed instructions are
provided in Section XI, Paragraph C, Application Format, in RFA HS 09-01:
1. X Completed Agency Information (Attachment C) form
2. X Full Description of Program
Note: Proposers may apply for Congregate and Home Delivered
Nutrition Services on the same application as well as new and
innovative ways to provide nutrition services to older
individuals (Pilot Program for Nutrition Services). This
application is submitted for the following nutrition service(s):
X Congregate Nutrition Services
o Home Delivered Nutrition Services
o Pilot Program for Nutrition Services
3. X Financial Statements (Three Years)
4, 0 Budget Summary (Attachment D) Per Prevo County Contracts
Exempt Government Agency
5. X Application Checklist (Attachment E)
30