HomeMy WebLinkAbout2018-2201
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RESOLUTION NO. 2018-220
RESOLUTION OF THE MAYOR AND CITY COUNCIL OF SAN BERNARDINO,
CALIFORNIA, RATIFYING THE EXECUTION OF THE THIRD YEAR OF A
THREE YEAR GRANT ALLOCATION, ON COUNTY CONTRACT 16-389 WITH
THE COUNTY OF SAN BERNARDINO, DEPARTMENT OF AGING AND ADULT
SERVICES (DAAS), ACCEPTING THE GRANT AMOUNT OF UP TO $335,000;
APPROPRIATE GRANT EXPENDITURES; ISSUING ANNUAL FOOD SERVICES
AND CONSUMABLE PRODUCT PURCHASE ORDERS TO SYSCO FOODS,
MERIT DAY, AND SMITH DISTRIBUTION; AND ISSUING AN ANNUAL
NUTRITION PURCHASE ORDER TO CONSULTING HEALTH & NUTRITION
SERVICES FOR THE PERIOD OF JULY 1, 2018 THROUGH JUNE 30, 2019 FOR
THE SENIOR NUTRITION PROGRAM.
WHEREAS, the City of San Bernardino was awarded a three (3) year grant in the
amount of $1,005,000, whereas $335,000 will be awarded for each of the three (3) years; and
WHEREAS, the grant requires a City Match of 11.11 %; and
WHEREAS, on August 16, 2017, the Mayor and City Council approved Year Two of
a three (3) year Grant Allocation from the County of San Bernardino, Department of Adult
and Aging Services (DAAS) for the Senior Nutrition Program pursuant to Resolution Number
2017-151; and
WHEREAS, the City of San Bernardino desires to provide nutrition services to the
senior community.
NOW, THEREFORE BE IT RESOLVED BY THE MAYOR AND CITY
COUNCIL OF THE CITY OF SAN BERNARDINO, CALIFORNIA AS FOLLOWS:
SECTION 1. The Mayor and City Council of the City of San Bernardino
hereby ratify year three (3) of a three (3) year Grant Allocation pursuant to the terms of the
County contract No. 16-389 with the County of San Bernardino to operate the Senior
Nutrition Program.
SECTION 2. The Mayor and City Council of the City of San Bernardino hereby
accept the grant award of up to $ 335,000 and authorize the Director of Finance, or designee,
to appropriate that amount for the continued operation of the Senior Nutrition Program
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pursuant to the Fiscal Year 2018-19 operating Budget and to issue annual purchase orders to
Sysco Foods, Merit Day, and Smith Distribution, Inc. for food services and consumable
supplies and to Consulting Health & Nutrition Services for nutrition and education services
for Fiscal Year 2018-19 per the third (3`d) year of a three (3) year grant allocation.
SECTION 3. The Director of Finance is directed to adjust the existing budget
appropriations amongst the Park & Recreation accounts to accurately reflect the grant match
budget consistent with this resolution.
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RESOLUTION OF THE MAYOR AND CITY COUNCIL OF SAN BERNARDINO,
CALIFORNIA, RATIFYING THE EXECUTION OF THE THIRD YEAR OF A
THREE YEAR GRANT ALLOCATION, ON COUNTY CONTRACT 16-389 WITH
THE COUNTY OF SAN BERNARDINO, DEPARTMENT OF AGING AND ADULT
SERVICES (DAAS), ACCEPTING THE GRANT AMOUNT OF UP TO $335,000;
APPROPRIATE GRANT EXPENDITURES; ISSUING ANNUAL FOOD SERVICES
AND CONSUMABLE PRODUCT PURCHASE ORDERS TO SYSCO FOODS,
MERIT DAY, AND SMITH DISTRIBUTION; AND ISSUING AN ANNUAL
NUTRITION PURCHASE ORDER TO CONSULTING HEALTH & NUTRITION
SERVICES FOR THE PERIOD OF JULY 1, 2018 THROUGH JUNE 30, 2019 FOR
THE SENIOR NUTRITION PROGRAM.
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor
and City Council of the City of San Bernardino at a Joint Regular Meeting thereof, held on
the 1 st day of August 2018, by the following vote, to wit:
Council Members:
AYES
MARQUEZ
X
BARRIOS
X
VALDIVIA
x(m)
SHORETT
X
NICKEL
RICHARD
X
MULVIHILL
AS)
NAYS ABSTAIN ABSENT
X
A(—le 21, C.11/2
Gec;rgeanrManna, 6k, City Clerk
The foregoing Resolution is hereby approved this 0 day of
Approved as to form:
Gary D. Saenz, City Attorney
3
2018.
R.ICarey Davis, _ yor
City of San Bern dino
Contract Number
ePro Qoptract WO,,
License
Total Contract Amount
Not to Exceed $1,005,00D
Cornmod'j Code
EXHIBIT "A"
O ' inal Amount
FOR COUNTY USE ONLY
95200
New FAS Vendor Code Dept
June 30, 2019
Change CITIOFS772 SC OOA A
Cancel
SAN SERNARDiNO
ePro Vendor Number
COUNTY
ODOD3036
300
County Department Dept Orgn.
Department of Aging and Adult Services ODA
AAF OOA 235
County Department Contract Representative TalephoneY
FAS
Becky Giroux (909)388-8146
STANDARD CONTRACT
Contract Type
11 �Wertue M Encumberedn mDemd_
Estimated Payment Total by Fiscal Year
Amount IID FY Amount IID
$335;000 I
If not encumbered or revenue contract type, provide reason: _
Contract Number
ePro Qoptract WO,,
License
Total Contract Amount
Not to Exceed $1,005,00D
Cornmod'j Code
I Contract Start Date Contract End Data
O ' inal Amount
Amendmentrvavunt
95200
July 1, 2016 i
June 30, 2019
$1,005,000
Fund Dept. Or anrcation Appt,
O mew Source
GRC/PROJ/JOt3 No
Amount T
AAF OOA 210
300
3357'1815,256
AAF OOA 235
300
3357
189.744
Project Name
FY
Elderly Nutrition Program 16/17
Estimated Payment Total by Fiscal Year
Amount IID FY Amount IID
$335;000 I
17/18 $335,000
18/19 $335,000
THIS CONTRACT is entered into in the State of California by and between the County of San Bernardino, Department of
Aging and Adult Services, hereinafter called the County, and
Name
City of San Bemardino hereinafter called Contractor
Address
300 North D Street T —
San Bernardino, -CA 92418 —
Telephone T Federal ID No. or Social Security No.
(909)384-.5434 -- ---- _......
IT IS HEREBY AGREED AS FOLLOWS:
WHEREAS, The County desires to provide nutrition programs for the elderly; and
WHEREAS, County has been allocated funds by the Older Americans Act of 1965 to develop nutrition programs for
the elderly; and
WHEREAS, County finds Contractor qualified to provide nutrition programs for the elderly; and
WHEREAS, County desires that such services be provided by Contractor "and Contractor agrees to perform these
services as set forth below;
NOW THEREFORE, County and Contractor mutually agree to the following terms and conditions:
Page 1 -of 24
TABLE OF CONTENTS
I.
DEFINITIONS.............................................................................................................
3
II.
CONTRACTOR SERVICE RESPONSONSIBILITIES...................................................... I.....
5
18.
CONTRACTOR GENERAL'RESPONSONSIBILITIES.........................................................
5
IV.
COUNTY RESPONSIBILITIES..........................................................................................
75
V.
FISCAL PROVISIONS...................................................................................................
15
VI.
RIGHT TO MONITOR AND AUDIT............................................................................I.......
18
VII.
CORRECTION OF PERFORMANCE DEFICIENCIES............................................................
19
VIII.
TERM.......................................................................................................................
19
IX.
EARLY TERMINATION...................................................................................................
19
X.
GENERAL PROVISIONS................................................................... .........................
19
XI.
CONCLUSION................................................................................................................
24
ATTACHMENTS
ATTACHMENT
A—
SCOPE OF WORK
ATTACHMENT
B—
CLIENT COMPLAINT AND GRIEVANCE PROCEDURES
ATTACHMENT
C—
ASSURANCE OF COMPLIANCE
ATTACHMENT
D -
DISCLOSURE OF LOBBYING ACTIVITIES
ATTACHMENT
E—
INFORMATION SHEET
ATTACHMENT
F—
COMMUNITY FOCAL POINTS LIST
ATTACHMENT
G—
PAYMENTS, BUDGETS, CLOSEOUT, AND AUDITS
ATTACHMENT
H—
PROGRAM BUDGET
ATTACHMENT
I —
MATCHING FUNDS NARRATIVE
ATTACHMENT
J—
MONTHLY EXPENDITURE REPORT
ATTACHMENT
K—
REQUEST TO PURCHASE PROP ERTYIEQUIPMENT
ATTACHMENT
L—
CONTRACTORIVENDOR CONFIDENTIALITY STATEMENT
ATTACHMENT
M—
SECURITY INCIDENT REPORT
Page 2 of 24
1. DEFINITIONS
A. CCR — California Code of Regulations
B. CDA -- California Department of Aging
C. CDA PM -- Title III Program Manual for Area Agencies on Aging — This manual is based on Federal
Regulations for Title III published March 31, 1980 (CRF, Chapter 8, Subchapter C, Part 1321), and
pertinent parts of 45 CFR Subtitle A, Part 74, published June 3, 1980.
D. CFDA — Catalog of Federal Domestic Assistance
E. CFR —Code of Federal Regulations
F. Congregate Nutrition Services (C-1) — Meals provided in a congregate setting for older individuals in an
atmosphere that is pleasant and encourages socialization.
G. Contractor — An entity providing nutrition services. The Contractor may either be an AAA providing
nutrition services directly with Department approval in accordance with subsection 7320(c) of Title 22,
or an entity under contrast with an AAA to provide nutrition services in accordance with Section 7352
of Title 22.
H. Cost Reimbursement — Payment method in which allowable and ' reasonable costs incurred by a
contractor in the performance of the contract, which may include overhead, personnel, utilities, etc.,
are reimbursed in accordance with the terms of the contract.
I. CRFC — California Retail Food Code (Section 113700 et seq., Califomis Health and Safety Code);
replaces California Uniform Retail Food Facilities Law (CURFFL)..
J. DAAS — Department of Aging and Adult Services and the designated Area Agency on Aging in San
Bernardino County.
K. DHS — California State Department of Health Services
L. DOJ —Department of Justice
M. Disability — A condition attributable to mental or physical impairment, or a combination of mental and
physical impairments, that results in substantial functional limitations in one (1) or more of the following
areas of major life activity:
1. Self-care
2. Receptive and expressive language
3. Leaming
4. Mobility
S. Seff-direction
6. Capacity for independent living
7. Economic self-sufficiency
B. Cognitive functioning
9. Emotional adjustment
N. Elderly—Any individual who is sixty (60) years'of age or older, also referred to as 'older individual."
O. Elderly Nutrition Program (ENP) —.A program which provides nutrition services, as authorized by the
Older Americans Act of 1965, as amended, and which shall be provided in accordance with the
provisions of this Act.
P. Equipment — Tangible personal property with a. useful life of more than one year and an acquisition
cost of $500 or more per unit.
Q. Financial Statement — For non -Federal entities that expend less than $750,000 in a fiscal year in
Federal awards, a statement that reflects the contractor's financial position, results of operations or
changes in net assets, and, where appropriate, cash flows for the fiscal year audited.
Page 3 of 24
R. General Program Income — Meal income received in the form of contributions or donations made by
the elderly for services rendered under this Contract.
S. HACCP — Hazard Analysis Critical Control Point.
T. HACCP Plan — A written document that delineates the formai procedures for following the HACCP
principles that were developed by the National Advisory Committee on Microbiological Criteria for
Foods and complies with the requirements of Section 114055, Health and Safety Code.
U. HACCP Principles - The seven basic steps of HACCP which are:
1. The completion of hazard analysis identification by identifying the likely hazards to consumers
presented by a speckfood.
2. The determination of critical control points in receiving, storage, preparation, display, and
dispensing of a food.
3. The setting of measurable critical limits for each critical control point determined.
4. Developing and maintaining monitoring practices to determine if critical limits are being met.
5. Developing and utilizing corrective action plans when failure to meet critical limits is detected.
6. Establishing and maintaining a recordkeeping system to verify adherence to a HACCP plan.
7. Establishing a system of audits to:
a. Initially verify the effectiveness of the critical limits set and appropriateness of the
detennination of critical control points.
b. Periodically verify the effectiveness of the HACCP plan.
V. Horne Delivered Nutrition Services '(C-2) — Meals provided to older individuals who are homebound.
W. HS — Human Services — A system of integrated services, where the programs and resources of nine
County departments come together to provide a rich, more complete array of services to the dtizens of
San Bernardino County under one coordinated effort.
X. Indirect Costs — Costs incurred for a common or joint purpose benefitting more than one cost objective
and not readily assignable to the cost objective specifically benefitted, without effort disproportionate to
the results achieved.
Y. Matching Contributions — The value of third -party in-kind contributions and that portion of program
and administrative costs funded. (cash or in-kind) by the Contractor, subcontractor, or other local
resources.
1. Cash — Cash other than program income contributed to the project from local or State funds.
With the exception of Community Development Block Grants (CDBG), Federal funds cannot
be used as cash match. Costs bome by the Contractor and cash contributions from any and
all third parties, i.e., company/private donations, vendor general fund, are considered cash
matching funds.
2. In -Kind— Contributions from third parties are considered in-kind matching funds. Examples
of in-kind match include volunteered time and use of facilities to hold meetings or conduct
project activities.
Z. MIS — Management Information System
AA. Non -Matching Contributions - Local funding that does not qualify as matching contributionsand/or is
not being budgeted as matching contributions (e.g., federal funds, overmatch, etc.)
BB. Nutrition Education — Informing recipients of congregate and home -delivered meals about current facts
and information which will promote improved food selection, eating habits, nutrition, health promotion,
and disease prevention practices.
CC. Nutrition Services — The procurement, preparation, transport, and service of meals, nutrition education,
and nutrition screening, to eligible individuals at congregate sites or in their homes.
Page 4 of 24
DD. OAA — Older Americans Act — Provides comprehensive, coordinated, .community-based systems of
services to the elderly to enable them to maintain health, personal dignity, and independence.
EE. Older Individual —A person sixty (60) years of age or older.
FF. OMB — Office of Management and Budget.
GG. Program Income — Revenue generated by the Contractor or subcontractor from contract -supported
activities. Program income is:
1. Voluntary contributions received from a participant or responsible party as a result of services.
2. Income from usage or rental fees of real or personal. property acquired with grant funds or
funds provided under this Agreement.
3. Royalties received on patents and copyrights from contract -supported activities.
4. Proceeds from sale of items fabricated under a contract agreement.
HH. Registered Dietitian —A person who shall be both:
1. Qualified as specified in Sections 2585 and 2586, Business and Professions Code and
2. Registered by the Commission on Dietetic Registration.
11. Reimbursable Item — Allowable cost and compensable item.
JJ. SEFA — Schedule of Expenditures of Federal Awards
KK. Single Audit Entity — Non -Federal entities that expend $750,000 or more in a fiscal year in Federal
awards. Single Audit Entities must have a single or program -specific audit conducted for the year in
accordance with OMB Circular A-133:
LL. State—State of California
MM. Title III — Title III of the Older Americans Act
NN. USC — United States Code .
00. USDA — United States Department of Agriculture.
PP. Volunteer — An individual who provides services without pay, but may receive reimbursement for
expenses.
QQ. W & i — California Welfare and Institutions Code
II. CONTRACTOR SERVICE RESPONSIBILITIES
Contactor shall provide all services as outlined in the Scope of Work (Attachment A)
III. CONTRACTOR GENERAL RESPONSIBILITIES
A. In the performance of this Contract, Contractor, its agents and employees, shall act in an
independent capacity and not as officers, employees, or agents of the County of San Bernardino.
Contractor agrees to comply with the applicable federal, suspension and debarment regulations,
including, but not limited to 7 Code of Federal Regulations (CFR) Part, 3017, 45 CFR 76, 40 CFR
'32, or 34 CFR 85.. By signing this Agreement, Contractor certifies that:
1. Neither it nor its principals is presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any
federal department or agency;
2. Have not within a three-year period preceding this Agreement been convicted of or had a
judgment rendered against them for commission of fraud or a criminal offense in connection
with obtaining, attempting- to obtain, or performing a public transaction or contract under a
public transaction; or a violation of Federal or State antitrust statutes or commission of
Page 5 of 24
embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false
statements, or receiving stolen property;
3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (Federal, State or local) with commission of any of the offenses enumerated in
Paragraph (A)(2) herein; and.
4. Have not within a three-year period preceding this Agreement had one or more public
transactions (Federal, State or local) terminated for cause or default.
B. Without the prior written consent of the Assistant Executive Officer for Human Services, this
Contract is not assignable by Contractor either in whole or in part.
C. Contractor agrees to provide or has already provided information on former County of San
Bernardino administrative officials (as defined below) who are employed by or represent Contractor.
The information provided includes a list of former County administrative officials who terminated
County employment within the last five. years and who are now officers, principals, partners,
associates, or members of the business. The information also includes the employment with or
representation of Contractor. For purposes of this provision, "County administrative official' is
defined as a member of the Board of Supervisors or such officer's staff, Chief Executive Officer of
the County or member of such officer's staff, County department or group head, assistant
department or group head, or any employee in the Exempt Group, Management Unit, or Safety
Management Unit.
D. If during the course of the administration of this Contract, the County determines that the Contractor
has made a material misstatement or misrepresentation or that materially inaccurate information
has been provided to the County, this Contract may be immediately terminated. If this Contract is
terminated according to this provision, the County is entitled to pursue any available legal remedies.
E. Contractor agrees not to enter into any subcontracts for work contemplated under this Contract
.without first obtaining written approval from the Director of DAAS through the HS Contracts Unit.
Any subcontractor shall be subject to the same provisions as Contractor. Contractor shall be fully
responsible for the performance of any subcontractor.
F. Contractor shall maintain all records and books pertaining to the delivery of services under this
Contract and demonstrate accountability for contract performance. Said records shall be kept and
maintained within the County of San Bernardino, but may be negotiated. County shall have the right
upon reasonable notice and at reasonable hours of business to examine and inspect such records
and books.
Records should include, but are not limited to, monthly summary sheets, sign -in sheets, and other
primary source documents. Fiscal records shall be kept in accordance with Generally Accepted
Accounting Principles and must account for all funds, tangible assets, revenue, and expenditures.
Fiscal records must also comply with the appropriate Office of Management and Budget (OMB)
Circulars that state the - administrative requirements, cost principles and. other standards for
accountancy.
All records shall be complete and current and comply with all Contract requirements. Failure to
maintain acceptable records per the preceding requirements shall be considered grounds for
withholding of payments for billings submitted and for termination of the Contract.
G. Contractor shall notify County in writing of any change in mailing address and/or physical location
within ten (10) days of the change, and shall immediately notify County of changes in telephone or
fax numbers.
H. Contractor shall notify County of any continuing vacancies and any positions that become vacant
during the term of this Contract that will result in reduction of services to be provided under this
Contract. Upon notice of vacancies, the Contractor shall apprise County of the steps being taken to
Page 6 of 24
provide the services and to fill the position as expeditiously as possible. Vacancies and associated
problems shall be reported to County on each periodically required report for the duration of said
vacancies and/or problems.
Contractor shall designate an individual to serve as the primary point of contact for the Contract.
Contractor shall notify the County when the primary contact will be unavailable/out of the office for
one (1) or more workdays. Contractor or designee must respond to County inquiries within two (2)
County business days.
J. Subcontracting
General
The Contractor shall have no authority to contract for, on behalf of, or incur obligations on behalf of
the County.
2. Awards
a. Policies and procedures used in processing and awarding the subcontracts must be:
1) Organized and structured;
2) Reasonable and equitable;
3) Documented and approved by appropriate authorities;
4) Consistent with applicable federal, state, and local ' procurement
requirements;
5) Uniformly applied; and
6) Open for public review and scrutiny
b. Copies of subcontracts, memoranda and/or letters of understanding shall be on file
With the Contractor and shall be made available for review at the request of the
County.
C. A copy of the executed subcontract shall be submitted to the Director of DAAS, and
the HS Contracts Unit.
3. Financial
a. Funds for this Contract shall not be obligated in subcontracts for services beyond the
ending date of this Contract.
b. Contractor must ensure cost incurred by the subcontractor is verifiable from their
records.
C. The Contractor shall review, approve, and monitor subcontractor performance,
budgets, and expenditures pertaining to the contracted service(s).
d. If applicable, the Contractor shall monitor on an ongoing basis, the subcontractor's
use of federal and state funds through' reporting, site visits, regular contact, or other
means to provide reasonable assurance that the subcontractor administers funds in
compliance with laws, regulations, and the provisions of contracts. (OMB Circular A -
133.400(d)(3).
e. The maximum reimbursement amount allowable for indirect costs is 10% of _
subcontractor's direct costs, excluding in-kind contributions and nonexpendable
equipment. An indirect cost plan must have federal and DAAS approval.
Page 7 of 24
4. Monitoring
a. Contractor shall monitor the budget and expenditures of its subcontractors and/or
vendors.
b. Contractor shall report immediately to DAAS in writing any incidents of alleged fraud
and/or abuse by either the Contractor or subcontractor:
C. Contractor shall monitor the insurance requirements of its subcontractors and/or
vendors.
d. Contractor shall monitor the performance of its subcontractors and/or vendors
requiring subcontractor to maintain adequate staff.
e. Contractor shall satisfy, settle, and resolve all administrative, programmatic, and
fiscal aspects of the program(s), including issues that arise out of any subcontract
agreement.
f. Contractor shall not delegate or contract the above responsibilities to any other
entity, including, but not limited to, disputes, claims, protest of award, or other
matters of a contractual nature.
g. Contractor shall provide support and technical assistance to subcontractors and
respond in writing to all written request for direction, guidance, and interpretation of
instructions to include client and service data.
5. Subcontract Termination
Contractor shall notify DAAS in writing of termination of any subcontract within three (3)
business days of receipt of notification of intent to terminate -subcontracted service(s).
K. Contractor shall provide a system, approved by the County, through which recipients of service
shall have the opportunity to express and have considered their views and complaints regarding the
delivery of services. The .procedure must be in writing and posted in 'clear view of all recipients.
Contractor will ensure that staff are knowledgeable on the San Bernardino County Human Services
Complaint and Grievance Procedures (Attachment B) and ensure that any complaints by recipients
are. referred to the County in accordance with the procedure.
L. Contractor shall notify the County of all upcoming meetings of the Board of Directors or other
governing party and shall keep the County apprised of any and all actions taken by its Board of
Directors, which may impact on the Contract. All Board of Directors' minutes shall be submitted to
the County with the monthly or as applicable report submitted in the month following approval of the
minutes. Further, a County representative shall have the option of attending Board meetings during
the term of this Contract.
M. Contractor shall protect from unauthorized use or disclosure names and other identifying
information concerning. persons receiving services pursuant to this Contract, except for statistical
information not identifying any participant. The Contractor shall not use or disclose any identifying
information for any other purpose other than carrying out the Contractor's obligations under this
Contract, except as may be otherwise required by law. This provision will remain in force even after
the termination of the Contract.
N. Contractor shall ensure that all staff, volunteers, and/or subcontractors performing services under
this Contract comply with the terms and conditions as set forth in the Human Services Information
Privacy and Security Requirements prior to providing any services. Contractor .shall immediately
notify the County of any suspected or actual breach of confidential information as further detailed in
the requirements. These requirements specified at hftp:fhss.sbcounty.gov/Privacy are hereby
incorporated by this reference.
Page 8 of 24
0. Contractor agrees to and shall comply with the County's Elder and Dependent Adult Abuse
Reporting requirements: Under the terms of this Contract, as changes in the Eldr and Dependent
Adult Reporting Laws are enacted, the Contractor is bound to comply with the most current
regulations. This responsibility shall include:
1. Who Must Report: In accordance with Welfare and Institutions Code (W & 1) Section 15630,
all employees of the Contractor.and its subcontractors are mandated reporters of elder and
dependent adult abuse. Contractor assures all employees, agents, consultants or volunteers
-who perform services under this Contract are mandated to report elder and dependent adult
abuse will sign a statement (SOC 341A) upon the commencement of their employment,
acknowledging their reporting requirements and their compliance with them at
hftp://Www.dss.cahwnet.gov/Forms/English/SOC34i.P
2. When to Report: Mandated reporters are required to report all instances of known or
suspected abuse of the elderly and dependent adults immediately or as soon as'practically
possible, under the following circumstances:
a. When the mandated reporter has observed or has knowledge of an incident that
reasonably appears.to be physical abuse, abandonment, isolation, neglect, financial
abuse, mental abuse, or sexual abuse; or
b. When the mandated reporter is told by an elder or dependent adult that he or she
has experienced behavior constituting physical abuse, abandonment, isolation,
neglect, financial abuse, mental abuse, or sexual abuse.
.3. To Whom to Report: Incidents of eider and dependent adult abuse must be reported to the
correct agency as follows:
a. If the abuse has occurred in a long-term care facility, except a state mental hospital
or state development center,.the report shall be made to the local Long -Term Care
Ombudsman or local law enforcement;
b. If the abuse has occurred in a state mental hospital or state developmental center,
the report shall be made to the designated investigators of the State Department of
Mental Health or the State Department of Developmental Services or the local law
enforcement;
C. If the abuse occurred anywhere other than a long-term care facility or State mental
hospital or state developmental center, the report shall be made to Adult Protective
Services (APS) or local law enforcement.
4. How to Report: Mandated reporters are required to take the following steps in all instances
of known or suspected abuse of the elderly and dependents:
a. Place an immediate telephone call to APS (1 877 565-2020) or local law
enforcement to report the incident.
b. Within two (2) working days of making the telephonic report to the responsible
agency, complete a written "Report of Suspected Dependent Adult/Elder Abuse"
(SOC 341) form, http://www.dss.cahwnet.covlForms/Enclish/SOC341.pdf. The
completed form must be submitted to the same agency to which the incident was
reported by telephone.
P. Contractor shall obtain from the Department of Justice (DOJ) records of all convictions involving
any sex crimes, drug crimes, or crimes of violence of a person who is offered employment or
volunteers for all positions in which he or she would have contact with a minor, the aged, the blind,
the disabled or a domestic violence client, as provided for in Penal Code section 11105.3 prior to
providing any services. This includes licensed personnel who are not able to provide documentation
of prior DOJ clearance. A copy of a license from the State of California, which requires a DOJ
Page 9 of 24
clearance, is sufficient proof. The County must be immediately notified of any records showing a
conviction. The County may instruct Contractor to .take action to deny/terminate employment or
terminate internship and/or volunteer services where the records show the person is unsuitable for
employment, internship, or volunteer services.
Q. Contractor shall notify the County of any staff member, paid intern or volunteer who is knowingly or
negligently employed who has been convicted of any crime of violence or of any sexual crime.
Contractor shall investigate all incidents where an applicant, employee, intern, or volunteer has
been arrested and/or convicted for any crime listed in Penal Code section 11105.3 and shall notify
the County. In the County's discretion, the County may instruct Contractor to take action to either
deny/terminate employment or terminate internship and/or volunteer services where the
investigation shows that the underlying conduct renders the person unsuitable for employment,
internship, or volunteer services.
Contractor shall immediately notify the County concerning the arrest and/or conviction, for other
than minor traffic offenses, of any paid employee, agent, consultant, intern, or volunteer staff, when
such information becomes known to Contractor.
R. Contractor shall make every reasonable effort to prevent employees, consultants or members of its
governing bodies from using their positions for purposes that are or give the appearance of being
motivated by a desire for private gain for themselves or others, such as those with whom they have
family, business, or other lies. In the event County determines a conflict of interest exists, any
increase in costs associated with the. conflict of interest may be disallowed by County and such
conflict may constitute grounds for termination of the Contract. This provision shall not be construed
to prohibit employment of persons with whom Contractor's officers, agents, or employees have
family, business or other ties so long as the employment of such persons does not result in
increased costs over those associated with the . employment of any other equally qualified
applicants and such persons have successfully competed for employment with other applicants on
a merit basis.
S. Contractor agrees to and shall comply with the following indemnification and insurance
requirements:
1. Indemnification -- The Contractor agrees to indemnify, defend (with counsel reasonably
approved by County) and hold harmless the County and its authorized officers, employees,
agents and volunteers from any and all claims, actions, losses, damages, and/or liability
arising out of this contract from. any cause whatsoever, including the acts, errors or
omissions of any person and for any costs or expenses incurred by the County on account
of any claim except where such indemnification is prohibited by law. This indemnification
provision shall apply regardless of the existence or degree of fault of indemnitees. The
Contractor's indemnification obligation applies to the County's "active" as well as "passive"
negligence but does not apply to the County's "'sole 'negligence" or "willful misconduct"
within the meaning of Civil Code Section 2782.
2. Additional Insured -- All policies, except for the Workers' Compensation, Errors and
Omissions and Professional Liability policies, shall contain endorsements naming the
County and its officers, employees, agents and volunteers as additional insureds with
respect to liabilities arising out of the performance of services hereunder. The additional
insured endorsements shall not limit the scope of coverage for the County to vicarious
liability but shall allow coverage for the County to the full extent provided by the policy. Such
additional insured coverage shall be at least as broad as Additional Insured (Form 13)
endorsement form ISO, CG 2010.11 85.
3. Waiver of Subrocation Rights — The Contractor shall require the carriers of required
coverages to waive all rights of subrogation against the County, its officers, employees,
agents, volunteers, contractors, and subcontractors. All general or auto liability insurance
Page 10 of 24
coverage provided shall not prohibit the Contractor and Contractor's employees or agents
from waiving the right of subrogation prior to a loss or claim. The Contractor hereby waives
all rights of subrogation against the County.
4. PoliciesPrimary and Non -Contributory — All policies required herein are to be primary and
non-contributory with any insurance or self-insurance programs carried or administered by
the County.
5. Severability of interests — The Contractor agrees to ensure that coverage provided to meet
these requirements is applicable separately to each insured and there will be no cross
liability exclusions that preclude coverage for suits between the Contractor and the County
or between the County and any other insured or additional insured under the policy.
6. Proof of Coverage — The Contractor shall furnish Certificates of Insurance to the County
Department administering the contract evidencing the insurance coverage, including
endorsements, as required, prior to the commencement of performance of services
hereunder, which certificates shall provide that such insurance shall not be terminated or
expirewithout thirty (30) days written notice to the Department, and Contractor shall
maintain such insurance from the time Contractor commences performance of services
hereunder until the completion of such services. Within fifteen (15) days of the
commencement of this contract, the Contractor shall furnish a copy of the Declaration page
for all applicable policies and will provide complete certified copies of the policies and
endorsements immediately upon request.
7. Acceptability of Insurance Carrier — Unless otherwise approved by Risk Management,
insurance shall be written by insurers authorized to do business in the State of California
and with a minimum "Best" Insurance Guide rating of "A- VII."
8. Deductibles and Self -Insured Retention — Any and all deductibles or self-insured retentions
in excess of $10,000 shall be declared to and approved by Risk Management.
9. Failure to Procure Coverer — In the event that any policy of insurance required under this
contract does not comply with the requirements, is not procured, or is canceled and not
replaced, the County has the right but not the obligation or duty to cancel the contract or
obtain insurance if it deems necessary and any premiums paid by the County will be
promptly reimbursed by the Contractor or County payments to the Contractor will be
reduced to pay for County purchased insurance.
10. Insurance Review — Insurance requirements are subject to periodic review by the County.
The Director of Risk Management or designee is authorized, but not required, to reduce,
waive or suspend any insurance requirements whenever Risk Management determines that
any of the required insurance is not available, is unreasonably priced, or is not needed to
protect the interests of the County. In addition, if the Department of Risk Management
determines that heretofore unreasonably priced or unavailable types of insurance coverage
or coverage limits become reasonably priced or available, the Director of Risk Management
or designee is authorized, but not required, to change the above insurance requirements to
require additional types of insurance coverage or.higher coverage limits, provided that any
such change is reasonable in light of past claims against the County, inflation, or any other
item reasonably related to the County's risk.
Any change requiring additional types of insurance coverage or higher coverage limits must
be made by amendment to this contract. Contractor agrees to execute any such
amendment within thirty (30) days of receipt.
Any failure, actual or alleged, on the part of the County to monitor or enforce compliance
with any of the insurance and indemnification requirements will not be deemed as a waiver
of any rights on the part of the County.
Page 11 of 24
11. The Contractor agrees to provide insurance set forth in accordance with the requirements
herein. If the Contractor uses existing coverage to comply with these requirements and that
coverage does not meet the specified requirements, the Contractor agrees to amend,
supplement, or endorse the existing coverage to do so. The type(s) of insurance required is
determined by the scope of the contract services.
Without in anyway affecting the indemnity herein provided and in addition thereto, the
Contractor shall secure and maintain throughout the contract term the following types of
insurance with -limits as shown:
a. Workers' CompensationlEmApy_e_ rs Liabil — A program of Workers' Compensation
insurance or a state -approved, self-insurance program in an amount and form to
meet all applicable requirements of the Labor Code of the State of California,
including Employer's Liability with $250,000 limits covering all persons including
volunteers providing services on behalf of the Contractor -and all .risks to such
persons. under this contract.
If Contractor has no employees, it may certify or warrant to the County that it does
not currently have any employees or individuals who are defined as "employees"
under the Labor Code and the requirement for Workers' Compensation coverage will
be waived by the County's Director of Risk Management.
With respect to Contractors that are non-profit corporations organized under
California or Federal law, volunteers for such entities are required to be covered by
Workers' Compensation insurance.
b. Commercial/General Liabilit Insurance —The Contractor shall carry General Liability
Insurance covering. all operations performed by or on behalf of the Contractor
providing coverage for bodily injury and property damage with a combined single
limit of not less than one million dollars ($1,000,000), per occurrence. The policy
coverage shall include:
1) Premises operations and mobile equipment.
2) Products and completed operations.
3) Broad form property damage (including completed operations).
4) Explosion, collapse, and underground hazards.
5) Personal injury.
B) Contractual liability.
7) $2,000,000 general aggregate limit.
C. Automobile Liability Insurance — Primary insurance coverage shall be written on ISO
Business Auto coverage form for all owned, hired, and non -owned automobiles or
symbol 1 (any auto). The policy shall have a combined single limit of not less than
one million dollars ($1,000,000) for bodily injury and property damage, per
occurrence.
If the Contractor is transporting one or more non-employee passengers in
performance of contract services, the automobile liability policy shall have a
combined single limit of two million dollars ($2,000,000) for bodily injury and property
damage per occurrence.
If the Contractor owns no autos, a non -owned auto endorsement to the General
Liability policy described above is acceptable.
Page 12 of 24
t y �
Umbrella Liability Insurance — An umbrella (over primary) or excess policy may be
used to comply with limits or other primary coverage requirements. When used, the
umbrella policy shall apply to bodily injury/property damage, personal
injury/advertising injury and shall include a "dropdown" provision providing primary
coverage for. any liability not covered by the primary policy. The coverage shall also
apply to automobile liability.
T. Contractor shall comply with all applicable laws, statutes, ordinances, administrative orders, rules,
or regulations relating to its duties, obligations, and performance under the terms of the Contract
and shall procure all licenses and pay all fees and other charges required thereby. Contractor shall
maintain all required licenses during the term of this Contract. Failure to comply with the provisions
of this section may result in immediate termination of this Contract.
U. Contractor shall comply with all applicable local health and safety clearances, including fire
clearances, for each site where services are provided under the terms of this Contract.
V. Contractor agrees to and shall comply with the County's Equal Employment Opportunity Program,
Employment Discrimination, and Civil Rights Compliance requirements:
1 Equal Employment Opportunity Program: The Contractor agrees to comply with the
provisions of the Equal Employment Opportunity Program of the County of San Bernardino
and all rules and regulations adopted pursuant thereto: Executive Orders 11246, as
amended by Executive Order 11375, 11625, 12138, 12432, 12250; Title VII of the Civil
Rights Act of 1964; Division 21 of the California Department of Social Services Manual of
Policies and Procedures; California Welfare and Institutions Code section 10000), the
California Fair Employment and Housing Act; and other applicable federal, state, and county
laws, regulations and policies relating to equal employment or social services to welfare
recipients, including laws and regulations hereafter enacted.
2. Employment Discrimination: During the term of the Contract, Contractor shall not
discriminate against any employee or applicant for employment or service recipient because
of race, religious creed, color, national origin, ancestry, physical disability, mental disability,
medical condition, genetic information, marital status, sex, gender, gender identity, gender
expression, sexual orientation, age, or military and veteran status. Contractor shall comply
with Executive, Orders 11246, 11375, 11625, 12138, 12432, 12250, 13672, Title VII of the
Civil Rights Act of 1964, the California Fair Housing and Employment Act and other
applicable Federal, State and County laws, and regulations and policies relating to equal
employment and contracting opportunities, including laws and regulations hereafter
enacted.
3. Civil Rights Compliance: The Contractor shall develop and maintain internal policies and
procedures to assure compliance with each factor outlined by state regulation. These
policies must be developed into a Civil Rights Plan, which is to be on file with the County
Human Services Contracts Unit within 30 days of awarding of the Contract. The Plan must
address prohibition of discriminatory practices, accessibility, language services, staff
development, and training, dissemination of information, complaints of discrimination,
compliance review, and duties of the Civil Rights Liaison. Upon request, the County shall
supply a sample of the Plan format. The Contractor shall be monitored by the County for
compliance with provisions of its Civil Rights Plan. Additionally, the Contractor shall submit
to County an Assurance of Compliance (Attachment C) with the California Department of
Social Services Nondiscrimination in State and Federally Assisted Programs Statement
annually.
W Contractor agrees to comply with all applicable provisions of the Americans with Disabilities Act
(ADA).
Page 13 of 24
X. Contractor shall observe the mandatory standards and policies relating to energy efficiency in the
State Energy Conservation Plan (California Code of Regulations title 20, section 1401 et $eq.);
Y. If the amount available to Contractor under this Contract, as specified in Section V, Paragraph A,
exceeds $100,000, Contractor agrees to comply with the Clean Air Act (42 U.S.C. Section 7606),
section 508 of the Clean Water Act (33 U.S.C. section 1368), Executive Order 11738 and
Environmental Protection Agency regulations (40 C.F.R. section 1.1 et seq.). _
Z. Contractor shall use recycled and recyclable products, whenever practicable; in fulfilling the terms
of this Contract. Recycled printed products shall include a symbol identifying the recycled material.
AA. Contractor understands and agrees that any and all legal fees or costs associated with lawsuits
concerning this Contract against the County shall be the Contractor's sole expense and shall not be
charged as a cost under this Contract. In the event of any Contract dispute hereunder, each Party
to this Contract shall bear its own attorney's fees and costs regardless of who prevails in the
outcome of the dispute.
BB. Contractor shall register with 211 San Bernardino County Inland Empire United Way within 30 days
of contract effective date and follow necessary procedures to be included in the 211 database. The
contractor shall notify the 211 San Bernardino County Inland Empire United Way of any changes in
program services, location, or contact information within ten (10) days of any change. Services
performed as a result of being included in the 211 database, are separate and apart from the
services, being performed under this Contract and payment for such services will not be the
responsibility of the County.
CC. Contractor agrees that any news releases, advertisements, public announcements, or photographs
arising out of the Agreement or Vendor's relationship with County shall not be made or used without
prior written approval of the DAAS Director or their designee.
DD. The Contractor, by signing this Contract, hereby certifies to the best of his or her knowledge and
belief, that: .
1. No federal appropriated funds have been paid or will be paid, by or on behalf of the
Contractor, 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 the awarding. of any federal contract, the making
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.
2. If any funds other than federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence 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
Contractor shall complete and submit Standard Form -LLL,. "Disclosure of Lobbying
Activities" form (Attachment D), in accordance with its instructions.
3. The Contractor shall require that the language of this certification be included in any
subcontracts at all tiers, and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. 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.
Page 14 of 24
I . t ,
EE. IRAN CONTRACTING ACT OF 2010, Public Contract Code sections 2200 et seq. (Applicable for
all Contracts of one million dollars ($1,000,000) or more). In accordance with Public Contract Code
section 2204(a), the Contractor certifies that at -the time the Contract is signed, the Contractor
signing the Contract is not identified on a list created pursuant to subdivision (b) of Public Contract
Code section 2203 as a person (as defined in Public Contract Code section 2202(e)) engaging in
investment activities in Iran described in subdivision (a)of Public Contract Code section 2202.5, or
as a person described in subdivision (b) of Public Contract Code section 2202.5, as applicable.
Contractors are cautioned that making a false certification may subject the Contractor to civil
penalties, termination of existing contract, and ineligibility to bid on a contract for a period of three
(3) years in accordance with Public Contract Cbde section 2205.
FF. Contractors shall complete and submit Information Sheet (Attachment E) in accordance with its
instructions.
GG. Department of Aging and Adult Services contract with California Department of Aging, Article 11,
Paragraph A (23), requires DAAS to provide contractors with additional resources for their
customers called Community Focal Points List (Attachment F).
IV. COUNTY RESPONSIBILITIES
County shall:
A. Monitor and evaluate the performance of the Contractor in meeting the terms of the Contract and
the quality and effectiveness of services provided based on the criteria as determined by the
County. .
B. Provide consultation and technical assistance in monitoring the terms of this'Contract.
C. Compensate the Contractor for approved expenses in accordance with Section V of this contract.
V. FISCAL PROVISIONS
A. The maximum amount of reimbursement under this Contract shall not exceed $1,005,000, of which
$880,179 may be federally funded, and shall be -subject to availability of funds to the County. The
consideration to be paid to Contractor, as provided herein, shall be in full payment for all
Contractor's services and expenses incurred in the performance hereof, including travel and per
diem. Overtime and holiday make up time will not be permitted. Payments are subject to provisions
in the Payments, Budgets, Closeout, and Audits (Attachment G).
B. -Contract shall be compensated on a cost reimbursement basis, limited to the obligations and
expenditures outlined in the Program Budget (Attachment H) for fiscal years 2017-19, attached
hereto and incorporated by reference into this Contract.
C. Matching Contributions
1. The Contractor shall provide in-kind matching contributions of a minimum of $25,569.11 per
year, which is the Federal Title III portion of the Contract multiplied by 11.11%.
2. Matching contributions must be allowable costs as determined by CDA. Allowable costs
may include, but are not limited to, rent, utilities, supplies, and personnel (volunteers).
3. Uncompensated indirect' expense or Contractor allocated overhead expenses may be
claimed as an in-kind matching expense if such expenses were determined on the basis of
an approved indirect cost rate plan.
4. Contractor shall provide a Matching Funds Narrative (Attachment 1) to DAAS with the
submittal of the initial budget identifying the type, rates applied and, if applicable,
source/location of allowable costs to be used as matching contributions for the period of the
Page 15 of 24
Contract. The identified matching contributions shall be reported to DAAS by the Contractor
on a monthly or quarterly basis as specified in Section V, Paragraph D.
Services of volunteers shall be valued at rates consistent with those ordinarily paid for
similar work by the Contractor. If the Contractor does not have similar work, the rate shall
be consistent with those in the labor market.
b. All other in-kind contributions shall be valued at current market value.
D. Reports
1. Contractor, at such times and in such forms'as DAAS may require, shall furnish statements,
records, reports, data, and information requested by DAAS pertaining to the Contractor's
performance of services hereunder and other matters covered by this Contract. The forms
shall be reviewed for timeliness, completeness, and correctness of the information
submitted, by the Program Director or his/her designee, prior to submission to DAAS.
Incomplete forms shall be returned to the Contractor for completion. (In the event of
changes in these forms, DAAS shall advise the Contractor via written notice.) The
Contractor shall develop and implement a process for ensuring quality control. Contractor
shall meet the following standards for the submission of required financial reports:
a. Financial Reporting — Accurate, current and complete disclosure of the financial
results of the program shall be made 'in accordance with the financial reporting
requirements, of this Contract. The following reports are to be submitted to DAAS
when indicated:
1) Monthly
a) Monthly Expenditure Report (Attachment J) (Request for
reimbursement) form — Due to DAAS Administration along with all
back-up documentation by the 1 Dt' working day of the month following
the month of services to the address stated below:
DAAS Administration
Attention: Nutrition Program Staff Analyst
686 bast Mill Street
San $emardino, CA 92415-0515
2) Annually — The following reports are due on an annual basis by no later than
August 1:
a) Financial Close-out Report
b) Periodic Inventory Report
c) Single Audit or Financial Statement
d) Schedule -of Expenditures of Federal Awards (SEFA)
3) Single Audit — If Contractor is- a Single Audit entity as defined in this
Agreement, Contractor shall:
a) Communicate the Catalog of. Federal Domestic Assistance (CFDA)
number to the independent auditor conducting the organization's
Page 16 of 24
Single Audit. The CFDA number for the III C Services is 93-045 and
93.053.
b) Provide a copy of Contractor's Schedule of Expenditures of Federal
Awards (SEFA) to DAAS on an annual basis.
E. Under normal conditions, Contractors shall expect payment approximately 60 days after submission
of a correctly prepared invoice.
F. Contractor shall accept all payments from County via electronic funds transfer (EFT) directly
deposited into the Contractor's designated checking or other bank account. Contractor shall
promptly comply with directions and accurately complete -forms provided by County required to
process EFT payments.
G. Costs for services under the terms of this Contract shall be incurred during the contract period
except as approved by County. Contractor shall not use current year funds to pay prior or future
year obligations.
H. Funds made available under this Contract shall not supplant any federal, state or any governmental
funds intended for services of the same nature as this Contract. Contractor shall not claim
reimbursement or payment from County for, or apply sums received from County with respect to
that portion of its obligations that have been paid by another source of revenue. Contractor agrees
that it will not use funds received pursuant to this Contract, either directly or indirectly, as a
contribution or compensation for purposes of obtaining funds from another revenue source without
prior written approval of the County.
I. County is not liable for the payment of any taxes, other than applicable sales or use tax, resulting
from -this Contract however designated, levied, or imposed, unless County would otherwise be
liable for the payment of such taxes in the course of its normal business operations.
J. Upon written demonstration of need by Contractor and at the option of County, upon to 10% of the
Federal -Title III funds may be advanced to Contractor by County upon approval of the Director of
DAAS. Any such advance will cause the amounts payable to Contractor in subsequent months to
be reduced to the amount determined by dividing the balance left by the number of months
remaining in the Contract term. No advance will increase the amount shown in Paragraph A of this
Section.
K. If, as a result -of advanced income, the project earns interest on funds awarded by DAAS, that
interest shall be identified as income to the program and used for program expenditures, with full
documentation on file.
L. Contractor shall expend all funds received hereunder in accordance with this Contract.
M. DAAS reserves the. right to refuse payment to the Contractor or later disallow costs for any
expenditure determined by DAAS and/or CDA not to be in compliance with this Contract, or
inappropriate .to such activities, or for which there is inadequate supporting documentation
presented, or for which prior approval is required but not granted.
N. Contractor shall return to DAAS, immediately upon written demand, any funds provided under the
Contract which are not payable for goods or services delivered prior to the termination, cancellation,
or expiration of this Contract, or the dissolution of the entity.
O. Contractor must return any unspent funds with submittal of the final invoice.
P. Contractor shall maintain accounting records to account for the funds received under the terms and
conditions of this Contract separate from any other funds administered by the Contractor.
Contractor shall maintain records in accordance with generally accepted accounting principles.
Page 17 of 24
Q. General program income shall be used to increase the number of elderly served by a project, to
facilitate access to such meals, and to provide supportive services directly related to nutrition as
defined in the Scope of Work (Attachment A). General program income shall be used within the
program in which it was earned.
VI. RIGHT TO MONITOR AND AUDIT
C. County shall have the absolute right to monitor the .performance of Contractor in the delivery of
services provided under this Contract.
D. County or any subdivision or appointee thereof, and the State of Caiifomia or any subdivision or
appointee thereof, including the Auditor General, shall have absolute right to review and audit all
records, books, papers, documents, corporate minutes, and other pertinent items as requested, and
shall have absolute right to monitor the performance of Contractor in the delivery of services
provided under this Contract. Full cooperation shall be given by Contractor in any auditing or
monitoring conducted.
E. Contractor. shall cooperate with County in the implementation, monitoring, and evaluation of this
Contract and comply with any and all reporting requirements established by this Contract.
F. All records pertaining to service delivery and all fiscal, statistical and management books and
records shall be available for examination and audit by county, federal and state representatives for
a period of three years after final payment under the Contract or until all pending county, state, and
federal audits are completed, whichever is later. Records of the Contractor which do not pertain to
the services under this Contract may be subject to review or audit unless provided in this or another
Contract. Technical program data shall be retained locally and made available upon the County's
reasonable advance written notice or turned over to County. If said records are not made available
at the scheduled monitoring visit, Contractor may, at County's option, be required to reimburse
County for expenses incurred due to required rescheduling of monitoring visit(s). Such
reimbursement will not exceed $50 per hour (including travel time) and may be deducted from the
following month's claim for reimbursement.
G. Contractor shall provide all reasonable facilities and assistance for the safety and convenience of
County's representatives in the performance of their duties. All inspections and evaluations shall be
performed in such a manner as will not unduly delay the work of the Contractor.
H. Upon County request, Contractor shall hire a licensed Certified Public Accountant, approved by the
County, who shall prepare and file with County, within 60 days after the termination of the Contract,
a certified fiscal audit of related expenditures during the term of the Contract and a program
compliance audit.
I. Pursuant to OMB Circular A-133, Contractors expending $750,000 or more in federal funds within
the Contractor's fiscal year must have a single audit or program -specific audit performed. A copy of
the audit performed in accordance with OMB Circular A-133 shall be submitted to the County within
thirty (30) days of *completion, but no later than nine months following the end of the Contractor's
fiscal year.
J. The following closely related programs identified by the Catalog of Federal Domestic Assistance
(CFDA) number are to be considered as an "Other cluster" for purposes of determining major
programs or whether a program specific audit may be elected. The contractor shall communicate
this information to the independent auditor conducting the organization's single audit.
US Department of Health and Human Services:
93.045 Older Americans Act Title III Grants for State
and Community Programs on Aging
93.053 Older Americans Act Section 311 -Nutrition
Services Incentive Program
Page 18 of 24
VI. CORRECTION OF PERFORMANCE DEFICIENCIES
A. Failure by Contractor to comply with any of the provisions, covenants, requirements, or conditions
of this Contract shall be a material breach of this Contract.
B. In the event of a non -cured breach, County may, at its sole discretion and in addition to any other
remedies available at law, in equity, or otherwise specified in this Contract:
1. Afford Contractor thereafter a time period within which to cure the breach, which period shall
be established at sole discretion of County; and/or.
2. Discontinue reimbursement to Contractor for and during the period in which Contractor is in
breach, which reimbursement shall not be entitled to later recovery; and/or
3. Withhold funds pending duration of the breach; and/or
4. Offset against any monies billed by Contractor but yet unpaid by County those monies
disallowed pursuant to Item "2" of this paragraph; and/or
5. Terminate this Contract immediately and be relieved of the payment of any consideration to
Contractor. In event of such termination, the County may proceed with the work in any
manner deemed proper by the County. The cost to the County shall be deducted from any
sum due to the Contractor urider this Contract and the balance, if any, shall be paid by the
Contractor upon demand.
VI1. TERM
This Contract is effective as of July 1, 2016 and expires June 30, 2019, but may be terminated earlier in
accordance with provisions of Section IX of the Contract.
V111. EARLY TERMINATION
A. The County may terminate the Contract immediately under the provisions of Section VI1, Paragraph
B, Item 5 of the Contract. In addition, the Contract may be terminated without cause by the County
by serving a written notice to the Contractor thirty (30) days in advance of termination. The Diretor
of DAAS for Human Services is authorized to exercise the County's rights with respect to any
termination of this Contract.
B. Contractor shall only be reimbursed for costs and uncancelable obligations incurred prior to the
date of termination. Contractor shall' not be reimbursed for costs incurred after the, date of
termination.
IX. GENERAL PROVISIONS
A. When notices are required to be given pursuant to this Contract, the notices shall be in writing and
mailed to the following respective addresses listed below.
Contractor: City of San Bernardino
300 North D Street
San Bernardino, CA 92418
County: County of San Bernardino
Human Services
Attn: Contracts Unit
150 S. Lena Road
San Bernardino, CA 92115-0515
B. Nothing contained in this Contract shall be construed as creating a joint venture, partnership or
employment arrangement between the Parties hereto, nor shall either Party have the right, power
or authority to create an obligation or duty, expressed or implied, on behalf of the other Party
hereto.
Page 19 of 24
C. Contractor shall not offer (either directly or through an intermediary) any improper consideration
such as, but not limited to, cash, discounts, service, the provision of travel or entertainment, or any
items of value to any officer, employee or agent of the County in an attempt to secure favorable
treatment regarding this Contract.
The County, by written notice, may immediately terminate any Contract if it determines that any
improper consideration as 'described in the preceding paragraph was offered to any officer,
employee, or agent of the County with respect to the proposal and award process. This prohibition
shall apply to any amendment, extension or evaluation process once a Contract has been awarded.
Contractor shall immediately ,report any attempt by a County officer, employee or agent to solicit
(either directly or through an intermediary) improper consideration from Contractor. The report shall
be made to the supervisor or manager charged with supervision of the employee or to the County
Administrative Office. In the event of a termination under this provision, the County is entitled to
pursue any available legal remedies.
D. Property
4. Unless otherwise provided for in this Section, property refers to all assets, capitaiized or non -
capitalized, used in operation of this Contract.
a. Property includes land, buildings, improvements, machinery, vehicles, furniture,
tools, and intangibles, etc.
b. Property does not include consumable office supplies such as paper, pencils, toner,
file folders, etc.
2. Property meeting all of the following criteria is subject to the capitalization requirements.
Subject property must:
a. Have a normal useful life of at least 1 year,
b. Have'a unit acquisition cost of at least $500 (a desktop or laptop setup including all
peripherals is considered a unit, if purchased as a unit); and
C. Be used to conduct business -under this Contract.
1 Additions, improvements, and betterments to assets meeting all of the above conditions must
also be reported.. Additions typically involve physical extensions of existing units.
Improvements and betterments typically do not increase the physical size of the asset.
Instead, improvements and betterments enhance the condition of an asset (e,g., extend life,
increase service capacity, and lower operating costs). Examples of assets that might be
improved and bettered include roads, bridges, curbs and gutters, tunnels, parking lots, streets
and sidewalks, drainage, and lighting systems.
4. Intangibles are property which lack physical substance but give valuable rights to the owner.
Examples of intangible property include patents, copyrights, leases, and computer software.
By contrast, hardware consists of tangible equipment (e.g., computer printer, terminal, etc.).
5. Ai( purchases of property meeting all of the following criteria above require the following:
a. If purchase of equipment is to be reimbursed by DAAS, the equipment to be purchased
must be specified in the budget previously submitted and approved by DAAS, or be
specified in a revised budget that Contractor submits to DAAS for approval.
b. Contractor must seek bids from multiple fines in selecting a supplier of goods. 'Multiple
firms" means a minimum of three (3) separate and distinct business entities in
competition to supply the same or similar good. When selecting a bid, Contractor must
consider such factors as type of goods/supplies needed, cost, schedule, and
availability.
Page 20 of 24
C. Prior to any property/equipment purchases of $500 or more by Contractor, the
"Request To Purchase Property/Equipment" (Attachment K), including the
"Property/Equipment Bid Form," must be submitted by Contractor and be approved by
DAAS.
6. The Contractor shall record the following information when property is acquired:
a. Date acquired;
b. Property description (include model number);
C. Property identification number (serial number);
d. Location of property;
e. Cost or other basis of valuation;
f. Fund source; and
g. Rate of depreciation (or depreciation schedule), if applicable.
7. The Contractor shall not use. DAAS funded property as collateral to obtain loans, etc. Any liens
placed against properties purchased with the funds available through this contract should be
reported to DAAS within five (5) days. The Contractor shall maintain and submit to DAAS
annually with the closeout, a current inventory of property furnished or purchased by either the
Contractor or the subcontractor with funds awarded under the terms of this Contract or any
predecessor contracts for the same purpose. The Contractor shall use the Report of Project
Property Furnished/Purchased with Agreement Funds (CDA 32), unless otherwise directed by
DAAS
8. Disposal of Property
a. Prior to disposal of any property purchased by the Contractor or the subcontractor with
funds from this Contract, the Contractor must obtain approval from DAAS regardless of
the acquisition value. Disposition, which includes sale, trade-in, discarding, or transfer
to another agency may not occur until approval is received from DAAS. The Contractor
shall use the Request to Dispose of Property (CDA 248) to dispose of property.
b. Contractor shall remove all confidential, sensitive, or personal information from CDA
property prior to disposal, including removal or destruction of data on computing
devices with digital memory and storage capacity. This includes, but is not limited to,
magnetic tapes, flash drives, personal computers, personal digital assistants (PDAs),
cell or smart phones, mufti -function printers, and laptops.
9. The Contractor shall immediately investigate, and within five (5) days, fully document the loss,
destruction, or theft of such property.
10. DAAS reserves We to all DAAS-purchased or financed property not fully consumed in the
performance of this Contract, unless otherwise required by federal law or regulations or as
otherwise agreed by the parties.
11. Contractor shall exercise due care in the use, maintenance, protection, and preservation of
such property during the period of the project, and shall assume responsibility for replacement
or repair of such property during the period .of the project, until the Contractor has complied
with all written instructions from DAAS regarding the final disposition of the property.
12. In the event of the Contractor's dissolution or upon termination of this Contract, the Contractor
shall provide a final property inventory to DAAS. DAAS reserves the right to require the
Page 21 of 24
Contractor to transfer such property to another entity, or to DAAS. To exercise the above right,
no later than 120 days after termination of the Contract or notification of the Contractor's
dissolution, DAAS will issue specific written disposition instructions to the Contractor.
13. The Contractor shall use the property for the purpose for which it was intended under the
Contract. When no longer needed for that use, the Contractor shall use it, if needed, and with
written approval of DAAS for other purposes in the following order:
a. Another DAAS program providing the same or similar service; or
b. Another DAAS-funded program.
14. Contractor may share use of the property and equipment or allow use by other programs, upon
written approval of the Director of DAAS. As a condition of the approval, DAAS may require
reimbursement under this Contract for its use.
15. The Contractor or subcontractor shall not use equipment or supplies acquired under this
Contract with federal and/or State monies for personal gain or to Usurp the competitive
advantage of a privately owned business entity.
16. Contractor shall include the 'provision. contained in this Section in all its subcontracts
awarded under this Agreement.
E. County shall have Power of Attorney to pay delinquent debts and unpaid wages for work provided
under this Contract from accounts payable to Contractor in the event debts and wages have not been
paid on a current basis.
F. No waiver of any of the provisions of the Contract shall be effective unless it is made in a writing which
refers to provisions so waived and which is executed by the Parties. No course of dealingand no
delay or failure of a Party in exercising any right under the Contract shall affect any other or future
exercise of that right or any exercise of any other right. A Party shall not be precluded from exercising
a right by its having partially .exercised that right or its having previously abandoned or discontinued
steps to enforce that right..
G. Any alterations, variations, modifications, or waivers of provisions of the Contract, unless specifically
allowed in the Contract, shall be valid only when they have been reduced to writing, duly signed and
approved by the Authorized Representatives of both parties as an amendment to this Contract. No
oral understanding or agreement not incorporated herein shall be binding on any of the Parties hereto.
H. If any provision of the Contract is held by a court of competent jurisdiction to be unenforceable or
contrary to law, it shall be modified where practicable to the extent necessary so as to be enforceable
(giving effect to the intention of the Parties) and the remaining provisions of the Contract shall not be
affected.
I. This Contract shall be governed by and construed in all aspects in accordance with the laws of the
State of California without regard to principles of conflicts of laws. The Parties agree to the exclusive
jurisdiction of the federal court located in the County of Riverside and the state court located in the
County of San Bernardino, for any and all disputes arising under this Contract, to the exclusion of all
other federal and state courts.
J. Contractor shall sign and return a ContractorNendor Confidentiality Statement (Attachment Q with this
Agreement. This is to ensure that Contractors are aware of, and agree to comply with, their obligations
to protect CDA information assets from unauthorized access and disclosure.
K. The State and County shall have all ownership rights in software or modifications thereof and
associated documentation designed, developed, or installed with Federal financial participation.
Page 22 of 24
S ' K '
The Federal Government (Department of Health and Human Services) reserves a royalty -free,
nonexclusive, -and irrevocable license to reproduce, publish, or otherwise use and to authorize
others to use for Federal Govemment purposes, such software modification, and documentation.
Proprietary software packages that are sold or leased to the general public are not subject to the
ownership provisions.
L. County shall have a royalty -free, non-exclusive and irrevocable license to publish, disclose, 'copy,
translate, and otherwise use, copyright or patent, now and hereafter, all reports, studies,
information, data, statistics, forms, designs, plans, procedures, systems, and any other materials or
properties developed under the Contract including those covered by copyright, and reserves the
right to authorize others to use or reproduce such material. All such materials developed under the
terms of the Contract shall acknowledge San Bernardino County as the funding agency and
Contractor as the creator of the publication. No such materials or properties produced in. whole or in
part under the Contract shall be subject to private use, copyright or patent right by Contractor in the
United States or in any other country without the express written consent of County. Copies of all
educational and training materials, curricula, audio/visual aids, printed material, . and periodicals,
assembled pursuant to the Contract must be filed with County prior to publication. Contractor shall
receive written permission from County prior to publication of said training materials.
M. All documents, data, products, graphics, computer programs, and reports prepared by Contractor
pursuant to the Contract shall be considered property of the County upon payment for services (and
product, if applicable). All such items shall be delivered to County at the completion of work under
the Contract, subject to the requirements of Section Vlll, Term. Unless otherwise directed by
County, Contractor may retain copies of such items.
N. Contractor shall complete the Security Incident Report (Attachment M) when CDA information assets
are accessed, modified, destroyed, or disclosed without proper authorization, or are lost or stolen. the
Contractor must report all security incidents to DAAS immediately upon detection.. The Security
Incident Report must be submitted to DAAS within five (5) business days of the date the incident was
detected.
O. All employeesisubcontractors of the Contractor will complete the required Security Awareness Training
module located at www.aAing.ca.Qov, within 30 days of the start date bf this Contract or -within 30 days
of the start date of any 'new employees or subcontractor(s). Contractor may substitute CDA's Security
Awareness Training program with its own Security Training provided Vrh training :meets or exceeds
CDA's training requirement.
Page 23 of 24
XI. CONCLUSION
A. This Contract, consisting of twenty-four (24) pages and Attachments A through M, is the full and
complete document describing services to be rendered by Contractor to County, including all
covenants, conditions, and benefits.
B. The signatures of the Parties affixed to this Contract affirm that they are duly authorized to commit
and bind their respective institutions to the terms and conditions set forth in this document.
C. IN WITNESS WHEREOF, the Board of Supervisors of the County of San Bernardino has caused
this Contract to be subscribed to by the Clerk thereof, and Contractor has caused this Contract to
be subscribed in its behalf by its duly authorized officers, the day, month, and year written.
COUNTY OF S.=', l -Ili NARDIN0
jr
James Ramo hairman,-BonW-Supervisors
Dated: NNW a.?> ,..r.*� •w.. .-� r
SIGNED AND c14--ERT1FFEV•iT¢�'4RT A •� Y F THIS
""AM
DOCUMENT F AS DIt01E IRE TO E
;a
CHAIRMAN O Tliq.''
Cleif tafriie of �u a rvisors
ofttte Colritgf���r nardino
By ;
Deputy,...
_ City of f San Bernardino
(Print or type na
me of oorporaUon, party, contractor, etc.)
10 -By
(Authorized signature - sign in blue ink)
Name Mark Scott
{Print or type name of person signing contract)
Title Civ Manager f
(Print or Type)
Dated:
Address 300 North D Street
San Bernardino, CA 92418
as to Legal Form Reviewed by Contract Gompllancs rn!
Ca Wilson, Depury County Regina Da` n, Contracts Manager Ko
Dates r Vj
anted to B05 for So na)y re
Buttrarn, Director
IS - ;1-3.-1 b
Date
Page 24 of 24
ATTACHMENT A
San Bernardino County
Elderly Nutrition Program
Scope of Work
July 1, 2016 through June 30, 2019
This Scope of Work contains the measurable objectives mandated by the Department of Aging and Adult Services
(DAAS) and the California Department of Aging (CDA) required of the Elderly Nutrition Program (ENP) Contractor,
The Scope of Work specifies and establishes monthly, quarterly, and annual time frames, and constitutes the primary
document for ongoing monitoring and annual Program and Fiscal monitoring. It will be used to measure the
Contractor's efforts towards providing quality nutrition services.
Contractor: City of San Bernardino
Service Area: San Bemardino and Surrounding Areas
i. Program Description:
A. Purpose — The purpose of the ENP is to provide nutrition services as described in the Older Americans
Act (OAA) 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.
B. Definition — Nutrition Services means the procurement, preparation, transport, and service of meals,
nutrition education, and nutrition screening to eligible individuals at congregate sites or in their homes.
C. Goats — To maintain or improve the physical, psychological, and social well-being of older individuals
by providing or securing appropriate nutrition services.
D. Objectives:
1. Give preference to older individuals age 60 and older, in .greatest economic and social need
with particular attention to low-income minority older individuals and older individuals residing in
rural areas.
2. Serve meals that provide one-third (113) of the Dietary Reference Intakes (DRIB) and are safe
and of good quality.
3. Promote and maintain high food safety and sanitation standards.
4. Promote good health behaviors through, nutrition education and nutrition screening of
participants.
5. Promote or maintain coordination with other nutrition -related supportive services for older
individuals.
E. Target Population — The ENP Contractor shall target individuals who are sixty (60) years of age
or older, minorities, low-income and living in rural areas of the County of'San Bernardino.
II. Eligibility for Nutrition Services:
A. Congregate Meals — Individuals eligible to receive a meal at a congregate nutrition site are:
1. Any older individual 60 or older.
2. The spouse of any older individual 60 or older.
3. A person with a disability, under age sixty (60) who resides in housing facilities occupied
primarily by older individuals (60 or older) 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.
B. Volunteer Meals:
A volunteer under age sixty (60) may be offered a meal if doing so will not deprive an older individual
who is 60 or older of a meal.
C. Home -Delivered Meals — Individuals eligible to receive a home -delivered meal are:
Page 1 of 15
ATTACHMENT A
1. Any older individual who is frail, as defined below, and homebound by reason of illness,
disability, or isolation:
a. "Frail" means that an older individual is determined to be functionally impaired because
the individual either:
1 } Is unable to perform at least two (2) activities of daily living, including bathing,
toileting, dressing, feeding,. breathing, transferring and mobility and
associated tasks, without substantial human assistance, including verbal
reminding, physical cueing or- supervision.
2) Due to a cognitive or other mental impairment, requires substantial
supervision because the older individual behaves in a manner that possesses
a serious health or safety hazard to the individual or to others.
2. A spouse of a person -in Section 11, Paragraph C, Item 1 above, regardless of age or
condition, if an assessment concludes that it is in the best interest of the homebound older
individual.
3. An individual with a disability who resides at home with older individuals if an assessment
concludes that it is in the best interest of the homebound older individual who participates in
the program.
4. Priority shall be given to older individuals in Section II, Paragraph C, Item 1 above.
Ill. Requirements for Nutrition Services:
A. Congregate Meals:
1. Each Congregate Meal Contractor shall:
a. Include procedures for obtaining the views of participants about the services
received.
b. Not preclude the service of a meal to a participant who has failed to make a
reservation when food is available.
C. Ensure each Congregate Meal participant completes the Client Intake Sheet
(provided by DAAS) .on the first day of service and annually thereafter.
d. Maintain appropriate documentation on each client. Documentation shall be kept on
file to be monitored by DAAS.
2. Each Congregate Meal site shall meet all of the following:
a. Have a paid staff or volunteer designated . to be responsible for the day-to-day
activities at each site, and physically be on-site during the time that ENP activities
are taking place.
b. Have restrooms, lighting, and ventilation, which meet the requirements of the
Califomia Retail Food Code (CRFC).
C. Have equipment, including tables and chairs that are sturdy and appropriate for older
individuals. Tables shall be arranged to assure ease of access and encourage
socialization.
B. Home -Delivered Meals:
Develop and implement criteria to assess the level of need for home -delivered nutrition
services of each eligible participant.
a. An initial determination of eligibility may be accomplished by telephone. This initial
contact with the participant shall include completion of sections 1, 2 and 3 of the
Client Intake Sheet (provided by DAAS).
b. A written assessment shall be done in the home within two (2) weeks of beginning
meal service, and shall include an assessment of the type of meal appropriate for
the participant in their living environment.
Page 2 of 15
1V.
0
ATTACHMENT A
C. An older individual eligible for receiving home -delivered meals shall be assessed for
need of nutrition -related supportive services, and referred as necessary.
d. Re -assessment of need shall be determined every quarter. Such re -assessment
shall be done in the home'of the participant at least every other quarter. Each re-
assessment shall include completion of sections 1, 2, and 3 of the Client Intake
Sheet (provided by DAAS).
2. Provide written instructions, in the language of the majority of the participants, for handling
and re -heating of the meals. Instructions must be legible.
3. Clearly label individual meals to indicate at least the entr6e and primary protein source.
Examples: "Chicken Enchilada,"- "Beef Lasagna."
4. Establish a waiting list for home -delivered meals whenever the home -delivered meal
Contractors are unable to provide meals to all eligible individuals. The decision to place
eligible. recipients of a home -delivered meal on a waiting list, and their position on such a
list, shall be based on greatest need and/or in accordance with policy established by the
home -delivered meal Contractor, in consultation with DAAS.
5. Provide home -delivered meals in pre-packaged divided'trays (hot or frozen meals).
6. Maintain appropriate .documentation on each client. Documentation shall be kept on file to
be monitored by DAAS.
Program Outcomes:
Total Number of Meals to be served: 55,833
A minimum of 95% of the total number of meals is to be provided to receive 100% of available funding.
The Director of DAAS must approve requests to serve less than 95% of the total number of meals to be
provided. All such requests must be in writing.
Program: C-1 Con re ate Meals Program C-2 Home -Delivered Meals
# of Das of Service: 250 # of Das of Service: N/A
Number of Meals: 55.833 Number of Meals: NIA
Sites to be Served: Areas to be Served: NIA
5t' St. Senior Center
Perris Hill Senior Center
Lytle Creek Community Center
New Hope Family Life Center
Highland Senior Center
lHernandez Community Center
Staffing:
A. Manager or Director:
1. The ENP Contractor shall have a manager on staff who shall conduct the day-to-day
management and administrative functions of the ENP, and either have (a), (b), or (c):
a. 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
b. 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
meeting the: hours, this individual's performance shall be evaluated through quarterly
monitoring by a registered dietitian, or
C. Two years' experience managing food services. Such experience shall be verified and
approved by a registered dietitian prior to hire.
Page 3 of 15
Registered Dietitian will review and approve the Staff Training Plan and return it to the Contractor, The
DAAS approved Staff Training Plan must be kept on file.
E. A minimum of four (4) hours of staff training shall be provided annually for paid and volunteer food
service staff, including congregate and home -delivered meal staff.
F. Training sessions shall be evaluated by those receiving the training.
G. The ENP Contractor shall maintain documentation of each training session on file. Documentation
includes, but is not limited to, sign -in sheets, agendas, handouts, and completed evaluations.
H. Ail staff, paid and volunteer, shall be oriented and trained to perform their assigned responsibilities and
tasks. Training, at a minimum, shall include:
1. Food safety, prevention of food bome illness, and Hazard Analysis Critical Control Points
(HACCP) principles.
2. Accident prevention, instruction on fire safety., first aid, choking, earthquake preparedness, and
other emergency.procedures.
3. Elder Abuse Law and reporting procedures.
4. CDA Security Awareness Training (annually).
VII. Senior Participants.,
A. Satisfaction Survey:
1. The ENP Contractor shall conduct a Client Satisfaction Survey at least annually. The Survey
instrument must be approved by DAAS prior to its use, and all findings from the Survey must
be used to improve services. The Coritractor must keep the completed Surveys and the
tabulated results on file. A copy of the tabulated results must be submitted to DAAS by March
r of the FY in which it is being conducted.
B. Complaint Procedures:
1. Each Contractor shall have a written Complaint Procedure.
2. The Complaint Procedure will be available for the participants and will provide them the
opportunity to provide positive as well as negative feedback to the Program Manager.
3. The Contractor shall have an assessment tool readily accessible for the seniors attending the
congregate site or receiving a home -delivered meal.
C. Nutrition Education Services for Participants:
1. Nutrition Education shall be provided a minimum of four (4) times per year to participants in
congregate and home -delivered meal programs.
a. Nutrition Education for congregate sites is defined as. demonstrations, presentation,
lectures or small group discussions, all of which may be augmented with printed
materials.
b. Nutrition Education for home -delivered meal participants may consist solely of printed
material that is in conjunction with a congregate meal Nutrition Education presentation.
2. Nutrition Education shall be based on the particular need of congregate and home -delivered
meal participants. An annual Needs Assessment shall be performed by the ENP Contractor to
make this determination.
3. The Nutrition Education Plan and annual Needs Assessment must be submitted to the DAAS
Registered Dietician and the DAAS Program Analyst by July 31st of the fiscal year in which it is
being provided.
4. Nutrition Education sessions must be reported monthly to DAAS using the Nutrition Education
Monthly Service Unit Report.
Nutrition Education Units of Service:
Program: C-1 Con r ate Meals P ram: C -Z Home -Delivered Meals
# of Units to be Provided: 215 # of Units to be Provided: NIA
# of Sites to be Presented at: 6 # of Partic' ants to be Presented to: NIA
Page 5 of 14
k
ATTACHMENT A
VIII. Menu Planning Guidelines/Menu Requirements:
A. A minimum of a 3 -month cycle shall be planned and submitted to the DAAS Registered Dietician.
S. Menu cycles shall include the availability of seasonal foods.
C. Health, cultural, ethnic, and regional dietary practices shall be considered in menu planning, food
selection, and meal preparation.
D. The menu cycle shall be approved by the Contractor's Registered Dietitian and upon approval
forwarded to the DAAS Registered Dietitian for certification. Menus shall be submitted to the DAAS
Registered Dietitian forty-five. (45) days prior to the beginning of the quarter containing the menu
start date. Allow thirty (30) days for the menu certification process. Menus submitted in a timely
manner will be returned to the Contractor at least fifteen (15) days prior to the menu start date.
ENP Contractors are required to have menus certified prior to the menu start date. All signatures
on the menu shall be original signatures.
E. A copy of the certified menu must be posted in a spot conspicuous to clients at each congregate
site.
F. Copies of the menus shall be made available to the participants upon request.
1. When planning the menus, the current California Food Guide and the Dietary Guidelines for
Americans (DGA) are to be considered. The criteria below are based on the sources
mentioned, such as the most current DRIB and the USDA Food Guide, as well as the most
recent CDA Program Memo and other guidance published by the CDA. Menus shall
conform to these criteria and any updates issued by CDA. Provide an average of 550 to 750
calories per meal.
2. Limit total fat to no more than 25 to 35% of the calories averaged for the week.
3. Choose and prepare foods with low amounts of salt, soy sauce, and other high sodium
items.
4. Include good sources of dietary fiber such as whole grains and cooked dry beans at least
four times a week.
5. Include a variety of foods and preparation methods with consideration to color,
combinations, texture, size, shape, taste, and preference of the participants served,
6. Dietary Reference Intake Values:
a. Table one (1) represents the most current Dietary Reference Intakes (DRI) values
and daily compliance range for target nutrients. The values provided are based on
the United States Department of Agriculture (USDA) Food Guide calculated for one
(1) meal for a woman over seventy (70) years of age whose activity level is
sedentary. This example represents a majority of the older adult population served
by the ENP.statewide.
1) The nutrients selected for this Table are based on the target nutrients to:
a). Promote health and prevent disease
b) Prevent deficiencies
c) Indicate diet quality
d) Manage disease
Page 6 of 15
ATTACHMENT A
Table 1
Target Nutrients
Nutrient
Target Value *
er meal
Daily Compliance Range
- - --1
Calories (Kcal)
>550 Kcal
_ _--
>550 Kcal 11
Protein
15 gm
15 gm (in the primary protein source)
Fat (% of total calories)
20-35%
<35% weekly average
Saturated Fat (% of total calories)
:<10%
<10%
CRFC Chapter 12.6 section 114377**
Trans Fat
<0.5g
A (pg RAE)
233 pg.
> 233 lag 3 out of 5 days /wk or 4 out of
7 days/wk
25 mg
Vitamin C (mg)
25 mg
Vitamin B6 (mg)
0.5 mg
>0.5 -mg
Vitamin 1312 -(pg) u
0.8 pg
0.8 pg (may average over a week)
Calcium (mg)
400 mg
>400 mg (may average over a week)
Magnesium (mg)
105 mg
>105 mg (may average over a week)
Sodium (mg)
<500-750 mg
<1,000 mg (over 1,000 mg place an
icon on the menu)
>7 gm (may average over a week)
1565 mg(may average over a week)
Fiber (gm)
>7 gm
~Potassium (gm)
1565 mg
Vitamin D
200 IU
200 IU (may average over a week)
*Target Value: This value represents one-third of the DRI for a 1600 -calorie range. The 1600 -calorie range was
chosen based on the requirements for a 70 -year-old sedentary female. If a majority of the senior population
served by the AAA ENP Program differs from the above example, use your ENP predominate demographic
characteristics to calculate target nutrient values.
*"California Retail Food Code: Commencing January 1, 2011, no food containing artificial trans -fat, including oil
and shortening that contains artificial trans -fat for use in the deep frying of yeast dough or cake batter, maybe
storage, distributed, served by, or used in the preparation of any food within a food facility.
***RAE = Retinol Activity Equivalent.
NOTE: Fortified foods should be used to meet Vitamin B12 needs.
A. Component Meal Pattern Requirements:
1. The California 1600 -calorie component meal pattern has been developed to reflect the new
DGA requirements for those programs that are not using -computerized nutrient analysis.
2. The ENP Contractor has the discretion to allow occasional flexibility in planning meals that
may not meet the meal pattern but does meet the nutrient value requirements. Fortified
food products and combination dishes used in a menu may not match the meal pattern but
may provide for the required nutrient values. For example, a fortified snack bar as a dessert
could be used to boost the nutrient value of a boxed lunch or special occasion meal,
3. Items that provide the following target nutrients should be identified on the menu when using
a component meal pattem template:
a. Vitamin C — Provide one-third (1/3) of the DRI for vitamin C each meal — 25 mg (for a
1600 -calorie menu).
Page 7 of 15
b. Vitamin A — Provide one-third (1/3) of the DRI for vitamin A at least three (3) times
per week, 250 µg (for a 1600 -calorie menu).
C. Sodium — Meals that contain over 1,000 mg of sodium must be noted on the menu
as a high sodium meal.
d. Fiber — Provide seven grams of fiber per meal. Programs may choose to average
fiber content over a week.
4. Table 2 below describes the elements in the California 1600 -calorie meal pattern. Serving
sizes are based on the USDA My Plate initiative (httpl/www.ChooseMvPlate�ov), which
replaced the Food Guide Pyramid. This sample component meal pattern does not assure
that meals meet one-third (1/3) of the DRIs and the DGA. Meals will require specific types
of fruits and vegetables, whole grains, and high fiber foods in order to assure the target
nutrients are provided. The component meal pattern may be deficient in vitamins E, B12,
requiring additional nutrition education for participants on the selection of foods that are
good sources of these nutrients.
a. The meal pattern in Table 2 below is based on the minimum requirements for a
sedentary female 70 years of age. If the majority of the population served by a
Contractor falls within another requirement range (e.g., active 60 year old men), the
serving sizes and minimum number of servings required can be adjusted to meet the
service population. ENP Contractors should verify the population served and
develop menu criteria accordingly.
Table 2
California 1600 -Calorie per Day Component Mea! Pattern
Minimum Recommended_ Elements
Food Group *Required servings for i calorie level es for 1600
550 calories per meat _ ---__
Lean meat or beans 1 serving 2 ounces = 1 serving
_... ........ _
2 ounces er meal --
Vegetable 1 — 2 servings '/s cup = 1 serving
Fruit 1 serving I '/x cup = 1 serving
Bread or Grain 1 --2 servings 1 slice Bread = 1 serving
At least 1/2 wholerain % cuo of rice or pasta =1 serving 1 cu
---
Low-fat milk or milk 1 serving P or equivalent measure
alternate_ - — -`
***Fat Optional f 7 grams
Dessert Optional - limit sweets use Select foods high in fiber and low in fat and
_ fruit su ar,
*The number of servings per meal estimates provision of one-third of the DRIB.
**Caloric value (1,600 KcaUday) based on -a 70 year-old female, "sedentary' physical activity level using Table
Estimated Caloric Requirements in Each Gender and Age Group at Three Levels of Physical Activity, from the
Dietary Guidelines for Americans 2010.
***Oils and soft margarines include vegetable, nut and fish oils, and soft vegetable oil spreads that have no
trans -fats.
B. Meal Components — Required for both computerized and component menus:
1. Protein — Meat, fish, poultry, legumes, eggs, and cheese:
a. A minimum of 2.0 ounces of cooked, edible portions of meat, fish, poultry, legumes,
eggs, cheese (or a combination thereof), providing at least 15 grams of protein.
Programs should consider the preferences of the participants they serve,
Page 8 of 15
ATTACHMENT A
b. Legumes should not be counted as both vegetable and protein. ENP Contractors
may use other protein sources to provide the occasional vegetarian meal.
2. Vegetables (1-2 % cup servings):
a. Vegetables as a primary ingredient in soups, stews, casseroles, or other
combination dishes should total'/: cup per serving.
b. Raw leafy vegetables (salads) should equal 1 cup if they are to be considered a
serving.
3. Fruit (1 serving):
a. A serving of fruit equals:
1) 1 medium sized whole fruit
2) Y2 cup, fresh, chopped, cooked, frozen, or canned drained fruit
3) '/ cup 100% fruit juice
b. Fresh, frozen, or canned fruit should be packed in juice, light syrup, or without sugar.
Fruit packed in high sugar content syrup may be rinsed before using.
4. Breads/Grains (1 ounce equivalent serving):
a. One-half of the daily intake of grains should be from whole grains. Grains that are
processed (not whole) must be fortified. Fifty-fifty mixtures of white and brown rice
meet the requirement for whole grain and have demonstrated acceptance amount.
b. ENP participants. For variety, consider serving other grains such as com, millet,
oats, or quinoa.
5. Milk (8 fl. oz.):
a. Each meal shall contain eight (8) fluid ounces of fortified skim, low fat, or buttermilk.
If religious preference precludes the acceptance of milk with the meal, it may be
omitted from the menu (however, an equivalent substitute must be used).
6. Fat (Optional):
a. Replace solid fats with plant based oils .to improve diet quality without added
calories.
b.. Choose plant based oils which have a high percentage of beneficial
monounsaturated and polyunsaturated fatty acids.
C. The DGAs encourage using oils as they contribute essential fatty acids to the diet.
No food containing artificial trans -fat may be stored, distributed, served, or used in
the preparation of any food within a food facility [CRFC114377].
d. Limit -the consumption of solid fats. Solid fats are those that are solid at room
temperature and have a high concentration of trans and saturated fats. Common
sources of solid fats include butter, beef, chicken, port, stick margarine, and
shortening.
7. Dessert (Optional):
a. Dessert may be provided as an option to satisfy the caloric requirements or for
additional nutrients. Use fruit as a dessert as often as possible and limit sweets.
The fruit, grains, and dairy products served as dessert can count towards the fruit,
grain, or dairy requirements. Desserts that are low in fat and/or low in sugar are
encouraged.
b. When a dessert contains % cup of fruit per serving, it may be counted as a serving of
fruit.
c. When a dessert contains the equivalent of 1 serving (1 ounce) starches/grains per
serving, it may be counted as a serving of starches/grains (example: rice pudding or
oatmeal cookie).
d. When a dessert contains the equivalent of/x cup of milk per serving, it may be
counted as'/ serving of milk.
Page 9 of 15
ATTACHMENT A
8. Condiments and Product Substitutes:
a. Sugar substitutes, pepper, herbal seasonings, lemon, vinegar, non-dairy coffee
creamer, salt, and sugar may be provided, but should not be counted as fulfilling any
part of the nutritive requirements.
b. Condiments such as salad dressings, ketchup, soy sauce, mustard, and mayonnaise
do not need to be counted in a menu analysis if they are served "on the side" and
are not combined with the food.
9. Sodium:
a. The DGAs encourage reducing daily sodium intake to 1,500 mg per day for persons
aged 51 or older, African Americans, persons who have hypertension, diabetes, or
chronic kidney disease.
b. The target value for sodium is 500 mg per meal. The acceptable range is 500 to 750
mg per meal. However, the ENP meal provides 40 to 50 percent of the nutrient
intake for the day for more than half of its participants. This fact provided the basis
for establishing an acceptable ENP sodium range that is slightly higher than the
DGAs recommend.
C. A potassium rich diet blunts the effect of sodium on blood pressure. Research
suggests that the general population does not consume sufficient amounts of
potassium and would benefit from increasing potassium intake from foods,
d. Menu planners should take steps to reduce the levels of sodium in meals over time,
including the following:
1) Focus on a stepwise reduction of sodium over time.
a) Set a goal to reduce sodium content of meals each year. For
example:
• "The local ENR will reduce the sodium level of the meals by 5
percent over this Fiscal Year" or
• The ENP will provide not more than two high sodium meals
per month.
b) Maintain documentation of the. reduction of sodium content of meals.
C) Place potassium rich foods on the -menu consistently.
d) Provide nutrition education on the health impacts of high sodium
intake on older adults.
e) Prepare foods without adding salt in the cooking process.
f) Use herbal seasoning to replace salt.
e. Avoid potassium chloride salt substitutes. Individuals should only use these products
under the supervision of a healthcare professional. Encourage using oil.and vinegar
as the preferred salad dressing: Provide at least one low -sodium salad dressing
option. Use an icon,'such as a salt shaker, to identify a high sodium meal or clearly
state on the menu that this meal contains more than 1,000 mg of sodium.
f. ENPs should establish policies and procedures for purchasing healthful foods that
incorporate the DGAs' sodium recommendations.
g. ENPs can participate in transforming the food service industry by creating a demand
for products that are lower in sodium and working with food purveyors to purchase
lower sodium foods. Responsibility to reduce the amount of sodium in the diet of all
Americans falls on both the food industry and consumers.
10. Meal Component/Nutrient Analysis:
A meal component/nutrient analysis of the entire menu cycle conducted and/or approved by
a Registered Dietitian shall be done to ensure compliance with Title 22, Division 1.8,
Chapter 4, Article 5.
Page 10 of 15
ATTACHMENT A
Computerized Nutrient Analysis Requirements
a. Although not required, use of computerized nutrient analysis is strongly
recommended and will help ensure and verify the nutritional adequacy of meals.
The goal of assessing nutrient intakes of groups is to determine the prevalence of
inadequate or excessive nutrient intakes within a particular group of individuals.
While meal patterns serve as a basic framework for menu planning, Contractors are
encouraged to use computerized nutrient analysis because it provides specific
information on nutrients the menu may not be providing. The information that a
menu is not supplying all of the desired nutrients will guide the development of future
menus. As required menu elements are expanded, 'it is more difficult to meet all of
the requirements on a daily basis. ENP Contractors should focus on:.
1) Vitamin A
2) Vitamin C
3) Protein
4) Fat
5) Sodium
6) Fiber
b. Not all nutrient guidelines will be met with each meal. However, areas that do not
meet the requirements should be the focus of future menu revisions and nutrition
education.
C. The following nutrients should be included in the analysis when the computerized
nutrient analysis method is used: calories; protein; carbohydrates; total fat; saturated
fat; total fiber; vitamins A, C, D, E, K, thiamin, riboflavin, niacin, B6, folate, B12,
.calcium, chromium, copper, iron, magnesium, sodium, and zinc. In addition to
meeting one-third of the DRIs, the menus should also follow the DGA.
IX. Food Procurement:
A. Food procurement procedures shall comply with Title 22, CRFC standards, and HACCP best
practices guidelines.
B. All food shall be of good quality and shall be obtained from sources that conform to Federal, State,
and local regulatory standards for quality, sanitation, and safety.
C. To the extent possible, Contractors are encouraged to participate in group food purchasing.
D. A comparative cost analysis shall be performed either by the ENP Contractor or its group
purchasing organization on an on-going basis to obtain the highest quality food for the lowest price
available.
X. Food Storage:
A. Food storage procedures shall comply with Title 22, CRFC standards, and HACCP best practices
guidelines.
B. Adequate and suitable space free from vermin, dirt, and contamination or adulteration shall be
provided for the storage of food and beverages, and cooking, serving, and eating supplies,
XI. Food Production:
A. Food production procedures shall comply with Title 22; CRFC standards, and HACCP best
practices guidelines..
B. Food production and meal service shall be under the supervision of a trained staff in food service
management to ensure food service_ sanitation and the practice of hygienic food handling
techniques are followed. This persori shall function with the advice of the Contractor's Registered
Dietitian
Page 11 of 15
ATTACHMENT A
C. Meals shall be served as indicated on the certified menus. In the event that a menu substitution
must occur, the following procedure must be followed:
1. The Contractor's Registered Dietitian must approve all menu substitutions.
2. A Menu Substitution Form must be completed and signed by the Contractor's Registered
Dietitian.
3. The completed Menu Substitution form shall be kept on file for DAAS review.
D. Production Control:
1. Production schedules or worksheets must be available in the food preparation area.
2. Food shall be prepared in sufficient quantities to serve all participants. Careful planning
shall minimize the leftover food and prevent waste.
3. Standardized recipes shall be used to ensure consistency of quality and quantity and
adherence to menu guidelines.
4. Appropriate utensils for correct and consistent portion -control shall be available and used at
each site.
E. Meal Service/Temperature Monitoring:
1. All food for congregate sites shall be packaged and transported and held before and during
serving in a manner in which it is protected from potential contamination and maintains
appropriate hot and cold food temperatures.
2. Meals shall be served to seniors "offer versus serve" – meaning participants are to be given
an opportunity to decline a menu item. Food trays shall not be served ahead of time.
3. Temperature checks:
b. All hot, cold, and frozen potentially hazardous meal components, including milk, shall
be checked daily immediately prior to dispatch from the central kitchen, Al hot, cold,
and frozen potentially hazardous meal components, 'including milk, shall be checked
at satellite congregate sites upon delivery and at all congregate sites immediately
before meal service.
C. The ENP Contractor must have written procedures for monitoring food temperature.
d. The ENP Contractor must use a form to document food temperatures daily, (i.e.,
Food Temperature Log). The ENP Contractor shall have a staff member review the
completed Food Temperature Logs at random a minimum of every other month. If
problems are discovered, an action plan'must be developed to resolve the issue.
e. All completed Food Temperature Logs must be maintained on file for DAAS review.
4. To maintain quality in prepared foods, holding times shall be kept to a minimum. Long
periods of holding hot foods at required temperatures diminishes the nutrient content and
palatability of foods.
5. Holding time shall not exceed 2 hours between the end of production and the beginning of
food service at the congregate site.
6. Milk and milk products shall be provided in individual, commercially filled containers, or shall
be poured by a staff member directly from commercially filled bulk containers into the clean
glass or cup from which they are to be consumed.
7. Cool water shall be offered with each meal to encourage fluid intake and lower the risk of
dehydration—a risk that is higher for older adults.
8. Single service utensils and tableware shall be used one time only and then discarded.
9. Safety of the food after it has been served at the congregate site and then removed by the
participant from the congregate site is the sole responsibility of the participant and may be -
consumed by the participant as he/she deems it appropriate.
10. The Contractor shall have a sign posted in the congregate site stating, "Food removed from
the congregate site is consumed at your own risk." _
Page 12 of 15
ATTACHMENT A
XII. Food Service Requirements:
A. The ENP Contractor shall ensure that the following forms are available, completed daily, and
maintained at each nutrition site for a minimum of 12 months:
1. Food Temperature Logs — Separate logs shall be available for congregate meals, home
delivered meals, and individual meals chilling process.
2. Cleaning Schedule.
3. Equipment Temperature Log — For all dish machines, refrigerators, and freezers.
4. Production Schedule — Applicable only if food is cooked at the site.
5. The current Environmental Health inspection detailed report shall be available at the site for
review.
6. Staff and volunteers who are involved in any part of food service operation or clean-up,
except home -delivered meals drivers, shall possess a current San Bernardino County -
issued Food Worker Card, and Certificate that shall be available for review.
XIII. Program Requirements:
A. Client Intake Sheets:
1. The ENP Contractor will ensure that each participant completes the Client Intake Sheet,form
(provided by DAAS) to determine his or her level, of nutritional risk. Forms shall be
completed for:
a. Congregate Meal Participants — At the beginning of service and then annually
thereafter for clients who remain on the program.
1) All bold and asterisked fields are required to be filled out for congregate
meals.
b. Home -Delivered Participants — At the beginning of service and then quarterly
thereafter for clients who remain on the program.
1) Sections 1, 2, and 3 are required for home -delivered meals.
2. ENP Contractors who are required to complete their own data entry into the Social
Assistance Management System (SAMS) must enter the annual and quarterly Client Intake
Sheets into the database in a timely manner.
3. ENP Contractors who are not required to complete their own data entry must send the
Client Intake Sheets to DAAS for data entry into the SAMS System.
B. Outreach/Marketing Activities:
1. ENP Contractors are required to provide outreach in the community through community
organizations and other groups. All outreach and marketing activities shall be documented
and kept on file for the annual monitoring visit conducted by DAAS.
2. ENP Contractors shall develop and have handouts, brochures, and/or signs available in
languages other than English and posted in locations such as churches, community service
locations, and small stores serving the minority communities.
C. Emergency Procedures:
1. ENP Contractors shall have a written Emergency/Disaster Plan,
2. Each nutrition site shall have an evacuation plan posted identifying the emergency exits and
assembly areas.
3. Staff must be knowledgeable of emergency procedures.
4. Where feasible and appropriate, ENP Contractors shall make arrangements for the
availability of meals to participants during a major disaster, as defined in 42 U.S.C., Chapter
68, Section 5122 (2). Such arrangements shall be included in the Emergency/Disaster
Plan.
Page 13 of 15
ATTACHMENT A
D. Donations and Confidentiality:
1. An Eligible individual who receives a meal shall be given the opportunity to contribute to the
cost of the meal.
2. The ENP Contractor shall develop a suggested contribution/donation amount. When
developing this contribution/donation amount, the income ranges of the older individuals in
the community and the Contractor's other sources of income shall be considered,
3. A sign indicating the suggested contribution for eligible individuals and the fee for guests
shall be posted near the contribution container at each congregate meal site. A guest fee
shall cover all meal costs. .
4. No eligible individual shall be denied participation because of failure or inability to contribute.
5. The Contractor shall ensure that the amount of the eligible participant's contribution is kept
confidential.
6. The ENP Contractor shall establish written procedures to protect contributions and fees
from loss, mishandling, and theft (i.e., Contribution/Donation Procedures). Such Procedures
shall be kept on file for DAAS review.
7. All contributions and fees shall be identified as program income and used to increase the
number of meals served, to facilitate access to such meals, and to provide nutrition -related
supportive services.
E. "No Soliciting" Sign:
1. The ENP Contractor shall ensure that a "No Soliciting" sign is posted on the door leading to
the congregate nutrition site. No soliciting of any kind is permitted on the premises during
the lunch hours for services or goods promoted by businesses.
F. Coordination:
1. If applicable, develop a fair and equitable policy and procedure for referring participants to
the appropriate transportation Contractor for securing public transportation to and from
nutrition sites and have the policy available for review by DAAS.
2. Include the following statement on all advertising, brochures, poster, etc., "Funding for this
service has been provided by the San Bernardino County Department of Aging and Adult
Services through a grant award from the California Department of Aging."
3. Coordinate service with other County departments and local agencies by providing time for
presentations or special activities that promote a community based system of care for the
participants attending nutrition sites.
G. Reporting:
1. All fiscal and program data must be reported monthly (e.g., Request for Reimbursement,
Rosters, Monthly Service Unit Report, etc.). All reports are due to DAAS by the 10"`
business day of the month following the month of service. DAAS will provide training as
needed.
2. The Contractor shall maintain support files, including, but not limited to, invoices, payroll,
Client Intake Sheets, and any other supporting documents to substantiate monthly reports
and expenditures.
3. ENP Contractors are required to report all known or suspected cases of elder abuse to
DAAS Adult. Protective Service or law enforcement immediately by telephone. A written
report must be sent within two (2) working days. Abuse of an elder or dependent adult
means physical abuse, neglect, intimidation, cruel punishment, fiduciary abuse,
abandonment, isolation, or other treatment resulting in physical harm or pain or mental
suffering or the deprivation by a. care custodian of goods or services which are necessary to
avoid physical harm or mental suffering.
4. Maintain records, by month, that support claimed in-kind expenditures.
5. Report expenditures funded with Deferred Income by September 30th of the FY in which it is
being claimed.
Page 14 of 15
ATTACHMENT A
6. Develop and have on hand for review by DAAS, a cost allocation plan which explains the
methods used to allocate costs betweencongregate and home -delivered meals or any other
program funded by DAAS.
7. In the event additional funds become available, the Contractor will use the funds to increase
the number of meals being provided to participants by either increasing the number of
individuals attending its present sites, or by opening new sites in communities not already
served by the Contractor. Exceptions to this requirement must be fully documented in
writing and submitted to the Director of DAAS for prior approval_
8. Other Reporting. Requirements:
a. SAMS:
1) The following reports are to be completed and submitted to DAAS by the 10`h
business day of the month following the month of service if the Contractor is
serving less than 500 clients per month:
a) Client Intake Sheets for any new clientsor any annual or quarterly
assessments completed in the month.
b) Meal Rosters
2) Contractors that are serving more than 500 clients shall secure the
appropriate licensing, have a dedicated staff responsible for maintaining the
client tracking software, obtain and maintain an Internet Service Contractor
and the appropriate hardware that can support the. program. These
Contractors shall be responsible for entering the following data into SAMS by
the 10th business day of the month following the month of service:
a) Client Intake Sheets for any new clients or any annual or quarterly
assessments completed in the month.
b) Rosters
c) Routes (if applicable)
9. Nutrition Education Monthly Service Unit Report
a. The Nutrition Education Monthly Service Unit Report is a tool that is used to report
the number of Nutrition Education service units that have been provided to
participants. This report is to be completed and submitted to DAAS by the 10a'
business day of the month following .the month of service. Copies of any handouts
presented to the participants as a component of the Nutrition Education shall be .
attached to the Nutrition Education Monthly Service Unit Report.
H. Disposal of Equipment:
1. If the Contractor wishes to dispose of equipment purchased with Nutrition grant funding,
they must submit a request, in writing, to DAAS. The request shall state the equipment
description, the location of the equipment, and the reason for disposal.
2. Contractor shall submit a list of equipment purchased with grant funding by location.
I. Mandatory Meetings
1. Contractor is required to attend all Nutrition Contractor meetings hosted by DAAS.
Page 15 of 15
ATTACHMENT B
CLIENT COMPLAINT AND GRIEVANCE PROCEDURES
Older Americans Act Programs
(Instructions: The service recipient is to read, sign, and receive a copy of this form. The original of the
form is to be filed in the service recipient's case file maintained by contractor. The reverse side of this
form may be used to file a complaint or grievance with the contractoriservice Contractor.)
If you believe you have been discriminated against, or that there has been a violation of any laws or regulations, or if
you have a problem regarding services received, you have the right to file a grievance.
The following procedures are to be followed when filing a grievance:
1. Identify the complaint/grievance. in writing and discuss it with the contractor/service Contractor.
Time frame: Within 1 week of discrimination/violation/problem.
if resolved at this level, no further action is required. If no resolution is apparent within 15 business days, proceed with
Step 2.
Forward the written complaint/grievance to the Deputy Director of Administration at the following address:
Department of Aging and Adult Services
686 East Mill Street
San Bernardino, CA 92415-0640
ATTN: Deputy Director
Time frame: Within 1 week of Step 1
If resolved at this level, no further action is required. If no resolution is apparent within 15 business days, proceed with
Step 3.
If no solution is apparent after Steps 1-2 have been exhausted, forward copy of written grievance to;
Human Services Group, Contract Administrator
150 S. Lena Road
San Bernardino, CA 92415-0515
You will be contacted within 15 business days of any actions being taken.
Please note: Each of these steps must be completed in the sequence shown.
If you believe that your civil rights have been violated, please contact:
Deputy Director, Administration
Department of Aging and Adult Services
686 East Mill Street
San Bernardino, CA 92415-0640
GRIEVANCE PROCEDURE CERTIFICATION
This is to certify that I have read, understood, and received a copy of the Client Complaint and Grievance Procedures
for Older Americans Act Programs.
Signature of Service Recipient
Date
Page 1 of 2
GRIEVANCE NOTICE
Your Name:
Date of Occurrence:
Approximate Time of Occurrence:
Name of Service Contractor:
Address of Service Contractor:
Nature of Grievance:
Resolution:
ATTACHMENT B
�— _ ----
Resolved by: _ _.
Signature Date
Signature of Service Recipient Date
Page 2 of 2
ATTACHMF-N t L,
ASSURANCE OF COMPLIANCE
ASSURANCE OF COMPLIANCE WITH ALL APPLICABLE LAWS
RELATING TO
NONDISCRIMINATION IN STATE AND FEDERALLY ASSISTED PROGRAMS
City of San Bernardino
CONTRACTOR
HEREBY AGREES THAT it will comply with Title VI and VII of the Civil Rights Act of
1964, Section 504 of . the Rehabilitation . Act of 1973, as amended, the Age
Discrimination Act of 1975, the Food Stamp Act of 1977- Section 272.6, The
Americans with Disabilities Act of 1990, Government Code (GC) section 11135 and
California Code of Regulations (CCR) Title 22 section 98000-98413, Title 24 of the
California Code of Regulations section 3105A(e), and other applicable federal and
state laws, as well as their implementing regulations (including 45 CFR, Parts 80, 84,
and 91, 7 CFR Part 15, and 28 CFR Part 42), by ensuring that employment practices
and the administration of public assistance and social services programs are
nondiscriminatory, to the effect that no person shall because of race, color, national
origin, political affiliation, religion, marital status, sex, age or disability be excluded
from participation in or be denied the benefits of, or be otherwise subject to
discrimination under any program or activity receiving federal or state assistance;
and HEREBY GIVES ASSURANCE THAT, it will immediately take any measures
necessary to effectuate this agreement.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining any
and all federal and state assistance; and THE AGENCY HEREBY GIVES
ASSURANCE THAT administrative methods/procedures which have the effect -of
subjecting individuals to discrimination will be prohibited.
BY ACCEPTING THIS ASSURANCE, the agency agrees to compile'data, maintain
records and submit reports as required, to permit effective enforcement of the
aforementioned laws and regulations and permit authorized County, state 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, County 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 11135-39, 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 agency directly or through contract, license, or
other Contractor services, as long as it receives federal or state assistance; and shall
be submitted annually with the required Civil Rights Plan Update.
DATE SIGNATURE
City of San Bernardino
ORGANIZATION
300 N. D Street, San Bernardino CA 92418
ADDRESS
Page 1 OF 1
ATTACHMENT c '
DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046
(See reverse for public burden disclosure.)
1. Type of Federal Action:
i a.
contract
b.
grant
c.
cooperative agreement
d.
loan
e.
loan guarantee
f.
loan insurance
2. Status of Federal Action: 3. Report Type:
a a. bid/offer/application a. initial filing
I b. initial award b. material change
C. post -award
4. Name and Address of Reporting Entity:
❑ Prime ❑ Subawardee
Tier , if known:
Congressional District, if known:
6. Federal DepartmentlAgendy:
For Material Change Only:
year ___quarter_
date of last report_ _—___
6. if Reporting Entity in No. 4 is a Subawardee, Enter Name
and Address of Prime:
Congressional District, if known:
7. Federal Program Name/Description:
i
CFDA Number, if applicable:
8. Federal Action Number, if known: f 9. Award Amount,
$
10. a. Name and Address of Lobbying Entity
(if individual, last name, first name, MO:
11. Amount of Payment (check all that apply):
. $ ❑ actual ❑ planned
12. Form of Payment (check all that apply):
❑ • a. cash
❑ b. in-kind; specify: nature
value _
b. Individuals Performing services (lncivaing aaaress it
different from No. 1Oa)
(last name, first name, MI)
Sheeks; SF-LLLA ifneoessa: •'
3. Type of Payment (check all that apply):
❑ a,
retainer
p b.
one-time fee
❑ c.
commission
❑ d.
contingent fee
❑ e.
deferred
❑ f.
other; specify:_.
Brief Description of Services Performed or to be Performed ana uatetsj or,ervice, mcructing oincertisl,
employee(s), or Member(s) contacted, for Payment Indicated in Item 11:
(attach Continuation Shest(s) SF -ULA, if necessary)
5. Continuation Sheet(s) SF-LLLA attached: ❑ Yes ❑Ivo
16. Information requested IhrmQh [his form is autliaized bydtle 31 U.S.C.
section 1352. This discloswe of lobbying ecdviltas is a material representation of
Fad upon vA[ich reliance was placed by fife liar above vkw this lransaction was
made or entered brio. This disclosure Is requited pumiard to 31 U.S.C.1352. Tide
iMotlnagon wAl be reported to She Congress semiannually and will be available for
public inspect[on Any person who fails to rile the required disclosure shell be
subject to a dw1 penalty of not less Vial S1r7.000 and not more than $100.00lar
each such failure. -
Federal Use Only:
Signature:
Print Name:
Telephone No.:
Date:
Authorized for Local Reproduction
Standard Form LLL (Rev. 7.97)
Page 1 of 2
Al l Ai:1'11YICIv 1 LJ
INSTRUCTIONS FOR COMPLETION OF SF -LLL, DISCLOSURE OF LOBBYING ACTMTIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or
receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a
form Is required for each payment or agreement to make payment to any lobbying entity 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 a covered Federal action. Use the SF-LLLA Continuation Sheet for additional information if the space
on the form is Inadequate. Complete all Items that apply for both the. initial filing and material change report. Refer to the
Implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity Is and/or has been secured to Influence the outcome
of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If. this is a follow up report caused by a material change to the
Information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously
submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip bode of the reporting entity. Include Congressional District, If known. Check
the appropriate classification of the reporting entity that designates if it Is, or expects to be, a prime or subaward recipient.
Identify the tier of the subawardee,e.g., the first subawardes of the prime is the 1st tier. Subawards Include but are not limited to
subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip
code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level
below agency name, It known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of
Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified In item 1 (e.g., Request for
Proposal (RFP) number, Invitation for Bid (iFB) number, grant announcement number; the contract, grant, or loan award
number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., 'RFP -DE -90-001:'
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal
amount of the award/loan commitment for the prime entity Identified in item 4 or S.
10. (a) Enter the full name, address, city. State and zip code of the lobbying entity engaged by the reporting entity identified in
item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address 9 different from 10 (a). Enter Last
Name, First Name, and Middle Initial (MI).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the
lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be amount of payment made or
planned to be made.
12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the
nature and value of the in-kind payment
13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform,
and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent In actual contact
with Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s)
of Congress that were contacted.
15. Check whether or not a SF-LLLA Continuation Sheet(s) Is attached.
16. The oertifying official shall sign and date the form, print Mather name, title, and telephone number.
According to the Paperwork Reduction. es amended, no persons are reWiredto respond to a cdiedlon of intermation untess It displays a vefid OMB Cmf
Number. The valid OMB control number for this nformatlon collection is OMB No. 0346.0046. Public reporting burden for this collection of Information
estirnated to average 30 minutes per response, including time for reviewing instructions, searching existing date sources. gathering and maintaining the di
needed, and completing and reviewing the or rection of Information. Send comments regarding the burden estimate or any other aspect of this collection
rotor maeon, including suggestions for reducing this burden, to the Office of Managemenland Budget, Paperwork Reduction Prged (0348-0045), Washingti
DC 20503.
Page 2 of 2
ATTACHMENI r
INFORMATION SHEET
(one Information Sheet per Vendor)
CONTRACTOR SHALL COMPLETE SECTION i OF THIS FORM AND RETURN
TO:
SAN BERNARDINO COUNTY
Department of Aging and Adult Services
Attn: CONTRACTS
Page 1 of 1
AI IAUHM NI r
'aoMMUNITY FOCAL POINTS LIST
. Name. m.
Address ..
CityfGornmuriity-
Adelanto Senior Club
11565 Cortez Avenue
Adelanto, CA 92301(760) 605-0549
Apple Valley Senior Club
13188 Central Road
Apple Valley, CA 92308 (760) 247-3155
Barstow Senior Citizens
Barstow, CA
Club
555 Melissa Avenue
92311-3031 (760) 256-5023
Big Bear Valley Senior
Center
42651 Big Bear Blvd.
Big Bear Lake, CA 92315 (909) 584-0323
Bloomington Senior Center
18317 Valley Blvd.
Bloomington, CA 92316 (909) 546-1399
Bonnie Baker Senior
Citizens Club
149350 Ukiah Trail
Big River, CA 92242 (760) 665-2667
Chemehuevi Indian Tribal
Center
1990 Palo Verde
Havasu Lake, CA 92363 (760) 8584219
Chino Senior Center
13170 Central Avenue
24658 San Moritz Drive
Chino, CA 91710 (909) 334-3453
Crestline, CA 92325 (909) 338-5036
Crest Forest Senior
Citizens Club
Delmann Heights
~
2969 N. Flores St.�
San Bernardino, CA 92407 (909) 887-2115
Senior Center
16707 Marygold Avenue
Fontana, CA 92335 (909) 350-0575
Dino Papavero
Senior Center
EI Mirage Senior Club
1488 Milton
16710 Ceres Avenue
EI Mirage, CA 92301 (760) 559-7683
Fontana, CA 92335 (909) 854-5151
Fontana Community
Senior Center
Ft. Mohave Tribal Senior
Nutrition Program
700 Harrison Street
Needles, CA 92363 (760) 629-2371
George M. Gibson
Senior Center
250 N. Third Avenue
Upland, CA 91786 (909) 981-4541
George White
8565 Nuevo Avenue/8572
Sierra Ave.(Main Ofc)
Fontana, CA 92335 {909) 822-4493
Senior Center
Grand Terrace
Senior Center
22627 Grand Terrace Road
Grand Terrace, CA 92313 (909) 824-1491
Helendale Senior Center
15350 Riverview Rd., Bldg. 2
Helendale, CA 92342 (760) 243-5690
Hesperia Leisure League
9122 Third Avenue
Hesperia, CA 92345 (760) 244-3223
Percy Baaker Community
9333 "E" Avenue/PO Box
Hesperia, CA 92340 (760) 244-5488
Center
104Q55
Highland Senior Center
3102 E. Highland Avenue
Patton, CA 92369 (909) 862-8104
Hinkley Community and
35997 Mountain View Road
Hinkley, CA 92347 (760) 2534677
Senior Center
Hutton Senior Center
660 Colton Avenue
Colton, CA 92324 (909) 370-6168
Rancho Cucamonga, CA
James L. Brulte
Senior Center
11200 Baseline Road
91701 (909) 477-2780
Joshua Tree Community
6171 Sunburst
Joshua Tree, CA 92252 (760) 366-2471
Center
Page 1 of 2
ATTACHMENT F
.:Nairne'
>Wcfress
i:I.. 1
Joslyn Senior Center
21 Grant Street
Redlands, CA 92373
(909) 798-7550
Loma Linda Senior Center
25571 Barton Road
Loma Linda, CA 92354
(909) 799-2820
Lucerne Valley Senior Club
10431 Allen Way
Lucerne Valley, CA 92356
(760) 248-2248
Luque Senior Center
292 East "O" Street
Colton, CA 92324
(909) 370-5087
P.O. Box 182/14082 Center
Lytle Creek Senior Center
Road
Lytle Creek, CA 92358
(909) 880-8659
Mentone Senior Center
1331 Opal Avenue
Mentone, CA 92359
(909) 794-5280
Montclair Senior Center
5111 Benito Street
Montclair, CA 91763
(909) 625-9483
Morongo Basin Senior
Support Center
57121 Sunnyslope Drive
Yucca Valley, CA 92284
(760) 365-9661
Mountain Communities
Senior Center
675 Grandview Road
Twin Peaks, CA 92391
(909) 337-1824
Needles Senior Center
1699 Bailey Avenue
Needles, CA 92363
(760) 3264789
Newberry Springs €aflief
Family Center
33383 Newbery Road
Newberry Springs, CA 92365
(760) 257-3284
Ontario Senior Center
225 East "B" Street
Ontario, CA 91764
(909) 395-2021
Perris Hill Senior Center
780 E. 21st Street
San Bernardino, CA 92404
(909) 384-5436
Phelan Senior Club
4128 Warbler Rd. #A
Phelan, CA 92371
(760)86 B-8067
Pinon Hills Senior Club
10433 Mountain Road
Pinon Hills, CA 92372
(760) 868-8637
Redlands Community Senior
Center
111 W. Lugonia
Redlands, CA 92374
I (909) 798-7579
Rialto Senior Center
1411 S. Riverside Avenue
Rialto, CA 92376
(909) 877-9706
San Bernardino 5th St Senior
Center
600 W 5th Street
San Bernardino, CA 92410
(909)-384-5430
San Moritz Lodge
24658 San Moritz Dr
Crestline, CA 92325
(909)-338-5036
Trona Community Senior
Center
13187 Market Street
Trona, CA 93562
(760) 372-5889
Twenty Nine Palms Senior
Twenty Nine Palms, CA
Center
6539 Adobe Road
92277
(760) 367-3891
Victorville Senior Center
14874 Mojave Road
Victorville, CA 92392
(760) 245-5018
Wnghtwood Community
Center
1543 Barbara Street
Wrightwood, CA 92397
(760) 249-3205
Yucaipa Senior Center
12202 First StreetYucaipa,
CA 92399
(909) 797-1177
Yucca Valley Senior Center
57088 29 Palms Highway
Yucca Valley, CA 92284
(760) 228-5453
Page 2 of 2
ATTACHMENT G
Payments, Budgets, Closeout, and Audits
July 1, 2016 through June 30, 2019
FUNDS
A. Expenditure of Funds
1. Contractor shall expend all funds received hereunder in accordance with this
Agreement.
2. Any reimbursement for authorized travel and per diem shall be at rates not to exceed
those amounts paid by the State in accordance with California Department of Human
Resources' rules and regulations. This is not to be construed as limiting Contractor from
paying any differences in costs between the rates specified above and any rates the
Contractor is obligated to pay under other contractual agreements from funds other than
those provided pursuant to this Agreement.
3. No travel outside the State of California shall be reimbursed unless prior written
authorization is obtained from County.
4. Contractor agrees to include these requirements in all contracts it enters into with
subcontractors or vendors to provide services pursuant to this Agreement.
5. County reserves the, right to refuse payment to Contractor or disallow costs for any
expenditure, when determined by the .County to be out of compliance with this
Agreement, unrelated or inappropriate to the contract activities, when adequate
supporting documentation is not presented, or where prior approval was required but
was either not requested or not granted..
B. Accountability for Funds
1. Contractor shall maintain accounting records for funds received under the terms and
conditions of this Agreement. These records shall be separate from those for any other
funds administered by Contractor, and shall be maintained in accordance with Generally
Acceptable Accounting Principles and Procedures, and the Office of Management and
Budget's Uniform Administrative Requirements, Cost Principles, and Audit Requirements
for Federal Awards.
2. Contractor shall promptly forward payroll taxes, insurances and contributions, including
State Disability Insurance, Unemployment Insurance, Old Age Survivors Disability
Insurance, and Federal and State income taxes withheld, to designated governmental
agencies.
3. Adequate source documentation of each transaction shall be maintained relative to the
allow ability of expenditures reimbursed by DAAS under this Contract. If the allow ability
of expenditures cannot be determined because records or documentation of Contractor
are nonexistent or inadequate according to Generally Accepted Accounting Principles
and Procedures, the expenditures may be disallowed by DAAS.
4. Financial Management Systems
Contractor shall meet the following standards for its financial management systems, as
stipulated in 45 CFR Section 92.20 (governmental) or 45 CFR Section 74.21 (not for
profit organizations):
a. Financial Reporting
b. Accounting Records
C. Internal Control
Page 4 of 7
ATTACHMENT G
d. Budgetary Control
e. Allowable Costs
Source Documentation
g. Cash Management
C. Unexpended Funds
Upon termination, cancellation, or expiration of this Agreement, or dissolution -of the entity, the
Contractor shall return to County immediately upon written demand, any funds provided under
this Agreement, which are not payable for goods or services delivered prior to the termination,
cancellation or expiration of this Agreement or dissolution of the entity.
D. Availability of Funds
1. It is understood by the parties that this Agreement may have been written before
ascertaining the availability or appropriation of funds, for the mutual benefit of both
parties, in order to avoid program and fiscal delays that would occur of this Agreement
were executed after that determination was made.
2. This Agreement is valid and enforceable only if sufficient funds are made available to the
County by the United States Government or State of Califomia for the fiscal years
appropriate for the purpose of the services described herein.
3. Funding Reduction(s)
a. If funding for any County fiscal year is reduced or deleted for the purposes of this
program, the County shall have the option to either:
1) Terminate the Agreement
2) Amend the agreement to reflect the reduced funding that will be available.
b. In the event that County elects to offer an amendment, it shall be mutually
understood by -both parties that 1) County reserves the right to determine which
contracts, if any, under this program shallbe reduced; 2) some contracts may be
reduced by a greater amount than others; 3) the County shall determine in its
sole discretion the amount that any or all of the contracts shall be reduced for the
fiscal year.
E. Program Income
1. Program Income must be reported and expended under the same terms and conditions
as the program funds from which it is generated.
2. Program Income must be used to pay for current allowable costs of the program in the
same fiscal year that the income was earned (except as noted below).
-3. Program Income must be spent before contract funds and may reduce the amount of
contract funds payable to Contractor.
4. If Program Income is earned in excess of the amount reported by County in the
Contractor's approved budget, the excess amount may be deferred for use in the first
quarter of the following contract period, which is the last quarter of the federal fiscal year,
if approved by County.
6. If Program income is deferred for use it must be used by the last day of the federal fiscal
year and reported when used.
6. Program Income may not be used to meet any requirements for matching contributions
specified in this Agreement.
Page 2 of 7
ATTACHMENT G
7. . Program Income must be used to expand baseline services.
F, One Time Only (OTO) Funds:
OTO funds shall be only be used for the following purposes:
1. The purchase of equipment that enhances the delivery of services to the eligible service
population. Home and. community-based projects that are approved by County in
advance.
2. Innovative pilot projects that are approved in advance by County, and are designed for
the development of a comprehensive and coordinated system of care as defined in (45
CFR 1321.53(a) & (b).
3. OTO funds may be used to maintain or increase baseline services; however, it is
understood by the parties that such use of OTO funds creates no expectation of service
delivery beyond the current contract period.
G. Matching Contributions
1. Cash and/or in-kind contributions may be counted as match if such contributions are
used to meet program requirements.
2. Matching contributions (cash or in-kind) must be verifiable from the records of the
Contractor or its subcontractors. Only allowable costs as established by Office of
Management and Budget (OMB) cost principles may be reported as matching
contributions.
3. Services of volunteers or other costs reported as "in-kind" matching contributions shall
be valued at rates consistent with those of similar work or services paid by Contractor, If
Contractor -does not offer similar work or purchase similar services, rates shall be
consistent with those in local market area.
H. Budget and Budget Revision
1. Contractor shall be compensated for expenses only as itemized in the approved budget
that is incorporated by reference into this Agreement. The Contractor shall not be
entitled to payment for expenses related to this Agreement until the budget has been
reviewed and approved by the County.
2. No budget revision may result in an increase of the maximum dollar amount stated in
Section V, Paragraph A. The written request must specify the line item or Service
Category changes requested, and must includejustification for the requested changes.
For the purposes of this section,
a. "Service Category" shall be defined as that classification of activities defined in
the Older Americans Act (OAA) that is specific to each OAA funded grant
program; and
b. "Service" shall be defined as the activities that are defined within a Service
Category.
Examples of Service Categories include Supportive Services, Congregate and Home -
delivered Nutrition Services, Disease Prevention/Health Promotion Services, and Family
Caregiver- or Grandparent Support Services. Examples of services include nutrition
education, transportation, information assistance, senior center staffing, respite care,
access assistance, and supplemental- services.
County shall notify the Contractor in writing of the status of the budget revision request
within fourteen (14) calendar days of receipt of the Contractor's written request. The
Page 3 of 7
ATTACHMENT G
County reserves the right to deny the Contractor's invoice for expenditures in excess of
the approved budgeted line item amount.
3. Contractor shall submit a budget revision to the County, in advance of expenditures when:
a. Changes to line item expenditures are expected to exceed the amount of the approved
budgeted line item by more than ten (10%) of the amount specified in Section V,
Paragraph A.
b. New budget line items are to be added.
C. When the changes being requested involve the transfer of funds between Service
Category.
d. When otherwise requested by the County.
4. Contractor shall maintain a written record of all budget changes including line item or service
category changes. This record shall be available to the Department upon request and shall be
maintained in the same manner as all other financial records.
5. The final date to submit to a budget revision is March 30 of the contract period unless otherwise
specified by the County.
I. Indirect Costs
1. Indirect costs are those that have been incurred for common or joint objectives and
cannot be readily identified with a particular final cost objective. After direct costs have
been determined and assigned directly to awards or other work as appropriate, indirect
costs are those remaining to be allocated to benefiting cost objectives. A cost may not
be allocated to an award as an indirect cost if any other cost incurred for the same
purpose, in like circumstances, has been assigned to an award as a direct cost.
2. Examples of indirect cost may include depreciation or use allowances on buildings and
equipment, the costs of operating and maintaining facilities, and general administration
and general expenses, such as the salaries and expenses of executive officers,
personnel administration, and accounting.
3. The maximum reimbursement amount allowable for indirect costs is -ten (10) percent of
Contractor's direct costs, excluding in-kind contributions and non -expendable
equipment. Indirect costs exceeding the ten (10) percent maximum may be budgeted as
cash match and be used to meet the minimum matching contribution requirements.
4. Contractor agrees to include the above requirement in all contracts it enters into with
subcontractors or vendors to provide services pursuant to this agreement.
5. Reimbursement for indirect costs shall be .on the basis of an indirect cost rate plan
documenting the methodology used to determine the indirect cost rate, which shall be
submitted by Contractor to the Federal government for approval. After Federal approval
the plan will submitted to DAAS and be approved by DAAS.
J. Financial Closeout
1. Contractor shall submit a final statement of expenditures and income ("Financial
Closeout") to. County within thirty days of the end of contract period, unless otherwise
specified by County.
Federal funds otherwise payable to Contractor by County may be reduced
proportionately .by County to maintain the required matching contributions ratio if amount
of matching contributions reported by Contractor is less than minimum required
matching contribution amount specified in Section V, Paragraph A, Fiscal Provisions of
this Contract .
Page 4 of 7
ATTACHMENT G
K. Subcontracts or Vendor Agreements
1. Without the prior written consent of the Director of DAAS or his/her designee through the
HS Contracts Unit, this Contract is not assignable by Contractor either in whole or in
part.
2. Contractor agrees not to enter into any subcontracts for work contemplated under this
Contract without first obtaining written approval from the Director of DAAS or his/her
designee. Any subcontractor shall be subject to the same provisions as Contractor,
Contractor shall be fully responsible for the performance of any subcontractor.
3. Contractor shall include language in all subcontracts that require subcontractor to
comply with all applicable State and Federal Laws.
4. Contractor shall have no authority to contract'for, on behalf of, or incur obligations on
behalf of County or State.
5. Copies of subcontracts, vendor agreements, Memoranda, and/or Letters of
Understanding shall be on file with the. Contractor and shall be made available to DAAS
upon request.
6. Contractor shall monitor the insurance requirements of its subcontractors and/or
vendors.
7. Contractor shall ensure that the subcontractor and/or vendor will complete all reporting
and expenditure documents requested by DAAS. These reporting and expenditure
documents shall be sent to Contractor in a timely manner and at intervals as determined
by DAAS. - ,
8. Contractor shall monitor the budget, expenditures, and performance of it subcontractors
and/or vendors.
9. Contractors shall provide support and technical assistance to subcontractors and
respond in writing to all written request for direction, guidance, and interpretation of
instructions to include client and service data.
L. Audits
1. Contractors that expend $750,000 or more in Federal awards shall arrange for an audit
to be performed as required by the' Single Audit Act of 1984, Public Law 98-502, Single
Audit Act Amendments of 1996, Public Law 104-156, and Office of Management and
Budget [2 CFR Part 200, Subpart F Audit Requirements] [formerly OMB Circular A-133].
2. A copy of audit report shall be submitted to DAAS within 30 days after receipt of the
auditor's report or nine months after the audit period, whichever occurs first, unless a
longer period is agreed to in advance by the recognized or oversight federal agency.
3. Contractor shall ensure that State -funded expenditures are dispiayed discretely along
with the related federal expenditures in the single audit report's "Schedule of
Expenditures of Federal Awards" (SEFA) under the appropriate Catalog of Federal
Domestic Assistance (CFDA) number as referenced herein. In addition, should
contractor's SEFA totals be reported on the -basis of a fiscal year period other than
County's fiscal year (July 1 through June 30), a supplemental schedule shall be provided
that reconciles Contractor's reported expenditures to County fiscal year periods.
4. For state contracts that do not have CFDA numbers, Contractor shall ensure that State -
funded expenditures are discretely identified in the SEFA by the appropriate program
name, identifying grant/contract number and as passed through the Califomia
Department of Aging.
Page 5 of 7
ATTACHMENT G
5. The following closely related programs identified by CFDA number are to be considered
as an Other Cluster" for purposes of determining major programs or whether a program
specific audit may be elected. Contractor shall identify the CFDA titles and numbers to
the independent auditor conducting the organization's single audit as well to each of
Contractor's sub -recipients.
6. The Federal Grantor for the following programs is the U.S Department of Health and
Human Services, Administration on Aging:
93.044 Special Programs for the Aging - Title 111, Part B = Grants for Supportive
Services and Senior Centers Title III -B).
93.045 Special Programs for the Aging - Title 11.1, Part C - Nutrition Services (Title
111-C
93.052 National Family Caregiver Support - Title III, Part E
93.053 Nutrition Services Incentive Program (NSIP)
7. The Federal Grantor for the following program is the U.S Centers for Medicare and
Medicaid Services:
93.779 State Health Insurance Assistance Program (HICAP}
93.071 MIPPA: MSP, LIS & Prescription Drug Enrollment Assistance through the
Aging Network, SHIP, and ADRCs
9_3.626 SHIP Options Counselin for Medicare/Medicaid (FA)
8. The Federal Grantor.for the following program is the Administration, for Community
Living grants:
L93.071 I MIPPA: Priori!Area 2 AAAs
9. Cluster of programs means a grouping of closely -related programs that share common
compliance requirements. The types of clusters of programs are research and
development (R&D), student financial aid (SFA) and other clusters. "Other Clusters" are
defined by the OMB in the Compliance Supplement or as designated by a State for
federal awards provided to its sub recipients that meet the definition of cluster of
programs. When designating an "other cluster', a State shall identify the federal awards
included in the cluster and advise the sub -recipients of compliance requirements
applicable to the cluster, consistent with S.400 (d) (1) and S.400 (d) (2), respectively. A
cluster of programs shall be considered as one program for determining major programs,
as described in S.520, and with the exception of R&D as described in S.200 (c), whether
a program -specific audit may be elected. (Federal Office of Management and Budget,
(OMB) Circular A-133, Audits of States, Local Governments, and Non -Profit
Corporations),
10. Contractor shall perform a reconciliation of its "Financial Closeout Report" to the audited
financial statements. The reconciliation shall be maintained and be made available to
DAAS for review.
11. Contractor shall ensure that subcontractor single audit reports for Contractor meet [2
CFR Part 200, Subpart F Audit Requirements] [formerly OMB Circular A-1331
requirements, including, but not limited to:
a. Performed timely - Not less frequently than annually and a report submitted
timely. The audit is required to be submitted within 30 days after receipt of the
auditor's report or nine months after the end of the audit period, -whichever
occurs first.
b. Properly procured - Use procurement standards provided for in OMB Circular A-
133 and provide maximum opportunities to small and minority audit firms.
Page 6 of 7
ATTACHMENT G
C Performed in accordance with Generally Accepted Government Auditing
Standards -- Shall be performed by an independent auditor and be organization -
wide
d. All inclusive — Includes an opinion (or disclaimer of opinion) of the financial
statements; a report on intemal control related to the financial statements and
major programs; .an opinion (or disclaimer of opinion) on compliance with laws,
regulations, and the provisions of contracts or grant agreements; and the
schedule of findings and questioned costs.
e. Performed in accordance with provisions applicable to this program as identified
in [2 CFR Part 200, Subpart F Audit Requirements] [formerly OMB Circular A-133
Compliance Supplement].
12. Requirements identified in the provision above shall be included by Contractor in all
subcontracts.
13.. Contractor shall include in its contract with the independent auditor that the auditor will
comply with all applicable requirements/standards, that the County shall have -access to
all audit reports and supporting work papers, and that the County shall have the option
to perform additional work if needed.
14. Unless prohibited by law, the cost of audits completed in accordance with provisions of
the Single Audit Act Amendments of 1996 is allowable charges -to Federal awards.
Contractor may not charge to Federal awards the cost of any audit under the Single
Audit Act Amendments of 1996 not conducted in accordance with the Act. Contractor
may not charge to Federal Awards the. cost of auditing a non-federal entity which has
Federal Awards expended of less than $500,000 per year, and is thereby exempted
under OMB Circular A-133, Subsection _..200 (d).
15. Contractor shall cooperate with and participate in any additional audits which may be
required by State or County.
Page 7 of 7
ATTACHMENT H
COUNTY_ OF SAN BERNARDINO NUTRITION SERVICES
PROGRAM BUDGET
PROGRAM BU13GET C-1 2016-17
Contractor: City of San Bernardino Period: 7/1/16-MO117 Original Fx � Armand
HOME DELIVERED
CONGREGATE SITES C-1 IX -1 MEALS C-2 TOTAL # OF MEALS 55,833_
Section 1: Prepare this section based on annual estimated cast to serve the meals # of Days Served 252
Match Requirement: $25,569.11
A
B
C A+B
Cost to Contractor for the Year
Expenditure Category:
Cash
Program Income & In-kind
Total
1
Personnel
-- -
2
Staff Travel & Training
3
E uipment
4
Non-Inventoriable E ui ment
I
5
Consultants
_
--
6
Catered Food
7
Raw Food
8
OtherExpenses:
a I Consumable SWpjies.
b Insurance
--
c R2pair & Maintenance
d RentlBuilding Space
f I Vehicle Operations
Miscellaneous
-
_
9 Indirect Cost
Total Expenditures add lines 1-10)
Revenue Sources:
DAAS
Program Income & In-kind
Total
State Funds
$41,607
_.
$41 607
Federal Funds
$230,145
v 1
$230145
$63,248
NSIP $63,248
.State Sp ecial Nutrition Funds
-
Coun Funds
`°
Program Income
t
Deferred Income
Maitchinq Cash
-
Matchirr In -Kind
Non -Match Cash
r..' �� F•
--
Non-Match In -Kind
7nfnl QAVanim
$335,000
_
$335,000
Submitted by:
Mitch Assumma
SigSigna re
DAAS Approval: Date:
May 9, 2016
Date
Page 1 of 3
'
ATTACHMENT H
COUNTY OF SAN BERNARDINO NUTRITION SERVICES
PROGRAM BUDGET
PROGRAM BUDGET C-12017-18
Amen!55,
Contractor: City of San Bernardino
Period: 7/1/17-6/30/18 Original
CONGREGATE SITES C-1 7 .
HOME DELIVERED MEALS C-2 El TOTAL 4 OF MEALS 833
Section 1: Prepare this section based on annual estimated cost to serve the meals ## of Days Served 252
MatchL
Requirement: $25,569.11
A B C=A+B
Cast to Contractor for the Year
Expenditure Category:
Cash Program Income & In-kind Total
1 Personnel
2
Staff Travel & Training
-.
3
Equi meet
-
4
Non-Inventoriable Equipment
5
Consultants
6 Catered Food
7 Raw Food
_-
8 Other Expenses:
a Consumable Supplies
-
b Insurance
c Repair & Maintenance
d Rent/Building Space
e Vehicle Operations
f Miscellaneous
-
9 1 Indirect Cost
Total Expenditures (add lines 1-10)
Revenue Sources
OAAS Program Income & In-kind Total
State Funds
$41,607 $41,$07
Federal Funds
$230145 $230,145
-NSIP
$63,248
State Special Nutrition Funds'
_$_63,2_48
CountyFunds
Program Income
Deferred Income
Matching Cash
-
Matching In -Kind
r
Non -Match Cash
Non -Match In -Kind
Total Revenue
$335,000 $335,000
Submitted by:
DAAS Approval: Date:
Mitch Assumma--
_
Ma
Signa ure
Date
Page 2 of 3
ATTACHMENT H
COUNTY OF SAN BERNARDINO NUTRITION SERVICES
PROGRAM BUDGET
PROGRAM BUDGET C-12018-19
Contractor: City of San Bernardino Period: 7/1118-6/30/19 Original
CONGREGATE SITES C-1 x❑ HOME DELIVERED MEALS C-2 D TOTAL # OF MEALS
Section 1: Prepare this section based on annual estimated cost to serve the meals # of Days Servet
Match
Requirement: $25,569.11 A B
Cost to Contractor for the Year
Cash Program Income & In-kind
H1Personnel
2 Staff Travel & Trainin
3 Equipment
4 Consultants
-5 Catered Food
6 Raw Food
7 Other Expenses:
a Consumable Suppiles
b Insurance
c Repair & Maintenance
d Rent/Building Space
e Vehicle Operations
f Miscellaneous
8 Indirect Cost
Tntal Fxnenditures (add lines 1-10)
Amend
55,833
1 252
C=A+B
Total
Submitted by: DAAS Approval:
Mitch A55umma
May 9, 2016
Date
Signa ure
Page 3 of 3
ATTACHMENT
COUNTY OF SAN BERNARDINO NUTRITION SERVICES
Matching Funds Narrative
Contractor: City of San Bernardino. Fiscal Year: 07101116-06130117 ORIG X Amend _
CONGREGATE SITES C-1 HOME DELIVERED MEALS C-2 Q
Provide justification, rates, comments, descriptions, etc. for the required 11.11 % of the total proposed
contract amount in matching funds whether in cash or in-kind. Matching funds may not be fees for
services, client donations or program income as defined by 45 CFR 74.41 match.
CONGREGATE MEALS C4
Line Item
Personnel
Raw Food
Annual
_$45,279 Senior volunteers are used at the r Street, Perris Hill and
Highland Senior Centers that help with the preparation and
I serving of the Senior Nutrition meal. The $10.00 rate is the
wage only paid to City Kitchen Helpers (an additional 7.5%
includes' benefits). (ApproAmately 39 hours per month aO
$10.00 = $390 X 9 employees = $3,510 X 12 months =
$42,120. plus $3,159 in benefits]. Note: State Minimum
Wa a increases are reflected In the totals.
Approxitely Through annual purchase.orders with primary food vendors
ma .
$10,000 for bulk purchasing, the City receives various discounts that
allow them to purchase more food (and consumables).
Being long-time providers, these vendors also provide food
for meals for special occasions at no cost as a donation.
There are between 250-350 different seniors in daily
attendance in our Senior Nutrition Program. Also, the
Christmas dinner is donated a non-profit agency. The listed
amount of $10,000 is a conservative estimate of the
donations, discounts, and specials given throughout the
year.
$63;567 The City of San Bemardinds utility bill for January through I
December 2015 for the 51i Street Senior Center, Perris Hill
Senior Center, Lytle Creek Community Center, and
Hernandez Community Center were used as the
benchmark for this in-kind contribution. The electric, gas
and domestic water use bills were totaled by meal site. Two
multipliers were developed for each site: one considered
the amount of building square footage for the facilities
amenities specifically obligated to the Senior Nutrition
Program (kitchen, dining room, restrooms, common areas,
office, etc.), as a percentage of the total building square
footage and the second was established as a percentage
of time for the Program preparation, meal serving, and
cleanup in comparison to each meal site total operating
time. The utilities In-kind contributions for both the New
Hope Family Life Center (Enterprise), and Highland Senior
Center sites were inferred from site City sites at
approximately $9,600 per site. (This does not include in-
kind match for custodial services and building
maintenance!. _..._—..
Page 1 of 3
ATTACHMENT I
COUNTY OF SAN BERNARDINO NUTRITION SERVICES
Matching Funds Narrative
Contractor: City of San Bernardino` 07/01117-06/30/1$ ORIG X_ Amend _
CONGREGATE SITES C-1 0 HOME DELIVERED MEALS C-2 D
Provide justification, rates, comments, descriptions, etc. for the required 11.11 % of the total proposed
contract amount in matching funds whether in cash or in-kind. Matching funds may not be fees for
services, client donations or program income as defined by 45 CFR 74.41 match.
CONGREGATE MEALS C-1 _
Line Item j Annual Amount Description/Justification. J
_... _.. — ... -- - -- - ——
Personnel $45,279 Senior volunteers are used at the 5 ` Street, Perris Hill and
Highland Senior Centers that help with the preparation and
serving of the Senior Nutrition meal. The $10.00 rate is the
wage only paid to City Kitchen Helpers (an additional 7.5%
includes benefits). [Approximately 39 hours per month
$10.00 = $390 X 9 employees = $3,510 X 12 months = I
$42,120 plus $3,159 in benefits]. Note: State Minimum
Wa a increases are reflected in the totals.
...._.... -- - - -
Approximately Through annual purchase orders with primary food vendors
$10.000 for bulk purchasing, the City receives various discounts that
allow them to purchase more food (and consumables).
Being long-time providers, these vendors also provide food
for meals for special occasions at no cost as a donation.
There are between 250-350 different seniors In daily
attendance in our Senior Nutrition Program. Also, the)
Christmas dinner is donated a non-profit agency. The listed j
amount of $10,000 is a conservative estimate of the !
donations, discounts, and specials given throughout the
Raw Food
The City of San Bernardino's utility bill for January through .
December 2015 for the 5"' Street Senior Center, Perris Hill
Senior Center, Lytle Creek Community Center, and
Hernandez Community Center were used as the
benchmark for this in-kind contribution_ The electric, gas
and domestic water use bills were totaled by meal site. Two
multipliers were developed for each site: one considered
the amount of building square footage -for the facilities
amenities specifically obligated to the Senior Nutrition
Program (kitchen, dining room, restrooms, common areas,
office, etc.), as a percentage of the total building square
footage and.the second was established as a percentage
of time for the Program preparation, meal serving, and
cleanup in comparison to each meal site total operating
time. The utilities in-kind contributions for both the New
Hope Family Life Center (Enterprise), and Highland Senior
Center sites were inferred from site City sites at
approximately $9,600 per site. (This does not include in-
kind match for custodial services and building
malntenanceL_- -. ..............
Page 2 of 3
COUNTY OF SAN BERNARDINO NUTRITION SERVICES
Matching Funds Narrative
Contractor: City of San Bernardino Fiscal Year. 07101118-06130119 ORIG X Amend
CONGREGATE SITES C-1 0
HOME DELIVERED MEALS C-2 Q
ATTACHMENT
Provide justification, rates, comments, descriptions, etc. for the required 11.11% of the total proposed
contract amount in matching funds whether in cash or in-kind. Matching funds may not be fees for
services, client donations or program income as defined by 45 CFR 74.41 match.
CONGREGATE MEALS
C-1
_ -
Line Item
—
Annual
Description/Justification
Amount
Personnel
$45,279
Senior volunteers are used at the 5 Street, Perris Hill and
Highland Senior Centers that help with the preparation and
serving of the Senior Nutrition meal. The $10.00 rate is the
wage only paid to City Kitchen Helpers (an additional 7.5%
includes benefits). [Approximately 39 hours per month (�
$10.00 = $390 X 9 employees = $3,510 X 12 months =
j $42,120 plus $3,159 in benefits). Note: State Minimum
W e increases are reflected in the totals.
Raw Food
Approximately Through annual purchase orders with primary food vendors
$10,004for bulk purchasing, the City receives various discounts that
allow them to purchase- more food (and consumables).
Being long-time providers, these vendors also provide food
for meals for spectral occasions at no cost as a donation.
There are between 250-350 different seniors in daily
attendance . in our Senior Nutrition Program. Also, the
h ' t d'nner is donated a non-profit agency. The listed
C ns mos i
amount of $10,000 is a conservative estimate of the
donations, discounts, -and specials given throughout the I
ear.
.The City of San.Bemard{no's utility bill for January through
December 2015 for the a Street Senior Center, Perris Hill
Senior .Center, Lytle Creek Community Center, and
Hernandez Community Center were used as the
benchmark for this in-kind contribution. The electric, gas
and domestic water use bills were totaled by meal site. Two
multipliers were developed for each site: one considered
the amount of building square footage for the facilities
amenities. specifically obligated to the Senior Nutrition
Program (kitchen, dining room, restrooms, common areas,
office, etc.)', as a percentage of the total building square
footage and the second was established as a percentage
of time for the Program preparation, meal serving, and
cleanup in comparison to each meal site total operating
time. The utilities in-kind contributions for both the New
Hope Family Life Center (Enterprise), and Highland Senior
Center sites were inferred .from site City sites at
approximately $9,600 per site. (This does not include in-
kind match for custodial services and building
maintenance).
Page 3 of 3
ATTACRMMT J
MONTHLY EXPENDITURE REPORT
(Due 10th working day of the following month) FY x016-2017
COUNTY OF SAN
BERNARDINO
DEPARTMENT_ OF AGING & ADULT
SERVICES
1.
2.
3.
4.
5.
6.
7
8.
9-
10
11
12
13
14
15
16
CONTRACTOR NAME AND ADDRESS:
CFDA #: Month: L.
MONTHLY NUTRITION PROGRAM EXPENDITURE REPORTIREQUEST FOR REIMBURSEMENT
(due on the 10th working day -of the following month)
HOME DELIVERED
CONGREGATE SITES C 1 ❑ MEALS C 2 Lj
# of meals served
A + B = C_
EXPENDITURES: COST TO CONTRACTOR TOTAL MONTHLY
CASH r IN-KIND EXPENSE
Personnel $ - $ $ -
St ff T I nd Trainin $ - $
r
a rave a _t _ —_
Equipment (including One -Time -Only
purchases)_
$
_
_Consultants
Catered Food
$
Raw Food _
$
_
- Other Expenses
a. Consumable Sup lies
$
b. Insurance
$
c. Repair & Maintenance
$
d. Rent/Building Spa_ ce
$
�e.- Utilities $
f. Vehicle O Orations $
g. Miscellaneous
$
Indirect Costs
$
Total Ex enditures add fines 1-S
$
DEDUCTIONS FROM EXPENDITURES:
Program Income (income- not from
DAAS _ ,
$
Deferred Income
$
Matching Cash
$
Matching In -Kind
HIM
Non -Match Cash
$
Non -Match In -Kind
Total Deductions add lines 10-15
REQUEST FOR
'
REIMBURSEMENT
"if.r_,
line 9 less line 16)
Page 1 of 2
d
Approved by•
A,TTACHMINT J
Date
Page 2 of 2
Repayment of Advance 10% of advance if -paid)
$
NSIP
NSIP OTO
Federal Funds
Federal OTO Baseline
Federal OTO Equipment
State Funds
State OTO
CDBG
County Funds
Re a ment of funds from rior enod s ecif :
Other
funding
source
(specify),
TOTAL REIMBURSEMENT
$
Date
Page 2 of 2
A`CTACHMENT N
SAN BERNARDINO COUNTY
DEPARTMENT OF AGING AND ADULT SERVICES
REQUEST TO PURCHASE PROPERTY/EQUIPMENT
This form is to be completed whenever a contractor is requesting to purchase property or equipment under
a California Department of Aging (CDA) grant. Contractor must obtain a minimum of three (3) bids and
attach a Property/Equipment Bid Form for each item requested.
Date:
FY:
Contractor Name: _
Address: Contact: ! Phone No:
Item(s) Requested (attach_ additional sheet if required):
DESCRIPTION ti AMOUNT FUNDING
SOURCE
Explain how requested item(s)-will be used to carry out the objectives related to the funding to be
received (attach additional sheet if required):
Administrative: 006_ Orilk
Revised 10/25/11
Page 1 of 2
ATTACHMENT K
SAN BERNARDINO COUNTY
DEPARTMENT OF AGING AND ADULT SERVICES
PROPERTY/EQUIPMENT BID FORM
Fund Source:
Contractor Name:
Address:
Item Description:
Date of Bid:
Date of Bid:
Vendor: Vendor: — —
Contact Contact
Phone: Phone:
i
Cost per unit:
Number of units:
Total Cost:
I Comments:
Cost per unit:
Number of units:
Total Cost:
Comments:
Contact:
Phone:
-........——
Date of Bid:
- -�-- --j Vendor:
{
Contact
Phone:
Cost per unit:
Number of units:
Total Cost:
Comments:
Page 2 of 2'
ATTACHMENT L
DEPARTMENT OF AGING
CONTRACTORIVENDOR CONFIDENTIALrry STATEMENT
CDA 1024 (REV 1107)
CERTIFICATION
I hereby certify that I have reviewed this Confidentiality Statement and will comply with the.following Statements.
NUMBER:
City of San Bernardino
AUTHORIZED SIGNATURE: PRINTED NAME AND TITLE OF PERSON SIGNING: Mark Sc
In compliance with Government Code" i 1019.9; Civil Code 1798 Et. Seq., Management Memo 0642 and Budget V ' ty
Letter 06-34 the California Department of Aging (CDA) hereby requires the ContractorNendor to certify that: Mgr
• confidential information shall be protected from disclosure in accordance with all applicable laws, regulations
and policies.
• all access codes which allow access to confidential Information will be properly safeguarded.
• activities by any individual or entity that is suspected of compromising confidential information will be reported
to CDA by completing a Security Incident Report, CDA 1025.
• any wrongful access, inspection; use, or disclosure of confidential information is a crime and is prohibited
under State and federal laws, Including but not limited to California Penal Code Section 502; California
Government Code Section 15619, California Civil Code Section 1798.53 and 1798.55, and Health insurance
Portability and Accountability Act.
• any wrongful access, inspection, use, disclosure, or modification of confidential information may result in
termination of this Contract/Agreement.
• obligations to protect confidential information obtained under this .Contract/Agreement will continue after
termination of the Contract/Agreement with CDA.
• all employees/subcontractors of the ContractorNendor will complete the required Security Awareness
Training module located at www,.aging.ca.00v, within 30 days of the start date of this Contract/Agreement. or [
within 30 days of the start date of any new -employee or subcontractor. Contractor/Vendor may substitute
CDA's Security Awareness Training program with its Security Training provided such training meets or
exceeds CDA's training requirement.
• all employees/subcontractors of the ContractorNendor will be notified of CDA's confidentiality and data
security requirements.
CDA or its designee will be granted access -by the Contractor or Vendor to any computer-based confidential
information within the scope of the Contract.
I agree to protect the following types of confidential information which include but not limited to:
Social Security number
Medical information
Claimant and employer information
Driver License information
Information about individuals that' relate to their personal life or identifies or describes an individual
Other agencies' confidential and proprietary information
Criteria used for initiating audit selection
Methods agencies use to safeguard their information (computer systems, networks, server
configurations, etc.)
Any other information that is considered proprietary, a•copyright or otherwise protected. by law or
contract.
1 agree to protect confidential information by:
Accessing, inspecting, using, disclosing or modifying information only for the purpose of performing
official duties
Never accessing, inspecting, using, disclosing, or modifying information for curiosity, personal gain,
or any non -business related'reason
Securing confidential information in approved locations
Never removine confidential information from the work site without authorization.
Page 1 of 1
_1 N
CALIFORNIA DEPARTMENT OF AGING (CDA)
SECURITY INCIDENT REPORT
CDA 1025 (New........__ -
1. AGENCY/CONTRACTOR NAME:
3. AGENCY/CONTRACTOR ADDRESS:
ATTACHMENT M
2. AGENCY/CONTRACTOR INFORMATION SECURITY OFFICERS
NAME:
14.- AGENCY/CONTRACTOR TELEPHONE
5. 1 DATEITIME OF 6. DATE INCIDENT 7. INCIDENT REPORTED=
INCIDENT: DETECTED: ❑ CALIFORNIA DEPARTMENT OF AGING ❑ DISTRICT
ATTORNEY
El UNKNOWN ❑ CA HWY PATROL E]ATTORNEY GENERALE]
r] UNKNOWN OTHER:
8. INCIDENT LOCATION:
9. DESCRIPTION OF INCIDENT:
10. MEDIA DEVICE TYPE, IF APPLICABLE:) 11. WAS THE PORTABLE STORAGE DEVICE
ENCRYPTED?
Cl YES EINO ❑ UNKNOWN --
12. IF NO, EXPLAIN:
13. DESCRIBE THE COSTS ASSOCIATED WITH RESOLVING THIS INCIDENT. INCIDENT $ ESTIMATED COST OF
EN
15. TYPE OF PERSONALLY IDENTIFIABLE INFORMATION (CHECK ALL THAT APPLY):
❑ NO PERSONAL INFORMATION ❑ SOCIAL SECURITY NUMBER ❑ HEALTH OR MEDICAL INFORMATION ❑
FINANCIAL ACCOUNT NUMBER
❑ NAME ❑ DRIVER'S LICENSE/STATE ID NUMBER ❑ OTHEISPECIFY)
16. IS A PRIVACY DISCLOSURE NOTICE 17. NUMBER OF1$. DATE NOTIFICATION(S) MADE TO
REQUIRED? INDIVIDUALS THE INDIVIDUAL:
❑ YES ❑ No AFFECTED:
"IF A PRIVACY DISCLOSURE NOTICE 1S
REQUIRED, ATTACH A SAMPLE OF THE
NOTIFICATION.' - - -
19. HAVE THOSE RESPONSIBLE FOR THE INCIDENT BEEN IDENTIFIED?
�
_ ❑ YES []NO
COMMENT: 20. CORRECTIVE ACTIONS TAKEN TO PREVENT FUTURE OCCURRENCES:
21. ESTIMATED COST OF CORRECTIVE 22. DATE CORRECTIVE ACTIONS WILL BE FULLY IMPLEMENTED:
ACTIONS:
SIGNATURES DATE:
23. PRINT -AGENCY/CONTRACTOR INFORMATION SIGNATURE:
SECURITY OFFICER:
__..._-...... - _ DATE:
24. PRINT - AGENCYICONTRACTOR PRIVACY OFFICER: SIGNATURE:
25. PRINT -AUTHORIZED SIGNATURE/DIRECTOR: SIGNATURE:
DATE:
Page 1 of 3
ATTACHMENI M..
DEPARTMENT OF AGiNG
SECURITY INCIDENT REPORT
INSTRUCTIONS
The following instructions will assist in completing the farm: All questions must be completed, even
when the response is a future action.
1. Agency/Contractor Name - Provide your agency, contractor, vendor, department, board,
bureau or commission's full name.
2. Agency/Contractor Information Security Officers Name - Provide your agency's' Information
Security Officer's Name.
3. Agency/Contractor Address - Provide your agency/contractor's address.
4. Telephone - Provide your agency/contractor's telephone number.
5. Daten'ime of incident - Provide the date/time when the incident occurred. If unknown, select
the "Unknown" checkbox.
6. Date Incident Detected - Provide the date the incident was discovered.
Incident Reported To - Select the appropriate checkbox. If applicable, select the other checkbox
and describe to whom the incident was reported.
S. Incident Location - Provide the location where the incident occurred. For example, If a laptop
was stolen from an employee's home, suggested content is "Employee's Home, Roseville,
CA'; or if the Incident occurred at the agency's headquarters office, suggested content Is
"Agency's Headquarters, 123 Any Street, Sacramento, CA."
9. Description of incident - include the following in the description:
• When the incident occurred and how it was discovered.
• The effect of the incident on the business and infrastructure of your agency.
• The number of people (inside your agency and outside your agency) affected by this
Incident.
The effects, if any, of this incident on people, businesses or services outside of your
agency.
The details of any law enforcement investigation of this incident, such as which agency
investigated It, when, and the report number.
Any personal, confidential, or sensitive information involved/disclosed.
10. Media Device Type, If Applicable - Provide the type of media or device involved In the incident,
such as paper (fax, mail, etc.) or electronic (CD, floppy drive, laptop, PDA, email, etc.).
11. Was the Portable Storage Device Encrypted? - Check the appropriate box.
12. if NO, Explain - Describe why the storage device was not encrypted.
13. Describe the Costs Associated with Resolving this Incident - Provide a cost estimate of resolving
the incident. Cost should include everything necessary to resolve the incident, including
hardware, software, staff time, contracting services, and any other pertinent costs that were
triggered due to the incident. The estimate should also include costs associated with a
disclosure notification (such as preparations, postage, call center activation, etc.).
14. Total Estimated Cost of Incident - Provide the total cost associated with handling the incident
as it relates only to information technology. For example, if a state vehicle was stolen with a
state -issued laptop in it, do not include the cost of the state vehicle.
15. Type of Personally Identifiable Information - If applicable, check the appropriate type(s) of
personally identifiable information that applies in this incident.
Page 2 of 3
ATTACHMENT M
16. Is a Privacy Disclosure Notice Required? - Check appropriate box. Sample — If yes, attach a
sample copy of the notification sent to the affected individuals. DO NOT provide a sample
that includes personally identifiable information.
17. Number of Individuals Affected - Identify the number of individuals whose personally
Identifiable Information was breached/disclosed.
18. Date Notification(s) Made to the Individual - Provide the date that the Notification was made to
the affected Individuals.
18. Have Those Responsible for the Incident Been Identified? - Check the appropriate box. If
applicable, add comment.
20. Corrective'Actions Taken To Prevent Future Occurrences - Provide a detailed description of the
corrective actions taken by the agency to prevent future occurrences of a similar incident
occurring again.
21. Estimated Cost of Corrective Actions - Provide cost estimations to implement the corrective
actions. For example, hardware and/or software may need to be upgraded, installed or
purchased; new policies may need to be developed; additional training may need to be given.
Include all related costs, such as stiff time, contracting services, and hardware or software
purchases.
22. Date Corrective Actions Will Be Fully Implemented - Provide a date when the corrective actions
were, or will be, fully implemented.
23. Print—Agency/Contractor Information Security Officer
24. Print — Agency/Contractor Privacy Officer - This is required only in those instances where
personally Identifiable information is involved. If personally Identifiable information is
Involved and no disclosure notice is required, the Privacy Officer's signature is still required.
25. Print—Authorized Sig nature/Director
Page 3 of 3