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Home My WebLink About8.1 City of Dublin Fiscal Year 2024-25 Human Services Grant Program Funding Recommendationsr DUBLIN CALIFORNIA STAFF REPORT CITY COUNCIL DATE: May 7, 2024 TO: Honorable Mayor and City Councilmembers FROM: Linda Smith, City Manager Agenda Item 8.1 SU B.ECT: City of Dublin Fiscal Year 2024-25 Human Services Grant Program Funding Recommendations Prepared by: Brad Olson, Management Analyst 11 EXECUTIVE SUMMARY: The City Council will consider the funding recommendation for the Human Services Grant Program and approve a funding allocation for Fiscal Year 2024-25. STAFF RECOMMENDATION: Adopt the Resolution Approving Funding Recommendations for the Fiscal Year 2024-25 Human Services Grant Program. FINANCIAL IMPACT: The City's Human Services Grant Program is currently supported by four funding sources - the General Fund, the Affordable Housing Fund, the Community Development Block Grant (CDBG) Program, and the American Rescue Plan Act (ARPA). Each qualifying program/project is eligible for a minimum award of $3,500 and a maximum award of $25,000. Attachment 2 shows the Human Services Grant Program funding by source. DESCRIPTION: The Human Services Grant Program provides financial support to local non-profit organizations serving the Dublin community. Each year, the City Council awards funding to organizations that best meet the community's needs in support of the City's adopted Mission and Vision (Attachment 4) and needs identified in the Tri-Valley Needs Assessment (Attachment 5). Organizations can submit multiple programs/projects for consideration, but a separate application is due for each program/project. Fiscal Year 2024-25 marks the 20th year of Dublin's Human Services Grant Program. The recent allocation history is shown in the table below. Prior to the availability of ARPA funds, the City's General Fund allocation was higher; however, overall contributions to the Grant Program have Page 1 of 4 1 increased during this ARPA period. TABLE 1: FUNDING SUPPORT HISTORY General Fund Affordable Fiscal Year Housing Fund CDBG ARPA TOTAL 2014-15 $120,000 $7,000 $67,402 $194,402 2015-16 $120,000 $8,000 $69,812 $197,812 2016-17 $140,000 $8,000 $75,602 $223,602 2017-18 $140,000 $8,000 $79,781 $227,781 2018-19 $130,000 $8,000 $91,462 $229,462 2019-20 $130,000 $8,000 $93,970 $231,970 2020-21 $160,000 $8,000 $99,711 $267,711 2021-22 $89,780 $0* $99,183 $163,251 $352,214 2022-23 $98,000** $0* $99,000 $163,000 $360,000 2023-24 $99,000 $8,000 $59,862 $163,000 $329,862 2024-25 $99,000 $8,000 $60,000*** $163,000 $330,000 * Forecasted annually at $8,000 since FY 2015-16 - not utilized in FY 2021-22 and FY 2022-23. ** Includes $8,460 in Homeless Housing, Assistance, and Prevention (HHAP) Funding. ***$15,000 of the $60,000 is earmarked for loan obligation, leaving $45,000 for public service grants. Alameda County Urban County CDBG Program Urban -County CDBG Program The City of Dublin participates in Alameda County's Urban -County CDBG Program, along with the cities of Albany, Emeryville, Newark, and Piedmont (cities whose population is/was less than 50,000). These are called the "Urban County Cities," along with the unincorporated areas of Alameda County. Public Service Grants Per County limits on each Urban County City's use of CDBG funds, only 15% of a city's CDBG allocation can be used for public -service -based projects. The remaining 85% must be used for capital projects. The County's past practice has been to review all applications received from each Urban County City to determine if the overall request for service -based projects exceeds the 15% limit. If so, the County requests that each city adjust the service -based project allocation. As recently as Fiscal Year 2022-23, CDBG accounted for almost $100,000 of the funds for public service projects in Dublin. Beginning in Fiscal Year 2023-24, the amount from CDBG was reduced to $59,862 as participants in the Urban -County CDBG Program began using more of their share. Anticipating similar usage in Fiscal Year 2024-25, an estimated $60,000 has been budgeted for CDBG. Of this $60,000, $15,000 is earmarked for the annual loan obligation for the Axis Community Health Clinic. This leaves an estimated $45,000 available from CDBG for the public service grants. Adjustments may be necessary before the start of the next fiscal year, as the City has not yet received actual numbers from HUD and Alameda County. Capital Project Grant Page 2 of 4 2 For Fiscal Year 2024-25, Tri-Valley Haven has requested capital funding to continue the rebuild of their Shiloh shelter building. Located in Livermore, Shiloh is the only domestic violence/homeless Shelter in the Tri-Valley area. This project was not included in the competitive review and allocation completed by the Human Services Commission. The request, totaling $250,000, is anticipated to be available as part of the Urban County CDBG Capital Allocation. The application, however, cannot be submitted to the County until after July 1, when funds are available. Staff will then return to the City Council to formally review the capital project and request funding support. Fiscal Year 2024-25 Competitive Grant Cycle Applications Typically, the City receives far more service project requests than capital project requests. This makes the public service grant program more competitive. Between December 6, 2023, and January 19, 2024, the City accepted applications for the public service grants program via the online platform, ZoomGrants. Twenty-one organizations submitted a combined total of 24 applications (three organizations submitted applications for multiple projects). Attachment 7 includes all 24 applications. In total, applicants requested $456,873 in funding, $141,873 more than is available in the Program. Review and Rating Criteria In February 2024, Staff and the Commission reviewed the public service grant applications to verify all requests qualified for funding based on adopted program guidelines. The Grant Rating Criteria Guide used in this review is included as Attachment 6. The rating guide was one of several factors used in determining funding recommendations. Other factors included consideration of: • The number of Dublin residents served and cost per participant. • Past performance of existing Dublin programs. • Whether the project addresses one or more of the 14 Key Areas of Concern identified in the 2011 Tri-Valley Needs Assessment report. • Whether City funds are used to leverage other funding sources. Two of the 24 public service grant applications were removed from consideration during the review process as they did not support a core human service need and/or would be better funded through alternate sources. Funding Recommendations At its meeting on March 28, 2024, the Human Services Commission discussed and considered funding allocations for the 22 qualifying applications. The amounts recommended by the Commission include reductions across all program/project requests to account for the reduced funding budgeted for Fiscal Year 2024-25. Attachment 3 summarizes the amounts recommended by the Commission for each project/program. Funding Breakdown by Project Type The table below breaks down the funding recommendations for the public service projects by project type (food, shelter, and other). Page 3 of 4 3 TABLE 2: SERVICE PROJECT FUNDING RECOMMENDATIONS BY TYPE Project Type Quantity Recommended Funding Services - Food 3 $49,000 Services - Shelter 7 $97,500 Services - Other * 12 $183,500 Total $330,000 * Services - Other includes projects/programs that provide safety -net services addressing issues like domestic violence/child abuse, disabled/special needs, financial/legal, medical/health, etc. STRATEGIC PLAN INITIATIVE: None. NOTICING REQUIREMENTS/PUBLIC OUTREACH: The City Council Agenda was posted, and all grant applicants were provided a web link to the Staff Report. Outreach and Promotion In November and December 2023, in preparation for the 2024-25 grant cycle, Staff conducted outreach and education efforts that included: • Providing notice of funding availability and upcoming community workshops to non-profit organizations. • Advertising the funding availability in the East Bay Times and on the City website. • Researching and reaching out to local non-profit organizations operating in Dublin. • Providing a Grant Application Workshop in coordination with the Cities of Pleasanton and Livermore to review the online application process and discuss program guidelines for the upcoming fiscal year. All applicants were required to attend this workshop. ATTACHMENTS: 1) Resolution Approving Funding Recommendations for the Fiscal Year 2024-25 Human Services Grant Program 2) Exhibit A to the Resolution - Fiscal Year 2024-25 Human Services Grant Program Funding Recommendations 3) Grant Summary Table 4) Dublin Mission and Vision Statements 5) Tri-Valley Needs Assessment - 14 Areas of Concern 6) Grant Rating Guide 7) Fiscal Year 2024-25 Human Services Grant Applications Page 4 of 4 4 Attachment I RESOLUTION NO. XX — 24 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF DUBLIN APPROVING FUNDING RECOMMENDATIONS FOR THE FISCAL YEAR 2024-25 HUMAN SERVICES GRANT PROGRAM WHEREAS, the City received 22 qualifying public service applications for the Fiscal Year 2024-25 Human Services Grant Program; and WHEREAS, funding sources for the Human Services Grant Program include the federally funded Community Development Block Grant (CDBG), the City of Dublin General Fund, the Affordable Housing Fund, and the American Rescue Plan Act (ARPA); and WHEREAS, on March 28, 2024, the Human Services Commission recommended 22 public service projects receive grant funding through the Human Services Grant Program; and WHEREAS, the City Council considered the recommended service projects attached hereto as Exhibit A. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Dublin approve the funding recommendations of all funds. BE IT FURTHER RESOLVED that the City Manager is authorized to take the following actions: 1. Direct Staff to work with the County of Alameda as required on the CDBG funding allocations by reallocating funds as needed based on the confirmed CDBG funding guidelines and funding level; and 2. Execute agreements with the County of Alameda for use of CDBG funds and the funding agreements with each grant recipient effective July 1, 2024, and take such further actions as may be necessary or appropriate to carry out the City Council's obligations pursuant to this Resolution. BE IT FURTHER RESOLVED that the City Manager is authorized to execute the amendments to the agreements, attached hereto as Exhibit A, and make any necessary, non - substantive changes to carry out the intent of this Resolution. {Signatures on the following page} Reso. No. XX-24, Item X.X, Adopted XX/XX/2024 Page 1 of 2 5 PASSED, APPROVED AND ADOPTED this 7th day of May 2024, by the following vote: AYES: NOES: ABSENT: ABSTAIN: Mayor ATTEST: City Clerk Reso. No. XX-24, Item X.X, Adopted XX/XX/2024 Page 2 of 2 6 City of Dublin - Fiscal Year 2024-25 - Human Services Grant Funding Exhibit A to Resolution XX-24 Organization Name Grant Proposal Assistance League of Amador Valley Axis Community Health Operation School Bell Enrollment Specialist Centro Legal de la Raza Tri-Valley Fair and Secure Housing Project Chabot -Las Positas Community College District dba Tri-Valley Career Center Chabot -Las Positas Community College District dba Tri-Valley Career Center City of Pleasanton City Serve of the Tri-Valley City Serve of the Tri-Valley Dublin Pathways to Employment Dublin VITA Services Section 108 Loan Obligation (Axis Community Health Clinic) Homeless Prevention and Family Stabilization Program Attachment 2 Exhibit A to the Resolution Grant Amount Grant Amount Requested FY24- Recommended FY24- CDBG Funding General Fund 25 25 $5,000.00 $0.00 $7,759.78 $7,000.00 $7,000.00 $18,500.00 $18,000.00 $24,989.00 $16,000.00 $20,733.00 $16,000.00 N/A $25,000.00 Senior 60+ Stabilization Program $25,000.00 Community Resources for Independent Living Housing and Independent Living Skills $16,000.00 Easterseals Northern California Goodness Village* Hively Hope Hospice & Health Services Legal Assistance for Seniors Lions Center for the Visually Impaired Love Never Fails Narika One Nation Dream Makers Open Heart Kitchen Partners for Change Tri-Valley Spectrum Community Services Sunflower Hill Tri-Valley Haven Tri-Valley Haven Kaleidoscope Community Adult Program $25,000.00 Goodness Village* $25,000.00 Hively Family Resource Center & Navigation Services Grief Support Services and Volunteer Services Legal and Supportive Services, Medicare Counseling and Education for Dublin Seniors $25,000.00 $20,000.00 $12,000.00 Dublin Seniors Vision Health $7,500.00 Dublin Street Outreach and Referrals to Transformational Solutions Culturally Responsive Domestic Violence Intervention & Prevention Services Last Mile Delivery and Food Recovery Program $25,000.00 $13,141.00 $25,000.00 Senior Meal Program $25,000.00 Alleviating Poverty and Homelessness in the Tri-Valley $15,000.00 Meals on Wheels: More Than A Meal $25,000.00 Program Support for Adults with Developmental Disabilities $16,250.00 Homeless and Family Support Services $25,000.00 Domestic Violence Services $25,000.00 Wishing Well Inc No One Should Sleep Hungry American Rescue Plan Act (ARPA) $18,000.00 $16,000.00 $16,000.00 $15,000.00 $15,000.00 $23,000.00 $23,000.00 $17,000.00 $17,000.00 $9,000.00 $9,000.00 $14,000.00 $14,000.00 $12,500.00 $12,500.00 $24,000.00 $24,000.00 $17,000.00 $17,000.00 $10,000.00 $10,000.00 $4,500.00 $4,500.00 $7,500.00 $7,500.00 $5,000.00 $5,000.00 $3,500.00 $3,500.00 $23,000.00 $23,000.00 $5,000.00 $5,000.00 $22,500.00 $22,500.00 $15,000.00 $15,000.00 $22,500.00 $22,500.00 $23,000.00 $23,000.00 $5,000.00 $0.00 *Includes $8,000 from Affordable Housing Fund $456,873 $330,000 $60,000 $107,000 $163,000 7 Attachment 3 City of Dublin Human Services Commission - Grant Funding for Fiscal Year 2024-25 Organization Name Grant Proposal Funding Received FY23-24 Grant Amount Requested FY24- 25 Staff Recommendation Application Points Estimated Unduplicated Average Cost Per (Average) Residents Served Unduplicated Resident Funding Type CAPITAL PROJECTS (FUNDED OUTSIDE OF COMPETITIVE GRANTS PROGRAM) '�i 1-1T1T1T1T11T1T1T1T1 City of Pleasanton Section 108 Loan Obligation (Axis Community Health Clinic) $15,000.00 $15,000.00 $15,000.00 CDBG One Nation Dream Makers Open Heart Kitchen Spectrum Community Services Wishing Well Inc Last Mile Delivery and Food Recovery Program Senior Meal Program Meals on Wheels: More Than A Meal No One Should Sleep Hungry New $24,800.00 $24,800.00 New $25,000.00 $25,000.00 $25,000.00 $5,000.00 $3,500.00 $23, 000.00 $22, 500.00 $0.00 35.5 70.75 70.25 56.75 9000 250 60 250 $0.39 $92.00 $375.00 $0.00 ARPA ARPA CDBG N/A Centro Legal de la Raza City Serve of the Tri-Valley Community Resources for Independent Living Goodness Village Love Never Fails Partners for Change Tri-Valley Tri-Valley Haven Tri-Valley Fair and Secure Housing Project Homeless Prevention and Family Stabilization Program Housing and Independent Living Skills Goodness Village* Dublin Street Outreach and Referrals to Transformational Solutions Alleviating Poverty and Homelessness in the Tri-Valley Homeless and Family Support Services $18,795.00 $24,795.00 $8,945.00 $12,295.00 $7, 295.00 $4, 796.00 $24,795.00 $18,500.00 $25,000.00 $16,000.00 $25,000.00 $25,000.00 $15,000.00 $25,000.00 $18,000.00 $23, 000.00 $9,000.00 $12,500.00 $7,500.00 $5,000.00 $22, 500.00 68.25 60.5 65.25 58.5 58.25 61.75 64.5 23 75 40 3 50 100 425 $782.61 $306.67 $225.00 $4,166.67 $150.00 $50.00 $52.94 ARPA ARPA ARPA GF ARPA GF CDBG Assistance League of Amador Valley Axis Community Health Chabot -Las Positas Community College District dba Tri-Valley Career Center Chabot -Las Positas Community College District dba Tri-Valley Career Center City Serve of the Tri-Valley Easterseals Northern California Hively Hope Hospice & Health Services Legal Assistance for Seniors Lions Center for the Visually Impaired Narika Sunflower Hill Tri-Valley Haven Operation School Bell Enrollment Specialist Dublin Pathways to Employment Dublin VITA Services Senior 60+ Stabilization Program Kaleidoscope Community Adult Program Hively Family Resource Center & Navigation Services Grief Support Services and Volunteer Services Legal and Supportive Services, Medicare Counseling and Education for Dublin Seniors Dublin Seniors Vision Health Culturally Responsive Domestic Violence Intervention & Prevention Services Program Support for Adults with Developmental Disabilities Domestic Violence Services *8,000 from Affordable Housing Fund New $5,000.00 $0.00 New $7,759.78 $7,000.00 $15,795.00 $24,989.00 $16,000.00 $15,795.00 $20,733.00 $16,000.00 $16,045.00 $25,000.00 $17,000.00 $12,295.00 $25,000.00 $14,000.00 $24,795.00 $25,000.00 $24,000.00 $12,595.00 $20,000.00 $17,000.00 $9,795.00 $12,000.00 $10,000.00 $3,545.00 $7,500.00 $4,500.00 New $13,141.00 $5,000.00 $15,795.00 $16,250.00 $15,000.00 $24,795.00 $25,000.00 $23,000.00 Totals: $456,873 $330,000 54.75 61.5 59 49.5 60.5 50.25 72.75 60 64.5 52.5 53.25 59.75 70.75 200 90 360 115 109 9 1200 800 15 15 350 40 75 $0.00 $77.78 $44.44 $139.13 $155.96 $1,555.56 $20.00 $21.25 $666.67 $300.00 $14.29 $375.00 $306.67 N/A GF ARPA ARPA GF GF ARPA GF GF GF GF GF ARPA 8 Attachment 4 IIs DUBLIN CALIFORNIA THE NEW AMERICAN BACKYARD MISSION IP- The City of Dublin promotes and supports a high quality of life, ensures a safe and secure environment, fosters new opportunities, provides equity across all programs, and champions a culture of diversity and inclusion. VISION Dublin is a great community to live, work, and raise a family. Dublin values: • Safety — We are dedicated to excellent public safety resources, including police and fire. • Finances — We will strive to be fiscally transparent and balance our budgets annually. • Inclusivity — We will advocate for programs and policies that support inclusive access to housing and cultural opportunities. • Diversity — We will support a wide range of programs and events that reflect and cater to the diversity of our residents. • Equity — We will deliver our services in a way that ensures equitable access to all. • Innovation — We will continue to innovate in every aspect of government and promote innovation within the business community. • Customer Service — We will provide welcoming, excellent customer services to our residents and businesses at all times. • Living an Active Lifestyle — We will continuously promote an active lifestyle through our parks and facilities and encourage participation in local sports. • History — We will honor our history through places and programs that remind people of our beginnings. • Business — We will provide a full spectrum of opportunity by supporting current and prospective businesses through ongoing economic development efforts and helping them grow and thrive locally. • Environmental Sustainability — We will continue to lead in building a well -planned sustainable community and protecting our natural resources. 9 Attachment 5 2011 Tri-Valley Needs Assessment Findings by Area of Concern * 4 6 7 Behavioral health (mental health and substance abuse) Affordable housing Health care Workforce development Homelessness Transportation services and access Domestic violence and child abuse s 9 10 11 12 13 14 Disabilities Food and nutrition Senior services Youth services Child care, early childhood development and education Changing demographics and growing diversity Financial assistance *Page 33 Eastern Alameda County Human Services Needs Assessment 10 Attachment 6 CITY OF DUBLIN HUMAN SERVICES GRANT RATING GUIDE Organization: Program: City Staff Score Each project has already been scored by city staff in the Grant Ratings Worksheet using the criteria below. These scores will automatically be added to the scores you add for every project that is selected to receive funding. Organization/Management (1 point each, maximum of 5) Description The organization previously received funding from Dublin and has fully complied with the City's management procedures, including invoice and report deadlines. The organization, as presented in the application, is able to achieve the stated goals and outcomes. The organization and its staff are qualified and have the capacity to provide for the program. (non-profit status, resumes for staff, Board of Directors, information on clients served) The organization has completed all required aspects of the application process. The proposed program has a successful proven track record (not a new program). Score Commission Member Rating Categories Please review each of the applications in ZoomGrants. For each application, provide a score (1-10) for each of the categories below. Descriptions of each score range are included below for guidance. Add your scores for each category, and any notes on each application, to the corresponding cells in the Grant Ratings Worksheet. Need — Rate the need for this program/service. Rating Low 0-2 Mid 3-5 High 6-10 Description The applicant does not articulate a clear need for the project in their application and is unlikely to address that need. The applicant identifies a clear need, but it is not a critical human service need, and/or the applicant does not demonstrate a high likelihood of addressing that need. The applicant identifies a critical human service need in Dublin that other organizations do not and demonstrates a high likelihood of addressing that need. Score 11 Benefit — Rate the benefit to low-income or high -risk individuals/households in Dublin. Rating Low 0-2 Mid 3-5 High 6-10 Description 1 Score Applicant demonstrates a low number of low-income or high -risk Dublin individuals/households who will benefit from the project, and the application fails to identify any outcomes or ways it will measure project success. Applicant demonstrates a moderate number of low-income or high -risk Dublin individuals/households who will benefit from the project. The application identifies outcomes but is unclear or unlikely to demonstrate a project impact. Applicant demonstrates a high number of low-income or high -risk Dublin individuals/households who will benefit from the project. The application identifies clear and measurable outcomes to demonstrate project impact. Funding Request — Rate the applicant's funding request. Rating Low 0-2 Mid 3-5 High 6-10 Description Score The funding request is unreasonably high given the project's proposed impact, and the number of people served; the project budget is unrealistic. The funding request is reasonable but does not demonstrate a high impact or cost effectiveness given the proposed number of people served and/or the project budget has significant questions or flaws. The funding request is a reasonable amount demonstrating high impact and cost effectiveness given the proposed number of people served; the project budget is feasible and sound. Funding Sustainability — Rate the diversification of the project's funding sources. Rating Low 0-2 Mid 3-5 High 6-10 Description 1 Score The Grant request is the only source of funds for the applicant's proposed project. The applicant has identified more than one funding source to support the proposed activity/service, but this grant request would be the main source of funds, and the long- term sustainability of the project is questionable. The applicant has identified multiple funding sources to support the proposed activity/service and ensure sustainability. The organization produces other income that may be used to support this program (fundraising). 12 City Funding Necessity — Rate the necessity of City funding for this project. Rating Low 0-2 Mid 3-5 Description The project is not appropriate for City funds and will not reduce demands on other City resources. The project is an appropriate use for City funds but will not reduce demands on other City resources and/or other types of funding sources would be a better fit for this project. High City funds are critical to the project, and funding request is appropriate for City sources and 6-10 reduces demands for other City resources. Score Consistency with Policies — Rate the proposal's consistency with the HUD Strategic Goals and HUD Policy Priorities. (To determine CDBG eligibility) Rating Low 0-2 Mid 3-5 High 6-10 Description Score The proposal does not address any of the HUD Strategic Goals or HUD Policy Priorities. The proposal addresses one of the HUD Strategic Goals or HUD Policy Priorities. The proposal helps address multiple HUD Strategic Goals or HUD Policy Priorities. City Council Priorities — Rate the extent the proposal addresses one or more of the City Council's priorities. Rating Low 0-2 Mid 3-5 High 6-10 Description The proposal does not address any of the Council's priorities. The proposal addresses one or two of the Council's priorities but does not have a high likelihood of doing so effectively. The proposal demonstrates a high likelihood of addressing multiple Council priorities. Score 13 Alameda County 14 Areas of Concerns — Rate the extent the proposal addresses one or more of the 14 areas of concern as identified by the Alameda County Needs Assessment Report. Rating Low 0-2 Mid 3-5 High 6-10 Description Score The proposal does not address any of the 14 areas of concern. The proposal addresses one or two of the 14 areas of concern but does not have a high likelihood of doing so effectively. The proposal is highly likely to address multiple areas of the 14 areas of concern. Innovation — If funds were allocated last year for the same project/activity, rate the extent to which the applicant adequately responds to changing community conditions. If the proposal is for a new project, rate the extent to which the project uses a new and innovative approach to solve an identified problem. Rating Low 0-2 Mid 3-5 High 6-10 Description Score The applicant does not demonstrate an ability to adapt the project to changing needs or is not using an innovative approach. It is unclear how the project will respond to changing community conditions identified in the application or use an effective but not particularly innovative approach. The applicant demonstrates a high likelihood of responding to changing conditions and/or using an innovative approach. Access — Rate the extent to which the project will ensure non-English speakers, people with disabilities, people experiencing homelessness, seniors, low-income families, and/or youth can access the proposed program or activities. Rating Low 0-2 Mid 3-5 High 6-10 Description The proposal does not mention accessibility concerns and does not describe how it will remove barriers or help community members access its services. The proposal addresses accessibility concerns but does not identify concrete or impactful ways the project will remove barriers for priority populations. The proposal describes concrete and impactful ways the applicant will improve language, technology, and/or transportation access for priority populations. Score 14 Email This Preview Save as PDF Attachment 7 Print Close Window AA DUBLIN Powered by ZoomGrantsT"' and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Deadline: 1/19/2024 USD$ 5,000.00 Requested Human Services Grant Program Assistance League of Amador Valley Operation School Bell Jump to: Oraanization Information Questions Budaet Documents Submitted: 1/19/2024 11:31:45 PM (Pacific) Project Contact Elke Rank 'rantschairealamadorvallev.ora Tel: 925-353-0280 Additional Contacts none entered Organization Information top 1. Business License Number 200234 Questions tnn Assistance League of Amador Valley Telephone 92 5-3 5 3-028 0 PO Box 11843 Fax Pleasanton, CA 94588 United States President Christina Perlin PresidenteA LAmadorVa l l ev. ora 1. Select the category that best describes your organization: (Select only one.) Li Non -Profit ❑ Public Agency El Other: Web www.assistanceleague.org/amador- valley 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Assistance League of Amador Valley's volunteers transform the lives of children and adults through community programs. Our vision is simple: Essential needs are met in our community and families flourish. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) Capital Project Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 15 operation. ❑ Yes :Y.!i No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Operation School Belie is Assistance League's signature program. The mission of Operation School Bell® programs is to provide children in need with appropriate assistance to enhance self-esteem, promote learning, and regular school attendance. Our programs under the Operation School Bell@ umbrella are rooted in education and family; Projects include supporting up to 400 kids in the valley with new school clothes, donating nearly 1,500 books to local children to take home as their own, and supporting the Gathering Place in Pleasanton by supplying reading books, games, and gift cards for activities the kids can do together with their birth parents during these visits - among other actions that support fosters and unhoused youth. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Assistance League relies on a combination of grants and fundraisers. Without grants we could not continue to increase the services provided each year. The need is growing, and so too much the budget. We are proud to say that 91 °/° of our revenue goes DIRECTLY to programming. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 200 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/9956/Applrcafion-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities Food and Nutrition ❑ Senior Services ❑,� Youth Services ❑d Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) $5,000 is requested to support two programs under the Operation School Bell program umbrella - Clothing the Children & Foster Kids. For Clothing the Children, funding will be used to purchase new school clothing for approximately 100 disadvantaged and/or homeless children living in Dublin (note: the program serves up to 400 total in the Tri-Valley). Each participant is paired with a caring volunteer member from the Assistance League for about an hour, and they fill a basket with al! the back to school essentials - shoes, coat, clothes, socks. They also receive a book and some toiletries. The pure joy and appreciation from the both the student and their parents cannot be adequately expressed. Total budget per child depends on their grade, but ranged 16 this year 1bU to 3,1 /b. I his event takes place over several designated weekends each tall. For Foster Kids, funding will be used (1) to support The Gathering Place by purchasing games, books, and gift cards used to create a gentle and supportive environment for foster kids to meet with their biological parents, and (2) to support unique needs identified by Dublin school district teachers such as their request this FY for support towards purchasing supplies needed at a food pantry serving both unhoused and foster students. This project runs nearly year -around. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our results are specific in terms of exact number of people served by our programs. We work with Title 1 school district teachers and counselors and social workers to identify the students and classrooms in most need and we tailor our work and budget around that. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gou/72/mission-vision Those who can be identified as being most in need will receive the benefits of our efforts. There are no other screening, etc., tools. Assistance League of Amador Valley is committed to transforming lives and pursuing greater diversity, equity and inclusion. Our practices will respect the dignity and intrinsic value of the individuals we serve and with whom we serve. We commit to increasing our cultural understanding including the recognition of underlying factors that impact members of our community. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. NA 13.*" QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.' Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding. n/a 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency Li Encourage networking and information sharing across service providers El Encourage process streamlining ❑ Consolidate service delivery EJI Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing El Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. El Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. 17 ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. • Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or �Js F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing El Strengthen Communities El Ensure Equal Opportunity in Housing El Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations O Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities d Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I ,seeking?") ❑ Availability/Accessibility El Affordability ❑ Sustainability ki Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. El Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. 18 Li Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. L j Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. El Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. i-'11 Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) ❑ Persons ❑ Households ❑.► Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless n/a Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you Dublin clients (EITHER Persons OR Households) your enter O. Area Median Income C"AMl") information is available online 40 Extremely Low Income (<30% AMI) 40 Very Low Income (30%-50% AMI) o Low Income (50%-80% AMI) selected above, please list the number of unduplicated agency anticipates serving in each category. If none, please at www.dublin.ca.govt1956/Application-Requirements-Process 19 0 Moderate Income (80%-120% AMI) n.n TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial nja Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ��i #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This programlproject has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This programlproject has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca. govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes Na 20 Budget toN Funding Sources/Revenues Budget Amount Amount Committed grant awards USD$ 37,300.00 USD$ 15,000.00 fundraising income (approx) USD$ 113,000.00 USD$ 50,000.00 Total USD$ 150,300.00 USD$ 65,000.00 Funding Uses/Expenses Budget Amount Amount Committed Operation School Bell USD$ 64,500.00 USD$ 15,000.00 Total USD$ 64,500.00 USD$ 15,000.00 Budget Narrative $5,000 is requested to support two programs under Operation School Bell - Clothing the Children & Foster Kids. For Clothing the Children, funding will be used to purchase new school clothing for approximately 100 disadvantaged and/or homeless children living in Dublin (note: the program serves up to 400 total in the Tri-Valley). For Foster Kids, funding will be used (1) to support The Gathering Place by purchasing games, books, and gift cards used to create a gentle and supportive environment for foster kids to meet with their biological parents, and (2) to support unique needs identified by Dublin school district such as their request this FY for monthly support for supplies at the school food pantry. $64,500 is the total budget for the tri-valley for the current FY ($60,000 for Clothing the Children, and $4,500 for Foster Kids). We increased the budget for the Clothing the Children program by $10,000 in a mid -year adjustment so we could increase the amount per child. We rely on both grants and fundraisers to support our programs. So far we have been awarded $15,000 in grants towards these AND other programs. We have approximately $50,000 in fundraiser income with more yet to come in the coming months. Documents top Documents Requested * Required?Attached Documents Program Expense Budget for ALL Grant Requests ❑v Budget Financial Information Form for ALL Grant Requests 0 Budget List of Board of Directors (or governing body) with Board Members agency contact information ora chart Current Annual Budget for the Entire Agency 0 Budget Copy of most recently submitted IRS 990 form or Tax 0 Financials Retum (include complete form) Board of Director's (or governing body's) designation 0 Authorize official of authorized official Board of Director's (or governing body's) authorization 0 AuthorizR fundino to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability ❑i Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT ❑,r IRS tax exempt DETERMINATION LETTER. All organizations MUST Fed IRS tax exempt have approved non-profit status from the State of California and Federal Tax identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Financials REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) 21 F< UUIhEL) I-UF< UL)titi ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsTm is not responsible for the content of uploaded documents. Application ID: 461198 Become a fan of ZoomGrants.' on Facebook Problems? Contact us at CuestionseZoamGrants. com 02002-2024 GrsntAnalystcc n. Al rights reserved_ "ZoormGrants' and the Zo mGrants logo are trademarks of G antAnaiystcom, LLC. �ogoflit I Browser 22 Email This Preview Save as PDF Print Close Window A■ 7 DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Dead! ine: 1 f 19/2024 USD$ 7,759.78 Requested Axis Community Health Enrollment Specialist Jump to: Organization Information Questions Budget Documents Axis Community Health Submitted: 1/18/2024 4:59:12 PM (Pacific) Project Contact Liz Perez -Howe con tracts(5 axishealth.ora Tel: 925.201.6068 Additional Contacts none entered Organization Information top 1. Business License Number Questions tors 5925 W. Las Positas Blvd., Suite 100 Pleasanton, CA 94588 United States CEO Liz Perez -Howe Ihowe a�iaxishealth.ora 1. Select the category that best describes your organization: (Select only one.) Pi Non -Profit ❑ Public Agency ❑ Other: Telephone(925) 201-6035 x Fax (925) 417-1503 x Web www.axishealth.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Axis Community Health, established in 1972, delivers comprehensive healthcare services to the Tri-Valley. We provide accessible primary care, mental health counseling, substance abuse treatment, dental, and preventive care to low-income residents. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 23 i✓� Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Axis Community Health is seeking funding for a new Enrollment Specialist to facilitate the January 2024 expansion of Medi- Cal, with a specific focus on serving newly eligible individuals, including undocumented residents. The specialist will play a crucial role in guiding people through the Medi-Cal redetermination process, providing vital support to those who have lost coverage and are now eligible for insurance as well as those who are newly eligible for health insurance. This project strategically addresses service gaps, ensuring continued access to essential healthcare for the community's most vulnerable members. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) In 2024, more Californians need help enrolling in healthcare for the first time and re -enrolling in public health insurance due to the Medi-Cal redetermination process. There are two main challenges regarding healthcare insurance enrollment. Firstly, the Medi-Cal redetermination process may lead to individuals losing their healthcare coverage, requiring them to re -enroll in eligible insurance plans. Secondly, new rules permit enrollment for individuals previously ineligible for Medi-Cal. However, the enrollment process is intricate, posing difficulties for many to navigate independently. Our Enrollment Specialist can assist both groups by determining their eligible insurance options and guiding them through the enrollment process for public health insurance. According to the 2017-2021 American Community Survey, over one in five people (53,667) in the Tri-Valley use a public health insurance option including Medi-Cal, Medicaid or Medicare. Adding to this need, about 7.2°/0 of people in Alameda County don't have any health insurance at all. In addition, fewer adults in Tri-Valley get regular check-ups compared to adults in the whole of California. The 2023-2025 Stanford Health Care Tri-Valley Needs Assessment stated that "smaller proportions of adults in the Tri-Valley cities had routine annual check-ups compared to all California adults.' The 2022 Community Health Needs Assessment (CHNA) by John Muir Health also stated that access to healthcare is one of the top needs in the Tri- Valley. People in Tri-Valley need better access to healthcare and that starts with enrollment into a healthcare plan. Our project is vital because it focuses on helping people keep their health insurance and get enrolled in the health insurance they qualify for. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 90 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/9956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing RI Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition El Senior Services El Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity • Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in 24 the "Documents" tab.) (What specifically will the grant funds be used for?) All grant funds will be solely allocated to the establishment and maintenance of the new Enrollment Specialist role. The new Enrollment Specialist will play a pivotal role in administering the project, focusing on the 2024 Medi-Cal redetermination process, and in serving Dublin's diverse community. The specialist will be extensively trained to understand intricate insurance eligibility criteria, ensuring a comprehensive grasp of the evolving healthcare landscape. In their first visit, the Enrollment Specialist will spend up to an hour guiding the community member on the documentation needed for application or renewal before helping them complete and submit the insurance enrollment application to Alameda Social Services. This role is a support position for anyone that needs to navigate the public health insurance system. Residents can easily connect with the project in different ways. If someone is new to Axis, they'll get an appointment with the enrollment department to check if they can get coverage through health plans. People who just walk in can also get help in the Enrollment department if they ask for it. For those who've been here before, they'll have planned meetings with the Enrollment Specialist when their coverage is ending or if something changes that might affect their eligibility for health plan coverage. With procedural reasons accounting for most disenrollments, there is an inherent risk of individuals experiencing breaks in coverage. The Enrollment Specialist will be instrumental in preventing such disruptions, facilitating a seamless transition for citizens who require ongoing healthcare access. The Enrollment Specialist's training includes a deep understanding of insurance eligibility criteria, enabling them to navigate the complexities of the redetermination process effectively. They will possess the knowledge and expertise to guide individuals through the intricacies of Medi-Cal and Covered California insurance, ensuring accurate assessments of eligibility. This training encompasses staying informed about the evolving landscape of healthcare policies and enrollment protocols, guaranteeing that the specialist remains well-equipped to assist clients throughout the redetermination process. The goal of this grant is to make enrollment services easily accessible to uninsured residents, providing personalized assistance in understanding their eligibility status, exploring health plan options, and making informed decisions about their healthcare coverage and to promote equitable access to healthcare services. In essence, the new Enrollment Specialist role will serve as a critical resource in safeguarding the health and well-being of our community members during this pivotal juncture in healthcare policy changes. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The position's effectiveness will be assessed through quantitative metrics, mainly focusing on the number of clients served and enrolled in insurance programs. Additionally, qualitative feedback from clients and periodic evaluations of the specialist's impact on community awareness and engagement will contribute to assessing effectiveness. This project is strategically designed to break down barriers to insurance enrollment, ensuring increased healthcare coverage for local citizens, with particular attention to vulnerable communities of color and those whose primary language is not English. Given research from the California Health Care Foundation highlighting disparities in disenrollment among communities of color and non-English speakers, this grant aims to mitigate such risks by empowering the new Enrollment Specialist to address this demand. Their targeted efforts will address the unique challenges faced by these populations, facilitating a more inclusive and equitable enrollment process. This grant is pivotal in fostering greater health equity. The Enrollment Specialist will proactively engage with the community, ensuring that individuals are informed about the need to take action to maintain their healthcare coverage during critical junctures like the Medi-Cal redetermination process. The role becomes crucial in preventing coverage lapses resulting from paperwork mistakes or missed notices, situations that disproportionately impact vulnerable populations. By providing personalized guidance and support, the Enrollment Specialist will serve as a reliable resource for individuals, mitigating the risk of coverage loss due to administrative challenges. This project's effectiveness will be rigorously assessed using a combination of quantitative metrics and feedback. Key performance indicators include: 1. Number of Clients Served: Tracking the volume of individuals actively engaged and served by the Enrollment Specialist, providing a tangible measure of outreach and assistance. 2. Successful Enrollments: Quantifying the number of individuals successfully enrolled in insurance programs, highlighting the project's impact on increasing healthcare coverage. 3. Community Awareness and Engagement: Periodic evaluations will measure the specialist's impact on community awareness, ensuring that the information reaches and resonates with diverse populations, particularly communities of color and non-English speakers. 25 Qualitative feedback from clients will be gathered to gain insights into the perceived effectiveness of the specialist's assistance, ensuring that the project is not only meeting quantitative targets but also addressing the unique needs and challenges faced by the community. By the end of this grant, we anticipate: 1. Increased Enrollment Rates: A demonstrable increase in the number of local citizens enrolled in healthcare programs, reflecting the success of the Enrollment Specialist in breaking down barriers to enrollment. 2. Enhanced Community Awareness: Greater awareness within vulnerable populations, reducing the likelihood of disenrollment and ensuring that community members are well-informed about the actions required to maintain healthcare coverage. 3. Improved Health Equity: A measurable reduction in disparities related to disenrollment, with a specific focus on addressing the needs of communities of color and non-English speakers. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision This project actively advances Diversity, Equity, and Inclusion (DEI) by addressing the unique challenges faced by low-income populations in Dublin. The Enrollment Specialist, with a specific focus on the 2024 Medi-Cal redetermination process, becomes a cornerstone for promoting greater health equity. By targeting enrollment efforts towards uninsured individuals, particularly undocumented residents who often fall within low-income brackets, the project takes deliberate steps to break down barriers to healthcare access. The Tri-Valley's diverse demographics, encompassing a notable undocumented and economically vulnerable population, underscore the critical need for initiatives that prioritize DEI principles. The Enrollment Specialist's role becomes instrumental in fostering an inclusive healthcare delivery system, ensuring that individuals from various backgrounds have equitable access to essential healthcare services. Through this targeted approach, the project not only acknowledges the diversity within the community but actively works to address the specific needs of low-income populations. By facilitating enrollment for those at risk during the Medi-Cal redetermination process, the project contributes to dismantling systemic barriers and fostering a more inclusive and equitable healthcare landscape for all residents, irrespective of their socioeconomic or immigration status. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Axis shifted our delivery of services and offerings overnight to meet the change in health needs brought on by the pandemic. This role will support marginalized communities negatively affected by the COVID pandemic by providing vital assistance to individuals in navigating insurance options. The Enrollment Specialist will be a crucial resource in helping these communities regain access to healthcare coverage, which is essential for their overall well-being in the post -pandemic recovery phase. 13. »x QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. " Are you are interested in applying for CDBG funds? Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Axis values diversity; many staff are bilingual. With translation services available to all patients, we ensure seamless access to care for all. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: R,r: Be culturally accessible, appropriate and inclusive i:71; Encourage community engagement and involvement 26 LJ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A} Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. [ i Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: €,:1 Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ I Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: {TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") F Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?) ❑� AvailabilitylAccessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: 27 Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated; etc. in a targeted area. Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfelds remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly. and those units designated for chronically homeless persons and persons with HIV/AIDS. Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units. section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling. and down payment assistance/closing costs. Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) J Persons Households Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 31 Seniors (62 and older) 5 People with Disabilities 28 14 Female -Headed Households 11 Youth 2 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income (AMl) information is available online at www.dublin.ca.govI1956IApplication-Requirements-Process 51 Extremely Low Income (<30% AMI) 3 Very Low Income (30%-50% AMI) 5 Low Income (50%-80% AMI) 8 Moderate Income (80%-120% AMI) 67.0C TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 3 White 3 White + HISPANIC 1 Black/African American 1 Black/African American + HISPANIC 5 Asian 1 Asian + HISPANIC 1 American Indian/Alaskan Native 1 American Indian/Alaskan Native + HISPANIC 1 Native Hawaiian/Other Pacific Islander 1 Native Hawaiian/Other Pacific Islander + HISPANIC o American Indian/ Alaskan Native and White o American Indian/ Alaskan Native and White + HISPANIC O Asian and White O Asian and White + HISPANIC o Black/African American and White O Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC 1 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 19.0 C; TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY !_ #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. 29 L.1 #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. if you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes J No Budget top Funding SourceslReven ues Budget Amount Federal Grant USD$ 33,734.51 Proposed Grant City of Dublin USD$ 7,759.78 Proposed Grant City of Livermore USD$ 18,230.85 Proposed Grant City of Pleasanton USD$ 9,637.37 Fundraising USD$ 1,893.49 Total USD$ 71,256.00 Funding Uses/Expenses Budget Amount Enrollment Specialist Salary USD$ 71,256.00 Total USD$ 71,256.00 Amount Committed USD$ 33,734.51 USD$ 33,734.51 Amount Committed USD$ 33,734.51 USD$ 33,734.51 Budget Narrative The new Enrollment Specialist role is proposed to be 50% funded through the CDBG grants from each Tri-Valley city. The annual salary is $58,406, and the benefits are $12,850. To determine the grant ask, we divided .5 FTE costs by the percentage of clients served by each respective city in the last year. Livermore patients made up 51.17% of patients served last year, therefore the CDBG grant request was 51.17% of the .5FTE total at $18,230.85. Dublin patients were 21.78% of patients served therefore the CDBG grant request was 21.78% of the requested total which represents a request of $7,759.78. 27.05% of patients were based in Pleasanton last year which reflects the percentage of the .5 FTE salary request at $9,637.37. The remaining .5 FTE that is not proposed to be funded by CDBG grants will be paid for through an existing federal grant ($33,734.51). The remaining $1,893.50 will be paid for through fundraising. Documents top Documents Requested * Required?Attached Documents * Program Expense Budget for ALL Grant Requests 0 Program Expense Form Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 ❑� Financial Info Form O list of RC}Q O 2024 Annual Budaet ❑+� 990 Tax Forms • BOD Authorized Official Designation EQD Funrlinn I?Acnlution Proof of insurance 30 andfor workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit LI Federal 501(c)3 Letter State 501(c13 Letter REQUIRED FOR CDBG ONLY - If requesting Capital Audit Funding, please upload your Capital expenditure budget (your awn format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 457819 Non -Discrimination and Anti-Harrassrnent Policy Patient Grievance Proaram Articles of Incorporation Bylaws Standards of Conduct Bylaws LEP Plan Became a Fan of ZoomGrants"' on Face -book Prdtiems? Contact us atP.cnn.,geZoomGran s. com ®2002-2024 GrantAnalystcan Al right reserved_ "ZoomGrants' and the ZoomGrants logo are trademarks of Grant Analystcan, LLC. Loala I EL417L;&: 31 Email This Preview Save as PDF Print Close Window Ar V DUBLIN Powered bvZoomGrantsTM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1 f 19/2024 Centro Legal de la Raza Tri-Valley Fair and Secure Housing Project Jump to: Oraanization Information Questions Budget Documents USD$ 18,500.00 Requested Submitted: 1/19/2024 3:33:04 PM (Pacific) Project Contact Brenda Orellana Ramos bare I la n aCa7 centro I ea al .ora Tel: 510-227-4451 Additional Contacts none entered Organization Information 1. Business License Number BL-113233 Questions op Centro Legal de la Raza 3400 E 12th St Oakland, CA 94601 United States Executive Director Monique Berlanga mberlancaScentroleaal.cra 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: Telephone510-437-1554 Fax Web https:!lwww.centrolegal.orgi 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Centro Legal maintains holistic legal programs supporting equity, copowerment, centering clients and collaborating with CBOs to support systems change. We are a leader in regional anti -displacement efforts and help ensure stable and healthy housing. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project Eli Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 32 operation. ❑ Yes No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Centro Legal proposes to provide legal consultations, representation, outreach, and tenant education services to low-income tenants facing housing instability, eviction and potential displacement to keep Dublin tenants housed and in safe, stable, and affordable housing. Our services model provides pre -eviction consultation in addition to eviction representation, and through outreach and education, we are able to address threats to housing stability early. Information sharing through know -your -rights workshops empowers communities to assert their rights. Centro Legal's proposed staffing for this program reflects a multilingualfmulticultural team of staff, ensuring access to interpretation services for all residents participating in this program. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Between 2010 - 2020, the share of renters that were burdened by the cost of housing in Dublin increased from 36% to 42%, whereas the 9-county Bay Area saw a decrease(https:ffbayareaequityatlas.orgfindicatorslhousing-burden). In FY 21-22, even with protections in place, 28% of the Dublin tenants reported receiving a termination notice, 14% reported that they were unable to pay rent. Since the end of the moratorium, 40% reported receiving a termination notice, 33% impacted by COVID-19, 33% unable to pay rent, and 33% were facing an unlawful detainer. Eviction filings have increased substantially, in many places far beyond pre -pandemic levels (Calmatters.org). Moreover, data from the American Housing Survey estimates that there are 5.5 times as many "informal evictions" as formal evictions. (Zainulbai & Daly, Informal Evictions: Measuring Displacement Outside of the Courtroom (2022).) "Informal evictions" occur when a tenant is coerced or otherwise pushed to leave their home outside of the court process. This often occurs because tenants do not understand their legal rights and options. Equipping tenants with information is critical to keeping tenants housed. Historically, there has been a lack of tenant legal services targeted specifically to Dublin and other Tri-Valley cities. This program is essential to meet the ongoing and increased need in Dublin. If we not receive funding, more Dublin residents will face eviction without the assistance of an attorney. If we receive a reduced amount, we will scale the project accordingly. Research shows that low-income residents who have the right to stay in their homes need legal representation in order to make that right a reality. As Professor Desmond noted in his book, Evicted: Poverty and Profit in the American City (2016), 'A program that ran from 2005-2008 in the South Bronx provided more than 1,300 families with legal assistance and prevented eviction in 86% of cases." 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 23 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1956/Application-Requirements-Process RI Behavioral Health (mental health and substance abuse) O Affordable Housing ❑ Health Care (including dental) D Workforce Development O Homelessness ❑ Transportation Services and Access O Domestic Violence and Child Abuse O Disabilities ❑ Food and Nutrition O Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity .•I Financial Assistance 33 LJ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) This project expands access to legal services spanning the entire continuum of homelessness prevention and anti - displacement interventions for low-income tenants at risk of displacement in Dublin. Having access to safe, stable, affordable housing is necessary to a high quality of life. Traditionally marginalized communities, such as persons of color, persons with disabilities, elderly persons, and domestic violence survivors face greater barriers to housing stability. The data bears this out. For example, the Bay Area Equity Atlas found that low-income and communities of color have not recovered financially from the COVID-19 pandemic, and are facing higher rates of being behind on rent (https:/fbayareaequityatlas.orgfrecovery-trackerlintro). Additionally, domestic violence is one of the leading causes of homelessness nationally (https://homelesslaw.org/wp-contentfuploadsl201 S/10/Lost-Housing-Lost-Safety.pdf). This project prioritizes helping those most at risk of eviction and displacement, including persons who fall within these identities, and thereby helps Dublin achieve its Vision Statement where Dublin tenants can safely live, work, and raise a family in a diverse and inclusive city. This project is designed to strategically target low-income tenants most at risk of displacement. Our model of legal services provision includes two key components: upstream and downstream prevention. (a). Upstream Prevention: Pre -eviction Consultations Broad, inclusive service provision via remote and/or in -person clinics and workshops. We provide one-to-one legal consultation services that can include drafting letters, providing legal advice, reviewing notices and contracts, helping tenants respond to notices, and providing other short-term, limited assistance to address risks such as eviction notices, rent increases, uninhabitable conditions, and landlord harassment. Legal consultations and clinics provide broad access to legal advice. Tenants can get legal advice on a wide range of housing issues, and legal services providers can spot emerging issues and trends that are contributing to displacement. Early intervention in landlord -tenant conflicts can prevent eviction lawsuits from being filed and provide tenants with important information about how to exercise their rights and the resources available. Consultations are an efficient way of preventing displacement since they can be made available to large numbers of people and can prevent resource -intensive litigation. Legal consultation services are short-term, limited legal services that may include: (1) advice and counsel; (2) assistance completing forms or preparing correspondence; (3) supporting individuals in representing themselves; (4) assistance with reviewing contracts, letters, or written documents; (5) addressing issues related to various tenant protections; and/or (6) other short-term, limited assistance aimed at preventing displacement. Many of the legal consultations provided will take place through regularly scheduled remote or in -person clinics or workshops for tenants. In -person clinics will be held in key locations to ensure that underserved populations are able to utilize services. (b). Downstream Intervention: Legal Representation Legal representation services are more expansive than legal consultation and will be provided where it is determined that more extensive services are necessary or appropriate to prevent displacement. Such services may include: (1) Representing a tenant in mediation or negotiations aimed at avoiding the filing of an unlawful detainer action and/or a rent increase that would result in displacement; or (2) Defending an unlawful detainer (eviction) action. We ensure this project is cost effective and that the budget meets the needs of the anticipated results by leveraging existing infrastructure funded through Alameda County Housing Secure (ACHS), State Bar funding, and foundation grants. ACHS is a program that Centro Legal has administered since 2018, and administrative infrastructure and staffing of the program has been well established. Staff such as our outreach coordinator, data and policy analyst, paralegals, housing advocates and staff attorneys are already doing this work. Additionally, ACHS provides emergency financial assistance funds that Dublin residents are eligible for. There will be increased access for Dublin tenants to an entire team of attorneys and staff dedicated to this work. This project allows for the ACHS program to be scaled up and leverages the program structure already created. Deliverables are based on average attorney caseloads and are in proportion to the amount of funding received, which creates realistic deliverable goals. Our proposed budget would fund 0.15 FTE housing attorney, benefits, outreach and administrative costs. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Outcome Measures 34 Our primary goal and objective is to enhance the quality of life for low-income tenants of Dublin via housing -related services to prevent homelessness and to promote stable, affordable, healthy housing. Measurable outcome for Goal 1: At least 90% of Tenants will be more aware of available resources and legal options and better prepared to successfully resolve their housing issues. Measurable outcome for Goal 2: After legal representation, at least 70% of Tenants will successfully resolve their legal matters and report improved housing stability, avoided an eviction, avoided homelessness, having a rent increase rescinded, receiving a rent reduction, or securing time and/or money to move. Performance Goal 1: 17 Tenants receive legal consultation for housing -related problems such as obtaining resources and information about their legal options and rights. Performance Goal 2: 8 Tenants receive legal representation for housing -related issues. Centro Legal uses the case management software JusticeServer, which allows us to track a significant amount of client data and assess quantitative goals on a monthly basis. During in -person services, Centro Legal also uses anonymous client surveys to measure our impact. Centro Legal uses case outcome data and program evaluations to determine if a program is effectively meeting clients' needs. We also use information on the number of clients we serve and the types of issues our clients are facing to determine the level and types of services needed. Based on this information, we make changes to program design and our budget to expand services and staffing as needed. Centro Legal has current CDBG contracts with the City of Hayward, Dublin, and Oakland. We are familiar with the CDBG guidelines and ensure that clients are low-income according to the guidelines. Prior to receiving a consultation, tenants certify their income so we can ensure eligibility. In addition to income information, Centro Legal is also collecting a lot of other demographic data such as race and ethnicity to ensure we are serving a diverse group. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Our project is focused on enhancing the quality of life for low-income tenants of Dublin via housing -related services to prevent homelessness and to promote safe, affordable, stable housing. Having access to safe, stable, affordable housing is necessary for a high quality of life. Traditionally marginalized communities, such as persons of color, persons with disabilities, elderly persons, and domestic violence survivors face greater barriers to housing stability. This furthers Dublin's values of safety, inclusivity, diversity, and equity. Our project focuses on underserved communities, empowering and advocating for them and ensuring that they are being served in an equitable way and can remain in their community. Having a safe and affordable place to live is key to a high quality of life, and the necessary base for so many other aspects of our lives. Our project supports low- income Dublin tenants in ensuring they have access to safe housing, that they can enforce their rights to maintain their housing stability, and reduces displacement of low-income underserved BIPOC (Black, Indigenous, (and) People of Color) communities. By helping those most marginalized stay in their homes, this project helps to ensure that Dublin is an inclusive, diverse, and equitable place to not only live, but thrive. Additionally, Centro Legal is deeply committed to diversity, equity, and inclusion. We have a diverse staff of advocates and attorneys who are committed to these values, and our representation of tenants reflects these values. This project prioritizes helping those most at risk of eviction and displacement, including persons who fall within these identities, and thereby helps Dublin achieve its Vision Statement where Dublin tenants can safely live, work, and raise a family in a diverse and inclusive city. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. We continue to see the economic impacts of the COVID-19 pandemic and inflation crisis on low-income tenants. They continue to be vulnerable to eviction when they cannot pay rent because they have lost income due to the pandemic. This has become even more critical with the end of the eviction moratorium in April 2023. Many reports for post -April 2023 eviction filings show that monthly averages far surpass pre -pandemic averages (Calmatters.org). This project is a direct response to the increased need for tenant representation because of the ongoing impacts of COVID-19, the end of pandemic -related protections, and the sharp rise of inflation, as well as the ongoing housing crisis. This project will enable us to intervene early and provide advice and representation to prevent displacement of those impacted economically by the COVID-19 pandemic. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for 35 CDBG funds? 11 Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA El Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Centro Legal is committed to providing high quality legal assistance regardless of a client's language or disability. Centro Legal utilizes multiple strategies to provide services to individuals who are non-English speaking or have limited English proficiency, including by making our services accessible through 3-way phone interpretation with a human interpreter. The interpreter facilitates meaning -for -meaning communication between a limited -English proficient person and our English- speaking staff. Centro Legal has substantial experience working with non- and limited English speakers. A majority of Tenants' Rights Practice staff are multilingual. Attorneys and paralegals speak the following languages: Spanish, French, and Mandarin. Centro Legal also has a dedicated Mann interpreter. Centro Legal's website has been fully translated into Spanish. Outreach and educational materials are translated into multiple languages. Workshops and clinics both in -person and virtual are conducted in Spanish and English using simultaneous interpretation. The COVID-19 pandemic forced us to explore additional ways to reach clients such as through Facebook Live and Zoom and by phone to allow Centro Legal to easily reach clients regardless of location. Centro Legal also does outreach to tenants through our website, social media, radio, community partners and word of mouth. For example, Centro Legal has run radio and digital ads in Spanish and Tagalog in order to reach Latino and Filipino Bay Area communities. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑,r Be culturally accessible, appropriate and inclusive ❑.� Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑,� Encourage networking and information sharing across service providers ❑,I Encourage process streamlining ❑,� Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) O A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. O Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. El Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑.I B) Homeless 2 Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. D C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. [I1 D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 36 RI Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers Promote Decent Affordable Rental Housing ❑,r Strengthen Communities ❑=► Ensure Equal Opportunity in Housing O Reduce Housing Discrimination O Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations D Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?) I i Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?"} ❑ Availability/Accessibility ❑ Affordability R Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. E Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. �J Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically 37 homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑�► Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) El Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) ❑ Persons Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 4 Seniors (62 and older) 10 People with Disabilities 4 Female -Headed Households Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 18.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income ("AMI") information is available online at www.dublin.ca.govt1956/Application-Requirements-Process 11 Extremely Low Income (<30% AMI) 10 Very Law Income (30%-50% AMI) - 2 Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) 2 3.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 2 White White + HISPANIC 8 Black/African American Black/African American + HISPANIC 1 Asian Asian + HISPANIC 38 American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC 12 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type NIA) 23.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY [ks #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Linder Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.gov/learn/pay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emalled for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes F! No Budget fat: Funding Sources/Revenues Budget Amount Amount Committed Personnel: Salaries USD$ 13,786.00 USD$ 76,763.00 Personnel: Benefits USD$ 3,033.00 USD$ 16,887.00 Administrative Indirect USD$ 1,681.00 USD$ 9,365.00 Total USD$ 18,500.00 USD$ 103,015.00 Funding Uses/Expenses City of Dublin City of Livermore City of Pleasanton Alameda County Housing Secure (ACHS) State Bar of California Budget Amount USD$ 18,500.00 USD$ 41,000.00 USD$ 46,500.00 USD$ 761,429.00 USD$ 66,874.00 Amount Committed USD$ 41,000.00 USD$ 66,874.00 39 Total USD$ 934,303.00 USD$ 107,874.00 Budget Narrative Centro Legal's legal services for the City of Dublin will expand on the existing ACHS program that Centro Legal has administered since 2018. Funds provided under this grant can be leveraged with ACHS funds to exponentially increase reach. Expanding on ACHS makes it so low-income tenants in Dublin can access Centro Legal's full team of tenants' rights attorneys, paralegals, advocates, outreach coordinator, policy and data analyst, administrative assistant and tenants' rights grants manager. This project will help Centro Legal reach low-income Dublin residents, build on existing infrastructure from the ACHS program and the momentum from the contract granted last year. This proposal requests funding for staff attorney time to provide legal consultations and representations, as well as know -your -rights presentations. Additional funding sources listed, apart from funds requested from the City of Livermore and the City of Pleasanton, are funds that are committed from other grants that allow Centro Legal to provide legal services to tenants throughout Alameda County or are not restricted funds and can be used to leverage City of Dublin funds. For the budget above, we have included 0.15 FTE of attorney time. We hope to obtain funding from the City of Pleasanton and the City of Livermore that will allow us to expand services in the Tri-Valley. In the event that additional funding is not obtained from the City of Pleasanton and the City of Livermore, services will be provided to low-income Dublin tenants in proportion to funding. We utilize 22% as our standard calculation for fringe which includes benefits. 10% indirect costs are intended to cover insurance, rent, utilities, postage, bar dues, office supplies, and other non - salary program expenses. Documents fog Documents Requested* Required?Attached Documents * Program Expense Budget for ALL Grant Requests E i Centro Leaal Proaram Exoense Budaet Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability and/or workers' compensation STATE AND FEDERAL NON-PROFIT ❑� DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements ❑�+ REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure ❑,r Centro Leaal Financial Information Form O Centro Leaal Board of Directors List FY 2024-2025 Centro Leaal Ora Budaet FY 23-24 O Centro Leaal Form 990 2021 ❑+� Centro Leaal Board Authorization Dublin ❑� Centro Lecal Board Authorization Dublin O Centro Leaal COI - City of Dublin Letter FY 24-25- Letter FY 24-25- Centro Coal Non -Profit DM rminatinn Letter Centro Leaal 2022 Audited Financial Statements Centro Leaal Audit Explanation Letter Centro Leaal Personnel Policy & Affirmative Action. Grievance Policy 40 F< UUIhEL) I-UF< UL}bti ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Lientro Leaal 2022 Audited Financial Statements Centro Leaal Audit Explanation Letter Centro Legal Articles of Inrnrnoratk n Rr I tylaws Oriainal & Amended Restated.pdf Centro Leaal Conflict of Interest Policy and Annual Disclosure Statement Centro Leaal Limited Enalish Proficiency Access Plan ZoomGrantsTm is not responsible for the content of uploaded documents. Application ID: 457975 Become a 'an cf 'oonG-arts'" on Facebook Problems? Contact us at anonsid?oon 3.r< ; •, 02002-2024 GrantAnalystcc n AI rights reserved. "ZoomGrants- and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. _oaoUL I gL.9: szr 41 sMi DUBLIN Powered by ZoomGrantsTM and Email This Preview Save as PDF City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 111912024 Print Close Window Ar V Chabot -Las Positas Community College District dba Tri-Valley Career Center Dublin Pathways to Employment Jump to: Oraanization Information Questions Budget Documents USD$ 24,989.00 Requested Submitted: 1 /19/2024 11:11:26 PM (Pacific) Project Contact Alcian Lindo ali n dolrr�cloccd.o ra Tel: 925-416-5108 Additional Contacts none entered Organization information to,c 1. Business License Number 010043 Questions tore Chabot -Las Positas Community College District dba Tri-Valley Career Center 5860 Owens Dr FI 3 Dba Tri-Valley Career Center Pleasanton, CA 94588 United States Vice Chancellor for Business Services, designated signer Jonah Nicholas inicholasOcloccd.ora 1. Select the category that best describes your organization: (Select only one) ❑ Non -Profit Public Agency ❑ Other: Telephone(925) 416-5100 Fax Web www..trivalleycareercenter.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). The Tri-Valley Career Center (TVCC) is part of the Chabot -Las Positas Community College District (CLPCCD). Our mission is as follows: We empower individuals and communities to thrive by creating career, education and economic opportunities" 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.r Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 42 operation. ❑ Yes :Y.!i No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Each year, TVCC helps job seekers find careers by offering free workshops, one-on-one counseling, comprehensive training programs and a variety of supportive services. Beginning in 2022 and continuing through the 2023 calendar year, TVCC worked with employers to identify the critical need for employees in Alameda County and created the Pathway to Employment program, a free training program providing pathways to high -demand occupations offering livable wages. We are seeking funding to continue providing job and supportive services to Dublin residents while offering free and paid job training, which includes forklift, CPR and OSHA warehousing and Certified Nursing Assistant (CNA), Office Administration, Medical Billing and Coding and EMT training certifications. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) TVCC serves residents of the Tri-Valley who are looking for career services and employers looking for qualified candidates. While the income demographics of our clients vary, our lower -income clients are frequently most impacted by job instability and without connection to services. While our career services continue at TVCC, we've added our Pathway to Employment program. This program trains low- income workers for occupational sectors experiencing critical challenges in finding workers. This year, our industry focus is on healthcare. To assist healthcare employers, TVCC is offering multiple free and paid training programs that provide state and industry recognized healthcare licenses and certifications to low-income individuals. Upon completion of these four to ten - week training courses, participants will have the opportunity to network and interview with local employers. The training programs planned in 2023-24 fiscal year are Certified Nursing Assistants (CNAs), Emergency Medical Technicians (EMTs), Patient Care Representative (with Medical Billing and Coding) and Phlebotomy. While there are job openings and career paths to high quality jobs in healthcare, many job -seekers have little knowledge of the pathways to these stable, high -paying careers. We will leverage our extensive network for both the outreach and implementation of our training programs, which will empower us to offer training programs for those who have been hit hard by the economic downturn. In this way, our center will create a direct pipeline from training to employment for job seekers, educating them about pathways in high -demand professions along the way. The funding we are requesting will help us pay for our services, including the training programs and supportive services described above for Dublin residents, If we do not receive funding, we will offer fewer services and training and will not be able to meet the demands of local employers to train new workers. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) This grant will support job services, workshops and job fairs with intense hands-on help for at least 160 Dublin clients, including 10 clients in our Pathway to Employment program. We also plan to help 200 more clients through our online resources. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/19561Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development El Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition ❑ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education 43 LJ Changing Demographics and Growing Diversity ❑ Financial Assistance Li None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) TVCC has been a part of the Tri-Valley for more than 20 years. In that time, the staff helped thousands of job seekers find their next path in life — stopping their reliance on unemployment and other benefits and helping them to return to the working world. Our successful combination of self -paced and staff -assisted services allow job seekers to find their own path. Our experienced staff walk beside them, teaching skills, offering encouragement and building confidence through our workshops, Job Club, one-on-one counseling, comprehensive training and hiring events. TVCC requests $24,989 to continue our services and expand our Pathway to Employment program with a focus on comprehensive training to get job seekers on a pathway to a career in the healthcare fields. This funding will specifically support staffing costs, targeted outreach and recruitment of Dublin residents, supportive services for those enrolled in the Pathway to Employment program and some operational costs. Staff who will be primarily working on this project are the Program Manager, Enrollment Specialist, two Case Managers, a Job Developer and an Administrative Assistant. In addition, a contracted Training Coordinator will track and manage the certification training and lead soft skills workshops. This program is staff -reliant and will include career counseling, job training, group mental health counseling, financial literacy workshops and job placement in highly in -demand occupations in Alameda County. Career counseling happens primarily in - person at two locations: TVCC's office in Pleasanton and the Livermore SSA office. Our general career services, along with our Pathway to Employment program will continue to outreach and serve the following populations: • Families with children • Seniors (age 55+) • Unemployed • Unhoused • Young Adults (age 18-24) • Adults (age 25-54) • Previously Incarcerated • Disabled • Veterans • Refugees • Asylees A portion of the funding from this grant will be used to support the outreach to these groups. Though TVCC receives many referrals from friends, family and agencies throughout the community, funds from this grant are needed to augment that. We have a robust community outreach plan that includes: • Participation in community and non-profit collaborations. • Co -location staff based at the Alameda County Social Service Agency offices in Livermore. • E-newsletter and emails to agencies serving people experiencing poverty. • Social media posts and advertisements. 44 Flyers and posters delivered to community partners. • Collaboration with agencies serving people experiencing poverty, including public housing developments, SSA, domestic violence and homeless shelters. • Hiring events at the Tri-Valley Career Center and in the community. • Partnerships with local adult schools, community colleges and job training programs. • Website, search engine optimization (SEO) and online job board. • Public relations. Our marketing plan includes: Partner outreach, collaboration and referrals • Facebook/lnstagram — paid promotion • Google Ad — paid promotion • Geofencing — paid promotion • Email Blast/Press Release • Social Media Posts (twitter, Instagram) Community/Cultural Event Tabling • Local Radio (101.7 KKIQ) — paid promotion • Newspaper Ads — paid promotion • Linkedln — paid promotion • Student Magazine (Las Positas College) • Chamber of Commerce Ads To ensure that job seekers successfully complete the Pathway to Employment program, this grant will help us offer free or paid training programs to participants along with supportive services in the form of transportation assistance, food assistance and/or small stipends to supplement income lost during unpaid training. Our goal for the Pathway to Employment program is to provide 10 low-income Dublin residents with free job training and employment placement. This training is a cohort model where clients work together from the beginning of the program through the certification testing, which is set up to advance completion and success. Along with this, the grant will support our job services, workshops and job fairs to meet the goals of serving 160 Dublin clients with intense hands-on help. We also plan to help an additional 200 Dublin clients through our website and YouTube channel. Operational costs for community service programs are often the most challenging to cover as they may not seem as compelling as specific projects. However, without funding for operational and staff expenses we could not serve our communities. With our delivery of services revolving around training cohort models, our operational costs and staff expenses have increased and the need for support to continue serving our community is greater than ever. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? TVCC's one-on-one career counseling and case management is tracked through CalJobs and adheres to the Alameda County Workforce Development Board (ACWDB) and WIOA regulations. All counseling activity is recorded online in clients' files (located in CalJobs) and recorded for the ACWDB to follow and aggregate for the agency's quarterly and annual reports. TVCC also keeps hard copies of client files including enrollment, training and placement data in a secured filing cabinet. Specific to TVCC, we track the number of enrollments, placements, trainings and credentials obtained. For those indicators not tracked through CalJobs, TVCC has several tracking mechanisms to assure quality of services. 45 Workshop leaders distribute evaluation forms at the close of their workshops to gauge training effectiveness and find areas for improvement. Based on the evaluations, workshop leaders revise their workshops to address any identified issues. We also provide online surveys to both clients and employers following training and events. Clients will also be asked to voluntarily provide written and video -recorded success stories. Program progress, activities, and outcomes will be reported through a semi-annual and annual report. Our criteria for success will be the achievement the following results at the end of this grant: • support 160 Dublin residents, providing hands-on career services • provide 10 Dublin residents with free career training, an industry recognized credential and placement in a job earning a livable wage • support an additional 200 Dublin residents through our online platforms (website and YouTube). 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision TVCC supports Dublin's Mission, Vision and Values that include inclusivity, diversity and equity through a variety of our services to low-income Alameda County residents. TVCC serves residents of the Tri-Valley who are looking for career services and employers looking for qualified candidates. While the income demographics of our clients vary, our lower -income clients are frequently most impacted by job instability. TVCC provides two services that can assist families and individuals: training and career services and referrals to wrap -around community services. Our career services help adults find better paying jobs and train for careers that bring stability and livable wages. Our resources include trainings, workshops, career counseling, and online opportunities designed to guide adult job seekers towards success in today's job market. We prioritize adult clients (18+) from disadvantaged backgrounds including but not limited to refugees, veterans, dislocated workers, individuals with disabilities, unhoused individuals, and re-entry participants. In addition to our Pleasanton -based TVCC, we have career coaches who work directly with CalWorks/CalFresh recipients, a re-entry coordinator who works directly with the formally incarcerated and a transition specialist who works directly with ESL students and adults working to obtain their GED. We offer our training aids in multiple languages; with staff who speak Spanish and Tagalog. Our training and one-on-one services assist ESL clients. We also provide culturally competent services that promote an inclusive environment that caters to the diversity of East Bay residents. These staff members provide direct outreach to our clients, referring them to our center for numerous services including our Volunteer Income Tax Assistance (VITA) program and our CalFresh application support program. To reach and serve our most marginalized communities, we will continue to expand on our outreach plan as discussed abov 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. TVCC has been a service of Chabot -Las Positas Community College District since 1983. TVCC offers career development, skills upgrading and employer services for residents of the Tri-Valley area and other parts of Alameda County. In 2020, we quickly moved our services online, and they remain in place today. This allows us to provide in -person and virtual workshops so that our services are available to Tri-Valley residents who cannot get to our offices. TVCC works with Back to Work and Welfare to Work clients who have been affected by COVID-19 to help them restart their career or pivot to a new one. While we're accepting all low-income residents, we're targeting residents who are receiving unemployment or coming off unemployment to get them re-employed as quickly as possible. We also partner with employers who have been hit by labor shortages post -pandemic, through training and outreach to our clients. In 2023, we worked with multiple employers to determine the most in -demand occupations so that our training offers are relevant and effective for everyone in the community. We've responded by creating the Pathway to Employment program with a focus on healthcare, a industry with major labor shortages in our area, where we can provide short-term occupational training to our clients that will get them back to work quickly. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL 46 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.'"r Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. I No. If no, check box here and enter NA El Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding. nia 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement Li Promote energy and resource efficiency EJ Encourage networking and information sharing across service providers I_1 Encourage process streamlining ❑ Consolidate service delivery Pi Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. El Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. El Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or F) Not Applicable. Not interested in CDBG funding. Fri 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 11 Public Services El Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing El Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 47 1 am seeking to addressi) ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities RI Not Applicable. Not interested in CDBG funding. lg. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?" ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability ❑,I Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. El Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services 48 to meet the needs of the service area, neighborhood, or community, as determined by the grantee. 1.1l Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) Persons ❑ Households Fes+ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless nja Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income ("AMI') information is available online at www.dublin.ca.govt1956/Application-Requirements-Process Extremely Low Income (<30% AMI) Very Low Income (30%-50% AMI) Low Income (50%-80% AMI) nja Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American BlacklAfrican American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black(African American and White + HISPANIC American Indian/Alaskan Native and Black/African American 49 American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial nia Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY _Yi #1 - This program/project has the agency's highest priority for funding. El #2 - This programlproject has the agency's 2nd highest priority for funding. ❑ #3 - This programlproject has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. El If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. Ei Yes .v1 No Budget tot Funding Sources/Revenues Budget Amount Amount Committed City of Pleasanton USD$ 31,635.00 USD$ 0.00 City of Livermore USD$ 31,785.00 USD$ 0.00 AC-OCAP USD$ 49,995.00 USD$ 40,000.00 Fed. Workforce Development Funds USD$ 176,000.00 USD$ 0.00 Prologis USD$ 166,000.00 USD$ 166,000.00 CLPCCD USD$ 735,561.00 USD$ 735,561.00 Total USD$ 1,190,976.00 USD$ 941,561.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 570,108.30 USD$ 10,005.00 Benefits USD$ 369,545.00 USD$ 4,774.00 Supplies USD$ 1,000.00 USD$ 0.00 Printing/Copying USD$ 200.00 USD$ 0.00 Rent & Utilities USD$ 239,490.00 USD$ 885.00 Marketing USD$ 15,000.00 USD$ 325.00 Contracted Services USD$ 92,000.00 USD$ 3,000.00 Training Software USD$ 2,800.00 USD$ 500.00 Client Training Fees USD$ 18,200.00 USD$ 1,500.00 Other (Supportive Services) USD$ 11,000.00 USD$ 4,000.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 Total USD$ 1,319,343.30 USD$ 24,989.00 Budget Narrative 50 I V(U is a grant-tuncled program of ULF'L:UU, through its Economic Uevelopment Department. Its main grant, which helps pay for select staff salaries has been rapidly dwindling over the last 7 years. Projects that we know will help the Tri-Valley community but are out of the scope of our Alameda County Workforce Development Board (ACWDB) contract need to be funded in other ways. The 3 cities of the Tri-Valley have been fantastic partners in this way for the past several years. The budget is broken into three areas: Salaries, Benefits, and Operating Costs. The total is shared between the three cities, the District, Alameda Workforce Development Board ,Alameda County Oakland Community Action Partnership (AC-OCAP) and Prologis. We are requesting Dublin's help to fund 2.2% of this total budget. Documents top Documents Requested * Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Retum (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability andfor workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Required?Attached Documents * ❑� Proaram Expense Budaet REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Financial Information Board of Directors Annual Budget Tax Exempt Letter BoD Designation of Authorized Official BoD Authorization to Reauest Funding COI Non -Profit Determination Letter Certified Audit 51 Supporting uocuments such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsml is not responsible for the content of uploaded documents. Application ID: 460088 Become a on racebook Problems? Contact us at e2082-2024 GrantAnalyst.cam. All rights reserved. "ZoomGrsnts' and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. �onout I Browser 52 sMi DUBLIN Powered by ZoomGrantsTM and Email This Preview Save as PDF City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 111912024 Print Close Window Ar V Chabot -Las Positas Community College District dba Tri-Valley Career Center Dublin VITA Services Jump to: Organization Information Questions Budget Documents USD$ 20,733.00 Requested Submitted: 1/19/2024 10:59:20 PM (Pacific) Project Contact Alcian Lindo ali n dolrr�cloccd.o ra Tel: 925-416-5108 Additional Contacts none entered Organization information to,c 1. Business License Number 010043 Questions tore Chabot -Las Positas Community College District dba Tri-Valley Career Center 5860 Owens Dr FI 3 Dba Tri-Valley Career Center Pleasanton, CA 94588 United States Vice Chancellor for Business Services, designated signer Jonah Nicholas inicholasOcloccd.ora 1. Select the category that best describes your organization: (Select only one) ❑ Non -Profit Public Agency ❑ Other: Telephone(925) 416-5100 Fax Web www..trivalleycareercenter.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). The Tri-Valley Career Center (TVCC) is part of the Chabot -Las Positas Community College District (CLPCCD). Our mission is as follows: We empower individuals and communities to thrive by creating career, education and economic opportunities" 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.r Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 53 operation. ❑ Yes :Y.!i No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). TVCC's Volunteer Income Tax Assistance (VITA) offers free tax preparation services to low- to moderate -income individuals and families, especially Earned Income Tax Credit (EITC)-eligible families. In addition to preparing the current year's taxes, we also help with previous years' taxes, amended taxes, paper returns and extensions. TVCC is the only accepting agency to prepare taxes for immigrants with ITIN numbers, who are individuals required to have a U.S. taxpayer identification number but who do not have, and are not eligible to obtain, a Social Security number and the only organization to offer free tax service in the Tri-Valley area. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Though the TVCC VITA program has grown from 26 returns when we started in 2013 to 619 returns last year, there are still hundreds of families who could benefit from our services. Some simply do not file taxes. Others pay extraordinary fees to have them done by a for -profit company. A 2023 report from the Tri-Valley Anti -Poverty Coalition states that 4.2% of Dublin residents live below the federal poverty line and 16,455 residents receive some form of public assistance. Despite the large number of households eligible for free tax preparation services, only 90 Dublin residents utilized our services last tax season. This is due in part to lack of consumer awareness of the program and a lack of initial trust that this free service provides the same or better results as a paid service. Another challenge is the recruitment of volunteers due to COVID and a lack of funding to do extensive outreach. VITA tumed away more than 50 residents last year due to a lack of volunteers. Based on the sheer number of Dublin residents living below the federal poverty line and those receiving public assistance, there is a clear need for free tax preparation services and free financial literacy counseling. To reach these residents, we plan to expand our services and outreach. Currently, TVCC staff provide direct outreach to our clients, referring them to our center for numerous services including the VITA program. More than 80 percent of these residents come from low, very low and extremely low-income households. To reach and serve our most marginalized communities, we need to expand the promotion of VITA to include paid campaigns and the development of online ads in multiple languages. If our budget comes up short, we cannot afford to pay for the development and placement of advertising, which will negatively affect both volunteer and clients recruitment. Fewer volunteers limit our ability to serve clients, leaving hundreds without access to this program. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) Our goal is to continually increase the number of working families served by the VITA program, and to increase the number of families who receive the federal and state EITC. Our goal for 2024-25 is to file a minimum of 115 Dublin tax retums. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑.1 Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition ❑ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity 54 FJ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) By law, the VITA program is a completely free service. However, it is riot free to operate. It takes dedicated organizations and people to establish the services and provide free tax preparation. It takes a small army of volunteers to be certified and prepare the taxes. And it takes funding. The IRS funds organizations nationwide to provide VITA services. In the Bay Area, that funding regularly goes to United Way, which then parcels out its allocation to organizations in seven Bay Area counties, including TVCC. However, this funding does not cover all our expenses to plan, market and execute a successful VITA program in the Tri-Valley. The COVID-19 pandemic has added expenses to the program not needed in prior years such as PPE and secure -sharing software. Due to our growing number of clients each year, we anticipate an even greater need for support. This year, we are projecting to reach more people through our new location and full-time operating hours. Most of our expenses comes from staff who will dedicate approximately 570 hours plus 45% in fringe benefits to the program. We also need to hire a Co -coordinator who will complete 300 hours, helping to expand the program further throughout the Tri-Valley. Since TVCC began providing VITA services in 2013, these dedicated individuals have prepared more than 3,470 tax returns, bringing more than $3.4 million dollars back to the Tri-Valley in federal refunds. The TVCC budget for the 2024-25 VITA program is $100,036.00. This does not include the donated time of volunteers which is estimated to cost approximately $161, 004.38. Should we meet our overall goals of 650 returns filed, residents would receive a combined total of approximately $771,550 in federal refunds. Moreover, research shows there is a multiplier effect of at least 1.5 on the refunds spent in the region meaning the return of the investment in the program could yield $1,157,325 in the Tri- Valley. Thus, the economic effect of the VITA program is far greater for the community than just for the families served. VITA is a workforce development program as the EITC has been shown to encourage work for low-income families. However, our efforts in this are outside our main workforce development contracts. As such, the program is entirely grant funded and must be exceedingly efficient with its small, dedicated funds. The program's efficiency come from these components: • By law, the taxes can only be prepared by volunteers. These volunteers must be certified by the IRS in the appropriate tax law and the software used nationally for the returned to be e-filed. TVCC usually has more than 40 volunteers who speak 5 different languages. Our project includes in -kind work of at least 2820 hours from volunteers, which equates to approximately $111,000. • The College district donates the supervisory management of VITA program. Though the Program Coordinator is the strength of the TVCC VITA program, it does take a manager to oversee it, plan the marketing and write reports. This time is donated to the program. • TVCC uses its network of other community service providers and as much free marketing placement as is feasible. As a nonprofit, TVCC has become effective in using free media and word of mouth for this program and others. This year, we plan to offer both in -person and drop-off tax preparation services at our location in Pleasanton. This location has ample parking and is accessible by bus and BART. We also plan to reopen our sites at the Livermore and Pleasanton library (pending library approval and volunteer numbers), providing the community with multiple tax prep sites and increasing accessibility to this service. We are investing in more education and outreach, along with volunteer recognition (including food for the volunteers as they complete 3 full, 8-hour training days) to ensure we recruit and retain at least 40 volunteers. Finally, we have been working with VITA for 9 years and have used the same equipment throughout. We have an urgent need for a new copier which will speed up the tax preparation process by allowing us to print and make any copies we need at a faster pace so that we may serve more clients. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Each year, we track the following measurements, from which we can extrapolate data for Dublin to measure effectiveness: • Total number of clients 55 • Percentage increase of clients • Total federal dollars returned to clients • Average and Total Earned Income Tax Credits (EITCs) returned to clients • Average Adjusted Gross Income of clients • The total number of ITIN applications filed The goal of the TVCC VITA program is to grow and serve more people in the region who are EITC-eligible. Given the nature of the service, our results are tracked meticulously by the IRS. Each tax return is e-filed through the IRS proprietary system. This system gives us information in aggregate of all our tax clients. Each tax returned e-filed is tracked by the IRS through our location codes. Not long after the end of each tax season, we are able to discern the number of tax returns filed as well as the amount of federal/state refunds, the total EITC returns, and the average household income among other things. As anti -poverty safety -net program, the population that the VITA program targets are low- to moderate -income working families. Like the Federal Poverty Guidelines, the VITA program sets its income limits at a national level. The federal income limit for the program is $72,000 per household, regardless of family structure. Due to the high cost of living in the Bay Area, we accept clients with incomes up to $75,000. For a family in the Tri-Valley, this is far below the living wage. The average income earned by families we served last tax season was $32,360. This number has been consistently low during the past 5 years that we have offered VITA services. Many of the families we serve year after year speak a language other than English at home. We offer the services in at least five languages, depending on our volunteers' bi-lingual abilities. Spanish and Tagalog are the main languages other than English that we serve. The VITA Program Coordinator's first language is Spanish and thus, we can help more families in the Tri-Valley who desperately need this service. Our goal is to reach and serve our most marginalized communities. We will continue to expand on our previous outreach plan, which successfully brought us more than 600 low-income and underrepresented tax filers during the 2022 tax season. At the end of this grant, we plan to bring in 650 tax filers, of which 115 will be from Dublin and process 10 ITIN applications. Our partners included in this plan are: • IRS: monitoring, training, software, tax law, technical support • United Way: funding, training, oversight • Pleasanton Library: tax site, marketing, computer and printing use • Livermore Library: tax site, marketing, computer and printing use (pending volunteer availability) • Las Positas College: marketing, tax site (pending volunteer availability) • CityServe of the Tri-Valley: outreach to seniors and low-income families, potential transportation support Our 2024-2025 outreach plan includes but is not limited to: • Email blasts to TVCC clients and job seekers in CalJobs database who live in the Tri-Valley region • Email blasts to Tri-Valley and Alameda County residents receiving unemployment benefits • Referrals from partnerships with local community -based organizations • In -person outreach and flyer distribution to: o Pleasanton low-income housing units o Local churches o Local libraries o Local food banks With increased funding, we could do outreach to: 56 • Tax Help (administered by the United Way) materials which provide information in multiple languages. • E-flyers to Dublin, Livermore, and Pleasanton families through school district's communication systems. • Peachiar — online flyers to the school system. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision TVCC supports Dublin's Mission, Vision and Values that include inclusivity, diversity and equity through offering a wide range of services and outreach strategies to low -to -moderate income taxpayers, especially those eligible for the Federal and State Earned Income Tax Credits and who feel most comfortable communicating in a language other than English. We also provide culturally competent services, promoting an inclusive environment that caters to the diversity of East Bay residents. Our resources include workshops, career counseling and online opportunities designed to guide adult job seekers towards success in today's job market. We prioritize adult clients (18+) from disadvantaged backgrounds including but not limited to refugees, veterans, dislocated workers, individuals with disabilities, unhoused individuals and re-entry participants. We are the only accepting agency in the Tri-Valley to prepare taxes for immigrants with ITIN numbers. These are individuals required to have a US taxpayer ID number but are not eligible for a Social Security number. We have career coaches who work with CalWorkslCalFresh recipients, a re-entry coordinator who works with the formally incarcerated and a transition specialist who works with ESL students and adults working to obtain GEDs. They provide direct outreach to our clients, referring them to our center for services including the VITA program. Their referrals, along with the referrals from our community -based partnerships and marketing campaigns, have helped us prepare more than 3,470 Tri- Valley tax returns over the past 10 years. As discussed earlier, most of these residents come from economically disadvantaged households. To reach and serve our most marginalized communities, we will continue to expand on our previous outreach plan as discussed in questions #6 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. TVCC has been hosted by Chabot -Las Positas Community College District since 1983. TVCC offers career development, skills upgrading and employer services for residents of the Tri-Valley area and other parts of Alameda County. The TVCC VITA program is one of three programs in the seven Bay Area counties that remained open to provide free, virtual tax services during the 2020 pandemic. These services remain in place today allowing us to provide both in -person and virtual workshops so that our services are available to Tri-Valley residents who cannot get to our offices. As the financial challenges of COVID continue, we continue to make our services readily available to Tri-Valley residents who do not have the time or resources to get to our offices so that our clients can access our services remotely. As an organization, we are responding directly to the impacts of the pandemic. We work with Back to Work and Welfare to Work clients who have been affected by COVID-19 to help them get back to work. While we accept all low-income residents, we're targeting residents who are unemployment or coming off unemployment to get them re-employed as quickly as possible. We also provide transportation support in the form of gas/clipper cards to unemployed and low-income clients to help them get to job interviews and trainings. The VITA program puts cash directly into the hands of clients through EITC and state and federal refunds, allowing residents to catch up on bills, begin or rebuild their savings and invest in their future. We also partner with employers who have been hit by labor shortages post -pandemic, through training and outreach to our clients. In 2023, we have been working with employers to determine the most in -demand occupations so that our employment service offerings are effective for everyone in the community. 13. »x QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? r] Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA 57 L I Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NSA" if you are not interested in qualifying for CDBG funding. nla 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive FA Encourage community engagement and involvement ❑ Promote energy and resource efficiency IJ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery [ i Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑� F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: • Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations [l Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities 58 F�! Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?" ▪ Availability/Accessibility ❑ Affordability ❑ Sustainability 1.11 Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. El Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. El Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Ri Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: 59 (Select only UN ) ❑ Persons ❑ Households ❑,r' Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless n/a Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0" Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process Extremely Low Income (<30% AMI) Very Low Income (30°I0-50% AMI) Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White BlacklAfrican American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial nja Not Applicable. Not interested in CDBG funding. (Type NIA) 60 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY El #1 - This program/project has the agency's highest priority for funding. !�! #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes QJ Na Budget .QN Funding Sources/Revenues Budget Amount Amount Committed City of Pleasanton USD$ 16,914.00 USD$ 0.00 City of Livermore USD$ 14,914.00 USD$ 0.00 United Way of the Bay Area USD$ 25,000.00 USD$ 0.00 Chabot -Las Positas Community College District USD$ 41,495.00 USD$ 41,495.00 Total USD$ 98,323.00 USD$ 41,495.00 Funding UseslExpenses Budget Amount Amount Committed Salaries USD$ 33,413.00 USD$ 5,121.00 Benefits USD$ 13,372.00 USD$ 2,304.00 Contracted Coordinator USD$ 10,500.00 USD$ 2,625.00 Supplies USD$ 1,698.00 USD$ 424.00 Equipment/Software USD$ 10,800.00 USD$ 2,700.00 Printing/Copying USD$ 1,500.00 USD$ 375.00 Rent & Utilities USD$ 22,140.00 USD$ 5,535.00 Transportation USD$ 393.00 USD$ 98.00 Marketing USD$ 2,500.00 USD$ 625.00 Other Program Expenses USD$ 3,720.00 USD$ 925.00 Total USD$ 100,036.00 USD$ 20,732.00 Budget Narrative Staff Salaries/Benefits/Coordinator: Due to our growing number of clients, we anticipate an even greater need resulting from the pandemic. So many people in the community are without jobs and living expenses are only increasing. This year, we are projecting to reach more people through our new location and full- time operating hours. Majority of our expenses comes from staff which total about 582 hours plus 45% in fringe benefits. We also have a necessity to hire a Ca -coordinator for 300 hours, which will help to expand the program to other areas including opening a site at the Livermore and Pleasanton libraries. Supplies/Printing/Marketing: Having adequate supplies and effective marketing will ensure that we recruit and retain a minimum of 35 volunteers. This number will ensure that we meet our tax filing goal. 61 Equipment/Software: We have been working with VITA for 10 years and have used the same equipment throughout. Our copier, which we use extensively for the program is extremely old and temperamental. Therefore, we need to purchase a new copier to speed up the process and be able to print and make any copies we need at a faster pace. Transportation: To support staff traveling to our multiple sites across the Tri-Valley to help volunteers and pick up/deliver supplies. Program Expenses: Includes incentives and recognition for volunteers for in -kind work as required by the VITA program. This expense also includes food for volunteers during their in -person, mandatory, 3 full -day trainings as well as transportation support for low-income clients who travel to our offices for services. This budget does not include the in -kind work of 4725 hours from 40 volunteers, which is about $111,037.50 Documents too Documents Requested* Required?Attached Documents * Program Expense Budget for ALL Grant Requests Program Expense Budaet Financial Information Form for ALL Grant Requests ❑.+ Financial Information Form List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Annual Budaet Copy of most recently submitted IRS 990 form or Tax 0 Tax Exemption Form Retum (include complete form) Board of Director's (or governing body's) designation • BoD Desianation of Authorized Official of authorized official Board of Director's (or governing body's) authorization • BoD authorization to reauest fundina to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability ▪ Proof of insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Certified Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. El NON-PROFIT DETERMINATION LETTER REQUIRED FOR CDBG ONLY - LEVERAGING 62 REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 460973 Become a : ^r.:f ?ooinG-ar.te '4 on Faceboak Prandems2 Contact us at •:.;:iestion"rL-r:O�l:�::l:'1 ®2002-2O24 GrantAnatyatcorrt a rights reserved. "ZoomGrants' and the ZoomGrants logo are trademarks of CxantAnalystcam, LLC. i ogout I Browser 63 sMi DUBLIN Powered by ZoomGrantsTM and Email This Preview Save as PDF Print Close Window Ar 7 City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1 f 1912024 City Serve of the Tri-Valley Homeless Prevention and Family Stabilization Program Jump to: Oraanization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/5/2024 2:15:30 PM (Pacific) Project Contact Christine Beitsch-Bahmani a ra nts&citvserveca res. ora Tel: 510-789-5443 Additional Contacts none entered Organization Information 1. Business License Number BL-109916 Questions op City Serve of the Tri-Valley P.O. Box 1613 Pleasanton, CA 94566 United States CEO Christine Beitsch-Bahmani ch risti n e ecit vserveca res. ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: Telephone 9 2 5-222-2273 Fax Web www.cityservecares.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our vision is to mobilize mercy, practical compassion, in the Tri-Valley by care coordination (case management), outreach to underserved communities and to inspire community engagement; this mobilization is designed to humanize the human services. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project 2 Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 64 operation. ❑ Yes :Y.!i No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Homeless Prevention and Family Stabilization Program is dedicated to supporting 75 at -risk households in Dublin, impacting 225 individuals. Our comprehensive approach includes safety net fiscal assistance, personalized non -clinical care coordination (inclusive of case management, street outreach, and specialized youth programs), along with targeted workshops focusing on education and skills training for stabilization. We prioritize underserved individuals and families in the extremely low, very low, and low-income categories in Dublin. Funding will be directed towards three pivotal components encompassing prevention, stabilization, and outreach, providing free individualized care and resources for individuals aged 0-59. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Our Homeless Prevention and Family Stabilization program strongly aligns with Dublin's 2020 updated Mission, Vision, and Values, particularly emphasizing Inclusivity, Diversity, and Equity. Inclusivity: We ensure accessibility to our services for all Dublin residents, irrespective of background. With bilingual staff and translation services, language barriers are mitigated, promoting indusivity in service delivery. Diversity: Acknowledging the diverse needs of Dublin's residents, our program provides tailored support to address individual challenges. Our team is culturally competent, respecting and valuing the unique backgrounds and traditions of the families we serve. Equity: The program contributes to equity by bridging gaps in housing and financial stability, ensuring fair access to crucial resources for all individuals and families. Addressing economic disparities, we strive to create equal opportunities for families to secure stable housing and financial independence. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 75 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/9956/Applicafion-Requirements-Process CI Behavioral Health (mental health and substance abuse) O Affordable Housing O Health Care (including dental) O Workforce Development O Homelessness O Transportation Services and Access O Domestic Violence and Child Abuse O Disabilities LI Food and Nutrition O Senior Services O Youth Services O Child Care, Early Childhood Development and Education O Changing Demographics and Growing Diversity O Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) 65 In order to continue providing free services to Dublin residents the Grant Funds will provide salary support for a Part -Time Resource Specialist (care coordinator) (47% of salary and benefits) and Intake/Crisis Call Coordinator (73% salary and benefits) who will be dedicated to serving Dublin residents. During FY 22/23 we answered 229 crisis calls from Dublin residents and have far surpassed that number already in our current contracted year. Without funding the response time and services for Dublin residents would greatly decrease. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Measuring Program Effectiveness: Process: Underserved Resident Reach: Evaluate outreach's effectiveness through demographic data, gauging service reach to underserved populations. Language Accessibility: Assess language efforts' success in making resources accessible to diverse linguistic communities. Enrollment Rates: Measure the success of care coordination or specialized program enrollment, indicating participant engagement. Quality: Action Plan Progress: Track progress towards established goals, ensuring alignment with participants' needs. Resource Utilization: Monitor expenses and time spent with participants, ensuring efficient resource allocation. Measurable Outcomes: Evaluate achievement of collaboratively established outcomes, like housing list placement and increased fiscal literacy. Impact: Life Change Assessment: Assess overall impact on participants' lives, examining indicators of sustainable self-sufficiency. Client Satisfaction: Utilize surveys to gather feedback on perceived program effectiveness and impact. Reporting: Demographic Data: Capture critical demographic info, including disability status, race/ethnicity, age, and language needs. Action Plan Tracking: Regularly update progress towards established action plans, ensuring transparency. Expense and Time Tracking: Document all expenses and time spent, maintaining accurate records. Measurable Outcomes Tracking: Continuously track and analyze outcomes, ensuring alignment with program objectives. HMIS/Well Sky Database Utilization: Leverage the Federal HMIS & Wellsky database for unsheltered client information. Coordinated Entry Meetings: Participate in regular meetings for effective collaboration with service providers that work with housing. Criteria for Success: Quantitative Metrics: Meeting or exceeding predetermined targets in outreach, enrollment, and measurable outcomes. Qualitative Impact: Demonstrating positive, life -changing impacts on participants. Client Satisfaction: High satisfaction reported through surveys. Efficient Resource Utilization: Maximizing impact while minimizing costs. Database Compliance: Maintaining accurate records in the HMIS & Well Sky database. Outcomes Expected at End of Grant: Transformative Changes: Positive, sustainable changes in participants' lives. Efficient Services: Successful delivery of services with minimal costs. Empowered Individuals: Participants demonstrating sustainable self-sufficiency. Database Accuracy: Up-to-date records in database, complying with reporting standards. In summary, success will be evident in transformative changes for participants, efficient service delivery, and the fulfillment of CityServe's mission. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Our Homeless Prevention and Family Stabilization program strongly aligns with Dublin's 2020 updated Mission, Vision, and Values, particularly emphasizing Inclusivity, Diversity, and Equity. Inclusivity: We ensure accessibility to our services for all Dublin residents, irrespective of background. With bilingual staff and translation services, language barriers are mitigated, promoting inclusivity in service delivery. Diversity: Acknowledging the diverse needs of Dublin's residents, our program provides tailored support to address individual challenges. Our team is culturally competent, respecting and valuing the unique backgrounds and traditions of the families we serve. Equity: The program contributes to equity by bridging gaps in housing and financial stability, ensuring fair access to crucial resources for all individuals and families. Addressing economic disparities, we strive to create equal opportunities for families to secure stable housing and financial independence. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the 66 City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. In direct response to the economic and public health challenges posed by the COVID-19 pandemic, our organization has quickly adapted and expanded programs to address critical community needs: Economic Impact Response: Emergency Financial Assistance: Providing rent and utility assistance to prevent homelessness due to pandemic -related economic hardships. Employment Support Services: Offering job placement assistance and skill development programs to aid individuals affected by unemployment. Emergency Hotel Program: Providing shelter for those 65 and above and/or medically fragile that were higher risk for COVID- 19 and related illnesses. Health Education and Resources: Intensifying health education efforts. promoting COVID-19 awareness, and providing resources for healthy practices. Mental Health Services: Expanding mental health services, including counseling and support groups, to address heightened emotional challenges. Access to Healthcare: Assisting with paperwork and helping clients navigate telehealth options, and ensuring vulnerable populations receive necessary support -securing mobile health care for the homeless. Community Wellness Initiatives: Launching supplemental food distribution programs and virtual wellness activities to address food insecurity and promote community well-being. Adaptability and Innovation: Remaining flexible and adaptive, we continuously assess community needs, adjusting programs to address emerging challenges and directly respond to the evolving economic and public health landscape. Through these initiatives, we aim to provide comprehensive support; fostering community resilience during these unprecedented times. 13. " QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.** Are you are interested in applying for CDBG funds? Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA J Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding. Our Limited English Proficiency/Language Access Plan prioritizes inclusivity through: 1. Bilingual Staff and Volunteers: Trained individuals proficient in commonly spoken languages in our community. 2. Translation Services: Professional translation for documents and outreach materials. 3. Multilingual Outreach: Materials and information in multiple languages distributed in relevant areas. 4. Language Access Hotline: Our care coordinators use the county hotline connecting residents to interpreters for immediate assistance. 5. Culturally Competent Programming: Programs designed with cultural awareness to meet diverse needs. 6. Community Partnerships: Collaborations with local organizations to enhance outreach in specific language communities. 7. In -Person Assistance: Staff providing in -person guidance and support at service centers. 8. Ongoing Training: Regular staff training on cultural competence and effective communication.This dynamic plan ensures language is not a barrier, fostering accessibility and trust within our diverse community. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: �. Be culturally accessible, appropriate and inclusive C Encourage community engagement and involvement CJ Promote energy and resource efficiency .2 Encourage networking and information sharing across service providers 2 Encourage process streamlining Q Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 67 Ed' A) Housing O Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑►� Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. E Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑� B) Homeless ❑d Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑�' C) Supportive Housing 0 Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Ell Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: O Public Services ❑ Public Facilities O Rental Assistance O Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers O Promote Decent Affordable Rental Housing O Strengthen Communities O Ensure Equal Opportunity in Housing O Reduce Housing Discrimination O Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?) bd Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing • Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?") �i Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: El Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. E I Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of 68 browntields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. El Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. El Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. El Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. El Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) ❑ Persons ❑.� Households El Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. o Seniors (62 and older) 18 People with Disabilities 39 Female -Headed Households 5 Youth 13 Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated 69 uunim clients (ti i H R Persons UK rtousenoias) your agency anticipates serving in eacn category. it none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 61 Extremely Low Income (<30% AMI) 13 Very Low Income (30%-50% AMI) 1 Low Income (50%-80% AMI) O Moderate Income (80%-120% AMI) 75.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 15 White 6 White + HISPANIC 15 Black/African American O Black/African American + HISPANIC 18 Asian O Asian + HISPANIC O American Indian/Alaskan Native O American Indian/Alaskan Native + HISPANIC 1 Native Hawaiian/Other Pacific Islander O Native Hawaiian/Other Pacific Islander + HISPANIC 1 American Indian/ Alaskan Native and White 1 American Indian/ Alaskan Native and White + HISPANIC O Asian and White O Asian and White + HISPANIC O Black/African American and White O Black/African American and White + HISPANIC O American Indian/Alaskan Native and Black/African American O American Indian/Alaskan Native and Black/African American + HISPANIC 18 Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ❑ #1 - This program/project has the agency's highest priority for funding. #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. CI #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:Ilwww.fppc.ca.govllearn/pay-to-play-limits-and-prohibitions. 70 It you answer Yes, it will not disqualify you tram the process or impact your application. An additional tarm will be ema?led tor you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes F '! Na Budget t2 Funding Sources/Revenues City of Pleasanton (HHC grants) City of Pleasanton PLHA City of Pleasanton General Fund (seniors) Alameda County City of Livermore Foundations Businesses Churches Individual donors Total Funding Uses/Expenses Part -Time Resource Specialist (care coordinator) (salary and benefits), Intake/crisis call Coordinator Total Budget Amount USD$ 160,000.00 USD$ 111,000.00 USD$ 88,000.00 USD$ 216,218.00 USD$ 226,000.00 USD$ 100,000.00 USD$ 100,000.00 USD$ 43,000.00 USD$ 100,000.00 USD$ 1,144,218.00 Amount Committed USD$ 111,000.00 USD$ 88,000.00 USD$ 216,218.00 USD$ 11,000.00 USD$ 44,000.00 USD$ 48,000.00 USD$ 518,218.00 Budget Amount Amount Committed USD$ 25,000.00 USD$ 518,218.00 USD$ 25,000.00 USD$ 518,218.00 Budget Narrative The $25,000 funding we are requesting will all be focused on homelessness prevention and homeless crisis intervention for extremely law, very low, and low income individuals and families in Dublin. It will go towards three critical aspects of preventionlstabilizationloutreach -- individualized care and resourcing in the form of a Part -Time Resource Specialist (care coordinator) (47% of salary and benefits), Intakefcrisis call Coordinator (75% salary and benefits) who will be dedicated to serving Dublin residents. Total monthly amount approximates $2100.00 and total annual cost equals $25,000. Documents Documents Requested* Required?Attached Documents Program Expense Budget for ALL Grant Requests ❑,t Program Expense Financial Information Form for ALL Grant Requests ❑�' List of Board of Directors (or governing body) with ❑+� agency contact information Current Annual Budget for the Entire Agency 0 Copy of most recently submitted IRS 990 form or Tax 0 Retum (include complete form) Board of Director's (or governing body's) designation 0 of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability and/or workers' compensation Financial Information Board of Directors Annual Budaet 990 Board Designation Board Authorization COI Insurance Blanket Insurance General STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of Federal Determination Letter 71 California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit andlor Certified Financial Statements ❑,r Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEPJLAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Employee Handbook Articles of Inrnrnnra Grievance Policy Collaborators (iitraarh Strateov Impact Report ZoomGrantsTm is not responsible for the content of uploaded documents. Application ID: 459256 Become a Fan of ZoomGrarrts"' on Facebook Problems? Contact us at Questonsr ZoomGrants. com @2002-2024 Grsr tAnalystcan Al righls reserved. "ZoomGrants- and the ZoomGrants logo are trademarks of GrantAnarrtcom, LLC. oaout I Braveser 72 sMi DUBLIN Powered by ZoomGrantsTM and Email This Preview Save as PDF Print Close Window Ar 7 City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1 f 1912024 City Serve of the Tri-Valley Senior 60+ Stabilization Program Jump to: Oraanization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/5/2024 2:12:17 PM (Pacific) Project Contact Christine Beitsch-Bahmani a ra nts&citvserveca res. ora Tel: 510-789-5443 Additional Contacts none entered Organization Information 1. Business License Number BL-109916 Questions op City Serve of the Tri-Valley P.O. Box 1613 Pleasanton, CA 94566 United States CEO Christine Beitsch-Bahmani ch risti n e ecit vserveca res. ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: Telephone 9 2 5-222-2273 Fax Web www.cityservecares.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our vision is to mobilize mercy, practical compassion, in the Tri-Valley by care coordination (case management), outreach to underserved communities and to inspire community engagement; this mobilization is designed to humanize the human services. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project 2 Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 73 operation. ❑ Yes :Y.!i No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Our Senior 60+ Stabilization Program provides bilingual: 1) Crisis Intervention: in -home visits (working with adult protective services) or street/car/hotel outreach, 2) Crisis Stabilization: Case ManagementlCare Coordination (non clinical), and 3) Community Support: Care Advocacy. We serve the most vulnerable Dublin senior residents (as confirmed by data) by supporting them with resourcing for safety net fiscal assistance, food security, transportation, housing navigation, individualized resourcing (aka case management, special programs), and enrollment for workshops focused on health education (Finding Wellness Curriculum), mental health and well-being counseling and/or specific fitness training such as fall prevention classes to ensure stabilization and wellbeing. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Our staff has also noticed a large spike in seniors who can care for themselves day to day, but are feeling extremely lonely and isolated. Due to this trend, CityServe has elevated its volunteer programs so that we can uplift and reinvigorate our clients' overall social connection. We are working to connect volunteers with seniors through hand delivering a holiday gift and visiting with the seniors. We are promoting the continuation of this new connection through monthly visits between the volunteers and senior gift recipients. Also, a recent modification made to an existing program that CityServe provides is connecting our volunteer drivers from our dedicated VAST medical transportation service with a Caring Visitor recipient. CityServe is able to provide support for individuals receiving medical rides by pairing them with a Caring Visitor volunteer who will not only drive them to and from their medical appointment within the city of Dublin but will also provide much needed social and emotional connection that many of our older adults clients are lacking. The Caring Visitor VAST driver fulfills CityServe's mission as they care for the senior, coordinate transportation and connect with the senior during their drive. In 2023 our data showed a very concerning trend of seniors becoming homeless. We served 105 Tri-Valley unsheltered seniors and 5 were Dublin residents. Senior 60+ living on a fixed income in the Tri-Valley are extremely vulnerable to becoming homeless. Our program works upstream with many preventative services, but also with those in immediate crisis of potentially losing or have already lost their home. Due to this startling trend, now is not the time to defund CityServe, we are right on the frontlines and if our program does not exist there would be terrible repercussions and a gap in critical care coordination services. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 109 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.govf99561Applicatian-Requirements-Process ❑� Behavioral Health (mental health and substance abuse) ❑.� Affordable Housing ❑►I Health Care (including dental) ❑ Workforce Development ❑r Homelessness ❑.I Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ❑,� Food and Nutrition ❑.l Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑,I Changing Demographics and Growing Diversity ❑,� Financial Assistance El None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should 74 include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) CityServe is guided by our mission to care, coordinate and connect individuals to vital services within their community. We provide supportive services in English, Mandarin and Spanish to older adults in need within the city of Dublin. CityServe's Care Wheel guides our employees when interviewing potential clients and helps us understand clients' needs in these 6 safety net areas: Financial stability Basic needs Community Physical health Emotional health and wellbeing Vocational education CityServe has established a vast network of resources, literature and personal connections from local government agencies, nonprofit organizations, for profit companies, churches and volunteer groups that can help us connect seniors to the resources in the Care Wheel areas that our clients need. It is our priority to learn about the unique needs of our senior clients and determine their eligibility for the array of services in the Tri-Valley and beyond. Our Care Coordinators listen to the senior, understand their story, and then educate the client in a caring manner so that the senior is able to make informed decisions that can greatly impact their quality of life, mobility and sense of independence, while retaining their personal dignity and sense of self-reliance. One modification that we are implementing is to streamline how we offer our services across different CityServe programs. We are cross training employees to be able to offer additional services to seniors during our first meeting to better meet their needs. In the past, Senior Support would send different employees to the seniors' home to offer care coordination, a connection to a Caring Visitor, enrollment in VAST and home modifications. We are now cross training employees so we can offer all of these services in one appointment. This wrap around service session reduces client anxiety and builds trust with those we serve. It also is much more efficient allowing us to serve more seniors in need. To ensure this happens we are requesting support for a Part -Time Senior Resource Specialist and Intake Coordinator (75% salary) who will be dedicated to serving Dublin residents. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Measuring Program Effectiveness: Process: Underserved Resident Reach: Evaluate outreach's effectiveness through demographic data, gauging service reach to underserved populations. Language Accessibility: Assess language efforts' success in making resources accessible to diverse linguistic communities. Enrollment Rates: Measure the success of care coordination or specialized program enrollment, indicating participant engagement. Quality: Action Plan Progress: Track progress towards established goals, ensuring alignment with participants' needs. Resource Utilization: Monitor expenses and time spent with participants, ensuring efficient resource allocation. Measurable Outcomes: Evaluate achievement of collaboratively established outcomes, like housing list placement and increased fiscal literacy. Impact: Life Change Assessment: Assess overall impact on participants' lives, examining indicators of sustainable self-sufficiency. Client Satisfaction: Utilize surveys to gather feedback on perceived program effectiveness and impact. Reporting: Demographic Data: Capture critical demographic info, including disability status, race/ethnicity, age, and language needs. Action Plan Tracking: Regularly update progress towards established action plans, ensuring transparency. Expense and Time Tracking: Document all expenses and time spent, maintaining accurate records. Measurable Outcomes Tracking: Continuously track and analyze outcomes, ensuring alignment with program objectives. HMIS/Well Sky Database Utilization: Leverage the Federal HMIS & Wellsky database for unsheltered client information. Coordinated Entry Meetings: Participate in regular meetings for effective collaboration with service providers that work with housing. Criteria for Success: Quantitative Metrics: Meeting or exceeding predetermined targets in outreach, enrollment, and measurable outcomes. Qualitative Impact: Demonstrating positive, life -changing impacts on participants. Client Satisfaction: High satisfaction reported through surveys. Efficient Resource Utilization: Maximizing impact while minimizing costs. Database Compliance: Maintaining accurate records in the HMIS & Well Sky database. Outcomes Expected at End of Grant: Transformative Changes: Positive, sustainable changes in participants' lives. 75 Efficient Services: Successful delivery of services with minimal costs. Empowered Individuals: Participants demonstrating sustainable self-sufficiency. Database Accuracy: Up-to-date records in database, complying with reporting standards. In summary, success will be evident in transformative changes for participants, efficient service delivery, and the fulfillment of CityServe's mission. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dubIin.ca.gov172/mission-vision The current program goal is to provide the Dublin senior community with crisis intervention, crisis stabilization and with connection to community support. With an established track record of success in Dublin, we are moving forward with previous offerings while adapting to meet the changing demographic of the Tri-Valley by expanding our program's offerings in different languages and locations. A popular event in the CityServe office is "Foot Care". Seniors can make an appointment with a podiatrist to care for their feet, a critical service that is beneficial in preventing foot problems. As seniors lose their mobility and eyesight, taking care of their feet can become a difficult task. Proper foot care promotes stability, good health, and the ability to manage in their own homes. Due to the high demand for this service and the changing demographic of the clients who attend the foot care event, we have expanded the offering to bring 2 doctors and 2 nurses into our office. They speak English, Mandarin, Cantonese, Farsi, Arabic, Spanish, Tagalog and ASL. We have doubled the appointment capacity for this critical service. A diverse team of VAST volunteers transport non -driving seniors to this event. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. We understand that seniors face challenges in accessing services especially during and after the pandemic, as it was/can be difficult for some to leave their homes or access information online. We offer in -home appointments, virtual events and partner with locations where seniors live and congregate to offer access to services that will connect them to the social, physical, emotional and wellness programs that we offer. Programs that we offer are:Crisis Intervention: We work with Adult Protective Services, the police department, fire department, county and city staff to stabilize seniors in their homes through connection to services and housing, or to move seniors to residential care facilities where they can receive the higher level of care that they can no longer provide for themselves.Crisis Stabilization: Our Care Coordinators work with seniors in crisis who need a guide as they navigate changing needs incident to the aging process. This may include assistance with health insurance applications, CalFresh applications, IHSS applications, utility assistance, other financial assistance, housing, caregiver support groups, and connection to resources that can help stabilize family or individual crisis situations. We also offer individual counseling sessions for caregivers who are caring for their older adult family members. Community Support: We provide a connection to a network of volunteers and CityServe staff who are dedicated to supporting and caring for seniors as they transition to this different phase of life. Volunteer drivers provide needed rides to medical appointments. Caring visitors visit with seniors in person, in homes, in the community and over the phone. Also, In -home "handyman" type of work connects community volunteer groups with seniors who are no longer able to complete their home maintenance. CityServe staff also teach exercise and wellness classes (virtual and in person) and alcohol and drug education. All our programs are free for seniors. 13. "* QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. *" Are you are interested in applying for CDBG funds? ill Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding. CityServe has established a vast network of resources, literature and personal connections from local government agencies, nonprofit organizations, for profit companies, churches and volunteer groups that can help us connect seniors to the resources in the Care Wheel areas that our clients need. We provide supportive services in English, Mandarin and Spanish to older adults in need within the city of Dublin. Classes and events are advertised in local papers, on NextDoor. Facebook. Instalram and Twitter. Recoanizina that many 76 seniors do not have ready access to the Internet, CityServe publishes a monthly "Newszine" magazine style newsletter highlighting all the programs and services available to seniors in Dublin. Flyers for individual lasses and events are distributed at senior living, medical offices and public facilities. We are actively engaged with Dublin Senior Center and Eden Housing Carlow at Court and Wicklow Square. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: CI Be culturally accessible, appropriate and inclusive ❑� Encourage community engagement and involvement ❑ Promote energy and resource efficiency F Encourage networking and information sharing across service providers ❑ Encourage process streamlining O Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) FBI A) Housing 171 Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. [J1 Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. r! Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. • B) Homeless `J Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑+� C) Supportive Housing ❑.I Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. El D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑=► Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑r Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: El Public Services ❑ Public Facilities ❑.I Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for lst Time Homebuyers ❑d Promote Decent Affordable Rental Housing ❑,r Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑.I Reduce Housing Discrimination ❑.� Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?) 1 Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 77 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?"} IA Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. 11 Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Pi Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) El Persons 78 i✓I Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. 109 Seniors (62 and older) 14 People with Disabilities 23 Female -Headed Households O Youth 4 Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 150.0(. TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income CAMP) information is available online at www.dublin.cagov/1956/Application-Requirements-Process 4 Extremely Low Income (<30% AMI) 7 Very Low Income (30%-50% AMI) 98 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) 109.0C: TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" 27 White 2 White + HISPANIC 12 Black/African American O Black/African American + HISPANIC 40 Asian O Asian + HISPANIC O American Indian/Alaskan Native O American Indian/Alaskan Native + HISPANIC O Native Hawaiian/Other Pacific Islander O Native Hawaiian/Other Pacific Islander + HISPANIC 1 American Indian) Alaskan Native and White O American Indian/ Alaskan Native and White + HISPANIC O Asian and White O Asian and White + HISPANIC O Black/African American and White O Black/African American and White + HISPANIC O American Indian/Alaskan Native and Black/African American 19 American Indian/Alaskan Native and Black/African American + HISPANIC 8 Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type NIA) 109. u . TOTAL 79 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY EJi #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. if you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes fJ No Budget too Funding SourceslRevenues Budget Amount Amount Committed City of Pleasanton General Fund City of Pleasanton (HHC grants) City of Pleasanton (PLHA funding committed) Alameda County (AAA & APS & Measure A) City of Livermore Foundations Businesses Churches Individuals USD$ 88,000.00 USD$ 160,000.00 USD$ 111,000.00 USD$ 216,218.00 USD$ 226,000.00 USD$ 100,000.00 USD$ 100,000.00 USD$ 43,000.00 USD$ 100,000.00 USD$ 88,000.00 USD$ 111,000.00 USD$ 216,218.00 USD$ 11,000.00 USD$ 44,000.00 USD$ 48,000.00 Total Funding Uses/Expenses Part -Time Senior Resource Specialist and Intake Care Coordinator Total USD$ 1,144,218.00 USD$ 518,218.00 Budget Amount USD$ 25,000.00 USD$ 25,000.00 Amount Committed USD$ 518,218.00 USD$ 518,218.00 Budget Narrative The $25,000 funding we are requesting will provide free services focused on senior homelessness prevention and at risk senior care coordination for extremely low, very low, and low income seniors 60+ in Dublin. It will go towards three critical aspects of prevention/stabilization/outreach -- individualized care and resourcing in the form of a Part -Time Senior Resource Specialist and Intake Coordinator (75% salary) who will be dedicated to serving Dublin residents. Total monthly amount approximates $2100.00 and total annual cost equals $25,000. Documents too Documents Requested * Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Required?Attached Documents * Program Expense ❑� Financial lnformation O Board of Directors 80 Current Annual Budget for the Entire Agency LI Copy of most recently submitted IRS 990 form or Tax 0 Retum (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization 0 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability ❑� and/or workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements ❑,r REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Annual Budaet 990 Board Desianation Board Authorization Insurances GP.naral IiahiIitvf N� Insurance Blanket General Federal Determination Letter audit Employee Handbook Grievance Policy Articles of Incorporation bylaws Oraanizational Chart Outreach Strateav CEO Resume Director Senior Services Impact Report ` ZoomGrants TM is not responsible for the content of uploaded documents. Application ID: 459218 Become a Fan of ZoomGrants' on Facebook Problems? Contact us at QuestionsfeZoomGrants. com e2002-2024 GrantAnaystcar. Al right; reserved_ "ZoornGrants" and the ZownGrants logo are i aderrauka of GrardAndystca ,, LLC. ocou I Browser 81 Email This Preview Save as PDF Print Close Window Ar 7 DUBLIN Powered by ZoomGrantsTM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year Deadline: 1 f 19/2024 2024-25, Human Services Grant Program Community Resources for Independent Living Housing and Independent Living Skills Jump to: Organization Information Questions Budget Documents USD$ 16,000.00 Requested Submitted: 1/19/2024 3:45:15 PM (Pacific) Project Contact Alejandra Hacker P ro a ram s 8cri l h avward. o ra Tel: 510 881 5743 x30 Additional Contacts none entered Organization Information• 1. Business License Number BL-009274 Questions op Community Resources for Independent Living 439 A Street Hayward, CA 94541 United States Executive Director Michael Galvan Michael.Galvanc crilhavward.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: Telephone(510) 881-5743 Fax (510) 881-1593 Web www_crilhayward.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). CRIL is a peer -based disability resource agency that provides advocacy, services and resources for people with disabilities to improve lives and make communities fully accessible. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ID Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 82 LJ Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). CRIL's Independent Living Services for Persons with Disabilities will provide low-income Dublin residents who have a disability with peer counseling, independent living skills & self -advocacy training, personal assistantlhomecare worker referrals, benefits advocacy, travel training, housing search assistance and emergency preparation planning. The primary goals of the program are to: 1) Enhance the self -efficiency of low income Dublin residents with disabilities, including youth and seniors with functional limitations; 2) Increase the availability of resources to Dublin's most vulnerable residents; and 3) Improve the integration of existing social services in Dublin. 4) Assist people with disabilities who use life-saving to obtain alternative sources energy during Public Safety Power Shut -offs (PSPS). 5) Assist people with disabilities to access the internet through a computer lab and classes, chromebooks and wifi access. CRIL will directly serve 40 low-income Dublin residents, In addition, CRIL will indirectly serve 100 more individuals and businesses through disability education, technical assistance and information & referral. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) CRIL's Housing & Independent Living Services will provide Dublin residents who have a disability with housing search assistance, peer counseling, independent living skills & travel training. In this program, CRIL provides an array of services to encourage independence - this is accomplished through peer work. 80% of CRIL's staff have a disability. With the COVID pandemic, CRIL has focused work on providing Personal Protective Equipment, Vaccine & Booster Information, addressing the Digital Divide through chromebooks and wifi access, and rental assistance. As recovery from the pandemic has happened, there has been a dramatic increase in the number of Dublin consumers. This is due not only to increased need but also to increased population. Without Dublin funding, CRIL will attempt to meet the needs of Pleasanton residents but this would place stress on the agency's flexibility and ability to address crises that arise. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 40 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.govi1966lApplication-Requirements-Process El Behavioral Health (mental health and substance abuse) ❑d Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑=r Homelessness ❑r Transportation Services and Access ❑d Domestic Violence and Child Abuse ❑.r Disabilities D Food and Nutrition ❑,r Senior Services ❑,I Youth Services ❑ Child Care, Early Childhood Development and Education ❑r► Changing Demographics and Growing Diversity O Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should 83 inciude any iana tenure issues. Adaitionai aocumentation inciude designs, site plans, etc. can tie attacnea later in the "Documents" tab.) (What specifically will the grant funds be used for?) The Tri-Valley Program operating budget of $65,000 covers the minimum costs for CRIL to continue operating a full -service branch office for the disabled residents of Livermore, Pleasanton and Dublin. With these funds, CRIL supports an Independent Living Coordinator who provides nearly 200 unduplicated Tri-Valley residents with disabilities with all of CRIL's numerous independent living services including the Housing & IL Services program along. CRIL estimates that 20% of consumers served at the CRIL Livermore Office will be Dublin Livermore Residents. Small portions of supervision and administrative time are also allocated to this program. The remaining non -personnel costs are associated with the necessary operations of an office: rent, utilities, accounting, IT support, insurance & staff travel reimbursement. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Consumers are also asked to complete a Satisfaction Survey which allows us to evaluate the type & quality of services provided. Consumers provide management & the board of directors with feedback on the impact that our services & supports have had on their level of independence. CRIL's Housing & IL Services for people with disabilities will provide 40 Dublin residents with improved access to housing, peer counseling, employment & benefits counseling, travel training, I & R, LTSS counseling, assistive technology information & AT device loans and advocacy, COVID vaccine info and access assistance, ipads for persons with speech impediments to access the phone, and chromebboks to assist with internet access. Housing counseling will include local resource info, application assistance, budgeting & credit counseling, transition services applications to Season of Sharing & Dept. of Rehabilitation's housing transition fund. CRIL will also provide indirect information & referral, technical & assistive technology support, ADA & disability law education and community advocacy to 100 additional Dublin residents & businesses to assist them with increasing their knowledge & independence. CRIL is now a core member of Alameda County's Aging and Disability Resource Connection (ADRC). The service which will be the ADRC's major focus will be transitions: assisting people with disabilities and older adults to transition from hospital or skilled nursing facility to home. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov172/missian-vision Community Resources for Independent Living (CRIL) is a peer -based disability resource organization that advocates and provides resources for people with disabilities to improve lives and make communities fully accessible. Everyone is welcome regardless of race, ethnicity, the nature of the disability or limitation, age, socioeconomic status, sexual orientation, gender identity, and expression, immigration status, health condition, or any other characteristics. In working for accessibility, CRIL reflects its commitment to indusivity, diversity and equity. CRIL believes all people must be included in the fabric of society and CRIL's consumers reflect the diversity of Alameda County. While equality means each individual or group of people is given the same resources or opportunities. Equity recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome. A person with disabilities may simply need different resources and opportunities to be fully involved in society. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Since March 2020, CRIL has actively reached out to the disability community, as well as the larger community, to provide resources and information. CRIL distributed 70,000 masks, hosted a COVID clinic, emailed vaccine information to over 2,500 people with disabilities, mailed vaccine information to over 600 people with disabilities and called over 4,000 people to provide vaccine information. In addition, CRIL has called its 1,000+ senior consumers three times to check in on their needs: physical and psychological. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. *" Are you are interested in applying for CDBG funds? RI Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your 84 agency outreacn to nmitea ngiisn speaking residents to encourage access to services? wnat access accommodations are used? Etc. Provide detail Please enter "WA" if you are not interested in qualifying for CDBG funding. CRIL strives to offer services in languages which are used in Eastern and Southern Alameda County. Services are offered in English, Spanish, ASL, Farsi, Pashto, Hindi, Punjabi, Bosnian, Croatian and Serbian. For other languages, CRIL uses Alameda County's Language Line. All printed materials are in English, Spanish, large font and available in electronic format. CRIL's most used materials are also in Chinese.. CRIL participates in over 50 outreaches throughout Alameda County. These outreaches indude different language groups, as well as, different cultural groups. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: P! Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement 111 Promote energy and resource efficiency EJ Encourage networking and information sharing across service providers I_1 Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. El Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑� D) Community Development ❑d Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑d Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17, CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: E i Public Services O Public Facilities O Rental Assistance O Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers O Promote Decent Affordable Rental Housing O Strengthen Communities O Ensure Equal Opportunity in Housing O Reduce Housing Discrimination ❑� Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 85 1 am seeking to addressi) P Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. lg. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?" 2 Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ▪ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. El Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. El Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services 86 to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) EMI Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 20 Seniors (62 and older) 25 People with Disabilities 5 Female -Headed Households 10 Youth 2 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income ("AMI') information is available online at www.dublin.ca.govt1956/Application-Requirements-Process 50 Extremely Low Income (<30% AMI) 30 Very Low Income (30%-50% AMI) 15 Low Income (50%-80% AMI) 10 Moderate Income (80%-120% AMI) 105.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 20 White 5 White + HISPANIC 10 Black/African American O Black/African American + HISPANIC 10 Asian O Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American 87 American Indian/Alaskan Native and Black/African American + HISPANIC 5 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY _Yi #1 - This program/project has the agency's highest priority for funding. El #2 - This programlproject has the agency's 2nd highest priority for funding. ❑ #3 - This programlproject has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. El If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. if you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. Ei Yes .v1 No Budget tot Funding Sources/Revenues Budget Amount Amount Committed City of Dublin City of Pleasanton City of Livermore Department of Rehabilitation: AB204IGF Administration of Community Living: ACL USD$ 16,000.00 USD$ 16,000.00 USD$ 15,000.00 USD$ 5,000.00 USD$ 11,590.00 Total Funding Uses/Expenses USD$ 47,000.00 USD$ 16,590.00 Budget Amount Amount Committed Personnel: Salaries Personnel: Benefits Operating: Supplies Operating: PrintingfCopying Operating: Postage Operating: Telephone Operating: Accounting & Audit Operating: Contracted Services Operating: Dues Operating: Insurance Operating: Travel (Mileage) USD$ 10,500.00 USD$ 4,000.00 USD$ 200.00 USD$ 100.00 USD$ 150.00 USD$ 545.00 USD$ 125.00 USD$ 150.00 USD$ 100.00 USD$ 80.00 USD$ 50.00 USD$ 3,200.00 USD$ 1,265.00 USD$ 100.00 USD$ 25.00 USD$ 50.00 USD$ 200.00 USD$ 50.00 USD$ 75.00 USD$ 25.00 USD$ 20.00 USD$ 15.00 Total Documents fo�� USD$ 16,000.00 USD$ 5,025.00 Documents Requested* Required?Attached Documents * 88 Program Expense Budget for ALL Grant Requests LEI Proaram Expense Financial Information Form for ALL Grant Requests 0 Financial Information List of Board of Directors (or governing body) with 0 Board Roster agency contact information Current Annual Budget for the Entire Agency 0 Budaet 23.24 Copy of most recently submitted IRS 990 form or Tax 0 990 Retum (include complete form) Board of Director's (or governing body's) designation 0 Signature Authorization of authorized official Board of Director's (or governing body's) authorization ❑.+ Board Resolution to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Insurance andfor workers' compensation STATE AND FEDERAL NON-PROFIT 0 IRS Determination DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit andfor Certified Financial Statements 0 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrants TM is not responsible for the content of uploaded documents. Application ID: 458794 Becane a f= 7; ,Ms' an Facetook Praiiiems? Cord us at QueslonsfaZoomGrans. com '&2002-2024 GrardAnalystcan PI right reserved_ "ZoamGrants' and the ZoanGrants logo are trademarks of GrantAnalystcan, LLC. _caoct 16ron•se- 89 Email This Preview Save as PDF Print Close Window A■ V DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1 f 1912024 Easterseals Northern California Kaleidoscope Community Adult Program: 2024/2025 Jump to: ❑raanization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2024 1:38:23 PM (Pacific) Project Contact Jasmine Bacot deve loomentno esnorcal.ora Tel: 925-532-9864 Additional Contacts none entered Organization Information 1. Business License Number BL-005301 Questions op Easterseals Northern California 5601 Arnold Road Suite 104 Dublin, CA 94568 United States CEO Andrea Pettiford cie relci:ment^SFsncrcal.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency Cl Other: Telephone(925) 326-0072 Fax Web www_esnorcal.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Easterseals Northern California is leading the way to ensure that individuals and families affected by disabilities and special needs can live, learn, work, and play to their fullest potential. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 90 LJ Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Kaleidoscope Community Adult Program provides specialized programming for adults with intellectual and developmental disabilities, fostering community integration and enhancing life skills. Our dedicated team of Life Skills Coaches, currently serving 44 participants, including 7.5 Dublin residents, plays a pivotal role in guiding goal setting, facilitating interactions, and ensuring safety. Beyond participant support, our coaches also extend their expertise to provide valuable training and assistance to parents and caregivers. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The Kaleidoscope Community Adult Program is attuned to addressing various challenges, needs, and service gaps in Dublin, particularly concerning adults with intellectual and developmental disabilities. Kaleidoscope is strategically positioned to expand, transitioning from 44 participants to at least 60 participants in 2024. This ambitious endeavor necessitates 20 total staff members (5 additional new staff members) to our dedicated team, ensuring that participant -staff ratios align with compliance standards and uphold safety measures. ESNorCal enjoys a prominent reputation within the Dublin community, with approximately 75% of our community engagements centered in the city of Dublin. These activities include patronizing local businesses and eateries, engaging in bowling events, and contributing to the local economy. Our commitment to community involvement extends across all the regions we serve, evident through our participation in transition fairs, transition class tours, and hosting Open Houses at Kaleidoscope. Moreover, our proactive outreach involves strategically placing informational flyers at prominent locations such as local eateries, libraries, and Starbucks, contributing to our establishment as a widely recognized and esteemed program within the community. The significance of grant funds cannot be overstated. Without the financial support from grants, the ability to hire additional staff members becomes precarious, posing a risk to the Kaleidoscope programs expansion and the corresponding increase in support and services provided to families. A potential consequence is that up to 8 participants, including 2 Dublin residents, may remain on our interest list in 2024, facing delays in accessing vital services. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 9 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.govi1956/Application-Requirements-Process L Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness O Transportation Services and Access ❑ Domestic Violence and Child Abuse O Disabilities O Food and Nutrition ❑ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education !! Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in 91 the "uocuments" tab.) (What specifically will the grant funds be used for?) Securing grant funding from the City of Dublin is crucial to bolster the Kaleidoscope Community Adult Program's 2024 initiative of hiring 5 full-time Life Skills Coaches. These dedicated professionals play a pivotal role in guiding participants and their families through the establishment of goals outlined in Individual Program Plans (IPP). Beyond goal setting, our coaches excel in fostering positive peer interactions, delivering safety training, addressing hygienic needs, and orchestrating enriching activities and trips. Grant support will directly contribute to supplementing the salaries of 5 new Life Skills Coaches, ensuring their commitment to comprehensive care and support remains unwavering. In addition to their direct impact on program participants, our coaches extend their expertise to provide invaluable support and training to parents and caregivers, thereby enriching the overall quality of life for individuals with intellectual and developmental disabilities within the Dublin community. The grant funds will play a pivotal role in achieving our staffing goals and, by extension, enhancing the effectiveness and reach of our program. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Successful outcomes within the Kaleidoscope Community Adult Program are systematically tracked through the participant's individual Program Plan (IPP), a comprehensive document updated bi-yearly. This collaborative process involves active participation from parents, caregivers, guardians, case managers from the Regional Center of the East Bay program, and the participants themselves, ensuring a holistic and inclusive approach to goal -setting and outcome assessment. Establishing baselines at the commencement of the program, our methodology guarantees that there is no regression to IPP goals, with ongoing tracking facilitated through participant attendance and engagement metrics. As a testament to our commitment to growth and impact, we anticipate expanding the program from 44 participants to 60 or more participants by the conclusion of the grant period. This expansion aligns with our overarching goal of reaching and positively impacting a broader demographic within the community, showcasing the tangible outcomes achieved through the support and resources garnered from the grant. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov172/missian-vision As an institution with a longstanding history of advocating for and supporting individuals with disabilities for nearly a century, our unwavering commitment remains steadfast towards the realization of equal rights and freedoms for all. Effecting such transformative change necessitates the cultivation of diverse, inclusive, and innovative perspectives, coupled with meticulous planning and execution. We firmly uphold the belief that the promotion of diversity, equity, and inclusion is a collective responsibility that extends to every individual, each day, and in perpetuity. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. NA 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.' Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. '_;± No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding. NA 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining 92 ❑ Consolidate service delivery Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. B) Homeless Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. C) Supportive Housing Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑� F) Not Applicable. Not interested in CDBG funding. ❑❑❑❑❑❑ 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ▪ Strengthen Communities • Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations b! Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ,Lei Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?") ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability ❑d Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: Li Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. 93 Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, !ow- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfelds remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed. acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units. section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected an the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) Persons Households •d' Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". NA; Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless 94 0.00 Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please fist the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income ("AMP) information is available online at www.dublin.ca.gov11956/Application-Requirements-Process Extremely Low Income (<30% AMI) Very Low Income (30%-50% AMI) Low Income (50%-80% AMI) 0.00 Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White BlacklAfrican American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial 0.00 Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ❑ #1 - This program/project has the agency's highest priority for funding. El #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City 95 of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:flwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes Na Budget tL Funding SourceslReven ues Budget Amount Foundation Grant USD$ 100,000.00 Regional Center of East Bay USD$ 1,406,551.00 Federal Grants USD$ 44,735.00 Total USD$ 1,551,286.00 Funding Uses/Expenses Budget Amount Amount Committed USD$ 100,000.00 USD$ 1,406,551.00 USD$ 1,506,551.00 Amount Committed Personnel Cost Program Supplies Rent Occupancy USD$ 1,533,758.00 USD$ 187,854.00 USD$ 84,246.00 USD$ 0.00 Total Documents Documents Requested * USD$ 1,805,858.00 USD$ 0.00 Required?Attached Documents * Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability andfor workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit andlor Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) Ii ProaramExoenseForm 2024 2 FinanciailnformationForm 2024 O BOD List 2024 O ESNorCai Budaet ❑� IRS 990 Form ESNorCal O A Pettiford Authorization for J Bacot ❑�' A Pettiford Authorization for J Bacot ❑^� ESNorCallnsurance ❑=+ Exemption Letter 2 2022 Audittd Financials (Cat+ESNorCaI+ESH) 96 F< UUIhEL) I-UF< UL)titi ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsTm is not responsible for the content of uploaded documents. Application ID: 460081 Become a fan of ZoomGrants.' on Facebook Problems? Contact us at CuestionseZoamGrants. com 02002-2024 GrsntAnalystcc n. Al rights reserved_ "ZoormGrants' and the Zo mGrants logo are trademarks of G antAnaiystcom, LLC. �ogoflit I Browser 97 Email This Preview Save as PDF Print Close Window A■ 7 DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Dead! ine: 1 f 19/2024 Human Services Grant Program Goodness Village Goodness Village Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/18/2024 10:49:46 AM (Pacific) Project Contact Kim Curtis Kimeaviivermore.ora Tel: 925-237-1108 Additional Contacts info@gvlivermore.org Organization Information top 1. Business License Number BL-114154 Questions op Goodness Village 1660 Freisman Rd Livermore, CA 94551 United States Executive Director Kim Curtis Kimr avlivermore.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency Cl Other: Teleph one925-237-1108 Fax Web www.gvlivermore.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our mission is to provide the Tri-Valley's formerly unhoused neighbors a safe and supportive community to live independently, heal, and thrive! 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 98 Li Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). We seek to renew our awarded funding from last year and request to increase the amount inorder to continue to provide current program and meet the cost of living increase for staffing and materials. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Goodness Village addresses chronic homelessness in the TriValley. We currently have 28 tiny homes and a 24 hour mental health focused program that supports our participants (GV neighbors) decrease negative behaviors that increase risk of returning to homelessness while increasing coping skills and improving quality of life. A vocational program is also available for neighbors to opt into, at this time 26 of our 28 neighbors are actively engaged in the program despite 13 of of 28 neighbors being 62 or older. The median age at the village is 59. The average number of years unsheltered is 5.6. Our 3 neighbors who identify as former Dublin residents prior to become homeless and while homeless are 58, 62, and 77 years old. 2 were unsheltered 6 years and our 77 year old female neighbor resided in her car for 3 years prior to moving to the village. Our village neighbors are required to pay a monthly program fee of 30% of their income, normally around $400. Same of our neighbors do not have an income or they have GA, these individuals are encouraged to work for the village 24 hours a month. Through this vocational program opportunity 3 were able to apply for SSI and 2 have secured employment off site. Those with an income and paying the monthly program fee are able to reduce their program fee by working at the village as a means to use their SSI/SSDI/SSAIVA to pay off a debt or to save for something approved by the Housing Manager such as car registration, insurance, medical, groceries, gas, home items, gifts for family/friends, etc. Our monthly Shared Land Cost Fee to Crosswinds is $9200 a month, our utilities is between $5-6000 a month. Our 24 hour staff are hourly between $22-25, and their mental health skills have resulted in 0 neighbors utilizing forensic or psychiatric emergency services since we opened in 2021, a huge savings for our Tri-Valley community members. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 3 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/l956fApplication-Requirements-Process LI Behavioral Health (mental health and substance abuse) O Affordable Housing El Health Care (including dental) ❑ Workforce Development O Homelessness O Transportation Services and Access ❑ Domestic Violence and Child Abuse !! Disabilities ❑+r Food and Nutrition ❑I Senior Services 0 Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) We fortunately were awarded a large grant that covers the village budget through Aug 31, 2024. When the greater TriValley learned of our award of this grant for our operations and direct services from Congressman Swalwell and of our Capital Build grant from Senator Glazer we experienced a significant drop in giving. We are actively working to change our image of being 99 Tully tunded and are asking the three cities to help bridge the gap in funds tor late 2U24 going in to 2025. I he tunding will cover the cost of our 24 hour support program staff as workday has awarded a $200,000 grant for general operations in 2024 and has promised to continue our partnership in 2025. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our effectiveness is shown through housing retention: 19 of our original 28 neighbors that moved in to the village during the summer of 2021 have retained their housing. 3 neighbors experienced a dignified death, 2 relocated independently to pursue less supportive housing, 3 neighbors have been asked to exit the program but are eligible to reapply if their position/situations change, and 2 have relocated to reside with family. At the end of this grant we are expecting a continued success in housing retention for those who are utilizing the programs intensive support as a means to retain housing, we also expect a small percentage to relocate to family, as our population continues to age we expect a small percentage to transition to higher level medical placements and others to experience a dignified death surrounded by a neighborhood that cares for them greatly. Since our opening in 2021 none of our neighbors have been arrested or psychiatrically hospitalized, we expect this to continue as our value is to assist our neighbors in remaining in the less restrictive housing possible. Another success is that our neighbors are advocating for village growth and have their friends on the waitlist. We hope to continue to work with Livermore, the county and the state on our goal to add additional homes to the village. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision 3 of Goodness Village's 10 core values (available to view on our website) are community, unity and inclusion. We value the contribution and innovation a diversified staff brings to our village. Our village is primarily caucasian directly reflecting the unsheltered populations, this has allowed our participants to engage with persons of color in ways they may not have ever had the opportunity to in the past. A few of our original neighbors even voiced their desire to not have a person of color as their case manager nor would they enter the shared community space if the staff were present. With time they began to seek services and a relationship of trust and respect was formed. With staff and village neighbors we allowed for more grace and rapport building due to the complexity of the population we serve. Amongst staff we have a zero tolerance policy. We've also been awarded a 3 year grant from John Muir Health to address Structural Racism in the workplace which has allowed us to offer opportunities to increase equity with in our employment opportunities. An area of struggle has been with the board which I understand is a shared struggle for the nonprofits in this area. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. N/A 13. " QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.** Are you are interested in applying for CDBG funds? Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: LJ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery C Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: 100 (Select Category and Applicable csaals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless El Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or F) Not Applicable. Not interested in CDBG funding. [J! 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: El Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers El Promote Decent Affordable Rental Housing ❑ Strengthen Communities Ei Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations .? Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: {TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities !! Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?"j ❑ Availability/Accessibility Affordability ❑ Sustainability ! Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ▪ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses 101 assisted, low- and moderate -income persons and households served, slum/blight demolition, number ot acres ot brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. LI Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ▪ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) ❑ Persons ❑ Households Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". O Seniors (62 and older) O People with Disabilities O Female -Headed Households O Youth O Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 102 1s. UUbti ONLY - fiasea on tne common inaicator you seiectea above, please list tne number or undupiicatea Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income (AMl) information is available online at www.dublin.ca.gov11956/Application-Requirements-Process O Extremely Low Income (<30% AMI) O Very Low Income (30%-50% AMI) O Low Income (50%-80% AMI) O Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" O White O White + HISPANIC O Black/African American O Black/African American + HISPANIC O Asian O Asian + HISPANIC O American Indian/Alaskan Native O American Indian/Alaskan Native + HISPANIC O Native Hawaiian/Other Pacific Islander O Native Hawaiian/Other Pacific Islander + HISPANIC O American Indian/ Alaskan Native and White O American Indian/ Alaskan Native and White + HISPANIC O Asian and White O Asian and White + HISPANIC O Black/African American and White O Black/African American and White + HISPANIC O American Indian/Alaskan Native and Black/African American O American Indian/Alaskan Native and Black/African American + HISPANIC O Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY L J #1 - This programlproject has the agency's highest priority for funding. ❑ #2 - This programlproject has the agency's 2nd highest priority for funding. ❑ #3 - This programlproject has the agency's 3rd highest priority for funding. El #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This programlproject has the agency's 5th highest priority for funding. El #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: 103 nttps:Iiwww.rppc.ca.gov!iearn!pay-to-play-emits-ana-proninitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emalled for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. Yes 0 No Budget LE Funding Sources/Revenues ACF-OPRE John Muir Workday Foundation Individual Donors Annual fundraiser events 3VCF 1st Pres Foundation Total Funding UseslExpenses Budget Amount USD$ 1,000,000.00 USD$ 62,000.00 USD$ 200,000.00 USD$ 100,000.00 USD$ 110,000.00 USD$ 20,000.00 USD$ 16,000.00 USD$ 1,508,000.00 Amount Committed USD$ 0.00 Budget Amount Amount Committed General Administration Personnel Fundraising O perations/Maintenance Util ities Shared Land Fee to Crosswinds USD$ 68,310.00 USD$ 1,034,520.00 USD$ 27,030.00 USD$ 165,892.00 USD$ 75,400.00 USD$ 95,004.00 Total USD$ 1,466,156.00 USD$ 0.00 Budget Narrative The ACF-OPRE funds are from Swalwell who covers the village financially from Jan -Aug minus the Shared Land Cost fee increase we received from Crosswinds this year which totals $4300 more a month as well as a payroll increase due to state law requirements. We have a small shortfall in a budget near the end of the year however we believe the city grants will bridge that gap while primarily being used for direct services and operations Jan -June 2025. Documents t� Documents Requested * Required?Attached Documents Program Expense Budget for ALL Grant Requests 0 Dublin expense 2024/25 Financial Information Form for ALL Grant Requests ❑,r List of Board of Directors (or governing body) with 0 agency contact information Current Annual Budget for the Entire Agency 0 Copy of most recently submitted IRS 990 form or Tax 0 Retum (include complete form) Board of Director's (or governing body's) designation 0 of authorized official Board of Director's (or governing body's) authorization 0 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 andfor workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of 0 Dublin Financials 2024 Board Document 2024 Budaet 2024 990 Board Document Board doc WC 2024 Insurance State Certificate IRS Certificate 104 ealitornia and Federal lax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements ❑+1 2094 Audit FxnlanRtion-C,1L CPA report for 2023 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrants TM is not responsible for the content of uploaded documents. Application ID: 459382 Become a .an cf 'oornG'ants„ on Facebook Prt l r,s? Contact us at GuesticnsidZacmS rams. ccr. '&2002-2024 GrantAnalystcam Ai right reserved_ "ZoornGrants' and the Zeal -Ca -ants logo are trademarks of GrantAnalystcom, LLC. Lggp{� Browser 105 sMi DUBLIN Powered by ZoomGrantsTM and Email This Preview Save as PDF Print Close Window Ar 7 City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 111912024 Hively Hively Family Resource Center & Navigation Services Jump to: Oraanization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2024 7:49:02 AM (Pacific) Project Contact Mary Hekl keiimabeh iveiv.ora Tel: (925) 417-8733 Additional Contacts kbrace@behively.org, cduperroir@behively.org, mary@behively.org Organization information top Hively 7901 Stoneridge Dr Ste 150 Pleasanton, CA 94588 United States CEO Mary Hekl marvfa?behiveiv.ora 1. Business License Number BL-109890 Questions top 1. Select the category that best describes your organization: (Select only one)JI Non -Profit ❑ Public Agency ❑ Other: Telephone(925) 417-8733 Fax Web wnnnv.behively.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). At Hively, the family is the center of all we do. Our mission is to strengthen Alameda County families so that everyone in our community can thrive. We offer child care stipends/referrals, family resources and clinical mental health services. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project 2 Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 106 operation. ❑ Yes No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Hively Family Resource Center (HFRC), conveniently located in Dublin near the 580 and 680 freeways, offers a variety of family resources, free -of -charge to meet the needs of the lowest income and most vulnerable families in the Tri-Valley. Since its opening in December 2021, the HFRC has grown to become a "one -stop shop,' providing not only family goods and necessities (food; clothing; diapers), but also essential community resources for growth & wellness (child care resource, referral & subsidy; mental health services, parenting classes; early childhood activities; and employment and housing search assistance). Funding is needed on a yearly basis to sustain operations, support families with increased staff and resource navigation, and multiply our impact in the community. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Like many Bay Area residents, Dublin families are burdened with high cost of living and the rise of inflation. Basic needs are more expensive, transportation costs are high and parents seeking employment must first solve the problem of child care. In our first year (2021-22), we supported 1,720 families via the Hively Family Resource Center (HFRC). Last year, we served 200 additional families. This year we already see increased need and project that with additional hours and staff we'll double the number of Tri-Valley clients served. Sustained funding for the HFRC is key to maintaining support. When families first access the center it is to secure basic goods (food, diapers and clothing). But, as our staff build relationships with these families, they begin to gain much more. Those families that access the center regularly see it as a community hub where they can gather. This frequency leads to increased engagement. Our bilingual (English/Spanish) staff then work to connect families with additional resources (child care, job search and our clinical mental health services). Staff can customize the support that will help move a family forward. Our community services team also designs year-round programming to promote community engagement and education. Additionally, the Hively Family Resource Center exists to support local child care providers. Due to the global pandemic, we lost 30% of child care providers in the Tri-Valley between 2020-2022. As we work to bring them back, the HFRC acts as a critical hub for providers where we distribute supplies and connect them to business resources in an effort to restore their work and the available supply of child care spaces in the Tri-Valley. When families can access affordable child care, they go to work or school and secure a better future for themselves and their children. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 1200 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/19561Application-Requirements-Process ❑.� Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑! Workforce Development O Homelessness ❑ Transportation Services and Access 0 Domestic Violence and Child Abuse O Disabilities O Food and Nutrition ❑ Senior Services O Youth Services O Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity CI Financial Assistance ❑ None of the Above 107 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Dublin grant funds will be used to both sustain operations and grow offerings at the Hively Family Resource Center (HFRC). This vital one -stop shop requires ongoing fiscal support for staffing, supplies, transportation of donated goods, and educational programming. A grant of $25k from the City of Dublin would support a portion of the projected personnel costs for the coming year. The Community Outreach Coordinator is an existing role that requires sustained funding. This staff member is essential and required for the FRC to run day-to-day. Our engagement with families shows that there is an increasing need for a Family Resource Navigator to further assist the growing number of families accessing the HFRC. A portion of grant funds will be used to support the Navigator. This person will provide one-on-one assistance and customized support to families. Remaining personnel funds help pay a portion of the VP of Community Services role. This person reports directly to the CEO and is in charge of overseeing staff, budget, operations and development at the HFRC. Last year, we offered our first series of in -person "Parent Cafes," an educational support group for families. Parents expressed that they valued having a "safe space to talk and connect." The program was subsequently highlighted in The Independent in November of 2023. The Cafes were developed, using the Strengthening Families Approach and the Five Protective Factors, which are: parental resilience, social connections, concrete support in times of need, knowledge of parenting and child development, and social and emotional competence of children. The Hively Parent Cafes exist to provide an outlet for families to meet, children to play and relationships to be built with Hively staff. This year, we intend to offer the Parent Cafes on a monthly basis, expanding our reach, increasing our education budget to $2500/per month. Grant funds will help support this important community offering and strengthen Dublin families. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The Family Resource Center is a sustained and vital Hively program. We derive usage and impact data from the center on a yearly basis. Last fiscal year, the FRC in Dublin served 1,960 families, over 200 more than the previous year. Since its inception, the center has grown to serve more families each year. One criteria for success will be in the data. How many more families were we able to serve with additional staff and programming? Our expectation, based on our past data and increased staffing/programming projections is that we will double the number of households we serve this fiscal year. Regularly we also survey Tri-Valley families and childcare providers to learn how, when and why they access the HFRC. We learn which resources they value the most and what additional resources would aid them further. Additionally, we can calculate the store "transactions" both as donations and outgoing support. As a referring agent for services, we don't merely hand-off a client to another agency. We follow-up with every single family we refer out to ensure the client received the support they needed. As the HFRC grows to connect families with more support, we can also tally the number of families we are able to serve with additional resources. Many families find us via the HFRC. As we establish relationships with them, we can multiply our support. In one example, a parent learned about Hively when she saw the advertisement for our Parent Cafe series. She attended all six cafes this past Fall. Over the course of those meetings, she expressed that she needed help paying for child care. Through our enhanced referral process, Hivey staff were able to locate care for her children. Last year, Hively provided 6,335 Child Care Referrals for Tri-Valley families and our agency enrolled 762 additional Alameda County children in child care subsidies. Furthermore, Hively Mental Health provided 2,527 individual therapy sessions and has grown to 3 locations. The Hively Family Resource Center is often the starting point for this impact. It is critical to maintaining our outreach and addressing the needs of families in the Tri-Valley. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision At Hively, not only do we share and embrace the same values of Inclusivity, Diversity and Equity as the City of Dublin, but we live them in our work. Strengthening families involves providing access to ALL and then nurturing relationships with clients from all backgrounds so we can support them in the best way possible. At Hively, we promote inclusivity, diversity and equity by ensuring that low-income families are treated with dignity and respect. Our multilingual staff is able to communicate to clients in their native language and understand their culture, creating ease of communication and more fluid connection to support and services. In addition, we regularly offer flyers and written resources in Spanish. 108 Our community services team is also certified and trained in family stress and trauma. In 2022, our entire staff completed a year -long training program with the Center for Leadership Equity and Research in Early Leaming (CLEREL). CLEREL's mission is to provide education to examine racism, sexism, ableism and cultural learning policies and practices impacting children's outcomes. Volunteers are also trained on how to approach clients with sensitivity. Furthermore, when we refer families to other agencies we don't just dump them off. We follow up with a call or email. We take the time to ensure that they receive the help they need. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. During the pandemic, we never once dosed our doors. We provided whatever remote assistance we could to keep families afloat. In 2021-22 we were able to more fully engage clients in -person. We moved from providing the basics (diapers and food) to hosting vaccine clinics for children. As we began to emerge from the restrictions, children were free to retum to school and parents could return to work. But, child care providers were devastated from the pandemic and many child care spaces were lost. Our work turned to intense, unwavering support for child care providers as they sought to bring their businesses back on line. Last year, we assisted with adding 2,276 new child care spaces in the Tri-Valley. We could not have done this without ARPA. As providers come back on line, our child care enrollments are up. We are making progress in this area. However, families remain emotionally and financially scarred from the pandemic. The support they need now often involves parenting support, mental health services for both parents and children and connection with the community. As we continue to build back from the pandemic, the HFRC will continue to be a critical hub for both families and providers to access the support they need. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. RI No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter 'NIA" if you are not interested in qualifying for CDBG funding_ NA 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ▪ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: {Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing 109 LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or R1 F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: {TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: {TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?" ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. 110 ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. • Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ ! Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons ❑ Households 21: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you Dublin clients (EITHER Persons OR Households) your enter "0" Area Median Income CAMP) information is available online O Extremely Low Income (<30% AMI) O Very Low Income (30%-50% AMI) O Low Income (50%-80% AMI) o Moderate Income (80%-120% AMI) TOTAL selected above, please list the number of unduplicated agency anticipates serving in each category. If none, please at www.dublin.ca.gov/1956/Application-Requirements-Process 111 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White BlacklAfrican American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY [i #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. El #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes /v1 No Budget top Funding Sources/Revenues Budget Amount Amount Committed 112 CDSS CRRP USD$ 60,000.00 City of Dublin USD$ 25,000.00 USD$ 0.00 City of Livermore USD$ 43,500.00 USD$ 0.00 City of Pleasanton USD$ 36,000.00 USD$ 0.00 Other Grant Revenue USD$ 0.00 USD$ 118,500.00 Sunlight Giving USD$ 0.00 USD$ 35,000.00 Albertsons Companies Foundation USD$ 0.00 USD$ 10,000.00 Total USD$ 104,500.00 USD$ 223,500.00 Funding Uses/Expenses Budget Amount Personnel Salaries USD$ 196,118.00 Operating: Supplies USD$ 30,000.00 Operating: Rent & Utilities USD$ 91,882.00 Operating: Other USD$ 10,000.00 Total USD$ 328,000.00 Amount Committed USD$ 0.00 Budget Narrative The Hively Family Resource Center (HFRC) provides a one -stop shop for families to obtain all the basic necessities they need, free of charge. Families will receive navigation services to find and pay for child care, mental health and wellness resources as well as Parent Cafes and education. Personnel The HFRC Coordinator supports both in the daily operations of the Hively Family Resource Center's (HFRC), as well as coordinating associated events and projects. The Navigator provides one on one assistance and support to access Hively programs and services as well ascommunity resources that meet the family's needs. Program objectives and community supports are overseen by the VP of Community Services (20% of time) Personnel costs are budgeted at the average salary for the role, with benefits estimated at 24°/0. Operating Operating expenses include rent and utilities (including internet, maintenance, cleaning) of 7066 Village Parkway Dublin. Parent Cafes are organized monthly at the HFRC and are budgeted at $2,500 per cafe. Parent Cafes and education support families in the development of raising safe and healthy children using the Five Protective Factors. These Cafes are in person at the Hively Family Resource Center where families are able to meet other families and build a safe place of community. Other operating expenses include accounting & operations support and services. Funds received from City of Dublin would offset personnel costs supporting roughly 30% of the HFRC Coordinator. Documents top Documents Requested* Required?Attached Documents * u Program Expense Budget for ALL Grant Requests Program [expense Budget Financial Information Form for ALL Grant Requests Financial Information List of Board of Directors (or governing body) with ❑.J Hively Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Annual Budget Copy of most recently submitted IRS 990 form or Tax 0 IRS 990 Retum (include complete form) Board of Director's (or governing body's) designation 0 Designation of Authorized Official of authorized official Board of Director's (or governing body's) authorization ❑.I Authorization to Reauest Fundina to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Insurance and/or workers' compensation 113 STATE AND FEDERAL NON-PROFIT U 501c3 Determination DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements ❑r Audit Report REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGranfsTm is not responsible for the content of uploaded documents. Application ID: 459151 Becomes fan of ZoomGrantsTM on Facebook Problems? Contact us al CC": ®2002-2024 GrantAnalystcan. M rights reserved. 'ZoomGrants' and the Zo mGrants logo are trademarks of GrantAnalystcom, LLC. _000utI Browser 114 Email This Preview Save as PDF Print Close Window A■ v DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Dead! ine: 1 f 19/2024 Hope Hospice & Health Services Grief Support Services and Volunteer Services Jump to: ❑raanization Information Questions Budget Documents USD$ 20,000.00 Requested Submitted: 1/12/2024 1:42:42 PM (Pacific) Project Contact Marc Rovetti marcrt@honehosoice. corn Tel: 4153109703 Additional Contacts none entered Organization Information top 1. Business License Number Questions tors Hope Hospice & Health Services 6377 Clark Avenue, Suite 100 Dublin, CA 94568 United States CEO Jennifer Hansen Jenniferhr hopehosoice.corn 1. Select the category that best describes your organization: (Select only one.) P1 Non -Profit ❑ Public Agency ❑ Other: Telephone4153109703 Fax Web https://hopehospice.comf 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Hope is committed to supporting patients and their loved ones with exceptional care, compassion, and dignity. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) El Capital Project ❑+I Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ❑ Yes FAA No 115 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Hope is seeking funding to help support our Grief Support Services and Volunteer Support programs. These two vital programs are provided free of charge, to help fill essential gaps of support within our community. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The Grief and Volunteer support programs at Hope Hospice address several challenges and critical needs in the Dublin community while catering to service gaps of missed opportunities that might otherwise go unmet. This past year we served a total of 772 patients, 700 of which were new admissions, resulting in a 2.9 percent increase over last year. As we bring on new patients, the need for continued emotional support for their families and loved ones is essential. The transition from leading a normal life to being thrust into the reality of a loved one being recommended for hospice is a jaring one. Most often we think of bereavement counseling or grief support as a means to an end after a loved one has passed, however this is not usually the case with hospice. The grieving support usually starts earlier, knowing that the end of life for a loved one might be near. Additionally, many of our family members of patients we cared for transition from using our grief support to supporting our work through volunteering to help others. This volunteer support takes on many forms. Some volunteers help current patients by reading books or just spending time with our patients. We have some volunteers who sit "vigil" with patients when they have no family. Others give back by volunteering to help at our events or by writing cards to patients. The volunteer opportunities we offer to the community help bridge the gap of transition to a new life without their loved one into a productive path to giving back and supporting others. These two programs rely soley on and exist only because of the support of community contrbutions and grants. Diversifying sources of charitable funding becomes imperative to ensure the continuous availability and quality maintenance of these programs, guaranteeing that compassionate grief support and our volunteer program remain accessible to all individuals in the Dublin community, regardless of financial constraints. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 800 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1955fApplicafion-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access Li Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition Pi Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure 116 to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) It's evident that Hope Hospice plays a crucial role in supporting families and patients during incredibly challenging times. The funding from the City of Dublin is instrumental to our work in maintaining and improving the quality of services we provide. The specific allocation of these grants funds to support the Director of Grief Support and the Manager of Volunteer services underscores the importance of specialized roles in addressing the diverse needs of the community. The statistics highlighting the shift in patient demographics, with a larger portion facing conditions like memory -related illnesses, are significant. This emphasizes the increasing demand for specialized care and family support that Hope Hospice strives to provide. The emphasis on allowing patients to remian at home, where they feel more comfortable, supported by a professional team and dedicated volunteers, not only improves the patients quality of life but also helps families navigate this difficult journey with more ease and reduced financial strain. The involvement of volunteers as companions, providing emotional support and respite to caregivers, is commendable. Their contribution not only enriches the lives of patients and families but also helps in cost reduction, enabling the hospice to allocate resources more effectively. The availability to offer free grief support services is a vital aspect of Hope's mission, offering a safe space for individuals and families to process their emotions and seek guidance during difficult times. This support can significantly impact their ability to cope and move forward positively. Overall, it's clear that the funding is essential to sustaining these critical services and ensuring that the community has access to quality support from our agency. In essence, the funding secured from the City of Dublin is not merely financial support; it's an investment in humanity, compassion, and the well-being of the community. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our organization maintains a comprehensive database management system to meticulously track service contacts and sessions for both the grief and volunteer support programs. In doing so, we can assess client progress, program success or areas needing more attention. Grief support diligently gathers client satisfaction surveys post -program, alongside evaluations from hospice families up to 13 months after their loss. These evaluations guage perceptions and access the coping mechanisms of participants in the grief journey. We also use this feedback to refine our work and approach to situations that may have been difficult or unique. From July 1, 2023 through December 31, 2023 our grief support team conducted 680 individual sessions free of charge to members fo the community. In addition to our work in grief support, our cohort of amazing volunteers are without question an important aspect of our work. The volunteers are part of a larger more diverse network of folks who help us adhere to our mission of serving the community. Each volunteer candidate will undergo an initial interview to identify their interests and commitment level. This important first step allows our volunteer manager the opportunity to provide details about the expectations and guidelines required to be successful and supportive in this role. For some volunteers, they prefer to help out at events or light duties assisting staff in the office, while others want to serve patients directly. Many of the volunteers who prefer to be with patients will read, play music or just a couple times a week for companionship. One of the most selfless types of volunteer opportunities we have is "sitting vigil"- This is when a volunteer will sit with a patient when they are close to death so that they don't die alone. Sometimes our patients have no family or none that are close enough to get to the patient before they pass. Once a volunteer is processed and has put in the 20 hours of orientation they are ready to move forward to be with patients. We then meticulously log and monitor their progress, hours, and interests. This is highly valuable information and keeps us keen to the preferences of our volunteers. The volunteer support program forms a unique component of our hospice patient care and mission. Given the sensitive nature of our environment, we are always evaluating, monitoring and recording the training and activities within our comprehensive database system. 117 bamilies also contribute by completing satisfaction surveys, enabling us to grasp and address evolving needs of those under our care, including our volunteers services. Moreover, our case managers, registered nurses, and medical social workers maintain constant contact with our patients and their families. We regularly conduct needs assessments and guage satisfaction levels. Additionally, our clinical staff undergoes annual evaluations by The Joint Comission, the regulating body of accreditation of health care facilities. Through this regulation, we remain aligned with best practices and compliance standards within our industry. Our Chief of Quality and Compliance, a vital member of our executive leadership team, constantly reviews the outcomes of these evaluations. Subsequently, they report all findings to our staff and board of directors. This weeklong process involes opening up of random patient files, charts and history of our care with each patient. This rigorous scrutiny help us to be better at what we do and ensures both quality service provision and adherence to all regulatory standards. Lastly, as we continue to evaluate and refine our work with our patients, volunteers and through the regulatory bodies, we are constantly looking for innovation of new services to offer to our community. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gav/72/mission-vision All of our services are open and available to anyone, regardless of ability to pay or if they are on our current service or not. These services are complimentary to all. No one who seeks our help or service will be tumed away for any reason. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. N/A 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. "* Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. J No. If no, check box here and enter NA El Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding_ N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive 118 ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery ?J! Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development El Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ▪ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals ,nrho are vulnerable or F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: El Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?") ❑ AvailabilitylAccessibility ❑ Affordability ❑ Sustainability ❑W Not Applicable. I am not interested in qualifying for CDBG funding. 119 2U. UUli[i ONLY - Select one HUU specific Indicator tnat relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownf€elds remediated: This indicator shows the number of acres of browntlelds that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. • Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifcations) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. El Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. WI Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: {Select only ONE) ❑ Persons ❑ Households ❑� Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) 120 People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income (AMI) information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process Extremely Low Income (<30% AMI) Very Low Income (30%-50% AMI) Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" White White + HISPANIC Black/African American BlacklAfrican American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White BlacklAfrican American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY :. ! #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. #4 - This program/project has the agency's 4th highest priority for funding. 121 ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. 1f you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes ❑ No Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Dublin USD$ 20,000.00 USD$ 0.00 Pleasanton Rotary North USD$ 5,000.00 USD$ 0.00 Community Funding USD$ 179,854.00 USD$ 179,854.00 Event Sponsorships USD$ 60,000.00 USD$ 60,000.00 Program specific donors USD$ 6,000.00 USD$ 6,000.00 Sunstate Equipment Foundation USD$ 3,047.00 USD$ 3,047.00 Tri-Valley Non-profit fund USD$ 3,000.00 USD$ 3,000.00 Rotarian Foundation of Livermore USD$ 5,000.00 USD$ 5,000.00 Total USD$ 281,901.00 USD$ 256,901.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 213,590.00 USD$ 213,590.00 Benefits USD$ 41,655.00 USD$ 41,655.00 Operational expenses USD$ 26,656.00 USD$ 26,656.00 General administrative Total Documents ttoc, USD$ 281,901.00 USD$ 281,901.00 Documents Requested* Required?Attached Documents * Program Expense Budget for ALL Grant Requests Ci Prooram Expense Financial Information Form for ALL Grant Requests 2 Financial Expense List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 FY23-FY24 Annual Rudaaq Copy of most recently submitted IRS 990 form or Tax ❑.! Hope Hosnirp Inc 990 Return (include complete form) Board of Director's (or governing body's) designation ❑,+ Board of Director's resolution of authorized official Board of Director's (or governing body's) authorization ❑+/ Board of Director's resolution to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability ❑.r Proof of Insurance andfor workers' compensation STATE AND FEDERAL NON-PROFIT 0 State and Federal Non -Profit Determination Letter 122 Lit I EKMI NA I IUN LE I I EH. 11 organizations MUS 1 have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit andlor Certified Financial Statements ❑,r Audited Financial Statement REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Annual Report * ZoomGrantsM is not responsible for the content of uploaded documents. Application ID: 457023 Become a far cf ?oonac:"arts^' on Facebook Prchiems? Contact us at e2002-2024 GrantAnalystcan- Al rights reaerved- "ZoornGrants' and the ZoomGrants logo are trademarks of GrantAnalystcom, LLC- toaout I Browser 123 Email This Preview Save as PDF Print Close Window A■ V DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1/19/2024 Legal Assistance for Seniors Legal and Supportive Services, Medicare Counseling and Education for Dublin Seniors Jump to: Oroanization Information Questions Budget USD$ 12,000.00 Requested Submitted: 1/19/2024 3:51:16 PM (Pacific) Project Contact Caitlin Chan cchan a&ashicao.oro Tel: (510) 832-3040 x316 Additional Contacts emercado@lashicap.org Organization Information too 1. Business License Number BL-110718 Questions too Legal Assistance for Seniors 333 Hegenberger Road Suite 850 Oakland, CA 94621 United States Executive Director Caitlin Chan cchania7lashicao.ora Documents 1. Select the category that best describes your organization: (Select only one.) E^!] Non -Profit ❑ Public Agency ❑ Other: Telephone(510) 832-3040 Fax (510) 842-1080 Web www.lashicap.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). The mission of Legal Assistance for Seniors (LAS) is to ensure the independence and dignity of seniors by protecting their legal rights through education, counseling, and advocacy. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 124 operation. ❑ Yes €;ri No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Legal Assistance for Seniors (LAS) will provide free legal services to Dublin's seniors in the areas of elder abuse, guardianship, naturalization, public benefits, consumer protection, health law and housing. LAS will provide free community education and outreach to seniors, their families, and service providers. LAS's Health Insurance Counseling and Advocacy Program (HICAP) will provide free, individualized counseling on Medicare and related health insurance issues. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Though as a percentage, Dublin's population aged 65 and older held steady between the 2010 and 2020 US Census, at 9.4%, the absolute number of seniors grew by approximately 2,400 residents because of the City's overall population growth. Along with the growth of the senior population in general, the growth of low-income seniors also continues to climb. The Eastern Alameda County Human Services Needs Assessment notes that along with the growing senior population and the rise in poverty, the demand for human services is growing, especially since seniors are often more dependent on such services. Specifically, the Dublin Housing & Human Services Grant Priorities include services to keep seniors housed and safety net access for seniors. LAS addresses these needs so that low-income seniors can live with greater independence and dignity. LAS's housing program assists seniors at risk of homelessness, both through legal advice and representation. To help clients access safety net programs, LAS provides public benefits legal assistance, ensuring seniors are receiving all benefits for which they are eligible, including Social Security, Supplemental Security Income (SS!), and Medi-Cal. Without support from the City of Dublin, we might not be able to serve as many Dublin residents. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 15 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1956?Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑,� Affordable Housing ❑� Health Care (including dental) ❑ Workforce Development ❑,I Homelessness ❑ Transportation Services and Access ❑.r Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition Iv! Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) LAS will provide services to a total of 305 unduplicated Dublin seniors across the legal services, Health Insurance Counseling 125 and Education Program (HICAP) and community education departments. While services are available to residents of any income, LAS focuses its efforts on serving low-income clients by conducting outreach in low-income areas and partnering with agencies that serve low-income communities. LAS will provide free legal services to 15 Dublin seniors. Areas of law covered by LAS include elder abuse, housing, conservatorship, guardianship, public benefits, health law, limited conservatorship, and naturalization. Services will be provided to Dublin residents ages 60 and older, or 50 and older for guardianship. For elder abuse, LAS will assist those 65 or older, or dependent adults of any age. Services range from legal counsel and advice to full representation in court. Legal services will be provided by LAS's 8 attorneys, a case manager, legal advocates, and legal volunteers. LAS will provide free Medicare counseling to 40 Dublin Medicare recipients through its HICAP division. While most Medicare recipients are seniors, LAS will also provide HICAP counseling to younger individuals who are eligible for Medicare due to disability. Our HICAP counselors help clients enroll in Medicare plans, supplemental insurance and prescription drug plans, and apply for cost -saving programs. Counselors also assist clients in resolving coverage issues, referring to LAS's legal program when needed. HICAP counseling is provided by our team of 30 state -registered volunteer HICAP counselors, who are supervised and supported by 10 paid staff counselors. HICAP appointments are available both in -person and virtually. LAS will provide 10 community education presentations and/or outreach events, reaching a total of 250 Dublin residents. These presentations will be targeted to Dublin seniors, pre -retirees, caregivers, and senior and disability service providers. Presentations will cover a wide variety of topics that are relevant to seniors' lives, including health care, avoiding scams and fraud, hiring and working with caregivers, and public benefits. LAS frequently gives in -person presentations at the Dublin Senior Center and Dublin Ranch Senior Apartments. The presentations are provided by our Community Education Coordinator and Advocate, by highly trained volunteers, and by other staff members as appropriate. Funds from the City of Dublin will contribute to salaries for LAS's program staff, including staff attorneys and advocates. Funds will also be used for overhead costs, primarily rent. To ensure services are provided in a cost-effective manner, LAS works extensively with volunteers who provide both overall program support and direct services to clients, with supervision and support from program staff. LAS also brings on legal interns and summer law clerks to provide support to the legal program, including legal research, writing, and intake. Because LAS has provided legal, educational, and HICAP services in Dublin for many years, we are able to base the current year's budget on past results. This budget is leveraged with additional public and private grants. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? LAS evaluates success through the lens of our mission: was the client able to retain their independence, safety, and dignity because of the interventions we provided? We collect these case outcomes by entering each client's information into a database, including the level of service provided, the result of the case, and whether the client recovered or saved any funds as a result of our interventions. Specifically for housing, the evaluation is focused on whether the client was able to retain housing with the supports and services necessary to make that housing permanent. We request feedback from our clients at the conclusion of services, including whether they felt supported and had their concerns addressed. Our goal is for every client to feel satisfied with the service they received, even if their case could not be resolved in an ideal manner due to outside factors. In addition to client feedback, LAS consults with its community partners to evaluate how we may be better able to serve their communities. We also evaluate our client data using equity, diversity and inclusion metrics. To measure whether the desired legal and HICAP outcomes were achieved, LAS's Legal Director and HICAP Manager review case notes for all completed cases, which are written by the staff or volunteer assigned to the case and include the client's goals, actions taken, and the outcome of the case. Examples of legal outcomes include obtaining an elder abuse restraining order, preventing eviction, obtaining guardianship of a minor in the client's care, or restoring a client's public benefits. HICAP outcomes include a client successfully enrolling in a Medicare Part D plan or applying for a cost -savings program. To measure effectiveness of community education activities, participant evaluations are used to determine if the education was informative and increased the person's knowledge of the subject. To measure client satisfaction, LAS's management team reviews completed client evaluations for all three programs. If there is any negative feedback, a member of the management team will follow up with the client to better understand the comments and determine whether the client needs further assistance. By the end of the grant, we expect to complete or exceed our program goals. We expect most clients will achieve their desired outcomes and the vast majority of returned evaluations will indicate that clients were satisfied with the services they received. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? 126 The full statements are available at www.dublin.ca.govI72/mission-vision LAS continues to find new ways to reach previously underserved communities through our diversity, equity, and inclusion (DEI) work. LAS's DEI Client Data Group as well as Equity, Diversity and Inclusion (EDI) Committee look at the demographics of the clients we serve and address any gaps in services we find. Ideas that have come out of the DEI Client Data Group include more robust translation and distribution of materials, more targeted community outreach, and trainings on white - dominant culture and implicit bias. LAS recently applied for a State Bar of California DEI Leadership Seal, using the seal's application process to make our DEI efforts more data -driven. We will soon be bringing our Board into our DEI work more meaningfully, as having a DEI framework is critical to proper governance of LAS. LAS's Board is currently 42% BIPOC and 42% women. LAS actively recruits board members from diverse backgrounds, as we believe our leadership should reflect the community we serve. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. N/A 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. "" Are you are interested in applying for CDBG funds? Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding_ LAS does not allow language to prevent clients from meaningfully accessing services. Our Language Access Plan requires that all program notices include a statement that translators will be available upon request for presentations, meetings, and other client activities. LAS staff and volunteers provide verbal and written translation in multiple languages, including Spanish, French, Mandarin, Cantonese, Danish, German, Ukrainian, Hindi, Punjabi, Korean, Urdu and Japanese. LAS also uses a telephone interpreter service (Language Line) for its legal and HICAP counseling services, which provides translators in 240 different languages. LAS recruits and trains HICAP counselors whose ethnicities and language capabilities reflect the diverse communities we serve. LAS arranges interpreter services with the courts in legal cases. LAS's educational presentations are all offered in multiple languages. To encourage limited English-speaking residents to access LAS's services, we coordinate with partnering agencies that specialize in serving seniors for whom English is not their primary language. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: i Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining R3 Consolidate service delivery 1 Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. F1 Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. 127 Li Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. tJ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers LI Promote Decent Affordable Rental Housing ❑=I Strengthen Communities ❑r► Ensure Equal Opportunity in Housing O Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Ll Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?"} ❑ Availability/Accessibility ❑ Affordability O Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. 128 L.1 Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. El Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Li Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding fJi 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) i1 Persons CTJ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. 15 Seniors (62 and older) 3 People with Disabilities 5 Female -Headed Households 0 Youth 3 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 12 Extremely Low Income (<30% AMI) 129 11 Very Low Income (3O%-5O% AMI) 1' Low Income (50%-3O% AMI) 1 Moderate Income (8O%-120% AMI) 15. o o l TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in racelethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 7, White 2 White + HISPANIC 31 Black/African American 1 Black/African American + HISPANIC 21 Asian 1 Asian + HISPANIC 1 American Indian/Alaskan Native 1 American Indian/Alaskan Native + HISPANIC 1 Native Hawaiian/Other Pacific Islander 1 Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC 1 Asian and White 1 Asian and White + HISPANIC 1 BlacklAfrican American and White 1 Black/African American and White + HISPANIC 1 American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC 1 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type NIA) 15.00I TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ^r #1 - This program/project has the agency's highest priority for funding. El #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. El #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. Li If you have mare than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:liwww.fppc.ca.govllearnipay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. Yes ▪ No 130 Budget too Funding Sources/Revenues Goverment/State of California Office of Emergency Services Government/Alameda County Social Services Agency: Title IIIB Legal Services, General Revenue, Adult Protective Services, Title VII, HICAP, MIPPA, Department of Children and Family Services (DCFS) and OAAR. Govemment/Contra Costa County HICAP Government/Cities of Alameda, Dublin, Fremont, Hayward, Livermore, Pleasanton & Union City Corporation/State Bar of California: IOLTA, EAF, Housing Preservation, Homelessness Prevention, EAP Guardianship, EAP Limited Conservatorship & Bank Grant. Foundations/Corporations: San Francisco Foundation, Bigglesworth, CHA, Hindu Community & Cultural Center, Stern Memorial Trust, VLS/Rembe Rock, West Davis & Bergard, Bernard E &Alba Witkin Charitable Foundation, Senior Assistance Foundation East Bay (SAFE Court Awarded Fees Individual Donations, Annual Appeal, Fundraising Event Elder Abuse Conference sponsorships & registration fees Other Revenue Total Funding Uses/Expenses Personnel: Salaries* (see instructions below) Personnel: Benefits* (see instructions below) Operating: Supplies Operating: Printing Operating: Postage Operating: Telephone Operating: Rent and Occupancy Building and Maintenance and Repair Operating: Accounting/Audit/Payroll Fees Operating: Bank Charges/Taxes and Filing Fees Operating: Contracted Services: Accounting, Information Technology, General, FR/Elder Abuse Conference Food& Entertainment Operating: Insurance/Dues & Memberships/Subscriptions & Publications/Client Litigations Costs/Advertising. Operating: Computer SupplieslComputer Software/Equipment Lease & Rental/Depreciation. Operating: Training & Seminar Fees/RecruitmentfTravelNolunteer Recognition. Total Budget Amount USD$ 123,600.00 USD$ 1,206,619.00 USD$ 15,000.00 USD$ 127,000.00 USD$ 319,641.00 Amount Committed USD$ 61,800.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 159,821.00 USD$ USD$ 666,000.00 580,000.00 USD$ 160,000.00 USD$ 50,000.00 USD$ 30,000.00 USD$ 2,697,860.00 Budget Amount USD$ 2,093,448.00 USD$ 453,411.00 USD$ 22,330.00 USD$ 3,677.00 USD$ 3,418.00 USD$ 35,000.00 USD$ 229,674.00 USD$ 197,721.00 USD$ 3,000.00 USD$ 81,285.00 USD$ 56,288.00 USD$ 10,101.00 USD$ 53,705.00 USD$ USD$ 3,243,058.00 801,621.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 801,621.00 Amount Committed USD$ 537,537.00 USD$ 116,423.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 58,974.00 USD$ 50,769.00 USD$ 20,872.00 USD$ 14,453.00 USD$ 2,593.00 Budget Narrative Legal Director (1% @ $93 plmol$1,113 per annum); 3 Supervising Attorneys (each @ 1%, $59 p/mo/$713 per annum each = $2,139), 5 Staff Attorneys (each @ 1%, $42 plmol$509 per annum each = $2,545); Advocate (1% @ $49 plmol $598 per annum) and Community Educator/Advocate (1% @ $48 plmo/$580 per annum). Fringe Benefits include FICAer (7.65%), SUI & workers compensation (1%), health/dental/vision/life insurance (10.85%) 131 and retirementfbenetit plan tees (:i Io) tor a total of 1,UZb (22.b Io). Actual agency fringe benefits are approximately 2/ 7o; the remaining 4.5% of benefits for staff salaries will be underwritten by the agency. Operating expenses include only rent ($3,000). The requested grant amount represents less than 1% of the total LAS agency budget. Our program services of legal assistance (guardianship, elder abuse prevention, immigration/naturalization, housing & public assistance), HICAP (Health Insurance Counseling and Advocacy) and community education presentation of these matters to the general public as well as assistance providers are all services that our agency provides to all Alameda County residents that enables their ability to live independently in safety and with dignity. In addition, LAS recognized in fiscal year 2022/23 in kind volunteer service hours (902) of combined attorneys and advocates with a value of $347,270. In addition, HICAP volunteer counselors provided 3,109 volunteer hours. Documents top Documents Requested * Required?Attached Documents * Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability and/or workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access ❑.r Program Expense Form O Financial Information Form O Board Roster O Annual Budaet 0 LAS 990 O BOD Authorization O BOD Authorization ❑� General Liability and Auto COI Workers Compensation COI ❑+� IRS Determination Letter State Determination Letter ❑� Audited Financial Statement Personnel Policies Audit Reouirements Articles of incorporation By Laws Conflict of Interest Statement LanguQoe Amass Plan 132 accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 459733 Became a Fan of ZoomGrants"' on Facebook Problems? Contact us at CuestlonsrTZocmGrancs. con', 02002-2024 GrsntAnaystcan AI right reserved_ "ZoomGrants" and the ZoomGrants logo are trademarks of GrarrtAnalystcorn, LLC. _000ut 16rov.ser 133 Email This Preview Save as PDF Print Close Window A■ DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Deadline: 1 f 1912024 Human Services Grant Program Lions Center for the Visually Impaired Dublin Seniors Vision Health Jump to: Organization Information Questions Budget Documents USD$ 7,500,00 Requested Lions Center for the Visually Impaired Submitted: 1/6/2024 7:51:12 PM (Pacific) Project Contact Yolanda Braxton vbraxton 5 ]cvi.ora Tel: 925-432-3013 Additional Contacts none entered Organization Information 1. Business License Number BL-114796 Questions op 175 Alvarado Avenue Pittsburg, CA 94565 United States Executive Director Yolanda Braxton vbraxton a�7lcvi.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency Cl Other: Telephone 9 2 5-432-3013 Fax 925-432-7014 Web www.LCVI.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our Mission is to preserve vision, foster independence and enhance the quality of life for adults who are blind or at risk for vision impairments and to serve as a trusted source of information and expertise on blindness in the community. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 134 LJ Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Dublin Seniors Vision Health will provide supportive services to seniors who are blind and visually impaired in City of Dublin. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) It is extremely difficult for older adults to maintain their health if they are unable to see well enough to read labels on their medication, prepare meals safely or get themselves to medical appointments. Based on statistics from the American Institute for the Blind as well as data from the US Census, we estimate at least 790 seniors in the city of Dublin are living with significant visual impairment -impairments; severe enough to need training in orientation, mobility, and independent living skills in order to maintain their independence and quality of life. The number of blind adults is expected to increase dramatically in the next five to ten years as the population ages. In fact, the Federal Department of Rehabilitation, Older Adults who are Blind estimates that there will be a 200°/0 increase in blindness in adults 65 and older. This increase is borne out in a rising demand for the services we provide and is reflected in our service statistics. With targeted outreach efforts we have made and will continue to make significant strides in serving more Native Americans, HispanicslLatinos Americans, Asian Americans, and African Americans; in the next several years we would like to expand our targeted outreach to include more cultural -ethnic groups, as well as LGBTQ+, Veterans, and Homeless as they make up a significant part of the population. We have conducted and will continue to focus our outreach efforts with a focus on vulnerable seniors with vision disabilities. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 15 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.govll956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access El Domestic Violence and Child Abuse ❑,r Disabilities ❑ Food and Nutrition PI Senior Services ❑ Youth Services El Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Funds will be used to expand our vision health services throughout the city of Dublin, specifically for staffing. The following staff will administer the Dublin Seniors Vision Health program: Executive Director Manager of Operations Orientation & Access Services Manager EDP Vision Screening Coordinator Activities & Marketing Coordinator 135 Vision Health Outreach Senior Specialist Office Administrator Our professional staff (orientation and mobility teacher and outreach/vision specialist) provide one-on-one in -home assessment, orientation and training to adults with vision impairments helping them to make the best possible adjustment to their vision loss so that they regain or maintain independence and dignity for as long as possible. Practical, professional help includes teaching clients how to shop and cook safely so they can maintain good nutrition, training them to use white canes and public transit to cross streets and travel safely in their community, teaching them how to manage their medications even when they are unable to see the labels, provide visual aids (such as lighted hand magnifiers), giving them instructions in adaptive living skills such as personal grooming, housekeeping, and financial management and linking them to peer support groups, and activities so they can maintain good mental and emotional health. Staff and outreach materials in Spanish, Chinese, Punjabi, Tagalog ensure that services are culturally appropriate and accessible for those with limited English. When a person loses their vision they tend to stay at home where they feel safe. The idea of leaving their home is very frightening, but social isolation and inactivity often leads to boredom, depression, and self -hurt. In addition to home visits by our staff we also regularly sponsor group classes and activities in order to meet our clients' need for recreation and socialization and even provide clients with vouchers for free transit to encourage their participation. These activities include one adult day program tailored for the visually impaired and other programs such as arts & crafts and exercise and field trips. Our center sponsors Support/Discussion groups by professionals (our own staff) at sites throughout the city to help clients share their personal fears, anger and frustration and receive practical tips and support from their peers. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The goal of Dublin Seniors Vision Health, indeed all our services is to preserve functional eyesight and prevent further vision loss, foster independence and safety for visually impaired seniors and improve their quality of life. We know that our services are successful with our target population as it shows in our quantitative and qualitative evaluation process, and with feedback from our consumers. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision From reflections on our Board of Directors, to staff, to the community we serve, LCVI has always embraced all who are in need of our supportive services. We ensure that our outreach efforts are reflective of the population we serve and that our high quality services from one-on-one to print materials and excursions reflect the cultural needs of the population. We serve with kindness and provide all of our resources free of charge to benefit those who are experiencing financial insecurity. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. As an organization we have experienced the impact of the COVID-19 pandemic. As a result, our services are hybrid, thus if any senior choose to utilize onsite or virtual options, both are available, and they are still able to have their vision health needs met. Post -pandemic, we continue to manage the most frequent and consistent barriers encountered for seniors who are blind and/or with visual impairments, including fear, transportation and lack of resources. Older adults often have mobility issues and other age -related challenges in addition to their visual impairment. This makes them fearful of venturing outside their own home, let alone traveling to an unfamiliar community. The paratransit systems in place are often inadequate and inconvenient. Despite offering free transportation to activities at LCVI facility, we have had limited success (although it has increased) in getting consumers from distant communities to come to our facility in Pittsburg for services. We have experienced greater success by bringing services to consumers in their homes. This is what sets us apart from other agencies and what has led to our success in serving the target population for in our program throughout the pandemic and beyond. Additionally, members of our target population are often not tech -savvy and are frequently afraid to try something new or are unable to develop new patterns of behavior. We have found that lots of patience on the part of staff is required to help consumers through the steep learning curve. This was most notable during the COVID-19 pandemic where we were able to successfully transition our consumers into virtual services. Lastly, the issue of insufficient resources continues to hinder us. The demand for our services grows every year as the Baby Boomers enter their senior years. The additional ARPA funds we may receive will allow much needed service expansion. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for 136 CDBG funds? 1.Ll Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding. Our organization engages in an annual multi -cultural Outreach Campaign. This includes use of social and traditional media. We utilize multiple languages in print to engage in Outreach that is Residential, Faith -Based Organization Postcard related, Public Transportation (i.e., BART, Bus), Billboard and Reader Boards, Cell Phone Adverts, etc. Engagement with multiple senior centers, senior residential facilities, and community centers all are included. 15, CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Pi B• e culturally accessible, appropriate and inclusive ▪ Encourage community engagement and involvement ❑ Promote energy and resource efficiency Li E• ncourage networking and information sharing across service providers Li Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B j Homeless Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Lv: Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: b Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing LIStrengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑=I Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 137 18. UUli[i ONLY - Select one I1UU objective tnat relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") RI Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing El Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking? €�! Availability/Accessibility El Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: El Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. El Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. El Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. El Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ri Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. El Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) - Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of 138 new businesses that remain operational for three years alter assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) Ed Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 15 Seniors (62 and older) 15 People with Disabilities Female -Headed Households Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income ("AMI") information is available online at www.dublin.ca.govI1956/Application-Requirements-Process 3 Extremely Low Income (<30% AMI) 5 Very Low Income (30%-50% AMI) 7 Low Income (60%-80%o AMI) Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" 7 White 2 White + HISPANIC 3 Black/African American Black/African American + HISPANIC 3 Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White 139 Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes R! No Budget rj Funding Sources/Revenues Budget Amount Amount Committed City of Dublin USD$ 7,500.00 DOR-OIB-Title VII USD$ 139,000.00 USD$ 139,000.00 East Bay Community Foundation USD$ 12,000.00 USD$ 12,000.00 Wells Fargo Foundation USD$ 20,000.00 USD$ 20,000.00 San Francisco Foundation USD$ 100,000.00 USD$ 100,000.00 Shirley Perry Foundation USD$ 79,000.00 USD$ 79,000.00 SAFE/Senior Assistance Foundation Eastbay USD$ 139,000.00 USD$ 139,000.00 Mechanics Bank Foundation USD$ 2,500.00 USD$ 2,500.00 Dermody Properties Foundation USD$ 2,500.00 USD$ 2,500.00 District 4C3 Lions Club USD$ 75,000.00 USD$ 75,000.00 Total USD$ 576,500.00 USD$ 569,000.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel: Salaries Personnel: Benefits Operating: Supplies Operating: Printing/Copying Operating: Postage Operating: Telephone Operating: Rent & Utilities Operating: Accounting/Audit Contractual Services USD$ 374,000.00 USD$ 45,000.00 USD$ 77,000.00 USD$ 25,000.00 USD$ 15,000.00 USD$ 15,000.00 USD$ 15,000.00 USD$ 20,000.00 USD$ 45,000.00 USD$ 374,000.00 USD$ 45,000.00 USD$ 77,000.00 USD$ 25,000.00 USD$ 15,000.00 USD$ 15,000.00 USD$ 15,000.00 USD$ 20,000.00 USD$ 45,000.00 Total USD$ 631,000.00 USD$ 631,000.00 140 Budget Narrative Salary support for: Manager of Operations - Joseph Wise - $57,000 (3% of HHSG funds) Vision Screening Coordinator - Botanesh Negash- $45,000 (4% of HHSG funds) Activities & Marketing Coordinator - Richard Grange - $40,320 (5% of HHSG funds) Vision Health Outreach Coordinator - Marilou Bautista - $40,320 (5% of HHSG funds) Orientation & Access Manager - Vicki McDaniel - $55,680 (3% of HHSG funds) Documents too Documents Requested* Required?Attached Documents Program Expense Budget for ALL Grant Requests U Budaet Financial Information Form for ALL Grant Requests • Financial Template List of Board of Directors (or governing body) with • LCVI Board of Directors agency contact information Current Annual Budget for the Entire Agency ODeratina Budaet Copy of most recently submitted IRS 990 form or Tax Retum (include complete form) Board of Director's (or governing body's) designation ❑+� of authorized official Board of Director's (or governing body's) authorization 0 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th 0 O 990 Desianation Letter Reauest Authorization Insurance Certificates State & Federal Letter Audit 141 Supporting uocuments such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsml is not responsible for the content of uploaded documents. Application ID: 458964 Become a on •=acebook Problems? Contact us at e2082-2024 GrarttAnalyst.cam. All rights reserved. "ZoomGrsnts' and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. �onout I Browser 142 Email This Preview Save as PDF Print Close Window A■ V DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Dead! ine: 1 f 19/2024 Love Never Fails Dublin Street Outreach and Referrals to Transformational Solutions Jump to: 0raanization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2024 11:18:49 AM (Pacific) Project Contact Vanessa Russell vanessa( Ioveneverfailsus.com Tel: 16507765833 Additional Contacts none entered Organization Information o 1. Business License Number 45-5551029 Questions LL Love Never Fails 6937 Village Parkway 2074 Dublin, CA 94568 United States Founding Executive Director Vanessa Russell vanessa(?loveneverfailsus.com Telephone16284009230 Fax Web www.loveneverfailsus.com 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency Cl Other: 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Love Never Fails restores, educates, and protects survivors of human trafficking by providing community -led comprehensive services to those being exploited or at risk of exploitation through integrated housing and wraparound restorative services. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 143 LJ Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). In response to the scale of human trafficking (HT) and the number of unhoused people in Dublin, LNF has implemented an intervention strategy to directly reach exploited individuals in the City's top human trafficking spots. Through this strategy, LNF delivers life -changing, trauma -informed, and culturally relevant services and referrals to long-term solutions such as safe housing, therapy, and workforce development, thus breaking the cycle of revictimization. LNF requests $25,000 from the City of Dublin Human Services Grants Program to support these efforts. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The relationship between homelessness and vulnerability to HT is strongly correlated, and a lack of adequate housing for those experiencing homelessness is a well -documented problem in Alameda County, including cities like Dublin and Livermore (with a 79°I° increase in homeless individuals from 2017-2022). The LNF approach to restorative housing is based on holistic wrap -around services with partnering organizations. This means partnering with community businesses and service providers to provide residents therapy, coaching, classes, and educational opportunities. LNF operates three safe housing options for survivors providing personalized wraparound restorative services. LNF is one of the only organizations in the county doing outreach to deliver these life -changing services directly to those who need them most. While other organizations provide in-house mental health services, the wait time is up to five weeks. People being trafficked or homeless generally do not have transportation or access to a phone for therapy sessions in order to provide a safe exit strategy; services are needed on the streets where they are. Without funding, outreach services to unhoused and at -risk individuals in Dublin will impact the number of people our collaborative program is able to serve. According to the San Francisco Chronicle, the number of people experiencing homelessness is quickly rising in the East Bay suburbs like Dublin (https:l/www.sfchronicle.com/eastbay/articleleast-bay- homeless-17179271.php). With only two homeless shelters in the Dublin area, the number of unhoused individuals still needing wraparound services is soaring. The overall effects of homelessness are profound and unhoused individuals are at an increased risk of exposure to diseases, requiring the most expensive publicly -funded services (U.S. Interagency Council on Homelessness), negatively impacting their community's economy. The only long-term solution is individualized care and wraparound services. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 50 unhoused individuals per month for a total of 600 individuals annually. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1956/Application-Requirements-Process Ei Behavioral Health (mental health and substance abuse) 2 Affordable Housing El Health Care (including dental) ❑ Workforce Development ❑.� Homelessness ❑ Transportation Services and Access 2 Domestic Violence and Child Abuse El Disabilities ❑d Food and Nutrition El Senior Services ❑►I Youth Services ❑ Child Care, Early Childhood Development and Education ❑.I Changing Demographics and Growing Diversity ❑=I Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure 144 to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) LNF's outreach strategy aims to reach 600 at -risk individuals annually through a two -pronged approach: 1) Centralized outreach resources from a human trafficking hot spot, providing harm reduction supplies (showers, bathroom access, clothing), meals and food distribution; and 2) A Mobile Outreach vehicle is dispatched weekly to offer wrap -around services such as family reunification and referrals to long term housing, workforce development, legal services, etc., as well as to distribute harm reduction supplies. In addition, in some locations, LNF provides Mobile Outreach counseling services, which are instant, on -the -street therapy sessions to help people get off the streets as soon as possible. The goal is to stabilize the individual in crisis and begin to create an appropriate plan for the next steps, including referrals to long-term solutions. Every outreach volunteer and staff member is trained in up-to-date de-escalation methods and trauma -informed therapeutic support specifically tailored to each person's lived experiences and needs. The following testimonial from a volunteer demonstrates LNF's effectiveness in building trust through this trauma -informed approach: "Alexis, age 17, and her family of eight (including her mom, a toddler, and four -month -old twins) were living in two cars near an LNF outreach location. Every time Alexis would see the LNF van pull up, she would run over with a big smile on her face to help unload supplies. Alexis seemed to look forward to weekly arrivals, and she often requested items like hygiene kits, body wipes, water, snacks, clothes, and toilet tissue. After setting up, she would invite others in the neighborhood to our Mobile Outreach Station. In time, we earned the trust of Alexis and her family. As a result, we have now helped them off the street and on a new journey toward healing with the assistance they so desperately need. This makes outreach well worth it - knowing that we have an opportunity to bring joy and relief to others." Funds from the Dublin Tri-City Human Services Grant will be used to help staff one full-time outreach manager and one full- time outreach coordinator and provide harm reduction supplies (food, water, toiletries, blankets, access to showers/bathrooms) to unhoused and trafficked people. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? LNF's goal is to reach 600 exploited and unhoused individuals annually (50 individuals per month) and those impacted by human trafficking in Dublin to provide harm reduction resources and supplies, trauma -informed care, counseling, mentoring, family reunification, and long-term stabilization referrals, including safe housing and workforce development. These combined services will ultimately enable these vulnerable individuals to make life -changing decisions. The projected outcomes of this goal are: Outcome 1: Increased knowledge about and resources utilized for exiting exploitation. Who and how many: 50 exploited individuals per month Timeline: 12 months Measure: Track the number of people reached, services received, and referrals made. Outcome 2: Increased access to mental health services Who and how many: 50 exploited individuals per month Timeline: 12-months Measure: Track the number of people reached, services received, and referrals made. Outcome 3: Receive 600 referrals to long-term stabilization services such as housing, workforce development, and mental health programs provided by LNF and our community partners. Who and how many: 600 exploited individuals annually Timeline: 12-months Measure: Track the number of referrals. LNF has established clear metrics and goals for each program. We maintain in-depth data collection practices and data -driven evaluations to track a program's effectiveness and make necessary adjustments for continuous improvement. We utilize Salesforce to track key metrics for outreach activities. This includes names, gender, age, services provided, location of the meeting, and outcome of outreach efforts. We maintain strict data management practices, including tracking long-term outcomes and impact. LNF's programs have a robust track record of consistently meeting the needs of survivors and victims of human trafficking. LNF's safe and transitional housing programs have an 80% completion rate as participants heal, become empowered, and transform their lives through economic sustainability and education. LNF's IT workforce development training experiences have an 89% retention rate, with 61 % of graduates securing a paid internship or living wage job within just six months of graduatior 145 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov172/mission-vision LNF was founded with diversity, equity, and inclusion (DEI) as a core value. It is central to employee compensation practices, hiring, marketing, program design, volunteer recruitment, fundraising, and service delivery. As a result, 80% of the LNF staff and Board are BIPOC, and 80% are women. Our DEI goals are 1) uphold a diverse blend of gender, religious beliefs, LGBTQIA+ identities, ethnic backgrounds, cultural traditions, socioeconomic statuses, and generational representation to enrich our community. And 2) foster an inclusive environment committed to ongoing education and continuous DEI growth. We track our progress in maintaining these goals by monitoring organizational DEI KPIs and reviewing them at an annual strategic planning meeting. LNF is committed to creating and maintaining a workplace where all employees can participate and contribute to the business's success and are valued for their skills, experience, and unique perspectives. Additionally, LNF works with law enforcement agencies, community organizations and other stakeholders to combat human trafficking at a systemic level. By advocating for policy changes, raising awareness, and promoting community engagement, the organization aims to create a safer environment for vulnerable individuals and survivors of human trafficking. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. In the Bay Area, there has been an alarming rise in human trafficking cases since the pandemic. This increase can be attributed to the heightened mental and economic instability experienced by individuals already grappling with poverty and generational trauma. Additionally, multiple policy changes and a general scarcity of resources to address the growing demand for assistance have further exacerbated the situation. A recent survey conducted by the Center for Disease Control (CDC) during the COVID-19 pandemic revealed that nearly 41% of respondents are grappling with mental health challenges stemming from the crisis. Out of the 5,412 individuals surveyed, 31°I0 reported experiencing symptoms of anxiety or depression, 26% reported symptoms of trauma or stressor-related disorders, 13% reported starting or increasing substance use, and 11% reported seriously considering suicide within the last 30 days. Furthermore, in addition to these mental health issues, a significant number of Dublin residents face unemployment, under- employment, and Adverse Childhood Experiences (ACES) which cause ongoing trauma. These further exacerbate vulnerabilities during this challenging time. Love Never Fails addresses each need by offering outreach and intervention services to people at risk through counseling, food, clothing, showers, access to bathrooms, and ongoing long-term stabilization referrals, and job training. 13. »x QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. " Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. g No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 146 LJ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or J F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations E2 i Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?) ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ▪ Creating Economic Opportunities Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: {TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?") ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability !! Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: • Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of 147 browntields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. El Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. El Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. Ll Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑d Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) ❑ Persons ❑ Households Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated 148 uunim clients (ti i H R Persons UK rtousenoias) your agency anticipates serving in eacn category. it none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process O Extremely Low Income (<30% AMI) O Very Low Income (30%-50% AMI) O Low Income (50%-80% AMI) O Moderate Income (80%-120% AMI) 0.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY 2] #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. CI #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearn/pay-to-play-limits-and-prohibitions. 149 It you answer Yes, it will not disqualify you tram the process or impact your application. An additional tarm will be ema?led tor you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes F '! Na Budget t2 Funding SourceslRevenues Tri-City Human Services Grant - City of Dublin Total Funding Uses/Expenses Budget Amount USD$ 25,000.00 USD$ 25,000.00 Amount Committed USD$ 0.00 USD$ 0.00 Budget Amount Amount Committed Outreach Manager Outreach Coordinator Payroll Tax & Benefits Outreach Supplies USD$ 8,000.00 USD$ 8,000.00 USD$ 3,504.00 USD$ 5,496.00 USD$ 8,000.00 USD$ 8,000.00 USD$ 3,504.00 USD$ 5,496.00 Total USD$ 25,000.00 USD$ 25,000.00 Budget Narrative The City of Dublin's generous investment of $25,000 will contribute to staff support (100% direct program cost) and harm reduction supplies. More specifically, costs include: Outreach Manager $ 8,000.00 .11 FTE Outreach Coordinator $ 8,000.00 .18 FTE Payroll Tax & Benefits @ 21.9% (Workers Comp - 3%, Unemployment - .25%, FICA - 7.65%, Medical 11 %) $ 3,504.00 Outreach supplies $5,496 for water, food, toiletries, bippy bags, wipes. Documents 'n? Documents Requested* Required?Attached Documents * Program Expense Budget for ALL Grant Requests [i LNF Dublin Outreach Budget Financial Information Form for ALL Grant Requests LNF Financial Form List of Board of Directors (or governing body) with LNF BOD agency contact information Current Annual Budget for the Entire Agency 0 LNF 2023 Annual Budget Copy of most recently submitted IRS 990 form or Tax 0 Retum (include complete form) Board of Director's (or governing body's) designation 0 of authorized official Board of Director's (or governing body's) authorization 0 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 LNF 990 LNF BOD Desianation LNF BOD Desianation for Fundina Proof of Insurance LNF State IRS Letter LNF IRS Letter LNF Audited Financials REQUIRED FOR CDBG ONLY - If requesting Capital 150 I-undmg, please upload your capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEPJLAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) LNF Outreach Overview ZoomGrantsT"' is not responsible for the content of uploaded documents. Application ID: 459439 Became a `ar cf Zoor. Gr;r:ts'" nn Facebook Prchien s? Contact us at C u estionsiai?ccn'3 ran-c. cc-n ®2002-2024 GrantAnalystcc n. Al rights reserved. "ZoomGrants" and the ZonalGrants logo are trademarks of GrantAnalystcom, LLC. oaoutl Browser 151 sMi DUBLIN Powered by ZoomGrantsTM and Email This Preview Save as PDF Print Close Window Ar 7 City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1/19/2024 Narika Culturally Responsive Domestic Violence Intervention & Prevention Services Jump to: Organization Information Questions Budget Documents USD$ 13,141.00 Requested Narika Submitted: 1/19/2024 3:19:45 PM (Pacific) Project Contact Shailaja Dixit narikaianarika.ora Tel: 9256999012 Additional Contacts none entered Organization Information 1. Business License Number 94-3162871 Questions op P 0 Box 1708 Telephone5104446068 Fremont, CA 94538 Fax Web https:llwww.narika.org Executive Director Shailaja Dixit shailaiaanarika.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Narika's mission is to promote women's independence, economic empowerment and well-being by helping domestic violence survivors with advocacy, support and education. Narika specializes in supporting South Asian & immigrant survivors of domestic violence. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project 2 Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 152 operation. ❑ Yes No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Narika seeks funding to boost the awareness and impact of our culturally responsive services for Dublin residents. We request support for our in -person Tri Valley `Saheli' support group that was initiated in Dublin last year as well as funding to enhance outreach and education for Dublin residents about the availability of Narika's culturally responsive services. We are also requesting funds to host two community wide information sessions for SAPHAL, Narika's Parenting Curriculum, developed under our Violence Prevention Program. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) According to the 2020 Census, Dublin is over 50% Asian and 40% foreign -born, a dramatic increase over the last few decades. And yet, the domestic violence movement has not diversified to meet the demand for culturally responsive services. Approximately —40% of South Asian women in the U.S. report intimate partner violence —higher than the national average at 25%. They also experience unique forms of abuse, such as immigration -related (26%) and in-laws related (19%), and and a higher rate of physical abuse (48°/0), attesting to the need for culturally & linguistically responsive services from advocates who understand these complexities. According to a Michigan State University study, "Asian victims...were at least 4x less likely to use mental health services' than other groups. They also underreport domestic violence significantly. According to the Dept. of Justice, there has been a 147% increase in domestic violence calls since 2013 in Dublin. Almost half involved a weapon, such as a firearm. Given these statistics, there is a great need to grow awareness of our culturally responsive intervention services among Dublin residents. Narika requests funding to provide year long sustained outreach and flyering in Dublin. We also request funds for our Tri-Valley `Saheli' support group that is conducted weekly in Dublin. We further request funding for two informational workshops in Dublin on Narika's Parenting Curriculum, SAPHAL, designed to break future pathways to violence. Without funding, domestic violence survivors will remain under -served or unserved and cycles of inter -generational trauma will continue. Without funding we also may not be able to provide nourishment in our groups, which is critical to promote healing, community and wellness. Narika served 11 survivors in 2023 from Dublin and 30 survivors from the Tri-Valley area overall. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) We expect to serve a total of 350 unduplicated Dublin residents through quarterly outreach campaigns, Narika services (referred by our outreach), 15 in -person support group sessions, and 2 parenting (SAPHAL) education sessions. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/19561Applicatran-Requirements-Process [!] Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) El Workforce Development Li Homelessness ❑ Transportation Services and Access O Domestic Violence and Child Abuse ❑ Disabilities O Food and Nutrition ❑ Senior Services El Youth Services ❑ Child Care, Early Childhood Development and Education O Changing Demographics and Growing Diversity El Financial Assistance ❑ None of the Above 153 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Funds will cover the following: (1) Our in -person Tri-Valley `Saheli' ('Girlfriend' in Hindi) Support Group which provides a culturally responsive space for survivors of domestic violence to process, share and heal. This is an intervention model that we have practiced for years that offers South Asian, immigrant and all survivors of abuse/violence a safe space to nurture community, foster self -care and mutual support, and learn grounding self -care techniques. The support group builds a space for conversation, self- examination, and connection through crafts, book discussions, mindfulness activities, movie nights, and breathing exercises & stretches. The support group occasionally also invites therapists and speakers to provide psychoeducation on subjects like coping with anxiety, grief, loss, building self esteem as well as self care. The support group is facilitated by Narika's Contra Costa Advocate (funded by other sources) and our trained direct service volunteers, as well as supervised by Narika's Executive Director. We request funding ($1550) for fresh food and nourishment for 15 sessions and 4 psychoeducation sessions with a bilingual therapist. All sessions provide chai, hot food, and other refreshments as offering food is necessary to welcome and support healing in our culture. It also ensures that survivors struggling to meet basic needs are able to gain crucial nutrition. We estimate our Dublin in -person support group sessions will serve 5-10 Dublin residents. (2) In -person culturally responsive info sessions in Dublin about our South Asian Parents & Caregivers Heal & Learn (SAPHAL) Parenting & Domestic Violence Prevention Program. SAPHAL creates safe spaces for parents & caregivers to learn with each other and build a community of care that promotes healthy relationships. For this project, it would take the form of two info sessions in Dublin sharing the details of the culturally responsive curriculum we have developed, covering topics like boundary setting, emotional regulation, praise and apology, self -compassion and more. Participants will be invited to access workbooks, videos and podcast episodes on healthy parenting and relationship -building as part of our effort to prevent domestic violence across multiple generations. All SAPHAL programming is backed by evidence -based practices and developed in collaboration with Sangita Biswas, a local bilingual Licensed Marriage and Family Therapist who has extensive experience working with the South Asian community. Narika requests funding ($5000) to support hours for an independent community facilitator, Megha Sharma Narang, and Sangita Biswas to facilitate these workshops and to coordinate food and program materials. These workshops will be supported by Narika's Executive Director and are intended to be offered in collaboration with local community centers, such as Rewire Community, Dublin Unified School District and the Dublin Library. We anticipate engaging 40 Dublin residents through these information sessions. (3) Quarterly outreach campaigns involve flyering and speaking/tabling at culturally relevant locations such as religious sites, cultural organizations, performances & events, all to bolster awareness of Narika's services and programs. We are partnering with local volunteer -based entities, such as Rewire Community, for this outreach. Every quarter, three volunteers will flyer Narika's key materials to identified locations in Dublin including ethnic grocery stores, beauty salons, cultural spaces and community spaces like Dublin Library. We request funding to provide $100 gift cards each for 3 volunteers to perform these tasks every quarter. We anticipate over 300 Dublin residents will be served through this outreach effort in the Dublin community. All outreach initiatives will be designed and led by Narika's Outreach Specialist and supervised by Narika's Executive Director. (4) Narika also requests funds to cover our Executive Director's time ($4,992 base salary at 0.05 FTE) to supervise all of the Dublin -related initiatives listed above. Please note: Counts for participants supported by our support groups and parenting groups are based on the number of registrations since all registered participants receive ongoing communication and support from Narika, including pathways to our other services. Group participants may belong to Dublin and/or other local cities. Narika will track and report counts for Dublin residents as well as other cities. Narika is providing conservative estimates for all in person sessions since we are still facing barriers for in person attendance, post pandemic. This project includes both prevention & intervention programming in recognition of the cyclical and deeply culturally -rooted nature of domestic violence. For every survivor we support, we hope to prevent another from experiencing domestic violence. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? By the end of this grant period, we expect to serve approximately 350 Dublin residents through outreach with 300+ touch points, Narika helpline support (made possible through these outreach efforts) for 5-10 Dublin survivors, in -person support group sessions engaging 5-10 Dublin residents, and parenting workshops engaging approximately 40 Dublin residents. Please note that Narika is providing conservative estimates for all in -person sessions since we face lingering post -pandemic 154 barriers, despite clear interest in in -person programs. Furthermore, our target audience is primarily immigrant and low-income survivors of domestic violence & intimate partner abuse with our typical survivor being a low-income and/or unemployed woman with children seeking shelter and recovery from an abusive household or partner. Barriers also include lack of transportation and model minority pressures. Given the high -risk, complicated, and unpredictable nature of domestic violence, survivors may struggle with in -person attendance. We will measure the impact of this project through the following methods: -The effectiveness of our `Saheli' support group sessions will be measured by number of registrations, number of attendees, qualitative and quantitative feedback and evaluation from participants, as well as client testimonials. -The effectiveness of our SAPHAL parenting information sessions will be measured by number of registrations, number of attendees, attendee feedback and self administered evaluation. Narika will also request all attendees to share their intent to continue their education by downloading our free, more detailed curriculum available online. -The effectiveness of our outreach will be measured by the number of locations reached, number of flyering initiatives completed, number of volunteers engaged, and number of estimated touch points generated. Narika will also track the number of Dublin based clients served by our agency through our Helpline, as an impact of increased outreach. Please note: Counts for attendees supported through our `Saheli' Circle and SAPHAL sessions are based on number of registrations since all registered participants receive ongoing communication and support from Narika, including pathways to our other services. All in person sessions may also include residents from other locations, since Narika's services are open to all. We will ensure our outreach strategy targets spaces and communities in which immigrant and low-income women frequent without their abuser, like grocery stores, public restrooms, medical centers, places of worship, hair/nail/threading salons & spas, cultural centers and local businesses. To ensure accessibility of our programs, we have funding from other grants to support transportation and childcare for those who need it. Our flyers are translated into different languages. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Narika promotes diversity & inclusivity by sustaining a workforce of trained advocates who represent the identities of our clients. 100% of our direct service staff and leadership are South Asians who collectively speak over 5 South Asian languages and understand the complexities immigrant survivors face: lack of family support in the US, lack of awareness of local resources, social stigmas, taboos around divorce and mental health, challenges to immigration status, fear of law enforcement, isolation, language barriers, and more. Furthermore, our programs promote inclusive access to mental health services, legal support, housing, economic empowerment, and community engagement & awareness for the diverse South Asian communities of the Bay Area. Over 90% of our clients identify as South Asian women with little to no access to or awareness of their finances due to financial abuse and would therefore be defined as low-income, very low-income, or extremely low-income. Our project specifically furthers these values by targeting the documented needs of a high -risk diverse population of low- income, South Asian & immigrant survivors in Dublin with high demand for culturally responsive wellness -related programming (addressed by our `Saheli' program), as well as culturally -responsive domestic violence prevention & awareness (addressed by our SAPHAL program and outreach). This project will foster equity by supporting survivors' escape from the cycle of abuse which will increase long-term safety, financial empowerment, housing stability, and mental wellbeing, necessary steps for women of color to build equity for themselves and future generations. Given the intersectionality of domestic violence, this project would, altogether, directly address the following Areas of Concern: domestic violence, behavioral health, and food & nutrition, as well as indirectly provide support for childcare, housing, workforce development, and homelessness through pathways to our other progra 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Narika was profoundly impacted by the pandemic with our total number of survivors served increasing by almost 74% from 2020-2023. The rise in domestic violence cases during the COVID-19 pandemic is often referred to as the "shadow pandemic"155 with survivors forced to shelter -En -place with their abusers, impacting their ability to escape or seek help. I his was made worse by immigration and court slowdowns. Narika's programs directly responded to the impact on survivors and continue to do so as these trends linger. This includes: (1) an increase in mental health -related programming to serve survivors dealing with loneliness, shame, grief, and trauma as a result of the pandemic and the isolation and abuse they experienced, (2) increased virtual case management sessions, support groups, and economic empowerment workshops to support the increase in clients, (3) an increase in economic empowerment and life skills programming, such as job trainings, financial literacy, English as Second Language trainings, resume & cover letter workshops, and more, to support clients laid off or furloughed, and (4) an increase in legal support through temporary restraining order support and partnerships with legal agencies to help survivors experiencing immigration & family court slowdowns, (5) food & transportation to help survivors meet basic needs through economic turmoil, (6) increased virtual community outreach through social media, radio, and webinars to facilitate community engagement & prevention of violence. To this day, Narika's services offer crucial long-term pathways out of the cycle of abuse by providing wraparound support to survivors experiencing the continued economic, mental health, legal, housing, and immigration -related challenges exacerbated by the pandemic. Narika would be grateful to receive additional funds to support our life skills and economic empowerment programs as well as legal services which have been in high demand since the pandemic. 13. " QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.' Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery F—� �r, Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A} Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. • Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and 156 individuals who are vulnerable or k�? F} Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing El Strengthen Communities El Ensure Equal Opportunity in Housing El Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") El Creating a Suitable Living Environment El Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?"j ❑ Availability/Accessibility El Affordability ❑ Sustainability !.l Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. El Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. El Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. 157 Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) El Persons ❑ Households ❑.� Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income (AMl) information is available online at www.dublin.ca.govI1956/Application-Requirements-Process N/A Extremely Low Income (<30% AMI) N/A Very Low Income (30%-50% AMI) N/A Low Income (50%-80% AMI) N/A Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" White White + HISPANIC Black/African American 158 BlacklAfrican American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Linder Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearn/pay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional farm will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. • Yes • No Budget r2 Funding Sources/Revenues Budget Amount Amount Committed CAL OES UV funds the salary and benefits for two key staff positions supporting outreach to underserved populations: Contra Costa Advocate and Outreach Specialist. 0.10 FTE assumed for this program budget CAL OES UV funds Support Group and access needs like childcare, transportation, etc. City of Dublin USD$ USD$ 12,183.00 12,183.00 USD$ 2,600.00 USD$ 2,600.00 USD$ USD$ 0.00 13,141.00 159 Kaiser Grant for tood tor 1 b support group session and 4 psychoeducation sessions CaIOES SD 21 contractor hours for designing online social media campaigns for SAPHAL USU 1,bbU.uU USD$ 1,138.00 USD$ 0.00 USu1) 1,bbu.uU USD$ 1,138.00 USD$ 0.00 Total Funding Uses/Expenses USD$ 30,612.00 Budget Amount USD$ 17, 471.00 Amount Committed Salary and benefits for Executive Director. Calculated at 0.05FTE Salary and benefits for Outreach Specialist and Contra Costa Advocate , 0.10 FTE Contract services for facilitation of 2 parenting information sessions and 4 Pyschoeducation groups Food and nourishment for 15 support groups Support group: childcare, transportation Contractor services for designing SAPHAL online campaigns Food for 15 support group sessions and 4 psychoeducational grouops Reimbursement for 4 psychoeducation sessions Gift cards for volunteers leading outreach campaigns USD$ 5,391.00 USD$ 0.00 USD$ 5,000.00 USD$ 750.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 800.00 USD$ 1,200.00 USD$ 0.00 USD$ 12,183.00 USD$ 0.00 USD$ 0.00 USD$ 2,600.00 USD$ 1,138.00 USD$ 1,550.00 USD$ 0.00 USD$ 0.00 Total Budget Narrative Narika requests $13,141 for the following_ USD$ 13,141.00 USD$ 17, 471.00 -$1200 for gift cards to appreciate volunteers spearheading quarterly outreach & flyering efforts in Dublin. We anticipate 3 volunteers every quarter and would like to offer a $100 gift card as appreciation to each volunteer. 3 volunteers x $100 gift cards each x 4 outreach campaigns = $1200 -$1550 to support 15 support groups in Dublin. We request $50 per session to provide fresh food, nourishment. 15 sessions X $50 each = $750. -We also request $800 to engage a local bilingual therapist to provide 4 sessions of psychoeducation to attendees. Hourly charge for therapist = $200. $200 x 4 sessions = $800 $5000 to support 2 parent education sessions in Dublin. The $5000 breaks down as follows: we request $1000 for a bilingual community based facilitator at the hourly rate of $50. We anticipate each session to take 10 hours of the community facilitator's time, including planning, design, recruitment and facilitation. $501Hr x 10 hours x 2= $1000. We request $3,200 to reimburse the bilingual therapist who is also the co -creator of SAPHAL, to work with our community facilitator at the rate of $200/Hr. We anticipate 8 hours of the therapist's time per parent information session. $200/Hr x 8 hours x 2 sessions = $3,200. Lastly, we request $400 per session to cover costs for fresh food, and program materials. $400 per session x 2 sessions = $800. $1000+$3,200+$800= total of $5,000 -Coverage of 0.5 FTE of our Executive Director's time to oversee all intervention and prevention efforts related to Dublin. 0.05FTE x $481Hr = $4,992 + $399 benefits (at 0.08%) Total Budget = $1200+$1550+$5000+$4992+$399= $13,141 Government funding sources do not allow spending on food which is a critical part of our culturally responsive care. Funding for our prevention program has also faced budget cuts just when we had all materials prepared to disseminate in our local communities. Documents LL Documents Requested * Required?Attached Documents * Program Expense Budget for ALL Grant Requests Proaram Budaet Form Itemized Budaet Financial Information Form for ALL Grant Requests 2 Financial Information Form List of Board of Directors (or governing body) with 0 Board List agency contact information Current Annual Budget for the Entire Agency 0 Narika Budaet 2024 160 Copy of most recently submitted IRS 990 form or Tax ❑.+ Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization 0 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability ❑+� and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) 2022 990 Authorization Letter - Desianation Authorization Letter - Reauest Fundina Proof of Insurance CA Tax Letter Fed Tax Letter CA Certificate of Status 2023 Financial Statement 2021 Financial Review Executive Director Resume SAPHAL Facilitator Resume SAPHAL Facilitator 2 Resume Tri-Vallev Saheli Circle Fiver SAPHAL Samnle FlvPr * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 460442 Became a fan of ZoomGrants"' on Facebook Problems? Confad us at C uesaonsfo7Zooni rams. corn @2002-2024 GrantAnalystcan Al righta reserved_ "ZoomGrants' and the ZoomGrants logo are trademarks of GradAnalyatcam, LLC. Ledout I Brow°er 161 Email This Preview Save as PDF Print Close Window A■ v DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1119I2024 One Nation Dream Makers One Nation Dream Makers Last Mile Delivery and Food Recovery Program Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2024 11:20:45 PM (Pacific) Project Contact Thomas Forbes Tho m asZone n ati and re amm a kers. o ra Tel: (510) 385-5035 Additional Contacts Ronnie@onenationdreanwakers.org Organization Information top 1. Business License Number Questions tors One Nation Dream Makers PO Box 92 Livermore, CA 94551 United States Director of Finance Thomas Forbes Tho m a stone n at i and ream m a kers. ora Telephone(510) 205-0484 Fax NIA Web onenationdreammakers_org 1. Select the category that best describes your organization: (Select only one) Pi Non -Profit ❑ Public Agency ❑ Other: 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). ONDM brings nutritious food to all individuals and families in need. We at ONDM help veterans and anyone else who needs to have hope restored, to get back on track and to become positive forces within their families and in their communities 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ❑ Yes 162 Na 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). We have been delivering dried food boxes and nutritious recovered food/groceries helping to meet the growing food and nutritional needs of home -bound seniors, youth, medically vulnerable individuals, and individuals and families that are experiencing food insecurity and hunger as a result of the aftermath of the Coronavirus (COVID-19) pandemic and those experiencing adverse economic conditions. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Our project addresses those who are experiencing food insecurity at all tangible levels. Those who are employed and have household budgetary insufficiencies and those who are unemployed greatly benefit from the services ONDM provides. The unhoused population also benefits from ONDM's services as it provides those community members with vital nutrition. If ONDM is unable to attain the funding sought in this grant application, it is probable that the services provided to the Dublin community, by ONDM may be at risk. The operational costs associated with the project providing nutritious food to those community members in need, are present and rising due to fluctuating inflation conditions. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) We project from 8,500 to 10,000 unduplicated Dublin residents will be served by this project. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.cagov/9956/Applrcatian-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing E Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ▪ Food and Nutrition ❑ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) We are requesting the maximum award of $25,000 in this grant application. The sought after funds will be utilized for vehicle maintenance, fuel expenses and vehide insurance costs. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? We plan to measure the effectiveness on our project by taking surveys and performing analysis of those surveys to examine the level of established mitigation and positive impact the services of ONDM is providing to those interfacing with food insecurity. Our criteria for project success will be documented on the surveying and analysis of those duplicate community members we have the honor to provide services to. We believe that the pool of community members who are experiencing food insecurity will be positively impacted by the ONDM project services. We expect to provide individuals and families with the opportunity t 163 have flexibility within their personal and or household budgets, which will hopetully allow them to reallocate their financial resources toward other areas of need, whether it be medical expenses, educational expenses or utility expenses. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/721mission-vision One Nation Dream Maker's project provides dried food boxes and recovered food groceries helping to meet the growing food and nutritional needs of home -bound seniors, youth, medically vulnerable individuals, and individuals and families that are experiencing food insecurity and hunger as a result of the aftermath of Coronavirus (COVID-19) pandemic and fluctuating economic conditions. Those community members that ONDM is honored to serve and assist are of all ethnic, race, creed and economic backgrounds, Having a desire to assist all community members who are experience food insecurity and at any level, we believe furthers the values of the Dublin City Council's updated Mission, Vision and Values in 2020. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. The priority and/or target populations that ONDM has served and continues to serve are home -bound seniors, youth, medically vulnerable individuals, and individuals and families that are experiencing food insecurity and hunger as an initial result of the Coronavirus (COVID-19). In an effort to significantly mitigate the nutritional needs of the abovementioned target population, ONDM will maintain and enhance the current mode! of providing "Last Mile," delivery and pop up food distribution sites close in proximity to or directly to the targeted population. ONDM currently delivers to over 34 locations weekly. This includes home- bound seniors, youth, medically vulnerable individuals, and individuals and families that are experiencing food insecurity and hunger as an initial result of the Coronavirus (COVID-19). 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.'"° Are you are interested in applying for CDBG funds? Yes. If so, check box here and answer questions 14 through 25. El No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Through our staff and volunteers, we intend to inform and advise the community members about the services ONDM provides, Through our staff and volunteer network, we are currently able to provide information translated into Spanish, Tagalog, Korean and Mandarin Chinese. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ID Be culturally accessible, appropriate and inclusive ❑►I Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑.I Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery Li Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) El A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing 164 LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. !A Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: `'z! Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑I Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination E1 Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: {TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") VI Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: {TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?" ❑ Availability/Accessibility ❑ Affordability El Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Pi Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. 165 ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) �I Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. 500+ Seniors (62 and older) 100+ People with Disabilities 250+ Female -Headed Households too+ Youth 200+ Homeless Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you Dublin clients (EITHER Persons OR Households) your enter "0" Area Median Income CAMP) information is available online 500+ Extremely Low Income (<30% AMI) 400+ Very Low Income (30%-50% AMI) 400+ Low Income (50%-80% AMI) 300+ Moderate Income (80%-120% AMI) TOTAL selected above, please list the number of unduplicated agency anticipates serving in each category. If none, please at www.dublin.ca.gov/1956/Application-Requirements-Process 166 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none; please enter "0" 300+1 White 300+1 White + HISPANIC 400+1 Black/African American 400+1 Black!African American + HISPANIC 250+1 Asian 350+1 Asian + HISPANIC 100+1 American Indian/Alaskan Native 150+1 American Indian/Alaskan Native + HISPANIC 100+1 Native Hawaiian/Other Pacific Islander 100+1 Native Hawaiian/Other Pacific Islander + HISPANIC 200+ American Indian/ Alaskan Native and White 250+I American Indian/ Alaskan Native and White + HISPANIC 100+ Asian and White 125+1 Asian and White + HISPANIC 300+1 BlacklAfrican American and White 350+I BlackfAfrican American and White + HISPANIC 400+1 American Indian/Alaskan Native and Black/African American 400+I American Indian/Alaskan Native and Black/African American + HISPANIC 500+I Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 5,075.001 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY u #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:flwww.fppc.ca.gov/learn/pay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed far you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. Yes No Budget Funding Sources/Revenues Budget Amount Amount Committed 167 City of Dublin CDBG (Pending) StopWaste, Inc Alameda County BOS District II ARPA Grant (Pending) Individual Contributions Corporate Donations (Pending) Total Funding Uses/Expenses Vehicle Maintenance - Repairs, Tires, Oil Changes Vehicle Fuel - ONDM seeks CDBG funding of $25,000 for vehide expenses Total USD$ 25,000.00 USD$ 20,000.00 USD$ 50,000.00 USD$ 45,000.00 USD$ 110,000.00 USD$ 250,000.00 Budget Amount USD$ 36,830.00 USD$ 38,510.00 USD$ 75,340.00 USD$ 0.00 USD$ 8,000.00 USD$ 0.00 L)SD$ 22,000.00 USD$ 0.00 USD$ 30,000.00 Amount Committed USD$ 9,880.00 USD$ 7,085.00 USD$ 16,965.00 Budget Narrative The Last Mile Delivery and Food Recovery project targets home -bound seniors, youth, medically vulnerable individuals, and individuals and families that are experiencing food insecurity and hunger initially as a result of the Coronavirus (COVID-19) pandemic and the subsequent economic fallout and or constraints that has occurred in the aftermath of the pandemic. In an effort to significantly mitigate the nutritional needs of the abovementioned target populations, ONDM will maintain and enhance the current model of providing "Last Mile,' delivery and pop up food distribution sites close in proximity to or directly to the targeted populations. ONDM currently delivers nutritious food to over 34 locations weekly. The associated operational budgetary costs allocated to vehicle maintenance and fuel expenses for the project amount to $75,340.00 base upon fuel cost accruals from the last 18 months and projections of fuel costs at current fuel prices. The vehicle maintenance costs have been deduced utilizing the same mathematical analysis. This application for CBDG Funding of $25,000 is a request to assist in solely mitigating ONDM's vehicle maintenance expenses. Documents top Documents Requested* Required?Attached Documents * Program Expense Budget for ALL Grant Requests • Proaram Expense Budget Financial Information Form for ALL Grant Requests 0 Financial Information for All Grant Reauests List of Board of Directors (or governing body) with 0 List of Board of Directors agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official O ONDM Budaet for Entire Oraanization ❑+� ONDM - 990 2022 ❑� ONDM Board Designation of Authorized Official Board of Director's (or governing body's) authorization 0 ONDM Board Designation of Authorized Official to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Proof of Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 State and Federal Non Profit Desianation Letters DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Certifed Audit of ONDM 2022 Financial Position REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Personnel Pnliries includinn AAP 168 Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ONDM Audited Financials with Highlighted Findings Articles of Organization and By -Laws Conflict of Interest Statement ONDM - LEP * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 459494 Become a Fan of ZoomGrants.. , Facebook Problems? Contact us at C. - -. 02002-2024 GrantAnalystcom. W I rights reserved. "ZoomGrants" and the ZoomGrsnls logo are trademarks of GranFAnalyst.com, LLC. LoQaut I Browser 169 Email This Preview Save as PDF Print Close Window Ar 7 DUBLIN Powered by ZoomGrantsTM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Deadline: 1 f 1912024 Human Services Grant Program Open Heart Kitchen Senior Meal Program Jump to: Oraanization Information Questions Budget USD$ 25,000.00 Requested Submitted: 1/17/2024 7:02:30 PM (Pacific) Project Contact John Bost execut i ved i recto rCa7o oen h eart kite h en. o ra Tel: 925-580-1616 Additional Contacts none entered Organization Information top 1. Business License Number BL-009270 Questions •op Open Heart Kitchen 1141 Catalina Drive #137 Livermore, CA 94550 United States Executive Director John Bost John( ooenheartkitchen.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: Documents Telephone(925) 580-1616 Fax Web www.openheartkitchen_org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Open Heart Kitchen's mission is to provide nutritious food today, while building a food secure tomorrow. We distribute nutritious meals and groceries for free in the Tri-Valley, and we are expanding soon to include a food bank and an overnight shelter. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 170 operation. ❑ Yes No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Open Heart Kitchen Senior Meal Program offers a place for Tri-Valley seniors to feel welcome as they seek nutrition support that fits their budgets and lifestyles. Our freshly prepared meals are tailored to the dietary needs of active seniors, and are served on weekdays in congregate dining rooms at the Dublin Senior Center, the Pleasanton Senior Center, and the Robert Livermore Community Center. These meals are offered free of charge to all seniors, bringing together a community into our dining rooms that encourages vital social -emotional support. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Our Senior Meal Program serves the senior community of the Tri-Valley by providing a free and social lunch program. Seniors can visit the Dublin Senior Center and take a seat at a communal dining table where they are served a meal consisting of a cup of soup, an entree course, fruit, and milk. According to a study by the Older Americans Act, participants in programs such as ours receive 40% of their daily calories and 35% - 47% of their daily recommended nutrition intake by eating these meals. Mounting hurdles that can hinder individuals from cooking as they age. Planning a list, traveling to the grocery store, and getting the groceries home (especially when alone and traveling by bus or ride share) can feel exhausting, and that's all before the actual cooking and cleaning. Financial barriers can lead to purchasing cheap, convenient foods that lack nutrients. As the cost of everyday goods increases, low-income seniors are already struggling to make ends meet. The Tri-Valley NonProfit Alliance (TVNPA) is a nonprofit organization established to create a collaborative network for Tri-Valley community -based organizations. TVNPA noted in their 2023 report, 'Just Getting By in the Tri-Valley', that 25.9% of Tri-Valley seniors have an annual income of less than $40,000, compared to $58,258 which is needed for someone to get by in our area. We receive funding from multiple sources. The largest funder is Alameda County, which accounts for 58% of the programs budget. We apply for city -specific funding from the cities of Livermore and Pleasanton, and we also seek out grant funding throughout the year from corporations, small businesses, social and charitable groups, and places of worship. If we do not receive this requested funding we will continue to operate in Dublin, but may have to consider reducing our daily meal count maximum and implementing a tiered eligibility system. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 250 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.govll956lApplication-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness L1 Transportation Services and Access �J Domestic Violence and Child Abuse ❑ Disabilities Ji Food and Nutrition Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later ir171 the "Documents" tab.) (What specifically will the grant funds be used for?) Dublin grant funds will be used for our Senior Meal Program operations at the Dublin Senior Center. These funds will be used for general program operations, including the purchasing of food and supplies. We take cost -saving measures to get fresh ingredients in bulk and at a discount. We participate in a group purchasing program through our food provider to cut food costs. Open Heart Kitchen is also a member agency of the Alameda County Community Food Bank (ACCFB). Later in 2024 we will be launching the Open Heart Food Bank, acting as an extension of ACCFB into the Tri-Valley. This will give us even greater capacity to receive items in bulk at a discount while also accepting larger food donations. Our paid staff oversee services to ensure sanitation, safety, and quality standards are upheld. We rely on a volunteer network to work alongside our team and keep salary costs down. We have been rebuilding our volunteer network since returning to pre -pandemic services. All of our volunteers must be at least 16 years old, and those over 18 must pass a background check. Volunteers are then subject to additional training depending on their assignment. Some program funds are allocated to volunteer training. Overseeing the team at our Dublin Senior Center location is Site Supervisor Evelyn, along with Food Service Assistant, Asiwarya. Evelyn has been with Open Heart Kitchen an impressive 16 years across multiple programs and sites, and has heavily contributed to our culture of service. Evelyn and Aiswarya are each scheduled to work 15 hours per week to administer our meal services at the Center, which includes overseeing setup of the kitchen and dining room, checking in and seating guests, plating and serving meals during a sit-down meal service, followed up with cleaning. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our overall goal is to provide nutrition access. Our meals follow Older Americans Act Nutrition Services Dietary Guidance for levels of fiber, vitamins A & C, protein content, and sodium. Our Registered Dietician works with our Chef and Operations Director to review each month's menu in advance to make sure that daily and weekly nutrition goals are being met. We want our guests to feel empowered to use food as a medicine to enhance their lives. The secondary pillar to this program is social -emotional support. The `effectiveness of established friendships' is not easy to quantify, but we know that for us it starts in the dining room. During the pandemic our communal dining room had to be shuttered as we shifted our services between walk-up and drive-thru setups. During those isolating times, many clients told our teams that their daily meal pickup was their only guaranteed interaction to look forward to. The return to original operations has given our staff and clients the opportunity to bond again and strengthen their community. We expect to continue to retain our core group of daily diners, as well as welcome new diners to our program during the grant period who will establish a regular dining frequency. We expect that our monthly meal counts will remain within our budget. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Open Heart Kitchen's vision is to work with community partners to meet the most basic needs of vulnerable people in our community by empowering them to build better futures. We work toward this vision by using our guiding principles of dignity, innovation, advocacy, and collaboration. Open Heart Kitchen has invested time, energy, and resources into the principles of IDEAL: Inclusion, Diversity, Equity, Access, and Liberation. We began our IDEAL adoption journey through our extensive work with the Center for Excellence in Nonprofits, including instructor -led virtual workshops for our team. In 2023 we partnered with the professional development coaches at LAR Workgroup to plan and facilitate a custom in -person workshop for our team to receive a refresher on these values. The members of our team put great effort and pride into fostering welcoming experiences for all guests, including volunteers. Since our founding in 1995, Open Heart Kitchen has become a trusted name in the Tri-Valley with a reputation for providing a space for community members to come together in an impactful way. Our senior meals are accessible to all seniors aged 60 or older, although there are exceptions including seniors' spouses or caregivers under the age of 60. Our meals are not only a source of sustenance, but also the result of carefully -calculated nutrition choices. By serving our guests the balanced meals that they need, we are supporting their ability to continue or regain an active lifestyle. Customer service skills are required when working with the public. Our team is aware that on any given day a client may be using our services while facing their largest life obstacles. We owe our clients the patience and understanding to help them fully participate in our services. Maintaining safety is always our team's priority. Our team has received de-escalation training and we review safety manuals regularly to help ensure a safe dining and workspace for everyone who comes to us. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. We are still seeing our community recover from the pandemic, and that includes older Americans living on fixed incomes despite rising costs of goods and the slashing of pandemic -era emergency assistance programs. According to the Tri-Valley NonProfit Alliance's report, "Just Getting By in the Tri-Valley", the emergency assistance programs operated during the Pandemic pulled many people further out of poverty, but that great progress will not last as the benefits are cut for vulnerable 172 community members. Senior Meal Program dining services have returned to pre -pandemic operations, which means diners are seated at communal tables. However, Open Heart Kitchen continues to monitor all guidelines and updates issued by the Alameda County Public Health Department in the event of another emergency health order. 13. "" QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. Are you are interested in applying for CDBG funds? FBI Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Our team, volunteers, and clients all come from varied backgrounds. One of our guiding principles is dignity, which takes the form of every person interacting with our organization being treated with respect. A way that we can acknowledge and respect one another is by supporting our clients' language needs. According to the Tri-Valley NonProfit Alliance report, "Just Getting by in the Tri-Valley", 50% of Dublin households use a language other than English at home, and 54°I0 of those households speak an Asian or Pacific Island language. Our menus are translated into simplified Chinese, Spanish, and Korean, and all four languages are printed on one paper so that no one has to feel singled out for requesting their copy in another language. These languages were chosen based on the needs of our guests, and efforts are taken to offer services in additional languages as well. Our onsite teams are trained to use iSpeak cards to identify a client's language, and to then call a real- time translation service called Boostlingo so that they can put the phone on speaker and communicate with their non English- speaking clients. Clients who call our administrative offices can also speak with our team members using the Boostlingo service by dialing a translator into the call. Through this process we have assisted community members with Cal Fresh eligibility applications, provided referrals to local resources, and signed guests up for our programs. Nutrition access and participation in community services should be guaranteed to all Tri-Valley community members. All languages are welcome at our dining tables. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑� Be culturally accessible, appropriate and inclusive ❑d Encourage community engagement and involvement ❑ Promote energy and resource efficiency R Encourage networking and information sharing across service providers ❑ Encourage process streamlining CI Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. El Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. El B) Homeless El Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. I.-01 Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or 173 L1 F} Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Ji Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers Promote Decent Affordable Rental Housing • Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ▪ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: {TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address? !. ] Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?"} ❑� Availability/Accessibility ❑ Affordability ❑ Sustainability El Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. RBI Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ▪ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIVIAIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial 174 assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) *71 Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 250 Seniors (62 and older) 34 People with Disabilities 60 Female -Headed Households 0 Youth 1 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 345.Ut TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Area Median Income (AMl) information is available online at www.dublin.ca.goo/1956/Application-Requirements-Process 183 Extremely Low Income (<30% AMI) 49 Very Low Income (30%-50% AMI) 18 Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" 49 White 12 White + HISPANIC 7 Black/African American 175 Black!African American + HISPANIC 13O Asian 6 Asian + HISPANIC 21 American Indian/Alaskan Native 31American Indian/Alaskan Native + HISPANIC 1 Native Hawaiian/Other Pacific Islander 1 Native Hawaiian/Other Pacific Islander + HISPANIC i American Indian/ Alaskan Native and White l American Indian/ Alaskan Native and White + HISPANIC 8I Asian and White Asian and White + HISPANIC 11 BlacklAfrican American and White 1 Black/African American and White + HISPANIC l American Indian/Alaskan Native and Black/African American 1 American Indian/Alaskan Native and Black/African American + HISPANIC 32I Multi Racial + HISPANIC OR other Multi Racial I Not Applicable. Not interested in CDBG funding. (Type N/A) fn.'TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY #1 - This program/project has the agency's highest priority for funding. #2 - This program/project has the agency's 2nd highest priority for funding. #3 - This program/project has the agency's 3rd highest priority for funding. #4 - This program/project has the agency's 4th highest priority for funding. [ 1 #5 - This program/project has the agency's 5th highest priority for funding. #6 - This program/project has the agency's 6th highest priority for funding. If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https://www.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. Yes No Budget Funding Sources/Reven ues Budget Amount City of Dublin USD$ 25,000.00 City of Livermore (for Livermore residents) USD$ 25,000.00 City of Pleasanton (for Pleasanton residents) USD$ 50,000.00 County of Alameda USD$ 396,000.00 Individual Contributions USD$ 57,500.00 In -Kind Contributions USD$ 122,000.00 Total USD$ 675,500.00 Amount Committed USD$ 0.00 176 Funding Uses/Expenses Salaries Benefits Auto (food transport) Facilities and equipment maintenance Food and kitchen supplies Information technology, telephone Insurance Postage and printing Rent and utilities Other expenses Total Budget Amount USD$ 346,000.00 USD$ 61,500.00 USD$ 9,500.00 USD$ 10,000.00 USD$ 163,000.00 USD$ 7,500.00 USD$ 4,000.00 USD$ 3,000.00 USD$ 43,000.00 USD$ 28,000.00 USD$ 675,500.00 Budget Narrative Other expenses include: uniforms, occupational health, office expenses, etc. Amount Committed USD$ 0.00 The $25,000 request from the City of Dublin will help defray 4% of the costs attributed to the Senior Meal program operations. The total budget for the Senior Meal program is 19% of Open Heart Kitchen's overall organization budget. Documents top Documents Requested * Required?Attached Documents * Program Expense Budget for ALL Grant Requests Proaram Expense Budget Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Retum (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability and/or workers' compensation ❑� Financial lnformation ❑� List of Board of Directors ❑•� Budget El Form 990 O Board Desionation • Authorization COI Endorsement STATE AND FEDERAL NON-PROFIT 0 Federal DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit State REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section Emplovee Handbook Audit Reauirements Audit Summary oaae 28 177 FttUUIhEL) I-UF< UL)titi ONLY - Articles of Articles Incorporation and Bylaws Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP./LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Conflict of Interest Policy LEP Plan * ZoomGranfsT"' is not responsible for the content of uploaded documents. Application ID: 457376 Become a Fan of ZoomGrantsTM on Face -book Problems? Contact us at ^uestlonsrb Zoom:= •a•r:. com 02002-2024 GrantAnalystcan AI rights reserved_ "ZoomGrants" and the ZoanGrants logo are trademarks of GrantAnalystcom, LLC. �oaout 16rov. ser 178 Email This Preview Save as PDF Print Close Window Ar V DUBLIN Powered by ZoomGrantsTM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1 f 19/2024 Partners for Change Tri-Valley Alleviating Poverty and Homelessness in the Tri-Valley Jump to: Organization Information Questions Budget Documents USD$ 15,000.00 Requested Submitted: 12/29/2023 11:57:03 AM (Pacific) Project Contact Terri Molano director( ofctv.oro Tel: 5107736356 Additional Contacts none entered Organization Information 1. Business License Number BL-114846 Questions op Partners for Change Tri-Valley 4743 East Ave. Livermore, CA 94550 United States Executive Director Terri Molano directorfa?Dfcty.ora 1. Select the category that best describes your organization: (Select only one.) F Non -Profit ❑ Public Agency [1 Other: Telephone5107736356 Fax Web www.pfctv.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). We equip and empower people to chart their course out of poverty to self-sustainability through transformative education and mentorship. We foster positive, supportive community by intentionally creating relationships that bridge socioeconomic lines. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 179 LJ Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). We equip and empower people to chart their course out of poverty to self-sustainability through a research -based, transformative, Tong -term education and mentorship program. We foster positive community by intentionally creating relationships that bridge socioeconomic lines and building a supportive team for our participants.. Our Vision is to end poverty in the Tri-Valley. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) There is a high return rate to destabilization when crisis support is not combined with whole person, long-term care. HACA reports they have <10 openings a month for Section 8 housing, & applicants can wait years, if ever, to be selected. Selection is based on a scoring system, & many of the Tri-Valley unhoused will never score high enough to find an opportunity. PFCTV provides essential solutions to reducing poverty in Tri-Valley. We offer casework & long-term mentorship to assist in completing housing applications & support to address gaps in their score which improves their chances. If for example, they are advised to get mental heath support, we provide a direct referral to mental health counseling at Axis. Their mentors check - in to ensure they're following through wi treatment & continued care. We provide financial literacy & individual casework addressing derogatory credit items that would eliminate them from private housing options. Participants can set goals to seek and improve employment & enter college, so they are not dependent on the lottery of current housing programs. We remove barriers that would prevent them from attending class by providing free childcare, a hot meal donated by Open Heart Kitchen & transportation solutions. Our curriculum provides an in-depth education on trauma resiliency, so they can begin to cope with their past and present in healthy ways. This is crucial in avoiding setbacks. In our weekly classes we offer a supportive experience where people can be fed, build community and feel safe. We believe Tong -term education & nnentoring is the answer to lowering return rate to crisis -mode and the need to solicit assistance from existing care providers & community organizations. Our Soc Svs system does not have the funding to help all those in need wi the current perspective of focusing on just crisis support. Without funding, numbers won't grow & fewer people will experience the transformative life change our Participants have seen 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 100 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.govi1956/Application-Requirements-Process 2 Behavioral Health (mental health and substance abuse) ❑� Affordable Housing ❑ Health Care (including dental) P i Workforce Development ❑+1 Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ❑,I Food and Nutrition ❑,I Senior Services ❑W Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later it 180 the "Documents" tab.) (What specifically will the grant funds be used for?) Our pressing issue is that we do need to bring on a Program Facilitator to support the growth of our program and the significant uptick in casework. Previous years found most of our participants living in subsidized housing who had some level of stabilization. This year 50% of our Tuesday cohort came to us unhoused, either living in hotels, in their cars at safe parking or on the streets. They represent the full spectrum of the unhoused and low-income including a teenager up to senior citizens, recovering addicts, people with mental and physical health issues, parents of Special Needs children, abused women, transgender youth, and all of them carry with them the significant trauma of their life experiences. Partners for Change Tri-Valley uses a transformative, research -based life skills curriculum to provide weekly education classes and mentorship to the under-resourced community. The classes are designed to equip and empower our participants to navigate their way out of poverty and into self-sustainability. Our curriculum provides an education around holistic poverty, financial literacy, personal introspection, all forms of addiction, racial equity, aspects of privilege, social capital, and the role of personal and community trauma. Reciprocal relationships are built over time through a shared cohort experience. Graduates of our program leave with skills for work -readiness, financial literacy, goal setting, planning, interpersonal skills, focus, self-awareness, self-control, flexibility, and resilience, all designed for better outcomes at home, school, work, and life. We cannot however continue to grow without additional support. Additional funds will support program supplies, transportation vouchers to attend class and funds to build out a Participant manual to align with our current curriculum so our Participants have a reference for when they are not in class. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our criteria for success varies for each individual participant. We have previously seen our participants access housing, vehicles, better paying jobs, enroll in college, improve their English for our ESL participants, open a bank account for the first time, and get their drivers licenses. There are also less tangible outcomes such as experiencing improvement in interpersonal relationships, significant increases in self-worth, identifying how past trauma is affecting their present and moving through it, and changing their relationship with money. We expect to see similar results with each cohort. Our classes help alter perspectives around self -responsibility and capability, that in turn, improves confidence and self- esteem, making life's challenges more surmountable. In addition, we foster positive community by intentionally creating personal relationships between our participants and mentors that bridge socioeconomic lines. This provides a supportive family and long-lasting relationships. Program success will be measured by increased numbers of Participants we see in class and are able to offer personalized casework to. We would like to offer more in -person cohorts at our local low-income housing projects so families can get support right where they live. We are working with a school in West Alameda County to come onsite as their in-house service provider as 70% of their students are considered low-income. All of this explains why bringing on a Program Facilitator is critical to the success of our growth and program. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Our current demographics are made up of 42% White 30% Hispanic 23% African American 3% Middle Eastern 2% Asian This is historically typical in our program and we believe it will continue to be. Empowering and mentoring individuals from economically disadvantaged backgrounds within any demographic is a crucial step towards fostering equity, ensuring equality, and promoting inclusion for that entire community. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. NA 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? 181 i✓j Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NSA" if you are not interested in qualifying for CDBG funding. Our Referring Partners serve a diverse domographic within the Hispanic community, and we have actively fostered collaborations with them to facilitate client referrals. Our Executive Director is a fluent Spanish speaker and has many years of involvement in the Hispanic community. These relationships also attract Spanish speaking participants. In our current cohort, 30% of our participants are Spanish speaking. We offer bi-lingual curriculum in our weekly classes as needed. Interestingly, a noteworthy proportion of our Spanish-speaking participants express a preference for the English language, recognizing its role in enhancing their proficiency. This linguistic diversity enriches the cultural tapestry of our program, promoting indusivity and effective communication. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑.I Be culturally accessible, appropriate and inclusive 2 Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑,� Encourage networking and information sharing across service providers 17 Encourage process streamlining ❑W Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑,� Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. J D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. El Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Fl Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing E Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination 182 RJ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") El Creating a Suitable Living Environment ▪ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?") ❑ Availability/Accessibility ❑ Affordability !! Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs 183 with employer -sponsored health care benetits, and the types of Jobs retained (using ELiA classrlications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) L] Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. 10 Seniors (62 and older) O People with Disabilities 10 Female -Headed Households O Youth 5 Homeless Not Applicable. Not interested in CDBG funding (Type NIA) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMP) information is available online at www.dublin.ca.gov/1955lApplication-Requirements-Process 13 Extremely Low Income (<30% AMI) 12 Very Low Income (30%-50% AMI) Low Income (50%-SO% AMI) Moderate Income (80%-120% AMI) 2 5.0 0 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" 7 White 8 White + HISPANIC 8 Black/African American BlacklAfrican American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC 2 Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian) Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White 184 Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY 2#1 - This program/project has the agency's highest priority for funding. ▪ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes €i Na Budget too Funding Sources/Revenues Budget Amount Amount Committed Individual Contributions City of Dublin Grant City of Pleasanton Grant City of Livermore Grant USD$ 12,597.09 USD$ 15,000.00 USD$ 15,000.00 USD$ 15,000.00 USD$ 0.00 USD$ 12,597.09 Total USD$ 57,597.09 USD$ 12,597.09 Funding Uses/Expenses Budget Amount Program Supplies USD$ 2,422.86 Printing and Copying USD$ 2,174.23 Transportation Vouchers USD$ 2,000.00 Wages USD$ 51,000.00 Total USD$ 57,597.09 Amount Committed USD$ 12,597.09 USD$ 12,597.09 Budget Narrative Program Facilitator Salary of $51,000 includes wages and taxes. 20.4% of this will come from the Dublin HHSG per year. Documents top 185 Documents Requested * Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Retum (include complete form) Board of Director's (or governing body's) designation ❑+� of authorized official Board of Director's (or governing body's) authorization 0 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 and/or workers' compensation Required?Attached Documents ❑�+ Proaram Budaet ❑.r STATE AND FEDERAL NON-PROFIT 0 DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LER/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) 2024 Budaet Board of Directors PFCTV Budat 2024 2022 990 Letter of Authorization Authorization Letter DO Policv Full Policv Workmans Como Insurance LOE 501 C3 State Entitv Letter Audit Reauirements Doc Affirmative Action Plan Audit Reauireements Articles of Incorporation Conflict of Interest ZoomGrantsTm is not responsible for the content of uploaded documents. Application ID: 457737 186 Become a fan of ZoomGrants. on Facebook Problems? Contact us at QuestionsaZoomGrants.com ©2002-2024 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logou[ Browser 187 Email This Preview Save as PDF Print Close Window Ar ■ DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1/19/2024 Spectrum Community Services Meals on Wheels: More Than A Meal Jump to: ❑raanization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2024 3:25:01 PM (Pacific) Project Contact Carrie Oldes LCalvert aasoectrumcs.ora Tel: 510-881-0301 Additional Contacts none entered Organization Information 1. Business License Number 006992 Questions op Spectrum Community Services 2621 Barrington Court Hayward, CA 94545 United States Executive Director Lara Calvert LCaivertaS?SoectrumCS.oro, 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: Telephone 510-876-8811 Fax (510) 537-3340 Web www.SpectrurCS.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Spectrum Community Services enhances the quality of life for older adults and residents experiencing low income in Alameda County. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 188 Li Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Spectrum's Meals on Wheels Program provides nutritious meals and vital safety checks daily to disabledlhomebound Dublin seniors. Our goal is to deliver 10,500 or more meals to 60 seniors. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Many vulnerable Dublin seniors rely on hot meal services because they are disabled/living alone/lack financial resources/have no support networks/are unable to prepare meals. They also face isolation and coupled with a lack of proper nutrition, they face intensified mental/physical health issues/reduced access to services. Spectrum's Meals On Wheels Program is vital in addressing the challenges/needs/service gaps in Dublin. We ensure frail homebound seniors have the proper nutrition they require and are safe in their homes. The 2021 Census shows that seniors over 65 make up 9.4% of Dublin's residents. As indicated above, a growing number of Dublin seniors need meal assistance. We continue to see significant need for Dublin seniors. Though some seniors seem to be aging successfully, our intake assessment shows nearly 75% face high nutritional risk and 25% are extremely low income. These two factors play a major role in the overall health of a senior. Each day, Spectrum dispatches our volunteer drivers to deliver nutritious meals and provide human contact/warms social interaction/perform a vital safety check. Our Meals on Wheels Coordinator supports seniors through home assessments, allowing them to discover hidden issues seniors are facing and identify/access resources to address these issues. Spectrum's Meals on Wheels Program is a life -line that better safeguards senior's health/combats their isolation/ensures their wellbeing and safety/allows vulnerable seniors to continue living at home. Without the City's support, we will not be able to fully serve eligible Dublin seniors seeking assistance and will have to implement a reduced number of meals seniors receive each week and a waitlist. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 60 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1966fApplication-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ▪ Workforce Development ▪ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse !! Disabilities g Food and Nutrition ❑I Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance O None of the Above g. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Spectrum Dublin Meals on Wheels will use this request to fund a portion of the salaries and benefits for two positions: Program Manager $12,866 and Dublin Meals on Wheels Coordinator $12,134. 189 Our Dublin Meals on Wheels Coordinator is the backbone of the program. They are the main contact for our seniors whether it is to register them for new service, complete their intake assessment, or talk to them about their meal schedule, preferences, and other needs. The Coordinator completes in-depth semiannual assessments with each senior adult. These initial and semiannual assessments are completed inside the client's home. This allows the Coordinator to provide personal attention and better understand each senior's needs and additional resources they might benefit from. The Dublin Meals on Wheels Coordinator also works daily with volunteer scheduling and planning routes to ensure all meals are delivered timely. Spectrum's Meals on Wheels Program Manager recruits, trains, schedules and manages the community volunteers. They oversee all of the operating functions of the program. Meals are delivered daily, primarily by volunteers, who are dedicated to the program and the senior adults they serve. The Program Manager is an active participant in the community and leads Spectrum's outreach efforts in the Tri-Valley. The Program Manager works to cultivate connections in Dublin with faith -based, cultural, business, community organizations where seniors and their families gather and are connected. Involvement in the community is not only important to raise awareness of services Meals on Wheels offers, it provides opportunities to support the program through recruiting volunteers. Trained volunteers are an essential component of providing daily meals and safety - checks for homebound seniors. Due to the limited number of meals funded through the Alameda County Area Agency on Aging (Federal/State/County funds), we must seek additional funds to meet the needs of all eligible homebound Dublin seniors. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The first and primary outcome measure crucial to Spectrum's Meals On Wheels Program success is to ensure all low/extremely low-income frail, homebound senior adults, who reside in Dublin, have access to our program services. This guarantees we can meet their nutritional needs through our home delivered meals, as well as safeguard their wellbeing through daily safety checks. We want to ensure if a senior adult qualifies and wants or needs our support, we will be there to assist. Our goal is to meet or exceed our contracted outcome by providing home -delivered meals to 60 or more unduplicated Dublin senior residents in FY 2024-2025. Another outcome that measures the success of our Program is the number of meals we deliver each fiscal year. In FY 2024- 2025, we will home -deliver 10,500 or more meals to Dublin seniors, sometimes the only full meal they get each day. Finally, the Meals on Wheels Program can only be successful if, not only the seniors served are happy with our meals and services, but we ensure Dublin seniors thrive by positively impacting their health through a well-balanced/nutrient-rich diet. To certify this outcome, our meals comply with the Dietary Guidelines for Older Americans, meeting 1/3 of the Dietary Reference Intakes for seniors, and meet strict food safety guidelines. We also guarantee seniors are happy with our meals through periodic Satisfaction Surveys filled out by our program clients. Spectrum's demographic data is collected daily through self -reporting of the client or family member of the client upon initial intake. The other outcome data are collected daily through program meal orders and then inputted into the agency's database. Reports are generated monthly and Spectrum's management staff review these reports to confirm the program is on track to meet our stated goals thus ensuring the success of Spectrum's Meals On Wheels Program. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Spectrum Community Services is excited that the City of Dublin shares our values of inclusivity, diversity and equity. We are assessing and implementing new ways to address racial equity, demonstrating our commitment to fostering diversity, equity, and inclusion across all facets of our operations. Institutional Efforts: A pivotal step in our commitment has been the appointment of a Director of People & Culture, who brings in 20 years of racial equity knowledge and experience, with an emphasis on racial equity policy. This role has proven instrumental in implementing initiatives that ensure a more inclusive environment. Representation in Demographics: We understand the importance of representation not only within our staff but also among our volunteers. We regularly assess the racial demographics of our volunteer pool, aiming for alignment with the communities we serve. Similarly, we analyze client demographics to ensure that a substantial percentage can identify with and see themselves represented among our volunteers. This commitment is integral to creating an environment where everyone feels welcome and understood. We also track LGBTQ+ demographics. We currently have four people in leadership and six total staff members in this demographic. Culinary Choices: In our program delivery, we have incorporated a racial equity lens into the menu options. We've introduced vegetarian choices and East Asian dishes with careful consideration. This decision is not arbitrary; it is a deliberate effort to align our offerings with the cultural specifications of the communities we serve. By doing so, we bridge gaps and create a more inclusive environment that respects diverse dietary and cultural needs. Benefits & Fair Compensation: Our dedication to racial equity extends to the benefits we offer through employee health and 190 wellness benefits, designed to be inclusive and supportive of a!I staff members. We are proud to commit to paying at least the Alameda County Livi 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Older adults and those with underlying health conditions continue to be the most vulnerable to both hospitalization and death due to the COVID-19 virus. We have not missed a single day of service to this most vulnerable population and have had no virus outbreaks. Continuing to provide daily nutritious food and safety checks as well as fulfilling other individualized needs for clients has been a joy. Face coverings, access to vaccinations, sharing information, and a friendly call have all been key life- lines for our clients, 75°/0 of whom live alone. Being a part of the Meals on Wheels program is truly more than a meal as we continue to work closely with Alameda County Public Health, the City and other organizations to share information and resources these residents may not have access to without this connection. In addition, we have seen the negative impacts of inflation causing stress to the older adults we serve. We ask for a $4.00 client donation toward the $13.50 total meal cost but currently only receive $0.76. The City's contributions as well as private donors have made it possible for us to not turn anyone away during these critical times. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.** Are you are interested in applying for CDBG funds? Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English ProficiencylLanguage Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "NIA" if you are not interested in qualifying for CDBG funding. Spectrum performs a language survey of staff, volunteers, clients, and the community, making note of any gaps and lining up resources and protocols to address needs. The plan informs our staffing goals, outreach activities, consumer materials, communications and operations. We have added a phone -based, on -demand or appointment -based translation service that all of our Meals on Wheels staff are trained to use. This is key when doing assessments and speaking with seniors about their specific needs at any time in any language. Spectrum's website is fully translated in multiple languages by the click of a button. Our goal is that all clients, prospective clients, and their families have access to Spectrum services in the spoken language in which they are proficient, that they are treated with respect, and that their questions are answered in a timely manner. We regularly reach out to other service agencies to help ensure that all Dublin seniors have access to our service. By sharing information with as many entities as possible our hope is that all are included. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Be culturally accessible, appropriate and inclusive EI Encourage community engagement and involvement ❑ Promote energy and resource efficiency Li Encourage networking and information sharing across service providers E Encourage process streamlining II Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) A) Housing Goal 1: Promote the production. rehabilitation. and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. B) Homeless Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. 191 LJ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. L!1 Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑d Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑=I Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: {TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") 1i Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?" El Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑.l Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. 192 Li Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. L j Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. El Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) I1,t1 Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. 60 Seniors (62 and older) 60 People with Disabilities 20 Female -Headed Households O Youth O Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) 140.CC TOTAL 23. CDBG ONLY - Based on the common indicator you Dublin clients (EITHER Persons OR Households) your enter O. Area Median Income ("AMl") information is available online 30 Extremely Low Income (<30% AMI) 15 Very Low Income (30%-50% AMI) 15 Low Income (50%-80% AMI) selected above, please list the number of unduplicated agency anticipates serving in each category. If none, please at www.dublin.ca.govt1956/Application-Requirements-Process 193 O Moderate Income (80%-120% AMI) 60.0 : TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 40 White 6 White + HISPANIC 5 Black/African American O Black/African American + HISPANIC 5 Asian O Asian + HISPANIC O American Indian/Alaskan Native O American Indian/Alaskan Native + HISPANIC O Native Hawaiian/Other Pacific Islander O Native Hawaiian/Other Pacific Islander + HISPANIC O American Indian/ Alaskan Native and White O American Indian/ Alaskan Native and White + HISPANIC O Asian and White O Asian and White + HISPANIC O Black/African American and White O Black/African American and White + HISPANIC O American Indian/Alaskan Native and Black/African American O American Indian/Alaskan Native and Black/African American + HISPANIC 6 Multi Racial + HISPANIC OR other Multi Racial O Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ��i #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This programlproject has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This programlproject has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca. govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes Na 194 Budget Funding Sources/Revenues Area Agency on Aging/Grant MOWAC/Donation City of Livermore/Grant City of Pleasanton/Grant City of Dublin/Grant Private Donations/Donation Program Revenue/Donations Volunteers/In Kind Total Funding Uses/Expenses Salaries & Wages Benefits & Payroll Taxes Supplies Taxes & Licenses Postage Telephone Rent & Utilities Accounting/Audit Contracted Services Travel & Co Vehicles In Kind Misc. Expense Total Budget Amount Amount Committed USD$ 136,428.00 USD$ 136,428.00 USD$ 75,000.00 USD$ 75,000.00 USD$ 74,000.00 USD$ 55,000.00 USD$ 25,000.00 USD$ 20,000.00 USD$ 85,000.00 USD$ 140,000.00 USD$ 610,428.00 USD$ 211,428.00 Budget Amount USD$ 225,000.00 USD$ 49,500.00 USD$ 19,500.00 USD$ 15,000.00 USD$ 750.00 USD$ 6,000.00 USD$ 5,500.00 USD$ 1,500.00 USD$ 93,625.00 USD$ 12,000.00 USD$ 140,000.00 USD$ 42,053.00 USD$ 610,428.00 Amount Committed USD$ 0.00 Budget Narrative We are asking for $25,000 from the City of Dublin to fund 4.2% of this project. We will use this funding for the salaries of two key individuals in this life saving service to Dublin residents as well as to continue to try to meet the needs of all of the Dublin seniors. These funds will help prevent us from going back to a wait list. Individual 1. Meals on Wheels coordinator who ensures that daily operations run smoothly - 32% of her salary which is $8531mos, $10,232 annually with benefits of $1,902 annually. 2. Meals on Wheels Program Manager establishes partnerships as well as trains, recruits, and appreciates volunteers which is vital to our program trains, recruits, and appreciates volunteers which is vital to our program - 13% of her salary which is $883.501mos, $10,602 annually with benefits of $2,264 annually Documents rL Documents Requested * Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Retum (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Required?Attached Documents ❑+� Proaram Expense Budget ❑,I Financial Information Form ❑ Board of Directors ❑+� Aaencv Budaet ❑� IRS 990 ❑ Board Authorization ❑,r Board Authorization 195 Proof of insurance carried, including bonding, liability IJ Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Financial Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ❑,+ IRS Exempt Letter State of Calif - Certificate of Status * ZoomGrantsTMl is not responsible for the content of uploaded documents. Application ID: 457014 Became a fan of ZoomGrants.. on Facebook Problems? Contact us at QuesuonsfarZoomGrants. com '&2002-2024 GrantAnaystcan Al right' reserved_ 'ZoomGrants' and the ZoomGrants logo are trademarks d GrartAnalyatcom, LLC. lout I Browser 196 Email This Preview Save as PDF Print Close Window A■ V DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1 f 1912024 Sunflower Hill Sunflower Hill's Program Support for Adults with Developmental Disabilities Jump to: Organization Information Questions Budget Documents USD$ 16,250.00 Requested Sunflower Hill Submitted: 1 /19/2024 10:11:37 PM (Pacific) Project Contact Jennifer Oxe info(sunflowerhill.ora Tel: 925-800-1042 Additional Contacts none entered Organization Information; 1. Business License Number BL-110708 Questions op PO Box 11436 Telephone925-800-1042 Pleasanton, CA 94588 Fax United States Web sunflowerhill.org Executive Director Jen Lenard -Benson jen 33 suntlowerhill.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency Cl Other: 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Sunflower Hill co -develop affordable housing and provides innovative programming for adults with intellectual and developmental disabilities. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 197 Yes J No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Sunflower Hill Garden is an outdoor, instructional space providing educational, therapeutic, and life skills training for adults with intellectual and developmental disabilities (I/DD). The Hands -On Garden Groups, currently open to 11 Tri-Valley adult day, transition, high school, and residential programs, as well as individuals, offer person -centered programming for adults with I/DD, including curriculum that provides opportunities to learn about organic gardening and healthy nutrition, while engaging in a supportive environment and building vital independent living and social skills. Funds requested for this project will support 25°I0 of the salary for our Programs Coordinator who plans and leads Garden programs. 6. Describe the challenges, needs, or service gaps in Dublin your programlproject addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) This project is specifically designed to meet the unique needs of adults with intellectual and developmental disabilities. The CDC estimates that 1 in 6 children aged 3-17 have one or more developmental disabilities. In California, it's estimated that there are 625.000 adults with IIDD. This population only grows over time with increased diagnosis, longer life expectancy, and a growing California population. Locally, these numbers are consistent with statewide trends, with approximately 5,500 individuals with I/DD living in Alameda County, and an estimated 395 Dublin residents with a developmental disability. Individuals with developmental disabilities represent overlooked population groups in Eastern Alameda County with respect to living options and job opportunities, as was reported in the Human Services Needs Assessment. It is critical for Id -Valley cities to support programs that address the diverse needs of the adult developmentally disabled population, as programs and activities are significantly reduced once a person ages out of the public -school system. Our in -person Hands -On Garden Group Program, open to Tri-Valley adult day, transition, high school, and residential programs, as well as individuals, offers person -centered programming for adults with I/DD. Sunflower Hill is one of the only organizations in the region offering therapeutic and life skills training in an educational, outdoor setting, and the demand for our in -person programs is very high. If we do not receive city funding, we will likely need to scale back our programming. In addition, without the necessary program participants to plant and harvest produce and flowers in our garden, we may have to reduce the food/flower donations provided to the local nonprofit community addressing food insecurity and medical challenges; this program has ripple effects. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 40 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at wwvv.dublin.ca.gov/1956IApplication-Requirements-Process L i Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse El Disabilities RI Food and Nutrition ❑ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should 198 include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The funds requested for this project will support 25% of the Sunflower Hill Programs Coordinator salary. Our Programs Coordinator is an integral member of the Sunflower Hill Programs team and is responsible for planning and leading hands-on, innovative programming at the Garden that is specifically designed to provide life and social skills for adults with I/DD so they can succeed and thrive. A former special education teacher, she develops and implements dynamic Garden programs to meet the diverse needs of our program participants. Our Hands -On Garden Groups Program is uniquely designed to honor all ability levels and the curriculum addresses educational, therapeutic, and life -skill topics to grow vital independent living skills. During their sessions at the Sunflower Hill Garden, groups and individuals learn skills that are imperative to keeping a garden growing, use tools and skills employed in such work, and enjoy extended time participating in field tasks, practicing what they have learned. Each 90-minute session in the Garden includes a welcome activity, time for individual gardening tasks, closing healthy snack, and discussion. Weekly tasks are designed with individual participants in mind, allowing for a variety of garden tasks to appeal to all abilities. Tasks include a range of gross and fine motor movements and a variety of standing, kneeling, lifting, and/or tabletop tasks. Additionally, participants explore tasting new and healthy foods and engage in a natural setting. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our multi -disciplinary Hands -On Garden Groups Program is designed for adults with I/DD, including those with autism, Down syndrome, cerebral palsy, epilepsy, and other chromosomal differences. Led by our knowledgeable and dedicated Garden staff, the curriculum is specially designed to offer unique experiences for adults with I/DD of all abilities. Through an engaging curriculum and guidance from staff, participants are able to achieve a number of objectives that lead to greater independence, empowerment, and confidence. Sessions are designed so that program participants are able to achieve the following: • Learn how to exercise the freedom of choosing their own task each week. • Work independently on a task until completion. • Follow step-by-step instructions and learn how to ask follow-up questions, as needed. • Practice simple math and life science concepts. • Improve social skills with instructors, peers, and community partners. • Learn how healthy food and flowers are grown from seed to harvest. • Have opportunities for physical activity in a natural environment that is accessible to all ability levels. Support of our Programs Coordinator will further enable the execution of the above objectives. Staff assess our program effectiveness through a variety of means. Our program is designed to offer residents opportunities to engage in self -reflection and provide regular feedback at the end of each session. We also gather feedback through surveys. Furthermore, Sunflower Hill as an organization values the input of people with I/DD to guide the design of our programs, activities, and residential communities, as outlined in our 2021-2025 Strategic Plan. This includes innovating our programming based on residents' and program participants' feedback and suggestions. In addition, we have created a Program Committee of the Board to assess best practices and industry trends. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Sunflower Hill's Hands -On Garden Groups Program promotes the values of inclusivity, diversity, and equity through a number of means. As previously shared, our curriculum is specifically designed to meet the diverse needs of adults with intellectual and developmental disabilities (I/DD) and ensure that each program participant is equipped with a variety of opportunities each week to be successful. We as an organization value the input of people with I/DD to guide the design of programs, activities, and residential communities, as set forth in our 2021-2025 Strategic Plan. This includes innovating our programming based upon feedback and suggestions from our program participants. As such, each week, our team assesses the needs of individual participants and modifies tasks, if needed. We also provide adaptable materials and tools to ensure that each participant can be fully engaged in our programming. The Sunflower Hill Garden is also accessible to all ability levels. This unique space features a series of decomposed granite pathways, raised garden beds, and a variety of seating options to ensure that it is fully accessible to all, including program participants who are visually impaired or use walkers or wheelchairs. Our Hands -On Garden Groups programming is free to all transition and day program participants, and as a result, it is fully 199 accessible regardless of their socioeconomic status. We do offer a weekly session to individual participants and caregivers for a small fee. Our fee in 2024 for our individual group sessions is $10 per class to ensure accessibility. We also offer fee waivers to encourage full participation to ensure that cost is never a barrier to participating in our programming. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. There are approximately 5,500 individuals with an intellectual or developmental disability (I/DD) living in Alameda County. It is estimated that roughly 395 Dublin residents have a developmental disability. Individuals with I/DD represent overlooked population groups with respect to housing options, job opportunities, and mental health services as was reported in the 2011 Eastern Alameda County Human Services Needs Assessment. Up until the age of 22, local school districts through IDEA (Individuals with Disabilities Education Act) are able to meet the needs of students with I/DD through Individualized Education Plans. However, programs, activities, and vocational opportunities are significantly reduced as a person ages out of the public school system. Therefore, adults with I/DD have a high risk of developing serious mental health issues. One particular common challenge is depression, which is often not recognized in people with intellectual disabilities and/or autism, often due to communication difficulties or atypical presentations of depression. Depression is likely to be much more common in people with intellectual disabilities than in the general population. Despite the prevalence of mental health challenges among individuals with IIDD, unfortunately, there are few resources or clear treatment paths for this vulnerable population group, and we know that mental health issues skyrocketed during the COVID-19 Pandemic. Mental health professionals have been overwhelmed with new patients, and individuals have a desperate need for assistance. Sunflower Hill programming, both at the Garden and Irby Ranch residential community, works to improve the lives and overall mental health of folks living with an MD in our community by building life and social skills, and making them feel like they belong and are accepted as part of the greater community. 13. " QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. " Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. �! No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive • Encourage community engagement and involvement ❑ Promote energy and resource efficiency El Encourage networking and information sharing across service providers ❑ Encourage process streamlining El Consolidate service delivery Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) El A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. • Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition 200 and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or E�1 F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities !�i Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I ,seeking?") ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability El Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of 201 homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ICJ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) Persons ❑ Households Eli Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you Dublin clients (EITHER Persons OR Households) your enter O. Area Median Income CAMP') information is available online N/A Extremely Low Income (<30% AMI) Very Low Income (30%-50% AMI) Low Income (50%-8O% AMI) Moderate Income (80%-120% AMI) selected above, please list the number of unduplicated agency anticipates serving in each category. If none, please at www.dublin.ca.gov/l956/Application-Requirements-Process a.ao TOTAL 202 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. ff none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Linder Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:llwww.fppc.ca.gov/learn/pay-to-play-limits-and-prohibitions. if you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes No Budget .tca Funding Sources/Revenues Budget Amount Amount Committed City of Dublin - partial salary for Programs Coordinator (Garden) USD$ 16,250.00 USD$ 0.00 203 L ity of Pleasanton - partial salary for Programs Uoordinator ((Arden) Three Valleys Community Foundation Tri-Valley Nonprofit Alliance Lawrence Livermore National Labs Giving Tuesday Safeway Pleasanton Weekly Holiday Fund Individual donations (includes year-end campaign, special events) Workday Total Funding Uses/Expenses Salaries (Garden) Benefits (Garden) Contracted services (water/soil testing; irrigation repair) Materials/Supplies (Garden) RentlUtil ities Other: General Operating Expenses Total USIA} 1t,2bU.UU USD$ 5,000.00 USD$ 4,000.00 USD$ 2,500.00 USD$ 6,000.00 USD$ 6,250.00 USD$ 10,000.00 USD$ 125,000.00 USD$ 2,620.00 USD$ 193,870.00 Budget Amount USD$ 186,250.00 USD$ 10,250.00 USD$ 3,000.00 USD$ 6,500.00 USD$ 3,625.00 USD$ 3,000.00 USD$ 0.00 USD$ 212,625.00 USIA) U.UU USD$ 5,000.00 USD$ 4,000.00 USD$ 2,500.00 USD$ 6,000.00 USD$ 0.00 USD$ 10,000.00 USD$ 40,000.00 USD$ 2,620.00 USD$ 70,120.00 Amount Committed USD$ 51,000.00 USD$ 3,000.00 USD$ 6,500.00 USD$ 3,000.00 USD$ 63,500.00 Budget Narrative Sunflower Hill staff structure has changed over the past 18 months. We previously had the following staff covering our Garden and Irby Ranch: - Garden: Non-residential Programs Manager - full-time, Non-residential Program Instructor (part-time) - Irby Ranch: Residential Programs Manager - full-time, Residential Activities Coordinator (part-time to full time) In order to maximize productivity, funding, and program synergy, we reduced staff and they now cover programs at both the Garden and at Irby Ranch: - Garden and Irby: Programs Manager (full-time), Programs Coordinator (full-time) - each staff covers each program 50% Sunflower Hill's funding request of $16,250 will cover 25% of the salary of our Program Coordinator, Olivia Christensen, who teaches and leads all programs in the Sunflower Hill Garden. The salary of $186,250 and benefits of $10,250 noted above are for the Sunflower Hill Team at the Garden as a whole, comprised of 50°/0 of the Programs Director, 100% of the Educational Garden Manager, 50% of the Programs Coordinator, and 100% of the GardenfPrograms Assistant. The remainder of the budget required for the Sunflower Hill Garden will be covered by contributed income from other local city, corporate, and private grants, as well as Sunflower Hill's robust fundraising efforts, including special events and individual donations. Please note that expenses above indicate costs needed to operate the Sunflower Hill Garden Program, rather than operational expenses for the entire organization. "Other operating costs noted above include mileage reimbursement for delivering donated produce, and partial software licensing fees. Documents too Documents Requested * Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests Required?Attached Documents* [� Proaram Expense Budaet for ALL Grant Reauests - Sunflower Hill 2024-2025 ❑r Financial Information Form for ALL Grant Reauests - Sunflower Hill 2024-25 204 List of Board of Directors (or governing body) with LEI SFH Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Copy of most recently submitted IRS 990 form or Tax 0 Retum (include complete form) Board of Director's (or governing body's) designation 0 of authorized official Board of Director's (or governing body's) authorization 0 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEPJLAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Sunflower Hill 2024 Budaet Sunflower Hill 990 SFH Board Authorization SFH Board Authorization SFH Insurance SFH Workers Comp Sunflower Hill Tax Exempt Letter Sunflower Hill 990 ZaomGranfsTkt is not responsible for the content of uploaded documents. Application ID: 458954 Beanie a fan of ZoomGrants.' on Facebook Prabterns? Corrfad us at CuestionseZoomG ran cc- 02002-2024 GrantAnalystcan. All rights reserved. "ZoormGrants"and the Zo mGrants logo are trademarks of GrantAnalyst.com, LLC. iocioutI Browser 205 Email This Preview Save as PDF Print Close Window A■ 7 DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Dead! ine: 1 f 19/2024 Human Services Grant Program Tri-Valley Haven Domestic Violence Services Jump to: Oraanization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/18/2024 6:35:30 AM (Pacific) Project Contact Christine Dillman cvnthia a�7trivallevhaven.ora Tel: 9254495845 Additional Contacts cynthia@trivalleyhaven.org,joe@trivalleyhaven.org Organization Information top 1. Business License Number BL-007058 Questions op Tri-Valley Haven 3663 Pacific Avenue Livermore, CA 94550 United States Executive Director Christine Dillman christinefrtrivallevhaven.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency Cl Other: Telephone(925) 449-5845 x Fax Web www.trivalleyhaven.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Tri-Valley Haven creates homes safe from abuse, contributes to a more peaceful society. One person, one family, one community at a time. Together we build a world without violence. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 206 Li Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Tri-Valley Haven's (TVH) Domestic Violence Services Program (DVSP) provides a 30 bed emergency shelter in a confidential location, job readiness and life skills groups, a 24-hour crisis line, case management, and both crisis and clinical counseling. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) According to the Dublin Police Department Annual Report, there were six rapes in Dublin in 2022. The California Department of Justice reports that there were 119 calls to Dublin police for domestic violence. Nine calls involved the use of a weapon, and six calls involved strangulation or suffocation of the victim. The Eastem Alameda County Human Services Needs Assessment calls the DV in the Tri-Valley Area underreported. DV includes verbal, emotional/psychological abuse as well as physical abuse. DV is a health care problem of epidemic proportions. In addition to the immediate trauma caused by abuse, DV contributes to a number of chronic health problems, including depression and substance abuse. It limits the ability of person to manage other chronic. The cycle of abuse continues in future generations without intervention. Growing up in a home where there is DV is the biggest predictor of who will become abused or abusive in their own teen and adult relationships. Shiloh is the only State sanctioned DV program and confidential emergency shelter serving the Tri-Valley area and, along with our homeless family shelter Sojourner House, the only shelter in the area that accepts boys over age 10. Survivors attempting to flee an abusive relationship often will often continue to stay if they are unable to flee with their children. TVH's 24-hour crisis line is a comprehensive resource for people seeking help or shelter. individuals are also referred via our website, the National DV Hotline, law enforcement, community referrals, 211 info line and at outreach events. If we do not receive funding staff positions will be reduced. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 75 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access RI Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition ❑ Senior Services ❑ Youth Services El Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) 207 The funds requested from Dublin will be used to pay part of the Case Manager's time, and part of the Linkages Case Manager's time. These positions are essential for the shelter operations. TVH's Domestic support Dublin's mission to have a high quality of life and a safe and secure environment for all residents through prevention and intervention services. Furthermore, we will make these services available to all residents through provision of services that are culturally sensitive and appropriate. Clients will benefit from our program or by creating a safety plan for themselves and their children, developing goals and plan of action towards achieving self-sufficiency, and connecting with the resources available in our community. In FY2223, we served 74 survivors of domestic violence from Dublin through our crisis line and shelter. Our services are life changing and our staff play an important role in the healing process in a myriad of ways which include providing life skills, and parenting skills, as well as respite for mothers who need time for their own healing. Our Family Case Manager can assist children with homework that they may need to catch up on as they may have missed out on several days of lessons in the process of fleeing to safety with their parent, or they may have moved to an entirely different school. The following is feedback from a client complementing our Family Case manager who works with children. It highlights the importance of having these services: "From the very first time I met her she was so very nice and very attentive. I think it was a GREAT idea to have her work with the shelter children. She is so patient and truly caring too. My child REALLY likes the time spent with her and it also gives me some free time to myself. Thank you." The DVSP utilizes in-house and donated services as much as possible to meet clients' needs and hold down costs. Residents are able to obtain food from the TVH Food Pantry, they are given clothing vouchers and referrals to our Thrift Store, they receive assistance applying for government services such as CAL Fresh, CalWORKS, and Linkages. We refer our clients to AXIS for their health related needs. Trained volunteers provide overnight crisis line coverage as well as (along with TVH staff) around the clock response to sexual assault calls and referrals from local police departments and hospitals, and volunteers provide childcare for shelter children while their parents participate in educational and support groups. All of this contributes to a very reasonable budget. Our confidential shelter, Shiloh, has operated from the same site for over 30 years. Shiloh is composed of two dwellings on one property. In 2021 closed one of the dwellings due to water damage and mold, resulting in our an auxiliary site in lieu of the original site. We initiated the planning process and fundraising to rebuild the entire Shiloh shelter in entirety. Demolition will take place this current fiscal year. During the rebuild of Shiloh, domestic violence services will not be interrupted. 14 clients will be served at the auxiliary site and 16 clients will be served at a hotel. TVH has entered into an agreement with a local hotel to secure 16 beds until Shiloh is rebuilt. TVH has entered into an agreement with Open Heart Kitchen to provide prepared hot meals to the clients in the hotel. The clients at the auxiliary site have a fully furnished kitchen on -site and prepare their meals with fresh groceries from our Food Pantry. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The success of the Program will be measured through evaluation of client surveys, statistical results, and the individual goals set by the program participant and their case manager. Those goals will be set up on a case -by -case basis and may include: reuniting with their children through completing their CPS Plan, finding housing or employment. Some clients will only stay one or two nights, and their goals will be very different such as safely relocating to a different county or a state. Client progress will be tracked by the case manager during weekly meetings. Progress is also monitored at weekly staff meetings during case review. Additionally, case managers consult with staff counselors or the Clinical Supervisor as needed in order to provide the best client services. We have multi -cultural staff members and volunteers who utilize their cultural backgrounds to enhance the services we provide to our clients. We presently have staff fluent in Spanish, Hindi, Punjabi, Russian, and several African languages. Multi language fluency is always a consideration when hiring staff and recruiting volunteers, and wage differentials are given to those fluent in Spanish, Cantonese, Mandarin, Russian, Hindi or Tagolog. All of the written materials at Shiloh are in both English and Spanish, and some are in Chinese. We make sure that at Shiloh we have cooking utensils and dishes that are multi -culturally appropriate such as rice cookers, chopsticks, and new sets of pots and pans for Muslim clients whose religious practice requires that these not be shared with other families. Ethnic food is available for our shelter clients at the Food Pantry and grocery store gift cards are available to assist with purchasing items that aren't at the Food Pantry. We continue educating our staff through participation in Cultural Responsiveness development projects. TVH staff maintains a good working relationship with CRIL, a local service provider for persons with disabilities and also is aware of key services such transportation for persons with disabilities and how to access them. Telephone screenings and intake processes include questions about needed accommodations (such as a bottom bunk, private room or special dietary needs). Our shelter is handicap -accessible. We conduct restraining order clinics at the Dublin library on the first and third Saturday of each month (during the pandemic, this assistance is available remotely; we will resume in -person clinics when it is safe to do so), which increased our overall visibility in addition to making this service more accessible to those Dublin residents who need it. We conduct annual briefings at Dublin Police Services to update them about issues of domestic violence, sexual assault and homelessness, and our agency's activities. All new staff and volunteers who attend our 70-hour domestic violence and sexual assault counselor training participate in a ride along with one of the three Tri-Valley police departments in order to maintain a strong connection to local law enforcement. Officers regularly tell us during the annual briefings that this is a positive experience for them. We are participants in the Family Violence Prevention Programs at Kaiser Permanente in Livermore and Pleasanton. While the Dublin Kaiser offices do not have a formal program in place, we have made presentations to staff about domestic violence, and they have supported several of our events, such as Back to School and the Pace for Peace. 208 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision We have multicultural staff members and volunteers, with linguistic diversity. Their experience, familiarity and understanding of their home culture greatly enhances the services we provide to our clients. Our present staff are fluent in Spanish, Hindi, Punjabi, Russian, and several African languages. Multi language fluency is always a consideration when hiring staff and recruiting volunteers, and wage differentials are given to those fluent in Spanish, Cantonese, Mandarin, Russian, Hindi or Tagalog. All of the written materials at Shiloh are in both English and Spanish, and some are in Chinese. We ensure that our clients feel comfortable at Shiloh, in many ways such as in the provision of cooking utensils and dishes that are important to different communities. Ethnic food stuff is available for our shelter clients at our Food Pantry and grocery store gift cards are available to assist with purchasing items that are not available. We continue educating our staff through participation in Cultural Responsiveness development projects. TVH staff maintains a good working relationship with CRIL, a local service provider for persons with disabilities and also is aware of key services such transportation for persons with disabilities and how to access them. Telephone screenings/intake processes include questions about needed accommodation (such as a bottom bunk, private room or special dietary needs). Our shelter is ADA compliant. We conduct annual briefings at Dublin Police Services to update them about issues of domestic violence, sexual assault and homelessness, and our agency's activities. All new staff and volunteers who attend our 70-hour domestic violence and sexual assault counselor training participate in a ride along with one of the three Tri-Valley police departments in order to maintain a strong connection to local law enforcement. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Our Domestic Violence Housing First program, funded by the Office of Emergency Services, offers case management and client assistance to help survivors of domestic violence access and/or retain safe housing after leaving an abusive relationship. During the pandemic, DVHF has helped survivors who lost their jobs or had their hours cut to pay rent and utility bills in order that they could remain safely housed. TVH continues to receive funds for the DVHF program and continues to provide this vital financial assistance to survivors of domestic violence. Both our Counseling and Legal Services are available remotely. 13. xx QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. " Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. nla 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery `J! Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. 209 Li Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑=I F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations R! Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities '•!s" Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?"} ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability 1!*!! Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. 210 Li Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. El Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons ❑ Households ❑,� Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless nja Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 75 Extremely Low Income (<30% AMI) 211 01 Very Low Income (3O%-5O% AMI) 0' Low Income (50%-3O% AMI) 0 Moderate Income (8O%-120% AMI) 75.0 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in racelethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC I Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native I American Indian/Alaskan Native + HISPANIC I Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC I BlacklAfrican American and White Black/African American and White + HISPANIC I American Indian/Alaskan Native and Black/African American I American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial nNal Not Applicable. Not interested in CDBG funding. (Type NIA) o.00l TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ❑ #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑.r #3 - This program/project has the agency's 3rd highest priority for funding. El #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. Li If you have mare than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:liwww.fppc.ca.govllearnipay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. Yes No 212 Budget too Funding Sources/Revenues Budget Amount Amount Committed Alameda County Domestic Violence Center Act USD$ 39,709.00 Alameda County HCD Linkages USD$ 56,808.00 Alameda County CaIWORKS USD$ 70,000.00 Alameda County SSA Sheller USD$ 79,760.00 CalOES DV USD$ 537,587.00 City of Dublin USD$ 25,000.00 City of Livermore USD$ 24,000.00 City of Pleasanton USD$ 60,000.00 DonationslFoundations USD$ 25,000.00 Alameda County HHAP USD$ 162,870.00 Total Funding Uses/Expenses USD$ 1,080,734.00 USD$ 0.00 Budget Amount Amount Committed Salaries USD$ 592,285.00 Benefits USD$ 99,402.00 Program and Office Supplies USD$ 28,410.00 Communications USD$ 25,538.00 Rent and Utilities USD$ 206,800.00 AccountinglAudit USD$ 8,600.00 Other: hotel stays for clients USD$ 2,000.00 Other: defined below USD$ 99,941.00 Other: client assistance USD$ 17,758.00 Total USD$ 1,080,734.00 USD$ 0.00 Budget Narrative Revenue: The composition of revenue is our best estimate based on the previous year of operation. Expenses: personnel costs include salaries and benefits. Sick leave, vacation, and holidays are not included in the benefits calculation for staff that will be paid with the City of Dublin grant funds. Other operating expenses include: travel and mileage, maintenance and repair expenses, payroll, staff development The Domestic Violence Services budget is part of the overall agency budget that includes other programs and departments: a) Homeless and Family Support Services, b) Sexual Assault and Counseling Services, c) Finance and Compliance, and d) Administration. Thus only a portion of liability insurance, auto insurance are being charged to this program. Documents top Documents Requested * Required?Attached Documents * Program Expense Budget for ALL Grant Requests • Program Expense Budget Financial Information Form for ALL Grant Requests • Financial Information Form List of Board of Directors (or governing body) with • BoD Roster agency contact information Current Annual Budget for the Entire Agency • Aaencv Budget Copy of most recently submitted IRS 990 form or Tax ❑,r Form 990 Return (include complete form) Board of Director's (or governing body's) designation ❑.r Resolution of authorized official Board of Director's (or governing body's) authorization 0 Resolution to request funding (may be same document as one 213 above) Proof of insurance carried, including bonding, liability 0 Dublin COI and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 Federal Non-profit Determination DETERMINATION LETTER. All organizations MUST Non-nrofit letermination have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements ❑,� Audit 1 Audit 2 Audit 3 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEPJLAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGranfsTm is not responsible for the content of uploaded documents. Application ID: 457297 Become a fan of ZoomGrants-^" on Face book Pr@idems? comma us at 011.Rtinr•s.A7nnr,:=•, ®2082-2D24 GrantAnalystcc n AI rights reserved. "ZoormGrants' and the Zo mGrants logo are trademarks of GrantAnalystcom, LLC. _r=oc; I E� ossz. 214 Email This Preview Save as PDF Print Close Window A■ V DUBLIN Powered by ZoomGrants TM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Dead! ine: 1119/2024 Tri-Valley Haven Homeless and Family Support Services Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/18/2024 6:39:34 AM (Pacific) Project Contact Christine Dillman cvnthia a�7trivallevhaven.ora Tel: 9254495845 Additional Contacts cynthia@trivalleyhaven.org,joe@trivalleyhaven.org Organization Information top 1. Business License Number BL-007058 Questions op Tri-Valley Haven 3663 Pacific Avenue Livermore, CA 94550 United States Executive Director Christine Dillman christinefrtrivallevhaven.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency Cl Other: Telephone(925) 449-5845 x Fax Web www.trivalleyhaven.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Tri-Valley Haven creates homes safe from abuse, contributes to a more peaceful society. One person, one family, one community at a time. Together we build a world without violence. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ❑.� Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 215 LJ Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Funding will support TVH's Homeless and Family Services programs (HFS). TVH's family shelter, Sojourner House, provides homeless clients with support services while the Food Pantry (FP) provides nutritious food to low income & homeless Tri- Valley residents. Sojourner House will continue to provide homeless clients (women, women with children, two parent families with children, men with children) with shelter and support services. Clients are offered up to six months shelter residency. Shelter clients are provided case management, life skills classes and counseling services. The Food Pantry will continue to provide groceries to Tri-Valley residents. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The 2011 Eastern Alameda County Human Services Needs Assessment discovered that in Eastern Alameda County there is a significant and increasing disparity between the growing demand for human services and a stagnating, and at times, declining supply of services. The quality of life for many residents is deteriorating, and at the same time, they are able to access fewer resources to help them recover. According to the Needs Assessment, those living below the poverty level, the mentally ill, the homeless and those at -risk of homelessness are most affected. Having a comprehensive program offering a wide variety of services and focuses on helping homeless or at -risk of becoming homeless to become self-sufficient is vital. We continue to fallow COVID-19 protocols for shelters as recommended by Alameda County Healthcare for the Homeless (ACHCH). We accept new families/individuals based on the bed space configuration of the shelter (16 beds). No COVID-19 cases have been reported. Cleaning rotations are done by staff and residents. A secure an isolated space is allocated for any clients who present themselves with COVID. Last fiscal year Sojourner House provided 4,234 bed nights to 26 adults and 19 children. TVH's Food Pantry services address the needs of Dublin households that are experiencing food insecurity. The Food Pantry provides a client choice model of service. Clients select from our daily inventory of food and choose which items they prefer. In addition to groceries, clients can also receive social service referrals at the FP. During the past fiscal year we 492 unduplicated Dublin residents were served by the Homeless Services programs. If not funded staff positions will be reduced. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 425 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.govll956/Applicafion-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑,I Homelessness ❑ Transportation Services and Access ❑W Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 216 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The funds requested from Dublin will be used to pay a portion of the salaries and benefits of the following positions: a) Sojourner House Case Manager and b) Food Pantry Manager. We utilize multiple funding sources to support the staff positions and operating costs at both Sojourner and the Food Pantry. The Food Pantry relies on a large number of volunteers to assist with the collection, sorting, shelving and distribution of food to clients. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The effectiveness of Sojourner House will be measured through statistical results and the individual goals set by the program participant and their case manager. Those goals may include: a resident gaining employment, a family transitioning into permanent housing, or a family addressing health and mental health needs. Long-term self-sufficiency achieved by a client would be a success. Sojourner House continues to provide homeless clients with shelter and support services to help them to overcome the barriers that led to their homelessness. Assisting each client with regards to their individual needs, such as health, mental health, permanent housing, employment, public entitlements is the result we expect to achieve. Our Food Pantry continues to be a success. During the past fiscal year we served 5,045 unduplicated individuals at the Food Pantry. Additionally, during TVH's annual Holiday Food Distribution event 1;071 households were provided groceries and gift cards. The basic criteria for success is being able to serve every single household that comes to the Food Pantry with nutritious food and, if needed, referrals to other publiclprivate community service agencies. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.govl72/mission-vision Tri-Valley Haven promotes and supports inclusivity, diversity and equity as evidenced in our mission statement: "Tri-Valley Haven creates homes safe from abuse, contributes to a more peaceful society one person, one family, one community at a time. Together we build a world without violence." Our Food Pantry program presents inclusive access to nutritional foods to all community members in need, provides in-house and mobile services that cater to the diversity of our clients and ensures the delivery of equitable access to all. Staff at Sojourner House respect and celebrate the diversity of the clients served and provide equitable access to support services for all clients. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. We have seen an increase in the number of households utilizing our Food Pantry due to the impacts of COVID-19 and financial difficulties. We continue to distribute food to our clients, only a few households at a time. to ensure appropriate social distancing and client . We provide masks, gloves and sanitizers to staff, volunteers and clients. All Food Pantry staff and volunteers are required to be vaccinated. All shelter staff are required to be vaccinated. We highly recommend vaccinations for our clients. We accept new families/individuals based on the bed space configuration of the shelter (16 beds). No COVID-19 cases have been reported. Cleaning rotations are done by staff and residents. A secure an isolated space is allocated for any clients who present themselves with COVID. 13. " QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.** Are you are interested in applying for CDBG funds? Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter 'NIA" if you are not interested in qualifying for CDBG funding. TVH is committed to providing services to limited English speaking clients. We presently have multiple staff fluent in Spanish. Additionally. staff is available to provide assistance in Russian, Punjabi, and Hindi. We seek out bilingual/bicultural staff and provide a wage differential for those that speak Spanish. At Sojourner House and the Food Pantry we offer the use of Alameda County Social Services Agency's Language Line Solutions service for clients to access an on -demand interpreter. In Dublin. 217 our largest LEH client group is L:hinese-speaking. VVe make sure that our intake torms tor the mobile toad pantry are available in Chinese. In addition, most flyers, client materials and other communications are created in both English and Spanish. We produce and distribute documents in other languages when available. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑+► Be culturally accessible, appropriate and inclusive ❑W Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers El Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. B) Homeless Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. C) Supportive Housing Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. El D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. El Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or El F) Not Applicable. Not interested in CDBG funding. ❑❑❑❑❑ 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: j Public Services ❑ Public Facilities ▪ Rental Assistance ❑ Affordable Housing El Increase Opportunities for 1st Time Homebuyers El Promote Decent Affordable Rental Housing F—; i Strengthen Communities ❑ Ensure Equal Opportunity in Housing El Reduce Housing Discrimination �.s Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment El Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?") 218 Availability/Accessibility Affordability Sustainability Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfelds remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly. and those units designated for chronically homeless persons and persons with HIV/AIDS. Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units. section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling. and down payment assistance/closing costs. Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. s' Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) Persons Households Not Applicable. Not interested in CDBG funding 219 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 2101 Seniors (62 and older) 10 People with Disabilities 501 Female -Headed Households ❑I Youth 501 Homeless 01 Not Applicable. Not interested in CDBG funding (Type N/A) 320.001 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0" Area Median Income (AAMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 1001 Extremely Low Income (<30% AMI) 401 Very Low Income (30%-50% AMI) 2851 Low Income (50%-80% AM1) 0 Moderate Income (80%-120% AMI) 425.01. TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0' 601 White 01 White + HISPANIC 251 Black/African American 01 Black/African American + HISPANIC 180 Asian 01 Asian + HISPANIC 01 American Indian/Alaskan Native 01 American Indian/Alaskan Native + HISPANIC 01 Native Hawaiian/Other Pacific Islander 01 Native Hawaiian/Other Pacific Islander + HISPANIC 01 American Indian/ Alaskan Native and White 01 American Indian/ Alaskan Native and White + HISPANIC 01 Asian and White Asian and White + HISPANIC 01 Black/African American and White 01 Black/African American and White + HISPANIC 01 American Indian/Alaskan Native and Black/African American 01 American Indian/Alaskan Native and Black/African American + HISPANIC 0 1601 Multi Racial + HISPANIC OR other Multi Racial 01 Not Applicable. Not interested in CDBG funding. (Type N/A) 425.001 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should 220 only be one #7 vti.t AfatNL:Y ❑ #1 - This program/project has the agency's highest priority for funding. ❑J #2 - This programlproject has the agency's 2nd highest priority for funding. ❑ #3 - This programlproject has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:IIwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. ❑ Yes 11 No Budget rL Funding SourceslRevenues Budget Amount Alameda County HCD Linkages USD$ 56,808.00 Alameda County SSA Food Pantry USD$ 114,000.00 Alameda County SSA Shelter USD$ 212,693.00 Alameda County StopWaste USD$ 20,000.00 Cal Recycle USD$ 60,000.00 City of Dublin USD$ 25,000.00 City of Livermore USD$ 75,000.00 City of Pleasanton USD$ 60,000.00 Individual Donations/Foundations USD$ 25,000.00 Total USD$ 648,501.00 Funding Uses/Expenses Amount Committed USD$ 0.00 Budget Amount Amount Committed Salaries USD$ 328,239.00 Benefits USD$ 81,081.00 Supplies USD$ 24,510.00 Communications USD$ 19,328.00 Rent and Utilities USD$ 84,345.00 Insurance: included in 'other' USD$ 0.00 Client Assistance USD$ 22,758.00 Vehicles Expenses: included in 'other' USD$ 0.00 Other: defined below USD$ 88,240.00 USD$ 0.00 Total USD$ 648,501.00 USD$ 0.00 Budget Narrative Revenue: The composition of revenue is our best estimate based on the previous year of operation. Expenses: personnel costs include salaries and benefits. Sick leave, vacation, and holidays are not included in the benefits calculation for staff that will be paid with the Dublin grant funds. Other operating expenses include: travel and mileage, maintenance and repair expenses, audit, accounting, payroll, staff development The Homeless and Family Supports Services budget is part of the overall agency budget that includes other programs and departments: a) Domestic Violence Services, b) Sexual Assault and Counseling Services, c) Finance and 221 compliance, and d) Administration. 1 hus only a portion of liability insurance, auto insurance, audit etc. are being charged to this program. Documents top Documents Requested* Required?Attached Documents * Program Expense Budget for ALL Grant Requests Proaram Expense Budaet Financial Information Form for ALL Grant Requests ❑.! Financial Information Form List of Board of Directors (or governing body) with ❑•! BoD Roster agency contact information Current Annual Budget for the Entire Agency ❑,r Aaencv Budget Copy of most recently submitted IRS 990 form or Tax ❑,I Form 990 Return (include complete form) Board of Director's (or governing body's) designation ❑v Resolution of authorized official Board of Director's (or governing body's) authorization 0 Resolution to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Dublin COI and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 Federal Non-profit Determination DETERMINATION LETTER. All organizations MUST State Non-profit Determination have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit 1 Audit 2 Audit 3 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section Resolution Personne[ Policies Audit Rprsuir¢manis Audit 1 Audit 2 Audit 3 REQUIRED FOR CDBG ONLY - Articles of Articles of Incorporation Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) By -Laws By -Laws LEP Access Plan 222 Other Supporting Documents (Not Required) * ZoomGrantsTMt is not responsible for the content of uploaded documents. Application ID: 457298 Become a fan of ZoomGrants.. on Face book Pwhlems? Contact us at 'Quest onsleZoonl: ],S. C9,1 e2002-2D24 GrantAnalystcan. Al rights reserved. "ZoomGrants' and the ZowmGrants logo are trademarks of GrantAnalystcom, LLC. _opout I Browser 223 Email This Preview Save as PDF Print Close Window Ar 7 DUBLIN Powered by ZoomGrantsTM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2024-25, Human Services Grant Program Deadline: 1/19/2024 Wishing Well Inc No one should sleep hungry Jump to: Oraanization Information Questions Budget Documents USD$ 5,000,00 Requested Wishing Well Inc Submitted: 1/19/2024 6:35:52 PM (Pacific) Project Contact Reena Jadhav reena1892aamail.ccm Tel: 6503462500 Additional Contacts abhilashachugh@gmail.com Organization Information 1. Business License Number 263642056 - EIN Questions •car) CEO Reena Jadhav Reenaefreemeais.ora 1. Select the category that best describes your organization: (Select only one) F Non -Profit ❑ Public Agency [1 Other: Telephone(650) 346-2500 Fax Web https://freemeals.org/ 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). We are on the mission to ensure no one sleeps hungry in our town. Children, Seniors, Disabled & homeless struggle despite presence of services like food pantries as: Not enough nourishing/allergen-free food available or Food delivery is available. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act ) ❑ Capital Project ID Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 224 Li Yes ❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). We are seeking $5000 to feed $1500 of Thanking Giving meal to seniors/sick/homeless people, $2000 to cancer patients and 1500 to Dublin school districts families corning from Axis Community Health, Culinary Angles and Tri-Valley Haven, CitySery etc. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) We feed single moms to end stage cancer patients to seniors in their 90s, and foster kids. There are 4 gaps in Dublin which our program can address: 1. Not enough nourishing food available 2. Not what they can eat due to allergies and cancer 3. They need more than what is provided and 4. Food delivery is not available We collaborate with local orgs such as Axis Community Health, Culinary Angles, Tri-Valley Haven, CitySery etc. to identity needy people, seniors living alone, sick people recovery from illness and homeless people. We collaborated with local stores including Wholefoods, Raleys, Walmart, Safeway, Traders Joes and local restaurants such as Chipotle to customize the nutritious meals based on their specific needs and deliver the hot nutritious meals to their door. Sometime we get food which is discounted but it's never free. Therefore, this funding is very critical for us. We are a 100% volunteer run organization and 100°/0 of the funds go to the people who are in need. We don't deduct any overhead costs from our funding for cause. If we don't get the funding, we will not be able to feed at least 250 family meals in Dublin this year especially during the holidays. Please read some family testimonials here: https:llfreemeals.orglread-family-stories-21 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 250 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Projects should meet the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2022 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑d Health Care (including dental) ❑ Workforce Development ❑.l Homelessness ❑ Transportation Services and Access El Domestic Violence and Child Abuse ❑ Disabilities ❑.� Food and Nutrition ❑.I Senior Services 2 Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) 225 VVe are requesting 4IbUUU in grants which will be used in the below categories: 1. $1500 to buy hot thanking giving meal for needy people, seniors living alone, sick people recovery from illness and homeless people coming through CitySery and homeless referral through Dublin schools. Here is the breakdown: $15 (per meal) *100 (clients) = $1500 2. $2000 to feed customized meals to cancer patient and patient with specific needs through Axis Community Health, Culinary Angles and Tri-Valley Haven. Here is the breakdown: $20 (per customized meal)*100 (clients) = $2000 3. $1500 to feed Families from Dublin school districts for 12 months. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our criteria for success is to ensure no one sleeps hungry in Dublin. To that extent, we will work with local authorities to identity homeless population as well as all families registered in the system for aid. We will be successful if we have fed 300 individual meals in Dublin by the end of 2024 through this program. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov172/mission-vision We feed families that meet Dublin City requirements of inclusivity, diversity and equity. We partner with local organizations such as Trivalley haven, Hively, Shepherd Gate, CityServe, Goodness Village and others to ensure we are supporting those who need hot healthy meals the most. We feed over 50% single women and over half of them are minorities. We also feed about 30% seniors and those very sick who cannot eat meals provided by other organizations due to cancer and other diseases. 12. For the Fiscal Year 2024-2025 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. NA 13. »x QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY.'"` Are you are interested in applying for CDBG funds? • Yes. If so, check box here and answer questions 14 through 25. ❑d No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter 'MA" if you are not interested in qualifying for CDBG funding_ NA 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement El Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless 226 LJ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development 111 Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑r F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations !f! Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?") ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities J Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I ,seeking?") ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability P! Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless 227 persons and persons with liIVJAIU5. 111 Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑d Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE) ❑ Persons D Households ❑r Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter O. Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless X Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you Dublin clients (EITHER Persons OR Households) your enter O. Area Median Income ("AMI") information is available online Extremely Low Income (<30% AMI) Very Low Income (30%-50% AMI) selected above, please list the number of unduplicated agency anticipates serving in each category. If none, please at www.dublin.ca.govl1956/Application-Requirements-Process 228 Low Income (50%-80% AMI) X Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White BlacklAfrican American and White + HISPANIC American Indian/Alaskan Native and BlacklAfrican American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial X Not Applicable. Not interested in CDBG funding. (Type NIA) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY IA #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This programlproject has the agency's 2nd highest priority for funding. ❑ #3 - This programlproject has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. 26. Has your organization or a paid employee of your organization made a political contribution to a current City of Dublin Councilmember or Mayor within the last 12 months? Under Section 84308 of the Political Reform Act, elected officials are prohibited from taking part in an entitlement for use proceedings if the official has received a contribution exceeding $250 from a party or participant in the proceeding within the preceding 12 months. More information can be found on the Fair Political Practices Commission (FPPC website) here: https:Ilwww.fppc.ca.govllearnlpay-to-play-limits-and-prohibitions. If you answer Yes, it will not disqualify you from the process or impact your application. An additional form will be emailed for you to provide details of the contributions for reporting purposes pursuant to the Political Reform Act. El Yes IA No 229 Budget op Funding Sources/Revenues Budget Amount Amount Committed Dublin City Grant USD$ 5,000.00 Total USD$ 5,000.00 USD$ 0.00 Funding Uses/Expenses Budget Amount Amount Committed Restaurant Meal USD$ 3,000.00 Groceries USD$ 2,000.00 Total USD$ 5,000.00 USD$ 0.00 Budget Narrative We are requesting $5000 in grants which will be used in the below categories: 1. $1500 to buy hot thanking giving meal for needy people, seniors living alone, sick people recovery from illness and homeless people coming through CitySery and homeless referral through Dublin schools. Here is the breakdown: $15 (per meal) *100 (clients) = $1500 2. $2000 to feed customized meals to cancer patient and patient with specific needs through Axis Community Health, Culinary Angles and Tri-Valley Haven. Here is the breakdown: $20 (per customized meal) *100 (clients) = $2000 3. $1500 to feed Families from Dublin school districts for 12 months. Documents :of:, Documents Requested* Required?Attached Documents * Program Expense Budget for ALL Grant Requests 2 Prnriram Fxnense 20.4 Financial Information Form for ALL Grant Requests ❑.I Financial Info List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 P&L Copy of most recently submitted IRS 990 form or Tax 0 Exception letter due to non-profit tax exempt status Return (include complete form) Board of Director's (or governing body's) designation 0 Board of Directors - Desianation of authorized official Board of Director's (or governing body's) authorization 0 Board of Directors - Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 State of CA - ANNUAL REGISTRATION RENEWAL DETERMINATION LETTER. All organizations MUST REPORT have approved non-profit status from the State of Federal E-fillino California and Federal Tax Identification Number at time of application. Non -compliant applicants will be State E-fillina disqualified. Certified Audit and/or Certified Financial Statements ❑,r Audit Letter REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section 230 FttUUIhEL) F-UF< L:L)titi ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsTm is not responsible for the content of uploaded documents. Application ID: 461182 Become a Fan of ZoomGrant on Facebook Problems? Contact us d OuestonsfaZoomGran[s. corn ®2002-2024 GrantAnatystcarn Al rights reserved. "ZoomGrants" and the Zo mGrants logo are trademarks of GrantAnalystcom, LLC. . )ul I Browser 231 Fiscal Year 2024-25 Human Services Grants Program Funding Recommendations May 7 , 2024 !�t DUBLIN CALIFORNIA .f�Y 232 Human Services Grants Overview • Outreach and Education: November — December 2023 o Advertising/Postings/Outreach o Grant Workshop • Application Period: December 6, 2023 —January 19, 2024 o 22 qualifying applications received (19 organizations) • Commission Review/Recommendation and City Council Approval: March — May 2024 • Funding Available: July I, 2024 Grant Program Priorities City Council Priorities: Basic Life Needs Healthcare Mission,Vision, and Values updated in 2020 Mental Health ‘,' •_A =v Diversity Equity IPII DUBLIN CALIFORNIA 234 Human Services Grants Program Funding by Source Source CDBG (estimated) City General Fund* ARPA Total Amount $60,000 $ 107,000 $ 163,000 $330,000 *Includes $8,000 from the Affordable Housing Fund Recommended Distribution of CDBG Funding Grant Amount Organization Program Requested FY24-25 City of Pleasanton (Axis) Spectrum Community Services Tri-Valley Haven Loan Obligation Meals on Wheels: More Than A Meal Homeless and Family Support Services $15,000 $25,000 $25,000 Total $65,000 Staff Adjusted Recommendation $15,000 $22,500 $22,500 Total $60,000 Application Estimated Cost Per Points Unduplicated Resident (Average) Residents Served (Rounded) N/A 70.25 64.5 N/A 60 425 N/A $375 $53 236 Recommended Distribution of General Funds Organization Axis Community Health City Serve of the Tri-Valley Easter Seals Bay Area Goodness Village Hope Hospice & Health Services Legal Assistance for Seniors Lions Center forVisually Impaired Narika Partners for Change Tri-Valley Sunflower Hill Program Enrollment Specialist Senior 60+ Stabilization Program Kaleidoscope Community Adult Program Goodness Village* Grief Support Services and Volunteer Services Legal and Supportive Services, Medicare Counseling and Education for Dublin Seniors Dublin SeniorsVision Health Culturally Responsive DomesticViolence Intervention & Prevention Services Alleviating Poverty and Homelessness in the Tri-Valley Program Support for Adults with Developmental Disabilities *Includes $8,000 from the Affordable Housing Fund. Grant Amount Requested FY24-25 $7,759.78 $25,000 $25,000 $25,000 $20,000 $12,000 $7,500 $13,141.00 $15,000 $16,250 Total $166,650.78 Staff Adjusted Recommendation $7,000 $17,000 $14,000 $12,500* $17,000 $10,000 $4,500 $5,000 $5,000 $15,000 Total $107,000 Application Points (Average) 61.5 60.5 50.25 58.5 60 64.5 52.5 53.25 61.75 59.75 Estimated Unduplicated Residents Served 90 109 9 3 800 15 15 350 100 40 Cost Per Resident (Rounded) $78 $156 $1,556 $4,167 $21 $667 $300 $14 $50 $375 237 Recommended Distribution of APRA Funding Organization Chabot -Las Positas Community College District dbaTri-Valley Career Center Chabot -Las Positas Community College District dbaTri-Valley Career Center Centro Legal de la Raza City Serve of the Tri-Valley Community Resources for Independent Living Hively Love Never Fails One Nation Dream Makers Open Heart Kitchen Tri-Valley Haven Program Dublin Pathways to Employment Dublin VITA Services Tri-Valley Fair and Secure Housing Project Homeless Prevention and Family Stabilization Program Housing and Independent Living Skills Hively Family Resource Center & Navigation Services Dublin Street Outreach and Referrals to Transformational Solutions Last Mile Delivery and Food Recovery Program Senior Meal Program DomesticViolence Services Grant Amount Requested FY24-25 $24,989 $20,733 Staff Adjusted Recommendation $16,000 $16,000 Application Points (Average) 59 49.5 $18,500 $25,000 $16,000 $25,000 $25,000 $25,000 $18,000 $23,000 $9,000 $24,000 $7,500 $3,500 68.25 60.5 65.25 72.75 58.25 35.5 $25,000 $23,000 70.75 $25,000 Total $230,222 $23,000 Total $163,000 70.75 Estimated Unduplicated Residents Served 360 115 Cost Per Resident (Rounded) $44 $I39 23 75 40 1,200 50 9,000 $783 $307 $225 $20 $I50 $0.40 250 $92 75 $307 .Y4 DUBLIN CALIFORNIA 1 238 Human Services Grants Program Funding by Type Project Type Quantity Services — Food Services — Shelter Services — Other* 3 7 I2 Total 22 Recommended Funding $49,000 $97,500 $ 183,500 $330,000 "Services — Other" includes projects/programs that provide safety - net services addressing issues like domestic violence/child abuse, disabled/special needs, financial/legal, medical/health, etc. Human Services Grants Next Steps • Review and consider the recommendation put forth by Staff and the Human Services Commission. • Adopt the Resolution Approving Funding Recommendations for the Fiscal Year 2024-25 Human Services Grant Program. • Approved grant amounts will be incorporated into the Fiscal Year 2024-25 Budget. o Agreement execution (City/County and City/Provider) o Invoicing and reporting o Monitoring Questions? Vt DUBLIN CALIFORNIA