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Home My WebLink AboutItem 8.1 CDBG Proj Applications c~rY ClER~ f~~e # D[J~[Q]..~[Q] AGE~DA STArIEMIE~T C~lY COU~C~l MlElEr~~G DATIE Jlalfl'illUJBH{)' i15p 2008 SUBJECT Commumty Development Block Grant (CDBG) Program for Fiscal Year 2008-2009 - Project ApplicatIOns Report Prepared by Gaylene Burkett, Housmg A5slstant A 'IT ACHMEN'fS 1 CDBG ApplicatIOns A AXIS Commumty Health - Women's Health Chmc B Bay Area Commumty Services (BACS) - CreatIve LIvmg Center C City of Dubhn - SIdewalk Ramps D Commumty Resources for Independent LIVIng (CRIL) E Eden CouncIl for Hope and Opportumty (ECHO) - Rental AssIstance Program F Open Heart KItchen - Weekend Box Lunch Program and Hot Meal Program G Semor Support Program of the Tn-Valley H Spectrum Commumty Services, Inc - Meals on Wheels I Tn-Valley Haven - DomestIc VlOlence Shelter/Homeless ServIces RECOMMlENJ[)A T.nON 1 ReceIve Staff presentatIOn, and T: u~ Direct Staffto request funds of $83,488 III CDBG fundIng ~ for FIscal Year 2008-2009 as outlIned below o Bay Area Commumty ServIces $ 4,967 " 0 City of Dubhn - SIdewalk Ramp Program $ 10,926 o Open Heart KItchen $ 9,934 o Semor Support Program of the Tn-Valley $ 10,407 o Spectrum Commumty Services -Meals on Wheels $ 5,541 o Tn-Valley Haven DomestIc VIOlence/ Homeless Shelter $ 14,900 o HOUSIng RehabIlItatIOn (County AdmInIstered Program) $ 14,786 o Annual ContrIbution toward AcqUIsitIOn/Rehabilitation of Tn-Valley Haven's SOjourner House as agreed III the PartIclpatmg JUflsdlctlOn Agreement between the CIties of LIvermore, Pleasanton and Dublm, and County of --------------------------------------------------.~.---------------_~____~_________________..__M____________ CO lPY 'fO Grant Apphcants In-House DlstnbutlOn Page 1 of9 K \Agenda '5talements\2008\CC\CDBnCC SR recommen I 15-07 (2) doc ]['fEM NO n G Alameda o Program AdmmIstratIOn TOTAL $ 5,427 $ 6,600 $ 83,488 and 3 Should there be a decrease m CDBG allocatIOn, Staff recommends that the percentage decrease, If more than $500, be dIstnbuted evenly across all the programs that do not have mandatory set amounts If the decrease IS less than $500, Staff recommends the amount be deducted from the City'S SIdewalk Safety Repalf and Curb Ramp Replacement Program In the event there IS an mcrease III CDBG fundmg, Staff recommends that the mcrease amount be placed mto the City's SIdewalk Safety Repair and Curb Ramp Replacement Program FINANCIAL STATEMENT (see dISCUSSIOn below) PROJECT DESCRIPTION Background CommUnIty Development Block Grant (CDBG) funds are provIded by the U S Department of Housmg and Urban Development (RUD) The CIty of DublIn works WIth Alameda County's Urban CDBG Program to allocate funds and WIth HUD to assure that all CDBG-funded actIvItIes are m complIance With federal regulatIOns Every year the County WIll dedIcate a percentage of each Urban County city's CDBG allocatIOn of funds toward the County of Alameda's Housmg Rehabilitation Program ThiS program IS available for reSidents wIthm each of the respectIve Urban County CItIes as well as the umncorporated County AdditIOnally, the County of Alameda contracts With two servIce proVIders to provIde Fair Housmg ServIces throughout the Urban County cIties as well as the umncorporated County area In Dublm, the Falr Housmg ServIce ProvIder IS currently ECHO Housmg The City of Dublm has partICIpated m the Alameda County's Urban-County CDBG Program SInce 1982 The City of Dublm, along With the cIties of Albany, EmeryvIIle, Newark and Piedmont, make up the Urban County CItIes Dunng tills current FIscal Year (FY 2007-2008), the CIty receIved $83,488 m CnBG fundmg DUTIng thIS year's applicatIOn cycle, the City of Dublm receIved nme (9) applIcatIOns for the use of2008- 2009 CDBG funds In addItIon, the City has a 10-year comnlltment to proVide fundmg III the amount of $5,427 to LIvermore per the JunsdIctlOnal ParticIpatIOn Agreement entered mto for the rehabIlItation of Tn-Valley Haven's SOJourner House FamIly Cnsls Center ThIS WIll be the 7th year of the CIty's 10-year commItment to pay thIS amount to the City of LIvermore Staff has reviewed the proposed actlvltIes and past program performance of the serviCe proVIders to ensure actiVItIes are m comphance With COBO guIdelInes Based on the reVIew, Staff IS recommendmg the request of funds for the non-profit agencies outlined m thiS report Page 2 of9 Followmg the City CouncIl's action on how the CIty'S CDBG proJect funds wIll be dIstnbuted, the approved applIcations wIll be submitted to the Urban County CDBG Program When the County reviews and approves Dublin's proJect applIcatIons, a Program Agreement between the CIty and the County Will be drafted, WhICh the City Council WIll be requested to authonze The final CIty-County Program Agreement Will be submitted to HUD m June 2008 ANAL YSJ[S FIscal Year 2008-2009 CDBG Allocations The County of Alameda Housmg and Commumty Development (HCD), the fiscal agent for the Urban County CDBG Program, has not yet receIved the 2008-2009 CDBG funds allocatIon figure from HUD for dIstnbutlOn to the Urban County cItIes When the amount IS unknown, for plannmg purposes, the County typIcally uses the same amount that was allocated the prevIOus year It IS possible, however, that the HUD budget for CDBG may be less than the amount allocated m Fiscal Year 2007-2008 Should there be a decrease m CDBG allocatIon, Staff recommends that the percentage decrease, If more than $500, be dlstnbuted evenly across all the programs that do not have mandatory set amounts If the decrease IS less than $500, Staff recommends the amount be deducted from the CIty'S Sidewalk Safety RepaIr and Curb Ramp Replacement Program In the event there IS an Increase In CDBG fundmg, Staff recommends that the mcrease amount be placed Into the CIty'S Sidewalk Safety Repair and Curb Ramp Replacement Program The table below Illustrates the followmg mformatIon regardmg the CDBG ApplIcatIOns 1) Total amount funded for Fiscal Year 2007-2008 2) Amount requested for Fiscal Year 2008-2009 3) Staffs recommended fundmg for Fiscal Year 2008-2009 Fundmg Amount Staff Recommendation Amount for Requested for 2008-2009 2007~2008 2008~2009 Current Service Providers Bay Area Community Services $ 4 967 $5 000 $ 4 967 Open Heart Kitchen $ 9 934 $18,000 $ 9,934 SenIor Support $10,407 $15,000 $1 0 407 Spectrum $ 5541 $ 6 077 $ 5 541 Tn-Valley Haven $14,900 $15,000 $14,900 Current Programs SIdewalk/Ramp Repalr* $10,926 $22,000 $10,926 SOjourner House* $ 5,427 $ 5,427 $ 5,427 Rehabl htatl on * $14786 $14 859 $14,786 Administration $ 6 600 $ 6 600 $ 6 600 TOTALS $83,488 $107,963 $83,488 Page 3 of9 Funding Amount Staff Recommendation Amount for Requested for 2008-2009 2007 -2008 2008~2009 NEW APPLICANTS AxiS Comm Health* -0- $10 000 -0- CRIL -0- $ 6 000 -0- Eden Housing - Rental Assistance -0- $ 5,585 -0- TOTALS $21,585 $83,866 $129,548 $83,488 * CapItal ProJects The followmg IS a bnefsynopsIs of the vanous programs funded In 2007-2008 and requestmg Commumty Development Block Grant funds for 2008-2009 Due to the tImmg of thIS staff report to CIty CouncIl, the status of current programs IS through the first quarter only (September 30,2007) City ofJ[)ubhn - Sidewalk Access Ramps for Handicapped AccesslbllItv Current $10.926 Requestme: $22.000 Staff Recommends $10.926 PrOf!ram Goals The CIty of Dublm SIdewalk RepaIr and Curb Ramp Replacement Program goal IS to Improve the Sidewalk access ramps m compliance WIth the Amencans With Dlsabllrhes Act (ADA) Currently there are 1,989 mdIvldual paths-of-access locatIOns m Dublm that are non-compliant With Federal regulatIons 2007-2008 Status - The City of Dublm PublIc Works Department requested $22,500 for the constructIOn of approxImately 9 concrete handIcap ramps at VarIOUS paths-of-access locatIOns The program was granted $10,926 whIch Will allow the constructIOn of approximately 4 ramps The proJect IS scheduled to open the RFP penod m March 2008 as part of the SIdewalk RepaIr and Curb Ramp Replacement Program It IS antIcipated that the project will be completed by the end of June 2008 2008-2009 ReQuest - The City's PublIc Works Department IS requestmg CDBG fundmg to contmue the program by completmg Improvements to ramps and publIc dnveway approaches Staff RecommendatIOn - Due to the hIgh demand for DublIn's CDBG funds from non-profit agencIes, Staff IS recommendmg a lesser amount than requested and any funds that may be remammg from CDBG allocatIons be applIed towards thIS Program Bav Area CommuDlty Services (BACS) - Vallev Creative lLIvme: Center Current $4.967 Requestme: $5,000 Staff :Recommends $4,967 PrOf!ram Goals - ThIS agency manages the Valley CreatIve LIvmg Services Program that provIdes a daytIme rehabllItatIon program for adults WIth severe and persistent psychIatnc dIsabIlItIes The Program IS open Tuesdays, Wednesdays, and Thursdays provIdmg SOCIal, educatIOnal and prevocatIonal actIvIties The Program cumculum mcludes educatIOnal and recreational activities that promote mdependent hvmg ThIS agency program contnbutes toward makmg servIces accessIble to eligIble low- and very lOW-Income Dublm resIdents Page 4 of9 2007-2008 Status - The Center IS under contract to provide aSsIstance to 9 DublIn resIdents Through the first quarter ofFY 2007-2008, 3 DublIn resIdents were served 2008-2009 ReQuest - Bay Area Commumty Services IS requestmg funds to contmue the delivery of services as mentIoned above to 9 Dublm residents In partIcular, fundmg wIll be appropnated to support the salary of a lIcensed mdlvldual provIdmg on-site tramIng and group actIvities Staff RecommendatIOn - Staffrecommends fundmg of$4,967 m FY 2008-2009 Open Heart KItchen - Weekend ]Box Lunch lProg:ram Current $ 9.934 ReQuestm2 $18.000 Staff Recommends $ 9.934 Prozram Goals - Currently, Open Heart Kitchen (OHK) admmIsters the Weekend Box Lunch Program to Arroyo VIsta residents and theIr famIlies which consists of the Fnday dIstrIbutIOn of box lunches Each box lunch contams 2 meals In September 2007 Open Heart K.1tchen started servIng hot meals from Cross Wmds Church located at 6444 SIerra Court m DublIn on Mondays from 430 to 600 pm Open Heart KItchen expects to serve over 7,000 free hot meals to Dublin residents m need of thIS servIce 2007-2008 Status -_Through the first quarter of 2007-2008, Open Heart KItchen has provided over 3,485 boxes, or 4,970 lunches PartIcIpation In the Program usually mcreases In the Spnng In addition, OHK has served over 900 meals from September 1 through November 30, through theIr hot-meal program 2008-2009 ReQuest - Open Heart KItchen requests fundIng to contmue dlstnbutlOg weekend box lunches to reSIdents at the Arroyo Vista Housmg Complex and to Arroyo VIsta reSIdents that have moved to the Groves at Dublin Ranch The goal IS to serve over 24,000 lunches dunng the year In additIon, OHK plans to serve between 7,000 and 8,000 hot meals to 100 to 350 Dublm reSIdents through theIr Monday hot meal program at Cross Wmds Church Staff RecommendatIOn - 5taff recommends fundmg of $9,934 m FY 2008-2009 With the emphaSIS on the new Hot Meals Program As the Arroyo VIsta reSidents move to other locatIOns, the Weekend Box Lunch Program WIll be dlmmlshed, and the amount of people movmg to the Groves at DublIn Ranch IS not yet known SeDlor Support J?ro2ram of the 'fn- V alley - Case Mana2ement Current $10A07 ReQUestID2 $15.000 Staff !Recommends $10.407 Prozram Goals - The Semor Support Program's goal IS to provIde a varIety of servIces for 30 new 10w- or very low-mcome semors m Dublm ServIces Include case management, Partners In Safety Program, drug and alcohol asSIstance and m-house reassurance (fnendly vIsItmg) Case Management servIces Involve makmg an mItIaI assessment of a semor's lIVIng SItuatIon and needs In additIon, the goal IS to assist 50 Dublin semors WIth one-time only services WhICh mclude referrals for semor health screemng, references for chore worker regIStry servIces and referrals for meal delivery ServIces are offered at the Dublin Semor Center, as well as the Pleasanton Semor Center Page 5 of9 2007-2008 Status - Through the first quarter of 2007-2008, 15 new semors have been provIded with case management services and 32 new semors have received one-hme servIces 2008-2009 Request - The SenIor Support Program IS requestmg mcreased funds to contmue wIth equal service levels as menhoned above The number of Dublm clients served each year exceeds theIr stated goals and obJectIves Staff Recommendatwn - Staff recommends fundmg $10,407 m FY 2008-2009 Spectrum CommuDlty Services. IDe - Meals on Wheels Current $ 5.541 ReQuestme: $ 6.077 Staff Recommends $ 5.541 Program Goals - Spectrum Commumty ServIce's goal IS to proVIde hot, nutntIOus meals to 15 low- mcome, homebound semors m the CIty of Dublm through the Meals on Wheels Program Meals are mdIvldually packaged, counted and placed In route-specIfic delivery eqUIpment, and sent out for ImmedIate delIvery Meals are delIvered Monday through Fnday, excludmg holidays All meals and food Items are delIvered wIthm 2 hours of packagmg, as reqUIred to satisfy food safety standards 2007-2008 Status - Through the first quarter of 2007-2008, 18 low-mcome semors WithIn DublIn are receIvmg meals through thIs Program 2008-2009 ReQuest -_Spectrum Commumty Services IS requestmg funds to contmue fundmg the Meals on Wheels Program In 2008-2009 Spectrum Commumty ServIces plans to contmue to deliver an averaze of 18 hot, nutntIous meals per day for 248 servmg days Over the course of one year, 10w-mcome, frail, homebound semor reSIdents of DublIn wIll reCeive daIly meals Sta([RecommendatlOn - Staff recommends fundmg $5,541 m FY 2008-2009 'In-Vallev Haven - Domestic VmlencellHIomeless Shelter Current $14.900 Requestme: $ 15.000 Staff Recommends $ 14.900 Prozram Goals -_Tn-Valley Haven proVIdes domestIc vlOlence and homeless servIces to Dublin reSIdents Domestlc VIOlence ServIces - Tn-Valley Haven has two domestic VIOlence shelters WIth 30 beds where famIlIes may stay for up to three and a half months Tn-Valley Haven offers additional servIces such as counselmg and a 24~hour Cnsls Hotlme Although Income data IS not collected from reSIdents recelvmg servIces through the CnsIs Hotlme, an attempt IS made to determme what CIty the person IS callIng from The goal IS to proVIde domestIc VIOlence services to 25 Dublm reSidents Homeless Servlces - The homeless servIces mclude a famIly cnSIS shelter, SOJourner House, m LIvermore and two offices m Pleasanton to better serve Dublm reSIdents In addItion to a food pantry The overall goal1s to proVIde homeless/food pantry services to 165 Dublm reSIdents PresentatlOns and EducatlOn - Tn-Valley Haven's goal IS to offer 16 commumty educatIOn and preventative presentatIOns to at least 600 Dublm reSidents These presentatIOns are pnmanly offered III the spnng and summer at schools, communIty meetmgs or for law enforcement agencIes Income data Page 6 of9 may not be collected on every person who' attends a presentatIon, however, the services are offered m Dublm schools and to the Dublm Police services m the hopes that the educatIOn IS reachmg a needed population m Dublin Tn-Valley Haven tracks these servIces on a presentatlon-by-presentatIon basIs 2007-2008 Status -_Through the quarter of FY 2007-2008, 13 DublIn reSIdents have been assIsted with domestIc VIOlence counselmg servIces and 42 have been assisted through the CnsIs HotlIne Through the first quarter of FY 2007-2008, 2 DublIn reSidents have receIved aSsIstance at the homeless shelter and 152 Dublm reSidents have receIved servIces through the food pantry 2008-2009 Request -In-Valley Haven has requested funds to support the provIsIOn of domestic violence servIces to at least 25 Dublm reSIdents at the domestic VIOlence shelter through counselmg and the CnsIs Hotlme In addItIon, 2008-2009 funds would support homeless services, mc1udmg the shelter and the food pantry, for at least 165 DublIn reSIdents and to provide commumty educatIOn and preventative presentatIons to 600 DublIn reSIdents at vanous schools and servIce orgamzatIOns Staff RecommendatiOn - Staff recommends fundmg $14,900 III FY 2008-2009 City of Livermore - ContrIbution of Repavment of Section 108 Loan City Comnlltted to $5,427 Staff Recommends $5,427 The City of Dublm entered mto a Partlclpatmg JunsdIctIon Agreement with Livermore, Pleasanton and the County of Alameda to pay back money borrowed for the purchase and rehabilItatIOn of Tn-Valley Haven's SOJourner House Family CnsIs Shelter The City of Dublm's commItment IS to provIde $5,427 annually, for ten years, to assist LIvermore m paymg back a HUD SectIOn 108 loan retamed to assist the Family CnsIs Shelter 2008-2009 would be year 7 of the CIty'S commItment to pay thiS amount to the CIty of LIvermore New A.ppilcatlOns for Fiscal Year 2008-2009 AXIS Commumty Health - Support Women's Health Chmc New ApplicatIOn ReQuestlDf! $10,000 Staff Recommends $ -0- Program Goal - AXIS Commumty Health IS seekmg funds m support of the constructIOn of a Women's Health ClImc at AXIS'S RaIlroad Avenue site m Pleasanton which WIll convert a 1,400 square foot office space mto a four-eXamInatIOn room obstetncal SUIte that will support AxIS'S rapidly growmg prenatal care program When the clImc IS complete, the proJect WIll target 20 low Income pregnant women for prenatal care, 100 DublIn reSidents who use the women's health clImc each year, 1,200 DublIn reSIdents With medIcal services and serve an additIOnal 184 Dublm reSidents With basIC medIcal needs 2008-2009 ReQuest - $10,000 to fund the above Program Staff RecommendatIOn - Staff does not recommend fundmg through CDBG funds for FIscal year 2008- 2009 CIty CounCIl would have to reduce funds for other servIce proVIders should CIty CounCIl deCIde to fund AXIS Commumty Health Page 7 of9 CommuDltv Resources for Independent lLIVID!! (CR.D:lL) New AppllcatlOn Current $ -0- ReQuestme: $6.000 Staff Recommends $ -0- Prof!ram Goals - eRn, offers mdependent hvmg services at no charge to persons wIth dIsabIlIties hvmg m southern and eastern Alameda County eRIL IS also a resource for disabIlIty awareness educatIOn and traImng, advocacy and techmcal advIce CRIL provIdes dIrect affordable, accessIble housmg assistance, mcludmg servIces to mamtam long-term housmg to Dublm residents and semors WIth dIsabIhtIes or functlOnal lImItatIOns The CIty CouncIl granted CRIL $15,413 for FY 2007-2008 through CIty CouncIl's CommunIty Based OrganIzations Program 2007-2008 Status - eRn, dId not meet the Request for Proposal submIssIon deadlIne for CDBG funds for Fiscal Year 2007-2008 However, CRIL was able to secure a grant wIth the CIty Council's CommuOlty Based OrganIzations Program for $15,413 Per the first quarter report, CRn, IS on target for meetmg their goals 2008-2009 Request - CRIL IS seekmg funds to provIde housmg services for persons WIth dIsabIlIties and semors WIth functIOnal hmltatlOns CRIL's proposed program goals for fiscal year 2008-2009 IS to provIde hOUSIng mformatlOn, direct housmg aSSistance, and create an mdependent hvmg plan (lLP) that addresses housmg needs CRn, IS requestmg $5,216 for personnel expenses and $784 for operatmg expenses for a total of $6,000 Starr RecommendatIOn - Staff does not recommend funding through CDBG funds for FIscal year 2008- 2009 City Council would have to reduce funds for other servIce provIders should CIty Council deCide to fund CRIL Eden Councd for Hope and Opportumty (ECHO) - Rental ASSistance New AppllcatlOn ReQuestme: $ 5.585 Staff Recommends $ -0- Program Goal - ECHO Housmg IS requestmg funds to proVIde a rent/depOSit guarantee program, whIch proVIdes aSSistance to low to moderate mcome tenants to pay secunty depOSits or dehnquent rent The goal through the Rental ASSIstance Program IS to ensure that 7 DublIn households will either be empowered to move mto housmg by paYIng their secunty depOSit or preserve thelf housmg by paYing the delmquent rent, and thereby preventmg homelessness and InstitutIOnalIzatIOn In addItion, the Program WIll aSSIst Dubhn reSIdents With Pre-Screemng for EhgIbIlIty (50 households), Support CounselIng (7 households), InformatIOn and Referral (20 households), Rent/DeposIt Guarantees (7 households) and follow up to 7 households 2008-2009 ReQuest - $5,585 to fund the above Program Staff RecommendatIOn - Staff does not recommend fundmg thIS Program fOf FIscal Year 2008/2009 City CounCIl would have to reduce funds for other servIce provIders should CIty CounCil deCide to fund ECHO Housmg Contracts With A!!encles lProPoslDe: Non-City ProJects If the City CounCIl approves Staff recommendations for fundmg for these vanous non-City proJects, the CIty of Dublm would need to enter mto a separate contract WIth each agency for purposes of proJect adnllmstratIon Page 8 of9 All of the recommended proJects meet the CDBG program's natIOnal obJectIves of benefitmg low-and moderate-mcome persons, homeless persons or persons WIth dIsabIlItIes and, they are an elIgIble uses of CDBG funds RECOMMlENJ[)A TKON Staff recommends that the CIty CounCIl 1) Receive Staff presentatIon, 2) DIrect Staff to submIt applIcatIOns to the County HeD for $83,488 m CDBG fundmg for FIscal Year 2008/2009 as outlIned below [] Bay Area Community ServIces $ 4,967 [] CIty SIdewalk Ramp Program $ 10,926 [] Open Heart KItchen $ 9,934 [] Semor Support Program of the Tn-Valley $ 10,407 [] Spectrum Community ServIces - Meals on Wheels $ 5,541 [] Tn-Valley Haven DomestIc VIOlence/Homeless Shelter $ 14,900 [] Housmg RehabilitatIOn (reqUIred by the County) $ 14,786 [] Annual ContrIbutIOn toward SOJourner House $ 5,427 [] Program AdmmIstratlOn $ 6,600 TOTAL $ 83,488 and 3) Should there be a decrease m CDBG allocatIOn, Staff recommends that the percentage decrease, If more than $500, be dlstnbuted evenly across all the programs that do not have mandatory set amounts If the decrease IS less than $500, Staff recommends the amount be deducted from the City's Sidewalk Safety RepaIr and Curb Ramp Replacement Program In the event there IS an mcrease m CDBG fundmg, Staff recommends that the mcrease amount be placed mto the CIty'S SIdewalk Safety RepaIr and Curb Ramp Replacement Program Page90f9 l~r.9:,3 lfW ~[IDQDiffi..~(ID[ffimJ WlID lIDlIlIDlI un UIl n/ij!! lID ~ Wl~ U lID IJD IIDD tm mJU [ffi a (OJ ~ /k{ rm IJ'fID UIlU lA\lJlJ IJ1l a Q ~fIDan tID IID Agency Name Address AXIS CommunIty Health 4361 RaIlroad Avenue Pleasanton, CA 94566 ExecutIVe Director Sue Compton Contact name and tItle Carol BeddomelDevelopment DIrector Contact phone and fax 925-201-6068/925-201_5303 Contact e-mail address cbeddome@axIshealth org Org an Izatlon al Backg rou n d Private Non-Profit ~ o Public Agency o Other (Descnbe) Tax 10 Number lIst years prevIously received City fundmg None at thiS tIme 94-22322394 RJECEH/EDl DEe 1 5 2007 DUBLIN PLAr~~iNG ~ ? 2 PLM STAFF USE ,l;.lfl"-blar" ,') "1 " j j :0 'ONlty , Date ReceIved \ OL ~ol M ~ \ 'A}# iJ CtIJ//Dml/J!!J/fIl1l/ffJeUeI/IPJIlIIIII/J6!!J1l /ll/oc/1r fGl18/!!Jfl MP/!ICIJ/IJ!J!!J ItllJual1 Shea/! ott"." iw ~ , ,," ..oj. < !rr ~ ~ "lte,yvdF g I IllS/OS ~ ATTACHMENT I A (] /Page 2 o? r J 33 Proposal Summary - ( A program may contam several goals) Capital Request [2J OR Public Service Request D (check one) Program name Women's Health Center Goals - Number of Program goals to be achieved In fiscal year 2008-2009 Number of Dublm residents served by thIs goal 184 new low Income Dublm resIdents/1,200 Increase the avatlabtltty of medical setv1ces for connnwng Dublm low-lllcome fanuhes and pregnant women reSIdents AXIS Commumty Health IS seekmg $10,000 III support of the constructIOn ofa Women's Health ClIme at AXIS'S Ratlroad Avenue sIte whIch WIll convert a 1,400 square foot office space mto a four- Brief Program eXamInatIOn room obstetncal sUIte The total Summary estimated budget for thIS proJect IS $511,076 lIst a brief deSCription of each program goal Amount of Dublm grant funding requested (match fIrst column budget form #2) $10,000 1,384 Overall Total number of Dublm reSidents to be served by this program Community Development Block Grant Appllcatron Certification To the best of my knowledge and belief, all Information and data In this application and attachments are true and correct No matenallnformatJon has been omItted, Including financial Information If funded, I certify that the Agency IS Willing and able to adhere to pollees and procedures speCified by the City of Dublin, and If applicable, the appropnate program regulatJons of the US Department of HOUSing and Urban Development Further, I understand thiS IS not an agreement for grant fundIng and cannot encumber funds until the City of Dublin and the Individual authonzed to execute contracts on behalf of the Applicant Agency, has Signed the contract and If applicable all federal regulatJons and paperwork are completed &\llUllIl1HIDli'n~SBmJJlDlBl~~;;; /blue !//I/}[} C to 'ii1I1ll1l111 1.1.- -(4 01- lDJalnlBl ' ~ c;f/33 Program Narrative 1 AXIS Commumty Health IS seekmg $10,000 In support of the constructlOn ofa women's clImc at AXIS'S Railroad Avenue site ThIS proJect mvolves the conversIOn of an eXIstmg office area (SUIte A) to clImcal space that will support AXIS'S rapIdly growmg prenatal care program AXIS IS the sole provIder of prenatal servIces for local residents who are mdlgent and unmsured For the past decade, our patIents were unable to access ValleyCare Medical Center for delIvery services ThIS necessItated an agreement wIth Alta Bates SummIt MedIcal Center m Berkeley to have our patlents delIver theIr babIes there Access to Alta Bates was difficult for our patlents One thIrd of our patients do not have cars and many others have Just one car to share among several familIes All faced difficultIes gettmg to Berkeley dunng commute hours WhIle thiS was not a satisfactory arrangement, It was the best we were able to arrange for our patIents In 2004, Dr MIchael Bleecker, a local obstetncIan, took on a new partner, Dr Scott Eaton ThIS partnershIp allowed Dr Bleecker to expand hIS servIces AXIS'S prenatal patients have been the beneficIafIes of thIS new partnershIp, as Dr Eaton and Dr Bleecker are now provIdmg prenatal servIces at our clImcs m partnershIp WIth our obstetncal nurse practitIOner ThIS partnershIp has allowed our patIents to dehver theIr babIes locally at ValleyCare and has resulted III rapId growth III our prenatal program 25% of aU of deltvenes at ValleyCare are AXlS S patIents Our VISIt statistIcs demonstrate thIS growmg need for prenatal servIces for low mcome resIdents Fiscal vear 01102 02/03 03/04 04/05 05/06 06/07 Prenatal VISItS 1 ,448 1,963 2,152 2,381 3,171 4,244 % Increase over preVIOUS year 8% 36% 10% 11 % 33% 34% Prenatal servIces for low mcome women are of crlllcallmportance m our commumty In the document Healthv People 2010, The U S Office of DIsease PreventIOn and Health PromotIOn establIshed health standards that have been Implemented natIOnWIde These standards are based upon the prevalence of cancer, chromc dIseases, ChIldhood ImmUnIZatIOns, obeSIty, and bIrth factors such as low blfth weIght, teen bIrths and mfant mortality Dublin meets the natIOnal standards m nearly every category wIth the excevtlOn of low birth weu!hts The established standard IS that fewer than 5% of newborns should be m the "low bIrth weIght" category (less than Sibs 8 oz) At a rate of 49%, CaucasIan women m Dublm are meetmg thIS standard The data IS not as posItIve for non-white Dublm reSIdents 82% ofHIspamcs and 77% of ASIans are dehvenng low bIrth weight babies (Alameda County Select Health IndIcators, 2004) Because bIrth weIght IS the most Important mdlcator of predlctmg the chances for surVival and for healthy growth and development (U S Dept of Health and Human ServIces, Healthy People, November 2004), tills data IS troubhng Factors that lead to low bIrth welght mclude premature bIrths, maternal smokmg, drug and alcohol use, poverty, poor nutntlOn, young maternal age, and low educatIOn attamment (Center for DIsease Control, MMWR, 1999) Prenatal care has a proven Impact on mltIgatmg these factors and bnngmg about posItive bIrth outcomes AxIS'S prenatal program IS comprehensIVe and mcludes (I) aSsIstance m enrollmg III a publIcly- supported health plan (which also prOVIdes Immediate medIcal coverage for newborns), (2) health educatIOn and nutrItIonal counselIng, (3) supplemental food through our WIC program, (4) drug and alcohol servIces as appropnate, and (5) prenatal and post partum medIcal care t; ~ t33 As the mdIgent and unmsured populatIOn grows m Dublm and the fn- Valley as a whole, our prenatal program has grown as well We are now out of clImcal space to meet thiS growmg need ThiS proJect wIll convert 1,400 square feet of office space mto a chmcal area that wIll Include four additIonal eXamInatIOn rooms It wIll also create a separate waItmg room for prenatal patIents, whIch IS preferable to havmg them share the wmtmg room With our general medIcal patIents, many of whom are III ThIS addItIOnal clImcal space wIll also be used for other gynecological services, mcludIng famIly planmng, cancer detectIOn servIces, and our breast cancer detectIon program The addItIOn of these four exammatlOn rooms wlll also mcrease our capacity to prOVide medIcal care for low Income Dublm residents by more than 30% We are propOSIng that thIS proJect encompass two fiscal years, and are requestmg $10,000 We wIll obtam the remammg $139,955 (27% of proJect costs) through commumty, foundatIOn and m~kInd donatIOns 2 ThIS proJect targets the 200 (20 DublIn residents) low mcome pregnant women who come to AXIS for prenatal care each year It wIll also prOVide Increased space for the 1,000 women (100 Dublm resIdents) who use our women's health servIces each year ThIS project Will also mcrease our overall capaCIty at our RaIlroad Avenue clIruc SIte by 30% We currently provIde medIcal servIces for 10,500 Tn-Valley residents (1,200 Dublm resIdents) between our two sites The addItIon of four examInatIOn rooms at our Pleasanton SIte will allow us to serve an additIonal 2,000 persons (184 Dublm resIdents) at thIS SIte Upon proJect completIOn we wIll be able to serve an estImated 1,384 DublIn residents at thIS SIte on an annual baSIS 3 25% of our patIents are chIldren under the age of twelve and 75% of the adults we serve are women of chIldbearIng age 62% of our patients are non-Enghsh-speakmg, WIth the maJonty of these (54%) beIng SpanIsh-speakmg Although 80% of our adult patIents are employed, nearly all are among the "workIng poor" 74% have a family InCome that lS less that $25,150 for a famIly of four (HUD "extremely low"), and 24% have an mcome between $25,150 and $41,900 for a famIly of four (HUD "very low") 97% of our prenatal patIents fall Into the "high fIsk" category due to complIcated medIcal and/or obstetrIcal hIstones, anemIa, poverty and poor nutntlOn DespIte these rIsks factors, Just 3% of our patIents expenence obstetncal complIcatIOns ThIS compares to natIonal rates that range from 10 - 30% for hIgh risk pregnancIes Outreach services Our staff partICIpates In a vanety of outreach actIVitIes on an ongoIng baSIS, IncludIng the CAPE/Head Start health faIr, Pleasanton's FIrst Wednesday events, school-based outreach and youth counselmg programs, and presentatIOns at local churches and commuruty group meetings Our staff also works closely WIth human servIce prOVIders throughout the Tn-Valley In a vartety of collaboratIve proJects as well as m provldmg dIrect outreach to clIents Culturally appropnate services AXIS IS commItted to provIdmg all servIces In a culturally appropnate manner Tills begInS WIth emplOYIng a staff wIth a varIety oflanguage capabilitIes Our front lme staff (telephone operators, receptIonIsts, enrollment speCIalIsts and medIcal assistants) are all SpanIsh/EnglIsh bIlmgual, and many members of the support staff speak other languages as well PatIent InfOrmatIOn and heal th educatIOn matenals are avaIlable III a varIety of languages We also conduct penodIc communIty focus groups so that we remam responsIve to the needs of the commUlllty we serve 4 The obJechves of this proJect are to expand our capacity to proVIde medical care for low lllcome Tfl- Valley reSIdents, as well as to lllcrease the avaIlabilIty of services for illgh fisk pregnant women IS ~ /33 These obJectIves WIll be met by completmg a capItal proJect at our Pleasauton slte WhICh wIll couvert a 1,400 sq ft office space mto a four~exammatIou room obstetncal sUIte The proJect WIll be evaluated on several levels mcludmg (1) the physIcal completIOn of the proJect wIthm the establIshed budget and tImelme, (2) the mcrease III the number of low mcome pregnant women we serve, and (3) the mcrease In the number of low Income Dublm resIdents we can accommodate at our Pleasanton clImc site AXIS has a comprehensIVe QualIty Assurance program which tracks all aspects of the services we proVide We also collaborate wIth the Commumty Health Center Network, whIch IS a consortIUm of commumty clImcs m Alameda County, to evaluate the qualIty and outcomes of our medical services As a result of our qualIty assurance actIvIties, we have documented a complIcatIOn rate of Just 3% among our obstetrlcal patients ThIS rate compares favorably WIth the 10 - 30% comphcatlOn rate m the U S for simIlar populatIOns ThIS success of our program also has a posItIve Impact on our commumty, as the net cost of care IS mImmIzed and reSidents enJoy a hIgher qualIty ofhfe 5 AXIS works wIth Tn-Valley human service proVIders III a Wide varIety of ways, mcludmg (1) our newly establIshed relatIOnshIp wIth ValleyCare's obstetncal servIce, (2) the provISIOn of counseling and health educatIOn servIces III all three school dIstrIcts, (3) collaboratIOn WIth Honzons Fanllly Counseling to prOVide servIces for at~rIsk youth and theIr families, and (4) health screemng services and servmg on the health advIsory commIttee of CAPE Head Start AXIS also established the Tn- Valley Health Collaborative, whIch has spearheaded several commumty proJects mcludmg the development and ImplementatIon of Tfl-ValleyHelp org, whIch IS a web~based mformatIOn and referral servIce for all members of the commumty 6 Our clImc SItes are fully accessIble to mdIVlduals WIth disabIlIties Both SItes are licensed by the State of CalIfornIa as communIty clImcs, and meet reqUIrements for access to clImcal servIces 7 Over the past year, AXIS has been extremely actIve In advocatmg for an eqUItable allocatIOn of Alameda County's Measure A funds m the Tn-Valley These efforts were successful, as the County mcreased our fundmg to proVIde pnmary care medIcal servIces by $400,000 annually One-tIme-only Measure A funds III the amount of $275,000 were also awarded III support of the LIvermore chmc expanSIOn proJect that was completed m October 2006 III the CIty of LIvermore's Multi-ServIce Center The additIOnal pnrnary care funds allowed us to ImmedIately mcrease our medIcal servICes capacity by 400 medIcal VISItS a month 6 '1')33 B Budget Narrative 1 Describe how this program IS cost effectIve and the budget IS reasonable for the anticipated result ThIS proJect WIll allow us to expand our prenatal care program, which IS the Tfl-Valley's only prenatal program for low mcome women PublIc health data consIstently demonstrates the cost- effectIveness of prenatal care The total cost of nme months of prenatal care at AXIS averages $1,000 per patient 97% of our patIents have favorable outcomes that do not reqUIre additIOnal medIcal care for mother or newborn Pregnant women who do not have prenatal care and theIr mfants have a complIcatIOn rate that ranges from 10 - 30% For some women and Infants, the complIcatIons are catastrophIc and necessItate extraordmary medIcal care that can cost $500,000 or more dunng the ImmedIate postpartum penod Some of these Infants face lIfelong phYSIcal difficultIes as well, that reqUIre costly long-term medIcal care and support ThIS proJect wIll also allow us to mcrease our capaCIty to prOVIde medical care for all patients at our Pleasanton SIte Pubhc health data consIstently demonstrates the cost-effectiveness of commumty chmc serVIces as well, as chmcs make ongOIng medical care available to those who do not otherwIse have access to medIcal care For example, a patient who has asthma who IS treated at a commumty clImc, receIves ongomg preventIve medIcatIOns and health educatIOn, whIch results m fewer and less senous asthma, attacks An average VISIt at AXIS IS $150, whIle a typical emergency room VISIt for an acute asthma attack IS $1,500 These savmgs are far greater when heart attacks and strokes can be prevented For umnsured patIents, hospItalization and emergency room VISits ultImately end up beIng a cost that IS born by the general publIc We are requestIng $10,000 In CDBG funds to create a clInIcal SUIte that wIll allow us to mcrease the capaCIty of our prenatal serVIces By addmg thIS SUIte, we Will also be mcreasmg our overall capaCIty to prOVIde medIcal servIces for low Income Dublm farmlIes by 30% The need for Increased capaCIty IS eVIdenced by the waIting lIsts for care we mamtam, especIally for adult preventive services and pedIatncs By mcreasmg our capaCIty, we Will be able to more fully meet the growmg need for medical care for low mcome famIlIes m our commumty 2 If thiS application does not receive fundmg, what will be the effect on the program? We are clearly at the pomt where we must expand our facIhty m order to meet the growmg needs of our communIty If CDBG fundmg IS not received, we wIll seek other sources of support for thIS proJect Unfortunately, thIS will sIgmficantly delay the expanSIOn of our chmc, whIch wIll dImInISh our capaCIty to meet the growmg need for health care for low mcome families In our commumty 3 Does the agency antiCipate haVing any unspent grant funds at the end of the fiscal year? If so, explain why The estImate for total costs for tlus proJect IS $511,076 We are requestmg a total of $10,000 m CDBG support from Dublm We do not antICIpate that would be any remaInmg CDBG funds upon proJect completIOn 4 Complete Fmanclal Information and Budget Forms Please See Attached ..... ..... 0'\ .j:!r. .... 0 <0 ..... N .j:!r. N _0 0 (..l 0) 0'\ W N ..... ~ 0 0 (0 0 0 0'\ 0 0 c.o ...... 0 0 0 0 0'\ 0'\ t~ ..... ..... ...... .....(0 ..... N .j:!r. N _0'\ 0(0 ~~ 0'\ W N ..... 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February 9, 2006 Thlstlethwarte ArchItectural Group 355 Bryant Street, SUIte 210 San FrancIsco, CA 94107 Fax (415)227-9839 Attention Reference Subject Mr David Thlstlethw21te AXIs Healtbcare Buddmg AddlltlOn In Pleasanton BuddlDg AddItlolll PortIOn Only Budget Dear Mr Thlstlethwalte We are pleased to submIt a budget for the bUIldmg addItIOn portIOn only of the referenced proJect (see the attached ExhibIt "A") The same exclusIOns and clanficatIOns from the last proposal apply to thIS budget a<; well We look fOIWard to dlscussmg our proposal III greater detad Smcerely, Geof[ Massa COO &~g FEB - 9 2006 Enclosure cc Henry Uyehara, AXIs Communltv HLrllth doclblds/axls healthcare bUlldmg addltlon portIon only In pleasanton budget #2 25001 0 Nell Avenue · Mailing Address POBox 637 · Hayward CA 94543-0637 . (510) 581 3362 Fax (510) 727 9171 22 q~B3 BUDGET RECAP EXHIBIT A' AxIs Health bUlldmg addItIon M Pleasanton SPEC # WORK ELEMENT SUB BID 115 GENERAL CONDITIONS NTL 17,658 116 SUPERVISION NTL 44 935 117 PUNCHLlST NTL 4,603 102 STAKI NG NTL 2459 206 SOFT DEMOLITION NTL 7,750 220 EARTHWORK & PAVING NTL 9047 250 SITE CONCRETE NTL 2973 300 BUILDING CONCRETE NTL 27,299 550 MISC METAL NTL 744 610 CARPENTRY AND FRAMING NTL 38 437 650 CABINETRY NTL 7360 720 INSULATION NTl 2,990 750 ROOFING - ASPHALT SHINGLE REGIVIG 6,196 770 SHEET METAL NTL 2,766 790 CAULKING NTL 744 810 DOORS, FRAMES & HARD NTL 4,196 880 GLASS GLAXING & STORE NTL 1,487 920 LATH & PLASTER NAVA 7,930 925 DRYWALL NTL 11 372 965 FLOORING NTL 3,073 990 PAINTING NTL 5,204 1052 FIRE EXTIN & CABINETS NTL 520 1080 TOILET ACCESSORIES NTL 669 1540 PLUMBING NTL 17,077 1580 HVAC NTl 11 ,153 1650 ELECTRICAL NTL 15,291 TEMPORARY FENCE NTL 1239 INSURANCE NTL 1,239 FINAL CLEAN-UP NTL 794 PLANS NTL 1863 SUBTOTAL 259 068 PERMITS/FEES @ 15% 38,860 CONTINGENCY@ 10% 25 907 BID 323,835 1- 23 0"'0 lr.2. ~~ ~~ ..~ Cia "'~ ~ f i In .... ~ ! ~ ~ "'0 il ~ i g ~ <> ~ 1. .. ~ II 3 f .$ '" : ]] ., ~ I i 3 e. 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I i ~~ c: o us C <<I 0, >< W J::"'O<C ~<' ~~S~ CD ll. f ~"C '-1 c Oz ::l E Wi E Q)~! 15 ~ ~I u 00 fn 20:: ~ =c... -:= U- <( en ~ 32 ::J co ~ ~; 01 i~ ~I .( ~~ ~d~ II' F-' ~[J ---......- ---~~ ~ - ==--:-~--=-~--=- ----"'------"--..........,- ------... -- 2S ,I ''t---~ I I I I I I I I I I I 1 I I I I '" I I I 1 I I I Capital Expenditure Narrative 1,)~/3.s 1 Provide a detailed budget and scope of work for each capital expenditure or a constructlon/ rehabIlitation budget and describe how you ascertained these costs This IS a maJ or capItal proJ ect that WIll convert an eXIstIng 1 ,400 square foot office space at 4361 RaIlroad Avenue Into a clIlllcal space that wIll accommodate women's health servIces for a hIgh rIsk low mcome populatIOn ThlS proJect will also allow AXIS Commumty Health to Increase ItS overall capacIty to provide medical care for low Income resldents at Its Pleasanton site by 30% There are five maJor components to the proJect's budget $323,835 for actual constructIOn costs, $4,875 for proJect permits and fees, $75,000 for project design, $25,525 for eqUIpment and furmshmgs, and $19,942 for proJect management We are requestmg CDBG support over a two- year penod for the proJect's constructIOn, permit and desIgn costs A detaIled budget for constructIOn costs IS mcluded m thIS appltcatlOn The ThIstlethwalte ArchItectural Group will provide all proJect desIgn servlces and has completed an InItIal proJect plan (see attachments) The ThIstlethwaIte Group has deSIgned AX1S'S adult medlcal cltmc (a Clty of Pleasant on CDBG proJect that was completed m 1990) and our pedIatrIc clImc (another CIty of Pleasanton CDBG proJect, completed m 1999) The ThlstlethwaIte group specIalIzes m medical facIlIties In the Bay Area, mcludmg proJects at John MUIr Hospital In Walnut Creek and Eden MedIcal Center m Castro Valley Rick Eastman IS our project manager for the Women's Health ClImc ProJect Mr Eastman has been an AXIS employee for SIX years and has extensIve experIence In program, proJect and facllIty management In 2006, we completed an expansIOn proJect at our Livermore chmc slte whlch Increased the capacIty of that clime by 45% Mr Eastman served as the aSSIstant prOject manager on that project and, WIth hIS gUIdance, the LlVermore clImc proJect fully met ItS objectives and was completed wlthm the establIshed tImehne 2 Will thiS project require Implementation of DaVis-Bacon/Fair Labor Standards Act? If requlfed, descnbe how your agency Will comply With thiS regulation (bid requirements, determme wage rates, mOnitor compliance, etc) Yes DavIs-Bacon/Fau Labor Standard Act costs were mcluded m thIS project estImate AXIS will fully comply WIth all DaVIs-Bacon reqUirements We have extensIve expenence With DavIs- Bacon reqUIrements through our past CDBG proJects, which have mc1uded the clImc eXpanSIOn project m LIvermore, two chmc expansIOn proJects III Pleasanton and a varIety of other proJects such as the InstallatIOn of new HV AC at the Pleasanton SIte J 31'33 ~ 0 [ffi (H] [ffi@ 0 fS) U U [ill U@[[mIDCIDno (ill []I] ~ (ill [[[Jlli] &\all all IT UIT ([!) [!1] lID ~ [p1 ~ ([!) rID ~ lID IID1l ~ [ll][IlHllJ IT [!1] lID $ ill)[llI [[(Cl (8J mJ ~ $UfID [fjJ IT [!1] (ill @(ID$U$ Attach addItIonal sheets If necessary Additional program funding sources could Include, but are not limited to foundations, corporations, IndiVidual contributions, events, reimbursements and in-kind contnbutlons Types of funds are loan, grants, donations, m-kmd, etc ~ llIl$rm rIDil, @lDHllIUlI1I1JnUUml[!llgn , .I.i, ,i l .1 .. ":" ~ ~ I ~ lDl unlrm;'(Hl , fR\lJ1JU rID un Ullll ' ' ^ \ , ~UllD1ll!ll $ V!~ I " Alameda County Health Servlces - Chole Measute A $150,000 ExpanSIon N CIty of Cluue Pleasanton/ CDGB $123,309 Expanslon Y Clmte CIty of Pleasanton $87,812 ExpanSIOn Y Chrue Cltv of Dubhn $10,000 ExpanSIon N Commumty, FoundatIons and 1n- Chme Kmd Donations $139,955 ExpanslOn N 1l'lID1l'&\[ $5i~~,lIJl~ffD llIT lflIDnn :m170 lIDmu~nnnmJ reJlIDlBHGl ffllDnol!lls llllD IIDmy ffllD17 Sll!llITff ClID$\t$. OD~IIll:m$ml UUSll 0:mclln 0unnunU(DJ~mllm/ltUllIlml :muol!ll ml8lm [IIllm17lt:lmUOllm!Jllml OllIT llllnl&n17 smllaJfm aJUDnlIlInl&UDl&ffRllS lllln!llll wunn 1ID1Ill1lD1BI~UlI iM~llllD reJlIDlBlOll UmHcUIlIlUlllBlllll8lBlllOllll:mn unnllDlIDlllIDlIiJ :mllDUII l!1Ill:m17n~ (c1ID$1l$llllD lllhulll reJlIDlBllGl OD17l1D!JIl17anunn OOllDllllll ~hll(clBlllnOIlllD, sncOt DmHBlYrellBlnuUIIllnlIDUnUII:mll's ITlID17 IIllnDDllDllOBlI'lIllrelS (clBllIDlIIllIDllllniBl It:!lUmlU'!JIlmlllllllllD reJlIDlBllGl :ms l!UU'lID!JIll7aJllD1IlIllltIlDIIllIIDSIIllS i ~ ,,,~' ^, ~ " , , OOIlll'!M 7. 1 DA{$'0lBln~U'!!./I!::rqIlDIIllDTIlIllllDUS" ,WiJIIDIID!tIlIllW UU1dl1i! !::r 'lflllllBlU'lllJ $1dlna1lli1l'l~ t _ {.iY" :.;:.:. ,,",,".f( <.,..f......:.:!! v ~~ I ~. ~,f, f'1 ,[pl!ID$TIUUIIDUD '[]'Ullnllll~" 'u ~,,: iL[]f1 " nUll ITllDU' l'MullIln'W]Ii'lllnoU $ \ lIDmlllDlBllfilll l!:lID$lt U!ID 1ID17mllJRll10;; 1.lIDmllJRffilll~U (clID$lllllID lID~~mlll ~ ~(ID IDJ ~tID ll1J1] ~ [lj] a[] mJ rB5 IT ~fID ~ll1J1] {q1 /3~ Attach additional sheets If necessary Total CDBG Program Grant Budget Capital Expenses Co nstruct 10 njReha b Illtat 10 n $10,000 $323,835 Permits and Fees $ $4,875 Design $ $75,000 Engineering $ $ AcquIsition $ $ Other Soft Costs (furmshmg/equlpment) $ $25,525 Project Contingency $ $44,649 Sulbl~()tal $10,000 $491,134 Personnel Expenses Salaries $ $19,942 Benefits $ $ Sulbl~()~a~ $0 $19,942 Operating Expenses Supplies $ $ Printing/CoPYing $ $ Postage $ $ Telephone $ $ Rent and UtilIties $ $ Accounting/AudIt $ $ Other (defme) $ $ SUI btota I $0 $ 1]'@1]'lAm $10,000 $511,076 Budget prepared by (Name, rltle, Telephone Number, E-mail) Caro I B eddome, Development DIrector, 925 - 201- 68 0 8, cbeddome@axIshealth org ~~[fff(Qm!ffi1)~mD~(ffi [ilii]fmtID~[lI]IT(ffi$ (fill out a Performance Measure for EACH goal and/or objectIve) Page 1 of 2 15;fB~ Agency AxIS Conunumty Health Program Women's Health Center Activity ConversIOn of eXlstmg office space to women's health center cl1mcal area Increase the avmlablhty of medical servIces for low-mcorne Dublm famIl1es and pregnant Goal/Objective women Please circle at least one of each of the followmg goals and priorities whIch are applicable to this activity, goal & objective Refer to Instructions to complete RFP for a list of the goals and priorities IlIIIlI1IID $llir&nlBl!D~lC [fl1(jIJmfi ll!llllHID IP lID Un lC~ lF~u lIDll'n IlY 1- 1 4 4 5 5 6 How Will your agency benefit Dublin residents? o Low Income DublIn pregnant women WIll have healthy pregnancies and WIll delIver healthy mfants Ii) Low mcome Dublm famlhes WIll have Improved access to health care WhICh WIll enhance theIr health status and qualIty of lIfe Please refer to InstructIons to complete RFP for description of Performance Measures ~~~ IDl~lllPlmnD~tBl;[$~~(BHCn,(IDQ1Ijjn! 12 ", lIDnnRltlIDrnIlHBl [$lBl~lBllCU lDlUnlBl]' l 0 [Z] Creatmg a SUitable llvmg Environment r2J Availability/Accessibility o Provldmg Decent Affordable Housmg o Creating Economic Opportumtles o Affordablllty o Sustamablllty I~ JS[IIllBllCDl!iill: nDnOllUlCmJnlID~[~$(f:~(Bla:n QllDll~]Ak "" o Public facIlity or mfrastructure rg] Public service o Owner occupied umts rehabilitated o Direct financIal assistance to homebuyers o Targeted reVitalization o Tenant Based Rental AssIstance (TBRA) o o o Rental umts constructed o Rental units rehabilitated o Homeownershlp Units constructed or acquired WIth rehabilitation D Busmess assistance Commercial fac;ade treatments or busmess building rehabIlitatIon Brownflelds remedlated o Homeless shelters D Emergency housmg D Homeless prevention o Jobs created o Jobs retained o Businesses providing goods or services 10 ~ 133 [pi (ffi u11mm U1ID fID lID (C; (ffi ffifil (ffi fID ~ [ill ~(ffi ~ Both pages must be completed for each program Page 2 of 2 ill" ~lIIlllDDlID01fuHD uniillllnlCm~lIIlli' a Total number of clients you anticipate serving - choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES Households Persons 1,384 lID lm~lmm!:!lDJlIDllllllnml HDORlffillllDmlli' lIIlIT lC~nlElHDll$ il'lIIlOll mDDllnCnllllmllllBl $lBHi!nDDIID nDD IlIInIBl ITlID~~lIIltMDDDIID l!:iBllllBl1IDlIIlli'lllBl$ lowd, 'I, , - < :v I'V: ""'''' "" ,,' Female p l' VerYdt~wf "'" Income '( , rlncome" , Disabled Headed Semor Youth Homeless J (>50%) , (<50%) ~ Households 1,061 323 350 1711~~ [FV' 2<<D(Q)8l<~(Q)(Q)S (C(Q)1IIDl mUll [1}D1ty' [Q)(!lflS~ (Ql[ID mla[1)~ ~~(Ql(C~ @rn[1}ft ~[ID~ DCiffi~Dm'O Agency Name Add ress Bay Area Commumty ServIces POBox 2269 Oakland, CA 94621 ExecutIVe Director Kent Ellsworth Contact name and title Lisa Gross, Ph D , Program DIrector ..j Contact phone and fax Phone 925/484-8457 Fax 925/484-1075 Contact e-mail address 19ross@bayareacs org Organizational Background Private Non-ProfIt x Public Agency o Other (Describe) D Tax 10 Number 94-1708069 List years previously received City fundmg 2005-2006,2006-2007,2007-2008 HECEIVED DEe 1 2 2007 (,n.ltlll.IN PLANNING \1 OOAVV\, ApP # -1- I ATTACHMENT 113 I STAFF USE ONLY DateRecewed 1;)((61! IJ7 (I RP1 1 CommunIty Development Block Grant Application CoTler Sheet Page 2 JG % /33 Proposal Summary & (A program may contam several goals) Capital PubliC Service Request 0 OR Request x (check one) Program name Bnef Program summary Valley Creative Llvmg Center Valley Creative Llvmg Center (CLC) IS a community based psychosocIal day rehabilItation program serving adults With psychiatric disabIlities In the Tn-Valley area The program provides the necessary structure and support to assist IndiViduals In their recovery and rei ntegrate mto the commumty through paId or volu nteer Jobs and ed ucatlonal Institutions Goals - Number of Program goals to be achieved In fiscal year 2008- 2009 LIst a brief descriptIon of each program goal 1 Valley Creative L1vmg Center WIll proVIde services to low and very low Income mdtvIduals WIth psychIatrIc dtsabIlItIes 2 PrOVIde on gomg day rehabilitatlOn semces t:hree days per week, year round Number of Dublin reSidents served by thiS goal 9 9 3 ProVIde the opporturuty for prevocatlOnaI and employment servIces 9 Use a separate sheet of paper If needed Amount of Dublin grant funding requested (match fIrst column budget form #2) $5000 00 Overall Total number of Dublin reSidents to be served by thIS program 9 Commu mty Development Block Grant Application Certification To the best of my knowledge and belIef, all rnformatlon and data In thiS application and attachments are true and correct No matenallnformatJon has been omitted, including financial information If funded, I cerbfy that the Agency IS wIlling and able to adhere to polices and procedures specmed by the City of Dublin, and if applicable, the appropnate program regulations of the US Depa rtment of Housl ng and U roan Development Further, I understand thiS IS not an agreement for grant funding and cannot encumber funds until the CIty of Dublin and the indiVIdual authonzed to execute contracts on behalf of the Applicant Agency, has signed the contract, and If applicable, all federal regulations and paperwork are completed Execu2We Dfrecior nile I ~rl./ZfJt) 7 ro te I 2 1'1 J- 133 PROPOSAL SUMMARY City of 1!)ublm CDBG FY 2008-2009 A fl"ognm Narrative 1 Valley CreatIve LIvrng Center (CLC), a program of Bay Area Commuruty ServIces (BACS), located m Pleasanton, IS a year-round, day rehabIlrtatlOn program provIdmg servIces for adults WIth severe and persIstent mental Illness The Valley CLC offers a WIde range of pre- vocatIonal, SOCIal, psycho-educatIOnal, and recreatIOnal actIVIties that promote mdependent hvmg It IS the only program of Its kmd m the Tn-Valley area IndIvIduaJs who attend the program are at a much hIgher nsk for homelessness and hosprtahzatIOn WIthout the support servIces offered at the program The absence of such servIces would lIkely mcrease CIty expendItures m other areas such as emergency and medICal servIces, as well as the mcreased hardshIP expenenced by the mdIvIduals lllvolved Mental health prOVIders based m COlTIrDluuty chrncs often refer clIents to Valley CLC The CLC provldes many servIces that are ImpossIble for the chmes to provIde, yet are essentIal aspects of treatment County chmcs can only see chents every four to SIX weeks for medIcatIOn support servIces and one time per week for case management services when a client IS In cnSIS The CLC IS open three days per week The CLC decreases Isolation and helps prevent mcreases In psychIatnc symptoms An advantage of the three day a week program IS that staff can momtor the daIly level of functlOrnng Early IdentificatIon of mcreasmg symptoms allows early mterventIOn to decrease the nsk of hospItalIzation In terms of employment servIces, the mental health populatIOn has been tradItIonally underserved, yet has proven to be hIghly productive and dependable when proVIded an opportunIty The Department of RehabIlItatIon prOVIdes referrals to our program, mdlcatmg an ongomg need for thIs servIce III the Tn-Valley Area The CLC offers groups assIstmg clIents to mcrease theIr Job slalls, proVIde IllwVIduaI support for Job searches, and work WIth the Department of RehabIlItatlOn to proVIde members With access to Job Opportwl1tIes Other activities focus on skIll bwldmg, mcludmg budgetmg, money management, cookmg, nutrItIon, gardemng, and other mdependent hvmg slalls ClInIcal staffwork WIth members on Issues such as self-esteem, symptom management, medIcatIon management, and Iearrung to access and utIlize supports WithIn the commuruty "More than one In four U S adults (28%) expenence a mental health or substance abuse wsorder III any gIven year Less than one-third of those adults WIth a mental dIsorder Will receIve treatment" (Forgotten Pohcy An ExamInation of Mental Health m the US, May 2001) The NatIOnal InstItute of Mental Health (NIW1) has shown the success rates of treatment for wsorders such as schIzophrema (60%), and depressIOn (70-80%) surpass those of other medical condItIons (heart dIsease, for example, has a treatment success rate of 45-50%) The NllvtH estimates that the annual cost of untreated mental Illness exceeds $300 bIllIon, pnmanly due to productrvIty losses (ID1ssed work days and premature death) of $150 bllhon, health care costs of $70 bIllIon, and socIetal costs (mcreased use of the cnmlOal JustIce system and SOCial welfare 3 ~ 0 ~ 133 costs) of $80 rmlhon 2 Valley CreatIve LIVIng Center Intends to aclueve the folloWIng goals Valley Creative LIVIng Center Will respond to the needs of the DublIn commuruty by servmg a l11lmmum of 9 very low and low-mcome DublIn reSIdents With psychIatrIC dIsabIlIties Program staff wIll aSSIst and support 9 Dublm reSIdents and thelf famIhes, If approprIate, understand mental Illness, manage thelT psychIatrIc symptoms, and utilIze mental health support servIces m order to prevent unnecessary hospItalIzatIons Valley CreatIve LIvmg Center WIll proVIde ongomg psYChOSOCIal day rehabIlItation servIces, three days per week, year round Valley Creative LIvmg Center Will provIde the opporturuty for prevocatlOnal and employment servIces to 9 DublIn reSIdents At least 1 Dublm reSIdent Will progress to or retaIn p31d or volunteer employment 3 BACS mental health programs provIde servICes for adults With severe and perSIstent mental Illness III Alameda County Valley CLC serves mdIVIduals from the Tn-Valley commumty One hundred percent of the mdIVIduals served have a psycluatnc disabIlIty AddrtIOnally, 100% of the people served are very low to extremely low Income, as defined by the US Department of HOUSIng and Urban Development ClIents pnmanly rely on Medl-Cal for theIr Insurance coverage ApproXImately 15% of the clients are from the City of Dublm Valley CLC staff provIde outreach WithIn the Tn-Valley commuruty On a monthly basIS a program calendar IS maIled to proVIders WithIn the commumty Staff coordmate and collaborate With fromly members, case managers, therapIsts, psychIatnsts, board and care operators, Department of RehabIlItation counselors, and others prOVIdIng servICes to clIents CoordmatIon happens on a regular basIS, daIly, weekly, monthly, or as needed TIus msures a necessary Imk WIth others mvolved III the lIves of our clIents as well as contInU1ty of care Chents come to Valley CLC WIth a vanety of backgrounds and belIefs All BACS programs support the phIlosophy that dIfferences are not only to be respected, but embraced In support of thIs pluIosophy and the focus on recovery, the program mcludes educatIon and celebratIon of numerous holIdays and culturally relevant events AddItIOnally, BACS encourages access to bmlted-EnglIsh populatIOns BACS proVIdes program matenals III a vanety of languages mcludmg, Spamsh, ChInese, and VIetnamese These matenals were developed speCIfically for BUD 4 Success WIll be defined III three ways (I) the number of mdIvIduals served and the number of program days (um ts of servIce) fulfilled m the 2008-09 year, (2) the number of mdIvIduals progressmg to or retauung pood or volunteer employment, and (3) the percent of low and very low mcorne mdIVIduals served (1) The Valley CLC shall serve a total of60 mmvIduals for a total of2500 program days (umts of servIce) Of those, at least 9 mdIvIduals sban be reSIdent of the CIty of Dub 1m (2) A total of 10 mdIvlduals shall progress to or retaIn prod or volunteer employment Of those, at least 1 shall be a reSIdent of the CIty of Dublm (3) 4 ~) ~ )33 At least 70% ofmdlvIduals served wIll be low or extremely low mcome Valley CLC meets the cntena for the natIOnal obJectives for CDRG, 70% of program partIcIpants meet the HOD defmrtIon of low to moderate mcome The program complIes StatIStICS monthly to track progress on goals Program phIlosophy focuses on recovery, clIent strengths, clIent empowerment, and chent-commuruty mtegratIon The Valley CLC program promotes self sufficIency, mcludIng the opportunIty and necessary supports for hvmg mdependently and workmg m the commuDlty These are clear and lastmg Im-provements eVIdenced through partIcIpatIOn In the program 5 Valley CLC staff engages In ongomg consultation and collaboratIon around chent care A maJor category of treatment contacts mclude commumty mental health chmcs such as Valley CommunIty Support ServIces, K8.J.ser, Pathways to Mental Health, Del Valle Chmc, and Eden Commumty Support ServIces The commuruty providers are able to see clIents on a less frequent basIS than CLC staff However, chmcs prOVIde ongomg medIcatIOn support sefVlces and case management servIces Early Identification of problems at CLC followed by case conferences With clImc staff allow for early mterventIOn, Amador Valley Adult School, part of the Pleasanton Umfied School Dlstnct, places an Adult Education Instructor at the CLC The mstructor augments the program by offenng expertJ.se III facIlItatmg groups m a vanety of areas lOcludmg hygiene, dressmg for work, ShOpplOg skIlls, exerCIse, cookIng, health, budgetmg, SOCIal slalls, problem solvmg techruques, and leIsure slaHs Chents Interested m obtaImng a GED can develop an mdIvldual educatIOnal plan WIth the Instructor There IS a great deal of cooperatiOn between the DIsabled Students Programs and Services (DSPS) at Las POSIts College and Valley CLC DSPS prOVIdes a resource for supportmg clIents retunnng to school ThIS enables the CLC clIents to stay In school, meet educational goals, and engage m meanmgful actiVIty Conversely, college staff makes appropnate referrals to the CLC The relationshIp between Valley CLC and these organIzations lOsures that our clIents receIve contmUlty of care and access to the best resourct:s aVaIlable By IdentIfymg and uuhzmg the expertIse of each orgaruzatlOn there IS less serviCe duplIcation and greater service mtegratIOn 6 The program IS deSIgned for adults WIth severe and persistent mental Illness In addItion, the Valley Creative LIvmg Center IS fully ADA accessIble 7 Alameda County BehaVIOral Health Care SeMces prOVides the maJonty offundmg for the servIces proVIded at the Valley CLC BACS m8.J.ntalDs an open and cornmUDlcatlve relatIOnshIp With the County as well as consIstently meetIng contract goals Grant fundmg from the Tn-Valley Communlty FoundatIOn as well as the CIties of LIvermore, Pleasanton, and Dublm has leveraged tIns III the past AdditIonally, the Department of RehabIhtatlOn proVIdes reImbursement for speCific servIces proVIded to mdIvIdual clIents 5 d~ ~ /33 lB Budget N arrratlve 1 Valley Creative Llvmg Center IS an extremely cost effective optIOn for the treatment of severe and persIstent mental Illness The cost per day at Valley CLC IS $6579 The MedI-Cal cost for Day RehabIlItation IS $134 91 per day The cost per day of an mpatIent stay m the hOSpItal IS $1035 57 2 The money receIved from the CIty of Dublm IS targeted for staffmg If the fundmg IS not receIved, thIS could result m decreased staffing ThIS would certamly Impact and decrease the servIces the program IS able to delIver Due to the staff to clIent ratio mandated by MedI-Cal, reduced staffing could reduce the number of chents the program could serve BACS WIll do everythmg possIble to secure fundmg so as not to be forced to reduce staffing and/or servlces 3 SACS does not antIcIpate havmg any unspent grant funds at the end of the fiscal year 4 Please see attached Fmanclal Informanon and Budget Forms 6 ~ 31/33 W~II1l81Il1l~~81~ ~Hllffllllrm81~~lDl[1l WlDllrm A~dl~mlm21~ ~r[lgr21Wl F~nd!!IIm ~o~rcls & ~tanin@ Costs Attach add1t1Onal sheets It necessary AddltlOnal program fundmg sources could mclude, but are not llmlted to foundatIons, corporatlOns, lndlvldual contnbutlOns, events, relmbursements and m kmd contnbutlOns Types of funds are loan, grants, donatlOns, m-kmd, etc Soures Amount , Use of funds Committed? Y/Rl Alameda County BehavlOral Health 149,579 Salanes and Opcratlng Costs y C1ty of Pleasanton -General fund 5,000 Salanes N Cny of Plea"anton - CDBG 5,000 Salar1es N C1ty of LIVermore - CDBG 5,000 Salanes N TOTAl S tM.578 If you are UbTlZ/JJg COBe hrnds to pay for staff costs please list each empIoyeeJbtle and Ule pgrcentage of their salary and benents that wdl be paul WIth COBG blclude the totaf munthJy 8I1d yearly costs to the COBG )lrOgram. Note- YacatlOn SIC~ IBalIe ami' Imlldays for employees cannot bu charOed to CUBe as proQram expellS8S.. Now r. saIary & aunts paId for Monthly salary & bonom Yearly salary & lrenent CI PositIOn Title [v/J\I] WIth orant S cost to orant .... to orant Program Dlrector N 60%FTE $44,780 (11 17%) $417 $5,000 SenIor Mental Health N Worker 60%FTE $28,549 (0%) 0 0 SenIor Mental Health N Worker 60% FrE $25,014 (0%) 0 0 7 ~Lf~ /33 ~rlOl~rrmHil1lIm[j]~~IBl~ WlDlrllllll Attach addItIOnal sheets 1[ necessary Capital Expenses Subtotal Personnel Expenses Salanes Beneflts Subtotal Operating Expenses Supplles Pn ntl ng/ Copymg Postage Telephone Rent and Utllltles Other Repair and Mamt Contracted ServIces Equlpment Advertlsmg/ Publ Transportation Conferences, Mbrs Insurance Mlscellaneous MHS Admm SACS Indlrect Cost Total OperatIng YDIAU BIIDCU CDBG Grant Total Program Budget s s o o S 5,000 $ S 5,000 S 77,118 $ 21,225 S 98,343 s s s s s $ 1 ,750 S 900 S 550 $ 2,350 S 28,300 S 500 $ 575 S 1,500 S 600 S 4,270 $ 850 S 500 S 50 S 13,365 S 15,176 S 71,236 S 169,579 S 5,000 Budget prepared by (Name, TItle, Telephone Number, E mOll) Barbard MacAullffe, CFO 510 613-0327 bmacaulltfe@bayareacs org 8 Program Staffing BACS-Valley Creative Llvmg Center Program DJrector, Llsa Gross, Ph D has been With BACS SInce 1996 SenIor Mental Health Worker, GaIl Schukle, B A has worked at Valley Creative Llvmg Center SInce 1 991 Semor Mental Health Worker, Lavonne Scroggs, B S, has worked at Valley CreatIve Llvmg Center smce April, 2007 9 ~5 ~ /33 f~[flf@(ffITIil~ !TiJ~~ M (!<al$IJ1Ill'(s)$ (fIll out a Performance Measure for EACH goal and/or obJectIve) Page 10f2 ~, ~ I.~' Age 1/11 CY Pl1'Ogram Bay Area Conunumty ServIces Valley Creative Llvrng Center Acf/:lvity Day RehabIlItatIOn GoaVObJactlva ProVIde day rehabilItatIOn servIces to 60 adults WIth mental Illness Pleas18 c!lrcle at least one of saclhl of lI:lhls fo~Dow~ng goals and Pli'oolrot!es which are aplPBlcabDe to tlhlls acl:Rvoty, goal Be objective Refer to Instructions to complete RFP for a list of the goals and pnontles D111U1D StnlJiegfc Goal IHIU[) Policy lPi"iIorlty 3 3 4 4 5 6 ~cw wm YOIlJIr agency baneUI'll: lOl&llb!lJl1l Irssidlernb? Valley CreatIve Llvmg Center WIll provIde ongomg psychoSOCIal day rehabIlItatIOn servIces, three days per week, year round to a mIrumum of rune DublIn resIdents Staff WIll asSIst and support chents and theIr famIlIes, If appropnate, understand mental Illness, manage theIr psycluatnc symptoms, and utIlIze mental health support servIces ill order to prevent unnecessary hOSpltahzatJ.ons I?ITaase Irelfslr to ITlI1I511:lrnocil:ooll1ls 11:0 comlPlla1l:e IR:fFlP> lfo17 fdI&S<CIl'~IP1tllOll1l olf IPsirlfoli'llll'Thillrmce iWeaslllJl7es i (ij)/l)nscnfilfe (sslec'lt orne) 2: (ij)1UI1tCOIl!l1lI& (sG!!DI!CI!: (JJl!De) o Creating a SUItable LIving Environment o AvailabIlity/AccessIbIlity o Provldmg Decent Affordable Housmg o Affordabllrty X Creatmg EconomIc OpportunItIes X Sustalnablhty 3 Stm:Mc UllDlUocawr (salad c1I1Ia) o Public faCilIty or Infrastructure o Owner occupied units rehabilitated X PublIC servIce o DIrect financial assIstance to homebuyers o Targeted reVItalization o Tenant Based Rental Assistance (TBRA) o CommerCial fac;ade treatments or busmess bUilding rehabllrtatlon o Homeless shelters o Brownflelds remedlated o Rental units constructed D Emergency housing o Homeless prevention o Rental unIts rehabIlItated o Jobs created o Homeownershlp Units constructed or acquIred With rehabilItation o Business assistance o Jobs retarned o Busmesses proVIding goods or services 10 t?i1 o;f 1':'3 jpJ~ [('[f(O) JrlJUll ta) 111) ~ ~ 00 ceJ tdJ $1],[1 [j(Sl$ Both pages must be completed for each program Page 2 of2 4 COll1l1lll1l1lon D1l1lltlloc.m11:olr a Total number of chents you anbclpate servmg - choose one orthe other DO NOT PROVlDIE STATS IN 80TH CAlIEGOR!ES Households Persons 60 b I8reaftout the number of clients YOM anbcupate s2roimg 1m the faJ~~OWIJU1g categories Low Very Low Female Income Income Disabled Headed Senior Youth Homeless (>50%) (<50%) Households 5 55 60 20 10 0 3 Appendix A Income Ltmrts by household Size, establIshed February 2007 This table IS provIded to assist with completmg question #3 m the narrative and the tables In Appendix B I I i Family Size I J I Extremely Low I 30% of Median Very Low 50% of Median I I low , 80% of Median I I MedIan Income , Moderate Income ~fPerson ~$17~600 $29,350 ~~u$46:350 -- $58,000 -, $69~606-- 2rer5ons $26,160 - $33,5000 - - ~ l53;OOo - -- $66,200 - - -- $79,440 - 3 Persons - - $22,650- -~- J - $37, locf - -- ~ $59:600 - --- $ il(soo - - - $89,400- I 4 Persons $25:150- - ~ ~$41.90-6 - - I $66~250 - - ~ $82,800 - ; $99,360- , 5 Persons $27,150- ~- 1 $45,250--- $71,550 ~- - $89,406 - - $107,280 - I ,----- - - -~ -- - - - - -- --- ------ --- - -- - - - -- - ------ --I I 6 Persons $29,100 $48,600 $76,850 $96,000 $115,200 17 Persons - - - -$31,266 $51,950 - - - - $Ef2~i50- ---- - -$-102~ 700 - - $ 123,i40- 1- 8-Persons - - $33,200- -$55,300 - $87,450 -- -- -$109,300 - ~-$i31,166u , ~ ~ ~~~~ HUD updates this Income chart each year The City will provide all FY 2008-2009 Subreclplents with the most current data when It becomes available Source US Department of Housing and Urban Development (HUD) Data for Oakland SMS 11 [P)teOOU'fIlJl1CB:l ITil~(! [Ml (fl~$lliI U'te$ (fill out a Performance Measure for EACH goal and/or obJective) Page 1 of 2 ~Q-1133 Age U1l cy l?rcgli'aM ActMty Bay Area Commuruty ServIces Valley Creative Llvrng Center PrevocatlOnal and Employment Servlces GcaljOlIlJ]ectlve A total of 10 mdlvIduals shall progress to or retam prod or volunteer employment I?lease circle at least one o~ eaclhl o~ iihle fcUcw!ll1g goals al1ld IlJlJ'icrri1l:les wihllclhi all'e aplPlDcalb!e to tll&~s actlv~ty, goa ~ &: objective Rete r to I nstructlons to com pI ete R FP to r a lIst of th e goa Is and pnontles II-mID Sba~egic Goal ~iJ[) Policy !Priority 1 1 2 (2) 3 3 4 4 5 6 lHIow wi~n yon.a1T agency belf1lsffu1t [)n.aIlJ!DD1llJ'esndell11ts? Dublm reSIdents With mental Illness will have access to groups that asSISt cltents to mcrease theIr Job slalls, proVIde IndIvIdual support for Job searches, and work With the Department of RehabIlttatlOn to proVIde members WIth access to Job opportunIttes It IS expected that a IDImIDum of one Dublm reSIdent wIll progress to or retaIn prod or volunteer employment fBeaM! lTe'lfSIT to BI1USl1:lTlllIctftOl1DS to OOmlJ]lfflSitlS !R/lFf 1fiOllT CIIIesa:li'DlJ]ltfiiOl!1ll og IF>elrifoli'lI1l1lalU1lC0 iWeaSlllIlTes. jl. (l)llD]ecijve (serred o01le) 2 Omcomrne (sIlIOl!cft@U1le) U Creating a Surtable LIVing EnVIronment o Availability/AccessibIlity o ProViding Decent Affordable HOUSing o Affordablllty X Creating EconomIc Opportunities X Sustamablllty 3 SBJeCWDc ~li1IdlicaiolT (seftec~ oOlle) o Public faCility or Infrastructure U Owner occupied units rehabilitated D Direct fmanclal assIstance to homebuyers o PubliC service o Targeted reVitalizatIon D Tenant Based Rental AssIstance (TBRA) D Commercial fat;ade treatments or bUSiness bUlldmg rehabilitation D Homeless shelters o Browntlelds remedlated D Rental units constructed D Rental units rehabilitated o Homeownershlp unIts constructed or acquired With rehabilitatIon o Emergency housmg o Homeless preventIon D Jobs created X Jobs retained o Busmess assistance D BUSinesses provldmg goods or services 12 d~ ':f /3J f(p)BilIDlrmrn;aHro~\S M~a1$illIl7!el$ Both pages must be completed for each program Page 2 of2 l\J. CcIl1l111lli1l01rn nfllldlica~oll' a Total number of chents you antiCipate servmg . choose one or the other DO NOr PROVlD!E STArs IN 180'1JlH CAlEGOlR~ES Households Persons 60 b IBrea~Olllt the number of cllelllts YOIJJ C1l1l'8ticlpate serving Ill! the folffowlng ca~egories Low Very Low Female Income Income DIsabled Headed Semor Youth Homeless (>50%) (<50%) Households 5 55 60 20 10 0 3 Appendix A Income Limits by household Size, established February 2007 This table IS provided to assist with completmg question #3 m the narratIVe and the tables In Appendix B ~ersons - r--=--~----- I 8 Persons 1----- --- - - -- --- - - -- --r --------- - --- - - --- -~--- I Extremely Low Very Low ILl Median Family Size ;1 50% of I ow I I 30% of Median Median: 80% of MedIan I Income I I I i lIPerson-- -~ ---- $-17,600 -- -- 1-- $29~356 -~-$46,350 --- 1--$58,000-- '--T6~600- - : !2 Persons -- - - $20,100 - -, -$33~5000- - -$53,000--- --$66,200 ---1- $79,440 r 3 Persons - - $22:650--- -~-$37,i60---$59,600-- - $74,506-- -$89,400-- l I 14Persons- - - $-25,150 ~. - -$41,900 -, $66,250~ --- $82,800- - - $99,360- is Persons- - - -$27,150- -- -- $-45,250 $71,550~---- -$89,406- -- - $107,280: - -......... ~--+ - ~ ~-~ - ~-............... ~~~ -- ~ ~~~~~~ ~~ ~~ ~~~-- ~ -~ ,...-~~~ ~ I $29,100 $48,600 $76,850 $96,000 $115,200 $31~200 $51~950 - "- 1- -$82~150 -~- -:- $-102",700 - I - $123~240 - $3:3,200 --- $55~300 n -r---$-S7,450 - - t - $109~300 -- ~$131,165- Moderate Income I6PerSons HUD updates this Income chart each year The City WIll provide all FY 2008-2009 Subreclplents wIth the most current data when It becomes available Source US Department of Housmg and Urban Development, (HUD) Data for Oakland SMS 13 [P)~D1f@I1'[l1]'i)CIDrm~~ 00 (f)(ffi$llJ.] li'$$ (fill out a Performance Measure for EACH goal and/or obJectIve) Page 10f2 2>O~133 \ Agl8 I11l ICY" Pli'cgli'am Aciivity Bay Area Commumty Servlces Valley Creative Livlllg Center Low Income Goal/Objective At least 70% of mdIvIduals served Will be low or extremely low Income P'ealS8 c!vlCls at least 0111118 o~ 18S1cihl 01 {Che iOllowh'ag goals 2181l1ollPli'oovlfJ:oes whiclll allre aplPlftcabDe {co 11:111118 ad:lvftty, goal &: objectOve Refer to Instructions to complete RFP for a Itst of the goals and prioritIes ~llJlD Stvategic Goal ~UlD fency IPlriority 6 lHlow win YOMii' agell1lcy ll>enef.fI'l1: IOlWlIbITDIl'll Ii'ssftldll8Ollfts? A mInIDlUm of 9 low to very low Income DublIn resIdents With psyclnatnc d1sablhttes wIll have access to psychosocial day rehabLlItatlOn fITe2lH velfeli' 11:0 UII1IS{cli'lLlIctftOIl'llS '11:0 cOIllI1lIPDe1l:e !RIFf lfillllT ldIascli'DIJll'icUilllll1l illllf l?eIT1fOIi'IIlI1lCllIl1lCa iViIeasnnrras jL Oll>>jadve (serrect cOlle) 2 OltBtcollllle (seDeclt IIIIJlIle) TI CreatIng a SUitable LIVing EnVironment X Availability/AccessIbility o Provldmg Decent Affordable HOUSing o Affordabrltty X Creatmg Economic Opportunltres o Sustalnab.llty 3 SIlllt!cll1llc hndlocaltoll' (seITed GOlle) o Public facllrty or mfrastructure o Owner occupIed Units rehabrlitated X PublIc servIce o Direct frnanclal assistance to homebuyers o Targeted revitalization D Tenant Based Rental Assistance (TBRA) D CommerCial fac;ade treatments or bUSiness bUlldmg rehabrlltatlon D Homeless shelters D Brownfrelds remedlated o Emergency housmg o Homeless prevention o Rental Units constructed D Rental unrts rehabrlrtated D Jobs created o Homeownershlp Units constructed or acqUired wIth rehabrlltatlon D Jobs retamed o BUSiness assistance o BUSinesses proViding goods or servIces 14 ~ 31 ~ 133 [P)(6Jrlf@lrmro~ [ffi@~ M(8}tal~[!1Ilr<e$ Both pages must be completed for each program Page 2 of 2 .ell. Common Dl'Illlllcaltorr a Total number of clients you anticipate seNtng - choose one or the other DO NOT PIROVllIO!E S1A1S ~1\l1B0THI CAlJlEGOIR~ES Households Persons 60 ~ b I8ll'ealkout the number of c~Denas YOILU antDcipate 5enrllllg In ~lue ao~~owh'Dg caftegories Low Very Low Female Income G Income Disabled Headed Semor Youth Homeless (>50%) (<50%) Households 5 55 60 20 10 0 3 AppendIx A Income LimIts by household Size, establJshed February 2007 This table IS proVided to assist wIth completing question #3 In the narrative and the tables In AppendIx B Extremely Low Very Low Low Median' Moderate I Family Size 30% of Median ~~~~~ i 80% of Median Income Income, I I ,- -- --- - - ~ - -- - - - r - --- --- -, - -- - - - - r ---- - - - - I 1 Person $17,600 $29,350 $46,350 I $58,000 I $69,600 I I , ~2PerSO-ns- - - - - $20~iOO - - - - $33,50-00- - -~$53:000~ - ~ --$66,260-~ - -$7~440 -- , 3 Persons -- - -$22,650--- -- ,- ~$3 7, 76o~- ,-- - $59,606 -- - - -$74,500 - I $89,400 I I4persons- $25150 -- - --- $41900 - ~ -- $66,250-- - ~- $82,800 - :-- $99,360 --- : 5 Persons-- ~--- $273.50- ---,--$45,250- - :~ -$ji~550~--- :-$89,400 ----$107,280-- I , r~6 perSons- $29,100 - -- F - $48~660 - - $76.850 --- -$96:000 ~$1i5)OO~- i7 Persons - --- -$31,200~ - $51,950 -- -- $82~150- - - $i6i 700 -- ,-- $123,240- I r-~-- ~~~ - r'.~ ~ ~ ~- ~ ~ ~~ - ~~ ~ ~ ~~~~ ~~-~~~--- -- -~ - ~ f"'"""'"~~ - -~~ - -~-~ ~~~-~ I I 8 Persons $33,200 $55,300 $87,450 $109,300 $131,160 HUD updates this Income chart each year The City Will proVide all FY 2008-2009 SubrectpJents wIth the most current data when It becomes available Source US Department of Housmg and Urban Development, (HUD) Data for Oakland SMS 15 ~~ I.;J [R{~(02(jJ~5)1J [F(O)~ [F(jJ~[D)~~@ ~[R{(o)~(o)~A!L A~r!L~CCtA\lJ~(o)~ r~t!K\~ " W:@[R{ ~~5)(cAlL YlEA~ 2(Q)(Q)~,,2(Q)(Q)~ (C{O) m m [Ul1J1] olty [D)e'Ve~(Ql!PJ mell1lft ~ ~(Q)~1k (GJ ll"auTilft !P>1l"@gll"aJm Slc~Wolt ~pc.\YL R'ECEfVEID DEe 1 3 2007 DUBliN PLANNING 2. L.f Cf P \IV\ ATTACHMENT 1 C A[p)[p)~ ~tCaJ~UOll'il <C~eclk~ US~ ~311.?iS [QltQJ NOll ll'etLlIm ~IhlBS slhlee~, Appell1](dI~ce A Oil' othell' mosce~~anemJ]s mfoll'lJ'81laimB1, W~Ul ym.nr alPlllJllca~ulln, Provide one ongmal and one cooy (total 2) of the followmg Items o Agency mformatIOn and proposal summary page o Program and Budget NarratIve - not to nceed four pages o C apI tal ExpendIture N arra tIVe . 11 apphca hIe - not to exceed 1 page o FmancIal InformatIOn Form o If applIcable, bnef background of staff and those bemg paId WIth CDBG funds (Do not exceed one page Attach to Budget Form #1) o Budget Form o Performance Measures ProvIde one CODV of the followlfll! mformatlon - Attach to onf!mal #1 Copy of current annual budget for the entIre agency #2 Copy of most recently submItted IRS 990 form (complete form) #3 LIst of Board of DIrectors Please submit ONE copy of each ItemJlsted below ,~ ~ Attach to ihe- ongmal~ , 1 ~~ I , ,., o 'i-:: j r-* 1..... " ; .......". ~ Background, expen~nce,'purpose, capacity, types of ~~.rYIce provIded h- - r .J.l "'" .." Resume or VIta of Executtve Dtrector, Program Manager, and Fiscal Offic.er ~ ..,...-.: ..... )- '" ~" o o Personnel polIcies mcludmg affirmatIve actIOn plan and gnevance procedure o Agency audIt reqwrements and copy of last audit o Type of msurance carried, bond111g, workers' compensatIon , , o ArtIcles of IncorporatIon/Bylaws ' o Confuct ofInterest Statement (If not mcluded III Bylaws) o State and Federal nonprofIt determmatIOn letters (If applIcable) o Orgamzatlon chart o Board of Dltectors' authonzatlOll to request CDBG fundlllg o Board of DIrectors' deMgnatlOu of authonzed offiCIal o LIS t of Bo ard of D1fectors WIth thelt contact lllforma tlOn ~~ /33 fY 2(ll(ll8-2([J)<<ll9 Commum~ lDle"e~olPmel1lt l8J~oclk Grant AIPIP~~ca~noll1l Agency Name Address City of Dublin 100 CIVIC Plaza Dublin, CA 94568 Executive Director Melissa Morton Contact name and title Ananthan Kanagasundaram, Assistant Engineer Contact phone and fax (925) 833-6630/ (925) 829-9248 Contact e-mail address Ananthan k@cl dublln ca us OrganizatIOnal Background Private Non Profit o o Public Agency [g) Other (Describe) Tax ID Number List years prevIously received City funding 200607 l;)j I J q 1 STAFF USE ONLY Date ReceIVed 1"3 \Jl M App # L1 Community Development Block Grant Appllcalion Cover Sheet PaKe 2 c.315 ~ j33 Proposal Sum mary - (A program may contam several goals) Capital Request Program name Brief Program summary [g] OR Public ServIce Request D (check one) Sidewalk Safety Repair Program and Curb Ramp Installation Repair sidewalk offsets to eliminate tripping hazards and provide curb ramps where It IS necessary Goals - Number of Program goals to be achieved In fiscal year 2008 2009 List a bnef description of each program goal Number of Dublin residents served by this goal N/A N/A Use a separate sheet of paper If needed Amount of Dublin grant fundmg requested (match fIrst column budget form #2) $ 22,00000 Overall Total number of Dublm resIdents to be served by this program NI A Co m m unity Develop m ent Block G ra nt Ap pi I cation Certlfl catIOn To the best of my knowledge and beJlef, all information and data In this applicatIon and attachments are true and correct No matenal informatIon has been omitted, including financIal information If funded, J certIfy that the Agency IS Willing and able to adhere to polices and procedures specIfIed by the CIty of Dublin, and If applicable, the appropnate program regulatIons of the US Department of HOUSing and Urban DeveJopment Further, I understand thiS IS not an agreement for grant funding and cannot encumber funds untIl the City of Dublin and the indiVidual authonzed to execute contracts on behalf of the Applicant Agency, has Signed the contract, and If applicable, all federal reguJatlons and paperwork are completed '---"J f tt. Authon~ature (s;' IR blue IRk) lss''T'1 Title C,,\\.... ~'h.!lC", '" 12./1~ 10'1 Date 0e; ;f 13~ You are required to answer each ofthe questions followmg the format below, using 8 %ll by 11" white paper, 12 pomt type, with 1 inch margms Do not Include the question In your narrative, however answers should be m order and refer to the correspondmg number The Program and Budget Narratives are not to exceed four (4) total pages All pages must be consecutively numbered Please answer each question even If It appears repetitiouS If applicable, complete an additional page answermg questions regardmg Capital requests A Program Narrative - maximum three (3) pages 1 Describe the program for which you are requesting funding Provide a deSCription of the problem(sj, need(s), Issue(s), or other service gaps to support the need for the program/activity In Dublrn In addition, supply data such as demographics, reports and/or other Information supporting your information and proving the need eXists rn Dublin DO NOT solely cite statIstics from Your own oraj:!ram to prove need 2 Wlthm your Program, you may break out mdlvldual goals you Intend to achIeve These goals should be measurable goals such as Present 3 community education meetings on agency's services, aSSist 10 Dublin residents with specific services the agency offers, serve 1,000 meals to 50 Dublin residents on a regular baSIS. Install 5 Sidewalk ramps on Dublin street corners, etc 3 Describe the population you anticipate serving with these funds How many are Dublm residents? Include the type and frequency of outreach efforts to the target population and how these efforts are acceSSible to limited-English speakers Describe your agency's language access capabilities and how you provIde CUlturally appropriate services 4 How do you define sUccess In thiS program? Please list and briefly describe the goals/outcomes that are crucIal to the success of your program Describe how participation In thiS program Will change, enhance, or provide lasting Improvements In the lives of potential clients 5 Identify the organizations that your agency works or cooperates wIth and describe their relevant capabilitIes that result In greater servIce integration 6 Provide an explanation of how your programs are accesSible to IndivIduals wIth vanous types of disabIlitIes 7 Descnbe leveraging or sustalnabillty efforts your organization IS Implementing to maintain current service levels B Budget Narrative - maXimum one (1) page 1 Descnbe how thiS program IS cost effectIve and the budget IS reasonable for the anticipated result 2 If thiS application does not receive funding, what Will be the effect on the program? 3 Does the agency anticipate haVing any unspent grant funds at the end of the flsca~1r~ 1';'..5 If so, explain why 4 Complete Fmancla! InformatIOn and Budget Forms (Please specify the total program budget You must provide Information on the common outcome IndIcator which defines the amount of dollars leveraged by the grant request If you have any questions, please refer to the instructions for gUIdance or contact program staff ) C Capital Expenditure Narrative - maximum one (1) page, If applicable 1 Provide a detailed budget and scope of work for each capital expenditure or a constructlon/ rehabilitation budget and describe how you ascertained these costs 2 Will thiS project require Implementation of DaVis-Bacon/Fair Labor Sta ndards Act? jf req UJred, descn be how you r agency will com ply with thiS regu latlon (bid req u I rements, determine wage rates, monitor compliance, etc) Please contact Staff immediately If you have any questIOns regardmg DaVIS Bacon requirements' D Performance Measures - use attached form 1 Select all goals and priorities that apply (Refer to InstructJOns ) 2 Choose ONE ObJective, Outcome and Specific Indicator (1,2 and 3) 3 Complete all three sectIons for Common I ndlcator number 4 (Refer to Appendix A) f~lnlallnl(c~BJ~ ~ lnl~<<JlWlmlal~~lCllnl lF~wll1l'il Ad(jllftuma~ I?rogll'amlFllulIdmg SOlllll'ces & SftaUmg Cosfts Attach addItional sheets If necessary 3~1133 i ,I Additional program funding sources could Include but are not limited to foundations, corporations, individual contributions, events, reimbursements and In kind contributions Types offunds are loan, grants donations, In kind, etc Source Amount Use o~ Funds Commntted? Y/i\! N/A TOTAL $ If you are utilizing COBG funds to pay for staff costs, please list each employee/title and the percentage of their salary and benefits that will be paid with COBG Include the total monthly and yearly costs to the COSG program Note VacatIOn, sick leave and holidays for employees cannot be charged to COBG as program expenses New % salary & benefits Monthly salary & Yearly salary & benefit POSition Title (YjN) paid forwittD grant $ benefit cost to grant cost to grant NjA r?W(Q)gl1'BJ lJ1l1I ra lUldl ge ft IF ([J) WnmJ 2f1 ~ \33 Attach additIOnal sheets If necessary ClDlBG Grant "fotal Pmgram Budget Capital Expenses ConstructJOnjReha bllltatlon $ 22,000 00 $ 65,00000 Permits and Fees $ $ Design $ $ Engineering $ $ AcquIsitIon $ $ Other Soft Costs (define) $ $ Subtotal $ 22,00000 $ 65,00000 Personnel Expenses Salanes $ $16,41200 Benefits $ $ Subtotal $ $ Operatl ng Expenses Supplies $ $100 Pn ntl n g/ Co PYI n g $ $ Postage $ $ Telephone $ $ Rent and Utilities $ $ Accou ntlng/ Aud It $ $ Other (define) $ $200 00 (legal) Subtotal $ $300 00 TOTAL $ 22,00000 $ 81,712 00 Budget prepared by (Name, Title, Telephone Number, E-mail) Ananthan Kanagasundaram, ASSistant Engineer, (925) 833 6630 IPs wffo wmmullce M sa s 1UI wes (fill out a Performance Measure for EACH goal and/or obJective) Page lof2 l-fo 1/33 Agency City of Dublin Sidewalk Safety Repair Program and Curb Ramp Installation Program Activity Goal/Objective Improve pedestnan safety and accessibility Please Circle at least one of each of the following goals and priorities which are applicable to this actIVIty, goal & objective Refer to Instructions to complete RFP for a list of the goals and pnorltles HUD Strategic Goal HUD Policy PrIOrity 1 1 2 2 4 4 5 5 6 How will your agency benefit Dublin residents? Improve pedestrian safety and accesslbJllty Improve pedestnan safety and accesslbilltv -"to' i5'f n~l Please refer to Instructions to complete RFP for description of Pell'formalllce Measures 1 Objective (select one) 2 Outcome (select one) [.SJ Creating a Suitable LIving Environment I:sJ Avallabilltyj Accessibility D Providing Decent Affordable Housing o Affordabillty D Creating Economic Opportunities D Sustalnablllty 3 Specific Indicator (select one) D Public facility or Infrastructure [Z] PubliC service D Owner occupied units rehabilitated D D,rect finanCial assistance to homebuyers o Targeted revitalization D Tenant Based Rental Assistance (TBRA) D CommerCial fa(fade treatments or bUSiness bUilding rehabilitatIon D Homeless shelters o Brownflelds remedlated o Rental units constructed o Rental units rehabilitated D Homeownershlp units constructed or acqUIred With rehabilitation D Emergency housing D Homeless prevention D Jobs created o Jobs retained D Business assistance ifl D Businesses providing goods or services lPlenflOlWMalll1lCe MeaJs~ wes Both pages must be completed for each program Page 2 of 2 4 Common Indicator a Total number of clients you antIcipate seIVlng choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES b Breakout the number of clients you anticipate serving In the following categories Low Very Low Female Income Income Disabled Headed Senior Youth Homeless (>50%) (<50%) Households All All 2,938** All All All All **Income not available for verification City capital Improvement project Appendix A Income Limits by household SiZe, established February 2007 This table IS provided to assist with completing question #3 In the narrative and the tables In AppendIx B - ~-r--- Very Low I Low 50% of I I 80% of Median Medran i Median Income Moderate Income I ~! $58,000 $69,600 I $66,200 I $79,440 I $74,500 I $89,400 I $82,800 --, $99,360 -I I $89,400 $107,280 $96,000-1$115,200 I -$102,700 - $123,240 I $109,300 $131,1601 HUD updates this Income chart each year The City Will provide all FY 20082009 5ubreclplents with the most current data when It becomes available Source U 5 Department of Housing and Urban Development, (HUD) Data for Oakland 5MS lfcJ_ ~ }3 3 5 Environmental Review Requirements Source documentation requested below Includes, --r but is not limited to 1) personal expenence of the Indlvld ual completing the application [Include name, title and date] 2) another individual expenenced with the subject [Include name, title and date] 3) publIcation or other documentation [Include title and date], etc ) Category A Hlstonc Preservation Will the project affect any hlstonc properties or areas? If so, project may ta ke up to 90 days to clear with State Hlstonc Preservation Officer before contracts can be executed B Floodplain Management C Wetlands Protection Does the project Involve new construction within or adjacent to wetlands, marshes, wet meadows, mud flats or natural ponds per field observation? D Coastal Zone Does the project Involve the placement, erection or remova I of matena Is, or an Increase In the use In a Coastal Zone E Sole Source Aquifers F Endangered SpecIes Will the project have any effect on any federally protected (listed or proposed) threatened or endangered species? Use personal expenence or contact the National Wildlife ASSociation to determine If there are endangered species present In or around the project site If the area IS already urbanized, note thIs citing your personal expenence/observatlon Include the name and title of the individual making the determination and the date, or the name of the publication that supports the fmdlng G Wild and Scenic Rivers H Air Quality Will the project affect air quality dunng construction and/or operation? (If there IS potential IS the project located within an "attainment" area or If It IS within a "non- attainment" area, It conforms with the EPA approved State Implementation Plan) Use personal expenence or obtain Information from local Planning Department or EPA regarding the effect of air quality In the area of the proJect Include the name and title of the individual making the determination and the date, or the name of the publication that supports the finding Source and/or Documentation To be completed by County staff The project IS not located within a US EPA-deslgnated sole source aquifer watershed area per Apnl 1990 Memoranda of Understanding [HUD EPA MOU of 1990J N/A - Urbanized Area - Personal Expenence - Melissa Morton, Public Works Director None In Alameda County N/A - No significant Impact - Personal Expenence - Melissa Morton, Public Works Director Category I Farmland Protection Does the project site Include prime or unique farmland, or other farmland of statewIde or local Importance? Use personal experience or the local Planning Department to determine whether or not the site wlIl affect local farmlands If the Site IS already urbanized, note thiS citing your personal experience Include the name and title of the I nd IVldua I ma kl ng the determ In atlon and the date, or the name of the publicatIon that supports the finding J NOise Abatement and Control Does the project Involve development of nOise senSitive uses, or IS the project In the line-of sight of a major or arterial roadway or railroad? K Explosive and Flammable Operations Is the project located an "Acceptable Separation Distance" from any above-ground explosive or flammable fuels or chemicals? Use personal experience or obtain Information from the local fire chief or EPA to determine If the project IS located an acceptable separation distance from any above-ground explosive or flammable fuels or chemical containers Include the name and title of the indIVidual making the determlnatlOn and the date, or the name of the publication that supports the finding L ToxIc ChemIcals/Radioactive Materials Are the subject and adJacent properties free from hazardous materials, contaminatIon, tOXIC chemIcals, gasses and radioactive substances which could affect the health or safety of occupants or conflict with the Intended use of the property? Use personal experience or the local fire chief to determine that the project IS not located within 2000 feet of a tOXIC or radioactive site Include the name and title of the individual making the determination and the date, or the name of the publication that supports the fl ndlng M Airport Clear Zones and ACCident Potential Zones N EnVironmental Justice A) The proposed site IS sUItable for ItS proposed use and will not be adversely Impacted by adverse environmental conditions B) Site sUitability IS a concern, the project IS adversely affected by environmental conditions Impacting low Income or mlnonty populations Li- 3 ~ 1-33 Source and/or DocumentatlorY] N/A - No Significant Impact - Personal Experience - Melissa Morton, Public Works Director N/A - No SIgnificant Impact - Personal Expenence - Melissa Morton, Public Works Director N/A - No Significant Impact - Personal Experience - Melissa Morton, Public Works Director To be completed by County staff Ill.{ } 133 Program & Budget Narrative The City s Annual Sidewalk Safety Repair Program (Remove and Replace) repairs sidewalk offsets of 3/4 Inch or more that may pose a tnpplng hazard The Remove and Replace process IS used In locations where the offset IS more significant or where tree roots are causing the offset This procedure requires removal of the eXisting sidewalk, and In the case of root problems, removal of the tree roots and then replacement of the concrete sidewalk As part of the Annual Sidewalk Safety Repair Program, the City also Installs cu rb ramps In locations where high levels of pedestnan traffic occur, such as walkways to schools, churches, retail centers, community and public facilities and where high numbers of disabled people reSide The City has allocated $20,000 per fiscal year for the installation/upgrade of curb ramps Any funding that we receive from this program will allow the City to provide more accessible routes for the disabled communIty The following locations have been chosen based on the number of dIsabled individuals that WIll utilize the curb ramps, and also based on the close proximity to multiple schools I!'ocatlon 0i: w: l'1 VJ 1. ,4w~ Regia Dnve/Castillan Road Juarez Lane/ Castilian Road Aldea StreeV Bondale Court Aldea StreeV Knollwood Place Total Locations 450500 450500 450400 450400 Jr<lwmtJeTr~lsabled I ~~eMQ's ~elVe~ ~_ 4 ! 697 697 772 772 The construction of these curb ramps are Included as part of the Sidewalk Safety Repair Program to minimize the cost of installing Individual curb ramps separately The contractor who removes and replaces sIdewalks also Installs/upgrades curb ramps, which minimiZeS the labor matenals and mobiliZing costs This allows the City to Install additional curb ramps without Inhentmg additional cost for mob!llzatlon A curb ramp costs the City anywhere from $2,200 to $2,500 Since the City has 10 locations needing Immediate attention the total cost to fund this program will be $22,000 to $25,000 As part of the bid documents, the City requires each contractor to provide certified payroll to conform to the DavIs Bacon/Fair Labor Standards As part of the contraction inSpection, the City Interviews workers to ensure that workers are paid accordingly to the designated Job tItle found In the certified payroll docu ment Also the City works with Ala meda Co u nty Housl ng Authonty perso n nel th roughout the project for compliance tf~ j 133 FY 2008-2009 Community Development Block Grant Application Agency Name Address Community Resources for Independent LIving (CRIL) 439 A Street Hayward, CA 94541 Tn-Valley Branch Office 3311 Pacific Avenue, Livermore, CA 94550 Execuuve Director Shen Burns Contact name and title John QUinn, Program Director Contact phone and fax (510) 881 5743 Contact e-mail address John qumn@crll online erg Organrzatlonal Background Private Non-Profit ~ D Public Agency D Other (Describe) Tax 10 Number 94-2598873 List years previously receIVed City funding 2006 (CDBG), 2007 (City Commumty Fund) ~StAFreJSEJ\v'l1 r... !J~ ~ ~ ~"r-'"\ r;~l'~"'I 3"..,,;;:.1' (0'"1,1 ~ ;iJiJ',:;~F~",;J,<,(\i: %';~ i<" t.. ~ 30;." \ ro- ~A. {'lo't JI itf1 \t, \ 0&.., "{ ~ l.. ~ :- f -J \""'~ 1" lI\ $- ?-~~ il~.!/ !0N&W\r"'":rr2;'h'i":,'tvDate1RecelVedJ.",,,>lf (l f1~.~~ ~l';J\?,\'i. \App#,,,~jjp';'/'~1/'~:A~ ~r;"\~'" Community Development Block Grant Application Cover Sheet Page 2 ;:( '7' <" ?l*,1' lie ;"",1 1 ,I{.~~ -ht \.. i ';'\. ~'T.J:. 'r. .d <t.... I.., ~h.ft ~~.....ij t.rt~ i',..,.-t'i RECEIVED DEe 1 5 2007 !DUBLIN PLANNING 1 ' I 0 PtA--\ ATTACHMENT 11) 1 Proposal Summary - ( A program may contam several goals) 4'r/33 Capital Request Program name Bnef Program summary o OR Public Service Request IZJ (check one) Housing Services for Persons with Disabilities & Semors with Functional Limitations Affordable, accessIble Housing Search and AcqUisItion Assistance for underserved, low~lncome resIdents of Dublin who have dIsabilities and seniors with functional lImitations and disabling conditions With the largest Increase In population within Alameda County from 2005 to 2006 occurring In the City of Dublin, more seniors and other persons with dlsabllltJes are living In thiS community (an estimated more than 3,100 Dublin residents over the age of five living with a disability) Forty~elght percent (48%) of all Dublin consumers served last fiscal year requested and received Housing Services CRIL IS the only non-profit agency In the Tn- Valley area provIding Housing and other SOCIal servIces to low-Income Dublin semors and residents with all types of disabilities CRIL Housing Services meet all HUD Goals and most HUD pnontles Goals ~ Number of Program goals to be achieved In fiscal year 20082009 LIst a brief description of each program goal 1) Provide Housing Information & Referral to 50 low-Income Dublin semors and other reSidents with disabilities and their families through outreach actiVities, presentatJons, workshops, mailings, and collaborative partnerships 2) ProVide direct affordable accessible Housing Assistance, including support servIces to maintain long term housing, to 15 Dubhn reSidents and seniors with disabilities or tuncllonalllmltatlons 3) 70% of Dublin reSidents with dlsabllllles and/or seniors or tunctlona/limltatlons who create an 'ndependent IIvmg plan (lLP) that addresses Housmg, will meet one or more selt-ldenllfled goals Use a separate sheet of paper If needed Number of Dublin reSidents served by thIS goal 50 15 70% self-Identified hOUSIng goals met Amount of Dublin grant funding requested (match first column budget form #2) Overall Total number of Dublin reSidents to be served by thiS program $ 6 000 65 Commumty Development Block Grant Application CertIfIcatIon To the best of my knowledge and belief, all information and data In thiS application and attachments are true and correct No matenallnformatlon has been omitted, including financlallnformallon If funded I certify that the Agency IS willing and able to adhere to polices and procedures speCified by the City of Dublin, and If applicable the appropnate program regulations of the US Department of HOUSing and Urban Development Further, I understand thiS IS not an agreement for grant funding and cannot encumber funds until the City of Dublin and the IndiVidual authorized to execute contracts on behalf of the Applicant Agency, has Signed the contract and if applicable, all federal regulations and paperwork are completed n ~~~'f Autnonzed Signature (sign In blue mk) 2 ~ ~",,-e...-c....._~~~ ~-,r~'--\-c--r- 1:tlr--i(07 TItle Date I 41 ~ 1.3.3 PROGRAM NARRATIVE DESCRIPTION 1 Proqram Description and Community Need Last fiscal year, Community Resources for Independent LIving (CRIL) assisted 23 very tow Income Dublin residents with disabilities In meeting their personal Independent hvrng goals, In addition to provIding another 84 low Income Dubhn residents with disability resource information and advocacYt totaling 107 Dublin reSidents with disabilities served by CRIL This was a 12% to 15% Increase over our proposed benchmarks for CRIL's Independent LIVing Services Program for Persons with DlSabllJtles and Seniors with Functional Limitations, funded by the Dublin City Community Organization Fund (In 2005-06, CRIL received Dublin COBG funds to support a portion of all serVices to the Dublin communrty) Nearly half (48%) of the 23 consumers served rn 2006 07, requested and received HOUSing ASSistance, makmg It the most requested service of the more than one dozen services CRIL provides One of those Dublm reSidents CRIL assisted last year was Juanita With the assistance of CRIL's staff and services, Juanita was able to move Into a safer, more affordable apartment Like all CRIL consumers Juanrta set her own goals, which were to (1) find another apartment, (2) get help managing her money, and (3) Improve her computer skills CRIL's Tn-Valley Coordinator was able to proVIde some peer counseling and hOUSing advocacy for thiS consumer and assist her with setting up an Independent LIVing Plan (ILP) that Included steps toward achieving her goals stated above As of August 2007, Juanita had 1) a September 1 st appointment to move Into a different apartment complex away from the mold that she felt was the cause of her seizures, (2) successfully went through a Section 8 annual reView, (3) completed her 7 ~week money man agemen t cou rse at HOUSing Opportu nltles, and (4) IS schedu led to receive needed depOSit assistance There are many more Dublin reSidents like Juanita who need and rely on CRIL services CRIL IS the only non-profitt social service agency In the Tn Valley area that provides comprehensive support services to people with all types of disabilities These services Include peer counseling, hOUSing assistance, personal assistance matching services, disability support groups, life skills classes, disability resource Information & referral, aSSI stlve technology assistance and advocacy skills tral n I ng CR I L also faCIlitates two support networks of community advocates, the Disability Action Network and Red de Acclon, a Latmo disability advocacy group One of CRIL's most utilized services throughout our service area IS HOUSing ASSistance We have developed a curnculum for our HOUSing Readiness Workshop that assists partIcIpants With learning and understanding the steps to achieVing the goal of renting or owning one's own home, which often can be a lengthy and difficult process ThiS workshop IS offered weekly at CRIL CRIL has also created two hOUSing gUides "Finding a New Apartment A Pocket GUIde" and "When It's Time to Go Home From a NurSing Home" Last year, 34% of CRIL consumers utilized our HOUSing ASSistance Services, With over 95% Indicating they had met one or more HOUSing Goals toward Independence The need for CR1L servlcesl espeCially HOUSing Asslstancet IS well supported statistically and demographically Census 2000 data shows that there are nearly 3,000 persons age five and older liVing In Dublin With a disability 34 Since 2000, there has been a population Increase In Dublin of significant proporllons In 2006, Dublin had the most significant Increase of all fourteen Alameda County Cities, an Increase of 54%, brrnglng the total population to nearly 42000, while Simultaneously haVing the lowest h OUSI ng vacancy rate 1,4 Most other AI ameda Cou n ty cIties saw a n egll g I b Ie ch an ge of less th an 1 % In their population growth dunng that same year 1 Moreover, Alameda County has one of the highest rates of poverty among adults WIth dlsablhtles age18 to 64 years than most Bay Area Counties Although mas! of Dublin reSidents are more affluent than other County reSidents, Census 2000 data showed that nearly 200 3 tFg ~ I 33 Dublin households are on supplemental security Income (SSI)1,4 which make them among the poorest Amencans by H U 0 Income G uldell n es 18% of th e med Ian I ncom e or 12% below stand ard s for very low Income 2 Goals/Outcomes The $6,000 allocation from Dublm CDBG funds would allow CRIL's Tn Valley Coordinator and part.tlme Services Assistant to provide Housmg Assistance Services to low Income Dublin City resIdents with disabilities and seniors with functional limitations CRIL's Coordinator Will 1) Provide Housing Assistance information and referral and resources to a minimum of 50 individuals through local outreach presentatJons, participation In Tn Valley fairs and festivals, workshops, direct mailings and collaboration with other Tn-Valley service agencies 2) Provide direct Housing Assistance and Housing Plan development to a minimum of 15 Dublin residents with disabIlities and seniors with functronallimltallons to Increase their ability to obtain affordable, acceSSible housing 3) Assist 70% of Dubhn consumers who create a Housing IL Plan with meellng one or more goals toward achieVing their desired Housing outcome 3 Population Served and LEP/LAP CRIL IS the only social service agency providing comprehensive services to people with all types of disabilities, of all ages In the southern and eastern CitIes of Alameda County We are a one-stop service agency and are acceSSible to all residents living throughout the county Unfortunately, people with disabilities are often segregated and Isolated In their homes They frequently are unable to access basIc social services and support In their commUnities due to lack of affordable, acceSSible transportation, architectural and athtudlnal barners, communlcalJon difficulties, lack of support systems and advocacy assistance, and legal and educational barners 2,6 CRIL's services directly address these barners through peer faCIlitated service dehvery that IS free and acceSSible Our regular and consistent presence In the Livermore Multi-Resource Center proVides an easy to reach and acceSSible opportunity for Dublin reSidents with disabilities to work one-on-one with CRIL serVice proVIders, as well as meet with other reSidents who have disabilities for support and camaradene In our bl-weekly disability support groups CRIL Staff and Volunteers (most of whom are students and/or prevIous or current consumers with disabilities) personally understand the barners to full and equal access to public facllttles affordable and acceSSible housing, education, employment and recrealJonal opportunities within their commUnities Conversely, they also have personal expenence In navigating through, over and around such barners, and are knowledgeable In disability nghts laws disability access laws, housing laws and subSidized housing search processes, disability benefits programs, asslslive technology and accommodations for work and personal life, and transportalton options Peer faCIlitated support IS what makes CRIL umquely qualified to assist persons with disabilities In planning and meeting their personal, professional and community Independent living goals CRIL's staff IS comprised of people who represent our county's commumty people wIth all types of disabilities of diverse ages and from all types of backgrounds and cultures Fourteen (14%) of Dublin reSidents Identify as Latino, the hIghest ethniC mlnonty In the City 1 Nearly one half of CRIL's service providers speak a language other than English, one-third speak Spamsh, including the Tn Valley Coordmator Additionally, our JL Generalist speaks Chinese Consumers who speak other languages are served via contracted translators through the Language Lme CRIL mformatlonal matenals are wntten In easy to understand English, Spamsh, large pnnt, Braille and CD and Include pictures to describe services ServIce ProViders also offer to complete forms and read mformatlon to consumers as requested or needed, and addllional pictures/graphics are available for some matenals for non-readers and those With cognrtlve and developmental disabilities 4 ~q ~ 163 4 Define Success In keepmg with CRIL's mdependent living philosophy, outcomes are mamly measured by the Individual Consu mer Th rou g h support, train lng, ed ucatlon and advocacy) C RI L staff work with each Consu mer m creating their own Independent Llvmg Plan (ILP) with measurable goals These goals are reviewed with the consumer as necessary, usually monthly, to track progress and assess the need for modifications The Consumers are ones to define success for their own goal(s) There are two mam methods for trackmg and reporting this Informabon 1) The ILP and Goals Chart The Consumer self-reports to the service provider re status with achieVing each step and goal on his or her Independent LIving Plan (ILP) and also mdlcates whether or not s/he has gamed some mcrease In personal Independence, 2) Independence and Satlsfacbon Surveys CRIL's survey IS given to each consumer to provide feedback to CRIL re service and provider quality While not a requirement In order to obtai n serVices, the Con su mers are asked to take 10 or 15 mm utes to com plete the Su rvey 81ther dunng or after completion of their Plan Surveys can be completed and returned anonymously to the office CRIL's Program Director semi annually complies the results of all Surveys completed and presents the Information to the Executive Director and Board Historically, 90% ~ 95% of all Consumers have rated CRIL Services and Providers at the Very Satisfied Level of Satisfaction and self reported that they have achieved a greater sense of Independence 5 & 6 Access and Collaborations CRIL has offices located strategically throughout southern and eastern Alameda County to accommodate everyone who can benefit from CRIL serVices Our main office IS In Hayward and our branch offices are m Livermore and Fremont All three offices are completely acceSSible to people with mobility and sensory disabIlities and Include automatic doors, Wide aisles, acceSSIble parkmg and restrooms, TDDITTY phones, and matenals In English, Spanish, Braille, text only and large prmt Thanks to a small, but significant, grant from the City of Dublin Community Fund last fiscal year, CRIL was able to Increase the staffing at the Tn Valley Office from 85% to 100% All three offices are open Monday through Fnday, 9 AM to 5 PM , accommodating both walk-ms and indiViduals With scheduled appomtments The Tn-Valley branch IS located In the Livermore Multi-Resource Center, allOWing CRIL to work closely With other service agenCies co located at the Center Often times, CRIL staff Will bnng a Consumer over to work With a colleague at Department of SOCial ServIces, Department of Rehabilitation, or ECHO HOUSing Other SOCial service agenCies With which CRIL staff routinely collaborate and refer Consumers Include Eden HOUSing, BACS, HOUSing Authonty, Senior Support Program and Spectrum, Tn Valley Haven the TrJ~ Valley Housmg and Opportunity Center and the One-Stop Career Center 7 Leveraqmq and Sustalnabllitv Funds contnbuted by the City of Dublin CDBG Public Services Program for CRIL s HOUSing ASSistance Program help leverage other CDBG and SOCial Services funds from other cllles In the Tn-Valley area The diverSIty of Trl-Valley funding speCifically allows CRIL to malntam a local presence m the Tn Valley area with a full time, full service capacity branch office Other fundmg that prOVides supportive operational and administrative services mclude CA State Department of Rehabilitation, US Department of Education (Rehabilitation Services Administration), Alameda County Public Authonty for IHSS, Kaiser Dl8blo Valley Fund, PaCific Disability BUSiness & Technical ASSistance Center and other fee for service contracts, pnvate donations and annual fundralsmg actiVIties The Dublin COBG funds are crucial to maintaining CRIL's presence In the Tn Valley area and the scope of comprehensive servIces prOVided to the reSidents of thiS commumty 5 50~133 Sources Cited 1 A!amed a County Commun Ity Oevelopmen I Agency DA T A 2006 Population and Housmg Estimates for Alameda County and Its Cities, Pu b N 06~0 1, May 2006 2 CalJfornla Behavioral Risk Factor Surveillance System (BRFSS), 2003 3 Hanson, S let al "Community Needs Assessment," Center for Applied Local Research, 2004 41CF Publlshmg Human Services Needs Assessment for the Tn Valle --Incorporatmg the Cities of Dublin, Livermore, and Pleasanton, Center for Applied Local Research, 2003 5 Kaye, PhO, Stephen IJ Disability, Health & Employment m Callforma", Disability Statistics Center, University of California, San FrancIsco, CA 6 Resnlsk, B "The Impact of self efficacy and outcome expectations on funclional status In older adults", Topics m Geriatric Rehabilitation, 14(4), 1 10,2002 6 ?J~ }33 BUDGET NARRATIVE DESCRIPTION Last fiscal year, Dublin Community Organlzabonal funds covered one third of the branch office operations, with 107 Dublin residents with disabilities served lhrough one or more CRIL services The average cost for CRIL to serve each person with Dublin funds was $141 52 Twenty~three (23) of those Individuals created personalized Independent Llvmg Plans and worked extensively with the Tn-Valley Coordinator In attaining their goals CRIL's 2008-09 Proposal for Dublin CDBG public service funds to proVide targeted Housmg Services for Persons with Disabilities and Semors with Functional Limitations will cost only $9230 per person and 9% of our overall operational costs for the Tn Valley branch ThiS per person cost IS extremely cost-effective, especially given lhe fact that the majority of consumers reqUire substantial hours of trammg and assistance in order to meet each goal and achieve their long range self sufficiency outcomes Smce the m8Jonty of consumers are extremely low Income, CRIL does not charge consumers for any program costs and does not limit the amount of services they can receive Dublin Community Organizational Funds and the clbes of Livermore and Pleasanton also contribute to the overall costs of operatmg CRIL's full-service branch office m Livermore CRIL prOVides more than one dozen programs and services to reSidents in the Dublm community, Including education, tramlng, and malenals to businesses and non~dlsabled Livermore reSidents, which Improve the acceSSibility and inclUSIVeness of the Livermore community Additionally, Kaiser Foundation's Diablo Valley Fund supports our efforts to proVide Healthy LIving Workshops and medical/dental office ADA advocacy CA State Department of Rehabilitation 204 funds cover much of the admlnlstrahve costs associated With supportmg the Tn-Valley program from our main office In Hayward We would not be able to operate a branch office m the Trl Valley Commumty Without the fundmg assistance we receive from Dublin The City of Dublin CDBG fundmg would support a portion of CRIL's Tn Valley staff -the backbone of the success of our services The Tn Valley Coordinator IS a profeSSional, highly skIlled woman With extensive expenence In Housing Services (HOUSing Authonty In Santa Clara County, IHSS In San FrancIsco County) and Advocacy (Family Support Services of the Bay Area) and a Tn-Valley reSident The Services AssIStant Will work With the Coordinator assisting With Implementation of vanous programs, Includmg faCilitating the bl weekly Tn-Valley Support Group Fifteen percent (15%) of CDBG funds Will support thiS part-time position Two percent (2%) of CDBG funds would cover a small percentage of administrative and supervisory time In fiscal year 2005-06, CRIL received $10,000 In Dublin CDBG funding to proVide Housing and other IL Services to Dublin reSidents With Disabilities ThiS funding, coupled With limited funding from the other Tn- Valley cllles, proVided only enough operational support to maintain a part-time (85%) presence In CRIL's Livermore branch office and fewer people served In 2006 07 due In large part to new funds from Dublin's Community Organizational Fund CRIL was able to Increase the Tn~Valley Branch Office staffmg back to 100% FTE, proVide a long overdue 3% COLA to staff, and proVide Disaster Preparedness Tralnmg and free Emergency Supply Kits to 100 low-income Dublin and Tn-Valley reSidents Without thiS valuable support from Dublm, CRIL Will not be able to maintain or Increase the higher level of services and pOSitive outcomes to low.mcome Dublin reSIdents With disabilIties or contmue to Implement the Disaster Preparedness and Planmng Program for the City's most vulnerable reSidents CRIL does not antiCipate having any unspent funds at the end of the current fiscal year 7 ~ d /2,3 Financial Information Form AddItional Program FundIng Sources & Staffing Costs Attach additional sheets If necessary Additional program funding sources could Include, but are not limited to foundations, corporations, individual contributions, events, reimbursements and In-kind contnbutlons Types of funds are loan, grants, donations, in-kind, etc t", ~r J. 1" }~j~ -.r l i ~,F; c'.... t '<'i ~ J~.., f,1t'tlft ~4 \>t< /:"'f ~1:;:tI'~ .r;-., J.\~"'.( ~ J"'" "{",, 1 . ~ " \ I" l' '" I' , ~ -ci1 ," AI>.l 1J '" .,' \;'t ", l!' ' III j f 1::' d "" It ',' <'"?,, Source~ '" >'-",f{'Z,.f" ," I" I- mour.1f.,,,, ~j,', ,I 'Cl5e'rO"'rlun 5' , I '" ~:k, .' f "ICe 1;\ \~ )), \- " I <1 -< \ ,,. ~j>lf ~~ ~,J1"~If'{'.'l.1l1~Nfr'~i ft~;~..,lll.,), \ tj \~t1.!'pa. "'1 1~ df-r1t</ Jl / ~ <f\1."':: "?'f,..r(Pt ~\.~ 1l\..~ Support programl admm salanes City of Livermore CDBG $11 630 00 Supports program/admln expenses Support programl admm salaries Clt of Pleasanton CDBG $14,50500 Su arts ro ram/admln expenses Support program salanes Clt $6,00000 Su orts ro ram ex enses Support programl admm salanes Clt of Dublm Communi Funds $1921400 Su orts ro ram/admm ex enses Support programl admm salanes Kaiser Foundation $8,64900 Su arts rogram/admln ex enses " ; I +' ~: Committed? It f" Y/N ,,\ ~ I '4. }.-- Ji .... ApphcatJon Due 01/25/08 Application Due 02/04/08 Application Due 03/05/08 Application Due 01/25/08 Application Due S fin 2008 Note AntiCipate notice of committed funds b June 2008 TOTAL $59,99800 If you are utlllzmg CDBG funds to pay for staff costs, please lIst each employee/title and the percentage of their salary and benefits that will be paid With CDBG Include the total monthly and yearly costs to the CDBG program Note Vacation, Sick leave and holidays for employees cannot be charged to COBG as program expenses ......;r }~ ...... ""1.l., l~ J ? '\/ .-J l'"-1 I~ -.J' ':1 ... Vi.I..q. -r <6.b.... .... -- ~"[f'd" VI. ~6nthly'salarY_& Benefit I - , _.' ~ ,,- ...... \} -'f '; y ~l ~ ( ~.fi ~:r I' ~ $J I' INeW \' "% salalY\& Iben ems 'paid' I "early sal aty'&;benefit \ I ~~ 1'..,) ..,.. F'(V ~r41 '",(y IN) ~ '" . ~" ~ "'~ "h -< ~ ... 'iF. J \, ~ \~ ~ 1'1' 8osltlon Tltle~" , IT, ' l ~, fon~wlth''6rant,$ 'i"';,. ", f '," ,,-cost tci/qrant''!.-.'' I : "cost to Qrant I Executive Director (Admin) N 2% $767 Averaqe $92 00 Finance Director (Admm) N 2% $1117 Average $134 00 Tn Valley Coordinator N 85% $29667 Average $3 560 00 Services ASSIstant Y 15% $11917 Average $1,43000 8 STAFFING PROFILE of those funded wIth Dublm CDBG Funds 55 ~ /3..3 Tn-Vallev IL Coordinator DemCla C Gressel Ms Gressel began this fall, 2007 with CRIL as the Tn-Valley Coordinator She IS a resident of the Diablo Valley area and is extremely familiar wIth the commumty and culture Ms Gressells bilingual In Spamsh and English, With Spanish being her pnmary language She has numerous years of work experience providing low-Income housing aSSistance, social serVices counseling, family support serVices, In Home Supportive Services screening and case management and social and cIvil rights work She has nearly completed her undergraduate degree In Social Work at San FrancIsco State Umverslty She has completed course work and training In interviewing skllls, stress management, cultural diversity and communication skills Tn Valley Services Assistant Jess Melton Jess Melton began working With CRIL last year as a college Intern I volunteer In our Commumty Advocacy programs and facIlitating one of CRIL's two biweekly support groups She IS a student at Chabot College, maJonng In social work and has extensive volunteer and paid work expenence In both individual and community advocacy Jess utilizes her own disability expenences, education and Interest In socia! work to assist others With learnmg the tools to effect positive changes In their own lives and In their community Fmance Director Apnl Monroe Ms Monroe has been the Finance Director for CRIL since 2002 She also superVIses the administrative/support service programs and manages the busmess and personnel operations of the center Ms Monroe has a Bachelor of Fine Arts degree In American Studies and a certificate of proficiency In accountmg She has experience With several accQunbng systems and computer software applications Pnor to her work With CRIL, she coordinated the Upward Bound tutonng program at University of Callforma at Berkeley, and was responsible for all accounting funcbons and payroll for 30 employees Executrve DIrector Shen Burns Ms Burns has been With CRIL since 2006 and has over twenty-three years of expenence In non-proflt business and Independent hVlng programs Prior to arnvmg at CRIL she was the Deputy Executive Director for seven years at SIlicon Valley Independent LIving Center In San Jose, CA Ms Burns has a Bachelor of SCience degree In Occupational Therapy and a certificate In non~profit management from the United Way, SIlicon Valley She has fifteen years of experience In disaster plannmg serVices, IS tramed In community disaster programs, IS a member of Alameda County s Collaborating Agencies Responding In Disasters (CARD), and currently serves on the Statewide Access to Readiness Coalition Ms Burns has effectively recrUited new Staff and Board members to CRIL that bnng cultural representallon for the Latino community and for people With disabilities who are tYPically underserved 9 Program Budget Form ~1f i I ~3 Attach additIOnal sheets If necessary CDBG Grant Total Program Budget Capital Expenses Con structlon/Reh abllltabon $ $ Permits and Fees $ $ Design $ $ Englneenng $ $ AcquIsition $ $ Other Soft Costs (define) $ $ Subtotal $ $ Personnel Expenses Salarres $4,26300 $44,80600 Benefits $953 00 $10,32200 Subtotal $5,21600 $55,12800 Operating Expenses Supplies $14400 $4,67900 Prrntlng/Copymg $12000 $669 00 Postage $165 00 $1,65500 Telephone $122 00 $1,38700 Rent and Utilities $800 $100 00 Accounbng/Audlt $39 00 $406 00 Outside Services $74 00 $780 00 Books, Dues and Publications $22 00 $226 00 Insurance $73 00 $768 00 Staff T rammg $17 00 $200 00 Subtotal $78400 $10,87000 TOTAL $6,00000 $65,99800 Budget prepared by (Name, Title, Telephone Number, E mall) April Monroe Fm an ce Director, 51 0-881 ~57 43 ext, 5932 aprl I man roe@crll-onllne org 10 Periormance Measures (fill out a Performance Measure for EACH goal and/or obJective) Page 1 of 2 ~5:} 133 Agency Community Resources for Independent living (CRIL) Program Housing Services for Persons with Dlsablhtles & Seniors with Funcllonal Llmltallons Housing Information and Referral for Low-Income People wIth Dlsablillles and Seniors with Functional Activity Limitations ProVide Housing Information & Referral to 50 low mcome Dublin seniors and other reSidents with disabilities and their families through outreach actiVities, presentations, workshops mailings, and collaborative partnerships ProVide direct Housing AsslStancefPlans to 15/ow-lncome Dublin reSidents with dlsabllllles Total Goal/ObJechve Served 65 Persons with Disabilities Please CIrcle at least one of each of the following goals and pnonbes which are applicable to thiS activity, goal & objective Refer to Instructions to complete RFP for a list of the goals and priorities How Will your agency benefit Dublin reSidents? CRIL's HOUSlnQ ASSistance ProQram meets all HUD Goals and all but one HUD Pohcv Pnontes Securing affordable housmq In the bay area IS extremelv difficult, mllJqatmq further barriers, such as lack of accessibility. and costs that are not affordable for reSidents whose Income IS 18% of the medIan Income IS nearly Impossible Nevertheless, CRIL's Houslnq Services speCifically tarqets the needs of thiS vulnerable qroup of reSidents WIth our QUldance, support, and resource expertise we Will assist the City of Dublin In securlnq houslnq for these members of their commumty Please refer to Instrucllons to complete RFP for descnpbon of Performance Measures ~11 ",'0blecbve;(select aite)}, -r ~ ~:d{f~i', -j J' " ';2()'10utcome1(sel'ecNine):r 'I f' / ~> I \t f , \" ( :.,. -,g' 1'; "" .... ....." (> t,,; I r t*" o Creating a SUitable LIVing EnVironment [gj A vallabl IIty f Accessl blllty C8J Provldmg Decent Affordable Housmg D Affordablllly D Creating Economic Opportunities D Sustain ability [2J PubliC service t ~" -\ ..W"' ,"it'f ) ~ \"@. rt"~ '"' ,;,.p!L,'f ~I l \ -IT" ;t'. ..... \;'#~--- .....~~ \ "';1l"" r"'6~o-l \$/>)-\ '!! \t 1(1'..... l.~ ~ o Owner occupied Units rehabilitated o Direct financial assistance to homebuyers o Targeted reVitalization o Tenant Based Rental ASSistance (TBRA) o Homeless shelters D Commercial fa<;:ade treatments or bUSiness bUilding rehablllta~on D Brownfields remedlated 11 :5fo 6J1 133 / D Rental units constructed D Homeless prevention D Rental units rehabilitated D Jobs created D Jobs retained D Homeownershlp Units constructed or acquired with rehabilitation D Business assistance D Businesses providing goods or services Performance Measures Both pages must be completed for each program Page 2 of 2 f ..... ~ X .... l;: t., 11-"'"' 'i;,. 1 ~ 1 f"" Jt'i'"" fl~ n. 'J: I 4!t CommonrlndJcator' > 1".', r < \~:. II t\, r ~I' At~'" ""I ~> b l,,,. ... J J .. a Total number of chents you anticipate servmg - choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES 11\'~ '"' ~ ~ " Households Persons 65 * Duplicated numbers of the 65 total unduplicated consumers served All, regardless of age, household status, and Income level will qualify as a lOW-Income person with a disability b Breakout the number of chents you anticipate serving In the following categones ) ~'\'(J/:J [\ ~ l .;r<fl (1.jj r ltjC l.\"I,~ r ~ j'~!4" >"~ !lt~.f~[J "~1"'~f'~~r >l.~" 1 rr ....../ ~ \ < ) t ~'J' -l:~~' /'c ,''''^ P I I ~ 'bow Income " f;er~ L:OWl In'come ~ " ~'~.. 31 i, . ~JFem ale~l1eaded~ f ~~i)."~" ~ \ ~"" .r I \ ~ l ft~t t ~b. 'y '''til I 1 I' Ie)'" or., ~ -1-" ~ '\ ,Disabled 1 ~- ;.,;:~...... ( :'ItoJ' .< ,'~Senlorv...l, ,Q" ou ~ j ,~ IHQmelesst \ ~ J?{:>50% ).'''tJ, ~.i\""(<50%r"rl\( ;. 1 I 'if-:"'-: "r}blouseQolds~' ;" r j iI>. ' \ h j 1 ll.~~ ~ j '1 t' ~~ 1;. . 'r{ r<l 't.t~ '" ~ ~ I if'1 l; , Ji"" I \'JI. ,r Iii , "" ,"1t ~ .z;1C~ D"tt", 0; ~ ~ "'l~ ..r""f""'f\~ ....,o~ 1)< ......, 't, t. ')'./1 Iov J /1" , v,l; "11 \ v: f r .~"\" F ~ {. 1..~,'r orb..........;. ~'11 ;,..{ ~ 1't~il","-'>. P;if' 1:1 \l 65 (60)* 65 (5)* (25)* (5)* Appendix A Income Limits by household Size, established February 2007 ThIS table IS provided to assist with completmg question #3 In the narrative and the tables m AppendiX B i I I I I f I , I I I I Extremely Low Very Low I Low i Median I , Moderate Family Size I I I I 30% of Median ; 50% of Median I 80% of Median I Income Income I I I I I I I I I I I f I 1 Person :1 $17,600 II $29,350 II $46,350 :1 $58,000 II $69,600 J I 2 Persons I $20,100 II $33,5000 ;1 $53,000 il $66,200 II $79,440 I I 3 Persons II $22,650 II $37,700 II $59,600 II $74,500 II $89,400 I I - I 4 Persons II $25,150 II $41,900 /i $66,250 JI $82,800 :1 $99,360 I I 5 Persons II $27,150 ~ I $45,250 i! $71 ,550 il $89,400 II $107,280 I I 6 Persons I[ $29 100 II $48,600 :1 $76,850 11 $96,000 II $115,200 I I 7 Persons II $31 ,200 :1 $51 ,950 II $82,150 II $102,700 II $123,240 I I :1 8 Persons ~ I $33,200 II $55,300 il $87,450 ~ I $109,300 II $131 ,160 I 12 ~1l" 133 Performance Measures (fill out a Performance Measure for EACH goal and/or obJective) Page 1 of 2 Agency Program Community Resources for Independent LIving (CRIL) Housing SerVices for Persons with Disabilities & Seniors with FunctIOnal Limitations Activity Housing Independent LIving Plan development Meeting Housing 90al(S) 70% of Dublin reSidents with dlsablhtles and/or seniors or funcbonallimltatlons who create an Goal/Objective Independent living plan (ILP) that addresses Housing, will meet one or more self-Identified goals Please circle at least one of each of the following goals and pnorltles which are applicable to thiS actiVity, goal & objective Refer to Instructions to complete RFP for a list of the goals and prlontles How will your agency benefit Dublin reSidents? CRIL's HouslnQ ProQram systematically QUldes Dublin reSidents with disabilities throuQh the Incremental steps toward achlevlnq their dream offindlnQ and securlnQ affordable, accessible, safe, 10nQ-term houslnq Consumers develop an Independent LIVlnQ Plan focusinG on their HouslnQ Goals With our support and expertise In Houslnq Search Skills, 70% of these Consumers will work toward meetlnQ one or more Goals In their HouslnQ IL Plan, more low-Income Dublin reSidents with disabilities will secure approPriate, lonQ-term houslnQ .-.:-~ .... ... '\ l' .~.~~ 1",~ ~.... ",11 ~ r ~~A n~ ~ C8l Provldmg Decent Affordable Housing o Creating Economic Opportunities o Affordablllty D Sustamablllty F3~<I\SpeClfic~lndlcatm (Selecf'one)\ ,,1 ~ Jf>, f~ 1,,1 o Public faCility or Infrastructure C8l Public service " ~ f,l)J, \! 'p ~~ ~ ~ ~ "k " ).t~ I f 1 \ ~ t.. ~~,..J I- 'l!- l "t ~ <:J -I !~t j..... .0 ':'l l; J.-- "f'" '/." of, 1-~ ~~ '\. !.,.'.,I o Owner occupied Units rehabilitated 1r\-t~\ /...'"1 3\~1 o Direct financial assistance to homebuyers o Targeted reVitalization o Tenant Based Rental ASSistance (TBRA) o Homeless shelters o CommercIal fat;:ade treatments or bUSiness bUilding rehabll1tatlon o Brownfields remedlated o Emergency hOUSing o Rental Units constructed o Rental units rehabilitated o Homeless prevention o Jobs created 13 o Homeownershlp Units constructed or acquired with rehabllltahon o Business assistance o Jobs retamed oods or services Performance Measures Both pages must be completed for each program Page 2 of 2 ~; C~r ~..,. I d '-t'Q 1,.---">rt" ...J :iJ.I "''I'' 1:11' 'ti:'v. -r.''l,. ......., I., \ .;r-'Iry'I-" '"r' rr ";i '>r' r- 1-.,; i; 1?"" ~'tI '" .,{ "f ~ "t I~'~ ommon n Icatorl,'/,t,"',,,,t ,v '''',~~\J , ~,\. ,,'- '\ ; ,,,,,, "\: "\JI>1fAl~ "'\l:c-.;il;~.,,- ~ a Total number of clients you anticipate serving - choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES Households 15 * Du pllcated n umbers of the 15 total u nd upll cated consu mers directly served All, reg ard less of age, household status, and Income level WIll qualify as a low Income person With a disability b Breakout the number of clients you anticipate serVing m the follOWing categones ~ i~, (, \ J ~ ~ \' I" 1'~1V'1;' ; ,; ),<> f) . -" }.t,~.~ "i;..1- i ;,'f~' '1' I ,'" ~ .,,- "1- < " 1 ~ J~9wt.lncorT!e;.1 "l ,-fJ)" 'J ~\ 11~ '" 'IF "0/ I tli d "(1\ \ !.. ~~1 >b4~:tl't.t!lb; J, p~ v 1- \\ "~o,iJ "'iVerYf;Low Income f '0 bn!r '. 1 ema e, l ea e r }..~:.<'i jt, fi.... .. I _, ,,.,:' ~ ) '1'., ~ \} ,:' ," '{ ~50~o/q ;''''' t t ~t Isa r e ~ I ~ h 't.."....l............ ,. ~, ,,,l";Senlor t ~$ ~'.fYouth' '\, ,,\ 'Homeless! ~ ,'" '" {>50% "4 , 3i!~ Households\:"it~ , . ~ ~~ '" ' 0 )l' ''1'''> !~ { I,., t ~ ~1 4 >t r-\l~ ~ \ , J \~J';' ~t"" ... ""I .j......;1'! '$ J.\ Jl,l ~.t ~ ~ ). .,.. ~~ "l";' t\ ~ 'Jk h,,,,, ~l<fit~ ~ M 1~~;, ~ i '.,."'f fit" ~t'?';;!! 44,,\ r~ u~ I 1.l31~""'''''o.a.. 1 r i') t-..Y ~ ~ J '" i'" .t \4l' ,"',:<, .J'I~ '\ l.r~" ,} ,,-,..1"1 T.~ \ 15 12* 15 2* 5* Appendix A Income Limits by household Size, established February 2007 This table IS provided to assIst With completmg question #3 m the narrative and the tables In Appendix B I I Family Size i I Extremely Low 30% of Median I I II 1 Person I 2 Persons f 3 Persons ;! 4 Persons I 5 Persons ! II il ,I II :1 $17,600 $20,100 $22 650 $25,150 $27,150 $29,100 $31,200 $33,200 6 Persons 7 Persons 8 Persons 14 I I i Very Low ! I 50% of Median I I I il $29,350 il :1 $33,5000 !I II $37,700 il :1 $41,900 II II $45,250 :1 II $48,600 :1 II $51,950 II II $55,300 II Low 80% of Median $46,350 $53,000 $59,600 $66,250 $71,550 $76,850 $82,150 $87,450 Median Income :1 II II :1 II :1 II II $58,000 $66,200 $74,500 $82,800 $89,400 $96,000 $102,700 $109,300 , J :1 :1 J II il ~ ! il [I Moderate Income $69,600 $79,440 $89,400 $99,360 $107,280 $115,200 $123,240 $131160 Approved 06128107 Allllllal Blldget 2008 =T1 1 1 1 1 I U , I BUDGET ~ FY 2008 ~ I I I 11 REVENUE !)Et 2 DEPT OF REHAB 204 $ 340 921 r~ 3 DEPT OF REHAB ASSISTIVE TECH 70 000 ~~ i 4 - DEPT OF RE HAB TECH N ICAL ASSISTANCE 7500P - DEPT OF ED VIIC I 5 r-- 82 822 ,~ 6 DEPT OF REHAB COMMUNITY ORGANIZING 68186 i ------=r HAYWARD H SSP 40000 I 8 HAYWARD CD B G t"} 9 SAN LEANDRO 9000~ 10 PUBLIC AUTHORITY (FEE FOR SERVICE) 49 051 f.! 11 PLEASANTQN CDBG (FEE FOR SERVICE) 14081 12 PLEASANTON SS 5 000 ,~~ 13 LIVERMORE 12000 P'1 14 FREMONT 10000 15 DUBLIN 15413 '11 16 CIL WIPA 10 000 ;, 17 FEE FOR SERVICE OTHER 6 000 il' 18 FOUNDATION I CORPORATE GRANT INCOME 8 500 ',: 19 DONATIONS 5 000 ~ 20 FUNDRAISING EVENTS 10000 I ~ 21 INTEREST 303 ~ 22 ~ 23 TOTAL REVENUE 763 777 f;' 24 I rlJ 25 EXPENSES 26 - SALARIES & BENEFITS f 27 WAGES 480 816 It~ 28 BENEFITS 119 689 ~~ 29 30 t~ 31 TOTAL SALARIES & BENEFITS 600 505 ~\ 32 Ij 33 OPERATING EXPENSES ~~\ 34 "I 35 ACCOMMODATIONS 1 600 I~ k' 36 AUDIT AND ACCOUNTING 5 000 1~i 37 BUILDING REPAIRS AND MAINTENANCE 6480 ft,J' 38 DEPRECIATION ~,~ 39 DUES PUBS AND BOOKS 7558 f;r. 40 EMPLOYEE RECRUITMENT 250 ~' 41 EQUIPMENT AND FURNITURE ACQUISITIONS 3000 ~ 42 EQUIPMENT REPAIRS & MAINTENANCE 2161 43 FUNDRAISING COSTS 1 000 Il~ 44 INSURANCE 7997 tit 45 INTEREST & SERVICE CHARGES 1 000 M~ 46 OUTREACH 1713 " 47 CONSUL TANT SERVICES 35 929 I"~: 48 POSTAGE r." 9 652 '~ 49 PRINTING AND COPYING 12 434 ~. 50 OCCUPANCY RENT AND OTHER 5 697 ~~ 51 STAFF DEVELOPMENT 5 157 f,~ 52 SUPPLIES OFFICE AND PROGRAM 23 725 ~~ 53 TELEPHONE 13 316 ~ 54 TRAVEL 9 885 ~~ 55 UTILITIES 5918 '" 56 MEETING EXPENSES 3 000 t% 57 VOLUNTEER RECOGNITION 800 J i 58 ul 59 t 60 TOTAL OPERATING EXPENSES 163272 I.. 611 Ill' 62 TOTAL EXPENSES 763777 tC 63 I'\,- 64 NET EXCESS (DEFICIT) I ,tt ~ };} I it""'- ",1{,~1'-' w I., 6'11' /33 ~(7) ~ } 32> N ~(Q)(Ql~-~(Q)(Q)~ to m m lUl U1l ofty fO>SlIS ~olPl mamft ~~ (Ql(C~ @ll'aJ U1lft AIPlIPl~ nCaJ~TI lOlU1l Agency Name Address Eden Council for Hope and Opportunity 770 A Street Hayward, CA 94541 Executive DIrector MarJorie A Rocha Contact name and tItle Marjorie A Rocha, Executive Director Contact phone and fax 510-581-9830 Fax 510 5374793 Contact e~mall address marE!le@echofarrhouslng org OrganizatIonal Background Private Non-ProfIt 1SJ o Public Agency o other (Descrrbe) Tax 10 Number 94-6124081 LIst years prevIously received CIty funding FIscal Years 2001-2002,2002-2003 ~~O~I\llE[)l DEe 1 3 Z007 DUBLIN PLANNING q,4~ AtI'^ ; "'4 '" , [,:)( ( - _ \ STAFF uSE O~lY r t Oale h'ece,ved '1' \ 15 tt~ 8 I..{~~"i ' ~ ApP # J- y , CommunIty Development Block Grant AppllcaiJon Cover Sheet j J,. , , ! J '> ~ .-.- f A TT ACHMllEN'I 1 C Page 2 ~/1133 Proposa I Sum m a ry - (A program may con tam several goals) Capital Request o OR Public Service Request [2J (check one) Program name Rental Assistance Program Brief Program summary The Rental AssIstance Program benefits low-income households with assistance to secure or preserve their housIng The program will provide fInancIal assistance In the form of a guarantee to tenants for payment of a secunty deposit or delinquent rent Goals - Number of Program goals to be achieved In fiscal year 2008~ 2009 List a brief descnptlon of each program goal Prescreen to determme potentIal applicant eligIbIlity, Support Counsehng for RAP clients, Information & Counseling for potential applicants who are not eligible, RenVDeposlt Guarantees for eligible clients, Follow-up for households that have signed the contract, Collection for clients who have defaulted on their payments, Outreach for marketing of thiS service Use a separate sheet of paper If needed Number of Dublin residents served by thiS goal 50 households 7 households 20 households 7 households 7 households As needed Unknown Amount of Dublin grant fundmg requested (match first column budget form #2) Overall Total number of Dublin resIdents to be served by this program $ 5,58500 7 households Community Development Block Grant AppllCatron CertificatIOn To the best of my knowledge and beltef, all information and data In thiS application and attachments are true and correct No matena I informatIOn has been omitted, Includl ng financial Infonnatlon If funded, I certify that the Agency IS WIlli ng and able to adhere to polices and procedu res speCified by the City of 0 ublm, and If applIcable, the a pproprtate program regu latIOns of the US Department of Housmg and Urban Development Further, I understand thiS IS not an agreement for grant fundmg and cannot encumber funds until the City of Du m and the indIVIdual authonzed to execute contracts on behalf of the Applicant f 7' has sl~noo ~?[(j:";IJ:;allled"'l regIIlabons and paperwork are completed V( /i C. ~ IV Executive DIrector 12/12/2007 Authorlz~ 51 nature (s/$t1/O blue Ink Title Date b:X o;y 133 You are requured to answer each 01 the questions following the format below, usmg 81h:: by j],1" white papert12-pomt -'5 -...r--...~ ..,.. \ "r1 ~ t"'~ .M 'If t' ~ ..... i ..... r L ,;j~"'" ._ -> i.. ~, A, ~'iI,.... ~ 1(.l tjpe, wlth'tincri margins "lDo not Include the questnon in your nall1'atlve, however answers should be 1111 ,order and refer .......,':r'.i..~ f~u t'1.:;.} ..... ~ t~.t? .__..... ... t:iI ,t\ "::1~~ .....~ J[:::' -""' ....;" I c.......'{"\ (oO,S: r ~ t ti' to\tlue~correspondlng number The IPro~am and Budget i\Iarrmtlves are not to exceed gour (4) aotallPages~'>-A11 pages ...\,...."'<" ~ Cj ~! ~ (: J <;' .....~ ..';>'- ); ~..... I ~ ~ ,J,.... "\;'Ii ( / l.. ~ J... -;..,. ;! ..... ~ r6;,,, ~.l....1-... 4' 07........ <';. { mlllst be consecllltwely numbered Please answer each ques!l:lon even If it appears repeiltlolUs If 81D1IJllcable, complete l j i'~.iIf J......._~...... 1 ~~ ,,,.... -:f 1... ,l ..-.- /.: i '.J" i.,.~\ 2 nt an additional page answering ques~ions Il'egan:llnng 9ap~tal requeslts~ (~ i: "" ",'; \ .}:!" f 31 I <d $ 01 .., \1< '\ ~: ";?~;l'.. c I A Program Narrative - maximum three (3) pages 1 DeSCribe the program for which you are requestmg funding ProVide a descnptlon of the problem(s), need(s), Issue(s), or other service gaps to support the need for the program/activity In Dublm In addition, supply data such as demographIcs, reports and/or other information supporting your informatIon and proving the need eXlsts In Dublin DO NOT solely cite statistiCs from your own program to prove need 2 Wlthm your Program, you may break out indiVidual goals you Intend to achieve These goals should be measurable goals such as Present 3 community education meetings on agency's services, assist 10 Dublin reSidents wlth speCifIc services the agency offers, serve 1,000 meals to 50 Dubiln reSidents on a regular baSIS, Install 5 SIdewalk ramps on Dublin street corners, etc 3 Descrrbe the population you anticipate servmg With these funds How many are Dublin reSidents? Include the type and frequency of outreach efforts to the target population and how these efforts are acceSSible to lImIted-English speakers Descrrbe your agency's language access capabIlities and how you prOVIde culturally appropnate servIces 4 How do you defrne success In thiS program? Please list and briefly deSCribe the goals/outcomes that are crucial to the success of your program DeSCribe how partiCipation In thiS program Will change, enhance, or proVIde lastmg Improvements In the lives of potential clIents 5 Identify the organIzations that your agency works or cooperates WIth and deSCribe their relevant capabilities that result In greater service Integration 6 ProVide an explanatIon of how your programs are acceSSible to mdlvlduals WIth various types of disabilities 7 Descnbe leveragIng or sustalnablllty efforts your organization IS ImplementIng to maIntain current service levels 18 Budget NallTratlVe ~ maximum orne (1) page 1 Describe how thiS program IS cost effective and the budget IS reasonable for the anticipated result 2 If this application does not receive funding, what Will be the effect on the program? 3 Does the agency anticipate havrng any unspent grant funds at the end of the fiscal year? If so, explain Why Page 3 ~3 *J33 4 Complete Fmanclal InformatIon and Budget Forms (Please specify the total program budget You must provide rnformatlon on the common outcome indIcator which defines the amount of dollars leveraged by the grant request If you have any questions, please refer to the Instructions for gUidance or contact program staff ) C CSlPitallExlPenltllotILoi'e Narrative - maximum one (1) page, o~ applDcable 1 Provide a detailed budget and scope of work for each capital expenditure or a constructlon/ rehabIlitation budget and descnbe how you ascertained these costs 2 Will this proJect require ImplementatIon of Davis-Bacon/Fair Labor Standards Act? If requIred, describe how your agency will comply with this regulation (bid requirements, determine wage rates, monitor compliance, etc) Please cOr1liaci Sian ilmlmediafrely iff yoUl have any qurestnoD1s regarding [)alIDs Bacon reQlLlHremen~ v D Perioll'maruce MeasllJll'es - use attached form 1 Select all goals and priorities that apply (Refer to instructions) 2 Choose ONE ObJective, Outcome and Specific Indicator (1,2 and 3) 3 Complete all three sectIons for Common Indicator number 4 (Refer to Appendix A) Page 4 EDEN COUNCIL FOR HOPE AND OPPORTUNITY htt ~ I~ A IProgll'am Nai'vatlve ~ maximum three (3) pages 1 The Rental Assistance Program (RAP) IS a rent/deposit guarantee program, which provIdes assistance to low- to moderate-mcome tenants to pay secunty deposits or delinquent rent A budget IS completed and If the client has Income left at the end of the month, the RAP Counselor contacts the owner and negotIates small, monthly payments of eIther the security depOSit or the delinquent amount of the rent until the amount owed IS pald A contract IS signed by both the tenant and the landlord, and ECHO acts as a guarantor In the event the tenant defaults The current housmg situation for very low- and low mcome families and mdlvlduals IS stressful at best In the CIty of Dublin, 30% of renters are paymg 35% or more of theIr Income toward rent 1 '-Because of meager resources, temporary financIal diffIculties can lead to eVictIon or force a move to an emergency shelter The Dublin's hOUSing pnces combined with high move-In costs, can serve to lock people out of the housmg market Even those who have the funds to pay depOSits must walt for their former landlord to repay previously paId depOSIts The most slgmficant causes of homelessness and Instttutlonal1zatlon are the high costs of hOUSing, low vacancy rates, long waiting I1sts for subsidIzed hOUSing combmed with dlmlnlshmg federal SubsIdies Impactmg growing numbers of lOW-Income households In the City of Dublin The renters who are most affected by these factors are female headed, Afncan Amencan, and Native Amencan households 2 Through utll1zatfon of the Rental ASSistance Program (RAP), affordable hOUSing can be attainable for lOW-income households Households who may otherwise be dIsplaced mto emergency shellers or on the streets, are provIded an additional option to prevent theIr displacement ThiS project Will serve Dublm residents on a citywIde baSIS The follOWing activities are provided to Rental ASSistance Program applJcants Pre Screemna for ASSistance ECHO staff WIll conduct pre-screening of chents to determine eligIbility Clients who have repayment ability WIll be referred to the next step of the program, described m the followmg sections Clients who have no apparent repayment abIlity may be offered Cntlcal Family NeedslHousmg ASSistance or FEMA funds for grant assistance, when available ECHO staff Will process their applicatIons Support Counseling ECHO staff Will provIde counseling regarding necessary support services to ensure long term placement and stabll1ty of loan guarantee recipients as well as assist other RAP clients, who have been found to be mehgrble for a RAP guarantee, with baSIC support and mformatlon Such counseling shall consist of budgeting mformatlon, homeseekmg tIpS, counseling on negative credit reports, atc 1 Source U S Census Bureau Census 2000 Summary FIle 3 2 CIty of Dublin HOUSing Element 1999 2006 A 15 A 24 PaGe 5 EDEN COUNCIL FOR HOPE AND OPPORTUNITY G.?~133 Information and Referral ECHO staff will provide informatIOn and referral regardmg addrtlonal services available to clients Such information Will Include AFDC Homeless ASSistance Funds, SSI Spec181 Circumstances Funds, emergency shelter availability, mental health services, emergency medical services, discount food programs, etc Rent/Deposit Guarantees ECHO staff Will conduct a formalmtake and loan application Interview with prospective applicants ThiS meeting Will be held to secure required documentation, Itablltty releases, and verifications Staff also wlllmltlate negotlatlon with the landlord regarding terms, conditions, and Information on RAP Follow UP ECHO staff Will proVide follow-up on a!lloan guarantees Additionally, support Will be proVided to the landlord and the tenant regardrng problems, which may anse dunng the course of the agreement Collection ECHO staff Will conduct collection on loan guarantees, which are III Jeopardy of default Collection will consist of letters of warnrng, and/or telephone communication ECHO Will reimburse the landlord wlthm a 15~20 day penod In cases of default Outreach ECHO staff Will dlstnbute matenals to community-based orgalllzatlons, schools, and churches, and air public service announcements and network extensively With other service proViders to ensure program productiVity 2 Pre-Screenmg for Eligibility - 50 households Support Counselmg - 7 households InformatIon and Referral- 20 households Rent/DepOSit Guarantees - 7 Follow up - 7 households CollectIon - As Needed Outreach - Quarterly public service announcements, dlstnbutlon of program matenals networking With service provIders 3 ECHO's target population rncludes lOW-Income tenants of the City of Dublin and theIr landlords Con tamed In that populatIon are the disabled, homeless, sm91e and dual head of households, female headed households, se lllorS , racIal and ethlllc minOrities, and emancipated youth One hundred percent are City of Dublin clrents Outreach WIll consist of quarterly public service announcements to local radiO and cable stations, dlstnbutlon of program matenals, and networkrng With service proViders ECHO's Counselors Will contrnue to proVide presentations to the One Slop Employment Center, Allred HOUSing, Adult Education School, and at Tn-Valley's shelters In addition to the above outreach actIVities, ECHO Houslllg marntarns a webslte at www echofalrhouslnq orq which IS updated no less than once monthly The webslte mcludes Irnks to other non-profit organizations and City, county, state, and Page 6 EDEN COUNCIL FOR HOPE AND OPPORTUNITY ~ G c;f 13 3 federal agencies to further assist our clients wIth their housing needs In order to serve non-English speaking households, ECHO Housmg provides Interpreting and translation services through the Language Lme and Legal Language Access Project, allOWing us to provides services to approximately 140 language groups ECHO has fully bilingual Spanish and Portuguese speakmg staff to conduct counseling activities m Spanish 4 ECHO HOUSing defines the success In the Rental ASSistance Program by ensuring that 7 households Will eIther be empowered to move mto housmg by paymg their security depOSit, or preserve their housmg by paymg the delmquent rent, and thereby preventrng homelessness and Institutionalization Families are aSSisted With the high expense of relocatron costs by haVing the ability to access the Rental ASSistance Program allowmg move-In or staY-in payments m monthly mstallments The tenant IS saved from homelessness, and City IS saved the cost of Instltutlonallzatlon It prevents persons whose rent IS delinquent from being eVicted by asslstmg them WIth a repayment plan ThiS also helps the landlord recoup rent, and spares them the cost of advertiSing for a new tenant ThiS program IS results-onented, and IS the difference between remammg housed and being homeless, and moves the client toward self-suffiCiency Progress IS measured each month by the Outreach/Compliance Coordmator through reports Issued by the RAP Counselor Contract goals and outcomes are reViewed and compared to the actual number of services proVided 5 ECHO IS part of a countyWide consortlum receiving funding from FEMA and the San FranCISco Chronicle's Season of Shanng to assist homeless and near-homeless households With rent and depOSit grants The Rental ASSistance Program uses these grants to reduce the financial !lablltty of the clients and ensure that they remam permanently housed Additionally, we have established linkages With Lutheran Care for the Agmg for leveragmg guarantees With grant funds 6 Our programs are phYSically acceSSible to the disabled because ECHO HOUSing has ItS office m the Multi-Service Center In the City of Livermore ECHO avails Itself of the California Relay Service for the deaf, sIgn language Interpreters, and readers 7 ECHO's grant developer seeks out and appltes for foundation and corporate funding In order to mamtaln current fundmg levels and to leverage the funding currently received We use our own Rental ASSistance Program dollars to guarantee payments to landlords In the event of tenant defaults, and proVide other funding receIVed to assist With payments of security depOSits and delinquent rent for RAP In recent years, tradltronal fundmg sources have been unable to fully support ECHO We have apphed to and received fundmg from HUD, foundation, and corporate grantmakers to support our efforts Pare 7 EDEN COUNCIL FOR HOPE AND OPPORTUNITY B Budget Narrative ~ maximum one (1) page 1 ECHO's servIce to the City of Dublin IS very cost effiCient ECHO Housing has established a default pool, which Will pay for any tenant defaults Currently, the default rate IS less than 1% The amount we are requesting from the City of Dublin IS solely for adminIstration of the program The cost to the CIty for the Rental Assistance Program IS $61 37 per hour In exchange for thiS unit of cost we provide prescreenlng, budget counseling, financial assistance, Information and referrals, mediatIOn, support counseling, outreach to 50 mterested households, and leverage City funds with grant funds from FEMA, Seasons of Shanng, and Lutheran Care AddItionally, ECHO IS able to provide other housing services such as Pre~purchase Counseling, Mortgage Default and Delinquency, and Homeownershlp classes at no additional cost to the City, through generous funding from the Department of Housing and Urban Development If the CIty were to take on the responsIbility of provIding all these same services or hire a for profit agency, the cost would be prohibitive 2 If thiS application IS not funded, we Will be unable to provide thiS essentIal program to the CIty of Dublm 3 No 4 See FmanClal InformatIOn and Budget Forms The total program budget IS $5,585 ApproxImately 30% of the program budget Will be spent on administration to7 ~/33 Pare 8 lFuIlilBlIlil~ua~ ij [!'i]~(Q)l1'mma~u(Q)llillF(Q)lrm AldlldlnbD)jl'iltal~ l?U'tOlgU'alm lFlUJ~~u~g ~<<DlUIU'lCeS & $~al(fffllll1lg Cosfts Attach additIOnal sheets If necessary (; ?r~)Z>3 AddItional program funding sources could Include, but are not lImIted to foundations, corporations, IndiVidual contributIons, events, reimbursements and In~klnd contributions Types offunds are loan, grants, donations, In.kmd, etc I , "J I I '<~ :: ~ I $ollDree~< ~ -- , +- t%:J T' -"j ~ ;.J.~ (\ ( Yl '~ M I ~.:.' I AUll'lHlllllDD'Ilft ' ! \ j ~ f ~ "'" ( +.:..... ...... rJ...... !J.. { . ' I I I \ \ r..... {' '; r lUlsa l!D1lFllHD1Hdls "~I ........ y}, A i'" j .... f ~~ '\1 :( i' #" j> { .;.. J f. , C<<DIl1J\lIlllllBtled? t; 1 -<'\l.... V .-, ! ~J "ji\t { ~""" C1 of Fremont - GJ:a11t $19,924 Rental ASSIstance PlO am $1,060 Rental ASsIstance Pm m $5,000 Rental A~<;lstance Pm !am $93,000 Rental AssIStance Pm am $11,482 Rental AssIStance Pro am N N C1 of San Leandm - Grant N CI of Oakland - Grant y y TOTAL $130,466 If you are utilizing CDBB funds to pay Hor staff costs, IPJeillse list each employee/title and the percentage 01 their salary and benefuts that will be paid with CIDI8G ~nci8.ldle the total monthly and yearly costs to the CDBG program Note Vacation, sick leave and holidays for employees cannot be charged to CDIBG as program expenses t '<j> ~' ;l~ r ....! /" ~fI" ~:.r~~ ~,...!.,t..~p ~r ~ t<< New'" , ~:.. ;% salary Be benefats ~ ':,." .f: MOll1liDlly sa~IllUY &", " \ ~ I." ~ ....t'" .p..-...,-r -} ~ ~ ~ r (V? .....~v::f~tf'\ :.r '!,I.,t? 4 le~r~y,saflll~ ~.~!e&1~!~t ~'l' .., ~ <;- 'i'" i"' <:-~ ) 'Ll., <l.. " ~ \ ~'"i. Y ~~ "!- ~ 1. '.! J ~ '-1. ;: "..~"t '-'" ?~ J.:,.....)-, 1 , '. .;::'~ lPosfitiOll1l Yi~le~~' IJ.",.J,' ~ ~'(Y/N) ,j ?,' p_ahl] forwJtIiJ gralR~ SAf' " Jien,e~lt cosi to glTan~ ~')~! " cost to grant 1:) !Executive IDlllTectol7 N 11% $52 25 $62700 IOllTect Services Specialist i\l 10% $44 92 $539 00 OlJJi:reach/Comp~lance Coordinator N 8% $35 83 $430 00 Receptionist N S% $29 67 $356 00 Bookkeeper i\l 9% $40 08 $481 00 RAP COLDnselol/' i\l 38% $17617 $2,114 00 Page 9 EDEN COUNCIL FOR HOPE AND OPPORTUNITY Gc; ~ 133 Personnel Assl~med to this Prolect Marjorie A Rocha, Executive Director Oversees and IS responsible for programs on agency wide basIs, and for fund development Ms Rocha IS responsIble for 14 employees m 4 work sites She has been wIth ECHO since 1988 Sheha Brunson, Direct Services Specialist - Responsible for reviewing RAP and grant activIties on an agency-wide basIs Supervises staff services to general public Provides support to the Executlve Director, the Bookkeeper, and direct-service staff Employed at ECHO since 1997 Audrey Perrott, Outreach/Compliance Coordinator - Responsible for direct program outreach and comphance Provides support to the Executtve Director and direct service staff Employed at ECHO since 2001 Mana Elena Vasquez, ReceptIonist - ResponsIble for directing all calls to appropriate ECHO personnel Employed at ECHO since 2007 Adrienne Padilla, Bookkeeper - Prepares all monthly InvoIcing and financial statements, disburses pay, and IS responsible for financial record-keepmg Employed at ECHO since 1986 Joyce Joyner, RAP Counselor - Responsible for the proVIsIon of servIces outlined In the proposal Prepares all statIstical reports for Program Director regarding Rental Assistance Program chents and housing Employed at ECHO since 1983 Page 10 CalPlta~ lExpe81lses Construction/Rehabilitation Permits and Fees Design Engmeenng AcquIsItion Other Soft Costs (defme) Subtotal Personnel Expenses Salanes BenefIts Subtotal Operating Expenses Supplies Pn ntl nglCo PYI n g Postage Telephone Rent and UtilIties Acee u ntl ngl Aud It Other (defme)* Subtotal 1/'OYAL lPlw@gWtdl!l'iTil [B1 [!1J (d]gte~ [F(Q) lr!l'iTil Attach add/tlOnal sheets If necessary '"1 fJ * /33 ClD>lBG Gll'ant l(])ta~ Pll'ogl7am IBlLndge'ft $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 3,740 $ 807 $ 4,547 $ 86,765 $ 18,726 $ 105,490 $ 94 $ 2,190 $ 19 $ 438 $ 58 $ 1,341 $ 130 $ 4,329 $ 371 $ 13,213 $ 48 $ 1,118 $ 318 $ 7,932 $ 1,038 $ 30,561 $ 5,585 $ 136.051 Budget prepared by (Name, rltle, Telephone Number, fE-mall) MaIJone A Rocha, Executive Director, 510-581-9380, margle@~chofalrhousIng org * AdvertIsmg, eqUIpment mamtenance/rental, DP/consultant servIces, Insurance, tramIng/educatIon, membershI p/pubhcatIOns, mIleage Page 11 ~te~(Q)rrll1J1ltdlll'il~e MStdlSlWrr<eS (fill out a Performance Measure for EACH goal and/or obJective) Page 1 012 '1/o;rr33 Agency Pll'Ogram ActiVIty Eden CouncIl for Hope and Opportumty Rental AssIstance Program Rent/DeposIt Guarantees * * Goal/Objective To prevent the homelessness and InstItutionalIzation of 7 DublIn households Please clvcre at lealst one off ealch of the ffollownrng goals and! prlol7ltles whlcll1 are alPpUcable to this activity, goal & objective Refer to Instructions to complete RFP for a list of the goals and pnontles HUD Sb'ateglc Goal 1 2 4 5 HUll) Policy Priority 2 3 4 6 lHIow wliI YOUII' agency benefit I!)ublm resIdents? lECIHIO benefits the Cltv of DllDbhn bv !prevell1ltlng the lhomelessl1less and! institutionalization of 7 Juolllse~olds IFlease Il'effell' to iB1lstll'lJIctlOI1lS to complete R:lFl? for d!escrlptlon of Performall1ce MeaSlUll'es jl. Olbjectil/'e (select Gillet ,-' ~ ~i I ~ \ Jl .{ ;, :: \.~.... J 'I l 2'" Ollltcome'(select,one)\11\ I , if,..,!," ....... 'r... ~ ~ \,J.l< i t! t, ~~ ~- ~ -.l~~ , .~ l 1 , 'f.' 1 ~.....r 1< ~ \ ~ [8J Creating a SUitable liVing EnVironment o AvaIlability/Accessibility o Providing Decent Affordable HOUSing [8J Affordablllty o Creating Economic Opportunities o Sustalnablllty j 3' Specif.ic IncllicaltoO' (select oneL f, o PubliC facility or Infrastructure o Public service 1;."..... ~ A ~ ~ J. "'" ~it 1 ~-: .... "i j ':; I J J( ..p. ..a '=t ~...... ~...... "1 'J ~ >' ~ ~ ~ {. ~ H;. 1" ~ z 1" ~ -...<>" ~ } ~ }. ft < ""~1 1J"l) ~ o Owner occupied units rehabilitated o Direct finanCIal assistance to homebuyers o Targeted reVItalizatIon o Tenant Based Rental AsSistance (TBRA) o Commercial fagade treatments or busrness bUIldrng rehabIlitatIon o Homeless shelters D Brownflelds remedlated o Rental units constructed o Rental units rehabilitated o Homeownershlp Units constructed or acquired WIth rehabilitation o Emergency hOUSing [8J Homeless preventIon o Jobs created o Jobs retained o Busrness assistance 9 o BUSinesses providing goods or servIces Page 12 /0< ~ f33 lPelli1<<lJ wmmaJ m) ~e M SaJ $ lliIll'eS Both pages must be completed for each program Page 2 of 2 4 Common Indicator, a Total number of chents you anticipate servmg choose one or the other DO NOT PROVIDE SlATS IN BOrn CATEGOR~ES Households 7 Persons b !Break.out the number of chents you anticipate semng IDllthe following categories J '. Low, ~ \ '" Very Low j ~ ,:'';. J.-t' J;: /4 (..... .fA ~"'t -r4 i ,. t::. l~ i~ <A \0 I .) .). .t ~rr . ~ ~ Income'" I, :\~""'Income './ "~j Disabled r 1 ~ " ::..., t M t l (' l,. i ~ "~(>50%)~ "7 ,'(-:;50%).< i'~ " Vr- c r I"~ , , , Female j '.01 T ~~ , , p, ) I' r , I H ',.' J / '" i;" ~ 1 l;.- ~I'.,"'T ~~..t J r:; I,Headed?; SenIOr ~ ,",. Youth~,,' Homeless,-) ) l, f I;, r..J:' f~i<J. -!..;...} "".......'\\~~"'-!. Households J t ,'~' ", , "vl" ': ~, 4 3 1 3 1 o 1 AppendIx A Income LImits by household SIze, established February 2007 This table IS provided to assist wltn completIng questIon #3 In the narratIve and the tables In Appendix B I Extremely Low Family Size 30% of Median I I I 1 P~r~~~_ J $17,600 I $29,350 1_ $46,350 i 2 ~:rson~ I $20,100 I $33,5000 l$5~-,~00 I __3 Per~ons 1._ $22,650 I _$37,700 I $5~,600 l_ 4 Pe~on_s I $25,150 I $41,900 l $66,250 r ~5~P~~ons J $27,150 I $45,250 I $71,550 _I $89,400 J I 6 Per~~n_s I $29,100 I $48,600 I $76,~50 r $96,000 / L 7 Persons $31,200 $51,950 I $82.:.150 i $102,700 I I 8 Persons $33,200 I $55,300 $87,450 I $109,300 I HUD updates this Income chart each year The CIty Will provide all FY 2008-2009 Subreclplents with the most current data when It becomes avaIlable Source US Department of Housmg and Urban Development, (HUD) Data for Oakland SMS Very Low 50% of Median Low 80% of MedIan - I I Median Moderate Income Income , I " 1_ $5_8,000 - I _ $_69,60?_ [$66,200 I $79,440 - I $74,500 I $89,400 - ~ I $82,800 I $99,360 I - - I $10~,2~0 I $115,200 _ j $123,~40 _I $131,160 I **Cllents recelvmg Rental AsSIstance Guarantees IS the only segment of RAP clients for which we take demographic informatIOn Therefore, we have not provided any other performance measures because ofthe lack of demographIcs Page 13 12 ~'J33 5 EnvIronmental Review Requirements Source documentation requested below Includes( but [S not limIted to 1) personal expenence of the mdlvldual completing the application [mclude name, title and date], 2) another mdlVldual experrenced with the subject [include name, title and date], 3) publicatIOn or other documentation [Include title and date], etc ) Category A Hlstonc Preservation Will the project affect any h[stonc properties or areas? If so, project may take up to 90 days to clear with State Hlstonc Preservation Officer before contracts can be executed B Floodplam Management C Wetlands Protection Does the project Involve new construction wlthm or adjacent to wetlands, marshes, wet meadows, mud flats or natural ponds per field observation? o Coastal Zone Does the project mvolve the placement. erection or removal of matenals, or an Increase rn the use In a Coastal Zone E Sole Source AqUIfers F Endangered Species Will the project have any effect on any federally protected (lIsted or proposed) threatened or endangered species? Use personal experrence or contact the National Wildlife Association to determme Ifthere are endangered species present In or around the project site If the a rea IS already urbanized, note thiS citing your personal experrence/observatlon I nclude the name a nd title of the mdlvldual making the determmatlon and the date, or the name of the publication that supports the finding G Wild and Scenic Rivers H Air Quality W[II the proJect affect air quality durrng construction and/or operatIOn? (If there IS potential, IS the project located within an "attainment" area or If It IS within a "non- attainment" area, It conforms with the EPA~ approved State Implementation Plan) Use personal experrence or obtain InformatIon from local Plannmg Department or EPA regarding the effect of aIr quallty In the a rea of the project Include the name and title of the IndIVidual making the determmatlon and the date, or the name of the publicatIon that supports the finding Source and/or DocumentatIOn NO To be completed by County staff NO NO The project IS not located within a US EPA.desfgnated sole source aquIfer watershed area per April 1990 Memoranda of Understanding [HUO EPA MOU of 1990J NO None m Alameda County NO Page 14 Category I Farmland Protection Does the project site Include pnme or unique farmland, or other farmland of statewide or local Importance? Use personal experience or the local Planning Department to determine whether or not the site will affect local farmlands If the site IS already urbanized, note this citing your personal experience Include the name and title of the Individual makmg the determination and the date, or the name of the publication that supports the finding J NOIse Abatement and Control Does the proJect mvolve development of nOise sensItive uses, or IS the project m the hne-of-slght of a maJor or artenal roadway or railroad? K Explosive and Flammable Operations Is the project located an "Acceptable Separation Distance" from any above-ground explosive or flammable fuels or chemicals? Use personal expenence or obtain mformatlon from the local fire chief or EPA to determine If the project IS located an acceptable separation distance from any above-ground explosIve or flammable fuels or chemical contaIners I nclude the name a nd title of the mdlvldual making the determmatlon and the date, or the name of the publicatIon that supports the flndmg L TOXIC Chemicals/Radioactive Matenals Are the subject and adJacent properties free from hazardous matenals, contamination, tOXIC chemicals, gasses and radioactive substances which could affect the health or safety of occupants or conflict with the mtended use of the p raperty? Use perso na I expe n e nce or th e loca I fl re chi ef to determme that the project IS not located wlthm 2000 feet of a tOXIC or radioactIve sIte Include the name and title of the mdlvldual making the determination and the date, or the name ofthe publication that supports the fmdlng M Airport Clear Zones and Accident PotentIal Zones N EnVironmental Justice A) The proposed Site IS sUItable for Its proposed use and will not be adversely Impacted by adverse environmental conditions, 8) Site sUitability IS a concern, the project IS adversely affected by environmental condItions Impactmg low Income or mmonty populations 74 aP/ r33 /. NO Source and/or Documentation NO NO NO To be completed by County staff N/A " Page 15 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ & ~ & ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ s t ' ~ ~ ~ ~ ~ ~ 15 ;f 133 [R{~~OJJ~~li [F'@[R? ~(!JJ~[Q)~~@ [?>~@[?1@~~[L ~~~[l~(Q;~ 1J~@ ~ ~ ~(Q;[K\~ ~(Q)~ lr~~(C;~[L W~!Ri d2(Q)(Q)~..~(Q)@~ ~@ llUiJ ll'iJill1llfffi u\iJ [ID(B)\w(B)~ @LIDIffi'iJ~fffifr ~ ~@@lk\ @ [[,CID ITil~ ~Ir(o) g~ rriTl1 Open Heart Kitchen, Inc.. ","~'~'~~~~~~~~7(1 RECEIVED DEe 1 5 Z007 ATTACHMENT 1 F DUBliN PLANNING II 2~ AV\A e @ I' @ '" ~ ~ ~ ~ rID ~ ~ ~ @ ~ ~ ~ ~ ~ ~ ~ ~ !t) , ~ ~ ~ ~ ~ ~ ~ ~ G ~ ~ ~ ~ ~ ~ ~ f ~ ~ ~ ~ ~ ~ I (d t' ';f)33 ~ ~(Q)(Q)~.~(Q)(Q)9 (C<OlMllVIllUlrrn nity [Q)te~16i(Q)~ mm16rrnft ~~(Q)CC:~ @ W~ rrnft A~~in(GaJftD(Q) rrn Agency Name Address Project Locations OPEN HEART KITCHEN, INC 1141 CATALINA DRIVE, #137 LIVEMORE, CALIFORNIA 94550 6700 Dougherty Road/3115 Fllll1la11 Way, and 6444 SIerra Court ExecutIve Director NANCY RICHARDSON (ActlnpJ. LINDA McKEEVER, ASSlStant Contact name and tItle NANCY RICHARDSON, PRESIDENT, BOARD OF DIRECTORS Contact phone and fax Phone 925-580-1616 Fax: 925-846-9219 Contact e-mail address nrlchard~on@openheartk1tchen org ox nanC~nCh'lldson(ip,cs com OrgamzatlOnal Background Pnvate Non-ProfIt ,/ Public Agency o Other (Descnbe) o Tax 10 Number 94--3396038 LIst years previously received Crty fundmg 2006-2007,2007-2008 (fo! Weekend Box Lunch prop;ram only) 1- STAFF USE ONLY DateRecelVelrl:J/1"l1iJ7 --t!3J 1li3 A.M, App# 5 Community Development Block GrantAppllcatJon Cover Sheet Page 2 l ~I 77 ~ 8311 - 11 I III II I I I, ,II I I I , CapItal Request Proposal Summary - (A program may contam several goals) Public Service o OR Request ../ (check one) "Hot Meals and Weekend Box Lunch" lformerfy Weekend Box Lunch for Arroyo Vzsta Housmg Complex) Program name 'I! I' I Bnef Program summary Open Heart Kttchen 1S the only orgamzatJon operatmg m DublIn prepanng and servmg free, hot, nutntJous meals on a "dme-m" or "take--ouC baSIS and chstnbutmg Weekend Box Lunches to 10w-wcome resldents We began servrng Hot Meals at 6444 Slena Court In September 2007, tlmlng tlus program W1th the phased relocatJon of reSidents from the Attoyo VISta Housmg Complex We contmue to dehver Weekend Box Lunches to reSidents and will use The Groves at Dubhn Ranch (the Groves) as a drop off pOInt for the Weekend Box Lunches over the course of the commg year At least 20 Arroyo VISta seruers are hvmg at the Groves now I IJ 1 I iJ ~ J II Goals - Number of Program goals to be achieved m fiscal year 2008-2009 list a bnef descnptlon of each program goal 2 Number of Dublm residents served by thiS goal Estlmate 470 (24,000 lunches yearly) Est:I:mate 100-350 rJ ,000 to 8,000 meals yearly) 1 PrOVIde the same or an mcreased number of Weekend Box Lunches to populatJons relocated from Attoyo V ISla, usmg the Groves at Dubhn Ranch as a drop off pomt 2 Contmue to proVIde hot meals to low-lUcorne fanuhes and adults on a weekly bas1s at 6444 SIena Court Use a separate sheet of paper If needed Amount of Dublin grant funding requested (match first column budget form #2) Overall Total number of DublIn reSIdents to be served by thiS program $18,000 ~ 600 ReSidents Commumty Development Block Grant Application CerbficatJon To the best of my knowledge and belief, all InformatIOn and data In thiS application and attachments are true and correct. No matenal mformatIon has been omitted, Includmg finanCial mformatIon If funded, I certify that the Agency IS wlllmg and able to adhere to polices and procedures specified by the City of Dublm, and If applicable, the appropnate program regulations of the US Department of HOUSing and Urban Development Further, I understand thiS IS not an agreement for grant fundmg and cannot encumber funds until the City of Dublm and the individual authonzed to execute contracts on behalf of the Applicant Agency, has Signed the contract, and If applicable, all federal regulations and paperwork are co a~ullre (Sllfnll1 blue Inft) President, Open Heart Coachen Titie 12-12 07 l!lla~e I ; II I jl I' II II I I ! I III , I I I j L I ~ P D D ~ D ~ D D ~ D o C G t) ~ ~ b) ~ ~ ~ ~ ~ to ~ ~ ~ ~ ~ ~ ~ ~ ~ b 78 ~ 133 VOLD are requDlfed to answell' each of tile questions following the famillt below, uSing 8 "h" by 111" white papel1', j],2-pOlnt type, WltIu l-nnch margins lDo not ID1clude the queshon nn your nallTab"e, however answers should be in oi'dell' and refer to \the COll'll'eSpondong number The lProgvam and !Budget i\laliTatwes are not to exceed four (4) total pages AU pages lUllusa be consecuinfely numbered! !Please all1swer each question evell1l of ia appeall'S repebbous If aIJohcable, comple~e an addatlonal page answel/1ll11g questions regall'dmg Caputal requests A I?l7Ogll'am Nall'li'atlve - maxlmlUlm 1tihlree (3) pages 1 Open Heart Kitchen IS requestrog fundtng to contInue to prov1de hot, nutt1t1ous meals and weekend box lunches free of charge to lOW-Income reSIdents of Dubhn Our 2008-09 budget projects SetVlIlg 7,175 Hot Meals, and 24,000 Weekend Box Lunches Accordmg to the Human Sennces Needs Assessment for the Tn- Vallry (ICF, May 2003), referencmg the cIt1es of Dubhn, uvennore, and Pleasanton. "econorruc expanslOn [has] also led to an extremely Ingh cost of hvmg tllitt has unpacted 10w- and moderate-mcome families d1spropomonately as they struggle to afford such baSIC necessIties as housmg, food, and serv1ces The ALmanac 0/ Hunger and Povcrry In CalifOT11til (2007) supports th1s findmg WIth data from the Alameda County Food Bank. 1 The Alameda County Food Bank found that among Its chentele, 43% of households made a chOIce to pay utilities rather than purchase food In choos1Og between food and hOUSIng, 47% of households allocated funds to hous1Og over food Thuty- percent made a chOIce to pay for heath care rather than food The result IS adults, seruors, and ch11dren eIther are gOlng hungry on a regular bas1S, or are SUbS1Strog on food that whtle mexpensIVe, has httle to no nutntiorull value To qualIfy for government-subsuhzed school lunches, an apphcant must have an annual household lDcome before taxes that must not exceed $23,107 If two people hve lD the household, $28,990 If three people hve ill the household, $34,873 If four people hve 10 the household, $40,756 If five people hve m the household, $46,639 If SIX people lIve m the household, or $52,222 If seven people hve lD the household, accordtng to the Cahfonua School Breakfast and Lunch program 2 Accordmg to the 2000 Census, 719 people hve m poverty lD Dubltn 3 G1ven the nsmg cost of hOUSlllg and gas, this number has hkely grown 1n the last ,>even years Open Heart KItchen will proVlde hot, nutt1tious meals:&om Its SetVlIlg location at 6444 SIena Court on Monday afternoons,:md deltvers Weekend Box lunche:. to former Arroyo VISta HouslDg Project reSIdents as well as low mcome Dubhn seOlO!S from July 2008 to June 2009 Hot Meals (mam prote1Il, vegetable, green salad, frutt salad, bread, dessert, and beverage) are served from 4 30-6 P m on both a "dme-lll" and "take-out" baSIS Multiple meals (up to 5) are allowed "to-go" Open Heart Kitchen proVlcies all meal free of charge and WIthout quahficatlon The Dubhn Hot Meal Program began III September 2007 ill response to a request from Cross Wmds Church to prov1de outreach to the communIty and theu: WItness of a grOWIng hunger I The Abnanac of Hunger and Poverty (2007), Hunger m Amenca Fmdmgs (2006), p 58 2 Cabforrua Department of EducatIOn, www ca.gov , http //www bayareacensus ca.gov/cmesJDublm htm Page 1 ~ ~ D D ~ D D p b D D D D D ~ D D D D ~ D D ~ D D P p ~ ~ p ~ ~ ~ ~ 9 ~ ~ D ~ ~ ~ ~ 9 D 19 % 13.3 problem ill Dubhn In three months (as of November 30), Open Heart Knchen has served over 900 meals Open Heart Kitchen currendy dehvers Weekend Box Lunches chrectly to Arroyo VIsta resIdents, and has begun drop off serv1ce at the Groves There IS no quahficatlOll process other than former residency ill the Arroyo Vista complex and detenmnauon by the Groves' adtn11IlSttal1on of ehgthtltty among ItS other eXlstmg tenants The cost of the grocenes and supplIes to prepare these lunches IS only notn1I1al. and two lunches are proVIded ill each box Wopung W1th an all- volunteer staff, other costs are rmnor and are pald out of Open Heart Kitchen's general budget. To-date (non-annuahzed), Open Heart Kitchen has delIvered Just under 22,OOOWeekend Box Lunches to low-illcome reS1dents at the Arroyo VISta HOUSlOg complex Out projected budget to contInue these programs IS $49,353, lOc1uslve 2 Our first goal 15 to contmue to serve the dtsplaced reSIdents of the Arroyo VISta Housmg complex by USIng The Groves as a drop pOIOt. Twenty-one fonner reSidents of Arroyo VIsta are hvmg at The Groves now We anl1Clpate a shght increase ill the number of Weekend Box Lunches, and esttmate servmg 470 Dubhn residents 24,000 lunches per year, as we also will make these lunches avatlable to the resIdents of the 16110w-mcome umts at the Groves who seek access to the program Our second goal IS to contInue the progress With our Hot Meal program, given Its prormsmg start at 6444 SIcr.ta Court Thts program has yet to be funded by the CIty, and to-date, we have served over 900 meals With a nm rate of 88 meals served every Monday between 4 30 and 6 00 P m As thIS program began In September 2007. we anl1Clpate that It will ramp up over the next 9 months, and out yearly total will range from 7,000 to 8,000 meals served to anywhere between 100 and 350 Dublm reSIdents Together, the Hot Meals and Weekend Box Lunch programs are workwg to address baSIC nutntlOn needs of Dubhn reSIdents who are hvmg at or below the poverty hne 3 Open Heart K1tchen IS overwhe1mmgly servmg the workmg poor In Dubhn The guests we serve ill Dubhn are Dubhn reSIdents who are strugghng to make ends meet and are at low or ve:ry low Income levels descnbed ill t:hts apphcal10n Many of our guests are female heads of households We have and will contInue to pubhaze out programs ill Spamsh and EnglIsh through the dtstnbuI100 of flyers and brochures We also conSlder the dietary needs of our guests, and often proVIde menus that feature fa.mthar Htspamc food and appropnate condunents 4 The measurement of success In our Hot Meals and Weekend Box Lunch programs IS two- fold Fits!, lUctease:. 10 the number of partlClpants means that we are provldmg a service that IS valued and the word IS bemg spread among guests of lts avatlability In addtnon to pubhC1Z1Ilg ill both Enghsh and Spamsh, Open Heart Kitchen "gets the word ou!," but teSl1mony from our guests IS the best source of new partlClpants Secondly, we stove to keep our food costs low The food cost for the Dubhn Hot Meal program 15 $1 25 per plate, the Weekend Box Lunch IS $100 per lunch We have been succeedmg 00 both front:. Page 2 ~ 1/33 IB IBlllll!llgea Narrrrarltuve - maXDlI1I'1IlUIm one (1.) page 1 Describe how this program IS cost effective and the budget IS reasonable for the anticipated result By leveragmg our food purchases W1th donated food, and proVIdIng our servtces W1th rmnunal staff and trulXlffium volunteensm, Open Heart Kitchen operatt..s extremely effecnvely The budgets we have estabhshed for the Hot Meals and Weekend Box lunch program are well researched and based on actual expenence proVldmg other hot meals and box lunches for programs operauog from our Ltvennore and Pleasanton locatlons 2 If th IS a ppllcatlo n does not receive fu nd lng, what WI II be the effect on the progra m? Our ability to contmue to proVlde hot meals and Weekend Box Lunches will be adversely affected by lack of fundmg At best, we would have to scale back the weekend box lunch d1stnbutlon and may not be able to conUOue servmg hot meals unless other fundlOg sources came forward to underwnte our costs to run these programs 3 Does the agency anticipate haVing any unspent grant funds at the end of the fiscal year? If so, explain why Open Heart Kitchen does not anncIpate haVIng any unspent grant funds at the end of the fiscal year 4 Complete Fmanc/allnformatlon and Budget Forms (Please specify the total program budget You must provide mformatlon on the common outcome indIcator which defines the amount of dollars leveraged by the grant request If you have any questions, please refer to the instructions for gUidance or contact program staff) I I , 'I II I I II ,) I tl ~ II I 2 WIll thiS proJect reqUire Implementation of Davis-Bacon/Fair Labor Standards Act? If reqUired, deSCribe how your agency will comply with thiS regulation (bid requirements, determine wage rates, monitor compliance, etc) " I Ih] , 'I, I [' I lill 11111,1 Iii II , C Ca[JJiUn IExlPellUldIfi1tll.nlJ'e lMalJ'lJ'a1tuve - lI1J1Iaidll'1l'1HllIm oll1le [1) pags, Ig a.1J)1P~fical!Ji~e 1 ProVide a detailed budget and scope of work for each capital expenditure or a constructlon/ rehabIlitation budget and deSCribe how you ascertamed these costs IPlleass counllSlc1t SllSliRf Dlllllllllllle<<llnaftelN n~ Y01lllll1laoo 2my 1llI1J.!IesftnollDs reg4l1l1'ldluIIDg lDJa.ms-lmacllDlIII rrelQIll.nlrrernrnellllfts i i I , I I , I 1'1 I I , ID l?al11forrmallllce ftfileasll.nlJ'e5 - iDse attacllJedl form 1 Select all goals and pnontles that apply (Refer to instructIons) " 2 Choose ONE ObJective, Outcome and SpeCific Indicator (1,2 and 3) ~ I , J I , I II I, I I 3 Complete all three sectIons for Common Indicator number 4 (Refer to AppendiX A ) I i I I II LI ~ l ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ; ~ b ~ ~ ~ b ~ D ~ ~ D P ~ D P D D D D ~t ~' /33 IF n UTI iID UTI ~ ij iBJ ~ ~ UTI fftOJ [i"U1J1] iID Rij (0) UTI [F (Q) lTU1J1] A<<ll<<llufru<<Dll1lcat~ JF>rogrraHnm [Fllilll1l<<llUll1lg $rlDllillr~e$ ~ $frcatff'ffUll1lg ~(Q)$fr$ Attach additIOnal sheets If necessary Additional program funding sources could Include, but are not limited to foundations, corporations, IndIvidual contnbutlons, events, reimbursements and In-kInd contnbutlons Types of funds are loan, grants, donations, in-kind, etc $(!l)lIIIrrce AlIlllHlIlllllll1lft !Use <<Il~ 1F1UIll1J(l:lls (C(!l)UU1l1l\l1l n Ittted? "IN Dublm CDBG 2008-09 18,000 Hot Meals and Weekend Box Lunches N Frve Bndges Foundatton 10,000 Hot Meals and Weekend Box Lunches y Safeway Foundatton 5,000 Hot Meals and Weekend Box Lunches Y EpiScopal Chanttes 4,000 Hot Meals and Weekend Box Lunches y Crescent Porte! Hale 10,000 Hot Meals and Weekend Box Lunches Y Cross Wtnd~ 2,353 Hot Meals y Church/IndtVIduals $49,353 31,353 I 18,000 I I I If you arre IlJJtlllzhug CfOllBiGi funds to pay auii' stnn costs, please lIst eillch el1lllJjJloyee/ftlile allll1l.tll tDue percenbge 01 tDneili' salal1'Y all1l.tll DDell1lefills ~l1lail: wnlllble paid wDttIhJ CIDIBG Include anue ~oUllllV1loll1llthly all1l.tll yearBy costs to !the CIDIBlG IIIr1'OgD'alm i\lo~e Yaca~nolll, SRCIlt leave amlllhlol!tlIays !roll' emJjJloyees call1lll1lot [be charrgecll io CIDlIBIG as IProgrr.m1l1l1l e1tlJlenses i\liOIl1lItlhJIy salarry & YearrDy salauy & New % salalrry & Iilelllelfnlts bellTIefift. coslt Itu bell1lefoft. cost to jplos!tiOD1l mUe cYjN) lIlalell ~OIi'WltIln gJrdlll1ll: $ granft. guall1lt OjplerraitfioD1ls Mall1lagell' N 5% $60 00 $722 00 $~8 $llJlllllel/'VlSOll' N 5% $21.00 $25700 lBooIkkeepeIi' N <1% - - j I I' (? ~ ~ C'J D ~ ~ [i) {;) ~ ~ (i) ~ ~ ~ [;) ~ E;l ~ ~ ~ ~ Q g ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ [;) ~ ~ ~ ~ ~ ~ ~ ~ ~ rJ.2a;[/33 Open Heart Kitchen Staff Quahficanons Nancy Wuson IS Open Heart Kttchen's Operanons Manager Nancy's background IS 20 years of guest semces and food preparanon She IS a graduate of the San FrancISCO Culmary Academy and Management College of San FranCISCO and IS Serv~Safe cemfied Evelyn Mattloh IS one of 3 Open Heart Kttchen SIte Supemsors She supetvlses the Dubhn Hot Meals program at 6444 SIerra Court along W1th other supemsory dunes at Open Heart KItchen Evelyn IS a h1gh school graduate and 15 Serv-Safe Cemf1ed She has been WIth Open Heart Kitchen for over 2 years Chene Stueve IS Open Heart Kitchen's Bookkeeper Chene's background Ulcludes accounnng and management majors at the Bachelor Leve~ as well as a Master of busUless Adnumstranon degree She currently holds a CPA cernficanon from the state ofWaslungton [i) b) b) Q ~ t;> ~ ~ ~ ~ 6) t;) ~ ~ ~ ~ ~ g ~ 9 G ~ ~ ~ ~ ~ [;) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ [& ~ ~ ~ ~ ~ ~ C.m1P1'Ital11Ex1lJ9111l5eS Constructlon/Reha bllltatlon PermIts and Fees Design Engineering AcquIsition Other Soft Costs (define) Subtotal Personnel Expenses Salanes:1 Benefits Subtotal Operating Expenses Supplles2 Pnntlng/CoPYlng Postage Telephone Rent and Utilities ACCD u ntl ng/ Aud It Other (Auto and EqUipment Repairs) Subtotal 'IT(Q)1A[, 8-3 1/33 JP>lTtIDglTaJlJ'i1illBSlliI(d]gte~ !F@lTlJ'i1il Dubhn Hot Meals/Weekend Box Lunch \c [Q) I81tGl G Ii' aI U1l1t 1J' o1taIB I?li'ogIi'aJ utnl 151U1(d]gceit $ $ $ $ $ $ $ $ $ $ $ $ $ $ $5,539/$5,185 $ $5~539/$5,185 $10,724 $ $10,724 $8,969/$24,000 $ $ $ $1,200/$1,260 $ $32,969 $ $ $ $2,460 $ $1,600/$1,600 $11~ 769/$26~860 $17.308/$32.045 $3,200 $38,629 $49.353 l8n.nrdlgel1: IPrellllalrrellll by (Name. 1Tlfle, 1Te/eph@D'De Number, IE-mall) LInda Hinton McKeever, Treasurer 925-580-1616 lmckeever7@comcast.net I Include, employer-responsible taxes workers camp & payroll S'-rvlce fees 2 Food and utensils (mcludmg contamcrs) 9 G Id ~ ~ B e 51 B B e ~ e e e e e 8 e ~ te ~ ~ {B ~ ~ ~ ~ o ~ Sip 1J33 ~te uif(Q) Ir[l'ffi](d][l'il~te M te(d]S [U] IrteS (fIll out a Performance Measure for EACH goal and/or obJective) Page 1 of 2 Agell1lcy I?vagl7am OPEN HEAR'! KI rCHEN DUBLIN HOT MEALS AND WEEKEND BOX LUNCH PROGRAM: Actuvu1ty Free meal ServIce to the workmg poor of Dubhn GoaljOlb]sctBve Weekend Box Lunches to populauons at and bemg relocated from Anoyo VIsta ProJect 1?%aaS0 CUH'C~S at ~sas(t allDs af a.mciIll off tillla 1foUUowBlI1lg goaRs alU'll([!] IPIi'RCI1u1tuSS wlhlicilll alii'S alP1P~DcabDs to 'ltihlus activDity, goa~ &; albjectuve Refer to Instructions to complete RFP for a list of the goals and prioritIes IHIIUIlll Sb'a1iegic Goal HUIlll !Policy iPlruOll'Dtty 1 1 4 4 ~ 5 6 1HI0w ws&R )fOIlDII' agsll1lcy Ibelnlsffutl: IOltllllblm I7SSUa:JISIl1l1ts? Many famtltes, adults, and smgle mothers are sttugghng to make ends meet The money they save by recelvmg box lunches on the weekends helps to fund other aspects of thett hves-money for gas, rent, uttllues and as they are healthy lunches, Open Heart KItchen IS pWVldmg nutnt10nal value to both adults and cluldren 1ll Dubhn JPlRsasa li'e1fsli' '!to RIlUS11:ll'tllIctUOl11ls to cOl11l1llJllIste !RIFf 1far lIIIescll'op8:i<<m o1f [FllellifOl7milll11lCa MeasllIlll'es :ll. Objedove (seUectoll1le) 2 OlUltcolll1le (select one) ~ Creating a SUitable LIVIng EnVironment o Availability/Accessibility D Providing Decent Affordable HOUSing ~ Affordablllty o Creating Economic Opportunities o Sustalnablllty 3 SllD12clifiic DIIllClIDCa1lolT (select lime) o PubliC faCility or Infrastructure @ PubliC servIce D Targeted revItalization o Commercial fac;;:ade treatments or bUSiness bUildIng rehabilitation o Brownflelds remedlated o Rental Units constructed o Rental Units rehabilitated D Homeownershlp units constructed or acquired With rehabilitation D BUSiness assistance D Owner occupied umts rehabilitated o Direct fmanclal assistance to homebuyers o Tenant Based Rental Assistance (TBRA) o Homeless shelters o Emergency hOUSIng o Homeless prevention o Jobs created D Jobs retained o BUSinesses prOViding goods or services " ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 6l 9 &1 ~ ~ & 9 9 & ~ @ b) & &1 9 ~ B ~ ~ 9 9 ~ ~ 9 9 9 ~ ~ & ~ ~ ~ ~ 85 ~ 133 [plceOO[1'IJ11ilSlD1l~ce M(fl~$IlII[1'ce$ Both pages must be completed for each program Page 2 of2 I ( \, 4 Commol1l ~lI1dDcator a Total number of chents you anticipate selVl ng - choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES " \ Households Persons ~ 600 b 18realllolUla tltae 1IU1UImbel1' of clients YUill an'tncDjpaie serving ~D1l tllne following caaegoB'lles Low , Very Low Female Income Income Disabled Headed Semor Youth Homeless (>50%) (<50%) Households 132 160 8 90 50 150 10 Appendix A Income LimIts by household Size, established February 2007 ThiS table IS provided to assist with completmg question #3 m the narrative and the tables In Appendix B Family Size Very Low 50% of Median ~ ~~-~- r--- l I I Low I 80% of Median I I Extremely Low I I 30% of Median 1 I I I I 11 person I $17,600 '------$29,350 $46,350 I $58,000 ! 2 Persons 1$20,100 :-$33,560--I$53mo-~ $66,200 1-"3 Perso-ns-i- $22,650 1$37,700~i $59,600 -1$74,500 i-4Persons-i$25,15()-i-$4i900 --1- $66,250 i -$82,800 r i 5 Persons r~--$27}50 ----I $45250 - ~7I:55o-l- $89,406~1 16 Persons I $29,100--[-$48:600--; $76,850 i $96,000 I I 7 Persons I $31,200 I I $51,950 T- $82]:50 -i $102,700 I I -r~-----I r 8 Persons I $33,200 I $55,300 I $87,450 $109,300! Median Income Moderate Income $69,600 $79,440 $89,400 $99,360 $107,280 $115,200 $123,240 I $131,160 ~ HUD updates thiS Income chart each year The City Will provide all FY 2008-2009 Subreclplents with the most current data when It becomes available Source US Department of Housmg and Urban Development, (HUD) Data for Oakland SMS ~ ~ ~ ~ 81 E9 ~ 8 E9 8 9 9 8 9 e E1 [1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ B ~ ~ ~ ~ ~ a ~ . ~ ~ , ~ l I I ~~/~ [?)<e R1lOl tJ'U1lil~ ll1l~<e Wi] <e(OJS [j] f1'<es (fill out a Performance Measure for EACH goal andjor obJective) Page 1 of 2 Agellllcy JPlvogrram OPEN HEART KITCHEN DUBLIN HO r MEALS AND WEEKEND BOX LUNCH PROGRAM AcftivBty Free meal serv:tce to the workmg- poor of Dubltn GoaDjfOlliJ]eCO:Dve Prepare and se1Ve 7,000 to 8,000 free hot meals for reSident:. of Dubltn I?~easa di'c~18 ail: Bl8ast Ofllle of each o1f 'I11h1l9 1foG~owfifl1lg gOill~s allrnidlll'lTOOrrfifdes whicll1 arre atll'll'~fic.iIIl\)~e '0:0 'I1:lln!s ac1thfu'I1:y, goaD!! olbwsctivs Refer to InstructIons to complete RFP for a list of the goals and prioritIes 1HI1U[ll Strategic Goal IHIIU IDlPoni cy IPri1 Dni)' 4 4 6 IHIIDW lIlfu~D YOllDrr ageflllcy l\)efl1le1fi1t ILlIlDIiJDufl1lll'ssoidlellll'lls? Many fanultes, adults, and SIngle mothers are strugghng to make ends meet The money they save by reCe1VUlg hot meals by dtrung 10 or taktng several <'to-go" helps to fund other aspects of theu: hves-money for gas, rent, ut1htles and as they are hot, healthy meals, Open Heart K1tchen IS prOVIdIng llutntlonal value I?~sase rre11'sli' '110 llll1lstlTllDctilDfl1lS frIO com[DDefcs IRIFI? 11'01i' idlsscrrnlPfculDlI1I of JPlerioll'matfl1lce MeasllDlTes n OllJ~ecfcDwe (seBec1l: oll1e) 2: Ou1l:come (seled one) ~ Creatmg a SUItable Llvmg Environment o Avallabllltyj Accessibility o ProViding Decent Affordable Housmg ~ Affordablllty o Creatmg Economic OpportunitIes o Sustamablhty 3 SIID&Cuific Dl1UcIIlcall:oli' (se~ec1l. one) o PublIC faCIlity or mfrastructure ~ Public servIce D Targeted revitalization o Commercial facade treatments or business bUildIng rehabilitation o Brownfields remedlated o Rental Units constructed o Rental unIts rehabilitated o Homeownershlp unIts constructed or acqUIred wrth rehabilitation o Busmess assIstance o Owner occupied units rehabilitated D DIrect fmanclal assistance to homebuyers o Tenant Based Rental Assistance (TBRA) o Homeless shelters o Emergency housmg o Homeless prevention o Jobs created o Jobs retamed I I I I I II, II o Busmesses provldmg goods or services [I III I \ I, f I g'11 /.~3 jp}<e 1llf<ID[flITn] iID 1l1l(C<e ~<eaJ$lllI [f~$ Both pages must be completed for each program Page 2 of 2 41 CommoUll nmjllcaoor a Total number of chents you anticipate selVln g choose one or the other DO NOT PROVIDE SlATS IN IBOTH CATEGORIES Households ~ 600 Persons ill I8reakollllt ilie llDumilJelT off cRienlls you i1ulDlticlpate seMr1Ig In the 1followirug categolTDes Low Very Low Female Income Income Disabled Headed Senior Youth Homeless (>50%) ( <50%) Households 132 160 8 90 50 150 10 Appendix A Income Limits by household Size, established February 2007 ~ ~ ~ ~ ~ ~ ~ This table IS proVided to assist with completing question #3 In the narrative and the tables In Appendix B & I-~ --1----- ----- , -- - -- -- -- r--- I I : Very Low I I I Extremely Low ' I Low I Median MOderat:-1 I Family Size 3001 f M d I 50% of I 8001 f M d Income I 10 0 elan M d 10 0 e Ian I Income I lie Ian i I I 1 I i 1 Person $17,600 ~~$29,350: $46,350-\ $58,000 $69,600 12 Persons r $20,100 :-$33]00 -:-$53,000--1 $66,200 1$79,440 I I 3 Persons--i$-22]5o----r $37,700 -1--- $59,600--:--$J,;f.5oo-1 $89,4001 i 4 Persons[- $25~150 [$41,900--- -;$66,250 --f $82,800 i $99,360 I I 5 Persons 1--$27.150---~- $45~256--r---$7L550--1 $89,400 r $107,280 I 6 Persons r $29,100 r-~860--O- $76,850 :- $96,000 I $115,200 I 7 Persons $31,200 I $51,950 $82,150 I $102,700 1$123,240 I !8 Persons 1$33~--r--$55,300--:-$8iA50--- I $109,300 I $131,160 J & & ~ ~ ~ & ~ ~ & & & ~ ~ ~ ~ l\ HUD updates this Income chart each year The City will proVide all FY 2008-2009 Subreclplents with the most current data when It becomes avaIlable Source U S Department of Housmg and Urban Development, (HUD) Data for Oakland SMS I 'I I I I I 'tl " , I I I , I I I ~ t;l ~ ~ ~ ~ ~ ~ @ E$ ~ ~ ~ ~ ~ ~ ~ ~ t\9 e @ @ ~ ~ ~ ~ ~ ~ @ ~ ~ ~ ~ ~ ~ @ l@ ~ @ ~ &2 i-J33 5 Environmental Review Requirements Source documentation requested below Includes, but IS not limited to 1) personal experience of the Individual completmg the application [mclude name, title and date], 2) another individual experienced with the subJect [mclude name, title and date], 3) publication or other documentation [Include title and date], etc ) Category Source and/or Documentation A Hlstonc PreservatIon Will the project affect any hlstonc properties or areas? If so, project may take up to NO 90 days to clear with State Hlstonc Preservation Officer before contracts ca n be executed B Floodplain Management To be completed by County staff C Wetlands ProtectIon Does the project Involve new construction within or adJacent to wetlands, marshes, wet NO meadows, mud flats or natural ponds per fIeld observation? 0 Coastal Zone Does the proJect Involve the placement, erection or removal of materials, or an NO Increase In the use In a Coastal Zone E Sole Source Aquifers The proJect IS not located wIthin a US EPA-deslgnated sole source aqUifer watershed area per Apnl 1990 Memoranda of Understanding [HUD EPA MOU of 1990] F Endangered Species Will the proJect have any effect on any federally protected (listed or proposed) NO threatened or endangered species? Use personal experience or contact the National Wildlife Association to determine If there are endangered species present m or around the project site If the area IS already urbanized, note thiS citing your personal expenence/observatlon Include the name and tItle of the mdlvldual makmg the determmatlon and the date, or the name of the publication that supports the fmdmg G Wild and Scemc Rivers None In Alameda County H Air Quality Will the proJect affect air quality durmg construction and/or operation? (If there IS potential, IS the NO project located within an "attainment" area or If It IS withIn a "non-attalnment" area, It conforms with the EPA- approved State Implementation Plan) Use personal experience or obtain mformatlon from local Planning De pa rtme nt or EP A rega rd mg the effect of a Irq ua IIty In the area of the proJect Include the name and title of the IndIVIdual making the determination and the date, or the name of the publIcation that supports the flndmg g,? ~ ~ f;l ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 9 ~ ~ ~ ~ ~ ~ ~ ~ ~ [@ ~ &9 ~ ~ ~ l?Y ~ 9 ~ ~ ~ ~ 811 133 Category Source and/or Documentation I Farmland Protection Does the project site Include pnme or unique farmland, or other farmland of statewide NO or local Importance? Use personal expenence or the local Plannmg Department to determme whether or not the site will affect local farmlands If the site IS already urbanized, note this cltmg your personal expenence Include the name and title of the mdlvldual makmg the determmatlon a nd the date, 0 r the na me of the pu bllcatlon that su p po rts the fmdmg J NOise Abatement and Control Does the proJect mvolve development of nOIse sensitive uses, or IS the NO project m the Ilne-of-slght of a major or artenal roadway or railroad? K Explosive and Flammable Operations Is the project located an "Acceptable Separation Distance" from any NO above-ground explosive or flammable fuels or chemicals? Use personal experience or obtain mformatlon from the local fire chief or EPA to determine If the project IS located an acceptable separation distance from any above-ground explosIve or flammable fuels or chemical containers Include the name and title of the mdlvldual makmg the determmatlon and the date, or the name of the publication that supports the fmdmg L ToxIc Chemicals/RadioactIve Matenals Are the subject and adjacent properties free from hazardous NO matenals, contaminatIon, tOXIC chemicals, gasses and radioactive substances which could affect the health or safety of occupants or conflict with the mtended use of the property? Use personal experience or the local fire chief to determme that the project IS not located wIthin 2000 feet of a tOXIC or radioactive site Include the name and title of the mdlVldual makmg the determination and the date, or the name of the publication that supports the fmdlng Airport Clear Zones and Accident PotentIal Zones To be completed by County staff N EnVironmental Justice IA) The proposed site IS sUitable for Its proposed use and Will not be adversely NA Impacted by adverse environmental conditIons, B) Site sUitabIlity IS a concern, the project IS adversely affected by envIronmental condItions Impacting low Income or minority popu lations , " ..... ~ ~ '" "''-", oii-- .y ~.... ~o ~ /3.3 ~[E@(Ul[E~u [P(Q)~ W(UJ~[Q)~~@ ~~(Q)~(Q)~~[L ~~~~~~~ lr~(Q)~ ~~~~[Elr IF@~ lF~~~~[L ~~ ~@@f25c~@@@ (C@[JUi] [ffii)[!J]!fi)D~ [D)~w~~@~[l'i]]~[ffi~ 1B5~@~~ @ [f'(aHru~ ~[f'@[g[f'(ffi [ffii] CS ((, Sl',pponX REC~I\flE[) DEe 1 3 2007 DUBLIN PLANNING /) IOPlAA ~" ~ c~ oGAl[t~~OOr~\-I ATTACHMENT 1 G: ~ IWjp)U U @tB]'ltu@Ui} ~ [)'i}~@ ~U u~~ [0)(0) N(Q)1I' Ir$~ll/lm ~lhJn$ $Ihlre$~y ~[pl$rrn(d]D~re ~ WIr witlhlrelr rnroD$&re~~~lTiltelwll/l$ DlTilroll'lJ1l'll~~D(IDUllQ 'Wfiitlhl W@ll/llr ~1Ul[ID~Dte~ihi$IT1l. q I 1/33 Provide one anginal and one cooy {total2l of the following Items o Agency tnformanon and proposal summary page o Program and Budget NarratIve -not to exceed four pages o Capital Expenditure NarratIve - 1f apphcabJe - not to exceed 1 page o Fmancla1 InformatIon Form o Ifapphcable',bnefbackground of staff and those bemg paid Wlth CnBG funds (Do not exceed one page Attach to Budget Form #1) o Bu(Jget Form o lPerformance Measures ProVIde one coQyof the fol/owmg mfol111atlon - b.\ttbJ~ 100 <<Dll'1iglll1laJ~ #! Copy of current annual budget for the entire agency , ' , #2 Copy of most recently submItted IRS 990 fonn (complete form) #3l.tst of Board ofDuectors . , , Please submit ONE copy of each Item listed below ~ b.\ttaldil1bol1tll11e m'UgHll1IaJ ~ , , ~ ~ ~ t:..,:;or I 01 Background, expenence, purpose, capaCity, types of Service proVIded o R~;um,e or Vita of ExecutIve Drrector, Program Manager, and Fiscal Officer f ; o Personnel pohCles mcludmg affirmatIve actton plan and gnevance procedure o Agency audit requuements and copy of last audit \ o Type of msurance carned, bondIng, workers' compensation o Arttcles of Incorporation/Bylaws o Contbct of Interest Statement (If not mcIuded m Bylaws) o State and Federal nonprofit determmatIon letters (If apphcable) o Orgaruzanon chart 0, Board of Duectors' authonzatIon to request CDBG fundIng o Board of Duectors' deSignatIon of authonzed offiClal o 11" 1St of Board of 01 rf"rtors With thf"tr contact mformatlOn ~c( ~ 133 [F1f ~@(Q)~~~@@!ID !CtID!lUll rnTil ll/l1r1l U ttv 1D)(6~re~lID [plrnTil $lTilit ~ ~ tIDte ~ (GJ rr~lIl1l~ ~[PJ ~ U ((;: al~U rID rrn Seruor Support Program of The Tn Valley Agency Name Address 5353 Sunol Boulevard Pleasanton, Cahforrua 94566 ExecutIve Director Marlene Petersen Contact name and title Marlene Petersen, Executive Drrector Contact phone and fax 925-931~5378~ 925-931-5391 Contact e-mail address MJcpetersen2002@yahoo com organizatIOnal Background Private Non-Profit C2J o Public Agency D Other (DeSCribe) Tax ID Number 20-3225569 List years previously received City fundmg 2003-2007 .-e , " ", .\ ' Date Recetved f~" 3 \ I # " ~ l STAFF USE ONLY CommuDlty Development Block Gran/ApplicatIon Cover Sheet Page 2 q8 &;f J~3 Proposal Summary - (A program may contalR sereral goals) Capital Request Program name Bnef Program summary o OR PubliC Service Request [gJ (check one) Case Management Case management IS a process that assesses, plans, Implements, coordmates, momtors, and evaluates the options and services reqUlred to meet the semor's health and human service needs promoting qualIty and cost effectIve mterventions and outcomes Goals - Number of Program goals to be achieved In fiscal year 2008- 2009 list a bnef descnptlon of each program goal Number of Dublm residents served by this goal 30 To provIde Dublm Semor Crozens With case management semces that W1l1 foster mdependence, promote safety and well being, preserve dIgmty and Improve quality of life To reach 50 semors With one lime Serv1ces 50 Use a separate sheet of paper If needed Amount of Dublm grant fundmg requested (match first column budget form #2) $15,000 Overall Total number of Dublin residents to be served by this program 80 Commumty Development Block Grant Appllcanon CertJficabon To the best of my knowledge and belief, all information and data In this applicatIOn and attachments are true and correct No matenallnformatlon has been omitted, including finanCial information Iffunded, I certify that the Agency IS wlllmg and able to ad here to polices and procedu res specified by the City of Du bll n, a nd If a pplJcable, the appropnate program regulations of the US Department of Housing and Urban Development Further, I understand this IS not an agreement for grant fundmg and cannot encumber funds until the City of Dublin and the indivIdual authonzed to execute contracts on behalf of the Applicant Agency, has signed the contract. and If applicable, all federal regulations and papelWork are completed tl..~) //k~; Auth ed Slgnaiture (sign In blue Ink) c/R/'d~ 1!2,fi1L L~ Title /<< /13 iuv7 Date ' Cf4 ,-.?3 VOIlB}a~e ~eClllDiretll to answer each of fthe (lfWlestJOIl1lS ifollo~ng fthe ifolJ'l1l1lalft IlJelowj using 8 Yz" by JUI." wllulte paper, 12 pol 111ft iyp~, Wlfth l-io1ci1'onalglns "Do ll'Roft 1'D1Ciude iBIs q~eSbou1ijUD yc)urt'navrilli~e, ltooWeVer ali'sweR's sholllld IlJe II'D order agu:i referr: .p. ..; .....~.....~ f ~ ~A ..~.~.,:~)..>q;-Y;;~ ....... '*\....:'~ be..o.~ .... i r l'i\ J' ~ ~.;L""~ !i4.....~ ",j .......'"'.t \ ~ Vl. L ~ l ~} r{o. "" ->I~r.:t'\(, '} J..,. ~Wi[oI{' "",-'fl:Io..~ \to 1I:he corresl!lOD'llding 1I11\J111i111lJer lhe Program and! Butllgeft i\larrraihfes arre" noft ftO exceed ifom (4) iotal pages An 'paigeSe n'{~ I;> J4 { ,.... ).. {.t.: ~ if '"Z. : .,., !{"w!; \'>'II.,.; '(' '!tt \J.o 1'..-p.....:J.;.1- X"- t .--- ~ J,.. {;";t.... mWlst 100 COIllSecl.lltwely nUJImberedl }Please answer eaclll CIIuestlol1l 8WlI1llf It allJpears\ IrepeiitioillS Df aIltJDllcable. compie~ ' a~ a~dfi'loUnaii~ge~ill1lsiklr(~g q'ue'sftlons' rregaf~ng Callplfta~ !iequtJs1lS' ", I " ',!,:~ < ,~' ((' ~ "~ t^: ;'A: II A Progl1'alm Narraft~"e ~ ma){lmum UOlree (3) pages 1 While sCience has enabled a greater number of people to hve longer, It has not found a way to ehmmate the problems associated with agmg Chromc Illnesses can prevent semors from mamtamIng an mdependent life The common practIce of rapId dIscharge from hospItals compounds the problem as sernors are routmely discharged long before fully convalescmg For these sentors especIally, the need for assIstance IS cntlcaI For sentors who are copmg With chromc Illness and disabIlities Simple tasks such as batInng, dressmg, cooking, shoppmg and handhng financial affairs are extremely drfficult, If not Impossible Ifleft alone. the serner's mabllIty to perform these daIly tasks can often lead to premature mstItutJOnahzatIon The financial burden can qUIckly deplete an entire lIfetime of savmgs When a semor no longer has the resources to pay for care, society must bear the burden, as tax dollars subSidize mstItutIonalIzatIon Case Management IS the cntlcallmk between seruors In need and assistance aVaIlable m the commumty The mltIal contact With a semor IS usually a request for help and/or mformatIon Most semors have never reqUIred asSIstance before and they do not know how to Identify theIr needs or what types of servIces are aVailable In the commumty Often times, they are III a CrISIS or dIlemma Case Management sefVIces are proVIded directly m the sernor's home An IllltIal assessment IS made of the hvmg Situation and needs TIns assessment conSists of an evaluatIOn of the seDlor's phYSical, mental and emotIOnal status, as well as an assessment of the need for assistance with daIly hvmg activIties After the IDltIal VISIt, a care plan IS formulated With the semor, and famIly If mvolved Case Management sefVIces mclude problem solVIng, locatmg, arrangmg and momtonng services such as transportatIon, meals, safety deVIces, to-home comparnons and workers, assessment for financial aide and benefits, and any other ServIces necessary There IS an Increase m clients who present complex SItuations requmng many additional hours of case management Many of these seruors have hIstones of mental Illness or have dependent functionally Imparred chIldren hvmg WIth them We are findmg semors whose homes have fallen mto dISrepaIr and/or are cluttered to the pomt of safety hazards These cases can seldom be closed as they reqUIre frequent momtonng over a hfetIme to prevent backshdmg The addition of semor housmg m the Dublm area also bnngs additIOnal seOlor reSIdents, many who are In need of case management services Other new semor reSidents reSIde In pnvate apartments and smgle fanuly dwellmgs and have moved to the area to be closer to theIr children Although they may have the support oftherr farruhes, mformatIon and referral wrII be needed to access resources Sometimes the most vulnerable IS the semor who has aged III place This IS the seruer who IS often hvmg alone and has been a long tIme CitIZen of the commumty, supporting ItS growth and contnbutmg taxes, tIme and employment that have helped Dublm to become an outstandmg City, and now IS m need of support themselves CfS- ~/33 In the City of DublIn the semor populatIon (65+) has grown by slgmficantly III the past aecade StatistIcs are not avaIlable for the 60-65 populatIOn but we do know there are approximately 1,381 semors (65+), of those 11% are over the age of 80 while 20% are 70-79 Current data shows that as many as 80% of semors have a chromc condItion such as arthrIttS, heart disease, dIabetes, and sensory Imparrments Nearly 20% are 10 need of support services These statIstics are mdIcatlve of the growmg need for support servIces We have minImum fundmg for case management services That IS why we appeal to each City m the Tn-Valley to provide thIS necessary service 2 30 low mcome or very low mcome semors will receIve Case Management services 50 will receIve one tIme only services 3 All program reCipIents served through this grant will be Dublm reSIdents aged 60+ Pnonty IS gIVen to those hvmg m the greatest economiC need, who are functionally ImpaIred and/or mmontIes Semor Support staff contmuously does outreach to the semor population and to the commumty at large BeSIdes one to one outreach we try to do a mmlmum of one commumty outreach monthly Our case manager works closely WIth the Dublm Seruor center coordmator and staff Our outreach efforts at semor apartment complexes allow us to reach semors who are homebound and unable to get out on their own We also conduct presentatIons to groups m the commumty, such as employee groups, clubs, churches, services groups and caregiver workshops We have multtlmgual staff, volunteers and mterns who can outreach m areas as needed Our brochures and handouts are pnnted m Chmese, Spamsh and English Semor support staff IS very senSItive to and aware of dIfferent cultural needs We work well WIth the seruor's familIes and frIends to make sure proper servIces are In place We also attend trammgs m multIcultural needs 4 Success III Case Management IS defined by the Improvement III the qualIty ofhfe of the seruors who have receIved our servIces ThIS Improvement may be evIdent m a deaner hvmg environment or Simply m the relationshIp forged between case manager and semor chent It may be eVIdent m the fact that the sent or has remamed at home or has been able to remam at home a lIttle longer It may be eVident m a smile when a fnendly VISItor calls or VISIts It may be eVIdent when the fire department no longer needs to make repeat calls to lIft a sentor off the floor Case management IS all about small successes Our pnmary functIon IS to gIve sentors the tools and support that Will enable them to make the chOices necessary to mamtam theIr mdependence, Improve their qualIty of lIfe and ensure thelr safety and well bemg With dIgmty m tact All of the components of SeDlor Support Program of the Tn-Valley are deslgned to enhance and Improve the bves of our semor CItIzens Case Management links seDlors to services that proVIde meals, transportatIOn, home care, safety deVices, socIal actiVIties, medical care, access to government benefits when appropnate and a multItude of other resources When baSIC phYSIcal, social and emotIOnal needs are met, even m small Increments, hves are changed and enhanced 5 q~ ~ 1!J3 Because of the geographIc IsolatIOn of the Tn-Valley, It has made It necessary for eXIstIng agencIes to work cooperattvely m order to deliver the most effectIve care possible We are proud to work collaboratIvely wIth many orgamzatIons and agencIes throughout the Tn-Valley and Alameda County We have establIshed hnes of commumcatlOn so that mformatlon and referral flow between agencies For example, Echo Housmg IS an agency that we work closely WIth to provIde semors WIth housmg aSSIstance, reverse mortgage mformatIOn and shared housmg In reverse we are able to provide them WIth services for theIr cltents We also have a strong collaboration WIth Spectrum Commumty serVIces When a chent needs meals brought to them we can have the meals started With one sImple phone call To attam one of our goals to reach the shut-ms m cnSIS, we developed a strong collaboration/partnership WIth the LIvermore/PJeasanton FIre departments and the Dublm, Pleasanton, and LIvermore PolIce Departments When a semor IS III CrISIS, these departments Will call us Our case manager responds by workmg With the chent or the famIly to provide essential servIces ThIS has helped to elImmate repeat 91 I calls We have been workmg closely WIth the DublIn Semor Center for many years TheIr staff often refers chents that they are concerned about The Semor Center IS often a part of our case manager's care plans In addItion to the above collaboratIOns we have developed strong relationshIps With the Valley Care and KaIser SOCial workers We have two ongomg support groups, which we do collaborattvely WIth the AlzheImer's ASSOCIation Some of the other agencies that we work WIth are Health Insurance CounselIng and Advocacy, Legal ASSistance for Semors, Legends, Adult Protective ServIces, Public Health, Open Heart Kitchen, Tn Valley Haven, WIesner FoundatIOn, Salvatlon Army, SOCIal Secunty, In-Home SupportIve ServIces and the local transportatIOn agenCIes Once a year, the staffworks closely with the CIty of Dub 1m and the Dublm Pohce Department, assIstmg semors With cleamng theIr homes, gardenmg and mITIor home mamtenance We also have a relatIOnship With The Tn-Valley Rotary provIdmg them WIth referrals ofsemors who need home clean ups or m100r home repaIr Several DublIn resIdents were mcluded m thiS project 6 The maJonty of semors served through our program are VISIted III their homes where a complete assessment IS made oftherr needs If they should need to corne to the offices, we are located III the Pleasanton SenIOr Center m the area that was ongmally deSIgned for an adult day care program It IS wheelcharr accesslble and has three handIcapped restrooms It IS also on a major bus route 7 Tltle ill fundmg, Area Agency on Agmg, funds our care-gIver program along WIth our fhendly vIsIt10g program Through the PublIc Authonty for rnss, we proVide our regrstry servIces BehavlOral Health ServIces IS our sole proVIder for our very successful Alcohol and Drug Program In the past three years we have been able to have fundmg from the Pubhc Health department to proVide a nutntIon and fitness program where the seOlors hve Tills along WIth grants and pnvate donatIons are what helps us to proVIde services to semors 10 thIS community As you can see all the above fundmg IS for program speCIfics We are m contmuous search for new fundlOg that could proVide case management servIces At tills tIme each CIty In the Tn Valley proVides fundmg for the elders III their own commumty Wlt~ thiS fundmg we are able to mamtam our current levels of servIce 8 Budget Narrative - maximum one (1) page 1 q1 ~ f33 Each new chent costs approximately $50000 per year, the services provided to the semors mclude but are not hmIted to o Imtml Intake o Home VISIt (assessment of senior's needs) o Care plan and Implementation of services o MOO1tonng on a regular basIs o Referral of registry workers o Referral of volunteers To serve 30 clIents the cost would be $15,000 The agency also responds to approxImately 500 InfOrmatlOn and referral calls per year and serves approximately 50 one tIme serves, clIents that take extra tIme for Information but we find It not necessary to open a case These costs, compared to a mInImUm of$68,000 per year per chent for InstltutlOnalIzatton, that often becomes the taxpayers responslblhty, are very cost effectIve Semor support stnves to keep cost at a IllinlffiUm We are grateful to the volunteers who help with office support and telephone reassurance 2 There would be no case management servIces for semors hvmg m the Dublm Community 3 The agency does not antIcipate havmg unspent funds at the end of the fiscal year 4 See Form ~ Uil[ffiIJ1]@UiID ~ ~ 1J1l1ITIDU'f{ffi]<a]{tUlIDUil!r@[I'[MJ AIDIIDIuftD(Q)IT1l~~ W>rrfIDgTfIBJrnTil lFll/llTilIDIurr1lg ~(Q)8.Il1i'@<e$ ~ $ft1Blff(ffill1lg t(!])~ Attach additIOnal sheets If necessary q$ ~ ,33 Additional program fundmg sources could mclude but are not limited to foundations, corporations, IndIVIdual contnbutlons, events, reimbursements and In-kind contributions Types of funds are loan grants, donations, In-kind etc ) v... l.e oS ~f' ..:.. ...~ ........... j ~ ~J ~ {1 ~ 01 of- , J Jle...... ~,.. tv.- t'" J ~ "" ~ ~. "" ~ 'li:lJlalllllR'Cll!u ~ 1;1 ~ :: /' 'A ~1IlI1I<<DllDUlIft' , t ' ~, .., \ ~;( I~) i -' X' \,1 -I'.t w,;, ,>> J r'" \ ~ 1'1"".). } 1- Y ;1, '<.. ",' .I "' \!J~ll! off ~~ITll~S " v; "I. .~ -t ~ t ~ \ ~..;:.. tf' \ 1 ((;<<DlIII1lll1l'llitt~tdI"i> I ~ 'tfl~ {C "','1' CIty of PI easanton 30,000 In-Kmd Office Space y Area Agency of Agmg 24,893 Case Management Tn Valley/Sunol y TOTAIL S54,8S3 nlFJOlIJI aIrS mUnWDDg CID>I8G ffuallUcIIs ~ ~ llullv sftsJW iOOsis, IIJ-se nnst Nelli ellTl1lplcyee/ltDRne allUdI ttItoe percellUtage m RMlr sanSJI'y allUtlJ OOBlle1Fib Rnnai wilB be panlll wltlII CDIaO IIneUude illBe total lITI1loniltdy and yearBy costs ro ftBie COBO progrrmonn i\lolte VacsticJlon, sftellt nemre aontDI ihlGJlUIllialys ill' elll1llllncyees CBlon6llGJlft IlDe cllB2lrtge(!l (to CDIiiG as lOWIlglrinM expenses ~ >c \ I <J I l' ",.c "~1;"Y 'j" .F' N I j Itf /.,.5 1"(' ,'l ,.. 1 Yearly salary & Ibeneii1~ ' '\, ^ , ~J' ~~ ,. ;1,,1;; , (f~""/ ?; lit 'jl ew " !/~ % salauy & IOOl1lefi'tsi ! ~ ~7 MoonttBlly 5aI1a&y & I .,,, ~ > ""\ Po !tf :r!~1 - & ',~' !. ! (y IN) r' ~ ~, be~e1lllft cOs~ Ro grall1lft r 1,..),if.. r ,. S 99, e , <f~ ~, S)SlICl11ov wiilll gmrot $! I ' cost ftGJl gU8nft 1 \ , Case Manageii' ~ 30% $79200 $9,50~ 00 Director/Case Manageii' N O~% $191 00 $2,292 00 Assistant i\l 05% $204 00 $2448 00 $jL4,24~ q1 f /33 " Personnel Assigned to this Project The key staff dIrectly responsIble for this program wIll be the dlrector,case manager and assistant Semor Support IS also fortunate to have a dedIcated staff of gerontology specialists Also on the team are a hcensed Marnage and FamIly Therapist, nurses, Our quahfied team WIll IdentIfy the semors and provide them wIth essentIal m-home services as needed to mamtam mdependence Marlene Petersen IS the Director of the Semor Support Program and case manager Ms Petersen has been In the field ofgenatncs SlOce 1985 She served as volunteer coordmator, case manager and aSSisted In the elder abuse preventlon program and regIstry services Ms Petersen has nearly two decades of expenence non on-profit servIces and has been a key player In Implementmg the m-home counseling services and the Partners m Safety, and the newest nutntlon and fitness program Ms Petersen also serves on a variety of boards mcludmg the Alameda County PublIc Health AdVISOry Board, the Alameda County Budget Committee, the Pleasant on Seruor Center Management Board, the Public Authonty In-Horne Support Service Board and the SeOlor Coahtlon of Alameda _1>- County AdVISOry Board ", Antonette Copeland IS our Case Manager, she has a BA 10 Psychology, and a M A III SpecIal Education and a Standard Teachmg CredentIal She IS also a certIfied RehabilItation Teacher She has an extenSIVe background III worlang with the blmd and vIsually ImpaIred She provIded Ill-home assessments Implemented program, developed care plans and InstructIOn of hvmg skIlls and use of aides to chents We feel very fortunate to have Tom as a part of our program She had brought extensive resources and mformatIOn to our program Sara 'fIngpen Graduated from Pasadena College wIth a major IS nurSIng She IS a certIfied Social worker deSignee through Chabot College She has been If the field of genatncs for the past 21 years She has been employed by Semor Support program for the past 17 years dunng that time she has held a variety of pOSItions, Health Screenmg Nurse, RegIstry Coordmator, Case Manager, and currently administratIve assistant Sara IS very knowledgeable III all areas concernmg semor needs Sara us truly an asset to SeOlor Support Program she IS understandmg, compassionate, canng and a fantastIC listener, all whIch help her to aclneve successes WIth her chents CapDtallExpenses Constructton/ Reha bllltatlo n PermIts and Fees Design EngIneering AcquIsItIOn Other Soft Costs (define) Subtotal Personnel Expenses Salanes Benefits Subtotal Operating Expenses SupplIes Pnntlng/CoPYlng Postage Telephone Rent and UtilitIes Accountl ng/ Audit Other (define) Subtotal TOTAIL ~1I'@grram ~lUldget ~orm Attach additional sheets If necessary ItKi ~ J33 CD18G Grant lota~ Program Budget $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 11,965 $ 2,279 $ 14,244 11,965 $ 2,279 $14,244 $ $ $ $ $ $ $ $ $ $ $ 756 $756 $ $ $ $ $15,000 $15,000 Budget prepared by (Name, TItle, Telephone Number, E-mail) Marlene Petersen, ExecutIve Director 925-931-5378 MJcpetersen2002(Q}yahoo com tp~uif@rrmmtIDrro@~ ffifi]~cal$l!1lre$ (fill out a Performance Measure for EACH goal and/or obJectIve) Page 1 of2 101 ~ )33 Agency I?ITOglTSI m Aci:h/lfcy GoaVfOJlllJec1tive Semor Support Program of The Tn Valley Case Management P~eSlse cilTcle SIt ~east one o~ eSlclhl olf the 1ollowlll1lg g:oa~ and priorities which! Sire 21ppllcalble to 1l:IhlDs Sldh{nv~ gOSli a: ob~ec1t:hte Refer to InstructIons to complete RFP for a lIst of the goals and priorities ~UD S~ra1legic Goal ~lIfD Poiicy l?U'imu'ty 4 4 5 5 6 lHlow '!RIm fOllllT ag:el11l~ benenll: JO>lIlblun lTesurDIell'Rb? l?~eSlse ITs1fsrr \CO Drrnstl/'lVIdlorros to comtpDe1t:e ~lFjpl1foli' rlIeSCITB!PituOI/I} o~ pell1ormSltnlC& lliiIeSlslllll'8s j\. iDlD]ecttlm (selecft 011118) , I I ;~, ~o-"A~'~ ,~\~; ~ ? 1, ,,~ ;j 2 'OlJlftcoD1lle (seiecione) 'i I,' It'" f J\/, ,,"") .,:1-: ) 1! ',' Creating a SUitable L1vmg EnVironment Availability/Accessibility o Provldmg Decent Affordable HOUSing o Affordablllty o Creating EconomiC Opportunities ['8J Sustalnablllty ,i~ 3 SBJeCllIiic Ii IiDd icato IT "select ol1le) <i11t;'~ 1-'; o Public faCIlity or Infrastructure ['8J Pubhc service D Targeted revitalization ~ ;r! <t ~ ..J )....,1. ,: ~'c"" ~ 't ~ \ ........ 4. ~ '5=! ~ ,] I ~ \ t 1~ :)v{ \4~, l..iv' -$" ~ 1):<';{ \ !0~' '1 t """ 1""'"'" ~ ,.,.. 'v: i V (" .~ 2.-~ ,... :.~ t" " ~ J ~ "\ Ii!;?\!'): 'f,/fO i,J U Owner occupied umts rehabilitated D Direct financial assistance to homebuyers D Tenant Based Rental ASSIstance (TBRA) o CommerCial fat;{ade treatments or bUSiness bUilding rehabilitation o Homeless shelters o Brownfields remedlated o Rental unIts constructed o Rental Units rehabilitated D Homeownershlp units constructed or acquired With rehabilitation D Emergency hOUSing D Homeless prevention D Jobs created D Jobs retained o BUSiness assistance D BUSinesses providing goods or services 10071 133 W>~ulf@U'IITl'ilCIDU'il@~ ~~<ID~l!1l~$ Both pages must be completed for each program Page 2 of 2 4 Comlnrnon ~iodlcaftoJl' "" ~ r - - ~ ~- ~ ~, , t") ~ II a Total n umber of clients you a nbClpate semng choose on e or the other DO NOT PROVIID!E STAllS IN 180m CATlEGORIES Households 30 b BreallmuR 1l:he number of cliell1lts you Blll1iiclpaie serving m tl:lI1le fFollowlng caiego nes ........:... L ~ "\ In"?! V ~ ',,", {;" 1'1< :".,,.... ! "{ ~ I ( Female A.,I, '\'t", '\ ] , ", ~ I ~J~ ,,,; (I, \1;1 IT, r ow ~ 1 "l" ery Low!' f ~'\~.rt I:t.' '#'y-td ~f~..\.{o11.j,1 i 1" j I tvL~ f..~ I I /~ t ( ,~ ; "\ ' 0> '11 1r "" \ l,t," , 'tJ~>!-~;; ~, 7"'. h' <" '-', i '~I Income ~ '1 tt'h I'1G,D!l1~i ~ Itl: 1 Disabled,'". \)'. Headed '\ " /~" Senior :: ' Youth \. I } ,Homeless, ~\;c J {>50%)'c.- J ~:' l' \ t r.l, f ~!:: ~ t.l,l,,- 'if ,}.:> l ~ ~ ~'l. \ ; ~,~ ~.... 'ttf<..,l "'j ....;~f'1.-, Y ~ r\ 2\'?~~(<50%LL~ ", I / l~."i-p. J. It.'...... "'f,jouseholds' j 1 "' ,'" (\W' if f( "' '" "t' ~~ .,r? '1~ ;' f ~ I "-t j :;1.. \.-':01.. -' ,f ~ '\ !,~)~.,,,,"{,, 30 20 30 Appendix A Income Limits by household Size, established February 2007 This table IS provided to assist WIth completing question #3 m the narrative and the tables In AppendIx 8 - - - - - - - - - ~ -_.~ - - - ~ -- - - - - - Extremely Low Very Low Low Median Moderate Family Size 30% of Median 50% of 80% of Median Income Income Median - ..-< - - -- - - - -~~- -- -- - I 1 Person I $17,600 I $29,350 I $46,350 J_ _$5~,000 _ J $69,600 - - - - - -- - - - -- - ~ ~ - - I 2 Persons L $20,100 __I $335000 I $53,000 ) _ _~~~,390_ __ I $79,440 -- - -- - - ~~7,7~ci_ ~ J _ - ~ $59,6~0 I $89 4-00-' I 3 Persons r $22650 --I I $ 74 500 - -- -- - I 4 Persons I $25150 _ J _ ~$41 900_ _1__ $6~,2~g___ I $82,800 I $99,360 - ~ ~~ - - ~~ ~~ .......-- ) 5 Persons I $27150 I $45,250 I $71,550 I $89,400 I $107,280 -~~- - -- -"- - ~ - - - I 6 Persons - I $29,100 I $48,600 J $76,850 I $96000 ) _$115,200 - - - - - ~ ~-_. ~~ - - - ~...... -~ ~ r 7 Persons I $31,200 1- $51,950 I $82,150 1 $102,700 I $123,240 - - - - - - - - - ~ - ~~ - - I 8 Persons I $33,200 _J $55,300 r $87,450 I $109,300 I $131,160 - - - - - - - - - - - - - - HUD updates thIS Income chart each year The CIty Will provide all FY 2008-2009 Subreclplents with the most current data when It becomes available Source U S Department of Housmg and Urban Development, (HUD) Data for Oakland SMS 'O~~133 fY 210ll08-2<<:DlIJl9 CommlUlmlty laJe"e~rmpmeD1l~ 1B~<<Dclk Grrall1l~ Application Spectrum Commumty ServIces Agency Name Add ress 1435 Grove Way Hayward, CA 94546 ExecutIve Director Mlchael Sweeney Contact name and tItle AlU1emane Parnsh, Semor NutntlOn Program Manager Contact phone and fax T (510) 881R0300 x 222 F (510) 537-3340 Contact e mall address aparnsh@spectrumcs org Orgamzatlonal Background Private Non-Profit x Public Agency o Other (Describe) o Tax ID Number 94-1748275 List years previously receIved City funding 200304,2004-05,2005-06,2006-07,2007-08 REC!EWIEIil DEe 1 5 2007 DUBLIN PLANNING f:2 :, 0 P v.,.... STAFF USE ONLY Date ReceIved App# ATTACIHIMENT 1 ij Commumty Development Block Grant ApplicatIon Cover Sheet Page 2 104 <D;f 133 Proposal Sum mary - (A program may con/am several goals) Capital Request D OR Public Service Request x (check one) Program name Dublin Meals on Wheels Brief Program summary The CIty of Dub 1m wlil ellsme that 32 fraIl, homebound elderly reSidents will receIve at least 4,460 meals over the course of fiscal year 2008-2009 Grant funds will support the Home-Delivery Dnver's salary and benefits and mIleage whIle dehvenng each meal to homebound Dublm semOfS Goals - Number of Program goals to be achieved In fiscal year 2008 2009 2 List a brief description of each program goal Number of Dublin reSidents served by this goal 1 :ensure 32 !ow-1l1come Dubhn semor~ ate re lsteted and receIve meals 2) Deliver a ln1l11mutn of 4,460 meals to frau homebound seniOrs In Dubhn An aVel'lge of 18 meAls dehvcted pel day 32 32 Use a separate sheet of paper If needed Amount of Dublin grant funding requested (match first column budget form #2) Overall Total number of Dublin reSidents to be served by this program $ 6,077 00 32 Community Development Block Grant ApplicatIOn CertificatIon To the best of my knowledge and belief, all mformatlon and data In thIS application and attachments are true and correct No matenal mfo rmatlOn has been om Itted, I ncl udl ng fl na nClal mformatlon If funded, I certify that the Agency IS Willi ng and able to adhere to pOlices and procedures specified by the City of Dublm, and If applicable, the appropnate program regulations of the US Department of Housmg and Urban Development Further, I understand thiS IS not an agreement for grant funding and cannot encumber funds until the City of Dublin and the IndIVidual authorIZed to execute contracts on behalf of the Applicant Agency, has signed the contract, and If applIcable, all federal regulations and paperwork are completed J3~k..btiul Title {2..-(4 -()!L Date 01) of DuM" CDBG Apphra/1I.I1l } Y 2008 2009 - Menls 011 Wheels p.:.(o5':f I~ A Program Narratlve- 1 Program Descnptwn and Commumty Need Wlnle most of DublIn's 2,156 semors age 60 and oldel are agmg successfully, many are becommg mCIeasmgly fnull In fact, ber-:veen 30 and 38 percent of Dub 1m resldents age 65 or older live wIth at least one dlsablhty 2 Among the many actIvIties of dally hvmg that are affected by decreased moblhty and mcreased mfirmlty IS food preparatIOn Eatmg well-balanced meals on a Iegular basIs IS tIed dIrectly to health and well-bemg 3 FOl semors, proper nutrItIOn and regular meals are essentIal to mamtall1ll1g weIght, metabolic functIOn, energy, balance dlld mental clanty Regular food and liqUid mtake are necessdry for many medicatIons to act safely and effectIvely StudIes ll1dlcate that low-mcome semors are <It greater IISk of mddequate nutrItiOn, lack of funds often forces these semOlS to skIp meals and cut 4 I out essentIal foods necessary for a balanced dIet The need for nutntlO11IS coupled wIth other needs for soclall11terachon, a sense that one IS cOl1tnbutmg, and a need to be loved AddItIOnally, there are d glOwmg number of semors who are 111 need of meal dsslstance as they recover from disease or surgery The amount of tIme needed to recuperate lllcreases wIth age NutntlOus food and human contact promote heahng and a return to normal actIvIty levels The dehvery of a meal to a frail, homebound elder fulfills a pnmary need - nutntlOn - and provIdes the opportUl1lty for humm1 contact, as well as a "safety check" by the Meals On Wheels Dllver In the past, block grant fundmg from Dublm has provIded Spectrum Commumty Services with the fleXIbIlity needed to restructure dehvery routes In order to serve Dublm's growmg elderly populatIOn Spectrum CommunIty ServIces requests Commumty Development Block Grant fundmg to sustdm Oul Meals On Wheels delivery route 111 Dublm m fiscdl year 2008-09 ThiS fundl11g WIll help to ensure that 32 frail, homebound, elderly Dubll11 reSIdents WIll receive dt least 4,460 nutntlOus medls over the course of the fiscal year Grant funds WIll be used speclficdlly to cover the mIleage and Home-Delivery Dnver's salary and benefits for the one Meals-On-Wheels delIvery route m Dubhn 2 Program Goals The goal of SpectlUm's home-delivered meal program IS to mamtam or Improve the well-bel11g of fraIl, homebound elders by provldmg them wIth helpful and nutntIOus meals Spectmm has established the followmg obJechves specific to the funds requested 111 thIS proposal Deliver d mmlmum of 4,460 meals to fraIl homebound elderly resldmg m Dublm (an average of 18 meals a day for 248 servll1g days) from July 1, 2008 through June 30, 2009 2 DUTIng the same pellod, proVIde home-delivered meals to at le<lst 32 selllors 3 PopulatIOn to be Served, Outreach, Culturally Appropriate Services The populatIon served by Spectrum's Meals-On- Wheels program IS slIghtly more diverse than the semor populatIOn ofDubhn -78% white, 12% Hlspamc, 2%) ASIan, 3% Afucan Amellcan 5 1 U S Census 2000 l IbId 3 The 1998 Surgeon General s Report on Nutn tlOn and Health noted Ihat two tlnrds of all dea ths are due to dlseases d~soclated with poor diets and dletalY habIts 4 20% of low mcome semors m Cahfomm cut back on meals m OJ der to pay for prescnptlOn dmgs 2002 Study by Safran Neuman et al PlescnptlOll Drug Coverage and Selllors How Well are State s Closmg the Gap?" ) [(hl11Clty of Dubhn MOW partlClpanls over the last SIX months ofFY 2006 07 IO{ rat /33 Cay of Dub/I!! CDBC Apphc(/IIoll FY 2008 2009 - Meals 011 Wheels Page 2 1 Also the Dublm 1 eSldents who partIcIpate m the meals program tend to be pOOler, older and fraller than theIr neIghbors For example o VIrtually 100% of Meals-an-Wheels partIcIpants In Dublm are functIonally nnpalred, unable to perform such essentlal actIvItIes as dressmg, bathmg, cookmg, shoppmg, household chores, etc o More than half (69%) are age 75 or older Spectmm exceeds the CDBG natIOnal objectives of "at least 70% oftlle program's particIpants must have low or moderate mcome" o 25% ofbomebound Dublm semors served by Spectrum are extremely lOW-income, o 75% are very low -low mcome (based on HUD gUIdelmes) Spectrum's commumty outreach IS ongomg The Home-Delivered Meals Coordmator wIll cultIvate relIgIOus and commumty orgamzatlOn lmkages, (1 e Fraternal Order of the Eagles, and H1l1du Commumty and Cultural Center), Chamber of Commerce, doctor's offices, publIc i1brary, semor resIdences and mobIle home parks where semors live, and bUSIness establIshments where semors frequent The SIte Coordmator WIll also seek opportumtIes to raIse awareness and accessIbIlIty to the services through contacts WIth local newspapers and cable statIons Spectmm's coordmated servlce network enables the Meals CoordInator (m theIr home VISItS to the homebound elders) to effectIvely provIde access to needed commumty semor support services such as the Semor Support Program of the Tn-Valley, and to Spectmm's contmuum of comprehensIve support servIces Low-Income Home Energy ASSIstance Program (LIHEAP) and WeathenutIon servIces, and VocatIonal SkIlls Trammg and EducatIOn Spectmm mamtams a suffiCIent number of workers who are bIhngualm EnglIsh, Spamsh, Tagalog, and Cantonese who WIll assist the Meals Coordmator and the Delivery Dnver to commumcate WIth the semor To lespond to the culturdl dIverSIty of our chents, the Valley Care HospItal, Spectmm's meals on wheels meal prOVIder, offers tortlllas and nce as a substItute for bread, alId d vegetanan menu to vegetarIans, as well as a substItute for days when the semOf dIslIkes the regular menu 4 Deflnmg Succes~ The program WIll help to ensure that at least 32 frml, homebound Dublm semors WIll receIve hot, nutntIous meals, thus contnbutmg to theIr mental and phYSIcal health and well-belllg Success for thIS program WIll be defined not only by meetmg or exceedmg our goals and obJectIves, but also by the qualIty ofthe serVIces proVIded EvaluatIOn of Spectmm's meals service has always been an on-goIng ach Vlty Weekly reviews of OpCl atIons and meals sel ved ensure that management dnd admllllstratlOn are able to IdentIfy and correct any potentIal productIOn or dehvery problems before they become slgmficant QUdhty assurance IS ofpnmary Importance to Spectrum We dlstIlhute Chent Surveys once a year, glvmg semors an opportumty to comment and gIve feedback about meals, serVIce, and qualIty The survey IS avatlable m EnglIsh, Spamsh and Chlllese The SNAP Program Manager welcomes telephone calls from semor partICIpants All suggestIOns are reVIewed by the Program ManageI, Annenldne ParrIsh, and If needed, appropnate actIOn IS Implemented Spectrum has worked hard to mamtmn a hIgh standard for ItS semor nutntlOn program SNAP IS momtored all11ually by the Alameda County Area Agency on Agmg m areas of food samtatlOn, safety, preparatIOn, performdnce, and cIrent satIsfactIOn The outcomes oCthe mom tor VISIt are submltted to the Program Manager and ExecutIve DIrector Spectmm consIstently earns h1gh mmks for mamtaIlllllg hIgh standards III food quality, delIvery system and program operatlons n""f DobIm CDBG App"em.." J n008 2009 - Um', 0" Whee', P"gd (0'1 r (33 Regular, good nutntlOn, soclahzatlon, and the safety net for access to needed commumty semor support services from Spectrum's Meals On Wheels program has had a direct and lastIng effect on the health Jnd well-bemg of our homebound fraIl selllor particIpants Although we wlll contmue to collect testImomals regardmg the weIght gam and stabIlIzed health achleved by program partIcipants, it IS beyond the scope of this project to conduct a clImcal outcome study 5 CooperatIVe RelatlOlJshlps with Other OrgamzatlOlJs SpeCific to the program's obJectlve, Spectrum cooperates with these orgamzatlOns ~ Valley Care Health System - Smce 1997, Valley prOVides the meal and packmg of the home-delIvered meals, Spectrum provIdes all the admlTIlstratlOll and delIvery >- Semor Support Program anhe Tn-Valley - Resource for Spectrum's particIpants ~ Alameda County Meals On Wheels - An exchange ofmfonnatlOll and techl1lques to enhance countYWlde semor nutntIon services, as well as to measure progress countYWide ;;. Alameda County Area Agency on Agmg - Provides countYWide servIces and IS the contractor with Spectrum's Congregate meals and Meals On Wheels to semors Spectrum's cooperatIve partners mc1ude the semor centers m Dublm, Pleasanton, and LIVermore, the Adult Day Care Center m LIVermore, and semor resIdences DIscharge planners [TOm Kaiser Permanente and Valley Care Health System are the pnmary referral sources The home- dehvery Dnver IS often the only person WIth whom the semor has any contact, and IS thus an Important component of the chent's safety net Dnvers are tramed to observe phYSIcal and envIromnental changes that mIght mdIcate need for other support servIces or aSsIstance and to report those changes Immediately to the Home-DelIvered Meals Coordmator, who Will connect the semor wIth appropnate services provIded by our cooperative partners 6 Disabled Access The Meal On Wheels serVIce dehvers meals to homebound, Isolated, fraIl semors wIth all types of disabIlItIes Through our effectIve coordmated servIces network and cooperative partnerships, Spectrum s Meals On Wheels servIce IS made accessible to semors m the Dublm commul1lty 7 Leveragmg and Smtamabtltty Recogmzmg the special needs of older adults, and the hIgh costs oftreatmg semors m acute care settmgs, Congress passed the 1972 Older Amencans Act It's purpose IS to serve those elderly ll1 the greatest SOCIal and economic need, glvmg particular attentIOn to low-mcome mdivIduals and pwvldmg servIces that assist them m mamtammg theIr mdependence and dIgmty Semor NutntlOn PlOgrdms (TItle In) have been a focal pomt of the servIces prOVIded under the Act WIth thIS foundatIOnal fundmg, Spectrum IS able to leverage other government and pnvate funds Although Spectmm IS commItted to provldmg nutntlOus meals to DublIn's needy semors, we also know that the cost of food and operatIOns mcreases, and the semor populatIOn IS growmg Semors ale hvmg longer and are consequently outlIvmg theIr savmgs Thus the need for semar nutntIon programs, and the need to subSIdize these programs, WIll remam an Important pnonty for the comrnullIty CII) of Dublin CD8G Apphcmwll r Y 2008 2009 - Meals Oil Wheels png)4 08 ~ /33 B Budget Narrattve 1 ])eSCrlhe how tillS program Ir cost effective ami the hudget lS reasonable for the antiClpated result With help from Clty of Dub 1m fundmg, Spectrum's Meals On Wheels Program WIll deliver at least 4,460 meals to at least 32 homebound DublIn semors 111 FY 2008-2009 On the delivery route for whIch fundmg IS bemg requested, delIverIes average 18 meals per day Monday-Fnday (m addition, pdrtlclpants may order meals for weekends and holIdays) The funds requested will cover the salary and benefits and mIleage of the Home-Delivery Dnver Our proposed budget IS based on actual program costs WhIle the cost of gasohne IS nsmg, thIS has been offset by a decrease m Workers CompensatIon rates, and stabIlIty m Spectrum's workforce costs as a whole Government dnd pnvate fundmg sources cover only a portion ofthe operatmg expenses GIVen the constIamts that Area Agency on Agmg Title III-C and USDA fundmg Imposes on the operatIOns of the SemOf Meals Program, Spectrum has become adept at leveragmg these funds to maximum effiCiency We feel thiS cost~effectJveness IS eVIdent In the attached budget 21ft/us applicatIOn does not receiVE ftllldlllg, what Wli! he the affect on the program? WIthout the funds to cover the salary and nuleage of the Home-DelIvery Dnver, It would be extremely dIfficult to effectIvely run the Meals On Wheels route In Dublin We ask the grant commIttee to consIder the Impact that the loss of this essential serVIce WIll have on the semors who currently rely on Spectrum's Meals On Wheels program m the Dublm commumty for sustenance and socIalizatIOn 3 Doer the agency antlClpate Jlllvmg allY llm,pentfllnd~ at tile end of tll e fiscal year) If~o, explam why No IFllJruaJlI1HCllaJ ~ ~ 1I1l~IO~lI111IaJftUIOJru 1F1O~1I1l1I Al(//ldIa~mll1lal lP'rogram lFlUIU1I[lmg SmJIl'CeS & Sftafflll1lg Cosfts Attach addItional sheets If necessary loC;~/33 AddItional program fundmg Sources could mclude, but are not limited to foundations, corporations, indIvIdual contributIOns, events, reimbursements and in-kind contributions Types offunds are loan, grants, donations, In kind, etc Source Amoun~ Use of Funds Committed? V/N Set.- 'lttachment TOTAL $786,213 If you are utlllzmg CDBG funds to pay for staff costs, please list each employee/title and the percentage of their salary and benefits that will be paid With CDBG Include the total monthly and yearly costs to the CDBG program Note Vacation, Sick leave and holidays for employees cannot be charged to CDBG as program expenses New % salary & benefits Monthly salary & Yearly salary & benefit PosItion Title (Y IN) paid for With grant $ benefit cost to grant cost to grant Home Delivery Coord N 25% 256 3,070 ~W(l]gwaJm l81l\.ndlge~ fa:nm I/o ;f /33 Attach additIOnal sheets If necessary CIDIBG Grant Total Program Budget Capital Expenses Co nstru ctl 0 nj R e h a b Illtatl 0 n $ $ Permits and Fees $ $ Design $ $ Englneenng $ $ AcquIsition $ $ Other Soft Costs (define) $ $ Subtotal $ $ Personnel Expenses Sa la nes $ 2,232 $ 400,289 Benefits $ 838 $ 108,915 Subtotal $ 3,070 $ 509,204 OperatIng Expenses Supplies $ $ 24,354 Pn ntlng/CoPYI ng $ $ 254 Postage $ $ 528 Telephone $ $ 6,036 Rent and Utilities $ $ 33,568 Accou ntlngl Aud It $ $ 16400 Other (Mileage) $ 3,007 (Mileage) $ 272,101 (see below) Subtotal $ 3,007 $ 352,713 TOTAL $ 6,077 $ 861,917 Budget prepared by (Name, rltle, Telephone Number, E mall) Leila ClmalTd - Controller (510) 881-0300 ext 218 lcImarra@spectrumcs org $5,573 EqUIp rental & mamtenance, $13,599 mIleage, $35,921 vehIcles, $210,450 raw food, $1,760 E Ulpment, $3,672 Insurance, $1,126 mISC expenses Ill~133 SPECTRUM COMMUNITY SERVICES, INC CDIBG - DnJb~in FY 2008..09 This Other Total PAID STAFF Request Sources Project Home Delivery Coordinator (248 serving days 25%) 2232 2232 Benefits FICA 138 138 MEDFICA 32 32 SUl/ETT 109 109 WCOMP 113 113 Medical 413 413 401k 33 33 Total Benefits 838 838 Total Salary & Benefits 3070 3070 OTHER EXPENSES Catered Meals ($1 18/meal" 15 meals/day" 248 days) 4 390 4 390 Mileage (25 miles/day" $0 485/mlle" 248 days) 3 007 3 007 Total Other Expenses 3007 4390 7397 TOTAL 6077 4390 10 467 ) Io? o;f /33 REVENUES TOTAL Type & Use of Funds COMMITTED City of Pleasanton 13 448 Mileage no City of Livermore 8075 Meal Subsidy & HD Driver no City of Dublin 0 Meals on Wheels no City of Union City 13 500 Meal Handler yes City of Hayward 25000 Meal SubSidy no Title III Older Am Act Funds 255 047 Overall SNAP Program yes USDA 39 463 Overall SNAP Program yes Five Star Night - County MOW 30 000 Overall SNAP Program no PG&E 5000 Overall SNAP Program no Eden Area Foundation 7500 Eden Area Meals no Kaiser Foundation 10 000 Overall SNAP Program no Walmart Foundation 1 500 Overall SNAP Program no Grand Aerie Fraternal Order of Eagle 1 500 Overall SNAP Program no Title III Client Donations 287031 Overall SNAP Program no Fremont Adult Day Care 1439 Fremont Adult Day Care yes Livermore Adult Day Care 3720 Livermore Adult Day Care yes OnLok 1 28 096 OnLok 1 yes Lady of Rosary 11 756 Lady of Rosary yes Non Senior Contnbutlon 2138 Overall SNAP Program no Fund Raising Fremont Bank 20 000 Overall SNAP Program yes AT&T 20,000 Overall SNAP Program no Community Support 2000 Overall SNAP Program no TOTAL FUNDS 786,213 [f>>eJl'~[bJl'mnla!l1l(Ce MeaSUlll'eS (fill out a Performance Measure for EACH goal and/or obJective) Page 1 of 2 113 1/33 Agency Spectrum CommunIty ServIces, Inc Program SenIor NutntlOn Program Activity Dublm Meals on Wheels Fundmg WIll support one Meals on Wheels delIvery route m DublIn, and wIll ensure that 32 frail, homebound seniors receIve meals III FY 2008-09 wIth a mlUImum of 4,460 Goal/Objective meals delrvered III FY 2008-09 Please circle at least one of each of the following goals and priorities which are applicable to this activity, goal & objective Refer to Instructions to complete RFP for a list of the goals and priorities HUD Strategic Goal 1 2 131 4 5 HUD Policy Priority 1 121 3 4 5 6 How will your agency benefit Dublin residents? All funds will be used for delivery of meals to Dublin seniors onlv Please refer to Instructions to complete RfP for description of Performance Measures 1 Objective (select one) I 2 Outcome (select one) x Creating a SUItable living Environment x Availability/Accessibility o Providing Decent Affordable Housing o Creating Economic OpportunIties o Affordablllty o SustalnablJlty 3 Specific Indicator (sel ect one) o PubliC facility or Infrastructure o Owner occupIed units rehabilitated [8] PubliC service o Direct financial assistance to homebuyers o Targeted reVitalization o Commercial fac;ade treatments or business bUilding rehabIlitation o Tenant Based Rental Assistance (TBRA) o Homeless shelters o Brownflelds remedlated o Rental units constructed o Rental unIts rehabilitated o Homeownershlp units constructed or acqUIred WIth rehabilitation o Emergency housing o Homeless prevention o Jobs created o Jobs retained 11'1 o Business assistance D Businesses providing goods or services P>ell'~[)WlllJ1lal.ll1llCe MeaSllB wes Both pages must be completed for each program Page 2 of 2 4 Common IndIcator a Total number of chents you anticipate servmg choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES Households Persons 32 b Breakout the number of chents you anticipate selVlng In the followmg categones Low Very Low Female Income Income Disabled Headed Senior Youth Homeless (>50%) (<50%) Households 30 2 32 9 32 Appendix A Income Limits by household Size, established February 2007 This table IS provided to aSSist with completing question #3 In the narrative and the tables In Appendix B ~ ---~- -= ~ ~ " - ~.._. ~- -- - - - - ~m-'IY Size I Very Low I Extremely Low 50% of Low Median Moderate 30% of Median ] 80% of Median Income Income I Median J I _. ~.. ~ =.... - -~. ~- - - - " ~.~ ~ I ~ P~r:,o~ _ _I $17,600 I $29,350 1 $46,350 J $58,000 1- $69,600 _. - ........;.=~ ~ = ~ - I 2 Persons I $20,100 1_ $335000 L$53 o~O ul $66,200 1- $79,440 - -- - - ~.. - - 1 3 Persons I $22,650 L $37,700 -'- $59,600 _J $74,500 I $89,400 - - -- - --- - I 4 Persons ,I $25,150 I $41,900 J $66,250 JI $82,800 I $99,360 ~ - - - - " I 5 Persons 1 $27,150 I ~45,2~~_J $71,550 J $~~,40~ _ J $107,280 - ~ ~~-...._~.~~- - - . I 6 Persons I $29,100 1 $48,600 J $76,850 1 $96,000 I $115,200 - - " -. -" - - - -- ~ N _ I 7 Persons I $31 200 I $51,950 I $82,150 1 $102,700 1 $123,240 - - ... = .- I 8 Persons I $33,200 J $55,300 [ $87,450 J $109,300 I $131,160 .- "-- - -- - ~ - - HUD updates this Income chart each year The City will provIde all FY 2008-2009 5ubreclplents with the most current data when It becomes available Source U 5 Department of Housmg and Urban Development, (HUD) Data for Oakland 5M5 1/51-/33 ~v ~~[ID~-~lDllID~ 1!:~IIIlllIlllJ]DII~~1tW ~~~~~~~[B1J~~n ~~lIDlm!::{ ~lr'lBHmn iR\~~~~lmlSln~mlUU Agency Name Address Tn-Valley Haven 3663 Pacific Avenue LiVellTIOle, CA 94550 Executive Director Ann Kmg Contact name and title Paul Hoffman, Data Manager Contact phone and fax VOice 925-449-5845 Fax 925-449-2684 Contact ewmall address paul@?tnvalleyhaven org Orga n Izatlon al Backg ro u nd Private Non-Profit [gJ o Public Agency D Other (Describe) Tax 10 Number 94~2462357 list years previously received City funding Fi'lcal Year& 2002-2003,2003-2004,2004-2005, 2005.2006,2006-2007, and present, 2007-2008 REC~IVED DEe 1 5 Z007 DUBLIN PLANNING 'L 00 P \..AA STAFF USE 1.;)( / C2 ill ONLY Date Received 14 U1 P N Clummooty Ilaflll!Jqnmml I/l!JJl{l Grs1d IJpjd!c!JbJJJJ CiJfJE? I/llml A # 7 ATTACHMENT 1 r IVH -/ P8t/JJ 2 )/~ ~ 1.33 Proposal Summary (A program may contam severa! goals) Capital Request Program name Bnef Program summary o OR Public Service Request ~ (check one) Domestic VlOlence & Homeles~ Servlces Tn-Valley Haven a<; a goal 0 f C! eating homes 'late trom abuse .ind contnbutmg to a more peaceful society Tills plOgram wlil help do that through foUl means Support to DV survIvors through Cnsls LlOe support and safe sheltel at TVH's DV Sheltel 2 Supp0l1 to Homeless thlough TVH's Food Pantry and TVH's Homeless Shelter 3 Prevention education sel vices through clas<;e~ given at pnmanly at local schools 4 Counseling on DV, Sexual Assault, and Homele...s Issues Goals - Number of Program goals to be achieved In fiscal year 2008- 2009 List a brief description of each program goal Domestic VIOlence Services (DV Shelter & Dublm Cnsls Lme Callers) 2 Homeles" Service') (Homeles~ Shelter & Dublin Food Panhy Chents) 3 Community Education PreventIOn PresentatlOn'l 4 Counseling Services Use a separate sheet of paper If needed Amount of Dublin grant funding requested (match first column budget form #2) Number of Dublin reSidents served by this goal 25 165 600 24 Overall Total number of Dublin reSidents to be served by thIs program $ IS, f2j09> 814 total, i 50 wIth detailed demogIaphlc'l mfo Community Development Block Grant Apphcatlon Certification To the best of my knowledge and belief alllnforma!lon and data In thiS application and attachments are true and correct No matenallnformatlon has been omitted Including Imanclallnformatlon If funded, I certify that the Agency IS willing and able to adhere to polices and procedures speCified by the City of Dublin and If applicable, the appropriate program regulations of the US Department of Housing and Urban Development Further I understand thiS IS not an agreement for grant fundmg and cannot encumber funds until the City of Dublin and the indiVidual authonzed to execute contracts on behalf of the Applicant Agency has Signed the contract, and If applicable, all federal regulations and paperwork are completed ~/~~ lluthorllHd SignaturBlGfJpJ m 1tiHJ!Jtd ExecutIve Director JitID /2-/ It) /6 7 Dato fl! tt -)... fJ1 ':f /33 Program Nilrrahve 1 The core of OUI Domestic VIOlence Proglam I':' Sh110h, a 30 bed emergency shelter m a wnfidentlallocahon where women and children may stay to! up to 105 days Each adult client attends counselmg on a weekly basIs, and participate" m the followmg glOups each week House Mcetmg, Parenting, Domestic VIOlence SuppOIi Group, Personal Empowermwt, CalWORKS Job Readmess, Life Skll1s, and Family Nlght Chlidren's individual coum,ehng and support group are also available A CalWORKS SpeclalIst provlde<; advocacy and mfOI matlOn regarding public benefits plOgrdm" and employment preparation and Job search assistance Sh110h also participates 111 Linkages, a subsldlzed hOUSing plOgram With case management for chents who are workmg toward self-sufficiency Clients who are accepted mto Lll1kdgcs may remdll1 In that program to! up to 24 months, contmgent upon their contmumg to work toward the1r goals Counseling <;ervlces are available to non-Sh110h reSidents at our Commumty Buildmg and In P!easanton Counselmg asslst" \l!(,tl1TIS to recover emotlOnally trom thc]r traumatic expenences and to mC1ease their level of self aWdreness, confidence, and functlOntng Chents receive md1v1dual and/or group counselIng Indlvldudl counselmg]5 also provIded for chIldlen, dlong w1th famJ!y counselmg tor families m cnS15 The help proVided can range from a one time consultation to a coun'lelmg relatlOnshlp that can last for a S]gmficdnt hme as the hcalmg process takes place A legal clImc ]s offered tWlCe a week, once m LlVermore, and once Il1 Pleasanton, to dSS1St Sh110h and commumty clients w1th restrammg orders Court accompamment IS otfeled to cl1ents who decIde to hie a restralnmg order Cns1s mterventlOn servIces are avaIlable through our toll-f]ee CllSI" Lme, which IS dnswered around the clock by staff and volunteers who hdve completed a State approved 65~hour trammg The Cnsls Lme ]<; f[ equently the pomt of entry to our ll1-person chent "erV1ces Tn-Valley Haven'.:. Rape Cnsls Center has servcd the Valley Sll1ce 1981 It proVides advocacy and lmmed]ate support fO! v]ctIms/survlvors and then slgmfieant others thlOugh the Tn-Valley SART (Sexual Assault Response Team) Ind1v]dual and group coun<;elmg IS al'lo proVided, as are Lommumty educatlOn presentatIOns and "elf-defense wurses 1 n- Valley Hdven added a. Homeless Shelter, SOjourner House, m 2002 Our Homeles" Serv1ccs mc1ude the 16-bed eme1gency shelter, and a Food Pantry that dl<;tnbutes food obtamed flom multIple .:.ourees SOjourner House offel s ~helter and case management for up to SIX months to two-parent families, smgle mothels dnd fathers With their children and smglc women SOjourner House lesldent') also recelve md]vldual counselmg, and group mectll1gs which mclude Life SkIll'l trammg, FamIly NIght and Parentmg Tn- Valley Haven'~ CalWORKs Speclahst prov]des services to domeStlc VIOlence SUrvlVOlS at the homeless shelter A Lmkages Cdse manager helps qUdlIfied chent.:. obtam tldnsltlonal housmg upon eXit from SOjourner The Food Pantry 1S located m Llvem10re, a mobile PantJy dehvels tood to two 'nte~ In Pleasanton tWice a month The pantry also proVides emergency motel vouchers, gas card'l, and phonc cards, d') well as ]efenals to other commumty serVlCe~ In 2005 (the latest published number) the rn- Valley Pollce Departments responded to 353 domestic d1sturbance calls The Tn-Valley Human Serv1ces Needs Assessment recogmze~ v]ctnTIS ot domestic VIolence as an underserved population m need of housmg WIth supportIve serv!(,es Sh110h IS the only SdnctlOned domestic vlOlence program and confidential emc]gency shelter servmg the Tn - Valley area It IS ImpcratIve these sel Vlces continue to be avaIlable IV ft-3 119 ~ /.33 Additionally, Shiloh and SOJoumel Home ale the only shelteIs In the area to accept boys over age 10 The Haven ::.tnves to ensUle that familIes with chlldlen of all ages have access to vital sel vlCe<; Pel late.:, t census-dll ven statl St1 cs on www Cl tv-dat a -com, the Tn - V all ey area has approximately 9000 Iesldents hVIng under the Federal Poverty Level Low Income familIes ale more likely to be forced to pay more than they Lan afford m lent, thus makmg them more susceptible to housmg problems such as eViction The Tn-Valley Human Needs and Services Assessment noted a lack of ]oldlly based homekss sel VIces SOjourner Hou5e IS the only shelter In the Tn-Valley that accepts two parent tamlhes and sIngle fathers M05t SOjourner Housc lesldents are from the Tn-Valley It I!;, Important to them to remaIn m their own comrnumty as they work towards self-sufficiency and bIeakmg the cycle of homelcssnes5 We ::.dW an 1l1Crea5e 111 DublIn re::'ldents seek1l1g <;elVlces dUllng the 2006107 Fiscal yea! Tn - Valley Haven' s ensl" L1l1e receIved 100 calls from Dublm residents 8 Dublm resIdent" wcre sheltered 111 our DV Shelter 255 Dub]m resIdents utilIzed OUI Food Pantry services m 2006- 2007 Last Fiscal year our Homeles.:. Shelter accommodated 6 people from Dublm 25 adults and 1 child from Dublm receIved counselIng servlccs 2 25 DublIn cbents wIllleltwe the Domestic Violence ServIces through the Cn::.ls lIne and the DV Shelter, 165 Dublm resIdents WIll utll1ze our Homeless Services 1l1cludmg the Homeless Shelter and the Food Pantry, 600 Dublin residents WIll attend our Commul11ty EducatIOn Prevention Presentations, held at local schools, 24 DublIn residents will rCleIve CounselIng SerVIce" 3 Tll-Valley Haven's mam outreach to DublIn residents IS through our Commul11ty Education program that WIll reach over 600 DublIn attendees Most classes are geared toward youth m DublIn schools We have also held commulllty educatIOn and self defense classes for semors m DublIn Our da,>ses mc1ude mfonnatlOn about all services provided by Tn-Valley Haven AddItIonal outIeach IS done through bnefing'> to the Dublm Police TI1-Valley Haven clIents m our OV, SA, and Counselmg programs cut dCIOSS all SOCIOeconomiC levels, yct mo~t qualIty (by mcome) for aSSIstance through CDBO fundmg Our Homeless Shelter and Food Pantry clIents atC almost exclUSively from extremely-low through low Income HUD COSO levels Many of our Food Pantry clIents are monolIngual Spamsh- speakmg We expect to serve approXImately 2000 calls through our Cl1SIS Lme, up to 100 of whom will IdentIfy thcmselves a<; DublIn callers Our Food Pantry will serve applOXlmately 7000, 165 of them DublIn reSidents Our combmed DV & Homeless shelter,> will proVide sheltel to approXimately 350, 15 from Dub]m CoumelIng will '>crve apPlOxllnately 500, 20 of them Low-Income from DublIn Fmally, we expect to provlde Commumty EducatlOn cla,>ses to 3000 attendee,>, 600 of whom wlll be DublIn ,>chool-agcd children Pel "city-data com", 19% of Dublm household,> speak a language other than Engllsh at home, and 13 6% ate fOlelgn-born In 2005 there were an e,>tnnated 2300 Dublm household,> WIth mcome under $50,000 HUD comlders hou<.,eholds of 3 or less With mcomc under $59,eiOO to be low mcome In 2005 the medIan value of hou'les and conclommmms III Dubiln wa~ $652,100, compared to $477,700111 CalIfornIa overall The TVH Cultural Competence Plan IS a multI-pronged approach to nnprovmg ,>ervlces to cbents With LllTIltcd English ProhcIency We have staft conversant In Spamsh, RUSSIan, German, Itahan, French, ArabiC, and Tagalog BIlIngual and bIcultural staff are 111 strong demand throughout Alameda County, they ale /vft ' tf I /)~ ~ /33 difficult to obtam and retam We seek out potentIal bdmguallblcultural "taff, and provide a wage dIffelentIal for theIr lmgUlstIc abilIttes We have a Video Relay Service (VRS) at our DV Sheltel for chent') conversant m Amencan SIgn Language If staff IS not available to converse dIrectly WIth an LEP chcnt, we make use of "Language Lme" phone-ha"ed Interpreter" Our largest LEP client group IS Spamsh-'3peakmg Most flyers and commumcatlOns are created In both English and SpJmsh We are m the proce')s of translating dll ehent matenals mto Spamsh We produce and dlstnbute documents 10 other languages when available We die currently lesearchmg alternatives to the "Ldnguage Lme", such as "Network Gmm " so see If other vendOls can better serve our needs 5 Coord1OatJon of servIce delivery IS accomplished thlOugh MODs With over 72 agenCIes, mc1udmg local pollce departments, hospitals, schools and therapIsts We provide pre')entatlO11') to local schools, trdm10g for local law enforcement and medical tauhtIes, and :.elf-defensc c1a%e:. The Haven' s commumty hnkages go beyond the Tn- Valley area via collaborattve" mcludmg the Alameda County FamIly ViOlence Council, the CalWORKS Domestic ViOlence Advl"ory Board, and the Alameda County Continuum ofCarc The CalWORKs Domestic. VIOlence Collaborative WIth Alameda County Socral ServIces plOvldes Job read mess and post- employment serVIces The Haven partICIpates WIth five other agenCIes m the Alameda County Housmg-Job,> L1Okage,> program to help clients obtamlong-term housmg, and achieve sel1- sufficIency 6 TVH stdffmamtams a good wOlkmg relattonshlp WIth CRlL, a local scrVIce provider fO! persons With dlsabIhtles and also IS aWdre of key service" for persons With dIsabllIttes and how to access them Entrance" to all Tn- Valley sites are clearly marked Telephone screemngs and m- per<.,on mtake processes mclude questIOns about needed accommodations (such as a bottom bunk, pnvate room or speCial dietary needs) Shelter has one 100m With adJ3Lent bathroom which 1<; "handicap fnend!y' Communal areas are a(,cessIble The kltLhen 10 ShIloh's STEP House has been fully renovated to Include JccessIble counter tops, knee space under the r;;mk and counter areas, level faucets and other handlcap-fllendly amemtles 7 Accountmg at TVH IS complex, WIth more then 40 contracts, many tted to each othel by some fom1 at leverage or other reqUIrement Fundlllg 1S lI1tentIOnally diverse to protect Lore :'.elVlces With few excepttons, 10s1Og anyone fundmg SOUf(,e alone would not Impact COle services Addmg to that complexity IS the fdct that seveIal of the contrdcts are collabOlatIOns With <;everJI partners to maXimIze dollars 111 servlcc -["fii -cJ }~O ~ /33 TII-Valley Haven Budget Narr.atlve 2008 - 2009 PERSONNEL Lead Case M<mager DV 7 50,1;, of F1 E $ 3.154 The Domestic VJOlence Lead Case Mdnagel IS d 40-hour posItion re~ponslble tOl COOl dmatmg case management at Shiloh, the domestic vJOlence sheltel Duties mclude ::,chedulmg shelter statf coverage, resolvmg dl<.,putes between I eSldent cllent<." and overscemg chent assl<.,tance funds She may al<.,o engage III baSIC case managuTIent serVIces as needed, mdudmg sueenlllg ,mct mtel vlewmg potential re::'lclent'3 Lead Case Manager HS 175% of FIE $ 8,100 The Homeless Servl<,es Lead Case Managel IS a 40-hour pOSitIOn responsIble for cootdmatmg case management at SOjourner Homeless Shelter DutIes Include schedulIng shelter statf covel age, resolvmg dIsputes between resident client::., and overseemg (,l1ent as'ilstance fund" She may also engage m ba::'le case management servlccs as needed, mdudmg ::,crcel11ng and mtervleWll1g potential residents Frmge Benefits $ 3,036 Computed at 26% of total salanes and wdges Fnnge benefits ll1cludc pa)f1ol1 taxes, life ll1surance, medical, dental and VISIOn Il1surance dncl worker's compensatIOn Tot.al Personnel Costs $14,690 OPERATING SupplIes $ 310 01fice '3uppher;; to be uttlu:ed by Case Managers Total OperatIOns $ 310 TOTAL DUBLIN CDRe COSTS $15,000 1,fWb IdLl ~ /33 ~~ITlliBl ITllrrn~iBl~ ~ITllmrn Ir UlI1llBl fi~llllllll ~ lllllrUll1l /A\~~mmlOlmJ~ ~gu~oonHDll ~lIJ]lm~~BDOO ~lIDUDrCml$ & ~Ulrrrr~BDOO ~lIDSi$ Attach addItIOnal sheets If necessary Additional program fundmg sources could Include, but are not limited to foundations, corporations, individual contributions, events, reimbursements and In-kind contnbutlons Types of funds are loan, grants, donations, In-kmd, etc SmllI"lI:lD 1.W1ll1ll1III~ Alameda Coun $ 92,216 Local/ Llvem10re ; Pleasanton $ 41,724 Collaboratlve ; Lmka es $ 81,154 Collaborative; GIWORKS $ 29,000 Federal Funds passed through Local Board / EHAP $ 14,880 Federal Funds p1ssed through Local Board; FEMA $ 10,000 Federal funds passed through State ; Federal Eme ene Shelter Grant $ 108,674 Federal; State funds - OffICe of Erne ene ServICes O[S $ 77,973 State - CA De t of Pubhc Health $ 87,193 Foundations $ 32,542 Donatlons $ 48,670 TOTAl. S 624028 1IJ$IIIIHIlrr~IIIIIII~S ~OIIIIl1l1llUl/lld7 '!fIR! Case eratlom./ Admm N Case Mana ement N N N Case 1v1ana ement N eratlons N e ratIo ns N Case y eratloTI'> / Admm Case y eratlons ; Admm Case Mana ement N Adrrumstratlon; Su lIes N If voo arB utilIZing COOS funds to pav for staff Gosts, plBasullBt Bach O_VDu/tltlo and tho parcootago of tholr salarv and baooms that will bo paid wnh COBI!:. IDcluda tho total monihlV and VBarl!t costs to tho COBG program NotD: Uacatlno sick IDatlO and holldavs for umplovu8S CHnDot bo chargad to COlliS as progrm ulIponsDB Now % salarv & bonaMs paid tor MonUlIV salarv & bonom 1f oarllt salarv & bona ut cost Posltlnn mID l1f/Nl ~fth firMt S cost to ~rant to DrBnt Lead Case Manager - DV Shelter N 75% $ 35400 $ 4,248 lead Case Manager - Homeless Shelter N 175% $ 870 18 $ 10,442 -rVH-7 JJ,} :r 13 3 Ann Kmg, Executive Director In 1987 Ann edrned a MSW III admllllstratlOn, focusmg on children, youth and taJ11lhes She has over 28 yems expenencc wOlkll1g wlth domestIc vIOlence dnd povelty mcludll1g 13 years Il1 homeless servIce" Ann has been ExeLuttve Director ofTVH for ovel 10 yedr,> Lmda Johnson, Director of Fmance and ComplIance Linda earned an MP A III 2002 She has ovel 17 years expenence In accounting, 9 m nonprofit dccountll1g LlI1c1a hds been the Director at FlOunce and Comphance fOl TVH smce 2002 Mary Stem, Chmcal Supervisor MalY graduatLd m1995 with a Masters 111 Mdfllage and famllyTherapy and emned her LMfT m 1999 Mal y has ovel 12 years expenence 10 counselmg, mcludmg 8 yedrs 111 DV Lounselll1g Mary ha,> been the Clmleal Supervlsol ofTVH S10Le 2002 Jenmfer Dow, Director of Domestic VIOlence Services Jenmfer became the DlrectOl ot DomestIc VlOlenLe ServIces m July of2006 She ha<; been with TVH smce 2002 when she Jomed the Homeless Services depmtment as their Life Sk1l1s Coordll1dtor S1Oc...e then she has held several positIOns wlthm the agent.. y 1I1cludmg Lll1kages Coordmator, I-lOPE PlOJect Coord1Oator/Assl<;tant Director of Homeless Scrvlces, and Director of Home1es,; Servlce<; len has over ten years expcnence III SOCIal serVices She ha<; a BA 111 Anthropology and Women's Studle~ Samantha Burrows, Lead Case Manager of Homeless Services Samantha has been at 1 n- Valley Havcn lor five yea] s dunng which ttme she has worked as a Cd<;e Manager at the Domestlc VlOlenee Shelter, as the Cnsls Lll1c Coordll1ator, and as Reliet StatTfor both the Domestic VIOlence and Homele~s Shelter,; PnOt to Tn Valley Haven, Samantha worked for two yems at Humboldt Domestic VIOlence Selvlces both a<:; She! ter Staff and as a Volunteer Samantha holds two BAs, one III Women's Studies (constnctlOn III Social and Commumty Service) and the othel III SoclOlogy as well as an AA III Llbelal Studle,:> She also hold~ mmors 111 Psychology and Ethl1ll. Studies Clare Gome!!, Food P .mtry Coordmator Clare JOllled 1 VH as the Food Pantry CoordmatOl III 2005 She hold,> two a BS m Chemistry and A BS In Hohsttc NutlltlOn Cldle has hve year~ expenence as a NutlltlOnal Consultant dt KlVaSpmt FoundatlOn and the St Laurencc Institute CoIs3na Henderson, Lead Case ManAger of DomestIc VIOlence Services ColsanaJomed TVH as the Ledd Case Manager 111 2007 She holds a BS 111 SOCIal Work and also a certification of Dome<;tlc VlOlence Counselor '3he has been In social services smce 1999 WOI kmg a<; a Cnsls Counselor, Chlldl en's Advocate and a Sexual Assault Counselor 1'0 --JH~6' } ~1r1DJ@1r~1I [ffi[lj]~@fID~ ~lImrmm 1:23 ~ /33 Attach addItIOnal sheets If necessary CDBG Grant Total Program Budget Capital Expenses Co n st ru ct 10 n/ R e h a b Illtat 10 n $ $ Permits and Fees $ $ Design $ $ Engmeermg $ $ AcquIsition $ $ Other Soft Costs (defme) $ $ Sl\.nb~otal $ $ Personnel Expenses Salarres $ 11,654 $ 391,165 Benefits $ 3,036 $ 102,488 Sl!lb~otal $ 14,690 $ 493,653 Operating Expenses Supplies $ 310 $ 10,350 P rr n t I ng! COPYI n g $ $ 8,500 Postage $ $ 273 Telephone $ $ 10,000 Rent and Utilities $ $ 28,000 Accountmg! Aud It $ $ 5,000 Other (Staff Development) $ $ 2,500 Other (MIleage) $ $ 5,500 Other (Admm ) $ $ 75,250 Subtotal $ 310 $ 145,373 nu\II. $ 15,000 $ 639,026 Budget prepared by (Name, TItle, Telephone Number, E-mail) Linda L Johnson Director of Flllance and Compliance (925) 667-2723 hnddJ@tnvalleyhaven Olg rv/l-'7 JPlmHrITmllrllll1liBlll1lmJfBl ~ fBliBl$lIltlrfBl $ (fill out a Performance Measure for EACH goal and/or obJective) Page 1 of 8 /ol'f ~ 133 Agency Program ActIvity Tn-Valley Haven Domcstlc VIOJen(,(, & Homeless Sel vices Goal/Objective #1 CIlSIS Line Support and/or Emergency DV SheltcI to SUI VIVOI <) ot DomestIc VlOlencc 25 DublIn Rcsldents to lecelve asslstanLe wIth Domestic VIOlence Issues thlOugh Cl1SI<, LIne clnd/or Dome<;tlc VIOlence Shelter servIces DetaIled dcmoglaphlc<; w1l1 be colleded on DublIn DV Shelter re<;ldents for HUD/CDBG reportIng Please Circle at least one of each of the following goals and priorities whIch are applicable to this activity, goal & objective Refer to Instructions to complete RFP for a list of the goals and pnorltles HUD Stratoglc Goal 1 2 131 4 5 HUD Pollllv Prlorltv 1 121 3 4 5 6 How will your agency benefit Dublm reSidents? Cnsts Line & DV ShelteI Services will help survIvors ofDome~ttc VIOlence work toward attdInmg a sdte enVllonment through a combJOdtIon ofreterrals, advIce, counseling, and sheltet and ca<;e mdnagemcnt Please refer to Instructions to complete RFP for description of Performance Measures 1 ~bIDGtI!f8 ISIDlumt IIInal 2. OuUGmJ1B [Ruloet onlBJ [8J Creatmg a SUitable living Environment liS] Availability/Accessibility D PrOViding Decent Affordable Housing D Affordablllty D Creating Economic Opportunities D Sustalnablhty 3. SPBClflC indicator IsolOGt OU91 \ D Public faCilIty or Infrastructure D Owner occupied units rehabilitated ~ Public service D Direct financial aSSIstance to homebuyers D Targeted reVitalization o Tenant Based Rental Assistance (TBRA) 0 Commercial fa'1'ade treatments or o Homeless shelters business bUilding rehabilitation 0 Brownflelds remedtated 0 Emergency housing 0 Rental Units constructed 0 Homeless prevention D Rental Units rehabilitated o Jobs created D Homeownershlp Units constructed or D Jobs retarned acqUired wIth rehabilitatIon 0 Business assistance o Busmesses prOViding goods or services {v H - {O JeJ5 ~ 133 !P'en'ff(Q)ll'millIf1lCe M eaJsl\lIll'leS Both pages must be completed for each program Page 2 of 8 4 Common Indicator GOAL #1 a Total number of clients you anticipate selVlng choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES Households Persons 'l~ ...) -- ---~~- --~--~- - b Breakout the number of clients you anticipate serving In the follOWing categones Low \ Very Low " Female Income Income ,. Disabled Headed Senior Youth Hamel (>50%) (<50%) Households - - -- 5 20 3 12 1 10 20 -. -- ess I ~ 11 ""VI t b<6 ~ )33 ~(ffilrH[IDlrmmCBlll1lllll~ ~(ffiCBl$[lJ]lF(ffi$ (fill out a Performance Measure for EACH goal and/or obJective) Page 3 of 8 Agency Tn-Valley Haven Program Dome<;tlc VlOlence & Homele<;s Servlces Homeles') ServIces through SOJourner, TVH'<; Homclcs') Shelter, and the TVH Food Pantry 165 Dublm resIdent" who aJ e homeless or dt n"k of becolTImg homeless to receive <;ervl(,es thlOUgh the Food Pantry and/or SOJournel House, Tn- V dlley I-laven's Homeles<; Sheltcl Ot these, 150 ate expected to meet HUD low and vuy-low Income thl eshold<; Detailed demographIcs will be wllected on both Food Pdnhy chents and Homeles~ Sheltel residents for HUD/COSO lep0l1mg ActiVity Goal/Objective #2 Please circle at least one of each of the following goals and priorities which are applicable to this activity, goal & objective Refer to Instructions to complete RFP for a list of the goals and pnorltles RUlli Slrataglc Goal 1 2 131 4 5 HUB PoUClf Prlurltv 1 121 3 4 5 6 How will your agency benefit Dublm residents? Food Pantry and Homeless Shelter service" wIll help llTIProve the qualIty of life tor homele% and at- n'lk-of-homelessness Dublin clients Please refer to Instructions to complete RFP for description of Performance Measures 1 U~DctltJD [salact unal t 2. Dutoomlll [samet ouall ~ Creating a SUitable LIving Environment ~ Availability/Accessibility 0 Provldmg Decent Affordable Housmg o Affordablhty D Creatmg Economic Opportunities D Sustamablhty a SpReut Indicator Isalaet UDal o PubliC facIlity or Infrastructure [Z] Public serVIce D Targeted revItalIzation D D D D D D o Owner occupied Units rehabilitated D Direct fmanclal aSSistance to homebuyers D Tenant Based Rental Assistance (TBRA) Commercial falfade treatments or busmess bUIlding rehabilitatIon Brownflelds remedlated Rental Units constructed Rental Units rehabilitated Homeownershlp Units constructed or acquired WIth rehabilitation Business assistance D Homeless shelters D Emergency housing D Homeless prevention o Jobs created D Jobs retained D Businesses provIding goods or services TifH It- j lJ'1 ~ /3?J !P>s~~l!J)~mall1l(Ce MSaSllil~eS Both pages must be completed for each program Page 4 of 8 4 Common Indicator GOAL #2 a Total number of chents you anticipate servmg choose one orthe other DO NOT PROVIDE STATS IN BOTH CATEGORIES Households Persons 165 b Breakout the number of chents you anticipate serving m the followmg categories Low Very Low Female Income Income Disabled Headed Senior Youth Hamel (>50%) (<50%) Households - -- 15 150 10 30 5 60 50 L-_ ess --lIr-" I ~lBnrff(IDrrUllllmJ[lJHrnrm ~l8lmJ$[lI]rrrm$ (fill out a Performance Measure for EACH goal and/or obJective) Page 5 of 8 ,~ <;:f /33 Agency Program Activity Tn-Valley Haven DOme'3tlc VlOlence & Homeless Services Go a 1/ 0 bJ ectlve #3 Plevcntton EducatIon classes given to DubllO resIdents 600 Dubl10 residents to receive Commumty EducatlOn Preventlon classes As the mdJonty of these students are mmors 10 the Dubl10 '3chool dlstnc.t, HUD/CDBG type demograhlcs will not be gathered or reported beyond number ot attendees Please cIrcle at least one of each of the followmg goals and priorities which are applicable to this actIvity, goal & objective Refer to Instructions to complete RFP for a list of the goals and priorities HUD Stratogle Goal 1 2 131 4 5 HOD Pnliev Priorltv 1 121 3 4 5 6 How Will your agency benefit Dublin residents? Food Pantry and Homeless Shelter services will help nTIProve the qUdl1tV ofl1te f01 homeless and at- nsk-of-homeles~ness Dublm clIent-. Please refer to Instructions to complete RFP for description of Performance Measures l O~lRctrn8 lSGllamt onol 2. 001:001118 laelua ORBl [2] Creating a SUitable LIving Environment cgJ Availability/AccessibIlity 0 Provldmg Decent Affordable Housing o Affordablllty 0 Creating EconomIc Opportunities o Sustalnablllty a heme Indicator liBlRct IIIRal o Public faCIlity or Infrastructure [2] Public service o Owner occupied Units rehabilitated o Direct financial assIstance to homebuyers o Targeted revitalizatIOn o Tenant Based Rental AssIstance (TBRA) D Commercial falfade treatments or business bUilding rehabilitation o Brownflelds remedlated D Rental Units constructed D Rental Units rehabilitated D Homeownershlp Units constructed or acquired with rehabilitation D Busmess assistance D Homeless shelters D Emergency housing D Homeless prevention D Jobs created D Jobs retained D Busmesses provldmg goods or services Tvl' I' J ~ell'~(Jlll'll1l1la[[n](ce MeaSllllll'eS Both pages must be completed for each program Page 6 of 8 Rq ~/8~ 4 Common Indicator GOAL #3 a Total number of clients you anticipate selVlng choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES Households Persons 600 b Breakout the number of chents you anticipate servmg m the followmg categones Low Income \ (>50%) Very Low Female Income Disabled Headed Senlor)< Youth Homeles ( <50%) , Households - " na na na na 600 na s na fVr' I:; J IPl!BUrITllIlIrUlllllBllIlllrnrnl ~rnlml$1lll1r rnl$ (fill out a Performance Measure for EACH goal and/or obJective) Page 7 of 8 f3rJ~ )33 Agency Program ActiVity Tn-Valley Haven Domestic Violence & Homeless Selvlces Goal/Objective #4 Coun<;ehng services to Dublm residents 24 Dublin resIdents to receive counseling at Tn-Valley Haven 's Commumty BUlldmg or <;atel] 1 te office In PI easan too 20 0 f these ex pelted to meet H U D defio I tl on s of Lo W 0 I Very-Low meome Coul1<,ehng focused on Domt,')tlc VIOlence Sexual Abuse, and Homeles5> Issues Please circle at least one of each of the following goals and pnorltles which are applicable to thiS activity, goal & objective Refer to Instructions to complete RFP for a list of the goals and prIOrities HUD StratlQllc ~oal 1 2 4 5 HUn PolleV Prlorltv 1 3 4 5 6 How will your agency benefit Dublin reSidents? Food Pantry and Homeless Shelter selVlces wlil help nnprove the quality ot hfe for home]es~ clod at- nsk-of-homele5>sness Dublm chent<; Please refer to InstructIOns to complete RFP for deSCription of Performance Measures 1 UblIIltlHII [s9lBCt ODal 2. lIIuUclllma [seloel Mill] [2J Creating a SUitable LIVing Environment [2J Availability/Accessibility 0 PrOViding Decent Affordable HOUSing D Affordablllty 0 Creating Economic Opportunities o Sustalnablllty 3. SDocll'ic IndICator (sabre! Dnu] D Public faCIlity or Infrastructure [gJ Public service D Owner occupied Units rehabilitated o Direct financial assistance to homebuyers D Targeted revitalization o Tenant Based Rental ASSistance (TBRA) o Commercial far;ade treatments or bUSiness bUilding rehabilitatIOn D Brownflelds remedlated o Rental umts constructed D Rental Units rehabilitated D Homeownershlp Units constructed or acqUired With rehabilitation o BUSiness assistance D Homeless shelters D Emergency housmg o Homeless prevention o Jobs created D Jobs retamed o Busmesses provldmg goods or services I IN "J Pa ~~(Q}~ll1l1la [l1l(Cs M sa s IUl ~es Both pages must be completed for each program Page 8 of 8 4 Common Indicator GOAL #4 a Total number of clients you anticipate selVlng choose one or the other DO NOT PROVIDE STATS IN BOTH CATEGORIES Households 24 Persons b Breakout the number of chents you anticipate servmg In the following categories Low Very Low Female Income Income Disabled Headed Senior Youth (>50%) ( <50%) , Households 11 9 1 10 1 2 ----- ~ /3 f ?f )32> Homeless 5 ~~~ /3J ~ 133 5 Environmental Review Requirements Source documentation requested below Includes, but IS not limited to 1) personal expenence of the indivIdual completing the application [mclude name, title and date], 2) another mdlvldual experienced with the subject (mclude name, title and date], 3) publicatIon or other documentation [Include title and date], etc ) Category A HIstOriC Preservation Will the project affect any histOriC properties or areas? If so, project may take up to 90 days to clear with State Hlstonc Preservation Officer before contracts can be executed B Floodplain Management C Wetlands ProtectIOn Does the project mvolve new construction wlthm or adjacent to wetlands, marshes, wet meadows, mud flats or natural ponds per field observa t I on? D Coastal Zone Does the project Involve the placement, erection or removal of matenals, or an Increase In the use m a Coastal Zone E Sole Source Aquifers F Endangered Species Will the project have any effect on any federally protected (lIsted or proposed) threatened or endangered species? Use personal experience or contact the National Wildlife ASSOCiatIOn to determme If there are endangered species present In or around the project site If the area IS already urbanized, note this cltmg your personal expenence/observatlon Include the name and title of the individual makmg the determination and the date, or the name of the publication that supports the fmdmg G Wild and Scenic Rivers H Air Quality Will the project affect air quality dunng construction and/or operatIOn? (If there IS potential, IS the project located wlthm an "attainment" area or If It IS wlthm a "noo- attamment" area, It conforms with the EPA- approved State ImplementatIon Plan) Use personal experience or obtam mformatlon from local Plannmg Department or EPA regardmg the effect of air quality In the area of the project Include the name and title of the mdlVldual making the determination and the date, or the name of the publication that supports the fmdmg Source and/or DocumentatIOn lri2J Paul Hoffman, TVH Data Manager, 11/20/2007 To be completed by County staff lti9 ConstructIOn lS not part ot this project Paul Hoffman, TVI-I Data Managel, 11/20/2007 ~] Paul Hoffman, TVH Data Manager, 11/20/2007 The project IS not located wlthm a US ,EPA-deslgnated sole source aquifer watershed area per April 1990 Memoranda of Understanding [HUD EPA MOU of 1990] ~ TillS prole(,t docs not Involve any new facllltles or outside actIvItIes Paul Hottman, Tv H Data Manager, I ] 120/2007 None m Alameda County t!i2I ThiS project doe,> not Involve any new facll1tJes or ac.tIvItIes that c.ould affect air qUality Paul Hoffman, TVH Data Manager, 11/20/2007 -(Jr l ......- Category I Farmland Protection Does the project Site mclude pnme or unique farmland, or other farmland of statewide or local Importance? Use personal experience or the local Planning Department to determme whether or not the Site will affect local farmlands If the site IS already urbamzed, note thiS citing your personal expenence Include the name and tItle of the mdlvldual making the determmation and the date, or the name of the publicatIon that supports the finding J NOIse Abatement and Control Does the project Involve development of nOise sensitive uses, or IS the project In the Ime-of-slght of a major or artenal roadway or railroad? K Explosive and Flammable OperatIOns Is the project located an "Acceptable Separation Distance" from any above-ground explosive or flammable fuels or chemicals? Use personal expenence or obtain information from the local fire chief or EPA to determine If the project IS located an acceptable separatIOn distance from any above-ground explosive or flammable fuels or chemical contamers Include the name and title of the indIvidual making the determination and the date, or the name of the publicatIOn that supports the fmdlng L TOXIC Chemicals/RadIoactive Matenals Are the subject and adjacent properties free from hazardous matenals, contamination, tOXIC chemicals, gasses and radioactive substances which could affect the health or safety of occupants or conflict with the Intended use of the property? Use personal expenence or the local fire chief to determine that the project IS not located within 2000 feet of a tOXIC or radIoactive site Include the name and title of the individual makmg the determination and the date, or the name of the publication that supports the fmdmg M Airport Clear Zones and Accident Potential Zones N EnVironmental Justice A) The proposed sIte IS sUitable for Its proposed use and Will not be adversely Impacted by adverse environmental conditions, B) Site sUitability IS a concern, the project IS adversely affected by environmental conditIons Impactmg low Income or mlnonty populations 133 133 Source and/or Documentation N No fannland IS mvolved Paul Hoffman, TVH Ddta Manager, 11120/2007 Ye All locatIOns utilIzed by thIS prOject me eXlstmg and have been 111- use with the same actIvIties for many years No new locations have been added, no major changes to eXlstmg facIlities or their sunoundmgs Pa.ul Hoffman, TVH Da.ta. Manager, 11120/2007 Ye All locations utilIzed by thl~ project dre eXI')tmg and have been m- use With the 'ldme activIties fOf many years No new locatlon~ have been added, no major changes to eXIstIng faclllhes Of thelf ')urroundmg<., r P Jul Hoffinan, TVH Data Managel, 11120/2007 To be completed by County staff A AlIlocatJons utIhzed by thIS prolect are eXlstmg and have been m-use WIth the <;ame actiVIties fOl many years No new locations have been added, no major changes to eXIstmg faclhhe<; or thelf sUlroundmg<; Paul Hottman, TVI-I Data Manager, 11120/2007 ~~