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8.1 City of Dublin Fiscal Year 2023-24 Human Services Grant Program Funding Recommendations
r %o DUBLI N C A L I F 0 R N I A DATE: May 2, 2023 STAFF REPORT CITY COUNCIL TO: Honorable Mayor and City Councilmembers Agenda Item 8.1 FROM: Linda Smith, City Manager SU 13,ECT: City of Dublin Fiscal Year 2023-24 Human Services Grant Program Funding Recommendations Prepared by.•JudyMWer, ManagementAnalystH EXECUTIVE SUMMARY: The City Council will consider the funding recommendation for the Human Services Grant Program and approve a funding allocation for Fiscal Year 2023-24. STAFF RECOMMENDATION: Adopt the Resolution Approving Funding Recommendations for the Fiscal Year 2023-24 Human Services Grant Program. FINANCIAL IMPACT: The City's Human Services Grant Program is currently supported by four funding sources - General Fund, the Affordable Housing Fund, Community Development Block Grant Program, and the American Rescue Plan Act. Further description of the funding by source is included in Attachment 2 to the Staff Report. Each organization applying for grant funding is eligible for a minimum award of $3,500 and a maximum of $25,000. DESCRIPTION: The Human Services Grant Program provides financial support to local non-profit organizations serving the Dublin community. Each year the City Council awards funding to organizations that best meet the community's needs in support of the City's adopted Mission and Vision (Attachment 4) and needs identified in the Tri-Valley Needs Assessment (Attachment 5). Fiscal Year 2023-24 marks the 191h year of Dublin's Human Services Grant Program, with the 10- year allocation history shown in the table below. Prior to the availability of APRA funds, the City's Page 1 of 4 194 General Fund allocation was higher; however, the overall contributions to the Grant Program have increased during this ARPA period. TABLE 1: FUNDING SUPPORT HISTORY Fiscal Year General Fund Affordable Housing Fund CDBG ARPA TOTAL 2013-14 $135,000 $33,000 $45,184 $213,184 2014-15 $120,000 $7,000 $67,402 $194,402 2015-16 $120,000 $8,000 $69,812 $197,812 2016-17 $140,000 $8,000 $75,602 $223,602 2017-18 $140,000 $8,000 $79,781 $227,781 2018-19 $130,000 $8,000 $91,462 $229,462 2019-20 $130,000 $8,000 $93,970 $231,970 2020-21 $160,000 $8,000 $99,711 $267,711 2021-22 $89,780 $0* $99,183 $163,251 $352,214 2022-23 $98,000** $0* $99,000 $163,000 $360,000 * Forecasted annually at $8,000 since FY 2015-16 - not utilized in associated Fiscal Year. ** Includes $8,460 in Homeless Housing, Assistance, and Prevention (HHAP) Funding. Alameda County Urban County CDBG Program The City of Dublin participates in Alameda County's Urban -County CDBG Program, along with the cities of Albany, Emeryville, Newark, and Piedmont (cities whose population is or was less than 50,000). These are called the "Urban County Cities," along with the unincorporated areas of Alameda County. Each year, the County limits the Urban County Cities to approximately 15% of the CDBG allocation for service -based organizations and projects. The County's past practice has been to review all applications to determine if the overall request for service -based projects exceeds the 15% limit. In recent years, Dublin has received approximately $99,000 in CDBG public service funding by accessing funds not used by other Urban County Cities. This has been reduced by approximately $40,000 to $59,862 (which is equivalent to the 15% limit allocation for public service) in Fiscal Year 2023-24, as participants in the Urban -County CDBG Program are using more of their share. Of the $59,862, $15,000 is earmarked for the annual loan obligation for the Axis Community Health Clinic. This leaves $44,862 of CDBG funds available for the public service grants. During this year's application period, the City of Dublin received 23 qualifying public service applications (Attachment 7) from 19 organizations. Of the 23 applications, nine are eligible for CDBG funding, and 14 are eligible for ARPA funding. The total dollar amount requested is $495,480. Review and Rating Criteria In February 2023, Staff and the Human Service Commission reviewed the Fiscal Year 2023-24 grant applications to verify all requests qualify for funding based on the adopted program guidelines. The Rating Criteria Worksheet applied to each grant application is included as Attachment 6. Page 2 of 4 195 The Rating Criteria worksheet is one of several factors used in determining funding recommendations. Other factors include consideration of: • The number of Dublin residents served and cost per participant. • Past performance of existing Dublin programs. • Whether the project addresses one or more of the 14 Key Areas of Concern identified in the 2011 Tri-Valley Needs Assessment report. • Whether City funds are used to leverage other funding sources. Funding Recommendations At its meeting on April 5, 2023, the Commission discussed and considered funding allocations based on their collective group averages of the application scores. The City received notice from the County after the posting of the Commission agenda about the reduction in anticipated CDBG funds. Therefore, the Commission included two options for the City Council's consideration - backfill the loss of CDBG with additional General Fund dollars or make an approximate 8.5% reduction across all recommended applicants. After further review by Staff, it is recommended that the City Council consider the option of reducing the funding across the board, except for the CDBG allocations. Attachment 2 summarizes the Staffs recommendation under the Adjusted Recommendations column. Lastly, Staff would like the City Council to consider the removal of the Calico Center from the list of applicants. The Calico Center already is a budgeted item for Dublin Police Services as they provide forensic interview services to children who are victims of crime or those that have witnessed crime. Their annual request for grant funding simply augments their operational support of the investigations division of Dublin Police Services and, as such, should be considered as part of the annual budget review, not the grants process. If the City Council agrees with this approach, Staff will work with Calico Center to add their anticipated total costs for services to the upcoming budget review. Tri-ValleyHaven Capital Project Request.• CDBG-Funded Typically, the City receives far more service project requests than capital project requests, and the public service fund allocation is competitive. For Fiscal Year 2023-24, Tri-Valley Haven has requested Capital Funding to demolish their shelter building, Shiloh, and rebuild with 50% more capacity. Shiloh, located in Livermore, is the only Domestic Violence/Homeless Shelter in the Tri- Valley area. This project was not included in the competitive review and allocation completed by the Human Services Commission. The request, totaling $240,205, is anticipated to be available as part of the Urban County CDBG Capital Allocation. However, the application cannot be submitted to the County until after July 1, when funds are available. Staff will then return to the City Council to formally review the capital project and request funding support. STRATEGIC PLAN INITIATIVE: None. Page 3 of 4 196 NOTICING REQUIREMENTS/PUBLIC OUTREACH: The City Council Agenda was posted, and all grant applicants were provided a web link to the Staff Report. Outreach and Promotion In November and December 2022, Staff conducted outreach and education efforts that included: • Providing notice of funding availability and upcoming community workshop to non-profit organizations from the past five grant cycles. • Advertising the funding availability in East Bay Times and on the City website. • Holding a Grant Application Workshop to review the online application process and discuss program guidelines for the upcoming fiscal year. • Conducting direct outreach to non-profit organizations in the Tri-Valley that qualified for funding but have not previously applied. Four new organizations applied for funding in this cycle. ATTACHMENTS: 1) Resolution Approving Funding Recommendations for the Fiscal Year 2023-24 Human Services Grant Program 2) Exhibit A to the Resolution -Fiscal Year 2023-24 Human Services Grant Program Funding 3) Human Services Grant Program Past Funding and Human Services Commission Recommendation for Fiscal Year 2023-24 4) City of Dublin Mission and Vision Statements 5) Tri-Valley Needs Assessment 14 Areas of Concern 6) Grant Application Rating Criteria Sheet 7) Fiscal Year 2023-24 Human Service Grant Applications Page 4 of 4 197 Attachment 1 RESOLUTION NO. XX - 23 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF DUBLIN APPROVING FUNDING RECOMMENDATIONS FOR THE FISCAL YEAR 2023-24 HUMAN SERVICES GRANT PROGRAM WHEREAS, the City received 23 qualifying public service applications for the Fiscal Year 2023-24 Human Services Grant Program; and WHEREAS, funding sources for the Human Services Grant Program include the federally funded Community Development Block Grant (CDBG), the City of Dublin General Fund, the Affordable Housing Fund, and the American Rescue Plan Act (ARPA); and WHEREAS, on April 5, 2023, the Human Services Commission recommended 22 public service projects receive grant funding through the Human Services Grant Program; and WHEREAS, the City Council considered the recommended service projects attached hereto as Exhibit A; and WHEREAS, the action taken by this Resolution shall approve the funding recommendations of all funds. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Dublin does hereby take the following actions: 1. Approve the Human Services Grant fund allocations for Fiscal Year 2023-24, attached hereto as Exhibit A; and 2. Direct Staff to work with the County of Alameda as required on the CDBG funding allocations by reallocating funds as needed based on the confirmed CDBG funding guidelines and funding level; and 3. Authorize the City Manager to execute agreements with the County of Alameda for use of CDBG funds and the funding agreements with each grant recipient effective July 1, 2023, and take such further actions as may be necessary or appropriate to carry out the City Council's obligations pursuant to this Resolution. {Signatures on the following page} Reso. No. XX-23, Item X.X, Adopted XX/XX/23 Page 1 of 2 198 PASSED, APPROVED AND ADOPTED this 2nd day of May 2023, by the following vote: AYES: NOES: ABSENT: ABSTAIN: Mayor ATTEST: City Clerk Reso. No. XX-23, Item X.X, Adopted XX/XX/23 Page 2 of 2 199 Attachment 2 Exhibit A to the Resolution City of Dublin - Fiscal Year 2023-24 - Human Services Grant Program Funding Exhibit A to Resolution XX-23 ORGANIZATION GRANT AMOUNT GRANTAMOUNT ADJUSTED CDBG GENERAL AMERICAN NAME GRANT PROPOSAL REQUESTED RECOMMENDED RECOMMENDATION FUNDING FUND RESCUE PLAN FY23-24 FY23-24 ACT Axis Community Axis Section 108 Loan $15,000 $15,000 $15,000 $15,000 Health Obligation Axis Community Triage Nurse $12,734 $12,500 $11,724 $11,724 Health CALICO Center Child Abuse Intervention $15,000 $11,750 $11,021 $11,021 Centro Legal Fair & Secure Housing $23 789 $19,000 $17,821 $17,821 Project Chabot -Las Positas CC Pathways to Employment $24,959 $16,000 $15,007 $15,007 District Chabot -Las Positas CC VITA Services $16,598 $16,000 $15,007 $15,007 District City Serve of the Tri- Homeless Prevention/Family $25,000 $25,000 $23,448 $23,448 Valley Stabilization City Serve of the Tri- Senior 60+ Stabilization $25,000 $16,250 $15,241 $15,241 Valley Program Community Resources Housing & Independent $16,000 $9,150 $8,582 $8,582 for Independent Living Living Skills Easterseals Northern Kaleidoscope Community $25,000 $12,500 $11,724 $11,724 CA Adult Program Goodness Village Goodness Village $25,000 $12,500 $11,724 $11,724* Hively Community Engagement $25,000 $0 $0 Coordinator Hively Family Resource Center $25,000 $25,000 $23,448 $23,448 Hope Hospice Inc. Grief & Volunteer Support $20,000 $12,800 $12,005 $12,005 Services Legal Assistance for Legal Services & Medicare $10,000 $10,000 $9,379 $2,216 $7,163 Seniors Counseling Lions Center for Seniors Vision Health $7,500 $3,750 $3,517 $3,517 Visually Impaired Love Never Fails Economic Freedom ITbiz $25,000 $7,500 $7,035 $7,035 Tech Academy Open Heart Kitchen Senior Meal Program $25,000 $25,000 $23,448 $21,414 $2,034 Partners for Change Education & Mentorship for $15,000 $5,000 $4,690 $4,690 Tri-Valley Poverty Alleviation Spectrum Community Meals on Wheels More Than $25,000 $25,000 $23,448 $23,448 Services a Meal Sunflower Hill Support for Adults with $18,900 $16,000 $15,007 $15,007 Developmental Disabilities Tri-Valley Haven Domestic Violence Services $25,000 $25,000 $23,448 $23,448 Tri-Valley Haven Homeless Services $25,000 $25,000 $23,448 $23,448 Wishing Well Inc. Free Meals $25,000 $5,000 $4,690 $4,690 $495,480 $350,700 $329,862 $59,862 $307,000* $163,000 * Includes $8,000 from the Affordable Housing Fund 200 City of Dublin Human Services Commission - Grant Funding for Fiscal Year 2023-24 Attachment 3 Loan obligation $15,575.00 $15,000 $15,000777.7 A NA CDBG $15,000 Axis Triage Call Nurse NA $12,734 $1 ,,500 1000 $13 ARPA $11,724 CALICO Center Child Abuse Prevention $14,675.00 $15,000 $11,750 79.7 18 $653 GF $11,021 Centro Legal Fair & Secure Housing Project $22,825.00 $23,789 $19,000 87.7 25 $760 GF $17,821 Chabot Las Positas Pathways to Employment $16,230.00 $24,959 $16,000 66.3 356 $45 ARPA $15,007 Chabot Las Positas VITA Services Program $15,950.00 $16,598 $16,000 60.0 100 $160 ARPA $15,007 City Serve of the Tri-Valley Homelessness Prevention/Family Stabilization $25,000.00 $25,000 $25,000 94.3 75 $333 ARPA $23,448 City Serve of the Tri-Valley Senior 60+ Stabilization Program $16,150.00 $25,000 $16,250 74.3 35 $464 GF $15,241 CRIL Housing and Independent Living Skills $14,350.00 $16,000 $9,150 66.0 40 $229 ARPA $8,582 Easterseals Northern CA Kaleidoscope Community Adult Program $15,250.00 $25,000 $12,500 55.3 9 $1,389 GF $11,724 Goodness Village Tiny Home Community $10,000.00 $25,000 $12,500 59.7 4 $3,125 GF** $11,724 Hively Community Engagement Coordinator $23,150.00 $25,000 $0 77.0 1,200 $0 NA $0 Hively Family Resource Center $23,225.00 $25,000 $25,000 74.7 1,200 $21 ARPA $23,448 Hope Hospice Inc. Grief & Volunteer Support Services $17,670.00 $20,000 $12,800 73.7 100 $128 GF $12,005 Legal Assistance for Seniors Legal Services & Medicare Counseling for Seniors $9 350.00 $10,000 $10,000 76.3 147 $68 GF/ARPA $9,379 Lions Center for Visually Impaired Seniors Vision Health New $7,500 $3,750 76.0 15 $250 GF $3,517 Love Never Fails Economic Freedom Itbiz Tech Academy New $25,000 $7,500 74.7 5 $1,500 ARPA $7,035 Open Heart Kitchen Dublin Meal Program $23,900.00 $25,000 $25,000 93.7 605 $41 CDBG/GF $23,448 Partners for Change Tri-Valley Education & Mentorship for Poverty Alleviation New $15,000 $5 000 68.7 15 $333 GF $4,690 Spectrum Community Services Meals on Wheels for Dublin's Homebound Elderly $24,479.00 $ 25,000 $25,000 87.3 60 $417 ARPA $23,448 Sunflower Hill Support for Adults with Developmental Disabilities $15,400.00 $18,900 $16,000 77.7 35 $457 GF $15,007 Tri-Valley Haven Domestic Violence Services Program $23,350.00 $25,000 $25,000 88.7 75 $333 ARPA $23,448 Tri-Valley Haven Homeless Services Program $24,000.00 $25,000 $25,000 101.7 425 $59 CDBG $23,448 Wishing Well Inc. Free Meals New $25,000 $5,000 60.3 Unclear $0 ARPA $4,690 Totals: $495 480 $350,700 *All reduced by % **Includes $8,000 from Affordable Housinging Fund. $329 862 201 Attachment 4 srs DUBLIN C A L I F 0 R N I A THE NEW AMERICAN BACKYARD MISSION The City of Dublin promotes and supports a high quality of life, ensures a safe and secure environment, fosters new opportunities, provides equity across all programs, and champions a culture of diversity and inclusion. VISION Dublin is a great community to live, work, and raise a family. Dublin values: • Safety — We are dedicated to excellent public safety resources, including police and fire. • Finances — We will strive to be fiscally transparent and balance our budgets annually. • Inclusivity — We will advocate for programs and policies that support inclusive access to housing and cultural opportunities. • Diversity — We will support a wide range of programs and events that reflect and cater to the diversity of our residents. • Equity — We will deliver our services in a way that ensures equitable access to all. • Innovation — We will continue to innovate in every aspect of government and promote innovation within the business community. • Customer Service — We will provide welcoming, excellent customer services to our residents and businesses at all times. • Living an Active Lifestyle — We will continuously promote an active lifestyle through our parks and facilities and encourage participation in local sports. • History — We will honor our history through places and programs that remind people of our beginnings. • Business — We will provide a full spectrum of opportunity by supporting current and prospective businesses through ongoing economic development efforts and helping them grow and thrive locally. • Environmental Sustainability — We will continue to lead in building a well -planned sustainable community and protecting our natural resources. 202 Attachment 5 M Behavioral health (mental health and substance abuse) Affordable housing Health care Workforce development Homelessness Transportation services and access Domestic violence and child abuse Disabilities Food and nutrition Senior services Youth services Child care, early childhood development and education Changing demographics and growing diversity Financial assistance 203 Attachment 6 CITY OF DUBLIN HUMAN SERVICES GRANT RATING SHEET Organization: Program: Citv Staff Section Organization/Management (1 point each, maximum of 5) The organization previously received funding from Dublin and has fully complied with the City's management procedures, including invoice and report deadlines. The organization, as presented in the application, is able to achieve the stated goals and outcomes. The organization and its staff are qualified and have the capacity to provide for the program. (non-profit status, resumes for staff, Board of Directors, information on clients served) The organization has completed all required aspects of the application process. The proposed program has a successful proven track record (not a new program). Total Points: The estimated total number of unduplicated Dublin Residents to be served: Qualifies for: ❑ CDBG ❑ General Fund ❑ ARPA ❑ Other Commission Member Section Need — Rate the need for this program/service. Rating Description Score Low 0-2 The applicant does not articulate a clear need for the project in their application and is unlikely to address that need. Mid 3-5 The applicant identifies a clear need, but it is not a critical human service need, and/or the applicant does not demonstrate a high likelihood of addressing that need. High 6-10 The applicant identifies a critical human service need in Dublin that other organizations do not and demonstrates a high likelihood of addressing that need. Comments: Benefit — Rate the benefit to low-income or high -risk individuals/households in Dublin. Rating Description Score Applicant demonstrates a low number of low-income or high -risk Dublin Low individuals/households who will benefit from the project, and the application fails to 0-2 identify any outcomes or ways it will measure project success. 204 Mid Applicant demonstrates a moderate number of low-income or high -risk Dublin individuals/households who will benefit from the project. The application identifies 3-5 outcomes but is unclear or unlikely to demonstrate a project impact. High Applicant demonstrates a high number of low-income or high -risk Dublin individuals/households who will benefit from the project. The application identifies clear 6-10 and measurable outcomes to demonstrate project impact. Comments: Funding — Rate the applicant's funding request. Rating Description Score Low The funding request is unreasonably high given the project's proposed impact, and the 0-2 number of people served; the project budget is unrealistic. Mid The funding request is reasonable but does not demonstrate a high impact or cost effectiveness given the proposed number of people served and/or the project budget 3-5 has significant questions or flaws. High The funding request is a reasonable amount demonstrating high impact and cost effectiveness given the proposed number of people served; the project budget is feasible 6-10 and sound. Comments: Funding Sustainability — Rate the diversification of the project's funding sources. Rating Description Score Low The Grant request is the only source of funds for the applicant's proposed project. 0-2 Mid The applicant has identified more than one funding source to support the proposed activity/service, but this grant request would be the main source of funds, and the long- 3-5 term sustainability of the project is questionable. High The applicant has identified multiple funding sources to support the proposed activity/service and ensure sustainability. The organization produces other income that 6-10 may be used to support this program (fundraising). Comments: City Funding — Rate the necessity of City funding for this project. Rating Description Score Low The project is not appropriate for City funds and will not reduce demands on other City 0-2 resources. The project is an appropriate use for City funds but will not reduce demands on other Mid City resources and/or other types of funding sources would be a better fit for this 3-5 project. High City funds are critical to the project, and funding request is appropriate for City sources 6-10 and reduces demands for other City resources. 205 Comments: Consistency with Policies — Rate the proposal's consistency with the HUD Strategic Goals and HUD Policy Priorities. (To determine CDBG eligibility) Rating Description Score Low 0-2 The proposal does not address any of the HUD Strategic Goals or HUD Policy Priorities. Mid 3-5 The proposal addresses one of the HUD Strategic Goals or HUD Policy Priorities. High 6-10 The proposal helps address multiple HUD Strategic Goals or HUD Policy Priorities. Comments: City Council Priorities — Rate the extent the proposal addresses one or more of the City Council's priorities. Rating Description Score Low 0-2 The proposal does not address any of the Council's priorities. Mid 3-5 The proposal addresses one or two of the Council's priorities but does not have a high likelihood of doing so effectively. High 6-10 The proposal demonstrates a high likelihood of addressing multiple Council priorities. Comments: Alameda County 14 Areas of Concerns — Rate the extent the proposal addresses one or more of the 14 areas of concern as identified by the Alameda County Needs Assessment Report. Rating Description Score Low 0-2 The proposal does not address any of the 14 areas of concern. Mid 3-5 The proposal addresses one or two of the 14 areas of concern but does not have a high likelihood of doing so effectively. High 6-10 The proposal is highly likely to address multiple areas of the 14 areas of concern. Comments: 206 Innovation — If funds were allocated last year for the same project/activity, rate the extent to which the applicant adequately responds to changing community conditions. If the proposal is for a new project, rate the extent to which the project uses a new and innovative approach to solve an identified problem. Rating Description Score Low 0-2 The applicant does not demonstrate an ability to adapt the project to changing needs or is not using an innovative approach. Mid 3-5 It is unclear how the project will respond to changing community conditions identified in the application or use an effective but not particularly innovative approach. High 6-10 The applicant demonstrates a high likelihood of responding to changing conditions and/or using an innovative approach. Comments: Access — Rate the extent to which the project will ensure non-English speakers, people with disabilities, people experiencing homelessness, seniors, low-income families, and/or youth can access the proposed program or activities. Rating Description Score Low 0-2 The proposal does not mention accessibility concerns and does not describe how it will remove barriers or help community members access its services. Mid 3-5 The proposal addresses accessibility concerns but does not identify concrete or impactful ways the project will remove barriers for priority populations. High 6-10 The proposal describes concrete and impactful ways the applicant will improve language, technology, and/or transportation access for priority populations. Comments: Proposal Total Score: Recommend Funding: ❑ Yes ❑ No Total Requested: Total Recommended: Commissioner Name Suggested determination of allocation amount: Date Points Percent Qualifies For 80+ Points 80-100% of request 60-79 Points 50-80% of request 59 and below 0-50% of request 207 Attachment 7 DUBLI N C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Axis Community Health Triage Nurse Jump to: Organization Information Questions Budget Documents USD$ 12,734.00 Requested Submitted: 1/20/2023 9:37:21 PM (Pacific) Project Contact Valerie Jonas vjonas cDaxishealth.org Tel: 925.201.6068 Additional Contacts none entered Organization Information top 1. Business License Number Questions top Axis Community Health 5925 W. Las Positas Blvd., Suite 100 Pleasanton, CA 94588 United States CEO Liz Perez -Howe Ihowe(a-).axishealth.org 1. Select the category that best describes your organization: (Select only one.) Non -Profit LJ Public Agency ❑ Other: Telephone(925) 201-6068 x Fax (925) 417-1503 x Web axishealth.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Axis provides quality, affordable, accessible and compassionate health care services that promote the well-being of all members of the community. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project Yi Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ❑ Yes 20E ,:/. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). This project ensures patients have remote access to a Triage Nurse to connect with about health symptoms and to guide them in accessing treatment. The Triage Nurse provides immediate information to patients seeking medical guidance and in providing ongoing health assistance. Access to the Triage Nurse ensures patients receive safe, timely and appropriate care for health issues, including COVID-19, and reduces risk for acute health problems. The role of the Triage Nurse is a vital part of the Axis care delivery system because it gives patients quick, remote access to medical advice. The provision of Triage Nurse services is central to providing an appropriate standard of health care. Moreover, the project is targeted to reduce health care costs by ensuring that appropriate care levels are accessed in relation to patient symptoms, and further reduces health care costs by prioritizing care access in appropriate timeframes. Without this resource, patients may delay accessing treatment which can escalate health problems and cost of care. This is of particular concern during this pandemic when it is essential that patient health be maintained and risk for acute care be lowered. The salary cost for Triage Nurse services are reasonable in relation to the cost -savings realized when people are able to access health information that directs them appropriately. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The Dublin grant funds, in combination with funds from the cities of Livermore and Pleasanton, will help support a .5 FTE Triage Nurse, who will be available to 2,175 Axis patients who are Dublin residents. Axis was receiving an operational support grant annually for 10 years from Blue Shield of California Foundation (BSCF) which helped support the Triage Nurse position. However, BSCF has depleted this special fund for community health centers and is not providing any future support. In order to continue to have this critical role in the care delivery system, Axis must find sufficient funding. Additionally, the number of Dublin residents served by Axis has more than doubled, from serving 1,012 residents to 2,175 residents (UDS Reports, 2010- 2021). This project will benefit these residents by providing them access to medical advice by phone or by MyChart patient portal. Funds from this grant will address the need to provide quick remote access to a medical professional when patients are experiencing a health problem. It is also the link for parents/guardians of children who tend to require more frequent medical guidance. This funding will ensure Axis's ability to fund this critical position without a reduction in service hours. Axis serves patients with multiple co -morbidities whereby timely access to medical personnel is of the essence. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 1000 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing Y'. Health Care (including dental) ❑ Workforce Development LJ Homelessness LJ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition IJ Senior Services LJ Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity ❑ Financial Assistance 209 IJ None of the Above FJ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) When a patient is experiencing symptoms of any nature, COVID-19 related or any health condition, they can call our main phone line or send a message through the MyChart patient portal. By doing so, the patient can be connected to the Triage Nurse, a licensed RN with specialized training in responding to patient calls or messages, gathering information on symptoms, and assisting patients with accessing appropriate care. The Triage Nurse is available during business hours to patients (Axis also has an on -call phone service for after-hours care). Depending upon the severity of the symptoms and the patient's condition, the nurse advises on the appropriate next step. Options include having the patient proceed to emergency care, scheduling a same -day appointment with their Axis provider, scheduling a future appointment for the patient, or giving the patient advice for home care and follow-up. During the COVID-19 pandemic, it should be noted that Axis continues to provide patient care via telehealth and in -person as needed. The nurse responds to patients of all ages, from newborns to geriatrics. As needed, the nurse brings a professional language translator to ensure clarity of information. The Triage Nurse is also the Specific Point of Contact (SPOC) for patients being discharged from the hospital. Through a dedicated phone line, area hospitals, including Stanford Healthcare Tri-Valley, Highland Hospital, and John George, call the Triage Nurse to arrange care for the patient after hospital discharge. This is a critical point of contact for ensuring continuity of care. In 2022, the Triage Nurse responded to over 10,000 calls and MyChart messages and assisted approximately 1,000 patients in discharge planning. This call volume was an increase of 12% over the prior calendar year. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Achieving appropriate levels of staffing that support a comprehensive system of care delivery is critical to the ongoing success of service delivery. The Triage Nurse is a position that, in many ways, is the backbone of medical serve delivery. Outcome measures that are crucial to the success of this project are: • Keeping patients who are experiencing symptoms safe by ensuring care that is timely and appropriate in relation to the symptoms. For example, directing a patient with chest pain or severe bleeding directly to emergency care which hastens access to essential care. • Preventing delay in care by promptly speaking with patients, or parents/guardians of patients, about the medical condition and facilitating appointments with care providers. • Assuring continuity of care for patients being discharged from an acute care setting by scheduling appropriate follow-up care with the patient's provider. • Addressing the needs of patients who are being discharged from other care settings. Strategies and objectives that will be used to track the progress are: • Tracking phone system data to monitor call volume and disposition, particularly encounters that required discharge planning and updates to a patient's EHR.. • Tracking the utilization of the MyChart patient portal, particularly encounters that required discharge planning and updates to a patient's EHR. • Ongoing review by the Nurse Manager and Chief Operating Officer of workflows for calls coming into the Triage Nurse and their disposition. • Ongoing review of patient health outcomes by Nurse Manager, Chief Operating Officer, and Quality Enhancement data team by utilization of our Electronic Health Records system (Epic) to track health data. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Axis serves low-income and uninsured Tri-Valley residents of all ages with medical, mental health and dental services. This program serves Dublin families living below 200% of the federal poverty level (FPL)—Dublin's most impoverished residents. Many are the working class who are struggling to maintain life's basic needs for their families. Dublin has experienced a substantial population growth and a growing poverty rate. The Alameda county population jumped more than 11 % over the past decade (Census 2020) and the number of Dublin residents in need of general assistance has doubled since 2003 (2011 Tri-Valley Needs Assessment). The past decade has seen growing diversity, with an increase of nearly 400% in the Asian population. Twenty-one percent of Dublin residents are foreign -born and 29% speak a language other than English at home. These demographics present cultural and linguistic barriers to attaining and maintaining good health. Axis has seen a 21 ( tremendous rise in the number of vulnerable Dublin residents in need of our services. In fact, the number of Dublin resid( served by Axis has more than doubled, from serving 1,012 residents to 2,175 residents (UDS Reports, 2010-2021). This project will benefit these residents by providing them access to medical advice by phone or MyChart patient portal. Axis serves these residents regardless of race, ethnicity, religious beliefs, gender identity, or sexual orientation. Axis remains committed to providing affordable access to care and is assessing how we can continue to improve our services with these values in mind. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Axis Community Health continues to be on the front line of the pandemic response. To date we have provided more than 20,000 COVID tests, administered more than 25, 000 COVID vaccinations, and continue to provide care for patients and community members impacted by the pandemic. Axis's Triage Nurse services have become essential during the COVID-19 pandemic as COVID-19 restrictions caused most clinical operations to migrate to telehealth. They remain the foundation of Axis's service care delivery and the bridge for continuity of care. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ✓, Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Axis's mission is to provide preventive and primary medical care to all members of the community, regardless of income, language, ethnicity or any other factor. Axis's services are designed to reach out to underserved and uninsured populations, including low-income racial and ethnic minority populations who otherwise lack access to health care. Our ability to effectively engage this population is evidenced by the increasing number of Dublin residents we serve. As the sole provider of medical services for the region's low-income and uninsured population, Axis serves a patient population that is ethnically and linguistically diverse. Because half of our medical patients are Spanish-speaking, all front-line staff (call center, case managers, enrollment staff, receptionists and medical assistants) are required to be bilingual in English and Spanish. Axis's medical staff speaks a variety of languages, including Spanish, Hindi, Farsi, Mandarin, and Urdu and also has expert multicultural health care skills and specific knowledge relevant to serving low-income, culturally diverse communities. This expertise successfully transcends cultural and other barriers, creating a bridge to health care and a medical home for Dublin's underserved residents. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Be culturally accessible, appropriate and inclusive Y'. Encourage community engagement and involvement Promote energy and resource efficiency LJ Encourage networking and information sharing across service providers Encourage process streamlining Y'. Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. LJ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. 211 J B) Homeless Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. LJ C) Supportive Housing LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. 201 Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: '. Public Services LJ Public Facilities LJ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities LJ Ensure Equal Opportunity in Housing LJ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') .^! Creating a Suitable Living Environment LJ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') Y'. Availability/Accessibility ❑ Affordability LJ Sustainability LJ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Y: Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. LJ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of 21 years of affordability, number of units occupied by the elderly, and those units designated for chron persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. LJ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. LJ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) LJ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. LJ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) *!: Persons Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 413 Seniors (62 and older) C 109 People with Disabilities C326 Female -Headed Households 500 Youth 44 Homeless �— Not Applicable. Not interested in CDBG funding (Type N/A) 1,392.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 1784 Extremely Low Income (<30% AMI) 152 Very Low Income (30%-50% AMI) 21; 239 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) 2,175.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 609 White 848 White + HISPANIC 87 Black/African American 0 Black/African American + HISPANIC 500 Asian 0 Asian + HISPANIC 22 American Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 22 Native Hawaiian/Other Pacific Islander 0 Native Hawaiian/Other Pacific Islander + HISPANIC 0 American Indian/ Alaskan Native and White 0 American Indian/ Alaskan Native and White + HISPANIC 0 Asian and White 0 Asian and White + HISPANIC 0 Black/African American and White 0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC 87 Multi Racial + HISPANIC OR other Multi Racial F 0 Not Applicable. Not interested in CDBG funding. (Type N/A) 2,175.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. LJ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues City of Livermore City of Pleasanton City of Dublin Community Donations Foundations Total Budget Amount USD$ 12,734.00 USD$ 0.00 USD$ 12,734.00 Amount Committed USD$ 30,099.00 USD$ 15,050.00 USD$ 10,000.00 USD$ 47,883.00 USD$ 103,032.00 21� Funding Uses/Expenses Triage Nurse Salary Triage Nurse Benefits Total Budget Amount USD$ 10,438.00 USD$ 2,296.00 USD$ 12,734.00 Budget Narrative Salary and benefits for a 1.0 FTE Triage Nurse at the rate of $45.62/hour plus benefits (22%). Amount Committed USD$ 0.00 The Dublin grant funds, in combination with funds from the cities of Livermore and Pleasanton, will help support a .5 FTE Triage Nurse, who will be available to 2,175 Dublin residents. Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests '❑ Program Expense Form download template Financial Information Form for ALL Grant Requests 0 Financial Info Form download template List of Board of Directors (or governing body) with 0 BOD List agency contact information Current Annual Budget for the Entire Agency 0 Annual Budget FY22-23 Copy of most recently submitted IRS 990 form or Tax 0 2021 990 Return (include complete form) Board of Director's (or governing body's) designation 0 Authorized Official Designation of authorized official Board of Director's (or governing body's) authorization 0 BOD Funding Resolution to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Proof of insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 State 501(c)3 Letter DETERMINATION LETTER. All organizations MUST Federal 501(c)3 Letter have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 21 2022 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit 2022 Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Articles of Incorporation Incorporation and Bylaws Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Bylaws Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LEP Plan LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach 21! to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 428472 Become a fan of ZoomGrantsTM on Facebook Problems? Contact us at Questions( )ZoomGrants.com 02002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. L000ut I Browser 21E INEmail This Preview Save as PDF Print Close Window A♦ IT16 DUBLI N C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 CALICO Center Dublin Child Abuse Intervention Jump to: Organization Information Questions Budget Documents USD$ 15,000.00 Requested Submitted: 1/20/2023 3:40:41 PM (Pacific) Project Contact Erin Harper calicocenter(a)yahoo.com Tel: 5108950702 Additional Contacts none entered Organization Information top 1. Business License Number BL-109881 Questions top CALICO Center 524 Estudillo Ave San Leandro, CA 94577 United States Executive Director Erin Harper executive.d irector@caIicocenter.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone(510) 895-0702 Fax (510) 895-0706 Web www.calicocenter.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). CALICO achieves justice and healing for abused children and adults with developmental disabilities, and promotes the safety and well-being of children everywhere. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 21i J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). CALICO proposes to conduct 10 forensic interviews with Dublin children who have been sexually or physically abused, provide support services to 8 caregivers of the Dublin victims and facilitate a multi -disciplinary response to the allegations. Forensic interviews are the cornerstone of a child -abuse investigation. A child's statement may be the only evidence to determine if a crime occurred, the child is safe at home or a licensed facility is adequately protective. Skilled interviewers meet individually with each child, asking non -leading, developmentally appropriate questions to elicit the child's account of the abuse. The interview is recorded, and the investigating team (DPS detective, child welfare worker and prosecutor) observes from another room. CALICO believes that to support an abused child, we must ensure s/he has the full and appropriate support of their caregiver. While children are interviewed, a Family Advocate (FA) meets with the caregiver, conducting a crisis assessment to learn more about the child, the traumatic experience, and the living environment. The FA follows up with the family at least twice by phone to provide further support. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The latest data from the U.S. Census estimates that 26.6% of the population of the City of Dublin is under the age of 18. National research states that 1 in 5 girls and 1 in 7-10 boys will be sexually abused before they reach the age of 18. In 2022, 40% of cases referred to CALICO involving children who were residents of Dublin involved allegations of sexual abuse (the remaining cases involved allegations of physical abuse.) While CALICO has a history of successfully leveraging needed resources, we have few guaranteed sources of income and have to seek funding each year. Funding from the City of Dublin would provide some short-term stability and security in the early part of the fiscal year while we pursue or await responses regarding other sources of funds. If CALICO did not exist, child abuse allegations would still need to be investigated and that responsibility would fully return to law enforcement and child welfare workers. In that case, the City of Dublin would incur considerably more costs by taking on those tasks themselves and would get less value for that investment than they do by engaging CALICO services. Lieutenant Matt Farruggia of the Dublin Police Services stated, "For over 20 years, we at the Dublin Police Department have worked very closely and have formed a professional partnership with them. We would like to add our support to their application for funding from the City of Dublin. CALICO provides forensic interviews for the children of the City of Dublin and provides emergency crisis support to their families. Our partnership is crucial to the work we do in our investigation's unit. This is a key concern for families, particularly those parents from culturally and linguistically diverse communities who face barriers when accessing advice and services." 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 18 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process Y'. Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) LJ Workforce Development LJ Homelessness LJ Transportation Services and Access *!: Domestic Violence and Child Abuse .: Disabilities ❑ Food and Nutrition ❑ Senior Services Y: Youth Services ❑ Child Care, Early Childhood Development and Education 21 E J Changing Demographics and Growing Diversity CI Financial Assistance ❑ None of the Above LJ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) City of Dublin Human Services Grant funding would help offset the cost of our Child Interview Specialist (CIS) team. CALICO's services are crisis -oriented, meaning that an interview may be scheduled with little notice to accommodate the urgent needs of a particular case. In most situations, fewer than 24 hours elapse from the time we get the initial referral from the Dublin detective or child welfare worker to seeing the child at our center. In some cases, that time may shrink to under one hour. For that reason, we have a minimum of two CIS scheduled to work during normal business hours (we maintain a minimum staff of two because CALICO works simultaneously out of two locations, San Leandro and Oakland). In addition, all CIS are available by pager evenings and weekends for situations that require immediate attention. Please note that our Family Advocates (FA) are also available, but funding for those positions will be covered by other sources. The estimated cost to ensure that CALICO staff are available, when needed, to respond to the referrals of Dublin children and families is approximately $23,000 in FY23-24. Of that, the most significant expenses are staff salaries and benefits. City of Dublin funds would specifically offset a portion of staff salaries and benefits of the CIS team, which includes five part-time interviewers (including two bilingual Latinas who serve bilingual and mono -lingual Spanish-speaking families). When interviewers are not conducting interviews, they are performing other related tasks, including client intakes, data entry and quality control, observing and providing feedback to other interviewers, participating in trainings, planning and participating in monthly case review meetings and testifying in court, all necessary for the successful completion of our forensic interviewing services. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? CALICO uses the following goals to track and measure the effectiveness of the Pleasanton Child Abuse Intervention Program. GOAL 1: Minimize trauma to abused children. 1a. At least 75% of children interviewed will feel positive/neutral about their experience. 1 b. At least 75% of caregivers will indicate that they feel positive/neutral about their experience. GOAL 2: Improve coordination of child -abuse case investigations among multiple agencies. 2a. A multi -disciplinary team (comprised of a prosecutor, Dublin detective, and/or child welfare worker) will observe at least 75% of interviews. 2b. At least 70% of children eligible for a forensic medical exam will receive one. 2c. Monthly case review meetings will be held at least 10 times per year to review select cases in depth from start to finish. GOAL 3: Improve the mental health of caregivers. 3a. An FA will conduct a crisis assessment with at least 75% of families. 3b. An FA will initiate a California Victim Compensation Program (CaIVCP) application (or ensure one was already completed) on behalf of at least 50% of caregivers (to access funds for mental health services for the caregiver). 3c. At least 75% of caregivers will report that CALICO gave them information about how to get services like counseling or family support for themselves. Goal 4: Improve the mental health of victims. 4a. At least 75% of caregivers will report that CALICO, provided them with resources to support their child(ren) and other needs. 4b. An FA will assist at least 75% of families with a CaIVCP application on behalf of the child to provide funds for counseling. 4c. At least 75% of caregivers contacted will report that CALICO gave them information about how to get counseling services for their child/children. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision CALICO treats all persons with respect, dignity and fairness. The multi -disciplinary team (MDT) provides services to toddlers, children, youth, and adults with developmental disabilities and their families regardless of age, race, color, religion, national origin, ancestry, gender, marital status, sexual orientation, disability, socio-economic status or any other cultural descriptors. CALICO requires that children and families from all backgrounds feel welcomed and acknowledged by staff and MDT 21E members, regardless of their appearance, background or beliefs. CALICO services are provided free of charge. referred to CALICO by the MDT will be denied services based on inability to pay. CALICO provides services that incorporate cultural sensitivity, humility, and competence. Our facilities are fully available to anyone in Alameda County and are accessible and smoke -free. The decor, print materials and toys reflect the diversity of its clients; for example, dolls represent a variety of skin tones, posters and bulletin boards reflect many cultures, and informational handouts are provided in multiple languages including Spanish, Cantonese and Mandarin. When an appointment is scheduled, CALICO staff inquires about the child's and caregiver's language and ethnic/cultural background and determine the need for an interpreter. If interpreter services are needed, CALICO will assist the investigating parties in obtaining a court -certified interpreter, when possible. We offers in-house services in English and Spanish. We also ask whether the client has any developmental disabilities or other conditions that may require consideration during the interview process. CALICO staff and the MDT are mindful that the child's and caregiver's perception of the criminal justice and dependency systems can be influenced by their cultural experience. Culture can affect a victim's and/or family's perceptions and attribution of shame and responsibility for abuse. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. N/A 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? Y: Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. CALICO is sensitive to the unique cultural and linguistic needs of each family served. At intake, we collect information about the race/ethnicity of the child, the child's primary language, and the caregiver's primary language. Two CALICO staff members are bilingual/bi-cultural Latinas who accommodate Spanish-speaking families as needed. Over the last five years, approximately 25% of the forensic interviews we conducted with Dublin victims were with children who identified as Latinx. If families speak a language other than English or Spanish (including ASL), we work with the referring agency to arrange for a court -certified interpreter and may use the services of the county's language line, called Language Line Solutions. In addition, CALICO has translated all of our key documents into Spanish, and we can download select materials in other languages. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Y: Be culturally accessible, appropriate and inclusive Y'. Encourage community engagement and involvement Promote energy and resource efficiency Y: Encourage networking and information sharing across service providers Y: Encourage process streamlining Y'. Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. LJ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. 22( J B) Homeless Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. LJ C) Supportive Housing LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. 201 Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: '. Public Services LJ Public Facilities LJ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing Y'. Strengthen Communities LJ Ensure Equal Opportunity in Housing LJ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') .^! Creating a Suitable Living Environment LJ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') Y'. Availability/Accessibility ❑ Affordability LJ Sustainability LJ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Y: Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. LJ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of 221 years of affordability, number of units occupied by the elderly, and those units designated for chron persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. LJ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. LJ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) LJ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. LJ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) *!: Persons Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 0 Seniors (62 and older) C 0 People with Disabilities C1 Female -Headed Households C 6 Youth C0 Homeless C Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 2 Extremely Low Income (<30% AMI) 4 Very Low Income (30%-50% AMI) 22e' 6 Low Income (50%-80% AMI) C 0 Moderate Income (80%-120% AMI) 12.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 2 White 4 White + HISPANIC 0 Black/African American 0 Black/African American + HISPANIC 4 Asian 0 Asian + HISPANIC 0 American Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 0 Native Hawaiian/Other Pacific Islander 0 Native Hawaiian/Other Pacific Islander + HISPANIC 0 American Indian/ Alaskan Native and White 0 American Indian/ Alaskan Native and White + HISPANIC 0 Asian and White 0 Asian and White + HISPANIC 0 Black/African American and White 0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC 2 Multi Racial + HISPANIC OR other Multi Racial F 0 Not Applicable. Not interested in CDBG funding. (Type N/A) 12.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. LJ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Request from the City of Dublin USD$ 15,000.00 Dublin Police Services USD$ 4,846.00 Alameda County District Attorney's Office (in -kind) USD$ 3,000.00 USD$ 3,000.00 Alameda County Social Services Agency USD$ 2,400.00 USD$ 2,400.00 Community Fundraising USD$ 5,000.00 California Office of Emergency Services Total USD$ 30,246.00 USD$ 5,400.00 22; Funding Uses/Expenses Budget Amount Amount Committed Personnel Salary: Staff USD$ 2,400.00 Personnel Benefits: Staff Personnel Salary & Benefits: ED (in kind) USD$ 3,000.00 USD$ 3,000.00 Supplies Printing USD$ 792.00 Postage USD$ 240.00 Communications Rent and Utilities USD$ 1,142.00 Audit and Accounting Outside Services Total USD$ 5,174.00 USD$ 5,400.00 Budget Narrative The request of $15,000 from the City of Dublin will support approximately 4.5 hours per week (or 304 hours per year total) at the average pay of approximately $39.72 per hour of three members of the Child Interview Specialist team to ensure there is full-time coverage to support Dublin children. Average pay is used to calculate the request because, due to the crisis -oriented nature of our work, CALICO does not know ahead of time which Child Interview Specialist will conduct each interview. Child Interview Specialist, $39.72 x 304 hours + 24% benefits = $15,000 annually ($1,083.33 monthly) CALICO's current benefit rate of 24% for employees includes payroll tax, workers comp, FICA, health, vision, dental, and 403b matching. CALICO's entire agency budget represents the cost of serving all of Alameda County, including Dublin citizens as represented by this grant program. Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests 21 Program Expense Budget download template Financial Information Form for ALL Grant Requests 0 Financial Information download template List of Board of Directors (or governing body) with 0 Board Roster agency contact information Current Annual Budget for the Entire Agency 0 CALICO Agency Budget Copy of most recently submitted IRS 990 form or Tax 0 CALICO Tax Return Return (include complete form) Board of Director's (or governing body's) designation 0 Board Designation of Authorized Official of authorized official Board of Director's (or governing body's) authorization 0 Board Designation of Authorized Official to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 CALICO Insurance Types and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 Federal Non -Profit Letter DETERMINATION LETTER. All organizations MUST State Non -Profit Letter have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 CALICO Financial Statement 224 Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Employee Manual Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Audit Reauirements Requirements and Copy of Last Audit Highlighting Last Audit "Findings" Section Audit/Financial Statement REQUIRED FOR CDBG ONLY - Articles of Articles of Incorporation Incorporation and Bylaws Articles of Incorporation Amended REQUIRED FOR CDBG ONLY - Conflict of Interest Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LEP/LAP LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Strategic Plan Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 425557 Become a fan of ZoomGrantS- on Facebook Problems? Contact us at Questions5ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 22! 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Centro Legal de la Raza Tri-Valley Fair and Secure Housing Project Jump to: Organization Information Questions Budget Documents USD$ 23,789.00 Requested Submitted: 1/19/2023 4:45:54 PM (Pacific) Project Contact Brenda Orellana borellana(o-)centrolegal.org Tel: 510-227-4451 Additional Contacts none entered Organization Information top 1. Business License Number bl-113233 Questions top Centro Legal de la Raza 3400 E 12th St Oakland, CA 94601 United States Executive Director Monique Berlanga mberlangaO)centrolegal.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency ❑ Other: Telephone510-437-1554 Fax Web https://www.centrolegal.org/ 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our holistic legal programs support equity and copowerment; centering clients' power, stories, and collaborating with CBOs to support systems change. We are a leader in regional anti -displacement efforts and ensure stable and healthy housing. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 22E ❑ Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Centro Legal proposes to provide legal consultations, representation, outreach, and tenant education services to low-income tenants facing housing instability, eviction and potential displacement to keep Dublin tenants housed and in safe, stable, and affordable housing. Our services model provides pre -eviction consultation in addition to eviction representation, and through outreach and education, we are able to address threats to housing stability early. Information sharing through know -your -rights workshops will empower communities to assert their rights. Centro Legal's proposed staffing pattern for this program reflects a multilingual/multicultural team of staff, ensuring access to interpretation services for all residents participating in this program. Alameda County's housing crisis and its impact on low-income tenants is currently being exacerbated and amplified by the COVID-19 pandemic. Even after the health impacts of COVID-19 diminish, the economic impacts will continue and low- income tenants will be vulnerable to eviction when they can't pay rent because they've lost income due to the pandemic. This project will enable us to intervene early and provide advice and representation to prevent displacement in a time of great need for our services. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Between 2010 - 2019, the share of renters that were burdened by the cost of housing in Dublin went from 36% to 42%, whereas for the nine -county Bay Area, it decreased from 50% to 47% (Bay Area Equity Atlas). In FY 21-22, even with the County eviction moratorium in place, 28% of the Dublin tenants we saw reported receiving a termination notice, and 14% reported that they were unable to pay rent. Based upon data from jurisdictions whose moratoria have ended, we anticipate a massive wave of evictions when Alameda County's moratorium ends, which will increase the demand for tenant legal services. Research shows that low-income residents who have the right to stay in their homes need legal representation in order to make that right a reality. As Professor Desmond noted in his book, Evicted: Poverty and Profit in the American City (2016), "A program that ran from 2005-2008 in the South Bronx provided more than 1,300 families with legal assistance and prevented eviction in 86% of cases." Moreover, data from the American Housing Survey estimates that there are 5.5 times as many "informal evictions" as formal evictions. Zainulbai & Daly, Informal Evictions: Measuring Displacement Outside of the Courtroom (January 20, 2022). "Informal evictions" occur when a tenant is coerced or otherwise pushed to leave their home outside of the court process. This often occurs because tenants do not understand their legal rights and options. Equipping tenants with information is critical to keep tenants housed. Historically, there has been a lack of tenant legal services targeted specifically to Dublin and other Tri-Valley cities. Centro's efforts over the last year have been critical in expanding access to services. This program is essential to meet the ongoing and increased need in Dublin. If Centro does not receive funding, more Dublin residents will face eviction without the assistance of an attorney. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 25 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956IApplication-Requirements-Process Y'. Behavioral Health (mental health and substance abuse) Y'. Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development Y'. Homelessness ❑ Transportation Services and Access .^'. Domestic Violence and Child Abuse Y'. Disabilities ❑ Food and Nutrition Y'. Senior Services ❑ Youth Services 221 J Child Care, Early Childhood Development and Education : Changing Demographics and Growing Diversity LJ Financial Assistance LJ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) This project expands access to legal services spanning the entire continuum of homelessness prevention and anti - displacement interventions for low-income tenants at risk of displacement in Dublin. Having access to safe, stable, affordable housing is necessary to a high quality of life. Traditionally marginalized communities, such as persons of color, persons with disabilities, elderly persons, and domestic violence survivors face greater barriers to housing stability. The data bears this out. For example, the Bay Area Equity Atlas found that low-income and communities of color have not recovered financially from the COVID-19 pandemic, and are facing higher rates of being behind on rent (https://bayareaequityatlas.org/recovery-tracker/intro). Additionally, domestic violence is one of the leading causes of homelessness nationally (https://homelesslaw.org/wp-content/uploads/2018/10/Lost-Housing-Lost-Safety.pdf). This project prioritizes helping those most at risk of eviction and displacement, including persons who fall within these identities, and thereby helps Dublin achieve its Vision Statement where Dublin tenants can safely live, work, and raise a family in a diverse and inclusive city. This project is designed to strategically target low-income tenants most at risk of displacement. Our model of legal services provision includes two key components: upstream and downstream prevention. A) Upstream Prevention: Pre -eviction Consultations Broad, inclusive service provision via remote and/or in -person clinics and workshops. We provide one-to-one legal consultation services that can include drafting letters, providing legal advice, reviewing notices and contracts, helping tenants respond to notices, and providing other short-term, limited assistance to address risks such as eviction notices, rent increases, uninhabitable conditions, and landlord harassment. Legal consultations and clinics provide broad access to legal advice. Tenants can get legal advice on a wide range of housing issues, and legal services providers can spot emerging issues and trends that are contributing to displacement. Early intervention in landlord -tenant conflicts can prevent eviction lawsuits from being filed and provide tenants with important information about how to exercise their rights and the resources available. Consultations are an efficient way of preventing displacement since they can be made available to large numbers of people and can prevent resource -intensive litigation. Legal consultation services are short-term, limited legal services that may include: (1) advice and counsel; (2) assistance completing forms or preparing correspondence; (3) supporting individuals in representing themselves; (4) assistance with reviewing contracts, letters, or written documents; (5) addressing issues related to various COVID-19 related eviction protections, and/or (6) other short-term, limited assistance aimed at preventing displacement. Many of the legal consultations provided will take place through regularly scheduled remote or in -person clinics or workshops for tenants. In -person clinics will be held in key locations to ensure that underserved populations are able to utilize services. B) Downstream Intervention: Legal Representation Legal representation services are more expansive than legal consultation and will be provided where it is determined that more extensive services are necessary or appropriate to prevent displacement. Such services may include: (1) Representing a tenant in mediation or negotiations aimed at avoiding the filing of an unlawful detainer action and/or a rent increase that would result in displacement; or (2) Defending an unlawful detainer (eviction) action. We ensure this project is cost effective and that the budget meets the needs of the anticipated results by leveraging existing infrastructure funded through ACHS, State Bar funding, and foundation grants. ACHS is a program that Centro has administered since 2018, and administrative infrastructure and staffing of the program has been well established. Staff such as our outreach coordinator, data and policy analyst, paralegals, housing advocates and staff attorneys are already doing this work. Additionally, ACHS provides emergency financial assistance funds that Dublin residents are eligible for. There will be increased access for Dublin tenants to an entire team of attorneys and staff dedicated to this work. This project allows for the ACHS program to be scaled up and leverages the program structure already created. 22E Deliverables are based on average attorney caseloads and are in proportion to the amount of funding received which creates realistic deliverable goals. Our proposed budget would fund 0.25 FTE housing attorney, benefits, outreach and administrative costs. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Outcome Measures Our primary goal and objective is to enhance the quality of life for low-income tenants of Dublin via housing related services to prevent homelessness and to promote stable, affordable, healthy housing. Measurable outcome for Goal 1: At least 90% of Tenants will be more aware of available resources and legal options and better prepared to successfully resolve their housing issues. Measurable outcome for Goal 2: After legal representation, at least 70% of Tenants will successfully resolve their legal matters and report improved housing stability, avoided an eviction, avoided homelessness, having a rent increase rescinded, receiving a rent reduction, or securing time and/or money to move. Performance Goal 1: 20 Tenants receive legal consultation for housing related problems such as resources and information about their legal options and rights. Performance Goal 2: 10 Tenants receive legal representation for housing related issues. Centro Legal uses a Salesforce database, which allows us to track a significant amount of client data and assess quantitative goals on a monthly basis. During in -person services, Centro Legal also uses anonymous client surveys to measure our impact. Centro Legal uses case outcome data and program evaluations to determine if a program is effectively meeting clients' needs. We also use information on the number of clients we serve and the types of issues our clients are facing to determine the level and types of services needed. Based on this information, we make changes to program design and our budget to expand services and staffing as needed. Centro Legal has current CDBG contracts with the City of Hayward, San Leandro and Oakland. We are familiar with the CDBG guidelines and ensure that clients are low-income according to the guidelines. Prior to receiving a consultation, tenants certify their income so we can ensure eligibility. In addition to income information, Centro Legal is also collecting a lot of other demographic data such as race and ethnicity to ensure we are serving a diverse group. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Our project is focused on enhancing the quality of life for low-income tenants of Dublin via housing related services to prevent homelessness and to promote safe, affordable, stable housing. Having access to safe, stable, affordable housing is necessary to a high quality of life. Traditionally marginalized communities, such as persons of color, persons with disabilities, elderly persons, and domestic violence survivors face greater barriers to housing stability. This furthers Dublin's values of safety, inclusivity, diversity, and equity. Our project focuses on underserved communities, empowering and advocating for them and ensuring that they are being served in an equitable way and can remain in their community. Having a safe and affordable place to live is key to a high quality of life, and the necessary base for so many other aspects of our lives. Our project supports low- income Dublin tenants in ensuring they have access to safe housing, that they can enforce their rights to maintain their housing stability, and reduces displacement of low-income underserved BIPOC (Black, Indigenous, (and) People of Color) communities. By helping those most marginalized stay in their homes, this project helps to ensure that Dublin is an inclusive, diverse, and equitable place to not only live, but thrive. Additionally, Centro Legal is deeply committed to diversity, equity, and inclusion. We have a DEI Director whose duties include ensuring that our service provision is grounded in these principles. We have a diverse staff of advocates and attorneys who are committed to these values as well, and our representation of tenants reflects these values. This project prioritizes helping those most at risk of eviction and displacement, including persons who fall within these identities, and thereby helps Dublin achieve its Vision Statement where Dublin tenants can safely live, work, and raise a family in a diverse and inclusive city. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Alameda County's housing crisis and its impact on low-income tenants is currently being exacerbated and amplified by the COVID-19 pandemic. Between 2010 and 2019, the share of renters that were burdened by the cost of housing in Dublin went 22E from 36% to 42%, whereas for the nine -county bay area, it decreased from 50% to 47% (Bay Area Equity Atlas). We know that this has only increased during the pandemic, especially for persons of color and other marginalized community members. https://bayareaequityatlas.org/recovery-tracker/intro. Even after the health impacts of COVID-19 diminish, the economic impacts will continue and low-income tenants will be vulnerable to eviction when they can't pay rent because they have lost income due to the pandemic. Tenant advocates are expecting a large wave of evictions after the Alameda County Eviction Moratorium lifts, given the widespread economic impacts of the COVID-19 pandemic. Data from other jurisdictions, including Contra Costa County, supports this expectation. https://www.mercurynews.com/2022/10/20/bay-area-sees-eviction-tsunami- as-pandemic-renter-protections-end/. This project is a direct response to the increased need for tenant representation we anticipate as a result of the COVID-19 pandemic, as well as the ongoing housing crisis. This project will enable us to intervene early and provide advice and representation to prevent displacement of those impacted economically by the COVID- 19 pandemic. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? Y'. Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA LJ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Centro Legal de la Raza (Centro Legal) is committed to providing high quality legal assistance regardless of a client's language or disability. Centro Legal utilizes multiple strategies to provide services to individuals who are non-English speaking or have limited English proficiency, including by making our services accessible through 3-way phone interpretation with a human interpreter. The interpreter facilitates meaning -for -meaning communication between a limited -English proficient person and our English-speaking staff. Video interpretation adds a visual component to the communication process, enabling face-to- face interaction with interpreters. Centro Legal has substantial experience working with non- and limited English speakers. 62% of our Tenants' Rights Practice staff are multilingual. Attorneys and paralegals speak the following languages: Spanish, Hindi, and Mandarin. Centro Legal also has a dedicated Mam interpreter. Centro Legal's website has been fully translated into Spanish. Outreach and educational materials are translated into multiple languages. Workshops and clinics both in -person and virtual are conducted in Spanish and English using simultaneous interpretation. The COVID-19 pandemic has forced us to explore additional ways to reach clients such as through Facebook Live and Zoom and by phone to allow Centro Legal to easily reach clients regardless of location. Centro Legal also does outreach to tenants through our website, social media, radio, community partners and word of mouth. For example, Centro Legal has run radio and digital ads in Spanish and Tagalog in order to reach Latino and Filipino Bay Area communities. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: *!: Be culturally accessible, appropriate and inclusive ' Encourage community engagement and involvement ❑ Promote energy and resource efficiency ?e'. Encourage networking and information sharing across service providers Y'. Encourage process streamlining *'. Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) Y'. A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. *!: Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. Y: B) Homeless 23( Y Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. C) Supportive Housing LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. Y'. D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Y'. Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 41 Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers '. Promote Decent Affordable Rental Housing : Strengthen Communities : Ensure Equal Opportunity in Housing '. Reduce Housing Discrimination Y'. Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') Y'. Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') ❑ Availability/Accessibility ❑ Affordability .: Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. .: Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. LJ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless 231 persons and persons LJ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. LJ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) LJ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. LJ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. LJ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons Y'. Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 4 Seniors (62 and older) C 8 People with Disabilities C0 Female -Headed Households C 0 Youth C0 Homeless C Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 13 Extremely Low Income (<30% AMI) 8 Very Low Income (30%-50% AMI) 23'9 4 Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) 25.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 4 White White + HISPANIC 8 Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC 12 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 24.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. LJ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Dublin USD$ 23,789.00 USD$ 0.00 City of Livermore USD$ 38,290.00 USD$ 0.00 City of Pleasanton USD$ 46,628.00 USD$ 0.00 Alameda County Housing Secure (ACHS) USD$ 496,632.00 USD$ 0.00 State Bar of California USD$ 171,409.00 USD$ 131,346.00 Alameda Co. Urban/Unincorporated USD$ 99,494.00 Total USD$ 876,242.00 USD$ 131,346,00 23: Funding Uses/Expenses Personnel: Salaries Personnel: Benefits Administrative Indirect Total Budget Amount USD$ 18,022.00 USD$ 3,604.00 USD$ 2,163.00 USD$ 23,789.00 Amount Committed USD$ 0.00 Budget Narrative Centro Legal's legal services for the City of Dublin will expand on the existing Alameda County Housing Secure (ACHS) program that Centro Legal has administered since 2018. Funds provided under this grant can be leveraged with ACHS funds to exponentially increase reach. Expanding on ACHS makes it so low-income tenants in Dublin can access Centro Legal's full team of tenants' rights attorneys, paralegals, advocates, outreach coordinator, policy and data analyst, administrative assistant and tenants' rights grants manager. This project will help Centro Legal reach low-income Dublin residents, build on existing infrastructure from the ACHS program, and the momentum from the contract granted last year. This proposal requests funding for staff attorney time to provide legal consultations and representations, as well as Know Your Rights (KYR) presentations. Additional funding sources listed, apart from funds requested from the City of Livermore and the City of Pleasanton, are funds that are committed from other grants that allow Centro Legal to provide legal services to tenants throughout Alameda County or are not restricted funds and can be used to leverage City of Dublin funds. For the budget above, we have included 0.25 FTE of attorney time. We hope to obtain funding from the City of Pleasanton and the City of Livermore that will allow us to expand services in the Tri-Valley. In the event that additional funding is not obtained from the City of Pleasanton and the City of Livermore, services will be provided to low-income Dublin tenants in proportion to funding. We utilize 20% as our standard calculation for fringe which includes benefits. 10% indirect costs are intended to cover insurance, rent, utilities, postage, bar dues, office supplies, and other non - salary program expenses. Documents top Documents Requested * Program Expense Budget for ALL Grant Requests download template Financial Information Form for ALL Grant Requests download template List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability and/or workers' compensation Required? Attached Documents * 21 Centro Legal Program Expense Budget 1 Centro Legal Financial Information Form 0 Centro Legal Board of Directors with Contact Info for Funders Sept2022.docx 0 Centro Legal Org Budget FY 22-23 0 Centro Legal 990_2020 0 Centro Legal Dublin BOD Authorization Letter 0 Centro Legal Dublin BOD Authorization Letter 0 Centro Legal COI - City of Dublin STATE AND FEDERAL NON-PROFIT 0 Centro Legal Non -Profit Determination Letter DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Centro Legal 2022 Audited Financial Statements RED FOR CDBG ONLY - If 234 Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Centro Legal Personnel Policy & Affirmative Action, Grievance Policy Centro Legal Personnel Policy & Affirmative Action, Grievance Policy Centro Legal 2022 Audited Financial Statements Centro Legal Articles of Incorporation & Bylaws Original & Amended Restated Centro Legal Conflict of Interest Policy Centro Legal Limited English Proficiency Access Plan * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 427183 Become a fan of ZoomGrants7m on Facebook Problems? Contact us at Questions5zoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 23! 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Chabot -Las Positas Community College District Dublin Pathways to Employment Jump to: Organization Information Questions Budget Documents USD$ 24,959.00 Requested Submitted: 1/19/2023 7:39:32 PM (Pacific) Project Contact Alcian Lindo alindo a)cloccd.org Tel: 925-416-5108 Additional Contacts none entered Organization Information top 1. Business License Number 200167 Questions top Chabot -Las Positas Community College District 5860 Owens Dr FI 3 Dba Tri-Valley Career Center Pleasanton, CA 94588 United States Vice Chancellor for Business Services, designated signer Jonah Nicholas 0nicholas(a.clpccd.org 1. Select the category that best describes your organization: (Select only one.) ❑ Non -Profit 1 Public Agency ❑ Other: Telephone(925) 416-5100 Fax Web www..trivalleycareercenter.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). The Tri-Valley Career Center (TVCC) is part of the Chabot -Las Positas Community College District (CLPCCD). Our mission is as follows: "We empower individuals and communities to thrive by creating career, education and economic opportunities." 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 23E J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Each year, TVCC helps job seekers find careers by offering free workshops, one-on-one counseling, comprehensive training programs and a variety of resources. During 2022, TVCC worked with employers to identify the critical need for employees in Alameda County and created the Pathway to Employment program, a free training program providing pathways to high - demand Transportation, Distribution and Logistics (TDL) and Healthcare occupations. We are seeking funding to continue our job services and offer this job training, which includes forklift, CPR and OSHA warehousing and Certified Nursing Assistant (CNA), Phlebotomy and EMT training certifications. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) TVCC serves residents of the Tri-Valley who are looking for career services and employers looking for qualified candidates. While the income demographics of our clients vary, our lower -income clients are frequently most impacted by job instability and without connection to services. While our career services continue at TVCC, we've added our Pathway to Employment program. This program trains low- income workers for occupational sectors experiencing critical challenges in finding workers, including TDL and Healthcare. To assist TDL employers, TVCC is offering a training program that provides forklift, CPR and OSHA warehousing safety certifications to low-income individuals. Upon completion of this three-week training, participants attend a TDL-focused job fair featuring local employers. We have similar training programs planned in 2023-24 fiscal year for Certified Nursing Assistants (CNAs), Phlebotomists and Emergency Medical Technicians (EMTs). While there are job openings and career paths to high quality jobs in TDL and healthcare, many job -seekers have little knowledge of these industries and their pathways to long-term high -paying careers. We will leverage our extensive network for both the outreach and implementation of our training programs, which will empower us to offer training programs for those who have been hit hard by the economic downturn. In this way, our center will create a direct pipeline from training to employment for job seekers, educating them about pathways in high -demand professions along the way. The funding we are requesting will help us pay for our services, including the training programs described above for Dublin residents, and a contracted training coordinator responsible for recruiting residents, supporting them through their training program and post -training job placement. If we do not receive funding, we will offer fewer services and trainings and will not be able to meet the demands of local employers to train new workers. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) This grant will support job services, workshops and job fairs with intense hands-on help for at least 152 Dublin clients, including 4 clients in our Pathway to Employment program. We plan to help 200 more clients through our online resources. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) Workforce Development Homelessness LJ Transportation Services and Access LJ Domestic Violence and Child Abuse LJ Disabilities LJ Food and Nutrition ❑ Senior Services Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity ❑ Financial Assistance 237 J None of the Above FJ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) TVCC has been a part of the Tri-Valley for more than 20 years. In that time, the staff have helped thousands of job seekers find their next path in life — stopping a reliance on unemployment and other benefits and to return to the working world. Our successful combination of self -paced and staff -assisted services allow job seekers to find their own path. Our experienced staff walk beside them, teaching skills, offering encouragement and building confidence through our workshops, Job Club, one-on-one counseling, comprehensive training and hiring events. This year, this grant will support our job services, workshops and job fairs to meet the goals of serving 152 Dublin clients with intense hands-on help. These services will include serving 4 Dublin clients in our Pathway to Employment program. We plan to help an additional 200 Dublin clients through our website and YouTube channel. TVCC requests $24,959 to continue our services and expand our Pathway to Employment program with a focus on comprehensive training to get job seekers on a pathway to a career in the TDL and healthcare fields. This funding will specifically support targeted outreach, recruitment, and services reaching adult workers and cover fees for enrollment in industry -recognized certifications. The program includes the following: Career Readiness Bootcamp Short-term hands-on skills training for 2 to 8 weeks. Cohort training with groups supporting each other. TVCC connecting these workers directly with employers through job fairs and existing relationships. We are assisting both Bay Area job seekers and employers by preparing individuals to join these in -demand occupations. Our goal for the Pathway to Employment program is to provide 4 low-income Dublin residents with free job training and employment placement. This training is a cohort model where clients work together from the beginning of the program through the certification testing, which is setup to advance completion and success. Staff who will be primarily working on this project are the Program Manager, Enrollment Specialist, two Case Managers, a Job Developer and an Administrative Assistant. In addition, a contracted Training Coordinator will track and manage the certification training and lead soft skills workshops. This program is staff -reliant and will include career counseling, job training, mental health counseling, financial literacy workshops and job placement in highly in -demand occupations in Alameda County. Career counseling happens primarily in - person at two locations: TVCC's office in Pleasanton and the Livermore SSA office. Operational costs for community service programs are often the most challenging to cover as they may not seem as compelling as specific projects. However, without funding for operational and staff expenses we could not serve our communities. Dublin residents accounted for more than 15% of the clients served in fiscal year 2022. However, we are only requesting that the City of Dublin cover 2% of our total operating expenditures. With our delivery of services revolving around training cohort models, our operational costs and staff expenses have increased and the need for support to continue serving our community is greater than ever. We will be serving the following populations: Families with children Seniors (age 55+) Unemployed Unhoused Young Adults (age 18-24) Adults (age 25-54) Previously Incarcerated Disabled Veterans Refugees Asylees 23f Outreach TVCC enjoys a high number of referrals from friends, family and agencies throughout the community. 53% of our clients learned of our services through a word-of-mouth referral. To augment that, we have robust community outreach efforts that include: Participation in community and non-profit collaborations. Co -location staff based at the Alameda County Social Service Agency offices in Livermore. E-newsletter and emails to agencies serving people experiencing poverty. Social media posts and advertisements. Flyers and posters delivered to community partners. Collaboration with agencies serving people experiencing poverty, including public housing developments, SSA, domestic violence and homeless shelters. Hiring events at the Tri-Valley Career Center and in the community. Partnerships with local adult schools, community colleges and job training programs. Website, search engine optimization (SEO) and online job board. Public relations. Our marketing plan includes: Partner outreach, collaboration and referrals Facebook/Instagram — paid promotion Google Ad — paid promotion Geofencing — paid promotion Email Blast/Press Release Social Media Posts (twitter, Instagram) Community Event Tabling Local Radio (101.7 KKIQ) — paid promotion Newspaper Ads — paid promotion Linkedln — paid promotion Student Magazine (Las Positas College) Chamber of Commerce Ads 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? TVCC's one-on-one career counseling and case management is tracked through CalJobs and adheres to the Alameda County Workforce Development Board (ACWDB) and WIOA regulations. All counseling activity is recorded online in clients' files (located in CalJobs) and recorded for the ACWDB to follow and aggregate for the agency's quarterly and annual reports. TVCC also keeps hard copies of client files including enrollment, training and placement data in a secured filing cabinet. Specific to TVCC, we track the number of enrollments, placements, trainings and credentials obtained. For those indicators not tracked through CalJobs, TVCC has several tracking mechanisms to assure quality of services. Workshop leaders distribute evaluation forms at the close of their workshops to gauge training effectiveness and find areas for improvement. Based on the evaluations, workshop leaders revise their workshops to address any identified issues. We also provide online surveys to both clients and employers following trainings and events. Ultimately, the most telling number is unemployed clients finding jobs that will not only allow them to continue living in the Tri- Valley but will also make them happy in their career. Clients will also be asked to provide written and video -recorded success stories on a voluntary basis. Program progress, activities, and outcomes will be reported through a semi-annual and annual report. Our goal is to continue our intense hands-on support services to 152 residents, including job training and employment placement to 4 low-income Dublin residents in our Pathway to Employment program. We plan to help an additional 200 Dublin clients through our website, YouTube channel and tip sheets. This training includes a cohort model where clients work together from the beginning of the program through the certification testing. We plan to create a direct pipeline from training to employment, partnering with employers in industries looking to fill open positions so that we select the appropriate training from our healthcare and TDL offerings. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision TVCC supports Dublin's Mission, Vision and Values that include inclusivity, diversity and equity through a variety of our services to low-income Alameda County residents. TVCC serves residents of the Tri-Valley who are looking for career services and employers looking for qualified candidates. 23E While the income demographics of our clients vary, our lower -income clients are frequently most impacted by job instability. TVCC provides two services that can assist families and individuals: training and career services and referrals to wrap -around community services. Our career services can help the adults find better paying jobs and train for careers that bring stability and livable wages. Our resources include workshops, career counseling, and online opportunities designed to guide adult job seekers towards success in today's job market. We prioritize adult clients (18+) from disadvantaged backgrounds including but not limited to refugees, veterans, dislocated workers, individuals with disabilities, unhoused individuals, and re-entry participants. In addition to our Pleasanton -based TVCC, we have career coaches who work directly with CalWorks/Cal Fresh recipients, a re-entry coordinator who works directly with the formally incarcerated and a transition specialist who works directly with ESL students and adults working to obtain their GED. We offer our training aids in multiple languages; half our staff is Spanish speaking. Our trainings and one-on-one services assist ESL clients. We also provide culturally competent services that promote an inclusive environment that caters to the diversity of East Bay residents. These staff members provide direct outreach to our clients, referring them to our center for numerous services including our Volunteer Income Tax Assistance (VITA) program. To reach and serve our most marginalized communities, we will continue to expand on our outreach plan as discussed in question #9. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. TVCC has been hosted by Chabot -Las Positas Community College District since 1983. TVCC offers career development, skills upgrading and employer services for residents of the Tri-Valley area as well as other parts of Alameda County. In 2020 we quickly moved our services online, and they remain in place today. This allows us to provide in -person and virtual workshops so that our services are available to Tri-Valley residents who cannot get to our offices. TVCC works with Back to Work and Welfare to Work clients who have been affected by COVID-19 to help them get back to work. While we're accepting all low-income residents, we're targeting residents who are on unemployment or coming off unemployment to get them employed as quickly as possible. We also partner with employers, who have been hit by labor shortages post -pandemic, through training and outreach to our clients. In 2022, we have been working with employers to determine the most in -demand occupations so that our trainings are effective for everyone in the community. We've responded by creating the Pathway to Employment program in TDL and Healthcare, two professions with labor shortages in our area where we can provide short-term occupational training to our clients that will get them back to work quickly. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. Y'. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. n/a 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency LJ Encourage networking and information sharing across service providers LJ Encourage process streamlining LJ Consolidate service delivery Yi Not Applicable. Not interested in CDBG funding. 24( 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or '.*.!'. F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: LJ Public Services LJ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Yi Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') LJ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y'. Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability Y: Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will 241 e number of persons that no longer have access to a su ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. LJ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. LJ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. . ; Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons ❑ Households Y: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 0 Seniors (62 and older) 0 People with Disabilities C0 Female -Headed Households C 0 Youth C0 Homeless n/a Not Applicable. Not interested in CDBG funding (Type N/A) 24'd TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956IApplication-Requirements-Process F 0 Extremely Low Income (<30% AMI) 0 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) 0.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 0 White C 0 White + HISPANIC C0 Black/African American 0 Black/African American + HISPANIC 0 Asian 0 Asian + HISPANIC 0 American Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 0 Native Hawaiian/Other Pacific Islander 0 Native Hawaiian/Other Pacific Islander + HISPANIC 0 American Indian/ Alaskan Native and White 0 American Indian/ Alaskan Native and White + HISPANIC C 0 Asian and White 0 Asian and White + HISPANIC 0 Black/African American and White 0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC 0 Multi Racial + HISPANIC OR other Multi Racial F 0 Not Applicable. Not interested in CDBG funding. (Type N/A) 0.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ;.: #1 - This program/project has the agency's highest priority for funding. LJ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. #5 - This program/project has the agency's 5th highest priority for funding. LJ #6 - This program/project has the agency's 6th highest priority for funding. LJ If you have more than 6 applications per organization, agency, district or entity, check here. Budget L(2p 24; Funding Sources/Revenues Budget Amount City of Pleasanton USD$ 34,002.00 AC-OCAP USD$ 49,995.00 CLPCCD USD$ 735,561.00 Fed. Workforce Development Funds USD$ 200,000.00 Jobs for the Future Foundation USD$ 100,000.00 Total USD$ 1,119,558.00 Funding Uses/Expenses Budget Amount Salaries USD$ 10,005.00 Benefits USD$ 4,774.00 Supplies USD$ 20.00 Printing/Copying USD$ 15.00 Postage USD$ 10.00 Telephone USD$ 15.00 Rent & Utilities USD$ 885.00 Marketing USD$ 250.00 Contracted Services USD$ 8,000.00 Other Program Expenses USD$ 985.00 Total USD$ 24,959.00 Amount Committed USD$ 0.00 USD$ 49,995.00 USD$ 735,561.00 USD$ 0.00 USD$ 0.00 USD$ 785,556.00 Amount Committed USD$ 500,267.00 USD$ 283,676.00 USD$ 1,000.00 USD$ 200.00 USD$ 1,200.00 USD$ 684.00 USD$ 239,490.00 USD$ 15,000.00 USD$ 92,000.00 USD$ 11,000.00 USD$ 1,144,517.00 Budget Narrative TVCC is a grant -funded program of CLPCCD, through its Economic Development Department. Its main grant, which helps pay for select staff salaries has been rapidly dwindling over the last 7 years. Projects that we know will help the Tri-Valley community but are out of the scope of our Alameda County Workforce Development Board (ACWDB) contract need to be funded in other ways. Operational costs for community service programs are often the most challenging to cover as they may not seem as compelling as specific projects. However, without funding for operational and staff expenses we could not serve our communities. Dublin residents accounted for over 15% of the clients served in fiscal year 2021-22. However, we are only requesting that the City of Dublin cover 2% of our total operating expenditures. With our delivery of services revolving around training cohort models, our operational costs and staff expenses have increased and the need for support to continue serving our community is greater than ever. Contracted Services: This line item will help us cover the cost of our training coordinator dedicated to our Pathway to Employment program. Client Supportive Services: This line item directly supports Dublin clients, providing them with transportation support during their training, job interviews and first 2 weeks of employment as needed. Documents top Documents Requested * Program Expense Budget for ALL Grant Requests download template Financial Information Form for ALL Grant Requests download template List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Required? Attached Documents * 0 TVCC Program Expense Budget - P2E 0 TVCC Financial Information - P2E 0 CLPCCD Board of Trustees 0 CLPCCD Adopted Budget 22-23 0 CLPCCD No tax return required 0 CLPCCD Board Policy 6100 0 CLPCCD Board/Administrative Policies 6150 244 Proof of insurance carried, including bonding, liability U CLPCCD Proof of Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 CLPCCD Tax Exempt Letter DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements ❑ CLPCCD Final Audit 2020-21 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 425787 Become a fan of ZoomGrantSTM on Facebook Problems? Contact us at Queslions5ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 24! 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Chabot -Las Positas Community College District Dublin VITA Services Jump to: Organization Information Questions Budget Documents USD$ 16,598.00 Requested Submitted: 1/19/2023 5:43:55 PM (Pacific) Project Contact Alcian Lindo alindo a)cloccd.org Tel: 925-416-5108 Additional Contacts none entered Organization Information top 1. Business License Number 200167 Questions top Chabot -Las Positas Community College District 5860 Owens Dr FI 3 Dba Tri-Valley Career Center Pleasanton, CA 94588 United States Vice Chancellor for Business Services, designated signer Jonah Nicholas 0nicholas(a.clpccd.org 1. Select the category that best describes your organization: (Select only one.) ❑ Non -Profit ❑ Public Agency ❑ Other: Telephone(925) 416-5100 Fax Web www..trivalleycareercenter.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). The Tri-Valley Career Center (TVCC) is part of the Eco. Dev. Dept. at Chabot -Las Positas Community College District. Our mission is to: "Empower individuals and communities to thrive by creating career, education and economic opportunities." 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 24E J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Volunteer Income Tax Assistance (VITA) offers free tax preparation services to low- to moderate -income individuals and families, especially Earned Income Tax Credit (EITC)-eligible families. In addition to preparing the current year's taxes, we also help with previous years' taxes, amended taxes, paper returns and extensions. TVCC is the only accepting agency to prepare taxes for immigrants with ITIN numbers, who are individuals required to have a U.S. taxpayer identification number but who do not have, and are not eligible to obtain, a Social Security number and the only organization to offer free tax service in the Tri-Valley area. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Though the TVCC VITA program has grown from 26 returns when we started in 2013 to 419 last year, there are still hundreds of families who could benefit from our services. Some simply do not file taxes. Others pay extraordinary fees to have them done by a for -profit company. The systemic challenge is both one of consumer awareness of the program and of an initial trust that a free service is perceived to be a government program. Another challenge is the recruitment of volunteers due to COVID and a lack of funding to do extensive outreach. VITA turned away more than 75 residents last year due to a lack of volunteers. We are planning to expand services and marketing and use more volunteers to overcome these challenges. The TVCC staff provide direct outreach to our clients, referring them to our center for numerous services including the VITA program. Our best marketing is achieved through word-of-mouth, and through repeated business born of success and gratitude. Their referrals, along with the referrals from our community -based partnerships and marketing campaigns have helped us serve more than 3,470 Tri-Valley residents with their taxes over the past 10 years, which includes operation during the pandemic. More than 80 percent of these residents come from low, very low and extremely low-income households. To reach and serve our most marginalized communities, we will continue to expand on our previous outreach plan, which includes the development of online ads in English and Spanish, which complement messages we have given other service partners. While we want to expand the promotion of our VITA services. If our budget comes up short, we cannot afford to pay for the development and placement of advertising, which will negatively affect both volunteer recruitment and new clients. The fewer volunteers we have limits our ability to serve clients. VITA turned away more than 75 residents last year due to a lack of volunteers. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) Our goal is to continually increase the number of working families served by the VITA program, and to increase the number of families who receive the federal and state EITC. Our goal for 2023-24 is to file a minimum of 100 Dublin tax returns. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) .: Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities ❑ Food and Nutrition ❑ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity Yi Financial Assistance LJ None of the Above 247 J Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) By law, the VITA program is a completely free service. However, it is not free to operate. It takes dedicated organizations and people to establish the services and provide the free tax preparation. It takes a small army of volunteers to be certified and prepare the taxes. And it takes funding. The IRS funds organizations nationwide to provide the VITA services. In the Bay Area, that funding regularly goes to United Way, which then parcels out its allocation to organizations in seven Bay Area counties, including TVCC. However, this funding does not cover all our expenses to plan, market and execute a successful VITA program in the Tri-Valley. The COVID-19 pandemic has added expenses to the program not needed in prior years such as PPE and secure -sharing software. Due to our growing number of clients each year, we anticipate an even greater need for support. This year, we are projecting to reach more people through our new location and full-time operating hours. Most of our expenses comes from staff who will dedicate approximately 570 hours plus 45% in fringe benefits to the program. We also need to hire a Co -coordinator who will complete 300 hours, helping to expand the program further throughout the Tri-Valley. Since TVCC began providing VITA services in 2013, these dedicated individuals have prepared more than 3,470 tax returns, bringing more than $3.4 million dollars back to the Tri-Valley in federal refunds. The TVCC budget for the 2022-23 VITA program is $68,796. Should we meet our overall goals of 550 returns filed, at total federal refunds of $652,600, the return of the investment on the program could be $978,915. Moreover, research shows there is a multiplier effect of at least 1.5 to the refunds spent in the region. Thus, the economic effect of the VITA program is far greater for the community than just for the families served. The TVCC VITA is a workforce development program as the EITC has been shown to encourage work for low-income families. However, our efforts in this are outside our main workforce development contracts. As such, the program is entirely grant funded and must be exceedingly efficient with its small, dedicated funds. The program's efficiency come from these components: • By law, the taxes can only be prepared by volunteers. These volunteers must be certified by the IRS in the appropriate tax law and the software used nationally for the returned to be e-filed. TVCC usually has more than 30 volunteers who speak 5 different languages. Our project includes in -kind work of at least 2820 hours from volunteers, which equates to approximately $93,660. • The College district donates the supervisory management of VITA program. Though the Program Coordinator is the strength of the TVCC VITA program, it does take a manager to oversee it, plan the marketing and write reports. This time is donated to the program. • TVCC uses its network of other community service providers and as much free marketing placement as is feasible. As a nonprofit, TVCC has become effective in using free media and word of mouth for this program as well as others. This year, we plan to offer both in -person and drop-off tax preparation services at our location in Pleasanton. This location has ample parking and is accessible by bus and BART. We also plan to reopen our sites at the Livermore and Pleasanton library (pending library approval and volunteer numbers), providing the community with multiple tax prep sites and increasing accessibility to this service. We also are investing in more education and outreach, along with volunteer recognition (including food for the volunteers as they complete 3 full, 8-hour days of training) to ensure that we recruit and retain a minimum of 30 volunteers. Finally, we have been working with VITA for 9 years and have used the same equipment throughout. We have an urgent need for a new copier which will speed up the tax preparation process by allowing us to print and make any copies we need at a faster pace so that we may serve more clients. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Each year, we track the following measurements, from which we can extrapolate data for Dublin to measure effectiveness: Total number of clients Percentage increase of clients 24E Total federal dollars returned to clients Average and Total Earned Income Tax Credits (EITCs) returned to clients Average Adjusted Gross Income of clients The total number of ITIN applications filed The goal of the TVCC VITA program is to grow and serve more people in the region who are EITC-eligible. Given the nature of the service, our results are tracked meticulously by the IRS. Each tax return is a -filed through the IRS proprietary system. This system gives us information in aggregate of all our tax clients. Each tax returned a -filed is tracked by the IRS through our location codes. Not long after the end of each tax season, we are able to discern the number of tax returns filed as well as the amount of federal/state refunds, the total EITC returns, and the average household income among other things. As anti -poverty safety -net program, the population that the VITA program targets are low- to moderate -income working families. Like the Federal Poverty Guidelines, the VITA program sets its income limits at a national level. The federal income limit for the program is $72,000 per household, regardless of family structure. Due to the high cost of living in the Bay Area, we accept clients with incomes up to $75,000. For a family in the Tri-Valley, this is far below the living wage. The average income earned by families we served last tax season was $32,360. This number has been consistently low during the past 5 years that we have offered VITA services. Many of the families we serve year after year speak a language other than English at home. We offer the services in at least five languages, depending on our volunteers' bi-lingual abilities. Spanish is the main language other than English that we serve. The VITA Program Coordinator's first language is Spanish and thus, we can help more families in the Tri-Valley who desperately need this service. Our goal is to reach and serve our most marginalized communities. We will continue to expand on our previous outreach plan, which successfully brought us more than 400 low-income and underrepresented tax filers during the 2021 tax season. This year, we plan to bring in approximately 550 tax filers, of which 100 will be from Dublin. Our partners included in this plan are: IRS: monitoring, training, software, tax law, technical support United Way: funding, training, oversight Pleasanton Library: tax site, marketing, computer and printing use Livermore Library: tax site, marketing, computer and printing use (pending volunteer availability) Las Positas College: marketing, tax site (pending volunteer availability) CityServe of the Tri-Valley: outreach to seniors and low-income families, potential transportation support Our 2023-2024 outreach plan includes but is not limited to: Email blasts to TVCC clients and job seekers in CalJobs database who live in the Tri-Valley region Email blasts to Tri-Valley and Alameda County residents receiving unemployment benefits Referrals from partnerships with local community -based organizations In -person outreach and flyer distribution to: o Pleasanton low-income housing units o Local churches o Local libraries o Local food banks With increased funding, we could do outreach to: • Tax Help (administered by the United Way) materials which provide information in multiple languages. 24E E-flyers to Dublin, Livermore, and Pleasanton families through school district's communication systems. PeachJar — online flyers to the school system. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision TVCC supports Dublin's Mission, Vision and Values that include inclusivity, diversity and equity through offering a wide range of services and outreach strategies to low -to -moderate income taxpayers, especially those eligible for the Federal and State Earned Income Tax Credits and who feel most comfortable communicating in a language other than English. We also provide culturally competent services, promoting an inclusive environment that caters to the diversity of East Bay residents. Our resources include workshops, career counseling and online opportunities designed to guide adult job seekers towards success in today's job market. We prioritize adult clients (18+) from disadvantaged backgrounds including but not limited to refugees, veterans, dislocated workers, individuals with disabilities, unhoused individuals and re-entry participants. We are the only accepting agency to prepare taxes for immigrants with ITIN numbers, who are individuals required to have a US taxpayer ID number but who do not have, and are not eligible to obtain, a Social Security number. In the absence of AARP (which shut down services during COVID), we are the only organization to offer free tax services in the Tri-Valley area. We have career coaches who work with CalWorks/CalFresh recipients, a re-entry coordinator who works with the formally incarcerated and a transition specialist who works with ESL students and adults working to obtain GEDs. They provide direct outreach to our clients, referring them to our center for services including the VITA program. Their referrals, along with the referrals from our community -based partnerships and marketing campaigns, have helped us prepare more than 3,470 Tri- Valley tax returns over the past 10 years. As discussed earlier, most of these residents come from economically disadvantaged households. To reach and serve our most marginalized communities, we will continue to expand on our previous outreach plan as discussed in questions #6 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. TVCC has been hosted by Chabot -Las Positas Community College District since 1983. TVCC offers career development, skills upgrading and employer services for residents of the Tri-Valley area as well as other parts of Alameda County. The TVCC VITA program is one of three programs in the seven Bay Area counties that provided virtual tax services during the 2020 pandemic. They remain in place today. This allows us to provide both in -person and virtual workshops so that our services are available to Tri-Valley residents who cannot get to our offices. As the challenge of COVID continues, we continue to make our services available to Tri-Valley residents who cannot get to our offices so that our clients can access our services remotely. As an organization, we are responding directly to the impacts of the pandemic. We work with Back to Work and Welfare to Work clients who have been affected by COVID-19 to help them get back to work. While we're accepting all low-income residents, we're targeting residents who are on unemployment or coming off unemployment to get them employed as quickly as possible. We also partner with employers, who have been hit by labor shortages post -pandemic, through training and outreach to our clients. In 2022, we have been working with employers to determine the most in -demand occupations so that our trainings are effective for everyone in the community. We've responded by creating the Pathway to Employment program in Transportation, Distribution and Logistics and Healthcare, two professions with labor shortages in our area where we can provide short-term occupational training to our clients that will get them back to work quickly. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. Y'. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 25( 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. n/a 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement LJ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery Y'. Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless LJ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. LJ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y: F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing LJ Increase Opportunities for 1st Time Homebuyers LJ Promote Decent Affordable Rental Housing ❑ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y'. Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') LJ Creating a Suitable Living Environment LJ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y'. Not Applicable. Not interested in CDBG funding. 251 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability Y'. Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Y Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons 251 Households !.*.!'. Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 0 Seniors (62 and older) 0 People with Disabilities 0 Female -Headed Households 0 Youth 0 Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) E7 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMP) information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 0 Extremely Low Income (<30% AMI) 0 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) O.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 0 White C 0 White + HISPANIC 0 Black/African American 0 Black/African American + HISPANIC 0 Asian 0 Asian + HISPANIC 0 American Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 0 Native Hawaiian/Other Pacific Islander 0 Native Hawaiian/Other Pacific Islander + HISPANIC 0 American Indian/ Alaskan Native and White 0 American Indian/ Alaskan Native and White + HISPANIC 0 Asian and White 0 Asian and White + HISPANIC 0 Black/African American and White 0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC 0 Multi Racial + HISPANIC OR other Multi Racial 0 Not Applicable. Not interested in CDBG funding. (Type N/A) 0.00 TOTAL 25: 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY LJ #1 - This program/project has the agency's highest priority for funding. '.: #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues United Way of the Bay Area City of Pleasanton Chabot -Las Positas Community College District Total Funding Uses/Expenses Salaries Benefits Contracted Coordinator Supplies Printing/Copying Rent & Utilities Equipment/Software Marketing Other Program Expenses Total Budget Amount USD$ 25,000.00 USD$ 22,822.00 USD$ 39,315.00 USD$ 87,137.00 Budget Amount USD$ 33,413.00 USD$ 13,372.00 USD$ 10,350.00 USD$ 3,100.00 USD$ 2,500.00 USD$ 24,000.00 USD$ 9,000.00 USD$ 5,600.00 USD$ 2,400.00 USD$ 103,735.00 Amount Committed USD$ 0.00 USD$ 0.00 USD$ 39,315.00 USD$ 39,315.00 Amount Committed USD$ 5,346.00 USD$ 2,140.00 USD$ 1,656.00 USD$ 496.00 USD$ 400.00 USD$ 3,840.00 USD$ 1,440.00 USD$ 896.00 USD$ 384.00 USD$ 16,598.00 Budget Narrative Staff Salaries/Benefits/Coordinator: Due to our growing number of clients, we anticipate an even greater need resulting from the pandemic. So many people in the community are without jobs and living expenses are only increasing. This year, we are projecting to reach more people through our new location and full- time operating hours. Majority of our expenses comes from staff which total about 570 hours plus 45% in fringe benefits. We also have a necessity to hire a Co -coordinator for 300 hours, which will help to expand the program to other areas including opening a site at the Livermore and Pleasanton libraries. Supplies/Printing/Marketing: Having adequate supplies and effective marketing will ensure that we recruit and retain a minimum of 30 volunteers. This number will ensure that we meet our tax filing goal. Equipment/Software: We have been working with VITA for 9 years and have used the same equipment throughout. Our copier, which we use extensively for the program is extremely old and temperamental. Therefore, we need to purchase a new copier to speed up the process and be able to print and make any copies we need at a faster pace. Program Expenses: Includes travel cost for staff to attending outreach meetings and events along with incentives and recognition for volunteers for in -kind work as required by the VITA program. This expense also includes food for volunteers during their mandatory, 3 full -day trainings. This budget does not include the in -kind work of 2820 hours from volunteers, which is about $93,660 Documents top Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests❑ TVCC Program Expense Budget - VITA 254 Financial Information Form for ALL Grant Requests 21 TVCC Financial Information - VITA download template List of Board of Directors (or governing body) with 0 CLPCCD Board of Trustees agency contact information Current Annual Budget for the Entire Agency 0 CLPCCD Adopted Budget 2022-23 Copy of most recently submitted IRS 990 form or Tax 0 CLPCCD No Tax Return Statement Return (include complete form) Board of Director's (or governing body's) designation 0 CLPCCD Board Policy 6100 of authorized official Board of Director's (or governing body's) authorization 0 CLPCCD Board/Administrative Policies 6150 to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 CLPCCD Proof of Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 CLPCCD Tax Exempt Letter DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 CLPCCD Final Audit 2020-21 REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 428023 Become a fan of ZoomGrantST on Facebook Problems? Contact us at Queslions5ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 25f 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 City Serve of the Tri-Valley Homeless Prevention and Family Stabilization Program Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/6/2023 4:53:43 PM (Pacific) Project Contact Christine Beitsch-Bahmani grants(o-)cityservecares.org Tel: 510-789-5443 Additional Contacts none entered Organization Information top 1. Business License Number B L-109916 Questions top City Serve of the Tri-Valley P.O. Box 1613 Pleasanton, CA 94566 United States CEO Christine Beitsch-Bahmani christine(c cityservecares.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency ❑ Other: Telephone 925-2 22-2273 Fax Web www.cityservecares.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our vision is to mobilize mercy and practical compassion through care coordination, outreach efforts and community engagement; this mobilization is designed to humanize human services. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 25E ❑ Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The $25,000 funding we are requesting will all be focused on homelessness prevention and homeless crisis intervention for extremely low, very low, and low income families in Dublin. It will go towards three critical aspects of prevention/stabilization/outreach -- individualized care and resourcing in the form of a Part -Time Resource Specialist (case manager) (47% of salary and benefits), Intake Coordinator (73% salary and benefits) who will be dedicated to serving Dublin residents 5 days a week 9-5pm and for special weekend outreaches. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Our program addresses a gap in crisis Care Coordination (client -centered case management services) for Dublin, Pleasanton and Livermore residents. This program is a regional effort as we work closely with all three cities and the country to strategize services and implement immediate solutions to localized human services issues. Although our we respond to immediate and emergency needs such as fires, critical weather events, pandemic to offer supportive resourcing, our ultimate goal is to both resource and motivate participants toward a future full of stability, self -efficacy, community and sustainability long-term. Without funding this regional impact will suffer and bring an imbalance to our Tri-Valley intentional effort that is currently making great progress. During 2022 we continued to apply new innovative ways of reaching our client base in a safe and effective way such as through pop-up rental assistance and resource events. We continued to operate without any closures and at maximum capacity while serving over 1900 households during the year 2022, a 29% increase from the prior year. We continued our extensive role of facilitating grants of rental assistance funds during COVID to 790 applicants. Our first report for our FY 22/23 grant cycle reported that we are 147% of our goal so far. The data shows us that there is a clear trend and need for our vital and safety -net services. In 2022, we served 253 households which is 743% above our goal of 30. We base our projected number on what a case manager is able to support. Clearly, we had to raise additional funds through other avenues to properly support Dublin residents. Of the 253 served, 190 were from the Extremely Low: Income is 30% AMI or less income category. 80 of the households were led by women. 84 were Black/African American and 22 were Asian. 30 people were unsheltered, 45 seniors and 26 had a disability. We feel were are targeting underserved communities and our data proves that. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 75 Households 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956IApplication-Requirements-Process *!: Behavioral Health (mental health and substance abuse) Y Affordable Housing Y: Health Care (including dental) .'. Workforce Development Y'. Homelessness Y: Transportation Services and Access : Domestic Violence and Child Abuse Y: Disabilities Food and Nutrition Y'. Senior Services i Youth Services ❑ Child Care, Early Childhood Development and Education Y. Changing Demographics and Growing Diversity Y: Financial Assistance LJ None of the Above .*: Please explain: Our Comprehensive care coordination assist individuals with the process of finding resources and/or addressing the selected areas of concern 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should 251 include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) We have two main focus areas in the crisis stabilization program: Intervention and Prevention. Intervention is done primarily through working with Alameda County Sheriff and local PD to provide street outreach support for homeless individuals. The prevention program requires a higher level of coordination between service providers, city, county & volunteers to care for the residents of Dublin with needs such as rental assistance, financial literacy, benefit navigation, code violations, care for children, improving life skills, mental health resourcing, family support and housing navigation. We believe the most cost- effective way to end homelessness is to prevent it in the first place. Our Homeless Prevention and Family Stabilization Program is the only program of its kind in the Tri-Valley which involves a multifaceted approach of providing safety -net emergency fiscal resources and individualized resourcing to connect those in need to existing programs in Dublin, Pleasanton and Livermore. Dublin is a priority for CityServe, we continue to apply new innovative ways of reaching our client base in a safe and effective way such as through pop-up rental assistance and special outreach events. In 2022, we served over 253 households (449 individuals) and received 876 crisis calls from Dublin residents. Going forward, in order to address the increasing service demand, we are requesting $25,000 to focus on homelessness prevention and homeless crisis intervention for extremely low, very low, and low income families in Dublin. It will go towards three critical aspects of prevention/stabilization/outreach -- individualized care and resourcing in the form of a Part -Time Resource Specialist (case manager) (47% of salary and benefits), Intake Coordinator (73% salary and benefits) who will be dedicated to serving Dublin residents 5 days a week 9-5pm and for special weekend outreaches. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? CityServe collects data on a diverse clientele with the population served being; Extremely Low Income (<30% AMI), Very Low Income (30%-50% AMI), Low Income (50%-80% AMI), Moderate Income (80%-120% AMI), Above Moderate Income (>120% AMI). Out of the 253 households we served in 2022, 198 of them were in the Extremely Low Income (<30% AMI) category. 38 households were in the Low Income (50%-80% AMI) category so we are targeting and attracting the most vulnerable Dublin residents. We also collect all necessary demographic data including race/ethnicity, veteran, female head of household, homeless, youth, senior as well as process, quality, and impact. We are also only 1 of 2 Tri-Valley Providers that also have access to HMIS (federal homeless database) to track and ensure homeless individuals are not falling through the cracks. This is a huge advantage to have this training and access for the Tri-Valley to help make sure our unsheltered residents are on the list for available housing and critical mental health services. The success of the project can be measured by our process, quality and impact. Process: How effective are we at reaching the residents regarding our services through outreach efforts targeting to underserved groups, is it easy to access resources through our referrals and/or if they enroll in either case management or a specialized program such as Emergency Rental Assistance Program (ERAP) and are our services available in languages that reflect our clientele and/or region to allow easier access for all residents regardless of their immigrations status, ethnicity or social -economic status. Quality: How well we track progress towards the established action plan goals (a plan that is crafted between case worker and the participant), track all applicable expenses and time spent with participants, and finally track the measurable outcomes that CityServe and the participant have worked together to facilitate. An example of outcomes may include eviction prevention, safety net fiscal assistance (utility bills), increased fiscal literacy, establishing sustainable transportation to and from work/school (in the form of auto repair, or license/registration fees), supporting the participant's increase of legal income through better employment, enrollment in school or job training program, and accessing higher levels of services (such as critical mental health care or medical care). Impact: Did their life change for the better? Our ultimate marker of success for all CityServe participants is demonstrated sustainable self-sufficiency. We also have implemented a client satisfaction survey to track overall impact. Reporting: CityServe has a custom and secure database that allows us to enroll participants in our programs and capture all critical demographic information (such as disability status, race/ethnicity, age, veteran status, self -reported income & income verification, and language translation needs), track progress towards the established care plan, track all applicable expenses and time spent with participants, and finally track the measurable outcomes such as increased income, benefits accessed, placed in shelter/housing and employment secureWe are also 1 of 2 Tri-Valley providers that have access to the Federal Homeless Management Information System (HMIS) to monitor wraparound services for unsheltered clients county wide. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision CityServe has made an intentional effort in 2022 to diversify our board and staff to reflect our community to embrace diversity, equity, and inclusion. We have also hired care coordinators that have lived experience with homelessness to give us better insight and understanding into the diverse Tri-Valley needs represented and the obstacles residents have to obtaining 25E services. As a result we are building an organizational culture for our clientele and staff by providing a sense of belonging. Our goal is to continue to invest in training our staff and board as well as craft materials and marketing resources with diversity, equity, and inclusion in mind in the year to come. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. I think we would probably qualify with the services we offer such as being the county's emergency winter relief contractor and also with past contracts with the county emergency rental assistance program, however, we will apply as we normally do and if you want us to switch let us know and we would be happy to provide you with the requested information. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. : No. If no, check box here and enter NA Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: : Be culturally accessible, appropriate and inclusive : Encourage community engagement and involvement Promote energy and resource efficiency Y'. Encourage networking and information sharing across service providers Encourage process streamlining .: Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) Y'. A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Y'. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. Y: B) Homeless Y Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. .f': D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Y'. Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Y: Public Services 25E Y Public Facilities '. Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for list Time Homebuyers .'. Promote Decent Affordable Rental Housing Y'. Strengthen Communities Y'. Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination '. Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') ' Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') ❑ Availability/Accessibility ❑ Affordability Y: Sustainability Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Y'. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. Y'. Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. LJ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. LJ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. 26( Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. LJ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons Households ;: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 1 0 Seniors (62 and older) F 0 People with Disabilities F 0 Female -Headed Households 0 Youth 0 Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) OJ TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 0 Extremely Low Income (<30% AMI) 0 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) F_ 0 Moderate Income (80%-120% AMI) 0.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 0 White 0 White + HISPANIC 0 Black/African American 0 Black/African American + HISPANIC 0 Asian 0 Asian + HISPANIC 261 0 American Indian/Alaskan Native 0 0 0 0 0 00 0 0 0 0 0 0 0 0.00 American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. #4 - This program/project has the agency's 4th highest priority for funding. LJ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Church Donations USD$ 74,300.00 USD$ 27,000.00 Businesses USD$ 106,000.00 Foundations USD$ 150,000.00 Individuals USD$ 160,000.00 City of Livermore USD$ 260,000.00 USD$ 130,000.00 City of Pleasanton (general fund) USD$ 80,000.00 USD$ 80,000.00 City of Pleasanton USD$ 160,000.00 Total USD$ 990,300.00 USD$ 237,000.00 Funding Uses/Expenses Budget Amount payroll/benefits USD$ 786,962.00 USD$ 0.00 Total USD$ 786,962.00 Amount Committed USD$ 237,000.00 USD$ 237,000.00 Budget Narrative The $25,000 funding we are requesting will all be focused on homelessness prevention and homeless crisis intervention for extremely low, very low, and low income families in Dublin. It will go towards three critical aspects of prevention/stabilization/outreach -- individualized care and resourcing in the form of a Part -Time Resource Specialist (case manager) (47% of salary and benefits), Intake Coordinator (73% salary and benefits) who will be dedicated to serving Dublin residents. Total monthly amount approximates $1862.64 and total annual cost equals $25,000. 26e' Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests CI Program Expense Sheet download template Financial Information Form for ALL Grant Requests 0 Financial Information download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Agency Budget Copy of most recently submitted IRS 990 form or Tax 0 990 Return (include complete form) Board of Director's (or governing body's) designation 0 Board Designation of authorized official Board of Director's (or governing body's) authorization 0 Board Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Workers Comp Ins and/or workers' compensation General Liability Blanket Insurance STATE AND FEDERAL NON-PROFIT 0 Federal Determination DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) 0 Audit Financials N/A Employee Handbook Articles of Incorporation N/A N/A Organizations we Coordinate with CEO Resume COO Resume Sr. Program Manager Other Supporting Documents (Not Required) Org Chart 261, Business Lic ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 427049 Become a fan of ZoomGrantsT. on Facebook Problems? Contact us at Questions( )ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. L000ut I Browser 264 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 City Serve of the Tri-Valley Senior 60+ Stabilization Program Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/6/2023 4:55:32 PM (Pacific) Project Contact Christine Beitsch-Bahmani rg ants0kityservecares.org Tel: 510-789-5443 Additional Contacts none entered Organization Information top 1. Business License Number B L-109916 Questions top City Serve of the Tri-Valley P.O. Box 1613 Pleasanton, CA 94566 United States CEO Christine Beitsch-Bahmani christine(c cityservecares.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone 925-2 22-2273 Fax Web www.cityservecares.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our vision is to mobilize mercy, practical compassion, in the Tri-Valley by care coordination (case management), outreach to underserved communities and to inspire community engagement; this mobilization is designed to humanize the human services. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project .'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 26! operation. LJ Yes ..' . No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Our Senior 60+ Stabilization Program provides bilingual: 1) Crisis Intervention: Street Outreach or homebound visits, 2) Crisis Stabilization: Case Management/Care Coordination, and 3) Community Support: Care Advocacy. We serve the most vulnerable Dublin senior residents by supporting them with resourcing for safety net fiscal assistance, food security, transportation, housing navigation, individualized resourcing (aka case management, special programs), and enrollment for workshops focused on health education (Finding Wellness Curriculum), mental health and well-being counseling and/or specific fitness training such as fall prevention classes to ensure stabilization and wellbeing. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) In 2022, we saw a deep increase in demand for senior services. So much so, In Sept 2022, CityServe merged with Senior Support of the Tri-Valley and acquired all the senior support programs and staff members to continue and enhance all the programs for our community. With our combined strengths we have already been able to reach over 200 new vulnerable seniors in the Tri-Valley. The challenge with this clientele is the growing number of homeless or very close to homeless seniors. We are seeing seniors discharged from the hospital to the streets or not being admitted for care and we are working hard at the county level to see a change. We are also seeing a sharp decline in health for many seniors who need a higher level of care and a huge gap with technology which impact connectivity. Without funding we will not be able to address these gap areas and/or keep up with the demand. Our services take a lot of time. So one household or one senior can take up to a minimum of 2 hours per session and sometimes continue on a caseload from 6 months to a year. Our goal is always for seniors to be as independent as possible and ensure that they are connected to a caring visitor volunteer or communicating well with their family members for ongoing support. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 35 households 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956IApplication-Requirements-Process *!: Behavioral Health (mental health and substance abuse) Yi Affordable Housing i Health Care (including dental) ❑ Workforce Development . i Homelessness Y'. Transportation Services and Access Y'. Domestic Violence and Child Abuse ❑ Disabilities Yi Food and Nutrition Y Senior Services ❑ Youth Services Child Care, Early Childhood Development and Education Y: Changing Demographics and Growing Diversity Y: Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The funds requested are to sustain capacity for our current Dublin senior resource and intake specialist. We have received over 550 crisis calls in the last six months from Dublin residents. Our intake specialist takes the initial crisis call and does ar 266 initial assessment then books a care session at either our Pleasanton office or in their home with a care coordinator. Once a care coordinator is connected with the client a care plan is created and the care coordinator sets up weekly meetings until the senior is out of crisis. For ongoing support the client will be offered a caring visitor or be enrolled in one of our other special programs based on their unique needs. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The success of the project can be measured by our process, quality and impact. Process: How effective are we at reaching Dublin senior residents with our services through outreach efforts, access points, partner referrals and/or if they enroll in either case management or a specialized program such as Fall Prevention or Finding Wellness classes or Medication Safety Program. Quality: How well we track progress towards the established care plan goal (a plan that is crafted between care coordinator and participant), track all applicable expenses and time spent with participants, and finally track the measurable outcomes defined in the care plan. Outcomes may include sustained housing, benefits applied for, entered a rehab program, safety net fiscal assistance (PG&E/Water Bill), increased fiscal literacy, establishing sustainable transportation (in the form of auto repair, or license/registration fees or signed up for the VAST program), or accessing higher levels of services (such as critical mental health care or medical care). Impact: Did their life change for the better? Our ultimate marker of success for all CityServe participants is demonstrated sustainable self-sufficiency. We also have implemented a client satisfaction survey to track overall impact. Reporting: CityServe has a custom database that allows us to enroll participants in our programs and capture all critical demographic information (such as disability status, race/ethnicity, age, homeless status, veteran status, self -reported income & income verification, and language translation needs), track progress towards the established care plan, track all applicable expenses and time spent with participants, and we can report the measurable outcomes such as increased income, benefits accessed and employment secured. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision CityServe has made an intentional effort in 2022 to diversify our board and staff to reflect our community to embrace diversity, equity, and inclusion. We have also hired care coordinators that have lived experience with homelessness or have direct experience with serving older adults to give us better insight and understanding into the diverse Tri-Valley needs represented and the obstacles residents have to obtaining services. As a result we are building an organizational culture for our clientele and staff by providing a sense of belonging. Our goal is to continue to invest in training our staff and board as well as craft materials and marketing resources with diversity, equity, and inclusion in mind in the year to come. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. We might be eligible. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? LJ Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive 26-1 ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers Encourage process streamlining LJ Consolidate service delivery Y. Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) LJ A) Housing LJ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. LJ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y'. F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing LJ Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y'. Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y'. Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability Y'. Not Applicable. I am not interested in qualifying for CDBG funding. 26f 0. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. LJ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. LJ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Y'. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons ❑ Households Y: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 0 Seniors (62 and older) 26E 0 People with Disabilities 0 Female -Headed Households 0 Youth 0 Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process L 0 Extremely Low Income (<30% AMI) 0 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) O.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 0 White 0 White + HISPANIC 0 Black/African American 0 Black/African American + HISPANIC 0 Asian 0 Asian + HISPANIC 0 American Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 0 Native Hawaiian/Other Pacific Islander 0 Native Hawaiian/Other Pacific Islander + HISPANIC 0 American Indian/ Alaskan Native and White 0 American Indian/ Alaskan Native and White + HISPANIC 0 Asian and White 0 Asian and White + HISPANIC 0 Black/African American and White 0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC 0 Multi Racial + HISPANIC OR other Multi Racial 0 Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ❑ #1 - This program/project has the agency's highest priority for funding. Y #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. 2A LJ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Pleasanton General Fund USD$ 80,000.00 USD$ 80,000.00 Alameda County (AAA, AC, APS, ACTIA, Dist 4) USD$ 893,975.00 USD$ 893,975.00 Total USD$ 973,975.00 USD$ 973,975.00 Funding Uses/Expenses Budget Amount Amount Committed Part -Time Resource Specialist and Intake Coordinator USD$ 22,089.00 Total USD$ 22,089.00 USD$ 0.00 Budget Narrative The $25,000 funding we are requesting will all be focused on homelessness prevention and homeless crisis intervention for extremely low, very low, and low income families in Dublin. It will go towards three critical aspects of prevention/stabilization/outreach -- individualized care and resourcing in the form of a Part -Time Resource Specialist and Intake Coordinator (72% salary) who will be dedicated to serving Dublin residents. Total monthly amount approximates $1840.82 and total annual cost equals $25,000. Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests LI Program Expense Sheet download template Financial Information Form for ALL Grant Requests 0 Financial Information download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Aaency Budget Copy of most recently submitted IRS 990 form or Tax 0 990 Return (include complete form) Board of Director's (or governing body's) designation 0 Board Designation of authorized official Board of Director's (or governing body's) authorization 0 Board Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Workers Comp Ins and/or workers' compensation General Liability Blanket Insurance STATE AND FEDERAL NON-PROFIT 0 Determination Letter DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit Financials REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) 271 REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Org Chart Employee Handbook Organizations we Coordinate with CEO Resume COO Resume Sr. Program Manager * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 427558 Become a fan of ZoomGrantsTm on Facebook Problems? Contact us at Questions( )ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGranls logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 27. 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Community Resources for Independent Living Housing and Independent Living Skills Jump to: Organization Information Questions Budget Documents USD$ 16,000.00 Requested Submitted: 1/20/2023 3:56:47 PM (Pacific) Project Contact Michael Galvan ProgramsCd)crilhayward.org Tel: 510 881 5743 x30 Additional Contacts Alejandra.Hacker@crilhayward.org Organization Information top 1. Business License Number BL-009274 Questions top Community Resources for Independent Living 439 A Street Hayward, CA 94541 United States Executive Director Michael Galvan Michael.Galvan(a)crilhayward.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency ❑ Other: Telephone(510) 881-5743 Fax (510) 881-1593 Web www.crilhayward.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). CRIL is a peer -based disability resource agency that provides advocacy, services and resources for people with disabilities to improve lives and make communities fully accessible. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 27; ❑ Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). RIL's Independent Living Services for Persons with Disabilities will provide low-income Dublin residents who have a disability with peer counseling, independent living skills & self -advocacy training, personal assistant/homecare worker referrals, benefits advocacy, travel training, housing search assistance and emergency preparation planning. The primary goals of the program are to: 1) Enhance the self -efficiency of low income Dublin residents with disabilities, including youth and seniors with functional limitations; 2) Increase the availability of resources to Dublin's most vulnerable residents; and 3) Improve the integration of existing social services in Dublin. 4) Assist people with disabilities who use life-saving to obtain alternative sources energy during Public Safety Power Shut -offs (PSPS). 5) Assist people with disabilities to access the internet through a computer lab and classes, chromebooks and wifi access. CRIL will directly serve 40 low-income Dublin residents, In addition, CRIL will indirectly serve 100 more individuals and businesses through disability education, technical assistance and information & referral. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) CRIL's Housing & Independent Living Services will provide Dublin n residents who have a disability with housing search assistance, peer counseling, independent living skills & travel training. In this program, CRIL provides an array of services to encourage independence - this is accomplished through peer work. 80% of CRIL's staff have a disability. With the COVID pandemic, CRIL has focused work on providing Personal Protective Equipment, Vaccine & Booster Information, addressing the Digital Divide through chromebooks and wifi access, and rental assistance. As recovery from the pandemic has happened, there has been a dramatic increase in the number of Dublin consumers. This is due not only to increased need but also to increased population. Without Dublin funding, CRIL will attempt to meet the needs of Pleasanton residents but this would place stress on the agency's flexibility and ability to address crises that arise. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 40 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) Y'. Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development Y'. Homelessness Transportation Services and Access Domestic Violence and Child Abuse Disabilities ❑ Food and Nutrition Y'. Senior Services .� Youth Services ❑ Child Care, Early Childhood Development and Education Y: Changing Demographics and Growing Diversity Y. Financial Assistance LJ None of the Above ❑ Please explain: CRIL provides services at no cost to persons with disabilities and seniors with functional limitations. CRIL's services are based on need. 274 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The Tri-Valley Program operating budget of $65,000 covers the minimum costs for CRIL to continue operating a full -service branch office for the disabled residents of Livermore, Pleasanton and Dublin. With these funds, CRIL supports an Independent Living Coordinator who provides nearly 200 unduplicated Tri-Valley residents with disabilities with all of CRIL's numerous independent living services including the Housing & IL Services program along. CRIL estimates that 20% of consumers served at the CRIL Livermore Office will be Dublin Livermore Residents. Small portions of supervision and administrative time are also allocated to this program. The remaining non -personnel costs are associated with the necessary operations of an office: rent, utilities, accounting, IT support, insurance & staff travel reimbursement. The three Tri-Valley cities and with Department of Rehabilitation, & Alameda County Transportation Commission (ACTC) share the diverse funding for CRIL's Tri-Valley branch operating budget. CRIL respectfully requests that the City of Dublin fund approximately $16,000 [this reflects a 7% inflation rate of last year's request of $15,000] of the Tri-Valley area Housing & IL program budget. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Consumers are also asked to complete a Satisfaction Survey which allows us to evaluate the type & quality of services provided. Consumers provide management & the board of directors with feedback on the impact that our services & supports have had on their level of independence. CRIL's Housing & IL Services for people with disabilities will provide 40 Dublin residents with improved access to housing, peer counseling, employment & benefits counseling, travel training, I & R, LTSS counseling, assistive technology information & AT device loans and advocacy, COVID vaccine info and access assistance, ipads for persons with speech impediments to access the phone, and chromebboks to assist with internet access. Housing counseling will include local resource info, application assistance, budgeting & credit counseling, transition services applications to Season of Sharing & Dept. of Rehabilitation's housing transition fund. CRIL will also provide indirect information & referral, technical & assistive technology support, ADA & disability law education and community advocacy to 100 additional Dublin residents & businesses to assist them with increasing their knowledge & independence. CRIL is now a core member of Alameda County's Aging and Disability Resource Connection (ADRC). The service which will be the ADRC's major focus will be transitions: assisting people with disabilities and older adults to transition from hospital or skilled nursing facility to home. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Community Resources for Independent Living (CRIL) is a peer -based disability resource organization that advocates and provides resources for people with disabilities to improve lives and make communities fully accessible. Everyone is welcome regardless of race, ethnicity, the nature of the disability or limitation, age, socioeconomic status, sexual orientation, gender identity, and expression, immigration status, health condition, or any other characteristics. In working for accessibility, CRIL reflects its commitment to inclusivity, diversity and equity. CRIL believes all people must be included in the fabric of society and CRIL's consumers reflect the diversity of Alameda County. While equality means each individual or group of people is given the same resources or opportunities. Equity recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome. A person with disabilities may simply need different resources and opportunities to be fully involved in society. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Since March 2020, CRIL has actively reached out to the disability community, as well as the larger community, to provide resources and information. CRIL distributed 70,000 masks, hosted a COVID clinic, emailed vaccine information to over 2,500 people with disabilities, mailed vaccine information to over 600 people with disabilities and called over 4,000 people to provide vaccine information. In addition, CRIL has called its 1,000+ senior consumers three times to check in on their needs: physical and psychological. 27! 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? f: Yes. If so, check box here and answer questions 14 through 25. LJ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. CRIL strives to offer services in languages which are used in Eastern and Southern Alameda County. Services are offered in English, Spanish, ASL, Farsi, Pashto, Hindi, Punjabi, Bosnian, Croatian and Serbian. For other languages, CRIL uses Alameda County's Language Line. All printed materials are in English, Spanish, large font and available in electronic format. CRIL's most used materials are also in Chinese.. CRIL participates in over 50 outreaches throughout Alameda County. These outreaches include different language groups, as well as, different cultural groups. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Be culturally accessible, appropriate and inclusive LJ Encourage community engagement and involvement LJ Promote energy and resource efficiency LJ Encourage networking and information sharing across service providers LJ Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. LJ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. LJ B) Homeless LJ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. Y'. D) Community Development Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Y'. Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: *!: Public Services .': Public Facilities Rental Assistance '. Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers '. Promote Decent Affordable Rental Housing 27E Y Strengthen Communities Y'. Ensure Equal Opportunity in Housing Y'. Reduce Housing Discrimination Y'. Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') Y'. Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities LJ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') Y'. Availability/Accessibility ❑ Affordability LJ Sustainability LJ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. Y'. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. LJ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. LJ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee- 271 sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) Y: Persons ❑ Households Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 15 Seniors (62 and older) 40 People with Disabilities F5 Female -Headed Households 5 Youth 2 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 67.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 50 Extremely Low Income (<30% AMI) 25 Very Low Income (30%-50% AM]) 15 Low Income (50%-80% AMI) 10 Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 15 White 5 White + HISPANIC 8 Black/African American 0 Black/African American + HISPANIC 8 Asian 0 Asian + HISPANIC 1 American Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 1 Native Hawaiian/Other Pacific Islander 0 Native Hawaiian/Other Pacific Islander + HISPANIC 0 American Indian/ Alaskan Native and White 27f 0 American Indian/ Alaskan Native and White + HISPANIC 0 Asian and White 0 Asian and White + HISPANIC 0 Black/African American and White 0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC 2 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 40.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY : #1 - This program/project has the agency's highest priority for funding. #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Dublin USD$ 16,000.00 City of Livermore USD$ 16,000.00 City of Pleasanton USD$ 16,000.00 Dept of Rehab GF USD$ 2,000.00 USD$ 2,000.00 Dept of Rehab AB204 USD$ 5,000.00 USD$ 5,000.00 ACL USD$ 10,000.00 USD$ 10,000.00 Total USD$ 65,000.00 USD$ 17,000.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel: Salaries USD$ 9,155.00 USD$ 9,105.00 Personnel: Benefits USD$ 5,250.00 USD$ 5,250.00 Operating: Supplies USD$ 250.00 USD$ 250.00 Operating: Postage USD$ 34.00 USD$ 34.00 Operating: telephone USD$ 386.00 USD$ 386.00 Operating: Accounting/Audir USD$ 250.00 USD$ 250.00 Operating: Contracted Services USD$ 400.00 USD$ 1,400.00 Operating: Dues, Publications USD$ 100.00 USD$ 150.00 Operating: Insurance USD$ 100.00 USD$ 100.00 Operating: Printing/Copying USD$ 75.00 USD$ 75.00 Total USD$ 16,000.00 USD$ 17,000.00 Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests❑ Program Expense download template 27E Financial Information Form for ALL Grant Requests U Financial Info download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information CRIL Board of Directors Current Annual Budget for the Entire Agency 0 CRIL Annual Budget Copy of most recently submitted IRS 990 form or Tax 0 990 Return (include complete form) Board of Director's (or governing body's) designation 0 authorized official of authorized official Board of Director's (or governing body's) authorization 0 Authorization for Funding to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Named Insured Policy and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 IRS Letter DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Employee Handbook Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Articles of Incorporation Incorporation and Bylaws Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S Language Outreach LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Strategic Plan Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 428532 Become a fan of ZoomGrantsTM on Facebook Problems? Contact us at QuestionsZoomGrants.com 02002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 28( INEmail This Preview Save as PDF Print Close Window A♦ IT16 DUBLI N C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/23/2023 Easterseals Northern California Kaleidoscope Community Adult Program - 2023/2024 Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/23/2023 7:28:56 PM (Pacific) Project Contact Doris Evans development@.esnorcal.org Tel: (510) 910-3089 Additional Contacts none entered Organization Information top 1. Business License Number BL-005301 Questions top Easterseals Northern California 5601 Arnold Road Suite 104 Dublin, CA 94568 United States CEO Andrea Pettiford development(a).esnorcal.orq 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency ❑ Other: Telephone(925) 326-0072 Fax Web www.esnorcal.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Easterseals Northern California is leading the way to ensure that individuals and families affected by disabilities and special needs can live, learn, work and play to their full potential. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 281 J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Kaleidoscope Community Adult Program offers specific programming for adults with intellectual disabilities or development. The services provided help adults integrate into the community and increase life skills and social engagement. Our Life Skills Coaches are currently providing services to thirty-nine (39) participants, nine (9) of which are Dublin residents. Our Life Skills Coaches help the participants and families set goals in their Individual Program Plans (IPP), facilitate proper peer -to -peer interactions, provide safety training, assist with hygienic needs, facilitate activities & trips, offer calendar suggestions, lead activities in person and via telehealth, report behavioral or medical needs/changes to the Program Manager, and lead by example. Our Life Skills Coaches also provide support and training to parents and caregivers. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The Kaleidoscope Community Adult Program plans to expand from 39 participants to at least 42 participants in 2023. In order to accomplish that, we need at least one additional staff member to join our team so that our ratios remain compliant and safe. Expanding the program has been a long-time goal of the organization and we are excited that we have prospective participants waiting to receive services. Being able to hire another staff member has additional benefits for the families we serve and the community. An additional staff member will expand the network of support that is provided to our family members and caregivers, and allow more family members to work, run errands, attend to other needs such as shopping, doctors' appointments, other family members, meetings, etc., all while their child is in trusted, professional care. If we do not receive grant funds, the ability to hire an additional staff member will be at risk along with the ability for Kaleidoscope to expand its program and services, including the support and time given to families. Up to 3 participants and families could remain on our waiting list and without services. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 9 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process 14-1 Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) Y'. Workforce Development Homelessness Y. Transportation Services and Access Domestic Violence and Child Abuse V; Disabilities Y: Food and Nutrition ❑ Senior Services LJ Youth Services ❑ Child Care, Early Childhood Development and Education : Changing Demographics and Growing Diversity LJ Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) 282 Grant funding from the City of Dublin is needed to help supplement the salary of a new Life Skills Coach. Our 2023 goal is to hire one, full-time additional staff member. The Life Skills Coaches help the participants and families set goals in their Individual Program Plans (IPP), facilitate proper peer -to -peer interactions, provide safety training, assist with hygienic needs, facilitate activities & trips, offer calendar suggestions, lead activities in person and via telehealth, report behavioral or medical needs/changes to the Program Manager, and lead by example. Our Life Skills Coaches also provide support and training to parents and caregivers. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Successful outcomes are tracked in the participant's Individual Program Plan (IPP) which is updated bi-yearly. Parents/guardians/caregivers, case managers from the Regional Center of the East Bay program as well as the participant are in the meetings and have direct input in the plans and outcomes. Baselines are established when a participant begins the program. The program ensures that there is no regression to IPP goals and successful outcomes can also be tracked by participant attendance and engagement in the program. By the end of the grant, we expect to have expanded the Kaleidoscope Community Adult program from 39 participants to 42 or more participants. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision As an organization that has been advocating for and serving people with disabilities for almost a century, we are 100% committed to equal rights and freedoms for all people. This level of change takes diverse, inclusive, and innovative thinking as well as well -thought-out planning and execution. We believe diversity, equity, and inclusion are everyone's work, every day and forever. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. N/A 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? LJ Yes. If so, check box here and answer questions 14 through 25. ;.: No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency LJ Encourage networking and information sharing across service providers Encourage process streamlining ❑ Consolidate service delivery Y'. Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. 28: ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. B) Homeless LJ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. LJ C) Supportive Housing LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y: F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: LJ Public Services ❑ Public Facilities IJ Rental Assistance ❑ Affordable Housing LJ Increase Opportunities for 1st Time Homebuyers LJ Promote Decent Affordable Rental Housing LJ Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y'. Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y'. Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (T/P: When selecting an outcome ask yourself, "What type of change or result am l seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. 284 ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. LJ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) LJ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. *! Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons LJ Households *!: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". F N/A Seniors (62 and older) C People with Disabilities CFemale -Headed Households Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 0.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMP) information is available online at www.dublin.ca.gov11956/Application-Requirements-Process N/A Extremely Low Income (<30% AMI) 28! Very Low Income (30%-50% AMI) Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" N/A White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 0.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ''. #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Regional Center of the East Bay Total Funding Uses/Expenses Budget Amount USD$ 738,862.00 USD$ 738,862.00 Budget Amount Amount Committed USD$ 0.00 Amount Committed 28E Program Supplies Rent/Occupancy Supervisor/Lead/Manager Total Documents top USD$ 144,000.00 USD$ 68,898.00 USD$ 192,000.00 USD$ 1,241,154.00 USD$ 0.00 Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests 21 Easterseals NorCal 2023-2024 Program Expenses download template Financial Information Form for ALL Grant Requests 0 Easterseals NorCal 2023 Financial Info. Form download template List of Board of Directors (or governing body) with 0 Easterseals NorCal Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Easterseals NorCal_2023 Budget Copy of most recently submitted IRS 990 form or Tax 0 Easterseals NorCal 2021 990 Tax Return Return (include complete form) Board of Director's (or governing body's) designation 0 Easterseals NorCal Author. Form of authorized official Board of Director's (or governing body's) authorization 0 Easterseals NorCal Author. Form to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Easterseals NorCal Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 Easterseals NorCal 501c3 Determination Letter DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic 0 Easterseals NorCal 2021 Audit 28-1 qu Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 428216 Become a fan of ZoomGrants'" on Facebook Problems? Contact us at Queslions5zoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 28E 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Goodness Village Goodness Village Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/20/2023 9:08:24 AM (Pacific) Project Contact Kim Curtis Kim(a)avlivermore.ora Tel: 925-237-1108 Additional Contacts none entered Organization Information top 1. Business License Number BL-114154 Questions top Goodness Village 1660 Freisman Rd Livermore, CA 94551 United States Executive Director Kim Curtis Kim(a_ gvlivermore.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone925-237-1108 Fax Web www.gvlivermore.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our mission is to improve the lives of the unsheltered population in the TriValley by providing a support housing community with 24 hour wrap are mental health support and an onsite 3 tier vocational skill building program. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 28E J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). We currently provide housing services for 4 Dublin identified unsheltered residents. These four are between 60 and 76 years old. They are actively engaged in the 24 hour wrap around services and are unlikely to be able to retain or maintain housing in an alternative setting with less support. We are asking for Dublin's financial assistance in supporting this TriValley program. Our budget for the village is currently slightly over one million dollars. This breaks down to roughly $98 per night per individual. We are asking for Dublin to provide $25,000 towards 85 bed nights for 3 individuals. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The income of these 4 formerly unsheltered Dublin residents is between $900 (SSA) and $3000 (Disabled Vet). Prior to moving to the village these 4 elderly individuals lived in their cars and did not address their mental health or medical needs. It is highly probable the extreme weather and/or covid would have terminated their lives if still unsheltered. All arrived to the village with problematic vehicles and expired registration, it is probable they would not have been able to retain their vehicles for much longer and would have moved to the streets. Without funding from Dublin we will continue efforts to raise funds within our local community as no one should be without housing especially our elderly population however we have promised funding to expand the village and we have turnover in the village with in our current homes, we will need to prioritize placements for those cities in the TriValley who are committed to engaging in supporting the village. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) At minimum we will continue to serve these 4, as individuals transition out and with the growth of the village we expect to provide services to more Dublin residents. 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process *!: Behavioral Health (mental health and substance abuse) Y'. Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development Homelessness Y: Transportation Services and Access Domestic Violence and Child Abuse ..' . Disabilities LJ Food and Nutrition *: Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity LJ Financial Assistance LJ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Goodness Village is successful due to the 24 hour onsite mental health support that provide crisis de-escalation, neighbor mediation, substance use eduction and prevention and case management. Individuals who have been unsheltered for 3-16 years, as in the cases of our former Dublin residents, require time to rebuild their social and communication skills in order to navigate the delicate relationships that are required in order to obtain and retain housing. We also provide a sliding scale for the monthly program fee, with the residents paying between $350-600 for their tiny home, utilities and 24 hour supportive services. 29C 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our KPIs include: length of time in housing, decrease of mental health symptoms, engagement with Primary Care Providers, decrease of substance use. Our case managers assist each of our participants with housing waitlist applications however due to their level of services need we believe our participants are not likely to be successful in a lower level of care housing option at this time. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision At Goodness Village we believe the primary cause of chronic homelessness is the catastrophic loss of family and community. Our Village is a living example of an inclusive society. We strive to offer a level playing field to those that have been less fortunate. We focus on eliminating barriers that prevent vulnerable, marginalized or disadvantaged population (unsheltered homeless) no matter what race, color or creed to fully participate in our social institutions. We are driving systemic change in how the homelessness challenge within our community is being addressed. We are a proof of concept that is demonstrating if you create an environment that offers the disadvantaged a safe permanent living space (includes 24 hour 7 day a week security site coverage) that more importantly provides the dedicated resources and support in a dignified approach to improve their well-being, they thrive to become contributing members of the community. We have also received a $5000 grant from John Muir to be a part of their DEI initiative. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. NA 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. Y'. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive LJ Encourage community engagement and involvement LJ Promote energy and resource efficiency LJ Encourage networking and information sharing across service providers Encourage process streamlining ❑ Consolidate service delivery .^'. Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) LJ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. 291 ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. B) Homeless LJ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. LJ C) Supportive Housing LJ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y: F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: LJ Public Services ❑ Public Facilities IJ Rental Assistance ❑ Affordable Housing LJ Increase Opportunities for 1st Time Homebuyers LJ Promote Decent Affordable Rental Housing LJ Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y'. Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y'. Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (T/P: When selecting an outcome ask yourself, "What type of change or result am l seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. 29` ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. LJ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) LJ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. *! Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons LJ Households *!: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". FSeniors (62 and older) C People with Disabilities CFemale -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) �0.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMP) information is available online at www.dublin.ca.gov11956/Application-Requirements-Process Extremely Low Income (<30% AMI) 29; Very Low Income (30%-50% AMI) Low Income (50%-80% AMI) N/A Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type N/A) 0.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ''. #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Congressman Swalwell USD$ 1,000,000.00 John Muir USD$ 62,000.00 Stanford Health USD$ 52,000.00 Workday USD$ 200,000.00 Pleasanton USD$ 100,000.00 291 Total USD$ 0.00 USD$ 1,414,000.00 Funding Uses/Expenses 24 hour wrap around services provided by 24 hour staff staff benefits Payroll taxes and fees Rent and utilities Total Budget Amount USD$ 830,335.92 USD$ 63,600.00 USD$ 66,580.92 USD$ 120,000.00 USD$ 1,080,516.84 Amount Committed USD$ 314,000.00 USD$ 120,000.00 USD$ 434,000.00 Budget Narrative We are asking for $25,000 to continue to provide 24 hour staffing to ensure stability and safety within the village. In the last 19 months of operating no participant has been psychiatrically hospitalized or arrested, we believe this is due to the availability of the staff during times of crisis. They've also been able to immediately respond when medical emergencies arise, such as initiating CPR at midnight when a participant experienced Cardiac Arrest. At this time we have been promised the Swalwell $1,000,000 for programming however we have not received a contract to know what the scope of funds will be distributed for. We also do not know when the funds will become available. At this time we are running with a bare bones budget and leaning heavily on the promise of the Congressman for additional funding to support our 2023 budget. Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests 21 Budget download template Dublin Budget Template Financial Information Form for ALL Grant Requests 0 Financial Template download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Annual Budget Copy of most recently submitted IRS 990 form or Tax 0 990 Return (include complete form) Signature page Board of Director's (or governing body's) designation 0 Board Approval -Quorum Met of authorized official Board of Director's (or governing body's) authorization 0 Board Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure CA IRS F21 Audit info REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section 29! REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 427729 Become a fan of ZoomGrantSTM on Facebook Problems? Contact us at Queslionsna.ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 29E 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Hively Community Engagement Coordinator Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/20/2023 5:52:53 PM (Pacific) Project Contact Mary Hekl kelly(a-)behively.org Tel: (925) 417-8733 Additional Contacts kbrace@behively.org, cduperroir@behively.org Organization Information top 1. Business License Number BL-109890 Questions top Hively 7901 Stoneridge Dr Ste 150 Pleasanton, CA 94588 United States CEO Mary Hekl mary(g behively.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency ❑ Other: Telephone(925) 417-8733 Fax Web www.behively.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Hively's mission is to provide resources so everyone in our community can thrive. Resources include community outreach programs (food, clothing, diapers); affordable mental health services; child care subsidies; parent education and support; and more. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project .'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 29i operatioi LJ Yes '. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Community Engagement Coordinator oversees operations at the Family Resource Center (FRC) and plays a critical role in helping to deliver goods to families -in -need while also connecting them to important services. The FRC is a "one -stop shop" for families seeking resources and daily essentials, providing free food, diapers, clothing, & household items while also connecting families to key services including child care referral & subsidy, job & housing searches, parenting classes, mental health services and more. The Community Engagement Coordinator receives, collects and picks up thousands of donations from in -kind donors, works with community and corporate partners, organizes service projects, maintains records and donor lists, trains, recruits & organizes volunteers and is the key navigator of the FRC experience, skillfully directing clients to the resources and services they need. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Low-income families struggled prior to the pandemic and the economic shutdown made the situation more dire. Now, as we begin to emerge from the pandemic, jobs are returning, but economic strife continues. Increasingly, Dublin families are burdened with unfavorable economic conditions and high costs associated with inflation. Basic needs are more expensive, transportation costs are high and parents seeking employment must first solve the problem of child care. The FRC is a critical hub for families seeking help with daily essentials and important resources. With this "one -stop shop" families are supported with their daily needs, but they are also able to access the resources which enable their entry or return to the workforce. If we do not receive funding to help pay for the Community Engagement Coordinator salary, we will have to constrain the number of hours the Family Resource Center is open. We would likely need to reduce the role to part-time, meaning less community engagement, fewer families served and a revised outlook for the ultimate vision of a "one -stop shop". As such, families will experience less accessibility to basic goods, child care resources & social services. Together, these factors could lead to increased homelessness and joblessness. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 1200 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process . i Behavioral Health (mental health and substance abuse) Y'. Affordable Housing FJ Health Care (including dental) *!: Workforce Development : Homelessness LJ Transportation Services and Access LJ Domestic Violence and Child Abuse FJ Disabilities Y: Food and Nutrition ❑ Senior Services Y: Youth Services : Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity : Financial Assistance CI None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should 29E include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) In December 2021, Hively opened the Family Resource Center (FRC) in Dublin, a "one -stop -shop" where families can visit an on -site Family Support Specialist to answer questions and enroll families into services as well as find resources such as food, diapers, clothing, and household items. This request is to help fund the salary of a full-time Community Engagement Coordinator to manage the FRC. Although we rely on donated merchandise, successful partnerships, and volunteers to make our program as cost effective as possible, we still face the necessary expense of staff time. It is extremely cost-effective to staff a full-time Community Engagement Coordinator because that one paid staff can coordinate potentially hundreds of unpaid volunteers to distribute goods, and staff, stock, and organize the storefront to serve our clients. It is essential that we hire a Coordinator because the FRC needs to be open about 30-40 hours per week to be available for our clients. Many of our families are low-income as the result of trauma they received either here or in a home country, so we are looking for more than just a body to staff the FRC. We need a dedicated, compassionate, trained, bi-lingual coordinator who can both supervise volunteers and respectfully and effectively interact with family clients. In addition to working with and training volunteers, the Coordinator educates and engages with the community to promote drives such as for diapers, food, and warm clothing. Local corporations are invited to host team -building events to raise awareness of need in our community. Corporate staff can work together on a specific project such as organizing the store, collecting, then sorting and displaying items on display, or assisting in special distributions. Having an experienced, skilled and competitively -compensated Coordinator also means that we can work to further the experience of client families. The Coordinator is adept at communication, greets families warmly, and treats them with dignity and respect, fostering a sense of hope and belonging. Once this important relationship is established, the Coordinator can assess key needs for each family and help direct them to the corresponding resources. Without a full-time coordinator, the FRC operations would become greatly minimized and fewer families would receive help. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The effectiveness of the Community Engagement Coordinator will be measured by a variety of criteria. First, the Hively Community Services Department, which oversees the Family Resource Center, sets yearly departmental goals for the FRC and its associated services. The yearly employee performance review, administered by the Director of Community Services & Education, Candy Duperroir, will assess how well the employee met or exceeded these goals in their role. In addition, data on successful donation campaigns, corporate events, partnerships and volunteer engagement tell us how well the Community Engagement Coordinator is performing their outreach. Finally, reviews and surveys from our client families rate the customer experience they receive in the Family Resource Center. When families are greeted by a smiling face and are treated with respect and dignity, they are delighted to share those stories with us. And, the more families we connect to services via the Family Resource Center, the more confidence we have that the Coordinator is working effectively to communicate with families and assess their needs. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Hively's mission is to provide resources that strengthen and support children and their families. That means our services at the Family Resource Center are available to ALL children and families who need them. To be inclusive and equitable in access, the location of the FRC was specifically chosen to be on a main thoroughfare, Valley Parkway in Dublin, and is accessible through nearby stops for County transit. It is also close to major freeway systems. The storefront is handicapped accessible. Hively is committed to a workforce that is diverse, and many of our staff are themselves immigrants to the United States and fluent in 14 languages. The Community Engagement Coordinator is also multi-lingual and, like all community services staff, trained in diversity and trauma awareness. The coordinator is also versed in the "Strengthening Families: Five Protective Factors," which enable a deeper understanding of the basic needs that ALL parents, regardless of race, ethnicity or income level need to strengthen their families. To make sure diversity and inclusion are also duplicated in our volunteer staff, our Coordinator is committed to working with various communities within the Tri-Valley area to engage volunteers matching the diversity of our client base, so that all feel welcome. Hively is absolutely dedicated to providing services to all who need them, and we strive to make it as easy as possible for all to feel included and welcome. In the end, if a family can't come to Hively, then Hively will meet them where they are and bring resources to them. 29E 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. The Family Resource Center continues to be a major hub for PPE distribution to both parents and child care providers. The COVID-19 pandemic has had a devastating and disproportionate effect on hourly and low -wage workers in service industries. Child care workers were also greatly affected. Having appropriate staffing to deliver, coordinate and inventory PPE to deliver to the community is essential. The Community Engagement Coordinator also works directly with our partners who provide us with these critical supplies. We supply hand sanitizer, masks and COVID-19 test kits. In addition, through partnership with Clorox, we provide cleaning supplies which are critical for providers in ensuring their safety, and that of their clients, as well as maintaining standards and compliance in their places of business. We hope that, together with the City of Dublin's partnership and support, we can continue to do this critical work of providing for the basic needs of the most vulnerable Dublin and Tri-Valley families. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. Y'. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive LJ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery Y: Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. LJ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. 30( Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y: F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services LJ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing LJ Strengthen Communities LJ Ensure Equal Opportunity in Housing LJ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y'. Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') LJ Creating a Suitable Living Environment LJ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y'. Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability .. Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. LJ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. LJ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and 301 number of units for the chron Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) LJ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Y'. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons Households Y: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) O.Of TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 0 Extremely Low Income (<30% AMI) 0 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) 0.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" i White C White + HISPANIC 301 Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type N/A) 0(- TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ❑ #1 - This program/project has the agency's highest priority for funding. *!: #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Department of Social Services USD$ 55,000.00 City of Dublin USD$ 25,000.00 Individual Donors USD$ 10,000.00 Total USD$ 90,000.00 Funding Uses/Expenses Budget Amount Salaries USD$ 90,000.00 Total USD$ 90,000.00 Budget Narrative N/A Amount Committed USD$ 55,000.00 USD$ 10,000.00 USD$ 65,000.00 Amount Committed USD$ 65,000.00 USD$ 65,000.00 Documents top 30: Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests❑ Program Expense Community Engagement download template Financial Information Form for ALL Grant Requests 0 Financial Information Engagement Cooridnator download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Annual Budget Copy of most recently submitted IRS 990 form or Tax 0 IRS 990 Return (include complete form) Board of Director's (or governing body's) designation 0 designation of authorized official of authorized official Board of Director's (or governing body's) authorization 0 authorization to request funding to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 liability insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 501C DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 427428 Become a fan of ZoomGrantsTM on Facebook Problems? Contact us at Queslions5ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. 304 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Hively Hively Family Resource Center Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/20/2023 5:55:34 PM (Pacific) Project Contact Mary Hekl kelly(a-)behively.org Tel: (925) 417-8733 Additional Contacts kbrace@behively.org Organization Information top 1. Business License Number BL-109890 Questions top Hively 7901 Stoneridge Dr Ste 150 Pleasanton, CA 94588 United States CEO Mary Hekl mary(g behively.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency ❑ Other: Telephone(925) 417-8733 Fax Web www.behively.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Hively's mission is to provide resources so everyone in our community can thrive. Resources include community outreach programs (food, clothing, diapers); affordable mental health services; child care subsidies; parent education and support; and more. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project .'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 30! operation. LJ Yes ,.' . No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Hively Family Resource Center (FRC), conveniently located in Dublin near the 580 and 680 freeways, offers a variety of family resources, free -of -charge, to meet the needs of the lowest income and most vulnerable families in the Tri-Valley. The Family Resource Center, since its opening in December 2021, has increasingly become a 'one -stop shop" providing not only family goods & necessities (non-perishable food; clothing; diapers; household items; school supplies; early childhood learning & literacy materials; PPE supplies), but also essential community resources (employment & housing search assistance; child care resource, referral & subsidy; mental health services; parenting classes & coaching). In addition, our community services team supports child care providers via the Family Resource Center, offering training, support, PPE supplies and additional resources to enable the growth of high -quality thriving child care businesses in the Tri-Valley. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Dublin families, like much of the nation, are burdened with unfavorable economic conditions and high costs associated with inflation. Basic needs are more expensive, transportation costs are at an all-time high and parents seeking employment must first solve the problem of child care. The Family Resource Center provides families -in -need with basic goods and resources and provides a warm hand-off to social service programs which offer temporary support in times -of -need. In addition, the FRC is a critical hub for both families seeking child care and providers seeking support for their childcare centers. During the pandemic, multiple child care providers closed their doors for good. In order to support job seekers, we need to support child care providers so there are more qualified child care spaces available. If we do not receive funding, families will experience less accessibility to basic goods, child care resources and social services. And, providers will have less accessibility to business support which will constrain the number of qualified child care spaces. Together, these factors could lead to increased homelessness and joblessness. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 1200 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956IApplication-Requirements-Process Y'. Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) Yi Workforce Development Y Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities Yi Food and Nutrition ❑ Senior Services i Youth Services ;.*.!'. Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity LJ Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being 30E requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Grant funds will be used to help expand the resources available at the Family Resource Center. In particular, we intend to purchase two desktop computers, a printer/scanner, desks and chairs in order to facilitate employment, child care, and social services searches for our clients. Additionally, grant money will be used to continue to fund basic operating expenses and the salary of our Community Engagement Coordinator. The Community Engagement Coordinator is the point -person at the Family Resource Center, picking -up, receiving, organizing, sorting & logging donations, purchasing program supplies, cultivating and maintaining relationships with donors & community partners. coordinating with volunteer groups and hosting events, supervising and training hundreds of volunteers, and helping clients to connect to Hively Family Support Specialists for extended needs. Furthermore, funds would be used for outreach as we seek to connect residents to services. With these funds, we also hope to increase the number of hours the Family Resource Center is open, adding two more hours on Saturdays and possibly opening for one evening during the week. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Regularly we survey Tri-Valley families and providers to learn how, when and why they access the Family Resource Center. We learn which resources they value the most and what resources would aid them further. Additionally, we can calculate the store "transactions" both as donations and outgoing support. As a referring agent for services, we don't merely hand-off a client to another agency. We follow-up with every single family we refer out for other services and ensure that the client received the support they needed. The key aim is to continue growing our one -stop shop for goods and services; the result being fewer unhoused families, more working parents, more child care support and referrals, and more families thriving and free from the worry that they will not have enough. What drives the mission of the Family Resource Center are the success stories. On one Wednesday evening in 2022, our Community Engagement Coordinator, Arianna, recalled a woman in tears in the store. She just wanted to thank Hively for "being such a blessing in my life." She said she had never had so many clothes for herself and her children. It had always been a struggle. This is just one of many stories which underscores the quiet need in our community and reminds us that our work is vital. We know that when people feel supported they are empowered to do more. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision At Hively, not only do we share and embrace the same values of Inclusivity, Diversity, and Equity as the City of Dublin, but the entire Hively staff has undergone a year -long training program by instructors at the Center for Leadership Equity and Research in Early Learning (CLEREL). CLEREL's mission is to provide educational services to examine racism, sexism, ableism and cultural learning policies and practices impacting children's outcomes. During the training, staff met twice per month via videoconference with CLEREL instructors to learn how to more effectively communicate and work with the children and families that we serve. The work has required vulnerability, self -reflection, and sometimes difficult conversations that have challenged our assumptions and our learned behaviors, but it has also been eye opening and deeply rewarding, and has led to real growth for each of us as employees and as individuals. At Hively, we promote inclusivity, diversity, and equity by ensuring that low-income families are treated with dignity and respect. Our community services team is certified and trained in family stress and trauma. Volunteers are also trained on how to approach clients with sensitivity. Furthermore, when we refer families to other agencies, we don't just dump them off. We follow up with a call or email. We take the time to ensure that they receive effective and efficient service and that they are on their way to a remedy with the support they need. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. During the pandemic, we never once closed for business. We have continued to serve our clients, by phone, email, videoconference. Gratefully, in 2022, we were able to resume some in -person client meetings. Knowing that low-income populations suffered from low COVID vaccination rates and lack of access, last year we partnered with agencies and local pharmacies and used our considerable outreach to advertise local COVID-19 vaccination clinics for young children who just a few months ago became eligible for vaccination. 30-1 The COVID-19 pandemic has had a devastating and disproportionate effect on hourly and low -wage workers in service industries. Child care workers were also greatly affected. The Family Resource Center continues to be a major hub for PPE distribution to both parents and child care providers. We supply hand sanitizer, masks and COVID test kits. In addition, through partnership with Clorox, we provide cleaning supplies which are critical for providers in ensuring their safety and that of their clients as well as maintaining standards and compliance in their places of business. We hope that, together with the City of Dublin's partnership and support, we can continue to do this critical work of providing for the basic needs of the most vulnerable Dublin and Tri-Valley families. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. .*!'. No. If no, check box here and enter NA LJ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive LJ Encourage community engagement and involvement LJ Promote energy and resource efficiency LJ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery Y'. Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. LJ D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y'. F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing 30E ❑ Increase Opportunities for 1st Time Homebuyers Promote Decent Affordable Rental Housing LJ Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y: Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') LJ Creating a Suitable Living Environment LJ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y: Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') LJ Availability/Accessibility ❑ Affordability ❑ Sustainability Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. LJ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. 30E ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Y'. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons LJ Households .^'. Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.0G TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 0 Extremely Low Income (<30% AMI) 0 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) 0.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" F White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander 31( Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed California State CCRP Contract USD$ 60,000.00 USD$ 60,000.00 Donations -financial (corporate & individual) USD$ 31,000.00 USD$ 31,000.00 City of Pleasanton USD$ 25,000.00 City of Dublin USD$ 25,000.00 Livermore Rotary Foundation USD$ 7,000.00 Sunlight Giving Foundation USD$ 25,000.00 USD$ 25,000.00 Sisters of the Holy Family USD$ 50,000.00 Total USD$ 223,000.00 USD$ 116,000.00 Funding Uses/Expenses Budget Amount Rent/Utilities USD$ 30,000.00 Program Staff Salaries USD$ 135,000.00 Personnel Benefits USD$ 33,500.00 Program Supplies USD$ 25,000.00 Total USD$ 223,500.00 Amount Committed USD$ 21,000.00 USD$ 85,000.00 USD$ 10,000.00 USD$ 116,000.00 Budget Narrative The partial staff salaries of Hively employees comprise the bulk of this grant request. Grand funding would be used to fund partial employee salaries and to purchase supplies to help run the Family Resource Center. Hively utilizes in -kind resources, community partnerships, fundraising strategies and volunteers to minimize costs to the fullest extent possible. Documents top 311 Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests❑ Program Expenses Hively Family Resource Center download template Financial Information Form for ALL Grant Requests 0 Financial Information Hively Family Resource Center download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Annual Budget Copy of most recently submitted IRS 990 form or Tax 0 IRS 990 Return (include complete form) Board of Director's (or governing body's) designation 0 designation of authorized official of authorized official Board of Director's (or governing body's) authorization 0 authorization to request funding to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 liability insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 501C DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 427478 Become a fan of ZoomGrantsTM on Facebook Problems? Contact us at Queslions5ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. 31'9 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Hope Hospice, Inc Grief Support Services and Volunteer Support Services Jump to: Organization Information Questions Budget Documents USD$ 20,000.00 Requested Submitted: 1/20/2023 8:40:07 PM (Pacific) Project Contact Jennifer Pettley 0enniferp@hopehospice.com Tel: (925) 719-6268 Additional Contacts marcr@hopehospice.com,marcr@hopehospice.com Organization Information top 1. Business License Number BL-005299 Questions top Hope Hospice, Inc 6377 Clark Avenue Suite 100 Dublin, CA 94568 Chief Executive Officer Jennifer Hansen 0enniferKDhopehospice.com 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency ❑ Other: Telephone(925) 829-8770 Fax (925) 829-0868 Web www.hopehospice.com 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Hope Hospice's mission is to support patients in their desire to be at home at the end of life with exceptional care, compassion and dignity. Family members are supported in their roles as caregivers and no one is turned away, regardless of their ability 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project .'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 31; operatioi LJ Yes '. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Hope Hospice seeks funding for its Grief Support and Volunteer Support programs that are provided at no charge to the community and to hospice families, respectively. These programs are not reimbursed by Medicare or private insurance. In fact, they have no reimbursement source and are supported only by grants and donations. Hope provides service to anyone who requests and needs this support, regardless of ability to pay. Vital members of the hospice team, Hope's volunteers help make it possible for people to remain at home for care and support at the end of life, where most want to be. The Volunteer and Grief programs collaborate closely with our clinical staff to provide a comprehensive circle of care and support for families. Hospice volunteers gracefully help family members in bedside vigil. They provide respite and are very present for families with an empathetic, listening ear which is very comforting to families during a highly fraught, emotional time. And, as 50 percent of Hope's patients have dementia, all patient care volunteers have specialized dementia support training. To prepare volunteers for this special assignment, Hope's manager of Volunteer Support Services recruits, onboards, and provides trainings, as well as schedules, tracks, and monitors all volunteer activities. Currently Hope Hospice has 89 volunteers, 58 of which work directly with patients. Others are office volunteers, or serve on special committees or at events. Grief support by Hope also extends out into the community, beyond our hospice families. Grief Support services staff plan, schedule and run one-on-one and group support sessions which provide comfort to people who have lost a loved one. They help the bereaved process their heartbreak and grief, and learn healthy coping skills. Participants have a safe, nonjudgmental environment to discuss their loss and learn positive ways to cope with their grief. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Hope Hospice admitted 794 patients last year, an 11 % increase over the previous year. 30% have dementia care needs. The Grief Support and Volunteer Support programs are provided at no charge to hospice families and to the community at large. As they are free of charge, these services have no revenue source other than from grants and donations. Hope provides service to anyone who requests and needs this compassionate support, regardless of ability to pay. Vital members of the hospice team, Hope's volunteers help make it possible for people at the end of life to remain at home, where most want to be, for care and to have a peaceful passing with dignity and respect surrounded by their loved ones. Specifically, they help family members in bedside vigil, they provide respite, and they are very present for families with a trained, empathetic, listening ear at a highly fraught, emotional time. And, as 30 percent of Hope's patients have dementia or related condition, all patient care volunteers have specialized dementia care training. To prepare volunteers for this human service, staff recruits, onboards, and provides training, as well as schedules, tracks, and monitors their activities. Currently Hope Hospice has 89 volunteers, 58 of which work directly with patients. Others are office volunteers, or serve on special committees or fundraising events. Hope's comforting grief support sessions help people who have lost a loved one process their heartbreak and grief, learn healthy coping skills, and receive the support and tools they need to move forward successfully in their lives. Participants have a safe, nonjudgmental environment to discuss their loss and to learn positive ways to cope with their grief. It is important that we diversify our sources of charitable funding for these programs to keep these programs available to anyone in the community who needs them, and that their quality remains high. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 100 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956IApplication-Requirements-Process Y'. Behavioral Health (mental health and substance abuse) ❑ Affordable Housing Y: Health Care (including dental) 31� ❑ Workforce Development Homelessness LJ Transportation Services and Access LJ Domestic Violence and Child Abuse LJ Disabilities LJ Food and Nutrition vo Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity LJ Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) This grant will be used to partially fund the salaries of two direct service providers: our Grief Support Manager who conducts family sessions and group sessions, and our Volunteer Services Manager who recruits, vets, trains, prepares, and monitors our volunteers in the field and throughout our organization. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Service contacts and sessions are tracked in a comprehensive database management system. Grief Support Services collects client satisfaction surveys following its programs, as well as evaluations from hospice families 13 months after their loss. The surveys and evaluations measure perceptions and assess how participants are coping in their grief experience. In CY2022, 670 individual sessions were held at no charge, 236 of these for members of the community - people not in our hospice service. All Hope volunteers are initially interviewed to determine their area of interest and level of time commitment and then complete a registration and orientation process. Their progress, hours and interests are carefully logged. Volunteer support is a unique aspect of the hospice patient care experience and, due to the highly sensitive environment, their training and activities are carefully monitored, evaluated and recorded in a comprehensive database system. Families complete satisfaction surveys which help us understand and respond to the ongoing and emerging needs of those in our care, including the volunteer services. In addition, our case managers, registered nurses, and medical social workers are in constant contact with our patients and families, and regularly conduct needs assessments and measure levels of satisfaction. We also are evaluated by The Joint Commission against its principles of health best practice and compliance. Hope's Chief of Quality and Compliance, a member of the executive leadership team, monitors, reviews the results of these evaluations and reports them to our staff and board of directors. These activities help ensure quality and regulatory compliance, as well as drive the development of new services, such as grief support for children and teens, and help to refine current services to ensure they continue to meet community needs and expectations. Hope consistently ranks in the 90th percentile in terms of satisfaction and service delivery and we expect to achieve these goals again. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision All of our services are open and available to anyone, regardless of ability to pay. These services are complimentary to all. No one who seeks our help and service is turned away for any reason. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. 31 As a health care organization, we sometimes receive patients for hospice care who are COVID positive. Our clinical staff is highly trained in COVID response and as necessary wears full PPE for their protection and for the patient and family's protection. Some facilities are still restricting visits by non -family caregivers, so telehealth systems may be employed or telephone check -ins as appropriate to monitor conditions. We work in close collaboration with physicians and other care providers to ensure that patient needs are met. Volunteer visits have been reduced during the pandemic period for the same reason. Volunteers are required to be vaccinated and can visit only vaccinated patients at home while wearing a mask. Other PPE can be worn as desired. Clinical staff responds to nonvaccinated patients. Grief support sessions are still being conducted virtually over a Zoom platform. In -person groups will resume when the situation warrants. We follow the guidance of the Departments of Health and CDC. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. No. If no, check box here and enter NA Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery Y: Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. LJ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. LJ B) Homeless LJ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. LJ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or : F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing 31E ❑ Increase Opportunities for 1st Time Homebuyers Promote Decent Affordable Rental Housing LJ Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y: Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') LJ Creating a Suitable Living Environment LJ Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y: Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') LJ Availability/Accessibility ❑ Affordability ❑ Sustainability Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. LJ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. 31i ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. Y'. Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons LJ Households .^'. Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 0 Seniors (62 and older) 0 People with Disabilities F0 Female -Headed Households 0 Youth 0 Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) E- 0.0G TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 0 Extremely Low Income (<30% AMI) 0 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) 0.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" F White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander 31 f Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Wayne and Gladys Valley Foundation USD$ 30,000.00 Sunstate Equipment Foundation USD$ 2,000.00 Community Donations USD$ 102,933.00 City of Pleasanton USD$ 15,000.00 City of Dublin USD$ 20,000.00 Total USD$ 169,933.00 Funding Uses/Expenses Budget Amount Salaries USD$ 169,933.00 Total USD$ 169,933.00 Amount Committed USD$ 30,000.00 USD$ 2,000.00 USD$ 102,933.00 USD$ 134,933.00 Amount Committed USD$ 134,933.00 USD$ 134,933.00 Budget Narrative Volunteer Services and Grief Support Services are separate departments within Hope Hospice, each with its own program manager. These programs both operate separately and collaborate together as needed, such as with volunteer grief facilitators for the grief support groups. As a Medicare -certified agency, only clinical services such as those provided by our registered nurses, home health aides, social workers, and chaplains are Medicare and insurance reimbursed, but this stops when the patient dies. Family support continues for up to 13 months after the patient dies, and community support is ongoing with no reimbursement source. Many of the dementia support and grief support services are conducted by trained volunteers who are supervised by skilled staff. These services are offered to the community at no charge and supported only by donations and grants. Staff Costs: Manager of Volunteer Services/staff $85,771 Grant Allocation/Yearly Cost: $10,000 (1/2 Grant Total) Percentage of Total Cost Covered by Grant: 11 % 31E Director of Grief Support Services/staff $84,162 Grant Allocation/Yearly Cost: $10,000 (1/2 Grant Total) Percentage Total Cost Covered by Grant: 12% Documents top Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests Y. Program Expense Budget Form download template Financial Information Form for ALL Grant Requests U Financial Information Form - Project download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Agency Budget Copy of most recently submitted IRS 990 form or Tax 0 IRS Nonprofit Designation Return (include complete form) Board of Director's (or governing body's) designation 0 Designation of official of authorized official Board of Director's (or governing body's) authorization 0 Authorization to Request Funding to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Workers Compensation and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 State and Federal Determination Letter DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) Annual Report 32( * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 427557 Become a fan of ZoomGrantsTM on Facebook Problems? Contact us at Questions;)ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 321 INEmail This Preview Save as PDF Print Close Window A♦ IT16 DUBLI N C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Legal Assistance for Seniors Legal and Supportive Services, Medicare Counseling and Education for Dublin Seniors Jump to: Organization Information Questions Budget Documents USD$ 10,000.00 Requested Submitted: 1/20/2023 10:21:31 AM (Pacific) Project Contact Caitlin Chan cchanCcDlashicap.org Tel: (510) 832-3040 x316 Additional Contacts none entered Organization Information top 1. Business License Number BL-110718 Questions top Legal Assistance for Seniors 333 Hegenberger Road Suite 850 Oakland, CA 94621 United States Interim Executive Director Caitlin Chan cchan(a)lashicap.org 1. Select the category that best describes your organization: (Select only one.) Non -Profit LJ Public Agency ❑ Other: Telephone(510) 832-3040 x316 Fax (510) 842-1080 Web www.lashicap.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). The mission of Legal Assistance for Seniors is to ensure the independence and dignity of seniors by protecting their legal rights through education, counseling and advocacy. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 41 Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 32e' operatioi LJ Yes '. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Legal Assistance for Seniors (LAS) will provide free legal services, community education, and health insurance counseling to Dublin's older adults. LAS' legal program will serve elder abuse survivors and those needing legal help with guardianship, naturalization, public benefits, health law and housing. Legal services include representation in court and administrative hearings, legal advice and counsel and referrals to other resources. Legal services are both responsive and preventative. Clients often seek help for an acute problem such as needing a restraining order to protect them from physical abuse (responsive). At the same time, LAS will also help the client prevent future harm, for example, by assisting them in executing a power of attorney (preventative). LAS will also provide free community education and outreach to older adults, their families, and service providers. Presentations include 'How to Get Help with Health Care Costs,' 'Navigating Medicare for LGBT Beneficiaries,' and 'Basic Housing Rights for Seniors,' and more. Finally, the Health Insurance Counseling and Advocacy Program (HICAP) will provide free individual counseling on Medicare and related health insurance issues. State -registered volunteer HICAP counselors help older adults and people with disabilities enroll in Medicare, supplemental and prescription drug plans, and apply for cost -saving programs. Counselors also assist clients in resolving coverage issues, referring to LAS' legal program if further help is needed. Legal Services are primarily provided by phone, video conferencing and text, though attorneys will meet with clients at their home or in our Oakland office on a case -by -case basis. HICAP services are similarly provided. Our community education program restarted in -person seminars during Summer 2021 at the Dublin Senior Center and Dublin Ranch Senior Apartments. These services are provided monthly, and we also provide them via video to those seniors who prefer to stay at 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Though as a percentage, Dublin's senior population aged 65 and older held steady between the 2010 and 2020 census, at 9.4%, the absolute number of seniors grew by approximately 2,400 residents because of the City's overall population growth (US Census). Along with the growth of the older adult population in general, the growth of low-income older adults also continues to climb. The Eastern Alameda County Human Services Needs Assessment notes that along with the growing older adult population and the rise in poverty, the demand for human services is also growing, especially since older adults are often more dependent on such services. Specifically, the Dublin Housing & Human Services Grant Priorities include services to keep seniors housed and safety net access for seniors. LAS addresses these needs so older adults, especially low-income older adults, can live with greater independence and dignity. LAS' housing program assists older adults at risk of homelessness, both through legal advice and representation. To help older adults access safety net programs, LAS provides public benefits legal assistance, ensuring older adults are receiving all benefits for which they are eligible, including Social Security, Supplemental Security Income (SSI) and Medi-Cal. LAS' Health Insurance Counseling and Advocacy Program (HICAP) also helps older adults apply for cost -saving programs and Medi-Cal. In the past year, LAS served 293 housing legal clients. Of those clients, 92% were low income. The racial demographic of those clients included 58% people of color, with 6% being non-native English speakers. In addition to legal services, 22 clients received case management to help stabilize their housing. Without support from the City of Dublin, we might not be able to serve as many individuals from the area. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 172 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956IApplication-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing Y'. Health Care (including dental) ❑ Workforce Development 32; Y: Homelessness Transportation Services and Access Y'. Domestic Violence and Child Abuse : Disabilities LJ Food and Nutrition : Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above Y'. Please explain: Senior services for elder abuse, eviction defense, health coverage. Culturally competent services, accessible for people with disabilities. 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The proposed funds from the City of Dublin will be used to provide free legal services, community education, outreach, and HICAP counseling to Dublin's older adults. Services will be focused on low- or extremely low-income older adults. LAS continues to provide the majority of its legal and HICAP services remotely as our agency continues to view the COVID public health epidemic as a serious threat to the health and well-being of our clients, most of whom are seniors. Though most HICAP and legal client meetings are through phone or video conference, clients with heightened needs, or those who would fare better with in -person consultation, are met with by staff at their home or at our Oakland offices, following all safety protocols. Staff will also pick up paperwork from clients' homes in order to avoid unnecessary court delays. In addition, because some court hearings are still conducted remotely, staff work with clients to prepare them for the remote hearing. LAS' community education program resumed monthly in -person presentations in Dublin beginning in the Summer of 2021. We will continue providing these services at the Dublin Senior Center and Dublin Ranch Senior Apartments. These presentations are also offered online for those individuals who find it either more convenient or safer to do so from their homes. Our community education department continually reaches out to organizations in Dublin and surrounding areas, including the Dublin Senior Center and Creating New Hope, to offer webinars and outreach materials. LAS staff attends the Tri-Valley Service Providers Meetings on a monthly basis. Our attendance has allowed us to work closely with each city and coordinate presentations and share information and updates. During the Fall 2022 Medicare Open Enrollment period, LAS partnered with Open Heart Kitchen, which serves meals in Livermore, provide materials about our services to ensure outreach to individuals who may be unaware of our services or who are not able to access them digitally. Funds from the City of Dublin will contribute to salaries for LAS' program staff, including staff attorneys and advocates. Funds will also be used for postage, phones, rent, and outreach activities, plus materials expenses such as printing costs for legal cases. COVID-19 has not impacted the range of services offered but has significantly impacted the time required per case. Arranging meetings and gathering documents, signatures and witnesses are all taking longer, meaning a greater amount of staff time and resources are spent on every case. Funding from the City of Dublin is critical to continue this high level of remote service. The loss of any city funds could reduce the number of Dublin clients we are able to serve. To ensure services are provided in a cost-effective manner, LAS works extensively with volunteers who provide both overall program support and direct services to clients, with supervision and support from program staff. For example, LAS currently has 30 extensively trained and state -registered volunteer HICAP counselors who provide hundreds of hours of service per year. Additionally, 10 paid staff counselors provide supervision and support to the volunteers. In addition to providing individual health insurance counseling, a select number of LAS' HICAP counselors also provide community education and translation services. LAS also works with legal interns and summer law clerks to provide support to the legal program, including legal research, writing, and intake. Because LAS has provided legal, educational, and HICAP services in Dublin for many years, we are able to base the current year's budget on past results. This helps to ensure that the current budget will meet the needs of the anticipated results. Further, the project budget is also leveraged with additional county grants. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. 324 What results do you expect to have achieved at the end of this grant? LAS will provide services to a total of 172 unduplicated Dublin older adults across the legal services, HICAP and community education departments. While services are available to residents of any income, LAS focuses its efforts on serving low-income clients, including conducting outreach in low-income areas and partnering with other agencies that serve low-income communities. Legal services will be provided to 7 Dublin older adults. LAS' legal services program will provide free services in the areas of elder abuse, health law, public benefits, guardianship, naturalization, housing, and general legal services for those needing assistance in other areas. Services will be provided to Dublin residents age 60 and older, or 50 and older for guardianship. For elder abuse, LAS will assist those over age 65, or dependent adults of any age. Services range from legal counsel and advice to full representation in court, depending on the client's situation. LAS' HICAP will provide free individual HICAP counseling to 40 Dublin Medicare recipients. While most Medicare recipients are older adults, LAS will also provide HICAP counseling to younger individuals who are eligible for Medicare due to disability. LAS will also provide 12 community education presentations and/or outreach events, reaching a minimum of 100 Dublin residents. These presentations will be targeted to Dublin older adults, pre -retirees, caregivers, and senior and disability service providers. Presentations will cover a wide variety of topics that are relevant to older adults' lives, including health care, avoiding scams and fraud, hiring and working with caregivers, public benefits, and more. LAS evaluates success through the lens of our mission: was the client able to retain their independence, safety, and dignity because of the intervention we provided? We collect these case outcomes by entering each client's information into a database, including the level of service provided, the result of the case, and whether the client recovered or saved any funds as a result of the case. Specifically for housing, the evaluation is focused on whether the client was able to retain housing with the supports and services necessary to make that housing permanent. We request feedback from our clients at the conclusion of services, including whether they felt supported and had their concerns addressed. Our goal is for every client to feel satisfied with the service they received, even if their case could not be resolved in their ideal manner due to outside factors. In addition to client feedback, LAS also consults with its community partners periodically to evaluate how we may be better able to serve their communities. We also evaluate our client data using equity, diversity and inclusion metrics. To measure whether desired legal and HICAP outcomes were achieved, LAS' managing attorney and HICAP manager review case notes for all completed cases, which are written by the staff or volunteer assigned to the case and include the client's goals, actions taken, and the outcome of the case. Examples of legal outcomes include obtaining an elder abuse restraining order, preventing eviction, obtaining guardianship of a minor in the client's care, or restoring a client's public benefits. HICAP outcomes include a client successfully enrolling in a Medicare Part D plan or submitting an application for a cost -savings program. To measure effectiveness of community education activities, participant evaluations are used to determine if the education was informative and increased knowledge of the subject. To measure client satisfaction, LAS' management team reviews completed client evaluations for all three programs. If there is any negative feedback, a member of the management team will follow up with the client to better understand the comments and determine whether the client needs further assistance. By the end of the grant, we expect to complete or exceed our program goals. We also expect most clients will achieve their desired outcomes. Finally, we expect that the vast majority of returned evaluations will indicate that clients were satisfied with the services received. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Legal Assistance for Seniors is committed to diversity, equity and inclusion (DEI) within our own organization. As part of this commitment, we expect to be more effective and impactful in our work for older adults in communities of color. LAS launched a DEI Client Data Group in 2021 to analyze our service programs and understand if our agency was meeting equity goals critical to serving the most vulnerable older adults in our community. This group focuses on understanding the demographics of clients served and looking to address any gaps in services that we find. The group pulls internal data, as well as reports from the local community, to do the analysis of whether the agency is reaching communities in need. The data is then presented to the full staff, so they can brainstorm outreach ideas to implement. Ideas have included more robust materials translation and distribution, as well as targeted outreach efforts. The program reviews shifts in client demographics quarterly, to see if additional program adjustments are required to meet goals. LAS also has an active Equity, Diversity and Inclusion (EDI) Committee comprised of staff from all branches of our agency, mainly focused on staff hiring, onboarding and staff development. LAS is prioritizing DEI leadership pipeline development in order to promote a more diverse leadership team. We have made great strides to increase the diversity of our senior staff. We are also contracting with a consultant to help our Board adopt a DEI lens for its work with the goal of helping them 32E understand how DEI is critical to their governance. LAS is focused on increasing diversity within our Board when new members are recruited. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Due to the pandemic, LAS has made great effort to provide enhanced remote services to our clients to protect the public's health. This has meant using phone interviews and email communications with legal clients and providing our HICAP and Community Education services on-line through video conferencing and webinar formats. In order to reach individuals who may not have access to technology, we have partnered with agencies like Meals on Wheels so that we leave no avenue of communication behind as we reach out to seniors in need. Substantively, LAS is well prepared to help Dublin tenants who continue to face housing instability linked to the COVID-19 pandemic. Particularly in matters related to unlawful detainers and negotiations with landlords, LAS' team of attorneys provide the services necessary to assist Dublin residents struggling to avoid displacement or homelessness. The anticipated outcome of these cases will be the preservation of client housing, which may be obtained through preventing pending evictions, negotiating more time and money for tenants to vacate their apartments, securing basic income, and reducing medical expenses to enable clients to afford rent, among other means. LAS supports both investment in housing and neighborhoods and legal services as part of its application to the City of Dublin. Our housing legal services program handled almost 300 cases countywide in Fiscal Year 2021-22. Of our legal services clients, the vast majority were women, 65 or older, persons or color, and low-income residents. Additionally, LAS' Community Education program includes timely and unique presentations for senior tenants who may be struggling, including: "Basic Housing Rights for Seniors" and "Protecting Your Home Equity: PACE Loans, Reverse Mortgages, and Other Common Risks." 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? Y: Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. LAS does not allow language to prevent clients from meaningfully accessing services. Our Language Access Plan states that all program notices include a statement that translators will be available upon request for presentations, meetings, and all other client activities. To encourage limited English-speaking residents to access LAS' services, we coordinate with partnering agencies that specialize in serving monolingual older adults whenever possible. For example, prior to COVID-19, we maintained Medicare counseling and community education sites in Alameda County serving predominately Latinx and Asian seniors. Although we had to pause in -person services due to the pandemic, we maintained our partnerships with these community sites to disseminate outreach materials to their clientele. LAS also outreaches to limited English speaking residents by making program materials available in various languages. We use translators to review any materials created and translated by LAS for accuracy. LAS also uses government documents for HICAP counseling that explain Medicare in multiple languages. In the past, we have provided written materials in Chinese, Farsi, Korean, Spanish, Tagalog, and Vietnamese. LAS recruits and trains HICAP counselors whose ethnicities reflect the diverse communities that we serve. It is common for LAS to have HICAP counselors that speak Cantonese, Mandarin, Spanish, Korean, Hindi, and Punjabi. LAS uses a telephone interpreter service (Language Line Solutions) for its legal and HICAP counseling services, which provides translators in 240 different languages, including American Sign Language. LAS also arranges interpreter services with the courts in legal cases to ensure a translator is available. In addition, LAS uses bilingual staff and volunteers to provide translation for all its services. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Y: Be culturally accessible, appropriate and inclusive 32E Y Encourage community engagement and involvement ❑ Promote energy and resource efficiency Y'. Encourage networking and information sharing across service providers : Encourage process streamlining ;.' Consolidate service delivery LJ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) .*.!'. A) Housing LJ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. .': Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. Y'. B) Homeless Y'. Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. '.*!'. D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Y'. Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing Y Strengthen Communities ❑ Ensure Equal Opportunity in Housing '. Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') Y'. Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') ❑ Availability/Accessibility ❑ Affordability .''. Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 321 0. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. LJ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. LJ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ;.: Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) Yi Persons ❑ Households Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 7 Seniors (62 and older) 32E 4 People with Disabilities 3 Female -Headed Households Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 14.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process L 1 Extremely Low Income (<30% AMI) 6 Very Low Income (30%-50% AMI) Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) 7.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 2 White White + HISPANIC 2 Black/African American Black/African American + HISPANIC 2 Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC 1 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY 0 #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. 32E LJ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Government/State of California Office of Emergency Services USD$ 123,600.00 USD$ 61,800.00 Government/Alameda County Social Services Agency: Title IIIB Legal Services, General USD$ Revenue, Adult Protective Services, Title VII, HICAP, MIPPA, Department of Children 1,312,849.00 and Family Services (DCFS) and OAAR. Government/Contra Costa County HICAP USD$ 8,000.00 Government/Cities of Alameda, Dublin, Fremont, Hayward, Livermore, Pleasanton & USD$ Union City 114,792.00 Corporation/State Bar of California: IOLTA, EAF, Housing Preservation, Homelessness USD$ USD$ Prevention, EAP Guardianship, EAP Limited Conservatorship & Bank Grant. 282,981.00 133,579.00 Foundations/Corporations: San Francisco Foundation, Bigglesworth, CHA, Hindu Community & Cultural Center, Stern Memorial Trust, VLS/Rembe Rock, West Davis & USD$ USD$ Bergard, Bernard E &Alba Witkin Charitable Foundation, Senior Assistance Foundation 404,909.00 205,500.00 East Bay (SAFE Court Awarded Fees USD$ 100,000.00 Individual Donations, Annual Appeal, Fundraising Event USD$ 222,500.00 Elder Abuse Conference sponsorships & registration fees USD$ 25,000.00 Other Revenue/Revenue Released from Restrictions USD$ 780,000.00 Total USD$ USD$ 3,374,631.00 400,879.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel: Salaries" (see instructions below) USD$ USD$ 1,904,872.00 233,706.00 Personnel: Benefits* (see instructions below) USD$ 455,773.00 USD$ 55,918.00 Operating: Supplies USD$ 21,779.00 Operating: Printing USD$ 5,857.00 Operating: Postage USD$ 9,367.00 Operating: Telephone USD$ 34,351.00 Operating: Rent and Occupancy Building and Maintenance and Repair USD$ 365,895.00 USD$ 44,891.00 Operating: Accounting/Audit/Payroll Fees USD$ 38,995.00 USD$ 4,784.00 Operating: Bank Charges/Taxes and Filing Fees USD$ 2,969.00 Operating: Contracted Services: Accounting, Information Technology, General, FR/Elder USD$ USD$ Abuse Conference Food& Entertainment 353,376.00 43,355.00 Operating: Insurance/Dues & Memberships/Subscriptions & Publications/Client USD$ USD$ Litigations Costs/Advertising. 114,204.00 14,012.00 Operating: Computer Supplies/Computer Software/Equipment Lease & USD$ 34,337.00 USD$ Rental/Depreciation. 4,213.00 Operating: Training & Seminar Fees/Recruitment/Travel/Volunteer Recognition. USD$ 32,856.00 Total USD$ USD$ 3,374,631.00 400,879.00 33( Budget Narrative Legal Director (1% @ $99 p/mo/$1,197 per annum); 3 Supervising Attorneys (each @ 1%, $64 p/mo/$767 per annum each = $2,301), 4 Staff Attorneys (each @ 1 %, $57 p/mo/$684 per annum each = $2,736); Advocate (1 % @ $27 p/mo/ $644 per annum) and Community Educator/Advocate (1 % @ $52 p/mo/$622 per annum). Fringe Benefits include FICAer (7.65%), SUI & workers compensation (1%), health/dental/vision/life insurance (10.85%) and retirement/benefit plan fees (3%) for a total of $1,685 (22.5%). Actual agency fringe benefits are approximately 27%; the remaining 4.5% of benefits for staff salaries will be underwritten by the agency. Operating expenses include only rent ($815). The requested grant amount represents less than .02% of the total LAS agency budget. Our program services of legal assistance (guardianship, elder abuse prevention, immigration/naturalization, housing & public assistance), HICAP (Health Insurance Counseling and Advocacy) and community education presentation of these matters to the general public as well as assistance providers are all services that our agency provides to all Alameda County residents that enables their ability to live independently in safety and with dignity. In addition, LAS recognized in fiscal year 2021/22 in kind volunteer service hours (1414) of combined attorneys and advocates with a value of $70,700. In addition, HICAP volunteer counselors provided 2,823 volunteer hours. Documents top Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests '❑ Financial Information Form download template Financial Information Form for ALL Grant Requests 0 Program Expense Form download template List of Board of Directors (or governing body) with 0 Board Roster agency contact information Current Annual Budget for the Entire Agency 0 FY2022-23 Board Approved Agency Wide Budget Copy of most recently submitted IRS 990 form or Tax 0 990 Form Return (include complete form) Board of Director's (or governing body's) designation 0 BOD Authorization of authorized official Board of Director's (or governing body's) authorization 0 BOD Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability ❑ 2022-23 GL and Auto Certificate of Insurance and/or workers' compensation 2022-23 WC Certificate of Insurance STATE AND FEDERAL NON-PROFIT ❑ IRS Determination Letter DETERMINATION LETTER. All organizations MUST State of CA Franchise Tax Determination have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section 0 FY2022-23 Board Approved Agency Wide Budget Personnel Policies Audit Requirements 331 REQUIRED FOR CDBG ONLY - Articles of Articles c Incorporation and Bylaws By Laws REQUIRED FOR CDBG ONLY - Conflict of Interest Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S Language Access Plan LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 425848 Become a fan of ZoomGrantsT" on Facebook Problems? Contact us at QuestionsZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logou[ I Browser 33"9 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Lions Center for the Visually Impaired Dublin Seniors Vision Health Jump to: Organization Information Questions Budget Documents USD$ 7,500.00 Requested Submitted: 1/17/2023 8:48:57 PM (Pacific) Project Contact Yolanda Braxton ybraxton(a lcvi.org Tel: 925-432-3013 Additional Contacts none entered Organization Information top 1. Business License Number Pending Questions top Lions Center for the Visually Impaired 175 Alvarado Avenue Pittsburg, CA 94565 United States Executive Director Yolanda Braxton ybraxton a-lcvi.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone 925-432-3013 Fax 925-432-7014 Web www.LCVI.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our Mission is to preserve vision, foster independence and enhance the quality of life for adults who are blind or at risk for vision impairments and to serve as a trusted source of information and expertise on blindness in the community. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 33; J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Dublin Seniors Vision Health will provide supportive services to seniors who are blind and visually impaired in City of Dublin. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) It is extremely difficult for older adults to maintain their health if they are unable to see well enough to read labels on their medication, prepare meals safely or get themselves to medical appointments. Based on statistics from the American Institute for the Blind as well as data from the US Census, we estimate at least 790 seniors in the city of Dublin are living with significant visual impairment -impairments; severe enough to need training in orientation, mobility, and independent living skills in order to maintain their independence and quality of life. The number of blind adults is expected to increase dramatically in the next five to ten years as the population ages. In fact, the Federal Department of Rehabilitation, Older Adults who are Blind estimates that there will be a 200% increase in blindness in adults 65 and older. This increase is borne out in a rising demand for the services we provide and is reflected in our service statistics. With targeted outreach efforts we have made and will continue to make significant strides in serving more Native Americans, Hispanics/Latinos Americans, Asian Americans, and African Americans; in the next several years we would like to expand our targeted outreach to include more cultural -ethnic groups, as well as LGBTQ+, Veterans, and Homeless as they make up a significant part of the population. We have conducted and will continue to focus our outreach efforts with a focus on vulnerable seniors with vision disabilities. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 15 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness Transportation Services and Access ❑ Domestic Violence and Child Abuse Y: Disabilities ❑ Food and Nutrition Y'. Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance LJ None of the Above Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Funds will be used to expand our vision health services throughout the city of Dublin, specifically for staffing. The following staff will administer the Dublin Seniors Vision Health program: Executive Director Manager of Operations Orientation & Access Services Manager EDP Vision Screening Coordinator 334 Activities & Marketing Coordinator Vision Health Outreach Coordinator Office Coordinator Our professional staff (orientation and mobility teacher and outreach/vision specialist) provide one-on-one in -home assessment, orientation and training to adults with vision impairments helping them to make the best possible adjustment to their vision loss so that they regain or maintain independence and dignity for as long as possible. Practical, professional help includes teaching clients how to shop and cook safely so they can maintain good nutrition, training them to use white canes and public transit to cross streets and travel safely in their community, teaching them how to manage their medications even when they are unable to see the labels, provide visual aids (such as lighted hand magnifiers), giving them instructions in adaptive living skills such as personal grooming, housekeeping, and financial management and linking them to peer support groups, and activities so they can maintain good mental and emotional health. Staff and outreach materials in Spanish, Chinese, Punjabi, Tagalog ensure that services are culturally appropriate and accessible for those with limited English. When a person loses their vision they tend to stay at home where they feel safe. The idea of leaving their home is very frightening, but social isolation and inactivity often leads to boredom, depression, and self -hurt. In addition to home visits by our staff we also regularly sponsor group classes and activities in order to meet our clients' need for recreation and socialization and even provide clients with vouchers for free transit to encourage their participation. These activities include one adult day program tailored for the visually impaired and other programs such as arts & crafts and exercise and field trips. Our center sponsors Support/Discussion groups by professionals (our own staff) at sites throughout the city to help clients share their personal fears, anger and frustration and receive practical tips and support from their peers. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The goal of Dublin Seniors Vision Health, indeed all our services is to preserve functional eyesight and prevent further vision loss, foster independence and safety for visually impaired seniors and improve their quality of life. We know that our services are successful with our target population as it shows in our quantitative and qualitative evaluation process, and with feedback from our consumers. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision From reflections on our Board of Directors, to staff, to the community we serve, LCVI has always embraced all who are in need of our supportive services. We ensure that our outreach efforts are reflective of the population we serve and that our high quality services from one-on-one to print materials and excursions reflect the cultural needs of the population. We serve with kindness and provide all of our resources free of charge to benefit those who are experiencing financial insecurity. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. As an organization we have experienced the impact of the COVID-19 pandemic. As a result, our services are hybrid, thus if any senior choose to utilize onsite or virtual options, both are available, and they are still able to have their vision health needs met. Post -pandemic, we continue to manage the most frequent and consistent barriers encountered for seniors who are blind and/or with visual impairments, including fear, transportation and lack of resources. Older adults often have mobility issues and other age -related challenges in addition to their visual impairment. This makes them fearful of venturing outside their own home, let alone traveling to an unfamiliar community. The paratransit systems in place are often inadequate and inconvenient. Despite offering free transportation to activities at LCVI facility, we have had limited success (although it has increased) in getting consumers from distant communities to come to our facility in Pittsburg for services. We have experienced greater success by bringing services to consumers in their homes. This is what sets us apart from other agencies and what has led to our success in serving the target population for in our program throughout the pandemic and beyond. Additionally, members of our target population are often not tech -savvy and are frequently afraid to try something new or are unable to develop new patterns of behavior. We have found that lots of patience on the part of staff is required to help consumers through the steep learning curve. This was most notable during the COVID-19 pandemic where we were able to successfully transition our consumers into virtual services. Lastly, the issue of insufficient resources continues to hinder us. The demand for our services grows every year as the Baby Boomers enter their senior years. The additional ARPA funds we may receive will allow much needed service expansion. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? 33! LJ Yes. If so, check box here and answer questions 14 through 25. Y: No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Our organization engages in an annual multi -cultural Outreach Campaign. This includes use of social and traditional media. We utilize multiple languages in print to engage in Outreach that is Residential, Faith -Based Organization Postcard related, Public Transportation (i.e., BART, Bus), Billboard and Reader Boards, Cell Phone Adverts, etc. Engagement with multiple senior centers, senior residential facilities, and community centers all are included. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: *!: Be culturally accessible, appropriate and inclusive Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers LJ Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Y: Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Public Services LJ Public Facilities LJ Rental Assistance LJ Affordable Housing LJ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing Y'. Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination '. Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: 33E an objective ask yourself, "What is the purpose of the activity"? What is the larger community ne 1 am seeking to address?') Y: Creating a Suitable Living Environment LJ Providing Decent Affordable Housing LJ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') Y: Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. : Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. LJ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. LJ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. LJ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. 33i ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) Y: Persons Households LJ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 15 Seniors (62 and older) 15 People with Disabilities Female -Headed Households Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 30.0(_ TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 3 Extremely Low Income (<30% AMI) 5 Very Low Income (30%-50% AMI) 7 Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) C 1500 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 1 7 White F 2 White + HISPANIC 3 Black/African American Black/African American + HISPANIC 3 Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC 33f American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 15.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. #4 - This program/project has the agency's 4th highest priority for funding. LJ #5 - This program/project has the agency's 5th highest priority for funding. LJ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Dublin USD$ 7,500.00 DOR-OIB-Title VII USD$ 177,000.00 Safeway Foundation USD$ 2,500.00 East Bay Community Foundation USD$ 11,000.00 Wells Fargo Foundation USD$ 20,000.00 NextFifty Initiative USD$ 137,000.00 Shirley Perry Foundation USD$ 79,000.00 SAFE Foundation USD$ 75,000.00 Mechanics Bank USD$ 2,500.00 San Francisco Foundation USD$ 100,000.00 Total USD$ 7,500.00 USD$ 604,000.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel: Salaries USD$ 354,000.00 USD$ 246,500.00 Personnel: Benefits USD$ 45,000.00 USD$ 45,000.00 Personnel ADP Management USD$ 15,000.00 USD$ 15,000.00 Operating: Supplies USD$ 77,000.00 USD$ 77,000.00 Operating: Printing/Copying USD$ 25,000.00 USD$ 25,000.00 Operating: Postage USD$ 15,000.00 USD$ 15,000.00 Operating: Telephone USD$ 15,000.00 USD$ 15,000.00 Operating: Accounting/Audit USD$ 20,000.00 USD$ 20,000.00 Contractual Services USD$ 45,000.00 USD$ 45,000.00 Total USD$ 611,000.00 USD$ 503,500.00 Budget Narrative The budget above provides an income and expense report of LCVI. We are requesting funds for staffing to assist with expansion of our Dublin Seniors Vision Health services within the City of Dublin. Documents top Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests❑ LCVI Expense Budget Template download template 33E Financial Information Form for ALL Grant Requests 21 LCVI Financial Information Template download template List of Board of Directors (or governing body) with 0 LCVI BOD List agency contact information Current Annual Budget for the Entire Agency 0 LCVI General Budget Copy of most recently submitted IRS 990 form or Tax 0 LCVI 990 FY20-21 Return (include complete form) Board of Director's (or governing body's) designation 0 LCVI BOD Authorization of authorized official Board of Director's (or governing body's) authorization 0 LCVI BOD Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 LCVI Insurance Certification and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 LCVI Federal & State Exemption Letters DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) 0 LCVI Audit FY20-21 * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 428367 Become a fan of ZoomGrants7m on Facebook Problems? Contact us at Questions5zoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGranls logo are trademarks of GrantAnalyst.com, LLC. L2g2jt I Browser 34( VZ9 DUBLIN C A L I F 0 R N I A Powered by ZoomGrantSTM and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Email This Preview Save as PDF Print Close Window A♦ Love Never Fails Economic Freedom with ITbiz Tech Academy USD$ 25,000.00 Requested Submitted: 1/18/2023 10:09:54 PM (Pacific) Project Contact Vanessa Russell vanessa@loveneverfailsus.com Tel: 16507765833 Additional Contacts none entered Organization Information top 1. Business License Number Questions top Jump to: Organization Information Questions Budget Documents Love Never Fails 6937 Village Parkway 2074 Dublin, CA 94568 United States Founding Executive Director Vanessa Russell vanessa anloveneverfailsus.com 1. Select the category that best describes your organization: (Select only one.) ^61 Non -Profit ❑ Public Agency ❑ Other: Telephone16284009230 Fax Web www.loveneverfailsus.com 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). We exist to empower all people to express and experience their best sense of humanity. We do that by restoring, educating and protecting survivors of human trafficking and their community. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project :e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ❑ Yes Y'. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). LNF seeks City of Dublin CDBG funding to support our ITbiz Tech Academy Program. IT Biz is a California certified Cybersecurity and Networking Pre - Apprenticeship Program, Cisco Network Academy, and Department of Rehabilitation Program. We introduce survivors of human trafficking and other no/low- income residents to technology by providing them industry certification training. We also provide business attire, mock interviews, and resume writing, interviewing technique, public speaking, and financial literacy classes, taught by people who are culturally relevant and have experienced interpersonal violence. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) 46.4% of families living in poverty in Dublin are single parent homes. In addition, teens and Transitional Aged Youth (TAY) ages 16-24 are also highly impacted by poverty in Dublin. (City Data - https://www.city-data.com/poverty/poverty-Dublin-California.html#:-:text=4.0%25°/`20of%2ODublin%2C%20CA% 20residents%20had%20an%20income,of%20non%20high%20school%20graduates%201ive%20in%20poverty. ) 341 Our ITbiz program was designed to achieve our mission by creating a bridge between Dublin's low-income residents, like these impoverished single parent families and youth, and the IT industry. We are well equipped to work with vulnerable populations. In 2022 our students were 98% Low Income, 72% Women and 87% BIPOC (47% Black, 25% Hispanic, 15% Native American, Pacific Islander, etc ). With CDBG funding, we will recruit and train 5 low-income residents and prepare them for paid internships with companies throughout the bay area such as Corporate E-Waste Solutions or externships with Google. They will also have access to apprenticeships with Bitwise. Bitwise and LNF work together to provide paid apprentices a full-time sustainable wage for 12 months while preparing for positions as Application Developers, Salesforce Administrators, CyberSecurity Technicians, Project Managers, Tech Support Specialists, Inside Sales reps, Call Center Agents, Online Marketing Specialists, and UX Designers. We are also placing some of our graduates directly into permanent positions at corporations such as BlueShield, Deloitte, Cisco, Verizon, Oomitza, Accenture, etc via our relationships with OneTen, YUPRO, etc. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 5 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) .I❑ Affordable Housing .I❑ Health Care (including dental) .I❑ Workforce Development J❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse '❑ Disabilities ❑ Food and Nutrition ❑ Senior Services ?] Youth Services 21 Child Care, Early Childhood Development and Education 0 Changing Demographics and Growing Diversity 0 Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) This grant will be used to fund 5 seats in our ITbiz Tech Academy. Each seat funds a portion of the salaries for two instructor, Sr. Program Director, a Job Developer and Tech Coordinator. It also provides each student access to case management for barrier removal, cloud -based training platform, incentives for the students which can be used for Wi-Fi, transportation, etc., business attire, resume writing, interviewing techniques, life coaching, and a paid internship. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Each student will reach the following milestones as part of program success metrics: (1) Complete at least three Cisco Systems, AWS, or Google certification courses (2) College credit for completing the program (3) Business attire (4) A paid internship (5) Have a professional resume and/or visume upon course completion (6) Complete multiple mock interviews with industry professionals (7) Black students will be enrolled in OneTen Talent Placement system. They are chartered to place 1 million black talent without four-year university degrees in family sustaining careers. (8) All students will be enrolled in YUPro Talent Placement system (9) Bi-weekly Life coaching We also survey all students for feedback on every aspect of our program and make adjustments along the way to ensure that their needs are met. At the completion of the program, we expect 100% of the students to complete a paid internship, apprenticeship or placement. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Love Never Fails vision directly aligns with the City of Dublin. We are also committed to Diversity, Equity, Inclusivity, Safety, Innovation, etc. Specifically in the area of Diversity, Inclusivity, and Equity our program was designed to address gaps in the IT industry. According to the Dept of Labor only 25% of the IT industry are women and only 3% black and 2% Latinx. Our goal is to address these disparities by training non-traditional people for the tech industry using culturally, experientially, and racially relevant instructors and staff. 92% of LNF staff are survivors of interpersonal violence (IPV). Our instructors are BIPOC survivors of IPV, our management are survivors of human trafficking and domestic violence. Most of our staff have the lived experience of being a single parent or a TAY youth living in poverty. We are proud to exemplify the endless possibilities for our students regardless of their previous experiences. We also have a training program for employers, organizations and churches called REDI an acronym which stands for Racial Equity Diversity and Inclusion. This program has been delivered to several businesses as part of our internship program to ensure that the environment is REDI to recruit, onboard and retain diverse candidates. 34'9 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. During the pandemic we shifted all of our classes online and ramped up our programming so that those who lost their physical jobs would be retooled to access digital careers as customer service reps, sales reps, engineers/technicians, project managers and entrepreneurs. If additional funding were available, we could educate more low-income community members who have lost their jobs as a result of COVID. It is extremely important that everyone have access to the digital economy. Just taking our Cisco technology 101 class prepares youth, adults and Seniors to access information on benefits, medical info, food sources, housing opportunities etc. online. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? r1❑ Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Our staff speaks english and spanish and we use Alameda County's Language Access Line for other languages such as Arabic, Russian, Tagalog, Vietnamese, etc. Also, our IT training platforms support multiple languages such as Spanish, Arabic, French, Portuguese, etc. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: 0 Be culturally accessible, appropriate and inclusive 0 Encourage community engagement and involvement ❑ Promote energy and resource efficiency 0 Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless 1 Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. 0 Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing 0 Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination 0 Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that I am seeking to address?') ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing 0 Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 34' 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP. When selecting an outcome ask yourself, "What type of change or result am I seeking?') ❑ Availability/Accessibility ❑ Affordability r❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. 0 Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee -sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 0 Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) People with Disabilities 3 Female -Headed Households 1 Youth 1 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 5.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 1 Extremely Low Income (<30% AMI) 4 Very Low Income (30%-50% AMI) 344 Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 1 White 1 White + HISPANIC 1 Black/African American 1 Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC 1 Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 5.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ❑ #1 - This program/project has the agency's highest priority for funding. J #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Microsoft USD$ 100,000.00 USD$ 100,000.00 James Irvine Foundation USD$ 375,000.00 USD$ 375,000.00 Department of Violence Prevention USD$ 100,000.00 USD$ 100,000.00 Alameda Adult School USD$ 25,000.00 USD$ 25,000.00 CROP USD$ 75,000.00 USD$ 75,000.00 Total USD$ 675,000.00 USD$ 675,000.00 Funding Uses/Expenses Budget Amount Amount Committed Sr. Program Manager USD$ 66,000.00 USD$ 66,000.00 Lead Instructor USD$ 65,000.00 USD$ 65,000.00 Instructor USD$ 47,840.00 USD$ 47,840.00 Job Developer/CAse Manager USD$ 55,000.00 USD$ 55,000.00 Tech Coordinator USD$ 28,600.00 USD$ 28,600.00 Life Coach USD$ 156,000.00 USD$ 156,000.00 Incentives USD$ 60,000.00 USD$ 60,000.00 Internship USD$ 150,000.00 USD$ 100,000.00 Business Attire USD$ 5,000.00 USD$ 5,000.00 Facility USD$ 38,400.00 USD$ 38,400.00 Overhead (insurance, accounting, etc.) USD$ 124,000.00 Fringe Benefits USD$ 45,181.00 Total USD$ 841,021.00 USD$ 621,84o.34! Budget Narrative Our 2022 budget of $2.4M and draft 2023 LNF Budget of $3.2M includes the program budget listed above. We will serve 100 students in 2023 and want to include 5 from Dublin. Each student will receive training, business attire, resume writing, interviewing techniques, case management for barrier removal (see our barrier removal inventory https:Hstatiel.squarespace.com/static/5417aa5ae4b0096c9Ol9daf7/t/63017dff5Oa3Ol237d6l8d2e/1661042175970/Barrier+Breakers+and+Bridge+Makers+2022.pdo , $100 incentive for every technology certificate they complete (there are up to 6 available), job placement services, bi-weekly access to life coaching, and a paid internship. Love Never Fails provides housing for many of our ITbiz program participants. This represents a much larger portion of our budget. Together workforce development and housing provide our students to long term financial freedom. Documents top Documents Requested Program Expense Budget for ALL Grant Requests download template Financial Information Form for ALL Grant Requests download template List of Board of Directors (or governing body) with agency contact information Current Annual Budget for the Entire Agency Copy of most recently submitted IRS 990 form or Tax Return (include complete form) Board of Director's (or governing body's) designation of authorized official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability and/or workers' compensation Required? Attached Documents r❑ Program Expense Budget 0 Finance Information 0 Board of Directors ❑ 2022 Budget 0 990 0 LNF BOD Cert 0 LNF BOD Cert 0 Proof of Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. '❑ IRS Determination Letter All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) " ZoomGrantsTM is not responsible for the content of uploaded documents. Policies Audit Articles of Incorporation Policies LAP Strategic Plan Application ID: 428322 Become a fan of ZoomGrants'^^ on Facebook Problems? Contact us at Questions5Zo Grants.com ©2002-2023 GrantAnalyst.com. All rights reserved. 'ZoomGrants' and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 34( s�� DUBLIN C A L I F 0 R N I A Powered by ZoomGrants'" and Email This Preview Save as PDF Print Close Window A♦ City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Open Heart Kitchen Senior Meal Program Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2023 3:26:43 PM (Pacific) Project Contact John Bost executived i rector(ai)o oe n hea rtki tc h e n .org Tel: 925-580-1616 Additional Contacts heather@open heartkitchen.org,tayl or@ope n h ea rtkitchen. org, d en ise@open hea rtkitchen. org,j oh n@open hea rtkitchen. org Organization Information top 1. Business License Number BL-009270 Questions top 1. Select the category that best describes your organization: (Select only one.) 21 Non -Profit Public Agency Other: Open Heart Kitchen 1141 Catalina Drive #137 Telephone(925) 580-1616 Livermore, CA 94550 Fax United States Web www.openheartkitchen.org Executive Director John Bost ohnna ooenheartkitchen.ora 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our mission is to provide equitable access to nutritious food today, while building a food secure tomorrow. We offer three free prepared meal programs to the community: the Hot Meal program, the Senior Meal program, and the Street Outreach program. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ❑ Yes d❑ No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Open Heart Kitchen serves senior citizens healthy meals made with their dietary needs in mind, Monday through Friday at the Dublin Senior Center. All meals are prepared fresh daily and offered free of charge. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Open Heart Kitchen is seeking funding for the Senior Meal Program conducted in Dublin, which fills the nutritional gap for low-income people over 60. According to the City of Dublin's 2021 study, over 15% of Dublin's population is over 60. Household expenses such as rent, utilities, healthcare, and groceries are constantly rising, leaving our community vulnerable to food insecurity. Our free and nutritious meals are available to be enjoyed onsite in our dining rooms, or taken to go, and offer peace of mind to guests who are struggling to juggle expenses on a budget. Our meal program follows guidelines established by the California Department of Aging to address the nutritional needs, and gaps, of senior diners. According to a study by the Older Americans Act, participants in programs such as ours receive 40% of their daily calories and 35-47% of their daily recommended nutrition intake by eating these meals. The Open Heart Kitchen Senior Meal Program in Dublin saw an increase from-14,800 meals served in FY19-20 to-46,800 meals served in FY21-22. A key benefit of our Senior Meal Program is the social interaction with peers and our teams. Interacting with our friendly staff and volunteers help combat the loneliness that many of our senior diners experience. Our staff takes the time to get to know new diners and introduce them to fellow seniors to promote socialization and connection. If we do not receive funding, access to healthy meals for seniors will decrease. Some seniors just don't have the energy or the skills to shop for budget -friendly groceries, prepare healthy meals, and clean up. It's not uncommon for seniors to rely on frozen meals and processed foods that are convenient, but unhealthy. We have had our senior diners tell us that when they eat out meals, they don't get sick. They say that they have to be careful everywhere else they eat, but they can always rely on our food to be healthy and appropriate for their diet. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 605 341 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov/1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities d❑ Food and Nutrition 21 Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above ❑ Please explain: Our program provides prepared meals to seniors that follow strict nutrition guidelines established by the California Department of Aging. 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The grant will address food insecurity in Dublin and increase access to food assistance through the distribution of free prepared meals to underserved community members, including low-income seniors. The grant funds will be used to purchase the food and supplies used in the Dublin Senior Meal Program, as well as program staff salaries. Throughout the year, Open Heart Kitchen utilizes donated food and holds virtual food drives in an effort to reduce the amount of food purchased. We are a member of US Foods' Premier Group Purchasing Organization, which takes advantage of group purchasing pricing and a rebate program for food purchases. Open Heart Kitchen is also a member of the local affiliate of Feeding America, the Alameda County Community Food Bank. As a member agency, Open Heart Kitchen is able to purchase food from the Alameda County Community Food Bank in bulk below wholesale prices. Open Heart Kitchen purchases food from a variety of partners and suppliers in order to provide the consumers with the greatest cost savings while maintaining high quality and diversity. Our Dublin Senior Center team is composed of a Site Supervisor and a Food Service Assistant who oversee a team of volunteers. The Site Supervisor, who is ServSafe certified, has built a career in the restaurant industry managing front and back -of -house teams. The Food Service Assistant, who is also ServSafe certified, is a Registered Dietician with a Masters in Nutrition. The Strategic Planning Committee of Open Heart Kitchen develops and assesses program objectives, including meal counts, to monitor program effectiveness. The Open Heart Kitchen Board of Directors develops annual budgets for each program and reviews them to make sure that all programs are staying within their allocated spending limits. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Due to federal funds and the Alameda County Area Agency on Aging Title III-Cl Congregate Meals Program funding, Open Heart Kitchen has more than ten years of expertise keeping track of and reporting on government grant awards. Open Heart Kitchen is required by the Title III-Cl meal program to keep daily records for each customer and meal served. A nutritional assessment is given to new clients, and their information is entered into social assistance management software. The clients' assessment records are kept up to date by a dedicated Senior Meal Program Program Coordinator. Additionally, this employee makes sure that client data, service unit deliveries, and nutrition education information are punctually and securely entered into the social assistance management software. The meals offered by programs like ours help seniors reach nutrition recommendation goals that can help them manage or prevent chronic illnesses like obesity, heart disease, type 2 diabetes, and some types of cancer, according to the most recent Older Californians Nutrition Program guidance from the California Department of Aging, and the Office of Disease Prevention and Health Promotion. People who are hungry need meals that won't make their current medical conditions worse. Our goal is to provide nutritious, high quality food. Open Heart Kitchen monitors if the meal count numbers continue to be consistent with our goals, and that costs are within budget in order to assess the success of our programs. We review the results of our annual evaluations of meal counts, meal expenses, and guest surveys before adjusting our program objectives. Our Board of Directors receive an extensive report every two months including the quantity of meals served, the price per meal, and the satisfaction of the program. If the meal count numbers continue to be in line with our nutritional goals, satisfaction levels, and other various objectives while the cost is within budget, we consider our programs successful. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision The menus for our meal programs have been translated into Spanish and Chinese to better serve our non-English speaking clients. Many of our low-income and unhoused clients use mobile devices to search for our services. A calendar of our menus, locations, and business hours can be found on our website. Additionally, our website is mobile -friendly, ADA compatible, and has Spanish and Chinese translations. We recently started translating menus in Korean in response to requests from seniors at our Dublin Senior Center. The people who make up our community and are struggling with hunger require more than just food; they deserve meals that are specially prepared for their dietary needs and way of life. The low-income, elderly, and unhoused population is acknowledged by Open Heart Kitchen as being an "at -risk" demographic. They are far more likely to experience health issues like diabetes and obesity. The cheapest and most convenient foods frequently lack essential nutrients like vitamins, protein, and healthy fats and are heavily processed. It is understandable why many seniors living on a fixed income, pressed for time, or with little to no access to cooking facilities, turn to these affordable and handy foods as an immediate solution, but these foods ultimately cause more harm than good and are not a healthy option. Our freshly prepared meals are ready to eat, and easy to eat on the go. The nutritional requirements of seniors, who have the most stringent limitations of any age group, are especially catered for in our meals. A Registered Dietitian reviews our menus before the Alameda Area Agency on Aging approves them. Although our meals meet the precise standards of a senior diet, they are also appropriate for the dietary requirements of our entire community. We keep a close eye on the amounts of protein, sodium, vitamins, and spices in our meals and make sure they are soft enough for clients with dental problems or for those who are unable to use a knife. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Our aging population of seniors is disproportionately impacted by food insecurity. The COVID-19 pandemic isn't over, and our senior meal program continues to grow along with housing, food, and healthcare costs. It has become clear that the health of our community members is more crucial than ever as we continue to work toward eradicating the pandemic. But the pandemic has erected obstacles that make it harder for senior citizens to get the food they require for a healthy lifestyle. Throughout the pandemic, we have distributed masks, sanitizers, safety information, vaccine clinic resources, and more to our diners alongside their meals. Some of our elderly neighbors remain hesitant to enter public spaces like grocery stores for fear of contracting the COVID-19 virus. Recent global supply chain problems, along with rising fuel costs, have raised prices for several food goods, which has an even greater impact on people living on fixed incomes, such as seniors. Participants in our program obtain 40% of their necessary daily calories, as well as 35-47% of their appropriate daily nutrition intake, according to an Older Americans Act study. The Open Heart Kitchen Senior Meal Program in Dublin saw a 12% increase from—34,200 meals served in FY2021 to—38,359 meals served in FY2022. The main challenge we faced during the pandemic was in distributing meals in the safest way possible to protect the health and safety of our workforce and our clients. Equipment is A sanitized between uses, and all kitchen surfaces and equipment are cleaned with either a sanitizer solution or with a water and bleach solution. Diners are encouraged to social 3 E distance, and we have reduced the number of guests that can share a table to enable seniors to create space. Our staff and volunteers are required to wear masks and food preparation gloves at all times. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? v❑ Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Open Heart Kitchen is dedicated to ensuring that people with limited English proficiency can participate in our programs. Our quarterly surveys and program posters are available in a variety of languages, and we actively seek out bilingual volunteers. We work with organizations that offer translation services, such as the Alameda County Community Food Bank and we use Boostlingo to answer phone calls in other languages. The "I Speak" cards have been sent to all Open Heart Kitchen program employees in order to help them identify the language interpretation a visitor would require should the need arise. The Open Heart Kitchen team is routinely formally surveyed about their interactions with limited English proficiency populations throughout the year. This makes it possible for Open Heart Kitchen to determine what translation services could be required in the future. Even though a relatively small portion of Open Heart Kitchen's clientele are limited English speakers, Open Heart Kitchen makes efforts to give visitors who struggle with communication in English the chance for meaningful access. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: 0 Be culturally accessible, appropriate and inclusive 0 Encourage community engagement and involvement ❑ Promote energy and resource efficiency 0 Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. 0 Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 0 Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing 0 Strengthen Communities ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that I am seeking to address?') 0 Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am i seeking?') 0 Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. 0 Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. 34( ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee -sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) J❑ Persons ❑ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". 605 Seniors (62 and older) 70 People with Disabilities 80 Female -Headed Households 0 Youth 0 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 756.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 351 Extremely Low Income (<30 % AMI) 95 Very Low Income (30%-50% AMI) 38 Low Income (50%-80% AMI) 108 Moderate Income (80%-120 % AMI) 295 00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 151 White 20 White + HISPANIC 10 Black/African American �0 Black/African American + HISPANIC 289 Asian 0 Asian + HISPANIC DAmerican Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 02 Native Hawaiian/Other Pacific Islander �1 Native Hawaiian/Other Pacific Islander+ HISPANIC 0 American Indian/ Alaskan Native and White 0 American Indian/ Alaskan Native and White + HISPANIC SO Asian and White 1 01 Asian and White + HISPANIC �0 Black/African American and White �0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American 0 American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial 35( Not Applicable. Not interested in CDBG funding. (Type N/A) 605.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY d❑ #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Dublin USD$ 25,000.00 City of Livermore (for Livermore residents) USD$ 25,000.00 City of Pleasanton (for Pleasanton residents) USD$ 50,000.00 County of Alameda USD$ 250,000.00 Individual Contributions USD$ 840,470.00 In -kind Contributions USD$ 70,000.00 Total USD$ 1,260,470.00 USD$ 0.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 480,068.00 Benefits USD$ 93,777.00 Auto (food transport) USD$ 22,228.00 Facilities and equipment maintenance USD$ 33,556.00 Food and kitchen supplies USD$ 433,515.00 Information technology USD$ 7,904.00 Insurance (non -employee related) USD$ 3,259.00 Laundry service (aprons and towels) USD$ 11,297.00 Postage and printing USD$ 6,706.00 Rent and utilities USD$ 116,812.00 Telephone and communications USD$ 6,291.00 Other expenses USD$ 45,057.00 Total USD$ 1,260,470.00 USD$ 0.00 Budget Narrative Other expenses include: uniforms, occupational health, office expenses, etc. The $25,000 request from the City of Dublin will help defray 2% of the costs attributed to the Senior Meal program operations. The total budget for the Senior Meal program is 35% of Open Heart Kitchen's overall organization budget. Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests 21 Program exp budget download template Financial Information Form for ALL Grant Requests 0 Financial info download template List of Board of Directors (or governing body) with agency contact information 0 BOD roster with emails Current Annual Budget for the Entire Agency 0 Annual Budqet Copy of most recently submitted IRS 990 form or Tax Return (include 0 IRS 990 complete form) Board of Director's (or governing body's) designation of authorized official '1❑ Authorized official Board of Director's (or governing body's) authorization to request funding (may '1❑ Authorization be same document as one above) Proof of insurance carried, including bonding, liability and/or workers' '1❑ 2023 COI Dublin compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All 0 Federal organizations MUST have approved non-profit status from the State of State California and Federal Tax Identification Number at time of application. Non- compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Employee Handbook Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Audit requirements Last Audit Highlighting "Findings" Section Audit highlighted findings REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws Articles of Inc Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included Conflict of Interest Policy in Bylaws) 351 REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH LEP PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, Strategic Plan etc. (Not Required) Other Supporting Documents (Not Required) ZoomGrantsT" is not responsible for the content of uploaded documents. Application ID: 425960 B—e a fan of Z—G—ts- on Fnebook Problems? Contact us at QueatunsAZo-G,ants.wm @2002.2023 GrantAnalysLcom. All dghts reservad. "ZoomGrants' and the Zo..GmMs logo are hademadcs of G antAnalyst.osm, LLC. L000ut I Browser 35i 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Partners for Change Tri-Valley Education and Mentorship Program for Poverty Alleviation Jump to: Organization Information Questions Budget Documents USD$ 15,000.00 Requested Submitted: 1/20/2023 5:31:21 PM (Pacific) Project Contact Terri Molano d i recto r(c�pfcty. org Tel: 5107736356 Additional Contacts none entered Organization Information top 1. Business License Number Questions top Partners for Change Tri-Valley 4743 East Ave. Livermore, CA 94550 United States Executive Director Terri Molano director g(pfctv.org 1. Select the category that best describes your organization: (Select only one.) Non -Profit LJ Public Agency CI Other: Telephone5107736356 Fax Web www.pfctv.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). We equip and empower people to chart their course out of poverty to self-sufficiency through an education and mentorship program. We foster positive community by intentionally creating personal relationships that bridge socioeconomic lines. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) CI Capital Project i Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. CI Yes 35; Y: No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). We equip and empower people to chart their course out of poverty to self-sufficiency through an education and mentorship program. We foster positive community by intentionally creating personal relationships that bridge socioeconomic lines. Our vision is to measurably reduce poverty in the Tri-Valley. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) There are a number of organizations in the Tri-Valley that provide financial assistance for people in crisis -mode related to helping with rent, car repair, PG&E, food insecurities, etc. However, none of them focus on coaching and personal development to make impacting long-term change to economic status as we do. The ERAP is an example of a significant outlay of financial aid that did not have any follow-up plan requirement, and therefore a large % of recipients made no economic changes and delinquencies resumed. This is common with a lot of crisis support. Partners for Change Tri-Valley collaborates with these organizations to be their educational referral resource. We work with participants to identify ways to make long-term habit and behavioral changes with focus on less reliance on short-term assistance. Graduates of our program leave equipped with skills for work -readiness, goal setting, healthy inter -personal relationships, self- awareness, self-control, and self-confidence, all designed for better outcomes at home, school, work, and life. We provide free childcare and a meal for our participants and mentors. We believe longer -term education and mentoring is the answer to lowering the return rate to crisis -mode and the need to solicit assistance from existing care providers. YouthBuild is designed for students from Dublin, Pleasanton, and Livermore. Our partnership with LVJUSD through the YouthBuild Program provides a separate cohort for at -risk -youth ages 16-24, who have either dropped out of school or are struggling to graduate. The program offers academic counseling, pre -apprenticeship training and job placement. YouthBuild students can earn their GED and other certifications to be work -ready. Our overall community benefits with these enduring and extensive life transformations. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 15 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) : Workforce Development Y: Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse ❑ Disabilities LJ Food and Nutrition ❑ Senior Services i Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity LJ Financial Assistance ❑ None of the Above LJ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should 354 include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later it the "Documents" tab.) (What specifically will the grant funds be used for?) Partners for Change Tri-Valley uses a transformative, research based, life skills curriculum to provide weekly education classes and mentorship to the under-resourced community. The class is designed to equip and empower our participants to navigate their way out of poverty and into self-sustainability. Our curriculum provides an education around personal introspection, all forms of addiction, racial equity, aspects of privilege, holistic poverty, social capital, the role of personal and community trauma. Reciprocal relationships are built over time over a shared cohort experience while accessing vulnerability. Graduates of our program leave with skills for work -readiness, goal setting, planning, inter -personal skills, focus, self- awareness, self-control, flexibility, and resilience, all designed for better outcomes at home, school, work, and life. We provide free childcare and a meal for our participants and mentors. We believe longer -term education and coaching is the answer to lowering the return rate to crisis -mode and the need to solicit assistance from social service programs and emergency aid for community organizations. Funds will be used for the purchase of AN equipment to allow us to provide hybrid classes including in -person and Zoom options. We have input from our participants that some prefer in person, while others need online options. We would like to accommodate both in order to serve the most people. We have received interest from programs at Goodness Village and MidPen for the hybrid option and are hoping this allows us to open up to other low-income housing developments in the Tri- Valley. The balance of the funds will go toward the staff salary to facilitate curriculum prep, class execution, recruiting and case work and our childcare workers. We currently employ 4 of staff with a full time Executive Director and 3 paid childcare workers. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our criteria for success varies for each participant. We have previously seen our participants access housing, vehicles, better paying jobs, enroll in college, experience improvement in interpersonal relationships, improve their English for our ESL participants, open a bank account for the first time, and get their drivers licenses. In 2022, we saw our first cohort of youth participants enroll in college. These kids were given support with college registration applications and their financial aid paperwork. This will break the cycle of poverty for future generations. We expect to see similar results with each cohort Our classes help alter perspectives around self -responsibility and capability, that in turn, improves confidence and self- esteem, making life's challenges more surmountable. In addition, we foster positive community by intentionally creating personal relationships between our participants and mentors that bridge socioeconomic lines. This provides a supportive community and long-lasting relationships. Our partnership with the Livermore Unified School District through the YouthBuild Program is a separate cohort for at -risk - youth ages 16-24, who have either dropped out of school or are struggling to graduate. The program offers academic counseling, pre -apprenticeship training and job placement. YouthBuild students can earn their GED and other certifications to be work -ready. Partners for Change Tri-Valley was a part of the original grant process to fund this program by offering the required mentorship component of the program. The students in YouthBuild receive our curriculum weekly as well and they will have a new graduating class in 2023. YouthBuild is a program that is designed to serve Tri-Valley students from Dublin, Pleasanton and Livermore. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Our inclusive community is created through cohorts that mirror the Tri-Valley community at large and represent diversity of various racial, economical and social backgrounds . We also respect sexual orientation and have a high school junior assisting in childcare who is transgender and 1/2 our participants are Spanish speaking. He has blossomed in this community having a safe place to make friends in a non -judgmental environment and in return we have supported him by attending his school's play. In addition, we have incorporated bi-lingual curriculum in our weekly classes to be more available to our ESL participants. The English / Spanish immersion allows them to improve their language skills which is a goal for several of them. We accept members of the community from every walk of life to offer them community. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please 35! describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. N/A 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? Y'. Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Our Referring Partners serve many people from the Hispanic community. We have encouraged them to refer their clients to us. Our Executive Director is a fluent Spanish speaker and have many years of involvement in the Hispanic community. These relationships also attract Spanish speaking participants. In our current cohort, 38 of our 90 participants are Spanish speaking. We offer bi-lingual curriculum in our weekly classes as needed. Most of our Spanish speaking participants prefer English because it helps them increase their proficiency with the English language. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Y: Be culturally accessible, appropriate and inclusive ;.*!'. Encourage community engagement and involvement LJ Promote energy and resource efficiency Y: Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing LJ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless .'. Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. LJ D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Y'. Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or LJ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Y'. Public Services FJ Public Facilities 35E Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers LJ Promote Decent Affordable Rental Housing Y: Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') Y'. Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities ❑ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') LJ Availability/Accessibility ❑ Affordability ' Sustainability LJ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. *. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. 35i ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) Y'. Persons LJ Households ❑ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 0 Seniors (62 and older) C 1 People with Disabilities 12 Female -Headed Households Youth 2 Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) 15.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMP) information is available online at www.dublin.ca.gov11956/Application-Requirements-Process L 12 Extremely Low Income (<30% AMI) C 2 Very Low Income (30%-50% AMI) C 1 Low Income (50%-80% AMI) C 0 Moderate Income (80%-120% AMI) TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 5 White C 10 White + HISPANIC CBlack/African American C Black/African American + HISPANIC CAsian C Asian + HISPANIC CAmerican Indian/Alaskan Native 35f American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Corporate & Business Grants USD$ 10,000.00 Foundation & Trust Grants USD$ 10,000.00 Nonprofit Organization Grants USD$ 5,000.00 Church Contributions USD$ 5,000.00 Corporate Contributions USD$ 5,000.00 Individual Contributions USD$ 15,000.00 State Grants USD$ 0.00 County Grants USD$ 6,000.00 City Grants USD$ 52,000.00 Total USD$ 108,000.00 Funding Uses/Expenses Budget Amount Payroll Expenses USD$ 74,635.80 A/V Equipment USD$ 2,000.00 Supplies USD$ 1,500.00 Participant Incentives USD$ 17,100.00 Total USD$ 95,235.80 Budget Narrative This program is the primary focus of the overall organization. Thank you. Amount Committed USD$ 0.00 USD$ 0.00 USD$ 3,000.00 USD$ 2,200.00 USD$ 0.00 USD$ 771.26 USD$ 0.00 USD$ 5,000.00 USD$ 0.00 USD$ 10,971.26 Amount Committed USD$ 5,971.26 USD$ 5,971.26 35E Documents top Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests❑ PFCTV Proaram Expense Budget download template Financial Information Form for ALL Grant Requests 0 PFCTV Financial Information download template List of Board of Directors (or governing body) with 0 PFCTV Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 PFCTV Current Annual Budget Copy of most recently submitted IRS 990 form or Tax 0 PFCTV 990 Return (include complete form) Board of Director's (or governing body's) designation 0 PFCTV Board Designation of Authorized Official of authorized official Board of Director's (or governing body's) authorization 0 PFCTV Board Authorization to request Funding to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 PFCTV Insurance Policy - Accident and/or workers' compensation PFCTV Insurance Policy - Full PFCTV Insurance Policy - Wkmn Comp PFCTV Insurance Policy - DO STATE AND FEDERAL NON-PROFIT 0 PFCTV 501C3 DETERMINATION LETTER. All organizations MUST PFCTV State Entity Status have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 PFCTV Audit Not Required REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) PFCTV Affirm Action Plan and Grievence Procedure PFCTV Audit Not Required PFCTV Articles of Incorporation, Bylaws, Conflict of Interest PFCTV Articles of Incorporation, Bylaws, Conflict of Interest * ZoomGrantsTM is not responsible for the content of uploaded documents. 36( Application ID: 428338 Become a fan of Zoon sTM on Facebook Problems? Contact us at Qua is(a)ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logou[ I Browser 361 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Spectrum Community Services Meals on Wheels More than a Meal Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/20/2023 8:47:43 AM (Pacific) Project Contact Lara Calvert LCalvert(a-)spectrumcs.org Tel: (510) 881-0300 ext. 243 Additional Contacts none entered Organization Information top 1. Business License Number 006992 Questions top Spectrum Community Services 2621 Barrington Court Hayward, CA 94545 United States Executive Director Lara Calvert LCalvert(g-.SpectrumCS.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone(510) 881-0300 x243 Fax (510) 537-3340 Web www.spectrumcs.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Spectrum Community Services strives to improve the health and safety of seniors and low income residents in Alameda County by enhancing their quality of life and helping them age at home with dignity. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 36� J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Spectrum Community Services' Meals on Wheels Program will deliver at least 10,500 nutritious, life -sustaining meals and a vital daily safety check to low/extremely low-income disabled and homebound seniors residing in Dublin. This will be achieved with a strong, devoted, and trained volunteer team utilizing safety protocols that were implemented because of COVID 19, which are now an integral part of how we serve our clients. We continue to strive to ensure the safety, well being and nutritional needs of our clients. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Many vulnerable Tri-Valley seniors rely on hot meal services because they are disabled/living alone/lack financial resources/have no support networks/are unable to prepare meals. They also face isolation, and coupled with a lack of proper nutrition, they face intensified mental/physical health issues/reduced access to services. Spectrum's Meals On Wheels Program is vital in addressing the challenges/needs/service gaps in Dublin. We ensure frail homebound seniors have the proper nutrition they require/are safe in their homes. The 2021 Census shows that seniors over 65 make up 9.4% of Dublin's residents. As indicated above, a growing number of Dublin seniors need meal assistance. In the past 4 years, we have had 25% growth in meals served. While some Dublin seniors are aging successfully, over 75% were categorized as a high nutritional risk on our intake assessments and 24% extremely low-income. Each day, Spectrum dispatches our volunteer drivers to deliver nutritious meals and provide human contact/warm social interaction/perform a vital safety check. Our Meals on Wheels Coordinator supports seniors through home assessments, allowing them to discover hidden issues seniors are facing and identify/access resources to address these issues. Spectrum's Meals on Wheels Program is a life -line that better safeguards senior's health/combats their isolation/ensures their wellbeing and safety/allows vulnerable seniors to continue living at home. Without the City's support, we will not be able to fully serve the eligible Dublin seniors seeking assistance and will implement reduced number of meals seniors recieve each week and a waitlist. In additon, funding from the Area Agency on Aging cannot be used for disabled adults under 60 years old, so this population will not have access to Meals on Wheels. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 60 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956IApplication-Requirements-Process LJ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development ❑ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse *!: Disabilities Food and Nutrition Y: Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity LJ Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being 362 requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Spectrum is asking for $25,000 to support the Meals on Wheels Program. This request will fund a portion of salaries and benefits for two key positions: Meals on Wheels Program Manager $8,750 and our Dublin Meals on Wheels Coordinator $8,892, benefits $3,528 and 666 additional meals for disabled adults under 60 years of age or additional Dublin seniors ($3,830). Our Dublin Meals on Wheels Coordinator is the backbone of the program. They are the main contact for each of our seniors and disabled adults, whether it is to register them for new service or to complete their intake assessment or to talk to them about their meal schedule, preferences and other needs. The Coordinator completes in-depth semiannual assessments with each senior/disabled adult. These initial and semiannual assessments are completed inside the client's home. This allows the Coordinator to provide personal attention and better understand each senior's needs and additional resources they might benefit from. The Meals on Wheels Coordinator also works daily with volunteer scheduling and planning routes to ensure all meals are delivered timely. Spectrum's Meals on Wheels Program Manager recruits, trains, schedules and manages the community volunteers. They oversee all of the operating functions of the program. Meals are delivered daily, primarily by volunteers, who are dedicated to the program and the seniors/ disabled adults they serve. The Program Manager is an active participant in the community and leads Spectrum's outreach efforts in the Tri-Valley. The Program Manager works to cultivate connections in Dublin with faith - based, cultural, business, community organizations where seniors and their families gather and are connected. Involvement in the community is not only important to raise awareness of services Meals on Wheels offers, it provides opportunities to support the program through recruiting volunteers. Trained volunteers are an essential component of providing daily meals and safety -checks for homebound seniors and disabled adults. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The first and primary outcome measure crucial to Spectrum's Meals On Wheels Program success is to ensure all low/extremely low-income frail, homebound seniors and disabled adults, who reside in Dublin, have access to our program services. This guarantees we can meet their nutritional needs through our home delivered meals, as well as safeguard their wellbeing through daily safety checks. We want to ensure if a senior qualifies and wants our support, we will be there to assist. Our goal is to meet or exceed our contracted outcome by providing home -delivered meals to 60 or more unduplicated seniors/disabled adult Dublin residents in FY2023-2024. Another outcome that measures the success of our Program is the number of meals we deliver each fiscal year. In FY2023- 2024 we will home -deliver 10,500 or more meals to Dublin seniors and disabled adults, sometimes the only full meal they get each day. Finally, the Meals on Wheels Program can only be successful if, not only the seniors served are happy with our meals and services, but we ensure Dublin seniors and disabled adults thrive by positively impacting their health through a well- balanced/nutrient-rich diet. To certify this outcome, our meals comply with the Dietary Guidelines for Older Americans, meeting 1/3 of the Dietary Reference Intakes for seniors, and meet strict food safety guidelines. We also guarantee seniors and disabled adults are happy with our meals through periodic Satisfaction Surveys filled out by our program clients. Spectrum's demographic data is collected daily through self -reporting of the client or family member of the client upon initial intake. The other outcome data are collected daily through program meal orders and then input into the agency's database. Reports are generated monthly and Spectrum's management staff review these reports to confirm the program is on track to meet our stated goals, thus ensuring the success of Spectrum's Meals On Wheels Program. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Spectrum Community Services is excited that the City of Dublin shares our values of inclusivity, diversity and equity. From our hiring and volunteer recruitment practices to our welcoming of all need -based residents into the program, we strive to be open for all. For example, we provide specific LGBTQ+ training focused on the older generation's life experiences. Beyond language needs, our assessments and continued feedback also focuses on food likes and preferences. We work with the Registered Dietitian from Stanford Health Care Tri-Valley to provide medically and culturally diverse menu items tailored to the Tri-Valley clients we serve. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please 36� describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Older adults and those with underlying health conditions continue to be the most vulnerable to both hospitalization and death due to the COVID-19 virus. We have not missed a single day of service to this most vulnerable population and have had no virus outbreaks. Continuing to provide daily nutritious food and safety checks as well as fulfilling other individualized needs for clients has been a joy. Face coverings, access to vaccinations, sharing information, and a friendly call have all been key life- lines for our clients, 75% of whom live alone. Being a part of the Meals on Wheels program is truly more than a meal as we continue to work closely with Alameda County Public Health, the City and other organizations to share information and resources these residents may not have access to without this connection. In addition, we have seen the negative impacts of inflation causing stress to the older adults we serve. We ask for a $3.75 client donation toward the $13.50 total meal cost, but currently only receive $0.98 The City's contributions as well as private donors have made it possible for us to not turn anyone away during this critical time. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? Y: Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. Spectrum performs a language survey of staff, volunteers, clients, and the community, making note of any gaps and lining up resources and protocols to address needs. The plan informs our staffing goals, outreach activities, consumer materials, communications and operations. We have added a phone -based, on -demand and/or appointment -based translation service that all of our Meals on Wheels staff is trained to use. This is key when doing assessments and speaking with seniors about their specific needs at any time in any language. Spectrum's website is fully translated in multiple languages by the click of a button. Our goal is that all clients, prospective clients and their families have access to Spectrum services in the spoken language in which they are proficient, that they are treated with respect and that their questions are answered in a timely manner. We regularly reach out to other service agencies to help ensure that all Dublin seniors have access to our service. By sharing information with as many entities as possible our hope is that all are included. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Be culturally accessible, appropriate and inclusive Y'. Encourage community engagement and involvement ❑ Promote energy and resource efficiency Y: Encourage networking and information sharing across service providers Yi Encourage process streamlining '.-I Consolidate service delivery ❑ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. LJ D) Community Development 36! ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. Y'. Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing Y: Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination Y'. Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations LJ Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities LJ Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') ;: Availability/Accessibility ❑ Affordability LJ Sustainability LJ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. .'. Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. LJ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number 36E of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. ❑ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. ❑ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ❑ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) Y: Persons LJ Households Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 60 Seniors (62 and older) 60 People with Disabilities 20 Female -Headed Households Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 140.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI") information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 30 Extremely Low Income (<30% AMI) 15 Very Low Income (30%-50% AMI) 15 Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) E7 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. 361 The sum entered below must match the total clients entered in Question #9 above. If none, ph 40 White 4 White + HISPANIC F5 Black/African American Black/African American + HISPANIC 5 Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC F 6 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 60.0r TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY : #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Area Agency on Aging/Grant USD$ 81,250.00 MOWAC/Donation USD$ 145,000.00 City of Dublin/Grant USD$ 25,000.00 City of Livermore/Grant USD$ 74,000.00 City of Pleasanton/Grant USD$ 53,000.00 Program Revenue/Donations USD$ 50,000.00 Volunteers/In Kind USD$ 140,000.00 Private Donations/Donation USD$ 25,000.00 Total USD$ 593,250.00 Amount Committed USD$ 81,250.00 USD$ 145,000.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 226,250.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries and Wages USD$ 225,000.00 36f Benefits & Payroll Taxes USD$ 49,500.00 Contracted Services USD$ 93,625.00 Supplies USD$ 9,500.00 Postage USD$ 500.00 Telephone USD$ 5,000.00 Rent and Utilities USD$ 4,000.00 Accounting/Audit USD$ 1,200.00 Volunteers - In Kind USD$ 140,000.00 Taxes & Licenses USD$ 10,050.00 Travel & Company Vehicles USD$ 9,875.00 Misc Expense USD$ 45,000.00 Total USD$ 593,250.00 USD$ 0.00 Budget Narrative We are asking for $25,000 from the City of Dublin to fund 4.2% of this project. We will use this funding for the salaries of two key individuals in this life saving service to Dublin residents as well as to continue to try to meet the needs of all of the Dublin seniors. These funds will help prevent us from going back to a wait list. Individual 1. - Meals on Wheels Coordinator who ensures that daily operations run smoothly - 27% of their salary which is $741/mos, $8,892 annually with benefits of $1,778 annually. 2. Meals on Wheels Program Manager establishes partnerships as well as trains, recruits, and appreciates volunteers which is vital to our program - 13% of her salary which is $729/mos, $8,750 annually with benefits of $1,750 annually The balance of the request for $3,830 is to cover the direct food cost of 666 meals for our disabled Dublin clients that are not funded by other sources. Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests❑ Program Expense Budget download template Financial Information Form for ALL Grant Requests 21 Financial Information Form download template List of Board of Directors (or governing body) with❑ Board of Directors agency contact information Current Annual Budget for the Entire Agency 21 Agency Budget Copy of most recently submitted IRS 990 form or Tax 21 Form 990 6.30.21 Return (include complete form) Board of Director's (or governing body's) designation 0 Authorized Official of authorized official Board of Director's (or governing body's) authorization 0 Board Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Certificate of Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 IRS Exempt Letter DETERMINATION LETTER. All organizations MUST State of Calif - Certificate of Status have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Financial Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance 36C. Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 426846 Become a fan of ZoomGrants7m on Facebook Problems? Contact us at Questions5zoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Loaout I Browser 37( 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Sunflower Hill Sunflower Hill's Program Support for Adults with Developmental Disabilities Jump to: Organization Information Questions Budget Documents USD$ 18,900.00 Requested Submitted: 1/20/2023 10:38:37 PM (Pacific) Project Contact Jen Lenard -Benson info(@sunflowerhill.org Tel: 925-800-1042 Additional Contacts none entered Organization Information top 1. Business License Number BL-110708 Questions top Sunflower Hill PO Box 11436 Pleasanton, CA 94588 United States Executive Director Jen Lenard -Benson ien .sunflowerhill.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone925-800-1042 Fax Web sunflowerhill.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Sunflower Hill is a Tri-Valley nonprofit organization dedicated to creating places and spaces where adults with intellectual and developmental disabilities (I/DD) live, work, learn, and thrive as part of the greater community. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 371 J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). The Sunflower Hill Garden, located at Hagemann Ranch in Livermore, is an outdoor, instructional space providing educational, therapeutic, and life skills training for adults with intellectual and developmental disabilities (I/DD). Our multi -disciplinary program is specifically designed for adults with I/DD, including those with autism, Down syndrome, cerebral palsy, epilepsy, and other chromosomal differences. The Hands -On Garden Groups, open to Tri-Valley adult day, transition, high school, and residential programs, as well as individuals, offer person -centered programming for adults with I/DD, including curriculum that provides opportunities to learn about organic gardening and healthy nutrition, while engaging in a supportive environment and building vital independent living skills. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) This project is specifically designed to meet the unique needs of individuals with I/DD living in the Tri-Valley. The CDC estimates that 1 in 6 children aged 3-17 have one or more developmental disabilities. These conditions begin early in childhood, impact day-to-day functioning, and continue throughout a person's lifetime. In California, it is estimated that there are 625,000 adults with I/DD. This population only grows over time with increased diagnosis, longer life expectancy, and a growing California population. Locally, these numbers are consistent with statewide trends, with approximately 5,500 individuals with I/DD living in Alameda County. Furthermore, it is estimated that roughly 395 Dublin residents, 471 Pleasanton residents, and 580 Livermore residents have a developmental disability. Individuals with developmental disabilities represent overlooked population groups in Eastern Alameda County with respect to living options and job opportunities, as was reported in the 2011 Human Services Needs Assessment. It is critical for Tri- Valley cities to solicit and implement programs that address the diverse needs of the adult developmentally disabled population, as programs and activities are significantly reduced once a person ages out of the public -school system. Individuals with developmental disabilities are also considered extremely low income, living as adults on Supplemental Security Income, or with assistance from family, if available. Our in -person Hands -On Garden Group Program, open to Tri-Valley adult day, transition, high school, and residential programs, as well as individuals, offers person -centered programming for adults with I/DD. Sunflower Hill is one of the only organizations in the region offering therapeutic and life skills training in an educational, outdoor setting, and the demand for our in -person programs is very high. If we do not receive city funding, we will likely need to scale back our programming in the garden. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 35 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.gov11956/Application-Requirements-Process LJ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) Workforce Development LJ Homelessness ❑ Transportation Services and Access ❑ Domestic Violence and Child Abuse : Disabilities Food and Nutrition ❑ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity LJ Financial Assistance ❑ None of the Above ❑ Please explain: 372 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The funds requested for this project are to be used to support Sunflower Hill's Hands -On Garden Groups Program and a portion of our Educational Garden Manager's and Program Instructor's salaries. Our Educational Garden Manager and Program Instructor are integral members of the Sunflower Hill Programs team and are responsible for providing hands-on, innovative programming that is specifically designed to equip adults with I/DD with life skills to be successful in our community. Our Educational Garden Manager spearheads all oversight and maintenance of the garden infrastructure and crop plan, as well as performs gardening and field work tasks to ensure a healthy crop production and a supportive environment for all program participants. The Educational Garden Manager is also responsible for developing and maintaining relationships with local nonprofits that receive our produce donations, along with delivering donated produce. Our Programs Instructor develops and implements dynamic programs in the garden to meet the diverse range of needs of our program participants and enhances their programmatic experience. We are currently offering our Hands -On Garden Groups Program to 10 different adult day, transition, and residential programs located throughout the Tri-Valley. We are providing programming in the garden to the following groups from Dublin specifically: Dublin Valley High School and the Kaleidoscope Adult Day Program. All groups provide their own transportation to the garden. We have also opened our garden sessions to individuals, and are currently providing programming to individuals from Dublin, Pleasanton, Livermore, Danville, Walnut Creek, and Fremont. Our Hands -On Garden Groups Program is uniquely designed to honor all ability levels. Led by knowledgeable staff with a passion for both people and plants, our curriculum addresses educational, therapeutic, and life -skill topics to grow vital independent living skills. During their sessions at the Sunflower Hill Garden, groups and individuals learn skills that are imperative to keeping a garden growing, use tools and skills employed in such work, and enjoy extended time participating in field tasks, practicing what they have learned. Each 90-minute session in the Garden includes a welcome activity, time for individual gardening tasks, closing healthy snack, and discussion. Weekly tasks are designed with individual participants in mind, allowing for a variety of garden tasks to appeal to all abilities. Tasks include a range of gross and fine motor movements and a variety of standing, kneeling, lifting, and/or tabletop tasks. Additionally, participants explore tasting new and healthy foods and engage in a natural setting. We also have a team of dedicated and talented volunteers who work in the garden each week. These individuals are vital to our program, assist with labor in the field, and are trained and supervised by our Garden Manager. We are currently providing volunteer opportunities for adults with I/DD as well as individuals who are neurotypical. Under the leadership of our Educational Garden Manager, our staff have taken significant efforts to ensure the garden's continued sustainability. The Educational Garden Manager sheet mulches, using cardboard and organic materials (wood chips and straw) between perennial beds, open spaces, and garden pathways. This practice conserves water, by reducing wind and heat evaporation, builds soil, and reduces weed pressure. The staff have also streamlined our composting practices by utilizing more of the green waste produced in the garden. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our multi -disciplinary Hands -On Garden Groups Program is designed for adults with I/DD, including those with autism, Down syndrome, cerebral palsy, epilepsy, and other chromosomal differences. Led by our knowledgeable and dedicated Garden staff, the curriculum is specially designed to offer unique experiences for adults with I/DD of all abilities. Through an engaging curriculum and guidance from staff, participants are able to achieve a number of objectives that lead to greater independence, empowerment, and confidence. Sessions are designed so that program participants are able to achieve the following: • Learn how to exercise the freedom of choosing their own task each week. • Work independently on a task until completion. • Follow step-by-step instructions and learn how to ask follow-up questions, as needed. • Practice simple math and life science concepts. • Improve social skills with instructors, peers, and community partners. • Learn how healthy food and flowers are grown from seed to harvest. • Have opportunities for physical activity in a natural environment that is accessible to all ability levels. 37; Support of our Educational Garden Manager and Programs Instructor will further enable the execution of the above objectives. Our staff assess our programs' effectiveness through a variety of means. We rely on gathering feedback from program participants, caregivers, teachers, and day program leaders and innovate our programs accordingly. Our programs are also designed to offer participants opportunities to engage in self -reflection and provide regular feedback at the end of each class or session. Furthermore, we measure success through the amount of produce we donate to local nonprofits. In 2022, we donated more than 2,500 pounds, 90% of our produce, to Culinary Angels, Tri-Valley Haven's Food Pantry, and Shepherd's Gate. These produce donations serve local residents, including those in Dublin, struggling with food or housing insecurity, or undergoing a significant medical challenge. In September 2022, we also began a floral donation program. Each week, program participants harvest flowers from the garden and create bouquets, which are then donated to patients at Hope Hospice. On average, we donate 30 bouquets per week, and the feedback from Hope Hospice has been overwhelmingly positive. Students from the transition class at Dublin Valley High School are not only creating the floral bouquets, but they are also making weekly deliveries to the Hope Hospice office in Dublin. Our floral donation program provides participants with a wide array of opportunities to improve dexterity, fine motor, communication, and community building skills. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Sunflower Hill's Hands -On Garden Groups Program promotes the values of inclusivity, diversity, and equity through a number of means. As noted above, our curriculum is specifically designed to meet the diverse needs of adults with I/DD and ensure that each program participant is equipped with a variety of opportunities each week to be successful. We as an organization value the input of people with I/DD to guide the design of programs, activities, and residential communities, as set forth in our 2021-2025 Strategic Plan. This includes innovating our programming based upon feedback and suggestions from our program participants. As such, each week, our team assesses the needs of individual participants and modifies tasks, if needed. We also provide adaptable materials and tools to ensure that each participant can be fully engaged in our programming. The Sunflower Hill Garden is also accessible to all ability levels. This unique space features a series of decomposed granite pathways, raised garden beds, and a variety of seating options to ensure that it is fully accessible to all, including program participants who are visually impaired or use walkers or wheelchairs. Our Hands -On Garden Groups programming is a free to all transition and day program participants, and as a result, it is fully accessible regardless of their socioeconomic status. We do offer a weekly session to individual participants and caregivers for a small fee. Our fee in 2023 for our individual group sessions is $10 per class to ensure accessibility. We also offer fee waivers to encourage full participation to ensure that cost is never a barrier to participating in our programming. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. NA 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. Y'. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: 371 ❑ Be culturally accessible, appropriate and inclusive LJ Encourage community engagement and involvement ❑ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers LJ Encourage process streamlining ❑ Consolidate service delivery Y: Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. LJ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y: F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: ❑ Public Services LJ Public Facilities ❑ Rental Assistance ❑ Affordable Housing LJ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing ❑ Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y'. Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') LJ Creating a Suitable Living Environment LJ Providing Decent Affordable Housing ❑ Creating Economic Opportunities *! Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') ❑ Availability/Accessibility ❑ Affordability LJ Sustainability *!: Not Applicable. I am not interested in qualifying for CDBG funding. 37! 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ❑ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. LJ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. LJ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. LJ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. LJ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. LJ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. LJ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. '. i Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) LJ Persons Households : Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) 37E People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process N/A Extremely Low Income (<30% AMI) Very Low Income (30%-50% AMI) Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) 0.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC F American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type N/A) E_ O.OG TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY Y: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. 3T ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Dublin - partial salary for Garden Manager USD$ 18,900.00 City of Pleasanton - partial salary for Programs Instructor USD$ 19,438.00 Clif Family Foundation USD$ 5,000.00 USD$ 5,000.00 Lawrence Livermore National Security Gift Program USD$ 3,800.00 USD$ 3,800.00 1 % Serano Community Gift Program USD$ 10,000.00 Pleasanton Weekly Holiday Fund USD$ 10,000.00 Drysdale Community Foundation USD$ 4,300.00 USD$ 4,300.00 Individual donations (includes year-end campaign, special events) USD$ 150,000.00 USD$ 6,100.00 Total USD$ 221,438.00 USD$ 19,200.00 Funding Uses/Expenses Salaries for Nonresidential Programs staff Benefits for Nonresidential Programs staff Contracted services (water/soil testing; irrigation repair) Telephone for Nonresidential Programs staff Rent/utilities (Garden) Other: General operating expenses Materials/supplies (Garden) Total Budget Amount Amount Committed USD$ 147,810.00 USD$ 10,400.00 USD$ 18,637.00 USD$ 2,975.00 USD$ 3,200.00 USD$ 0.00 USD$ 3,000.00 USD$ 13,500.00 USD$ 189,122.00 USD$ 10,400.00 Budget Narrative Sunflower Hill's funding request of $18,900 will cover 20% of the salary of our Educational Garden Manager ($12,400) and $20% of the salary for our Programs Instructor ($6,500) in FY 2023. The salary of $147,810 and benefits of $18,637 noted above are for the Sunflower Hill Nonresidential Programs' Team as a whole, comprised of half of the Programs Director's salary, two thirds of the Garden and Programs Assistant salary, and all of the Educational Garden Manager and Programs Instructor salaries. The remaining budget required for the Sunflower Hill Nonresidential Programs' Team salaries, as well as funds needed to maintain the Hands -On Garden Groups Program, will be covered by contributed income from other local city, corporate, and private grants, as well as Sunflower Hill's robust fundraising efforts, including special events and individual donations. Please note that expenses above indicate costs needed to operate the Sunflower Hill Garden Program, rather than operational expenses for the entire organization. "Other" operating costs noted above include mileage reimbursement for delivering donated produce, and software licensing fees. Documents top Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests 21 Program Expense Budget Form - Sunflower Hill - download template 2023-2024 Financial Information Form for ALL Grant Requests 0 Additional Project Funding Sources and Staffing download template Costs - Sunflower Hill - 2023-2024 List of Board of Directors (or governing body) with 0 Sunflower Hill Board of Directors List 2023-2025 agency contact information Current Annual Budget for the Entire Agency 0 Sunflower Hill 2023 Budaet 37E Copy of most recently submitted IRS 990 form or Tax U Sunflower Hill 990 Return (include complete form) Board of Director's (or governing body's) designation 0 Sunflower Hill Board Authorization of authorized official Board of Director's (or governing body's) authorization 0 Sunflower Hill Board Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Sunflower Insurance verification and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 Sunflower Hill 501c3 status DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) 0 Sunflower Hill 990 Sunflower Hill Garden Program video * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 425252 Become a fan of ZoomGrantST on Facebook Problems? Contact us at Questions().ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 37S 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Tri-Valley Haven Domestic Violence Services Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2023 7:24:28 PM (Pacific) Project Contact Christine Dillman Dillman cynthiaCa)trivalleyhaven.org Tel: 9254495845 Additional Contacts cynthia@trivalleyhaven.org,joe@trivalleyhaven.org Organization Information top 1. Business License Number BL-007058 Questions top Tri-Valley Haven 3663 Pacific Avenue Livermore, CA 94550 United States Acting Executive Director Christine Dillman christine(cDtrivalleyhaven.orq 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone(925) 449-5845 x Fax (925) 449-2684 x Web www.trivalleyhaven.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Tri-Valley Haven creates homes safe from abuse, contributes to a more peaceful society. One person, one family, one community at a time. Together we build a world without violence. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 38( ❑ Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). TVH's Domestic Violence Services Program is an existing project. Our 24-hour Crisis Line is the main point of entry for survivors seeking shelter. Clients are referred to us via our website, law enforcement, hospitals, 211, shelter networks and other agencies. Clients are screened via telephone to assess their needs and safety, and then, if appropriate, an in -person intake is conducted. Each client is assigned to a Case Manager and individual counseling is available to adults and children. The following groups are available for adult clients: DV Support, Job Readiness, Parenting, Life Skills and Family Night. Goals are set with each client depending on their specific needs while meeting with their Case Manager, who will assist them in working toward their goals. The maximum length of stay at Shiloh is 105 days. Shiloh has its own vehicle which is used for client intakes and emergency transportation. While in the Shiloh program, Clipper cards, BART tickets and gas cards are available to clients. During their stay, clients can receive food from our pantry and Open Heart Kitchen.. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The funds requested from Dublin will be used to pay part of the Bilingual Case Manager's time, and part of the Overnight staffs time. These positions are essential for the shelter operations. Tri-Valley Haven's domestic violence services support Dublin's mission to have a high quality of life and a safe and secure environment for all residents through prevention and intervention services. Furthermore, we will make these services available to all residents through provision of services that are culturally sensitive and appropriate. Clients will benefit from our program or by creating a safety plan for themselves and their children, developing goals and plan of action towards achieving self-sufficiency, and connecting with the resources available in our community. In FY 21-22, we served 224 survivors of domestic violence from Dublin through our crisis line and shelter. The Domestic Violence Services Program utilizes in-house and donated services as much as possible to meet clients' needs and hold down costs. Residents are able to obtain food from the TVH Food Pantry, they are given clothing vouchers and referrals to our Thrift Store, they receive assistance applying for government services such as CAL Fresh, CalWORKS, and Linkages. We refer our clients to AXIS for their health related needs. Trained volunteers provide overnight crisis line coverage as well as (along with TVH staff) around the clock response to sexual assault calls and referrals from local police departments and hospitals, and volunteers provide childcare for shelter children while their parents participate in educational and support groups. All of this contributes to a very reasonable budget. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 75 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development LJ Homelessness LJ Transportation Services and Access Y: Domestic Violence and Child Abuse LJ Disabilities LJ Food and Nutrition LJ Senior Services ❑ Youth Services ❑ Child Care, Early Childhood Development and Education ❑ Changing Demographics and Growing Diversity ❑ Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should 381 include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The funds requested from Dublin will be used to pay part of the Bilingual Case Manager's time, and part of the Overnight staffs time. These positions are essential for the shelter operations. Tri-Valley Haven's domestic violence services support Dublin's mission to have a high quality of life and a safe and secure environment for all residents through prevention and intervention services. Furthermore, we will make these services available to all residents through provision of services that are culturally sensitive and appropriate. Clients will benefit from our program or by creating a safety plan for themselves and their children, developing goals and plan of action towards achieving self-sufficiency, and connecting with the resources available in our community. In FY 21-22, we served survivors of violence from Dublin through our crisis line and shelter and an additional 121 Dublin callers seeking information and referral. The Domestic Violence Services Program utilizes in-house and donated services as much as possible to meet clients' needs and hold down costs. Residents are able to obtain food from the TVH Food Pantry, they are given clothing vouchers and referrals to our Thrift Store, they receive assistance applying for government services such as CAL Fresh, CalWORKS, and Linkages. We refer our clients to AXIS for their health related needs. Trained volunteers provide overnight crisis line coverage as well as (along with TVH staff) around the clock response to sexual assault calls and referrals from local police departments and hospitals, and volunteers provide childcare for shelter children while their parents participate in educational and support groups. All of this contributes to a very reasonable budget. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? As required by Alameda County, TVH uses Results Based Accountability (RBA) to measure the success of our program. Our performance measures include: a) at least 75% of participants will report that they are Satisfied or Very Satisfied on the satisfaction surveys; b) 75% of Shelter program participants will be safely housed upon exit. Last Fiscal Year we met or nearly met both performance measures. The success of the Program will be measured through evaluation of client surveys, statistical results, and the individual goals set by the program participant and her/his case manager. Those goals will be set up on a case -by -case basis and may include: reuniting with their children through completing their CPS Plan, finding housing or employment. Some clients will only stay one or two nights, and their goals will be very different such as safely relocating to a different county or a state. Client progress will be tracked by the case manager during weekly meetings. Progress is also monitored at weekly staff meetings during case review. Additionally, case managers consult with staff counselors or the Clinical Supervisor as needed in order to provide the best client services. We conduct annual briefings at Dublin Police Services to update them about issues of domestic violence, sexual assault and homelessness, and our agency's activities. All new staff and volunteers who attend our 70-hour domestic violence and sexual assault counselor training participate in a ride along with one of the three Tri-Valley police departments in order to maintain a strong connection to local law enforcement. Officers regularly tell us during the annual briefings that this is a positive experience for them. We are participants in the Family Violence Prevention Programs at Kaiser Permanente in Livermore and Pleasanton. While the Dublin Kaiser offices do not have a formal program in place, we have made presentations to staff about domestic violence, and they have supported several of our events, such as Back to School and the Pace for Peace. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision We strive to make our services available to all through the provision of culturally sensitive services as detailed in question 10 above, in the languages of our clients. Toward this end, we have consciously worked to diversify our staff through offering a wage differential to direct service staff fluent in the languages most commonly spoken in the Tri-Valley area. Our shelters are accessible to clients with disabilities, and we inquire upon intake if any accommodations are needed. All of our facilities are LGBTQ welcoming. We have multi -cultural staff members and volunteers who utilize their cultural backgrounds to enhance the services we provide to our clients. We presently have staff fluent in Spanish, Hindi, Punjabi, Russian, French and several African languages. Multi language fluency is always a consideration when hiring staff and recruiting volunteers, and wage differentials are given to those bilingual. All of the written materials at Shiloh are in both English and Spanish, and some are in Chinese. We make sure that at Shiloh we have cooking utensils and dishes that are multi -culturally appropriate such as rice cookers, chopsticks, and new sets of pots and pans for Muslim clients whose religious practice requires that these not be shared with other families. Ethnic food is available for our shelter clients at the Food Pantry and grocery store gift cards are available to assist with purchasing items that aren't at the Food Pantry. We continue educating our staff through participation in Cultural Responsiveness development projects. TVH staff maintains a good working relationship with CRIL, a local service provider for persons with disabilities and also is aware of key services such transportation for persons with disabilities and how to access them. Telephone screenings and intake processes include questions about needed accommodations (such as a bottom bunk, private room or special dietary needs). Our shelter is handicap -accessible. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. 38e' Enter "NA" if not eligible. Our Domestic Violence Housing First program, funded by the Office of Emergency Services, offers case management and client assistance to help survivors of domestic violence access and/or retain safe housing after leaving an abusive relationship. During the pandemic, DVHF has helped survivors who lost their jobs or had their hours cut to pay rent and utility bills in order that they could remain safely housed. In 2021 Tri-Valley Haven hosted two vaccination clinics by Alameda County Healthcare for the Homeless at our Livermore community building. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. Y'. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. n/a 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive Encourage community engagement and involvement LJ Promote energy and resource efficiency ❑ Encourage networking and information sharing across service providers ❑ Encourage process streamlining ❑ Consolidate service delivery Y'. Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. LJ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or *! F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: LJ Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing ❑ Increase Opportunities for 1st Time Homebuyers LJ Promote Decent Affordable Rental Housing ❑ Strengthen Communities 38; ❑ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Y'. Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') ❑ Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities L! Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am 1 seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability Y'. Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. LJ Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. LJ Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. LJ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) 384 e number of persons unemployed before taking LJ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. .�: Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) ❑ Persons ❑ Households Y'. Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless n/a Not Applicable. Not interested in CDBG funding (Type N/A) TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process n/a Extremely Low Income (<30% AMI) C n/a very Low Income (30%-50% AMI) n/a Low Income (50%-80% AMI) n/a Moderate Income (80%-120% AMI) E7 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" I White F White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC CAmerican Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC 38! Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial n/a Not Applicable. Not interested in CDBG funding. (Type N/A) 0.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ❑ #1 - This program/project has the agency's highest priority for funding. Y'. #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. LJ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. LJ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Alameda County Domestic Violence Center ACT USD$ 26,305.00 Alameda County HCD Linkages USD$ 56,808.00 Alameda County CalWORKS USD$ 70,000.00 Alameda County SSA Shelter USD$ 79,760.00 CalOES DV USD$ 537,587.00 Local Dublin/Pleasanton/Livermore USD$ 84,000.00 Donations/Foundations USD$ 12,000.00 EFSP USD$ 25,000.00 Total USD$ 891,460.00 USD$ 0.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 568,437.00 Benefits USD$ 112,578.00 Supplies USD$ 45,386.00 Postage USD$ 100.00 Communications USD$ 13,239.00 Rent and Utilities USD$ 39,582.00 Accounting/Audit USD$ 22,484.00 Other USD$ 64,654.00 Other: hotel stays for clients USD$ 25,000.00 Total USD$ 891,460.00 USD$ 0.00 Budget Narrative Revenue: The composition of revenue is our best estimate based on the previous year of operation. Expenses: personnel costs include salaries and benefits. Sick leave, vacation, and holidays are not included in the benefits calculation for staff that will be paid with the Dublin grant funds. Other operating expenses include: travel and mileage, payroll, portion of liability, property, D&O, and auto insurance, auto expense, staff development and client 38E nce. Domestic Violence Services budget is part of the overall agency budget that includes other programs and departments such as Homeless and Family Support Services, Sexual Assault Services, Finance, and Administration. thus only a portion of liability insurance, auto insurance, audit etc. are being charged to this program. Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests J Program Expense Budget download template Financial Information Form for ALL Grant Requests❑ Financial Information download template List of Board of Directors (or governing body) with 0 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Agency Budget Copy of most recently submitted IRS 990 form or Tax 0 IRS Form 990 Return (include complete form) Board of Director's (or governing body's) designation 0 BoD Resolution of authorized official Board of Director's (or governing body's) authorization 0 BoD Resolution to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 Non-profit Status DETERMINATION LETTER. All organizations MUST Non-profit Status State have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit Audit Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Strategic Plan 38-1 qu Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 426248 Become a fan of ZoomGrants'" on Facebook Problems? Contact us at Queslions5zoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout I Browser 38E 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Tri-Valley Haven Homeless Services Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2023 7:35:14 PM (Pacific) Project Contact Christine Dillman Dillman cynthiaCa)trivalleyhaven.org Tel: 9254495845 Additional Contacts cynthia@trivalleyhaven.org,joe@trivalleyhaven.org Organization Information top 1. Business License Number BL-007058 Questions top Tri-Valley Haven 3663 Pacific Avenue Livermore, CA 94550 United States Acting Executive Director Christine Dillman christine(cDtrivalleyhaven.orq 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone(925) 449-5845 x Fax (925) 449-2684 x Web www.trivalleyhaven.org 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Tri-Valley Haven creates homes safe from abuse, contributes to a more peaceful society. One person, one family, one community at a time. Together we build a world without violence. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project 'e'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 38E J Yes *!. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). Funding will support TVH's Homeless and Family Support Services programs. TVH's family shelter, Sojourner House, provides homeless clients with support services while the Food Pantry (FP) provides nutritious food to low income & homeless Tri-Valley residents. Sojourner House will continue to provide homeless clients (women, women with children, two parent families with children, men with children) with shelter and support services to help them to overcome the barriers that led to their homelessness and to assist them in securing stable housing. Program participants are offered up to six months shelter residency. Shelter clients are provided case management, life skills classes and counseling services. The Food Pantry will continue to provide food to low income, homeless, and "at risk of becoming homeless" Tri-Valley residents. TVH's Mobile Food Pantry distributes USDA items, meat and/or produce to Dublin Ranch Senior Apartments twice each month. The Food Pantry receives food through the Alameda County Community Food Bank monthly and participates in the local Grocery Rescue program on weekday mornings. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) The 2011 Eastern Alameda County Human Services Needs Assessment discovered that in Eastern Alameda County there is a significant and increasing disparity between the growing demand for human services and a stagnating, and at times, declining supply of services. The quality of life for many residents is deteriorating, and at the same time, they are able to access fewer resources to help them recover. According to the Needs Assessment, those living below the poverty level, the mentally ill, the homeless and those at -risk of homelessness are most affected. A growing number of seniors are among the new homeless. Having a comprehensive program offering a wide variety of services and focuses on helping homeless or at -risk of becoming homeless to become self-sufficient is vital. We continue to follow COVID-19 protocols for shelters as recommended by Alameda County Healthcare for the Homeless (ACHCH). We provide staff and residents with gloves, masks, cleaning disinfectant and hand sanitizers. Staff and residents are self -tested weekly utilizing COVID-19 Rapid at Home Test Kits provided by ACHCH. Last fiscal year Sojourner House provided 3,365 bednights to 29 adults and 18 children. TVH's Food Pantry services address the needs of Dublin households that are experiencing food insecurity. The Food Pantry's larger space — occupied in February 2022 - offers clients the ability to select from our daily inventory of food and choose which items they prefer - the "Client Choice" model for the distribution of food. TVH utilizes our Food Pantry not only as a place where people in need can receive free groceries, but also as a venue for providing social services referrals and information about assistance available. During the past fiscal year we 2,598 unduplicated Dublin residents were served by the Homeless Services programs. If not funded staff positions will be reduced. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 425 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing ❑ Health Care (including dental) ❑ Workforce Development Y: Homelessness LJ Transportation Services and Access : Domestic Violence and Child Abuse LJ Disabilities Food and Nutrition ' Senior Services LJ Youth Services ❑ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity ❑ Financial Assistance 39C None of the Above ?�'. Please explain: TVH provides a homeless shelter, a food pantry and mobile FP for seniors 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) The funds requested from Dublin will be used to pay a portion of the salaries and benefits of the following positions: a) Sojourner House Case Manager and b) Food Pantry Coordinator. We utilize multiple funding sources to support the staff positions and operating costs at both Sojourner and the Food Pantry. The Food Pantry relies on a large number of volunteers to address the collection, sorting, shelving and distribution of food to clients. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? The effectiveness of Sojourner House will be measured through statistical results and the individual goals set by the program participant and their case manager. Those goals may include: a resident gaining employment, a family transitioning into permanent housing, or a family addressing health and mental health needs. Long-term self-sufficiency achieved by a client would be a success. Sojourner House continues to provide homeless clients with shelter and support services to help them to overcome the barriers that led to their homelessness. Assisting each client with regards to their individual needs, i.e. health, mental health, housing, employment, public entitlements is the result we expect to achieve Last fiscal year Sojourner House provided 3,365 bednights to 29 adults and 18 children. We believe that our Food Pantry continues to be a success. We define success in terms of both the quality of our services and in our ability to meet, and hopefully exceed, the needs of our program participants from the Tri-Valley community. During the past fiscal year we served 4,307 unduplicated individuals at the Food Pantry; 497 of which were from Dublin. Additionally, during TVH's annual Holiday Food Distribution event 443 households were served in November with groceries, chickens/turkeys and gift cards. At our December Food Distribution event 628 households were served with groceries, chickens/turkeys and gift cards. The basic criteria for success is being able to serve every single household that comes to the Food Pantry with nutritious food and, if needed, referrals to other public/private community service agencies. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? The full statements are available at www.dublin.ca.gov/72/mission-vision Tri-Valley Haven promotes and supports inclusivity, diversity and equity as evidenced in our mission statement: "Tri-Valley Haven creates homes safe from abuse, contributes to a more peaceful society one person, one family, one community at a time. Together we build a world without violence." Our Food Pantry program presents inclusive access to nutritional foods to all community members in need, provides in-house and mobile services that cater to the diversity of our clients and ensures the delivery of equitable access to all. Staff at Sojourner House respect and celebrate the diversity of the clients served and provide equitable access to support services for all clients. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. We have seen an increase in the number of households utilizing our Food Pantry due to the impacts of COVID-19. We continue to distribute food to our customers, only a few households at a time, to ensure appropriate social distancing. We provide staff and volunteers masks, gloves and sanitizers, and have required all customers to wear face masks. All Food Pantry staff and volunteers are required to be vaccinated. The number of clients served at Sojourner House continues to be affected due to the Covid-19 pandemic. Since March of 2020 we have designated the four shelter bedrooms to either individuals or families in order to practice social distancing. All shelter staff are required to be vaccinated. We highly recommend vaccinations for our clients. Shelter staff complete a daily Resident Symptoms Screening Log that includes the taking of temperatures and inquiries into health status. If residents report having Covid-19 related health symptoms and/or fevers staff refer them to the county's Operation Comfort program for placement into a hotel for isolation and testing. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? Y: Yes. If so, check box here and answer questions 14 through 25. ❑ No. If no, check box here and enter NA 391 Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. TVH is committed to providing services to limited English speaking clients. We presently have multiple staff fluent in Spanish. Additionally, staff is available to provide assistance in Russian, Punjabi, and Hindi. We seek out bilingual/bicultural staff, and provide a wage differential for those that speak Spanish. At Sojourner House and the Food Pantry we offer the use of Alameda County Social Services Agency's Language Line Solutions service for clients to access an on -demand interpreter. In Dublin, our largest LEP client group is Chinese -speaking. We make sure that our intake forms for the mobile food pantry are available in Chinese. In addition, most flyers, client materials and other communications are created in both English and Spanish. We produce and distribute documents in other languages when available. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: Y: Be culturally accessible, appropriate and inclusive Y'. Encourage community engagement and involvement ❑ Promote energy and resource efficiency .f': Encourage networking and information sharing across service providers LJ Encourage process streamlining LJ Consolidate service delivery LJ Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. ❑ B) Homeless '. Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. LJ D) Community Development LJ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or ❑ F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing LJ Increase Opportunities for 1st Time Homebuyers ❑ Promote Decent Affordable Rental Housing *!'. Strengthen Communities LJ Ensure Equal Opportunity in Housing ❑ Reduce Housing Discrimination '. Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations ❑ Not Applicable. Not interested in CDBG funding. 39'9 18. CDBG ONLY - Select one HUD Objective (TIP: When selecting an objective ask yourself, 1 am seeking to address?') Y'. Creating a Suitable Living Environment ❑ Providing Decent Affordable Housing ❑ Creating Economic Opportunities hat relates to your project: "What is the purpose of the activity? What is the larger community need that Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') Y'. Availability/Accessibility ❑ Affordability ❑ Sustainability ❑ Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. ❑ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. ❑ Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. ❑ Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. ❑ Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. LJ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically homeless households assisted. Y: Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. ❑ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. LJ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of 39; new businesses that remain operational for three years after assistance. CI Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. LJ Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) *!: Persons LJ Households FJ Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". L 225 Seniors (62 and older) 35 People with Disabilities 120 Female -Headed Households 0 Youth 25 Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) 405.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMP) information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 400 Extremely Low Income (<30% AMI) 25 Very Low Income (30%-50% AMI) 0 Low Income (50%-80% AMI) 0 Moderate Income (80%-120% AMI) 425.01 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" 100 White 0 White + HISPANIC 50 Black/African American 0 Black/African American + HISPANIC 200 Asian 0 Asian + HISPANIC 5 American Indian/Alaskan Native 0 American Indian/Alaskan Native + HISPANIC 0 Native Hawaiian/Other Pacific Islander 0 Native Hawaiian/Other Pacific Islander + HISPANIC 0 American Indian/ Alaskan Native and White 0 American Indian/ Alaskan Native and White + HISPANIC 0 Asian and White F_ 0 Asian and White + HISPANIC 0 Black/African American and White 391 0 Black/African American and White + HISPANIC 0 American Indian/Alaskan Native and Black/African American C0 American Indian/Alaskan Native and Black/African American + HISPANIC 70 Multi Racial + HISPANIC OR other Multi Racial 0 Not Applicable. Not interested in CDBG funding. (Type N/A) TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY : #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. ❑ #5 - This program/project has the agency's 5th highest priority for funding. ❑ #6 - This program/project has the agency's 6th highest priority for funding. ❑ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Alameda County HCD Linkages USD$ 56,808.00 Alameda County SSA Food Pantry USD$ 109,952.00 Alameda County SSA Shelter USD$ 212,693.00 Alameda County StopWaste USD$ 20,000.00 CalRecycle USD$ 0.00 USD$ 57,000.00 Local Dublin/Livermore/Pleasanton USD$ 175,000.00 Individual Donations/Foundations USD$ 32,000.00 USD$ 0.00 Total USD$ 606,453.00 USD$ 57,000.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 321,306.00 USD$ 47,595.00 Benefits USD$ 81,662.00 USD$ 9,405.00 Supplies USD$ 30,820.00 USD$ 0.00 Communications USD$ 20,627.00 USD$ 0.00 Rent and Utilities USD$ 91,595.00 USD$ 0.00 Insurance USD$ 9,689.00 USD$ 0.00 Client Assistance USD$ 9,000.00 USD$ 0.00 Vehicle Expenses USD$ 3,698.00 USD$ 0.00 Other: defined below USD$ 38,056.00 USD$ 0.00 Total USD$ 606,453.00 USD$ 57,000.00 Budget Narrative Revenue: The composition of revenue is our best estimate based on the previous year of operation. Expenses: personnel costs include salaries and benefits. Sick leave, vacation, and holidays are not included in the benefits calculation for staff that will be paid with the Dublin grant funds. Other operating expenses include: travel and mileage, maintenance and repair expenses, audit, accounting, payroll, staff development The Homeless and Family Supports Services budget is part of the overall agency budget that includes other programs and departments such as Domestic Violence Services, Sexual Assault Services, Finance, and Administration. Thus only a portion of liability insurance, auto insurance, audit etc. are being charged to this program. 39! Documents top Documents Requested * Required? Attached Documents Program Expense Budget for ALL Grant Requests f. Program Expense Budaet download template Financial Information Form for ALL Grant Requests 6 Financial Information download template List of Board of Directors (or governing body) with 21 Board of Directors agency contact information Current Annual Budget for the Entire Agency 0 Agency Budget Copy of most recently submitted IRS 990 form or Tax 0 IRS Form 990 Return (include complete form) Board of Director's (or governing body's) designation 0 BoD Resolution of authorized official Board of Director's (or governing body's) authorization 0 BoD Resolution to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 Non-profit Status DETERMINATION LETTER. All organizations MUST Non-profit Status State have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements 0 Audit Audit Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Audit Requirement Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Articles of Incorporation Incorporation and Bylaws By -Laws REQUIRED FOR CDBG ONLY - Conflict of Interest Conflict of Interest Policy Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LEP Policy LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Strategic Plan Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) * ZoomGrantsTM is not responsible for the content of uploaded documents. 39E Application ID: 426249 Become a fan of ZoomGrantSTM on Facebook Problems? Contact us at Queslions5ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Lopout I Browser 391 9 Email This Preview Save as PDF Print Close Window A♦ ITIC DUBLIN C A L I F 0 R N I A Powered by ZoomGrantsTm and City of Dublin PCS - Human Services Division City of Dublin, Fiscal Year 2023-24, Human Services Grant Program Deadline: 1/20/2023 Wishing Well Inc FreeMeals Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/20/2023 4:02:59 PM (Pacific) Project Contact Reena Jadhav seemachawla@amail.com Tel: 6503462500 Additional Contacts none entered Organization Information top 1. Business License Number 263642056- EIN Questions top Wishing Well Inc 1225 Lozano Ct Pleasanton, CA 94566 United States CEO Reena Jadhav Reena(a)freemeals.org 1. Select the category that best describes your organization: (Select only one.) i Non -Profit ❑ Public Agency LJ Other: Telephone(650) 346-2500 Fax Web https://freemeals.org/ 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Since our founding at the start of Covid our mission has been to feed hot nourishing meals to families in need. Our motto is "no one should sleep hungry. We are 100% volunteer run organization and all donations are used to purchase meals and groceries. 3. Select the category that best describes the project: (Select only one. For Capital Projects, please contact City Staff ahead of the grant application submission to review additional requirements including the Davis-Bacon/Fair Labor Standards Act) ❑ Capital Project .'. Public Service Program or Project 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in 39E operatioi LJ Yes '. No 5. Provide a brief summary of the program/project for which your agency is seeking funding (No more than three sentences. This text will be used widely during the review and implementation process to describe your project). FreeMeals allows families in need to fill out a form on our website with a request for a meal. Volunteers screen requests and order nutritious hot meals to be delivered or picked up. We feed single moms to end stage cancer patients to seniors in their 90s, and foster kids. 6. Describe the challenges, needs, or service gaps in Dublin your program/project addresses. If you do not receive funding, what would the impact be? (You should reference Dublin demographics, statistics, and reports to make your case.) Dublin has a high number people seniors, single moms, who are not able to afford a healthy meal. FreeMeals would like to ensure no one sleeps hungry in Dublin. We work with local authorities to identity homeless population as well as all families registered in the system for aid. We are planning to feed at least 2000 needy individuals to make their life better. If we don't receive funding, we won't be able to meet these numbers. 7. Estimate the total number of UNDUPLICATED Dublin residents to be served by this project. (UNDUPLICATED means client is counted only once regardless of number of services received in a year.) 2000 residents 8. Which of the 14 Areas of Concern identified in the Eastern County 2011 Needs Assessment Report does your project identify with? Please explain how your project meets the selected Areas of Concerns as well as helps the City of Dublin archive its Vision Statement that was included in its 2018 Strategic Plan. The mission and vision statements are available online at www.dublin.ca.goW1956/Application-Requirements-Process ❑ Behavioral Health (mental health and substance abuse) ❑ Affordable Housing LJ Health Care (including dental) ❑ Workforce Development ❑ Homelessness LJ Transportation Services and Access LJ Domestic Violence and Child Abuse LJ Disabilities : Food and Nutrition ❑ Senior Services LJ Youth Services LJ Child Care, Early Childhood Development and Education LJ Changing Demographics and Growing Diversity LJ Financial Assistance ❑ None of the Above ❑ Please explain: 9. Describe in detail how Dublin grant funds will be used for this project. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) 100% of the grant funds will be used to feed the needy in Dublin in 2023. These funds will also be used for hot Thanksgiving and Holiday meals. We also partner with Dublin schools to deliver nutritious meals to children in need. 10. Describe how you will measure the effectiveness of this program/project. Describe your criteria for success. What results do you expect to have achieved at the end of this grant? Our criteria for success is to ensure no one sleeps hungry in Dublin. To that extent, we will work with local authorities to identity homeless population as well as all families registered in the system for aid. Just as we have fed families at the Goodness Village, we will feed all such families identified in Dublin. We will be successful if we have fed 2000 individual meals in Dublin by the end of 2023. 11. The City Council updated Dublin's Mission, Vision, and Values in 2020 to include Inclusivity, Diversity and Equity. How does your project further these values? 39E The full statements are available at www.dublin.ca.gov7727mission-vision We focus on diversity, inclusivity and equity by ensuring that we are reaching those families through our partnerships. We are listed in all local resource directories such as ........ that target such population. We feed single moms to end stage cancer patients to seniors in their 90s, and foster kids. We do not ever say NO to any meal request based on any criteria other than their ability to afford a nutritious meal. 12. For the Fiscal Year 2023-2024 Human Services Grant Cycle, additional funding may be available through the City's American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization's programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. FreeMeals.org was founded during COVID specifically due to the economic hardships and serious illnesses. We continue to feed families impacted by Covid by delivering meals to their house, shelters or tents to homeless. 13. ** QUESTIONS 14 THROUGH 24 ARE FOR THOSE ORGANIZATIONS INTERESTED IN APPLYING FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDING ONLY. ** Are you are interested in applying for CDBG funds? ❑ Yes. If so, check box here and answer questions 14 through 25. Y'. No. If no, check box here and enter NA ❑ Don't know. If you are unsure, please call City staff at (925) 833-6645. 14. CDBG ONLY- Explain your Limited English Proficiency/Language Access Plan (LEP/LAP). How does your agency outreach to limited English speaking residents to encourage access to services? What access accommodations are used? Etc. Provide detail Please enter "N/A" if you are not interested in qualifying for CDBG funding. N/A 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: ❑ Be culturally accessible, appropriate and inclusive ❑ Encourage community engagement and involvement ❑ Promote energy and resource efficiency LJ Encourage networking and information sharing across service providers Encourage process streamlining ❑ Consolidate service delivery Y'. Not Applicable. Not interested in CDBG funding. 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ❑ A) Housing ❑ Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. ❑ Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. ❑ Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. LJ B) Homeless ❑ Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. ❑ C) Supportive Housing ❑ Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. ❑ D) Community Development ❑ Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. ❑ Goal 2: Fund economic development, micro -enterprise, and on-the-job training. ❑ Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or Y'. F) Not Applicable. Not interested in CDBG funding. 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 40( Public Services ❑ Public Facilities ❑ Rental Assistance ❑ Affordable Housing LJ Increase Opportunities for 1st Time Homebuyers LJ Promote Decent Affordable Rental Housing ❑ Strengthen Communities LJ Ensure Equal Opportunity in Housing LJ Reduce Housing Discrimination ❑ Promote Participation of Grass -Roots, Faith -Based, and other Community -Based Organizations Not Applicable. Not interested in CDBG funding. 18. CDBG ONLY - Select one HUD Objective that relates to your project: (TIP: When selecting an objective ask yourself, "What is the purpose of the activity? What is the larger community need that 1 am seeking to address?') ❑ Creating a Suitable Living Environment Providing Decent Affordable Housing ❑ Creating Economic Opportunities Y'. Not Applicable. Not interested in CDBG funding. 19. CDBG ONLY - Select one HUD Outcome that relates to your project: (TIP: When selecting an outcome ask yourself, "What type of change or result am I seeking?') ❑ Availability/Accessibility ❑ Affordability ❑ Sustainability Y'. Not Applicable. I am not interested in qualifying for CDBG funding. 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: LJ Public facility or infrastructure: This indicator shows the number of persons that have been assisted by public facility or infrastructure activities that provide individuals with new or improved access to the facility or infrastructure. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of household units that no longer have access to a substandard service. ❑ Public Service: This indicator shows the number of persons that have been assisted with new or improved access to a service. If the activity was used to meet a quality standard or to measurably improve quality, then this indicator will report the number of persons that no longer have access to a substandard service. ❑ Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses assisted, low- and moderate -income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. ❑ Commercial facade treatments or business building rehabilitation: This indicator shows the number of commercial facade treatments undertaken and the number of business buildings that were rehabilitated. LJ Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Rental units constructed: This indicator shows the number of affordable rental units created, as well as the number of years of affordability, number of units occupied by the elderly, and those units designated for chronically homeless persons and persons with HIV/AIDS. ❑ Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. Homeownership units constructed or acquired with rehabilitation: This indicator shows the total number of homeownership units constructed, acquired, and/or acquired with rehabilitation per activity. This includes total number of affordable units, number of years of affordability, Energy Star qualified units, section 504 accessible units, and number of households previously living in subsidized housing. In addition, data will be collected on the number of units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. LJ Owner occupied units rehabilitated: This indicator shows the total number of owner occupied units rehabilitated, including the number of these units occupied by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. ❑ Tenant Based Rental Assistance (TBRA): This indicator shows the total number of households receiving TBRA as well as the number with short-term rental assistance (less than 12 months) and the number of homeless and chronically 401 Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. ❑ Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. LJ Jobs created: Of the total number of jobs created, this indicator shows the number of jobs that have employee - sponsored health care, the types of jobs created (using Economic Development Administration (EDA) classifications) and the number of persons unemployed before taking the job. ❑ Jobs retained: Of the total number of jobs retained, this indicator shows the number of jobs retained, the number of jobs with employer -sponsored health care benefits, and the types of jobs retained (using EDA classifications) ❑ Business assistance: This indicator shows the total number of businesses assisted. Specifically, it shows the number of new businesses, existing businesses, and the DUNS number of each business so that HUD can track the number of new businesses that remain operational for three years after assistance. ❑ Businesses providing goods or services: This indicator shows whether an assisted business provides goods or services to meet the needs of the service area, neighborhood, or community, as determined by the grantee. ,:/: Not Applicable. Not interested in CDBG funding 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) LJ Persons Households f: Not Applicable. Not interested in CDBG funding 22. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Seniors (62 and older) People with Disabilities Female -Headed Households Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.00 TOTAL 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ('AMI') information is available online at www.dublin.ca.gov11956/Application-Requirements-Process 1 700 Extremely Low Income (<30% AMI) F 500 Very Low Income (30%-50% AMI) 250 Low Income (50%-80% AMI) Moderate Income (80%-120% AMI) 1,450.00 TOTAL 24. CDBG ONLY - List the number of clients your agency anticipates serving in race/ethnicity categories. Per HUD, "Hispanic" is an ethnicity, not a race. The sum entered below must match the total clients entered in Question #9 above. If none, please enter "0" White C White + HISPANIC CBlack/African American C Black/African American + HISPANIC CAsian C Asian + HISPANIC 40'9 American Indian/Alaskan Native American Indian/Alaskan Native + HISPANIC Native Hawaiian/Other Pacific Islander Native Hawaiian/Other Pacific Islander + HISPANIC American Indian/ Alaskan Native and White American Indian/ Alaskan Native and White + HISPANIC Asian and White Asian and White + HISPANIC Black/African American and White Black/African American and White + HISPANIC American Indian/Alaskan Native and Black/African American American Indian/Alaskan Native and Black/African American + HISPANIC Multi Racial + HISPANIC OR other Multi Racial N/A Not Applicable. Not interested in CDBG funding. (Type N/A) 0.00 TOTAL 25. If your agency is submitting more than one application or the same agency has different programs within it, please RANK the priority of this application, with number 1 being the highest priority for funding. There should only be one #1 PER AGENCY ;: #1 - This program/project has the agency's highest priority for funding. ❑ #2 - This program/project has the agency's 2nd highest priority for funding. ❑ #3 - This program/project has the agency's 3rd highest priority for funding. ❑ #4 - This program/project has the agency's 4th highest priority for funding. LJ #5 - This program/project has the agency's 5th highest priority for funding. LJ #6 - This program/project has the agency's 6th highest priority for funding. LJ If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Donations Total Funding Uses/Expenses Meals Expenses Total Budget Amount USD$ 0.00 USD$ 0.00 Budget Amount USD$ 120,000.00 USD$ 120,000.00 Budget Narrative 2000 individual meals will purchased from Dublin restaurants totally $25000. Documents top Amount Committed USD$ 0.00 Amount Committed USD$ 0.00 Documents Requested * Required? Attached Documents * Program Expense Budget for ALL Grant Requests 21 FreeMeals Program Expenses download template Financial Information Form for ALL Grant Requests 21 FM - Financial Information download template List of Board of Directors (or governing body) with❑ FreeMeals Website for Board of Directors agency contact information 40' Current Annual Budget for the Entire Agency❑ Annual Budaet Copy of most recently submitted IRS 990 form or Tax ❑.� IRS filling Return (include complete form) IRS History IRD filling confirmation Board of Director's (or governing body's) designation 0 Board of Directors - Designation of authorized official Board of Director's (or governing body's) authorization 0 Board of Directors - Authorization to request funding (may be same document as one above) Proof of insurance carried, including bonding, liability 0 Proof of Insurance and/or workers' compensation STATE AND FEDERAL NON-PROFIT 0 NON PROFIT DETERMINATION LETTER DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non -compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) REQUIRED FOR CDBG ONLY - AGENCY'S LIMITED ENGLISH PROFICIENCY LANGUAGE ACCESS PLAN (LEP/LAP). Must include outreach to limited English speaking residents to encourage access to services & housing. Include what access accommodations are used. REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Other Supporting Documents (Not Required) 0 FreeMeals Certified Audit Statements * ZoomGrantsTM is not responsible for the content of uploaded documents. Application ID: 426654 Become a fan of ZoomGrantSTM on Facebook Problems? Contact us at Queslions5ZoomGrants.com ©2002-2023 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Lonout I Browser 404 a :man Services Grant tgram FiscalYear 2023=24 292023 -. To AL f Human Services Grants Overview • November & December 2022: Outreach and education efforts • Advertising/Postings/Outreach • Grant Workshop • Application Period: December 6, 2022 - January 19, 2023 • The City received 23 qualifying applications -19 different organizations, and 4 new • Commission Review and Recommendation and City Council Approval: March — May 2023 • Funding Available: July 1,2023 DUBLIN s&� -M CALIFORNIA 406 Human Services Grants Criteria & Priorities • Tri-Valley Needs Assessment - Areas of Concern and the City's Adopted Mission and Vision • In recent years, the Human Services Commission has emphasized needs in the areas of Behavioral Health (mental health and substance abuse), Health Care (including dental), and Senior Services • City Council Emphasis: Focus on the Most Critical Human Service Needs • Mental Health Services • Healthcare • Food & Nutrition • Shelter & Homelessness • Grants for arts or school -based programs should not be awarded Human Services Grant funding DUBLIN I &� I CALIF 0RNIA 407 Human Services Grants Funding by Source Funding Sources CDBG Public Service Funds General Fund/ARPA Funds Sub 1 FY 2023-24 unds Requested $182,523 $312,957 $495,480 FY 2023-24 Funds Available $59,862* $2701000* * $329,862 *This allocation is the final adjustment and was a reduction from the original estimated amount of $99,000 **Includes $8,000 in Affordable Housing Funds DUBLIN s CALIF 0RNIA ON Human Services Grants - Distribution of Funding Organization Grant Proposal Amount Requested Initial Recommendation Allocation CDBG Reduction CDBG General Fund American Rescue Plan Act Axis Community Health Axis Section 108 Loan Obligation $15,000 $15,000 $15,000 $15,000 Axis Community Health Triage Nurse $12,734 $12,500 $11,724 $11,724 CALICO Center Child Abuse Intervention $15,000 $11,750 $11,021 $11,021 Centro Legal Fair & Secure Housing Project $23,789 $19,000 $17,821 $17,821 Chabot -Las Positas CC District Pathways to Employment $24,959 $16,000 $15,007 $15,007 Chabot -Las Positas CC District VITA Services $16,598 $16,000 $15,007 $15,007 City Serve of the Tri-Valley Homeless Prevention/Family Stabilization $25,000 $25,000 $23,448 $23,448 City Serve of the Tri-Valley Senior 60+ Stabilization Program $25,000 $16,250 $15,241 $15,241 CRIL Housing & Independent Living Skills $16,000 $9,150 $8,582 $8,582 Easterseals Northern CA Kaleidoscope Adult Day Program $25,000 $12,500 $11,724 $11,724 Goodness Village Goodness Village $25,000 $12,500 $11,724 $11,724* Hively Community Engagement Coordinator $25,000 $0 $0 Hively Family Resource Center $25,000 $25,000 $23,448 $23,448 Hope Hospice Inc. Grief & Volunteer Support Services $20,000 $12,800 $12,005 $12,005 Legal Assistance for Seniors Legal Services & Medicare Counseling $10,000 $10,000 $9,379 $2,216 $7,163 Lions Center for Visually Impaired Seniors Vision Health $7,500 $3,750 $3,517 $3,517 Love Never Fails Economic Freedom ITbiz Tech Academy $25,000 $7,500 $7,035 $7,035 Open Heart Kitchen Senior Meal Program $25,000 $25,000 $23,448 $21,414 $2,034 Partners for Change Tri-Valley Education & Mentorship for Poverty Alleviation $15,000 $5,000 $4,690 $4,690 Spectrum Community Services Meals on Wheels More Than a Meal $25,000 $25,000 $23,448 $23,448 Sunflower Hill Support for Adults with IDD $18,900 $16,000 $15,007 $15,007 Tri-Valley Haven Domestic Violence Services $25,000 $25,000 $23,448 $23,448 Tri-Valley Haven Homeless Services $25,000 $25,000 $23,448 $23,448 Wishing Well Inc. Free Meals $25,000 $5,000 $4,690 $4,690 Totals: $495,480 $350,700 $329,862 $59,862 $107,000* $163,000 DUBLIN CALIFORNIA nll�*] Human Services Grants Next Steps • Review grant requests and consider funding allocations with the following considerations: • Original Human Services Commission Funding Recommendation • Adjusted Human Services Commission Recommendation based on CDBG reduction • Further adjusted funding allocations based on the removal of Calico from the competitive process • Adopt the Resolution Approving Funding Recommendations for Fiscal Year 2023-24 Human Services Grant Program • Grant amounts will be incorporated into the Fiscal Year 2023-24 Budget • Agreement execution (City/County and City/Provider) • Invoicing and reporting • Monitoring DUBLIN s& CALIFORNIA 410 Questions?.