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03-24-2022 Agenda Packet
March 24, 2022 Dublin Human Services Commission Agenda 1 Regular Meeting of the DUBLIN HUMAN SERVICES COMMISSION Thursday, March 24, 2022 Location: Council Chamber Civic Center 100 Civic Plaza Dublin, CA 94568 Regular Meeting 7:00 PM 1. CALL TO ORDER 2. PLEDGE OF ALLEGIANCE 3. ORAL COMMUNICATIONS 3.1 Public Comment At this time, the public is permitted to address the Human Services Commission on non- agendized items. Please step to the podium and clearly state your name for the record. COMMENTS SHOULD NOT EXCEED THREE (3) MINUTES. In accordance with State Law, no action or discussion may take place on any item not appearing on the posted agenda. The Commission may respond to statements made or questions asked, or may request Staff to report back at a future meeting concerning the matter. Any member of the public may contact the Recording Secretary’s Office related to the proper procedure to place an item on a future Human Services Commission agenda. The exceptions under which the Commission MAY discuss and/or take action on items not appearing on the agenda are contained in Government Code Section 54954.2(b)(1)(2)(3). 4. CONSENT CALENDAR Consent Calendar items are typically non-controversial in nature and are considered for approval by the Human Services Commission with one single action. Members of the audience, Staff or the Human Services Commission who would like an item removed from the Consent Calendar for purposes of public input may request the Chair to remove the item. 4.1 Approval of the January 27, 2022 Human Services Commission Regular Meeting Minutes The Commission will consider approval of the minutes of the January 27, 2022 Human Services Commission Regular Meeting. STAFF RECOMMENDATION: Approve the minutes of the January 27, 2022 Human Services Commission Regular Meeting. Staff Report 1 March 24, 2022 Dublin Human Services Commission Agenda 2 Attachment 1 - Minutes of the January 27, 2022 Human Services Commission Regular Meeting 5. WRITTEN COMMUNICATION – NONE 6. PUBLIC HEARING – NONE 7. UNFINISHED BUSINESS – NONE 8. NEW BUSINESS 8.1 City of Dublin Fiscal Year 2022-23 Human Services Grant Program Funding Recommendations On an annual basis, the Human Services Commission reviews Human Services Grant Program applications and makes a funding recommendation to the City Council for the upcoming fiscal year. The Commission will receive a presentation from Staff regarding community non-profit organizations applying for funding, discuss the grant applications, review preliminary allocations, and make a final funding recommendation. STAFF RECOMMENDATION: Receive the preliminary recommendation on funding levels, deliberate, and make a recommendation to the City Council for approval. Staff Report Attachment 1 - City of Dublin Mission and Vision Attachment 2 - Tri-Valley Needs Assessment 14 Areas of Concern Attachment 3 - Grant Rating Criteria Worksheet Attachment 4 - Preliminary Funding Allocations Summary Attachment 5 - Fiscal Year 2022-23 Applications 9. OTHER BUSINESS Brief information only reports from the commission and/or Staff, including committee reports and reports by the commission related to meetings attended at City expense (AB1234). 10. ADJOURNMENT This AGENDA is posted in accordance with Government Code Section 54954.2(a) If requested, pursuant to Government Code Section 54953.2, this agenda shall be made available in appropriate alternative formats to persons with a disability, as required by Section 202 of the Americans with Disabilities Act of 1990 (42 U.S.C. Section 12132), and the federal rules and regulations adopted in implementation thereof. To make a request for disability-related modification or accommodation, please contact the City Clerk’s Office (925) 833-6650 at least 72 hours in advance of the meeting. 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. 2 STAFF REPORT Human Services Commission Page 1 of 1 Agenda Item 4.1 DATE:March 24, 2022 TO:Honorable Chair and Commissioners FROM:La Shawn Butler, Parks & Community Services Director SUBJECT:Approval of the January 27, 2022 Human Services Commission Regular Meeting Minutes Prepared by: Robert Stone, Senior Office Assistant EXECUTIVE SUMMARY: The Commission will consider approval of the minutes of the January 27, 2022 Human Services Commission Regular Meeting. STAFF RECOMMENDATION: Approve the minutes of the January 27, 2022 Human Services Commission Regular Meeting. FINANCIAL IMPACT: None. DESCRIPTION: The Commission will consider approval of the minutes of the January 27, 2022 Regular Meeting. STRATEGIC PLAN INITIATIVE: None. NOTICING REQUIREMENTS/PUBLIC OUTREACH: The Commission Agenda was posted. ATTACHMENTS: 1)Minutes of the January 27, 2022 Human Services Commission Regular Meeting 3 Attachment 1 MINUTES OF THE HUMAN SERVICES COMMISSION Regular Meeting: January 27, 2022 HUMAN SERVICES COMMISSION MINUTES 1 REGULAR MEETING JANUARY 27, 2022 A Regular Meeting of the Human Services Commission was held on Thursday, January 27, 2022, via Zoom Communications. The meeting was called to order at 7:02p.m., by Commission Chair Janet Songey. 1. Call to OrderAttendeeName Title StatusJanet Songey Commission Chair PresentShawn Costello Commissioner Vice Chair AbsentAnkita Sharma Commissioner AbsentRegis Harvey Commissioner PresentAdam Lumia Commissioner Present Rose Hunt Alternate Commissioner PresentBaljeet Sangha Alternate Commissioner Absent 2. Pledge of AllegianceThe pledge of allegiance was led by Chair Songey and recited by the Commission and Staff. 3. Oral Communications 3.1. Public Comment – None. 3.2 Informational Presentations by Fiscal Year 2021-22 Human Services Grant RecipientsPresentations were made to the Commission by the following Fiscal Year 2021-22 Human Services Grant Recipients:1) Calico Center2) Centro Legal3) Chabot-Las Positas Community College District4) Community Resources for Independent Living5) Easter Seals Bay Area6) Hope Hospice7) Narika8) Senior Support of the Tri-Valley9)Tri-Valley Haven 4 HUMAN SERVICES COMMISSION MINUTES 2 REGULAR MEETING JANUARY 27, 2022 4. Consent Calendar 4.1 Approval of the Minutes of November 18, 2021 Regular Human Services Commission Meeting.The Commission voted to approve the Consent Calendar.RESULT:APPROVED [UNANIMOUS]MOVED BY:Janet Songey, ChairSECOND:Regis Harvey, CommissionerAYES:Harvey, Lumia, Songey, Alternate Commissioner HuntABSENT:Costello, Sharma, Alternate Commissioner Sangha 5.Written Communication – None. 6.Public Hearing – None. 7.Unfinished Business – None. 8.New Business 8.1 Election of Chairperson and Vice ChairpersonShaun Chilkotowsky, Heritage and Cultural Arts Manager, provided information on theterm and duties of the Chair and Vice Chair.The Commission voted to elect Commissioner Lumia as Chairperson and CommissionerHarvey as Vice Chairperson for the 2022 calendar year.RESULT:APPROVED [UNANIMOUS]MOVED BY:Janet Songey, Chair SECOND:Rose Hunt, Alternate Commissioner AYES:Harvey, Lumia, Songey, Alternate Commissioner HuntABSENT:Costello, Sharma, Alternate Commissioner Sangha 8.2 Overview of the Fiscal Year 2022-23 Human Services Grant ProgramJudy Miller, Management Analyst II, presented an overview of the Fiscal Year 2022-23Human Services Grant Program. 5 HUMAN SERVICES COMMISSION MINUTES 3 REGULAR MEETING JANUARY 27, 2022 The Commission discussed the item. 9.Other BusinessStaff and Commissioners gave updates on various projects. 10.AdjournmentThe meeting was adjourned at 8:52 p.m. ____________________________________ Human Services Commission Chair ATTEST: ____________________________________ La Shawn Butler Parks and Community Services Director 6 STAFF REPORT HUMAN SERVICES COMMISSION Page 1 of 6 Agenda Item 8.1 DATE:March 24, 2022 TO:Honorable Chair and Commissioners FROM:La Shawn Butler, Parks & Community Services Director SUBJECT:City of Dublin Fiscal Year 2022-23 Human Services Grant Program Funding Recommendations Prepared by: Judy Miller, Management Analyst II EXECUTIVE SUMMARY: On an annual basis, the Human Services Commission reviews Human Services Grant Program applications and makes a funding recommendation to the City Council for the upcoming fiscal year. The Commission will receive a presentation from Staff regarding community non-profit organizations applying for funding, discuss the grant applications, review preliminary allocations, and make a final funding recommendation. STAFF RECOMMENDATION: Receive the preliminary recommendation on funding levels, deliberate, and make a recommendation to the City Council for approval. FINANCIAL IMPACT: The Human Services Grants Program is supported by funding sources including the federally funded Community Development Block Grant (CDBG) Fund and the City’s General Fund. For Fiscal Year 2022-23, additional funding is available from the Federal American Rescue Plan Act (ARPA). Table 1 presents the Fiscal Year 2022-23 funding by source. Table 1: Human Services Grants Program Funding by Source Source Amount CDBG (estimated)$99,000 City General Fund $98,000 ARPA $163,000 Total $360,000 The CDBG amount is currently estimated since the allocations from the U. S. Department of Housing and Urban Development are not final. This could be adjusted again in May or June prior to 7 Page 2 of 6 approval of the City budget. DESCRIPTION: Background Fiscal Year 2022-23 marks the 18th year of Dublin’s Human Services Grants Program which provides financial support to local non-profit organizations serving the Dublin community. Each year, the Human Services Commission (HSC) reviews applications and provides a recommendation to the City Council which then awards funding to organizations best meeting the community’s needs in support of the City’s Mission and Vision (Attachment 1), needs identified in the Tri-Valley Needs Assessment (Attachment 2), and priorities identified by the City Council. At its October 20, 2015 meeting, the City Council discussed funding priorities for future grant cycles, and directed that the Grants Program should emphasize funding programs specifically directed towards core human service needs, such as health care, food and nutrition, homelessness, and childcare. Furthermore, the City Council specified that grants would not be awarded to arts- or school-based programming or events. Further, the HSC’s preference in recent years has been to address needs in the areas of Behavioral Health (mental health and substance abuse), Health Care (including dental), and Senior Services. CDBG Funding, Estimated Allocations, and Uses The CDBG fund is provided by the U.S. Department of Housing and Urban Development (HUD). The City of Dublin works with Alameda County’s Urban County CDBG Program to allocate funds and to assure that all CDBG funded activities comply with Federal regulations. The City of Dublin has participated in Alameda County’s Urban-County CDBG Program since 1982. Dublin, along with the cities of Albany, Emeryville, Newark, and Piedmont (cities with a population below or near 50,000 residents), are called the “Urban County Cities,” along with the unincorporated areas of Alameda County. As shown in the table below, the City’s total CDBG allocation for community programs or uses for Fiscal Year 2022-23 is estimated at $99,000. Table 2: Use of CDBG Funds Program Fiscal Year 2022-23 Estimated Amount Human Services Grant Program $83,700 Existing Facility Project Loan Obligation (Axis Community Health - Health Center) $15,300 Total estimated CDBG allocation $99,000 Of the total estimated CDBG funding available to the City, $15,300 is already allocated for the City to make its annual payment under the Axis Community Health Facility Project Loan Agreement. This is a result of a 2014 resolution by the City Council authorizing Dublin to enter into a Public 8 Page 3 of 6 Participating Jurisdiction Agreement with the cities of Pleasanton and Livermore, and the County of Alameda, to borrow $1.25 million to support Axis Community Health’s facility construction. The loan obligation agreement, executed in July 2015, provides for a 20-year repayment commitment, through 2035, using annual CDBG funds. The funding allocation for repayment of the loan is identified as part of the Staff recommendation since it is a project funded with CDBG funds. Dublin’s total obligation is estimated at $217,674 based on the latest projection of interest rates. As a final note on the annual CDBG funds, the County limits teach Urban County City’s use of these funds to approximately 15% of the CDBG allocation for service-based organizations and projects, with the remaining 85% for capital projects. The County’s past practice has been to review all applications received from each Urban County City to determine if the overall request for service- based projects exceeds the 15% limit. If so, the County requests that each city adjust the service- based project allocation. If such adjustments are needed for Fiscal Year 2022-23, Staff will work with eligible grant applicants and the County to make prorated reductions for all CDBG awards. Fiscal Year 2022-23 Grant Cycle In November and December 2021, in preparation for the grant cycle, Staff conducted outreach and education efforts that included: Providing notice of funding availability and upcoming community workshops to non-profit organizations. Advertising the funding availability in East Bay Times and on the City website. Holding two Grant Application Workshops to review the online application process and discuss program guidelines for the upcoming fiscal year. Attendance at one of these workshops was a requirement of applicants. Between December 6, 2021 and January 19, 2022, the City accepted applications for the Grants Program via an online platform, ZoomGrants. Fifteen organizations submitted a total of 19 qualifying applications (three organizations submitted applications for multiple projects). In total, the applicants requested $42,711 more than is available in the Program. Table 3 summarizes the total funding requests and funding sources. Table 3: Funding Requests by Source FY 2022-23 Funding Source Funding Requested Available Funding CDBG Fund*/ARPA**$154,575 $99,000 City GeneralFund/ARPA**$247,711 $98,000 ARPA $163,000 Total $402,711 $360,000 *Minor adjustments may be necessary before the start of the fiscal year. **Of the requests for CDBG funding, $89,000 also qualifies for ARPA funds. Of the requests for the General Fund, $149,791 also qualifies for ARPA funds. Preliminary Recommendation 9 Page 4 of 6 In reviewing and rating the applications, the HSC was asked to consider the following factors (in no specific order): Grant Rating Criteria Worksheet (Attachment 3). Determination that the request meets the adopted program guidelines and qualifications. Whether the project addresses one or more of the 14 Key Areas of Concern identified in the 2011 Tri-Valley Needs Assessment Report. Whether the project addresses basic life needs such as food, shelter, health care, and mental health services. Past performance of projects that received grant funds in prior years. Whether City funds are used to leverage other funding sources. The number of Dublin residents served and cost per resident. Compliance with grant application requirements including attendance at grant workshops, presentations to the HSC, and reporting deadlines. The eligible uses for each of the three funding sources. For CDBG only: Compliance of proposed programs and service providers to ensure the activities comply with HUD/CDBG guidelines. For ARPA only: Compliance of proposed programs and service providers to ensure the activities mitigate the negative economic impacts resulting from the Covid-19 pandemic. Based on those factors, the HSC and Staff made preliminary recommendations to allocate funding to all 19 applications. Five applicants qualified for CDBG funds and indicated they were willing to meet the related strict federal guidelines including benefiting income-qualified persons, homeless persons, or persons with disabilities. The remaining 14applications are eligible for, and are recommended to receive, a percentage of the General Fund allocation or the ARPA funds allocation. Table 4 summarizes the preliminary funding recommendations (also included as Attachment 4). Since requests exceeded available funds, the City is unable to fully fund all requests. Table 4: RECOMMENDATIONS FOR FISCAL YEAR 2022-23 GRANT PROGRAM Organization Name and Proposal Title Requested Amount Recommended Amount Recommended Source(s) Axis Community Health - Loan Obligation NA $15,300 CDBG CALICO Center - Dublin Child Abuse Prevention $15,000 $14,425 CDBG Centro Legal de la Raza – Fair and Secure Housing Project $25,000 $22,575 CDBG Community Resources for Independent Living - Housing and Independent Living Skills $15,000 $14,100 CDBG Legal Assistance for Seniors - Legal Services, Medicare Counseling and Education for Dublin Seniors $10,000 $9,100 CDBG 10 Page 5 of 6 Spectrum Community Services - Meals on Wheels for Dublin's Homebound Elderly $25,000 $23,500 CDBG CDBG TOTAL $90,000 $99,000 CDBG Chabot-Las Positas Community College District/Tri-Valley Career Center – Job Support Expansion $18,341 $16,230 ARPA Chabot-Las Positas Community College District/Tri-Valley Career Center – EITC Support Program $15,950 $13,580 ARPA City Serve of the Tri-Valley - Homelessness Prevention Family Stabilization $25,000 $24,050 ARPA Easter Seals Bay Area - Kaleidoscope Community Adult Program $25,000 $15,250 General Fund Goodness Village - Tiny Home Community $25,000 $16,230 General Fund Hively – Family Resource Center $25,000 $22,400 ARPA Hively – Busy Bees Learning Lab $12,000 $10,100 General Fund Hively – Community Engagement Coordinator $25,000 $23,150 ARPA Hope Hospice - Grief Support Center and Hospice Volunteer Program $20,000 $17,670 General Fund Open Heart Kitchen - Dublin Senior Meal Program $25,000 $23,900 ARPA Senior Support Program of the Tri Valley - Case Management $16,500 $16,150 ARPA Sunflower Hill - Program Support for Adults with Developmental Disabilities $16,500 $15,400 General Fund Tri-Valley Haven – Domestic Violence Services $24,000 $23,350 General Fund Tri-Valley Haven – Homeless Services $24,000 $23,540 ARPA GF/ARPA TOTALS $297,291 $261,000* GRAND TOTALS $387,291 $360,000 *The $261,000 total comprises $98,000 from the General Fund and $163,000 from ARPA. Next Steps The HSC will review the preliminary funding allocations and adjust as necessary to ensure grant awards best meet program objectives and guidelines. In particular, the HSC should carefully consider programs that have a high average cost per unduplicated resident as shown in Attachment 4. Program guidelines and rating criteria specifically state that the cost should be reasonable for the number of unduplicated residents served and adjustments should be made to programs not meeting this criterion. Additionally, the Commission should consider the need/benefit and that the number of beneficiaries is appropriate for the grant funding being 11 Page 6 of 6 recommended. After the Commission deliberates and makes a recommendation, Staff will present the final recommendation to the City Council for consideration. This is tentatively scheduled for the meeting of April 19, 2022. Since the CDBG allocation is still estimated, if adjustments are necessary to comply with the 15% service-based project cap, Staff will work with the organizations and the County to bring grant allocations into compliance. Approved grant amounts will be incorporated into the Fiscal Year 2022-23 budget, after which all grant awardees are required to enter into an agreement with the City of Dublin. Organizations receiving funds will be required to submit insurance documents, timely invoices, and quarterly (if CDBG-funded) or twice-yearly reports on their progress in reaching projected goals. CDBG-funded organizations will also be required to participate in annual site monitoring visits. STRATEGIC PLAN INITIATIVE: None. NOTICING REQUIREMENTS/PUBLIC OUTREACH: The Commission Agenda was posted with copies provided to grant applicants. ATTACHMENTS: 1) City of Dublin Mission and Vision 2) Tri-Valley Needs Assessment 14 Areas of Concern 3) Grant Rating Criteria Worksheet 4) Preliminary Funding Allocations Summary 5) Fiscal Year 2022-23 Applications 12 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. Attachment 1 13 2011Tri ͲValleyNeeds Assessment FindingsbyAreaofConcern* 1 Behavioralhealth(mental healthandsubstanceabuse) 8 Disabilities 2Affordablehousing9Foodandnutrition 3 Healthcare 10 Seniorservices 4 Workforce development 11 Youth services 5 Homelessness 12 Childcare, earlychildhood developmentandeducation 6 Transportationservicesand access 13 Changing demographicsand growingdiversity 7 Domesticviolenceandchild abuse 14 Financialassistance *Page33EasternAlamedaCountyHumanServicesNeedsAssessment Attachment 2 14 1 Criteria Rating Sheet CITY OF DUBLIN UNIVERSAL GRANT RATING SHEET Organization:Program: PROPOSAL SCORE Maximum of 15 points RECOMMEND FUNDING Yes No FUNDING SOURCE CDBG Comm. Grant Incl. Fund Total Requested Total Recommended IF RECOMMENDING CDBG FUNDING, NOTE THAT CDBG FUNDS MAY ONLY BE USED FOR THE FOLLOWING ACTIVITIES AS DEFINED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (CHECK ONE). CAPITAL PROJECTS PUBLIC SERVICE HOUSING ECONOMIC DEVELOPMENT THE WORD “PROGRAM” IS U SED BELOW ON THIS FORM TO INCLUDE SERVICES, ACTIVITIES OR IMPROVEMENTS. 1.Organization/Management 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 their staff are qualified and have the capacity to provide for the program. (i.e. non-profit status, resumes for staff, a 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). (Maximum of 5) ______ 2. Needs/Benefit The beneficiaries are an appropriate target group (lower income residents, handicapped, elderly, youth, etc.) The organization provides an activity to Dublin residents that other organizations do not provide. Applicant’s activity: (choose a or b) a. benefits a majority of Dublin residents by meeting the City’s Mission, Vision and Values OR b. meets at least one of the U.S. Department of Housing and Urban Development’s Strategic Goals or Policy Priorities. The organization’s program meets one of the 14 Areas of Concern as identified in the 2011 Eastern Alameda County Needs Assessment Report The organization collaborates with other agencies to enhance services. (Maximum of 5) ______ Attachment 3 15 2 Criteria Rating Sheet 3. Funding/ Budget The amount of funding requested compared to the number of Dublin residents served is reasonable. Fiscal responsibility - evaluation of the most current audit does not reveal one or more *material weaknesses* (or equivalent) that could jeopardize other funding. Program and administrative budget covers the cost to provide for the program. The organization leverages other funding sources to provide activities/services/improvements. The organization charges a fee and/or produces other income that may be used to support this program (review submitted fee schedule if applicable). (Maximum of 5) ______ *Standardized accounting audit statements 1. A “Control Deficiency”, which is the lowest of the three deficiencies, exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions, to prevent or detect misstatements on a timely basis. 2. A “Significant Deficiency” is a control deficiency or a combination of control deficiencies, that adversely effects the organization’s ability to initiate, authorize, record, process or report financial data in accordance with the Generally Accepted Accounting Principles, and that the likelihood of a misstatement of the organization’s financial statement that is more than inconsequential which will not be prevented or detected by the organization’s established internal controls. 3. A “Material Weakness”, is a significant deficiency or a combination of significant deficiencies, that results in more than a remote likelihood that a material misstatement of the financial statements which will not be prevented or detected by the organization’s established internal controls. Rating Criteria is subject to change from time to time to reflect the current industry or to address the type of applications received. Attachmenr 3 16 Organization Grant Proposal Funding Received FY21-22 Grant Amount Requested FY22-23 Human Services Commissioners' Avg. Recommended Staff Adjusted Recommendation Human Services Commissioners' Points Average Estimated Unduplicated Residents Served Average Cost Per Unduplicated Resident Funding Type Axis Loan Obligation $15,575.00 $15,300.00 $15,300.00 $15,300.00 NA NA NA CDBG CALICO Center Child Abuse Prevention $15,000.00 $15,000.00 $14,625.00 $14,425.00 13.7 18 $801 CDBG Centra Legal De Raza Fair and Secure Housing Project $22,984.00 $25,000.00 $22,850.00 $22,575.00 12.7 30 $753 CDBG Community Resources for Independent Living Housing and Independent Living Skills $15,000.00 $15,000.00 $14,287.50 $14,100.00 13.7 30 $470 CDBG Legal Assistance for Seniors Legal Services, Medicare Counseling and Education $7,500.00 $10,000.00 $9,250.00 $9,100.00 14.0 142 $64 CDBG Spectrum Community Services Meals on Wheels for Dublin's Homebound Elderly $20,000.00 $25,000.00 $23,800.00 $23,500.00 14.0 60 $392 CDBG Chabot Las Positas Dublin Community Jobs Support Expansion 2022-23 $9,400.00 $18,341.00 $15,960.25 $16,230.00 13.7 108 $150 ARPA Chabot Las Positas Dublin EITC Support Program 2022- 23 $9,240.00 $15,950.00 $13,362.50 $13,580.00 13.3 147 $92 ARPA City Serve of the Tri-Valley Homelessness Prevention/ Family Stabilization $25,000.00 $25,000.00 $23,625.00 $24,050.00 13.3 30 $802 ARPA Easter Seals Bay Area Kaleidoscope Community Adult Program $10,830.00 $25,000.00 $15,113.63 $15,250.00 11.0 5 $3,050 GF Goodness Village Tiny Home Community New $25,000.00 $16,076.13 $16,230.00 11.3 2 $8,115 GF Hively Family Resource Center New $25,000.00 $22,000.00 $22,400.00 13.7 1,200 $19 ARPA Hively Busy Bees Learning Lab New $12,000.00 $10,000.00 $10,100.00 13.7 750 $13 GF Hively Community Engagement Coordinator New $25,000.00 $22,750.00 $23,150.00 14.0 750 $31 ARPA Hope Hospice Grief Support Center and Hospice Volunteer Program $10,830.00 $20,000.00 $17,500.00 $17,670.00 13.3 40 $442 GF Open Heart Kitchen Dublin Senior Meal Program $25,000.00 $25,000.00 $23,500.00 $23,900.00 14.0 500 $48 ARPA Senior Support Program of the Tri-Valley Case Management $15,020.00 $16,500.00 $15,875.00 $16,150.00 13.7 25 $646 ARPA Sunflower Hill Program Support for Adults with Developmental Disabilities $13,790.00 $16,500.00 $15,250.00 $15,400.00 13.7 30 $513 GF Tri-Valley Haven Domestic Violence Services Program $24,000.00 $24,000.00 $23,125.00 $23,350.00 14.3 75 $311 GF Tri-Valley Haven Homeless Services Program $24,000.00 $24,000.00 $23,125.00 $23,540.00 14.3 425 $55 ARPA Totals:$402,591.00 $360,000.00 City of Dublin Human Services Commission - Grant Funding for Fiscal Year 2022-23 Attachment 4 17 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 CALICO Center Dublin Child Abuse Intervention Jump to: Organization Information Questions Budget Documents USD$ 15,000.00 Requested Submitted: 1/19/2022 11:54:11 AM (Pacific) Project Contact Erin Harper calicocenter@yahoo.com Tel: 5108950702 Additional Contacts none entered CALICO Center 524 Estudillo Ave San Leandro, CA 94577 United States Executive Director Erin Harper executive.director@calicocenter.org Telephone(510) 895-0702 Fax (510) 895-0706 Web www.calicocenter.org Organization Information top 1. Business License Number BL-109881 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔Public Service Program or Project Attachment 5 18 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. CALICO proposes to conduct 10 forensic interviews with 7 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. For many children, their CALICO interview is the first time they fully describe what happened and, if handled appropriately, an essential first step toward healing. At CALICO, children are welcomed into a comfortable setting. 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. Each child leaves with a stuffed animal, book and blanket donated by community partners. 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. 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔Operational funding gfedc None ✔✔✔✔Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development gfedc Homelessness gfedc Transportation Services and Access ✔✔✔✔Domestic Violence and Child Abuse ✔✔✔✔Disabilities gfedc Food and Nutrition gfedc Senior Services ✔✔✔✔Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 19 (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 $22,000 in FY22-23. 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. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . CALICO uses the following goals to track and measure the effectiveness of the Dublin 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. 1b. At least 75% of caregivers will indicate that their child felt safe at CALICO. 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 (CalVCP) 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 CalVCP 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 members, regardless of their appearance, background or beliefs. CALICO services are provided free of charge. No victim 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 décor, 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. Attachment 5 20 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 2022-2023 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? 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 26% 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 Lionbridge. 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ✔✔✔✔ Yes. If so, check box here and answer questions 14 through 25. gfedc No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. ✔✔✔✔ Be culturally accessible, appropriate and inclusive ✔✔✔✔ Encourage community engagement and involvement gfedc Promote energy and resource efficiency ✔✔✔✔ Encourage networking and information sharing across service providers ✔✔✔✔ Encourage process streamlining ✔✔✔✔ Consolidate service delivery gfedc Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development Attachment 5 21 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc 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. gfedc 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 gfedc F) Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing ✔✔✔✔ Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Availability/Accessibility gfedc Affordability gfedc Sustainability gfedc Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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 Attachment 5 22 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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. gfedc Not Applicable. Not interested in CDBG funding ✔✔✔✔ Persons gfedc Households gfedc Not Applicable. Not interested in CDBG funding 1 Disabled 3 Women/Female Headed Households 0 Seniors 10 Youth 0 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 14.0014.00 TOTAL 13 Low Income (50%-80% AMI) 5 Extremely Low Income (<30% AMI) Not Applicable. Not interested in CDBG funding (Type N/A) 18.0018.00 TOTAL Attachment 5 23 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 11 White 5 White + HISPANIC 2 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 Not Applicable. Not interested in CDBG funding. (Type N/A) 18.0018.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 4,500.00 Alameda County DA'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 USD$ 0.00 California Office of Emergency Services USD$ 17,949.00 USD$ 17,949.00 Total USD$ 47,849.00 USD$ 23,349.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel Salary: Staff USD$ 26,572.00 USD$ 14,475.00 Personnel Benefits: Staff USD$ 6,377.00 USD$ 3,474.00 Personnel Salary & Benefits: ED (in kind) USD$ 3,000.00 USD$ 3,000.00 Supplies USD$ 2,551.00 USD$ 459.00 Attachment 5 24 Printing USD$ 792.00 USD$ 150.00 Postage USD$ 240.00 USD$ 100.00 Communications USD$ 2,547.00 USD$ 200.00 Rent and Utilities USD$ 1,142.00 USD$ 175.00 Audit and Accounting USD$ 1,258.00 USD$ 241.00 Outside Services USD$ 3,370.00 USD$ 1,075.00 Total USD$ 47,849.00 USD$ 23,349.00 Budget Narrative The request of $15,000 from the City of Dublin will support slightly less than 6 hours per week (or 304.6 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 304.33 hours + 24% benefits = $15,000 annually ($1,250 monthly) CALICO's current benefit rate of 24% for employees includes payroll tax, workers comp, FICA, health, vision, dental, and 403b matching. CALICO plans on securing funding for a child interview specialist and two family advocates to serve Dublin children and their caregivers from other sources. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Expense Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board Roster Current Annual Budget for the Entire Agency ✔✔✔✔ Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Tax Return Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Board Authorization and Designation Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Board Authorization and Designation Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Federal Non-Profit Letter State Non-Profit Letter Certified Audit and/or Certified Financial Statements ✔✔✔✔ 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 Employee Manual REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section highlighted audit Attachment 5 25 Application ID: 381086 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws Bylaws Articles of Incorporation Articles of Incorporation - Amended REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) Conflict of Interest Policy 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. LEP/LAP REQUIRED FOR CDBG ONLY - LEVERAGING REPORT- this is due with the 2nd quarter report no later than January 15th Leveraging Report Supporting Documents such as Agency Strategic Plan, Needs Assessment, etc. (Not Required) Strategic Plan Other Supporting Documents (Not Required) Attachment 5 26 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Centro Legal de la Raza Fair and Secure Housing Project Jump to: Organization Information Questions Budget Documents USD$ 33,199.00 Requested Submitted: 1/19/2022 6:24:51 PM (Pacific) Project Contact Brenda Orellana borellana@centrolegal.org Tel: 510-227-4451 Additional Contacts none entered Centro Legal de la Raza 3400 E 12th St Oakland, CA 94601 United States Executive Director Monique Berlanga mberlanga@centrolegal.org Telephone510-437-1554 Fax Web https://www.centrolegal.org/ Organization Information top 1. Business License Number BL-113233 Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Protecting and advancing the rights of low-income, immigrant, Black, and Latinx communities through bilingual legal representation, education, and advocacy. By combining quality legal services with know-your-rights education and youth development. 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 27 operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary 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. Additionally, we advise and assist clients with other tenant/landlord related matters and provide legal representation when appropriate. Our services model provides pre-eviction consultation in addition to eviction representation, and through outreach and education, we are able to address threats to housing stability early. Information sharing through know-your-rights workshops empowers communities to assert their rights. Centro Legal’s proposed staffing 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. 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). 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 displacemen 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.) 30 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No ✔✔✔✔ One-time funding gfedc Seed funding gfedc One-time and Seed funding gfedc Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) ✔✔✔✔ Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development ✔✔✔✔ Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities gfedc Food and Nutrition gfedc Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 28 (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. This project is designed to strategically target low-income tenants most at risk of displacement. About 5,000 unlawful detainer (eviction) actions are filed in Alameda County yearly. More than 88% of these landlords are represented by counsel, while only 11% of renters are (Information obtained by EBCLC through observing 46 weeks of court calendars and roll call in court in conjunction with Volunteer Legal Services Corporation data). 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. In addition, preservation of an affordable tenancy for a low-income resident saves public spending on the production of more affordable housing and homelessness services (Flaming, Daniel John and Toros, Halil and Burns, Patrick. 2015). Our model of legal services provision includes two key components: upstream and downstream prevention. (1) Upstream Prevention: Pre-eviction Consultations Broad, inclusive service provision via remote and/or in-person drop-in 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 drop-in clinics or workshops for tenants. These clinics will be held in key locations to ensure that underserved populations are able to utilize services. Centro Legal has developed strategies to serve large numbers of people during shelter-in-place orders due to the coronavirus pandemic and will continue to provide services remotely until it is safe to resume in-person services. (2) 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. 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 0.33 FTE housing attorney, benefits, outreach and administrative costs. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . 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 self sufficiency, creating housing stabilization. Performance Goal 1: 20 Tenants receive legal consultation for housing related problems such as resources and information about their legal options and rights. Attachment 5 29 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. 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. Marketing and Outreach Centro Legal provides Know-Your-Rights (KYR) community-based training to low-income, underserved populations. By training community members and community leaders, we seek to embed tenants’ rights expertise within the community itself, thereby better informing underserved communities of their rights and empowering them to seek legal services when faced with unlawful housing practices. Our existing Centro Legal outreach coordinator will conduct outreach to community organizations, schools, and places of worship and coordinate KYR training for their staff and leadership. We coordinate and conduct Know-Your-Rights workshops at community-based sites such as schools, community centers, libraries, and places of worship or remotely, with simultaneous Spanish translation if appropriate. The team works to train community leaders to generate widespread grassroots knowledge of tenants’ rights. We also hold regular mass eviction workshops on Zoom that combine Know-Your-Rights presentations and 1-on-1 consultations. We invite members of the community, tenants and other organizations to present services and resources, and we provide simultaneous translation for Spanish-speaking attendees. We also created a position within the Tenants' Rights team to handle direct referrals from our ERAP staff when ERAP applicants have questions about their rights. This helps us connect with tenants who are at increased risk of displacement, and has already increased our ability to connect with Dublin tenants. 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. Materials are translated into various languages and staff speak Spanish, Arabic, Mandarin, Hindi. In addition, we have a dedicated Mam interpreter on staff. We use a phone interpretation service for additional languages. Phone interpretation is a three-way phone conversation 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. Lastly, Centro Legal’s website has been fully translated into Spanish. 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 self sufficiency, creating housing stabilization. This furthers Dublin’s values of safety, inclusivity, diversity, and equity. Our project focuses on underserved communities, empowering and advocating for them to have increased access to programs and services, ensuring that a diverse population is being served in an equitable way. 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, and that they can enforce their rights to maintain their housing stability, and reduce displacement of low-income underserved BIPOC (Black, Indigenous, (and) People of Color) communities. 12. For the Fiscal Year 2022-2023 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 from 36% to 42%, whereas for the nine-county bay area, it decreased from 50% to 47% (Bay Area Equity Atlas). 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. 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 Attachment 5 30 pandemic. This project is a direct response to the increased need for tenant representation we anticipate as a result of the COVID-19 pandemic. 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? 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. We incubate community empowerment by advocating for positive change in local and state governments, creating meaningful dialogue on issues through our communications and media strategies, and by engaging in true, collaborative based, community lawyering. Finally, we ensure equity through high quality bilingual legal services and courtroom advocacy. 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. 95% of our Tenants’ Rights Practice staff are multilingual. Attorneys and paralegals speak the following languages: Spanish, Hindi, Mandarin, and Arabic. 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. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ✔✔✔✔ Yes. If so, check box here and answer questions 14 through 25. gfedc No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. ✔✔✔✔ Be culturally accessible, appropriate and inclusive ✔✔✔✔ Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ A) Housing gfedc 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. gfedc 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. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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 Attachment 5 31 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: centers. gfedc 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 gfedc F) Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc 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 gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities gfedc Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability ✔✔✔✔ Sustainability gfedc Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. Attachment 5 32 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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. gfedc Not Applicable. Not interested in CDBG funding gfedc Persons ✔✔✔✔ Households gfedc Not Applicable. Not interested in CDBG funding 7 Disabled Women/Female Headed Households 3 Seniors Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 10.0010.00 TOTAL 7 Low Income (50%-80% AMI) 23 Extremely Low Income (<30% AMI) Not Applicable. Not interested in CDBG funding (Type N/A) 30.0030.00 TOTAL White White + HISPANIC Attachment 5 33 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 7 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 21 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 30.0030.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Contributions & Donations USD$ 2,000.00 USD$ 2,000.00 City of Livermore USD$ 38,381.00 City of Pleasanton USD$ 41,131.00 Alameda County Housing Secure (ACHS) USD$ 125,593.00 USD$ 125,593.00 USD$ 0.00 USD$ 0.00 East Bay Community Foundation USD$ 50,000.00 USD$ 50,000.00 Ruth Arnhold Endowment Fund USD$ 20,000.00 USD$ 20,000.00 The San Francisco Foundation USD$ 100,000.00 USD$ 100,000.00 Tipping Point USD$ 60,000.00 USD$ 60,000.00 State Bar Formula Grant USD$ 262,691.00 USD$ 262,691.00 Total USD$ 699,796.00 USD$ 620,284.00 Funding Uses/Expenses Budget Amount Amount Committed Housing Attorney USD$ 24,318.00 Benefits USD$ 4,863.00 Outreach USD$ 1,000.00 Attachment 5 34 Indirect USD$ 3,018.00 Total USD$ 33,199.00 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. ACHS has a significant marketing budget that can be used to create broad awareness of legal services provided to low-income tenants throughout the Tri-Valley. 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, and Know Your Rights (KYR) presentations etc. 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 *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Expense Budget for ALL Grant Requests Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information Form for ALL Grant Requests List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ List of Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Cento Legal_FY20-21_Organizational Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Centro_Form 990_2019 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Dublin BOD Acknowledgement Letter - Signed Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Dublin BOD Acknowledgement Letter - Signed Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Centro COI - City of Dublin STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Centro Legal Non-Profit Determination Letter Certified Audit and/or Certified Financial Statements ✔✔✔✔ Centro Legal de la Raza 2021 Audited Financial Statements (1) 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 Centro Legal Personnel Policy & Affirmative Action, Grievance Policy Attachment 5 35 Application ID: 380578 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section Centro Legal de la Raza 2021 Audited Financial Statements REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws Centro Legal Articles of Incorporation & Bylaws Original & Amended Restated REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) Centro Legal Conflict of Interest Policy 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. Centro Legal Limited English Proficiency Access Plan 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) Attachment 5 36 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Chabot-Las Positas Community College District Dublin Community Jobs Support 2022-23 Jump to: Organization Information Questions Budget Documents USD$ 18,341.00 Requested Submitted: 1/19/2022 7:04:28 PM (Pacific) Project Contact Alcian Lindo alindo@clpccd.org Tel: 925-416-5108 Additional Contacts agallegos@clpccd.org, jdozier@clpccd.org Chabot-Las Positas Community College District 5860 Owens Dr Fl 3 Dba Tri-Valley Career Center Pleasanton, CA 94588 United States Vice Chancellor for Business Services, designated signer Jonah Nicholas jnicholas@clpccd.org Telephone(925) 416-5100 Fax Web www..trivalleycareercenter.org Organization Information top 1. Business License Number 200167 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 department's 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in gfedc Non-Profit ✔✔✔✔ Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 37 operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. Each year, TVCC helps job seekers find new careers by offering free workshops, one-on-one counseling and a variety of resources. We teach essential skills to help job seekers succeed in the complicated job market of today, including creating connections to employers. Pre-Covid, 87% of our job seekers found work within six months. Our success is due to the serving hearts of our highly experienced staff and our commitment to human-centered services. TVCC’s dedicated staff is always looking for ways to improve our services. As the challenge of Covid continues, we want to expand the reach of our services to Tri-Valley residents who cannot get to our offices or do not yet know about our programs. Though we have helped thousands of unemployed clients, the pandemic has created a significant increase of job seekers who could use our help. Future plans for TVCC include taking our services into the community through our community partners. Without knowledge of TVCC, so many people who vitally need our services are struggling by themselves. We are requesting funds to share the value of the services that TVCC offers to help Dublin residents and employers, including: assist the unemployed to find jobs with at least a "living wage"; provide training for those who are under-employed as a means to greater income and security; and assist employers find qualified candidates to meet their needs. 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.) 147 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) ✔✔✔✔ Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities gfedc Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity ✔✔✔✔ Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 38 (What specifically will the grant funds be used for?) Though the number of clients we serve grows each year, our largest challenge is to continue to serve clients in a human- centered capacity while we grow our brand awareness so that more unemployed and underemployed job seekers learn of our services. In today's Covid-impacted employment environment, TVCC needs to: • Continue serving the newly unemployed and building our brand for those who need our services in the future; • Seek out and serve individuals with high barriers to employment, which requires additional case management and collaboration with partner agencies; • Be available to help employers, large and small, who need to fill vacancies in order to grow their businesses; • Increase opportunity for employers and job seekers to meet; and • Increase services and informational workshops to small businesses. With your help ,TVCC can continue to do each of the above. In addition to serving our job seekers directly, TVCC partners with businesses, employers and agencies to help job seekers of all skill levels find work. There are no other organizations in the area who work with large and small businesses alike in order to help their businesses grow. The funds being requested are to cover the costs of staff who assist job-seekers and employers looking for employees, as well as marketing costs to help spread the word about our services to the people of Dublin, and beyond. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . TVCC serves residents of the Tri-Valley who are looking for career services, as well as employers looking for qualified candidates. While the income demographics of our clients vary, our lower-income clients are frequently most impacted by job instability. We offer our training aids in multiple languages and are looking to expand even further. Half of our staff is Spanish- speaking and our trainings and one-on-one services can assist ESL clients. We measure by individual success and in aggregate. Every time a job seeker finds work, we celebrate. Traditionally, the newly-hired job seekers bring treats to our weekly Job Club to celebrate with the people who helped them on their journey. Their gratefulness is our reward and a measure that we are doing something right. It’s not uncommon to get thank you notes from our job seekers with quotes such as these: “Thank you for having such a wonderful staff. The knowledge and human kindness that they provide is invaluable. Their professional expertise help career dreams become a reality.” Or: “The Tri-Valley Career Center gave me training on how to best represent myself in today’s job market and gave me the confidence I needed to assertively apply for jobs in the fields that I was looking to move into.” In the aggregate, we look at the total number of people we have served and the number of job seekers enrolled in our WIOA program. We analyze the time they take to find work, the hourly wages they earn, and the ratio of clients to placements. These all show us whether we are improving our services or not, year over year. We also track the number of employers with whom we work and their repeat business. To measure our marketing efforts, we track clicks to our website, Google searches, visits to our job board, views of the online ads, calls and increased traffic to both our website and our office. Ultimately, the final number is that of the jobs that people who were unemployed find that will not only allow them to continue living in the Tri-Valley,but will also make them happy in their career choices. Our work continually builds to that final number, over and over 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 Dublin's mission speaks of the goals of a high quality of life, safety and security, opportunities and equity for its residents. Unfortunately, for those residents who live in poverty, those goals are often unobtainable. Every day is a struggle to survive: families with children and often extended family members have to work multiple jobs just to provide the basics. Opportunity and equity may seem forever out of reach. TVCC provides two services that can assist those families and individuals: our career services can help the adults find better paying jobs and/or train for careers that bring stability and livable wages. Our staff are compassionate, knowledgeable and trained, and we have multi-lingual services available for those need it. We work with individuals at all income levels, but often our services have the biggest affect on our lower-income clients, as we are able to provide training and career services, but also provide referrals to wrap-around community services, if needed. An Attachment 5 39 added bonus is that when they utilize our career services, our clients learn about our free tax preparation services which may help them obtain federal funds that were previously unknown or uncollected. Our department's mission is: "We empower individuals and communities to thrive by creating career, education and economic opportunities." Together, we can help those in our communities, including Dublin residents, reach those goals. 12. For the Fiscal Year 2022-2023 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. Statistics from the employment impact of Covid show that low-income households were often the hardest hit. Many people in low-income jobs prior to the pandemic either lost those jobs, had their hours cut, or were exposed to health risks that impacted them or their family members - with health care costs adding to the financial burden. Additionally, parents of school- aged children suddenly became responsible for their children's schooling - often in homes that didn't have adequate space available for children to learn without distractions. Financial instability impacted every member of the family. TVCC assists individuals, including those who are low-income, find jobs that provide more than a basic minimum wage, including providing training for new careers. The pandemic pushed more people into poverty, especially in the extremely expensive Bay Area environment - our services seek to help them find careers that can lift them out of poverty towards financial security. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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 Attachment 5 40 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: centers. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. Attachment 5 41 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding n/a Disabled n/a Women/Female Headed Households n/a Seniors n/a Youth n/a Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL White White + HISPANIC Attachment 5 42 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 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) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 18,341.00 City of Livermore USD$ 18,341.00 City of Pleasanton USD$ 22,415.00 Federal Workforce Development Funds USD$ 200,000.00 JFF USD$ 100,000.00 USD$ 100,000.00 CLPCCD USD$ 773,056.00 USD$ 773,056.00 Total USD$ 1,132,153.00 USD$ 873,056.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel Salaries USD$ 500,267.00 USD$ 385,871.00 Personnel Benefits USD$ 283,676.00 USD$ 218,714.00 Supplies USD$ 2,700.00 USD$ 2,082.00 Rent & Utililties USD$ 239,490.00 USD$ 184,647.00 Travel USD$ 1,900.00 USD$ 1,465.00 Marketing USD$ 15,000.00 USD$ 11,565.00 Training & Professional Services USD$ 79,600.00 USD$ 61,372.00 Attachment 5 43 Postage USD$ 620.00 USD$ 478.00 Other: Software, Licenses, etc. USD$ 8,900.00 USD$ 6,862.00 Total USD$ 1,132,153.00 USD$ 873,056.00 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. The 3 cities of the Tri-Valley have been fantastic partners in this way for the past several years. The budget is broken into three areas: Salaries, Benefits, and Operating Costs. The total is shared between the three cities, the District, Alameda Workforce Development Board, and Jobs for the Future (JFF). We are requesting Dublin's help to fund 1.62% of this total budget. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ TVCC Program Budget Form Financial Information Form for ALL Grant Requests ✔✔✔✔ TVCC Financial Form List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ CLPCC Board of Trustees 2022 Current Annual Budget for the Entire Agency ✔✔✔✔ CLPCCD Adopted Budget 2021-22 Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ CLPCCD No Tax Returns Submitted Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ CLPCCD Board Authorization Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ CLPCCD Board Authorization Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ CLPCCD Current Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ CLPCCD IRS Tax Exempt Letter Certified Audit and/or Certified Financial Statements ✔✔✔✔ CLPCCD Most Recent 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 Attachment 5 44 Application ID: 384620 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) TVCC 3-Year Plan Other Supporting Documents (Not Required) Attachment 5 45 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Chabot-Las Positas Community College District Dublin EITC Support Program 2022-23 Jump to: Organization Information Questions Budget Documents USD$ 15,950.00 Requested Submitted: 1/19/2022 7:03:48 PM (Pacific) Project Contact Alcian Lindo alindo@clpccd.org Tel: 925-416-5108 Additional Contacts agallegos@clpccd.org, jdozier@clpccd.org Chabot-Las Positas Community College District 5860 Owens Dr Fl 3 Dba Tri-Valley Career Center Pleasanton, CA 94588 United States Vice Chancellor for Business Services, designated signer Jonah Nicholas jnicholas@clpccd.org Telephone(925) 416-5100 Fax Web www..trivalleycareercenter.org Organization Information top 1. Business License Number 200167 Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Tri-Valley Career Center (TVCC) is part of the Chabot-Las Positas Community College District (CLPCCD). Our department mission is: "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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. gfedc Non-Profit ✔✔✔✔ Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 46 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. The Earned Income Tax Credit (EITC) is the most effective anti-poverty program run by the federal government and augmented by the state. The EITC has been shown to encourage work, help families meet basic needs and improve children's success in school. It has the ability to lift families out of poverty and is often used by families as a short-term safety net when there is a job loss or other event that reduces income. The only way to receive EITC is to file taxes. However, this can be both challenging and expensive for our client families who may believe they have to pay for filing assistance. The Volunteer Income Tax Assistance (VITA) program, run by TVCC, offers free tax preparation, provided by fully trained volunteers, to low-to moderate income individuals and families. Its sole purpose is to help people in poverty, especially EITC-eligible families, access their benefits and to file taxes as required by law. There are no other VITA programs in the Tri-Valley area. In 2023, we will offer virtual services in addition to those at TVCC, Pleasanton Library and Las Positas College. Our main challenge is alerting potential clients of our VITA services. In 2021 we served 98 families from Dublin, with an average household income of $28,093. According to the US Census ACS, there are over 6500 additional families in the area who could benefit from VITA. We have relied on referrals and low-cost marketing in the past but need assistance reaching more clients. 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.) 108 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially funded. (If capital funding is being requested, this narrative should include a detailed project scope and project gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) ✔✔✔✔ Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities gfedc Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity ✔✔✔✔ Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 47 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?) Although the official tax season is considered 13 weeks long, the VITA program takes 9-10 months of planning, execution and follow-up/post-season wrap-up. TVCC's VITA Program Coordinator spends 4-5 months planning for the program and recruiting volunteers for the upcoming season, during which she learns new tax laws, establishes processes and trains the volunteer- preparers. Additionally, our Co-Coordinator assists with the virtual portion of our services as well as support for our satellite sites. Volunteers - many of whom are retired professionals and/or senior citizens - are trained on three consecutive Saturdays in January. This training teaches volunteers both tax law and the use of the preparation software. Several other TVCC staff assist with the VITA program, but our Program Coordinator is the lead, responsible for the planning, volunteer management and overall execution and delivery of services. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . Although TVCC's main focus is on career services, we were approached to serve as a regional tax preparation resource for extremely low-, very low- and low-income families and individuals and we are happy to provide that service to our communities. The Volunteer Income Tax Assistance (VITA) program, run by TVCC, offers free tax preparation, provided by fully trained volunteers. By assisting VITA clients, we can help them get access to their tax refunds, including their earned income tax credit. In 2021, our clients received an average of over $1500 per family (combined federal and state refunds). These refunds can make a significant difference for our families, often being used to help stabilize the family's finances. VITA's sole purpose is to help people in poverty, and especially EITC-eligible families, access their benefits and to file taxes as required by law. Unfortunately, the reality of our region is that people who live in poverty are often People of Color, ESL persons and/or disabled. In 2021, 45% of the people using our services were people of color. In 2023 we anticipate our clients will access our services both in person and virtually. Appointments will be made either online or by phone. Clients who select in-person assistance (if public safety allows) will be able to choose between our TVCC location, the Pleasanton Library, or Las Positas College. Virtual services will be offered either completely remotely, where forms are delivered electronically and volunteers process them online; or partially remotely, where clients drop off their forms, which are then scanned and sent to the volunteers to be processed, and then picked up a week later. This variety of options offers maximum flexibility to meet our taxpayer clients' needs. Each year, we track the following statistics for our VITA program: - total number of clients served - percentage increase of clients served over the previous year - total federal and state dollars refunded to client-taxpayers - average total Earned Income Tax Credits (EITCs) return to clients - average adjusted gross income of clients - total number of ITIN applications filed for clients From this, we can extrapolate Dublin's data to identify these statistics specific to the city. The goal of the TVCC VITA program is to grow and serve as many EITC-eligible clients as possible. Given the nature of this service, our results are tracked meticulously by the IRS. Each e-filed tax return is tracked by the IRS through our location codes. Not long after the end of each tax season, we are able to identify statistics specific to our program, including categories such as the number of tax returns filed, as well as the amount of federal and state refunds, number of EITC returns and average household income. In 2023, we are expecting to process a minimum of 108 tax returns for Dublin residents. This will exceed the number of clients served in the 2022 season. The number of clients utilizing our services in 2020 and 2021 was lower than in previous years - we believe due to Covid restrictions - and we hope to increase our numbers to previous pre-Covid levels in 2023. Our request for funds is to promote and offer our services to more individuals and families. We currently use low cost or free advertising but could be more effective with targeted paid advertising, thereby reaching more of those who need our services. 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 Attachment 5 48 Dublin's mission encompasses the goals of a high quality of life, safety and security, opportunities and equity for its residents. Unfortunately, for those residents who live in poverty those goals are often unobtainable. Every day is a struggle to survive: families with children and often extended family members have to work multiple jobs just to provide the basics. Opportunity and equity may seem forever out of reach. TVCC provides two important services that can assist those families and individuals: our career services can help the adults find better paying jobs and/or train for careers that bring stability and livable wages. Additionally, our VITA program can offer assistance in a much more direct and immediate manner. Without understanding tax laws and regulations, filing taxes may seem overwhelming, sometimes including the stressful assumption that the family will owe taxes. With the earned income tax credit, families in the low-income bracket qualify for a lump sum that can help ease financial strain for the family. Our volunteers are compassionate, knowledgeable and trained, and we have multi-lingual services available for those need it. We can help with the burden of filing income taxes and ensure access to the funds owed to these families. An added bonus is that when they utilize our VITA services, our clients learn about our career services, which may help them with their longer- term financial goals. Our department's mission is: "We empower individuals and communities to thrive by creating career, education and economic opportunities." Together, we can help everyone in our communities, including Dublin residents, reach those goals. 12. For the Fiscal Year 2022-2023 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. Statistics on the employment impact of Covid show that low-income households are often the hardest hit. Many people in low- income jobs prior to the pandemic either lost those jobs, had their hours cut, or were exposed to health risks that impacted them or their family members. Additionally, parents of school-aged children suddenly became responsible for their children's schooling - often in homes that didn't have adequate space available for children to learn without distractions. The EITC assists families and individuals who are low-income (including very-low income and extremely-low income) gain access to federal funds for which they qualify - often unknowingly. The pandemic pushed more people into poverty - our services seek to help them access resources due to them. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. Attachment 5 49 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. Attachment 5 50 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Attachment 5 51 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" 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 Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL 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) 0.000.00 TOTAL gfedc #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. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 15,950.00 USD$ 0.00 City of Pleasanton USD$ 19,495.00 USD$ 0.00 City of Livermore USD$ 15,950.00 USD$ 0.00 United Way USD$ 20,327.00 USD$ 0.00 CLPCCD USD$ 16,889.00 USD$ 16,889.00 Total USD$ 88,611.00 USD$ 16,889.00 Attachment 5 52 Funding Uses/Expenses Budget Amount Amount Committed Personnel Salaries USD$ 33,431.00 USD$ 6,372.00 Personnel Benefits USD$ 13,372.00 USD$ 2,549.00 Contracted Coordinator USD$ 6,200.00 USD$ 1,182.00 Operating Supplies USD$ 400.00 USD$ 76.00 Printing/Copying USD$ 1,933.00 USD$ 368.00 Rent & Utilities USD$ 24,000.00 USD$ 4,574.00 Travel USD$ 75.00 USD$ 14.00 Marketing Development USD$ 3,000.00 USD$ 572.00 Marketing Placement USD$ 6,200.00 USD$ 1,182.00 Total USD$ 88,611.00 USD$ 16,889.00 Budget Narrative By law, the VITA program is a completely free service; however, it is not free to operate. The largest share of the budget is for staff salaries and benefits, of which the Program Coordinator is the largest portion. She is assisted by a short- term, contracted site coordinator, two other staff members and the manager during the season. The value of the experienced volunteers is nearly double the over-all budget. Operational costs include supplies needed to run the program, printing/paper required so tax payers have a copy of their return, rent and utilities for the space used, marketing and travel. Though critical to the successful growth of the program, marketing is the one variable cost that will not be spent if there is no funding to cover it. 10.4% of the operating budget is earmarked for the development and placement of marketing. However, these are also funds that can only be spent if the money is available. Depending on the amount of grants received each year, the College District invests anywhere from 20-40% of the total program budget to its success. The ask for the City is to cover 18% of the total budget, which is the percentage of the Dublin residents served by the program (18%). We believe this is a fair ask, with an incredible return on investment for the City. Overall, the VITA program is a small percentage of the Career Center’s annual budget and even smaller amount of the College District’s budget. It constitutes about one percentage of the Career Center’s overall budget, which is turn less than one tenth of one percentage of the College District’s budget. This does not, however, negate the impact that this small program makes on the lives of people in poverty in the Tri-Valley. The dollars spent on the VITA program bring nearly 600 families out of poverty and allow them to survive another year in the region. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ CLPCCD-TVCC EITC Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ CLPCCD-TVCC Financial Form List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ CLPCCD Board of Trustees 2022 Current Annual Budget for the Entire Agency ✔✔✔✔ CLPCCD Adopted Budget 2021-22 Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ CLPCCD - no tax returns Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ CLPCCD Authorized Designation Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ CLPCCD Authorized Designation Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ CLPCCD Current Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at ✔✔✔✔ CLPCCD Tax Exempt IRS Letter Attachment 5 53 Application ID: 383675 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. time of application. Non-compliant applicants will be disqualified. Certified Audit and/or Certified Financial Statements ✔✔✔✔ CLPPCD Most Recent 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) TVCC 3-Year Plan Other Supporting Documents (Not Required) Attachment 5 54 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 CityServe of the Tri-Valley Homeless Prevention and Family Stabilization Program Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 12/27/2021 5:30:33 PM (Pacific) Project Contact Christine Beitsch-Bahmani grants@cityservecares.org Tel: 510-789-5443 Additional Contacts none entered CityServe of the Tri-Valley P.O. Box 1613 Pleasanton, CA 94566 United States CEO Christine Beitsch-Bahmani christine@cityservecares.org Telephone925-222-2273 Fax Web www.cityservecares.org Organization Information top 1. Business License Number BL-109916 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 (case management), 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 55 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. We exist to CARE for people in crisis, COORDINATE vital resources and CONNECT volunteers to mobilize mercy (practical compassion) throughout the Tri-Valley. CityServe serves underserved individuals, primarily low income, homeless or destitute. Our project focus area is Care Coordination (client-centered case management services) for Dublin, Pleasanton and Livermore residents. Our goal is to both resource and motivate participants toward a future full of stability, self-efficacy, community and sustainability. We have two main programs: 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 & volunteers to care for the residents of Dublin with needs such as rental assistance, bills, benefit navigation, care for children, mental health resourcing, senior 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 it’s 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. We serve over 1500 households per year sheltered and unsheltered. 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.) 30 Dublin Households– will receive safety net fiscal assistance, individualized resourcing (aka case management, special programs), and have access to workshops focused on education and specific skill training to ensure stabilization. 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None ✔✔✔✔ Behavioral Health (mental health and substance abuse) ✔✔✔✔ Affordable Housing gfedc Health Care (including dental) ✔✔✔✔ Workforce Development ✔✔✔✔ Homelessness ✔✔✔✔ Transportation Services and Access ✔✔✔✔ Domestic Violence and Child Abuse ✔✔✔✔ Disabilities ✔✔✔✔ Food and Nutrition ✔✔✔✔ Senior Services ✔✔✔✔ Youth Services gfedc Child Care, Early Childhood Development and Education ✔✔✔✔ Changing Demographics and Growing Diversity ✔✔✔✔ Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 56 (What specifically will the grant funds be used for?) The requested funding of $25,000 will go specifically to sustain current capacity for our Homeless Prevention and Family Stabilization Program which includes crisis intake, street outreach response and care coordination. This program in its entirety serves Dublin, Pleasanton and Livermore residents. This is a regional program and costs approximately $800,000 to run annually. Without proper funding we will have to cut or reduce our current service and/or response times provided to Dublin residents. Specifically, the funds requested will pay the partial salary for one care coordinator (caseworker) who will be available for Dublin residents that need individualized action planning, resourcing, and help navigating existing support systems such as federal and state benefits. The average caseload for a Full-Time Resource specialist is 20 households at a time (with an average case turn-over of 2-3 times a year), which means that at .4 FTE, this Case Worker will be able to, conservatively, provide 15 households with highly individualized care, which amounts to an averaged annual total of 30 Dublin Residents served with the $25,000 investment averaging service cost of approximately ($416) per household. In addition to this individualized care, $3,000 requested in this grant application will go towards direct service safety-net fiscal assistance (formerly known as Community Care funds) that will serve to stabilize and keep Dublin residents housed/sheltered. With a City Council focus on, “critical or essential needs and services such as food shelter and healthcare” we can assure you that our safety-net fiscal and supportive services assess critical needs such as utility payments, shelter, gas cards, car repair, childcare expenses and car registration payments (and back-payments) to allow individuals to access employment and services, transportation costs for those without vehicles, clothing, food and other necessary supplies for families and individuals for work or education, and other critical expenditures that help stabilize our participants and their families so they can continue working towards self-sufficiency. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . CityServe has 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) 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 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. CityServe has a robust client database framework that allows us to enroll participants in our programs, capture all critical demographic information (such as disability status, race/ethnicity, age, veteran status, self-reported income & income verification, and language translation needs), As mentioned, we also track progress toward goals, all applicable expenses and time spent with participants. Lastly, we track all measurable outcomes such as increased income, benefits accessed and employment secured and client satisfaction. We are only 1 of 2 Tri-Valley Providers that has 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 and helps us to make sure our unsheltered residents are on the list when available housing and critical mental health services become available. In regard to accessibility, CityServe staff members are available via virtual meetings, phone calls, at local resource pop-up outreaches throughout the Tri-Valley, at one of our two Pleasanton offices and as of February 2022 our Livermore Public office will open to all Tri-Valley residents. Access should never be a problem, residents can call for an appointment and we can go Attachment 5 57 to the individual if needed to capture their information and create action plans with them. We are a bilingual staff (currently have 2 Spanish speaking team-members), as well as widening our network with local churches and community groups that can translate other languages on our behalf. CityServe’s marketing strategy starts with relationships. We host quarterly Community Meetings that bring together Tri-Valley focused service providers, school social workers, city and county employees and faith groups to share services and best resources. From this meeting we built a local resource directory for all residents to use when in need. We also market our services via our website, email/social media presence, through our partners, working closely with the city and police department, schools and churches. We are also a direct referral agency with 211 and are a part of the Alameda County Continuum of Care which allows higher levels of interagency collaboration for increased social impact. 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 leadership is focused on making meaningful efforts towards diversity, equity, and inclusion. As a result we are building a culture both with our clientele and staff by providing a sense of belonging. We have also invested in training our team through supporting employee resourcing and have hired staffing reflective of our clientele to better give us insight and understanding into the diverse Tri-Valley cultures represented and the needs and/or obstacles they have to obtaining services. Our team is also researching underserved communities to set up specific resource pop-ups in those areas in 2022. 12. For the Fiscal Year 2022-2023 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 would probably qualify with the services we offer, however, we will apply how we normally apply 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. Attachment 5 58 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number Attachment 5 59 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Attachment 5 60 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" 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 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) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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 Contributions USD$ 89,300.00 USD$ 24,000.00 Business Contributions USD$ 175,000.00 Foundation Contributions USD$ 150,000.00 Individual Contributions USD$ 160,000.00 City of Pleasanton USD$ 160,000.00 City of Livermore USD$ 130,000.00 City of Dublin USD$ 25,000.00 In-Kind Donations USD$ 5,000.00 Total USD$ 894,300.00 USD$ 24,000.00 Attachment 5 61 Funding Uses/Expenses Budget Amount Amount Committed Payroll: Salaries, Taxes and Benefits USD$ 788,900.00 Rent Expense USD$ 6,000.00 Building Costs & Utilities USD$ 15,500.00 Professional Services (including Audit & Legal) USD$ 23,200.00 Technology Expense USD$ 47,000.00 Program Supplies, Printing, and Postage USD$ 8,200.00 Outreach Mileage USD$ 5,500.00 Total USD$ 894,300.00 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 (case manager) who will be dedicated to serving Dublin residents, as well as $3000 Safety-Net Fiscal Assistance (formerly referred to as Community Care funding). In our continually expanding role of providing critical safety net services for the three Alameda County Tri-Valley cities, we are in need of this funding in order to provide responsive, effective services to Dublin residents in crisis. Our overall organization budget is designed to reduce homelessness, prevent homelessness, and increase housing security and household stability in Dublin and the Tri-Valley through our services. This project highlights our services for vulnerable Dublin residents. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ CityServe Program Expense Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information Form List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ 2022 Draft Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Board Designation Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Board Authorization Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ General Liability Workers Comp Ins Employers Final Audit STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Federal Determination Articles of Incorporation Certified Audit and/or Certified Financial Statements ✔✔✔✔ Audit Financials 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 Attachment 5 62 Application ID: 382082 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) Agencies we Collaborate With Org Chart CEO Resume Finance Manger Resume Employee Handbook Other Supporting Documents (Not Required) Attachment 5 63 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Community Resources for Independent Living Housing and Independent Living Skills Jump to: Organization Information Questions Budget Documents USD$ 15,000.00 Requested Submitted: 1/12/2022 11:18:59 AM (Pacific) Project Contact Michael Galvan Programs@crilhayward.org Tel: 510 881 5743 x30 Additional Contacts none entered Community Resources for Independent Living 439 A Street Hayward, CA 94541 United States Executive Director Michael Galvan Michael.Galvan@crilhayward.org Telephone(510) 881-5743 Fax (510) 881-1593 Web www.crilhayward.org Organization Information top 1. Business License Number BL - 009274 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 64 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. CRIL's Independent Living Services for Persons with Disabilities will provide low-income Dublin residents who have a disability with peer counseling, independent living skills & self-advocacy training, personal 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 30 low-income Dublin residents, In addition, CRIL will indirectly serve 75 more individuals and businesses through disability education, technical assistance and information & referral. 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.) 30 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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?) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) ✔✔✔✔ Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development ✔✔✔✔ Homelessness ✔✔✔✔ Transportation Services and Access gfedc Domestic Violence and Child Abuse ✔✔✔✔ Disabilities gfedc Food and Nutrition ✔✔✔✔ Senior Services ✔✔✔✔ Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity ✔✔✔✔ Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 65 CRIL is requesting $15,000 in Dublin funding for FY 2022-23, which will allow us to increase Independent Living (IL), Housing Search Services, Youth Services, Travel Training, as well as, Job Readiness support in the Tri-Valley area. CRIL projects to serve 30 low income Dublin seniors and residents with disabilities (a 380% increase in consumers since 2011), as well as provide I & R to 75 other residents. CRIL will actively recruit youth to form a Disability Action Network for Youth (group advocacy) and to offer a Community Leadership Academy: Leaders Without Leaders which develops leadership skills and encourages participants to join community and government committees and commissions. FY 2021-22 will continue to see an increase in the number of Dublin consumers served. As we continue to deal with the COVID pandemic, requests and needs for services are greater. There will be more persons with disabilities from COVID and many will have delayed services. Funds will primarily cover 25% of the salary and benefits of the IL Coordinator with a small amount for shared indirect costs associated with necessary program admin and office operations (e.g., admin, telephone, supplies, insurance, etc.). 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . CRIL's Housing, Employment & IL Services for people with disabilities will provide 30 Dublin residents with improved access to affordable housing, peer counseling, employment & benefits counseling, travel training, I & R, assistive technology info & AT device loans & advocacy. Housing Search Counseling will include local resource info, application assistance, budgeting & credit counseling, landlord mediation and/or applications to Season of Sharing and Dept. of Rehabilitation's housing transition fund. CRIL will work with persons with disabilities to bridge the digital divide through a computer lab and classes, chromebooks and wifi access. CRIL will also provide indirect information & referral, technical & assistive technology support, ADA & disability law education and community advocacy to 75 additional Dublin residents & businesses to increase their knowledge & independence. CRIL utilizes a national online database management system called CILSuite, which is specifically designed to track data and services for independent living centers. Data can be entered securely from any computer with internet access and CRIL management is able to monitor the timeliness and completeness of every consumer's service record. The structure of the online Intake form and data logs allows for uniformity and consistency in all consumer service records. CILSuite allows CRIL staff and management to regularly track and monitor each consumer's status with completing steps to achieve their personalized goals, as well as progress toward achieving the defined program outcomes: retention or placement in affordable, accessible housing & an increase in personal independence & self-sufficiency. Consumers complete an annual 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. 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 2022-2023 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 Attachment 5 66 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 2,000 people to provide vaccine information. In addition, CRIL has called its 800+ senior consumers three times to check in on their needs: physical and psychological. As the need for 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities Attachment 5 67 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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) Attachment 5 68 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" and the number of persons unemployed before taking the job. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless N/AA Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL 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 Attachment 5 69 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 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) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 15,000.00 City of Pleasanton USD$ 15,000.00 City of Livermore USD$ 15,000.00 Department of Rehabilitation - General Fund USD$ 14,500.00 Department of Rehabilitation - VIIB USD$ 3,000.00 Total USD$ 45,000.00 USD$ 17,500.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel: Salaries USD$ 34,125.00 USD$ 8,620.00 Personnel: Benefits USD$ 19,250.00 USD$ 4,868.00 Operating: Supplies USD$ 800.00 USD$ 125.00 Operating: Printing/Copying USD$ 400.00 USD$ 75.00 Operating: Postage USD$ 250.00 USD$ 75.00 Operating: Telephone USD$ 2,900.00 USD$ 300.00 Operating: Accounting/Audit USD$ 750.00 USD$ 250.00 Contracted Services USD$ 3,250.00 USD$ 587.00 Dues, Books, Publications USD$ 400.00 USD$ 100.00 Total USD$ 62,125.00 USD$ 15,000.00 Budget Narrative Anne Adams, Tri-Valley IL Coordinator is housed at the Livermore Multi-service Center. 25% of Anne's salary and benefits are covered by this Dublin Grant. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Expenses Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Info Attachment 5 70 Application ID: 382030 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Annual Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ CRIL IRS Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Board Resolution Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Board Resolution Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ IRS Determination Certified Audit and/or Certified Financial Statements ✔✔✔✔ 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) CRIL Strategic Plan Other Supporting Documents (Not Required) Attachment 5 71 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Easterseals Northern California Kaleidoscope Community Adult Program - 2022/2023 Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2022 3:19:34 PM (Pacific) Project Contact Doris Evans development@esnorcal.org Tel: (510) 910-3089 Additional Contacts none entered Easterseals Northern California 5601 Arnold Road Suite 104 Dublin, CA 94568 United States CEO Andrea Pettiford development@esnorcal.org Telephone(925) 326-0072 Fax Web www.esnorcal.org Organization Information top 1. Business License Number BL-005301 Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Our mission is to lead 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 72 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. In June of 2021 the Kaleidoscope Community-based Adult Program returned to providing in person services. Since returning the program has shifted to a hybrid model of services where participants attend in person three days per week and remote telehealth learning is performed the other two. The Kaleidoscope program focuses on life, leisure, recreational, pre-vocational, money management, and social skills. Through extensive planning the group is able to focus on these goals both in person and through telehealth. To meet the needs of the community and limit extremely large groups we have shifted to two separate groups, the Adventure Group and the Explorer Group. Both groups are able to participate in the same activities, projects, and learning on different days. Monday – All groups together AM – Bowling focus on turn taking PM – Lunch focus on money management Tuesday – Zoom Hygiene/Chores Wednesday – Adventure Group Oakland Museum - Explorer Group Karaoke at Round 1 Thursday – Zoom Nutrition/Games Friday – Adventure Group Karaoke at Round 1 – Explorer Group Oakland Museum 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None ✔✔✔✔ Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) ✔✔✔✔ Workforce Development gfedc Homelessness ✔✔✔✔ Transportation Services and Access gfedc Domestic Violence and Child Abuse ✔✔✔✔ Disabilities ✔✔✔✔ Food and Nutrition gfedc Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education ✔✔✔✔ Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 73 (What specifically will the grant funds be used for?) Grant funding from the City of Dublin would reimburse staff salaries of our ten (10) Life Skills Coaches who are providing services to thirty-two (32) participants. Life Skills Coaches help the participants and families with goals set forth in the Individual Program Plan, facilitate proper peer to peer interactions, provide safety training, assist with hygienic needs, facilitate activities, trips, offer calendar suggestions, lead activities via telehealth, report any behavioral or medical needs/changes to the Program Manager, and lead by example. Currently we are providing services to 32 participants, this number does not include family members who also receive support. While individuals are engaged in program, family member are able to work, attend to other needs such as shopping, doctors’ appointments, other family members, meetings, etc. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . Successful outcomes are tracked in the participants Individual Program Plan (IPP) which is updated bi-yearly. Parents/guardians/caregivers, case managers from Regional Center of the East Bay, program as well as the individual are in these meetings and have direct input in these plans. Baselines are established when a participant begins program. Program ensures that there is no regression to IPP goals. Successful outcomes can also be tracked by participant attendance and engagement in the program. Kaleidoscope staff, participants, and accomplishments are regularly featured on all social media platforms, in direct mail marketing pieces, quarterly newsletters, annual reports, and via printed materials distributed throughout Northern California. 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 Needs Approval: As an organization that has been advocating for and serving people with disabilities for over a century, we are 100% committed to equal rights and freedoms for all people. This level of change takes diverse, inclusive and innovative thinking, planning and execution. We believe diversity, equity and inclusion is everyone’s work, every day and forever. 12. For the Fiscal Year 2022-2023 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? 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: gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. Attachment 5 74 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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 Attachment 5 75 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". report the number of persons that no longer have access to a substandard service. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding 0 Disabled 0 Women/Female Headed Households 0 Seniors 0 Youth 0 Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) Attachment 5 76 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" 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 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL 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) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Attachment 5 77 Funding Sources/Revenues Budget Amount Amount Committed Regional Center of the East Bay USD$ 671,692.00 USD$ 0.00 Total USD$ 671,692.00 USD$ 0.00 Funding Uses/Expenses Budget Amount Amount Committed Direct Staff Cost USD$ 414,000.00 USD$ 414,000.00 Program Supplies USD$ 144,000.00 USD$ 144,000.00 Rent/Occupancy USD$ 120,000.00 USD$ 120,000.00 Supervision/Lead/Manager USD$ 192,000.00 USD$ 192,000.00 Total USD$ 870,000.00 USD$ 870,000.00 Budget Narrative Currently the Regional Center of the East Bay reimburses a set cost for each participant per day. The funding from this grant would assist in covering staffing expenses for 10 Life Skills Coaches. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Expenses Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Info List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Easterseals NorCal_Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ 2022 Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Easterseals NorCal_2020 990 Tax Return Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Easterseals NorCal_Author. Form Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Easterseals NorCal_Author. Form Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Easterseals NorCal_Proof of Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Easterseals NorCal_501c3 Determination Letter Certified Audit and/or Certified Financial Statements ✔✔✔✔ Easterseals NorCal_2020 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 Attachment 5 78 Application ID: 383444 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) Attachment 5 79 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Goodness Village Goodness Village Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/18/2022 2:06:14 PM (Pacific) Project Contact Kim Curtis Kim@gvlivermore.org Tel: 925-237-1108 Additional Contacts none entered Goodness Village 1660 Freisman Rd Livermore, CA 94551 United States Executive Director Kim Curtis Kim@gvlivermore.org Telephone925-237-1108 Fax Web www.gvlivermore.org Organization Information top 1. Business License Number Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Goodness Village is a tiny home community intentionally designed to end homelessness through safe, healthy living environment and onsite supportive staff offering vocational training, substance use services, mental health support and case management. 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 80 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. We provide 24 hour a day support and security to those who were once considered chronically homeless in the Tri-Valley. Due to our unique situation of building a healthy community focused on recovery and wellness rather than integrating a formerly homeless individual into a pre-existing housing with out services we are able to provide supportive interventions, de- escalation and education to help the individuals transition and retain their housing until ready to move on to independent housing. Our clients have been selected to reside at the village due to their need for intensive support in order to be successful in housing. 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.) Currently we have 2 individuals who report having been homeless in Dublin. 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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?) In order to provide the 24 hours of supportive services to ensure the safety and wellness of the village it cost $88 a night per individual. The request for $25,000 will cover 142 bed nights for each individual from Dublin. They will be provided a tiny home with a kitchen, bath and bed, individualized case management, finance training and budgeting as they both have income, mental health care and counseling, transportation to medical care, and food stability. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) ✔✔✔✔ Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development ✔✔✔✔ Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities ✔✔✔✔ Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 81 ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . One of the clients has an income through disability but also has a goal for employment that will enable her to leave the village for an apartment. We are working on vocational training for employment that she is able to do within the limitations of her disability. She is enrolling in courses and also heavily involved in our garden program. She also does admin work for the village. We track attendance of support groups and case management. The other client is in her late 60's and resides in one of our ADA homes. She formerly lived in her car in Dublin with chronic pain. It is unlikely her income will increase past social security and she was up in the 9000s for Alameda County's housing waitlist. She will enjoy an approved quality of life for her final years and hopes to remain with us as she now see's her neighbors and staff as family. She is often supporting her neighbors with trips to the grocery store in her van. She now has a sense of purpose and a sense of belonging. 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 staff is made up of a range of cultural backgrounds and differing ethnicities and religious backgrounds. We wanted to ensure that we reflected the macro community within our micro community. Our core value at the village is to treat all who enter the village with Dignity and Respect. 12. For the Fiscal Year 2022-2023 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. A few of clients were deemed "High Risk" due to their comorbities on top of the extreme vulnerability of being homeless. Are client's are elderly, had poor access to hygiene, poor diets, and lack of information. We have greatly improved their chances of recovering if they were to become sick. They now have a place to sleep 8 or more hours a night, access to showers daily, access to fresh hot meals and water to stay hydrated, and 24 hour staff to assist as needed. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. Attachment 5 82 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc Rental units rehabilitated: This indicator shows the number of affordable rental units rehabilitated as well as the number Attachment 5 83 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process of years of affordability, units for chronically homeless persons, elderly persons, and persons with HIV/AIDS. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding 0 Disabled 0 Women/Female Headed Households 0 Seniors 0 Youth 0 Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL 0 Low Income (50%-80% AMI) 0 Extremely Low Income (<30% AMI) 0 Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Attachment 5 84 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" 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 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 n/a Not Applicable. Not interested in CDBG funding. (Type N/A) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed local church support USD$ 50,000.00 USD$ 50,000.00 Individual donors "Club 88" and "BOLD" USD$ 60,000.00 USD$ 48,000.00 City of Livermore USD$ 96,000.00 USD$ 0.00 City of Pleasanton USD$ 143,520.00 USD$ 0.00 Foundations USD$ 120,000.00 USD$ 10,000.00 Local Civic Clubs USD$ 25,000.00 USD$ 5,000.00 June Fundraiser Event USD$ 100,000.00 USD$ 57,042,910.00 Homekey USD$ 200,000.00 USD$ 0.00 City of Dublin USD$ 25,000.00 USD$ 0.00 Corporate USD$ 100,000.00 USD$ 12,000.00 Total USD$ 919,520.00 USD$ 57,167,910.00 Attachment 5 85 Funding Uses/Expenses Budget Amount Amount Committed Personnel Salaries USD$ 712,208.00 Benefits USD$ 70,398.00 Office Supplies USD$ 13,000.00 Rent and Utilities USD$ 96,000.00 Total USD$ 891,606.00 USD$ 0.00 Budget Narrative We anticipate a stabilization of the village amongst the 28 individuals receiving services at our one year mark, which is 6 months from now. At that time we plan to re-assess staffing needs, our goal is to have a healthy "neighborhood watch" which will enable us to decrease from 2 awake over night staff to 1 "sleep" staff decreasing our budget significantly and allowing us to begin to save for expansion of the village. A goal to double our efforts to end homeless in 5 years. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ budget Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Form List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board Current Annual Budget for the Entire Agency ✔✔✔✔ budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ F990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Authorization Letter Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ authorization Letter Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ insurance umbrella city of Livermore insurance cert STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ IRS affirmation letter California Certified Audit and/or Certified Financial Statements ✔✔✔✔ Audit explanation 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 Attachment 5 86 Application ID: 384263 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) strategic plan ED resume Other Supporting Documents (Not Required) Attachment 5 87 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Hively Hively Community Engagement Coordinator Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2022 4:28:07 PM (Pacific) Project Contact Kelly O'Lague kelly@behively.org Tel: (925) 417-8733 Additional Contacts vdilks@behively.org, etrueblood@behively.org Hively 7901 Stoneridge Dr Ste 150 Pleasanton, CA 94588 United States CEO Kelly O'Lague kelly@behively.org Telephone(925) 417-8733 Fax (925) 730-4942 Web www.behively.org Organization Information top 1. Business License Number BL-109890 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 88 operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. Low-income families struggled prior to the pandemic and the economic slowdown has made the situation more dire. Hively has stretched more and more to provide needed resources, but we can’t continue to grow to meet these needs without a community of active and engaged donors and volunteers. For that, we need a full-time Community Engagement Coordinator. We recently opened the Hively Family Resource Center (FRC) in Dublin. The FRC provides the essential services of delivering free food, diapers, and household items to low-income families in Dublin and the rest of the Tri-Valley area. It is a ‘one-stop- shop’ with an on-site Family Support Specialist to answer questions and enroll families into services. In order that these critical needs be met, the FRC will be staffed with volunteers who need to be engaged, trained, and supervised. The Coordinator will also engage with the community for drives such as for diapers, food, and coats. They will begin working with local corporations to host team-building events to raise awareness of need in our community, where 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. We want to give people who CAN help the opportunity to see people who NEED help as the same community, not as ‘problems’ in our society. And for this we need someone who can concentrate on recruiting, training and supervising 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.) 750 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development ✔✔✔✔ Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities ✔✔✔✔ Food and Nutrition gfedc Senior Services ✔✔✔✔ Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 89 (What specifically will the grant funds be used for?) Low-income families struggled prior to the pandemic and the economic shutdown made the situation more dire. As a mission- focused organization, we constantly ask ourselves, "What do our clients need and how can we meet those needs?" Based on a client needs assessment, Hively launched a community closet in 2018, where donated new and gently-used items were provided free of charge. To expand those services to meet current needs, this year we opened a new Hively 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 fund a 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 unavoidable 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 dedicated, compassionate, trained, and supervised volunteers to interact with the families who come in. In addition to working with volunteers, the Coordinator will educate and engage with the community to promote drives such as for diapers, food, and warm clothing. Local corporations will be invited to host team-building events to raise awareness of need in our community, where 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. But having a Coordinator also means that we can work to further the experience of both the volunteer and the client families. For volunteers, the connection they feel to those they meet is the best thing we offer. Once people feel a connection, the ‘return’ on this ‘investment’ can be seen immediately. A ‘soccer mom’ hands out coats from a coat drive, and when a family cannot find one to fit their teenage son, she goes home and gets one from her own son’s closet. A teen helps hand out food and diapers, and when it’s her birthday, she hosts a fundraiser on Facebook to support our diaper pantry. A middle school student sees pictures of the families lined up at our distribution and donates profits from her homemade ice cream business to Hively. For families, this means an experience of being treated with dignity and respect, and being given a sense of hope and belonging. The population to be served is our client families who are enrolled in California Stage 1, 2, and 3, alternative payments, or foster bridge programs. If we don't receive funding, we won't be able to engage enough volunteers and FRC hours will be limited. It will be harder for our client families to get to the FRC during open hours to receive the items they need. Babies may go without clean diapers until the parents can find a time that they aren't working to pick up their diapers. A family may go hungry because we aren't open to provide those extra cans or bags of food to help them through until the next pay check. A child will continue to sleep with only a towel for cover and a thin sweatshirt to go to school during an unexpected cold spell, because their parents can't find a time to come in get in to get a donated jacket and blanket. We need a Community Engagement Coordinator to make absolutely sure we have the volunteers to keep the FRC open enough hours and at times that are convenient to meet the needs of those we serve. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . Volunteering offers vital help to people in need, worthwhile causes, and the community, but the benefits can be even greater for the volunteer. We will record volunteer hours as well as gather qualitative data from participants to see what they learned and how they've grown by volunteering at Hively. We will continue to collect demographic data for the families we serve, and seek to engage volunteers from the various cultures in our community so that we can better meet the needs of our client families. In addition, we will continue to keep track of how many diapers are distributed, how many books we give out, how many meals we've provided, etc. Using the Results Based Accountability model to measure impact, we will answer the quantitative questions (how much did we do?) along with the qualitative questions (how well did we do our work and are people better off because of it?). We expect to have increased our volunteers enough to keep the FRC open during the week and at least one half day on the weekend. We expect to be able to keep up with the growing need for diapers, currently 300 families per month. We want to begin a program for corporations for team building to enhance their teamwork and enlighten them to issues of hunger and poverty in the community. We serve a population of very-low-income families enrolled in California Stage 1, 2, and 3, alternative payments, or foster bridge programs. Our employees are diverse and speak 14 different languages and we strive to have volunteers who also are ethnically diverse and bilingual, and closely mirror our client base. Our storefront is physically accessible for disabled persons. We have active social media accounts, but specifically use ConstantContact for outreach to our client families in both English and Spanish. We have separate email lists for clients and for donors and other members of the community. Our storefront is well-marked and highly visible on Village Parkway in Dublin and we often have our neighbors come in out of curiosity. Once they learn of Hively’s mission, they often end up as a volunteer or donor. We need a Community Engagement Coordinator to match those who want to help with those who need a hand. Attachment 5 90 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. To make sure this is 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. 12. For the Fiscal Year 2022-2023 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. Low-income families struggled prior to the pandemic, and the economic shutdown made the situation more dire. The families we served were already in the lowest income brackets, enrolled in CalWORKS Stage 1, 2, and 3, alternative payments, or foster bridge programs. Those who were working and qualified for the alternative payment programs (child care subsidies) were low wage and hourly employees. Their jobs could not be switched to work-at-home and they were either let go, or their hours were drastically cut. Their already meager incomes plummeted. This includes jobs such as restaurant, retail, hospitality, car washes, and other service jobs, which were the first to shut down and have been the slowest to recover. We have seen the number of families coming to us for diapers triple since the pandemic began. Food insecurity has increased, and those who previously only needed child care referrals are now coming in asking about food. When money is tight and you can barely pay rent, there is no money for 'luxuries', like shoes that fit and warm clothing, pajamas, socks, and maybe a toy or two. The Covid-19 pandemic has hit those at the bottom of the economic scale the worst, and those are the clients Hively is attempting to serve to retain their dignity and hope during this ongoing public health crisis. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. Attachment 5 91 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. Attachment 5 92 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Attachment 5 93 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" 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 Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL 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) 0.000.00 TOTAL gfedc #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. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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 Community Grants USD$ 25,000.00 City of Pleasanton Community Grants USD$ 25,000.00 USD$ 0.00 City of Livermore Grants USD$ 15,000.00 Individual Donors USD$ 10,000.00 USD$ 10,000.00 Children's Emergency Food Bank USD$ 5,000.00 USD$ 5,000.00 Attachment 5 94 Faith Communities USD$ 5,000.00 USD$ 5,000.00 Total USD$ 85,000.00 USD$ 20,000.00 Funding Uses/Expenses Budget Amount Amount Committed Community Outreach Manager USD$ 7,500.00 USD$ 0.00 Community Engagement Coordinator USD$ 56,000.00 USD$ 0.00 Taxes and Benefits USD$ 18,300.00 USD$ 18,300.00 Telephone USD$ 1,200.00 USD$ 1,200.00 Computer USD$ 1,500.00 USD$ 0.00 Professional Development USD$ 500.00 USD$ 500.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 Total USD$ 85,000.00 USD$ 20,000.00 Budget Narrative Grant funds would be used to fund 40% of a full-time Community Engagement Coordinator position and 3.3% of a supervisory position. Community Engagement Coordinator @$56,000 per year x .4 = $22,500. Salary cost per month for this position would be $1,875.00 Community Outreach Manager @ $75,000 per year .0333 =$2,500. Salary cost per month for this position would be $208.33. Funding one full-time community engagement coordinator would allow us to utilize volunteers to staff our Family Resource Center. 30 hours per week x 4 volunteers per hour providing customer service = 120 volunteer hours per week. This equals approximately 6,000 hours of volunteer service in a year. 20 hours per week x 4 volunteers per hour providing assistance with stocking, sorting donations, picking up donations, etc. = 80 volunteer hours per week. This equals 4000 hours of volunteer service in a year. One staff person would be able to recruit, train and supervise these volunteers who would, in total, provide the equivalent of five full-time staff people for a year; thus, saving the agency over $200,000 in staff costs and providing the volunteers the opportunity to engage with the mission of the organization and serve their community. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ EngageCoord Program Expense Financial Information Form for ALL Grant Requests ✔✔✔✔ EngageCoord Financial Information List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Hively Agency Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Form 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Designated Official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Authorization for Funding Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Certificate of Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Hively 501C Attachment 5 95 Application ID: 384557 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. Certified Audit and/or Certified Financial Statements ✔✔✔✔ Hively 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) Attachment 5 96 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Hively Hively Busy Bees Learning Lab Jump to: Organization Information Questions Budget Documents USD$ 12,000.00 Requested Submitted: 1/19/2022 4:24:58 PM (Pacific) Project Contact Kelly O'Lague kelly@behively.org Tel: (925) 417-8733 Additional Contacts none entered Hively 7901 Stoneridge Dr Ste 150 Pleasanton, CA 94588 United States CEO Kelly O'Lague kelly@behively.org Telephone(925) 417-8733 Fax (925) 730-4942 Web www.behively.org Organization Information top 1. Business License Number BL-109890 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 97 operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. Recognizing that not all start from the same place, Hively seeks to challenge educational disparities in our community through our Busy Bee’s Learning programs. First 5 Alameda has found that 44% of children in our county are not ready for kindergarten. A student not at reading grade-level by the end of third grade is four time more likely to drop out of high school, six times more likely if low-income. And high school dropouts are 63 time more likely to be incarcerated than college graduates! Our Little Scholars program seeks to remedy these grim statistics by providing literacy materials and books to approximately 300 families per month, 50 teachers from child care centers or home and family providers per week, and through a virtual children’s book club. STEM (science, technology, engineering, and math) skills are the key to jobs which pay on average twice as much as non-STEM jobs, and STEM job growth will outpace non-STEM jobs in the decade to come. Our Little Scientists program introduces children 4-8 to STEM concepts in a fun way at a time when natural curiosity is at its highest and before gender and ethnic stereotypes discourage participation. Children are guided in various hands-on activities to learn science principles in a fun way using paper, glue, paints, sponges, cotton balls, etc. Our Little Scholars and Little Scientists programs are the first step in getting our youngest children off to a great start and preparing them for the future. 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.) 750 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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 Little Scholars portion of our Busy Bees Learning programs includes a provider book club and book and literacy materials gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities gfedc Food and Nutrition gfedc Senior Services ✔✔✔✔ Youth Services ✔✔✔✔ Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 98 to families. Dublin grant funds will mean we can continue to provide literacy materials and age-appropriate books at no cost with every diaper distribution to eligible families, 300 families per month and rising. We provide books each week to 50 teachers from child care centers and home and family providers through a virtual reading program so they can work with students in their charge to inspire a love of reading. The cost of books and shipping are going up and without additional funding we would have to reduce the number of sessions or attendees. We began a children’s book club for Currently we are averaging 25 children per week in this program, and we would use Dublin grant funds to continue and expand the program because we will be able to buy more books to distribute to them. These programs are vital because the National Literacy Trust found that children who own their own books have more positive attitudes towards reading, leading to enjoying reading and reading more often, resulting in higher reading attainment than children who don’t have their own books. We introduced our Little Scientists program as a pilot program last year for those aged 4-8. We currently are limiting enrollment to 20 students in our twice monthly pilot program. The program is limited by the cost of providing materials, which are provided free of charge to each child; receiving Dublin grant funds will mean we can offer this program to more families because we will have the funding to purchase the necessary materials and ship them to enrollees. The program is cost- effective because it uses supplies that are commonly used materials and we can buy in bulk. These are items that would be considered inexpensive for many of us, but for families that are at the poverty line they are luxuries that are lower priority than food or rent. Without funding for these supplies, our children could not participate, further exacerbating the educational gap our children are facing. Without additional funding, we might miss another child like James. Unbeknownst to us, James was obsessed with rockets, and his bedroom was covered with pictures and posters of rockets. When he found out the next session involved building his own rocket, he was 'over the moon' with excitement. Maybe James will be a future astronaut, encouraged by the Little Scientists program! Without funding, what other child might miss their opportunity for the future? All programs will continue virtually for the foreseeable future. In addition to meeting Covid restrictions, the online sessions remove many barriers to low-income families such as transportation and child care for other family members. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . Outcomes crucial to the success of our Busy Bees Learning programs are attendance and getting books into hands. Hively will measure these outcomes by counting unduplicated attendees at all provider book club, Little Scholars book club, and Little Scientists lab sessions. We will also track the number of books distributed to providers, families, and children. The population we serve is families who are very-low-income recipients of California Stage 1,2, and 3 programs, alternative payment programs, or foster bridge programs. Both our provider and our Little Scholars reading clubs use books that are often bilingual, and include stories of children from diverse backgrounds, ethnicities, abilities, and personalities. They will cover a wide variety of social emotional topics such as celebrating our differences, bullying, friendships, positivity, and how to manage emotions. The provider book club uses volunteer readers who may be bilingual, and who are from varying ethnicities, ages, communities, and genders to model and discuss how to use the books in a home or center based child care setting. The Little Scholars club includes reading similar books with a wide variety of social emotional topics relevant to children, such as how to manage emotions, making friends, dealing with change, and recognizing and celebrating their own uniqueness, as well as singing and movement using music and songs from different languages and cultures. The Little Scientists labs are examined to ensure they are science based with no cultural, ethnic, gender, or religious biases and have a skill level ensuring success for all children in the target age-range. Both the Little Scholars and Little Scientists programs are offered through video conferencing, allowing access to low-income families with barriers such as transportation and child care for other children, and to disabled persons. Hively uses a variety of ways to communicate with our families and network of child care professionals: directly through our Family Support Specialists as well as electronically in both Spanish and English through email, social media, ConstantContact, and the Community Calendar on the Hively web page. Many of our families use the services of our Family Resource Center to access the Diaper Pantry, Food Pantry, and Community Closet and information is available there. Communications regarding all of Hively's services are easily accessible to families through all of these outreach strategies. 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 Inclusivity, diversity, and equity are about fairness and justice, and recognize that not all start from the same place. Hively's Busy Bees programs actively promote inclusivity, diversity, and equity by ensuring that literacy and STEM (science, technology, engineering, and math) education are available to ALL children in the county, no matter their socioeconomic status, address, or ethnicity, and seeks to overcome barriers that low-income children face. Educational equity begins with literacy and reading skills. First 5 Alameda County has found that 44% of county children are not kindergarten ready. A student not at reading grade-level by the end of third grade is four times more likely to drop out of high school, six times more likely if low-income. And high school dropouts are 63 times more likely to be incarcerated than college graduates! Economic equity is driven by access to jobs sustaining a family above the poverty line; STEM skills are the key to future high-paying jobs. STEM education can help break down ethnic and gender gaps sometimes found in science, engineering, and healthcare professions. STEM jobs pay on average twice as much as non-STEM jobs. The growth of STEM jobs will outpace non-STEM jobs in the decade to come. Attachment 5 99 Our programs seek to include those who otherwise might be left behind and are a first step in getting our youngest children off to a great start and preparing them for the future. 12. For the Fiscal Year 2022-2023 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. According to a CNN article, the negative effects of the pandemic hit low-income students like our target audience particularly hard. During remote learning, lower-income students were less likely to have personalized attention and help with homework or difficult subjects; their parents work at hourly wage jobs that are not able to be done at home. Students from low-income homes tend to have less access to educational enrichment programs, and are more likely to live in areas with historically under-funded schools. Experts call this an 'opportunity gap' which limits access to resources that enhance learning and development. Hively's programs are designed to bridge this 'opportunity gap' by providing opportunities to complement and enhance what is learned in schools in the two most important areas: reading, and STEM. These same experts found in 2017, even before the pandemic, that children who fall behind in their early education can rarely make up for these losses. Hively is absolutely committed to making sure that low-income children have the enrichment opportunities that can help them achieve their educational potential and prepare for a successful future. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. Attachment 5 100 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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 Attachment 5 101 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" number of units for the chronically homeless. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL White White + HISPANIC Black/African American Attachment 5 102 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 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) 0.000.00 TOTAL gfedc #1 - This program/project has the agency's highest priority for funding. gfedc #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. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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 Community Grants USD$ 12,000.00 Sunlight Giving Foundation USD$ 2,500.00 USD$ 2,500.00 City of Pleasanton Youth Grant USD$ 7,500.00 East Bay Community Foundation USD$ 2,500.00 USD$ 2,500.00 Individual and corporate donations USD$ 42,000.00 USD$ 29,000.00 Oakland Literacy Coalition USD$ 1,000.00 USD$ 1,000.00 Total USD$ 67,500.00 USD$ 35,000.00 Funding Uses/Expenses Budget Amount Amount Committed Director of Community Services USD$ 9,000.00 USD$ 9,000.00 Community Services Coordinator USD$ 19,000.00 USD$ 5,850.00 Community Outreach Specialist USD$ 4,800.00 USD$ 2,400.00 Office supplies - copy costs and paper for handouts and directions USD$ 600.00 USD$ 300.00 Books for literacy programs USD$ 16,400.00 USD$ 8,200.00 STEM supplies USD$ 15,600.00 USD$ 8,200.00 Postage/shipping costs USD$ 900.00 USD$ 450.00 Accounting/audit USD$ 1,200.00 USD$ 600.00 Total USD$ 67,500.00 USD$ 35,000.00 Attachment 5 103 Budget Narrative Funding from the City of Dublin Community Grant would be used for staff and for purchasing supplies and postage/shipping costs. This allows us to provide the materials free of charge for low-income families, who otherwise would be precluded from participating in this important program. Although the supplies are commonly used materials that would be considered inexpensive for many of us, for families that are at the poverty line they are luxuries that are lower priority than food and rent. Additional staff costs and program expenses would be received from other sources. Please note when reviewing the agency budget that the vast majority of Hively's budget is received via contracts with state and local agencies and funds are restricted as they pass through Hively in the form of client services and subsidies to child care providers. Additional programs and services are funded through grants and individual financial and in-kind donations. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ BusyBees Program Expense Financial Information Form for ALL Grant Requests ✔✔✔✔ BusyBeesFinancial Information List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Hively Agency Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Form 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Designation of Authorized Official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Authorization for Funding Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Certificate of Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ 501(c) Certified Audit and/or Certified Financial Statements ✔✔✔✔ Hively 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 Attachment 5 104 Application ID: 383471 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) Attachment 5 105 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Hively Hively Family Resource Center Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2022 4:27:17 PM (Pacific) Project Contact Kelly O'Lague kelly@behively.org Tel: (925) 417-8733 Additional Contacts vdilks@behively.org, etrueblood@behively.org Hively 7901 Stoneridge Dr Ste 150 Pleasanton, CA 94588 United States CEO Kelly O'Lague kelly@behively.org Telephone(925) 417-8733 Fax (925) 730-4942 Web www.behively.org Organization Information top 1. Business License Number BL-109890 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 106 operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. In December 2021, Hively achieved a goal we have been working towards for the past several years and opened a Family Resource Center (FRC) in the Tri-Valley. Conveniently located in Dublin near the 580 and 680 freeways, the FRC offers resources free of charge to meet the basic needs of the lowest income, most vulnerable families in the Tri-Valley. Resources include a month’s supply of diapers and wipes, an age-appropriate children’s book, and parent education materials promoting children’s literacy; fresh and non-perishable food items, toilet paper, hand soap, and other basic necessities; and clothing, shoes, baby items, books, toys, and household goods. When families come to Hively’s Family Resource Center, they receive more than just diapers, food, and clothing. They gain access to a wealth of resources and services offered by Hively, including affordable mental health services; child care subsidies and referrals; parent education workshops; family-strengthening events like Parent Cafe and Parent-Child Book Club; resources for job seekers; and help in finding other available resources in the community. Offering a “one-stop shop” is crucial so families don’t waste their time and energy cobbling together resources from several different agencies to obtain all the resources and services they need. Just as important as ease of access to resources and services, when families come to Hively, they receive compassion, are treated with dignity, and gain a renewed sense of hope. 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None ✔✔✔✔ Behavioral Health (mental health and substance abuse) gfedc Affordable Housing ✔✔✔✔ Health Care (including dental) ✔✔✔✔ Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities ✔✔✔✔ Food and Nutrition gfedc Senior Services ✔✔✔✔ Youth Services ✔✔✔✔ Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 107 (What specifically will the grant funds be used for?) Grant funding would be used to increase staffing for the Family Resource Center. Community Outreach Supervisor Tommy McCoy and Community Outreach Coordinator Arianna DeLillo are responsible for operations at the FRC - picking up donations; sorting, organizing, and storing donated items; supervising hundreds of volunteers; purchasing program supplies; and cultivating and maintaining relationships with donors and community partners. These positions are reliant on partnerships with grant funders, individual donors and community partners. 100% of the operational expenses come through these partnerships as well. Hively is fiscally responsible and strives to be as cost effective as possible in running the Family Resource Center. Hively has built a strong network of in-kind donors. Last year, several individuals and community organizations conducted supply drives (food, clothing, diapers, etc.) on our behalf, including the Rebecca Bauer-Kahan for Assembly, St. Raymond's Catholic Church, the Chevron Moms Group, the Church of Jesus Christ of Latter-Day Saints and many others. Hively’s corporate partners who donate new merchandise to the FRC include Joann Fabrics, Target, Cost Plus World Market and Lowe's. Hively has partnered with several charitable and community organizations, who collect gently used material goods from their members and provide the donations to Hively. These organizations include Tri-Valley Haven, Shepherd's Gate, and CityServe of the Tri-Valley. In turn, Hively provides donated items to eligible clients of these organizations, thereby reaching more people in need through these partnerships. Finally, last year over 1,000 individuals donated in-kind items to Hively. Through these supply drives and through in-kind and monetary donations from individual donors, local businesses, and philanthropic organizations, Hively procures the majority of resources for our families at NO cost to us. Hively utilizes individual volunteers and volunteer organizations like Boys Team Charity, National Charity League, boy scouts, and church groups, who not only help with the day-to-day of sorting/organizing/storing donations, but also help re-stock merchandise and provide customer service to shoppers. By cultivating partnerships with community supporters, who provide a significant portion of food, diapers, clothing, and volunteer manpower, we are able to stretch every dollar of program funding to support as many families as possible. Our clients best express the needs that our FRC fulfills: “No words can describe what a blessing Hively has been since I started fostering the boys. Going into this, I was a terrified single parent wondering how I was going to support two boys on a single income. Then by some miracle, I found Hively and you made it possible. Not just with child care assistance, but with the diaper pantry, free clothes, Christmas gifts, and parenting classes. It’s a great service you offer. You are all angels!” - “K” “I want to express my immense gratitude for what you do to help families in need like myself! When I picked up the diapers, you guys had great necessities that we could take for our families. In addition to food for my family, there was a bag of pretend food that my little one loves playing with in addition to the children’s books! I have not had the money to buy toys or books for my children, so receiving these items meant the world to me!” - “D” “I have to tell you about a mother in Pleasanton with whom I spoke today. She and her husband both lost their jobs due to COVID, are struggling to care for four children, two with ASD (autism spectrum disorder), and an aging parent in a small two- bedroom apartment. The family is being kept afloat in part by the work you are doing at Hively and they are grateful for the diaper pantry.” - a project manager at Tri-Valley Anti-Poverty Collaborative This feedback reminds us that behind every statistic of need, there are real people struggling every day just to provide for their family’s basic needs. The feedback is also a reminder to us of why we do the work we do every day. Our work matters and our work makes a difference. The difference between having something to eat or going hungry. The difference between having warm clothes in the winter or being cold. The difference between having enough clean diapers to last the month or reusing soiled diapers. If we do not receive funding from the City of Dublin, the result would be that fewer families would receive resources to meet their basic needs. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . Criteria for success include: cost effectiveness; accessibility to clients; and coordination with other service providers. The Family Resource Center is cost effective because we have tremendous community support and enjoy successful partnerships with community-based organizations, local businesses, volunteer organizations, and individual community members. We seek in-kind donations and monetary donations from community members; our community-based partners solicit in-kind donations on our behalf; we seek grant funding from other sources, including corporate philanthropies and local philanthropic organizations; and we rely on volunteer manpower instead of staff whenever possible. These cost-saving Attachment 5 108 measures allow us to stretch grant funding further and to serve even more families. The Family Resource Center is highly accessible. Located near the 580 and 680 freeway interchange, the FRC is easily accessible via car, bus, and BART and it is wheelchair accessible. Moreover, the FRC offers varied hours of operation to accommodate a variety of schedules, including evening and weekend hours. With many of our clients being Spanish speakers, we employ Spanish-speaking staff in order to communicate effectively with our clients. Finally, in emergency situations, Hively can meet the person where they are and bring resources to them (including crisis intervention services from a mental health professional, food, clothing, and diapers). Hively partners with CityServe of the Tri-Valley, Axis Community Health, and WIC of Pleasanton, all of whom refer qualified clients to Hively. Other partners like Shepherd’s Gate provide donated clothing and shoes to Hively’s Family Resource Center. In turn, Shepherd’s Gate brings their clients to Hively to “shop” at the Family Resource Center. By collaborating with these partners, Hively aims not only to minimize duplication of services, but also to deliver the most comprehensive services to our families. Our outreach efforts also include digital and printed community resource materials, Constant Contact, SurveyMonkey, social media, community events, and the agency website. To measure progress, we will keep track of how many diapers are distributed, how many books we give out, how many meals we've provided, as well as how many families we serve. Using the Results Based Accountability model to measure impact, we will answer the quantitative question “How much did we do?” along with qualitative questions “How well did we do our work?” and “Are people better off because of it?” Hively is extremely well-positioned to provide outreach to vulnerable populations in the Tri-Valley. The majority of Hively's families are low income; families with young children (0-5 yrs); Black, Latino and Asian; immigrant; and non-native English speakers. These are the populations we serve and engage with every day and they are the populations who would seek resources at the Family Resource Center. All of Hively services are culturally appropriate. We are inclusive and strive to employ staff who reflect the communities we serve and who are experienced in providing support and resources to the target populations. In addition, all Hively staff undergo trauma-informed care training as well as diversity and inclusivity training to ensure that our clients feel understood and welcomed at Hively. 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 goal is to provide comprehensive, holistic support to the lowest income, most vulnerable members of our community. 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 is currently undergoing 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. Beginning in May 2021, the entire Hively staff has met twice per month via videoconference with CLEREL staff 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 have access to the resources and supplies that others in the relatively wealthy San Francisco Bay Area take for granted. Moreover, at Hively, we strive to employ staff and volunteers who reflect the communities we serve and who are experienced in providing support and resources to the target populations. With a large portion of our clients being Spanish speakers, we employ Spanish-speaking staff and seek Spanish-speaking volunteers in order to communicate effectively with our clients. 12. For the Fiscal Year 2022-2023 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, and, when an in-person meeting is necessary, by appointment only. Hively minimizes COVID risk amongst it's staff by encouraging those who can work from home to do so. For staff who must work at the office, we observe all safety precautions and guidelines issued by the Alameda County Health Department and the State of California. At our Family Resource Center, we require everyone to wear face coverings and we limit the number of people who are in the space at one Attachment 5 109 time. We offer disposable masks to those who don't have them. Knowing that low-income populations suffered from low COVID vaccination rates and lack of access, last year we partnered with local pharmacies and hosted COVID vaccination clinics for low-income, BIPOC, and hard-to-reach populations and administered over 1,400 doses of COVID vaccine. The pandemic may have affected how we do business. However, it has not stopped us from doing our everyday work of supporting the lowest income, most vulnerable families in our community. The COVID-19 pandemic has had a devastating and disproportionate effect on hourly and low-wage workers in service industries, who already struggled to make ends meet prior to the pandemic. The need for basic resources skyrocketed dramatically due to the pandemic. Families who had never before sought our help were now struggling to pay for rent and food. The need has only gotten greater during the pandemic. Funding safety net programs to fulfill basic needs is crucial now more than ever before. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. Attachment 5 110 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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 Attachment 5 111 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" homeless households assisted. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL White White + HISPANIC Black/African American Black/African American + HISPANIC Asian Asian + HISPANIC American Indian/Alaskan Native Attachment 5 112 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 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) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Sunlight Giving Foundation USD$ 30,000.00 USD$ 30,000.00 Sisters of the Holy Family USD$ 50,000.00 USD$ 50,000.00 Individual Donors USD$ 64,440.00 USD$ 25,000.00 City of Dublin USD$ 25,000.00 USD$ 0.00 City of Pleasanton USD$ 25,000.00 USD$ 0.00 City of Livermore USD$ 25,000.00 USD$ 0.00 StopWaste USD$ 10,000.00 Rotary Clubs USD$ 7,500.00 Share the Spirit USD$ 7,500.00 Walmart USD$ 7,500.00 Total USD$ 251,940.00 USD$ 105,000.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel salaries USD$ 133,440.00 USD$ 60,000.00 Personnel benefits USD$ 33,500.00 USD$ 15,000.00 Program Supplies USD$ 25,000.00 USD$ 10,000.00 Rent/Utilities USD$ 60,000.00 USD$ 20,000.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 USD$ 0.00 Total USD$ 251,940.00 USD$ 105,000.00 Attachment 5 113 Budget Narrative Proposed spending using City of Dublin funding: .167 FTE Community Outreach Manager = $12,360 .167 FTE Community Outreach Coordinator = $9,880 Program Supplies = $2,760 TOTAL = $25,000 The partial salaries of Hively employees comprise the bulk of this grant request. Grant funding would be used to fund partial employee salaries and to purchase supplies to help run the Family Resource Center. Community outreach staff ensure the smooth, everyday running of the programs - picking up donations; sorting, organizing, and storing donated items; supervising hundreds of volunteers; purchasing program supplies; stocking and replenishing merchandise; and cultivating and maintaining relationships with donors. In addition, developing and maintaining community partnerships and executing successful fundraising strategies will maximize resources, secure diverse funding streams, and reduce program costs. Hively utilizes in-kind resources, community partnerships, fundraising strategies, and volunteers to minimize costs to the fullest extent possible. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ FRC Program Expense Financial Information Form for ALL Grant Requests ✔✔✔✔ FRC Financial Information Form List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Hively Agency Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Form 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Designated Official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Authorization for Funding Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Certificate of Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Hively 501C Certified Audit and/or Certified Financial Statements ✔✔✔✔ Hively 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 Attachment 5 114 Application ID: 384112 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) Attachment 5 115 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Hope Hospice, Inc Grief Support and Volunteer Services Jump to: Organization Information Questions Budget Documents USD$ 20,000.00 Requested Submitted: 1/19/2022 5:26:58 PM (Pacific) Project Contact Jennifer Pettley jenniferp@hopehospice.com Tel: (925) 719-6268 Additional Contacts marcr@hopehospice.com Hope Hospice, Inc 6377 Clark Avenue Suite 100 Dublin, CA 94568 Chief Executive Officer Jennifer Hansen jenniferh@hopehospice.com Telephone(925) 829-8770 Fax (925) 829-0868 Web www.hopehospice.com Organization Information top 1. Business License Number BL-005299 Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Hope Hospice’s mission is to support patients at home who are at the end of life with exceptional care, compassion and dignity. Families are also supported in their roles as caregivers. No one is turned away from Hope Hospice, regardless of ability to pa 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 116 operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. Hope Hospice’s Grief Support and Volunteer Services Programs work collaboratively with our patient care staff to support hospice patients and their families from admission to bereavement. Volunteer Services includes the recruitment, onboarding, and training of volunteers who visit and help patients in their homes, as well as scheduling, tracking, and monitoring their activities. Currently Hope Hospice has 60 active volunteers and 37 on leave of absence during the pandemic. Grief Support Services involves the planning, scheduling and facilitation of individual and group support sessions for our deceased patient families and members of the community. These sessions help people who have lost a loved one process their heartbreak and grief and receive the support they need to move forward successfully in their lives. The support groups provide a safe environment to discuss loss and to learn about positive ways to cope with their grief emotions. In fiscal 20/21, Hope cared for 741 patients, a nine percent increase in admissions and growth in services over the previous fiscal year (19/20). These programs are available to anyone regardless of their ability to pay, and are made possible because of community contributions and grants, such as funding from the City of Dublin. It is important that we diversify our funding sources to help ensure these community service programs remain available and that their quality is sustained. 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None ✔✔✔✔ Behavioral Health (mental health and substance abuse) gfedc Affordable Housing ✔✔✔✔ Health Care (including dental) gfedc Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities gfedc Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 117 (What specifically will the grant funds be used for?) Funding from the City of Dublin will help Hope Hospice provide grief support to families in our community and volunteer support to patients and families in our care. Specifically, the funding will help support two vital positions: the Director of Grief Support Services and the Manager of Volunteer Services. Both are long-time specialists in their disciplines. Grief Support is available to all community members at no charge. Volunteer Support services assist our patients and families and collaborate with our bereavement department. Both are supported by community contributions and grants. This funding is vital to keep these programs available and to sustain their high quality. The general population in our community and beyond is living longer with more diverse and chronic conditions. Eighty-nine percent of Hope patients are age 70 years or older. Memory, nervous system, and dementia-related conditions account for 37 percent of cases, surpassing cancer as the primary diagnosis on admission to Hope. These cases require greater family assistance by Hope's specially trained volunteers and staff. Hope offers an alternative for families to care for their dying family member at home where he or she can be more comfortable, the environment is more familiar, and where most people want to be when they die. With good quality support and guidance from the hospice team, which includes our volunteers, families can avoid expensive and often the unnecessary hospitalization of their loved one. Hospice patients receive care by a team of health care professionals who work together to relieve pain and uncomfortable symptoms and provide support that protects the patient's dignity as he or she remains at home. With professional and volunteer support coming in, a family's feelings of inadequacy and anxiety are greatly reduced. Trained volunteers are key members of the hospice team and are unique to the hospice-at-home experience. Volunteers provide vital companionship and support to families with in-home visits, telephone and correspondence. Patients and families enjoy these special visitors who will read, even sing or play an instrument to the patient, provide respite time to caregivers, and in general provide enriching companionship that helps families cope in their situation. Volunteers provide hundreds of hours of their time to help Hope's patient care team and in other capacities. This helps us conduct our mission of support and service at a much lower cost than if these functions were handled solely by paid staff members. Also, as families are grieving their loss, they have a myriad of free grief support services available through Hope's grief support individual and group sessions, including those for spousal loss or loss of a child. Hope does not charge for these services, making this help available to all who need it in the community. With our Grief Support services, individuals and families find a safe place to turn to express their emotions, access specialists who will empathetically listen and validate their feelings, help them learn coping strategies, and overall help them avoid more serious complicated grief issues of long-term depression and anxiety. The goal is to help them move forward successfully in their lives. These funds are vital to helping Hope keep these services available to the community and to sustain their high quality. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . 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. 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. 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. Hope's Chief of Quality and Compliance, a member of the executive leadership team, monitors, reviews and reports the results of these evaluations. 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. Attachment 5 118 Ninety percent of Hope's patients are aged 70 and above and are referred to us by their physician, medical group or discharge planner, and we serve anyone regardless of their ability to pay. If someone requests hospice services independently, we contact their primary care physician for an official referral. For grief support, open to all residents, a physician referral is not needed. Individual or group counseling is free of charge, and participants are followed for up to 13 months after their loss. Currently, grief sessions are held online as in-person sessions are not possible during the pandemic. If someone does not have access to a computer, we will conduct sessions by telephone or reach out through correspondence. In normal times, the Grief Support Center is open in our Dublin office, accessed by elevator on our second floor. The Dublin office on Clark Avenue is centrally located in the Tri-Valley, near freeways and bus stops, and is a short walking distance from BART. In patient care, our volunteers and staff visit patients in their homes. All services are provided with cultural sensitivity, including any language barriers. Many Hope Hospice staff members are bi- lingual, however, we do employ a language translation service when needed. Hope Hospice has an extensive outreach program that includes public presentations at local senior centers, residential care facilities, assisted living communities, and other gathering places; to staff at medical practices and at health care facilities. Staff presents a wide variety of end-of-life care educational programming, such as understanding advance healthcare directives, nutrition for seniors, and dementia care. We also offer a monthly, 13-class Family Caregiver Education Series of workshops to help families learn about and find support for their caregiving of their loved one. Some 589 people attended in FY20/21 at no charge. In addition, Hope posts information on its website and through its social media outlets about the programs and services we offer, as well as through newspapers, radio, television, and direct mailings. 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 Hope Hospice serves all who come to us for service without regard to race, religion, orientation, or income status. Not only is this a core value of Hope Hospice, it is a Medicare requirement. The compassionate approach to hospice care, extended through not only our clinical care staff but also our volunteer and grief support services, is culturally sensitive and follows the wishes of the patients, families, and clients in order to best serve their needs and wishes. It seeks to retain the patient's dignity and affirm life. 12. For the Fiscal Year 2022-2023 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. Hope Hospice patient care providers-our nurses, home health aides, social workers, chaplains, volunteers and others wear full PPE when visiting patients in their homes, wherever that may be (single-family residence, senior care residence, board and care, etc.). Hope's care providers are vaccinated and Hope offers weekly PCR, sometimes daily antigen testing to ensure their safety as well as others in their care. At this time, only vaccinated volunteers visit with vaccinated patients. Nonvaccinated patients are visited only by Hope Hospice staff. All non-patient care programs moved to an online format and are offered through teleconference platforms such as Zoom. These would include our grief support services and our community education programs, including our Family Caregiver Education series. These programs are all made available to the public at no charge. 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? 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: gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers Attachment 5 119 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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 Attachment 5 120 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Attachment 5 121 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" 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 Youth Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) 0 Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL 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 0 Not Applicable. Not interested in CDBG funding. (Type N/A) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc If you have more than 6 applications per organization, agency, district or entity, check here. Attachment 5 122 Budget top Funding Sources/Revenues Budget Amount Amount Committed City of Dublin USD$ 20,000.00 City of Pleasanton USD$ 20,000.00 City of Livermore USD$ 15,000.00 Sunstate Equipment Foundation USD$ 2,000.00 USD$ 2,000.00 San Ramon Rotary USD$ 2,000.00 USD$ 2,000.00 Community Donations USD$ 274,389.00 USD$ 274,389.00 Sponsorships USD$ 50,000.00 USD$ 50,000.00 Total USD$ 383,389.00 USD$ 328,389.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 231,471.00 USD$ 231,471.00 Benefits USD$ 37,036.00 USD$ 37,036.00 Operational Expenses USD$ 26,407.00 USD$ 26,407.00 General Administrative USD$ 88,475.00 USD$ 88,475.00 Total USD$ 383,389.00 USD$ 383,389.00 Budget Narrative Volunteer Services and Grief Support Services are two separate departments within Hope Hospice, each with its own program manager. These programs both operate separately and collaborate as needed such as with volunteer grief facilitators for the grief support groups. The services provided by these two programs are vital to the hospice-at-home experience for patients and families and then in the aftermath of loss. As a Medicare-certified agency, most clinical services such as those provided by our registered nurses, home health aides, social workers, chaplains, and others receive some reimbursement. Medicare does not reimburse for the range of volunteer support services and grief support services that are provided by Hope Hospice. These are possible only with community contributions and grants. These figures are based on the operational budget for both programs for FY21/22. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Expense Budget Form Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information Form - Project List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Budget - Agency FY21/22 Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Form 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Designation of official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Designation of official Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Certificate of Liability Insurance Workers Compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Nonprofit Determination - State and Federal Certified Audit and/or Certified Financial Statements ✔✔✔✔ Audit Attachment 5 123 Application ID: 380900 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) Attachment 5 124 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Legal Assistance for Seniors Legal Services, Medicare Counseling and Education for Dublin Seniors Jump to: Organization Information Questions Budget Documents USD$ 10,000.00 Requested Submitted: 1/19/2022 4:39:51 PM (Pacific) Project Contact James Treggiari jtreggiari@lashicap.org Tel: (510) 832-3040 x302 Additional Contacts none entered Legal Assistance for Seniors 333 Hegenberger Road Suite 850 Oakland, CA 94621 United States Executive Director James Treggiari jtreggiari@lashicap.org Telephone(510) 832-3040 x302 Fax (510) 842-1080 Web www.lashicap.org Organization Information top 1. Business License Number BL-110718 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 125 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary 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 older adults. LAS’ legal program will serve elder abuse survivors and those needing legal help with guardianship, citizenship, public benefits, health law and housing. Legal services include representation in court and administrative hearings, legal advice and counsel and referrals to other resources. 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 to resolve coverage issues, referring to LAS’ legal program for further help if necessary. Though many in-person services have been paused due to COVID-19, and substituted with phone, email, video and webinar communications, our Community Education department restarted in-person seminars during Summer 2021 at the Dublin Senior Center and Dublin Ranch Senior Apartments, recording 267 attendees within six months. 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.) 142 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing ✔✔✔✔ Health Care (including dental) gfedc Workforce Development ✔✔✔✔ Homelessness gfedc Transportation Services and Access ✔✔✔✔ Domestic Violence and Child Abuse ✔✔✔✔ Disabilities gfedc Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above ✔✔✔✔ Please explain: Senior services for elder abuse, eviction defense, health coverage. Culturally competent services, accessible for people with disabilities. Attachment 5 126 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 older adults. Services will be focused on low or extremely low-income older adults. As mentioned, these services cannot safely be provided in-person at LAS’ office or directly in the Dublin community at this time. As such, LAS has now shifted its efforts to providing outstanding remote services so every older adult can meaningfully access help despite the pandemic. HICAP and legal client meetings are through phone or video conference, but for clients with heightened needs, staff will meet in person, following all safety protocols. Staff will also pick up paperwork from clients' homes in order to avoid unnecessary court delays. In addition, because court hearings are conducted remotely, staff work with clients to prepare them for the remote hearing. Community education is being offered online, and the 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. Once it is safe to do so, all in-person and community-based services, including home visits, HICAP appointments at the Dublin Senior Center, and community education at various Dublin locations, will resume. 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, ten 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. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . LAS will provide services to a total of 142 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 seven 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 65 Dublin Medicare recipients. Again, all HICAP counseling is currently being performed remotely; in-person counseling at the Dublin Senior Center will resume when safe. 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 three 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. Currently, presentations are being provided via webinar only; in-person event will resume when it is safe to do so. 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. To monitor the progress of these outcomes, LAS will utilize client databases that track client demographics and case outcomes. Periodic database reports will be generated and reviewed by LAS’ management team to ensure LAS is on track to Attachment 5 127 meet all project goals. If LAS notices a deficiency in one program area, adjustments will be made to ensure that all goals are met, including increasing outreach efforts in Dublin to make more seniors aware of LAS’ services. LAS also distributes evaluation forms to all clients and community education participants to assess the quality of services provided. LAS’ management team reviews all returned evaluations to ensure compliance with LAS’ standards of service. LAS’ services are designed to be easily accessible for older adults who have language barriers. To make sure non-English speaking seniors can meaningfully access LAS’ services, written materials are provided in multiple languages. LAS staff and volunteers can also provide services in several languages, and for all other language needs, a phone interpretation service is used. Community education presentations are provided in multiple languages, including Cantonese, Mandarin, Spanish, Hindi and Punjabi. For court appearances, LAS attorneys arrange with the court to have an interpreter provided when needed. While we are currently unable to conduct home visits due to the pandemic, to ensure older adults with heightened needs or disabilities are able to access services, LAS staff continue to meet with these clients when necessary, following all safety protocols for the safety of staff and the client. To ensure older adults from isolated or underserved areas are aware of the services offered, LAS also conducts extensive outreach activities across the county, which we have increased since the pandemic. These increased efforts include finding new pathways to connect with older adults, such as partnering with Meals on Wheels and Open Heart Kitchen to include LAS outreach materials, in multiple languages, with deliveries. Since the pandemic, LAS has distributed over 1000 fliers on our services and other important information for older adults, such as avoiding COVID-19 fraud and scams. To ensure LAS’ services are culturally appropriate, LAS collaborates with several cultural centers, including Multicultural Institute, Asian Health Services, and The Fruitvale Senior Center. LAS is also continuing its comprehensive Equity, Diversity and Inclusion (EDI) initiative, including agency-wide staff training and a staff EDI committee, and DEI demographic workgroup to make our services as welcoming as possible to all older adults, regardless of ethnicity, sexual orientation, language, or disability. LAS’ marketing and outreach strategies include distributing marketing communications to the Dublin Senior Center and throughout its robust network of partners. These marketing communications include event and service fliers, a quarterly newsletter, blog posts on LAS’ website, Facebook posts, other publicity, and informative li 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 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 client demographic shift quarterly, to see if additional program adjustments need to be made to meet goals. LAS also has an active 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 of employees. We have made great strides to increase the diversity of our senior staff. Mariel Kusano, a staff attorney of 15 years, was recently promoted to Supervising Attorney. Christine Sung, another staff attorney, was also promoted last year to Senior Staff Attorney. Both positions are senior in the organization and reflect the growing diversity of our employees within higher management positions. We have also recently contracted with a consultant to help our Board adopt a DEI lens for its work, with the goal of helping them 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 2022-2023 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 format. 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 Attachment 5 128 communication behind as we reach out to seniors in need. Substantively, Legal Assistance for Seniors is well prepared to help Dublin tenants who are facing housing instability linked to the COVID-19 pandemic. Particularly in matters related to unlawful detainers and negotiations with landlords, LAS’ team of attorneys is able to provide the services necessary to assist Dublin residents who are 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 organization’s third largest practice group is housing legal services with 201 cases countywide in Fiscal Year 2020-21. Of our legal services clients, 65% were women, 74% 65 or older, 55% persons or color, 12% non-native English speakers, 74% low-income residents, 50% below the poverty level and 51% disabled. Additionally, LAS’ Community Education program includes 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? 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 at Fruitvale Senior Center, which serves predominately Hispanic seniors in Oakland, and Asian Health Services, serving many mono-lingual seniors, also in Oakland. Although we had to pause in- person services for the time being, we have maintained communication 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. In addition, 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: ✔✔✔✔ Yes. If so, check box here and answer questions 14 through 25. gfedc No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. ✔✔✔✔ Be culturally accessible, appropriate and inclusive ✔✔✔✔ Encourage community engagement and involvement gfedc Promote energy and resource efficiency ✔✔✔✔ Encourage networking and information sharing across service providers ✔✔✔✔ Encourage process streamlining ✔✔✔✔ Consolidate service delivery gfedc Not Applicable. Not interested in CDBG funding. Attachment 5 129 (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: ✔✔✔✔ A) Housing gfedc 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. gfedc 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. gfedc C) Supportive Housing gfedc 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 gfedc 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. gfedc 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 gfedc F) Not Applicable. Not interested in CDBG funding. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing ✔✔✔✔ Strengthen Communities gfedc Ensure Equal Opportunity in Housing ✔✔✔✔ Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities gfedc Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability ✔✔✔✔ Sustainability gfedc Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc Targeted revitalization: This indicator shows a range of outcomes such as jobs created and retained, businesses Attachment 5 130 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". assisted, low- and moderate-income persons and households served, slum/blight demolition, number of acres of brownfields remediated, etc. in a targeted area. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc 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. gfedc 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. gfedc 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) gfedc 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. gfedc 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. gfedc Not Applicable. Not interested in CDBG funding ✔✔✔✔ Persons gfedc Households gfedc Not Applicable. Not interested in CDBG funding 4 Disabled 3 Women/Female Headed Households 7 Seniors 0 Youth 0 Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) 14.0014.00 TOTAL Attachment 5 131 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" 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 Low Income (50%-80% AMI) 6 Extremely Low Income (<30% AMI) Not Applicable. Not interested in CDBG funding (Type N/A) 7.007.00 TOTAL 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) 7.007.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 60,000.00 USD$ 60,000.00 Attachment 5 132 Government/Alameda County Social Services Agency: Title III lgl services (incls General Funds/APS), Title VII, HICAP, MIPPA, DCFS, Home Safe, HCD USD$ 0.00 USD$ 887,745.00 Government Pass thru/contractual non-profit corporations: Family Support Services, DayBreak Adult Care Centers USD$ 0.00 USD$ 8,000.00 Government/Contra Costa County HICAP USD$ 0.00 USD$ 8,000.00 Government/Cities of Alameda, Dublin, Fremont, Hayward, Livermore, Pleasanton & Union City USD$ 0.00 USD$ 84,500.00 Corporation/State Bar of CA: IOLTA, EAF, EAP, & Bank Grants USD$ 260,181.00 USD$ 110,649.00 Foundations/Corporations: Bigglessworth, CHA, Hindu Comm&Cultural Cntr, Menorah Park's Comm., Stern Memorial USD$ 175,000.00 USD$ 305,459.00 Court Awarded Fees USD$ 0.00 USD$ 150,000.00 Individual Donations, Annual Appeal, Fundraising Event, Donor Solicitations USD$ 0.00 USD$ 138,000.00 Elder Abuse Conference Sponsorships/Registration Fees USD$ 0.00 USD$ 60,000.00 Total USD$ 495,181.00 USD$ 1,812,353.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel: Salaries* (see instructions below) USD$ 1,374,764.00 USD$ 295,015.00 Personnel: Benefits* (see instructions below) USD$ 376,522.00 USD$ 80,799.00 Operating: Supplies & Minor Equipment USD$ 13,000.00 USD$ 2,790.00 Operating: Printing/Copying USD$ 18,000.00 USD$ 3,863.00 Operating: Postage USD$ 8,000.00 USD$ 1,717.00 Operating: Telephone & Faxing USD$ 15,000.00 USD$ 3,219.00 Operating: Rent & Utilities USD$ 248,785.00 USD$ 53,387.00 Operating: Accounting/Audit/Payroll Service USD$ 22,500.00 USD$ 4,828.00 Operating: Contracted Services: Computer, Database, Translation, General, FR/Elder Abuse Conference Food& Entertainment USD$ 49,000.00 USD$ 10,515.00 Operating: Insurance, Membership/Dues, Books, Client Costs & Outreach USD$ 97,500.00 USD$ 20,923.00 Operating: Equipment Leases & Maintenance, Computers/Software/Upgrades, Technology (on-line research, forms & access). USD$ 56,463.00 USD$ 12,116.00 Operating: Staff & Volunteer Travel/Training, Support & Recruitment USD$ 28,000.00 USD$ 6,009.00 Total USD$ 2,307,534.00 USD$ 495,181.00 Budget Narrative The requested budget from the City of Dublin for Salaries are as follows: Legal Director (1% @ $99 p/mo/$1,197 per annum); 3 Supervising Attorneys (each @ 1%, $64 p/mo/$767 per annum each = $2,301), 3 Staff Attorneys (each @ 1%, $76 p/mo/$912 per annum each = $2,737); Advocate (1% @ $54 p/mo/ $643 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 .4% 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 2020/21 in kind volunteer service hours (898.25) of combined attorneys and advocates with a value of $44,912.50. In addition, HICAP volunteer counselors provided 2,318 volunteer hours. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Expense Budget Attachment 5 133 Application ID: 383150 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. Financial Information Form for ALL Grant Requests ✔✔✔✔ Dublin Financial Form List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ List of Board Current Annual Budget for the Entire Agency ✔✔✔✔ Annual Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ 990 Doc Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Board Authorization Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Board Authorization Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Dublin Insurance Dublin Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ IRS Tax Determination Letter CA Tax Determination Letter Certified Audit and/or Certified Financial Statements ✔✔✔✔ LAS 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) Attachment 5 134 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Open Heart Kitchen Dublin Meal Programs Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/14/2022 3:53:02 PM (Pacific) Project Contact Heather Greaux executivedirector@openheartkitchen.org Tel: 925-580-1616 ext 402 Additional Contacts denise@openheartkitchen.org,taylor@openheartkitchen.org Open Heart Kitchen 1141 Catalina Drive #137 Livermore, CA 94550 United States Executive Director Heather Greaux executivedirector@openheartkitchen.org Telephone(925) 580-1616 Fax Web www.openheartkitchen.org Organization Information top 1. Business License Number BL-009270 Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Open Heart Kitchen’s Mission is to serve prepared, nutritious meals free of charge to the hungry people of the Tri-Valley area. 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 5. Is this request for one-time, seed or operational funding? ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding Attachment 5 135 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. Open Heart Kitchen serves nutritious prepared meals tailored to the dietary needs of seniors, Monday through Friday, at the Dublin Senior Center. We also deliver meals, and other essentials, to community members experiencing homelessness at encampments Monday through Saturday. All meals are prepared fresh daily and offered free of charge. 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.) 500 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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 the underserved community members, including low-income seniors and people experiencing homelessness. The grant funds will be used to purchase the food and supplies used in the Dublin meal programs, as well as the program staff salaries. Open Heart Kitchen sources food items from multiple sources to take advantage of the largest cost savings while maintaining excellent quality and variety for the diners. Open Heart Kitchen purchases food items in bulk from US Foods, while also participating in their rebate program. Our status as a member agency with the Alameda County Community Food Bank allows us to place weekly orders for the free bulk produce and expensive individual milk servings we serve to our guests daily as part of a balanced nutritious meal. We also partner with private and religious organizations that donate bulk food items to Open Heart Kitchen by way of grants or grassroots food drives and fundraisers. Open Heart Kitchen’s Strategic Planning Committee establishes and evaluates program goals, including meal counts, to track program effectiveness. Annual budgets are created for each program and reviewed regularly by the Open Heart Kitchen Board of Directors to ensure that all programs are operating within budget. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . Objective: End hunger by providing nutritious and accessible food Activities: -Work with the Alameda County Community Food Bank to distribute fresh produce. -Follow nutrition guidelines for meal programs and incorporate diner feedback. -Provide nutrition education to clients so they make healthy food choices. gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development ✔✔✔✔ Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities ✔✔✔✔ Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 136 -Advertise programs in the community, including updating local agencies on program offerings and distributing program materials in print and online. Outcomes: -Clients have access to fresh produce. -Clients only receive food that is healthy, appealing, and culturally appropriate. -Nutrition education outreach for seniors will be performed quarterly. -Clients are made aware of Open Heart Kitchen resources, how to participate in them, and how to refer others. Measurement: -Pounds of produce delivered. -Nutritional analysis by a Registered Dietitian. -Client satisfaction surveys. -Number of outreach days. -Number of people served. -Languages that menus and other resources are offered in. -Diversity of meals, including origin of cuisine and dietary considerations such as vegetarianism or pork free. -Number of outreach events. According to the most recent Older Californians Nutrition Program guidance from the CDA and the Office of Disease Prevention and Health Promotion, the meals provided by programs such as ours assist seniors with reaching nutrition recommendation goals that can help them manage or prevent chronic illnesses including obesity, heart disease, type 2 diabetes, and some types of cancer. People facing food insecurity deserve food that will not aggravate their existing medical predispositions. Open Heart Kitchen focuses on distributing food that is high quality and healthful. 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 To improve our service to non-English speakers, we have meal program menus translated in Spanish and Chinese. We find that many of our unhoused and low-income clients utilize mobile devices to find our services. Our website lists a calendar of our menus, locations, and hours of operations. Our website is also formatted to be mobile friendly, ADA compliant, and can be translated into Spanish and Chinese. The individuals that make up our community who are facing food insecurity need more than just food: they deserve meals that are uniquely suited to their dietary requirements and lifestyles. Open Heart Kitchen recognizes that the low-income, senior, and unhoused population is considered an “at-risk” population. They are much more likely to suffer from health problems such as obesity and diabetes. Oftentimes the cheapest and most convenient foods are highly processed and lack key elements such as vitamins, protein, and healthy fats. These cheap and convenient foods offer a quick solution to individuals who are on a fixed income, are short on time, or have limited or no access to cooking facilities. However, these foods ultimately do more harm than good and are not a dignified solution to the multifaceted obstacles that our diners face. Our fresh packaged meals are ready to eat and are both easy to transport and eat on the go. Our meals are specifically designed to meet the dietary needs of seniors, who have the most specific restrictions of any age group. Our menus are reviewed by a Registered Dietitian, then approved by the Alameda Area Agency on Aging. Our meals may be approved for the strict requirements of a senior diet, but they are suitable for the dietary needs of our whole community. We closely monitor protein, sodium, vitamin levels, spice levels, and ensure that our meals are soft enough for clients with dental problems, or for those who are unable to use a knife (such as is the case with the degeneration of motor skills). 12. For the Fiscal Year 2022-2023 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. Food insecurity especially impacts our growing senior population. Our Senior Meal Program sees continued growth as the cost of housing, food, and health care continues to rise and the COVID-19 pandemic continues. The pandemic has also posed unique challenges to our unhoused community members, who now need access to PPE equipment and basic facilities such as shower and laundry services, which have been dramatically reduced. Throughout the pandemic we have distributed masks, sanitizers, safety information, vaccine clinic resources, and more throughout the Tri-Valley unhoused community. We also participate in a network of local agencies and individuals in order to connect our clients who are experiencing homelessness with information on resources such as showers and laundry options, and distribute free bus passes to help get them to these resources. As our community continues to work toward overcoming the pandemic, it has become apparent that the health of our community members is more important than ever. However, the pandemic has created barriers that make it difficult for older people to get access to the nutrition they need for a healthy lifestyle. Fear of exposure to the COVID-19 virus prevents some of our senior neighbors from going into public places like grocery stores. Recent global supply chain disruptions have resulted in price increases for some food items, which further impact individuals on a fixed income including seniors. 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 a dramatic increase from ~13,000 meals served in FY1920 to ~34,200 meals served in FY2021. 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. Attachment 5 137 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. OHK is committed to making sure individuals with limited English proficiency have access to our programs. We recruit multilingual volunteers and offer our quarterly surveys and program flyers in multiple languages. We collaborate with agencies like the Alameda County Community Food Bank that provide translation services. All OHK program staff have been provided with "I Speak" cards to assist in identifying the language interpretation a guest may need should the occasion arise. The OHK staff are informally surveyed periodically on their experience concerning any contact with LEP persons during the year. This allows OHK to identify what translation services may need to be provided in the future. OHK takes reasonable steps to provide the opportunity for meaningful access to guests who have difficulty communicating in English, although a very low percentage of OHK clients are limited English speaking. 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") gfedc No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. ✔✔✔✔ Be culturally accessible, appropriate and inclusive ✔✔✔✔ Encourage community engagement and involvement gfedc Promote energy and resource efficiency ✔✔✔✔ Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery gfedc Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc 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. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc 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 gfedc F) Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities Attachment 5 138 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". gfedc Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability ✔✔✔✔ Sustainability gfedc Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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. gfedc Not Applicable. Not interested in CDBG funding ✔✔✔✔ Persons gfedc Households gfedc Not Applicable. Not interested in CDBG funding 40 Disabled Attachment 5 139 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" 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 50 Women/Female Headed Households 470 Seniors 0 Youth 3 Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 563.00563.00 TOTAL 40 Low Income (50%-80% AMI) 340 Extremely Low Income (<30% AMI) Not Applicable. Not interested in CDBG funding (Type N/A) 380.00380.00 TOTAL 170 White 30 White + HISPANIC 15 Black/African American 1 Black/African American + HISPANIC 225 Asian 0 Asian + HISPANIC 5 American Indian/Alaskan Native 1 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 2 Asian and White 1 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 50 Multi Racial + HISPANIC OR other Multi Racial 0 Not Applicable. Not interested in CDBG funding. (Type N/A) 500.00500.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Attachment 5 140 City of Dublin USD$ 25,000.00 County of Alameda USD$ 109,980.00 Individual Contributions USD$ 256,066.00 In-Kind Food Donations USD$ 30,154.00 Total USD$ 421,200.00 USD$ 0.00 Funding Uses/Expenses Budget Amount Amount Committed Personnel Expenses USD$ 196,775.00 Food USD$ 120,502.00 Printing/Copying USD$ 1,690.00 Postage USD$ 250.00 Telephone USD$ 1,770.00 Rent and Utilities USD$ 27,600.00 Contracted Services USD$ 8,920.00 Transportation - meal delivery USD$ 7,200.00 Facility/Equipment Maintenance USD$ 10,900.00 Information Technology USD$ 2,500.00 Insurance USD$ 2,100.00 Office Expenses USD$ 1,350.00 Other USD$ 39,643.00 Total USD$ 421,200.00 USD$ 0.00 Budget Narrative The $25,000 request from the City of Dublin will help defray 10% of the cost of the food used in the Dublin meal programs, primarily the meals served at the Dublin Senior Center. In addition to food costs, the grant from the City of Dublin will also help pay for 7% of staff salaries attributed to Dublin meal program operations. More specifically it will pay one staff member's salary who works at the Dublin Senior Center operating the Senior Meal Program. The total budget for the Dublin Meal program ($421,200) is approximately 36% of Open Heart Kitchen's Tri-Valley senior meal program budget. The total budget for the Dublin Meal program is 6% of Open Heart Kitchen's overall organization budget. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ OHK Board Roster Current Annual Budget for the Entire Agency ✔✔✔✔ OHK Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Authorized Official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Authorization Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ State determination Federal determination Certified Audit and/or Certified Financial Statements ✔✔✔✔ 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 Employee Handbook REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section Audit requirements Attachment 5 141 Application ID: 381251 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws Articles Bylaws REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) Conflict of Interest Policy 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. LEP 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) Strategic Plan Other Supporting Documents (Not Required) Attachment 5 142 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Senior Support Program of the Tri-Valley Case Management Jump to: Organization Information Questions Budget Documents USD$ 16,500.00 Requested Submitted: 1/14/2022 6:25:07 PM (Pacific) Project Contact mercel amin mamin@ssptv.org Tel: 925-931-5378 Additional Contacts none entered Senior Support Program of the Tri-Valley 5353 Sunol Blvd Plesanton , CA 94566 United States Interim Director Mercel Amin mamin@ssptv.org Telephone925 931 5379 Fax Web ssptv.org Organization Information top 1. Business License Number BL-007038 Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Senior Support Program of the Tri-Valley's mission is to deliver free, comprehensive services and assistance to seniors aged 60 and better in the Tri-Valley (Pleasanton, Dublin, Livermore, and Sunol). 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 143 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. The program seeking funding is Case Management. This program is an integral part of older adults’ quality of life; case management services offer advocacy through assessments, resource matching and care coordination that identify and help resolve older adult challenges. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual’s health needs. It uses communication and available resources to promote health, quality, and cost-effective outcomes in support of the “Triple Aim,” of improving the experience of care, improving the health of populations, and reducing per capita costs of health care (commissions for case management, 2022). 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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 Dublin grant funds will be used primarily for direct service. The staff who will administer the program are Case Managers. Currently the agency has 2.5 Case Managers servicing the community, in both English and Spanish. This department is overseen by the Interim Director who will be responsible for City reporting, oversight, and facilitation of meetings. Access to case management services is as easy as making a phone call; it's actually the best way to receive services due to the Pandemic and protocols constantly changing. Currently, our office is open Monday-Thursday 9am -2pm with a skeleton gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None ✔✔✔✔ Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse gfedc Disabilities gfedc Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity ✔✔✔✔ Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 144 crew to ensure safety but still being present in the community where talking to a “real” person is preferred. Senior Support Program has been around for 40 years and quality of care continues to improve year to year to best support the growing aging population. Essential service appointments are being conducted in a variety of fashions because of COVID19. Our services have become more accessible with visits outside of the older adults home, with proper PPE and social distancing. Case Managers typically meet with the senior in their home to gain a better understanding of their environment and eliminate potential barriers surrounding transportation. Phone/Zoom visits are popular to receive fast resources to meet an individual’s needs. Appointments are also available from our office which is located in the Pleasanton Senior Center. Together the senior and Case Manager create a comprehensive, practical plan identifying available resources for the senior's many needs. Every case is different as every senior's needs vary. All cases are monitored on an on-going basis through phone calls and check-ins. All activity is documented; client files are considered confidential. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . The case management program shall provide free, individualized assessments and care coordination to older adults (60 years+) in the City of Dublin to help resolve current challenges, improve self-management skills, and sustain independence. Transitioning into late adulthood creates socio-economic challenges such as a fixed income, lack of transportation, and healthcare access contributing to a decline in health, increased dependency, and financial instability. To address these age- related challenges and ensure successful outcomes, SSPTV’s case managers use a client-centered approach during services provided; each care plan is specifically tailored to the client’s culture, values, and preferences. Case Managers ensure timely access to services by navigating their clients through the healthcare system or other governmental systems. Strive to improve client rapport by being accessible through multiple communication services (phone, email, Zoom, in-person) and addressing common barriers such as lack of transportation to medically-necessary appointments. The case management program strives to be culturally aware and sensitive to older adults of different backgrounds and disabilities by knowing the current demographic population they serve and offering multilingual resources. Additional steps to lessen the language barrier include bilingual case managers or county interpreter services such as the Language Line to complete necessary services. Older adults with disabilities seeking assistance and support are referred to appropriate disability services through Alameda County Social Services. Our organization acknowledges the importance of outreach and marketing; annual collaboration with the City of Dublin’s Senior Information Fair and the Alameda County’s Healthy Living Festival ensure that hard-to-seek clients are made aware of case management services. 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 case management program further values Dublin’s Mission, Vision, and Values in 2020 in various ways. SSPTV collectively has over 12 programs geared towards improving the quality of life for older adults. These programs including case management are free of charge to address equitable disparities. On-going training enhances case managers’ customer service, inclusivity, and diversity sensitivity. Appropriate referrals are made to aging and local government services when necessary for client welfare checks. Case managers advocate for an active lifestyle by referring clients to interagency and city services. Additionally, encouraging continuous client education by providing monthly prevention handouts that promote healthy aging and independence. 12. For the Fiscal Year 2022-2023 Human Services Grant Cycle, additional funding may be available through the City’s American Rescue Plan Act allocation. Organizations that are eligible for this funding must provide services that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization’s programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Older adults account for 10% of the City of Dublin’s current population, many of whom face economic hardships and are categorized as “poor” or “very poor.” With the increase in the cost of living and the uncertainty of the pandemic (Omicron variant), SSPTV anticipates an influx of service rendered. This program has been instrumental to the community throughout the pandemic, connecting individuals to critical services: health care, mental health, food, transportation, caregiving, income assistance, etc. Though senior resources and services are scarce, our organization strives to provide our clients with updated information in this vastly changing environment. We continue to be the support and stability to our clients in these challenging 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? Attachment 5 145 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. NA 15. CDBG ONLY - Identify at least one HUD Guiding Principle that relates to your project: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment Attachment 5 146 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 Attachment 5 147 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding N/A Disabled N/A Women/Female Headed Households N/A Seniors N/A Youth N/A Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL N/A Low Income (50%-80% AMI) N/A Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL N/A White N/A White + HISPANIC N/A Black/African American N/A 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) Attachment 5 148 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 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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 (in-kind space & utilities) USD$ 78,012.00 Area Agency on Aging USD$ 68,039.00 City of Pleasanton (Case Management) USD$ 41,000.00 City of Dublin (Case Management) USD$ 16,500.00 City of Livermore (Case Management) USD$ 17,939.00 Total USD$ 143,478.00 USD$ 78,012.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 14,389.00 PR Taxes/Fringe USD$ 2,111.00 Total USD$ 16,500.00 USD$ 0.00 Budget Narrative The total amount requested ($16,500) will be used for direct Case Management services. Case Managers 1 & 2 both are full time and Case Manager 3 is part-time. The Executive Director oversees the program, attends City meetings, and fills in as Case Manager as needed. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Budget-Dublin Financial Information Form for ALL Grant Requests ✔✔✔✔ Agency wide budget List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board Roster Current Annual Budget for the Entire Agency ✔✔✔✔ Agency Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Autho. Letter Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Autho. Letter Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Insurance WC Dublin Attachment 5 149 Application ID: 382990 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ 501c3 Certified Audit and/or Certified Financial Statements ✔✔✔✔ Financials 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) Attachment 5 150 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Spectrum Community Services Dublin Meals on Wheels Jump to: Organization Information Questions Budget Documents USD$ 25,000.00 Requested Submitted: 1/19/2022 11:32:16 AM (Pacific) Project Contact Lara Calvert LCalvert@spectrumcs.org Tel: (510) 881-0300 ext. 243 Additional Contacts none entered Spectrum Community Services 2621 Barrington Court Hayward, CA 94545 United States Executive Director Lara Calvert lcalvert@spectrumcs.org Telephone(510) 881-0300 x243 Fax (510) 537-3340 Web www.spectrumcs.org Organization Information top 1. Business License Number Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Spectrum Community Services’ mission is 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project gfedc Yes Attachment 5 151 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary 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. Safety protocols that were implemented because of COVID 19 are now an integral part of how we serve our clients. Meals are delivered in a contactless manner. Our processes are continually evaluated and updated to meet ever changing health and safety requirements. We continue to strive to ensure the safety, well being and nutritional needs of our clients. 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.) Spectrum’s Meals On Wheels Program will provide daily meals to approximately 60 unduplicated Dublin senior/disabled adult 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially funded. (If capital funding is being requested, this narrative should include a detailed project scope and project timeline. The scope of work should include any land tenure issues. Additional documentation include designs, site plans, etc. can be attached later in the "Documents" tab.) (What specifically will the grant funds be used for?) Spectrum is asking for $25,000 to support its Meals on Wheels Program. This request will fund a portion of salaries and benefits for two positions: our Meals on Wheels Program Manager ($9,550) and our Dublin Meals on Wheels Coordinator ($8,884), benefits ($3,692) and 500 additional meals for disabled adults under 60 years of age or additional Dublin seniors ($2,874) 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 ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse ✔✔✔✔ Disabilities ✔✔✔✔ Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above ✔✔✔✔ Please explain: Spectrums Meals on Wheels Program provides a hot nutritious meal and a daily wellness to homebound seniors and disabledresidents of Dublin. Attachment 5 152 about their meal schedule, preferences and other needs. The Coordinator completes in-depth semiannual assessments with each senior/disabled adult. Before and again after the pandemic, these initial and semiannual assessments are completed inside the client's home. During the pandemic, we have adjusted to a combination of extended phone calls or physically distanced 'front Porch" in-person assessments. 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 new volunteers. Trained volunteers are an essential component of providing daily meals and safety-checks for homebound seniors and disabled adults. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . 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 FY2022-2023. Another outcome that measures the success of our Program is the number of meals we deliver each fiscal year. In FY2022- 2023 we will home-deliver 10,500 or more meals to Dublin seniors and disables 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 disable 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. Through our partnerships with other non profit agencies will we continue to inform the community of this program designed for the homebound senior and disabled adults. We will continue with outreach to local medical offices, hospitals, faith based groups and places where seniors gather, to ensure that all eligible Dublin residents in need are served. 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 in 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 Healthcare/Valley Care to provide medically and culturally diverse menu items tailored to the Tri-Valley clients we serve. 12. For the Fiscal Year 2022-2023 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 Attachment 5 153 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, providing toilet paper 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 cause stress to the older adults we serve. We ask for a $3.75 client donation toward the $10.00 total meal cost, but currently only receive $0.93 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? 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 an annual 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, outreach activities, consumer materials, web site, communications and operations. In between the annual language survey, we periodically update our Internal Language Directory that allows staff to quickly access non-English proficient speakers on staff (we update this document whenever there is a staff change). Should a staffer with language expertise be on vacation or out sick, Spectrum’s management staff uses the Language Directory so that, should the need arise, a fluent speaker from another department can assist. Our goal is that all clients and prospective clients and their families have access to Spectrum services in the language in which they are proficient, that they are treated with respect and that their questions are answered in a timely manner. In conjunction with our annual survey we reach out to other service Agencies to help ensure that all 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ✔✔✔✔ Yes. If so, check box here and answer questions 14 through 25. gfedc No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. ✔✔✔✔ Be culturally accessible, appropriate and inclusive ✔✔✔✔ Encourage community engagement and involvement gfedc Promote energy and resource efficiency ✔✔✔✔ Encourage networking and information sharing across service providers ✔✔✔✔ Encourage process streamlining ✔✔✔✔ Consolidate service delivery gfedc Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and Attachment 5 154 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. gfedc 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 gfedc F) Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing ✔✔✔✔ Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities gfedc Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability ✔✔✔✔ Sustainability gfedc Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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 Attachment 5 155 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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. gfedc Not Applicable. Not interested in CDBG funding ✔✔✔✔ Persons gfedc Households gfedc Not Applicable. Not interested in CDBG funding 60 Disabled 20 Women/Female Headed Households 60 Seniors Youth Homeless Not Applicable. Not interested in CDBG funding (Type N/A) 140.00140.00 TOTAL 30 Low Income (50%-80% AMI) 30 Extremely Low Income (<30% AMI) Not Applicable. Not interested in CDBG funding (Type N/A) 60.0060.00 TOTAL 40 White Attachment 5 156 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 4 White + HISPANIC 5 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 6 Multi Racial + HISPANIC OR other Multi Racial Not Applicable. Not interested in CDBG funding. (Type N/A) 60.0060.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc If you have more than 6 applications per organization, agency, district or entity, check here. Budget top Funding Sources/Revenues Budget Amount Amount Committed Area Agency on Aging USD$ 45,000.00 MOWAC USD$ 150,000.00 USD$ 150,000.00 City of Livermore USD$ 74,000.00 City of Pleasanton USD$ 53,000.00 Private Donations USD$ 35,500.00 Program Revenue USD$ 60,000.00 Volunteers - In Kind USD$ 110,000.00 Total USD$ 527,500.00 USD$ 150,000.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries and Wages USD$ 195,000.00 USD$ 0.00 Benefits & Payroll Taxes USD$ 42,900.00 USD$ 0.00 Supplies USD$ 4,750.00 Contracted Services USD$ 145,000.00 Postage USD$ 850.00 Attachment 5 157 Telephone USD$ 2,000.00 Rent and Utilities USD$ 3,725.00 Accounting/Audit USD$ 1,200.00 In Kind USD$ 110,000.00 Taxes & Licenses USD$ 10,050.00 Travel & Company Vehicles USD$ 8,475.00 Misc Expense USD$ 28,550.00 Total USD$ 552,500.00 USD$ 0.00 Budget Narrative We are asking for $25,000 from the City of Dublin to fund 4.5% 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 - 33% of her salary which is $740/mos, $8,884 annually with benefits of $1,777 annually. 2. Meals on Wheels Program Manager will establish business, financial, governmental, and service partnerships throughout the Tri-Valley area as well as helping to foster current partnerships; will recruit and retain volunteers for Meals on Wheels; supervise Meals on Wheels Coordinators; and participate in fundraising efforts which is vital to our program - 15% of her salary which is $796/mos, $9,550 annually with benefits of $1,915 annually. The balance of the request for $2,874 is to cover the cost of 500 meals for our disabled clients that we must pay for . Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Expense Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information Form List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Agency Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ 990 Tax Return Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Authorized Official Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Board Authorization Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Certificate of Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ IRS Exempt Letter State of Calif - Certificate of Status Certified Audit and/or Certified Financial Statements ✔✔✔✔ Financial Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) Capital Funding Attachment 5 158 Application ID: 380774 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. REQUIRED FOR CDBG ONLY - Personnel Policies Including Affirmative Action Plan and Grievance Procedure Affirmative Action Plan Grievance Procedure REQUIRED FOR CDBG ONLY - Agency Audit Requirements and Copy of Last Audit Highlighting "Findings" Section Financial Audit REQUIRED FOR CDBG ONLY - Articles of Incorporation and Bylaws Articles of Incorporation REQUIRED FOR CDBG ONLY - Conflict of Interest Statement (if not included in Bylaws) Conflict of Interest 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. Language Access Plan 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) Attachment 5 159 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Sunflower Hill Sunflower Hill's Program Support for Adults with Developmental Disabilities Jump to: Organization Information Questions Budget Documents USD$ 16,500.00 Requested Submitted: 1/19/2022 6:03:45 PM (Pacific) Project Contact Pamela Zielske Kathyl@sunflowerhill.org Tel: 925-519-1347 Additional Contacts none entered Sunflower Hill P.O. Box 11436 Pleasanton, CA 94588 United States Interim Executive Director Jan Cohen jan@sunflowerhill.org Telephone925-519-1347 Fax Web www.sunflowerhill.org Organization Information top 1. Business License Number BL-110708 Questions top 1. Select the category that best describes your organization: (Select only one.) 2. Please describe your agency's mission (no more than 3 sentences or 250 characters). Sunflower Hill is a Tri-Valley nonprofit dedicated to creating places and spaces where adults with intellectual and developmental disabilities 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 ) 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 160 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary will be used widely during the review and implementation process to describe your project. The Sunflower Hill Garden is an outdoor, instructional space providing educational, therapeutic, and life skills training for adults with intellectual and developmental disabilities (I/DD). Our Hands-On Garden Groups Program meets weekly and bi- weekly at the Sunflower Hill Garden in Livermore. The program, which is open to Tri-Valley adult day, transition, high school, and residential programs, offers person-centered programming for adults with I/DD, providing opportunities to learn, explore, and engage in new and supportive ways. This multi-disciplinary program is specifically designed for adults with I/DD, including those with autism, Down syndrome, cerebral palsy, ADHD, epilepsy, and other chromosomal differences. 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. In addition, the Sunflower Hill Garden produces thousands of pounds of fresh, organic produce each year. With the assistance of our program participants and volunteers, Sunflower Hill staff donate the majority of our produce to local nonprofit organizations. In 2021, we donated over 3,400 pounds, 94% of our produce, to Tri-Valley Haven’s Food Pantry, Culinary Angels, and Shepherd’s Gate. 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.) 30 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 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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.) gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) ✔✔✔✔ Workforce Development gfedc Homelessness gfedc Transportation Services and Access gfedc Domestic Violence and Child Abuse ✔✔✔✔ Disabilities ✔✔✔✔ Food and Nutrition gfedc Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education ✔✔✔✔ Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: Attachment 5 161 (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 Garden Manager’s salary. Our Garden Manager, Andrea del Rio, is an integral member of the Sunflower Hill Nonresidential Programs team. The Garden Manager is responsible for spearheading oversight and maintenance of the garden infrastructure and crop plan and performing gardening and field work tasks to ensure a healthy crop production and a supportive environment for our program participants. The Garden Manager is also responsible for developing and maintaining relationships with local nonprofits that receive our produce donations, along with delivering donated produce. Additionally, the Garden Manager collaborates with Sunflower Hill’s Programs Instructor and Nonresidential Programs Manager to implement dynamic programs in the Garden to enhance the experience and meet the diverse range of needs of our program participants. We are currently offering our Hands-On Garden Groups Program to 10 different high school, transition, adult day, 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. During their sessions at the Sunflower Hill Garden, groups learn skills that are imperative to keeping a garden growing, 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 snack, and discussion. Weekly tasks are designed with individual participants in mind, allowing for a variety of garden tasking to appeal to all functioning levels. 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 engaging 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 those who are neurotypical. While we have scaled back our volunteer program to comply with COVID-related safety protocols, we are grateful for the generosity and expertise of our small group of regular garden volunteers. Under the leadership of our Garden Manager, our staff have taken significant efforts to ensure the Garden’s continued sustainability. The 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. Our Garden Manager and Nonresidential Programs Team in the Garden provide unique, innovative programming that is specifically designed to equip adults with I/DD with success. If we do not receive funding, we will likely need to scale back our programming. Sunflower Hill is one of the only nonprofits in the region offering therapeutic and life skills training in a beautiful, outdoor setting, and the demand for our in-person programs is very high. We have seen a steady increase in the number of groups that are interested in our weekly or biweekly Hands-On Garden Groups Program. In the fall, we had more groups interested in programming than spaces available. For our spring session, which begins in February, we increased our weekly and bi-weekly availability to better meet this demand, enabling us to reach a greater number of adults with I/DD. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . 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. In addition, individuals with developmental disabilities are considered extremely low income, living as adults on Supplemental Security Income, or with assistance from family, if available. Our multi-disciplinary Hands-On Garden Groups Program is designed for adults with I/DD, including those with autism, Down syndrome, cerebral palsy, ADHD, 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. Attachment 5 162 Through an engaging curriculum and guidance from staff, participants are able to achieve a number of objectives that lead to greater independence and empowerment. 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 how to ask follow-up questions, as needed. • Practice simple math and life science concepts. • Improve social skills with instructors and peers. • Learn how healthy food is grown from seed to harvest. • Have opportunities for physical activity in a natural environment that is accessible to all ability levels. Support of our Garden Manager 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 through surveys of program participants, caregivers, teachers, and day program leaders, and we then 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 2021, we donated over 3,400 pounds, 94% 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 insecurity or undergoing a major, medical challenge. For example, our produce donations are supporting Tri-Valley Haven’s Food Pantry, which served over 150 Dublin households this past year with produce grown in Sunflower Hill’s Garden. Culinary Angels, a nonprofit providing meals to individuals undergoing a significant medical challenge, uses our produce to prepare approximately 120 nutrient-rich meals each month that serve households throughout the Tri-Valley. In 2021, they served an average of 15 households each month in Dublin. The Sunflower Hill staff provides vital information about the services we provide for the developmentally disabled population in the Tri-Valley and beyond through our robust community outreach efforts. Our Communications Manager maintains an active social media presence and produces a monthly newsletter and regular blog posts to encourage community engagement. The Sunflower Hill Garden also provides ample volunteer opportunities for members of the community, including opportunities to volunteer for adults with I/DD and their families, corporate groups, and local youth and adult philanthropic groups. Additionally, our staff provide regular presentations on our programming and residential communities to local philanthropic clubs, organizations, and corporations. Throughout the pandemic, these have taken place virtually, however, we are eager to move towards providing in-person presentations and tours of the Garden later in 2022. 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 is fully accessible to all, including our program participants who are visually impaired or use walkers or wheelchairs. Our Hands-On Garden Groups Program is also a free program, and as a result, it is fully accessible to our program participants regardless of their socioeconomic status. 12. For the Fiscal Year 2022-2023 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. Attachment 5 163 We initially responded to COVID-19 by launching both our Online Activities and a series of virtual programs, including our cooking class series. Our Online Activities are a robust and creative offering of virtual programs designed for individuals with I/DD. These are free, activity videos posted regularly and designed to keep viewers learning and physically active. Activities include garden updates, scavenger hunts, simple cooking lessons, meditation exercises, and art projects. Anyone with access to the internet is able to view our free Online Activities through the Sunflower Hill website. To date, we have created a robust repository of 205 free activity videos, which have been viewed over 25,000 times. Our Online Activities and other virtual programs have continued to be very popular and have enabled us to reach a wider audience beyond Tri-Valley residents. As a result, we will continue to offer these regular, virtual programs throughout 2022. With respect to our in-person programming, Sunflower Hill began implementing a strict, safety protocol at the onset of the pandemic, as many of our participants have pre-existing medical conditions that increase their risk for severe symptoms. This protocol includes: • Program participants, staff, and volunteers wear masks at the Garden. • Everyone entering the Garden has their temperature taken and completes a symptom survey. Staff is available to assist participants as needed. • Gloves are worn while harvesting, weighing, and packaging all produce for donation. • Participants are divided into small groups while they are working on tasks or enjoying their closing snack to ensure appropriate social distancing. • All surfaces are washed and sanitized regularly. • Participants engage in frequent handwashing during programming. The above protocol enables our staff to continue to offer opportunities for in-person programming, as well as allows us to donate produce to our nonprofit partners. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc Goal 1: Make improvements, including ADA accessibility and rehabilitation to public facilities, such as curbs and Attachment 5 164 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: sidewalks, neighborhood parks and recreational improvements, homeless facilities and other public facilities/community centers. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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 Attachment 5 165 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" by the elderly, number of units designated for persons with HIV/AIDS, and number of units for the chronically homeless. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) N/A Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL White Attachment 5 166 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 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) 0.000.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 16,500.00 City of Pleasanton - partial salary for Nonresidential Programs staff USD$ 25,080.00 Clif Family Foundation USD$ 5,000.00 USD$ 5,000.00 Lawrence Livermore National Security Gift Program USD$ 2,190.00 USD$ 2,190.00 Alameda County Urban Farm Conservation USD$ 1,870.00 USD$ 1,870.00 Rotarian Foundation of Livermore USD$ 3,400.00 Whole Foods Community Gift Program USD$ 4,000.00 Individual donations (includes year-end campaign) USD$ 64,907.00 Special events (Fun Run, Sunflower Showcase) USD$ 77,964.00 USD$ 0.00 Total USD$ 200,911.00 USD$ 9,060.00 Funding Uses/Expenses Budget Amount Amount Committed USD$ 0.00 Salaries for Nonresidential Programs staff USD$ 171,724.00 Attachment 5 167 Benefits for Nonresidential Programs staff USD$ 3,398.00 Supplies USD$ 17,178.00 Contracted services (water/soil testing; irrigation repair) USD$ 222.00 Telephone for Nonresidential Programs staff USD$ 2,304.00 Rent/utilities (Garden) USD$ 3,181.00 Operating: Other USD$ 2,904.00 USD$ 0.00 Total USD$ 200,911.00 USD$ 0.00 Budget Narrative Sunflower Hill's funding request of $16,500 will cover 30% of the salary of our Garden Manager in FY 2022. The salary of $171,724 and benefits of $3,398 noted above are salaries for the Sunflower Hill Nonresidential Programs' Team as a whole, comprised of the Nonresidential Programs Manager, the Garden Manager, Programs Instructor, and Garden Coordinator. 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 worker's compensation, mileage reimbursement for delivering donated produce, and software licensing fees. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ FY 22 Sunflower Hill Garden Program Expense Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ FY 22 Sunflower Hill Financial Information List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Sunflower Hill Board of Directors - 2022 Current Annual Budget for the Entire Agency ✔✔✔✔ FY 22 Sunflower Hill Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Sunflower Hill 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ Letter of authorization Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ Letter of authorization Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Sunflower Hill Certification of Liability - General Sunflower Hill Certification of Liability - Worker's Compensation STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Sunflower Hill 501c3 status Certified Audit and/or Certified Financial Statements ✔✔✔✔ Sunflower Hill 990 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 Attachment 5 168 Application ID: 381513 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) 2021 Year-end Garden Program Update video Attachment 5 169 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Tri-Valley Haven Domestic Violence Services Jump to: Organization Information Questions Budget Documents USD$ 24,000.00 Requested Submitted: 1/19/2022 9:35:39 AM (Pacific) Project Contact Cynthia Cunningham Morales cynthia@trivalleyhaven.org Tel: (925) 449-5845 Additional Contacts vicki@trivalleyhaven.org, christine@trivalleyhaven.org, cynthia@trivalleyhaven.org Tri-Valley Haven 3663 Pacific Avenue Livermore, CA 94550 United States Executive Director Ann King ann@trivalleyhaven.org Telephone(925) 449-5845 x Fax (925) 449-2684 x Web www.trivalleyhaven.org Organization Information top 1. Business License Number BL-007058 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 170 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary 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. During the COVID 19 pandemic, we have reduced our on-site census to ensure that clients do not have to share rooms with non-family members and to allow for social distancing in common areas. We continue to shelter up to 30 adults and children by utilizing a rented house in Livermore. Clients see our staff daily, have access to our Food Pantry, and the rent is more economical that motel costs. 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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 gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development gfedc Homelessness gfedc Transportation Services and Access ✔✔✔✔ Domestic Violence and Child Abuse gfedc Disabilities gfedc Food and Nutrition gfedc Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above gfedc Please explain: We are the only confidential domestic violence shelter in the Tri-Valley, with over 43 years of experience in providing supportive services. Attachment 5 171 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 staff's 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 20-21, 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. 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . 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 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 fluent in Spanish, Cantonese, Mandarin, Russian, Hindi or Tagolog. All of the written materials at Shiloh are in both English and Spanish, and some are in Chinese. We make sure that at Shiloh we have cooking utensils and dishes that are multi-culturally appropriate such as rice cookers, chopsticks, and new sets of pots and pans for Muslim clients whose religious practice requires that these not be shared with other families. Ethnic food is available for our shelter clients at the Food Pantry and grocery store gift cards are available to assist with purchasing items that aren’t at the Food Pantry. We continue educating our staff through participation in Cultural Responsiveness development projects. TVH staff maintains a good working relationship with CRIL, a local service provider for persons with disabilities and also is aware of key services such transportation for persons with disabilities and how to access them. Telephone screenings and intake processes include questions about needed accommodations (such as a bottom bunk, private room or special dietary needs). Our shelter is handicap-accessible. Since the beginning of the pandemic, we have not been permitted to hold our twice-monthly restraining order clinics art the Dublin library. We have resumed in-person clinics at our facilities Livermore and Pleasanton, and continue to offer remote restraining order services to any client who is unable to attend those clinics. We look forward to resuming the Dublin clinics as soon as the library permits. 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. 12. For the Fiscal Year 2022-2023 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 Attachment 5 172 that are responding to the economic and public health impacts of the COVID-19 Pandemic. If applicable, please describe how your organization’s programs and services directly respond to negative economic or public health impacts of the COVID-19 Pandemic. Enter "NA" if not eligible. Our Domestic Violence Housing First program, funded by the Office of Emergency Services, offers case management and client assistance to help survivors of domestic violence access and/or retain safe housing after leaving an abusive relationship. During the pandemic, DVHF has helped survivors who lost their jobs or had their hours cut to pay rent and utility bills in order that they could remain safely housed. Though we lowered our on-site shelter population in order to facilitate social distancing and minimize COVID 19 risk to clients, we continued to provide safe shelter to up to 30 adults and children fleeing domestic violence through the use of a motel and, since July, a rented house in Livermore. 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: gfedc Yes. If so, check box here and answer questions 14 through 25. ✔✔✔✔ No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. gfedc Be culturally accessible, appropriate and inclusive gfedc Encourage community engagement and involvement gfedc Promote energy and resource efficiency gfedc Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc Goal 3: Use resources to assist low-income residents make rental assistance payments in response to Covid-19. gfedc B) Homeless gfedc Goal 1: Use resource to end homelessness by funding and supporting homeless service programs. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc 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. gfedc Public Services gfedc Public Facilities gfedc Rental Assistance Attachment 5 173 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing gfedc Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination gfedc Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities ✔✔✔✔ Not Applicable. Not interested in CDBG funding. gfedc Availability/Accessibility gfedc Affordability gfedc Sustainability ✔✔✔✔ Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Homeless shelters: This indicator shows the number of homeless persons given overnight shelter. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency Attachment 5 174 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process 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" housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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 gfedc Persons gfedc Households ✔✔✔✔ Not Applicable. Not interested in CDBG funding Disabled Women/Female Headed Households Seniors Youth Homeless n/a Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL Low Income (50%-80% AMI) Extremely Low Income (<30% AMI) n/a Not Applicable. Not interested in CDBG funding (Type N/A) 0.000.00 TOTAL 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 Attachment 5 175 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 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) 0.000.00 TOTAL gfedc #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. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 0.00 USD$ 26,035.00 Alameda County HCD Linkages USD$ 47,340.00 USD$ 0.00 Alameda County SSA Shelter USD$ 79,760.00 USD$ 0.00 Alameda County CalWORKS USD$ 70,000.00 USD$ 0.00 CalOES DV USD$ 537,587.00 USD$ 0.00 Local Dublin/Livermore/Pleasanton USD$ 83,000.00 USD$ 0.00 Donations/Foundations USD$ 12,000.00 USD$ 0.00 Total USD$ 829,687.00 USD$ 26,035.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 539,029.00 USD$ 20,978.00 Benefits USD$ 105,213.00 USD$ 5,057.00 Supplies USD$ 45,386.00 USD$ 0.00 Postage USD$ 100.00 USD$ 0.00 Telephone USD$ 13,239.00 USD$ 0.00 Rent and Utilities USD$ 39,582.00 USD$ 0.00 Accounting/Audit USD$ 22,484.00 USD$ 0.00 Other USD$ 64,654.00 USD$ 0.00 Total USD$ 829,687.00 USD$ 26,035.00 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 Attachment 5 176 benefits calculation for staff that will be paid with the Dublin grant funds. Other operating expenses include: travel and mileage, portion of liability, property, D&O, and auto insurance, auto expense, staff development and client assistance. 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 ✔✔✔✔ Program Expense Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Agency Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Form 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ BoD Resolution Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ BoD Resolution Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Non-profit Status Non-profit Status State Certified Audit and/or Certified Financial Statements ✔✔✔✔ 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) Strategic Plan Other Supporting Documents (Not Required) Attachment 5 177 Application ID: 380818 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. Attachment 5 178 Powered by ZoomGrants™ Email This Preview Save as PDF Print Close Window A▲▼ City of Dublin PCS - Human Services Division Fiscal Year 2022-2023 Human Services Grant Program Deadline: 1/19/2022 Tri-Valley Haven Homeless Services Jump to: Organization Information Questions Budget Documents USD$ 24,000.00 Requested Submitted: 1/19/2022 9:47:26 AM (Pacific) Project Contact Cynthia Cunningham Morales cynthia@trivalleyhaven.org Tel: (925) 449-5845 Additional Contacts ralph@trivalleyhaven.org, christine@trivalleyhaven.org, cynthia@trivalleyhaven.org Tri-Valley Haven 3663 Pacific Avenue Livermore, CA 94550 United States Executive Director Ann King ann@trivalleyhaven.org Telephone(925) 449-5845 x Fax (925) 449-2684 x Web www.trivalleyhaven.org Organization Information top 1. Business License Number BL-007058 Questions top 1. Select the category that best describes your organization: (Select only one.) 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 ) ✔✔✔✔ Non-Profit gfedc Public Agency gfedc Other: gfedc Capital Project ✔✔✔✔ Public Service Program or Project Attachment 5 179 4. Is this a "new" service, program, project or activity? "New" is identified as not yet started, implemented or in operation. 5. Is this request for one-time, seed or operational funding? 6. Provide a concise, executive summary of the project (no more than 1500 characters). This summary 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, parenting groups and counseling services. The FP will continue to provide food to low income, homeless, and “at risk of becoming homeless” Tri-Valley residents. On the 1st and 3rd Wednesday of each month our Mobile Food Pantry distributes USDA items, meat and/or produce to Dublin Ranch Senior Apartments. The Food Pantry receives food through the Alameda County Community Food Bank monthly and participates in the local Grocery Rescue program on weekday mornings. 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.gov/1956/Application-Requirements-Process 9. Describe in detail how Dublin grant funds will be used for this project. In this narrative, please include what measures are taken to ensure this project is cost effective, and how the budget meets the needs of the anticipated results. If the funds are used for staffing, be sure to provide specific details on the number and types of positions being funded. Be sure to include any effects on the project should the request not be funded, or only be partially 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 time of the following positions: a) Sojourner House Case gfedc Yes ✔✔✔✔ No gfedc One-time funding gfedc Seed funding gfedc One-time and Seed funding ✔✔✔✔ Operational funding gfedc None gfedc Behavioral Health (mental health and substance abuse) gfedc Affordable Housing gfedc Health Care (including dental) gfedc Workforce Development ✔✔✔✔ Homelessness gfedc Transportation Services and Access ✔✔✔✔ Domestic Violence and Child Abuse gfedc Disabilities ✔✔✔✔ Food and Nutrition ✔✔✔✔ Senior Services gfedc Youth Services gfedc Child Care, Early Childhood Development and Education gfedc Changing Demographics and Growing Diversity gfedc Financial Assistance gfedc None of the Above ✔✔✔✔ Please explain: TVH provides a homeless shelter, a food pantry and mobile FP for seniors Attachment 5 180 Manager and b) Food Pantry Coordinator. We utilize multiple funding sources to support the staff positions and operating costs at both Sojourner and the FP. The staffing at both programs is sufficient to meet and exceed the anticipated results. The FP relies on a large number of volunteers to address the collection, sorting, shelving and distribution of food to clients, as well as the implementation of the Mobile Food Pantry. Tri-Valley Haven will be relocating its Food Pantry operations to a new and larger location in downtown Livermore in February 2022. We will also be adopting a “Client Choice” model for the distribution of food. A Client Choice Pantry allows customers to select their own food instead of receiving a prepacked or standard bag of groceries. With this method, clients do not have to take items they already have, do not like, or cannot eat for health or personal reasons. Benefits of Client Choice pantries include: • Limits food waste - customers take food they will use and leave the rest for others • Makes ordering easier - pantries know what popular food to stock • Upholds the dignity of customers • Meets customers health needs • Makes customers feel like they are food shopping for their own food and needs • Helps pantry staffs get to know customers better • Reduce time spent pre-packing food items 10. Please list and briefly describe the outcome measures that are crucial to the success of this project. What strategies or objectives will your agency use to track the progress of meeting the outcome(s)? This should include the population your agency anticipates serving, how this project is culturally appropriate, and how low-income, ESL persons, and/or disabled persons will access this project. Be sure to include your agencies marketing and outreach strategies and efforts as they relate to ensuring hard to reach clients are made aware of services. . The success of the Sojourner House will be measured through statistical results and the individual goals set by the program participant and their case manager. Examples of those goals will include: a resident gaining employment, a family transitioning into a permanent living and feeling confident that it will be able to keep it, a family obtaining medical insurance etc. Long-term self-sufficiency achieved by a client would be a success. The population that we anticipate serving at Sojourner House continues to be drastically different from the population served in previous years. This is due to the County mandated Coordinated Entry System (CES). During the past year we have experienced a higher rate of individuals with mental health and/or substance abuse issues, conflicts arising between clients and a resistance to comply with shelter guidelines and expectations. The number of clients served has also been affected due to the Covid-19 pandemic. Since March of 2020 we have designated the four shelter rooms to either individuals or families in order to practice social distancing. We provide both staff and residents with gloves, masks, disinfectant and hand sanitizer. Other than employment or school, residents have limited hours to be in the community for medical care, food shopping and exercise. Sojourner House and Food Pantry clients are almost exclusively extremely low through low income single parents with their children, two parent families, single women, disabled individuals and seniors. Clients will also benefit from our Food Pantry by receiving free groceries that in many cases they can’t afford. Our clients in Dublin, most of them being seniors, will be getting their food from our Mobile Food Pantry, meaning that the transportation issues will be minimized. In FY 2021 Sojourner served 56 unduplicated clients, providing 3,023 bed nights, and the Food Pantry served 4,398 unduplicated clients. Statistics are maintained on the agency’s Os-Soft database which include individuals served at each program and services provided. We have multi-cultural staff members and volunteers who utilize their cultural backgrounds to enhance the services in the homeless program. We presently have multiple staff fluent in Spanish, Russian, Hindi, and Punjabi. Multi language fluency is always a consideration when hiring staff and recruiting volunteers. All of the Sojourner House and Food Pantry intake forms, paperwork and flyers are in English and Spanish, and some are in Chinese. We make sure that we have cooking utensils and dishes that are multi-culturally appropriate such as rice cookers, chopsticks, etc. Our Food Pantry has a capacity to offer ethnic food when needed. Every year our Holiday Program for low-income families from the Tri-Valley area brings new participants and spreads the word about our services. 197 Dublin residents participated in our 2021 Holiday Program. 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. Sojourner House was remodeled before it was opened in 2002 to include a ramp and a handicap accessible bathroom. No ramps are needed at the Food Pantry due to our moving distribution services to the parking lot due to Covid-19. TVH regularly conduct presentations to the Dublin Police Services on Domestic Violence, Sexual Assault and Homelessness issues and the programs that Tri-Valley Haven offers. Our Community Education Program reaches 1,350 students through Health Education classes that we teach in Dublin High School covering topics such as healthy relationships and teen dating violence. Attachment 5 181 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 2022-2023 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 outside in the parking lot 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? 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: 16. CDBG ONLY - Identify at least HUD Consolidated Plan Goal that relates to your project: (Select Category and Applicable Goals) ✔✔✔✔ Yes. If so, check box here and answer questions 14 through 25. gfedc No. If no, check box here and enter NA gfedc Don't know. If you are unsure, please call City staff at (925) 833-6645. ✔✔✔✔ Be culturally accessible, appropriate and inclusive ✔✔✔✔ Encourage community engagement and involvement gfedc Promote energy and resource efficiency ✔✔✔✔ Encourage networking and information sharing across service providers gfedc Encourage process streamlining gfedc Consolidate service delivery gfedc Not Applicable. Not interested in CDBG funding. gfedc A) Housing gfedc Goal 1: Promote the production, rehabilitation, and preservation of affordable housing (rental and ownership) through acquisition, rehabilitation, new construction, and minor repair. Attachment 5 182 17. CDBG ONLY - Identify at least one HUD Strategic Goal that relates to your project: 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?") 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?") 20. CDBG ONLY - Select one HUD Specific Indicator that relates to your project: gfedc Goal 2: Reduction of housing discrimination through provision of fair housing and tenant/landlord services. gfedc 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. gfedc C) Supportive Housing gfedc Goal 1: Increase the availability of services enriched housing for persons with special needs by supporting acquisition and new construction of housing units. gfedc D) Community Development gfedc 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. gfedc Goal 2: Fund economic development, micro-enterprise, and on-the-job training. gfedc Goal 3: Support public service programs for low income residents, preserving safety net services for families and individuals who are vulnerable or gfedc F) Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Public Services gfedc Public Facilities gfedc Rental Assistance gfedc Affordable Housing gfedc Increase Opportunities for 1st Time Homebuyers gfedc Promote Decent Affordable Rental Housing ✔✔✔✔ Strengthen Communities gfedc Ensure Equal Opportunity in Housing gfedc Reduce Housing Discrimination ✔✔✔✔ Promote Participation of Grass-Roots, Faith-Based, and other Community-Based Organizations gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Creating a Suitable Living Environment gfedc Providing Decent Affordable Housing gfedc Creating Economic Opportunities gfedc Not Applicable. Not interested in CDBG funding. ✔✔✔✔ Availability/Accessibility gfedc Affordability gfedc Sustainability gfedc Not Applicable. I am not interested in qualifying for CDBG funding. gfedc 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. gfedc 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. gfedc 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. gfedc 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. Attachment 5 183 21. CDBG ONLY - Please choose a common indicator that your agency will use to track clients: (Select only ONE.) 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". 23. CDBG ONLY - Based on the common indicator you selected above, please list the number of unduplicated Dublin clients (EITHER Persons OR Households) your agency anticipates serving in each category. If none, please enter "0". Area Median Income ("AMI") information is available online at www.dublin.ca.gov/1956/Application-Requirements-Process gfedc Brownfields remediated: This indicator shows the number of acres of brownfields that were remediated. gfedc 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. gfedc 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. gfedc 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. gfedc 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. gfedc Direct financial assistance to homebuyers: This indicator shows the number of homebuyers receiving direct financial assistance, housing counseling, and down payment assistance/closing costs. gfedc 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. gfedc Emergency housing: This indicator shows the number of beds created in an overnight shelter or other emergency housing. gfedc Homeless prevention: This indicator shows the number of households that received emergency financial assistance to prevent homelessness and emergency legal assistance to prevent homelessness. gfedc 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. gfedc 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) gfedc 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. gfedc 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. gfedc Not Applicable. Not interested in CDBG funding ✔✔✔✔ Persons gfedc Households gfedc Not Applicable. Not interested in CDBG funding 35 Disabled 120 Women/Female Headed Households 225 Seniors 0 Youth 25 Homeless 0 Not Applicable. Not interested in CDBG funding (Type N/A) 405.00405.00 TOTAL Attachment 5 184 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" 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 25 Low Income (50%-80% AMI) 400 Extremely Low Income (<30% AMI) 0 Not Applicable. Not interested in CDBG funding (Type N/A) 425.00425.00 TOTAL 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 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 70 Multi Racial + HISPANIC OR other Multi Racial 0 Not Applicable. Not interested in CDBG funding. (Type N/A) 425.00425.00 TOTAL ✔✔✔✔ #1 - This program/project has the agency's highest priority for funding. gfedc #2 - This program/project has the agency's 2nd highest priority for funding. gfedc #3 - This program/project has the agency's 3rd highest priority for funding. gfedc #4 - This program/project has the agency's 4th highest priority for funding. gfedc #5 - This program/project has the agency's 5th highest priority for funding. gfedc #6 - This program/project has the agency's 6th highest priority for funding. gfedc 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$ 47,340.00 USD$ 0.00 Alameda County SSA Food Pantry USD$ 106,749.00 USD$ 0.00 Alameda County SSA Shelter USD$ 212,693.00 USD$ 0.00 Alameda County StopWaste USD$ 20,000.00 USD$ 0.00 EFSP USD$ 27,500.00 USD$ 0.00 Attachment 5 185 Local Dublin/Livermore/Pleasanton USD$ 198,000.00 USD$ 0.00 Individual Donations/Foundations USD$ 32,000.00 USD$ 0.00 Total USD$ 644,282.00 USD$ 0.00 Funding Uses/Expenses Budget Amount Amount Committed Salaries USD$ 342,424.00 USD$ 0.00 Benefits USD$ 83,109.00 USD$ 0.00 Supplies USD$ 40,235.00 USD$ 0.00 Printing/Copying USD$ 1,200.00 USD$ 0.00 Postage USD$ 30.00 USD$ 0.00 Telephone USD$ 10,640.00 USD$ 0.00 Rent and Utilities USD$ 128,086.00 USD$ 0.00 Accounting/Audit USD$ 2,400.00 USD$ 0.00 Other USD$ 36,158.00 USD$ 0.00 Total USD$ 644,282.00 USD$ 0.00 Budget Narrative Revenue: The composition of revenue is our best estimate based on the previous year of operation. Expenses: personnel costs include salaries and benefits. Sick leave, vacation, and holidays are not included in the benefits calculation for staff that will be paid with the Dublin grant funds. Other operating expenses include: travel and mileage, maintenance and repair expenses, portion of liability, property, D&O, and auto insurance, auto expense, staff development, program expenses and client assistance. 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. Documents top Documents Requested *Required?Attached Documents * Program Expense Budget for ALL Grant Requests ✔✔✔✔ Program Expense Budget Financial Information Form for ALL Grant Requests ✔✔✔✔ Financial Information List of Board of Directors (or governing body) with agency contact information ✔✔✔✔ Board of Directors Current Annual Budget for the Entire Agency ✔✔✔✔ Agency Budget Copy of most recently submitted IRS 990 form or Tax Return (include complete form) ✔✔✔✔ Form 990 Board of Director's (or governing body's) designation of authorized official ✔✔✔✔ BoD Resolution Board of Director's (or governing body's) authorization to request funding (may be same document as one above) ✔✔✔✔ BoD Resolution Proof of insurance carried, including bonding, liability and/or workers' compensation ✔✔✔✔ Insurance STATE AND FEDERAL NON-PROFIT DETERMINATION LETTER. All organizations MUST have approved non-profit status from the State of California and Federal Tax Identification Number at time of application. Non-compliant applicants will be disqualified. ✔✔✔✔ Non-Profit Status Non-Profit Status State Certified Audit and/or Certified Financial Statements ✔✔✔✔ Audit REQUIRED FOR CDBG ONLY - If requesting Capital Funding, please upload your Capital expenditure budget (your own format is acceptable) Attachment 5 186 Application ID: 380819 Become a fan of ZoomGrants™ on Facebook Problems? Contact us at Questions@ZoomGrants.com ©2002-2022 GrantAnalyst.com. All rights reserved. "ZoomGrants" and the ZoomGrants logo are trademarks of GrantAnalyst.com, LLC. Logout | Browser * ZoomGrants™ is not responsible for the content of uploaded documents. 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) Strategic Plan Other Supporting Documents (Not Required) Attachment 5 187