HomeMy WebLinkAboutFMAAA - Senior Hot Meals - 2017 44- 1-q - ) �
'r Agency on Aging
Serving Fresno & Madera
Connecting the Community
Fiscal Year 2017-2018 Contract
between
City of Fresno
and
Fresno-Madera Area Agency on Aging
Contract No. 18-0310
Site Management
i
Area Plan Grant Award
Table of Contents
Documents Required to Execute Contract....................................................................i
CONTRACT................................................................................................................ 1
AREA PLAN GRANT AWARD TERMS AND CONDITIONS DECLARATION......... 3
Article I. Definitions and Resolutions of Language Conflicts..................... 3
Article II. Agreement .................................................................................. 5
Article III. Term of Agreement..................................................................... 5
Article IV. Reasonableness of Compensation ............................................. 6
Article V. Assurances ........................................... ................................. 6
ArticleVI. Funds........................................................................................ 23
Article VII. Budget and Budget Revision..................................................... 26
ArticleVIII. Payment.................................................................................... 30
Article IX. Subcontracts............................................................................. 31
Article X. Records and Reports ................................................................ 32
ArticleXI. Property .................................................................................... 34
ArticleXI I. Access ...................................................................................... 36
Article XIII. Monitoring and Evaluation......................................................... 37
Article XIV. Audit Requirements................................................................... 37
Article XV. Insurance .................................................................................. 42
ArticleXVI. Donations.................................................................................. 44
Article XVII. Termination ............................................................................... 45
Article XVIII. Remedies and Appeal Process................................................. 48
Article XIX. Amendments, Revisions or Modifications ................................. 48
ArticleXX. Noticing ..................................................................................... 49
Area Plan Grant Award ii FY 2017-2018
Table of Contents
Area Plan Grant Award
Table of Contents (Continued)
APPENDICES
Resolution of Authorization to Contract ......................................................Appendix A
Certification.................................................................................................Appendix B
ContractorNendor Confidentiality Statement..............................................Appendix C
Method of Providing Audit Compliance.......................................................Appendix D
Required Reports and Due Dates...............................................................Appendix E
SanctionPolicy ........................................................................................... Appendix F
Appeal Procedure for Service Providers.....................................................Appendix G
Fresno-Madera Area Agency on Aging Contact List for Service Providers.....Appendix H
Fresno-Madera Area Agency on Aging Emergency Contact Information..........Appendix I
Community Focal Points List .......................................................................Appendix J
Request for Taxpayer Identification Number and Certification....................Appendix K
EXHIBITS
ProgramExhibit .............................................................................................. Exhibit A
Budget ........................................................................................................... Exhibit B
Annual Summary of Activities ......................................................................... Exhibit C
Program Cost Efficiency ......................... ........................... .. Exhibit D
Program Narrative .......................................................................................... Exhibit E
Service Provider Emergency Resource Information ....................................... Exhibit F
Area Plan Grant Award iii FY 2017-2018
Table of Contents
CONTRACT BETWEEN
CITY OF FRESNO
AS SERVICE PROVIDER
AND
FRESNO-MADERA AREA AGENCY ON AGING
(HEREINAFTER REFERRED TO AS AGENCY ON AGING)
3837 NORTH CLARK STREET
FRESNO, CA 93726
A. Name and principal address of service contractor(hereinafter referred to as service provider):
City of Fresno
1515 E Divisadero Street
Fresno, CA 93721
B. The starting date of this Agreement shall not precede the date the Agreement is signed by both parties
hereto. The term of this Agreement is from July 1, 2017 to June 30, 2018, subject, however, to earlier
termination as provided herein.
C. No expenditure or obligation for the funding allocation for the July 1, 2017 through September 30, 2017
period may be incurred after September 30,2017. No expenditure or obligation for the funding allocation
for the October 1, 2017 through June 30, 2018 period may be incurred after June 30, 2018.
D. Maximum funds available for the following program, contingent upon sufficient funds made
available from the State of California to the Agency on Aging and/or by the U.S. Government or
the Budget Acts of the appropriate fiscal years for the purposes of this program:
Approved by Fresno-Madera Area Agency on Aging Governing Board on May 18,2017
Federal Grantor: U.S. Department of Health and Human Services
Pass Through Grantor: Fresno-Madera Area Agency on Aging
Older Americans Act Title: Title III C1 Congregate Nutrition, Federal CFDA No. 93.045
Service Agency on Aging Funding Period Grant
Contract No. Amount
Site Management 18-0310 July 2017 - September 2017 $17,000
(Six Sites) October 2017-June 2018 $51,000
fTotal Fiscal Year 2017-2018 Grant Award: $68,000
E. This document together with any attached program exhibits, assurances, budgets, and narratives is a
firm agreement to provide services for older Americans in Fresno and/or Madera counties (including
cities contained therein)as specified in a manner consistent with the intent of, and regulations applicable
to, service programs under Title III/VII of the Older Americans Act as amended.
F. The provisions of the Area Plan Grant Award Terms and Conditions Declaration (Articles I through XX)
attached thereto, plus all enclosures listed, herein, constitute a part of this contract.
Area Plan Grant Award Page 1 FY 2017-2018
Contract
ADDENDUM TO
CONTRACT NO. 18.0310
BETWEEN
CITY OF FRESNO
AS SERVICE PROVIDER
AND
FRESNO-MADERA AREA AGENCY ON AGING
(HEREINAFTER REFERRED TO AS AGENCY ON AGING)
3837 NORTH CLARK STREET
FRESNO, CA 93726
The following provisions of the Area Plan Grant Terms and Conditions Declaration (Articles I
through XX) attached thereto, are modified as follows:
1. Article V, Assurances, Section H Paraara h 11 (page 161:
Provisions of Information Integrity and Security
The provisions contained in Article V, Section H, Information Integrity and Security, shall be
included in all contracts relating to the Agency on Aging Fiscal Year 2017-2018 Grant
Award of both the Contractor and its subcontractors.
2. Article XV. Insurance, Section J (pages 43-44)
Contractor agrees to indemnify, defend, and save harmless the Fresno-Madera Area
Agency on Aging, State of California, their officers, agents, and employees from any and all
claims and losses occurring or resulting to any and all Contractors, subcontractors,
material, laborers, and any other person, firm or corporation furnishing or supplying work,
services, materials or supplies in connection with the performance of this Agreement, and
also from any and all claims and losses occurring or resulting in any person, firm or
corporation, who may be injured or damaged by Contractor's active negligence or willful
misconduct in the performance of this Agreement.
Addendum to Area Plan Grant Award Addendum Pagel FY 2017-2018
Contract No. 18-0310
G
I
I
FOR SERVICE PROVIDER:
9 I
Signa re of individu7nam on Exhibit E,page 5, as having Date
primary, hands-on innt and oversight of the day-to-day
operations of the coprogram.
SHAUN SCHAEFER COMMUNITY SERVICES MANAGER
Type Name Title
7
q-i1-1 -7
Signature c Authorized Contractinq Official Date
(Refer to Appendix A)
KRISTINA CHAMBERLIN ASSISTANT DIRECTOR,PARCS
Type Name of Authorized Contracting Official Title
ei"��& &"W� q. p .,L0j-j
Signature Date
ATTEST: YVONNE SPENCE CITY CLERK
Type Name ; _ _ v _.'�'-.:: -:`°� Title
APPROVED AS TO FORM
CITY AT ftN"Y'S off U
Signature Gf-PUTY rr Date
rr e0u TY U�Y Y
Type Name N,._W, e: �.,,: .., :-,rr._ -.�_,.. Title
Contractor Federal Employer I.D. Number: 94-600338
FOR FRESNO-MADERA AREA AGENCY ON AGING:
42 d2 IV)b tk� / 7
Sign Date
Jean Robinson Executive Director
Area Plan Grant Award Page 2 FY 2017-2018
Contract
I
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1
FRESNO-MADERA AREA AGENCY ON AGING
AREA PLAN GRANT AWARD
TERMS AND CONDITIONS DECLARATION
Activities under this award shall be carried out in accordance with Title III and Title VII of
the Older Americans Act of 1965, as amended (United States Code Title 42, Section
3001); the program regulations and policy directives relating thereto; federal and State
laws; and the California Welfare and Institutions Code, Sections 9000-9023, all of which
are, or may be, operative during the term of this sub-grant award. This Agreement
incorporates the terms and conditions which support an award of Area Plan Funds.
ARTICLE I. DEFINITIONS AND RESOLUTIONS OF LANGUAGE CONFLICTS
A. "Agency on Aging" and "FMAAA" means the Fresno-Madera Area
Agency on Aging interchangeably.
B. "Agreement" or "Contract" shall mean the Fresno-Madera Area Agency
on Aging Area Plan Agreement; Area Plan Grant Award Terms and
Conditions Declaration (Articles I through XX); Appendices; Program
Exhibits; Budget Display; Attachments; Amendments; and any other
documents incorporated by reference, unless otherwise provided in this
Article.
C. "Contractor" or "Service Provider" means the legal entity awarded funds
under this Agreement and which is accountable to the Agency on Aging,
the State, and/or federal government for use of these funds and which is
responsible for executing the provisions for services provided under this
Agreement.
D. "CCR" means California Code of Regulations.
E. "CFR" means Code of Federal Regulations.
F. "In-Kind Contributions" means the value of non-cash contributions
donated to support the project or program (e.g. property, service, etc.).
G, "Matching Contributions" means local cash and/or in-kind contributions
made by the Contractor, a subcontractor, or other local resources that
qualify as match for the contract funding.
H. "OAX means Older Americans Act.
I. "OMB" means the federal Office of Management and Budget.
J. "Program Income" means revenue generated by an Area Agency on Aging
or Contractor from contract-supported activities. Program Income is:
Area Plan Grant Award 3 FY 2017-2018
Terms and Conditions Declaration
1. Voluntary contributions received from a participant or responsible
party for services received.
2. Income from usage or rental fees of real or personal property
acquired with grant funds or funds provided under this
Agreement.
3. Royalties received on patents and copyrights from contract-
supported activities.
4. Proceeds from the sale of items fabricated under a contract
Agreement.
K. "PSA 14" means the State Planning and Service Area comprised of
Fresno and Madera Counties.
L. "Reimbursable item" also means "allowable cost" and "compensable
item."
M. "State" and "Department" means the State of California and the
California Department of Aging (CDA) interchangeably.
N. "Subcontract" means any form of legal agreement between the
Contractor and the Subcontractor, including an agreement that the
Contractor considers a contract, including vendor Agreements that
provide for the provision of goods or services to the Contractor during
the Contractor's performance of this Agreement.
O. "Subcontractor" means the legal entity that receives funds from the
Contractor to carry out part of a federal award identified in this
Agreement.
P. "USC" means United States Code.
Q. As used throughout this Agreement, the term "shall" is mandatory; the
term "may" is permissive.
R. The terms and conditions of this grant award and other requirements
have the following order of precedence if there is any conflict in what
they require:
1. The Older Americans Act of 1965 and Amendments of 2016
(OAA as amended).
2. Other applicable federal statutes and their implementing
regulations.
3. Older Californians Act,
Area Plan Grant Award 4 FY 2017-2018
Terms and Conditions Declaration
4. Title 22 CCR §7000 et. seq.
5. Contract Agreement, including Area Plan Grant Award Terms and
Conditions Declaration, all Appendices, all Exhibits, and any
amendments thereto.
6. Any other documents incorporated herein by reference, including,
if applicable, the federal Health and Human Services (HHS) terms
and conditions found in Part II of the HHS Grant Policy
Statement. The HHS Grant Policy Statement is available under
the HHS Policy Requirements Topic at
https://www.hhs.goS/_, rq ants/grants/grants-policies-
regulations/index.html
7. Program memos and other guidance issued by the California
Department of Aging.
ARTICLE II. AGREEMENT
A. All elements of this Agreement, as defined in Article I, Section B, and as
approved by the Agency on Aging in making this award, are hereby
incorporated by reference, as if fully set forth herein.
B. Time is of the essence in this Agreement. All contracts must be signed
and returned to the Fresno-Madera Area Agency on Aging within forty-
five (45) days of the date on the contract cover letter. If the signed
contract is not returned by the designated date and there has been no
approval granted, then the funds may be reallocated by the Fresno-
Madera Area Agency on Aging Governing Board. The Agency on Aging
will send a Notice of Termination of Negotiations to the non-responsive
Service Provider on the 46th day from the date of the contract cover
letter by certified mail. A copy of the Fresno-Madera Area Agency on
Aging Appeal Procedure will be sent with the letter.
C. A copy of this Agreement is on file and available for inspection at the
Fresno-Madera Agency on Aging, 3837 North Clark Street, Fresno, CA
93726.
ARTICLE III. TERM OF AGREEMENT
A. This Agreement is of no force or effect until signed by both parties
hereto and approved by the Agency on Aging. The Contractor may not
commence performance until such approval has been obtained, or until
a signed Letter of Authority has been provided by the Agency on Aging.
B. The term of this Agreement is from July 1, 2017, through June 30, 2018,
at which time the Agreement expires, subject however, to earlier
Area Plan Grant Award 5 FY 2017-2018
Terms and Conditions Declaration
termination or cancellation as herein provided. Contract awards are
limited to a one-year period; however, at the discretion of the Agency on
Aging, contracts may be renegotiated up to a maximum of three
additional one-year periods subject to annual renegotiation and
availability of federal, State, and local funding.
C. Should the Contractor or subcontractor begin work in advance of
receiving notice that the Agreement is approved, and before obtaining a
signed Letter of Authority from the Agency on Aging, that work may be
considered as having been performed at-risk as a mere volunteer and
may not be reimbursed or compensated.
ARTICLE IV. REASONABLENESS OF COMPENSATION
Compensation for work or services performed under this Agreement shall be
reasonable and based on an analysis of job requirements and comparability
with similar work or services in the local labor market.
ARTICLE V. ASSURANCES
A. Agreement Authorization
1. If a public entity, the Contractor shall submit to the Agency on
Aging a copy of the resolution, order, or motion referencing this
Agreement number authorizing execution of this Agreement. If a
private entity, the Contractor shall submit to the Agency on Aging
an authorization by the Governing Board of the Contractor to
execute this Agreement, referencing this Agreement number.
These documents, including minute orders, must also identify the
action taken.
2. Documentation in the form of a resolution, order, or motion by the
Governing Board of the Contractor is required for the original and
each subsequent amendment to this Agreement. This
requirement may also be met by a single resolution from the
Governing Board of the Contractor authorizing the designee to
execute the original and all subsequent amendments to this
Agreement.
B. Administration
1. The Contractor shall be a public entity, private nonprofit entity, or
Joint Powers Authority (JPA). If a private nonprofit corporation or
JPA, the Contractor shall be in good standing with the Secretary
of State of California and shall maintain that status throughout the
term of the Agreement.
Area Plan Grant Award 6 FY 2017-2018
Terms and Conditions Declaration
a. Any grant awards to for-profit entities are subject to review
and approval by the California Department of Aging prior to
issuance of a contract by the Agency on Aging to the
Contractor. [22 CCR §7362]
2. The Contractor shall ensure that any subcontractors providing
services under this Agreement shall be of sound financial status.
Any subcontracting private entity or JPA shall be in good standing
with the Secretary of State of California and shall maintain that
status throughout the term of the Agreement.
3. Failure to maintain good standing by the contracting entity shall
result in suspension or termination of this Agreement with the
Agency on Aging until satisfactory status is restored. Failure to
maintain good standing by a subcontracting entity shall result in
suspension or termination of the subcontract by the Contractor
until satisfactory status is restored.
4. This Agreement is not assignable by the Contractor, either in
whole or in part, without the written consent of the Agency on
Aging in the form of a formal written amendment.
5. The Contractor, and the agents and employees of the Contractor,
in the performance of this Agreement, shall act in an independent
capacity and not as officers or employees or agents of the State
or the Agency on Aging.
6. In the event that any provision of this Agreement is unenforceable
or held to be unenforceable, then the parties agree that all other
provisions of this Agreement have full force and effect and shall
not be affected.
C. Debarment, Suspension, and Other Responsibility Matters
1. The Contractor certifies to the best of its knowledge and belief,
that it and its subcontractors:
a. Are not presently debarred or suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from
covered transactions by any federal department or agency.
[45 CFR §92.35]
b. Have not, within a three-year period preceding this
Agreement, been convicted of, or had a civil judgment
rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to
obtain, or performing a public (federal, State, or local)
Area Plan Grant Award 7 FY 2017-2018
Terms and Conditions Declaration
transaction or contract under a public transaction; violation
of federal or State antitrust statues or commission of
embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or
receiving stolen property.
C. Are not presently indicted for or otherwise criminally or
civilly charged by a governmental entity (federal, State, or
local) with commission of any of the offenses enumerated
in Section B.1 of this Article.
d. Have not, within a three-year period preceding this
Agreement, had one or more public transactions (federal,
State, or local) terminated for cause or default.
2. The Contractor shall report immediately to the Agency on Aging,
in writing, any incidents of alleged fraud and/or abuse by either
the Contractor or subcontractors. The Contractor shall maintain
any records, documents, or other evidence of fraud and abuse
until otherwise notified by the Agency on Aging.
3. The Contractor agrees to timely execute any and all amendments
to this Agreement or certificates, other required documentation
relating to the Subcontractor's debarment/suspension status.
4. The Contractor shall notify the Agency on Aging immediately of
any intention to discontinue existence of the entity or to bring an
action for dissolution.
D. Law, Policy and Procedure, Licenses, and Certificates
1. This Agreement is governed by and shall be interpreted in
accordance with the laws of the State of California.
2. The Contractor agrees to administer this Agreement and require
any subcontractors to administer their subcontracts in accordance
with this Agreement, and with all applicable local, State, and
federal laws and regulations including, but not limited to,
discrimination, wages and hours of employment, occupational
safety, and to fire, safety, health, and sanitation regulations,
directives, guidelines, and/or manuals related to this Agreement
and resolve all issues using good administrative practices and
sound judgment. The Contractor and its subcontractors shall
keep in effect all licenses, permits, notices, and certificates that
are required by law.
Area Plan Grant Award 8 FY 2017-2018
Terms and Conditions Declaration
E. Provision of Services, Staffing, and Standards of Work
1. The Contractor shall ensure the provision of services under this
Agreement, as specified by the attached exhibits, which are
hereby incorporated by reference. Inadequate performance or
failure to make progress so as to endanger performance of this
Agreement may result in imposition of sanctions as described in
Appendix F, Sanction Policy, or termination of the Agreement as
described in Article XVII, Termination.
2. The Contractor shall make every effort to meet the goals and
objectives stipulated in this Agreement. Performance shall not be
unilaterally reduced or otherwise changed without prior
consultation with, and written approval of, the Agency on Aging.
A service unit reduction that impacts the Agency's ability to
provide service levels defined in its Area Plan or Area Plan
Update service unit objectives requires:
a. Written approval from the California Department of Aging
to the Agency on Aging if such reduction is greater than 10
(ten) percent.
b. An Amendment to the Agency on Aging's Area Plan if such
reduction is greater than 20 (twenty) percent, including a
public hearing; approval by the Agency's Governing Board
and Advisory Council chairpersons and the Agency's
Executive Director; and approval by the California
Department of Aging. [22 CCR §7306(a)]
3. The Contractor agrees that the performance of work and services
pursuant to the requirements of this Agreement shall conform to
accepted professional standards.
4. The Contractor shall maintain adequate staff to meet the
Contractor's obligations under this Agreement.
5. The Contractor shall make staff available to the Agency on Aging
for training and meetings, which the Agency on Aging may find
necessary from time to time.
F. Payroll Taxes and Deductions
The Contractor shall promptly forward payroll taxes, insurances, and
contributions, including State Disability Insurance, Unemployment
Insurance, Old Age Survivors Disability Insurance, and federal and State
income taxes withheld, to designated governmental agencies as
required by law.
Area Plan Grant Award 9 FY 2017-2018
Terms and Conditions Declaration
G. Nondiscrimination
The Contractor shall comply with all federal statutes relating to
nondiscrimination. These include those statutes and laws contained in the
Contractor Certification Clauses (Appendix B), which are hereby
incorporated by reference. In addition, Contractor shall comply with the
following:
1. Equal Access to Federally-Funded Benefits, Programs, and
Activities (Title VI of the Civil Rights Act of 1964)
Contractor shall ensure compliance with Title VI of the Civil
Rights Act of 1964 (42 USC §2000d; 45 CFR §80), which
prohibits recipients of federal financial assistance from
discriminating against persons based on race, color, religion, or
national origin.
2. Equal Access to State-Funded Benefits, Programs, and Activities
Contractor shall, unless exempted, ensure compliance with the
requirements of California Government Code §11135 et seq., and
2 CCR §11140 et seq., which prohibit recipients of State financial
assistance from discriminating against persons based on race,
national origin, ethnic group identification, religion, age, sex,
sexual orientation, color, or disability. [22 CCR §98323]
3. California Civil Rights Laws
The Contractor shall ensure compliance with the requirements of
California Public Contract Code §2010. The California Civil
Rights Laws Certification ensures Contractor compliance with the
Unruh Civil Rights Act (California Civil Code §51) and the Fair
Employment and Housing Act (California Government Code
§12960), and ensures that Contractor internal policies are not
used in violation of California Civil Rights Laws.
4. Contractor assures the State that it complies with the Americans
with Disabilities Act (ADA) of 1990, which prohibits discrimination
on the basis of disability, as well as all applicable regulations and
guidelines issued pursuant to the ADA. [42 USC §12101 et seq.]
5. During the performance of this Agreement, the Contractor and its
subcontractors shall not unlawfully discriminate, harass, or allow
harassment against any employee or applicant for employment
because of sex, race, color, ancestry, religious creed, national
origin, physical disability (including HIV and AIDS), mental
disability, medical condition (cancer), age (over 40), marital
Area Plan Grant Award 10 FY 2017-2018
Terms and Conditions Declaration
status, and denial of family care leave. The Contractor and its
subcontractors shall insure that the evaluation and treatment of
their employees and applicants for employment are free from
such discrimination and harassment. Contractor and
subcontractors shall comply with the provisions of the Fair
Employment and Housing Act (California Government Code
§12990 (a-f) et seq.) and the applicable regulations promulgated
thereunder (2 CCR §7285 et seq.). The applicable regulations of
the Fair Employment and Housing Commission implementing
California Government Code §12990 (a-f), set forth in Chapter 5
of Division 4 of Title 2 of the California Code of Regulations, are
incorporated into this Agreement by reference and made a part
hereof as if set forth in full. Contractor and its subcontractors shall
give written notice of their obligations under this clause to labor
organizations with which they have a collective bargaining or
other Agreement.
6. Adhere to 48 CFR 3.908, implementing Section 828, entitled
"Pilot Program for Enhancement of Contractor Whistleblower
Protections," of the National Defense Authorization Act (NDAA)
for Fiscal Year 2013 (Public Law 112-239 enacted January 2,
2013), applies to this Agreement.
7. Recognize any same-sex marriage legally entered into in a
United States (U.S.) jurisdiction that recognizes their marriage,
including one of the 50 states, the District of Columbia, or a U.S.
territory, or in a foreign country so long as that marriage would
also be recognized by a U.S. jurisdiction. This applies regardless
of whether or not the couple resides in a jurisdiction that
recognizes same-sex marriage. However, this does not apply to
registered domestic partnerships, civil unions or similar formal
relationships recognized under the law of the jurisdiction of
celebration as something other than a marriage. Accordingly,
recipients must review and revise, as needed, any policies and
procedures which interpret or apply federal statutory or regulatory
references to such terms as "marriage," "spouse," family,"
"household member" or similar references to familial relationships
to reflect inclusion of same-sex spouse and marriages. Any
similar familial terminology references in the U.S. Department of
Health and Human Services' (HHS) statutes, regulations, or
policy transmittals will be interpreted to include same-sex
spouses and marriages legally entered into as described herein.
(1 USC 7 §3 of the Defense of Marriage Act)
Area Plan Grant Award 11 FY 2017-2018
Terms and Conditions Declaration
8. The Contractor shall not require proof of age or citizenship as a
condition of receiving services.
9. Contractor agrees to include these requirements in all contracts it
enters into with subcontractors to provide services pursuant to
this Agreement.
10. The Contractor shall require language in all subcontracts to
require all subcontractors to comply with all applicable State and
federal laws.
H. Information Integrity and SecuritX
1. Information Assets
The Contractor, and its SubcontractorsNendors, shall have in
place operational policies, procedures, and practices to protect
Agency on Aging information assets including those assets used
to store or access Personal Health Information (PHI), Personal
Information (PI), and any information protected under the Health
Insurance Portability and Accountability Act (HIPAA), (i.e.,
confidential, sensitive and/or personal identifying information) as
specified in the State Administrative Manual, §5300-5365.3;
California Government Code §11109.9; Department of General
Services Management Memo 06-12; Department of Finance
Budget Letter 06-34; CDA Program Memorandum 07-18,
Protection of Information Assets; and the Statewide Health
Information Policy Manual.
Information assets include, but are not limited to:
a. Information collected and/or accessed in the administration
of Agency on Aging programs and services.
b. Information Assets may be in hard copy or electronic
format and may include, but are not limited to:
1) Reports;
2) Notes;
3) Forms;
4) Computers, laptops, cellphones, printers, scanners;
5) Networks (LAN, WAN, WIFI), servers, switches,
routers;
Area Plan Grant Award 12 FY 2017-2018
Terms and Conditions Declaration
6) Storage media, hard drives, flash drives, cloud
storage;
7) Data, applications, databases.
2. Encryption of Portable Computing Devices
The Contractor and its SubcontractorsNendors are required to
encrypt (or use an equally effective measure) data collected
under this Agreement that is confidential, sensitive, and/or
personal information, including data stored on all computing
devices (including, but not limited to, workstations, servers,
laptops, personal digital assistants, notebook computers, and
backup media) and/or portable electronic storage media
(including, but not limited to, discs, thumb/flash drives, portable
hard drives, and backup media).
3. Disclosure
a. The Contractor, and its SubcontractorsNendors, shall
ensure that all confidential, sensitive, and/or personal
identifying information is protected from inappropriate or
unauthorized access or disclosure in accordance with
applicable laws, regulations, and State and Agency on
Aging policies. The requirement to protect information shall
remain in force until superseded by laws, regulations, and
State and Agency on Aging policies.
b. The Contractor, and its SubcontractorsNendors, shall
protect from unauthorized disclosure, confidential,
sensitive, and/or personal identifying information, such as
names and other identifying information concerning
persons receiving services pursuant to this Agreement,
except for statistical information not identifying any
participant.
C. "Personal Identifying Information" shall include, but not be
limited to: Name; identifying number; social security
number; State driver's license or State identification
number; financial account numbers; and symbol or other
identifying characteristic assigned to the individual, such
as finger or voice print or a photograph.
d. The Contractor, and its SubcontractorsNendors, shall not
use confidential, sensitive, and/or personal identifying
information above for any purpose other than carrying out
Area Plan Grant Award 13 FY 2017-2018
Terms and Conditions Declaration
the Contractor's obligations under this Agreement. The
Contractor and its Subcontractors are authorized to
disclose and access identifying information for this purpose
as required by the Older Americans Act.
e. The Contractor, and its Subcontractors/Vendors, shall not,
except as otherwise specifically authorized by law or
required by this Agreement or court order, disclose any
identifying information obtained under the terms of this
Agreement to anyone other than the Agency on Aging
without prior written authorization from the Agency on
Aging. The Contractor may be authorized, in writing, by a
participant to disclose identifying information specific to the
authorizing participant.
f. The Contractor, and its Subcontractors/Vendors, may
allow a participant to authorize the release of information
to specific entities, but shall not request or encourage any
participant to give a blanket authorization or sign a blank
release, nor shall the Contractor accept such blanket
authorization from any participant.
4. Information Security Awareness Training
a. The Contractor's employees, Subcontractors/Vendors, and
volunteers handling confidential, sensitive, and/or personal
identifying information must complete the required
Information Security Awareness Training module available
on the CDA Web site under Providers and Partners,
Information Security Awareness Training, at the following
URL:
http://www.aging.ca.gov/ProgramsProviders/
If Internet access is not available, a hard copy of the
training module is available from the Agency on Aging
upon request.
b. Information Security Awareness Training must be
completed within thirty (30) days of the start date of the
Contract/Agreement; within thirty (30) days of the start
date of any new employee, Subcontractor, Vendor, or
volunteer's employment; and annually thereafter.
Area Plan Grant Award 14 FY 2017-2018
Terms and Conditions Declaration
C. The Contractor must maintain certificates of completion on
file and provide them to the Agency on Aging and the
California Department of Aging upon request.
5. Health Insurance Portability and Accountability Act (HIPAA)
The Contractor agrees to comply with the privacy and security
requirements of the Health Insurance Portability and
Accountability Act (HIPAA) and ensure that Subcontractors/
Vendors comply with the privacy and security requirements of
HIPAA.
6. Contractor/Vendor Confidentiality Statement
The Contractor shall sign and return to the Agency on Aging the
Contractor/Vendor Confidentiality Statement(Appendix C of this
agreement), which is hereby incorporated by reference, and shall
comply with all statutes and laws contained in the statement. This
is to ensure that the Contractor is aware of, and agrees to comply
with, their obligations to protect CDA and Agency on Aging
information assets from unauthorized access and disclosure.
7. Security Incident Reporting
A security incident occurs when CDA and/or Agency on Aging
information assets are or reasonably believed to have been
accessed, modified, destroyed, or disclosed without proper
authorization, or are lost or stolen. The Contractor and its
Subcontractors/Vendors must report all security incidents to the
Agency on Aging immediately upon detection. A Security Incident
Report form (CDA 1025) must be submitted to the CDA
Information Security Officer, via the Agency on Aging, within five
(5) business days of the date the incident was detected. The
Security Incident Report form (CDA 1025) is available on the
CDA Web site at the following URL:
https://www.aging.ca.gov/ProgramsProviders/
8. Security Breach Notifications
Notice must be given by the Contractor, and/or its
Subcontractors/Vendors, to anyone whose confidential, sensitive,
and/or personal identifying information could have been breached
in accordance with HIPAA, the Information Practices Act of 1977,
and State policy.
Area Plan Grant Award 15 FY 2017-2018
Terms and Conditions Declaration
9. Software Maintenance
The Contractor shall apply security patches and upgrades and
keep anti-virus software up-to-date on all systems on which State
and/or Agency on Aging data may be used.
10. Electronic Backups
The Contractor, and its Subcontractors/Vendors, shall ensure that
all electronic information is protected by performing regular
backups of automated files and databases, and ensure the
availability of information assets for continued business. The
Contractor, and its Subcontractors/Vendors, shall ensure that all
data, files, and backup files are encrypted.
11. Provisions of Information Integrity and Security
The provisions contained in Article V, Section H, Information
Integrity and Security, shall be included in all contracts of both the
Contractor and its Subcontractors/Vendors.
I. Copyrights
1. If any material funded by this Agreement is subject to copyright,
the State reserves the right to copyright such material and the
Contractor agrees not to copyright such material, except as set
forth in Section J of this Article.
2. The Contractor may request permission to copyright material by
writing to the Executive Director of the Agency on Aging. The
Executive Director shall forward such request to the State and
shall relay the State's response to the Contractor within sixty (60)
days from the date of receipt of the State's decision.
3. If the material is copyrighted with the consent of the State, the
State reserves a royalty-free, non-exclusive, and irrevocable
license to reproduce, prepare derivative works, publish, distribute
and use such materials, in whole or in part, and to authorize
others to do so, provided written credit is given the author.
4. The Contractor certifies that it has appropriate systems and
controls in place to ensure that funds provided under this
Agreement will not be used in the performance of this Agreement
for the acquisition, operation, or maintenance of computer
software in violation of copyright laws.
Area Plan Grant Award 16 FY 2017-2018
Terms and Conditions Declaration
J. Rights in Data
1. The Contractor shall not publish or transfer any materials, as
defined in Section J.2 of this Article, produced or resulting from
activities supported by this Agreement without the express written
consent of the Executive Director of the Agency on Aging. That
consent shall be given or the reasons for denial shall be given
and any conditions under which it is given or denied within thirty
(30) days after the written request is received by the Agency on
Aging. The Agency on Aging may request a copy of the material
for review prior to approval of the request. This subsection is not
intended to prohibit the Contractor from sharing identifying client
information authorized by the participant or summary program
information that is not client-specific.
2. As used in this Agreement, the term "subject data" means
writings, sound recordings, pictorial reproductions, drawings,
designs or graphic representations, procedural manuals, forms,
diagrams, workflow charts, equipment descriptions, data files and
data processing or computer programs, and works of any similar
nature (whether or not copyrighted or copyrightable) which are
first produced or developed under this Agreement. The term does
not include financial reports, cost analyses, and similar
information incidental to contract administration.
3. Subject only to the provisions of Article V, Section H, Information
Integrity and Security, and Article V, Section I, Copyrights, of this
Agreement, the State and the Agency on Aging may use,
duplicate, or disclose in any manner, and have or permit others to
do so subject to State and federal law all subject data delivered
under this Agreement.
4. Materials published or transferred by the Contractor and financed
with funds under this Agreement shall: (a) state "The materials or
product were a result of a project funded by an Agreement with
the Fresno-Madera Area Agency on Aging and the California
Department of Aging;" (b) give the name of the entity, the
address, and telephone number at which the supporting data is
available; and (c) include the following statement: "The
conclusions and opinions expressed may not be those of the
Agency on Aging and/or the California Department of Aging and
this publication may not be based upon or inclusive of all raw
data."
5. The Contractor agrees to acknowledge the receipt of all funding
support from the Agency on Aging in news releases (radio,
Area Plan Grant Award 17 FY 2017-2018
Terms and Conditions Declaration
television, and newspaper); printed materials such as brochures,
pamphlets, newsletters; the Contractor's Web site; and any other
printed documents. Such acknowledgement shall make accurate
reference to the service for which funding is provided, in whole or
in part, by the Agency on Aging.
6. The Contractor shall forward a copy of all products and material
developed in whole or in part with Agreement funds to the Agency
on Aging for file.
K. Certifications
The Contractor shall comply with all statutes and laws contained in the
Contractor Certification Clauses (Appendix B), which is hereby
incorporated by reference. In addition, Contractor shall comply with the
following:
1. Contracts in Excess of$100,000
If funding provided herein exceeds $100,000, the Contractor shall
comply with all applicable orders or requirements issued under
the following laws:
a. Clean Air Act, as amended. [42 USC §7401]
b. Federal Water Pollution Control Act, as amended.
[33 USC §1251 et seq.]
C. Environmental Protection Agency Regulations.
[40 CFR §29] [Executive Order 11738]
d. State Contract Act. [California Public Contract Code
§10295 et seq.]
e. Unruh Civil Rights Act [California Public Contract Code
§2010]
L. Lobbying Certification
The Contractor, by signing this Agreement, hereby certifies to the best of
his or her knowledge and belief, that:
1. No federally appropriated funds have been paid or will be paid, by
or on behalf of the Contractor, to any person for influencing or
attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the
Area Plan Grant Award 18 FY 2017-2018
Terms and Conditions Declaration
awarding of any federal contract, the making of any federal grant,
the making of any federal loan, the entering of any cooperative
agreement, and the extension, continuation, renewal,
amendment, or modification of any federal contract, grant, loan,
or cooperative agreement.
2. If any funds other than federally appropriated funds have been
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any federal agency, a Member
of Congress, an officer or employee of Congress or an employee
f a Member of Congress in connection with this federal
Agreement, grant, loan or cooperative agreement, the Contractor
shall complete and submit Standard Form LLL, Disclosure Form
to Report Lobbying, in accordance with its instructions.
3. The Contractor shall require that the language of this certification
be included in the award documents for all subcontracts at all
tiers (including contracts under grants, loans, and cooperative
agreements which exceed $100,000) and that all subcontractors
shall certify and disclose accordingly. This certification is a
material representation of fact upon which reliance was placed
when this transaction was made or entered into. This certification
is a prerequisite for making or entering into this transaction
imposed by 31 USC §1352. Any person who fails to file the
required certification shall be subject to a civil penalty of not less
than $10,000 and not more than $100,000 for each such failure.
M. Conflict of Interest
1. The Contractor shall prevent employees, consultants, or
members of governing bodies from using their positions for
purposes including, but not limited to, the selection of
subcontractors, that are, or give the appearance of being,
motivated by a desire for private gain for themselves or others,
such as family, business, or other ties. In the event that the
Agency on Aging determines that a conflict of interest exists, any
increase in costs associated with the conflict of interest may be
disallowed by the Agency on Aging, and such conflict may
constitute grounds for termination of the Agreement.
2. This provision shall not be construed to prohibit employment of
persons with whom the Contractor's officers, agents, or
employees have family, business, or other ties, so long as the
employment of such persons does not result in a conflict of
interest (real or apparent) or increased costs over those
associated with the employment of any other equally qualified
Area Plan Grant Award 19 FY 2017-2018
Terms and Conditions Declaration
applicant, and such persons have successfully competed for
employment with the other applicants on a merit basis.
N. Covenant Against Contingent Fees
1. The Contractor warrants that no person or selling agency has
been employed or retained to solicit this Agreement. There has
been no agreement to make commission payments in order to
obtain this Agreement.
2. For breach or violation of this warranty, the Agency on Aging shall
have the right to terminate this Agreement without liability or at its
discretion to deduct from the Agreement price or consideration, or
otherwise recover, the full amount of such commission,
percentage, brokerage, or contingency fee.
O. Facility Construction or Repair
1. This section applies only to Title III funds and not to other funds
allocated to other Titles under the Older Americans Act.
a. When applicable for purposes of construction or repair of
facilities, the Contractor shall comply with the provisions
contained in the following and shall include such provisions
in any applicable agreements with subcontractors:
i) Copeland "Anti-Kickback" Act [18 USC §874,
40 USC §3145] [29 CFR §3];
ii) Davis-Bacon Act [40 USC §3141 et seq.]
[29 CFR §5];
iii) Contract Work Hours and Safety Standards Act
[40 USC §327-333] [29 CFR §5, 6, 7, 8]; and
iv) Executive Order 11246 of September 14, 1965,
entitled "Equal Employment Opportunity" as
amended by Executive Order 11375 of October 13,
1967, as supplemented in Department of Labor
Regulations [41 CFR §60].
b, Payments are not permitted for construction, renovation,
alteration, improvement, or repair of privately owned
property which would enhance the owner's value of such
property except where permitted by law and by the Agency
on Aging.
Area Plan Grant Award 20 FY 2017-2018
Terms and Conditions Declaration
C. When funding is provided for construction and non-
construction activities, the Contractor must obtain prior
written approval from the Agency on Aging before making
any fund or budget transfers between construction and
non-construction.
P. If this Agreement includes services in excess of$200,000, the
Contractor shall give priority consideration in filling vacancies in
positions funded by the Contract to qualified recipients of aid under
Welfare and Institutions Code §11200 in accordance with California
Public Contract Code 10353.
Q. Grievance Process
1, The Contractor must establish a written grievance process for
reviewing and attempting to resolve complaints of older
individuals receiving services funded by this Agreement. At a
minimum, the process shall include all of the following:
a. Time frames within which a complaint will be acted upon.
b. Written notification to the complainant of the results of the
review, including a statement that the complainant may
appeal to the Fresno-Madera Area Agency on Aging if
dissatisfied with the results of the Contractor's review.
C. Confidentiality provisions to protect the complainant's
rights to privacy. Only information relevant to the complaint
may be released to the responding party without the older
individual's consent.
2. The Contractor shall notify older individuals of the grievance
process available to them by:
a. Posting notification of the process in visible and accessible
areas, such as the bulletin boards in multipurpose senior
centers. For areas in which a substantial number of older
individuals are non-English speaking, the notification shall
also be posted in the primary language of a significant
number of older individuals.
b_ Advising homebound older individuals of the process either
orally or in writing upon the Contractor's contact with the
individuals.
3. Complaints may involve, but not be limited to, any or all of the
following:
Area Plan Grant Award 21 FY 2017-2018
Terms and Conditions Declaration
a. Amount or duration of a service.
b. Denial or discontinuance of a service-
C. Dissatisfaction with the service being provided or with the
service provider. If the complaint involves an issue of
professional conduct that is under the jurisdiction of
another entity, such as the California Medical Board or the
State Bar Association, the complainant shall be referred to
the proper entity.
d. Failure of the service provider to comply with any of the
requirements set forth in CDA regulations or in this
Agreement.
4. Nothing in this Article shall be construed as prohibiting older
individuals from seeking other available remedies, such as
presenting their complaints at an open meeting of the
Contractor's governing board.
R. Disaster Plan
1. The Contractor shall prepare and maintain a disaster plan that
ensures provision of critical services to meet the emergency
needs of consumers they are charged to serve during medical or
natural disasters, such as earthquakes or floods, and make such
plan available to the Agency on Aging upon request.
2. The Contractor shall provide annual disaster response training
and a current list of community resources for all employees and
volunteers, and maintain documentation of such training.
3. The Contractor shall designate a primary and a secondary
emergency contact. Following an emergency or disaster, the
Contractor's designated contact shall update the Agency on
Aging with the Contractor's operational status.
4. The Contractor shall complete Exhibit F, Service Provider
Emergency Resource Information, included with this agreement,
and advise the Agency on Aging whenever a change to this
information occurs.
S. Community Focal Points
The Vendor acknowledges that the Agency on Aging has designated
locations as Community Focal Points, as required by Title 22 CCR
Area Plan Grant Award 22 FY 2017-2018
Terms and Conditions Declaration
Article 3 §7302(a)(14), 45 CFR §1321.53(c), and OAA 2006 §306(a),
which are attached as Appendix J, Community Focal Points List.
ARTICLE VI. FUNDS
A. Expenditure of Funds
1. The Contractor shall expend all funds received hereunder in
accordance with this Agreement.
2, The Contractor shall comply with the standards and guidelines for
procurement of supplies, equipment, and services as set forth in
45 CFR §92.36.
3. The Contractor and its Subcontractor/Vendors shall comply with
California Governor's Executive Order 2-18-2011, which bans
expenditures on promotional and marketing items colloquially
known as "S.W.A.G." or "Stuff We All Get."
4. Travel Reimbursement
a. Any reimbursement by Contractor from funds provided
under this Agreement for authorized travel and per diem
shall be at rates not to exceed those paid by the State in
accordance with the California Department of Human
Resources (CaIHR) rules and regulations.
In State:
Mileage:
http://www.calh r.ca.gov/employees/Pages/travel-
personal-vehicle.aspx
Per Diem (meals and incidentals):
http://www.calhr.ca.gov/employees/Pages/travel-
meals.aspx
Lodging:
http://www.calhr.ca.gov/employees/Pages/travel-
lodging-reimbursement.aspx
Out of State:
http://www.calhr.ca.gov/employees/Pages/travel-
out-of-state.aspx
b. This is not to be construed as limiting the Contractor from
paying any differences in costs, from funds other than
Area Plan Grant Award 23 FY 2017-2018
Terms and Conditions Declaration
those provided by this Agreement, between the CaIHR
rates and any rates the Contractor is obligated to pay
under other contractual agreements. No travel outside the
State of California shall be reimbursed unless prior written
authorization is obtained from the Agency on Aging and
the State. [2 CCR §599.615 et seq.]
5. The Agency on Aging reserves the right to refuse payment to the
Contractor or later disallow costs for any expenditure, as
determined by the Agency on Aging not to be in compliance with
this Agreement, unrelated or inappropriate to Agreement
activities, or when inadequate supporting documentation is
presented, or where prior approval was required but was not
requested or not granted.
B. Accountability for Funds
1. The Contractor shall maintain accounting records for funds
received under the terms and conditions of this Agreement.
These records shall be separate from those for any other funds
administered by the Contractor, and shall be maintained in
accordance with Generally Accepted Accounting Principles and
Procedures and the Office of Management and Budget's Uniform
Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards. [2 CFR §200] [45 CFR §75]
2- The Contractor shall ensure that funding for services as outlined
herein are managed and prorated monthly to ensure that
adequate Older Americans Act funding is available to provide
services through the ending date of this Agreement.
3- Funds made available under this Agreement shall supplement,
and not supplant, any federal, State, or local funds expended by a
State or unit of general purpose local government to provide
Title III (excluding Title III E) and Title VII services.
4. Financiai Management Systems
The Contractor shall meet the following standards for its financial
management systems, as stipulated in 2 CFR §200.302 and
45 CFR §75.302:
a. Financial Reporting.
b. Accounting Records.
C. Complete Disclosure.
Area Plan Grant Award 24 FY 2017-2018
Terms and Conditions Declaration
d. Source Documentation.
e. Internal Control.
f. Budgetary Control.
g. Cash Management (written procedures).
h. Allowable Costs (written procedures).
C. Unexpended Funds
1. No later than March 31 of the Agreement year, the Contractor
shall report to the Agency on Aging if any Older Americans Act
funds will remain unexpended at the ending date of this
Agreement.
2, The Agency on Aging shall request and receive from the
Contractor release of Older Americans Act funds for an amount
mutually agreed upon by both parties, not to exceed the
estimated amount of unexpended funds. The Agency on Aging
shall be reasonable in its request for funds and the Contractor
shall not unreasonably withhold permission for release of funds.
3. The Agency on Aging retains all rights to reallocate released
funds into other programs, projects, or activities.
4. Upon termination, cancellation, or expiration of this Agreement, or
dissolution of the entity, the Contractor shall return to the Agency
on Aging immediately upon written demand, any funds provided
under this Agreement, which are not payable for goods or
services delivered prior to the termination, cancellation, or
expiration of this Agreement, or the dissolution of the entity.
D. Funding Contingencies
1. It is understood between the parties that this Agreement may
have been written before ascertaining the availability or
appropriation of funds, for the mutual benefit of both parties, in
order to avoid program and fiscal delays that would occur if this
Agreement were executed after that determination was made.
2. This Agreement is valid and enforceable only if sufficient funds
are made available to the State, and subsequently to the Agency
on Aging, by the United States Government or the Budget Acts of
the appropriate fiscal years for purposes of the contracted
program(s). In addition, this Agreement is subject to any
Area Plan Grant Award 25 FY 2017-2018
Terms and Conditions Declaration
additional restrictions, limitations, or conditions enacted by the
Congress or the Legislature that may affect the provisions, terms,
or funding of this Agreement in any manner.
3. Payment for performance by the Contractor shall be dependent
upon the availability of future appropriations by the Legislature or
Congress for the purposes of this Agreement and approval of an
itemized budget. No legal liability on the part of the State or the
Agency on Aging for any payment may arise under this Contract
until funds are made available; the itemized budget is approved
by the State; and the Contractor has received an executed
Agreement.
4. If funding for any State or Agency on Aging fiscal year is reduced
or deleted by the State, Legislature, or Congress for the purposes
of this program, the Agency on Aging shall have the option to
either:
a. Terminate the Agreement pursuant to Section A.1 of
Article XVII, Termination, of this Agreement; or
b. Offer a contract amendment to the Contractor to reflect the
reduced funding for this Agreement.
5, The Agency on Aging reserves the right to increase and/or
decrease funds available under this Agreement to reflect any
restrictions, limitations, or conditions.
ARTICLE VII. BUDGET AND BUDGET REVISION
A. The Contractor shall be reimbursed for expenses only as itemized in the
approved budget with the exception of line item budget transfers as
noted in Section E of this Article and shall not be entitled to
reimbursement for these expenses until this Agreement is approved and
executed by the Agency on Aging. The approved Contractor's budget is
hereby incorporated by reference into this Agreement as a part of
Exhibit B.
B. The final date to submit a budget revision to the Agency on Aging for
this Agreement is March 15, 2018.
C. Indirect Costs
1. The maximum reimbursement amount allowable for indirect costs
is ten percent (10%) of the Contractor's direct costs, excluding in-
kind contributions and nonexpendable equipment unless there is
Area Plan Grant Award 26 FY 2017-2018
Terms and Conditions Declaration
an accepted negotiated rate accepted by all Federal awarding
agencies [2 CFR 200.414(c)(1),(f)] [45 CFR 75.414(c)(1),(f)].
2. Contractors requesting reimbursement for indirect costs shall
retain on file an approved indirect cost rate or an allocation plan
documenting the methodology used to determine the indirect
costs.
3. Indirect costs exceeding the ten percent (10%) maximum may be
budgeted as in-kind and used to meet the minimum matching
requirements (Title III and Title VII only).
4. For major Institutes of Higher Education and major nonprofit
organizations, indirect costs must be classified within two broad
categories: "Facilities" and "Administration." "Facilities" is defined
as depreciation on buildings, equipment and capital
improvement, interest on debt associated with certain buildings,
equipment and capital improvements, and operations and
maintenance expenses. "Administration" is defined as general
administration and general expenses such as the director's
office, accounting, personnel and all other types of expenditures
not listed specifically under one of the subcategories of
"Facilities" (including cross allocations from other pools, where
applicable). [2 CFR 200.414(a)] [45 CFR §75.414(a)]
D. Program Specific Funds
1. Program Income
a. Program Income must be reported and expended under
the same terms and conditions as the program funds from
which it is generated.
b. Program Income must be used to pay for current allowable
costs of the program in the same fiscal year that the
income was earned (except as noted in Section D.1.d of
this Article).
C. For Title III B, III C, III D, III E, VII Ombudsman, and VII
Elder Abuse Prevention programs, Program Income must
be spent before contract funds (except as noted in Section
D.1.d of this Article) and may reduce the total amount of
contract funds payable to the Contractor.
d. For Title III B, III C, III D, III E, VII Ombudsman, and VII
Elder Abuse Prevention programs, if Program Income is
earned in excess of the amount reported in the Area Plan
Area Plan Grant Award 27 FY 2017-2018
Terms and Conditions Declaration
Budget, the excess amount may be deferred for use in the
first quarter of the following contract period, which is the
last quarter of the federal fiscal year.
e. If Program Income is deferred for use, it must be used by
the last day of the federal fiscal year and reported when
used.
f. Program Income may not be used to meet the matching
requirements of this Agreement.
g. Program Income must be used to expand baseline
services.
h. If as a result of advanced funds, the project earns interest
on funds awarded by the Agency on Aging, that interest
shall be identified as income to the program and used for
program expenditures, with full documentation on file for
all programs.
2. One-Time-Only (OTO) Funds
a. OTO Funds, if any, are non-transferable between funding
sources. This means that OTO funds can only be used in
the program in which they were accrued.
b. Titles III and VII federal program OTO funds shall only be
used for the following purposes:
1) The purchase of equipment that enhances the
delivery of services to the eligible service population.
2) Home and community-based projects that are
approved in advance by the California Department of
Aging, and are designed to address the unmet needs
of the eligible service population identified in the Area
Plan.
3) Innovative pilot projects that are approved in advance
by the California Department of Aging, and are
designed for the development or enhancement of a
comprehensive and coordinated system of services as
defined in 45 CFR §1321.53(a)(b).
4) OTO funds can be used to maintain or increase
baseline services; however, the Contractor shall
assure that services funded with OTO funds will not
create an expectation of service delivery beyond the
Area Plan Grant Award 28 FY 2017-2018
Terms and Conditions Declaration
current Contract period. Expenditures for baseline
services do not require advance approval from the
California Department of Aging.
C. NSIP OTO funds shall only be used to purchase food used
in the Elderly Nutrition Program.
E. Line Item Budget Transfers
The Contractor may transfer Agreement funds between line items under
the following terms and conditions-
1. The Contractor shall obtain prior approval from the Agency on
Aging for any line item transfer of funds that exceeds ten percent
(10%) of the total budget for each funding source, and submit a
revised budget to the Agency on Aging.
2. The Contractor shall maintain a written record of all budget
changes and clearly document line item budget changes. The
record shall include the date, amount, and purpose of the
transfer. This record shall be available to the Agency on Aging
upon request and shall be maintained in the same manner as all
other financial records.
F. Matchina Contributions
1. "Matching Contributions" is defined in Article I, Section H.
a. Cash and/or in-kind contributions may count as match, if
such contributions are used to meet program
requirements.
b. Any matching contributions (cash or in-kind) must be
verifiable from the records of the Contractor or
subcontractor.
C. Matching contributions must be used for allowable costs in
accordance with the Office of Management and Budget
cost principles.
2. Minimum matching contributions for Older Americans Act funded
grants awarded by the Fresno-Madera Area Agency on Aging are
determined as follows:
a. Title III B Supportive Services (not including Ombudsman),
Title III C1 Congregate Nutrition, and Title III C2 Home-
Delivered Nutrition: Ten percent (10%) of the sum of the
grant award, plus the minimum matching contributions.
This is computed by dividing the grant amount by nine (9).
Area Plan Grant Award 29 FY 2017-2018
Terms and Conditions Declaration
b. Title III E Family Caregiver Support Program:
Approximately ninety percent (90%) of the sum of the grant
award.
3. Minimum matching requirements are calculated on net costs,
which are total costs less program income, non-matching
contributions, and State funds.
4. Matching contributions generated in excess of the minimum
required are considered overmatch.
ARTICLE VIII. PAYMENT
A. The Contractor shall prepare and submit a monthly expenditure report,
as indicated in Appendix E, Required Reports and Due Dates, by the
15th of each month to the Agency on Aging, unless otherwise specified
by the Agency on Aging.
B. The Agency on Aging shall review the Contractor's report to ensure
compliance with the approved Agreement budget.
C. Depending upon funding availability, the Agency on Aging shall make
monthly reimbursement payments to the Contract as specified in
Appendix E, Required Reports and Due Dates, of this Agreement. The
Agency on Aging shall pay the Contractor a total not to exceed the
amount shown on page one (1) of this Agreement.
D. The Agency on Aging may withhold payment if the Agency on Aging
determines that the Agreement with the Contractor is at-risk, as
described in Appendix F, Sanction Policy.
E. The Agency on Aging shall be relieved of any payments should the
Contractor fail to perform the requirements of this Agreement at the time
and in the manner herein provided. Payments made after a decision to
withhold funds or terminate the Agreement will be governed by
Article XVII, Termination.
F. The Agency on Aging may require financial reports more frequently than
indicated in Section A of this Article or more detail (or both), upon written
notice to the Contractor, until such time as the Agency on Aging
determines that the financial management standards are met.
G. Closeout
1 The Financial Closeout Report for this Agreement shall be
submitted to the Agency on Aging by July 15, 2018. If Agreement
is terminated or cancelled prior to June 30, 2018, the Financial
Area Plan Grant Award 30 FY 2017-2018
Terms and Conditions Declaration
Closeout Report shall be submitted to the Agency on Aging within
fifteen (15) days of termination or cancellation of the Agreement.
2. Federal funds will be reduced proportionately to maintain the
required matching ratios if a Contractor fails to report sufficient
match.
ARTICLE IX. SUBCONTRACTS
A. The Contractor must obtain approval from the Agency on Aging prior to
awarding any subcontracts for services contracted in this Agreement.
B. The Contractor shall not obligate funds for this Agreement in any
subcontracts for service beyond the ending date of this Agreement.
C. The Contractor shall have no authority to contract for, or on behalf of, or
incur obligations on behalf of the State of California or the Agency on
Aging.
D. The Contractor shall maintain on file copies of subcontracts,
memorandums, and/or Letters of Understanding which shall be made
available for review at the request of the Agency on Aging.
E. The Contractor shall monitor the insurance requirements of its
subcontractors in accordance with Article XV, Insurance, of this
Agreement.
F. The Contractor shall require language in all subcontracts to require all
subcontractors to indemnify, defend, and save harmless the Agency on
Aging, its officers, agents, and employees from any and all claims and
losses accruing to or resulting from any contractors, subcontractors,
suppliers, laborers, and any other person, firm, or corporation furnishing
or supplying work services, materials, or supplies in connection with any
activities performed for which funds from this Agreement were used and
from any and all claims and losses accruing or resulting to any person,
firm, or corporation who may be injured or damaged by the
subcontractor(s) in the performance of this Agreement.
G. The Contractor shall ensure that the subcontractor will complete all
reporting and expenditure documents requested by the Agency on
Aging. These reporting and expenditure documents shall be sent to the
Contractor in a timely manner and at intervals as determined by the
Agency on Aging.
H. The Contractor shall require all subcontractors to maintain adequate
staff to meet the subcontractor's agreement with the Contractor. This
staff shall be available to the California Department of Aging and the
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Terms and Conditions Declaration
Agency on Aging for training and meetings, which the California
Department of Aging or the Agency on Aging may find necessary from
time to time.
I. If a private non-profit corporation, the subcontractor shall be in good
standing with the Secretary of State of California and shall maintain that
status throughout the term of the Agreement.
ARTICLE X. RECORDS AND REPORTS
A. Records
1. The Contractor shall maintain complete records which shall
include, but not be limited to, accounting records, contracts,
agreements, a reconciliation of the Financial Closeout Report to
the audited financial statements, and a summary worksheet
identifying the results of performing audit resolution of its
subcontractors in accordance with Article XIV, Audit
Requirements, of this Agreement. This includes the following:
Letters of agreement, insurance documentation, Memorandums
and/or Letters of Understanding, patient or client records, and
electronic files of its activities and expenditures hereunder in a
form satisfactory to the Agency on Aging. All records pertaining
this Agreement must be made available for inspection and audit
by the Agency on Aging or its duly authorized agents, at any time
during normal business hours.
2. All such records, including confidential records, must be
maintained and made available by the Contractor as follows:
a. Until an audit has occurred and an audit resolution has
been issued or unless otherwise authorized in writing by
the Agency on Aging or the California Department of
Aging's Audit Branch;
b. For such longer period, if any, as is required by applicable
statute, by any other clause of this Agreement, or by
Sections 3 and 4 of this Article; and
C. For such longer period as the Agency on Aging or the
State deems necessary.
3. If this Agreement is completely or partially terminated, the records
relating to the work terminated shall be preserved and made
available for the same periods as in Sections A.2.a through A.2.c
of this Article. The Contractor shall ensure that any resource
directories and all client records remain the property of the
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Terms and Conditions Declaration
Agency on Aging upon termination of this Agreement, and are
returned to the Agency on Aging or transferred to another
Contractor as instructed by the Agency on Aging.
4. In the event of any litigation, claim, negotiation, audit exception,
or other action involving the records, such records shall be
maintained and kept available until every action has been cleared
to the satisfaction of the Agency on Aging and the State and so
stated in writing to the Contractor.
5. Adequate source documentation of each transaction shall be
maintained relative to the allowability of expenditures reimbursed
by the Agency on Aging under this Agreement. If the allowability
of expenditures cannot be determined because records or
documentation of the Contractor are nonexistent or inadequate
according to guidelines set forth in 2 CFR §200.302 and 45 CFR
§75.302, the expenditures will be questioned in the audit and may
be disallowed by the Agency on Aging or the State during the
audit resolution process.
6. After the authorized period has expired, confidential records shall
be destroyed by shredding and disposed of in a manner that will
maintain confidentiality.
B. Reports
1. The Contractor shall prepare and submit fiscal and performance
reports as designated in Appendix E, Required Reports and Due
Dates. Reports shall be submitted on forms in a format approved
by the Agency on Aging.
2, The Contractor shall assure that all fiscal and program data
submitted to the Agency on Aging are timely, complete, accurate,
and verifiable.
3. If supporting documentation is required as stated in Article XIV,
Audit Requirements, all such documentation must accompany the
monthly expenditure report.
4. All Program Income received by the Contractor shall be included
on the monthly expenditure report, and expenditures supported
by Program Income shall be stated in the appropriate column.
Program Income shall be tracked on a "first in-first out" method.
Unspent Program Income shall not exceed the equivalent of thirty
(30) days average Program Income.
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Terms and Conditions Declaration
5. The Contractor shall cross-train staff on program data collection
and reporting requirements in the event of planned or unplanned
prolonged absences to ensure timely and accurate submission of
data.
ARTICLE XI. PROPERTY
A. Unless otherwise provided for in this Article, property refers to all assets
used in operation of this Agreement. Property includes land, buildings,
improvements, machinery, vehicles, furniture, tools, intangibles, etc.
Property does not include consumable office supplies such as paper,
pencils, toner cartridges, file folders, etc.
B. Property meeting all of the following criteria is subject to the reporting
requirements:
1. Has a normal useful life of at least one (1) year.
2. Has a unit acquisition cost of at least $500 including any
appropriate sales tax, shipping, and installation costs, etc. (a
desktop or laptop setup, including all peripherals is considered a
unit, if purchased as a unit).
3. Is used to conduct business under this Agreement.
C. Intangibles are property which lack physical substance but give valuable
rights to the owner. Examples of intangible property include patents,
copyrights, leases, and computer software. By contrast, hardware
consists of tangible equipment (e.g., computer printer, terminal, etc.).
Costs include all amounts incurred to acquire and to ready the intangible
asset for its intended use. Typical intangible property costs include the
purchase price, legal fees, and other costs incurred to obtain title to the
asset.
D. The Contractor shall report property acquired with funds provided under
this Agreement to the Agency on Aging:
1. Title III B, Title III C, and Title VII (b): On the Monthly Report of
Expenditures and Donations Revenue for the month in which the
property was acquired.
2. Title III E: On the Title III E Monthly Report of Expenditures (for
the Family Caregiver Support Program) for the month in which
the property was acquired.
3. Long-Term Care Ombudsman Program: On the Budget
Summary/Monthly Expenditure Report and Request for Funds,
Area Plan Grant Award 34 FY 2017-2018
Terms and Conditions Declaration
Special Deposit Fund (SDF) & Skilled Nursing Facility Quality &
Accountability Fund (SNFQAF) (CDA-OMB-300) for the month in
which the property was acquired.
E. The Contractor shall attach receipts for the property and a list of the
following information for each item of property acquired: Date acquired;
complete description; model number; serial number (if applicable); cost
or other basis of valuation; and specific location of the property.
F. The Contractor shall maintain a cumulative inventory, including all
information required by Section E of this Article, of all property furnished
or purchased by the Contractor with funds awarded under the terms of
this Agreement or any predecessor agreement for the same purpose.
G. The Contractor shall affix the Asset Tag provided by the Agency on
Aging to tangible property upon receipt of the asset tag from the agency,
which identifies the property as State of California property. The
Contractor shall enter the asset tag number on the cumulative inventory
records maintained by the Contractor for this Agreement.
H. The Contractor shall conduct an annual physical inventory of all property
furnished or purchased by the Contractor with funds awarded under the
terms of this Agreement or any predecessor agreement for the same
purpose, and corresponding reconciliation must be kept on file and
available for review by the Agency on Aging.
I. Prior to disposal of any property purchased by the Contractor with funds
from this Agreement or any predecessor Agreement, the Contractor
must obtain approval from the Agency on Aging. Disposition, which
includes sale, trade-in, discarding, or transfer to another agency may not
occur until approval is received from the Agency on Aging. The
Contractor shall submit a Request to Dispose of Property(CDA 248) to
the Agency on Aging, and the Agency on Aging will then instruct the
Contractor on disposition of the property. Once approval of the disposal
has been received from the Agency on Aging, the item(s) shall be
removed from the Contractor's inventory report.
J. The Contractor must remove all confidential, sensitive, or personal
information from Agency on Aging property prior to disposal, including
removal or destruction of data on computing devices with digital memory
and storage capacity, and certify this action on the Request to Dispose
of Property(CDA 248). This includes, but is not limited to, magnetic
tapes, flash drives, personal computers, personal digital assistants, cell
or smart phones, multi-function printers, and laptops.
Area Plan Grant Award 35 FY 2017-2018
Terms and Conditions Declaration
K. Any loss, damage, or theft of equipment shall be investigated and fully
documented, and the Contractor shall promptly notify the Agency on
Aging. In addition, the Contractor shall complete a Request to Dispose
of Property(CDA 248) and provide it to the Agency on Aging.
L. The State reserves title to all property purchased or financed with funds
provided through the Agency on Aging that is not fully consumed in the
performance of this Agreement, unless otherwise required by federal law
or regulations.
M. The Contractor shall exercise due care in the use, maintenance,
protection, and preservation of such property during the period of the
project, and shall assume responsibility for replacement or repair of such
personal property during the period of the project and until the
Contractor has complied with all written instructions from the Agency on
Aging regarding the final disposition of the property.
N. In the event of the Contractor's dissolution, or upon termination of this
Agreement, the Contractor shall provide a final property inventory to the
Agency on Aging. The Agency on,Aging reserves the right to require the
Contractor to transfer such property to another entity, or to the Agency
on Aging.
O. The Contractor shall use the property for the purpose for which it was
intended under this Agreement.
P. The Contractor shall not use equipment or supplies acquired under this
Agreement with federal and/or State monies for personal gain or to
usurp the competitive advantage of a privately-owned business entity.
Q. If purchase of equipment is a reimbursable item, the equipment to be
purchased will be specified in the Schedule of Program/Site Supplies
and Equipment Purchases (page 4 of Exhibit B, Budget).
R. The Contractor shall include the provisions contained in this Article in all
its subcontracts awarded under this Agreement.
ARTICLE XII. ACCESS
A. The Contractor shall provide access to the Agency on Aging, federal or
State contracting agency, Bureau of State Audits, the Comptroller
General of the United States, or any of their duly authorized federal or
State representatives to any books, documents, papers, and records of
the Contractor or subcontractor which are directly pertinent to this
specific Agreement for the purpose of an audit, examination, excerpts,
and transcriptions. The Contractor shall include this requirement in its
subcontracts.
Area Plan Grant Award 36 FY 2017-2018
Terms and Conditions Declaration
ARTICLE XIII. MONITORING AND EVALUATION
A. Authorized Agency on Aging, State, and federal representatives shall
have the right to monitor and evaluate the Contractor's administrative,
fiscal, and program performance pursuant to this Agreement. Said
monitoring and evaluation may include, but is not limited to,
administrative processes, fiscal, data, and procurement components.
This will include policies, procedures, procurement, audits, inspections
of project premises, interviews of project staff and participants, and,
when applicable, inspection of food preparation sites.
B. The Contractor shall cooperate with the Agency on Aging and the State
in the monitoring and evaluation processes, which include making any
administrative, fiscal, and program staff available during any scheduled
process.
ARTICLE XIV. AUDIT REQUIREMENTS
A. Contractors that expend $750,000 or more in federal funds shall arrange
for an audit to be performed as required by the Single Audit Act of 1984,
Public Law 98-502; the Single Audit Act Amendments of 1996, Public
Law 104-156; 2 CFR §200.501 to 200.521; and 45 CFR §75.501 to
75.521.
A copy shall be submitted to the:
Fresno Madera Area Agency on Aging
3837 North Clark Street
Fresno, California 93726
The copy shall be submitted within the earlier of thirty (30) days after
receipt of the auditor's report or nine (9) months after the end of the
audit period, whichever occurs first, or unless a longer period is agreed
to in advance by the cognizant or oversight agency.
The Contractor shall ensure that State-funded expenditures are
displayed discretely along with the related federal expenditures in the
single audit report's "Schedule of Expenditures of Federal Awards"
under the appropriate Catalog of Federal Domestic Assistance (CFDA)
number as referenced in Section B of this Article.
For State contracts that do not have CFDA numbers, the Contractor
shall ensure that the State-funded expenditures are discretely identified
in the "Schedule of Expenditures of Federal Awards" by the appropriate
program name, identifying Agency on Aging grant/contract number, and
as passed-through the California Department of Aging.
Area Plan Grant Award 37 FY 2017-2018
Terms and Conditions Declaration
B. This Section B applies only to Title III and Title VII.
The following closely related programs identified by CFDA number are
to be considered as an "other cluster" for purposes of determining major
programs or whether a program-specific audit may be elected. The
Contractor shall identify the CFDA titles and numbers to the independent
auditor conducting the organization's single audit along with each of its
subcontractors. The funding source (Federal Grantor) for the following
programs is the U.S. Department of Health and Human Services,
Administration for Community Living.
93.041 Special Programs for the Aging —Title VII, Chapter 3 —
Programs for Prevention of Elder Abuse, Neglect, and
Exploitation (Title VII, Chapter 3)
93.042 Special Programs for the Aging —Title III-BNII-A, Chapter 2 —
Long Term Care Ombudsman Services for Older Individuals
(Title III-BNII-A, Chapter 2)
93.043 Special Programs for the Aging —Title III, Part D — Disease
Prevention and Health Promotion Services (Title III D)
93.044 Special Programs for the Aging —Title III, Part B — Grants for
Supportive Services and Senior Centers (Title III B)
93.045 Special Programs for the Aging — Title III, Part C — Nutrition
Services (Title III C)
93.052 National Family Caregiver Support Program — Title III, Part E
(Title III E)
93.053 Nutrition Services Incentive Program (NSIP)
"Cluster of programs" means a grouping of closely related programs that
share common compliance requirements. The types of clusters of
programs are research and development, student financial aid, and
other clusters. "Other clusters" are defined by the consolidated CFR in
the Compliance Supplement or as designated by a State for federal
awards provided to its subcontractors that meet the definition of"cluster
of programs." When designating an "other cluster," a State shall identify
the federal awards included in the cluster and advise the subcontractors
of compliance requirements applicable to the cluster. A "cluster of
programs" shall be considered as one program for determining major
programs, as described in 45 CFR §75 [formerly OMB Circular A-133],
whether a program-specific audit may be elected. (Federal Office of
Management and Budget, [45 CFR §75, Subpart F, Audit Requirements]
Area Plan Grant Award 38 FY 2017-2018
Terms and Conditions Declaration
i
[formerly OMB Circular A-133], Audits of States, Local Governments,
and Non-Profit Organizations)
a
C. The Contractor shall perform a reconciliation of the Financial Closeout
Report to the audited financial statements, single audit, and general
ledgers. The reconciliation shall be maintained and made available for
review by the Agency on Aging.
D. The Contractor shall, at a minimum, perform Contract resolution within
fifteen (15) months of the Financial Closeout Report.
E. The Contractor shall have the responsibility for resolving its contracts
with subcontractors to determine whether funds approved under this
Agreement are expended in accordance with applicable laws,
regulations, and provisions of contracts or agreements. Contract
resolution includes:
1. Ensuring that subcontractors expending $750,000 or more in
federal awards during the subcontractor's fiscal year have met
the audit requirements of 2 CFR §200.501-200.521 and 45 CFR
§75.501-75.521 as summarized in Section F of this Article;
2. Issuing a management decision on audit findings within six (6)
months after receipt of the subcontractor's single audit report and
ensuring that the subcontractor takes appropriate and timely
corrective action;
3. Reconciling expenditures reported to the Agency on Aging to the
amounts identified in the single audit or other type of audit, if the
Contractor was not subject to the single audit requirements. For a
Contractor who was not required to obtain a single audit and did
not obtain another type of audit, the reconciliation of expenditures
reported to the Agency on Aging must be accomplished through
performing alternative procedures (e.g., risk assessment [2 CFR
§200.331] [45 CFR §75.352]; documented review of financial
statements; and documented expense verification, including
match; etc.).
4. When alternative procedures are used, the Contractor shall
perform financial management system testing which provides, in
part, for the following:
a. Accurate, current, and complete disclosure of the financial
results of each federal award or program.
b. Records that identify adequately the source and
application of funds for each federally funded activity.
Area Plan Grant Award 39 FY 2017-2018
Terms and Conditions Declaration
C. Effective control over, and accountability for, all funds,
property, and other assets to ensure these items are used
solely for authorized purposes.
d. Comparison of expenditures with budget amounts for each
federal award.
e. Written procedures to implement the requirements of
2 CFR §200.305 and 45 CFR §75.100 et. seq.
f. Written procedures for determining the allowability of costs
in accordance with 2 CFR §200, Subpart E—Cost
Principles and 45 CFR §75, Subpart E-Cost Principles.
[2 CFR §200.302] [45 CFR §75.302]
5. The Contractor shall document system and expense testing to
show an acceptable level of reliability, including a review of actual
source documents.
6. Determining whether the results of the reconciliations performed
necessitate adjustment of the Contractor's own records.
F. The Contractor shall ensure that its single audit report meets 2 CFR
§200, Subpart F—Audit Requirements and 45 CFR §75, Subpart F-Audit
Requirements:
1. Performed timely: Not less frequently than annually and a report
submitted timely. The audit is required to be submitted within
thirty (30) days after receipt of the auditor's report or nine (9)
months after the end of the audit period, whichever occurs first.
[2 CFR §200.512] [45 CFR §75.515]
2. Properly procured: Use procurement standards for auditor
selection. [2 CFR §200.509] [45 CFR §75.509]
3. Performed in accordance with Generally Accepted Government
Auditing Standards. [2 CFR §200.514] [45 CFR §75.514]
4. All inclusive: Includes an opinion (or disclaimer of opinion) of the
financial statements; a report on internal control related to the
financial statements and major programs; an opinion (or
disclaimer of opinion) on compliance with laws, regulations, and
the provisions of contracts; and the schedule of findings and
questioned costs. [2 CFR §200.515] [45 CFR §75.515]
Area Plan Grant Award 40 FY 2017-2018
Terms and Conditions Declaration
5. Performed in accordance with provisions applicable to this
program as identified in 2 CFR §200, Subpart F—Audit
Requirements and 45 CFR §75, Subpart F-Audit Requirements.
G. The Contractor shall be required to include in its contract with the
independent auditor that the auditor will comply with all applicable audit
requirements/standards, the Agency on Aging shall have access to all
audit reports and supporting work papers, and the Agency on Aging has
the option to perform additional work, as needed.
H. A reasonably proportionate share of the costs required by, and
performed in accordance with, the Single Audit Act Amendments of
1996, as implemented by requirements of this part, are allowable.
However, the following audit costs are unallowable:
1. Any costs when audits required by the Single Audit Act, 2 CFR
§200, Subpart F—Audit Requirements and 45 CFR §75, Subpart F
—Audit Requirements have not been conducted or have been
conducted but not in accordance therewith; and
2. Any costs of auditing a non-federal entity that is exempted from
having an audit conducted under the Single Audit Act, 2 CFR 200,
Subpart F—Audit Requirements and 45 CFR §75, Subpart F —
Audit Requirements because its expenditures under federal awards
are less than $750,000 during the non-federal entity's fiscal year.
a. The costs of a financial statement audit of a non-federal
entity that does not currently have a federal award may be
included in the indirect cost pool for a cost allocation plan
or indirect cost proposal.
b. Pass-through entities may charge federal awards for the
cost of agreed-upon-procedures engagements to monitor
subcontractors who are exempted from the requirements
of the Single Audit Act, 2 CFR 200, Subpart F —Audit
Requirements and 45 CFR §75, Subpart F —Audit
Requirements. This cost is allowable only if the agreed-
upon-procedures engagements are conducted in
accordance with Generally Accepted Government Auditing
Standards attestation standards, paid for and arranged by
the pass-through entity, and limited in scope to one or
more of the following types of compliance requirements:
Activities allowed or not allowed; allowable costs/cost
principles; eligibility; and reporting.
[2 CFR 200.425] [45 CFR §75.425]
Area Plan Grant Award 41 FY 2017-2018
Terms and Conditions Declaration
I. The Contractor shall cooperate with and participate in any further audits
which may be required by the Agency on Aging.
J. The Contractor shall indicate which method of providing audit
compliance will be in force during this Agreement (Appendix D, Method
of Providing Audit Compliance).
ARTICLE XV. INSURANCE
A. Prior to commencement of any work under this Agreement, the
Contractor shall provide for the term of this Agreement, the following
insurance:
1. General Liability of not less than $1,000,000 per occurrence for
bodily injury and property damage combined (higher limits may be
required by the Agency on Aging in cases of higher than usual risks).
2. Automobile Liability, including non-owned auto liability, of
not less than $1,000,000 for volunteers and paid employees
providing services supported by this Agreement.
If applicable, the Contractor and subcontractors shall comply with
the Public Utilities Commission General Order No. 115-F which
requires higher levels of insurance for charter party carriers of
passengers and is based on seating capacity as follows unless
otherwise amended by future regulation:
■ $ 750,000 if seating capacity is under 8.
■ $1,500,000 if seating capacity is 8-15.
■ $5,000,000 if seating capacity is over 15.
3. Professional Liability of not less than $1,000,000 as it
appropriately relates to services rendered. Coverage shall include
errors and omissions.
B. The insurance will be obtained from an insurance company acceptable
to the State Department of General Services, Office of Risk and
Insurance Management, or be provided through partial or total self-
insurance acceptable to the Department of General Services.
C. Evidence of insurance shall be in a form and content acceptable to the
State Department of General Services, Office of Risk and Insurance
Management.
D The Contractor shall notify the Agency on Aging within five (5) business
days of any cancellation, non-renewal, or material change that affects
required insurance coverage.
Area Plan Grant Award 42 FY 2017-2018
Terms and Conditions Declaration
E. Insurance obtained through commercial carriers shall meet the following
requirements:
1. The Certificate of Insurance shall include the Contract Number
listed on page 1 of this Agreement and provide the statement:
"The Fresno-Madera Area Agency on Aging, its officers,
agents, employees, and servants are included as
additional insureds, with respect to work performed for the
Fresno-Madera Area Agency on Aging under this
Agreement."
Professional Liability coverage is exempt from this requirement.
2. The Fresno-Madera Area Agency on Aging shall be named as the
certificate holder and its address (3837 N. Clark St., Fresno, CA
93726) must be listed on the certificate.
F. The insurance provided herein shall be in effect at all times during the
term of this Agreement. In the event the insurance coverage expires
during the term of this Agreement, the Contractor agrees to provide the
Agency on Aging, at least thirty (30) days prior to the expiration date, a
new Certificate of Insurance evidencing insurance coverage as provided
herein for a period not less than the remaining Agreement term or for a
period not less than one (1) year. In the event the Contractor fails to
keep in effect at all times said insurance coverage, the Agency on Aging
may, in addition to any other remedies it may have, terminate this
Agreement.
G. A copy of each appropriate Certificate of Insurance, or letter of self-
insurance, referencing this Agreement number shall be submitted to the
Agency on Aging with this Agreement.
H. The Contractor shall be insured against liability for Worker's
Compensation or undertake self-insurance in accordance with the
provisions of the Labor Code and Contractor affirms to comply with such
provisions before commencing the performance of the work of this
Agreement. [Labor Code §3700]
I. The entity providing Ombudsman services must be insured or self-
insured for professional liability covering all Ombudsman activities
including, but not limited to, investigation of patient complaints.
J. Contractor agrees to indemnify, defend, and save harmless the Fresno-
Madera Area Agency on Aging, State of California, their officers, agents,
and employees from any and all claims and losses occurring or resulting
Area Plan Grant Award 43 FY 2017-2018
Terms and Conditions Declaration
to any and all Contractors, subcontractors, material, laborers, and any
other person, firm or corporation furnishing or supplying work, services,
materials or supplies in connection with the performance of this
Agreement, and also from any and all claims and losses occurring or
resulting in any person, firm or corporation, who may be injured or
damaged by Contractor in the performance of this Agreement.
ARTICLE XVI. DONATIONS
A. The Contractor assures that voluntary contributions shall be allowed and
may be solicited in accordance with the following requirements
[OAA §315(b)]:
1. The Contractor or any subcontractors for any Title III or Title VII
services shall not use means tests.
2. Any Title III or Title VII client who does not contribute toward the
cost of the services received shall not be denied services.
3. Methods used to solicit voluntary contributions for Title III and
Title VI services shall be non-coercive. Donation letters sent to
clients shall stipulate that contributions are voluntary and not
required to receive service. Donation letters may not resemble a
bill or statement.
4. Each Service Provider will:
a. Provide each recipient with an opportunity to voluntarily
contribute to the cost of the service;
b. Clearly inform each recipient that there is no obligation to
contribute and that the contribution is purely voluntary;
C. Protect the privacy and confidentiality of each recipient
with respect to the recipient's contribution or lack of
contribution; and
d. Establish appropriate procedures to safeguard and
account for all contributions.
e. Use all collected contributions to expand the services for
which the contributions were given and to supplement (not
supplant) funds received under this Agreement.
Area Plan Grant Award 44 FY 2017-2018
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ARTICLE XVII. TERMINATION
A. Termination Without Cause
1. The Agency on Aging may terminate performance of work under
this Agreement without cause in whole or in part, if the Agency on
Aging determines that a termination is in the Agency on Aging's
best interest. The Agency on Aging may terminate the Agreement
upon ninety (90) days written notice to the Contractor. The Notice
of Termination shall specify the extent of the termination and shall
be effective ninety (90) days from the delivery of the Notice. The
parties agree that if the termination of the contract is due to a
reduction or deletion of funding by the State of California, the
Legislature, or Congress, the Notice of Termination shall be
effective thirty (30) days from the delivery of the Notice. The
parties agree that for the terminated portion of the Agreement, the
remainder of Agreement shall be deemed to remain in effect and
is not void.
2. The Contractor may terminate this Agreement at any time during
the Agreement term by giving the Agency on Aging ninety (90)
days written notice. In the event of termination notice, the Agency
on Aging will present written notice to the Contractor of any
condition, such as, but not limited to, transfer of clients, care of
clients, return of unspent funds, and disposition of property, which
must be met prior to termination of the Agreement.
3. Contractor shall, at least ninety (90) days prior to the end of the
term of this Agreement, give written notice to the Agency on
Aging if it intends to discontinue provision of any programs or
services included in this Agreement during the subsequent
Agreement period. The purpose of this requirement is to provide
sufficient planning and transition time during the course of this
Agreement period to ensure continuity of services to clients.
B. Termination for Cause
1. The Agency on Aging may terminate, in whole or in part, for
cause the performance of work under this Agreement. The
grounds for termination for cause shall include, but are not limited
to, the following:
a. In case of threat of life, health, or safety to the public.
b. A violation of the law or failure to comply with any condition
of this Agreement.
Area Plan Grant Award 45 FY 2017-2018
Terms and Conditions Declaration
C. Inadequate performance or failure to make progress so as
to endanger performance of this Agreement.
d. Failure to comply with reporting requirements.
e. Evidence that the Contractor is in an unsatisfactory
financial condition as determined by an audit of the Agency
on Aging or evidence of a financial condition that
endangers performance of this Agreement and/or the loss
of other funding sources.
f. Delinquency in payment of taxes or payment of costs for
performance of this Agreement in the ordinary course of
business.
g. Appointment of a trustee, receiver, or liquidator for all or a
substantial part of the Contractor's property, or institution
of bankruptcy, reorganization or the arrangement of
liquidation proceedings by or against the Contractor.
h. Service of any writ of attachment, levy of execution, or
commencement of garnishment proceedings against the
Contractor's assets or income.
i. The commission of an act of bankruptcy.
j. Finding of debarment or suspension.
k. The Contractor's organizational structure has materially
changed.
L The Agency on Aging determines that the Contractor may
be considered a "high risk" agency as described in
45 CFR §92.12 for local government and 45 CFR §74.14
for non-profit organizations. If such a determination is
made, the Contractor may be subject to special conditions
or restrictions, as described in Appendix F, Sanction
Policy.
m. Program operations have been suspended for more than
three (3) consecutive months in any budget year, unless a
longer period is granted in writing by the Agency on Aging.
2. Termination of this Agreement shall take effect immediately in the
case of an emergency, such as threat to life, health, or safety of the
public, or when program operations have been suspended for more
than three (3) consecutive months in any budget year. In all other
Area Plan Grant Award 46 FY 2017-2018
Terms and Conditions Declaration
cases of termination for cause, the termination shall take effect thirty
(30) days subsequent to written notice to the Contractor.
3. In the event of termination for cause, the Agency on Aging may
proceed with the work in any manner deemed proper by the
State. All costs to the Agency on Aging shall be deducted from
any sum due the Contractor under this agreement and the
balance, if any, shall be paid to the Contractor upon demand.
C. In the event of termination of this Agreement by the Agency on Aging,
the Agency will present written notice to the Contractor describing the
action being taken by the Agency on Aging, the reason for such action,
and any conditions of the termination, including, but not limited to, the
date of termination, transfer of clients, care of clients, return of unspent
funds, and disposition of property, which must be met prior to
termination. Said notice shall also inform the Contractor of its right to
appeal such decision to the Agency on Aging and of the procedure for
doing so. (Appendix G, Appeal Procedure for Service Providers)
D. Contractor's Obligation After Notice of Termination
1. After receipt of a notice of termination, and except as directed by
the Agency on Aging, the Contractor shall immediately proceed
with the following obligations, as applicable, regardless of any
delay in determining or adjusting any funds due under this clause.
The Contractor shall:
a. Stop work as specified in the Notice of Termination;
b. Place no further subcontracts for materials, or services,
except as necessary to complete the continued portion of
the contract;
C. Terminate all subcontracts to the extent they relate to the
work terminated;
d. Settle all outstanding liabilities and termination settlement
proposals arising from the termination of subcontracts (the
approval or ratification of which will be final for purposes of
this clause); and
e. Comply with all additional terms of this Agreement
pertaining to termination or cancellation of the Agreement.
Area Plan Grant Award 47 FY 2017-2018
Terms and Conditions Declaration
ARTICLE XVIII. REMEDIES AND APPEAL PROCESS
A. The Contractor agrees that any remedy provided in this Agreement is in
addition to and not in derogation of any other legal or equitable remedy
available to the Agency on Aging as a result of a breach of this
Agreement by the Contractor, whether such breach occurs before or
after completion of the project. Specifically, the Agency on Aging
reserves the right to pursue all remedies allowed to it under the Older
Americans Act, and all regulations adopted pursuant to the Act or
implementing the Act, regarding the expenditure of federal funds.
B. The Contractor may appeal an adverse determination by the Agency on
Aging using the Appeal Procedure for Service Providers, which is set forth
in Appendix G, for actions subject to appeal, as defined in Appendix G,
Section I.A, Actions Subject to Appeal.
C. The Contractor may appeal the Agency on Aging's final adverse
determination once all administrative remedies contained in Appendix G,
Appeal Procedure for Service Providers, have been exhausted, using the
appeal process established in Title 22 CCR §7700 to 7710.
D. The Contractor shall continue with the responsibilities under this
Agreement during any dispute.
E. Appeal costs or costs associated with any court review are not
reimbursable.
ARTICLE XIX. AMENDMENTS, REVISIONS OR MODIFICATIONS
A. No amendment or variation of the terms of this Agreement shall be valid
unless made in writing, approved as required by the Agency on Aging
amendment process, and signed by a duly authorized representative of
the Contractor and of the Agency on Aging. No oral understanding or
agreement not incorporated in this Agreement is binding on any of the
parties.
B. Should either party during the term of this Agreement desire a revision,
waiver or modification in this Agreement, such revision, waiver or
modification shall be proposed in writing to the other party. The other
party shall accept or reject the proposal within thirty (30) days of receipt
of request. Once accepted, such revision may require an amendment
through the Agency on Aging's contract process to provide for the
change mutually agreed to by the parties.
C. The Agency on Aging reserves the right to revise, waive, or modify the
Agreement to reflect any restrictions, limitations, or conditions enacted
Area Plan Grant Award 48 FY 2017-2018
Terms and Conditions Declaration
by Congress or the Legislature or as directed by the Executive Branch of
State Government.
D. An amendment is required to change the Contractor's name as listed on
this Agreement. Any notice given to the Agency on Aging for a
Contractor's change of legal name, main address, or name of Director
shall be addressed to the Fresno-Madera Agency on Aging's Executive
Director on the Contractor's letterhead. Upon receipt of legal
documentation of the name change, the Agency on Aging will process
the amendment. Invoices presented by the Contractor with the
Contractor's new name cannot be paid prior to the Agency on Aging's
approval of said amendment.
ARTICLE XX. NOTICING
A. Any notice to be given hereunder by either party to the other may be
effected by one of the following methods, provided Contractor retains
receipt, and shall be communicated as of actual receipt: 1) Personal
delivery in writing; 2) Registered or certified mail, postage prepaid and
return receipt requested; or 3) Overnight mail.
B. Notices to the Agency on Aging shall be addressed to the Fresno-
Madera Area Agency on Aging at its current address, 3837 North Clark
Street, Fresno, CA 93726, and notices to the Contractor shall be
addressed to the Contractor's address as indicated on page 1 of this
Agreement, unless otherwise requested in writing.
C. Each party may change its address originally provided in this Agreement
by written notice to the other party in accordance with this Article.
Area Plan Grant Award 49 FY 2017-2018
Terms and Conditions Declaration
i
E
APPENDIX A
RESOLUTION OF AUTHORIZATION TO CONTRACT
The governing board of the CITY OF FRESNO
(Service Provider)
hereby authorizes KRISTINA CHAMBERLIN, ASSISTANT DIRECTOR, PARCS
(Name and Title)
to execute the contract(s) listed on Page 1 of this Agreement with the Fresno-
Madera Area Agency on Aging for the fiscal year beginning July 1, 2017, to
June 30, 2018, including any subsequent amendments and all necessary
supporting documents.
IV
lh
Name of Chair (Please Print)
Governing Board
NJ Sign a of Chair Date
Gov ing Board
Resolution of Appendix A FY 2017-2018
Authorization to Contract
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APPENDIX B
CONTRACTOR CERTIFICATION CLAUSES
CERTIFICATION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective Contractor to the clause(s) listed below. This
certification is made under the laws of the State of California.
CITY OF FRESNO 94-6000338
Contractor/Vendor Name (Typed) Federal ID
Authorized Signature Date
KRISTINA CHAMBERLIN, ASSISTANT DIRECTOR, PARCS
Name and Title of Person Signing (Typed)
CONTRACTOR CERTIFICATION CLAUSES
1, STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with
the nondiscrimination program requirements. (Gov. Code §12990 (a-f) and CCR,
Title 2, Section 8103) (Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following actions:
a. Publish r a statement notifying employees that unlawful manufacture,
distribution, dispensation, possession or use of a controlled substance is
prohibited and specifying actions to be taken against employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
1) the dangers of drug abuse in the workplace;
2) the person's or organization's policy of maintaining a drug-free workplace;
3) any available counseling, rehabilitation and employee assistance programs;
and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of
employment on the Agreement.
Contractor Certification Appendix B— Page 1 FY 2017-2018
Clauses
APPENDIX B
CONTRACTOR CERTIFICATION CLAUSES
Failure to comply with these requirements may result in suspension of payments
under the Agreement or termination of the Agreement or both and Contractor may
be ineligible for award of any future State or Fresno-Madera Area Agency on Aging
(Agency on Aging) agreements if the State or the Fresno-Madera Area Agency on
Aging determines that any of the following has occurred: the Contractor has made
false certification, or violated the certification by failing to carry out the
requirements as noted above. (Gov. Code §8350 et seq.)
3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies
that no more than one (1) final unappealable finding of contempt of court by a
Federal court has been issued against Contractor within the immediately preceding
two-year period because of Contractor's failure to comply with an order of a
Federal court, which orders Contractor to comply with an order of the National
Labor Relations Board. (Pub. Contract Code §10296) (Not applicable to public
entities.)
4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO
REQUIREMENT: Contractor hereby certifies that Contractor will comply with the
requirements of Section 6072 of the Business and Professions Code, effective
January 1, 2003.
Contractor agrees to make a good faith effort to provide a minimum number of
hours of pro bono legal services during each year of the contract equal to the lessor
of 30 multiplied by the number of full time attorneys in the firm's offices in the State,
with the number of hours prorated on an actual day basis for any contract period
of less than a full year or 10% of its contract with the Agency on Aging.
Failure to make a good faith effort may be cause for non-renewal of an Agency on
Aging contract for legal services, and may be taken into account when determining
the award of future contracts with the Agency on Aging for legal services.
5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an
expatriate corporation or subsidiary of an expatriate corporation within the meaning
of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with
the Agency on Aging.
6. SWEATFREE CODE OF CONDUCT:
a. All Contractors contracting for the procurement or laundering of apparel,
garments or corresponding accessories, or the procurement of equipment,
materials, or supplies, other than procurement related to a public works
contract, declare under penalty of perjury that no apparel, garments or
corresponding accessories, equipment, materials, or supplies furnished to the
Agency on Aging pursuant to the contract have been laundered or produced in
Contractor Certification Appendix B — Page 2 FY 2017-2018
Clauses
APPENDIX B
CONTRACTOR CERTIFICATION CLAUSES
whole or in part by sweatshop labor, forced labor, convict labor, indentured
labor under penal sanction, abusive forms of child labor or exploitation of
children in sweatshop labor, or with the benefit of sweatshop labor, forced
labor, convict labor, indentured labor under penal sanction, abusive forms of
child labor or exploitation of children in sweatshop labor. The Contractor further
declares under penalty of perjury that they adhere to the Sweatfree Code of
Conduct as set forth on the California Department of Industrial Relations
website located at www.dir.ca.gov, and Public Contract Code Section 6108.
b. The Contractor agrees to cooperate fully in providing reasonable access to the
Contractor's records, documents, agents or employees, or premises if
reasonably required by authorized officials of the Agency on Aging, the
California Department of Aging, the Department of Industrial Relations, or the
Department of Justice to determine the Contractor's compliance with the
requirements under paragraph (a).
7. DOMESTIC PARTNERS: For contracts over$100,000 executed or amended after
January 1, 2007, the Contractor certifies that Contractor is in compliance with
Public Contract Code section 10295.3.
DOING BUSINESS WITH THE STATE OF CALIFORNIA
The following laws apply to persons or entities doing business with the State of California.
1. CONFLICT OF INTEREST: Contractor needs to be aware of the following
provisions regarding current or former state employees. If Contractor has any
questions on the status of any person rendering services or involved with the
Agreement, the awarding agency must be contacted immediately for clarification.
Current State Employees (Pub. Contract Code §10410):
1) No officer or employee shall engage in any employment, activity or enterprise
from which the officer or employee receives compensation or has a financial
interest and which is sponsored or funded by any state agency, unless the
employment, activity or enterprise is required as a condition of regular state
employment.
2) No officer or employee shall contract on his or her own behalf as an
independent contractor with any state agency to provide goods or services.
Former State Employees (Pub. Contract Code §10411):
1) For the two-year period from the date he or she left state employment, no
former state officer or employee may enter into a contract in which he or she
Contractor Certification Appendix B — Page 3 FY 2017-2018
Clauses
APPENDIX B
CONTRACTOR CERTIFICATION CLAUSES
engaged in any of the negotiations, transactions, planning, arrangements or
any part of the decision-making process relevant to the contract while
employed in any capacity by any state agency.
2) For the twelve-month period from the date he or she left state employment, no
former state officer or employee may enter into a contract with any state agency
if he or she was employed by that state agency in a policy-making position in
the same general subject area as the proposed contract within the 12-month
period prior to his or her leaving state service.
If Contractor violates any provisions of above paragraphs, such action by
Contractor shall render this Agreement void. (Pub. Contract Code §10420)
Members of boards and commissions are exempt from this section if they do not
receive payment other than payment of each meeting of the board or commission,
payment for preparatory time and payment for per diem. (Pub. Contract Code
§10430 (e))
2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of
the provisions which require every employer to be insured against liability for
Worker's Compensation or to undertake self-insurance in accordance with the
provisions, and Contractor affirms to comply with such provisions before
commencing the performance of the work of this Agreement. (Labor Code Section
3700)
3, AMERICANS WITH DISABILITIES ACT: Contractor assures the Agency on Aging
that it complies with the Americans with Disabilities Act (ADA) of 1990, which
prohibits discrimination on the basis of disability, as well as all applicable
regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.)
4. CALIFORNIA CIVIL RIGHTS LAWS: Pursuant to Public Contract Code section
2010, a person that submits a bid or proposal to, or otherwise proposes to enter
into or renew a contract with, a state agency with respect to any contract in the
amount of$100,000 or above shall certify, under penalty of perjury, at the time the
bid or proposal is submitted or the contract is renewed, the following: For contracts
executed or renewed after January 1, 2017, the contractor certifies compliance
with the Unruh Civil Rights Act (Section 51 of the Civil Code) and the Fair
Employment and Housing Act (Section 12960 of the Government Code).
5, EMPLOYER DISCRIMINATORY POLICIES: Pursuant to Public Contract Code
section 2010, a person that submits a bid or proposal to, or otherwise proposes to
enter into or renew a contract with, a state agency with respect to any contract in
the amount of$100,000 or above shall certify, under penalty of perjury, at the time
the bid or proposal is submitted or the contract is renewed, the following: For
Contractor Certification Appendix B — Page 4 FY 2017-2018
Clauses
APPENDIX B
CONTRACTOR CERTIFICATION CLAUSES
contracts executed or renewed after January 1, 2017, if a Contractor has an
internal policy against a sovereign nation or peoples recognized by the United
States government, the Contractor certifies that such policies are not used in
violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair
Employment and Housing Act (Section 12960 of the Government Code).
6. CONTRACTOR NAME CHANGE: An amendment is required to change the
Contractor's name as listed on this Agreement. Upon receipt of legal
documentation of the name change, the Agency on Aging will process the
amendment. Payment of invoices presented with a new name cannot be paid prior
to approval of said amendment.
7. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:
a. When agreements are to be performed in the state by corporations, the
contracting agencies will be verifying that the Contractor is currently qualified
to do business in California in order to ensure that all obligations due to the
state are fulfilled.
b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any
transaction for the purpose of financial or pecuniary gain or profit. Although
there are some statutory exceptions to taxation, rarely will a corporate
contractor performing within the state not be subject to the franchise tax.
c. Both domestic and foreign corporations (those incorporated outside of
California) must be in good standing in order to be qualified to do business in
California. Agencies will determine whether a corporation is in good standing
by calling the Office of the Secretary of State.
8, RESOLUTION: A county, city, district, or other local public body must provide the
Agency on Aging with a copy of a resolution, order, motion, or ordinance of the
local governing body which by law has authority to enter into an agreement,
authorizing execution of the agreement.
9. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor
shall not be: (1) in violation of any order or resolution not subject to review
promulgated by the State Air Resources Board or an air pollution control district;
(2) subject to cease and desist order not subject to review issued pursuant to
Section 13301 of the Water Code for violation of waste discharge requirements or
discharge prohibitions; or (3) finally determined to be in violation of provisions of
federal law relating to air or water pollution.
10. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all
contractors that are not a state agency or other governmental entity.
Contractor Certification Appendix B — Page 5 FY 2017-2018
Clauses
APPENDIX C
CONTRACTORIVENDOR CONFIDENTIALITY STATEMENT
CERTIFICATION
I hereby certify that I have reviewed this Confidentiality Statement and will comply with
the following Statements.
CITY OF FRESNO 18-0310
Contractor/Vendor Name (Typed) Contract Number
a
Authorized Signature Date
KRISTINA CHAMBERLIN, ASSISTANT DIRECTOR, PARCS
Name and Title of Person Signing (Typed)
1
In compliance with California Government Code 11019.9, California Civil Code 1798
Section 1798 et seq., California Department of Aging (CDA) Management Memo 06-12
and CDA Budget Letter 06-34, the Fresno-Madera Area Agency on Aging (Agency on
Aging) hereby requires the Contractor/Vendor to certify that:
• The Contractor's employees, Subcontractors/Vendors, and volunteers handling
confidential, sensitive and/or personal identifying information must complete the
required CDA Security Awareness Training module located at
https://www.aging.ca.gov/ProgramsProviders/#Resources within thirty (30) days of the
start date of the Contract/Agreement, within thirty (30) days of the start date of any
new employee, Subcontractor, Vendor or volunteer's employment and annually
thereafter. The Contractor must maintain certificates of completion on file and provide
them to the Agency on Aging or CDA upon request.
• Confidential information shall be protected from disclosure in accordance with all
applicable laws, regulations and policies.
• All access codes which allow access to confidential information will be properly
safeguarded.
• Activities by any individual or entity that is suspected of compromising confidential
information will be reported to the Agency on Aging immediately by providing the
Agency on Aging with a completed Security Incident Report (CDA Form 1025),
available online at https://www.aging.ca.gov/ProgramsProviders/#Resources.
• Any wrongful access, inspection, use, or disclosure of confidential information is a
crime and is prohibited under State and federal laws, including but not limited to
California Penal Code Section 502; California Government Code Section 15619,
California Civil Code Section 1798.53 and 1798.55, and the Health Insurance
Portability and Accountability Act.
Contractor/Vendor Appendix C— Page 1 FY 2017-2018
Confidentiality Statement
APPENDIX C
CONTRACTORNENDOR CONFIDENTIALITY STATEMENT
Any wrongful access, inspection, use, disclosure, or modification of confidential
information may result in termination of this Contract/Agreement.
Obligations to protect confidential information obtained under this Contract/Agreement .
will continue after termination of the Contract/Agreement with the Agency on Aging.
All employees, volunteers, and subcontractors of the ContractorNendor will be notified
of the Agency on Aging's and CDA's confidentiality and data security requirements.
The Agency on Aging, CDA, or their designees will be granted access by the Contractor
or Vendor to any computer-based confidential information within the scope of the
Contract.
1 agree to protect the following types of confidential information which include, but are
not limited to:
- Social Security number.
- Medical information.
- Claimant and employer information.
- Driver's License information.
- Information about individuals that relates to their personal life or identifies or
describes an individual.
- Other agencies' confidential and proprietary information.
- Criteria used for initiating audit selection.
- Methods agencies use to safeguard their information (computer systems,
networks, server configurations, etc.).
- Any other information that is considered proprietary, a copyright, or otherwise
protected by law or contract.
• I agree to protect confidential information by:
- Accessing, inspecting, using, disclosing, or modifying information only for the
purpose of performing official duties.
- Never accessing, inspecting, using, disclosing, or modifying information for
curiosity, personal gain, or any non-business related reason.
- Securing confidential information in approved locations.
- Never removing confidential information from the work site without
authorization.
Contractor/Vendor Appendix C — Page 2 FY 2017-2018
Confidentiality Statement
APPENDIX D
METHOD OF PROVIDING AUDIT COMPLIANCE
The service provider shall indicate which method of providing audit compliance to the
Fresno-Madera Area Agency on Aging (Agency on Aging) will be in force during this
Agreement.
Please place an X in the appropriate box:
An independent audit shall be performed in accordance with the
1 requirements of 2 CFR §200, Subpart F -Audit Requirements, and
45 CFR §75, Subpart F -Audit Requirements, and a copy submitted to
the Agency on Aging.
An independent audit shall be performed and a copy submitted to the
Agency on Aging.
All supporting documentation shall be submitted to the Agency on
Aging for review along with any request for reimbursement.
Enter Fiscal Year Ending Date 0 06 30 2018
Month Day Year
Method of Providing Appendix D FY 2017-2018
Audit Compliance
C
APPENDIX E
REQUIRED REPORTS AND DUE DATES
Fiscal Reports
*Expenditure Reports by Program
Title III B, Title III C, Title III D, and Title VII Programs Due 151 of each month
• Monthly Report of Expenditures and
Donations Revenue
Title III E Family Caregiver Support Program Due 151 of each month
• Title III E Monthly Report of Expenditures
Title V Senior Community Service Employment Program Due 101 of each month
• Monthly Expenditure Report and Request for Funds (CDA 29)
Health Insurance Counseling and Advocacy Program Due 1511 of each month
■ HICAP Monthly Report of Expenditure/Request for Funds (CDA 245)
Long-Term Care Ombudsman Program Due 151 of each month
• Budget Summary/Monthly Expenditure Report & Request for Funds, Special Deposit
Fund & Skilled Nursing Facility Quality and Accountability Fund (CDA-OMB-300)
*Payments are made on or about the 20t'' of the month, or the following business day if the 20th
falls on a holiday or weekend, for accurate expenditure reports received by the due date. Late
or inaccurate expenditure report submissions will result in delay of payments until reporting
requirements have been met.
Additional Fiscal Reports - All Programs
• Final Budget Revisions
o Due by March 15th
■ Annual Financial Close Out Report
o Due by July 15th with exception of HICAP
• 1st HICAP Financial Closeout Report for federal funds from July 1-
March 31 due by April 30th
• 2"d HICAP Financial Closeout Report for State funds from July 1-June 30
and Federal funds from April 1-June 30 due by July 30th
■ Copy of Audit, as required by contract
o Due within 30 days after receipt of auditor's report, or nine months after end
of audit period, whichever is earliest
• Request to Dispose of Property
o Due within 5 days of the loss, destruction, or theft of property, or if the
property will no longer be used for the contracted program
Required Reports & Due Dates Appendix E— Page 1 FY 2017-2018
APPENDIX E
REQUIRED REPORTS AND DUE DATES
Program Reports
Monthly Service Unit Report (Form 186M) Due 71" working day of each month
• Title III B Adult Day Care
o Attach Q Monthly Service Roster
o Attach associated Client Intake Forms
o Attach Client Deactivation Request
• Title III B Legal Assistance
• Title III B Transportation
■ Title III D Health Promotion
• Title VII (b) Elder Abuse Prevention, Education, & Training
• *Health Insurance Counseling and Advocacy Program (HICAP)
o Attach final version of HICAP Performance Measures and Benchmark
Report generated from SHARP system for reporting month
*Due date subject to California Department of Aging notifications
Monthly Title III C Due 7th working day of month
Elderly Nutrition Program Reports
• Q Monthly Service Roster • Nutrition Volunteer Summary Report
• Daily Sign-In Sheets • Cash Count Sheet
■ Associated Client Intake Forms • Food Preparation Center Food Service
• Client Deactivation Request • Check Sheet
Quarterly Reports Due 15th of month following reporting period
• Title III B California Legal Services Quarterly Aggregate Report (CDA 1022)
• Title VII (b) Elder Abuse Prevention Quarterly Activity Report (CDA 1037)
• **Title V Senior Community Service Program Quarterly Service Unit Report
(Form 186Q)
o Attach final version of Quarterly Progress Report from SPARQ system
• Title V Senior Community Service Program Quarterly Narrative Report
**Due date subject to California Department of Aging notifications
Quarterly Reports Due 301 of month following reporting period
is Long-Term Care Ombudsman Program
o Copy of completed Quarterly Ombudsman Reporting Form (OSLTCO
S301) as submitted to the California Department of Aging
■ Attach program performance data from the Ombudsman Data
Integration Network for July 1 st through last day of reporting quarter
Required Reports & Due Dates Appendix E — Page 2 FY 2017-2018
APPENDIX F
FRESNO-MADERA AREA AGENCY ON AGING SANCTION POLICY
I. At-Risk Designation
Title 45 of the Code of Federal Regulations (45 CFR), sections 74.14 and 92.12,
defines factors that determine if an Agreement with a Contractor is at risk. In
accordance with 45 CFR, the Fresno-Madera Area Agency on Aging (Agency
on Aging) may consider an Agreement with a Contractor to be at-risk if the
Agency on Aging determines that the Contractor:
A. Has a history of unsatisfactory performance, for which examples include,
but are not limited to:
1. Grant funds are not obligated properly, are not disbursed, or are
not spent for the contracted purpose;
2. Financial reports do not include program income and the required
match of funds;
3. The quantity of service units provided is less than 95% of the
projected level at any time following the third month of the
Agreement period;
4. The Targeting Plan is not implemented as described in the
Program Narrative section of the Agreement;
5. Complaints received from clients, their caretakers, or the general
public indicate that the Contractor is not providing the contracted
service at a satisfactory level.
B. Is not financially stable;
C. Has a management system which does not meet the management
standards set forth in Article VI, Section B, Accountability for Funds, of
this Agreement;
D. Has not conformed to terms and conditions of previous awards; or
E. Is otherwise not responsible, for which examples include, but are not
limited, to:
1. Financial or program reports are late, incorrect, or incomplete;
2. Responses to corrective actions requested by the Agency on
Aging are not provided by the due date;
3. Corrective action plans are not implemented by the due date;
4. Findings from a prior contract monitoring are repeated in a
subsequent monitoring;
Sanction Policy Appendix F— Page 1 FY 2017-2018
5. Failure to respond to telephone or written communications from
the Agency on Aging in a timely manner; or
6. A violation of the law or failure to comply with any condition of this
Agreement.
II. Sanctions
The Agency on Aging may impose sanctions (special conditions and/or
restrictions) on the Contractor that correspond to the at-risk condition. Such
sanctions may include:
A. Withholding of funds;
B. Requiring additional, more detailed, and/or more frequent financial and/or
program reports;
C. Requiring preparation and implementation of an acceptable corrective
action plan;
D. Additional contract monitoring;
E. Requiring the Contractor to obtain technical or management assistance;
F. Establishing additional prior approvals; and/or
G. Withholding authority to continue provision of service within a given
funding period.
Sanctions may be imposed upon approval by the Executive Director of the
Agency on Aging, with the exception of Item II.G above, which requires approval
by the Agency on Aging Governing Board.
For sanctions identified in Items ILA through II.F above, the Agency on Aging
will promptly remove sanctions once the conditions that prompted them have
been corrected.
For the sanction identified in Item II.G above, the sanction will be removed when
the Contractor takes corrective action satisfactory to the Agency on Aging
and/or the Contractor has been restored to satisfactory status in accordance
with the terms and conditions of this Agreement.
III. Notification to Provider
The Agency on Aging will provide written notification to the Contractor of any
sanctions imposed via certified or overnight mail, return receipt requested. Such
notification will include:
Sanction Policy Appendix F— Page 2 FY 2017-2018
A. The nature of the sanctions;
B. The reason(s) for imposing them;
C. The effective date of the sanctions;
D. The legal or contractual citation upon which the sanction is based;
E. The corrective actions which must be taken before they will be removed
and the time allowed for completing the corrective actions; and
F. The Agency on Aging's appeal procedure for service providers.
IV. Unresolved At-Risk Condition(s)
Should the at-risk condition(s) remain unresolved following the imposition of
sanctions, the Agency on Aging may proceed to terminate the Agreement with
the Contractor, in accordance with the Termination section of this Agreement
(Article XVII, Title III and Title VI Area Plan Contracts; Article XVI, Title V
Contract; Article XVI, Health Insurance Counseling and Advocacy Program
Contract).
Sanction Policy Appendix F— Page 3 FY 2017-2018
I
i
APPENDIX G
FRESNO-MADERA AREA AGENCY ON AGING
APPEAL PROCEDURE FOR SERVICE PROVIDERS
I. Actions Subject to Appeal
A. A contracted or potential provider of service (service provider) has the
right to appeal an adverse determination made by the Fresno-Madera
Area Agency on Aging (Agency on Aging). The actions below shall be
considered adverse determinations that are subject to appeal
[Title 22 CCR §7704 (c)(1) — (c)(3)(C)]:
1. A reduction in the level of funding to an existing Contractor during
an Agreement period; however, a reduction directly attributable to a
reduction in the funding to the Area Agency on Aging by the State
or federal government shall not be considered an adverse
determination.
2. A cancellation or termination of an existing Agreement with the
Contractor prior to the Agreement's expiration date.
3. Denial of an application to provide services when any of the
following exist:
a) The presence of a conflict of interest, real or apparent, as
specified in 45 CFR 92.36(b)(3);
b) The occurrence of a procedural error or omission, such as
the failure of the Agency on Aging to include a federal
mandate in its solicitation request;
c) The lack of substantial evidence to support the Agency on
Aging's action.
II. Method of Notification
A. The service provider shall provide notification of appeals, and the Agency
on Aging shall provide notification of subsequent appeals determinations,
by certified or overnight mail, return receipt requested, or by personal
delivery in writing.
B. Notices to the Agency on Aging shall be addressed to the Fresno-Madera
Area Agency on Aging, 3837 North Clark Street, Fresno, CA 93726.
Appeal Procedure Appendix G — Page 1 FY 2017-2018
for Service Providers
C. The Agency on Aging shall transmit notification to the address listed on
the service provider's appeal; if this address differs from the address listed
on page 1 of the service provider's Agreement with the Agency on Aging,
the Agency on Aging shall transmit a copy of the notification to the
address contained on page 1 of the Agreement.
D. The Agency on Aging shall include a copy of this Appeal Procedure for
Service Providers with all notifications to service providers of adverse
appeals determinations.
III. Process
A. The service provider shall give notice of intent to appeal to the Executive
Director of the Agency on Aging within ten (10) business days of the
Agency on Aging's notice of adverse determination. The notice of intent to
appeal shall be in writing, must state the specific grounds upon which the
action by the Agency on Aging is appealed, and must be accompanied by
all supporting documents.
B. The Executive Director of the Agency on Aging shall investigate the
appeal and issue a written determination to the service provider within
fifteen (15) business days of receipt of the appeal. The determination shall
set forth the Agency on Aging's position and specify applicable sections of
the service provider's Agreement with the Agency on Aging, government
regulations, government statutes, or other provisions relied upon.
C. If the service provider is dissatisfied with the Agency on Aging Executive
Director's determination, the service provider may appeal to the Executive
Committee of the Agency on Aging Governing Board within ten (10)
business days of the date of the Agency on Aging Executive Director's
written determination. The appeal shall be in writing, shall specify the
grounds upon which the determination is appealed, and must be
accompanied by all supporting documents.
D_ The Executive Committee of the Agency on Aging Governing Board
(Executive Committee) shall, within fifteen (15) business days of receipt of
the service provider's appeal:
1. Review the service provider's appeal, considering any additional
evidence or documentation provided by the Agency on Aging
Executive Director;
2. Determine if the appeal should be denied, or if a recommendation
should be made to the full Agency on Aging Governing Board at its
next scheduled meeting to take action to grant the appeal; and
Appeal Procedure Appendix G — Page 2 FY 2017-2018
for Service Providers
3. Provide written notification of its determination to the service
provider.
E. If the service provider is dissatisfied with the Executive Committee's
determination, the service provider may request a hearing before the full
Agency on Aging Governing Board. The service provider must request the
hearing within ten (10) business days of the Executive Committee's written
notification of determination. The hearing request shall be in writing, shall
specify the grounds upon which the determination is appealed, and must
be accompanied by all supporting documents.
F. If the Agency on Aging Governing Board does not accept and implement
the Executive Committee's recommendation to grant the service provider's
appeal:
1. The Agency on Aging shall provide written notification to the service
provider of the Governing Board's decision within two (2) business
days following the decision;
2. The service provider may request a hearing before the Agency on
Aging Governing Board. The service provider must request the
hearing within ten (10) business days of the date of the notification
of the Agency on Aging Governing Board's decision. The hearing
request shall be in writing, shall specify the grounds upon which the
determination is appealed, and must be accompanied by all
supporting documents.
G. Upon receipt of the service provider's request for a hearing before the
Agency on Aging Governing Board, the Agency on Aging will place the
hearing on the agenda of the next regularly scheduled meeting of the
Agency on Aging Governing Board, and provide the service provider with
a copy of the published agenda.
1. The hearing before the Agency on Aging Governing Board shall
consist of:
a) Receipt and review of all previously submitted documents
concerning the appeal;
b) Submission in writing by the service provider of any
additional information or documentation supporting the
service provider's position;
c) An oral presentation by the service provider, not to exceed
thirty (30) minutes; and
Appeal Procedure Appendix G — Page 3 FY 2017-2018
for Service Providers
d) An oral presentation by the Agency on Aging Executive
Director and/or Agency on Aging staff, not to exceed thirty
(30) minutes.
2. At the conclusion of the hearing, the Agency on Aging Governing
Board shall vote to accept or deny the service provider's appeal.
a) If the appeal is denied, the Agency on Aging Governing
Board shall notify the service provider in writing of the
reason(s) the appeal was denied, including a statement that
all appeal procedures to the Agency on Aging and its
Governing Board have been exhausted, and of the service
provider's right to appeal the Governing Board's decision to
the California Department of Aging. Such notification shall
include a copy of Sections 7700 through 7710 of Title 22 of
the California Code of Regulations, which contains the
process for appealing the determination to the California
Department of Aging.
Appeal Procedure Appendix G — Page 4 FY 2017-2018
for Service Providers
APPENDIX H
FRESNO-MADERA AREA AGENCY ON AGING
CONTACT LIST FOR SERVICE PROVIDERS
Telephone Number for All Contacts: (559) 600-4405
Linda Descoteaux Contract Administration
Administrative Manager Administrative& Program Monitoring (excluding
Email: Iescoteaux@fmaaa.org Nutrition and Adult Day Care)
Fax: (559) 243-5918 Area Agency on Aging Area Plan and Updates
Service Unit Planning and Performance
Q Care Access Client Database Administration
Teresa Scheidt Budget Questions
Senior Accountant Financial Close-Out Reports
Email: tscheidt@fmaaa.org Fiscal Monitoring
Fax: (559) 243-5918 Monthly Payments to Service Providers
Quarterly Reports of Expenditures & Donation
Revenue
Adam Vinogradoff Monthly Service Unit Reports and Supporting
Administrative Analyst Rosters
Email: avinogradoff@fmaaa.org Quarterly Service Unit Reports
Fax: (559) 243-5918 Client Intake Forms
Congregate Meal Site Rosters & Daily Sign-In
Sheets
Nutrition Volunteer Summary Report
Stephanie Jenkins Congregate Nutrition Site Procedures
Program Coordinator Daily Congregate Meal Counts
Email: sjenkins@fmaaa.org Nutrition Site Food Safety
Fax: (559) 243-5651 Nutrition Supply Order Forms
Nutrition Site Monitoring
Adult Day Care Site Monitoring
Peggy Bakeman Home-Delivered Meals:
Jessica Jacobo Lopez Discontinue or Restart
Program Coordinators Eligibility & Assessments
Email: pbakeman@fmaaa.org Missed Deliveries
jjacobolopez@fmaaa.org Short-Term Temporary (STT) Program
Fax: (559) 243-5651
Fresno-Madera Area Agency on Aging
3837 N. Clark St.
Fresno, CA 93726
Fresno-Madera Area Agency on Aging Appendix H FY 2017-2018
Contact List for Service Providers
APPENDIX I
FRESNO-MADERA AREA AGENCY ON AGING
EMERGENCY CONTACT INFORMATION
Information and Assistance: (559) 600-4405
(800) 510-2020
Executive Director, Jean Robinson
Emergency Coordinator,
and Public Relations Officer
Business Address: 3837 N. Clark St.
Fresno, CA 93726
Office Phone: (559) 600-4405
After Hours Phone: (559) 930-5847
Administrative Manager, Linda L. Descoteaux
Alternate Emergency
Coordinator
Business Address: 3837 N. Clark St.
Fresno, CA 93726
Office Phone: (559) 600-4405
After Hours Phone: (559) 270-9939
Fresno-Madera Area Agency on Aging Appendix I FY 2017-2018
Emergency Contact Information
I
i
APPENDIX J
COMMUNITY FOCAL POINTS LIST
CCR Title 22,Article 3, Section 7302(a)(14),45 CFR Section 1321.53(c), OAA 2006 306(a)
Definition of Focal Point: A facility established to encourage the maximum collocation and
coordination of services for older individuals. (42 USC Section 3002 (21))
Planning and Service Area 14 - Designated Community Focal Points
Fresno County
Fresno-Madera Area Agency on
Aging (includes Senior Resource 3837 N. Clark St. Fresno, CA 93726
Center/Sierra Resource Campus)
Clovis Senior Center 850 4th St. Clovis, CA 93612
Coalinga Senior Center 220 E. Forest Ave. Coalinga, CA 93210
Edwin Blayney Senior Center 108 N. 31d St. Fowler, CA 93625
Firebaugh Senior Center 1601 Thomas Conboy Ave. Firebaugh, CA 93622
Huron Senior Center 16900 5th St. Huron, CA 93234
Kerman Senior Center 720 S. 8th St. Kerman, CA 93630
Kingsburg Senior Center 1450 Ellis St. Kingsburg, CA 93631
Mary Ella Brown Community 1350 E. Annadale Ave. Fresno, CA 93706
Center
Mendota Senior Center 415 Sorenson Ave. Mendota, CA 93640
Mosqueda Community Center 3670 E. Butler Ave. Fresno, CA 93702
Nick Medina Senior Center 2301 Selma St. Selma, CA 93662
Orange Cove Senior Center 699 6th St. Orange Cove, CA 93646
Pinedale Community Center 7170 N. San Pablo Ave. Pinedale, CA 93650
Reedley Senior Center 100 N. East Ave. Reedley, CA 93654
Sanger Senior Center 730 Recreation Ave. Sanger, CA 93657
Sierra Oaks Senior and 33276 Lodge Rd. Tollhouse, CA 93667
Community Center
Ted C. Wills Community Center 770 N. San Pablo Ave. Fresno, CA 93728
Madera County
Chowchilla Senior Center 820 Robertson Blvd. Chowchilla, CA 93610
Frank A. Bergon Senior Center 238 S. D St. Madera, CA 93637
Pan-American Community Center 703 E. Sherwood Way Madera, CA 93638
Ranchos/Hills Senior Center 37330 Berkshire Dr. Madera Ranchos, CA 93636
Sierra Senior Center 49111 Cinder Ln. Oakhurst, CA 93644
Community Focal Points Appendix J FY 2017-2018
i
Form W"9 Request for Taxpayer Give Form to the
(Rev.December 2014) requester.Do not
ncpartmonl of the Treasury Identification Number and Certification send to the IRS.
Inlernal Revenue Service
1 Namn f.r:sWwrl on your®Cor116 tOx vlllunl,Name is reclifloa on this flan;do not zt, iiiw[r ai i`%
CITY OF FRESNO
N R pvalnnss uamoldisregn►clon entity name,If different from above
3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to
❑aIn9I dwells hP proprietor a ❑ C Caporalaon ❑S Corporation ❑ Partnership ❑Truet/estate
certaln entities,not Individuals;see
e instructions on page 3):
aingimmeuilser LLC
❑Orntled linhlhly company.Enter the tax classlAcation(C=C corporation,S=S corporation,P=partnership)► Exempt payee code(If any)
Note.For a single-member LLC that Is dlsre0tvded,do not check LLC;check the appropriate box In the line above for Exemption from FATCA reporting
�j the tax classification of the single-member owner. code(If any)
M= ❑Other(ace instructions)► Tax Exempt Government or Public Agency (a{avnvl,re A 1m 1n11.t.bodn'011dulhnu.dl
9 51111111UPIUM130F.street,and apt.or suite no,) uester's name and address(opllonsp
' 1515 E.DIVISADERO ST.
E City,state,and W code
FRESNO,CA 93721
7 List account nxlnthsris)hero(optional)
Taxpayer Identi catiort Number(M)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid f Social securltynumbe►
backup withholding.For individuals,this is generally your social security number( However,for page
resident alien,sole proprietor,or disregarded entity,see the Part I Instructions on page 3.For other
entitles,it is your employer Identification number(EIN).If you do not have a number,see How to get a
TIN on page 3. Or
Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for EMPT*YW
guidelines on whose number to enter.
Y � Fn4 - 6 1 0 1 0 0 3 3 8
Certification
Under penattles of perjury,I certify that:
1. The number shown on this form is my correct taxpayer Identification number(or I am waiting for a number to be Issued to me);and
2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all Interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3. 1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(f any)indicating that I am exempt from FATCA reporting is correct.
Certification Instructions.You must cross out Rem 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.For real estate transactions,Item 2 does not apply.For mortgage
interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and
generally,payments other than Interest and dividends,you are not required to sign the certificatlon,but you must provide your correct TIN.See the
Instructions on page 3.
8n Signature of ` r/ 7
—
Here U.S.peraon► r Date 0- f/
General Instructions •Form 1098(home mortgage Interesl1,1098-E(student loan Interest),109E-T
(tuitlon)
Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-C(canceled debt)
Future developments.Information about developments affecting Form W-9(such .Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release It)is at www.1rs.gov/fw9.
Use Form W-9 only If you we a U.S.person(including a resident allen),to
Purpose of Form provide your correct TIN.
An Individual or entity(Form W-9 requester)who is required to file an information If you do not relum Form W-9 to the requesfer with a TIN,you might be subject
return with the IRS must obtain your correct taxpayer Identification number(TIN) to backup svithhoklfng,See What Is backup withhoMlap?on page 2.
which may be your social security number(SSN),individual taxpayer identification By signing the filled-out form,you:
number(ITIN),adoption taxpayer identification number(ATIN),or employer 1_Certify that the TIN you are giving is correct(or you are welling for a number
identification number(El",to report on an Information return the amount paid to to tic issued),
you,or other amount reportable on an Information return.Examples of Information
returns include,but are not limited to,the following: 2.Certify that you are not subject to backup wthholding,or
•Form 1099-INT(Interest earned or paid) 3.Claim exemption from backup withholding If you are a U.S.exempt payee.If
•Form 1099-DN(dividends,Including those from stooks or mutual funds) applicable,you are also certifying that as a U.S,person,your allocable share of
any partnership Income from a U.S.trade or business Is not subject to the
•Form 1099-MISC(various types of Income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-B(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form(If any)Indicating that you are
brokers) exempt from the FATCA reporting,Is correct.See What Is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further Information.
•Form 1099-a((merchant card and third party network transactions)
Cat.No.10231X T Form tN-9(Rev.12-2014)
i
EXHIBIT A
TITLE III PROGRAM EXHIBIT
Title III C1 — Elderly Nutrition Program Site Management
I. Definitions Specific to Title III Programs:
A. Program Requirements is defined as Title III program requirements
found in the Older Americans Act (OAA) [42 USC §3001-3058]; the Code
of Federal Regulations (CFR) [45 CFR §1321]; the California Code of
Regulations (CCR) [22 CCR §7000 et seq.]; California Department of
Aging Program Memoranda; and California Retail Food Code (CRFC).
B. Title III C1 Congregate Nutrition Services is defined as nutrition
services for older individuals in a congregate setting. Services include
meals, nutrition and health promotion education, health promotion
programs, nutrition risk screening, and opportunities for socialization.
Each meal shall provide one-third (1/3) of the Dietary Reference Intakes
(DRI), and comply with the most current Dietary Guidelines for Americans.
To be an eligible Title III C1 congregate nutrition site, the site must meet
all of the following criteria:
1. Be open to the public [45 CFR §1321.53(b)(3)].
2. Not means test [OAA §315(b)(3)].
3, Provide participants the opportunity to make voluntary contributions
and not deny service for not contributing to the cost of the service
[OAA §315(b)(4)] [22 CCR §7638.9].
4. Not receive funds from another source for the cost of the same
meal, equipment, or services [2 CFR §200.403(f)].
C. Title III C2 Home-Delivered Nutrition Services is defined as nutrition
services provided to homebound older individuals including meals,
nutrition and health promotion education, and nutrition risk screening.
Each meal shall provide one-third (1/3) of the Dietary Reference Intakes
(DRI), and comply with the most current Dietary Guidelines for Americans.
Elderly Nutrition Program Exhibit A— Page 1 FY 2017-2018
Site Management
D. Eligible Service Population is defined as individuals 60 years of age or
older, with emphasis on those in economic and social need with particular
attention to low income minority individuals, individuals with limited English
proficiency, and older individuals residing in rural areas.
[OAA §305(a)(2)(E)] [22 CCR §§7125, 7127, 7130, 7135 and 7638.7].
E. Site Management is defined as 1) oversight and responsibility for the day-
to-day operations of an Elderly Nutrition Program nutrition site with respect
to meals; 2) oversight of and responsibility for Elderly Nutrition Program
staff and volunteers, including provision of required program training; 3)
collection of required Elderly Nutrition Program data from program
participants; 4) keeping records and preparing reports concerning meals
ordered and served, nutrition volunteer hours, and donations; and 5)
ensuring the Elderly Nutrition Program nutrition site meets all federal,
state, and local regulations, including applicable licensing laws and
ordinances related to food service operations and sanitation.
F. CRFC means the California Retail Food Code, which is a uniform
statewide health and sanitation standard for food facilities, found in
Section 113700 et seq., California Health and Safety Code.
G. Urban, for purposes of this Agreement, is defined as: 1) urbanized areas
(a central place and its adjacent densely settled territories with a
combined minimum population of 50,000; and 2) and incorporated place
or a census designated place with 20,000 or more inhabitants. A rural
area is any area that is not defined as urban.
H. Eligible Participant is defined as-
1 Congregate Meals: Individuals eligible to receive a meal at a
congregate nutrition site are:
a. Any older individual (sixty (60) years of age or older).
b. The spouse of any older individual.
C. A person with a disability, under age sixty (60) who resides
in housing facilities occupied primarily by older individuals at
which congregate nutrition services are provided.
d. A disabled individual who resides at home with and
accompanies an older individual who participates in the
program.
[22 CCR §7638.7(a)(1)-(4)]
Elderly Nutrition Program Exhibit A— Page 2 FY 2017-2018
Site Management
2. Volunteer Meals
a. The Contractor may offer a meal to a volunteer under age
sixty (60) if doing so will not deprive an older individual of a
meal. [22 CCR §7638.7(b)(1)]
b. The Contractor shall develop and implement a written policy
for providing and accounting for volunteer meals.
[22 CCR §7638.7(b)(2)]
3. Home-Delivered Meals: Individuals eligible to receive a home-
delivered meal are:
a. Any older individual (sixty (60) years of age or older) who is
frail and homebound by reason of illness, disability, or
isolation. [22 CCR §7638.7(c)(1)]
i. Frail means that an older individual is determined to
be functionally impaired because the individual either:
1) Is unable to perform at least two activities of daily
living, including bathing, toileting, dressing,
feeding, breathing, transferring, and mobility and
associated tasks, without substantial human
assistance, including verbal reminding, physical
cueing, or supervision; [22 CCR §7119(a)] or
2) Due to a cognitive or other mental impairment,
requires substantial supervision because the older
individual behaves in a manner that poses a
serious health or safety hazard to the individual or
to others. [22 CCR §7119(b)]
b. A spouse of an eligible individual as described in item H.2.a
above, regardless of age or condition, if an assessment
concludes that it is in the best interest of the homebound
older individual. [22 CCR §7638.7(c)(2)]
C. An individual with a disability who resides at home with older
individuals, if an assessment concludes that it is in the best
interest of the homebound older individual who participates
in the program. [22 CCR §7638.7(c)(3)]
d. Priority shall be given to eligible older individuals as described in
item H.3.a. above.
[22 CCR §7638.7(c)]
Elderly Nutrition Program Exhibit A— Page 3 FY 2017-2018
Site Management
I. Current Meal Rate is defined as the current vendor meal rate plus an
additional amount established by the Fresno-Madera Area Agency on
Aging (Agency on Aging) to recover costs associated with this process.
J. Eligible Meal is defined as meals served to an eligible participant which
provide one-third (1/3) of the Dietary Reference Intakes (DRI), and
complies with the most current Dietary Guidelines for Americans.
K. Volunteer means an individual who provides services without pay, but
may receive reimbursement for expenses, and who has been provided
with orientation and training in compliance with Title 22, CCR §7635.5,
II. Scope of Work
The service provider is charged with providing site management services to the
"eligible service population" within the service provider's area of influence as
specified in Exhibit E, Item 2 of this Agreement.
A. Assurances
1. The service provider will comply with all the Program Requirements
and those required under the California Retail Food Code (CRFC).
2. Meal Count Allocation
a. The service provider will be charged at the current
established meal rate for all meals ordered in excess of the
number of eligible meals served to the Eligible Participants
within the Title III C program. Participant eligibility is as
defined in Title 22, CCR, Article 5, §7638.7.
b. The service provider may, at the option of the Agency on
Aging, be held financially responsible (at the current meal
rate) for all meals ordered which exceed the annual
allocation for that site. The Agency on Aging has the option
to increase or decrease the meal target allocations to
individual sites in the event of changes in available funding,
or changes in average service levels at individual meal sites.
C. Only those meals that are served to an eligible participant
which provide one-third (1/3) of the Dietary Reference
Intakes (DRI), and comply with the most current Dietary
Guidelines for Americans, are allowable and counted as
meals served.
Elderly Nutrition Program Exhibit A— Page 4 FY 2017-2018
Site Management
3. Site Management Responsibilities
In compliance with Title 22, CCR, Article 5, and the Agency on
Aging Nutrition Policies and Procedure Manual, the service provider
will:
a. Assure accurate and timely completion of Client Intake forms,
client rosters, daily meal sign-in sheets, Client Deactivation
requests, and Nutrition Volunteer Summary reports for the
Congregate and Home-Delivered Meals programs;
b. Verify and order meal counts for Congregate (Cl) and
Home-Delivered (C2) meals no later than 12:00 noon the
business day prior to the service day;
C. Monitor daily meal service numbers to maintain total monthly
meals ordered near or at allocation level stated in this
Agreement (however, this is not to be construed that the
service provider is precluded from serving above the
allocation level by using donations or other sources of
revenue to supplement the number of meals supported by
this Agreement);
d. Comply with all Title III C Program and CRFC requirements for
client eligibility, and meal service safety and sanitation practices;
e. Maintain separate and verifiable records of all program
income and expenses for Congregate (Cl) and Home-
Delivered (C2) meals (all donations received from C1 clients
must be expended on C1 costs, and all donations received
from C2 clients must be expended on C2 costs);
f. Assess new and continuing home-delivered meal clients for
program eligibility. Reassessments of home-delivered meal
clients are to be completed quarterly, alternating two in-
home visits per year with two telephone reassessments;
g. Assess new and continuing Congregate Meals clients for
program eligibility. Congregate Meals client reassessments
are to be conducted at least once during each fiscal year.
h. Ensure client records are available only to authorized service
staff assisting the individual, and keep client records in a
secure, locked file cabinet to protect client confidentiality.
i. Recruit volunteers as needed to provide in-center services
for the Congregate (Cl) and Home-Delivered (C2) Meals
programs, and provide orientation, training, and supervision.
A minimum of four hours of training shall be provided
Elderly Nutrition Program Exhibit A— Page 5 FY 2017-2018
Site Management
annually for all volunteer food service staff, to include, at a
minimum:
i) Food safety, prevention of foodborne illness, and
Hazard Analysis and Critical Control Points (HACCP)
principles.
ii) Accident prevention, instruction on fire safety, first aid,
choking, earthquake preparedness, and other
emergency procedures.
j. Identify and make known available services to eligible
individuals through outreach efforts in their community;
k. Attend Agency on Aging Site Management in-service training
meetings as required;
1. Comply with all Agency on Aging monthly memos and other
Agency on Aging correspondence;
m. Procure and maintain food service and cleaning supplies
inventories;
n. Post menus in a location easily seen by participants at each
congregate meal site; ensure menus are legible and easy to
read in the language of the majority of the participants; and
ensure menus are available in large print;
o. Not preclude the service of a congregate meal to a
participant who has failed to make a reservation, when food
is available;
P. Have a paid staff member, or volunteer, designated to be
responsible for the day-to-day activities at each congregate
meal site, and physically be on-site during the time that
Elderly Nutrition Program activities are taking place;
q. Have restrooms, lighting, and ventilation which meet the
requirements of the CRFC;
r. Include procedures for obtaining the views of Congregate
Meals Program participants about the services received;
S. Have equipment at congregate meal sites, including tables
and chairs, that are sturdy and appropriate for older
individuals. Tables shall be arranged to assure ease of
access and encourage socialization;
t. Provide a welcoming, pleasant dining environment for
congregate meals that affords older adults an opportunity for
Elderly Nutrition Program Exhibit A— Page 6 FY 2017-2018
Site Management
socialization with their peers and enhancement of a healthy
and enriching lifestyle; and
u. Observe any physical or emotional changes in participants'
conditions and report any cases of known or suspected elder
abuse to local law enforcement.
Additional Assurances
A. Facilities shall be properly maintained by the service provider with regards
to repairs and maintenance, cleanliness, accessibility, etc.
B. The service provider must submit the reports specific to this program as
listed in Appendix E of this Agreement.
C. All reports required by the Agency on Aging must be submitted by the due
dates listed in Appendix E of this Agreement.
D. The service provider shall have a plan to ensure accuracy of data from all
levels. This plan shall include a method for the service provider to verify
the accuracy of their data prior to submission to the Fresno-Madera Area
Agency on Aging.
W. Approved Holidays for Nutrition Sites
There are a total of nine recognized holidays (ten days) in which food service will
not be provided by central kitchens to congregate meal sites and sites are
assumed to be closed:
Independence Day Tuesday, July 4, 2017
Labor Day Monday, September 4, 2017
Veterans Day Friday, November 10, 2017
Thanksgiving Holiday Thursday, November 23, 2017 and
Friday, November 24, 2017
Christmas Holiday Monday, December 25, 2017
New Years Holiday Monday, January 1, 2018
Martin Luther King Jr. Day Monday, January 15, 2018
Presidents Day Monday, February 19, 2018
Memorial Day Monday, May 28, 2018
Elderly Nutrition Program Exhibit A— Page 7 FY 2017-2018
Site Management
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EXHIBIT C
ANNUAL SUMMARY OF ACTIVITIES
PROGRAM: Elderly Nutrition Program Site Management
SERVICE PROVIDER: City of Fresno
CONTRACT NUMBER: 18-0310
SITES: Six Sites in City of Fresno (See List Below)
CONTRACT EFFECTIVE: July 1, 2017 to June 30, 2018
GOAL: The goal of the Elderly Nutrition Program is to reduce hunger and food
insecurity; promote health and well-being; promote socialization; and delay adverse
health conditions of older individuals.
DEFINITION: Site Management is defined as 1) oversight and responsibility for the day-
to-day operations of an Elderly Nutrition Program nutrition site with respect to meals; 2)
oversight of and responsibility for Elderly Nutrition Program staff and volunteers,
including provision of required program training; 3) collection of required Elderly
Nutrition Program data from program participants; 4) keeping records and preparing
reports concerning meals ordered and served, nutrition volunteer hours, and donations;
and 5) ensuring the Elderly Nutrition Program nutrition site meets all federal, state, and
local regulations, including applicable licensing laws and ordinances related to food
service operations and sanitation.
Congregate Nutrition Meal Sites
Lafayette Neighborhood Center
Mary Ella Brown Community Center
Mosqueda Community Center
Pinedale Community Center
Senior Citizens Village
Ted C. Wills Community Center
Meals are subject to allocation and reallocation at any time by the Agency on Aging based
upon available funding and nutrition program participation. When allocations are imposed,
any meals allocated but not served revert to the Agency on Aging for reallocation.
Elderly Nutrition Program Exhibit C FY 2017-2018
Site Management
i'�
I�
1
EXHIBIT D
PROGRAM COST EFFICIENCY
Not Applicable —
Elderly Nutrition Program
Site Management
Program Cost Efficiency Exhibit D FY 2017-2018
Exhibit E
Program Narrative
1. AGENCY'S HISTORY OF SERVICE TO OLDER ADULTS
City of Fresno 1885
Organization Name Year
Established
Type of Organization (Check One)
X City Government Non-Profit 501(c)(3)
County Government For-Profit
Joint Powers Authority (JPA) Other:
List programs/services your organization provides for older adults, and
the number of yearsyouur organization has provided the program/service.
Program/Service #of
Years
Congregate Nutrition Program 22
L
2. SERVICE AREA
Where will the contracted program be provided?
Street Address City Zi2 Code
Lafayette Neighborhood Center Fresno 93704
1516 E Princeton Ave
Mary Ella Brown Community Center
1350 E Annadale Ave Fresno 93706
Mosqueda Community Center Fresno 93702
4670 E Butler Ave
Pinedale Community Center Fresno 93650
7170 N San Pablo Ave
Senior Citizens Village Fresno 93702
1917 S Chestnut Ave
Ted C. Wills Community Center Fresno 93728
770 N San Pablo Ave
Program Narrative Exhibit E— Page 1 FY 2017-2018
Title III C Nutrition Site Management
i
Exhibit E
Program Narrative
3. LANGUAGE TRANSLATION NEEDS & PROVISIONS
Enter an "X" in the boxes below to indicate who
_speaks the Ian age listed to the left.
Program Program Program
Participants Staff Volunteers
English X X X
Spanish X X X
Hmong X X X
Arabic
Armenian X
Cantonese
Farsi (Persian)
Filipino (Pilipino/Tagalog)
Hindi
Japanese X
Khmer (Cambodian) X
Khmu
Korean
Lao X
Mandarin (Putonghua)
Mien (Yao)
Mixteco
Portuguese
Punjabi
Russian X
Thai
Ukrainian
Urdu
Vietnamese X
Other:
Program Narrative Exhibit E— Page 2 FY 2017-2018
Title III C Nutrition Site Management
Exhibit E
Program Narrative
What resources does your organization use, or have available to use, when
interpretation is needed fora program participant?
Staff and volunteers fluent in respective language will translate or interpret
documents, pamphlets, menus, presentations, daily activities and assist
individuals with filling out forms.
How does your organization provide the contracted service to individuals who
speak a language that is not spoken by program staff or volunteers?
Assistance/translation can be obtained from the following
agencies/organizations: Fresno Center for New Americans, FIRM, Fresno
Metro Ministries, PARCS staff and local non profits.
4. CONFIDENTIALITY PROCEDURES
How does your organization protect the confidentiality of the program JI
participant during verbal discussions? (For example, asking the program
participant for their date of birth, phone number, and any other information that
identifies the individual and is needed to complete the client intake form) _
Participant interviews are conducted in private and remain confidential.
How does your organization protect confidential information obtained from
program participants, such as client intake forms, from disclosure?
Nutrition program records, including client intake forms, client reassessments
and program reports are filed and kept in locked file drawers, cabinet and/or
behind locked door.
Program Narrative Exhibit E — Page 3 FY 2017-2018
Title III C Nutrition Site Management
i
Exhibit E
Program Narrative
Contracted Program: Title III C Nutrition Site Management
5. PROGRAM DESCRIPTION
Provide a brief description of how your organization provides the contracted
program.
The city of Fresno provides congregate nutrition site management at six (6)
safe locations, offering a nutritious meal, social activities, educational
presentations and resources to maintain and improve the physical and social
being of older adults.
What was the primary accomplishment achieved by the contracted program in
the past ear?
Increasing participation by expanding center activities available to seniors and
bringing in speakers to present informational seminars.
Please describe another accomplishment achieved by the contracted program 1
in the past year.
Spring Fling — brought seniors from all over Fresno to receive information that
would enhance their lives.
6. CASE STUDY
Briefly describe how the contracted program successfully met the needs of a
program participant in the past year. Do not use real names.
A single male has been attending the senior site for the past 20 years. He has
been a real asset as a volunteer in the nutrition program. He had a catastrophic
event resulting in loss of vision. The seniors from the site visited him on a
regular basis, helping when they could by giving encouragement as he
underwent treatment to restore his vision. After a long struggle he is back at
the site, and now able to volunteer again in a very limited but much appreciated
manner.
Program Narrative Exhibit E — Page 4 FY 2017-2018
Title III C Nutrition Site Management
Exhibit E
Program Narrative
7. STAFFING
Please provide the names and titles of all staff listed in the Personnel
section of the contract budget (Exhibit B).
Name Title
Shaun Schaefer Community Recreation Supvr II
Rich Rodriguez Community Recreation Supvr I
Daniela Gonzalez Recreation Supervisor
Dana Liberty Services Aide — Clerical
Bonnie Audas Site Manager
Lucia Terra Site Coordinator— TCW
Caroline Garcia Site Coordinator—TCW
Lischa Hinojosa Site Coordinator— Pinedale
Karen Gill Site Coordinator- Mosqueda
i
*Please provide the name and contact information for the person who has
primary, hands-on involvement and oversight of the day-to-day operations
of the contracted program.
Shaun Schaefer Community Recreation Supvr II
Name Title
(559) 621-2910 Shaun.Schaefer@fresno.gov
Telephone Number E-mail Address
*Attach the following documents to the "Documents Required to
Execute Contract" checklist:
➢ The job description for this position;
➢ The resume for the person occupying this position.
Program Narrative Exhibit E— Page 5 FY 2017-2018
Title III C Nutrition Site Management
Exhibit E
Program Narrative
8. SERVICE PROVIDER TIME FRAME
What days and hours will the Nutrition Site Management program be
available? (Please note that these are not necessarily the same hours your
organization/facility is open.)
Site Days Open Start Time Close Time
Lafayette M-T-W-Th-F 9:00 AM 1:00 PM
Mary Ella Brown M-T-W-Th-F 9:00 AM 1:00 PM
Mosqueda M-T-W-Th-F 9:00 AM 1:00 PM
Pinedale M-T-W-Th-F 9:00 AM 1:00 PM
Senior Citizens Village M-T-W-Th-F 9:00 AM 1:00 PM
Ted C. Wills M-T-W-Th-F 9:00 AM 1:00 PM
Month Enter Dates of Holidays Total Days Service
& Other Planned Closures to be Provided
I
July 2017 7/4/17 20
August 2017 23
September 2017 9/4/17 20
October 2017 22
November 2017 11/10/17, 11/23/17, 11/24/17 19
December 2017 12/25/17 20
January 2018 1/l/18, 1/15/18 21
February 2018 2/19/18 19
March 2018 22
April 2018 21
May 2018 5/28/18 22
June 2018 21
Total Days of Contracted Service to 250
be Provided under this Agreement:
Program Narrative Exhibit E — Page 6 FY 2017-2018
Title III C Nutrition Site Management
Exhibit E
Program Narrative
9. PROGRAM EVALUATION/IMPROVEMENT
In reviewing the past year's performance, identify areas that your organization could
focus on for improvement of the contracted program.
The city provides on-going training of SHM program staff to provide a better
experience at the meal sites. We have several organizations that make
presentations to the participants on living a healthy life and ways to eat healthier.
_ I
How would participants of the contracted program benefit from these improvements?
Our goal is to provide to our participants a better quality of life by having one
nutritious meal daily to supplement their own meals. We also provide activities to
stimulate individuals both mentally and physically.
The city also sponsors a monthly senior dance where seniors can meet and enjoy
music and dance.
Describe the specific steps your organization will take to make these improvements
during the current fiscal year.
The city continues to make outreach efforts to the surrounding communities, and will
provide a survey to get feedback on the center, the food and the services offered.
Staff attends events to provide information on our programs.
Describe how you will know if your improvement efforts are successful, and how you
will measure your achievements.
The site monitor visits the sites a minimum of twice monthly to check on the level of
service and to sit with participants and talk with them regarding participation
satisfaction.
Program Narrative Exhibit E — Page 7 FY 2017-2018
Title III C Nutrition Site Management
i
Exhibit E
Program Narrative
10. OUTREACH ACTIVITIES/TARGETING PLAN (22 CCR§ 7310, WIC § 9103)
Targeted Group of How will the Targeted Group be informed of the Month(s)
Older Individuals contracted program & encouraged to participate? Scheduled
Reside in rural areas Target faith based organizations around the Mary Ella November
Brown Center and contact businesses and schools &
with information about the center April
Greatest economic need Provide information on SHM program to seniors, their September
(Income level at or below children and/or caregivers at the September Carnival October
the federal poverty line) at Mosqueda, October Kids Fest @ Holmes May
Playground, Spring Fling in May at Mosqueda and the
Big Fresno Fair in October
Greatest social need Promote SHM program to older adults who have lost j November
(Need caused by non- a love one by inviting them to the center for
economic factors) companionship and a hot meal.
Native Americans SHM staff will target Tribal TANF in order to reach Jamuary
older Native Americans. We will provide a flyer
handout for the Board/Chapter meeting.
Minorities with greatest Provide a discussion seminar regarding program March
economic and/or social opportunities that exist for older adults.
need
Limited English Flyers in both English and Spanish will be given to January
proficiency Central La Familia and local faith based Thru
organizations. June
Severe disabilities Contact Valley Caregiver Resource Center and February
(Severe, chronic physical Resources for Independence, Central Valley to give
and/or mental impairment their information to SHM program participants and
that is likely to continue give them information on our program.
indefinitely & results in
substantial functional
limitation in 3 or more major
life activities)
Alzheimer's disease or Contact Valley Caregiver Resource Center to give May
related disorders with them information on the SHM program to handout to
neurological & organic their clients.
brain disfunction (and the
caregivers of these
individuals)
Lesbian, gay, bisexual, or Make a presentation to the Gay Fresno quarterly November
transgender meeting with information on the SHM program
Program Narrative Exhibit E — Page 8 FY 2017-2018
Title III C Nutrition Site Management
City of Fresno R67
COMMUNITY RECREATION SUPERVISOR II
_C a s DgfInition
Under direction,supervises the day-today activities of one or more community centers or City-wide or District-
wide community service or recreational programs.
Characteristics
Community Recreation Supervisor It is a specialized,supervisory class in the Parks,Recreation,and Community
Services Department. Incumbents supervise the day-today activities of one or more community centers or the
social,recreational,cultural,senior citizens,therapeutic,and/or physical development programs provided to the
community. These programs include civic/cultural arts, sports, after school recreation, counseling and/or
workshops for youth,adults,and senior citizens. Incumbents are also given considerable latitude in accomplishing
assignments. This class is distinguished from Community Recreation Supervisor I in that incumbents of the latter
supervise the day-today activities of community centers, neighborhood parks, neighborhood centers, or a
segment of the community service or recreational programs within established guidelines and procedures.
Tyj2ic I Tasks
(This list is neither inclusive nor exclusive. Consequently,this information may not reflect Essential Functions for
this class.)
Plans, implements and evaluates community service programs.
Consults with administrative staff,school principals and various school officials regarding the provision offacilities,
personnel,and programs utilizing school facilities.
Makes inspections of recreational facilities;reviews operating activity records and reports.
Evaluates programs to ascertain efficiency and effectiveness of personnel assigned and type of in-service training
required;advises and instructs personnel on methods and techniques for improving programs.
Studies and makes recommendations on equipment and materials needed for various playgrounds,centers,pools
and their programs.
Makes presentations before clubs and organizations regarding community service programs;assists organizations
and civic groups in utilization of the programs and facilities offered by the City.
Orients,trains,assigns and evaluates subordinates.
Reviews programs with neighborhood councils and private agencies.
Acts as liaison between the division and various boards and commissions, and a variety of public and private
agencies in cc-sponsored programs.
Supervises and coordinates the activities and operations of a large community center or several smaller centers.
Community Recreation Supervisor II
Page 2
Prepares correspondence, informational statements, reports, and budget requests on the operations of a
Community Center and/or program activities.
Supervises the collection and analysis of programmatic data and preparation of staff reports.
Issues permits for use of sports fields and tennis courts and secures permits for use of school facilities.
Assigns sports officials to league games and keeps records of leagues.
Performs related duties as required.
Knowledge.Abilities. and SWk
Knowledge of the principles,practices,procedures,and techniques employed in public recreation programs.
Knowledge of the purposes of clubs,centers or other units established to meet the leisure time and recreational
needs of community groups including children,adults and senior citizens.
Knowledge of the methods involved in organizing,conducting and supervising recreation activities.
Knowledge of the facilities and equipment needed in a broad recreation program.
Knowledge ofthe principles of municipal administration and budgeting,and federal and state grant program rules
and regulations.
Knowledge of first aid methods and safety precautions used in recreation work.
Abilityto understand the various community social conditions throughout the City to determine special recreation
needs.
Ability to train and supervise the personnel required to execute the authorized recreational programs.
Ability to establish and maintain effective working relationships.
Ability to speak and write clearly and concisely.
Ability to establish and maintain effective operating records and reports.
inim m uali`ccr i ns
Graduation from an accredited college or university with a Bachelor's Degree in recreation, education,physical
education, public administration, or related field; and two years of experience similar to that gained as a
Community Recreation Supervisor I with the City ofFresno. Additional qualifying eKpedence may be substituted
for the required education on a year-for-year basis.
SHAUN R. SCHAEFER,MA
S hau n.Sc haefe rk).fres no.zt)v
37101 Avenue 12 '/4 • Madera,California 93638 • (559)696-7899
—General Business Management—Leadership and Organizational Development
Results — oriented leader with over 25 year portfolio of successful programming, strategic
marketing, project development, direction and management; innovative thinker driving
community partnerships and customer return on investments to increase contracts, enhance
performance, and increase revenue and participation in order to achieve maximun utilization of
facilities, resources and staff; community team builder with sound budgetary management and
fiscal accountability.
Expertise Includes:
• Strategic Project Leadership • Marketing&Communications
• Entreprenurial Contract Service • Budget Building&Administration
Development • Corporate,Non-Profit& Foundation
• Cross-Functional Team Leadership Relations
■ Customer Service Assessments& ■ Government&Media Relations
Campaigns • External,Internal&Community Relations
• Grant Aqustion&Fundraising • Stakeholder Relations
• Creative Outreach Strategies
PROFESSIONAL EXPERIENCE
CITY OF FRESNO,PARCS DEPARTMENT,Fresno,CA 1985—Present
Community Recreation Supervisor II 2010—Present
• PARCS Mayoral Initiative Campaign of Adopt-a-Park and Go Green and Clean will
eclipse $1,000,000 (current value $927,813) of community service work value by 16,012
volunteers in early 2014 with 60,326 of volunteer hours to supplement and enhance
PARCS Planned Maintenance and Public Works Landscape Maintenance Service.
• Managed Division and staff through unprecedented organizational downsizing while
maintaining and in some cases increasing service levels.
• Directed stakeholder meetings with Pinedale Community Association, Hinton Muliti-
Cultural Community Center Board, Chicano Youth Center, Leadership Fresno, Church of
Latter Day Saints, and Reading and Beyond to educate and garner partnership support for
service and events.
• Crafted and provided unique annual envents of"Mosqueda Carnaval and Mosqueda Idol"
at the Mosqueda Community Center (Council District 5). The events boosted community
support, service awareness and appreciation for PARCS services and brand.
• PARCS Lead for FUN and has managed fundraisers (Annual Charity Golf Tournaments)
to over $100,000 of net proceeds which have sent thousands 'of inner-city youth to
summer camps since 2006 and generated over $1,000,000 of grants, fundraising and
donations.
■ In 2013 assisted in acquistion of$60,000 community grant from Kaiser Permanente that
enabled PARCS to open up four (4) closed learner pools for the summer aquatics
program.
• In 2013 assisted in the opening of the California& Elm Community Center/Gynasium by
developing the relationship, business plan and contract with lead community based
organization lead—Leadership lst,Boise, Idaho.
SHAUN R.SCHAEFER Shaitn.Schaeferir7rresiml!ou
■ Rebranded contracted services programs to solidify service to vendors and created
overhead charge to recoup staff for direct service time.
Recreation Manger, Community Services Division 2007—2010
Responsible for Community Services Division and providing exemplary service, capital
improvement and management in the areas of Senior Hot Meals, local area school district
contracted services (Elementary Spark Physical Fitness Community Science, Life and
Enviromental Science Program, High School Youth Job Prep Program (YJPP), Summer
Aquatics Program, Community Center Reservations, Volunteer and Work Experience Programs,
Neighborhood Park Services at Mosqueda Community Center and Granny's Science Center,
Community Special Events, Community Based Organization (CBO) Management at Dickey
Youth Development Center, Dog Parks, Department Special Projects and PARCS 501(c)3 non-
profit Fresno United Neighborhoods (FUN).
• Working Fresno County, City of Fresno Human Resources and Personnel Department
and the United States Economic Stimulus Program, acquired funding to stave off layoffs
for over a hundred City of Fresno workers and continue services.
• In 2008 assisted in the opening of the Dickey Youth Development Center and fostered
partnerships with stakeholders, the Chicano Youth Center and the community; building
developed into a tremendous community asset.
• In conjuction with Department Director handled media and public appearances to educate
and inform public with television,radio, print media and public meetings.
■ Transformed in 2009 the discontinued After School Recreation Enrichment Program
(ASR) with Fresno Unified School District (FUSD) and changed services to physical
fitness and nutrition program (SPARK);program is core piece of FUSD elementary after
school program, fiscally sustainable and thriving.
• Awarded 2009 `Achievement Award' for the Youth Job Prep Program(Fresno BEST) by
the California Parks and Recreation Society(CPRS).
■ Awarded 2010 `Bright Idea Award' from the Harvard University School of Business for
the Youth Job Prep Program.
• Ignited working relationships with Fresno State University, Fresno Pacific University,
Fresno City College, Fresno Unified School District and Fresno County to create
opportunities for youth, volunteerism services, education and employment (current and
future).
Community Recreation Supervisor H 2005—2007
Served as lead for direct service programming in the Community Services Division under the
lead of the Division Manager; supervised a team of six (6) supervisors and community
coordinators. Built Mayoral Initiative High School Job Skills Development Program Fresno
BEST and expanded it to provide service to all FUSD High Schools. Implemented Mayor
Technology Access Initiative of Fresno Connect which provided computer access and
programming at PARCS Community Centers and Neighborhood Parks. Implemented Mayoral
Initiative to provide employment opportunities to Fresno citizens with the Mayor's Job Initiative
(MR). Evaluated programs to ascertain efficiency and effectiveness of resources, outcomes and
staff.
Utlimately,promoted to Community Services Division Manager for the PARCS Department.
Exhibit F
Service Provider Emer enc Resource Information
Please complete for each location from which contracted services are offered.
Organization CITY OF FRESNO
Site Name LAFAYETTE
Street Address 1516 E. PRINCETON AVE.
City/ST/Zip FRESNO, CA 93704
Primary Contact SHAUN SCHAEFER
Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFER@FRESNO.GOV
Office Phone 559 621-2910 Cell Phone 559 696-7899
Secondary RICH RODRIGUEZ
Contact:
Job Title COMMUNITY REC SUP I E-mail RICARDO.RODRIGUEZ@FRESNO.GOV
Office Phone 559 621-6622 Cell Phone 559 246-9628
Please check all emergency services that could be provided from this site:
Emergency Power/Generator CB Radio
X Emergency First Aid Ham Radio
X Cookinq Facilities Internet Access
X Distribution Site for Food & Water Spanish Translation
Counseling Services _ Sign Language Translation
Home/Neighborhood Cleanup _f Other Translation:
Yes No
Can this site provide temporary shelter space for 48 hours or more in the X
event of an emergency?
Is this site able to help with assessing the needs of older individuals in the X
neighborhood or community following a disaster?
Following a major disaster, can this site help transport older individuals to X
disaster services?
Does this site have a dedicated vehicle that is lift-equipped? X
Given the resources, can this site expand meal services following a X
disaster to meet needs in the community?
How many people can this facility provide emergency shelter for? 60
How many days can this facility function using its back-up power source? 0
How many gallons of water are stored on-site as an emergency supply? NONE
Please list any additional services your site can provide in the event of a disaster: UNKNOWN
Emergency Resource Information Exhibit F FY 2017-2018
i
��
Exhibit F
Service Provider Emergency Resource Information
Please complete for each location from which contracted services are offered.
Organization CITY OF FRESNO
Site Name MARY ELLA BROWN
Street Address 1350 E. ANNADALE
City/ST/Zip FRESNO, CA 93706
Primary Contact SHAUN SCHAEFER
Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFER@FRESNO.GOV
Office Phone 559 621-2910 Cell Phone 559 696-7899
Secondary RICH RODRIGUEZ
Contact:
Job Title COMMUNITY REC SUP I E-mail RICARDO.RODRIGUEZ@FRESNO.GOV
Office Phone 559 621-6622 Cell Phone 559 246-9628
Please check all emergency services that could be provided from this site:
Emergency Power/Generator CB Radio
X Emergency First Aid Ham Radio
Cooking Facilities Internet Access
X Distribution Site for Food &Water Spanish Translation
Counseling Services Sign Language Translation
Home/Neighborhood Cleanup Other Translation:
Yes No
Can this site provide temporary shelter space for 48 hours or more in the X
event of an emergency? _
Is this site able to help with assessing the needs of older individuals in the X
neighborhood or community following a disaster?
Following a major disaster, can this site help transport older individuals to X
disaster services?
Does this site have a dedicated vehicle that is lift-equipped? X
Given the resources, can this site expand meal services following a X
disaster to meet needs in the community?
How many people can this facility provide emergency shelter for? 165
How many days can this facility function using its back-up power source? 0
How many gallons of water are stored on-site as an emergency supply? NONE
Please list any additional services your site can provide in the event of a disaster: UNKNOWN
Emergency Resource Information Exhibit F FY 2017-2018
i
Exhibit F
Service Provider Emer_qency Resource Information
Please complete for each location from which contracted services are offered.
Organization CITY OF FRESNO
Site Name MOSQUEDA
Street Address 4670 E. BUTLER AVE
City/ST/Zip FRESNO, CA 93702
Primary Contact SHAUN SCHAEFER
Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFER@FRESNO.GOV
Office Phone 559 621-2910 Cell Phone 559 696-7899
Secondary RICH RODRIGUEZ
Contact:
Job Title COMMUNITY REC SUP I E-mail RICARDO.RODRIGUEZ@FRESNO.GOV
Office Phone 559 621-6622 Cell Phone 559 246-9628
Please check all emergency services that could be provided from this site:
Emergency Power/Generator CB Radio
X Emergency EmeEgency First Aid Ham Radio
X Cooking Facilities X Internet Access
X Distribution Site for Food & Water Spanish Translation
Counseling Services Sign Language Translation
Home/Neighborhood Cleanup Other Translation:
Yes No
Can this site provide temporary shelter space for 48 hours or more in the X
event of an emergency?
Is this site able to help with assessing the needs of older individuals in the X
neighborhood or community following a disaster?
Following a major disaster, can this site help transport older individuals to X
disaster services?
Does this site have a dedicated vehicle that is lift-equipped? X
Given the resources, can this site expand meal services following a X
disaster to meet needs in the community?
How many people can this facility provide emergency shelter for? 234
How many days can this facility function using its back-up power source? 0
How many gallons of water are stored on-site as an emergency supply? NONE
Please list any additional services your site can provide in the event of a disaster: UNKNOWN
I
Emergency Resource Information Exhibit F FY 2017-2018
Exhibit F
Service Provider Emergency Resource Information
Please complete for each location from which contracted services are offered.
Organization CITY OF FRESNO
Site Name PINEDALE
Street Address 7170 N. SAN PABLO
City/ST/Zip FRESNO, CA 93650
Primary Contact SHAUN SCHAEFER
Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFER@FRESNO.GOV
Office Phone 559 621-2910 Cell Phone 559 696-7899
Secondary RICH RODRIGUEZ
Contact:
Job Title COMMUNITY REC SUP I E-mail RICARDO.RODRIGUEZ@FRESNO.GOV
Office Phone 559 621-6622 Cell Phone 559 246-9628
Please check all emergency services that could be provided from this site:
Emergency Power/Generator CB Radio
X Emergency First Aid Ham Radio
X Cooking Facilities Internet Access
X Distribution Site for Food & Water Spanish Translation
Counseling Services Sign Language Translation
Home/Neighborhood Cleanu Other Translation:
Yes No
Can this site provide temporary shelter space for 48 hours or more in the X
event of an emergency?
Is this site able to help with assessing the needs of older individuals in the X
neighborhood or community following a disaster?
Following a major disaster, can this site help transport older individuals to X
disaster services?
Does this site have a dedicated vehicle that is lift-equipped? X
Given the resources, can this site expand meal services following a X
disaster to meet needs in the community?
How many people can this facility provide emergency shelter for? 252
How many days can this facility function using its back-up power source? 0
How many gallons of water are stored on-site as an emergency supply? NONE
Please list any additional services your site can provide in the event of a disaster: UNKNOWN
Emergency Resource Information Exhibit F FY 2017-2018
r
Exhibit F
Service Provider Emergency Resource Information
Please complete for each location from which contracted services are offered.
Organization CITY OF FRESNO
Site Name SENIOR CITIZENS VILLAGE
Street Address 1917 S. CHESTNUT AVE
City/ST/Zip FRESNO, CA 93702
Primary Contact SHAUN SCHAEFER
Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFER@FRESNO.GOV
Office Phone 559 621-2910 Cell Phone 559 696-7899
Secondary RICH RODRIGUEZ
Contact:
Job Title COMMUNITY REC SUP I E-mail RICARDO.RODRIGUEZ@FRESNO.GOV
Office Phone 559 621-6622 Cell Phone 559 246-9628
Please check all emergency services that could be provided from this site:
X Emergency Power/Generator CB Radio
X Emergency First Aid Ham Radio
X Cooking Facilities Internet Access
X Distribution Site for Food &Water Spanish Translation
Counseling Services Si n Language Translation
Home/Neighborhood Cleanup Other Translation:
Yes No
Can this site provide temporary shelter space for 48 hours or more in the X
event of an emer enc ?
Is this site able to help with assessing the needs of older individuals in the X
neighborhood or community following a disaster?
Following a major disaster, can this site help transport older individuals to X
disaster services?
Does this site have a dedicated vehicle that is lift-equipped? X
Given the resources, can this site expand meal services following a X
disaster to meet needs in the community?
How many people can this facility provide emergency shelter for? 175
How many days can this facility function using its back-up power source? 0
How many gallons of water are stored on-site as an emergency supply? NONE
Please list any additional services your site can provide in the event of a disaster: UNKNOWN
Emergency Resource Information Exhibit F FY 2017-2018
r
Exhibit F
Service Provider Emergency Resource Information
Please complete for each location from which contracted services are offered.
Organization CITY OF FRESNO
Site Name TED C WILLS
Street Address 770 N. SAN PABLO AVE.
City/ST/Zip FRESNO, CA 93728
Primary Contact SHAUN SCHAEFER
Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFER@FRESNO.GOV
Office Phone 559 621-2910 Cell Phone 559 696-7899
Secondary RICH RODRIGUEZ
Contact:
Job Title COMMUNITY REC SUP I E-mail RICARDO.RODRIGUEZ@FRESNO.GOV
Office Phone 559 621-6622 Cell Phone 559 246-9628
Please check all emergency services that could be provided from this site:
Emergency Power/Generator CB Radio
X Emergency First Aid Ham Radio
X Cooking Facilities X Internet Access
X Distribution Site for Food &Water Spanish Translation
Counseling Services Sign Language Translation
Home/Neighborhood Cleanup Other Translation:
Yes No
Can this site provide temporary shelter space for 48 hours or more in the X
event of an emergency?
Is this site able to help with assessing the needs of older individuals in the X
neighborhood or community following a disaster?
Following a major disaster, can this site help transport older individuals to X
disaster services?
Does this site have a dedicated vehicle that is lift-equipped? X
Given the resources, can this site expand meal services following a X
disaster to meet needs in the community?
How many people can this facility provide emergency shelter for? 531
How many days can this facility function using its back-up power source? 0
How many gallons of water are stored on-site as an emergency supply? NONE
Please list any additional services your site can provide in the event of a disaster: UNKNOWN
Emergency Resource Information Exhibit F FY 2017-2018
p
City of Fresno
Parks,After School, Recreation and Community Services Department
l Senior Hot meals and Recreation Program (SHM)
Bruce Rudd
Interim PARCS Director
Shaun Schaefer
Community Recreation Supervisor II
Ricardo Rodriguez
Communitv Recreation Supervisor I
Daniela Gonzalez
Recreation Specialist
Site Clerical
Monitor 7 Services Aide
FMAAA
Site Coordinators
i
CITY OF FRESNO COUNCILMEMBERS
AND COUNCIL DISTRICTS
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