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HomeMy WebLinkAboutFresno-Madera Area Agency on Aging - Site Management Agmt 19-0310 Agency on A8in8 Serving Fresno & Madera Connecting the Community Fiscal Year 2018-2019 Contract between City of Fresno and Fresno-Madera Area Agency on Aging Contract No. 19-0310 Site Management Area Plan Grant Award Table of Contents (Continued) APPENDICES Resolution of Authorization to Contract ......................................................Appendix A Contractor Certification Clauses .................................................................Appendix B Information Integrity and Security 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 ProgramNarrative .......................................................................................... Exhibit E Service Provider Emergency Resource Information ....................................... Exhibit F Area Plan Grant Award iii FY 2018-2019 Table of Contents Summary of Substantive Revisions Fresno-Madera Area Agency on Aging Fiscal Year 2018-2019 Area Plan Service Provider Contracts Article V, Assurances Section H, Information Integrity and Security, Paragraphs 2 and 2.a ................ 128-Bit encryption required for data that is confidential, sensitive, and/or personal information, including data stored on all computing devices. New paragraph added to prohibit use of portable electronic storage media (including, but not limited to jump drives, thumb drives, and flash drives; portable hard drives; and CDs, DVDs, and other discs). Section H, Information Integrity and Security, Paragraph 4.a Information Security Awareness Training renamed to Privacy and Information Security Awareness Training; hard copy no longer available. (Training must be completed online.) Section H, Information Integrity and Security, Paragraph 6 Contractor/Vendor Confidentiality Statement (Appendix C) renamed to Information Integrity and Security Statement. Article VII, Budget and Budget Revision Section D, Program Specific Funds Paragraphs 1.d (permitted deferral of excess program income to first quarter of following contract year) and 1.e (use of deferred program income by last day of fiscal year) from fiscal year 2017-2018 contract deleted; paragraphs f-h renumbered to d-f. Paragraph 2.b.1) from fiscal year 2017-2018 contract deleted (permitted purchase of equipment with one-time-only funds). Article VIII, Payment Section A, Payment Last sentence added, pertaining to monthly expenditure reports: The report shall include all costs and funding sources for the month prior. Section G, Closeout Paragraph 1 revised to include requirement for submittal of Fixed Assets Acquired through Grants with the Fresno-Madera Area Agency on Aging (FMAAA 32) with Financial Closeout Report. -- ........ Article XI, Property Section B Paragraphs 1 and 2 revised to change definition of Property. Paragraph 2.a added to prohibit purchase and use of portable electronic storage media. Summary of Substantive Revisions Page 1 of 2 Fiscal Year 2018-2019 Area Plan Service Provider Contracts 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, 2018 to June 30, 2019, subject, however, to earlier termination as provided herein. C. No expenditure or obligation for the funding allocation for the July 1, 2018 through September 30, 2018 period may be incurred after September 30, 2018. No expenditure or obligation for the funding allocation for the October 1, 2018 through June 30, 2019 period may be incurred after June 30, 2019, 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 April 18,2018 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 _.- . .-----........_ Contract No.: 19-0310 Service: I Site Management Site July 2018- October 2018- FY 2018-2019 September 2018 June 2019 Grant Amount Inspiration Park $2,000 $6,000 $8,000 Lafayette Neighborhood Center $2,000 $6,000 $8,000 Mary Ella Brown Community Center $2,000 $6,000 $8,000 Mosqueda Community Center $3,000 $9,000 $12,000 Pinedale Community Center $3,000 $9,000 $12,000 Senior Citizens Village $4,000 $12,000 $16,000 Ted C, Wills Community Center $4,000 $12,000 $16,000 Total Fiscal Year 2018-2019 Grant Award: $80,000 Area Plan Grant Award Page 1 FY 2018-2019 Contract 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 2 FY 2018-2019 Contract FOR SERVICE PROVIDER: Signature of individual named on Exhibit E,page 5, as having Date primary, hands-on involvement and oversight of the day-to-day operations of the contracted program. Type Name Title 7� Signature of Authorized Contracting Official Date (Refer to Appendix A) PARVIN J. NELOMS, JR DIRECTOR, PARCS Type Name of Authorized Contracting Official Title CII�OVEO��TOY'SOORM FFICE Signature �_ Date A RNEY Type Name Title U ATTEST: YVONNE SPENCE, CMC Signature CITY CLERKJ/-75/IT 5l'q Date By Type Name eeputy Title Contractor Federal Employer I.D. Number: 94-600338 FOR FRESNO-MADERA AREA AGENCY ON AGING: S' ature Date Jean Robinson Executive Director Area Plan Grant Award Page 2a FY 2018-2019 Contract i ADDENDUM TO CONTRACT NO. 19-0310 BETWEEN CITY OF FRESNO AS SERVICE PROVIDER AND FRESNO-MADERA AREA AGENCY ON AGING (HEREINAFTER REFERRED TO AS AGENCY ON AGING) I 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, Paragraph 11 (page 16): 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 2018-2019 Grant Award of both the Contractor and its subcontractors. 2. Article XV, Insurance, Section J (page 44a: 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 2018-2019 Contract No. 19-0310 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. "OAA" means Older Americans Act. I. "OMB" means the federal Office of Management and Budget. S "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 2018-2019 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.goylgrants/,qrants/grants-policies regu lations/index.htm I 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, 2018, through June 30, 2019, at which time the Agreement expires, subject however, to earlier Area Plan Grant Award 5 FY 2018-2019 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 2018-2019 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 2018-2019 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 2018-2019 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 Subcontractors/Vendors are required to use 128-Bit encryption for 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). a. Use of portable electronic storage media (including, but not limited to jump drives, thumb drives, and flash drives; portable hard drives; and CDs, DVDs, and other discs) is not allowed under this Agreement. 3. Disclosure a. The Contractor, and its Subcontractors/Vendors, 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 Subcontractors/Vendors, 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 Subcontractors/Vendors, shall not use confidential, sensitive, and/or personal identifying Area Plan Grant Award 13 FY 2018-2019 Terms and Conditions Declaration 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 H I PAA. 6. Information Integrity and Security Statement The Contractor shall sign and return to the Agency on Aging the Information Integrity and Security 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:/Iwww.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. 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. Area Plan Grant Award 15 FY 2018-2019 Terms and Conditions Declaration 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, 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. Area Plan Grant Award 17 FY 2018-2019 Terms and Conditions Declaration 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 applicant, and such persons have successfully competed for employment with the other applicants on a merit basis. Area Plan Grant Award 19 FY 2018-2019 Terms and Conditions Declaration 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. ollowing: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: a. Amount or duration of a service. Area Plan Grant Award 21 FY 2018-2019 Terms and Conditions Declaration 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.calhr.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.cal h r.ca.gov/employees/Pages/trave I- lodging-reimbursement.aspx Out of State: http://www.ca[hr.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 those provided by this Agreement, between the CaIHR rates and any rates the Contractor is obligated to pay Area Plan Grant Award 23 FY 2018-2019 Terms and Conditions Declaration 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 additional restrictions, limitations, or conditions enacted by the Area Plan Grant Award 25 FY 2018-2019 Terms and Conditions Declaration 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. Program Income may not be used to meet the matching requirements of this Agreement. e. Program Income must be used to expand baseline services. Area Plan Grant Award 27 FY 2018-2019 Terms and Conditions Declaration 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. Matching 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). b. Title III E Family Caregiver Support Program: Approximately fifty percent (50%) of the sum of the grant award, plus the minimum matching contributions. 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. Area Plan Grant Award 29 FY 2018-2019 Terms and Conditions Declaration 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 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. Area Plan Grant Award 31 FY 2018-2019 Terms and Conditions Declaration 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. 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. Area Plan Grant Award 33 FY 2018-2019 Terms and Conditions Declaration 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, Special Deposit Fund (SDF) & Skilled Nursing Facility Quality & Accountability Fund (SNFQAF) (CDA-OMB-300) for the month in which the property was acquired. F. 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; fund source; and specific location of the property. G. The Contractor shall maintain a cumulative inventory, including the Asset Tag number and all information required by Section F 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. H. 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. I. 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 submit Fixed Assets Acquired through Grants with the Fresno-Madera Area Agency on Aging (FMAAA 32) with the annual Financial Closeout Report to the Agency on Aging. Corresponding reconciliation must be kept on file and available for review by the Agency on Aging. J. 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 California Department of Aging, through the Agency on Aging, for all reportable property as defined in Section B of this Article. The Contractor shall submit a Request to Dispose of Property(FMAAA 248) to the Agency on Aging to request disposal of property. Area Plan Grant Award 35 FY 2018-2019 Terms and Conditions Declaration Q_ 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. 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. 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 Area Plan Grant Award 37 FY 2018-2019 Terms and Conditions Declaration 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] [formerly OMB Circular A-133], Audits of States, Local Governments, and Non-Profit Organizations) 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 Area Plan Grant Award 39 FY 2018-2019 Terms and Conditions Declaration 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] 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. Area Plan Grant Award 41 FY 2018-2019 Terms and Conditions Declaration 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. 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. Area Plan Grant Award 43 FY 2018-2019 Terms and Conditions Declaration 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. ARTICLE XVII. TERMINATION A. Termination Without Cause 1. The Agency on Aging may terminate performance of work under this Agreement at any time during the Agreement term, 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, 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 Agency on Aging may, at its discretion, decline to negotiate additional one-year Agreement periods with the Contractor beyond the initial one-year contract award term, or, as a result of the Request for Proposal process, reject the Contractor's proposal for provision of service beyond the term of this Agreement; in such cases, the Agency on Aging shall provide a minimum of thirty (30) days written notice to the Contractor of non-renewal or non-award of the contract, effective on the last day of the term of this Agreement. 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. Area Plan Grant Award 45 FY 2018-2019 Terms and Conditions Declaration 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. I. 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 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) Area Plan Grant Award 47 FY 2018-2019 Terms and Conditions Declaration 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 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. Area Plan Grant Award 49 FY 2018-2019 Terms and Conditions Declaration APPENDIX A RESOLUTION OF AUTHORIZATION TO CONTRACT CITY OF FRESNO The governing board of the /Ccrvir a Prnvirfizr) hereby authorizes PARVIN J. NELOMS JR, 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, 2018, to June 30, 2019, including any subsequent amendments and all necessary supporting documents. STEVE BRANDAU, COUNCIL PRESIDENT Name of Chair (Please Print) Governing Board I ?) 19 Signature of Chair Date Governing Board Resolution of Appendix A FY 2018-2019 Authorization to Contract 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 C acto endor Name (Typed) Federal ID Number 1 9 Autjorized Signature Date Executed PARVIN J. NELOMS JR, DIRECTOR, PARCS Name and Title of Person Signing (Typed) CONTRACTOR CERTIFICATION CLAUSES Source: State of California CCC 04/2017 1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the nondiscrimination program requirements. (Gov. Code §12990 (a-f) and CCR, Title 2, Section 11102) (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 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. 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 Contractor Certification Appendix B— Page 1 FY 2018-2019 Clauses APPENDIX B CONTRACTOR CERTIFICATION CLAUSES any future State agreements if the department 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 State. Failure to make a good faith effort may be cause for non-renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State 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 State of California. 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 state pursuant to the contract have been laundered or produced in 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.aov, 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 Contractor Certification Appendix B— Page 2 FY 2018-2019 Clauses APPENDIX B CONTRACTOR CERTIFICATION CLAUSES authorized officials of the contracting agency, 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 of$100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.3. 8. GENDER IDENTITY: For contracts of$100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.35. 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 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)) Contractor Certification Appendix B— Page 3 FY 2018-2019 Clauses APPENDIX B CONTRACTOR CERTIFICATION CLAUSES 2. LABOR CODEMORKERS' 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 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 U.S.C. 12101 et seq.) 4. 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 State will process the amendment. Payment of invoices presented with a new name cannot be paid prior to approval of said amendment. 5. 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. 6. RESOLUTION: A county, city, district, or other local public body must provide the State 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. 7. 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. 8. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity. Contractor Certification Appendix B— Page 4 FY 2018-2019 Clauses APPENDIX C INFORMATION INTEGRITY AND SECURITY STATEMENT CERTIFICATION I hereby certify that I have reviewed this Confidentiality Statement and will comply with the Statements below CITY OF FRESNO 19-0310 ContractorNen r Name (Typed) Contract Number Authorized Signature Date PARVIN J. NELOMS JR., DIRECTOR, PARCS Name and Title of Person Signing (Typed) In compliance with California Government Code Section 11019.9, California Civil Code Section 1798 et seq., Management Memo 06-12 and Budget Letter 06-34 the California Department of Aging (CDA) hereby requires the Contractor/Vendor to certify that: • 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 CDA by completing a Security Incident Report (CDA 1025). • 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. • 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 ContracVAgreement will continue after termination of the Contract/Agreement with CDA. Information Integrity and Appendix C— Page 1 FY 2018-2019 Security Statement APPENDIX C INFORMATION INTEGRITY AND SECURITY STATEMENT ® All employees/subcontractors of the Contractor/Vendor will complete the required Privacy and Information Security Awareness Training module located at www.aginq_ca.cgov. within 30 days of the start date of this Contract/Agreement or within 30 days of the start date of any new employee or subcontractor, and annually thereafter. ® All employees/subcontractors of the Contractor/Vendor will be notified of CDA's confidentiality and data security requirements. CDA or its designee will be granted access by the Contractor/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. a 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. Information Integrity and Appendix C— Page 2 FY 2015-2019 Security 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. 1 . Review Article XIV of this Agreement (Audit Requirements). 2. Place an X in the appropriate box below: XAn independent audit shall be performed in accordance with the 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. I I An independent audit shall be performed and a copy submitted to the Agency on Aging. FAll supporting documentation shall be submitted to the Agency on Aging for review along with any request for reimbursement. Enter Fiscal Year Ending Date-o-L063� 219 Month Day Year Method of Providing Appendix D FY 2018-2019 Audit Compliance 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 W of each month • Monthly Report of Expenditures and Donations Revenue Title III E Family Caregiver Support Program Due W of each month Title III E Monthly Report of Expenditures Health Insurance Counseling and Advocacy Program Due 151 of each month ■ HICAP Monthly Report of Expenditure/Request for Funds (CDA 245) Long-Term Care Ombudsman Program Due W 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 by the last day of the month 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 and FMAAA 32, Fixed Assets Acquired through Grants with the Fresno-Madera Area Agency on Aging 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 w 2nd 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 (FMAAA 248) 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 2018-2019 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, associated Client Intake Forms, and Client Deactivation Request • Title III B Legal Assistance ■ Title III B Transportation ■ Title III D Health Promotion i 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 *See Policy and Procedure Manual, provided to Site Coordinator, for full instructions ■ Q Monthly Service Roster with client signatures and a "1" entered for each meal ■ Daily Sign-In Sheets with initials entered by client for each meal • Associated Client Intake Forms (originals; must be completed July 1, 2018 or later) ■ Client Deactivation Request • Nutrition Volunteer Summary Report • Food Preparation Center Food Service Check Sheet Quarterly Reports Due 15m 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) Quarterly Reports Due 3e of month following reporting period ■ 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 1St through last day of reporting quarter Required Reports & Due Dates Appendix E- Page 2 FY 2018-2019 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 2018-2019 5. Failure to respond to telephone or written communications from the Agency on Aging in a timely manner; or & 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 2018-2019 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, Health Insurance Counseling and Advocacy Program Contract). Sanction Policy Appendix F— Page 3 FY 2018-2019 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 2018-2019 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 2018-2019 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 2018-2019 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 2018-2019 for Service Providers APPENDIX H FRESNO-MADERA AREA AGENCY ON AGING CONTACT LIST FOR SERVICE PROVIDERS Telephone Number for All Contacts: (559) 6004405 Linda Descoteaux Contract Administration Administrative Manager Administrative & Program Monitoring Email: Idescoteaux@fmaaa.org (excluding 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 Yvonne Hamilton Monthly Service Unit Reports and Supporting Administrative Analyst Rosters Email: yhamilton@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 2018-2019 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 2018-2019 Emergency Contact Information 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 (2 1)) Planning and Service Area 14 - Designated Community Focal Points Fresno County Fresno-Madera Area 3837 N. Clark St. Agency on Aging Fresno, CA 93726 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. 3'd 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 11450 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 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 2018-2019 Form W-9 Request for Taxpayer Give Form to the (Rev.November 2017) IdenMcat on Number and CertMicatlon requester.Do not Ueparsmem of the Treasury send to the IRS. Internal Mvenue Service 00,Go to www.k&gov1Form W9 for instructions and the tsbst information. 1 !Name(as shown on your income rax return).Name Is eoqulrud on this fhDo:do not leave this Tlno 111nnk, CITY OF FRESNO 2 SuSinsss narnWdiSregardad entity name,if different from above 3 Check appropriate box for federal lax classification of the person whose name Is entered on line 1.Check only one of the 4 Exemptions(codes appy only to following seven boxes. certain entities,not individuals;see p ❑ IndlvklueUsole proprietor or 11C Corporation ❑S Corporation instructions on page 3): n slrtgle member LLC ❑ Pertrtership ❑Trusf/estate oe Exempt payee code(If any) ` ❑ Umkad WIRY company.Enter the tax classi fcatlorr(C=C corporation,S S Corporation.P=Parfnership)000 2 Noor_Chock tiro appropriate box Tn the line above for the tax classftahon of tho sing le-rr aa"r owner, do not Check Exemption from FATCA reporting LLC If the LLC is claasifed as a aingla-member LLC that is disr&9mx stf frnrrr Itis owner un Is as The owner of the LLC Ls coda(If any) IL U anotherpar LLC that is not dlsraded from The owner for U.S.fadwat tax purposes � ,Otherwise,a singmembar LLC that Is disregarded from the owner shouki Clock the appropriato box:for She tux cassiflcstion of its ownar. ✓ Other(see rnstrtlptibn8)► (Agri.to eanouatr m•hmow cub(de the u sj 5 Address(number,street,and apt.or suits no.}See Instructions. Repuester's name and address(opsicnao 1515 E.DNISADERO ST. 6 City,state,and ZIP code FRESNO,CA 93721 7 List account mmnads)horn(aptlom4 Taxpayor identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social serurtty number backup withholding.sole For individuals,this is dgen orallyantsy, your social security number(55N).F However,er,fora resident align,sofa prop rletnr,or disregarded entity,sea the Instructions for Part I,(star.For other entities,it is your employer identification number(ERN).if you do not have a num bor.see How to get a TIN,later. or Note:If the account is in more than one name,see the instructions for litre 1.Also see What Name and Employer kfantNication number Number To Give the Requester for guidelines on whose number to enter. 9 4 — 6 0 0 0 3 3 8 Certification Under penalties of perjury,I certify that: 1.The number shown on Ihls 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 Into mat Revenue Service(IRS)that f am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)Iha 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(if any)indicating that I am exempt from FATCA reporting is correct. Certification inshuctions,You must Cross out item 2 above if you have been noti(led by the IRS Shat you are currenUy subject to backup wlthhokfing because You have failed to report all interest and dividends on your sax relum.For real estate transactions,item 2 does not apply.For rnortgage interest paid, acquisition orabandonmunt of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRAs).and gonamiy.payments other than Interest and dividends,you are not required to sign the Ctartificatfon.but you must provide your correct TIN.See the Instructions for Pout 11,later. Sign Here U-S,person . pats■ 1- to Ir General In., ructibns •Form 1099-DN(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise f Form 1099-MISC various p noted. ( types of income,prizes,awards,or gross proceeds) Future to Form W- an For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as 1e91siatf4n enacted t after they were published,go to www.irs.govlFotransactions by brokers) Form tons b rmW9. t S(proceeds from real Purpose of Form •Form 1099-K(merchant card and estate transactions) b party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1099-E(student ban interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identsfrcation number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SS N),Individual taxpayer identification number(ITItN),adoption •Form 1099-A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer Identification number (EIM,to report on an Information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN, returns include,but are not limited to,the following. It you do not return Form W-9 to the requester with a T1N,you might •Form 1099-INT(Interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.Nn.10231X Form W-9(Rev.11-2017) City of Fresno Parks,After School, Recreation and Community Services Department Senior Hot meals and Recreation Program (SHM) Parvin Neloms PARCS Director Shaun Schaefer Community Services Manager Community Recreation Supervisor II Ricardo Rodriguez Communitv Recreation Supervisor I Daniela Gonzalez Recreation Specialist Program Community Coordinator 8 _ Recreation SHM Site Coordinators Assistant 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 2018-2019 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 2018-2019 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 (as defined in paragraphs i. 1) and i. 2) below); homebound by reason of illness or disability; or otherwise isolated. [22 CCR §7638.7(c)(1)] These individuals shall be given priority in the delivery of services. [45 CFR §1321.69(a)] 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)] [22 CCR §7638.7(c)] Elderly Nutrition Program Exhibit A— Page 3 FY 2018-2019 Site Management 1. 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 Agency on Aging mandated 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 Agency on Aging reserves the right to allocate meal quantities for the Elderly Nutrition Program. The service provider may be held financially responsible, at the Current Meal Rate, for all meals ordered which exceed the site's assigned allocation. 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 2018-2019 Site Management 3. Site Management Responsibilities In compliance with Title 22, CCR, Article 5, and the Agency on Aging Nutrition Policies and Procedure Manual provided to the service provider's site coordinator, 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 levels (however, this is not to be construed that the service provider is precluded from serving above allocation levels assigned by the Agency on Aging by using donations or other sources of revenue to supplement the number of meals; 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 2018-2019 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; I. 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; Elderly Nutrition Program Exhibit A— Page 6 FY 2018-2019 Site Management t. Provide a welcoming, pleasant dining environment for congregate meals that affords older adults an opportunity for 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. IV, 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 Wednesday, July 4, 2018 Labor Day Monday, September 3, 2018 Veterans Day Monday, November 12, 2018 Thanksgiving Holiday Thursday, November 22, 2018 and Friday, November 23, 2018 Christmas Holiday Tuesday, December 25, 2018 New Years Holiday Tuesday, January 1, 2019 Martin Luther King Jr. Day Monday, January 21, 2019 Presidents Day Monday, February 18, 2019 Memorial Day Monday, May 27, 2019 Elderly Nutrition Program Exhibit A— Page 7 FY 2018-2019 Site Management W d rn m v O T O m 00 00 meq 00 kfj W) In kn O N O W r" . a G7 0 0 o " 0 0 0 0 00 00 m 00 Z A o 0 0 m v, v) Wn O V O OO 1: O� T C O� 00 00 E" a$a N .Nr .. .r .r n n W a ,a zs 6s z z � m o u s� z " 00 � z c vi 00 D M (71 In o iw A N O O N b O VC7 M N N b M o00 W N !k7 F ❑ z el \0 \ a°. e 0 p0 tW� O o W O O q O O O G O O n n zj ;2 ��' (�pj� O O O pp p O pp I gC N N in O r r- H .� - C O V ti A ./7 u ti O qu C7 a o 0 o r� 0 00 m m oo s A S00 Zas a 000 N Off+' Obi O�ia N N N N p� O ts a C V 0. QI �l LL iT a V w pq b o 0 W v -e N N N N N �T+ 0. pCQ r� e� R R ' y z d G S U U $ J z q O � : � a� � U U U P, •rnv� a � H1nH z Q m U� 146 00 Z O b O en b o 00 06 oe � F Z pa C N O u g :zs C �D 10 �D Y1 A L7 00 00 00 n n ° o� z F tr. ou w N � a H C zo w en m 9 W 0 C1 0 'a W rn o u w AE" ocr] , n. mM o�o g $ eo z .y 4 0 IN � w 1 0 � � � a i� ; � F � i� ;fj � o. y '� � •9 � e erg � U � rj aai aa � � A O • > E aQ W ° •� �yr D � I PWS" � ' '43 z •a F O 0�• = w > o. d ci W iF; ad ei ,W U a ..i r .N N rii 4 vi z o o �o q oo M J V a o km w a W AN Z A H Iq N OA a M yNo A e� .O V1 4 A t,S Is Certificate Number Issue Date 20190026 CERTIFICATE OF SELF-INSURANCE 12/27/18 City of Fresno COVERAGE AFFORDED BY THIS CERTIFICATE IN NO Personnel Services Department EVENT EXCEEDS THE COVERAGE AFFORDED BELOW. Risk Management Division THIS COVERAGE DOES NOT EXTEND TO THE SOLE Fresno, CA 93721-3612 NEGLIGENCE OR WILFUL MISCONDUCT OF THE (559) 621-6900 ADDITIONAL INSURED, COVERAGES THIS IS TO CERTIFY THAT THE CITY IS SELF-INSURED FOR THE COVERAGE AND PERIOD SHOWN BELOW, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE FOR GENERAL LIABILITY AND AUTO LIABILITY IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF THE SPECIAL EXCESS LIABILITY POLICY FOR PUBLIC ENTITIES, WHICH THE CITY MIRRORS IN PROVIDING THIS SELF-INSURANCE. Type of Coverage Effective Date Expiration Date Limits of Liability General Liability 07/01/2018 06/30/2019 Each occurrence $1,000,000 Single Limit Automobile Liability 07/01/2018 06130/2019 Combined Sing ,000,000 — (each accident) Workers' Compensation Statutory Limits Each Accident $1,000,000 Employer's Liability 07/01/2018 06/30/2019 Disease-Each employee $1,000,000 Disease-Polis Limit $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS The Fresno-Madera Area Agency on Aging (FMAAA) its officers, agents, employees, and servants are included as additional insureds with respect to work performed for the FMAAA under this Agreement: Contract No. 19-0310, Site Management. CERTIFICATE HOLDER CANCELLATION COVERAGE IS IN EFFECT AS STATED ABOVE AND Fresno-Madera Area Agency on Aging WILL NOT BE CANCELLED BEFORE THE EXPIRATION 3837 N Clark Street DATE THEREOF, EXCEPT UPON 30 DAYS WRITTEN Fresno CA 93726 NOTICE TO THE CERTIFICATE HOLDER, City of Fresno eatifer Haupt, Risk Analyst KACertificates of Insurance1FY2019\Cert 20190026 FMAAA.docx EXHIBIT C ANNUAL SUMMARY OF ACTIVITIES PROGRAM: Elderly Nutrition Program Site Management SERVICE PROVIDER: City of Fresno CONTRACT NUMBER: 19-0310 SITES: Seven Sites in City of Fresno (See List Below) CONTRACT EFFECTIVE: July 1, 2018 to June 30, 2019 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. Conqregate Nutrition Meal Sites Inspiration Park Pinedale Community Center Lafayette Neighborhood Center Senior Citizens Village Mary Ella Brown Community Center Ted C. Wills Community Center Mosqueda 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 2018-2019 Site Management EXHIBIT D PROGRAM COST EFFICIENCY Not Applicable — Elderly Nutrition Program Site Management Program Cost Efficiency Exhibit D FY 2018-2019 Exhibit E Program Narrative 1. AGENCY'S HISTORY OF SERVICE TO OLDER ADULTS City of Fresno881 5 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 yearsyour organization has provided the program/service. Program/Service # of Years Congregate Nutrition Program 22 2. SERVICE AREA Where will the contracted program be provided? Street Address J City Zip Code Inspiration Park 5770 W Gettysburg Ave Fresno 93722 Lafayette Neighborhood Center Fresno 93704 1516 E Princeton Ave ... . ........ Mary Ella Brown Community Center Fresno 93706 1350 E Annadale Ave ... ................. . .... .... Mosqueda Community Center Fresno 93702 4670 E Butler Ave - Pinedale Community Center 7170 N San Pablo Ave Fresno 93650 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 2018-2019 Title III C Nutrition Site Management Exhibit E Program Narrative 3. LANGUAGE TRANSLATION NEEDS & PROVISIONS Enter an "X" in the boxes below to indicate who speaks the language 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) M ixteco Portuguese Punjabi X Russian X Thai l Ukrainian Urdu Vietnamese X Other: Program Narrative Exhibit E — Page 2 FY 2018-2019 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. We also have translator available at City Hall. 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 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, I How does your organization protect confidential information obtained from �ogram participants, such as client intake forms, from disclosure? Nutrition program records, including client intake forms, client reassessments and program report are filed and kept in locked file drawers, cabinet and/or behind locked doors. Program Narrative Exhibit E — Page 3 FY 2018-2019 Title III C Nutrition Site Management 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 _grogram. The city of Fresno provides congregate nutrition site management at seven (7) 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 year? The city of Fresno added a new nutrition meal site for seniors in an area where seniors did not have any place to meet, socialize or have a meal. The city also brings in activities for seniors and brings in many presentations annually on subject of interest to seniors. Please describe another accomplishment achieved by the contracted program in the past year. The third annual Spring Fling —this event grows each year and brings in seniors from all around Fresno. Vendors bring in information on programs and products that seniors find to be very helpful. Entertainment is brought in to perform during lunch (meal is also provided to seniors). 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. The children of a recently widowed senior in her 80's contacted our office for help. They were worried that she was declining because she missed her husband and had no friends to visit or socialize with. We suggested she may want to attend one of our meal sites. We explained we have many activities and serve a meal daily. They began bringing her and before long she started smiling and visiting with other seniors. She participates in all activities and appreciates the lunch and has begun volunteering to help new seniors that come to the center. She is now our ambassador for the center. Program Narrative Exhibit E— Page 4 FY 2018-2019 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 Sup II Rich Rodriguez Community Recreation Sup i Daniela Gonzalez Recreation Specialist Dana Liberty Services Aide - Clerical Bonnie Audas Program Coordinator Lucia Terra SHM — Site Coordinator (TCW) Nancy Duran ISHM — Site Coordinator (TCW) Lischa Hinojosa SHM — Site Coordinator (Pinedale) Karen Gill SHM — Site Coordinator (Mosqueda) *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 Sup 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 2018-2019 Title III C Nutrition Site Management SHAUN R. SCHAEFER, MA 37101 Avenue 12 '/4 1 Madera, California 93638 1 (559) 916-2440 shaunschaeferl4@gmail.com Results-oriented, experienced PARKS (Parks and Recreation Department) Division Manager with 30+ years' experience who consistently delivers quality and excellence in the oversight, management and supervision of all Green Space (playgrounds), Blue Space (aquatics) and Community Service programs and services in a city municipality. Has the initiative and drive to develop and maintain mission driven sustainable programs and services using varied funding sources, consistent with the Parks Master Plan. As a senior-level member of the executive staff, works cohesively with Recreation and Planned Maintenance Managers, Business Manager and Department Director to create, monitor and report on progress of program deliverables and budgets • Strategic Project Leadership ■ Corporate, Non-Profit& Foundation Relations e Entreprenurial Contract Service Development ■ Government& Media Relations • Cross-Functional Team Leadership ■ External, Internal & Community Relations • Customer Service Assessments & Campaigns . Positive Stakeholder Relations for Diverse . Grant Acquisition & Fundraising Extended Fresno Communities Creative Outreach Strategies • Developing Staff for Career Growth and ® Marketing &Communications Advancement • Innovative Budget Building &'Administration EDUCATION MA, Leadership and Organizational Development Fresno, CA Fresno Pacific University 2011 BA, English Fresno, CA CSU Fresno 1990 Graduate —NPRA - National Recreation and Parks Wheeling, WV Association Directors School 2015 REFERENCES Will be furnished upon request. PROFESSIONAL EXPERIENCE COMMUNITY SERVICES/RECREATION MANAGER 2007 — Present City of Fresno, PARCS Fresno, CA Parks, After School, Recreation and Community Services Mananement Skills: ■ Takes an active role in the department's executive management team, demonstrating a commitment to building, cooperation and collaboration among managers, staff, programs and departments; SHAUN R. SCHAEFER sli.iui�sr�i�ief'erl4rrr'�rn.iil.c�tan • Ensures the development and implementation of program Scopes of Work including program goals and measurable outcomes consistent with the PARKS Master Plan; • Develop and maintain program procedures and guidelines ensuring the highest quality of program services in collaboration with supervisors and staff by adhering to the NPRA standards of excellence and encouraging ethical and professional competency and conduct among program staff; • Works collaboratively with the executive-level team to participate in the development of program, project and department budgets; monitors monthly financial reports to confirm that programs are stewarded in a sound, fiscal manner; • Routinely submits monthly, quarterly and annual reports that include an analysis of program and fiscal data with solutions to address deviations from the original fiscal and program service goals. Quality Assurance ■ Enjoys training and working with supervisors and staff to ensure that program evaluations address desired outcomes, are conducted annually and that the data is appropriately analyzed and reported to the Department Director and City Manager [or other appropriate parties] to validate program effectiveness; • Assists Research and Development efforts by identifying and reporting community and program needs, program and service descriptions, outcomes and achievements for the purposes of grant applications, reports, publicity and marketing. Community-Building and Program Development • Continually seeks opportunities to grow new funding streams and contracts within the community including local, regional and federal government entities or Community Based Organizations — ex. Development and implementation of Green and Blue Space programs; • Particular strength is the ability to build, nurture and maintain partnerships with other organizations aimed at fostering the development of collaborative projects, Ex. hosting community stakeholder meetings; • Regularly engages in community outreach promoting PARCS programs and services to increase the department's visibility with partner agencies and potential stakeholders. Reporting • Monitors programs' compliance with contractual agreements and grant requirements to ensure the accuracy of data to be reported and verifying that all deadlines are met in a timely manner; • Delivers monthly, quarterly and annual reports to the Department Director regarding programs' productivity and progress, ensuring that all staff resources are used effectively to promote an efficient service delivery system and report any problems or incidents as they arise; • Willingly attends City Council, advisory and stakeholder meetings as necessary to provide education related to Community Service programs, to assess community needs, solicit participation in program reviews and recommendations, and to provide programmatic outcomes while responding to questions Councilmembers, the community or other stakeholders. Staff Development and Supervision • Facilitates program service staff meetings and arranges for and/or facilitates staff in-service training; • Responsible for the recruitment, hiring, on-boarding, supervision and performance evaluation of Recreation Supervisors and Aides identifying goals and benchmarks for professional development and/or improvement; SHAUN R. SCHAEFER shauiisciiiie£eri4i�47i!i►naii.c<<in Strives to guarantee that supervision provides the highest degree of professionalism, autonomy, quality of service and collaboration between staff, the Department and the Divisions; • Has developed and maintains a strong, collegial work relationship with the local state and community colleges that serve as a natural resource for future PARCS employees via placement of student interns in collaboration with Bachelor's and Master's level Recreation, Physical Education, Counseling programs; ■ Will mentor and guide students in developing their field education plans, meetings for supervision on a consistent basis and conducting evaluations with an eye toward stated educational goals. Will meet with school liaisons and/or representatives as necessary; Community Recreation Supervisor I/Community Recreation Supervisor II 1996 — 2007 Supervised City of Fresno PARCS Department services and employees in Adult and Youth Sports, Senior Hot Meals, Summer Aquatics Program, After School Recreation, Neighborhood Parks and Community Centers recreation, Sack Lunch Program, Theraputic Recreation, Special Events, grant and contracted service programs and fee for service programs. Assisted in the assessment, planning and administering community recreational programs to provide for the social and recreational needs of the community. Lifeguard, Pool Manager and Services Aide 1985 - 1995 Provided temporary services to the City of Fresno PARCS Department for seasonal aquatics program, neighborhood parks and after school elementary recreational services. Adult Sports Coordinator 1988 - 1994 Calwa Recreation and Park District Fresno, CA Managed softball complex when other local field closed; transitioned hundreds of teams to Southeast Fresno venue and significantly increased tournament and team participation rates. PROFESSIONAL AFFILIATIONS - Sports Official, San Joaquin Valley Officials Association ■ Member, Golden Valley Chamber of Commerce Member, California Parks and Recreation Society Professional Member, National Parks and Recreation Association Alumni, Leadership Fresno 4 Past Member, Fresno Rotary Club CERTIFICATIONS • Certification in Sports Officiating—Amateur Softball Association (ASA) and California Inner-Scholastic Federation (CIF) • Certification in Lifeguarding—American Red Cross AWARDS 2015 Distinguished Top Five Categorical Award of Excellence from the California Parks and Recreation Society Award in the area of Community Service for the Highway City Community Science Workshop 2010 Bright Idea Award from the Harvard University School of Business for the Youth Job Prep Program. 2009 Achievement Award for the Youth Job Prep Program (Fresno BEST) by the California Parks and Recreation Society (CPRS) City of Fresno 520025 RECREATION MANAGER DEFINITION Under general direction, plans, organizes, manages, and controls the day-to-day activities of the Recreation and Community Services Division; coordinates assigned activities with other City departments, divisions and outside agencies; and provides highly responsible and complex administrative support to the Department Director. SUPERVISION RECEIVED/EXERCISED Receives general direction from the Department Director of Assistant Director. Exercises supervision over subordinate staff. DISTINGUISHING CHARACTERISTICS The Recreation Manager, a division head, is responsible for directing the day-to-day operation of the Recreation and Community Services Division. The incumbent implements general policy directives for the City's recreation programs. Work involves administering, through assigned staff, the activities of the Recreation and Community Services Division. This is an unclassified position in which the incumbent serves at the will of the Department Director. EXAMPLES OF IMPORTANT AND ESSENTIAL DUTIES may include, but not limited to, the following: Plans, organizes, manages, and controls the activities of the Recreation Division; ensures that all services and activities adhere to approved City policies and procedures. Develops, implements, and administers a comprehensive recreation and community services program in cooperation with, and utilizing the facilities of school districts, flood control districts, and other public agencies. Reviews plans, programs, policy recommendations, and budget estimates submitted by assigned staff; confers with and advises individuals on all policies, activities, and problems relating to the activities and services of the division. Develops general divisional policies for the operation, maintenance, and development of various recreation programs. Prepares, reviews, analyzes, and administers both annual operating and capital improvement budgets for all programs of the division. Meets with representatives of Federal, State, County, and civic and community organizations on matters of recreation facilities services, and programs. Recreation Manager Page 2 Confers with the Superintendent of Schools, school administrative staff, and principals on coordination and operation of all recreation programs. Participates in intra-City and inter-agency committee work as directed by the Department Director. Responds to and resolves difficult and sensitive citizen inquiries and complaints. Performs related duties as required. JOB RELATED AND ESSENTIAL QUALIFICATIONS Knowledge of: Operations, services and activities of a comprehensive recreation program. The principles, practices, and methods of recreation administration. Modern municipal management and public administration, including current budgetary and fiscal operations and controls. Current literature, recent developments, and sources of information in recreation services and administration. Office procedures, methods, and equipment including computers and applicable software applications such as word processing, spreadsheets, and databases. Principles and practices of program development and administration. Principles of supervision, training and performance evaluation. Occupational hazards and standard safety practices. Pertinent federal, state, and local laws, codes and regulations. Skills to: Use computers and applicable software applications Ability to: Oversee and participate in the management of a comprehensive recreation program. Determine the recreation needs of the community and to develop necessary plans and programs to meet such needs. Recreation Manager Page 3 Select, supervise, train and evaluate staff. Participate in the development and administration of division goals, objectives and procedures. Prepare and administer program budgets. Prepare clear and concise administrative and financial reports. Research, analyze and evaluate new service delivery methods and techniques. Ensure adherence to established safety rules, regulations and guidelines. Analyze problems, identify alternative solutions, project consequences of proposed actions and implement recommendations in support of goals. Interpret and apply federal, state and local policies, laws and regulations. Respond to requests and inquiries from the general public. Maintain cooperative relations with government agencies, private agencies, and the general public. Communicate clearly and concisely, both orally and in writing. MINIMUM QUALIFICATIONS Education: Graduation from an accredited college or university with a Bachelor's Degree in recreation, education, physical education, public administration or a closely related field; and Experience: Four years of management and administrative experience in a public agency recreation program. Additional qualifying experience may be substituted for the required education on a year-for-year basis, up to a maximum of two years. Recreation Manager Page 4 Special Requirements: Possession of a valid California Driver's License at time of appointment. APPROVED: DATE Director of Personnel Services MR/TP/sn/02/24/88 2518CIO012C Revised:5/18/2015 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 �haun Schaefer Community Recreation Sup II Rich Rodriguez Community Recreation Sup i Daniela Gonzalez Recreation Specialist Dana Liberty Services Aide - Clerical Bonnie Audas Program Coordinator ................ Lucia Terra :SHM – Site Coordinator (TCW) Nancy Duran ISHM – Site Coordinator (TCW) Lischa Hinojosa SHM – Site Coordinator (Pinedale) Karen Gill ,SHM – Site Coordinator (Mosqueda) *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 Sup II 1 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 2018-2019 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 Inspiration Park M-T-W-Th-F 9:00 AM 1:00 PM 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 July 2018 17/4/18 21 August 2018 23 September 2018 9/3/18 19 October 2018 23 November 2018 11/12/18, 11/22/18, 11/23/18 19 December 2018 12/25/18 20 January 2019 1/l/19, 1/21/19 22 February 2019 2/18/19 19 March 2019 21 April 2019 22 May 2019 5/27/19 22 June 2019 20 Total Days of Contracted Service to 251 be Provided under this Agreement: Program Narrative Exhibit E — Page 6 FY 2018-2019 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 healthy life and ways to eat healthier. We have hired staff to assist with new exercise programs. . ..... .... How would participants of the contracted program benefit from these improvements? Our goal is to provide 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 dance where seniors can meet and enjoy music and dance. Describe it ebit eb 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 centers, 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. I Program Narrative Exhibit E — Page 7 FY 2018-2019 Title III C Nutrition Site Management Exhibit E Program Narrative 10. OUTREACH ACTIVITIES/TARGETING PLAN (22 CCR§ 7310, WIC § 9103) How does your organization reach older adults in greatest economic need (income level at or below the Federal Poverty Level) to inform them of the contracted program and welcome them to participate? Community outreach to churches, and events in the area. We also hold free or low cost events for the seniors to attend. (Carnival at Mosqueda, Spring Fling at Mosqueda, October Kids Fest at Holmes Playground and the Big Fresno Fair. How does your organization reach older adults who are socially isolated (need caused by non-economic factors) to inform them of the contracted program and welcome them to participate? Community outreach to churches and word of mouth from participants. How does your organization reach older adults who are of lesbian, gay, bisexual, or transgender orientation to inform them of the contracted program and welcome them to participate? All seniors are welcome to come to the center regardless of their orientation. When at the center they are made to feel welcome. Attempts to inform the Gay Fresno at their quarterly meetings. How does your organization reach older adults who are ethnic minorities, and particularly those with greatest economic and/or social need, to inform them of the contracted program and welcome them to participate? Community outreach to churches, and events in the area. Word of mouth from our participants. Program Narrative Exhibit E — Page 8 FY 2018-2019 Title III C Nutrition Site Management Exhibit E Program Narrative How does your organization reach older adults who are Native Americans to inform them of the contracted program and welcome them to participate? We have sent information to Tribal TANF to reach Native Americans. .... How does your organization reach older adults with limited English proficiency to inform them of the contracted program and welcome them to participate? We have staff that is bi-lingual and we are working on our outreach materials to translate into other than English. How does your organization reach older adults who live in rural areas to inform them of the contracted program and welcome them to participate? Faith based organizations, businesses and schools. How does your organization reach older adults with severe disabilities (severe, chronic physical and/or mental impairment that is likely to continue indefinitely & results in substantial functional limitation in 3 or more major life activities) to inform them of the contracted program and welcome them to participate? Contact organizations such as Valley Caregiver Resource Center and Resources for Independence to provide information regarding the SHM programs. How does your organization reach older adults with Alzheimer's disease or related disorders with neurological & organic brain disfunction, and the caregivers of theses individuals, to inform them of the contracted program and welcome these older adults to participate? Contact Valley Caregiver Resource Center with information on our SHM program. Program Narrative Exhibit E — Page 9 FY 2018-2019 Title III C Nutrition Site Management EXHIBIT F SERVICE PROVIDER EMERGENCY RESOURCE INFORMATION Please complete for each location from which contracted services are offered. Organization CITY OF FRESNO Site Name INSPIRATION PARK Street Address 5770 W. GETTYSBURG City/ST/Zip FRESNO, CA 93723 Primary Contact SHAUN SCHAEFER Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFEROFRESNO.GOV Office Phone (559) 621-6910 Cell Phone (559) 696-7899 Secondary RICH RODRIGUEZ 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 EmeEgency EmergencyFirst Aid Ham Radio 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 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 communit ? How many people can this facility provide emergency shelter for? 210 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 2018-2019 EXHIBIT F SERVICE PROVIDER EMERGENCY 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 City/ST/Zip FRESNO, CA 93704 Primary Contact SHAUN SCHAEFER Job Title COMMUNITY REC SUP II E-mail SHUN SCCHAEFER(@FRESNO.GOV Office Phone (559) 621-6910 Cell Phone (559) 696-7899 Secondary RICH RODRIGUEZ Job Title COMMUNITY REC SUP I E-mail RICARDO.RODRIGU EZ@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 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? f X Given the resources, can this site expand meal services following a X l 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 2018-2019 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, FRESN_QRQV Office Phone (559) 621-6910 Cell Phone (559) 696-7899 Secondary RICH RODRIGUEZ 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 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? 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 2018-2019 EXHIBIT F SERVICE PROVIDER EMERGENCY 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 I SHAUN SCHAEFER Job Title COMMUNITY REC SUP II E-mail SHALIN.SCHAEFERaFRESNO.GQV Office Phone (559) 621-6910 Cell Phone (559) 696-7899 Secondary RICH RODRIGUEZ 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? 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 Emergency Resource Information Exhibit F FY 2018-2019 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.SCHAEFERpAFRESNO.GOV Office Phone (559) 621-6910 Cell Phone (559) 696-7899 Secondary RICH RODRIGUEZ 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 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 communityfollowing 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-e uipped? _ 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 CHow 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 2018-2019 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 City/ST/Zip FRESNO, CA 93702 Primary Contact SHAUN SCHAEFER Job Title COMMUNITY REC SUP II E-mail sw UN.SCHAEFER FRE V Office Phone (559) 621-6910 Cell Phone (559) 696-7899 Secondary RICH RODRIGUEZ 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 x Internet Access X1 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 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? 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 2018-2019 Exhibit F Service Provider EmergencV Resource Information Please complete for each location from which contracted services are offered. Organization CITY OF FRESNO Site Name TED C WILLS Street Address j 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 L - 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 TED C WILLS Street Address 770 N. SAN PABLO City/ST/Zip FRESNO, CA 93728 Primary Contact 3 SHAUN SCHAEFER Job Title COMMUNITY REC SUP II E-mail SHAUN.SCHAEFERfc6FRESNO.GOV Office Phone (559) 621-6910 Cell Phone (559) 696-7899 Secondary RICH RODRIGUEZ 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 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? 531 How many days can this facility function using its back-up power source? 0 L 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 2018-2019 PARCS Senior Hot Meals + w and Recreation Program Sites LL � Copper s Inlernsonai Beliymer Council Disttict#1:1 Perrin . Council District#2:1 ? 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