HomeMy WebLinkAboutAgreement A-20-356 with Centro La Familia Advocacy Inc..pdf-1-
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A G R E E M E N T
THIS AGREEMENT is made and entered into on this 22nd day of September, 2020, by and
between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to
as "COUNTY", and CENTRO LA FAMILIA ADVOCACY SERVICES, INC., a California private non-profit
corporation, whose address is 302 Fresno Street, Fresno, CA 93706, hereinafter referred to as
"SUBRECIPIENT."
W I T N E S S E T H:
WHEREAS, County, through the Department of Social Services (DSS) receives allocation funding
from the California Department of Social Services (CDSS) to administer Bringing Families Home (BFH)
Program established by Assembly Bill 1603 (Chapter 25, Statutes of 2016) and updated by Senate Bill (SB)
80 (Chapter 27, Statutes 2019) to reduce the number of families in the child welfare system experiencing or
at risk of homelessness, to increase family reunification, and to prevent foster care placement.
WHEREAS, the COUNTY has a significant population of families experiencing homelessness and
families at imminent risk of becoming homeless who are in need of rapid rehousing assistance; and
WHEREAS, the SUBRECIPIENT is willing and able to provide said rapid rehousing assistance and
related supportive services to homeless families pursuant to the terms and conditions of this Agreement.
NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions herein
contained, the parties hereto agree as follows:
1.OBLIGATIONS
A. SUBRECIPIENT shall perform all services as set forth in Exhibit A, Summary of
Services, attached hereto and incorporated herein by this reference.
B. SUBRECIPIENT shall provide services pursuant to the staffing patterns and
program expenses detailed in Exhibit B, Budget Summary, attached hereto and incorporated herein by
this reference.
C.SUBRECIPIENT shall maintain membership in the FMCoC and participate in
Coordinated Entry throughout the term of this Agreement, as described in Exhibit A. If, for any reason,
this status is not maintained, the COUNTY may terminate this Agreement pursuant to Section Three (3)
of this Agreement.
Agreement No. 20-356
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2.TERM
The term of this Agreement shall be for a period of twenty-two (22) months, commencing
on September 22, 2020 through and including June 30, 2022.
3.TERMINATION
A.Non-Allocation of Funds - The terms of this Agreement, and the services to be
provided hereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated, at any time by giving the SUBRECIPIENT thirty (30) days advance written notice.
B.Breach of Contract - The COUNTY may immediately suspend or terminate this
Agreement in whole or in part, where in the determination of the COUNTY there is:
1)An illegal or improper use of funds;
2)A failure to comply with any term of this Agreement;
3)A substantially incorrect or incomplete report submitted to the COUNTY;
4)Improperly performed service.
In no event shall any payment by the COUNTY constitute a waiver by the COUNTY of any
breach of this Agreement or any default which may then exist on the part of the SUBRECIPIENT. Neither
shall such payment impair or prejudice any remedy available to the COUNTY with respect to the breach or
default. The COUNTY shall have the right to demand of the SUBRECIPIENT the repayment to the
COUNTY of any funds disbursed to the SUBRECIPIENT under this Agreement, which in the judgment of
the COUNTY were not expended in accordance with the terms of this Agreement. The SUBRECIPIENT
shall promptly refund any such funds upon demand.
C.Without Cause - Under circumstances other than those set forth above, this
Agreement may be terminated by SUBRECIPIENT or COUNTY or COUNTY’s DSS Director, or
designee, upon the giving of thirty (30) days advance written notice of an intention to terminate this
Agreement.
4.COMPENSATION
For actual services provided pursuant to the terms of this Agreement, COUNTY agrees to
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pay SUBRECIPIENT and SUBRECIPIENT agrees to receive compensation in accordance with Exhibit
B, Budget Summary. Mandated travel shall be reimbursed based on actual expenditures and mileage
reimbursement shall be at SUBRECIPIENT’s adopted rate per mile, not to exceed the IRS published
rate.
In no event shall compensation for services performed under this Agreement be in excess of
Four Hundred Eight Thousand, Two Hundred Seventy-Five and No/100 Dollars ($408,275). Payments by
COUNTY shall be in arrears, for services provided during the preceding month, within forty-five (45) days
after receipt, verification and approval of SUBRECIPIENT’s invoices by COUNTY.
It is understood that all expenses incidental to SUBRECIPIENT'S performance of services
under this Agreement shall be borne by SUBRECIPIENT. If SUBRECIPIENT should fail to comply with any
provision of the Agreement, COUNTY shall be relieved of its obligation for further compensation. Any
compensation which is not expended by SUBRECIPIENT pursuant to the terms and conditions of this
Agreement shall automatically revert to COUNTY. The services provided by the SUBRECIPIENT under this
Agreement are funded in whole or in part by the State of California. In the event that funding for these
services is delayed by the State Controller, COUNTY may defer payment to CONTRACTOR. The amount
of the deferred payment shall not exceed the amount of funding delayed by the State Controller to the
COUNTY. The period of time of the deferral by COUNTY shall not exceed the period of time of the State
Controller’s delay of payment to COUNTY plus forty-five (45) days.
5.INVOICING
SUBRECIPIENT shall invoice COUNTY’s DSS in arrears by the tenth (10th) day of each
month for expenditures incurred and services rendered in the previous month to:
DSSInvoices@fresnocountyca.gov. Payments by COUNTY’s DSS shall be in arrears for actual services
provided during the preceding month, within forty-five (45) days after receipt, verification, and approval
of SUBRECIPIENT’s invoices by COUNTY’s DSS. A monthly activity report shall accompany the
invoice, reflecting services supported by the invoiced expenditures and be in a form and in such detail
as acceptable to the COUNTY’s DSS. All final claims for funding shall be submitted by SUBRECIPIENT
within sixty (60) days following the final month of services.
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At the discretion of COUNTY’s DSS Director or designee, if an invoice is incorrect or is
otherwise not in proper form or detail, COUNTY’s DSS Director or designee shall have the right to
withhold full payment of the invoice that is incorrect or improper after five (5) days prior written notice or
email correspondence to SUBRECIPIENT. SUBRECIPIENT agrees to continue to provide services for a
period of ninety (90) days after written or email notification of an incorrect or improper invoice. If after the
ninety (90) day period the invoice(s) is still not corrected to COUNTY’s DSS satisfaction, COUNTY or
COUNTY’s DSS Director or designee may elect to terminate this Agreement, pursuant to the termination
provisions stated in Paragraph Three (3) of this Agreement.
6.INDEPENDENT CONTRACTOR
In performance of the work, duties and obligations assumed by SUBRECIPIENT under
this Agreement, it is mutually understood and agreed that SUBRECIPIENT, including any and all of the
SUBRECIPIENT'S officers, agents, and employees will at all times be acting and performing as an
independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
employee, joint venture, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no
right to control or supervise or direct the manner or method by which SUBRECIPIENT shall perform its
work and function. However, COUNTY shall retain the right to administer this Agreement so as to verify
that SUBRECIPIENT is performing its obligations in accordance with the terms and conditions thereof.
SUBRECIPIENT and COUNTY shall comply with all applicable provisions of law and the rules and
regulations, if any, of governmental authorities having jurisdiction over matters the subject thereof.
Because of its status as an independent contractor, SUBRECIPIENT shall have absolutely
no right to employment rights and benefits available to COUNTY employees. SUBRECIPIENT shall be
solely liable and responsible for providing to, or on behalf of, its employees all legally-required employee
benefits. In addition, SUBRECIPIENT shall be solely responsible and save COUNTY harmless from all
matters relating to payment of SUBRECIPIENT'S employees, including compliance with Social Security
withholding and all other regulations governing such matters. It is acknowledged that during the term of this
Agreement, SUBRECIPIENT may be providing services to others unrelated to the COUNTY or to this
Agreement.
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7.MODIFICATION
A.Any matters of this Agreement may be modified from time to time by the written
consent of SUBRECIPIENT and COUNTY without, in any way, affecting the remainder.
B.Notwithstanding the above, changes to line items in Exhibit B, Budget, in an
amount not to exceed ten percent (10%) of the total maximum compensation as identified in Section
Four (4) of this Agreement, may be made with the written approval of COUNTY’s DSS Director or
designee and SUBRECIPIENT. Budget line item changes shall not result in any change to the maximum
compensation amount payable to SUBRECIPIENT, as stated herein.
C. SUBRECIPIENT hereby agrees that changes to the compensation under this
agreement may be necessitated by a reduction in funding from State and/or Federal sources.
COUNTY’s DSS Director or designee may modify the maximum compensation depending on State and
Federal funding availability, as stated in Section Four (4) in this Agreement. SUBRECIPIENT further
understands that this Agreement is subject to any restrictions, limitations or enactments of all legislative
bodies which affect the provisions, term, or funding of this Agreement in any manner.
8.ASSIGNMENT AND SUBCONTRACTING
SUBRECIPIENT shall not assign, transfer or sub-contract this Agreement nor their rights or
duties under this Agreement without the prior written consent of the COUNTY or COUNTY’s DSS Director
or designee. Any transferee, assignee, or subcontractor will be subject to all applicable provisions of this
Agreement, and all applicable State and Federal regulations. SUBRECIPIENT shall be held primarily
responsible by the COUNTY for the performance of any transferee, assignee, or subcontractor unless
otherwise expressly agreed to in writing by COUNTY. The use of subcontractor by SUBRECIPIENT shall
not entitle SUBRECIPIENT to any additional compensation than is provided for under this Agreement.
9.HOLD HARMLESS
SUBRECIPIENT agrees to indemnify, save, hold harmless, and at COUNTY'S request,
defend the COUNTY, its officers, agents, and employees from any and all costs and expenses (including
attorney’s fees and costs), damages, liabilities, claims, and losses occurring or resulting to COUNTY in
connection with the performance, or failure to perform, by SUBRECIPIENT, its officers, agents, or
employees under this Agreement, and from any and all costs and expenses (including attorney’s fees and
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costs), damages, liabilities, claims, and losses occurring or resulting to any person, firm, or corporation who
may be injured or damaged by the performance, or failure to perform, of SUBRECIPIENT, its officers,
agents, or employees under this Agreement.
10. INSURANCE
Without limiting the COUNTY's right to obtain indemnification from SUBRECIPIENT or any
third parties, SUBRECIPIENT, at its sole expense, shall maintain in full force and effect, the following
insurance policies or a program of self-insurance, including but not limited to, an insurance pooling
arrangement or Joint Powers Agreement (JPA) throughout the term of the Agreement:
A. Commercial General Liability
Commercial General Liability Insurance with limits of not less than Two Million Dollars
($2,000,000.00) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000.00). This
policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including
completed operations, products liability, contractual liability, Explosion-Collapse-Underground, fire legal
liability or any other liability insurance deemed necessary because of the nature of this contract.
B. Automobile Liability
Comprehensive Automobile Liability Insurance with limits of not less than One Million
Dollars ($1,000,000.00) per accident for bodily injury and for property damages. Coverage should include
any auto used in connection with this Agreement.
C. Professional Liability
If SUBRECIPIENT employs licensed professional staff, (e.g., Ph.D., R.N., L.C.S.W.,
M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less than One Million
Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) annual aggregate.
D. Worker's Compensation
A policy of Worker's Compensation insurance as may be required by the California Labor
Code.
E. Additional Requirements Relating to Insurance
SUBRECIPIENT shall obtain endorsements to the Commercial General Liability
insurance naming the County of Fresno, its officers, agents, and employees, individually and
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collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned. Such coverage for additional insured shall apply as primary insurance and any other
insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be
excess only and not contributing with insurance provided under SUBRECIPIENT's policies herein. This
insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written
notice given to COUNTY.
SUBRECIPIENT hereby waives its right to recover from COUNTY, its officers, agents,
and employees any amounts paid by the policy of worker’s compensation insurance required by this
Agreement. SUBRECIPIENT is solely responsible to obtain any endorsement to such policy that may be
necessary to accomplish such waiver of subrogation, but SUBRECIPIENT’s waiver of subrogation under
this paragraph is effective whether or not SUBRECIPIENT obtains such an endorsement.
Within Thirty (30) days from the date SUBRECIPIENT signs and executes this Agreement,
SUBRECIPIENT shall provide certificates of insurance and endorsement as stated above for all of the
foregoing policies, as required herein, to the County of Fresno, P.O. Box 1912, Fresno, CA 93718-1219,
Attention: Contract Analyst, stating that such insurance coverage has been obtained and is in full force;
that the County of Fresno, its officers, agents and employees will not be responsible for any premiums
on the policies; that for such worker’s compensation insurance that SUBRICIPIENT has waived its right
to recover from the COUNTY, its officers, agents, and employees any amounts paid under the insurance
policy and that waiver does not invalidate the insurance policy; that such Commercial General Liability
insurance names the County of Fresno, its officers, agents and employees, individually and collectively,
as additional insured, but only insofar as the operations under this Agreement are concerned; that such
coverage for additional insured shall apply as primary insurance and any other insurance, or
self-insurance, maintained by COUNTY, its officers, agents and employees, shall be excess only and
not contributing with insurance provided under SUBRECIPIENT's policies herein; and that this insurance
shall not be cancelled or changed without a minimum of thirty (30) days advance, written notice given to
COUNTY.
In the event SUBRECIPIENT fails to keep in effect at all times insurance coverage as herein
provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate this
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Agreement upon the occurrence of such event.
All policies shall be issued by admitted insurers licensed to do business in the State of California,
and such insurance shall be purchased from companies possessing a current A.M. Best, Inc. rating of A
FSC VII or better.
11.CONFLICT OF INTEREST
No officer, employee or agent of the COUNTY who exercises any function or
responsibility for planning and carrying out of the services provided under this Agreement shall have any
direct or indirect personal financial interest in this Agreement. In addition, no employee of the COUNTY
shall be employed by the SUBRECIPIENT under this Agreement to fulfill any contractual obligations with
the COUNTY. The SUBRECIPIENT shall comply with all Federal, State of California and local conflict of
interest laws, statutes and regulations, which shall be applicable to all parties and beneficiaries under
this Agreement and any officer, employee or agent of the COUNTY.
12. NON-DISCRIMINATION
During the performance of this Agreement SUBRECIPIENT shall not unlawfully discriminate
against any employee or applicant for employment, or recipient of services, because of ethnic group
identification, gender, gender identity, gender expression, sexual orientation, color, physical disability,
mental disability, medical condition, national origin, race, ancestry, marital status, religion, or religious
creed, pursuant to all applicable State of California and Federal statutes and regulations.
13.RECRUITMENT OF EMPLOYEES AND SERVICES TO CLIENTS
SUBRECIPIENT shall ensure that its employment recruitment efforts, including
administrative and professional staff positions, are carried out so as to adequately reflect the cultural
and ethnic diversity of the population of Fresno County. SUBRECIPIENT shall use their best efforts to
serve all cultural and ethnic groups residing in Fresno County. SUBRECIPIENT’s employment efforts
will be monitored by COUNTY at periodic intervals.
14.LIMITED ENGLISH PROFICIENCY (LEP)
SUBRECIPIENT shall provide interpreting and translation services to persons
participating in SUBRECIPIENT’s services who have limited or no English language proficiency,
including services to persons who are deaf or blind. Interpreter and translation services shall be
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provided as necessary to allow such participants meaningful access to the programs, services and
benefits provided by SUBRECIPIENT. Interpreter and translation services, including translation of
SUBRECIPIENT’s “vital documents” (those documents that contain information that is critical for
accessing SUBRECIPIENT’s services or are required by law) shall be provided to participants at no cost
to the participant. SUBRECIPIENT shall ensure that any employees, agents, subcontracts, or partners
who interpret or translate for a program participant, or who directly communicate with a program
participant in a language other than English, demonstrate proficiency in the participant’s language and
can effectively communicate any specialized terms and concepts peculiar to SUBRECIPIENT’s
services.
15.CLEAN AIR AND WATER
In the event the funding under this Agreement exceeds One Hundred Thousand and
No/100 Dollars ($100,000.00), SUBRECIPIENT shall comply with all applicable standards, orders or
requirements issued under the Clean Air Act contained in 42 U.S. Code 7601 et seq; the Clean Water
Act contained in 33 U.S. Code 1368 et seq.; and any standards, laws and regulations, promulgated
thereunder. Under these laws and regulations, SUBRECIPIENTS shall assure:
A.No facility shall be utilized in the performance of the Agreement that has been
listed on the Environmental Protection Agency (EPA) list of Violating Facilities;
B.COUNTY shall be notified prior to execution of this Agreement of the receipt of
any communication from the Director, Office of Federal Activities, U.S. EPA indicating that a facility to be
utilized in the performance of this Agreement is under consideration to be listed on the EPA list of
Violating Facilities;
C. COUNTY and U.S. EPA shall be notified about any known violation of the above
laws.
D.This assurance shall be included in every nonexempt subgrant, contract, or
subcontract.
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16.CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
A.COUNTY and SUBRECIPIENT recognize that SUBRECIPIENT is a recipient of State
funds under the terms of this Agreement. By signing this Agreement, SUBRECIPIENT agrees to notify
COUNTY of any past, present, or future Federal suspension or debarment. By signing this Agreement,
SUBRECIPIENT attests to the best of its knowledge and belief, that it and its principals:
1)Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded by any Federal department or agency; and
2)Shall not knowingly enter into any covered transaction with an entity or person
who is proposed for debarment under Federal regulations, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in such transaction.
B.SUBRECIPIENT shall provide immediate written notice to COUNTY if at any time
during the term of this Agreement SUBRECIPIENT learns that the representations it makes above were
erroneous when made or have become erroneous by reason of changed circumstances.
C. SUBRECIPIENT shall include a clause titled “Certification Regarding Debarment,
Suspension, Ineligibility, and Voluntary Exclusion – Lower Tier Covered Transactions” and similar in
nature to this paragraph in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
D.SUBRECIPIENT shall, prior to soliciting or purchasing goods and services in
excess of $25,000 funded by this Agreement, review and retain the proposed vendor’s suspension and
debarment status at https://www.sam.gov/SAM/.
17.ACKNOWLEDGMENT
SUBRECIPIENT shall acknowledge in all public relations activates, materials and
publications that the COUNTY is the funding source for services to be provided through this Agreement.
18.CONFIDENTIALITY AND SECURITY
All services performed by SUBRECIPIENT under this Agreement shall be in strict
conformance with all applicable Federal, State of California, and/or local laws and regulations
relating to confidentiality. SUBRECIPIENT shall require its employees, agents, officers and
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subcontractors to comply with the provisions of Sections 10850 and 14100.2 of the Welfare and
Institutions Code, as well as the California Department of Social Services (CDSS) Manual of
Policies and Procedures, Division 19-0000 and the California Department of Health Care Services
(DHCS) Medi-Cal Eligibility Procedures Manual, Section 2H. These Code sections provide that:
A. All applications and records concerning any individual made or kept by any
public officer or agency in connection with the administration of any provision of the Welfare and
Institutions Code relating to Medicaid or any form of public social services for which grants-in-aid
are received by the State of California from the United States government shall be confidential,
and shall not be open to examination for any purpose not directly connected with the
administration of such public social services.
B. No person shall publish, disclose or use or permit or cause to be published or
disclosed any list of persons receiving public social services, except as is provided by law.
C.No person shall publish, disclose, or use or permit or cause to be published,
disclosed or used any confidential information pertaining to an applicant or recipient, except as is
provided by law. SUBRECIPIENT shall inform all of its employees, agents, officers and
subcontractors of the above provisions and that any person knowingly and intentionally violating
such provisions is guilty of a misdemeanor.
In addition, SUBRECIPIENT, its employees, agents and officer shall comply, and
require all of its subcontractors to comply, with (1) the DHCS Medi-Cal Privacy and Security
Agreement between the California DHCS and the County of Fresno that is then in effect, and (2)
the Privacy and Security Agreement between the CDSS and the County of Fresno that is then in
effect, both of which together shall be referred to as “the Agreements” and are incorporated herein
by this reference. The current versions of both the DHCS and CDSS Privacy and Security
agreements are available upon request or can be viewed at:
http://www.co.fresno.ca.us/MediCalPrivacy/. SUBRECIPIENT shall insure that all personally
identifiable information (PII), as defined in the Agreements, concerning program recipients shall be
kept confidential and shall not be opened to examination, publicized, disclosed, or used for any
purpose not directly connected with the administration of the program. SUBRECIPIENT shall use
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appropriate administrative, physical, and technical safeguards to protect PII, as set forth in the
Agreements. Upon discovery of a breach, security incident, intrusion, or unauthorized access, use,
or disclosure of PII, SUBRECIPIENT shall immediately report the incident to the COUNTY by
calling (559) 600-2300 or E-mailing at dssprivacyofficer@fresnocountyca.gov. SUBRECIPIENT
shall certify that all employees, agents, officers and subcontractors have received privacy and
security training before accessing any PII and have received refresher training annually, as
required by the Agreements.
19.DATA SECURITY
For the purpose of preventing the potential loss, misappropriation or inadvertent
disclosure of COUNTY data including sensitive or personal client information; abuse of COUNTY
resources; and/or disruption to COUNTY operations, individuals and/or agencies that enter into a
contractual relationship with COUNTY for the purpose of providing services under this Agreement must
employ adequate data security measures to protect the confidential information provided to
SUBRECIPIENT by COUNTY,
including but not limited to the following:
A. SUBRECIPIENT-Owned Mobile/Wireless/Handheld Devices may not be
connected to COUNTY networks via personally owned mobile, wireless or handheld devices, except
when authorized by COUNTY for telecommuting and then only if virus protection software currency
agreements are in place, and if a secure connection is used.
B. SUBRECIPIENT-Owned Computers or Computer Peripherals may not brought
into COUNTY for use, including and not limited to mobile storage devices, without prior authorization
from COUNTY’s Chief Information Officer or her designee. Data must be stored on a secure server
approved by COUNTY and transferred by means of a VPN (Virtual Private Network) connection, or
another type of secure connection of this type if any data is approved to be transferred.
C.County-Owned Computer Equipment – SUBRECIPIENT or anyone having an
employment relationship with COUNTY may not use COUNTY computers or computer peripherals on
non-COUNTY premises without prior authorization from COUNTY’s Chief Information Officer or her
designee.
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D. SUBRECIPIENT may not store COUNTY’s private, confidential or sensitive data
on any hard-disk drive.
E. SUBRECIPIENT is responsible to employ strict controls to insure the integrity and
security of COUNTY’s confidential information and to prevent unauthorized access to data maintained in
computer files, program documentation, data processing systems, data files and data processing
equipment which stores or processes COUNTY data internally and externally.
F. Confidential client information transmitted to one party by the other by means of
electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128
BIT or higher. Additionally, a password or pass phrase must be utilized.
G. SUBRECIPIENT is responsible to immediately notify COUNTY of any breaches or
potential breaches of security related to COUNTY’s confidential information, data maintained in
computer files, program documentation, data processing systems, data files and data processing
equipment which stores or processes COUNTY data internally or externally.
H. The requirements in this Data Security provision shall apply to SUBRECIPIENT’s
subcontractors, if any.
20. DRUG-FREE WORKPLACE REQUIREMENTS
For purposes of this paragraph, SUBRECIPIENT will be referred to as the “grantee”. By
drawing funds against this grant award, the grantee is providing the certification that is required by
regulations implementing the Drug-Free Workplace Act of 1988, 45 CFR Part 76, Subpart F. These
regulations require certification by grantees that they will maintain a drug-free workplace. False
certification or violation of the certification shall be grounds for suspension of payments, suspension or
termination of grants, or government wide suspension or debarment. SUBRECIPIENT shall also comply
with the requirements of the Drug-Free Workplace Act of 1990 (California Government Code section
8350 et seq.).
21. POLITICAL ACTIVITY
None of the funds, materials, property or services provided directly or indirectly under this
Agreement shall be used for any political activity, or to further the election or defeat of any candidate for
public office.
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22. GRIEVANCES
SUBRECIPIENT shall establish procedures for handling client complaints and/or
grievances. Such procedures will include provisions for informing clients of their rights to a State
Hearing to resolve such issues.
23. STATE ENERGY CONSERVATION
SUBRECIPIENTS must comply with the mandatory standard and policies relating to
energy efficiency which are contained in the State Energy Conservation Plan issued in compliance with
42 United States (US) Code sections 6321, et. Seq.
24. CHARITABLE CHOICE
SUBRECIPIENT may not discriminate in their program delivery against a client or
potential client on the basis of religion or religious belief, a refusal to hold a religious belief, or a refusal
to actively participate in a religious practice. Any specifically religious activity or service made available
to individuals by the SUBRECIPIENT must be voluntary as well as separate in time and location from
County funded activities and services. SUBRECIPIENTS shall inform County as to whether they are
faith-based. If SUBRECIPIENTS identify as faith-based, they must submit to DSS a copy of their policy
on referring individuals to alternate treatment SUBRECIPIENT and include a copy of this policy in their
client admission forms. The policy must inform individuals that they may be referred to an alternative
provider if they object to the religious nature of the program and include a notice to DSS. Adherence to
this policy will be monitored during annual site reviews, and a review of client files. If SUBRECIPIENT
identify as faith-based, by July 1 of each year SUBRECIPIENT will be required to report to DSS the
number of individuals who requested referrals to alternate providers based on religious objection.
25.FRATERNIZATION
SUBRECIPIENT shall establish procedures addressing fraternization between
SUBRECIPIENT’S staff and clients. Such procedures will include provisions for informing
SUBRECIPIENT’S staff and clients regarding fraternization guidelines.
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26.LOBBYING AND POLITICAL ACTIVITY
None of the funds provided under this Agreement shall be used for publicity,
lobbying or propaganda purposes designed to support or defeat legislation pending in the
Congress of the United States of America or the Legislature of the State of California.
SUBRECIPIENT shall not directly or indirectly use any of the funds under this
Agreement for any political activity or to further the election or defeat of any candidate for
public office.
27.INTERPRETATION OF LAWS AND REGULATIONS
COUNTY reserves the right to make final interpretations or clarifications on issues
relating to Federal and State laws and regulations, to ensure compliance.
28.RECORDS
A.Record Establishment and Maintenance – SUBRECIPIENT shall establish and
maintain records in accordance with those requirements prescribed by COUNTY, with respect to all
matters covered by this Agreement. SUBRECIPIENT shall retain all fiscal books, account records, and
client files for services performed under this Agreement for at least five (5) years from the date of final
payment under this Agreement or until all State and Federal audits are completed for that fiscal year,
whichever is later. Pursuant to State and Federal law, it is the intent of the parties to this Agreement that
the SUBRECIPIENT shall be reimbursed for actual costs incurred in the performance of this Agreement
not to exceed the contract maximum but that no profit is to accrue to the SUBRECIPIENT on account of
such performance.
B.Monthly Activity Reports - SUBRECIPIENT shall submit to COUNTY by the tenth
(10th) of each month, all fiscal and program reports for the previous month. SUBRECIPIENT shall also
furnish to COUNTY such statements, records, receipts, reports, data and other information as
COUNTY may request pertaining matters covered by this Agreement. Said support documentation
must indicate the line item budget account number to which the cost is charged. In the event that
SUBRECIPIENT fails to provide reports or other information required hereunder, it shall be deemed
sufficient cause for COUNTY to withhold payments until compliance is established. In addition,
SUBRECIPIENT shall provide written notification and explanation to COUNTY of any funds received
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from another source to conduct the same services covered by this Agreement within five (5) days of the
receipt of such funds. The invoice and monthly activity reports shall be in a form and in such detail as
acceptable to COUNTY’s Director of Social Services or designee.
C. HMIS Data Entry - HMIS entry must be completed by the 10th of each month for
all services provided the previous month.
29. TAX EQUITY AND FISCAL RESPONSIBILITY ACT
To the extent necessary to prevent disallowance of reimbursement under section 1861
(v) (1) (1) (I) of the Social Security Act, (42 U.S.C § 1395x, subd. (v)(1)[I]), until the expiration of four (4)
years after the furnishing of services under this Agreement, SUBRECIPIENT shall make available, upon
written request to the Secretary of the United States Department of Health and Human Services, or
upon request to the Comptroller General of the United States General Accounting Office, or any of their
duly authorized representatives, a copy of this Agreement and such books, documents, and records as
are necessary to certify the nature and extent of the costs of these services provided by
SUBRECIPIENT under this Agreement. SUBRECIPIENT further agree that in the event
SUBRECIPIENT carries out any of their duties under this Agreement through a subcontract, with a value
or cost of Ten Thousand and No/100 Dollars ($10,000) or more over a twelve (12) month period, with a
related organization, such Agreement shall contain a clause to the effect that until the expiration of four
(4) years after the furnishing of such services pursuant to such subcontract, the related organizations
shall make available, upon written request to the Secretary of the United Sates General Accounting
Office, or any of their duly authorized representatives, a copy of such subcontract and such books,
documents, and records of such organization as are necessary to verify the nature and extent of such
costs and regulations.
30. CHILD ABUSE REPORTING
SUBRECIPIENT shall utilize a procedure acceptable to COUNTY to ensure that all of
SUBRECIPIENT’S employees, volunteers, consultants, subcontractors or agents performing services
under this Agreement shall report all known or suspected child abuse or neglect to one or more of the
agencies set forth in Penal Code Section 11165.9. This procedure shall include having all of
SUBRECIPIENTS’ employees, volunteers, consultants, subcontractors or agents performing services
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under this Agreement sign a statement that he or she knows of and will comply with the reporting
requirements set forth in Penal Code Section 11166. The statement to be utilized by SUBRECIPIENTS
is set forth in Exhibit C, attached hereto and by this reference incorporated herein.
31.PROPERTY OF COUNTY
SUBRECIPIENT agrees to take reasonable and prudent steps to ensure the security of
any and all said hardware and software provided to it by COUNTY under this Agreement, to maintain
replacement-value insurance coverages on said hardware and software of like kind and quality
approved by COUNTY.
All purchases over Five Thousand Dollars ($5,000) made during the life of this
Agreement that will outlive the life of this Agreement shall be identified as fixed assets with an assigned
Fresno County DSS Accounting Inventory Number. These fixed assets shall be retained by COUNTY,
as COUNTY property, in the event this Agreement is terminated or upon expiration of this Agreement.
SUBRECIPIENT agrees to participate in an annual inventory of all COUNTY fixed assets and shall be
physically present when fixed assets are returned to COUNTY possession at the termination or
expiration of this Agreement. SUBRECIPIENT is responsible for returning to COUNTY all COUNTY
owned fixed assets upon the expiration or termination of this Agreement.
32.AUDITS AND INSPECTIONS
The SUBRECIPIENT shall at any time during business hours, and as often as the COUNTY
may deem necessary, make available to the COUNTY for examination all of its records and data with
respect to the matters covered by this Agreement. The SUBRECIPIENT shall, upon request by the
COUNTY, permit the COUNTY to audit and inspect all of such records and data necessary to ensure
SUBRECIPIENT'S compliance with the terms of this Agreement.
If this Agreement exceeds ten thousand dollars ($10,000.00), SUBRECIPIENT shall
make available all records and accounts for inspection and audit by COUNTY, the State of California,
the Comptroller General of the United States, a Federal Grantor Agency, or any of their duly authorized
representatives, at all reasonable times for a period of at least five (5) years following final payment
under this Agreement or the closure of all other pending matters, whichever is later (Government Code
Section 8546.7).
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In addition, SUBRECIPIENT shall cooperate and participate with COUNTY’s fiscal review
process and comply with all final determinations rendered by the COUNTY’s fiscal review process. If
COUNTY reaches an adverse decision regarding SUBRECIPIENT’s services to consumers, it may result in
the disallowance of payment for services rendered; or in additional controls to the delivery of services, or in
the termination of this Agreement, at the discretion of COUNTY’s DSS Director or designee. If as a result of
COUNTY’s fiscal review process a disallowance is discovered due to SUBRECIPIENT’s deficiency,
SUBRECIPIENT shall be financially liable for the amount previously paid by COUNTY to SUBRECIPIENT
and this disallowance will be adjusted from SUBRECIPIENT’s future payments, at the discretion of
COUNTY’s DSS Director or designee. In addition, COUNTY shall have the sole discretion in the
determination of fiscal review outcomes, decisions and actions.
33.NOTICES
The persons and their addresses having authority to give and receive notices under this
Agreement include the following:
COUNTY SUBRECIPIENT
Director, COUNTY OF FRESNO Executive Director
Department of Social Services Centro La Familia Advocacy Services
P.O. Box 1912
Fresno, CA 93718-1912
302 Fresno Street, Suite 102
Fresno, CA 93706
All notices between the COUNTY and SUBRECIPIENT provided for or permitted under this
Agreement must be in writing and delivered either by personal service, by first-class United States mail, by
an overnight commercial courier service, or by telephonic facsimile transmission. A notice delivered by
personal service is effective upon service to the recipient. A notice delivered by first-class United States
mail is effective three COUNTY business days after deposit in the United States mail, postage prepaid,
addressed to the recipient. A notice delivered by an overnight commercial courier service is effective one
COUNTY business day after deposit with the overnight commercial courier service, delivery fees prepaid,
with delivery instructions given for next day delivery, addressed to the recipient. A notice delivered by
telephonic facsimile is effective when transmission to the recipient is completed (but, if such transmission is
completed outside of COUNTY business hours, then such delivery shall be deemed to be effective at the
next beginning of a COUNTY business day), provided that the sender maintains a machine record of the
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completed transmission. For all claims arising out of or related to this Agreement, nothing in this section
establishes, waives, or modifies any claims presentation requirements or procedures provided by law,
including but not limited to the Government Claims Act (Division 3.6 of Title 1 of the Government Code,
beginning with section 810).
34. CHANGE OF LEADERSHIP/MANAGEMENT
In the event of any change in the status of SUBRECIPIENT’s leadership or management,
CONTTRACTOR shall provide written notice to COUNTY within thirty (30) days from the date of
change. Such notification shall include any new leader or manager’s name, address and qualifications.
“Leadership or management” shall include any employee, member, or owner of SUBRECIPIENT who
either a) directs individuals providing services pursuant to this Agreement, b) exercises control over the
manner in which services are provided, or c) has authority over SUBRECIPIENT’s finances.
35. DISCLOSURE OF SELF-DEALING TRANSACTIONS
This provision is only applicable if the SUBRECIPIENT is operating as a corporation (a
for-profit or non-profit corporation) or if during the term of the agreement, the SUBRECIPIENT changes
its status to operate as a corporation. Members of the SUBRECIPIENT’s Board of Directors shall
disclose any self-dealing transactions that they are a party to while SUBRECIPIENT is providing goods
or performing services under this agreement. A self-dealing transaction shall mean a transaction to
which the SUBRECIPIENT is a party and in which one or more of its directors has a material financial
interest. Members of the Board of Directors shall disclose any self-dealing transactions that they are a
party to by completing and signing a Self-Dealing Transaction Disclosure Form, attached hereto as
Exhibit D and incorporated herein by reference, and submitting it to the COUNTY prior to commencing
with the self-dealing transaction or immediately thereafter.
36. GOVERNING LAW
Venue for any action arising out of or related to this Agreement shall only be in Fresno
County, California.
The rights and obligations of the parties and all interpretation and performance of this
Agreement shall be governed in all respects by the laws of the State of California.
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37.SEVERABILITY
The provisions of this Agreement are severable. The invalidity or unenforceability of any
one provision in the Agreement shall not affect the other provisions.
38.ENTIRE AGREEMENT
This Agreement constitutes the entire agreement between the SUBRECIPIENT and
COUNTY with respect to the subject matter hereof and supersedes all previous Agreement negotiations,
proposals, commitments, writings, advertisements, publications, and understanding of any nature
whatsoever unless expressly included in this Agreement.
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1 IN WITNESS WHEREOF , the parties hereto have executed this Agreement as of the day and year
2 first hereinabove written .
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SUBRECIPIENT:
Centro La
Print Name : __s;...:..::....:..r£_d=C)...!../;.:....;:1s~· ---
Title : Ch!iJC
COUNTY OF FRESNO
£._ ~
Ernest Buddy Men s, Chairman of the Board of
Supervisors of the County of Fresno
ATTEST:
Bernice E. Seidel
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By 1t~ ~~
Print Name : ;J.j,;; Ml{ Cf&
Clerk of the Board of Supervisors
County of Fresno , State of California
By : &li;).1
) t ~
Title : :r~\,J.,V'.Q..r
Mailing Address :
302 Fresno Street, Su ite 102
Fresno , CA 93706
FOR ACCOUNTING USE ONLY :
Fund : 10000
Subclass : 0001
ORG No .: 56107001
Account No .: 7870/0
Requisition No .: 5612000337
DEN : bed
Deputy
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Exhibit A
Page 1 of 4
SUMMARY OF SERVICES
ORGANIZATION: Centro La Familia Advocacy Services, Inc.
ADDRESS: 302 Fresno Street, Suite 102, Fresno, CA 90706
TELEPHONE: (559) 237-2961
CONTACT: Margarita Rocha
EMAIL: mrocha@centrolafamilia.org
CONTRACT: Bringing Families Home
CONTRACT TERM: September 22, 2020 to June 30, 2022
SUMMARY OF SERVICES
Centro La Familia Advocacy Services, Inc. (CLFA), will provide Bringing Families Home (BFH)
services to County of Fresno Department of Social Services (DSS) families. Services are
designed to house families involved in the child welfare system and experiencing homelessness
or who are at imminent risk of becoming homeless. The goal of BFH is to support family
reunification, family maintenance, and housing stability in addition to preventing entry into foster
care. CLFA shall provide housing financial assistance, housing navigation services, and case
management, to help families obtain permanent housing, reunify or maintain the family unit, and
achieve long-term housing and family stability.
BFH program data will be entered into the Homeless Management Information System (HMIS)
as part of the local homeless response system which enable CLFA to track services and make
appropriate referrals to other services in the Coordinated Entry System.
TARGET POPULATION
BFH program services are for families involved in the child welfare system who are experiencing
or are at risk of homelessness, as defined by the California Department of Social Services
(CDSS). CLFA will provide services to families from the entire County of Fresno region,
including both metro and rural areas.
HOUSING FIRST SERVICES
In accordance with California state law, State-funded programs for housing people experiencing
homelessness must follow a Housing First model. All CLFA BFH activities must comply with the
following Housing First requirements:
1. Low barriers to entry;
2. Intake process is expedited, family-centered, and flexible;
3. Access to housing is without preconditions;
4. Families are connected to permanent housing as early as possible in case planning;
5. Temporary housing/emergency shelter is offered;
6. Services are family-centered and delivered in accordance with evidence-based
practices;
7. Leases or contractual agreements are used and reflect the same rights and
responsibilities as other tenants; and
8. Every effort is made to prevent a return to homelessness.
Exhibit A
Page 2 of 4
PROGRAM COMPONENTS
FAMILY ENGAGEMENT
CLFA shall assertively engage enrolled families and be proactive in its efforts and adaptive
when responding to the needs of families. CLFA will utilize successfully proven interviewing
techniques, evidence-based intervention(s) and work creatively and collaboratively with families
and their Child Welfare Social Workers in order to address each family’s unique needs.
TEMPORARY HOUSING (EMERGENCY SHELTER)
Upon receipt of a referral, CLFA will immediately contact the family to begin the program intake
process and commence services. CLFA must attempt contact with referred families within one
business day. Temporary housing will be provided in the DSS-operated, El Puente facility for a
maximum of 90 days (with exceptions on an individual basis). If a family is determined to be
ineligible for BFH services, DSS staff will refer the family to other programs using the
Coordinated Entry System. While the family is in temporary housing, CLFA will assess each
family’s need. CLFA shall immediately begin working with the family on rapid rehousing services
and work proactively to move each family into permanent housing as soon as possible.
RAPID REHOUSING
CLFA shall provide Rapid Rehousing services to BFH families in accordance with rapid
rehousing best practices.
Rapid Rehousing services consist of three core components: Housing Search and Placement
(Housing Navigation), Direct Financial Assistance, and Case Management. Services required of
each component are as follows:
1. Housing Search and Placement
Housing Search and Placement services provided by CLFA shall include but not be
limited to the following:
• Meet with families to assess housing needs and barriers.
• Develop a housing plan that includes a budget specific to each household income,
set goals based on each family’s need, and steps required to meet those specific
goals.
• Assist families in locating and securing housing that meets their needs and assist
with finding rental vacancies/listings; completing rental applications; meeting with
and speaking to landlords and providing transportation as needed throughout the
process.
• Assist in securing all documents needed to apply for housing; and educating families
about their rental lease and legal rights and responsibilities.
• Work with families to identify shared housing solutions, including with other families
in the program, as needed.
• Provide ongoing liaison between families and landlords, if needed, to resolve issues
directly related to families’ housing and tenancy.
2. Direct Financial Assistance
CLFA shall pay for housing and related financial assistance on behalf of families for the
following:
a. Rental assistance
b. Security deposits
c. Utility deposits
Exhibit A
Page 3 of 4
d. Utility payments
e. Moving/storage costs
f. Furniture/making home habitable
• All financial assistance will be provided in compliance with the Progressive
Engagement model and dependent on family’s need. This model is supported by
research and provides a small amount of assistance to stabilize household but is an
individualized and flexible approach for those families that require more assistance. It
maximizes resources by only providing the assistance to the households who truly
need it.
• Families will be required to pay a portion of rent, even if very minimal, in efforts to
support sustainability and long-term success. Share of cost ratio for housing
expenses and other financial assistance will be determined by CLFA.
• Monthly evaluations must be completed in correlation with each family’s housing plan
and in order to determine a family’s ongoing ability to pay (based on family’s budget
and needs).
• All methods and models applied by CLFA should be tailored to each family’s needs
and goals and be carefully coordinated with the DSS Family Reunification or Family
Maintenance Social Worker.
3. Case Management:
CLFA shall provide families with case management on a regular basis, including
guidance, supportive services, promotion of incremental responsibilities, budget analysis
and techniques, and problem-solving skills in correlation with the housing plan
developed with families.
Case management services provided by CLFA shall include but are not limited to:
• Integration of service planning and development with the DSS Family Reunification
Social Worker.
• Teach families budgeting, planning, and expense tracking techniques to assist with
saving money towards securing permanent housing; maintaining housing and
increasing income to maintain housing.
• Identify and address any other barriers to permanent housing. Link families to
community resources such as health care, childcare, counseling, support groups,
job readiness training/support and educational or employment resources. etc.
• Prepare families for exit from the program; identify solutions and resources for each
family to access, should a financial or housing crisis arise in the future.
• Maintain caseload of no more than 30 open ongoing cases per Housing Navigator,
and 30 open cases per Case Manager.
• Perform regular home visits to make sure families are properly maintaining their
rental unit and maintain frequent contact with families for compliance as follows:
Contact families every 3 days initially with a gradual decrease dependent
upon families’ successful progression. Documentation with explanation
should be provided whenever contact is reduced. Contact with families
should continue in the program once they have exited from the financial
assistance component.
Perform at least 2 case management home visits with each family after
financial exit from the program (3 and 6 month housing retention follow-
up).
Exhibit A
Page 4 of 4
CLFA RESPONSIBILITIES
CLFA shall:
• Maintain membership in good standing in the Fresno Madera Continuum of Care
(FMCoC) as defined by FMCoC bylaws and participate in the Coordinated Entry
System (CES). Attendance at weekly FMCoC case conferencing meetings is
mandatory to fulfill this requirement.
• Accept direct referrals from DSS and cooperate with DSS on CES referral
integration process.
• Contact all families referred within one business day and work with DSS staff to
ensure immediate placement into shelter.
• Meet with County staff monthly, or as often as needed, for service coordination,
problem/issue resolution, information sharing, training, review, and monitoring of
services.
• Meet with Child Welfare Social Worker monthly, at minimum to coordinate services
and planning for each family.
• Engage families in a linguistically and culturally appropriate manner, including the
use of interpreters when needed.
• Provide complete and accurate monthly activity reports to the County of Fresno, in
a report format approved by the County by the 10th of each month.
• Case Manager and Navigator will maintain a caseload of no more than 30 open
ongoing cases.
• Case Manager and Navigator shall attend weekly CE Conferencing meetings and
other meetings relevant to the needs of BFH families.
• Provide annual Civil Rights training to staff at the beginning of every calendar year
and provide relevant verification to the County of Fresno by April 1.
• Adhere to and be responsible for compliance with, all applicable Federal, State and
local laws and regulations. In the event any law, regulation or policy referred to in
the Agreement or this Exhibit A, is amended during the term of this Agreement, the
parties agree to comply with the amended provision.
• Enter participant information into the Homeless Management Information System
(HMIS) in compliance with HUD data collection, management, and reporting
standards. Ensure all HMIS entries are completed within 3 days of program entry.
PERFORMANCE OUTCOMES
CLFA will meet the following outcomes within each 12-month period (or a prorated portion
thereof):
• Serve a minimum of 14 unduplicated families.
• Place at least 11 families into permanent housing.
• A minimum of 11 families will exit to permanent housing.
• A minimum of 10 families will remain in permanent housing three months after
exiting the program. Housing status must be confirmed through a home visit
• A minimum of 9 of families will remain in permanent housing six months after
exiting the program. Housing status must be confirmed through a home visit.
Exhibit B
BUDGET SUMMARY
ORGANIZATION: Centro La Familia Advocacy Services, Inc.
SERVICES: Bringing Families Home Program
CONTRACT TERM: September 22, 2020 through June 30, 2022
CONTRACT TOTAL: $408,275
22 Month Budget
Budget Categories Amount
Direct Financial Assistance
Rental Assistance
Security Deposits
Utility Deposits
Utility Payments
Making Home Habitable/Furniture
Moving Costs/Storage
Subtotal $281,648
Housing Navigation Services
Salaries
.5 FTE Housing Navigator
Taxes
Benefits
Operational Costs
Subtotal $ 57,141
Case Management Services
Salaries
.5 FTE Housing Navigator
Taxes
Benefits
Operational Costs
Subtotal $ 57,141
Administration
Salaries
.1 FTE Program Manager
Taxes
Benefits
Operational Costs
Subtotal $ 12,345
Total $408,275
Exhibit C
0872fcfx
NOTICE OF CHILD ABUSE REPORTING LAW
The undersigned hereby acknowledges that Penal Code section 11166
and the contractual obligations between County of Fresno (COUNTY) and
Centro La Familia Advocacy Services, Inc. (PROVIDER) related to provision
of Bringing Families Home services for COUNTY’s Child Welfare families,
requires that the undersigned report all known or suspected child abuse or
neglect to one or more of the agencies set forth in Penal Code (P.C.) section (§)
11165.9.
For purposes of the undersigned’s child abuse reporting requirements,
“child abuse or neglect” includes physical injury inflicted by other than accidental
means upon a child by another person, sexual abuse as defined in P.C.
§11165.1, neglect as defined in P.C. §11165.2, willful cruelty or unjustifiable
punishment as defined in P.C. §11165.3, and unlawful corporal punishment or
injury as defined in P.C. §11165.4.
A child abuse report shall be made whenever the undersigned, in his or
her professional capacity or within the scope of his or her employment, has
knowledge of or observes a child whom the undersigned knows or reasonably
suspects has been the victim of child abuse or neglect. (P.C §11166.) The child
abuse report shall be made to any police department or sheriff’s department (not
including a school district police or security department), or to any county welfare
department, including Fresno County Department of Social Services’ 24 Hour
CARELINE. (See PC §11165.9.)
For purposes of child abuse reporting, a “reasonable suspicion” means
that it is objectively reasonable for a person to entertain a suspicion, based upon
facts that could cause a reasonable person in a like position, drawing, when
appropriate, on his or her training and experience, to suspect child abuse or
neglect. The pregnancy of a child does not, in and of itself, constitute a basis for
reasonable suspicion of sexual abuse. (P.C. §11166(a)(1).)
Substantial penalties may be imposed for failure to comply with these child
abuse reporting requirements.
Further information and a copy of the law may be obtained from the
department head or designee.
I have read and understand the above statement and agree to comply with
the child abuse reporting requirements.
__________________________________ ________________________
SIGNATURE DATE
Exhibit D
Page 1 of 2
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as “County”),
members of a contractor’s board of directors (hereinafter referred to as “County Contractor”),
must disclose any self-dealing transactions that they are a party to while providing goods,
performing services, or both for the County. A self-dealing transaction is defined below:
“A self-dealing transaction means a transaction to which the corporation is a party and in
which one or more of its directors has a material financial interest”
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member’s name, job title (if applicable), and date this disclosure is being
made.
(2) Enter the board member’s company/agency name and address.
(3) Describe in detail the nature of the self-dealing transaction that is being disclosed to
the County. At a minimum, include a description of the following:
a. The name of the agency/company with which the corporation has the
transaction; and
b. The nature of the material financial interest in the Corporation’s transaction that
the board member has.
(4) Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self-dealing
transaction described in Sections (3) and (4).
Exhibit D
Page 2 of 2
(1) Company Board Member Information:
Name: Date:
Job
Title:
(2) Company/Agency Name and Address:
(3) Disclosure (Please describe the nature of the self-dealing transaction you are a party to):
(4) Explain why this self-dealing transaction is consistent with the requirements of Corporations
Code 5233 (a):
(5) Authorized Signature
Signature: Date: