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CC - Item 7A - Public Hearing on the Fiscal Year 2011-12 Annual Action Plan For Federally Funded ProgramsROSEMEAD CITY COUNCIL STAFF REPORT TO: THE HONORABLE MAYOR AND CITY COUNCIL FROM: JEFF ALLRED, CITY MANAGER DATE: FEBRUARY 8, 2011 SUBJECT: PUBLIC HEARING ON THE FISCAL YEAR 2011 -12 ANNUAL•ACTION PLAN FOR FEDERALLY - FUNDED PROGRAMS SUMMARY The City of Rosemead is a federal entitlement grant recipient of Community Development Block Grant and HOME Investment Partnership funds from the U.S. Department of Housing and Urban Development (HUD). As part of the process to receive funding, the City must undertake development of a Consolidated Plan and Annual Action Plan. It is called a Consolidated Plan because it consolidates the application process for HUD's four (4) entitlement grants into one consolidated plan and application. The four grants are: Community Development Block Grant (CDBG), HOME Investment Partnership Program (HOME), Housing Opportunities for Persons with AIDS (HOPWA), and Emergency Shelter Grant (ESG). All four grants are driven by an entitlement formula process set by the federal government. The City is eligible to participate in two (2) of these programs: CDBG and HOME. As part of the requirements of the federal Consolidated Plan process, the City is required to hold a public hearing regarding the projected use of funds prior to adoption of its Consolidated Plan and Annual Action Plan. In order to receive the FY 2011 -12 allocations, the City must comply with the following requirements of the Consolidated Plan final rule regarding pre- submission requirements: ➢ Fulfill citizen participation requirements by conducting a public hearing to receive citizen input regarding annual funding needs; Publish a draft Plan and Annual Action Plan for a 30 -day comment period in order to receive citizen input regarding the final document; and Conduct a public hearing adopting the final Plan and the Annual Action Plan. The Annual Action Plan is a part of the Consolidated Plan, which takes all HUD requirements regarding planning, needs analysis, reporting, budgeting, citizen participation and certifications and incorporates them into one process. The full Consolidated Plan must be completed once every five (5) years and the Annual Action Plan must be completed annually. ITEM NO. _JL� APPROVED FOR CITY COUNCIL AGENDA: City Council Report " February 8, 2011 Paae 2 of 3 Staff Recommendation Staff recommends that the City Council conduct a public hearing and take public testimony on the Annual Action Plan covering the period July 1, 2011 — June 30, 2012. No further City Council action is necessary. ANALYSIS While the City has not yet been notified of the grant amount that will be available to meet identified needs within Rosemead for the new year, it is estimated that the City will receive a 10% decrease in both the current $1,242,049 allocation of CDBG funds and $547,221 allocation of HOME funds. In conducting this public hearing, written invitations were sent to the five (5) non - profit organizations that are currently receiving CDBG funding. These organizations include the Family Counseling Services, People for People, Rosemead High School, Rosemead School District, and Southern California Housing Rights Center. Copies of the written proposals received from these organizations have been included in Attachment A. It is expected that all five (5) organizations will be represented at the public hearing. In addition, several new parties have communicated their interest in submitting a first time funding request and may attend the meeting to state their interest to the City Council. The hearing is also open to the general public and anyone present can submit a funding request for the Council's consideration. However, in accepting these recommendations only three broad funding categories are considered eligible under CDBG regulations. A project must either provide benefits to low or moderate - income persons, eliminate slum or blighted conditions, or is an urgent need. In addition, of the CDBG funds received, no more than 15% of the annual grant amount can be used for public services and no more than 20% of the grant amount can be used for Planning and Administrative services. More than 70% of all funds received must be used for low -to- moderate income activities. Of the HOME funds received, no more than 10% can be used for administrative and program delivery activities. 15% is set aside for Community Housing Development Organizations, as constituted under the regulations. The balance of funds can only be used for housing activities. Due to limited resources, it may not be possible for the Council to endorse all of the projects that are submitted by staff and the various parties that attend this hearing. Therefore, to properly evaluate the proposed projects, staff would recommend that the Council defer making any final recommendations until all funding requests are submitted to the City. A summary of all funding requests and staff - endorsed projects will be provided to the Council for review at a future meeting. PUBLIC NOTICE PROCESS Notice of the public hearing was published in the San Gabriel Valley Tribune on January 24, 2011, as well as through the regular agenda notification process. City Council Report February 8, 2011 Pace 3 of 3 I Prepared by: cm Michelle G. Ramirez Community Development Manager Submitted by: Stan Wong Community Development Director Attachment A — Social Service Requests ATTACHMENT A FAMILY COUNSELING SERVICES CITY OF ROSEMEAD PRIVATE OR NON - PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding — Fiscal Year (FY) 2011 -2012 Name of Organization: Santa Anita Family Service Address: 121 S Santa Anita Street, San Gabriel, CA 91776 Executive Director: Dr. Fred Lova Contact Name: Dr. Jennifer Foote Telephone: 626.308.1414 Fax: 626.308.1818 Email: ddjfootena,sbcglobal.net Purpose of Organization: Santa Anita Family Service was founded in 1951 to foster well -being of the San Gabriel Valley creating healthier families and communities through professional leadership and the provision of hi - quality educational, mental health and social service program. Enter "X" by the appropriate designation: X Non - profit organization* For- profit organization ( *Non - profit applicants please submit a copy of your agency's Determination Letter from the IRS) Enter "X" by all that apply: A faith -based organization An institution of higher education X Not Applicable Employer Identification Number (EIN): 95- 1816014 TOTAL UNDUPLICATED CLIENTS RECEIVED: FY 08 -09 45 (hours of treatment: 689) (Please Complete Attached Backup — Performance Report) FY 09 -10 42 (hours oft trnent 785.5) (Est.) FY 10 -11 50 ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: Exhibit A AGENCY TOTAL BUDGET FOR FY 2011 -2012: Exhibit B FY 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEWAD: $40.000 1. State the Agency's mission, goals and major objectives. In addition, describe programs designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments. Missions Statement: Santa Anita Family Service was founded in 1951 to foster well -being of the San Gabriel Valley creating healthier families and communities through professional leadership and the provision of high - quality educational, mental health and social service programs. Goals: • Support Family Stability • Sober Living • Drug — Free Lifestyle • Violence —Free Lifestyle • Child Abuse Prevention/Intervention • Older Adults Stability/Independence • Emotional Well -Being of Adults and Children Objectives: • Provide: • Individual, group, family, and conjoint treatment • Parent — Education • Drug/Alcohol Treatment • Domestic Violence Treatment • Case Management • Linkages • Information and Referrals for Housing, Food, In Home Supportive Services, Child Care, etc. Programs designed to meet goals and objects: • Rosemead Program • Senior Services • Pathways • P.A.C.T. (Parents and Children in Transition) • PC 1000 • Domestic Violence Batterers Program • White Cap Foundation • Family Support • DV CalWORKS • CalWORKS Substance Abuse Program • General Relief Substance Abuse Program • Proposition 36 • CDBG — Domestic Violence • CDBG — Senior Services • CDBG — Case Management • Image Plus: Alcohol and Drug Prevention and Education • Impact Plus: Project: Violence/Gang Prevention Program • Family Preservation • YAB (Youth Accountability Board) • Food Stamp Program • Monterey Park — Ethnic Harmony Program • Arcadia Unified School District Program • Covina Unified School District Program 2 2. Briefly explain any new programs or services to Rosemead residents during FY 2010 -2011. Are any planned for FY 2011 -2012? No new programs /services 3. How are clients referred to your agency? Community Agencies, Schools, Police Department, Department of Children and Family Services, Prototypes, Residents of Rosemead 4. List and explain any major changes in funding patterns or expenditures Decrease in funding through State and Federal contracts 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, fees, program income, etc.) See attached (EXHIBIT C) 6. What facilities in Rosemead are used to conduct services or are requested to be used? None at this time. Services are provided out of our San Gabriel office. We have made past attempts to work with the local schools to provide a variety of services, such as parent education; however, space is often an issue and the families are also able to commute to the SG office where the services are already being provided. 7. The proposed Community Service would be provided to: Mark each that apply X Low and Moderate - Income persons or households X Abused Children X Handicapped Persons X Illiterate Persons X Battered Spouses X Homeless Persons X Migrant Farm Workers X Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program/project in FY 2011 -12: 50 Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) (Participant Drawings also included on Exhibit D & Exhibit E) Our program is geared towards an array of issues many face; thus, to speak on one becomes a challenge. Therefore, I have chosen two that can narrate some of the issues our Rosemead Program participants deal with. Jennifer, a Hispanic woman in her mid 30s , was finally able to disclose to herself and close friends that she had been sexually molested by her uncle for several years, beginning a the age of 4. Although she told her mother, nothing was done to stop the abuse. Growing up, Jennifer began to believe that she deserved the abuse and that it was her fault. After many abusive relationships, she found herself feeling very depressed and, at one point, suicidal. Having very little economic resources, Jennifer did not think she could afford the help she needed. However, through the no to low cost counseling program through the City of Rosemead, Jennifer was able to reach out receive the treatment she needed. She began attending a group for adults molested as children (AMAC) and individual therapy on a weekly basis. Jennifer, thus far, has begun to discuss her intense feelings of shame and lack of self worth stemming from such early and ongoing trauma. As a result, Jennifer is beginning to understand that the abuse was not her fault and she is rebuilding her self esteem. Because of the no to low cost counseling program through the City of Rosemead, Jennifer was able to seek help and begin the process of breaking the cycle of abuse. The other case involves children: Johnny, who at the time was 10 years of age, and Kimberly who was 14 years old were mandated into to treatment by Department of Children Services (DCFS) after being removed from their mother's care and placed with a family member. Both Johnny and Kimberly had seen their mother and her boyfriend severely abuse each other physically, verbally, and emotionally and a child abuse report was made. For years, Johnny and Kimberly had seen their mother rotate in and out of their lives as she was often incarcerated. In addition, Kimberly had also been sexually abused by her biological father; therefore, their father was also not a part of their lives. This; however, would be the first time that Johnny and Kimberly would seek treatment for all the abuse and instability in their lives. Therapy in the past was not an option, as it was thought of as too expensive. However, with the Rosemead program both Johnny and Kimberly could receive treatment. Therefore, both Johnny and Kimberly began individual therapy once a week. Johnny, in the beginning, was shy and quiet. He soon started to open up about all his fears. He began to be more animated and verbal about his thoughts and feelings. In addition, Johnny started to recognize his strengths and praise himself for his efforts at school. Kimberly in the beginning was also quiet; however, she seemed more reserved and untrusting. Though out therapy, Kimberly began to discuss the traumatic events in her life, such as the sexual abuse and the instability of her mother, and was building a strong social support at school. As therapy transitioned to include family reunification with their mother, both Johnny and Kimberly were able to express their hesitancy with their mother's return and fears of her inability to refrain from trouble with the law and incarceration. This was important for both Johnny and Kimberly as this was a cycle that had been happening through out their life. In the end, Johnny and Kimberly's mother did return to prison. However, Johnny and Kimberly were able to utilize therapy as a consistent part of their life to cope. And, in the end, both Johnny and Kimberly began the process of not blaming themselves, have a greater support network, utilize school as a positive outlet, developed boundaries to prevent future abuse, and have other coping skills to deal with the parents and the trauma they have endured. Because of the Rosemead program, Johnny and Kimberly could receive the help 4 they needed and know that there is help available to them. 10. Has your organization conducted the proposed activity before? Yes X No 11. Describe your organization's experience with CDBG Santa Anita Family Service has had an extensive experience with CDBG. For over 21 years we have worked with one or more of the following CDBG: Azusa, Baldwin Park, Monterey Park, Rosemead, Gloria Molina's office. In addition, Santa Anita Family Service was awarded 4 CSBG grants — two for Supervisory Districts 1 and 5 for domestic violence, case management, and senior services. 5 N 0 N°o 0 0 0 Q 0 0 0 ? 0 0 0 N N HHH� HHH��+HHH 1 0 C A A eC G A A p A A e � C C 000 C O . 000 c O 0 C r. C ya+ o nc. cr c o lla < a n 6. Nd 6OA GL UA n 9 u u m 00 00 Fn C N 3 °o � w N O [� 0 b W W A w O c 9 O' m W 0. b O� R. a n 0 -n 0 N w a ,:i ) / � k 2 § / )� \ �)n § §§ j]? k §\ ]�M r \) �m }� c0z >> wa y q 2 »| &E ƒ _ N) w § )£ m / Cil cn > ; . / ( } §k\ °([ } r(��\ 2 %«m, *)§# cn ® ® - «_ 0 § §§ } p% \[[§ ]( {r2 §22« / \ \/\ / )� \ �)n § §§ j]? k §\ ]�M r \) �m }� KE ) / ) D cr ) J q2 # ¥q §§\ (qq §?? kj\ 2> r \§ d* $ `®£ >> ~> ® ($-(■E» � $ )( $ m ƒ \ (® . / { {\§� ( . - ° §( E ® &\/ / § ® ® -!_ § §| / � /)\[[] §( §« \ \ e t w //\ J q2 # ¥q §§\ (qq §?? kj\ 2> r \§ d* $ _ ) / ) j § rr � q 0 � \ ion 51 � tz k�\ ]2> \� )\ \ � 3 # g /!!! / r )£ m § } \ � u � � /\ 2 \ \ \ }� ( - ° k(/ \(DES o 0 2)) <\ §§| E ® . E) } //d § &z § 0. ( ! )) 4' CD � q 0 � \ ion 51 � tz k�\ ]2> \� )\ \ � 3 13. Proposed Program Budget — FY 2011 -2012 (Public Service Requests Only) 10 CDBG SHARE OTHER SOURCES Personnel $35887 $329212 Equipment $0 $0 Supplies $600 $8400 Consultant Services $0 $0 Space Rent & Utilities $4500 $82500 Audits $0 $10000 Program Income $1200 $10800 Fees $0 $2000 Other $213 $21787 $[2400] $0 Total Costs $40000 $464699 10 TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B)B. No changes greater than 15% ** Explain What is Included in the "Other" Category. ►i tiT'iT 11 A Most recent fiscal year 2009/2010 B Current Operating Year 2010/2011 C Proposed Budget July 1, 2011 to June 30 2012 D Percent Change* Expense Salaries 283500 297675 297675 0 Employee Benefits 39690 44652 44652 0 Employees Payroll Taxes 21688 22772 22772 0 Profes. & Consultant Fees 0 0 0 Supplies 7000 7000 7000 0 Telephone & Fax 12000 12000 12000 0 Postage & Shipping 0 0 0 Occupancy & Utilities 89000 89000 89000 0 Rental & Maint. of Equip. 0 0 0 Printing & Publishing 0 0 0 Travel and Transportation 2000 2000 2000 0 Conferences 0 0 0 Specific Assist. To Individuals 0 0 0 Membership Dues 0 0 0 Awards & Grants 0 0 0 Insurance 22000 22000 22000 0 Equipment Purchased 0 0 0 Misc. Expenses 10000 10000 10000 0 Transfer to Other Funds 0 0 0 Dues to National Organizations 0 0 0 Other ** 0 0 0 486878 507099 507099 Surplus (or Deficit) of Total Support & Revenue Over Expenses * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B)B. No changes greater than 15% ** Explain What is Included in the "Other" Category. ►i tiT'iT 11 TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only *Column A is the Audited or Most Recently completed 1 -Mouth Period ** Percent Change From B and C (C -B)B. Please Explain Changes Greater than 15% Percent None 12 A Most Recent Fiscal Year 2009 -2010 B Current Operating Year 2010 -2011 C Proposed Budget July 1, 2011 to June 30, 2012 D Percent Change* Public Support Contributions 1000 1000 1000 0 Foundation & Private Grants 20000 20000 20000 0 Fundraising/ special Events 1500 1500 1500 0 Legacies and Bequests 0 0 0 Other Federated Org. 0 0 0 United Way 0 0 0 Misc. Organizations 0 0 0 Other 0 0 0 Subtotal 22500 22500 22500 0 Government Federal 66000 86221 86221 0 State 330000 330000 330000 0 Local 65000 65000 65000 0 Subtotal 461000 481221 481227 0 Other Revenue Membership Dues 0 0 0 0 Program Services Fees 3378 3378 3378 0 Investment Income 0 0 0 0 Transfer From Other Fund Q 0 0 0 All Other Revenue Q 0 0 0 Subtotal 3378 3378 3378 0 TOTAL REVENUE 486878 507099 507099 *Column A is the Audited or Most Recently completed 1 -Mouth Period ** Percent Change From B and C (C -B)B. Please Explain Changes Greater than 15% Percent None 12 • As requested in cover letter: o Agency Certificate of Liability Insurance (Exhibit F) I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING J k** ( L d22al d - �fi r/c* Em Organization Dat� 13 -III xz� Phone Number EXHIBITS CONTENTS EXHIBIT A - ROSEMEAD 2010.201 1 FINANCIAL SUPPORT EXHIBIT B - AGENCY TOTAL BUDGET FOR FISCAL YEAR 2011-2012 EXHIBIT C - FUNDING SOURCES & AMOUNTS EXHIBIT D - PARTICIPANT DRAWING EXHIBIT E - PARTICIPANT DRAWING EXHIBIT F - CERTIFICATE OF LIABILITY INSURANCE Exhibit A 1 of 2 pages Santa Anita Family Service Budget 09 -10 Exhibit Jul '09 -Jun 10 Jul '10 -Jun 11 Income 4000 • Donations 23,080.00 12,000.00 4100 - Program Fundraising 800.00 1,000.00 4200 • Board Contributions 5,000.00 2,000.00 4600 • Revenue - Assoc Org. Monrov 2,000.00 2,000.00 5001 • Senior Center Contract 979,302.00 936,541.00 50012 • Family Support Contract 150,000.00 133,777.00 50015 • DV Calworks Contract 229,038.00 229,038.00 50018 • DV Calworks Grow Dist 1 27,672.00 27,672.00 5002 • Pathways Contract 19,682.00 19,682.00 5003 • Pact Contract 116,666.00 116,666.00 5006 • City of Azusa Contract 10,000.00 10,000.00 5007 • City of Covina 2,500.00 2,800.00 5013 • City of Baldwin Park-SC 5,000.00 5,000.00 5014 • Covina Unified School Dist 22,830.00 22,500.00 5015 • Arcadia Unified School 10,000.00 13,020.00 5016 • Pathways GR- Contract 8,007.00 8,007.00 5017 • Pathways Calworks- Contract 7,144.00 6,357.00 5019 • Proposition 36 Contract 50,163.00 46,000.00 5020 • Family Preservation Contract 500,830.00 559,000.00 5022 • City of Rosemead Contract 40,000.00 40,000.00 5023 • General Relief /FCS Contract 5,069.00 40,763.00 5024 • Calworks /FCS Contract 19,000.00 10,000.00 5025 • Image Plus Contract 74,047.00 74,047.00 5026 • Impact Plus- CDBG Contract 15,000.00 15,000.00 5027 • City of Monterey Park Contrac 5,000.00 5,000.00 5032 • LEARN 1,080.00 1,080.00 5050 • DPSS- Food Stamp Contract 2,880.00 1,500.00 5060 • DPSS 5 SS 19,432.00 57,522.00 5070 • CSBG 1 SS 15,178.00 27,655.00 5080 • CSBG SC 5CM 26,012.00 32,432.00 5090 • CSBG DV 1 73,671.00 75,384.00 6000 • Murex Petroleum Corp. 2,255.00 1,300.00 6100 • Amerada Hess Corp. 8,151.00 3,500.00 6150 • Danbury 800.00 1,000.00 6175 • Ranch Oil Co. 639.00 425.00 6185 • Fidelity0il Company 100.00 100.00 6195 • Assistance League 17,500.00 - 6196 • Hillsides - Family Pres 2,358.00 18,000.00 6200 - Counseling Fees 30,995.00 30,757.00 6201 • Pathways Fees 250.00 93.00 6202 • PC 1000 Fees 9,115.00 4,875.00 6203 • PACT Fees 15,956.00 11,343.00 6204 • Domestic Violence Fees 41,985.00 22,226.00 6205 • Prop 36 -1 Fees 4,000.00 2,460.00 6206 • Parenting Fees 4,760.00 3,672.00 6207 • Senior Center income 7,692.00 5,901.00 6208 • Sex Offenders Fees - 6209 - Rosemead fees 1,100.00 531.00 6211 • Anger Management Fees 4,238.00 5,022.00 6212 • Adolescent Group Fees 450.00 - 6213 • Chronic Illness Fees 760.00 870.00 6214 • Empowerment Group Fees 2,485.00 2,250.00 6215 • FCS /GR Fees 382.00 - 6220 • YAB Fees 45.00 6221 • MFG Fees 85.00 - 6230 • Rental income 4,488.00 4,492.00 Page 1 of 2 Exhibit A 1 of 2 pages Santa Anita Family Service Budget 09 -10 Exhibit Jul '09 -Jun 10 Jul '10 -Jun 11 6500 • Miscellanous Income 410.00 630.00 6520 • Interest 500.00 444.00 6811 • United Way Donor Contributic 1,234.00 786.00 Total Income 2,628,816.00 2,654,120.00 Expense 7000 • Salaries 7050 - Salaries - Clerical 7090 • Salaries - Para Professional 7100 • Health Insurance 7210 • Payroll taxes 7230 • WIC Insurance 7240 • Unemployment Insurance 7400 • Stipens /SC 8040 • Accounting Services 8041 • ADP Fees 8110 8150 8175 8200 8300 8410 8420 8425 8426 8430 8440 8445 8490 8501 8525 8530 8600 8720 8810 9000 9100 9200 9500 9520 9540 9550 9570 9590 9592 9593 9594 9610 9615 Office supplies Educational Supplies Educational Training Telephone Postage Rent Mortgage Interest Expense Line of Credit Interest Expens Fidelity Mortgage Interest Utilities Maintenance - Building Maintenance Service & Repel Other Building Expense Rental & Maint of Equipment Equipment Tax Computer Maintenance Printing Mileage Educational Conferences Membership Dues Filing Fees Liability Insurance Miscellaneous Bank charges /Fees Business License Renewal Gateway Billing Purchase of Service Drug Testing Fam PresSubcontractor DV Cal -works Subcontractors Family Support Subcontracto Van Expense Gas Expense Total Expense Net Income 1,009, 990.00 1,035, 766.00 18,000.00 159, 261.00 159, 261.00 535,563.00 596,724.00 1,000.00 140, 000.00 126, 633.00 135, 600.00 128,000.00 1,400.00 55,000.00 37,469.00 15,000.00 30,000.00 5,000.00 - 23,000.00 23,000.00 12,160.00 10,000.00 22,000.00 21,000.00 2,500.00 2,500.00 500.00 1,500.00 36,000.00 30,347.00 7,000.00 2,217.00 82,000.00 43,100.00 42,000.00 42,000.00 1,600.00 1,736.00 55,000.00 45,500.00 34,000.00 48,325.00 7,000.00 11,620.00 4,000.00 6,410.00 6,000.00 4,000.00 18,000.00 20,000.00 300.00 300.00 500.00 2,500.00 10,000.00 10,000.00 16,000.00 24,712.00 5,000.00 3,500.00 2,000.00 500.00 26,000.00 30,533.00 18,000.00 100.00 1,000.00 4,000.00 1,600.00 1,000.00 506.00 506.00 660.00 660.00 1,400.00 14,000.00 21,000.00 - 900.00 81,000.00 69,000.00 18,876.00 18,000.00 i 40,000.00 40,401.00 1,000.00 1 500.00 700.00 1,400.00 2,628,816.00 2,654,120.00 0.00 0.00 Page 2 of 2 Santa Anita Family Services Projected Budget FY 10 -11 Exhibit B EXHIBIT B 1 OF 2 pages Income 4000 - Donations 4100 • Program Fundraising 4200 • Board Contributions 4600 - Revenue - Assoc Org. Monrovia 5001 • Senior Center Contract 50012 • Family Support Contract 50015 - DV Calworks Contract 50018 • DV Calworks Grow Contract 5002 • Pathways Contract 5003 • Pact Contract 5006 • City of Azusa Contract 5007 • City of Covina 5013 - City of Baldwin ParkSC 5014 • Covina Unified School Dist 5015 • Arcadia Unified School 5016 - Pathways GR- Contract 5017 - Pathways Calworks- Contract 5019 • Proposition 36 Contract 5020 • Family Preservation Contract 5022 • City of Rosemead Contract 5023 • General Relief /FCS Contract 5024 • Calworks/FCS Contract 5025 - Image Plus Contract 5026 • Impact Plus- CDBG Contract 5027 • City of Monterey Park Contract 5050. DPSS -Food Stamp 5060 • DPSS Senior Srvs 5080. CSBG SCM 5090. CSBG DV1 5091. CSBG 1SS 6000 - Murex Petroleum Corp. 6100 • Amerada Hess Corp. 6150 - Denbury 6175 • Ranch Oil Co. 6185 • FidelityOil Company 6195 - Assistance League Hillsides 6200 - Counseling Fees 6230 - Rental income 6520 - Interest 6811 - United Way Donor Contributions Total Income Expense 7000 - Salaries 7050 • Salaries - Clerical Jul'11 -June 12" 16,100.00 1,000.00 2,000.00 2,000.00 1,036,541.00 150,000.00 229,038.00 27,672.00 19,682.00 116,666.00 10,000.00 2,800.00 5,000.00 22,500.00 13,020.00 8,007.00 6,357.00 46,000.00 527,000.00 40,000.00 40,763.00 16,632.00 74,047.00 15,000.00 5,000.00 1,500.00 57,522.00 32,432.00 75,384.00 27,655.00 1,300.00 3,500.00 1,000.00 425.00 100.00 18,000.00 90,000.00 4,493.00 444.00 786.00 2,747,366.00 1,085,151.00 159,261.00 Page 1 of 2 Santa Anita Family Services Projected Budget FY 10 -11 EXHIBIT B 1 OF 2 pages 7090 - Salaries - Para Professional 7100 • Health Insurance 7210 • Payroll taxes 7230 - WIC Insurance 7240 • Unemployment Insurance 8040 • Accounting Services 8041 • ADP Fees 8110. Supplies 8175 • Educational Training 8200 Telephone 8300 • Postage 8410 • Rent 8420 • Mortgage Interest Expense 8430 • Utilities 8440 • Maintenance - Building 8445 • Maintenance Service 8 Repairs 8490 • Other Building Expense 8501 - Rental & Maint of Equipment 8525• Equipment Tax 8530 • Computer Maintenance 8600 - Printing 8720 • Mileage 8810 - Educational Conferences 9000 • Membership Dues 9100 - Filing Fees 9200 • Liability Insurance 9520 • Bank charges/Fees 9540 • Business License Renewal 9550 - Gateway Billing 9570 - Purchase of Service 9590 • Drug Testing 9592 • Fam PresSubcontractor 9593 - DV Cal -works Subcontractors 9594 • Family Support Subcontractor 9600 - U.S Finger Print Expense 9610 - Van Expense Total Expense Net Income Jul'11 - June 12" 596,724.00 126,633.00 141,309.00 37,000.00 24,000.00 23,000.00 10,000.00 21,000.00 360.00 30,347.00 5,000.00 43,100.00 90,828.00 48,325.00 11,620.00 6,410.00 4,000.00 21,870.00 121.00 2,000.00 10,711.00 24,713.00 6,566.00 500.00 50.00 30,533.00 1,603.00 300.00 600.00 19,000.00 1,603.00 91,932.00 18,876.00 50,912.00 408.00 1,000.00 2,747,366.00 Page 2 of 2 EXHIBIT C 2010 -2011 Funding Resources FUNDING SOURCES ALLOCATION AMOUNT Donations 17,000 Client Fees 90,000 Contracts CSBG — Senior Services Districts 1 & 5 85,177 CSBG — Domestic Violence /Case Management 107,816 City of Azusa 10,000 City of Baldwin Park 5,000 City of Covina 25,300 Arcadia Unified School District 13,020 Senior Center Contract 936,541 P.A.C.T. Contract 116,666 Pathways Contract 19,682 General Relief 48,770 CaIWORKS Contract 16,357 Proposition 36 46,000 Family Preservation Contract 577,000 Family Support Contract 133,777 Domestic Violence Calworks /GR Contract 256,710 City of Rosemead 40,000 City of Monterey Park 5,000 Learn 1,080 DPSS Food Stamps 1,500 Impact Plus 15,000 Royalties 6,325 Image Plus 74,047 Miscellaneous 6,352 TOTAL 2,654,120 A . nw C ;tRyg l� a f MwK -- "T opp�� ��: j� fA o . eb a , -, � ,,>y+ �� tyrA 1� �'� �'t�p �' � �x� �o S�`�. . ���� ,��� �.y. y?e�,i' PR,FFE %�� -, " g S L OW S ow ME MOW o l l , . 7 v ' T", ��\ t� 4.�, fiI.VKL! CERTIFICATE OF LIABILITY INSURANCE L r 1012612010 PRODUCER ftwe: 626332 -2256 Fax: 626339 -9921 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LILLIAN ROMERO GOMEZ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BAKER ROMERO & ASSOCIATES INSURANCE BROKERS, INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 750 TERRADO PLAZA SUITE 238 ALTER THE COVERAGE AFFORDED BY ME POLICIES BELOW. COVINA CA 91723 Lnunry l lrlh nr.�vYOn INSURERS AFFORDING COVERAGE I NAIC # INSURED SANTA ANNTA FAMILY SERVICES 605 S. MYRTLE AVE MONROVIA CA 91016 rnvFRAr.Fc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, 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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ER LTR AO INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M FFEC POLICY E%PIMiIOH OATS MIM00 LIMITS GENERAL LIABILITY PAC7575140 11110110 11/10111 EACH OCCURRENCE $ 1000000 X COMMERCIAL GENERALLIABILITY PR 9ES R ENTED w $ 100,000 CLAIMS MADE OCCUR NED. EXP (Anyone person) $ 5, 000 PERSONAL &ADV INJURY $ 1,000,000 A X P ROFESSIONAL LIABILITY X A BUSE MOLESTATION GENERALAGGREGATE $ 3,000,000 GENTAGGREGATE LIMIT APPLIES PER: PRODUCTS- COMPIOPAGG S 1,000,000 POLICY PR a LOC $ AUTOMOBILE LIABILITY ANY AUTO CAP7575141 11110/10 11110/11 COMBINED SINGLE LIMIT (Ea amdont) $ 1 X BODILY INJURY (Per parson) $ ALL OWNED AUTOS SCHEDULED AUTOS A HIRED AUTOS NON -0WNEO AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per as ent) $ GARAGE LIABILITY AUTO ONLY - EAACCIDENT b OTHER THAN $ ANY AUTO $ AUTO ONLY: AGO EXCESS I UMBRELLA LIABILITY UMB8049268 11110/10 11110111 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 X OCCUR a CLAIMS MADE ABUSE $ INCLUDED A $ DEDUCTIBLE $ X RETENTION $ 10,000 WORKERS COMPENSATION AND TORV o E.L. EACH ACCIDENT $ EMPLOYERS' UABILTTY Y'M ANY PROPgMTORAARTXFJiIEA£CNNE E.L. DISEASE -EA EMPLOYEE S OFFCw E eMEMBIA CLUOEDa ❑ (M.a .p In NH) E.L. DISEASE - POLICY LIMIT $ ff m,d. ee.rd., ePECUL PROVISIONS balox OTHER DESCRIPTION OF OPERATIONSILOCATIONS /VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED - FUNDING SOURCE TOTAL ABUSE LIMITS $2M1$2M reer,nrnrC unr noo r-ANrFI I ATION ACORD 25 (2009101) Certificate # 7527 ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CITY OF ROSEMEAD SHOULD ANY OF THE MOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS 6636 E. VALLEY BLVD. WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO ROSEMEAD, CA 91770 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Attention: AUTHORIZED REPRESENTATIVE Illian Romero -Gomez ACORD 25 (2009101) Certificate # 7527 ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PEOPLE FOR PEOPLE CITY OF ROSEMEAD PRIVATE OR NON - PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding — Fiscal Year (FY) 2011 -2012 Name of Organization: J t C © / ;' (`� J' � l� � j'O /L j �s� U LC I ( h Address: 6 0 N, /A4; s S J n A) 1C ( 0,4 Executive Director: /V D P Contact Telephone: rr�� t',a 6 - - 77 ? 2 C - / � as�l ' 9 Fax: 6 g6 _ ;C b p D — 0 "! 2 6 'j` Email: Purpose of Organization: `FP 1/ At n Enter "X" by the appropriate designation: � Non -profit organization For -profit organization Enter "X" by all that apply: V A faith -based organization An institution of higher education Not Applicable TOTAL UNDUPLICATED CLIENTS RECEIVED: FY 08 -09 / tJ (Please Complete Attached Backup — Performance Report) FY 09 -10 /, (Est.) FY 10 -11 D D O ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: 7 �D AGENCY TOTAL BUDGET FOR FY 2011 -2012: r 0_�;21) FY 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: oC •peawasob to Ally ayl ul 'slenpinlpul palgeslp pue AlJapla ayl of AJanllap awoq apinoJd am •slseq papaau a uo slaluelq pue's4q aual;lAq 'Bulylol:)'pool uanl8 aJe ssalawoy ayl •luawAoldwa paau oqm sluall:) of do mollol pue y:)Jeas qof apinoJd osle aM - spaau Jlayl of SulpJox)e slseq auo of auo a uo gullasuno:) Sulpnhul';iulylol:)'pool leluawalddns yllm aldoad pa!l!lenb auras of anulluo:) of sl weiSoid Jno to pafgo ayl saAllpafg0 (:)) g sleo9 8 ,; say:)Jny:) gulledggped ay; to salllunwwo:) aql ul Apaau ayl Jol salllunlJoddo leuolle3npe of lenalaJ pue 'Bullasuno3 '2ul41013 'pool 40 a:)uelslsse ayl !Rulpnj3ul Allunwwo:) Jno ul sanleA uellsuy:) pue asne:) uellsu43 @41 1 3!lauaq lenlnw Jol aq Illm se ]Jolla anlleJadoo:) leuolleulwouapJalul to swJol asoyl alowoJd of slaas uollezluESJO NJ,,, ;wawale35 uolsslW y -quawssasse spaau Jo sweJgoJd }o suollenlena lua3aJ Aue g3elll/ •sanlhafgo pue sleog laaw o; pau>llsap sweJfoJd aq!nsap 'uol;lppe ul •saklhafgo Jofew pue sleOS'uolsslw sA3uagV ayl alelS I •lJoddns leJow pue sall!unl,oddo qof lulylop'pool BulpinoJd slseq Algluow a uo aldoad dlay of sl asodJnd Jno - sauepunoq a:)lAJas Jno u!4llm seaJe Aluno:) paleJodJo:)ulun aql Ile pue elpe:)JV'lJed Aoialuow IAl!:) aldwal'peawasoH'laugeg ueS'eJgweylylo sally ayl aivas am •slenpinlpul pue salilwel ssalawoy 'AlJaple ayl'salllWel awo:)w -mol 'sJaylel pue sJaylow aJellam'paAoldwaun ayl panuas aney am uayl a:)uls pue t6861 'I y:)Jeyy uo suolleJado ue;laq aM •weJ2oJd pool 3!loJd -uou a sl aldoad Joj aldoad :uoilezluegio to asodJnd ZIOZ 21V3A 1V:)SIJ 21031S3n*03V NOIIVZINb9HO 33IA213S A11NRW WOE 113021d-NON HO 31VARld (M W 3SOH JO Alit H Y i . u L C of :a 0 U `u u 0 u G OD . W 0 E L 00 0 d Q V U s V s U a .a Q C cn h 1 s u E as z u G OD Q� v t o G O O j vi �.- 61 O p L C — j p T C N A � C v �• y j OC 9 �— E T v L � T U O' N Y L d •n N C N Y N— y vE u❑ 3U - Efi � a _ V Vl 16 n W o P 1 � � 3 C uU o ❑. � v p�N ro d E E l C o � � ¢� u g •� o a o 'a o -'� v `o — y T y N E ° E N � U a a c o v o 0 one ° o U c U G V H L L + N N p u _ o O d p O v i 3 c 3 x •° Y o o m m o� =� Y O � ° a 3 v O Y Z 3 p 0 O 0 Q V U s V s U a .a Q C cn h 1 s u E as z u G OD Q� 1. State the Agency's mission, goals and major objectives. In addition, describe programs "designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments. Missions Statement: G & l3 4 ti �D Goals: Objectives: Programs designed to meet goals and objects: ,9 L- - o /4 2. Briefly explain any new programs or services to Rosemead residents during FY 2010 -2011. Are any planned for FY 2011 -2012? 3. How are clients referred to your agency? 4. List and explain any major changes in funding patterns or expenditures 2 CITY OF ROSEMEAD GRANT CONT. 3. How are clients referred to your agency? By local churches, The Los Angeles County 211 service, word of mouth, local chambers, schools and by other organizations, in our service area. S. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising. Etc.) Churches & Individuals $ 70,000.00 Fundraisers $ 28,000.00 CDBG Grant $ 27,600.00 Our food donations come from churches, local markets, food drives during the holidays and from the Postal Workers Food Drive the second Saturday in May each year. This food drive fills our pantry each year. In 2010 we collected 104 ton of canned and dry foods. 8. (a) Provide a specific example of case study of a client that exemplifies how the program objectives were achieved during the past year: Our home delivery has been successful. We provide food and fellowship to 35 Rosemead residents on a monthly basis. These residents have no transportation to come to our location for help. The holiday season brought much joy to our seniors and our other clients. Each family was given a large box of food, with choice of a turkey or chickens, plus toys for the children. These generous gifts of toys and food came from the City of Rosemead, El Monte Rotary Club and the citizens of Rosemead. 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, fees, program income, etc.) 6. What facilities in Rosemead are usad to conduct services or are requested to be 7. The proposed Community Service would be provided to: Mark each that apply 8. How_ many Rosemead citizens do you project will benefit from your program /project in FY 2011 -12: Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) 10. Has your organization conducted the proposed activity before? Yes ^ No 11. Describe your organization's experience with CDBG 3 Low and Moderate - Income persons or households Abused Children Handicapped Persons Illiterate Persons Battered Spouses x Homeless Persons Migrant Farm Workers �( Elderly Persons 8. How_ many Rosemead citizens do you project will benefit from your program /project in FY 2011 -12: Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) 10. Has your organization conducted the proposed activity before? Yes ^ No 11. Describe your organization's experience with CDBG 3 CITY OF ROSEMEAD GRANT CONT. 11. Describe your organization's experience with CDBG People For People has had a successful and harmonious relationship with the City of Rosemead for many years. We were so pleased to become a recipient of the CDBG Grant in 2000 -01 which has continued to the present time. We have learned many ways to improve our ability to serve the people of our communities. We have upgraded our methods of record keeping, fiscal responsibilities, working with State, Federal and City employees, community service workers and our faithful volunteers. We are so grateful for the opportunity the Grant has provided for our clients. Plus, the association, with the HUD representatives. 12. Total number served in prior years funded by the city of Rosemead. 2005/06 1,393 2006/07 1,495 2007/08 1,664 2008/09 1,700 2009/10 1,014 A C O' O y n O C 7 y m O G c a e 7 co Y � �z O d O COQ h�3 �>> >� < �] N r N 0 F, c oz as y a m m Z = a o n yz d O _ n L� x O b v 0 G r' a e o = o ° m m m CD 0 0 c �o Q 0 C CL n w o N (D N bi, W V w r N O 4s o •� f [ C I Q N n C _ F 0 E _ Q5 a 7 co Y � �z O d O COQ h�3 �>> >� < �] N r N 0 F, M x S 0 e S y O m 0 e 3 0 y m S O C c e ro ` O il Q �a �z � y G�ro■C CA h yay r �a C N y N C-7 0 rn `? N 0 0 coz >>7> a o = n d z= D �: c = o n S y m o 2 m n' >� r' > o o n n N v N O O C O G U Q CD 0 = of _` n n w o = o N a CD � � r'• ` owor Vy1 /., N (C C_ F O F r' S a ro ` O il Q �a �z � y G�ro■C CA h yay r �a C N y N C-7 0 rn `? N 0 0 S A C O' y 0 n 0 3 0 y 7 O C C O C m b Q y � a 0 h � Iii t d r C O r.n N H H h c o_z aay_a m S ' m 3 r y w -i E G• G � � = _ m G � n o � � O x z m o n' V V 9 . � m n' O � vv aW e o n O 0 � m y v = N C o F c 0 0 0 0 3 M �2 O = Q N o O C C C CL c c (D (p � o rn v m' = H 0 < m C _ O F _ G �� W G l `�J �l s o a b Q y � a 0 h � Iii t d r C O r.n N H H h 13. Proposed Program Budget — FY 2011 -2012 (Public Service Requests Only) CDBG SHARE OTHER SOURCES Personnel $ ya 3. & $ Equipment $ $ Supplies $ $ Consultant Services $ $ Space Rent & Utilities $ (o �(o , $ Audits $ $ Program Income $ $ Fees $ $ Other $ $ Total Costs $ 7 6 0 $ TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only * Percent Change Between Items in Columns Band C. Please explain Changes Greater than 15 1 /o / between colun}ns B an4 C (C -B) /B. - , , , A ** Explain What is Included in the "Other" Category. A Most recent fiscal year 2009/2010 B Current Operating Year 2010/2011 C Proposed Budget July 1, 2011 to June 30 2012 D Percent Change* Expense Salaries 5 yDa S Employee Benefits OD �Da Employees Payroll Taxes / ( D D 1A D D lo 0/2 Profes. & Consultant Fees QD Supplies D)�: eu � - w n , `'4i� 6 Telephone & Fax 3.001) a (� `� D 1 3 0 0 D v Postage & Shipping 66 `b 60D &0 Occupancy & Utilities Loo 33 L 6 3 3 4e D Rental & Maint. of Equip. M C5 'DD 3 DD Printing & Publishin Travel and Transportation Conferences Specific Assist. To Individuals 6 - 0 2) Membership Dues &/j-e4& 2,S D 9,�6 Awards & Grants Insurance c5 ODD hY p h10d Equipment Purchased / Q Misc. Expenses �j�Q 7QQ Transfer to Other Funds Dues to National Organizations Other * * F D Old 8 4,v/< D D?. 2 D D Surplus (or Deficit) of Total Support & Revenue Over Expenses * Percent Change Between Items in Columns Band C. Please explain Changes Greater than 15 1 /o / between colun}ns B an4 C (C -B) /B. - , , , A ** Explain What is Included in the "Other" Category. TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)B. Please Explain Changes Greater than 15% Percent 9 A Most Recent Fiscal Year 2009 -2010 B Current Operating Year 2010 -2011 C Proposed Budget July 1, 2011 to June 30, 2012 D Percent Change* Public Support Contributions D Do e 70 . C D Foundation & Private Grants Fundraising/ special Events Legacies and Bequests Other Federated Org. United Way Misc. Organizations OtherTl 2,j R D DD 3 D Subtotal 9 - 0 Government Federal �°,p `7, lo Q,� 6 DD g, 9 D Z State Local Subtotal rJ D Other Revenue Membership Dues Program Services Fees Investment Income Transfer From Other Fund All Other Revenue Subtotal TOTAL REVENUE D / IM *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)B. Please Explain Changes Greater than 15% Percent 9 I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Signature Na Title b,;z & - � Phone Number 1)(,C- 47 6hj Em 1 Or anization D e 10 ROSEMEAD HIGH SCHOOL CITY OF ROSEMEAD PRIVATE OR NON - PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding - Fiscal Year (FY) 2011 -2012 Name of Organization: � c � ` wS Address: ` L- SA. C-•&. CwI'l•o Executive Director: J �1 Contact Name: SAP Telephone: Z.g(0 - 3\�1 Fax: Q_ 2 (.) - LS (0 — (039 (0 Email: Purpose of Organization: Enter "X" by the appropriate designation: V� Non - profit organization For - profit organization Enter "X" by all that apply: A faith -based organization Not Applicable TOTAL UNDUPLICATED CLIENTS RECEIVED: (Please Complete Attached Backup - Performance Report) An institution of higher education FY 08 -09 FY 09 -10 (Est.) FY 10 -I1 ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: 13 (0S0 • o 0 AGENCY TOTAL BUDGET FOR FY 2011 -2012: FY 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: 13(.5 00 Purpose of Organization: "``''"'Rosemead High School is a comprehensive four -year high school. The school is situated in a culturally diverse community which serves students from low to middle —class socioeconomic families with a median income of $36000. The Rosemead High School Guidance Department has provided students related services to assist them with skills in the social domain. Related services include and not limited to classroom guidance, guidance in planning students' programs, peer facilitation, and individual and group counseling. In order for students to maintain their academic standing facilitate their educational process, related services assist students in developing life skills necessary to become a productive citizen. Due to the budget state budget crisis, related service programs are vanishing and there has been an increase in the demands counseling and social assistance for students in need. Rosemead continues to seek support to assistance our students in the Rosemead community particularly when non - academic crisis occurs and student require immediate attention. Counselors estimate that at least 30% of the school's 2001 students come from homes with significant dysfunctions. Counselors routinely see students who are traumatized due to child neglect, homelessness, domestic violence, conflicts with step- parents, sexual abuse, family illness and death of a parent, drug and /or alcohol abuse in the home, involvement with gangs, prostitution, rape, and incidents relating to suicide and self — mutilation. The Rosemead High School Guidance Department seeks assistance in providing related services to our students in need of counseling, planning and guidance. The department would be able to offer services to enhance our program at the school site. State the Agency's mission, goals and major objectives. In addition, describe programs designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments. Missions Statement: Goals: Objectives: Programs designed to meet goals and objects: 2. Briefly explain any new programs or services to Rosemead residents during FY 2010 -2011. Are any planned for FY 2011 -2012? 3. How are clients referred to your agency? 4. List and explain any major changes in funding patterns or expenditures 2 1) Mission Statement: The mission of Rosemead High School is to enable all students to acquire the skills needed to live productively and creatively in a diverse society. We will develop self - esteem and empower students to take positive control of their own lives. We will foster an appreciation of individuals of all cultures and beliefs. We will encourage life -long intellectual curiosity and sensitivity to the arts. We will promote physical well-being and self - discipline in a safe environment. We intend to produce educated, responsible citizens who will become contributing members of our democratic society. Goals: The overarching goal of the program is to provide crisis intervention counseling and support to resolve at -risk high school students' short-term problems that are overwhelming and traumatic. Within this framework, our goals are several. Most immediately, the goal is to provide crisis intervention for teens: a) Suicide prevention b) Protecting children from exploitation c) Managing intense grief, acute anxiety, recent sexual assault, acute depression, hallucinations, violent tendencies, toward self and others, problems with alcohol, and substance abuse, neglect, and homelessness. Longer -term goals relate to: a) Drop out prevention b) Anger management c) Pregnancy prevention d) Recovery from trauma e) Stabilization Objective: a) Decrease in teen suicide attempts b) Decrease in 911 calls c) Decrease in arrests d) Decrease in hospitalization e) 100% short-term response to children seen Long -term objectives, relate to longer -term goals, include: a) Preparation of crisis management plan b) Decrease in teen on teen violence, cutting, or suicide attempts c) Decrease in teen pregnancy d) Decrease in accidents 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, fees, program income, etc.) 6. What facilities in Rosemead are used to conduct services or are requested to be used? 7. The proposed Community Service would be provided to: Mark each that apply Low and Moderate - Income persons or households Abused Children Handicapped Persons Illiterate Persons Battered Spouses s " Homeless Persons Migrant Farm Workers Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program /project in FY 2011 -12: Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) 10. Has your organization conducted the proposed activity before? Yes No 11. Describe your organization's experience with CDBG 3 e) High School graduation f) Positive planning Programs designed to meet goals and objects: This crisis intervention for teens program consists of guidance, education, and referral to resources. The crisis intervention counselor, for whom we are seeking funding, works with over 80 each year. She counsels students, attends to students having breakdowns or suicidal episodes, and otherwise provides services to help students cope with and recover from traumatic experiences. 2) Services will remain the same, however, due to additional problems occasioned by the economic crisis, we anticipate an increase for services. 3) The school refers students experiencing crises to a qualified crisis intervention specialist. She will provide short-term (1 -3) months crisis intervention services, family outreach, referrals for long -term mental health, medical, and other community agencies' services. 4) There are no anticipated changes in either funding patterns or expenditures. 5) None for the specific program. 6) Rosemead High School 7) See form 8) 80+ students The crisis intervention counselor, Joan Elvidge, has consistently spent hours with a 15 year old girl for the past year and half. The young girl has Crohn's Disease and has faced issues at school, as well as at home. With her diagnoses, Crohn's Disease requires frequent use of the restroom in order to prevent inflammation and hospitalization. She is faced with social issues at social dealing constant trips to the restroom, accidents, and people questioning the issues. Joan has counseled her to help understand on how to deal with issues at school and how to approach pressing concerns people may have. She is the youngest of her siblings and feels neglected from parents because of the physical pain endured during the time her gastrointestinal bouts occur. Parents often tell her to sleep it off or fail to renew her prescriptions. The young girl is battling her issues with the strong support of Joan Elvidge. 10) yes 11) This program received funding for the academic years of 2005 -2006, 2007 -2008, 2009- 2010. 12) 180+ N O\ O O N O F 5 Wwz A U W � c H � � VU O z� W P. 0 d p r C E 0 0 U m 0 F s 7 O d r F 0 w � Y p p rC m m � �� •/ F � 3 0 C a p v y O m u N C O d E E 'N y o 0 0 a� L d p � > J C2 � F � a ;N U "c Iv x' d o p t U � � �• 0 d p r C E 0 0 U m 0 F s 7 O d r F 0 0 0 N O H N F A�C W�w Ww rij 00� r � w U W N Op� H � w U U O �d w a. a c d q N E 0 0 U 0 F 7 O d s F WI moo a � mp � y1 3 0 c U N N G N N `o �o E o 0 0 0 0 U N � � L U p M V ��0 1 N �o F Y N_ W U A \ s `o d m O C4 G z A U O o � A ❑ � i 3 F rA ¢- ¢¢ z 'J a c d q N E 0 0 U 0 F 7 O d s F WI W F d' W � H � H F O H N O H A eq Q W W ti W � F^ awe Oo� V00 Wa. a x � U� x 0 a 0 c d 0 s G' E 0 U m 0 F A 0 d s H U °oo i � 3 0 c 5 v y 00 W N m � C U y C � a-Oi EO O 7 O U N N v a ° co ° Ln r _ F U a r 9 U C z o L U ro d fC � :2 3 A •y m E�° as z c m ¢tea¢ 0 c d 0 s G' E 0 U m 0 F A 0 d s H U 13. Proposed Program Budget — FY 2011 -2012 (Public Service Requests Only) CDBG SHARE OTHER SOURCES Personnel $ $ Equipment $ $ Supplies $ $ Consultant Services $ 0 $ Space Rent & Utilities $ $ Audits $ $ Program Income $ $ Fees $ $ Other $ $ Total Costs $ 0 $ TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only * Percent Change Between Items in Columns B and 15% between columns ` and C (C -B) ` B. `11 � S T b ` � s✓� b.eQ * * Explain What is Included in the "Other" Category , Please explain Changes Greater than A Most recent fiscal year 2009/2010 B Current Operating Year 2010/2011 C Proposed Budget July 1, 2011 to June 30 2012 D Percent Change* Expense Salaries Employee Benefits Employees Payroll Taxes Profes. & Consultant Fees Supplies Telephone & Fax Postage & Shippin Occupancy & Utilities Rental & Maint. of Equip. Printing & Publishin Travel and Transportation Conferences Specific Assist. To Individuals Membership Dues Awards & Grants Insurance Equipment Purchased Misc. Expenses Transfer to Other Funds Dues to National Organizations Other * * Surplus (or Deficit) of Total Support & Revenue Over Expenses * Percent Change Between Items in Columns B and 15% between columns ` and C (C -B) ` B. `11 � S T b ` � s✓� b.eQ * * Explain What is Included in the "Other" Category , Please explain Changes Greater than TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)/B. Please Explain Changes Greater than 15% Percent 0' A Most Recent Fiscal Year 2009 -2010 B Current Operating Year 2010 -2011 C Proposed Budget July 1, 2011 to June 30, 2012 D Percent Change* Public Support Contributions Foundation & Private Grants Fundraising/ special Events Legacies and Bequests Other Federated Org. United Way Misc. Organizations Other Subtotal Government Federal State Local Subtotal Other Revenue Membership Dues Program Services Fees Investment Income Transfer From Other Fund All Other Revenue Subtotal TOTAL REVENUE *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)/B. Please Explain Changes Greater than 15% Percent 0' I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING ignature Name Title \\ �(Oyp) - mom , 31`11 Phone Number csAA e-¢- n , jlnso. Y-tZ ,, Js Email '2ose�.. Al 9 �A s Organization Date `1120 10 ROSEMEAD SCHOOL DISTRICT CITY OF ROSEMEAD PRIVATE OR NON - PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding — Fiscal Year 2011 -2012 Name of Organization: Rosemead School District Address: 3907 Rosemead Blvd. Rosemead, CA 91770 Executive Director: Dr. Amy Enomoto- Perez, Superintendent Contact Name: Mr. John Lovato. Director of Educational Services Telephone: (626) 312 -2900, Ext. 233 Fax: (626) 312 -3814 Email: ilovato(a)rosemead.kl2.ca.us Purpose of Organization: The Rosemead School District provides a challenging academic learning environment which encourages lifelong learning. In partnership with parents and community, our mission is to nurture the intellectual, aesthetic, physical, emotional and ethical growth of each child to be prepared Enter "X" by the appropriate designation: X Non - profit organization For - profit organization Enter "X" by all that apply: A faith -based organization An institution of higher education X Not Applicable TOTAL UNDUPLICATED CLIENTS RECEIVED: FY 09 -10 141 (Please Complete Attached Backup — Performance Report) FY 10 -11 98 (Est.) FY I1 -12 210 ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: $11.707 AGENCY TOTAL BUDGET FOR FISCAL YEAR 2010 -2011: $22,769,440 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: _$11.707_ State the Agency's mission, goals and major objectives. In addition, describe programs designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments. Missions Statement: Rosemead School District provides a challenging academic learning environment that encourages lifelong learning. In partnership with parents and community, our mission is to nurture the intellect, aesthetic, physical and emotional growth of each child in preparation for new horizons. Goals: Increase parent participation in classes provided during the Peace Fair and Conflict Resolution. Reduce bullying and suspensions by 10% as indicated in the California Healthy Kids Survey and school site documentation. Objectives: Provide parents with tools to help their child increase student achievement and help parents development effective parenting strategies. Programs designed to meet goals and objects: Parenting classes are provided for all parents of the five school sites, the District -wide Peace Fair, and Parent Encounter. 2. Briefly explain any new programs or services to Rosemead residents during FY 2010 -2011. Are any planned for FY 2011 -2012? We will continue to provide parenting classes on the 7 Habits for Successful Families and Conflict Resolution strategies, and continue focusing on closing the achievement gap with our Hispanic subgroup parents. We will continue to educate parents on understanding the assessment system used by the state, how to interpret their child's results, and how to improve academic performance. How are clients referred to your agency? The parents of all K -8 grade students are notified in English, Spanish, Vietnamese and Chinese about the events via our community liaisons, flyers, and our District -wide phone message system. Parents are also referred to parent programs during Student Study Teams and parent conferences. 4. List and explain any major changes in funding patterns or expenditures No changes to funding are projected. 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, etc.) Title I Funding - $500.00 6. What facilities in Rosemead are used to conduct services? 4 elementary and I middle school sites 7. The proposed Community Service would be provided to: Mark each that apply X Low and Moderate - Income persons or households Abused Children Handicapped Persons X Illiterate Persons Battered Spouses X Homeless Persons X Migrant Farm Workers Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program /project: 210 Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) Mrs. Garcia has two children attending the Rosemead School District, Mrs. Garcia's children are both English Learners and the family is low income with limited educational background. Mrs. Garcia has attended our parenting classes for more than 7 years. Both ofher children are meeting grade -level expectations and are model citizens in their success to setting clear expectations when it comes to behavior and academic performance. Mrs. Garcia is grateful to the parenting classes offered by the Rosemead School District because the classes is where she developed some of the effective strategies she uses with her children. 10. Has your organization conducted the proposed activity before? Yes X No 11. Describe your organization's experience with CDBG In 1996, the District was awarded CDBG funds to provide training in Conflict Resolution to the City of Rosemead Park and Recreation leaders, as well as, families in the community. The funding has been renewed through 2011. 12. Total number served in prior years funded by the city of Rosemead To date, 1, 784 clients have been served through the Conflict Resolution Classes and Peace Fair Classes. k§ ° e \� u � < z� 4� w / \\ �§® z7 # \( k ( � M ) � � 0 ¥;!!_ f)2 §! y } \\ƒ �) R @ 7 \ e R ! \7 l\ ! # )® ) {) � M k§ k\ \\ $ 7 / � ? W } r . / / § ( 3 0 a 2 § \ « 0 � a 0 k } 4 2 0 A / § \)) & _ Cl) !) �§ CO @ ■ ; ) e } }\ƒ LO m �) ©) § $ § LO !} > 7 z § w F GO W W N Fy O r.w N N u �F �w U � c F wW O� wa F w C4 O O y, a U z� O w QV w w O �i w O U m 0 a 3 O H E 0 0 U m `o F F n. S 0 u V V � = M J 0 p O O F N 0 u .n N c � V w . 3 �.1� a N �sEo�o 3 ..v 0 C', 0 m E° E = - °vo C _ O N o o � � �q o V C O a0 Q m c N = F rn � O O N O F O N y 5 O m m V z° ° o N `u c C o W a > t Q a o z"o m 0 a 3 O H E 0 0 U m `o F F n. 13. Proposed Program Budget — FY 2011 -2012 (Public Service Requests Only) CDBG SHARE OTHER SOURCES Personnel $11 $ Equipment $ $ Supplies $ $ 500.00 Consultant Services $ $ Space Rent & Utilities $ $ Audits $ $ Other $507.00 $ Total Costs $11,707.00 $500.00 TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B) /B. The previous year's restricted ending balance and deferred revenue carded over to the current year increased the expenditures. —Explain What is Included in the "Other" Category. N/A A B C D Most recent fiscal year 2009/2010 Current Operating Year 2010/2011 Proposed Budget July 1, 2011 to June 30, 2012 Percentage Change* Expense Salaries 15,918,459 15,156,538 15,442,663 1.89% Employee Benefits 4,237,804 4,118,071 4,102,260 -0.38% Employees Payroll Taxes 476,794 461,547 498,264 7.96% Profes. & Consultant Fees 889.032 150 1 1,154,815 5.31% Supplies 858,114 1 436 - 72.87% Telephone & Fax 98,917 70,884 70,884 0.00% Postage & Shipping 18,434 19,105 21,000 9.92% Occupancy & Utilities 485,491 470,574 470,574 0.00% Rental & Maint. Of Equip 130,560 113,762 113,564 -0.17% Printing & Publishing 27.529 ``I'a.�' y5T100': 58.439 2.35% Travel and Transportation 408,839 256,076 246,582 -3.71% Conferences 112,306 49,019 40,754 - 16.86% Specific Assist. To Individuals #DIV 101 Membership Dues 16,996 16 530 16,530 0.00% Awards & Grants #DIV 10I Insurance 118,173 123,477 123,477 0.00% Equipment Purchased 355 0 #DIV /01 Misc. Expenses 857,387 769,173 688,189 - 10.53% Transfer to Other Funds 308,479 251,900 253,432 0.61% Dues to National Organizations 0 #DIV /01 Others '• 0 0 0 #DIV /01 TOTAL OPERATING BUDGET EXPENDES 24963,669 24638467 23,737694 -3.66% Surplus (or Deficit) of Total , Support & Revenue 1,652,845 608,192 968,254 Over Expenses 1,296,172 968,254 Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B) /B. The previous year's restricted ending balance and deferred revenue carded over to the current year increased the expenditures. —Explain What is Included in the "Other" Category. N/A TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only ` Column A is the Audited or Most Rencently completed 1 -Month Period Percent Change From B and C (C -B) /B. Please Explain Changes Greater than 15% Percent Due to one -time Federal Stimulate Funds $1.7 Million, American Recovery and Reinvestment Act (ARRA), are going to exhaust in 2010 -11. A B C D Most recent fiscal year 200912010 Current Operating Year 2010/2011 Proposed Budget July 1, 2011 to June 30, 2012 Percentage Change' Public Support Contributions #DIV /01 Foundation & Private Grants #DIV /0! Fundraising/ special Events #DIV /0! Legacies and Bequests #DIV /0! Other Federated Or g. #DIV /0! United Way #DIV /0! Misc. Organizations #DIV /0! Other #DIV /0! Subtotal 0 0 0 #DIV /0! Government Federal 2,850,184 4,008,838 2,539,462 State 18,754,582 18,281,468 17,694,001 Local 1,706,058 1,739,969 1,665,977 A36. Subtotal 23,310,824 24,030,275 21,899,440 Other Revenue Membership Dues #DIV /0! Program Services Fees #DIV /0! Investment Income #DIV /0! Transfer From Other Fund 870,000 #DIV /0! All Other Revenue #DIV /0! Subtotal 0 0 870,000 #DIV /0! TOTAL REVENUE - 23,310,824 24,030,275 22,769,440 - 5.25% ` Column A is the Audited or Most Rencently completed 1 -Month Period Percent Change From B and C (C -B) /B. Please Explain Changes Greater than 15% Percent Due to one -time Federal Stimulate Funds $1.7 Million, American Recovery and Reinvestment Act (ARRA), are going to exhaust in 2010 -11. I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Sio �l ( 5e.yiczs Title 626 - 3l2--2- 0 100 X 233 Phone Number R&se rnead ScLt9o( ✓Ivf Organization 1 -5—(( Date HOUSING RIGHTS CENTER 520 5. Virgil Ave, Suite 40o 215 -387 -8400 January 14, 2011 Pat Piatt Management Analyst City of Rosemead 8838 E. Valley Blvd. Rosemead, CA 91770 Dear Mr. Piatt, Los Angeles, CA 90o2o 215 -581 -8555 Attached please find the Housing Rights Center's Funding Application for the 2011 -2012 Program Year. The Housing Rights Center appreciates this opportunity to continue our commitment to the City of Rosemead and its residents. So far this year, we've assisted 72 clients from Rosemead. Please do not hesitate to contact me with any questions. I can be reached at (213) 387 -8400 x35 or via a -mail at caltnansour @housingrightscenter.org. Sincerely, Chancela Al- Mansour Executive Director Enclosure: Request for Funding Application HRC's Proposal Exhibit 1 Certificate of Liability Insurance Financial Statement 2010 1020 N. Fair Oaks Ave. 3415 5 5epulveda Blvd., Ste .I 50 Pasadena, CA 91105 Los Angeles,CA 900}4 (W) 791 -0211 (600)477 -5977 Proposalto City of Rosemead For Housing Discrimination Complaint and Fair Housing Outreach Services 2011 -2012 Submitted by: Housing Rights Center 520 S. Virgil Ave., Suite 400 Los Angeles, CA 90020 (213) 387 -8400 (800) 477 -5977 www.housingrightscenter.org January 14, 2011 CITY OF ROSEMEAD PRIVATE OR NON - PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding — Fiscal Year 2011 -12 Name of Organization: Housing Rights Center Address: 520 S Virgil Avenue Suite 400 Los Angeles, CA 90020 Executive Director: Chancela Al- Mansour Contact Name: Chancela Al- Mansour Telephone: (213) 387 -8400 ext. 35 Fax: (213) 381-8555 Email: calmansour @housingrightscenter.org Purpose of Organization: The Housing Rights Center's purpose is to promote equal opportunity in housing by affirmatively furthering fair housing. We do this by offering City of Rosemead residents services from our four key areas: (1) Discrimination Complaint Investigation, (2) Enforcement and Legal Services, (3) Landlord/Tenant Fair Housing Counseling, and (4) Education and Outreach. (See Exh. 1, Proposal) Enter "X" by the appropriate designation: X Non - profit Organization _For- profit organization Enter "X" by all that apply: _A faith -based organization _An institution of higher education ___X _Not Applicable TOTAL UNDUPLICATED CLIENTS RECEIVED: (Please Complete Attached Backup — Performance Report) FY 08 -09 164 FY 09 -10 143 (Est.) FY 10 -11 150 ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: $ 25,000 AGENCY TOTAL BUDGET FOR FISCAL YEAR 2011 -12: $2.48 M 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: $2500 Page 1 of 11 1. State the Agency's mission, goals and major objectives. In addition, describe programs designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments, Mission Statement: The Housing Rights Center's mission is to actively support and promote fair housing through education and advocacy, to the end that all persons have the opportunity to secure the housing they desire and can afford, without discrimination based on their race, color, religion, gender, sexual orientation, national origin, familial status, marital status, disability, ancestry, age, source of income, or other characteristics protected by law. Goals: (1) 14RC will assist a minimum of 150 Rosemead residents with housing discrimination and landlord /tenant concerns; (2) At least 10% of Rosemead clients will be assisted in languages other than English; and, (3) At least 85% of Rosemead residents who complete an evaluation about a Rosemead housing rights workshop will rate the information provided as being useful. Objectives: To educate /inform as many Rosemead residents as possible about the fair housing laws. Programs designed to meet goals and objectives: I . Documentation of Activities HRC's comprehensive intake database includes a reporting component that makes the production of statistics and other diagnostic data accurate and efficient. Statistical reports will include all demographic and complaint issue data, which will facilitate the analysis of trends and emerging needs. We also track all our outreach activities in a database that allows us to track our activities by event type. 2. Documentation of Discrimination Complaints HRC will continue our practice of maintaining complete and organized case files. Our case files adhere to a strict format, which facilitates case management and review. Case files include all relevant documents and materials produced in the investigation and resolution of our cases. 2. Briefly explain any new programs or services to Rosemead residents during FY 2010 -2011. Are any planned for FY 2011 -2012? In 2010/11, 1-IRC updated 3 of our fair housing brochures (Housing Rights Center brochure, What Is Fair Housing? brochure, Unlawful Detainer brochure) to include recent changes in the fair housing laws regarding familial status and sexual orientation. These updated brochures have been distributed throughout Rosemead. The new FY 2011 -12 will see an updated, more user - friendly HRC website, and HRC plans to produce several 30 minutes local public access television programs called FAIR HOUSING FORUM. During the FY 2011 -12, HRC will be partnering with HUD, the Department of Fair Employment and Housing and Rio Hondo Community College to provide volunteer opportunities for the college's students (who reside in Rosemead and the neighboring communities) to promote fair housing opportunities. 3. How are clients referred to your agency? City Hall, HRC Website (www.housingrightscenter.org), Phone Book, Outreach Events, Community Organizations, word -of- mouth. 4'. List and explain any major changes in funding patterns or expenditures. There have not been any major changes in funding patterns or expenditures Page 2 of 11 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, etc.). a^ 10 /11 e r �sr : [J � �: OI1.If � ,rra3.,�Owm« Alhambra € „ $28,200 10 /11 Baldwin Park $15,000 10 /11 Carson $31,150 10 /11 Culver City $21,786 10 /11 El Monte $15 10 /11 Glendale $15,000 10 /11 Glendora $15000 10 /11 IUD FHIP Grant $275,000 10 /11 Hawthorne $40,800 10 /11 Inglewood $57,300 10/11 Lancaster $25,853 10/11 Los Angeles $770,000 10/11 Los Angeles County $250,000 10 /11 Montebello $20,000 10 /11 Monterey Park $25,000 10 /11 Oxnard $28,200 10 /11 Palmdale $26,520 10/11 Pasadena $63,000 10 /11 Pico Rivera $20,000 10 /11 Pomona $30 10 /11 Redondo Beach $24,000 10 /11 Rosemead $25,000 10 /11 Simi Valley $23,300 10/11 Ventura City $9,000 10 /11 Ventura County $47,263 1/11 West Covina $15,000 10 /11 Whittier $25,000 IO /11 Attorney Fees/Registration from Training Seminars $300,000 . 6. What facilities in Rosemead are used to conduct services? HRC conducts Fair Housing and Housing Rights Workshops at the Garvey Community Center. 7. The proposed Community Service would be provided to: Mark each that apply X Low and Moderate - Income persons or households Abused Children X Handicapped Persons Illiterate Persons Page 3 of 11 Battered Spouses X Homeless Persons Migrant Farm Workers X Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program /project: 150 9. Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional pages if necessary) The HRC recently conciliated a case involving a Rosemead resident with a disability. The resident's rent was due by the first of the month and he receives his SSI benefits by the third of the month. HRC contacted the manager of the apartment building and requested a reasonable accommodation on behalf of the resident; specifically to allow the resident to pay his rent by the third of the month without having to pay a late fee. The manager denied HRC's request and stated that if the resident pays his rent late, he will have to charge him a late fee. Six days later, the resident informed HRC that he was hospitalized due to stress and anxiety caused by his interactions with the manager. The resident also provided HRC with a letter from his doctor verifying that his health is worsening due to his interactions with the manager and asked us to contact the owner and ask to allow him to break his lease without having to pay a penalty. HRC sent a letter to the owner requesting a reasonable accommodation; specifically to allow the resident to break his lease without having to pay a penalty. The owner agreed to allow the resident to vacate the unit without having to pay any penalty. 10. Has your organization conducted the proposed activity before 7 Yes X No ] 1. Describe your organization's experience with CDBG The Housing Rights Center has over 25 years of experience working with CDBG grants to provide fair housing services to local cities and counties. These cities and counties conduct annual programmatic and financial reviews. HRC has always received excellent reviews. 12. Total number served in prior years funded by the City of Rosemead Page 4 of 11 O\ g 00 � O N �F �i w W W Pa U c og U p W yi U rA W a a b a q O V O F 0 F O W a b d O { x x N 00 1 N r Cl) N O N O Cl) N O O 3 0 5 y a� Q C v a 0 ° Q u 0 . 8 J d W' O> O N r a r d (Q 0 o 77� QU C 7 \5 3 0 0 r (O r N M (O V' O � � o c j b rl � O N 01 N aa M 8 av m O m F N O co N O '- O z� N G Cl) N 0 z a b a q O V O F 0 F O W a §� 2b � H \k/ K fR W4 q o § §3 u Q� / z � 2 ƒ � � d 2 k � ( I- )j\ 04 (D _ d§ _ co It N ; ) L\� \ \�f\ ` ky]99§ n.1 \ \�� r f § , \ /f\ B�§©3 � \} \] < a : . = Q )/ e 00 « m o o /? / e Cl) 2 .) .c « m 7 @ q \�}4 k 4 ) ) 2 ƒ � � d 2 k � ( I- n F G N N G O N E.y N d W c um W F k"U oa� HwA ugo O a '0 F U O F p H W O n a voa w x N CO) 't F rn 00 n N O o � 0 O C a v ° o w u Sj O p u y T7 p 1 O y U v d � e O M m 7 ! U o 9 N N M N M O E � e OUT « N N M N N cu a o ^ .9 - a m co O rp F O) 00 N O O o In U . �0. z a Q) 00 N M !JS a ' S� I� g � o i iY x„a i O '0 F U O F p H W O n a 13. Proposed Program Budget — FY 2011 -2012 (Public Service Requests Only) Page 8 of 11 CDBG SHARE OTHER SOURCES Personnel $ 22,000 $ 1 Equipment $ 400 $ 40 Supplies $ 150 $ 32 Consultant Services $ 50 $ 10,450 Space Rent & Utilities $ 1,000 $ 134,000 Audits $ 50 $ 10 Program Income $ $ Fees $ $ Other $ 1,350 $ 666,150 Total Costs $ 25,000 $ 2,402,000 Page 8 of 11 TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B)B. HRC will reduce out -of -town employee trainings & seminars, as well as implement some cost- cutting measures on some overhead (misc. expenses). ** Explain What is Included in the "Other" Category. HRC's sub - recipients for our contracts with the City of Los Angeles & Los Angeles Page 9 of 11 A Most recent fiscal year 2009/2010 B Current Operating Year 2010/2011 C Proposed Budget July 1, 2011 to June 30 2012 D Percent Change* Expense Salaries 1 120 679 1354 565 1 - 4.03 Employee Benefits 117,466 1 131,204 125 000 -4.73 Employees Payroll Taxes 93,368 112,721 105 500 -6.41 Profes. & Consultant Fees 10,000 10,000 10,500 1 5.00 Supplies 19,988 37,960 32,500 - 14.3 Telephone & Fax 17,481 20,610 18,000 -12.66 Postage & Shipping 12,035 13 050 12,000 -8.05 Occupancy & Utilities 99,705 136J77 135,000 -1.30 Rental & Maint. of Equip. 45 353 40,885 40 500 -.94 Printing & Publishin Travel and Transportation 12 15,540 8,00-0- -48.52 Conferences 12,510 1500 1 0.00 Specific Assist. To Individuals Membership Dues Awards & Grants Insurance 14,269 15,250 15,000 -1.64 Equipment Purchased Misc. Expenses 15-8- 177 550 1-50- -15.01 Transfer to Other Funds Dues to National Organizations Other ** 474 472,598 472,600 0.00 Surplus (or Deficit) of Total Support & Revenue 328,882 53,500 Over Expenses 60 000 * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B)B. HRC will reduce out -of -town employee trainings & seminars, as well as implement some cost- cutting measures on some overhead (misc. expenses). ** Explain What is Included in the "Other" Category. HRC's sub - recipients for our contracts with the City of Los Angeles & Los Angeles Page 9 of 11 TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B) /B. Please Explain Changes Greater than 15% Percent Page 10 of 11 A Most Recent Fiscal Year 2009 -2010 B Current Operating Year 2010 -2011 C Proposed Budget July 1, 2011 to June 30, 2012 D Percent Change* Public Support Contributions Foundation & Private Grants Fundraising/special Events 16,125 19,000 20,000 5.26 Legacies and Bequests Other Federated Or g. United Wa Misc. Organizations Other Subtotal 16,125 19,000 20,000 5.26 Government Federal State Local 2,020,816 2,029,609 2,035,500 .29 Subtotal 2,020,816 2,029,609 2,035,500 .29 Other Revenue Membership Dues Program Services Fees Investment Income Transfer From Other Fund - All Other Revenue 500,304 431,601 425,000 1 .1.53 Subtotal t 500,304 431,601 425,000 -1.53 TOTAL REVENUE 2,537,245 12,480,210 12,480,500 .02 *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B) /B. Please Explain Changes Greater than 15% Percent Page 10 of 11 I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING gnature Name Executive Director Title (213) 387 -8400 ext. 35 Phone Number Housing Rights Center Organization January 14, 2011 Date Page 11 of 11 Exhibit 1 Fair Housing Program Proposal EXHIBIT 1 2011 -2012 Fair Housing Services Proposal Part I Qualifications and Experience A. Mission Statement and Organizational History The Housing Rights Center (HRC) is Southern California's largest non - profit civil rights organization dedicated to securing the right to equal access in housing. HRC's mission is to actively support and promote fair housing to the end that all persons have the opportunity to secure the housing they desire and can afford, without discrimination based on their race, color, religion, gender, sexual orientation, national origin, familial status, marital status, disability, ancestry, age, source of income, or other characteristics protected by law. Following the currents of rigorous social reform, the Housing Rights Center was founded in 1968, the same year Congress passed the Fair Housing Act. The Fair Housing Act committed all governments, federal, state, and local, to the goals of equal access in housing. HRC has addressed the challenges of housing discrimination without interruption since that time, and continues to expand and diversify its services and programs to meet the growing needs and ever changing issue of fair housing. HRC has mobilized a highly effective and diverse staff reflective of the communities we serve. We have the capacity to provide fair housing services in seven languages: English, Armenian, Cantonese, Korean, Mandarin, Russian and Spanish. B. Type of Client Complaints Handled HRC investigates housing discrimination complaints brought under both State and Federal fair housing Irws. From January 1, 2010 to December 31, 2010, F'RC received 1,575 housing discrimination inquiries. We opened and thoroughly investigated 437 housing discrimination cases. (Figure 1) Figure i Housing Discrimirr Source of Income Discrim 1% General Info StudentStatus� <1% 13% Sexual Orientation 2% ition Complaints - 2010 Age Arbitrary Familial Status 1 /"/ _ Gender " 3% tarltal Status 1% I Disability 14% 1% 9% Physical Disability 41% National Origin 4% In our investigations of the 437 cases, we found sufficient evidence of discrimination to warrant enforcement activity in 59 %. Regarding the outcomes of our investigations, HRC successfully conciliated 29% of our cases, which typically meant that that client was able to retain their housing and 4% were referred to our legal department. Housing Rights Center Page 1 of 5 January 14, 2011 Part II is and Services A. Housing Discrimination Complaint Services The Housing Rights Center's Investigations Department conducts thorough and efficient investigations with the goal of achieving the most favorable results available for our clients. 1. Inquiries In order to screen our calls for fair housing issues, HRC's Counselors are trained to ask basic questions that are likely to reveal potential discrimination without prompting the caller to prematurely identify discrimination as the cause. When the Counselor suspects discrimination may be a factor in the caller's problem, the Counselor will complete the Discrimination Inquiry components of the intake database, in which HRC obtains contact and site information, as well as demographic information about the client. The Counseling Director then refers the inquiry to the Director of Investigations ("DOI'O, who will review the basic allegation and assign the inquiry to one of several Case Analysts ('CA'). The CAs conduct a more thorough phone interview with the client who has alleged discriminatory practices. If the CA determines there is cause to suspect discrimination has occurred or is occurring, he or she will schedule an intake interview with the client. 2. Housing Discrimination Complaints a. Discrimination Case Intake HRC's intake form gives us a comprehensive picture of the rental scenario and is the first step toward launching an investigation. The intake form includes all contact information for the client, demographic data, and tenancy information. Key information about the complaint address is also gathered, including the names and addresses of the owner, management company, and on -site manager, whether the building is rent controlled or stabilized, the number of vacancies in the building (useful for testing), and how units at the complaint address are advertised for rental or sale. Finally, the intake form requires that the client provide a signed narrative of his or her experience, which describes the alleged discriminatory practice or practices in context and in chronological order. Upon completion of the intake, a case number is assigned and the CA and DOI meet again to discuss case investigation strategy. b. Case Investigation HRC uses five (5) principal methods when investigating complaints of housing discrimination. While paired testing and surveying are the most common, all methods can be an important part of gathering evidence and each is used as appropriate. i. Testing: Every effort is made to initiate testing in cases where it is appropriate as soon as possible after intake. Typically, this is within 2 or 3 days of the initial complaint. A concerted effort is made to test immediately in complaints by a prospective renter of a refusal to rent. We have designed standardized report forms to elicit Information gathered during tests. The forms require testers to provide a comprehensive narrative of their experience in addition to detailed specific information. The Case Analyst then compares and analyzes the reports. II. Surveys: When testing of the kind described above is not possible or appropriate, for example, because there are no vacancies or because the allegation is by an in -place tenant complaining of harassment, HRC will often conduct surveys of other tenants at the complaint address. This is often the case where the apartment building has only a small number of units and tenant turnover is minimal. We seek comprehensive information from those surveyed about their tenancy, as well as their general impressions about the Housing Rights Center Page 2 of 5 January 14, 2011 conditions at the complaint address, with specific attention to the issues raised in the complaint. When other tenants of the same protected class as the client report similar treatment, surveys provide strong evidence of a pattern or practice of discrimination and become invaluable in conciliation efforts and /or settlement negotiations. iii. On -site Visits: On -site visits by HRC staff can be an important investigative tool when the physical conditions of the rental premises are at issue. This is often the case in an investigation of alleged disability discrimination. Physical evidence, such as photographs and diagrams, will verify the lack of an accommodation, such as a ramp, and the feasibility of installation. iv. Witness Statements: Clients frequently have witnesses who can verify elements of their allegation. We interview the witness and document the information they provide in signed and dated declarations. As with surveys, this sort of corroborating evidence is key in subsequent efforts to resolve the housing issue. V. Document requests and review: When building a case, we seek to maintain a complete file of the tenant and landlord's interaction. We will obtain rental agreements, advertisements, notices, and any correspondence that has been exchanged. We also conduct respondent property searches. This helps us determine whether there are other testing options, which can assist in establishing a pattern and practice of discrimination. C. Findings Once we have concluded our investigation, we make a determination about the strength of the evidence that corroborates the client's allegation of discrimination, assigning the case one of three possible findings. The strongest finding, "Sustains Allegation" (SA), is given to those cases for which we have obtained sufficient evidence to pursue diligent advocacy and /or legal remedies for the client. When the evidence we have obtained partially supports the allegation, or is otherwise inadequate for us to take further steps, we designate a finding of "Inconclusive Evidence" (IE) of discrimination. When our Investigation reveals that the complaint lacked merit as a fair housing violation, we make a finding of "No Evidence of Discrimination" (NED). d. Resolution of Compliant If our investigation finds evidence supporting the allegation of discrimination, we work with the client to achieve his or her goal. At the intake interview, the CA will have explained the available options to the client and determined the client's goals. This fundamental question drives the investigation, and results in our office pursing one of the following actions: i. Conciliation This is often our first step in trying to resolve the problem. When conciliating a complaint, we act as advocates for the client. Typically, we contact the respondent by letter and detail the basis of the allegation, the results of our investigation, the applicable law, and a proposed solution. If the client's goal is to secure the housing at issue, this will be our first priority. These "complaint letters" give the respondent an early opportunity to avert further action. It also serves to put the respondent on notice that HRC has and will continue to intervene on the client's behalf. Occasionally, a respondent is unaware that a violation of fair housing law has occurred and is willing to make a good faith effort to correct the problem. HRC obtains that assurance in writing and continue to monitor the situation. When the client feels that the issue is resolved, the case is closed as "Successfully Conciliated" (SC). There are times, however when a respondent is unwilling to consider conciliation. As before, HRC presents the client with his remaining options. If there is strong evidence of discrimination, we encourage the client to consider legal remedies. Housing Rights Center Page 3 of 5 January 14, 2011 ii. Referral to an Attorney and Continued Investigation When we have gathered evidence sustaining an allegation of discrimination, and the respondent has been unwilling to conciliate the matter or the client's stated goal is litigation, we pursue the appropriate legal remedies. HRC's Legal department is able to represent clients in federal and state fair housing litigation. When the alleged discrimination practice implicates housing policy or gives HRC an opportunity to highlight an issue of particular importance, HRC will join as a plaintiff. B. Enforcement and Legal Services HRC will maintain a legal department staffed with three attorneys licensed to practice law in state and federal courts, as well as a legal assistant to support the department with its filing and case management needs. The legal department will provide the following services: a. Legal Representation: The department will provide legal representation to clients and to HRC when evidence exists to support a meritorious claim of housing discrimination. b. Investigation support: The department will provide case analysis of discrimination complaints and guidance in investigation strategy for HRC's Investigation Department staff as needed. C. Staff Training: The department will conduct periodic training of investigation and counseling staff members on fair housing, predatory lending, and other housing law issues of note. d. Management Training: The department will conduct management certification trainings for housing industry professionals. e. C. General Housing and Tenant /Landlord Referrals HRC provides telephone and in- person counseling to both tenants and landlords regarding their respective rights and responsibilities under California law and local city ordinances. For example, staff members commonly cite specific civil codes that pertain to the client's matter and /or provide sample letters that discuss a particular Issue. Tenant /landlord counseling not only facilitates housing - rights education of residents, but also serves to empower them in their efforts to achieve fair housing for themselves and in their communities. In our database, we refer to these calls as 'resolved" since we have provided the caller the Information required to resolve the issue on their own. When Counselors determine that a particular client's matter is outside the scope of our agency's services, we provide appropriate referral information. Using referral books compiled by HRC, staff members provide'dients with agency names, phone numbers, and addresses in that client's locality. These referral lists are updated regularly to verify that the services continue to be provided. These agencies include, but are not limited to local housing authorities, health and building & safety departments, and other social service providers. D. Fair Housing Outreach Services HRC will implement a citywide fair housing Outreach Program that will create greater public awareness of fair housing throughout the City and address specific needs of the protected classes listed in federal, state, and local fair housing laws. HRC will facilitate large citywide outreach activities and increase the opportunities for media exposure while also focusing resources on targeted outreach regarding specific issues. 1. Housing Rights Workshops HRC will host two Housing Rights Workshops In Rosemead. The housing rights workshops include a comprehensive fair housing presentation, a discussion about common Housing Rights Center Page 4 of 5 January 14, 2011 forms of housing discrimination and a question and answer session. At these presentations, we will distribute agency literature to which participants can refer when specific issues arise. 2. Development and Distribution of Materials HRC staff will develop and distribute materials in the City that describe how housing injustices arise, the applicable laws that protect against housing discrimination and ways to prevent housing inequity. Our materials and programs will be offered to a variety of audiences such as housing professionals (e.g., landlords, property managers, and realtors), tenants, prospective homebuyers, city employees, and other non - profit organizations. Depending on the audience, the written materials will be translated by HRC staff and volunteers into Armenian, Cantonese, Cambodian, Mandarin, Russian, Vietnamese, or Spanish. Materials will be distributed during neighborhood visits and mailings throughout the City ensuring that all residents have access to fair housing information and services. 3. Fair Housing Presentations HRC will provide fair housing presentations in Rosemead at sites throughout the City and in collaboration with local programs and services. Our programs will be offered to a variety of audiences such as housing professionals (e.g., landlords, property managers, and realtors), tenants, prospective homebuyers, city employees, and other non - profit organizations. Depending on the audience, the presentations can be conducted by Center staff in Armenian, Cambodian, Cantonese, Mandarin, Russian, Spanish, or Vietnamese. The fair housing presentations entail an overview of fair housing laws, a discussion about common forms of housing discrimination and a question and answer session. HRC increases its effectiveness at these events by soliciting feedback in the form of evaluations that ask about fair housing issues addressed, presentation format, materials provided and overall program. 4. Property Management and Landlord Training HRC also holds monthly Fair Housing Certification Training seminars for housing (iidustry professionals at our main office in Los Angeles. These seminars are tailored to provide detailed analysis of fair housing law and interpretation, with specific information on discrimination against families with children, people with disabilities, sexual harassment, hate crimes, and advertising. S. Booths HRC will staff booths at community festivals, apartment owners' association annual events, college events and other events as they occur. We have developed eye- catching poster boards and banners that have proven helpful in drawing attendees to our booths. 6. Media HRC will use all media tools available to publicize fair housing and HRC's services. HRC will contact local media outlets and request that they publish or air public service announcements (PSA's') about fair housing laws and HRC's services. 7. Special Events HRC will conduct our annual Housing Rights Summit on April 12, 2011 that will bring together fair housing groups, social service providers, community members, and government entitles to address fair housing and other related issues, such as immigration, community development and affordable housing. Persons not directly involved in fair housing will bring a fresh perspective to ways of addressing fair housing impediments and gain a new understanding of connections between fair housing and other Issues. S. Collaborative Efforts HRC will also continue to actively participate in several coalitions. Specifically, we will continue our role on the Los Angeles Times Fair Housing Advertising Task Force and with Call to Action. Housing Rights Center Page 5 of 5 January 14, 2011 AC CERTIFICATE OF LIABILITY INSURANCE OP ID KD DATE(MWODNYYY) HOUSI -1 06/28/10 PRODUCER Driscoll Ine. Services, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CA. License OB99775 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P 0 Box 92526 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Long Beach CA 90809 -2526 DATE MWDDNY LIMITS Phone:562 -595 -5355 Fax:562- 427 -6069 INSURERS AFFORDIN COVERAGE NAIC# INSURED INSURERA: TRAVELE PROPERTY CAGUA ATTN: S California Housing Rights Center Dn 52 rg 520 Virgi Kaplan, Es l Avenue Suite 400 Los Angeles CA 90020 INSURERS: ACE American • INSURER C: Underwriters at Lloyds A+ X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X� OCCUR INSURERS: Zar1Ch Insurance Com 10317 INSURERS PREMISESEaaccurence $100,000 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH'rHIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRINSRE TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIM DATE MWDDNY LIMITS NOTICE TO THE CERTIFICATE HOLDER NAMED TO 714E LEFT, BUT FAILURE TO DO SO SHALL CITY GENERAL LIABILITY ATTN: EACH OCCURRENCE $1,000,000 • X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X� OCCUR 6607719A29110 07/01/10 07/01/11 PREMISESEaaccurence $100,000 MED EXP(Any one Person) $ 5,000 • X CRIME /$125,000 6607719A29110 07/01/10 07/01/11 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 BENZ AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 X POLICY JECT LOC EMPL BEN$ 1,000,000 X AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea acdden0 51,000,000 BODILY INJURY (Pw PerscN $ ALL OWNED AUTOS SCHEDULED AUTOS • • X HIREDAUTOS NON-OWNEDAUTOS 6607719A29110 6607719A29110' 07/01/10 07/01/10 07/01/11 07/01/11 BODILY INJURY (Pe'acddant) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY -FA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTOONLY: AGO EXC ESSIUM BRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ E DEDUCTIBLE $ $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEIVEXECUTIVE C46324110 07/01/10 07/01/11 X TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1, O O D, 000 O EXCLUDED? SPECIALS E.L. DISEASE - POLICY LIMIT $1,000,000 PROVISIONS bolow OTHER C PROFESSIONAL LIAB 86273 12/04/09 12/04/10 PROF LIAB 11000,000 . D D &O and EPL DOC913902302 1 08/09/0 08/09/10 1 D &O & EPL 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The City of Rosemead is named additional insured's per CO2026(11/85) endorsement attached. *10 -day notice of cancellation will be mailed for non - payment of premium. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2007/08) ® ACORD CORPORATION 1988 ROSEM -1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAVE WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 714E LEFT, BUT FAILURE TO DO SO SHALL CITY OF ROSEMEAD ATTN: MICHELLE RAMIREZ IMPOSE NO OBLIGATION OR LIABILRY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 8838 E. VALLEY BLVD. REPRESENTATIVES. AUTJ MQRJ2ED REPRE9 TATNP.I� E , . ROSEMEAD CA 91770 ACORD 25 (2007/08) ® ACORD CORPORATION 1988 Southern California Housing Rights Center, Inc. COMMERCIAL GENERAL LIABILITY POLICY NUMBER: x- ee0- 7719A291- TCr -10 ISSUE DATE: 06 -17 -10 Effective: 07 -01 -10 thru 07 -01 -11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHARITY FIRST - AMENDMENT OF COVERAGE - WHO IS AN INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization (Additional Insured): City of Rosemead Attn: Michelle Ramirez 8838 E. Valley Blvd. Rosemead, CA 91770 Designation Of Premises (Part Leased to You) WHO IS AN INSURED (Section II) is amended to financial include as an insured: A. Your members and volunteers but only with that respect to their liability for your activities or ac- tivities they perform on your behalf; B. Your trustees or members of the board of gover- nors insurance while acting within the scope of their. duties as such on your behalf; and C. Person(s) or organization(s), whether or not shown in the Schedule above, but only with respect to their liability arising out of 1. Their financial control over you; 2. Their requirements for certain performance placed upon you, as a non - profit organiza- tion, in consideration for funding or contributions you receive from them; 3. The ownership, maintenance or use of part of a premises leased to you; or 4. "Your work' for that insured by or for you. As respects Part C.3. above, this insurance does not apply to: (a) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) organiza- tion(s); or (b) Any "occurrence" which takes place after you cease to be a tenant in that premises. GN 0188 01 96 Copyright, Travelers Indemnity Company. Page 1 of 1 So. California Housing Rights Center Comparative Income Statement and Budget For the Twelve Months Ending June 30, 2010 Current Year Year To -Date Month ..... TO-Date Budget Revenues: -- ....... —•- ----- ---- -- — ..... .............. -- --- Grant Funds Earned - Current Year 177,388.51 2,020,816.08 1,949,625.00 Fundraiser -Sale of E'Bocks _ Annual HRC Summit- Registration - 2,215.00 - Sponsorship 5,000.00 13,910.00 Case Awards-Los Angeles - 21,550.00 Case Awards - Outside City of LA 89,277.57 360,909.78 232,915.00 Services- Training -City of LA 350.00 2,750.00 Services - Training- Outside City of LA 7,850.00 59,430.00 Interest Income 933.25 15,661.58 Miscellaneous Income 4,884.33 40,002.15 Total Revenues ........... . ... - -- 285,683.66 .... — ..... ..••• —•• 2,537,244.59 --- ........... _... 2,182,540.00 Cost of Sales: — -- — — ..................... ... — ...... — ... — ... Fundraiser -Cost of E'Books Gross Profit 285,683.66 2,537,244.59 2,182,540.00 Expenses: Non - Reimbursable: Board Expenses 16,361.87 24,101.87 Exe. Director -Non Program Expense 238.00 26,572.05 Office Expense 410.27 4,564.38 14,000.00 Office Consumable Supplies 18180 493.17 Subscription/Tralning Materials 669.30 Conventions /Meetings 296.00 Public Info-Advtg. 118.83 Total Non•Relmbursable Expenses ............. . .... 17,193.94 .................. —. 66,816.60 ................... 14,000.00 Reimbursable Expenses - Grants ................ ................. _.. Salaries 85,011.09 1,000,229.55 1,031,270.00 Payroll taxes 6,611.36 83,710.60 85,220.00 Workers Compensation - 9,742.32 8,869.00 Medical Insurance 4,227.98 58,651.73 58,621.00 Pension Plan 3,011.28 36;145.71 40,808.00 Professional Services - Single Audit 10,000.00 10,000.00 Fieldfrelephone Testing Costs 4,003.03 36,877.60 73,690.00 Tester Training Costs - 2,145.00 7,580.00 Travel - Mileage and Parking 2,678.97 8,348.94 13,282.00 Rent - Office, Parking and Storage 8,285.45 99,425.40 100,501.00 Office Consumable Supplies 1,386.91 17,139.95 13,300.00 Public Info Consumable Supplies 1,023.96 600.00 Equipment Rental- Copier 1,533.34 18,722.77 18,138.00 Equipment Rental -Mail Machine 833.78 3,294.11 3,240.00 Equipment Rental -Water Cooler 131.59 1,579.08 1,572.00 Equipment Repairs and Maintenance 535.72 1,359.54 1,200.00 Computer Consultant 3,655.00 20,397.50 21,228.00 Telephone Use and Equipment 1,419.17 17,166.88 23,608.00 Postage 2,000.00 12,036.03 16,500.00 Insurance Public Info /Expense- Direct to Contract - 14,269.14 1,325.00 14,000.00 - Public Information- Advertising 1,097.38 3,487.36 7,800.00 Public Info- Internet/Website 1,247.94 5,628.63 5,400.00 Subscriptionrrratning Materials - 1,941.80 3,600.00 Conventions /MeetingslTrainings 40.00 3,400.00 900.00 Taxes /Licenses /Permits 10.00 352.66 600.00 Sub Contracted Services.FHC.SFV 22,205.68 _ 259,597.62 254,223.00 Sub Contracted Services.FHF 17,661.04 214,761.20 218,375.00 Project Costs 108.00 814.00 780.00 Total Reimbursable Expenses-Grants - --••••-- •----- --- 167,694.71 ----- ----- --• ••... 1,943,673.07 – •••— •••-•--•-- 2,034,906.00 Program Income Income Expenses -----•----- -•-•---- -- --- °- ------ --- Salaries 7,358.32 120,449.03 121,555.00 Payroll taxes 551.14 9,657.64 9,796.00 Workers Compensation 1,105.68 1,045.00 Medical Insurance 421.83 7,242.92 6,869.00 Pension Plan 340.53 4,577.17 4,626.00 Filing Fees -LA City 1,688.75 3,488.75 Filing Fees - Outside City of LA - 2,833.00 Other Litigatlon Costs -City of LA 3,725.45 5,206.70 Other Litigation Costs - Outside City of LA 3,365.00 24,684.90 30,000.00 Mediation Fees 1,300.00 1,300.00 Travel - Mileage and Parking 164.60 4,456.64 Office Supplies - 1,330.87 Subscriptions -City of LA 165.22 Subscriptions- Outside City of LA 9,303.56 Conference /Educat ion /meetings -LA City 132.75 5,753.71 Conference /Education /meetings -O /S L.A. - 3,356.61 Telephone Use & Equipment 314.06 314.06 Postage - Litigation Costs 31.57 266.54 Rent/Parking 140.00 280.00 Fleld/relephone Testing - 2,201.17 Project Costs Total Program Income Expenses 19,534.00 ........ 207,974.17 173,891.00 Total Expenses – .. ... -- 204,422.66 --- •••......•••• -- 2,208,362.84 ..........– . - -.... 2,222,796.00 Net Income . 81,261.01 328,881.76 (40,256.00) aaaaaaa —aa a-- aaaaeaa maaameaaaae So. California Housing Rights Center Comparative Statement of Financial Position June 30, 2010 /June 30, 2009 /June 30, 2008 June 30, 2010 June 30, 2009 June 30, 2008 Unaudited Audited Audited ASSETS .................... -------•------- -- .._ ...... —...... Current assets: Cash and cash equivalents 809,397 755,282 806,659 Grants receivable 614,649 340,335 257,451 Miscellaneous receivable (2,081) (1,432) (1,776) Deposit 7,042 6,642 6,642 Prepaid expenses 4,343 1,518 2,861 Total Current Assets .............. . ... 1,433,351 .................... 1,102,346 --------------- --- --- 1,071,837 Other assets: Equipment & furniture, net 444 444 2,154 Total Other Assets 444 444 2,154 Total Assets 1,433,795 1,102,790 1,073,991 LIABILITIES AND FUND BALANCE Liabilities: Deferred revenue 5,404 4,793 4,793 Accrued vacation 55,373 55,362 50,473 Client Trust - Client Deposit 9,208 9,920 9,920 Total liabilities 69,985 70,075 65,186 Net assets: Unrestricted 1,363,366 1,032,270 1,006,651 Unrestricted - Invested in equipment and furniture 444 444 2,154 Total fund balance 1,363,810 1,032,714 1,008,805 Total Liabilities and Fund Balance 1,433,795 1,102,789 1,073,991 RIO HONDO TEMPORARY HOME 12300 Fourth Street, Building 213 Norwalk, CA 90650 (562) 863 -8805 Fax (562) 863 -4529 w tow.riohondohome. org January 11, 2011 Ms. Michelle G. Ramirez Community Development Manager City of Rosemead 8838 East Valley Boulevard Box 399 Rosemead, CA 91770 . Dear Ms. Ramirez: RIO HONDO TEr"ORARY HOME Attached please find the completed funding application from Rio Hondo Temporary Home to the City of Rosemead for the Community Development Block Grant Program for FY11 -12. As per your request, enclosed also in our most recent organizational audit, 501(c)(3) letter, and Articles of Incorporation. Our future planning can only be viable financially if Rio Hondo Temporary Home can continue to secure the essential funding, as requested, from sources such as the City of Rosemead. We look forward to continuing to serve homeless families with dependent children. If you have any further questions, please do not hesitate to contact me at 562/863 -8805 ext. 222. Sincerely, David Littlehales Executive Director Encl. Request for Funding Application - FY11 -12 IRS Determination Letter Independent Audit Articles of Incorporation RHTH is a project of STOP HOMELESSNESS in the RIO HONDO AREA, INC. 'CITY OF ROSEMEAD PRIVATE OR NON - PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding — Fiscal Year (FY) 2011 -2012 Name of Organization: Stop Homelessness in the Rio Hondo Area. Inc. (dba Rio Hondo Temporary Home Address: 12300 Fourth Street, Building 213, Norwalk, CA 90650 Executive Director: David Littlehales Contact Name: David Littlehales Telephone: 562/863 -8805 (ext. 222) Fax: 562/863 -4529' Email: dlittlehales@riohondohome.orQ Purpose of Organization: Rio Hondo Temporary Home assists disenfranchised families with dependent children end their cycle of homelessness and gain self - sufficiency in their homes, schools, communities and workplaces. Enter "X" by the appropriate designation: _Non-profit organization* _x_ For- profit organization ( *Non -profit applicants please submit a copy of your agency's Determination Letter from the IRS) Enter "X" by all that apply: A faith -based organization An institution of higher education _x_ Not Applicable Employer Identification Number (EIN): _954084509 TOTAL UNDUPLICATED CLIENTS RECEIVED: FY 08 -09 (Please Complete Attached Backup — Performance Report) FY 09 -10 (Est.) FY 10 -11 ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: AGENCY TOTAL BUDGET FOR FY 2011 -2012: FY 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: 154 (0 - Rosemead _117 0 famif4 referred by Rosemead) _110 (family of 2 from Rosemead) $0 $ 751,000 est._ $10,000 State the Agency's mission, goals and major objectives. In addition, describe programs designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments. Mission Statement: The mission of Rio Hondo Temporary Home is to help disenfranchised families end their cycle of homelessness and gain self - sufficiency in their homes, schools, communities and workplaces. Goals: Families will achieve residential stability by the time of exiting the program. 60% of the homeless families entering the program will move from transitional housing to either Section 8 or non - subsidized permanent housing upon exiting the program as indicated in case management exit form for each client and noted on a master roster for all successful discharges from the program. 80% of the homeless families placed in permanent housing will remain in housing for six months after exiting the program as monitored on a caseload roster by the case managers. Programs designed to meet goals and objects: Case Management with components of counseling, debt reduction counseling, financial planning and management, social service goals, child development and parenting support, linkage to homeless court and other legal support, housing search. 2. Briefly explain any new programs or services to Rosemead residents during FY 2010 -2011. Are any planned for FY 2011 -2012? Rio Hondo Temporary Home is planning to implement a number of community-based "scattered- site" units preferably placed as close as possible to the city of origin. Families will reside in such units for approximately 6 months as transitional housing. Case management and other supportive services will be in place. 3. How are clients referred to your agency? Social service providers, emergency shelters, domestic violence settings, faith based organization, 211, and local government (DPSS, DMH, DCFS, LAHSA) fax or call referrals for potential placement. 4. List and explain any major changes in funding patterns or expenditures. None at this time. 2 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, fees, program income, etc.) Donations & Foundation Support - $179,916; Cities - $201,744 (Cerritos — CDBG @ $50,000; Whittier — CDBG @ $50,000; Montebello - CDBG @ $10,000; Downey — CDBG @ $17,500; Pico Rivera — CDBG @ 42,000; Santa Fe Springs — CDBG @ $30,000; Norwalk — CDBG @ $12,750); Churches & Organizations - $11,004; Contracts & Grants - $534,432; Dividends/interest Earned - $60; Other Income - $1,356; In -Kind - $355,896; Special Events - $5,004 - -- TOTAL: $1,289,412 6. What facilities in Rosemead are used to conduct services or are requested to be used? N/A 7. The proposed Community Service would be provided to: Mark each that apply X Low and Moderate- Income persons or households X Abused Children X Handicapped Persons X Illiterate Persons X Battered Spouses X Homeless Persons X Migrant Farm Workers X Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program/project in FY 2011 -12: — 12 -15 (4 -5 families average) Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) Single mother family with two children was able to obtain subsidized housing in the Rio Hondo Area in an apartment setting. The parent attended all case management meetings, therapeutic sessions, and other related support activities. The children, ages 9 and 10, attended school in the local school district, and participated in agency childcare related activities. The mother completed vocational training as a certified nursing assistant. She also obtained her learner's permit from the DMV and subsequently obtained her driver's license. The agency was able to help the mother with a legal matter that previously had prohibited her from receiving the CNA (vocational) certification. 10. Has your organization conducted the proposed activity before? Yes _x_ No 11. Describe your organization's experience with CDBG. Rio Hondo Temporary Home has collaborated in providing homeless services with the local Rio Hondo Area cities through CDBG funding for nearly a decade. We adhere to HUD standards in reporting and provide each city with quarterly and annually demographic counts including the number of families, the number of individuals, the night of residence, and other demographic data of ethnicity and sex. 3 H3 ) / \ } B ) k 6/ )2 � �qn � \§ m Q2i k )]? ( k�\ 7 2 §M * / j�� ( j) E m$ ] � (f(k(\ [ E \/ § \ )) ; & { }§� °( \ r$}/ 22 �±« 2(`®7 �)§ /( *)) |%aR2 § /]« / \ )� ( \\ k 6/ )2 � �qn � \§ m Q2i k )]? ( k�\ 7 2 §M * / j�� ( j) E m$ ] t. .j S A C y O A 0 e B e 0 c a A C b Oil C O O d O y � wo Oq yM 'A � O N O 0 c0zaa w `i F ?; z O a Y S y' z S N b O �n >� r a 0 0 � � a 0 o� O U O 3� < o�, n e � m ° o m o 0 0 O � r� m m S " w b Oil C O O d O y � wo Oq yM 'A � O N O 0 0 S A C 4' 0 m A 0 c B e m m C O C a A C b y y ry J O cz Oyy �n rz mno zr� y> >Nv O C O CrJ � y y y ll aw c zaaHa N a n N y � � o a S n S N A O� >� k a o _o o � � o . ;r 0 00 0 a � O o � 3o F a N m C e 0 0 F 0 O v, aw r' T ?w b y y ry J O cz Oyy �n rz mno zr� y> >Nv O C O CrJ � y y y ll aw 13. Proposed Program Budget — FY 2011 -2012 (Public Service Requests Only) 7 CDBG SHARE OTHER SOURCES Personnel $ 4,965 $ 367,869 Equipment $ 55 $ 6,245 Supplies $ 25 $ 2,475 Consultant Services $ 0 $ 0 Space Rent & Utilities $ 50 $ 5,550 Audits $ 100 $ 9,900 Program Income $ 0 $ 0 Fees $ 0 $ 0 Other (Spec. Asst- client rent) $ 3,850 $ 271,515 Other — misc. $ 955 $ 87,746 Total Costs $ 10 1$751,00 0 7 TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B)B. Program design changes that revamps the model from shelter setting to a community based "scattered site ". This change is promulgated largely due to a notice to vacate the site on Metropolitan State Hospital grounds due to seismic conditions of the building. ** Explain What is Included in the "Other" Category. In -Kind H A Most recent fiscal year 2009/2010 B Current Operating Year 2010/2011 C Proposed Budget July 1, 2011 to June 30 2012 D Percent Change* Expense 1,283,315 1,289,424 total 751,000 (41.7 %) Salaries 439,919 473,604 283,324 (40.1 %) Employee Benefits 122,978 126,708 79,510 (37.2 %) Employees Payroll Taxes (combined in benefits ) (combined in benefits - -- Profes. & Consultant Fees 82,254 70,500 10,000 (85.8 %) Supplies 22,451 21,324 2,500 (88.2 %) Telephone & Fax 11,352 9,996 5,000 (49.9 %) Postage & Shipping 1,055 948 1,000 5.4% Occupancy & Utilities 49,145 50,772 6,000 (88.1 %) Rental & Maint. of Equip. 5,759 6,300 6,300 0% Printing & Publishing 711 1,104 500 54.7% Travel and Transportation 5,555 5,004 3,000 (40.0 %) Conferences 4,157 6,000 3,000 (50 %) Specific Assist. To Individuals 138,737 114,732 275,366 140% Membership Dues 342 504 500 (.7 %) Awards & Grants 0 0 0 0% Insurance 23,360 22,824 0 -- Equipment Purchased 0 0 0 0% Misc. Expenses 15,195 23,208 25,000 7.7% Transfer to Other Funds 0 0 0 0% Dues to National Organizations 0 0 0 0% Other ** In -Kind 360,345 355,896 50,000 (85.9 %) Surplus (or Deficit) of Total Support & Revenue (23,586) 0 01 0% Over Expenses - -- 0 0 0% * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B)B. Program design changes that revamps the model from shelter setting to a community based "scattered site ". This change is promulgated largely due to a notice to vacate the site on Metropolitan State Hospital grounds due to seismic conditions of the building. ** Explain What is Included in the "Other" Category. In -Kind H TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)/B. Please Explain Changes Greater than 15% Percent Changes in program design and a possible acquisition of the Rio Hondo Temporary Home by another community based agency will likely change funding structure for FY11 -12. M A Most Recent Fiscal Year 2009 -2010 B Current Operating Year 2010 -2011 C Proposed Budget July 1, 2011 to June 30, 2012 D Percent Change* Public Support Contributions 16,117 11,004 15,000 36.3% Foundation & Private Grants 163,880 179,916 93,191 (48.25)% Fundraising/ special Events 0 15,000 15,000 0% Legacies and Bequests 0 0 0 0% Other Federated Org. 0 0 0 0% United Way 33,250 31,500 unknown - -- Misc. Organizations Other 39,184 49,567 - - -- - -- Subtotal 252,431 286,987 123,191 Government Federal 365,437 341,439 226,707 0% State 0 0 0 0% Local (County & Cities) 305,102 305,102 315,102 3.3% Subtotal 670,539 646,541 541,809 1.9% Other Revenue Membership Dues 0 0 0 0 0 /0 Program Services Fees 0 0 0 0% Investment Income 0 10 0 0% Transfer From Other Fund 0 0 0 0% All Other Revenue (In -Kind 360,345 355,896 50,000 (85.9 %) Subtotal 360,345 355,896 50,000 85.9% TOTAL REVENUE 1,283,315 1,289,424 715,000 44.5% *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)/B. Please Explain Changes Greater than 15% Percent Changes in program design and a possible acquisition of the Rio Hondo Temporary Home by another community based agency will likely change funding structure for FY11 -12. M I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Signature Name Executive Director Title 562/863-8805 (ext. 222) Phone Number d l ittlehales(a) riohondohome.ore Email Rio Hondo Temporary Home Organization 1/11/11 Date 10 Quigley & Mir INDEPENDENT AUDITOR'S REPORT Board of Directors Stop Homelessness in the Rio Hondo Area, Inc. dba Rio Hondo Temporary Home Norwalk, California We have audited the accompanying statement of financial position of Stop Homelessness in the Rio Hondo Area, Inc., dba Rio Hondo Temporary Home (Organization) as of June 30, 2009 and 2008, and the related statements of activities, functional expenses, and cash flows for the years then ended. These financial statements are the responsibility of the Organization's management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and the significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Stop Homelessness in the Rio Hondo Area, Inc., dba Rio Hondo Temporary Home as of June 30, 2009' and 2008, and the changes in its net assets and its cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America. Los Angeles, California April 13, 2010 Certified Public Accountants Suite 1660 Suite 317 3550 Wilshire Boulevard 528 Arizona Avenue Los Angeles, California 90010 Santa Monica, California 90401 Telephone: (213) 639 -3550 Telephone: (310) 394 -6667 Facsimile: (213) 639 -3555 Facsimile: (310) 394 -6027 INDEPENDENT AUDITOR'S REPORT Board of Directors Stop Homelessness in the Rio Hondo Area, Inc. dba Rio Hondo Temporary Home Norwalk, California We have audited the accompanying statement of financial position of Stop Homelessness in the Rio Hondo Area, Inc., dba Rio Hondo Temporary Home (Organization) as of June 30, 2009 and 2008, and the related statements of activities, functional expenses, and cash flows for the years then ended. These financial statements are the responsibility of the Organization's management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and the significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Stop Homelessness in the Rio Hondo Area, Inc., dba Rio Hondo Temporary Home as of June 30, 2009' and 2008, and the changes in its net assets and its cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America. Los Angeles, California April 13, 2010 STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY NOME STATEMENTS OF FINANCIAL POSITION June 30, 2009 and 2008 ASSETS CURRENT ASSETS Cash and cash equivalents Pledges receivable Grants receivable Other assets TOTAL CURRENT ASSETS 2009 2008 S 101,382 $ 143,909 8,750 104,124 104,980 7,716 11,216 221,972 260,105 PROPERTY, NET 51,057 40,314 TOTAL ASSETS S 273,029 S 300,919 LIABILITIES AND NET ASSETS CURRENT LIABILITIES Accounts payable and accrued liabilities $ 40,040 $ 27,089 Unearned revenue 50,382 TOTAL CURRENT LIABILITIES 90,422 27,089 NET ASSETS Unrestricted 152,804 259,490 Temporarily restricted 29,803 13,840 TOTAL NET ASSETS 182,607 273,330 TOTAL LIABILITIES AND NET ASSETS S 273,029 S 300,419 See notes to financial statements. E STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME STATEMENT OF ACTIVITIES Year Ended June 30, 2009 PUBLIC SUPPORT AND REVENUE Grants Contributions In -kind donations Special events income net Interest Other income Net assets released from restrictions Temporarily Unrestricted Restricted Total $ 553,994 $ 203,029 29,803 355,894 5,651 35 2,343 13,840 (13,840 TOTAL PUBLIC SUPPORT AND REVENUE 1,134,786 15,963 1,150,749 EXPENSES Program services 1,201,361 Management and general 20,229 Fund development 19,882 TOTAL EXPENSES 1,241,472 INCREASE (DECREASE) IN NET ASSETS NET ASSETS AT BEGINNING OF YEAR (106, 686) 15,963 $ 553, 994 232,832 355,894 5,651 35 2,343 1,201,361 20,229 19,882 1,241,472 (90,723) 259,490 13,840 273,330 NET ASSETS AT END OF YEAR S 152,804 S 29,803 S 182,607 See notes to financial statements. 3 STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME STATEMENT OF ACTIVITIES Year Ended June 30, 2008 PUBLIC SUPPORT AND REVENUE Grants Contributions In -kind donations Interest Other income Net assets released from restrictions Temporarily Unrestricted Restricted 'Total $ 541,036 $ $ 541,036 243,365 13,840 257,205 336,471 336,471 1,242 1,242 3,376 3,376 TOTAL PUBLIC SUPPORT AND REVENUE 1,125,490 13,840 1,139,330 EXPENSES Program services 1,195,799 Management and general 24,401 Fund development 6.101 TOTAL EXPENSES 1,226,301 INCREASE (DECREASE) IN NET ASSETS (100,811) 1,195,799 24,401 6,101 1,226,301 13,840 (86,971) NET ASSETS AT BEGINNING OF YEAR 360,301 360,301 NET ASSETS AT END OF YEAR $ 259,490 $ 13,840 $ 273,330 See notes to financial statements. 4 STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME STATEMENT OF FUNCTIONAL EXPENSES Year Ended June 30, 2009 Accounting and auditing Advertising Contract serv_ces Depreciation and amortization Education, seminars, and materials Equipment lease Food Insurance Miscellaneous Office supplies Postage Printing Program supplies Rent and utilities Repairs and maintenance Telephone Travel and transportation 30,235 Program Management Fund 60 Services and General Development Total 15,825 128,756 12,347 497 Salaries $ 476,071 $ 7,445 $ 1 $ 485,377 Payroll taxes 44,072 693 173 44,938 Benefits 83,245 1,239 310 84,794 TOTAL SALARIES, 289 22,244 797 775 TAXES, AND BENEFITS 603,388 9,377 2,344 615,109 Accounting and auditing Advertising Contract serv_ces Depreciation and amortization Education, seminars, and materials Equipment lease Food Insurance Miscellaneous Office supplies Postage Printing Program supplies Rent and utilities Repairs and maintenance Telephone Travel and transportation 30,235 1,178 295 31,708 60 60 108,931 4,000 15,825 128,756 12,347 497 124 12,968 24,866 24,866 6,492 273 68 6,833 102,827 38 9 102,874 20,798 1,157 289 22,244 797 775 194 1,766 7,626 376 94 8,096 1,153 43 11 1,207 1,583 17 4 1,604 92,723 92,723 155,693 1,840 460 157,993 10,918 21 5 10,944 10,187 429 107 10,723 10,737 208 10, 998 TOTAL EXPENSES S 1,201,361 L ,229 $ 19,882 S 1,241,472 See notes to financial statements. 5 STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME STATEMENT OF FUNCTIONAL EXPENSES Year Ended June 30, 2008 Salaries Payroll Taxes Benefits TOTAL SALARIES, TAXES, AND BENEFITS Accounting and auditing Contract services Depreciation and ,amortization Education, seminars, and materials Equipment lease Food Insurance Miscellaneous Office supplies Postage Printing Program supplies Rent and utilities Repairs and maintenance Telephone Travel and transportation Program Management Fund Services and General Development Total $ 480,296 $ 9,539 $ 2,385 $ 492,220 45,140 889 222 46,251 83,209 844 211 84,264 608, 645 27,941 215,961 4,373 7,405 5,034 44,857 28, 627 1,607 7,497 912 1,540 47,701 155,757 15,772 11,353 10,817 11,272 2,818 622,735 1,177 294 29,412 5,279 1,320 222,560 1,363 341 6,077 7,405 344 86 5,464 322 81 45,260 1,205 301 30,133 723 181 2,511 318 80 7,895 39 9 960 38 9 1,587 47,701 1,843 461 158,061 15,772 478 120 11,951 10,817 TOTAL EXPENSES S 1,195,799 S 24,401 S 6,101 S 1,226,301 See notes to financial statements. R STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME STATEMENTS OF CASH FLOWS Years Ended June 30, 2009 and 2008 OPERATING ACTIVITIES Change in net assets Adjustments to reconcile change in net assets to net cash used in operating activities: Depreciation and amortization Changes in operating assets and liabilities: Pledges receivable Grants receivable Other assets Accounts payable and accrued liabilities Unearned revenue NET CASH USED IN OPERATING ACTIVITIES INVESTING ACTIVITIES Purchase of property and equipment NET CASH USED IN INVESTING ACTIVITIES DECREASE IN CASH AND CASH EQUIVALENTS. CASH AND CASH EQUIVALENTS AT BEGINNING OF YEAR 2009 2008 S (90,723) $ (86,971) 12,968 6,077 (8,750) 856 60,913 3,500 (7,894) 12,951 (3,483) 50,382 (18,816) (31,358) (23,711 (8,485 (23,711 (8,485 (42,527) (39,843) 143,909 183,752 CASH AND CASH EQUIVALENTS AT END OF YEAR S 101,382 S 143,909 See notes to financial statements. 7 STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME NOTES TO FINANCIAL STATEMENTS June 30, 2009 and 2008 NOTE A-- SUMNIARY OF SIGNIFICANT ACCOUNTING POLICIES Organization -Stop Homelessness in the Rio Hondo Area, Inc., dba Rio Hondo Temporary Home (the Organization) was formed to help disenfranchised families end their cycle of homelessness and gain self - sufficiency in their homes, schools, communities, and workplaces. The Organization is committed to keeping fragile families together as it provides transitional housing and supportive services, empowering the families to obtain and remain in permanent housing, increase their skills and income, and achieve greater self- determination. The Organization's supportive services include case management, mental health therapists, and an occupational therapist. The Organization also provides child care and has a medical clinic to address its residents' health needs throughout the year. The Organization's primary sources of revenue. and support are from governmental agencies. During the years ended June 30, 2009 and 2008, government agencies provided 70o and 67 %, respectively, of the Organization's revenue and support excluding in -kind donations. Financial Statement Presentation -The financial statements are prepared on the accrual basis of accounting. Cash Equivalents - -The Organization considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. Income Taxes - -Stop Homelessness in the Rio Hondo Area, dba Rio Hondo Temporary Home is a nonprofit organization exempt from income taxes under Section 501(c)(3) cf the Internal Revenue Code (Code). Accordingly, no provision for income taxes is included in the financial statements. In addition, the Organization has been determined by the Internal Revenue Service not to be a private foundation within the meaning of Section 509(a) of the Code. In July 2006, Financial Accounting Standards Board ( "FASB ") Interpretation ( "FIN ") No. 48, Accounting for Uncertainty in Income Taxes ( "FIN 48 ") was issued. Under FIN 48, an organization must evaluate its tax positions and provide for a liability for any positions that would not be considered "more likely than not" to be upheld under a tax authority examination. The FASB has granted nonpublic companies and nonprofit organizations the election to defer the effective date for implementation of FIN 48 to years beginning after December 15, 2008. Management has elected to defer the application of FIN 48 and will continue to evaluate its tax positions using the guidance of FASB Statement No. 5, Accounting for Contingencies. Use of Estimates -The orenaration of financial statements in conformity with generally accented accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME NOTES TO FINANCIAL STATEMENTS -- Continued NOTE A-- SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES -- Continued Property -- Property and land are capitalized if there is a useful life greater than one year and the cost is above a minimum threshold established by the management. Property and equipment are recorded at cost or, if donated, at fair market value at the date of donation. Depreciation of medical equipment, automobiles, computers, and furniture and equipment is computed using the straight line method over the estimated useful lives of the related assets, which range from four to seven years. Leasehold improvements are amortized over the useful lives of the related assets or the expected terms of the leases, whichever is shorter, using the straight line method. Contributions -- Contributions from the general public are recognized as revenue when the unconditional promise to give is made. Contributions in kind are valued at their estimated fair market value at the date of receipt, if determinable. All contributions are considered to be available for unrestricted use unless specifically restricted by the donor. In -kind donations - -The Organization assigns values to contributed services when such services would otherwise be performed by salaried personnel. Such values are reflected in the accompanying financial statements as both revenue and expenses, comparable to what would be paid to salaried personnel. The value of in -kind donations, included as revenue in the financial statements for the years ended June 30, 2009 and 2008, was as follows: Government Grants - -The Organization recognizes grant revenue from government agencies when it is earned and receives such support based on reimbursable costs as defined by the grants. Reimbursements recorded under these grants are subject to audit by the grantor. Management believes that no material adjustments will result from subsequent audits, if any, by governmental agencies of costs reflected in the accompanying financial statements. 2009 2008 Donated food S 97,480 $ 27,560 Donated rent 112,000 112,000 Donated shelter resources 78,986 34,960 Donated services 55,356 154,586 Donated Transportation 3,.432 4,200 Donated education services 8,640 3,165 TOTALS L____15.5894 S 336,971 Government Grants - -The Organization recognizes grant revenue from government agencies when it is earned and receives such support based on reimbursable costs as defined by the grants. Reimbursements recorded under these grants are subject to audit by the grantor. Management believes that no material adjustments will result from subsequent audits, if any, by governmental agencies of costs reflected in the accompanying financial statements. STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME NOTES TO FINANCIAL STATEMENTS -- Continued NOTE B-- RESTRICTIONS ON NET ASSETS The temporary restrictions on net assets at June 30, 2009 and 2008 relate to donor- restricted amounts and pledges received which require the payment of specified program service expenses in satisfaction of the restriction.. NOTE C-- CONCENTRATION OF CREDIT RISK The Organization maintains cash balances at two financial institutions. Accounts at the institutions are insured by the Federal Deposit Insurance Corporation (FDIC) up to $250,000. Cash: balances of the Organization may typically exceed the FDIC limits in the normal course of operations during the year. NOTE D-- GRANTS RECEIVABLE Grants receivable at June 30, 2009 and 2008 were all due within one year and consisted of the following: U.S. Department of Housing and Urban Development U.S. Department of Homeland Security County of Los Angeles Los Angeles Homeless Services Agency South Bay Center For Counseling Various cities 2009 2008 $ 25,491 $ 36,599 5,535 4,397 4,565 8,709 1, 716 16,155 50,662 55,275 TOTALS S 104,124 $ 104,980 NOTE E -- PROPERTY, NET Net property at June 30, 2009 and 2008, consists of the following: 2009 2008 Medical equipment Automobiles Computers Furniture & equipment Leasehold improvements Less accumulated depreciation 10 $ 10,000 $ 10,000 105,953 105,953 38,539 29,383 59,921 59,921 397,826 383,271 612,239 588,528 (561,182 (548,214 NET $ 51,057 $ 40,314 STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. dba RIO HONDO TEMPORARY HOME NOTES TO FINANCIAL STATEMENTS -- Continued NOTE F-- COMMITMENTS AND CONTINGENCIES Grants require the fulfillment of certain conditions as set forth in the instrument of the grant. Failure to fulfill the conditions could result in the return of the funds to the grantors. Although that is a possibility, the Board deems the contingency remote, since by accepting a grant and its terms, the Board is acknowledging the requirements of the grantor at the time of receipt of the grant. The Organization maintains an operating lease with the State of California for buildings 213 and 215 located on the premises of the Metropoli --an State Hospital in Norwalk, California. The current lease expired in March 2003. The Organization is currently occupying the premises under a month -to -month arrangement and being charged a monthly rental of $3,747. Rent and utilities expense under this operating lease, including in -kind rent of $112,000, was $157,993 and $158,061 for the years ended June 30, 2009 and 2008, respectively. 11 INTERNAL REVENUE SERVICE DISTRICT DIRECTOR 2350 ROOM A�Ti : E.O. AK�[L��, CA 9V0532350 S7oF ��MEi[SS�ESS IN AkE� WHI7TIER, 0604 THE RI ,-, KONDU �eer AyplicEnIC� DEPARTMENT DF THE TREASURY En�!oyer Iden Nunb*r: ;5-408A505 Ca-* Number: Y5�9E7O56 Contac` Person: �IOLEK, THERESE A. Con'-.act Telephone Number: (213) ; Our Letter Dated: March 26, 19 Addendum App No lhis no�ifies our ]eti of the above date in which we stated that you would be treated as an organization which is not a private foundation until t)e expiration nf your advance ruling period. Yo"r exenyt status under spctinn 501(a) of the Internal Revenue Code as an nrqanizo� dpscribed �o 501(c)(3) is still in effeci. Based on the inforn+�ian you submitted. we ave determined - .chat you are not a private found�iion with �he neani"Q of section 509(a) of the code because you ars an cru aniza of the described in section 509(a)<>) and 170(b )<1>(A)(vi>" ! � / Grontors and ccn�rihutcrs may rely on this detprnination unless the In��roa� Rev�nue Sprvlce yubli notice to the contrary. However, if �su your seciion 5O9(a)(1) -tatus, a grantor or contributor may rut rely on thi.4 if he or shpwas in par+ responsible for, or wa� aw�re of �L� or failure to act, or the substantial or materi^l choncle on the ?ari ofthe� ur�ani that resu'ted in your lc--m of such or if he or she acquired kncwledQe that the In+ernal Revenue Servirp had given nctice Ukai you wcL�ld no longer be classified as a section orQaniza - 'ion Ycv ar* require� to file Fern ?�� only if ycur prcss receipt� each y*Rr are ncrn«3.ly wcre than 2' ,0 0 For C! uidence in deternining whpther your 9r��s rec�iPt ar+ ^xprwaI - ,y , nore t an s25 , see thp ins for Form "70 , T 8 ret,n� is rp�ci;e�, it nx be filEU by thE 15 4 h day D fifih ncnth �ftp� Phe enu of yecr annu,� accpuntinQ Period ^ A pena1ty cf �1O a d�y is �ken a ret1crn is fi�e� late unles� t�ere is reaponeb�y �c l4i Krwe: r, ihe wui pena)ty rnorged cannut exrped 4 5 ` 000 Dr 5 PerEen y(or �rus�� re��ipis for th � ys�r` w�ich��er is less Thi- Penz!ty ne i lso �* cF!arwcL a r r �s no� ��n��et� �s �le�se b* scrs �our retcrp� is ti-e heorjng -1 letter tk - t on ad p1 �art p ier Le�+er I6�O(I G ) 1537449 HONDO AREA. AL L 1 8 1986 ARTICLES OF INCORPORATION MUCH FONG EU, Secretary of State OF STOP HOMELESSNESS IN THE RIO HONDO AREA I The name of this corporation is STOP HOMELESSNESS IN THE RIO II A. This corporation is a nonprofit public benefit corporation and is not organized for the private gain of any person. It is organized under the Nonprofit Public Benefit Corporation Law' for charitable purposes. B. The specific purpose of this corporation is to coordinate activities to provide funds, facilities and other assistance to homeless persons, and to provide the general public with information about the needs of the homeless. III The name and address in the State of California of this corporation's initial agent for service of process is: Dale Ryan, 16010 East Milvern Drive, Whittier, California 90604. IV ENDORSED FILED In fm ulihr of *A Secretory of 5" of *d State of Cclilottno A. This corporation is organized and operated exclusively for charitable purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code. B. No substantial part of the activities of this corporation shall consist bf carrying on propaganda, or otherwise attempting to influence legislation, and the corporation shall not participate or intervene in any political campaign (including the publishing or distribution of statements) on behalf of any candidate for public office. V The property of this corporation is irrevocably dedicated to charitable purposes and no part of the net income or assets of this corporation shall ever inure to the benefit of any director, officer or member thereof or to the benefit of any private person. Upon the dissolution or winding up of the corporation, its assets remaining after payment, or provision for payment, of, all debts and liabilities of this corporation shall be distributed to a nonprofit fund, foundation or corporation which is organized and operated exclusively for charitable purposes and which has established its tax exempt status under Section 501(c)(3) of the Internal Revenue Code. Dated: 7 6 DAW RYAN, Incorporator I hereby declare that I am the person who executed the foregoing Articles of Incorporation, which execution is my act and deed. l�f DALIE RYAN, Incorporator jDc062402 2 ATTACMMNT 9a ARTICLES OF INCORPORATION 153'7449 ENDORSED FiLED in 0, 'Hi, o f M. s.ciwe�. a sow, a «. s... a C=i JUL 1 g 1986 ARTICLES OF INCORPORATION OF MARCH FDNC EU, Sembry of State STOP HOMELESSNESS IN THE RIO HONDO AREA I The name of this corporation is STOP HOMELESSNESS IN THE RIO HONDO AREA. II A. This corporation is a.nonprofit public benefit corporation and is-not organized for the private gain of any Person. It 'is :organized under the Nonprofit Public Benefit Corporation law for charitable purposes. B. The specific purpose of this corporation is to coordinate activities to provide funds, .facilities and other assistance to homeless persons, and to provide the general . public with information about the needs of the homeless. III The name and address in the State of •California .of this corporation's initial agent fox service of process; is: Dale Ryan, 16010 East Milvezn Drive, Whittier, California 9D6D4. Iv A. This 'corporation is organized and operated exclusively for charitable purposes -within the meaning of .Section 501(c)(3) of the Snternal'Revenue Code. H45 _ B. No substantial part of the activities, of this corporation shall consist of carrying on propaganda, or otherwise attempting to influence legislation,' and the corporation shall not participate or intervene in any political campaign (including the publishing or distribution of statements) on behalf of any candidate for public office. V The property of this corporation is irrevocably dedicated to charitable purposes and no part of the net income or assets of this corporation shall ever inure to the benefit of any director., officer or member thereof or to the benefit of any Private person. Upon the dissolution Or .winding up of the corporation, its - assets remaining after payment; or provision for payment, of all debts and liabilities of this corporation shall be distributed to a nonprofit fund., foundation or corporation .which is .organized and operated exclusively for charitable purposes and whicb.has established its tax exempt status under Section 501(c)(3) of the Internal Revenue Code. • Dated: —7/1 DAWRYA1q Incorporator I hereby declare that I an the person who executed the foregoing Articles of Incorporation, .which execution is .my act and deed.. `tJ MALS RYAN Incorporator PcDb2902 ••• 2 - ST ,.. or Iy + • + *air rrf Shone:(91DFGA 6 C -2020 ' � _ ELTEL f {{ILZTT�II�f.�•JJtM�`tE Pnone: (818)-2D20 C "IIO.M \ry STATEMENT BY DOMESTIC NONPROFIT CORPORATION THIS STATEMENT MUST BE FILED WITH- nnnenDAnnNC nnncl ' DUE DATE: OCTOBER 18, 1986 STOP HOMELESSNESS IN THE RIO HONDO AP.E?1 u:' . i DO NOT WRRE IN "THIS • "?HE CORPORATION NAMED HEREIN UNDER THE LAWS OF THE STATE OF CALIFORNIA, MANEs'THE FOLLOWING STATEMENT aurm DA ROOM P.A. 2 8R18ET 'AOLAEBB OF' ►AINCR'AL OFFICE , ^F NONE. OO/ " P ``� TSB) Whittier, California 9060 16010 Milvern Cm AND STATE ZIP Cal (DO NOT UeE P.O. SOX NO.) 9D. HUBS DA A00M 8ti . 8. .yAWNO ADDAeB6 (OPTIONAL) .• • '.. . • .. .._ CRY AND STATE TIP cc i'L'MAMES Or 'ME FOLLOWING OFFICERS , ARE. - as, ac CA' 906 16010 •Milvern WFiittYer; - Dale Ryan m ANP STAT ". c •• _ _ -_._ BUSINESS OR RESIDENCE ADORERS 100 NOT UBH P.O. 80X) - SC 5' Whittier, CA I 90E Pauline Barnett 6007 Alta Ave. CIPE Cm AND MATE SECRETARY BUHINE98 OA'AEBIDENCE AODACB6 IDO NDT VBB P.O. BOX) 8B 61;. 8M 6 9.504 Boughton Santa Fe Springs Ave. CA 90f Patricia Deter em AND STAYa ziP C.NR.F FINANCIAL HER eU 50 N DR'pHB ht = ADOREBB we N OT Y88 P.O. BO %) 7. ADENt POA EERTIDE OP mccu S ' ,i 1. ..: :. 't..... : in • .. T• ... .�.._. n .. DAYFDANIA •eVBIN699.PA AeB108NCE ADPRCBS W AN INDmOUAL (DD NOT UBE P.O.'80X) ONLY ONE AGENT CAN B e HAM=. 00 NOT INCMAE�ADDAPeS IP A6 w CONPPRATION. • ••:•' •• .... •• 6. 1 PeOLARE *MAT .1 i1APB FJfAMIN® TNI6 BTATEM@!T AND TD 1MC lC:JT OF'MY KNDWLCDOE AND BBaJW. IT P TRMH, COP 8/18/8.6 President'.:... Dale S. Ryan- BAw�n� _— _ •rove ne .114T NAME '01 sl imlwo OFFICER OH A 7. 153'7449 SECRETARY OF STATE "• "` "� " "` P.O. BOX 2830, SACAAMENTO'86812.°' INSTRUCTIONS FOR FILING PERIOD:, FILING PEE: IA ITEMS 2 -2B: COMPLETING STATEMENT BY DOMESTIC NON-PROFIT CORPORATION All Nonprofit Corporations must file within 90 days after filing articles of incorporation, Thereafter, corporations must file annually by the end of the calendar month-.of the anniversary date of its incorporation, or when theagent tpr service of processor his/her address is changed. All Nonprofit Corporations must submit aTWO DOLLAR -FIFTY CENT ($2,50) filing fee with this statement. (Section 12210(8) Government Code.) Check or money order should be made payable to Secretary of State. PLEASE DO NOT SEND CASH. The address'to be entered Is the STREET address of the corporation's principal office, Enter room or suite number.and zip code. Do not use post office box number, ITEMS 3,38: • ', `The address to be entered is the MAILING ADDRESS for the corporation. ITEMS 4-BC:: •• Complete by entering the names and complete business or residence addressasAt the cor -'"� poration:s chief executive officer (i.e., president, chairperson or other tkle); seorefary;aand — chief financial officer (i.e., treasurer, chairperson or other title). No list of additional officals` ti 7 should.be -submitted. Do not .use ost office box numb -P ;._.'.• ...•«:w.. a - =' ITEM 7:'."`' .:.. Sections 13210; 8210 of the Corporations Code, makes tt man story trial comestic Nonpro, Corporations designate.an agent for service -of process: An agent servict�:of laces leans --who may accept papers in case of•a lawsuit against•the ooryoration.Ttieaye ley be en: ::.:.;.:•..• dividualwho' lean. officerordirector .otthanorporetiori anyntherperaon.7hepers ' Di namad as agent must be a resident of California. Only.one individual may-bo named 88.0 totes►, - •vice of process. Or, the agent may be. another''norporation.'However,4 corporationrameti'as agent for service of process for another corporation must have an Ilia this office, 8•ceitifii: at pursuant to Section 1505, Corporations Code.The certificate Is required ONLY'If,e' ...... $tmxti - is named as agent for service of process for other.corporations. A CORPORATION CANNOT • •NAMED AS AGENT FOR SERVICE OF PROCESS FOR'RSELF. (For-example,-ABC 'Doi'poration. cannot name ABC Corporation as its agent for service of process.)' If the agent is a person, enter name and complete business or residence address. If agent'ls '•`; . another corporation, enter name of.corporation only, and do not complete address portion. Only one agent tar service of process is to be named. ITEM B: Signature of corporate officer or agent is required to complete the town. Enter title and date signed.: (NOTE) ITEM 1: Do not alter the preprinted corporate name. If corporation name is not correct, please attach - mote of-explanation. If space is blank enter exact corporate name and number,•domot include our DBA'name. sri+AILURE TO FILE 'THIS FORM BY THE.DUE.DATE IN ITEM 1 WILL RESULT IN THE ASSESS -_ -, : •::: +MENT OF A PENALTY. (Sections 6810, 8810, .Corporations Code, and Section 25936, Revenue ' and7axation Code.) .. .•. r ... .mss! � .•.•. • .IY .. rLYY •. :Yi: NOTE: Your canceled check Is your receipt of filing. We suggest that you make a copy of this form before mailing, It _- you wish one for,your files. .. .,Y••, t l. • • ... , f �-1 date Ca OFFICE OF THE SECRETARY OF STATE I, MARCH FONG EU, Secretary of .State of the State of California, hereby certify: . That the annexed transcript has been compared with the record on .file in this office, of. which it purports to be _a copy, and that same is full, true and correct. IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California. this JUL 2 4198 Secretary of State I- ,Y ATTACHMENT 9c The Corporation has been in existence less than one (1) year. ATTACHMENT 9d Proposed Budget: Income Contributions: Churches $ 5 Individuals 5,000 Businesses 5,000 Service Organizations 2,500 Grants: Government Agencies 10,000 Foundation Grants 25,000 Area Events: Christmas Cards 10,000 Thanksgiving Appeal 2,000 Other 3,500 Total: $68,000 Expenses Salaries and Wages 25,000 Insurance 5,000 Utilities 2,000 Rental /Lease 15,000 Furnishings 2 Office Expenses 3,000 Food /Clothing /Transportation 3,000 Fund Raising Expenses 8,000 Accounting and Legal Expenses 2,000 Misc. Expenses . ' '3,'0OQ' . Total: 68,000 ATTACHMENT-9e STATEMENT OF SPECIFIC PURPOSE The specific purposes of Stop Homelessness in the Rio Hondo Area are as follows: - To identify individuals and institutions in the area which are interested in the problems of homelessness and to provide regular meetings to encourage coordination of efforts, to promote creativity and sharing of ideas, and to mutually encourage the efforts being made on behalf of homeless people. To provide referral services to appropriate care providers for homeless individuals and families. - To provide temporary housing (up to 60 days) for homeless families. - To provide appropriate social services to families which have been provided with temporary housing. - To educate the local community as to the needs of the �,; homeless population in the Rio Hondo Area. ATTACHMENT 9f STATEMENT OF PROGRAMS AND ACTIVITIES Programs and activities Stop Homelessness in the Rio Hondo area intends to: Stop Homelessness has sponsored and plans to continue to sponsor a monthly series of meetings on the topic of homelessness for interested individuals and agency representatives. Stop Homelessness intends to lease or purchase facilities suitable for temporary housing of homeless families and to hire staff to maintain such housing and to provide appropriate social services to families in the program (e..g. assistance with job searches, assistance with application for appropriate benefits, assistance in returning to fair market value housing, networking to other social service agencies). - Stop Homelessness intends to provide coordinated referral services to homeless individuals and families for whom we are unable to provide shelter. stop Homelessness intends to provide information on resources for homeless individuals and families to local social service agencies, churches, business and interested private citizens. This may include activities such as publication of a guide to finding housing and other resources for our area. - Stop Homelessness intends to increase the awareness of the general public to the problem of homelessness in our area by a variety of means including a) creating of a speakers bureau on the topic of homelessness b) coordinating efforts to have talks on homelessness made on a regular basis at local civic organizations and clubs c) preparation of a newsletter on homelessness for distribution, etc. ATTACHMENT =9g STATEMENT OF FUND RAISING ACTIVITY Stop Homelessness intends to solicit contributions using a variety of fund raising activities. This may include: - Direct mail appeals. Fund raising letters will be -sent to churches, clubs, agencies and private individuals interested in the problems of the homeless. - Stop Homelessness will sponsor various events (Stop Homelessness Day, Run to Stop Homelessness, etc.) which provide an opportunity for interested individuals to make contributions. - A Christmas fund- raising drive is planned which will involve providing Christmas cards to owners of local businesses who make contributions to Stop Homelessness in lieu of traditional holiday gifts to clients. - Application for funds will be made to local civic organizations, local churches and to appropriate foundations and government agencies as suitable funding sources become available. ATTACHMENT h Activities Sponsor monthly meetings on the topic of homelessness for interested individuals and agency representatives. Referral services to homeless persons and families. None Discontinued. ATTACHMENT 9i Leases None. ATTACHMENT 9j LITERATURE Attached is a copy of a proposed brochure which is currently in print. BYLAWS OF STOP HOMELESSNESS IN THE RIO HONDO AREA. INC. ARTICLE I. OFFICES Principal Office Section 1.01. The principal ottice of the Corporation for its transaction of business is located in the City of Whittier and County of Los Angeles, Calitornia. Change of Address Section 1.02. The Board of Directors is hereby granted tull power and authority to change the principal ottice of the Corporation from one location to another in Calitornia. Any such change shall be noted by the Secretary in these Bylaws, but shall not be considered an amendment of these Bylaws. ARTICLE II. MEMBERS Members Prohibited Section 2.01. The Corporation shall not have any members. Ettect of Prohibition Section 2.02. Any action which would otherwise require approval by a majority of all members or approval by the members shall require only approval of the Board of Directors. All rights which would otherwise vest under the Non — profit Religious Law in the members shall vest in the Directors. ARTICLE III. Number Section 3.01. The Corporation shall have not less than nine (9) nor more than seventeen (17) Directors. The exact number of Directors snail be nine (9) and this number shall be fixed from time to time, within the limits specified in this Bylaw by an amendment to this Bylaw duly adopted by approval of the Board of Directors, as that term is defined in Section 5032 of the Corporations Code. Qualifications Section 3.02. The Directors of the Corporation shall be residents of the State of California. Nomination Section 3.04. Any person qualified to be a Director under Section 3.02 of these Bylaws may be nominated by the method or nomination authorized by the Board or by any other metnod authorized by law. Election Section 3.05. The Directors shall be elected at each regular meeting of the Board of Directors as prescribed by Section 3.07 of these Bylaws. The candidates receiving the hignest number of votes up to the number of Directors to be elected are elected. Directors shall be eligible for reelection without limitation on the number of terms they may serve, provided they continue to meet the qualifications required by Section 3.02 by these Bylaws. Compensation Section 3.06. The Directors shall serve without compensation. Meetings Section 3.07. (a) Meetings of the Board may be called by the Chairman of the Board or the President or any Vice - President or Secretary or any two (2) Directors. (b) All meetings of the Board shall be held at 6706 South Friends Avenue, Whittier, Calitornxa. VI (c) Regular meetings of the Board of Directors shall be held, without notice, on the second Thursday of the month at 9:00 a.m. if any day fixed for the regular meetings of the Board of Directors falls on a legal holiday, the meeting scheduled for that day shall be held at the same hour on the next succeeding day which is not a legal holiday. Special Meetings called by the Chairman oP the Boar the President or Vice - President or Secretary of any two (2) Directors. •Special meetings shall be held on four (4) days' notice by first class mail, postage prepaid, or on forty -eight (48) hours' notice delivered personally or by telephone or telegraph. Notice of: the special meeting need not be given to any Director who signs a waiver of notice or a written consent to holding the meeting or an approval of the minutes thereof, whether before or after the meeting, or who attends the meeting without protesting, prior thereto or at its commencement, the lack of such notice to such Director. All such waivers, consents, and approvals shall be filed with the corporate records or made a part of the minutes of the meeting. (e) A majority of the authorized number of Directors constitutes a quorum of the Board of Directors for the transaction of business, except as hereinafter provided. Transactions of Board (f) Except 'as otherwise provided in the Articles,-in these Bylaws, or by law, every act or decision done or made by a majority of the Directors present at a meeting duly held at which a quorum is present shall be the act of the Board of Directors; provided, however, that any meeting at which a quorum was initially present may continue to transact business notwithstanding the withdrawal of Directors, if any action taken shall be approved by at least a majority-of the required quorum for such meeting, or such greater number as is required by law, the Articles, or these Bylaws. [4 0 TI 1• (g) The Chairman of the Board or, in his or her absence, any Director selected by the Directors present, shall preside at meetings of the Board of Directors. The Secretary of the Corporation or, in the Secretary's absence, any person appointed by the presiding officer, shall act as Secretary of the Board. Members of the Board of Directors may participate in a meeting through use of conference telephone or similar communications equipment, so long as all members participating in such meeting can hear one another. Such participation shall constitute personal presence at the meeting. Adjournment (h) A majority of the Directors present, whether or not a quorum is present, may adjourn any meeting to another time and place. If the meeting is adjourned - for more than twenty -four (24) hours, notice of the adjournment to another time or place shall be given pr.ior to the time fo the adjourned meeting to the Directors who:were not present at the time of the adjournment. Action Without Meeting Section 3.08. Any action required or permitted to be taken by the Board of Directors maybe taken without at meeting, if all members of the Board of Directors individually or collectively consent in writing to such action. Such written consent or consents shall be filed with the minutes of the proceedings of the Board of Directors. Such action by written consent shall have the same force and effect as the unanimous vote of such Directors. Removal of Directors Section 3.09. (a) The Board of Directors may declare vacant the office of the Director on the occurrence of any of the following events: (1) The Director has been declared of unsound mind by a final order of court; or (2) The Director has been convicted of a felony; or (3) The Director has failed to attend five (5) regular meetings of the Board during the Directors year term. Removal Without Cause (b) Except as provided in the Articles, any Director may be removed without cause if such removal is approved by the Board of Directors within the meaning of Section 5032 of the Corporatins Code. Resignation of Director Section 3.10. Any Director may resign effective on giving written notice to the Chairman of the Board of Directors, the President, the Secretary, or the Board of Directors of the Corporation, unless the notice specifies a later time for the effectiveness of such resignation. If the resignation is effective at a future time, a successor maybe elected to-take -. J office when the resignation becomes effective. A Director shall. not assign where the Corporation would then be left without a duly elected Director of Directors in charge of its affaims. Vacancies in the Board Causes Section 3.11. (a) Vacancies on the Board of Directors shall exist on the death, resignation, or removal of any Director-, whenever the number of .Directors authorized is increased; and on the failure of the members in any election to elect the full member of Directors authorized. J (b) Vacancies on the Board of Directors may be filed by approval of the Board of Directors, or, if the number of Directors then in office is less than a quorum, by (1) the unanimous written consent of the Directors then in office; (2) the affirmative vote of a majority of the Directors then in office at a meeting held pursuant to notice or waivers of the notice as provided in Section 3.07(d) of these Byaws; or (3) a sole remaining Director. ARTICLE IV. OFFICERS Number and Titles Section 4.01. The officers of the Corporation shall be a Chairman of the Board, a Vice - President, a Secretary, a Chief Financial Officer, and such other officers with such titles and duties as shall be determined by the Board and as may be necessary to enable it to sign instruments.. The Chairman is the general manager and the chief executive officer of the Corporation. Any number of offices may be held by the same person, except that neither the Secretary nor the Chief Financial Officer shall serve concurrently as the Chairman of the Board. Appointment Section 4.02. The officers of the Corporation shall be chosen by and shall serve at the pleasure of the Board of Directors to the rights, if any, of an officer under any contract of employment. Duties of Officers �-� Chairman of th Bo - rd Section 4.03. (a.) The Chairman of the Board shall be the general manager and chief executive officer of the Corporation and shall, subject to the control of the Board of Directors, have supervision, director, and control of the business and affairs of the Corporation. Such officer shall preside at all meetings of the Board of Directors. Such officer shall perform all duties incident to the office of Chairman of the Board and such other duties as maybe required by law, by the Articles of Incorporation of the Corporation, or by these Bylaws, or which maybe prescribed from time to time by the Board of Directors. The Chairman of the Board is hereby authorized to exercise any right to vote or execute a proxy to vote shares of stock of, any bonds, debentures, or other evidences of indebtedness of, any other corporation or corporations owned or possessed by the Corporation. (b) in the absence of the Chairman of the Board, or in the event of his inability or refusal to act, the Vice— President shall perform all the duties of the Chairman of the Board, and when so acting shall have all the powers of, and be subject to all the restrictions on, the Chairman of the Board. The Vice — President shall have such other powers and perform such other dutes as maybe prescribed by law, by the Articles of Incorporation, or by these Bylaws, or as may be prescribed by the Board of Directors. (c) The Secretary shall keep or cause to be kept at the principal office of the Corporation, or such other place as the Board of Directors may order, a book of minutes of all meetings of the Baord of Directors. The Secretary shall perform such other and further duties as may be required by law or as may be prescribed or required from time to time by the Board of Directors. Chief Financia� r (d) The Chief Financial Officer of the Corporation shall keep and maintain a written form in any other form capable of being converted into written form adequate and correct books and records of account of the properties and business transactions of the Corporation, including accounts of its assets, liabilities, receipts, disbursements, gains, and losses. The books and records of account shall at all times be open to inspection by any Director of the Corporation. The Chief Financial Officer shall deposit all moneys and other valuables in the name of and to the credit of the Corporation with such depositaries as may be designated by the Board of Directors.: The Chief Financial Officer shall disburse the funds of the Corporation as ordered by the Board of Directors, and shall render to the Chairman of the board and the Directors, on request, an account of all such officer's transaction as Chief Financi al Officer, and of the financial condition of the Corporation. The Chief Financial Officer shall perform such other and further duties as may be required by law or as maybe prescribed or required from time to time by the Board of Directors or these Bylaws. Resignation or Removal of Officers Section 4.04. Any officer may resign at any time on written notice to the Corporation without prejudice to the rights, if any, of the Corporation under any contract to which the officer is a party. Officers may be removed with or without cause at any meeting of the Board of Directors by the affirmative vote of a majority of all of the Directors. CERTIFICATE OF SECRETARY OF STOP HOMELESSNESS IN THE RIO HONDO AREA, INC. J a California Nonprofit Corporation �.i I hereby certify that I am the duly elected and acting Secretary of Stop Homelessness in the Rio Hondo Area, Inc., and that the foregoing Bylaws, comprising seven (7) pages, constitut the Bylaws of said Corporation as duly adopted at a meeting of the Board of Directors thereof held on Dated: Secretary Typed Name �� i WOMEN'S FEDERATION FOR WORLD PEARCE CITY OF ROSEMEAD PRIVATE OR NON - PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding — Fiscal Year (FY) 2011 -2012 Name of Organization: Women's Federation for World Peace, Inc. Address: 950 Holly Vista Dr., Pasadena, CA 91105 Executive Director: Contact Telephone: (626) 203 -9404 Fax: Email: Purpose of Organization: To educate youth, parents and community on the risk and protective factors of teen pregnancy, focusing on the positive development of our youth. To form Partnerships with service organizations and provide outreach to educate the community at large. Enter "X" by the appropriate designation: X Non -profit organization* For -profit organization ( *Non -profit applicants please submit a copy of your agency's Determination Letter from the Ms' ) Enter "X" by all that apply: A faith -based organization An institution of higher education Not Applicable Employer Identification Number (EIN): _13- 3712630 TOTAL UNDUPLICATED CLIENTS RECEIVED: FY 08 -09 (Please Complete Attached Backup — Performance Report) FY 09 -10 (Est.) FY 10 -11 ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: AGENCY TOTAL BUDGET FOR FY 2011 -2012: FY 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: 560 0 $26,500 $ 12,000 1. State the Agency's mission, goals and major objectives. In addition, describe programs designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments. Mission Statement: Women working together to establish a culture of heart in the family, community and world in order to achieve genuine and sustainable peace under God." Goals: To educate youth, parents and community on the risk and protective factors of teen pregnancy with the goal in reducing the risk factors and increasing the protective factors. To motive and equip youth to live a healthy lifestyle, engaging in healthy choices for a healthy future Objectives: To educate youth on the value of teen pregnancy prevention by providing education programs and at least 80% of participants completing the program and 85% learning the risk and protective factors associated through a pre /post test survey. Programs designed to meet goals and objects: Free Teens curriculum provides a power point presentation with a series of topics related to teen pregnancy prevention. The curricula is a proven effective program that is being implemented in the United States and other countries and has been in existence for over 15 years. 2. Briefly explain any new programs or services to Rosemead residents during FY 2010-2011. Are any planned for FY 2011 -2012? This is a new program that was tested in some schools in Rosemead in FY 2009 -10 and 1000 youth participated. In the current FY 2010-11 the program is being provided by volunteers to only a few youth. In the upcoming FY 2011 -12 we hope to partner with the City of Rosemead and with sufficient funding to reach 1000 youth in the school community. 3. How are clients referred to your agency? The program is first advertised to the local middle and high schools in the district. Those who are able to accommodate the program are given a program overview, work plan and program schedule. Schools select those classes /youth who are most at risk and can benefit from the program. Additionally, the program will participate in community events, health fairs in order to invited the community to participate in parent workshops. 4. List and explain any major changes in funding patterns or expenditures The program was first funded locally by the US Department of Health and Human Services, with the contract ending in September, 2010. However, US Dept. of HHS terminated a division that was involved in the implementation of the community based abstinence education. The program is currently is search for partnerships and funding to be able to continue to meet the community needs. 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, fees, program income, etc.) In -kind contributions were donated through volunteers, food, space and auction items 6. What facilities in Rosemead are used to conduct services or are requested to be used? School facilities are the usual venue where the program services are provided, including the program presentation to youth and the parent workshops. Local church sites are also utilized to provide the message and lastly, city community center may be requested when and if large groups show interest in the program. 7. The proposed Community Service would be provided to: Mark each that apply Low and Moderate- Income persons or households Abused Children Handicapped Persons Illiterate Persons Battered Spouses Homeless Persons Migrant Farm Workers Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program /project in FY 2011 -12: _ 1, 100 youth/parents- Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) 10. Has your organization conducted the proposed activity before? Yes X_ No It. Describe your organization's experience with CDBG Our partner organization, JADE Family Services in South Gate has been funded by CDBG funds from the - cities of South Gate, Huntington Park and currently Cudahy. The partner agency will be available to provide assistance in dealing with low -mod income eligibility for City of Rosemead residents. 3 ) / \ ) § k A E ) \ � ] \ }� {/ƒ / �\ / �¢ � �Qn \2§ §�o @� j]? (�q 7 7$ ] >> r® \ §p W / ( \ \ / \ c2(a > > ; ;> @ @ + + - § / / § \( § }� \ ƒ ƒ \ \ }� ° EA \ ° {/ /)) { ) &ee3 �0 CD \ \ cr )&` � \] } } E)0 Ell )Kam! ; ƒ)« . . / / �\ / �¢ � �Qn \2§ §�o @� j]? (�q 7 7$ ] >> r® \ §p W / ( \ \ / \ k � ; � k � E § ) \ } } B . 22( ¥ }2§ ¥ { /® $® § y \ ° (A } F)) {/ )1 ® :5 )7 E[) { { \ )&`© k } / \0 2KRe! ,22« \ � .\ )) n � \/ a� � � �Qn \ \§ q °o q� )]§ k §\ ] >> r® ) 4 )K Ea y m C S y O m O e 3 0 H Q O C d A C d O cz �ro Oz CO n� y v� CsJ � zr y N n y° C N r.i O � n+ Cl7 y y 7 Y y �1 n �r O 0 FBI d d a N y _ c o rn o w rn co z ° N � W w v n' 0) N W m OD D W OD .] aw > r' a a o o�� ° N CD 0 na w rn aD r c ° `Dp6 3 D O C 80 C ° awo� pl (D CD r N rn o 'o ° c 0 0 O �n >❑ aw r' o x ^n a m m � w � o On w a O cz �ro Oz CO n� y v� CsJ � zr y N n y° C N r.i O � n+ Cl7 y y 7 Y y �1 n �r O 0 FBI d 13. Proposed Program Budget — FY 2011 -2012 (Public Service Requests Only) CDBGSHARE OTHER SOURCES Personnel $ 900 $ Equipment $ $ Supplies $ 1 $ Consultant Services $ 1 $ Space Rent & Utilities $ $ Audits $ $ Program Income $ $ Fees $ $ Other $ $ Total Costs $ 12 $ TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B) /B. We plan to hire more teachers /contractors to reach more population, invite guest speakers to make more impact with the kids and we will provide incentives to inspire the kids to choose a ** Explain What is Included in the "Other" Category. E:1 A Most recent fiscal year 2009/2010 B Current Operating Year 2010/2011 C Proposed Budget July I, 2011 to June 30 2012 D Percent Change* Expense For months onl SalariesIPT 1099 0 9,600 100% Employee Benefits 0 0 Employees Payroll Taxes N 0 0 Profes. & Consultant Fees O 100 1,000 90% Supplies N 700 1,400 50% Telephone & Fax 360 720 Postage & Shipping O 100 200 Occupancy & Utilities P Rental & Maint. of Equip. E 360 720 Printing & Publishing R 300 600 Travel and Transportation A 1200 2400 Conferences T 600 1200 Specific Assist. To Individuals I Membership Dues O Awards & Grants N Insurance A Equipment Purchased L 400 800 Misc. Expenses Transfer to Other Funds Dues to National Organizations Other ** 4120 18640 Surplus (or Deficit) of Total Support & Revenue Over Expenses * Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15% between columns B and C (C -B) /B. We plan to hire more teachers /contractors to reach more population, invite guest speakers to make more impact with the kids and we will provide incentives to inspire the kids to choose a ** Explain What is Included in the "Other" Category. E:1 Credit card services and fees TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)/B. Please Explain Changes Greater than 15% Percent A Fundraising event is planned seeking support for the Teen Pregnancy prevention program Rosemead CDBG is a planned award to benefit low -mod income residents 9 A Most Recent Fiscal Year 2009 -2010 B Current Operating Year 2010 -2011 For 6 mos. C Proposed Budget July 1, 2011 to June 30, 2012 D Percent Change* Public Support N 1250 2,500 Contributions O 6000 12,000 Foundation & Private Grants T Fundraising/ special Events 500 1 Legacies and Bequests A Other Federated Org. P United Way P Misc. Organizations L Other I Subtotal C Government A Federal B State L Local (Rosemead CDBG) E 12,000 100% Subtotal Other Revenue Membership Dues Program Services Fees Investment Income Transfer From Other Fund All Other Revenue Subtotal TOTAL REVENUE 7750 27,500 *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)/B. Please Explain Changes Greater than 15% Percent A Fundraising event is planned seeking support for the Teen Pregnancy prevention program Rosemead CDBG is a planned award to benefit low -mod income residents 9 I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Signature Name WFWP Chairwoman/Proiect Director Title (626) 203 -9404 Phone Number isedana,iuno.com Email Women's Federation For World Peace Organization January 13, 2011 Date 10 f i INTERNAL REVENUE SERVICE DISTRICT DIRECTOR G.P.O. BOX 1680 BROOKLYN, NY 11202 Date: AR 2 0 1535 WOMEN'S FEDERATION FOR WORLD PEACE, INC. 4 WEST 43RD STREET NEW YORK, NY 10036 Dear Applicant: DEPARTMENT OF THE TREASURY _ Employer Identification Number: 13 3712630 Case Number 115083023 Contact Person: J. MOSES Contact Telephone Number: (718) 488 -2971 Accounting Period Ending: DECEMBER 31 Form 990 Repuired: YES Addendum Applies: YES 'Based on information supplied, and assuming your. operations will be as stated in your application for recognition of exemption; we have determined you are exempt from Federal income tax under section 501(a) of the Internal Revenue Code as an organization described in section We have further determined that you are nut a`•arika,2C foundation within the meaning of section 509(a) of the Code, bec3usel are an organization described in section 509(a)(2). If your sources of support, or your purposes, character, or method of operation change, please let us know so we can consider the effect of the change on your exempt status and foundation status.. In the case of an amend- ment to your organizational document or bylaws, 'Please send us a copy of the amended document or bylaws. Also, you should inform us of all changes in your name or address. As of January 1, 1984 you are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more you pay to each of your employees during a calendar year. You are not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA). Since you are not a private foundation, you are not subject to the excise taxes under Chapter 42 of the Code. However, you are not automatically exempt from other Federal excise taxes_ If you have any questions about excise., employment, or other Federal taxes, please let us know. Grantors and contributors may rely on this determination unless the Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a)(2) status, a grantor or contributor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act, or the substantial or material change on the part of the organization that resulted in your loss of such - status, or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section 509(a)(2) organization. Donors may deduct contributions to you as provided in section 170 of the Letter 947 (DO /CGI -2- WOMEN'S FEDERATION FOR WORLD PEACE, Code. Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of Code sections 2055, 2106, and 2522. Contribution deductions are.allowable to donors only to the extent that their contributions are gifts, with no consideration received. Ticket pur- chases and similar payments in conjunction with fundraising events may not necessarily qualify as deductible contributions, depending on the circum- stances. See Revenue Ruling 67 -246, published in Cumulative Bulletin 1967 -2, on page 104, which sets forth guidelines regarding the deductibility, as chari- table contributions, of payments made by taxpayers for admission to or other participation in fundraising activities for charity. In the heading of this letter we have indicated whether you must file Form 990, Return of Organization Exempt From Income Tax. If Yes is indicated, you are required to file Form 990 only if your gross receipts each year are normally more than $25,000. However, if you receive a Form 990 package in the mail, please file the return even if you do not exceed the gross receipts test. If you are not required to file, simply attach the label provided, check the box in the heading to indicate that your. annual gross receipts are normally $25,000 or less. and sign the return. If a return is required, it must be filed by the .15th day of the fifth month after the end of your annual accounting period. A penalty of Sio a day is charged when a return.is filed late, unless there is reasonable cause for the delay. However, the maximum penalty charged cannot exceed $5,000 or 5 per- cent of your gross receipts for the year, whichever is less. This penalty may also be charged if a return is not complete, so please be sure your return is complete before you file it. You are not required to file Federal income tax returns unless you are subject to the tax on unrelated business income under section 511 of the Code. If you are subject -to this tax, you must file an income tax return on Form 990-T, Exempt Organization Business Income Tax Return. In this letter we are not determining whether any of your present or proposed activities are unre- lated trade or business as defined in section 513 of the Code. You need an employer identification number even if.you have no employees. If an employer identification number was not entered on your application, a number will be assigned to you and you will be advised of it. please use that number on all returns you file and in all correspondence with the internal Revenue Service. In accordance with section 508( &) of the Code, the effective date of this determination letter is 2/2/93. This determination is based on evidence that your funds are dedicated to the purposes listed in section 501(c)(3) of the Code. To assure your continued. exemption, you should maintain records to show that funds are expended only for those purposes. If you distribute funds to other, Letter 947 - (DO /cs) -3- WOMEN'S FEDERATION FOR WORLD PEACE, organizations, your records should show whether they are exempt under section Soi(c)(3). in cases where the recipient organization is not exempt under section. 501(c)(3), there should be evidence that the funds will remain dedicated to the required purposes and that they will be used for those purposes by the recipient. If we have indicated in the heading of this letter that an addendum applies, the enclosed addendum is an integral part of this letter. Because this letter could help resolve any questions about your exempt status and foundation status, you should keep it in your permanent records. If you have any questions, please contact the person whose name and telephone number are shown in the heading of this letter. Sincerely yours. Herbert V Muff District Director Enclosure(s): Addendum Letter 947 (00 /CG) YMCA OF W. SAN GABRIEL VALLEY CITY OF ROSEMEAD PRIVATE OR NON- PROFIT COMMUNITY SERVICE ORGANIZATION Request for Funding — Fiscal Year (FY) 2011 -2012 Name of Organization: YMCA OF WEST SAN GABRIEL VALLEY Address: 401 EAST CORTO STREET ALHAMBRA. CALIFORNIA 91801 Executive Director: VALARIE R. GOMEZ Contact Name: VALARIE R. GOMEZ Telephone: YMCA- 626 -576 -0226 CELL:626- 660 -6681 Fax: Email: VAL.YMCAnGMAIL.COM Purpose of Organization: Y is a powerful association of men. women and children joined together by a shared commitment to nurturing the potential of kids promoting healthv living and fostering a sense of social responsibility. We believe that lasting personal and social chance can only come about when we work together to invest in our kids our health and our neighbors. That's whv. at the Y strengthening community is our cause. Even day, we work side -bv -side with our neighbors to make sure that evervone regardless of age income or background. has the opportunity to learn, grow and thrive. E t r "X" by the appropriate designation: _X_ Non -profit organization* For - profit organization ( *Non - profit applicants please submit a copy of your agency's Determination Letter from the IRS) Enter "X" b_v all that apply: A faith -based organization An institution of higher education Not Applicable Employer Identification Number (EIN): 95 -] 644051 TOTAL UNDUPLICATED CLIENTS RECEIVED: FY 08 -09 (Please Complete Attached Backup — Performance Report) FY 09 -10 .(Est.), FY 10 -11 ROSEMEAD 2010 -2011 FINANCIAL SUPPORT: AGENCY TOTAL BUDGET FOR FY 2011-2012: FY 2011 -2012 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: 0'5 -0 D 452/'�;1 0 State the Agencv's mission. goals and major objectives. In addition. describe programs designed to meet goals and objectives. Attach any recent evaluations of programs or needs assessments. Missions Statement: Reason for Being (our Mission) To put Christian principles into practice through programs that build healthy spirit, mind and body for all. Goals: All Y programs, iniatives and events are encouraged into one of three areas of focus that frame our value, enhancing understanding of what we do and why it matters. FOR YOUTH DEVELOPMENT nurturing the potential of every child and teen FOR HEALTHY LIVING Improving the nation's health and well being FOR SOCIAL RESPONSIBILITY Giving back and providing support to our neighbors THE Y VALUES Our values unite us. Thee are the shared beliefs and essential principles that guide our behavior, our interactions with each other, our programs and curriculum and our decision making. CARING -Show a sincere concern for others HONESTY -Be truthful in what you say or do RESPECT - Follow the Golden Rule RE, E,SPONSIBH ITY -Be accountable for our promises and actions The Y is the nation's leading nonprofit committed to strengthening communities through youth development, healthy living and social responsibility Objectives: Los Angeles has the highest street homeless population in the nation. Even' dl, we see them —men, women and children with no place to call home. On any given night, nearly 50,000 people are homeless in Los Angeles County. Of those, 2 in 3 have no shelter and are living on the streets. Almost 7,000 are veterans Homeless, low income and uninsured families have no health care or resources. Homeless or low income families have no financial resources for quality child care for the Summer, while they seek employment opportunities or educational training. Programs designed to meet goals and objects: Project Goal: 1. To provide individuals looking for a new or better career we offer skilled employment specialists, training resources, phones, computers with Internet access, resume building and a yearly job fair. 2. To provide hot showers and child watch and a yearly health fair for the homeless and low income 3. To provide 5 -10 weeks of Children's Summer Day Camp, 7:00 a.m. to 6:00 p.m. Monday thru Friday for homeless, low income or uninsured families whose parent is seeking employment or educational training. 2. Briefly explain any new programs or services to Rosemead residents during FY 2010 -2011. Are any planned for FY 2011 -2012? To provide individuals looking for a new or better career we offer scheduled employment specialists, training resources, phones, computers with Internet access, resume building and a yearly job fair 10 provide hot showers, child watch and a yearh health fair for the homeless loA income and uninsured. To provide 5 -10 weeks of Children's Summer Da}' Camp, 7:00 a.m. to 6:00 p.m. Monday thru Friday. 3. How are clients referred to your agency? Our clients are referred to the P through the Cit. School District, Churches, Temples, and the community. 4. List and explain any major changes in funding patterns or expenditures The Y offered one California State Funded Program for our Special Needs Families which consisted of 1.25 children and adults with Down Syndrome and Autism. The State of California cut /discontinued the program completely. The loss of revenue for the program was $350,000 for the year 2010. 5. List major sources of funding and the amount (i.e. cities, county, state, federal fundraising, fees program income, etc.) As of January 13, 2011, the Y receives no City. County. Stale or Federal Funding. All sources of income are done through membership, donations and fundraising. We are an Independent Y, chartered by the City of Rosemead in 1913. 6. What facilities in Rosemead are used to conduct services or are requested to be used? The Y was chartered by the Cite of Rosemead in 1913 with the sole purpose of support in parmerstnp with four surrounding cities. 7. The proposed Community Service would be provided to: Mark each that apply X Low and Moderate- Income persons or households X Abused Children X Handicapped Persons X Illiterate Persons X Battered Spouses X Homeless Persons X Migrant Farm Workers X Elderlv Persons S. How many Rosemead citizens do you project will benefit from your progranvproject in FY 2011 -12: no oo a (ar 0 be - K(rn.¢al &vd a-V Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) This is a new program for the City of Rosemead. 10. Has your organization conducted the proposed activity before? Yes X_ No 11. Describe vour organization s experience with CDBG 1 spoke to our Immediate Past President Stan Yonemoto and his recollection is prior to 2005. The Y found no record keeping for the City of Rosemead. The Y received CDBG funding from Monterey Park for childcare in 2009 -2010 but discontinued because of state funding. 0 r m G U v v T v. �i T .7 7 N � L-7 N L a r 4 y L V � � L O L w G �I C z Q 4 C C C c C cz G ICI Gn 0 L . d O v N U C. O U. C G> kn N N F v, p 0 F Y U ^ N K Y U G y � N N — > > \ L CO — N '- K 0 m r , N m � v r L G > F C ! nom. v, O v F C. U G F z v G e ICI Gn 0 L . d O v N U C. O U. C G> kn (§ \\ =e =f/ 42¥ ell -� ƒ�[ oo= \\§ o5E 62= � \\ f? }\ ( a � 9 E � / / 0 _ c Q t \ a 7 � \ \ 3 \{ / \�\ \\ \ \ \ ) \ \\ ) .( `\ \ \ \ \)\/ a � 9 E � / / 0 _ c Q t \ a 7 � \ \ 3 L-] G.. C G _ H r O r N ✓ � r V N L- = Z � U � H = O � � H VOO L-j G U Z � G x 0 L-1 U J _ h Y i U N O L T O C is i L W .r � F r �.d r r 0 Y 0 O Y y v. Y �I Y r h O G v 0 U N ^ O N o N F N O M v r O v C v O Cv U y' C O C r J O C U, rn O � v N � - e: 0 U N - f6 c L F — ° o > o — �a �F rn p F G c a T 0 Z v N _ r G o7 zz h Y i O C i L W .r r �.d r r Y 0 O Y Y �I Y r h Qd U O OA o v r O v C v O Cv U y' O C r — C U, rn O � v V e: 13. Proposed Program Budget —FY 2011 -2012 (Public Service Requests Only) CDBG SHARE OTHER SOURCES Personnel summer Da $400 $ Camp, Counselors, lifeguards, membership /fundraisers /donations swim instructors Equipment sports $500. $ equipment - balls, jump ropes, membership /fundraisers /donations games. transportation -gas Supplies soap. towels, $5,000 $ paper, pens, folders, craft membership /fundraisers /donations supplies, cleaning supplies, bathing suits -child and adults, child camp 1 -shirt Consultant Services $0 $ membership/fundraisers/donations Space Rent & $0 $ utilities membership /fundraisers /donations Audits $1,000 $ membership/fundraisers/donations Program Income $0 $ membersh /fundraisers /donations Fees Summer Day Camp per $ 22,000 $ student $100 per week,55 hours membership /fundraisers /donations a week,$1.80 an hour, $1,000 per child for summer 10 week program, includes 20 %z hour swim lessons, 550 hours, field trips $20.00 per week/child watch toddler - 4 year olds, $3.00 an hour, Job training no charge, Showers no cliarge, No child or adult will be turned awav for services. Other $0 $ membersh /fundraisers /donations $ $ membership /fundraisers /donations Total Costs $32,500 $ membership /fundraisers /donations TOTAL OPERATING BUDGET EXPENSES Use Whole Dollars Only Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15 0 1'0 between colutmis B and C (C -B) /B. 9 q Most recent fiscal year 2009/2010 B Current Operating Year 2010 /2011 C Proposed Budget July 1, 2011 to June 30 2012 D Percent Change* Expense $1,608,786.14181,348,503.00 81,348,50100 No Change Salaries $ 769,744.70 8 599,084.64 8 599,084.64 No change Employee Benefits $ 26,390.50 8 19,913.59 8 19,913.59 No change Employees Payroll Taxes $ 66,123.97 61,054.68 $ 61,054.68 No change Profes. & Consultant Fees $ 85,91 9.57 $ 84554.92 8 84,554.92 No change Supplies $ 193,907.75 8 178,988.88 8 178988.88 No change Telephone & Fax $ 9,156.84 8 7,607.81 $ 7,607.81 No change Postage & Shipping $ 2,937.34 8 2,241.99 8 2,241,99 No change Occupancy & Utilities $ 221,619.96 8 204,835.30 8 204,835.30 No change Rental & Maint. of Equip. $ 26,721 .59 8 28,504.66 8 28,504.66 No change Printin & Publishing $ 11,953.02 8 6.956.77 8 6.956.77 No change Travel and Transportation $ 52,142.98 8 32,257.31 8 32,257.31 No change Conferences $ 3,493.08 8 3,489.75 8 3.489.75 No change Specific Assist. To Individuals Membership Dues $ Awards & Grants $ 12,500.00 8 100.500.00 8 100,500.00 No change Insurance S 27,799.53 8 30,558.90 8 30,558.90 No change Equipment Purchased $ 1,955.14 0 5 2,000.00 No change Misc. Expenses $ 688.44 S 200.00 S 200.00 No change Transfer to Other Funds $ 0 8 0 S 0 No change Dues t0 National Organizations $ 36,779.64 8 33,440.22 8 33.440 22 No change Other ** $ 0 0 Surplus (or Deficit) of Total Support & Revenue $ 10,300.53 $ - 5,95.51 financials are not audited and complete as of' January 13, 2011 $ Our hope is to break even and prosper through the lives we change in our communities we serve. $ No change other than the lives we help enrich one by one through the services we provide at the YMCA. Over Expenses $ 0 $ 0 $ 0 Percent Change Between Items in Columns B and C. Please explain Changes Greater than 15 0 1'0 between colutmis B and C (C -B) /B. 9 No chan«e other than the lives we help enrich one by one through the services w p rovide at the YMCA. ** Explain What is Included in the "Other' Category. We have $0 in the "Other" Category TOTAL OPERATING BUDGET REVENUE Use Whole Dollars Only *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)B. Please Explain Changes Greater than 15% Percent 10 A Most Recent Fiscal Year 2009 -2010 B Current Operating Year 2010 -2011 C Proposed Budget July 1, 2011 to June 30, 2012 D Percent Change* Public Support Contributions $85.360.87 $37,331.72 $37,331.72 No change Foundation & Private Grants $12,500.00 $100,500.00 $100,500.00 No change Fundraising/ special Events $112,425.68 $129,800.11 $129,800.11 No change Legacies and Bequests $ 0 $ 0 $ 1.,000,00 100% Other Federated Org. $ 0 $ 0 $ 0 No change United MA I ay $ 286.50 $ 376.18 $ 376.18 No change Misc. Organizations $ 1,147.06 $ 474.38 $ 474.38 No change Other $ 0 $ 0 $ 0 No change Subtotal $214.336.10 1 $267,631.83 No change Government $ 0 $ 0 No chan e Federal $ 0 $ 0 No change State $ 0 $ 0 No ehan e Local $ 0 $ 0 No change Subtotal $214,336.10 $267,631.83 $267,631.83 No change Other Revenue $ 0 $ 0 No change Membership Dues $36,779.64 $33,440.22 $33,440.22 No change Program Services Fees $ 0 $ 0 $ 0 No change Investment Income $ 0 $ 0 $ 0 No change Transfer From Other Fund $ 0 $ 0 $ 0 No change All Other Revenue Is 0 1 $ 0 $ 0 No change Subtotal 1 $251,115,74 1 $301,072.05 $301,072.05 No change TOTAL REVENUE $251,115,74 1 $301 I $301.072.05 No change *Column A is the Audited or Most Recently completed 1 -Month Period ** Percent Change From B and C (C -B)B. Please Explain Changes Greater than 15% Percent 10 One chance for grant received to fight obesity from the Center Of Disease Control. I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR Vafarie omez Signature Name < Chief Executive Officer Title 626 - 576- 0226/Cell:626- 660 -6651 Phone Number yal.% n email.com Email ]'MCA of West San Gabriel Valley Organization January 13. 2011 Date Internal Revenue Service Date: October 18, 2002 Young Men Christian Association of West San Gabriel Valley 401 East Corto Street Alhambra, CA 91801 -4553 Dear Sir or Madam: Department of the Treasury P. O. Box 2508 Cincinnati, OH 45201 Person to Contact: Jeremy L. Vogelpohl 31 -03888 Customer Service Representative Toll Free Telephone Number: 8:00 a.m. to 6:30 p.m. EST 877 - 829 -5500 Fax Number: 513- 263 -3756 Federal Identification Number: 95- 1644051 Accounting Period Ends: December 31 This is in response to your request for a letter affirming your organization's exempt status. In December 1944 we issued a determination letter that recognized your organization as exempt from federal income tax under section 101(6) of the Internal Revenue Code of 1939 (now section 501(c)(3) of the Internal Revenue Code of 1986). That determination letter is still in effect. We classified your organization as a publicly supported organization, and not a private foundation, because it is described in sections 509(a)(1) and 170(b)(1)(A)(vi) of the Code. This classification was based on the assumption that your organization's operations would continue as stated in the application. If your organization's purposes, character, method of operations, or sources of support have changed, please let us know so we can consider the effect of the change on the organization's exempt status and foundation status. Your organization is required to file Form 990, Return of Organization Exempt from Income Tax, only if its gross receipts each year are normally more than $25,000. If a return is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period. The law imposes a penalty of $20 a day, up to a maximum of $10,000, when a return is filed late, unless there is reasonable cause for the delay. As of January 1, 1954, your organization is liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more the organization pays to each of its employees during a calendar year. There is no liability for the tax imposed under the Federal Unemployment Tax Act (FUTA). Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code. However, these organizations are not automatically exempt from other federal excise taxes. If you have any questions about excise, employment, or other federal taxes, please let us know. & A�