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CC - Item 2A - Public Hearing on The Fiscal Year 2014-15 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 11, 2014 SUBJECT: PUBLIC HEARING ON THE FISCAL YEAR 2014 -15 ANNUAL ACTION PLAN FOR FEDERALLY - FUNDED PROGRAMS SUMMARY The City Council will conduct its required annual public hearing regarding the projected use of federal Community Development Block Grant (CDBG) and HOME Investment Partnership (HOME) funds for the upcoming 2014 -15 fiscal year. The U.S. Department of Housing and Urban Development (HUD) has not yet announced the final amounts to be allocated to participating communities; however, cities have been warned that Congress will again make cuts to these programs. Under federal regulations, no more than 15 % of the CDBG allocation can be used for "social service" activities. Written proposals have been received from four (4) organizations that are current recipients, which include the Family Promise, Family Service, People for People, and Southern California Housing Rights Center. Due to impending federal funding reductions, allocations to social service agencies may need to be reduced or in some cases eliminated. 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, 2014 — June 30, 2015. No further City Council action is necessary. BACKGROUND 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. lr APPROVED FOR CITY COUNCIL AGENDA: nw NO• City Council Report February 11, 2014 Paae 2 of 3 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 2014 -15 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. ANALYSIS The Federal government is currently working on allocating CDBG and HOME funding awards and has not yet announced the final amounts to each participating community; however, cities have been warned that Congress will again be making cuts to these programs. While the City has not yet been notified of the grant amounts that will be available to meet identified needs within Rosemead for the FY 2014 -15, HUD has warned that it is estimated that Rosemead will receive a decrease in its current $675,126 allocation of CDBG funds and a decrease in its current $209,511 allocation of HOME funds. It will not be certain until federal notification of awards. In conducting this public hearing, written invitations were sent to the four (4) non - profit organizations that are currently receiving CDBG funding. These organizations include the Family Promise, Family Service, People for People, 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 four (4) organizations will be represented at the public hearing. 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 social service activities and no more than 20% of the grant amount can be used for administrative and program delivery activities. 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 and 15% must be set aside for a City Council Report February 11, 2014 Paae 3 of 3 Community Housing Development Organization (CHDO), as constituted under the regulations. The balance of funds can only be used for housing activities. Due to limited resources and potential cuts in funding; it may not be possible for the Council to endorse all of the projects that have been submitted by the various parties that attend tonight's public hearing. In addition, due to the federal funding restrictions discussed above, the Council will be limited in the amount of funds available for social service activities. To properly evaluate all proposed projects, it is recommended that the Council defer making any recommendations this evening until the City has received confirmation of our grant amounts with HUD. A summary of all funding requests and staff recommendations will be provided to the Council for review at a future meeting. PUBLIC NOTICE PROCESS Notice of the public hearing was published in the Rosemead Reader on January 30, 2014, as well as through the regular agenda notification process. Submitted by: r Qv "Jlu Michelle G. Ramirez Community Development Director Attachment A — Social Service Requests Reserved ATTACHMENT A Reserved Social Service Agencies Applicant Review FY 2014 -15 FY 2013 -14 Funding Existing Allocation Agency Program Description Request Provider Amount Family Counseling Counseling Services $ 5,000.00 Yes $ 5,000.00 Service Location 605 S. Myrtle, Monrovia, Ca 91606 Contact Person Jennifer Foote Contact Phone Number 626- 308 -1414 Contact Email Address drioote(dsbcolobal.net Family Promise Homeless Services $ 5,000.00 Yes $ 5,000.00 Service Location 1005 E Las Tunas Dr #525 San Gabriel, Ca 91176 Contact Person Karen Roberson Contact Phone Number 626- 569 -0991 Contact Email Address karen.roberson(g )fosgv.org Housing Rights Center Affirmative Housing $ 18,000.00 Yes $ 18,000.00 Service Location 3255 Wilshire Blvd. Ste 1150, Los Angeles, Ca 90010 Contact Person Chancela AI- Mansour Contact Phone Number 213 - 381 -8555 Contact Email Address calmonsour(c housingrightscenter.org People for People Provide food and clothing $ 10,000.00 Yes $ 10,000.00 Service Location 1311 E Las Tunas Dr., San Gabriel, Ca 91776 Contact Person Norene Rand Contact Phone Number 626 -285 -2549 Contact Email Address wsgvccfoodgantrv(aaol.com Reserved ATTACHMENT A — Family Promise Reserved CITY OF ROSEMEAD 8838 E. Valley Boulevard Rosemead, CA 91770 (626) 569 -2102 ppiaft@cityofrosemead.org NON - PROFIT COMMUNITY SERVICE ORGANIZATION REQUEST FOR FUNDING FISCAL YEAR 2014 -2015 Legal Name of Organization: Family Promise of San Gabriel Valley Tax ID #: 27- 0315194 DUNS #: Address: 1005 E. Las Tunas #525. San Gabriel, Calif 91776 Executive Director: Karen Roberson (interim) Contact Name: Karen Roberson Telephone: 626 354 -6514 Fax: 626 280 -2070 Email: Karen.roberson@f Purpose of Organization: Food shelter, case management for homeless children and their families. Primary focus is helping families return to stable housing and , if appropriate, helping them seek employment. 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 Not Applicable TOTAL UNDUPLICATED ROSEMEAD CLIENTS: FY 12 -13 3 (Please Complete Attached Backup — Performance Report) (Est.) FY 13 -14 5 ROSEMEAD FY 2013 -2014 FINANCIAL SUPPORT: $5000.00 FY 2014 -2015 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: $5000.00 AGENCY TOTAL BUDGET FOR FISCAL YEAR 2014 -2015: $170,300.00 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: The mission of Family Promise of San Gabriel Valley is To help homeless families with children stay intact and regain stable housing and employment within a supportive volunteer- driven community. Goals: • Provide safe place for families to sleep, eat, and be sheltered from burdens of adversity /violence . • Intervene to reverse the downward spiral of homelessness and societal alienation for the children and families • Help parents /caretakers obtain gainful employment • Help families attain psychosocial stability with the goal of returning to stable housing Objectives: Provide case management services to • Provide immediate shelter • Assess client system and identify physical, social and psychological barriers to stable housing • Devise individual case plans to address family and systems issues • Collaborate with schools, social service agencies, mental health and substance abuse delivery systems to stabilize the family system • Assist families to locate, apply for and obtain housing (includes helping families save income in order to have needed deposits, etc) • Assist with development of work resume and applications, obtain appropriate clothing and support for job interviews. • Provide life skills classes /programs to support families' independence and success Programs designed to meet goals and objectives: • Case management services: assessment and implementation of an individualized case plan with oversight from a Licensed Clinical Social Worker. • Social work internship program to assist families with job resumes, provide life skills classes, provide counseling as needed. - • Collaboration with housing programs and landlords and actively refer families to appropriate programs and services. • Collaboration with other social service agencies /programs to meet needs of individual clients and client groups 2. Briefly explain any new programs or services to Rosemead residents during FY 2013 -2014. Are any planned for FY 2014 -2015? Family Promise began serving families in December, 2011. 2012 was the first full year of service, and the entire program was new to Rosemead residents. Program accomplishments for this past year (2013) included the following: • Continued outreach to Rosemead schools and social service agencies to provide access to potential Family Promise clients. • Family Promise worked closely with McKinneyNento caseworker in Montebello School District since Montebello Schools provide education for Rosemead children. 2 • Social work intems at Family Promise developed and provided Anger Management skills training for client families. • Family Promise participated in Rosemead CONNECTIONS meetings and Rosemead Kiwanis • Family Promise was recipient of holiday activities and gifts from SCE Int'1 and Muscatel Middle School. This provided teaching and community service opportunities for residents. • Meditation/stress management training was provided in collaboration with Buddhist chaplain from University of West FY 2014 -2015 program goals include but are not limited to: • Life Skills workshops /education. • Financial Literacy workshops. • Stress Management skills training • Anger Management skills training- developed and implemented in 2012 and available ongoing. • Family Promise Family Reunion and volunteer conference • Collaboration with TAY and DV housing services 3. How are clients referred to your agency? Clients are referred to our program from other social service agencies with whom we collaborate, from school homeless services workers, from churches, and self referral. 4. List and explain any major changes in funding patterns or expenditures There are no major changes in funding or expenditures. 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, etc.) City funding: City of Rosemead: $5000. Contributions from individuals and organizations: $74,000. Fundraisina: $17.000. 6. What facilities in Rosemead are used to conduct services? The Resource Center (hub of operations) is located at 1255 San Gabriel Blvd, Rosemead 91770, on the grounds of Evergreen Baptist Church. 7. The proposed Community Service would be provided to: Mark each that apply XX Low and Moderate - Income persons or households Abused Children Handicapped Persons Illiterate Persons Battered Spouses 3 XX Homeless Persons Migrant Farm Workers Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program/project: 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) Case study of Frankie and Jennifer; As a young couple they were both working and had a 7 year old son. When Jennifer became 6 mos pregnant (a high risk pregnancy and carrying twins) she had to quit her job. Soon after Frankie lost his job, and eventually the family became homeless. They couch surfed for a while, then ended up being referred to Skid Row. Even the mission was full when they arrived, so they slept in a park in LA the night before coming to Family Promise. On 9/11, Jennifer delivered healthy twin boys, Frankie was eagerly seeking work daily and he finally landed a warehouse job. They found a rental house and Jennifer began home schooling her 7 year old son. They saved enough to have at least one month's rent in savings. This month Frankie was again laid off from the warehouse job, so Family Promise supported him to seek his Commercial B Drivers License, and he was hired as a part time driver with FP. During this time Frankie's car died, and a Family Promise volunteer provided him with another vehicle. It is hoped that he will be able to find more work with his new job skill of commercial driving. In the meantime, we keep providing supportive resources to this great family. 10. Has your organization conducted the proposed activity before? Yes _X_ No 11. Describe your organization's experience with CDBG Family Promise of San Gabriel Valley was granted $16,000. over two years during the FY2010 /2011 and FY 2011/2012 by the City of Monterey Park. The funds were for the purpose of establishing the Day Center (now referred to as the Resource Center) and to provide shelter to families in the communities of the Monterey Park, Rosemead, San Gabriel/Pasadena area. The terms and conditions of the Brant were met. 2013 -2014. is a recipient of a grant 12. Do you charge any fees to your clients? If so, what is the fee structure? We do not charge clients. 11 �z �W o� N M C/2 N A wo x� o� H F" �5 aH W� z w U 0. 1 A Q F� W a o • " o G ❑ C a� o� o u+ O N m .-a tn =oo W wx x a F 0 F M CA N L E �0 go d w N O P . ° o b000� ro a 0 w 0 e L1n >ao� x 0 y T e o M o� U �O w� F * M . to d x M U_ z v d A m .r z = w _ N L O O l r n {G r o � x a • s a o • " o G ❑ C a� o� o u+ O N m .-a tn z Q H K1 O N Q N �Q71 O w UCon C w� P4 w P� O� ww U� OA WO w I On a a N G Y G 0 p T W � O n 'O �N d � c Vy al moo x 0 F a N v y 3 r o m nn -• ¢ C m N O PG 3 c o w b o l e ro � V CL C w 0 > a o Z o 0 A m y wo 7 m o � E e ] o z k % y W o a U roo �F a� m U x i m o CP z °• x > y N z ❑ ,� A � p " a m d V O Q •= 3 am m ¢ ¢ z o a a a N G Y G 0 p T W � O n 'O �N d � c Vy al PROGRAM BUDGET TT- Uut-l- n.,n.,.. n,.h. Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013- 14 and FY 2014 -15. Salari 81-nm-cs hi of netwofl< director Occupancy expense includes e s helt e r in 20 and not expected in 2014; utilities expense has increased annually Insurance expense has increased primarily due to workers compensation market Please explain what expenses are included in the "Other" Category. 0 FY 2012 Current operating Year FY 2013 Proposed Budget FY 2014 COW SHARE FY 2014 -15* Expense Salaries 58,254 46,000 110,000 Employee Benefits 1,98 1,900 0 Employees Payroll Taxes 5,384 4,500 11000 Profes. & Consultant Fees 2,255 2 500 2,700 Supplies 2,750 6,000 5,000 Telephone & Fax 1,643 Imul 00 Postage & Shipping 481 90 2,400 Occupancy &Utilities 5,162 11,000 6,400 Rental & Maint. of Equip. 0 0 0 Printing & Publishing 1,085 1,200 1,000 Trave\ and Transportation 6,025 5,100 6,100 Conferences 5,897 800 3,00 Specific Assist. To Individuals 0 0 0 Membership Dues 0 0 Awards & Grants 0 0 Insurance 9,843 13,00 15,000 Equipment Purchased 327 0 0 Misc. Expenses 3,723 4,10 5,000 Transfer to Other Funds 0 0 n Dues to National Organizations 1,500 1,500 1500 Total Expenses 108,992 100,300 170,300 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013- 14 and FY 2014 -15. Salari 81-nm-cs hi of netwofl< director Occupancy expense includes e s helt e r in 20 and not expected in 2014; utilities expense has increased annually Insurance expense has increased primarily due to workers compensation market Please explain what expenses are included in the "Other" Category. 0 PROGRAM REVENUE Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. C ontributions were lower in 2013 from key donors; expect to focus on developing key donors in 2014 and grants Additional fiindraicing expected to bP added in 9014 FY 2012 Cut'rent Operating Year FY 2013 Proposed for FY 2014 Public Support Contributions Foundation &Private Grants 71,270 60,000 103,00 25,00 Fundraising/ special Events 17,463 15,000 36,000 Legacies and Bequests Other Federated Org. United Way Misc. Organizations 1,000 3,000 Other Subtotal 88,733 66,000 167,00 Government Federal State Local 2,87C 4,000 5,00 Subtotal Other Revenue Membership Dues 2,870 4,000 5,00 Program Services Fees Investment Income Transfer From Other Fund All Other Revenue Subtotal TOTALREVENUE 91,603 80,000 172,00 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. C ontributions were lower in 2013 from key donors; expect to focus on developing key donors in 2014 and grants Additional fiindraicing expected to bP added in 9014 IHAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Signature [� it / /,l' I—A A A S/ZJ, PrintName 1• .GI// /r RAeezo� / fC'GTd/T TitI6 Email Address Phone Number Organizati —% /�✓ Date DO NOTCOMPLETETHIS SECTION-FORCITY USE ONLY Date Application Received: Date Reviewed by Rosemead Staff: Approved or Declined: Date Notification Letter Sent to Applicant: INTERNAL REVENUE SERVICE P. O. BOX 2508 CINCINNATI, OH 45201 Date: OCT 22 2009 FAMILY PROMISE OF SAN GABRIEL VALLEY C/O LATHAM & WATKINS - LLP EEE -MIN NGIAM 355 S GRAND AVE LOS ANGELES, CA 90071 -1560 DEPARTMENT OF THE TREASURY Employer Identification Number: _ 27- 0315194 DLN: 17053258350029 Contact Person: RENEE RAILEY NORTON ID# 31172 Contact Telephone Number: (877) 829 -5500 Accounting Period Ending: December 31 Public Charity Status: 170(b) (1) (A) (vi) Form 990 Required: Yes Effective Date of Exemption: May 12, 2009 Contribution Deductibility: Yes Addendum Applies: NO Dear Applicant: We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c) (3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 501(c) (3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter. Please see enclosed Publication 4221 -PC, Compliance Guide for 501(c) (3) Public Charities, for some helpful information about your responsibilities as an exempt organization. Letter 947 (DO /CG) ATTACHMENT A — Family Service Reserved CITY OF ROSEMEAD 8838 E. Valley Boulevard Rosemead, CA 91770 (626) 569 -2102 ppiatt@cityofrosemead.org NON - PROFIT COMMUNITY SERVICE ORGANIZATION REQUEST FOR FUNDING FISCAL YEAR 2014 -2015 Legal Name of Organization: SANTA ANITA FAMILY SERVICE Tax ID #: 95- 1816014 DUNS #: Address: 206 E. Las Tunas Dr., Suite 12; San Gabriel, CA 91776 Executive Director: Dr. Fred Lova Contact Telephone: (626) 308 -1414 Fax: Email: drfoote @santaanitafamilvservice.org 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 high quality educational, mental health and social service programs. 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 ROSEMEAD CLIENTS: FY 12 -13 18 (provided over 200 hours in counseling hours) (Please Complete Attached Backup — Performance Report) (Est.) FY 13 -14 15 ROSEMEAD FY 2013 -2014 FINANCIAL SUPPORT: Exhibit A FY 2014 -2015 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: $5,000 AGENCY TOTAL BUDGET FOR FISCAL YEAR 2014 -2015: Exhibit B 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: o Individual, group, family, and conjoint treatment o 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 • Family Support • DV CalWORKS • Ca1WORKS Substance Abuse Program • General Relief Substance Abuse Program • CDBG — Domestic Violence • CDBG — Senior Services • CDBG — Case Management • CDBG — Substance Abuse Prevention/Treatment • Family Preservation • YAB (Youth Accountability Board) • WIA -YEP (Workforce Investment Act -Youth Employment Program) • Food Stamp 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 2013 -2014. Are any planned for FY 2014 -2015? The Workforce Investment Act — Youth Employment Program (WIA -YEP) is a new Federal grant acquired by Santa Anita Family Service. The WIA -YEP Program provides young adults with services to reduce barriers to education and employment success. The services include: • Education Services: reading and math tutoring, post - secondary education placement, diploma/GED assistance, and assistance with applying for financial aid. • Employment Services: occupational skills training placement, paid work experience, employment placement, and job skills training. • Supplemental Services: case management, adult mentoring, leadership development, guidance and counseling, and supportive 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 No changes in funding this year 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising, etc.) See attached 6. What facilities in Rosemead are used to conduct services? 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 • Low and Moderate - Income persons or households • Abused Children • Handicapped Persons • Illiterate Persons • Battered Spouses • Homeless Persons X Migrant Farm Workers • Elderly Persons 8. How many Rosemead citizens do you project will benefit from your program/project: _ 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) 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. Mary, a Hispanic woman in her mid 20s, sought counseling because she felt "depressed" and "disconnected to her daughter ". She was taught early on that expressing her feelings were futile. She witnessed her mother and father engage in a number of physical altercations. Later, she found herself in an abusive relationship similar to her mothers. Thinking that having a baby would change her situation, she gave into her partner's wishes to have a child. However, Mary, after having her daughter, felt "disconnected" to her and "depressed ". She came to Santa Anita Family Service and has worked on identifying the barriers to expressing her sadness, understanding post- partum depression and the impact it has on her and her child, understanding domestic violence and the impact it has not only the victim but the family unit as a whole, and ways to increase her self - esteem. Having very little economic resources, Mary did not think she could afford the help she needed. However, through the no to low cost counseling program through the City of Rosemead, Mary was able to reach out receive the treatment she needed. She has begun individual counseling on a weekly basis. Her main focus and motivation has been her daughter. As a result, she has been making strides connect and be a mother who can provide a positive and solid foundation for her daughter's life, she is attending school, and working to improve the family relationships she can. Another example of someone benefiting from the Rosemead Program: Jim, a Caucasian male in his mid 40s, came to Santa Anita Family Service after he attempted to end his life. He had been laid off from work and became "extremely depressed" when he could not find another job resulting in him "not being able to provide for [his] family ". After he was released from the hospital he knew he needed help but was concerned that he could not afford the help he needed. Jim did not have a history of depression, suicide attempts, substance abuse, and/or other mental illnesses; therefore, where the hospital referred him after his release could not treat him as he did not meet their requirements. That agency, however, did refer him to SAFS. Jim was still hesitant on his ability to receive treatment — he was afraid of the being turned down again and even more concerned of the potential cost. Therefore, when he contacted SAFS and he was informed of the Rosemead Program he immediately felt like he could come in for the appointment. Because of the Rosemead program Jim had been able to receive individual and later couples counseling on a weekly basis. The Rosemead Program has provided him the opportunity to look at the stressors that triggered his suicide attempt, his depressive symptoms, his current self- esteem and the impact it has had on his family without adding more pressure to him. 0 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 25 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, substance abuse prevention /treatment, and senior services. 12. Do you charge any fees to your clients? If so, what is the fee structure? N/A for Rosemead clients Rosemead clients may be asked for up to $10.00 in co- payments for service, however most are $0 or $5.00 5 R §} k/ [( �[ ƒ( \\ k i §_ k2 § �o §� m §j ) §� q§ \/ \c \ j � ( § ( ( ( \ E [ � } ( p k § ( Ex � E G { @� r/ ( ' ) \ / \L O CL % § ■ �)r([ .` cc ° - \ \ (/ƒ © _ k i §_ k2 § �o §� m §j ) §� q§ \/ \c \ j w §) §/ }/ !/ \( |§ � a k� � i) o§ §/ q� §( e nK e� ]� 7 � ] « / f \ ( \ ) \ \ ( E e � \ ( � / ( e k ( � /® $ # \ � & \( &/ ~ ) / / \( CD \ \�0 IA ) § {CL ° \ b � \& } � a k� � i) o§ §/ q� §( e nK e� ]� 7 � ] « / f \ ( \ ) PROGRAM BUDGET Use Whole Doll ars Onl Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. N/A Please explain what expenses are included in the "Other" Category. N/A FY 2012 -2013 Current Operating Year FY 2013 -2014 Proposed Budget FY 2014 -2015 CDBG SHARE FY 2014 -2015* Expense Salaries 223,256 223,256 223,256 28,000 Employee Benefits 33,489 33,489 33,489 6,062 Employees Payroll Taxes 17,079 17,079 17,079 0 Profes. & Consultant Fees 0 0 0 0 Supplies 6,000 6,000 6,000 1,800 Telephone & Fax 12,000 12,000 12,000 1 Postage & Shipping 1,800 1,800 1,800 300 Occupancy & Utilities 36,000 36,000 36,000 1,200 Rental & Maint. of Equip. 0 0 0 0 Printin & Publishing 0 0 0 0 Travel and Transportation 2,000 2 2,000 838 Conferences 0 0 0 0 Specific Assist. To Individuals 0 0 0 0 Membership Dues 0 0 0 0 Awards & Grants 22,000 22,000 22,000 1,200 Insurance 0 0 0 0 Equipment Purchased 10,000 10 10,000 0 Misc. Expenses 0 0 0 0 Transfer to Other Funds 0 0 0 0 Dues to National Organizations 0 0 0 0 Over Expenses 0 0 0 0 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. N/A Please explain what expenses are included in the "Other" Category. N/A PROGRAM REVENUE Use Whole Dollars Only Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. N/A 0 FY 2012 -2013 Current Operating Year FY 2013 -2014 Proposed for FY 2014 -2015 Public Support Contributions 10,000 10 10 Foundation & Private Grants 20 9 000 20,000 20 Fundraising/ special Events 20,000 20 20 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 50 9 000 50 50 Government Federal 122 122 122 State 125 9 000 125 125 Local 65 9 000 65 65 Subtotal 312 312 312 Other Revenue Membership Dues 0 0 0 Program Services Fees 1 9 200 1 9 200 1 9 200 Investment Income 0 0 0 Transfer From Other Fund 0 0 0 All Other Revenue 0 0 0 Subtotal 1 9 200 1 9 200 1 9 200 TOTAL REVENUE 363 363 363 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. N/A 0 I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Clinical Director/Licensed Psycholoeist Title drfoote (d)santaanitafamilyservice.orQ Email Address 626.966.1755 est 5684 Phone Number Santa Anita Family Service Organization 1/22/2014 Date DO NOT COMPLETE THIS SECTION - FOR CITY USE ONLY Date Application Received: Date Reviewed by Rosemead Staff: Approved or Declined: Date Notification Letter Sent to Applicant: Print Name Exhibits Contents Exhibit A — Rosemead 2013 - -2014 Financial Support Exhibit B — Agency Total Budget for Fiscal Year 2014 -2015 Exhibit C — Funding Sources & Amounts Exhibit D — Certificate of Liability insurance Exhibit E — Profit & Loss Fiscal Year 2012 -2013 Exhibit F — Agency Balance Sheet 2013 E WA Jul Yx -Jlmn Jul Y3 -Jun 14 Immm. 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E]hlbN B Income Total Income Eapenee Total Expense Net Income 9enb....I, Se.. nuE6M l yl] Poea1 MI 2u1 '14 -Jun 16 EXHIBI C Exhibit C 2014 -2015 Funding Resources AMOUNT Donations 17.000 l..___.. ., i.ucuc i'cc nn r.n^ i iv,vvv Contracts CSBG - Senior Servirr -.es districts 1 & S ? QS,wvt i CSBG - Domestic Violence /Case Management 180,000 City of Azusa ii%,vviJ City of Baldwin Park 5,000 �ILY ^' V 1 ^ -• Arcadia Unified School District 13,020 Senior Center Contract t (11't Sh4 P.A.C. T . Contract 116,666 Pathways Contract 19,682 General Relief 48,770 CalWORKS Contract 16,357 Family Preservation Contract 577,000 Family Support Contract 121,200 Domestic Violence Calworks /GR Contract 256,710 City of Rosemead 5,000 Learn 1,080 DPSS Food Stamps 1,500 Royalties 6,325 Workforce Investment Act 1,000,000 Miscellaneous 6,352 TOTAL 3,605,226 �— -1 ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE MULDG YYI 11115/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poliey(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endomement(s). PRODUCER Ph..: 629332 -2258 F.: 628339 -9921 LILLIAN ROMERO GOMEZ BAKER ROMERO & ASSOCIATES INSURANCE BROKERS, INC. 750 TERRADO PLAZA SUITE 238 COVINA CA 91723 Agency Lid: 9622790 CONTACT Ch ristine Sousa rNE EA' 626 339 -9921 IL Ea 626)_ 332.2258 I ac Nm ( ) BAI " Christine @bakerrome _ ADDRESS _ INSURER(S) AFFORDING COVERAGE "C# INSURERA : Gre American Insurance Companies 16691 INSURED - "- SANTA ANITA FAMILY SERVICES -�' -' INSURER e EACH OCCURRENCE INSURERC 605 S. MYRTLE AVE INSURERD MONROVIA CA 91016 INSURERS OA ZTOREWM PREMISES (En o nS,o,) INSURER IF MED. EAP(Anyone person) $ 5,000 COVERAGES CERTIFICATE NUMBER: 11394 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN Y HAVE BEEN REDUCED BY PAID CLAIMS. iLTRR TYPEOFINSURANCE IIMR S W D POLICY NUMBER MNDO EFF MWICYIXP LIMITS A GENERAL LIABILM PAC7575140 11/10113 11110114 EACH OCCURRENCE $ 1 X COMMERCIALGENERALLIABILITY OA ZTOREWM PREMISES (En o nS,o,) $ 100 MED. EAP(Anyone person) $ 5,000 CLAIMS -MADE 1XI OCCUR X PROFESSIONALUABILITY PERSONAL &ADV INJURY $ 1,000,000 X ABUSE MOLESTATION GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OPAGG $ 3,000,000 PRO- POLICY _ LOC EIJEU —" $ A AUTOMOBILE LIABILITY CAP7575141 11/10113 11110114 COMBINED SINGLE LIMIT $ 1'000'000 BODILYINJURY(P, person) $ X ANYAUTO ALL OWNED SCHEDULED AUTOS UTOS NON-OWNED X HIRED AUTOS X U --- BODILY INJURY (PelevddenU $ PRO ERTY DAMAGE (pe<ecdaanq - $ $ A UMBRELLA uAa X occuR UMB8049268 71110113 4 111/10/14 EACH OCCURRENCE - $ 1 AGGREGATE -- $ 1,000,000 exLESS LAS CLAIMS-MADE OED X RETENTION $ 10,000 ABUSE $ INCLUDED E COM MID ANY EMPLOYERS' S' LIA ANY PROPRIETORIPARTNENRTNEWE %FCNTNE �YIN� oFNGETUMEMBER E(CLBOEOV mansatory In N h XIA .. VIC STATII- OTH TORY LIMITS ER $ E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ _ E.L. DISEASE - POLICY LIMIT $ Ryas, aewine wWer DESCRIPTION OF OPERATIONS Lelmv DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is mquimd) CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED - FUNDING SOURCE TOTAL ABUSE LIMITS $2M1$2M CITY OF ROSEMEAD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 8838 E. VALLEY BLVD. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ROSEMEAD, CA 91770 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE Attention: Christine Sousa Arnan 9R fin4nmR1 ®1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 2:44 PM 01/16/14 Accrual Basis Santa Anita Family Services Profit & Loss July 2012 through June 2013 Jul'12 -Jun 13 Jul '11 -Jun 12 $Change %Change Ordinary Income /Expense Income 4000. Donations 11,049.85 12,356.94 - 1,307.09 -10.6% 4020. Business Donations 8,550.00 4,100.00 4,450.00 108.5% 4030 • Foundation Donations 75,000.00 1,000.00 74,000.00 7,400.0% 4100. Program Fundralsing 40.00 0.00 40.00 100.0% 4200. Board Contributions 2,750.00 5,930.00 - 3,180.00 -53.6% 4600. Revenue - Assoc Org. Monrovia 2,000.00 1,025.00 975.00 95.1% 5001 - Senior Center Contract 1,001,750 -79 998,683.57 3,067.22 0.3 9 /6 50012. Family Support Contract 121,200.00 121,200.00 0.00 0.0% 60015. DV Calworks Contract 228,766.00 228,572.00 194.00 0.1% 50018 . DV Calworks Grow Dist 1 27,579.00 27,537.00 42.00 0.2% 5002 - Pathways Contract 16,186.84 7,790.96 8,395.88 107.8% 5003. Pact Contract 114,186.44 98,326.82 15,859.62 16.1% 5006. CDBG - Azusa Contract 10,000.00 10,000.00 0.00 0.0% 5007. City of Covina YAB 1,370.00 4,795.00 - 3,425.00 -71.4 5008 - San Gabriel Schools Interv. 0.00 3,000.00 - 3,000.00 -100.0% 5013. CDBG - Baldwin Park 3,500.00 4,150.00 - 650.00 -15.7% 5014. Covina USD 4,445.00 17,640.00 - 13,195.00 -74.8% 5015. Arcadia USD 13,500.00 13,500.00 0.00 0.0% 5016. Pathways GRContract 11,868.61 8,007.00 3,861.61 48.2 0 /6 5017. Pathways Calworks - Contract 0.00 1,496.00 . 1,496.00 - 100.0% 5020 • Family Preservation Contract 438,873.26 465,324.77 - 26,451.51 -5.7% 5022. CDBG - Rosemead 4,997.50 39,000.00 - 34,002.50 -87.2% 5023 - General Relief /FCS Contract 925.37 7,047.43 - 6,122.06 -86.9% 5024. Calworks/FCS Contract 0.00 209.00 - 209.00 -100.0% 5025 - Image Plus Contract 0.00 37,020.00 - 37,020.00 - 100.0% 5026. Impact Plus CDBG Contract 0.00 15,000.00 - 15,000.00 - 100.0% 5035 • Prototypes-Calworks 9,302.68 12,632.94 . 3,330.26 - 264°/ 5050. Food Stamp Contract 2 680.00 1,320.00 194.1% 5060. CSBG 5 SS 57,370.00 57,369.00 1.00 0.0% 5070. CSBG 1 SS 27,546.00 27,547.00 -1.00 0.0% 5080. CSBG SC 5CM 32,346.00 32,346.00 0.00 0.0% 5090 - CSBG DV 1 64,613.70 64,613.70 0.00 0.0% 6000. Murex Petroleum Corp. 1,699.33 2,273.94 - 574.61 -25.3 6100. Amerada Hess Corp. 8,471.19 3,581.31 4,889.88 136.5% 6120. Peregrine Petroleum 213.89 0.00 213.89 100.0% 6150. Danbury 2,799.94 3,244.02 - 444.08 -13.7% 6175. Ranch Oil Co. 164.44 215.09 -50.65 -23.6% 6185. Fidelity011 Company 0.00 100.36 - 100.36 -100.0% 6196. Hillsides - Family Pres 9,612.00 4,806.00 4,806.00 100.0% 6200. Counseling Fees 24,725.00 32,085.58 - 7,360.58 - 22.9% 6201 - Pathways Fees 762.50 1,329.00 - 566.50 -42.6% 6202. PC 1000 Fees 3,942.40 6,639.00 . 2,696.60 -40.6% 6203 • PACT Fees 14,185.55 14,781.57 - 596.02 -4.0% 6204. Domestic Violence Fees 19,893.00 27,580.25 - 7,687.25 -27.9% 6206. Parenting Fees 1,455.00 2,304.50 - 849.50 -36.9% 6207 - Senior Center Income 5,089.35 5,089.50 -0.15 0.0% 6209 - Rosemead fees 360.00 1,186.00 - 826.00 -69.7% 6211 . Anger Management Fees 2,188.50 3,206.40 - 1,017.90 -31.8% 6212. Adolescent Group Fees 460.00 69.50 390.50 561.9% 6213 • Chronic Illness Fees 265.00 625.10 - 360.10 -57.6% 6214. Empowerment Group Fees 2,278.50 3,087.50 - 809.00 -26.2% 6215. FCS /GR Fees 27.00 97.00 -70.00 -72.2% 6217. Image Plus 0.00 505.00 - 505.00 - 100.0% 6218. Victims of Crime 600.00 0.00 600.00 100.0% 6219. Blue Cross/Blue Shield 0.00 60.58 -60.58 - 100.0°/ 6230 - Rental income 4,118.40 4,492.80 - 374.40 -8.3% 6500. Miscellanous Income 2,435.87 724.55 1,711.32 236.2% 6515. Vending machine Income 456.39 0.00 456.39 100.0% 6520. Interest 1,217.03 408.99 808.04 197.6% 6530 - Fidelity Exploration 100.36 0.00 100.36 100.0% Page 1 2:44 PM Santa Anita Family Services 01/16/14 Profit & Loss Accrual Basis July 2012 through June 2013 Jul'12 - Jun 13 Jul '11 - Jun 12 $ Change %Change 6811 • United Way Donor Contributions 226.53 0.00 226.53 100.0 6900. Gift in -kind income 0.00 182,289.00 - 182,289.00 - 100.0% Total Income 2,399,464.21 2,628,682.67 - 229,218.46 -8.7% Gross Profit 2,399,464.21 2,628,682.67 - 229,218.46 -8.7% Expense 7000 - Salaries 969,658.14 928,925.01 40,733.13 4.4% 7050 - Salaries- Clerical 154,517.95 144,940.49 9,577.46 6.6 0 / 7090 . Salaries - Para Professional 587,364.49 540,717.36 46,647.13 8.6% 7100. Health Insurance 106,083.50 124,168.01 - 18,084.51 -14.6% 7210 • Payroll taxes 130,086.17 122,429.08 7,657.09 6.3 1 /6 7230. WIC Insurance 63,828.00 47,916.89 15,911.11 33.2% 7240. Unemployment Insurance 3,925.05 21,225.39 - 17,300.34 -81.5% 8001 . Food Stamps Donations 1,160.00 0.00 1,160.00 100.0% 8040. Accounting Services 23,245.00 20,293.83 2,951.17 14.5% 8041 - SBS Fees 6,832.30 7,927.03 . 1,094.73 8110. Office supplies 42,978.19 36,770.81 6,207.38 16.9% 8150 . Educational Supplies 338.03 6,443.62 - 6,105.59 -94.8% 8175. Educational Training 1,974.16 1,666.85 307.31 18.4 1 /6 8180. CCS Consulting expense 0.00 30,000.00 - 30,000.00 - 100.0°/ 8181 - Fundralsing Consultant 14,44100 2,165.00 12,275.00 567.0% 8182. Professional Consulting 514.90 0.00 514.90 100.0% 8200. Telephone 43,133.51 33,113.83 10,019.68 30.3% 8300 - Postage 6,953.77 4,33728 2,616.49 60.3% 8410. Rent 34,500.00 35,600.00 - 1,100.00 -3.1% 8420. Mortgage Interest Expense 24,089.54 25,345.85 - 1,256.31 -5.0% 8425. Line of Credit Interest Expense 737.83 0.00 737.83 100.0% 8426 - Fidelity Mortgage Interest 40,184.34 41,000.61 - 816.27 -2.0% 8430. Utilities 27,143.40 30,912.26 - 3,768.86 -12.2% 8440 • Maintenance - Building 10,495.72 8,151.83 2,343.89 28.8% 8442. Maintenance Vehicle 567.38 0.00 567.38 100.0% 8445. Maintenance Service & Repairs 4,383.60 4,557.63 - 174.03 3.8% 8450 • Special Events Rental Expense 0.00 500.00 - 500.00 -100.0% 8490. Other Building Expense 2,886.01 4,768.43 - 1,902.42 -39.7% 8501 • Rental & Maint of Equipment 11,432.90 18,154.70 - 6,721.80 -37.0% 8520. Equipment 5,485.75 0.00 5,485.75 100.0% 8525 Equipment Tax 349.76 39.68 310.08 781.5% 8530. Computer Maintenance 8,571.68 419.40 8,152.28 1,943.8% 8600. Printing 6,212.00 5,793.38 418.62 7.2 9 /6 8720. Mileage 21,814.92 20,236.36 1,578.56 7.8% 8810. Educational Conferences 4,232.99 344.50 3,888.49 1,128.7% 8900 Gift in Kind Expense 0.00 182,289.00 - 182,289.00 - 100.0% 9000. Membership Dues 1,096.20 593.80 502.40 84.6% 9100. Filing Fees 507.60 8,366.00 - 7,858.40 -93.9% 9200 - Liability Insurance 20,381.13 30,111.50 - 9,730.37 -32.3% 9500. Miscellaneous 6,39523 1,981.56 4,413.67 222.7% 9520. Bank charges/Fees 4,920.98 4,307.62 613.36 14.2 9 /6 9530. Outreach Activity 1,000.00 26 -98 973.02 3,606.5 9540- Business License Renewal 659.00 1,109.00 - 450.00 -40.6% 9570. Purchase of Service 24,746.44 31,674.36 - 6,927.92 -21.9% 9580. Attorney Fees 7,255.02 0.00 7,255.02 100.0 9590. Drug Testing 25.83 869.50 - 843.67 -97.0% 9592. Fam Pres - Subcontractor 98,180.64 92,099.82 6,080.82 6.6% 9593. DV Cal -works Subcontractors 3,381.00 4,802.00 - 1,421.00 -29.6% 9594 - Family Support Subcontractor 50,174.92 49,293.56 88136 1.8% 9600 - Finger Print Expense 20.00 0.00 20.00 100.0% 9610. Van Expense 272.90 236.99 35.91 15.2 9615. Gas Expense 165.30 461.10 - 295.80 -64.2% Page 2 2:44 PM Santa Anita Family Services 01/16/14 Profit & Loss Accrual Basis July 2012 through June 2013 9800. Depreciation 9805. Amortization Expense Total Expense Net Ordinary Income Net Income Jul '12 -Jun 13 Jul' -Jun 12 $Change %Change 0.00 14,306.00 - 14,306.00 - 100.0°/ 0.00 1,186.00 - 1,186.00 - 100.0% 2,579,303.17 2,692,599.90 - 113,296.73 -4.2% - 179,838.96 - 63,917.23 - 115,921.73 - 179,838.96 - 63,917.23 - 115,921.73 - 181.4% - 181.4% Page 3 2:47 PM Santa Anita Family Services 01116114 Balance Sheet Accrual Basis As of June 30, 2013 Jun 30, 13 Jun 30, 12 $ Change %Change ASSETS Current Assets Checking /Savings 1002. Citizens Business Bank 5,617.25 40,070.08 -34,452.83 -86.0% 1003. Citibank 3,538.67 3,531.27 7.40 0.2% 1004. One West Bank -Fund Development 74,970.39 56,039.78 18,930.61 33.8% 1005 - One West Bank -Fund Developmem2 4,955.00 0.00 4,955.00 100.0% 1007 . Citizens Business Bank - Property 2,218.02 12,183.62 - 9,965 -81.8% Total Checking /Savings 91,299.33 111,824.75 . 20,525.42 -18.4% Accounts Receivable 1120. Accounts receivable 213,364.79 312,608.98 - 99,244.19 -31.9 Total Accounts Receivable 213,364.79 312,608.98 - 99,244.19 - 31.8% Other Current Assets 1220. Prepaid insurance 13,323.29 16,614.29 - 3,291.00 -19.8 1250. Cerllflcate of Deposit -CBB 103,445.93 102,531.46 914.47 0.9% Total Other Current Assets 116,769.22 119,145.75 - 2,376.53 -2.0% Total Current Assets 421,433.34 543,579.48 - 122,146.14 -22.5% Fixed Assets 1300 • Land 314,050.31 314,050.31 0.00 0.0% 1335. Building 551,542.16 551,542.16 0.00 0.0% 1336. Furniture and Equipment 98,311.06 98,311.06 0.00 0.0°/ 1337 . Accumulated Depreciation - Bldg - 292,650.80 - 292,650.80 0.00 0.0% 1338. Accumulated Depreciation F & F - 98,309.75 - 98,309.75 0.00 0.0% 1340. Building Improvements 31,773.40 0.00 31,773.40 100.0% Total Fixed Assets 604,716.38 572,942.98 31,773.40 5.6% Other Assets 1500 - Security Deposit 3,625.00 3,625.00 0.00 0.0% 1600. Loan costs 23,726.00 23,726.00 0.00 0.0% 1650 - Loan costs- amortization - 4,151.00 - 4,151.00 0.00 0.0% Total Other Assets 23,200.00 23,200.00 0.00 0.0 1 /6 TOTAL ASSETS 1,049,349.72 1,139,722.46 - 90,372.74 -7.9% LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable 2040 • Accounts payable 129,840.61 64,131.46 65,709.15 102.5% Total Accounts Payable 129,840.61 64,131.46 65,709.15 102.5% Other Current Liabilities 2042- Deferred Compensation - Employee 1,513.34 1,713.34 - 200.00 -11.7 2054. United Way- Employee Contrib 6,569.67 6,569.67 0.00 0.0% 2056 - Accrued vacation 39,535.65 39,535.65 0.00 0.0% 2605 . Wage Garnishment - employee cunt 393.62 393.62 0.00 0.0% Total Other Current Liabilities 48,012.28 48,212.28 - 200.00 -0.4% Total Current Liabilities 177,852.89 112,343.74 65,509.15 58.3% Long Term Liabilities 2540. Mortgage 342,068.04 359,424.42 - 17,356.38 -4.8% 2570. Line of Credit 49,861.11 0.00 49,861.11 100.0% 2660 - Fidelity Loan 368,635.28 377,182.94 - 8,547.66 -2.3% Total Long Term Liabilities 760,564.43 736,607.36 23,957.07 3.3 0 /6 Total Liabilities 938,417.32 848,951.10 89,466.22 10.5% Page 1 2:47 PM Santa Anita Family Services 01/16/14 Balance Sheet Accrual Basis As of June 30, 2013 Equity 3001 - Unrestricted net assets 3900 Retained Earnings Met Income Total Equity TOTAL LIABILITIES & EQUITY Jun 30, 13 Jun 30, 12 $ Change %Change 737,053.45 737,053.45 0.00 0.0% - 446,282.09 - 382,364.86 - 63,917.23 -16.7% - 179,838.96 - 63,917.23 - 115,921.73 - 181.4% 110,932.40 290,771.36 - 179,838.96 -61.9% 1,049,349.72 1,139,722.46 - 90,372 -7.9% Page 2 ATTACHMENT A — People for People Reserved CITY OF ROSEMEAD 8838 E. Valley Boulevard Rosemead, CA 91770 (626) 569 -2102 ppiaft@cityofrosemead.org NON - PROFIT COMMUNITY SERVICE ORGANIZATION REQUEST FOR FUNDING FISCAL YEAR 2014 -2015 Legal Name of Org S / ls K}.f�(S/�.1j 12J 2 2 C i h t P 4 � W PLD��i'J Tax ID 4: 7U� + / /Q J-1D � DUNS n: /1 �C5 Address: �L 14S Wk11 S D�. c 7_i!� dJ(�A 917 71, Executive Director: Contact Name: / 1/ t y (; /L/C � Telephone: �Li '� 9� ✓ �f4k) p4 Fax: b 6 - 1 �?6__ L/ / V U/ Email: W S .Q V C' Purpose of Organization: r v X41 Enter "X" by the appropriate designation: ) Non - profit organization For - profit organization Enter "X" by all that apply: A faith -based organization An institution of higher education Not Applicable TOTAL UNDUPLICATED ROSEMEAD CLIENTS: (Please Complete Attached Backup – Performance Report) (Est) ROSEMEAD FY 2013 -2014 FINANCIAL SUPPORT: FY 2014 -2015 FINA -NCLAL REQUEST FROM CITY OF R AGENCY TOTAL BUDGET FOR FISCAL YEAR 2014 -2015 FY 12 -13 FY 13 -14 / /Q, Q49 OSEYIEAD: / D8? I. 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: '�S Goals: &'c- A /1.4 (. ff A 1' Objectives: A Programs designed to meet goals and objects: o G� } 7 2. Briefly explain any new prams or services to Rosemead residents during FY 2013 - 2014. Are any planned for FY 2014 -2015? J. How are clients refereed to your agency? 4• List and explain any major changes in funding patterns or expenditures N©IL)& z 5. List major sources of funding and the amount (i.e. cities, county, state federal, fundraising, etc.) 6. what facilities in Rosemead are used to conduct services? ?. The proposed Community Service would be provided to: Mark each that apply V Low and Nfoderate- 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: L ? T 0 Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attaeh additional page if necessary) 10. Has your organization conducted the proposed activity before? Yes V No 11. Describe your organization's experience with CDBG ]2. Do you charge any fees to your clients? If so, what is the fee structure? 3 \ ( \ � v � � Ck. � ( } E2. $ � J / / \ \ { \ a I _ t . � §; f )00 zgE[I 0` ( { �| }\ # I / I � { � ) / \/ o� {\ d )/ \� §) \k �3 97 )( «) 0 (/ \ . / z (( }\ }\ (� )} e \\ 2/ \� §\ \ § )/ /A \( o� «§ 9 � \\ _ )\ \� { \ { \ � , � �� I� Q � � k S z /EJ( \\F[I - \]`0 § >§ . { \ \ \\ \/ }// )} e \\ 2/ \� §\ \ § )/ /A \( o� «§ 9 � \\ _ )\ \� PROGRAM BUDGET Use Whole Dollars Onl Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. Please explain what expenses are included in the "Other" Category. FY 2012 -2013 Current Operating Year FY 2013 -2014 Proposed Budget FY 2014 -2015 CDBG SHARE FY 2014 -15* Expense Salaries 6' '7�3 (5 D ' 6 6 �cso2 Employee Benefits Em to ees Payroll Taxes Profes. & Consultant Fees Supplies 1pb Telephone & Fax ZJ e6 8 , D Da 8,6 — j Postage & Shipping 600 Q D & ©o Occupancy & Utilities 33 Ob Da 3.3 /a Rental & Maint. of E Printing & Publishing I Travel and Transportat Conferences Specific Assist. To Individuals .1 hntpb Membership Dues c, A y1 ,, �t (� k D =26-D. Awards & Grants Insurance Equip Purchased �{ C70 ✓�D1� . �a X071 Misc. Expenses a D® 6, Transfer to Other Funds Dues to National Organizations Over Expenses Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. Please explain what expenses are included in the "Other" Category. PROGRAM REVENUE Use Whole Dollars Only 7 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and /or FY FY 2012 -2013 Y Current Operating Proposed for Public Support Contributions Foundation & Private Grants 3 3 0 D4 f fioo D DQo Fundraising/ special Events Q Q f Q Q Legacies and Bequests Other Federated Org. United Way Misc. Organizations Other Subtotal D D(� ._ � ��� Q Q� Governme Federal _ _ -- Local Subtotal 7 Z Z72,2 Other Revenue Membership Dues Program Services Fees Investment Income Transfer From Other Fun All Other Revenue Subtotal TOTAL REVENLE Q Q� Q 7 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and /or FY I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Signature JVD,'. & if 4N40 Print Nam Title C-c'- poIJPAhlr� t f�0�.C1Jrj Email Address �- 6J4 -,Z 96 Phone Number Organ ation / 4 *�v te DO NOT COMPLETE THIS SECTION — FOR CITY USE ONLY Date Application Received: Date Reviewed by Rosemead Staff: Approved or Declined: Date Notification Letter Sent to Applicant: CITY OF ROSEMEAD PRIVATE OR NON- PROFIT COMMUNITY SERVICE ORGANIZATION REQUEST FOR FUNDING - FISCAL YEAR 2014 -2015 Purpose of Organization: People For People is a non - profit food program. We began operations on March 1, 1984 and since then we have served the unemployed, Cal works mothers and fathers, low- income families, the elderly, homeless families and individuals. We serve the cities of Alhambra, San Gabriel, Rosemead, Temple City, Monterey Park, Arcadia and all the unincorporated county areas within our service boundaries. Our purpose is to help people on a monthly basis providing food, clothing, job opportunities and moral support. 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. A Mission Statement "The organization seeks to promote those forms of interdenominational cooperative effort as will be for mutual benefit of the Christian cause and Christian values in our community including; the assistance of food, clothing, counseling, and referral to educational opportunities for the needy in the communities of the participating churches." B Goals & (C) Objectives The object of our program is to continue to serve qualified people with supplemental food, including counseling on a one to one basis according to their needs. We also provide job search and follow up to clients who need employment. The homeless are given food, hygiene kits, and blankets on a needed basis. We provide home delivery to the elderly and disabled individuals, in the city of Rosemead. CITY OF ROSEMEAD GRANT CONT. 2. Briefly explain any new programs or services to Rosemead residents during FY 2013 -2014. Are any planned for FY 2014 -2015? NONE 3. How are clients referred to your agency? By local churches, The Los Angeles County 211 service, the Los Angeles Regional food bank, word of mouth, local chambers, schools and by other organizations, in our service area and beyond our service area. 5. List major sources of funding and the amount (i.e. cities, county, state, federal, fundraising. Etc.) Churches & Individuals $ 49,000.00 Fundraisers $ 11,200.00 CDBG Grant $ 10,000.00 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 2013 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. 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. ° CERTIFICATE OF LIABILITY INSURANCE I 5/23/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. 11 SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the PRODUCER � ° Belly Grant FICK Church S Casualty �oNE . (800) 995 -7525 f No): (8 - 7 521 3440 Irvine Ave EMAIL ... kellv(dchurchandcasualty. com Beach CA 92660 IINSURERA:Church Mutual Insurance Co INSURED WEST SAN GABRIEL VALLEY CHURCH COUNCIL DBA 1311 E LAS TUNAS SAN GABRIEL bu0 THIS IS TO CERTIFY THAT 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 AEEnon =,+ -• -• •- - -- - -- IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF - - CEDARS'SINAI Laboratory Services 1,000 300 10 1,000 3,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE r OFFICERMIEMBER EXCLUDED? Partners in Patient Care Since 1987 (310)423 - 2200•(80 -2757 RY (Per parson) $ "Y (Per accitlen[) $ "MAUL $ Is DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ABaoh ACORD 101, Additional Remarks Schedule, R more apace is required) Evidence of insurance for Grant issued to West San Gabriel Valley Church Council. Certificate holder is named additional insured only with respect to the activities of the Named Insured. l•la:•r l a iff ll4: [C 11111= a: MdJfN]�Ir.0 U1J GENERAL LIABILITY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE FO OCCUR AUTHORIZED REPRESENTATIVE ROSEMEAD, CA 91770 -1714 /? Belly Grant /BELLY GEN'L AGGREGATE UMIT APPLIES PER: X POLICY 1PRO LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNEI AUTOS UMBRELLA UAB OCCUR EXCESS LIAB CLAIMS-A _ DELI I I RETENTIONS CEDARS'SINAI Laboratory Services 1,000 300 10 1,000 3,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE r OFFICERMIEMBER EXCLUDED? Partners in Patient Care Since 1987 (310)423 - 2200•(80 -2757 RY (Per parson) $ "Y (Per accitlen[) $ "MAUL $ Is DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ABaoh ACORD 101, Additional Remarks Schedule, R more apace is required) Evidence of insurance for Grant issued to West San Gabriel Valley Church Council. Certificate holder is named additional insured only with respect to the activities of the Named Insured. l•la:•r l a iff ll4: [C 11111= a: MdJfN]�Ir.0 U1J ACUHU 25 (201U/05) 0198 8-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).D1 The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ROSEMEAD ACCORDANCE WITH THE POLICY PROVISIONS. 8838 E VALLEY BLVD AUTHORIZED REPRESENTATIVE ROSEMEAD, CA 91770 -1714 /? Belly Grant /BELLY ACUHU 25 (201U/05) 0198 8-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).D1 The ACORD name and logo are registered marks of ACORD ATTACHMENT A — So. California Housing Rights Center Reserved CITY OF ROSEMEAD 8838 E. Valley Boulevard Rosemead, CA 91770 (626) 569 -2102 ppiatt@cityofrosemead.org NON - PROFIT COMMUNITY SERVICE ORGANIZATION REQUEST FOR FUNDING FISCAL YEAR 2014 -2015 Legal Name of Organization: Southern California Housing Rights Center Tax ID #: 95- 2572642 DUNS #: 944936798 Address: 3255 Wilshire Blvd., Suite 1150, Los Angeles CA 90010 Executive Director: Chancela Al- Mansour Contact Name: Chancela Al- Mansour Telephone: (213) 387 -8400 ext. I111 Fax: (213) 381-8555 Email: Purpose of Organization: The Housing Rights Center's purpose is to promote equal opportunity in housing by affirmatively farthering fair housing We do this by offering City of Rosemead residents services from our four key areas: (1) Discrimination Complaint Investigation (2) Fair Housing Legal Services. (3) Landlord/Tenant Fair Housing Counseling and (4) Education and Outreach (See Exhibit 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 ROSEMEAD CLIENTS: FY 12 -13 117 (Please Complete Attached Backup — Performance Report) (Est.) FY 13 -14 120 ROSEMEAD FY 2013 -2014 FINANCIAL SUPPORT: $18,000 FY 2014 -2015 FINANCIAL REQUEST FROM CITY OF ROSEMEAD: $18,000 AGENCY TOTAL BUDGET FOR FISCAL YEAR 2014 -2015: $2.2M 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) HRC will assist a minimum of 120 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 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 objects: 1. 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. HRC also tracks all 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 2013 - 2014. Are any planned for FY 2014 -2015? FY 2013 -14 saw an updated, more user - friendly HRC website including a new fair housing blog feature that is updated monthly with fair housing news and articles. In FY 2014 -2015, HRC will create a series of new fact sheets designed to provide information and resources specific to LA County's most vulnerable populations, including veterans, senior citizens and people at -risk of homelessness. Additionally, HRC will identify agencies within the City of Rosemead and surrounding communities that provide services to those populations, and provide them with copies of the fact sheets. 3. How are clients referred to your agency? City Hall, HRC Website (www.housingrightscenter.org), Phone Listing, Outreach Events, Community Organizations, Public Service Announcements and Press Releases, literature distribution, 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. PA 5. List major sources of finding and the amount (i.e. cities, county, state, federal, fundraising, etc.). YEAR FUNDING SOURCE AMOUNT RECEIVED 13/14 Alhambra $25,000 13/14 Baldwin Park $8,000 13/14 Carson $32,240 13/14 E1 Monte $17,905 13/14 Glendale $15,000 13/14 Glendora $15,000 13/14 HUD FHIP grant $324,980 13/14 Hawthorne $50,800 13/14 Inglewood $57,300 13/14 Lancaster $28,204 13/14 Los Angeles City $660,000 13/14 Los Angeles County $200,000 13/14 Montebello $5,000 13/14 Monterey Park $10,000 13/14 Oxnard $28,992 13/14 Palmdale $27,448 13/14 Pasadena Mediation $15,000 13/14 Pasadena $50,400 13/14 Pico Rivera $15,000 13/14 1 Pomona $30,000 13/14 Redondo Beach $22,800 13/14 Rosemead $18,000 13/14 Simi Valley $24,000 13/14 Ventura City $8,000 13/14 Ventura County $39,421 13/14 West Covina $10,000 13/14 Whittier $10,000 13/14 HUD/HDS $122,834 13/14 Attorney Fees /Registration from Training Seminars, etc. $285,000 6. What facilities in Rosemead are used to conduct services? HRC conducts Fair Housing and Housing Rights Workshops at the Garvey Community Center. 7. The proposed Community Service would be provided to: Mark each that apply • Low and Moderate - income persons or households Abused Children • Handicapped Persons Illiterate Persons Battered Spouses X Homeless Persons Migrant Farm Workers X Elderly Persons 3 8. How many Rosemead citizens do you project will benefit from your program /project: 120 9. Provide a specific example or case study of a client that exemplifies how program objectives were achieved during the past year: (Attach additional page if necessary) 10. Has your organization conducted the proposed activity before? Yes X No 11. Describe your organization's experience with CDBG. The Housing Rights Center has over 30 years of experience working with CDBG grants to provide fair housing services to local cities and counties. These cities and counties conduct annual programmatic and financial reviews. HRC has always received excellent reviews. 12. Do you charge any fees to your clients? If so, what is the fee structure? HRC provides its wide array of programs and services to its clients free of charge. N ( k o) §$ ]§ )� %\ °H j§ \( «� \\ )B H § 2� m? /\ / � \■ §) 3{ \� t� (k \i ) e mA/ \ ) a §j \§ / § ` �\( \- (D - = r r o o = a(t\ m = CO o a §>;\\ \() \- 2) \y e co = \m G/ )2 �A C11 (0 \ _ _ = e o I / _\ 2 A. & a = ® _ = G ) \ \ \ \ * ~ 2 @ ] \ \ \ 2 = § \ § ) ) ) \ 2 \■ §) 3{ \� t� (k 3\ a§ jk /( )z 92 (� �< 25 \\ §4 \/ §) §° Q �o \( \§ Q � §! §j 3{ \\ \/ §§ r-I )\) TFI *±0 \ § a �t \_ f0 r - m § J \- \( ©)(� ^ w , 7 Qb\ \- §2 ; } § a m 2 & k . J) \t§) ® ° \± » co 2m §/ )) rA ) \ OD 00 �) C14 LO ® _ \ ) j ) 0 ® m y e § I a §! §j 3{ \\ \/ §§ r-I PROGRAM BUDGET Use Whole Dollars Only Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. Changes due to reduction of funds from CDBG contract cities and no HUD/HDS contract. Please explain what expenses are included in the "Other" Category. Testing costs; internet; website; subscriptions; equipment lease; public information. 7 FY 2012 -2013 Current Operating Year FY 2013 -2014 Proposed Budget FY 2014 -2015 CDBG SHARE FY 2014 -15* Expense Salaries $1,390,000 $1,427,247 $1,341,800 $13,150 Employee Benefits 156,000 166,610 156 1,450 Employees Payroll Taxes 109,500 122,294 114,900 1,125 Profes. & Consultant Fees 13,500 13,750 15,900 80 Supplies 24,500 22,800 21,000 100 Telephone & Fax 20,000 22,910 24,800 125 Postage & Shipping 12,000 12,100 13,200 50 Occupancy & Utilities 135,000 182,472 177,500 1,100 Rental & Maint. ofEquip. 40,500 48,115 50,250 225 Printing & Publishing - - - - Travel and Transportation 20,000 18,970 8,200 30 Conferences 3,500 11,500 8,700 25 Specific Assist. To Individuals - - - - Membership Dues - - - - Awards & Grants - - - - Insurance 15,000 18,225 19,500 140 Equipment Purchased - - - - ❑ Misc. Expenses 615,500 164,760 160 400 Transfer to Other Funds - - - - Dues to National Organizations - - - - Over Expenses 13,500 13,727 - 49,350 0 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. Changes due to reduction of funds from CDBG contract cities and no HUD/HDS contract. Please explain what expenses are included in the "Other" Category. Testing costs; internet; website; subscriptions; equipment lease; public information. 7 PROGRAM REVENUE Use Whole Dollars Only Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. Changes due to reduction of funds from CDBG contract cities, and no HUD/HDS contract. FY 2012 -2013 Current Operating Year FY 2013 -2014 Proposed for FY 2014 -2015 Public Support Contributions Foundation & Private Grants Fundraising/ special Events $ 18 $ 16 9 000 $ 18 Legacies and Bequests Other Federated Org. United Way Misc. Organizations Other Subtotal $ 18 9 000 $ 16 9 000 $ 18,000 Government Federal State Local $2,125 $1,722,980 $1,720,500 Subtotal $2,125,500 $1 $1 Other Revenue Membership Dues Program Services Fees Investment Income Transfer From Other Fund All Other Revenue $ 425,000 $ 506,500 $ 325 9 000 Subtotal $ 425 9 000 $ 506,500 $ 325,000 TOTAL REVENUE $2 9 568 9 500 $2 $2,063 Please explain Changes Greater than 15% between FY 2012 -13 and FY 2013 -14 and/or FY 2013 -14 and FY 2014 -15. Changes due to reduction of funds from CDBG contract cities, and no HUD/HDS contract. I HAVE BEEN AUTHORIZED TO SUBMIT REQUEST FOR FUNDING Signature Chancela AI- Mansour Print Name Executive Director Title calmansour(a), housingrigh tscenter.ore Email Address (213) 387 -8400 ext. 1111 Phone Number Housing Riehts Center Organization January 21, 201 Date DO NOT COMPLETE THIS SECTION — FOR CITY USE ONLY Date Application Received: Date Reviewed by Rosemead Staff: Approved or Declined: Date Notification Letter Sent to Applicant: m Reserved