2200 - CalWORKs - LA County Department of Community and Family Services Work Experience/Work Study/Community Serviced Combined Agreementv!O-3`b14
Contract No. 14 — WO81
California Work Opportunity and Responsibility to Kids (CalWORKs)
Greater Avenues for Independence (GAIN)
LA County Department of Community and Family Services (DCFS)
Work Experience/Work Study /Community Service Combined Agreement
This Subcontract Agreement is entered into this 1" day of April 2014 between the South Bay
Workforce Investment Board, Inc. on behalf of the City of Inglewood, hereinafter referred to as
INTERMEDIARY CONTRACTOR, and City of Rosemead, hereinafter referred to as
SUBCONTRACTOR.
Recitals:
This contract is a subcontract under the terms of a Prime Contract with the County of Los Angeles,
hereinafter referred to as COUN'fl'. All representations and wa¢anties expressed herein shah inure to the
benefit of the COUNTY. The contract is non - financial.
Non - financial agreements connote that there shall be no cost to the INTERMEDIARY
CONTRACTOR or the COUNTY for services provided by the SUBCONTRACTOR. All representations
and warranties expressed herein shall inure to the benefit of the COUNTY.
In providing activities for the CaIWORKs /GAIN /DCFS Programs hereunder, SUBCONTRACTOR
shall conform to the provisions set forth in this subcontract agreement, including any and all Exhibits
hereto and all current and future CaIWORKs /GAIN /DCFS directives. INTERMEDIARY
CONTRAC "f OR will notify SUBCONTRACTOR of any CaIWORKS /GAIN /DCFS directives in writing
upon receiving said CaIWORKs /GAIN /DCFS directives from the COUNTY. This shall be done in order
to maintain the various programs integrity and avoid any conflict of interest in its administration.
For this agreement, if applicable, Work Experience (WEX) shall be defined as a salaried or non -
salaried work assignment with a public, private for - profit or private non -profit organization that supplies a
given participant with work behavior skills and a reference for future unsubsidized employment or on -the-
job enhancement of existing or recently acquired work skills.
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For this agreement, if applicable, Work Study (WS) shall be defined as an academic program that
enables college students to gain work experience while continuing their studies. The employment is
temporary and the worksite is not expected to retain the participant beyond the work assignment.
For this agreement, if applicable, Community Service (CS) is a non - salaried activity performed by the
eligible participants in the public or private non -profit sector under the close supervision of a community
service provider. Community Service activities are intended to provide participants with necessary job
skills that can lead to full -time unsubsidized employment and self - sufficiency.
L GENERAL PROVISIONS
A. STATEMENT OF WORK
SUBCONTRACTOR agrees to perform the duties and activities contained in the V.brk
Experience/Work Study Statement of Work, which is attached hereto, respectively labeled EXHIBIT 1,
and is incorporated herein by reference, as if set forth in full.
B. TERM OF AGREEMENT
The term of this agreement shall be effective from the date of its execution through February 29,
2016. Both parties shall perform and complete services for those activities covered by this subcontract
until this subcontract expires or is terminated in writing by either party.
C. CHANGES AND AMENDMENTS OF TERMS
This Agreement may be amended upon mutual written consent of both parties.
D. NOTICE
Any notice or notices required pursuant to this subcontract may be personally served on the other
party, or may be served by certified mail, postage prepaid or return receipt request. All notices required to
be given to the INTERMEDIARY CONTRACTOR shall be delivered or mailed to the panics as follows:
Mr. Jan Vogel, Executive Director
South Bay Workforce Investment Board, Inc.
11539 Hawthorne Boulevard, 5th Floor
Hawthorne, CA 90250
310.970.7700
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All notices required to be given to the SUBCONTRACTOR shall be delivered or mailed to the
address below:
Mr. Matthew Hawkesworth, Assistant City Manager
City of Rosemead
8838 E. Valley Blvd.
Rosemead, CA 91770
626 -569 -2107
Either party may designate a new address by giving written notice to the other party.
E. SUBCONTRACTOR CONFIDENTIALITY AGREEMENT
Employees of SUBCONTRACTOR who have access to participant files and/or information must
complete, sign, and adhere to the `SUBCONTRACTOR EMPLOYEE ACKNOWLEDGMENT AND
CONFIDENTIALITY AGRF,EMEN L- attached hereto as EXHIBIT 2, which is incorporated herein by
reference, as if set forth in full Subcontractor will identify specific staff who will have access to
participant files. A copy of this form must be on file prior to a worksite employee commencing any work
under to this agreement.
F. SUBCONTRACTING
No pan of the SUBCONTRACTOR'S service obligations may be further subcontracted to any person
or entity without the express written consent of the INTERMEDIARY CONTRACTOR and the
COUNTY.
G. SUBCONTRACTOR RATING
SUBCONTRACTOR shall complete and return to INTERMEDIARY CONTRACTOR, the Los
Angeles County Department of Public Social Services "Agency Rating System Sheet" attached hereto as
EXHIBIT 3, which is incorporated herein, as if set forth in full. Said rating system sheet will be used by
INTERMEDIARY CONTRACTOR, COUNTY, and participants to evaluate the employment
development services offered by SUBCONTRACTOR under this agreement.
M INSURANCE
SUBCONTRACTOR agrees to maintain in force at all times Comprehensive General Liability
Insurance that willfully protect the SUBCONTRACTOR, INTERMEDIARY CONTRACTOR AND
COUNTY from claims arising out of any act or employer's liability laws. Policies shall stipulate that the
INTERMEDIARY CONTRACTOR, its employees, officers and agents and COUNTY, its Special
Districts, its officials, officers and employees be named as additional insured and that INTERMEDIARY
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CONTRACTOR be given 30 days written notice of any modification or cancellations of insurance by the
carrier. SUBCONTRACTOR, prior to the commencement of a subcontract with INTERMEDIARY
CONTRACTOR, shall deliver to INTERMEDIARY CONTRACTOR a current certificate evidencing the
required insurance coverages, secured through carriers reasonably satisfactory to the INTERMEDIARY
CONTRACTOR. SUBCONTRACTOR shall maintain coverages and limits as follows:
1. General Liability
SUBCONTRACTOR is required to maintain a general liability insurance policy (written on
ISO policy form CG 00 01 or its equivalent) with limits of not less than the following:
General Aggregate: S2 million
Products iCemplcted Operations Aggregate: SI uld ion
Personal and Advertising Injury $1 million
Each Occurrence: $1 million
2. Automobile Liability
If a SUBCONTRACTOR, in conducting activities under this Agreement, uses motor vehicles,
the SUBCONTRACTOR is required to maintain an automobile insurance policy (written on
ISO policy forth CA 00 01 or its equivalent) with a limit of liability of not less than $1 million
for each accident. Such insurance shall include coverage for all "owned ", "hired" and "non -
owned" vehicles, or coverage for "any auto" Should SUBCONTRACTOR and its employees
not use any motor vehicles to provide the services required under this agreement,
SUBCONTRACTOR shall famish to INTERMEDIARY CONTRACTOR, on
SUBCONTRACTOR's letterhead, a letter stating "Company owned or operated vehicles will
not be used to perform any of the services contemplated by the agreement between
SUBCONTRACTOR and the South Bay Workforce Investment Board, Inc."
3. Workers Compensation and Employers' Liability
SUBCONTRACTOR is required to maintain and provide evidence of insurance providing
workers compensation benefits for subcontractor's employees, as required by the Labor Code
of the State of California or by any other state, and for which sub - contractor is responsible.
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Such insurance also shall include Employers' Liability coverage with limits of not less than the
following:
Each Accident: $lmillion
Disease - policy limit: $1 million
Disease - each employee: $1 million
SUBCONTRACTOR shall not be responsible to provide workers compensation benefits for
participants under this subcontract agreement. The parties hereto further agree and recognize that the
participants assigned to Subcontractor's worksites are not employees of SUBCONTACLOR and are not
entitled to any benefits to which SUBCONTRACTOR's employees are entitled, including, but not limited
to, unemployment insurance, state disability, or health insurance.
1. PUBLIC ENTITY EVIDENCE OF INSURANCE
Subject to review and approval by INTERMEDIARY CONTRACTOR'S counsel, INTERMEDIARY
CONTRACTOR will accept from public entity subcontractors evidence of an on -going self- insurance
program as an equivalent for such coverage as described above in Section H, parts 1, 2, and 3. (General
Liability and Automobile Coverage Limits).
J. RELIGIOUS ACTIVITIES PROHIBITED
SUBCONTRACTOR agrees that no participant shall be asked or required to participate in the
promotion of religious activities. Furthermore, SUBCONTRACTOR agrees that it will not perform, nor
permit to be performed, any religious activities in connection with the performance of this subcontract
agreement.
K. POLITICAL ACTIVITIES PROHIBITED
No participant shall be asked or required to participate in any political activity of any kind. Participants
shall not be asked or required to participate in any manner in any partisan political activity, or activity for
or against the election of candidates for office.
L. REPORTING WELFARE FRAUD, ELDER ABUSE AND CHILD ABUSE
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SUBCONTRACTOR shall report all suspected or actual welfare fraud, elder abuse and child abuse
discovered by SUBCONTRACTOR. Welfare fraud is specified in the State Operations Manual, Section
20000, elder abuse is specified in DPSS Administrative Directive 2898, and child abuse is specified in
Penal Code 11166 and 11167. Reports shall be made by telephone call as required by the referenced
regulations and followed up in writing to the GAIN Services Worker (GSW) or DCFS Counterpart
within three (3) workdays after discovery.
11. COMPLIANCE WITH THE LAW
A. CIVIL RIGHTS
SUBCONTRACTOR shall ensure that services and benefits are provided without regard to race,
color, religion, sex, age or national origin, political affiliation, marital status or disability in accordance
with Title Vt of the Civil Rights Act of 1964, and California Government Code, Section 11135.
SUBCONTRACTOR shall comply with Section 504 of the Rehabilitation Act of 1973, as amended,
pertaining to the prohibition of discrimination against qualified disabled persons under any program or
activity which receives or benefits from Federal or State financial assistance. SUBCONTRACTOR shall
comply with provisions of Titles VI and VII of the Federal Civil Rights Act of 1964 as amended;
Executive Order 11246, as amended; the Age Discrimination in Employment Act of 1973, as amended;
Title IX of the Education Amendments Act of 1972; the Food Stamp Act of 1977, as amended; the
Welfare and Institutions Code Section 1000; DPSS Operations Handbook Section 21; the Americans with
Disabilities Act (ADA) of 1990; and other applicable nondiscrimination laws.
The SUBCONTRACTOR is required to complete and return the "Certificate of Non- Discrimination,"
attached hereto as EXHIBIT 4, which is incorporated herein by reference, as if set forth in full.
Additionally, SUBCONTRACTOR staff working with CalWORKs/GAIN/DCFS participants must
undergo Civil Rights and Cultural Awareness Training provided by DPSS at a mutually agreeable date.
INTERMEDIARY CONTRACTOR shall provide SUBCONTRACTOR with a supply of PA 607 - forms
for participants' use should they wish to file a Civil Rights complaint. A copy of said PA -607 form is
attached hereto as EXHIBIT 5, and is incorporated herein by reference, as if set forth in fill.
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INTERMEDIARY CONTRACTOR is required to conduct an investigation of civil rights complaints
received from GAIN /DCFS participants against SUBCONTRACTOR. SUBCONTRACTOR agrees that
its staff shall be available at times agreeable to both parties to consult with INTERMEDIARY
CONTRACTOR's staff as needed.
R. DISPLACEMENT GRIEVANCE
SUBCONTRACTOR shall ensure that labor unions and non -union employees are notified that
GAIN/DCFS participants are working or otherwise participating at specified work locations and that
employees have the right to grieve displacement by such participants. Regulations establish a three -fold
grievance process for regular employees who believe they have been displaced by GAIN /DCFS
participants. Employees must be notified of the following:
1. GAIN /DCFS participants have been included in the workforce at their location.
2. State law prohibits employers from using GAIN /DCFS participants in a way that will cause
employees to lose theirjob, or have their hours reduced
3. Employers may not place GAIN/DCFS participants in jobs that would be promotional
opportunities for employees.
4. Employers may not violate any personnel rules when including a GAIN /DCFS participant in the
workforce.
Grievance procedures for both the Work Experience and Work Study programs are available through
the South Bay Workforce Investment Board , 11539 Hawthorne Blvd., 5t' Floor, Hawthorne, CA 90250.
All complaints against an employer must be in writing and contain the following information:
I. The full name, address and telephone number of the employee.
2. The full name and address of the employer.
3. A clear and brief statement of the facts, including dates, which have led to the complaint.
4. A statement that this complaint has been filed under penalty of perjury.
5. The complaint must be sent to City of South Bay Workforce Investment Board- (at above listed
address).
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SUBCONTRACTOR agrees that its staff shall be available at times agreeable to both parties to
consult with INTERMEDIARY CONTRACTOR'S staff as needed on matters related to this section.
C. DRUG FREE WORKPLACE COMPLIANCE
SUBCONTRACTOR shall comply with Government Code Section 8355, in matters related to
providing a drug -free workplace as follows:
L Publish a statement notifying employees /participants that unlawful manufacture, distribution,
dispensation, possession, or use of a controlled substance is prohibited and specifying actions to
be taken against employees /participants for violations, as required by Government Code Section
8355(a).
2. Establish a Drug -Free Awareness Program as required by Government Code Section 8355 (b), to
inform employees /participants about all of the following:
a. The dangers of drug abuse in the workplace,
b. SUBCONTRACTOR'S policy of maintaining a drug -free workplace,
c. Any available counseling, rehabilitation and employee/participant programs,
d. Penalties that may be imposed upon employees /participants for drug abuse violations.
D. NON - DISCRIMINATION
SUBCONTRACTOR shall ensure that no portion of its programs shall in any way
discriminate against, deny benefits to, deny employment to, or exclude from participation any
person on the grounds of race, color, national origin, religion, sex, condition of disability,
political affiliation or belief. Subcontractor further agrees not to employ legally - prohibited
discriminatory practices of any kind and to take positive measures to assure that equal
employment opportunities, including employment, training, and promotion in all job
classifications are made available without regard to race, color, religion, sex, age, national origin,
physical or condition of disability, marital status, political affiliation or belief as required by
Federal and State Laws and regulations.
E. COMPLIANCE WITH OTHER LAWS
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SUBCONTRACTOR agrees to comply with all applicable Federal, State, and local laws, rules,
regulations and ordinances, and all provisions required thereby to be included herein, and are hereby
incorporated by this reference. These shall include, but are not be limited to:
1. California Welfare and Institutions Code
2. State Department of Social Services Manual of Policies and Procedures
3. Social Security Act
4. Title 24, California Administrative Code - Energy Plan
5. Occupational Safety Act of 1970, as amended.
6. Family Economic and Security Act
American Recovery and imesuncnt Act
8. Fair Labor Standards Act
9. Applicable Child Labor Laws
10. California Education Code
11. Workforce Investment Act
SUBCONTRACTOR acknowledges that Los Angeles County has established a goal of ensuring that
all individuals and businesses that benefit financially from the County through contracts are current in
paying their property tax obligations (secured and unsecured roll) in order to mitigate the economic
burden otherwise imposed upon the County and its taxpayers.
SUBCONTRACTOR warrants and certify that to the best of its knowledge that it is now in
compliance, and during the term of this Contract will maintain compliance, with Los Angeles County
Code Chapter 2.206, unless Contractor qualifies for an exemption or exclusion.
F. HOLD HARMLESS
SUBCONTRACTOR shall release, indemnify, defend, and hold harmless INTERMEDIARY
CONTRACTOR, the COUNTY and its agents, officers and employees from and against any and all loss,
damage or expense arising out of or relating to, or by reason of any act or omission in performance of this
subcontract by SUBCONTRACTOR or any of SUBCONTRACTOR'S officers and employees.
Conversely, INTERMEDIARY CONTRACTOR, shall release, indemnify, defend, and hold harmless
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SUBCONTRACTOR, and its agents, officers and employees from and against any and all loss, damage
or expense arising out of or relating to, or by reason of any act or omission in performance of this
subcontract by INTERMEDIARY CONTRACTOR, or any of INTERMEDIARY CONTRACTOR'S
officers, employees or participants.
III. RECORDS
A. CONFIDENTIALITY OF RECORDS
SUBCONTRACTOR agrees to comply and require employees to comply with the provisions of
Section 10850 of the California Welfare and Institutions Code and Chapter 19 -000 of the SDSS Manual
of Policies and Procedures, Federal, State, and local laws, regulations, ordinances, and directives relating
to confidcntiabq. SUBCONTRACT OR shall comply with the following provisions in matters relating to
confidentiality:
1. All applications and records coneeming an individual made or kept by any public officer or
agency in connection with the administration of any provision of the Welfare and Institutions
Code relating to any form of public social services for which grants -in -aid are received by this
State from the Federal Government will be confidential and will not be open to examination for
any purpose not directly connected with administration of such public social services.
2. No person will publish or disclose, or use or permit, or cause to be published, disclosed or used,
any confidential information pertaining to an applicant or recipient. SUBCONTRACTOR agrees
to inform its employees, agents, subcontractors and partners that any person who knowingly and
intentionally violates the provisions of Stale law is guilty of a misdemeanor.
3. SUBCONTRACTOR agrees that all information and records obtained in the course of providing
services to project participants shall be subject to confidentiality and disclosure provisions of
applicable Federal and State statutes and regulations adopted pursuant thereto and no such
information may be relayed to anyone except those employees of the Los Angeles County
Department of Public Social Services (DPSS) and Department of Children and Family Services
(DCFS) so designated, GAIN/DCFS contractors, as approved by the County, and organizations
approved and designated by DPSS/DCFS.
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B. RECORDS RETENTION
SUBCONTRACTOR agrees to maintain all records pertaining to participant attendance for five years
following the term of the subcontract agreement or until all pending Federal, State, COUNTY or
INTERMEDIARY CONTRACTOR audits are completed, whichever is later. Upon request, the
SUBCONTRACTOR shall make these records available to all authorized Federal, State, (including the
Auditor General), COUNTY and INTERMEDIARY CONTRACTOR personnel. Such records shall be
kept in the County of Los Angeles, State of California and be accessible to authorized Federal, State,
COUNTY representatives, and representatives of INTERMEDIARY CONTRACTOR for the retention
period spccificd herein.
IV. TERMINATION OF AGREEMENT
A. TERMINATION WITHOUT CAUSE
Either parry may, at any time during the term of this agreement hereof, terminate it without cause by
giving thirty (30) days written notice to the other party.
I. Should INTERMEDIARY CONTRACTOR give notice of termination, upon receipt,
SUBCONTRACTOR shall immediately cease all work under this Subcontract, unless the notice
otherwise expressly provides. In the event this Subcontract is terminated by SUBCONTRACTOR, it
shall be deemed released from any liability for any work assigned but not completed as of the
effective date of such termination.
2. Should SUBCONTRACTOR terminate this agreement, SUBCONTRACTOR shall defend, indemnify
and hold INTERMEDIARY CONTRACTOR, its employees, officers and agents harmless from any
and all claims of liability or damage against INTERMEDIARY CONTRACTOR resulting from such
termination.
B. TERMINATION WITH CAUSE
INTERMEDIARY CONTRACTOR may immediately terminate this Agreement upon written
notification to SUBCONTRACTOR without complying with Subsection A above for any of the following
reasons:
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I. If INTERMEDIARY CONTRACTOR determines that there is an immediate danger of injury to
participant(s) or increased potential liability to INTERMEDIARY CONTRACTOR.
2. Violation by SUBCONTRACTOR of any term of this Subcontract.
3. Failure by SUBCONTRACTOR to accept and/or implement any additional conditions that may
be required by law.
V. REQUIRED FORMS
When necessary, SUBCONTRACTOR shall complete the forms listed on EXHIBIT 6. Such fortes
shall be completed according to the conditions described in the Scope of Work, or as directed by
INTERMEDIARY CONTRACTOR or the COUNTY. These forms shall be provided by either the
INTERMEDIARY CONTRACTOR or a COUNTY Gain Service Worker /DCFS Case Worker when
needed to ensure program integrity.
VI. CONTRACT OBLIGATION
The signatories hereto assure that in providing activities for the CaIWORKs /Greater Avenues for
Independence (GAIN) /Department of Children and Family Service (DCFS), Work Experience, Work
Study and /or Community Service programs, they will comply with the terms set forth in this subcontract
agreement including all Exhibits thereto, which collectively constitute the entire agreement.
VII - ENTIRE AGREEMENT
This agreement, including all Exhibits referenced, constitutes the entire agreement of the parties
and supersedes any previous oral negotiations or written expressions of intent between the parties.
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IN WITNESS WHEREOF, the parties herein have executed this Agreement as of the date first above
written.
CITY OF ROSEMEAD
print)
Jan Vogel, CEO
M
SUBCONTRACTOR
SOUTH BAY WORKFORCE INVESTMENT BOARD, Inc.
APPROVED AS TO FORM:
Qjx�� J
Jack Ball4s, Attorney at
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EXHIBIT 1
WORK EXPERIENCE //WORK STUDY /Community Service
STATEMENT OF WORK
General Description of Work Experience
Work Experience (WEX) is a GAIN /DCFS work activity in which participants receive salaried or
non - salaried work assignments with public, private for -profit or private non - profit organizations.
The goal of WEX is to prepare participants for permanent unsubsidized employment and self -
sufficiency.
A WEX assignment should provide work behavior skills, acquisition of new skills, enhancement
of existing or recently acquired skills and employment references to use when seeking salaried
employment. A successful WEX work assignment will result in helping a participant transition to
salaried employment.
Participation in WEX is limited to a period no longer than twelve (12) months, but may be limited
to shorter durations depending upon program goals and funding considerations.
General Description of Work Study
Work Study is a GAIN work assignment that provides part-time paid internships to CalWorks
participants enrolled in Community Colleges to help offset college expenses at Public Agencies,
assisting them in meeting their work requirements under Temporary Assistance for Needy
Families Reauthorization (TANF) legislation. CalWorks participants earn $9.00 per hour working
at subcontracted agencies on or off campus for a period of time to be determined by the
college /County. Community Colleges will fund a portion of the hourly wage with the County to
fund the remaining percentage and employer taxes. Wages paid to participants will be paid by
the Intermediary Contractor as Employer of Record. Worksites may be with public, private for-
profit or private non - profit organizations.
General Description of Community Service
Community Service is a non - salaried work activity performed eligible CaIWORKs participants in
the public or private non - profit sector. While fulfilling an unmet community need, they are
intended to provide participants with jobs skills training that may lead to full -time unsubsidized
employment and self - sufficiency.
General Provisions
A. SUBCONTRACTOR shall ensure that a WEX/WS /CS position will not be created as the
result of, or may not result in:
The displacement of current employees, including overtime currently worked by
these employees.
2. The filling of established unfilled positions, unless the positions are unfunded in a
public agency budget.
3. The filling of positions which would otherwise be promotional opportunities for
current employees.
4. The filling of positions, prior to compliance with applicable personnel procedures
or provisions of collective bargaining agreements.
5. The filling of a position created by termination, layoff, or reduction in workforce.
6. The filling of a work assignment customarily performed by a worker in a job
classification within a recognized collective bargaining unit in that specific work
site, or the filling of a work assignment in any bargaining unit in which funded
positions are vacant or in which regular employees are on layoffs.
B. SUBCONTRACTOR shall assist and encourage qualified WEX/WS /CS participants to
compete for job openings within the SUBCONTRACTOR'S organization.
C. Public agency SUBCONTRACTORS shall ensure to the extent permitted under federal
or state law, local ordinances, applicable bargaining agreements or personnel
procedures, that time worked in the WEX/WS /CS position will apply toward the
participant's seniority, if applicable in merit system employment positions.
D. Public agency SUBCONTRACTORS, to the extent possible, shall allow GAIN /DCFS
WEX/WS /CS participants to participate in:
Classified service examinations equivalent to the WEX/WS /CS position.
All open and promotional examinations for which experience in the position or
other relevant experience would qualify the person to the extent permitted under
federal or state law, local ordinances, applicable collective bargaining
agreements, or personnel procedures.
E. Upon request SUBCONTRACTOR shall provide WEX/WS /CS assignments within the
GAIN Priority Occupations, or the Los Angeles County growth occupations.
F. SUBCONTRACTOR shall comply with a six month review requirement, if appropriate,
consisting of a discussion with the GAIN Services Manager, participant's supervisor and
participant regarding the assignment, the participant's progress in the assignment and
job search activities.
G. The California Department of Social Services (COSS) contracts with the State
Compensation Insurance Fund (SCIF) to administer the workers' compensation benefits
to GAIN participants assigned to non - salaried WEX/WS /CS activities.
H. Subcontractor shall provide a safe and healthy work environment with the same job
safety and working conditions as provided to regular employees.
I. Subcontractor shall supervise all participants at the Worksite at all times and require
participant conformance with Subcontractor's standard of conduct for agency personnel.
Participants are not to be considered a part of the Subcontractor's personnel.
Subcontractor shall provide an orientation to each participant prior to beginning work
-'-
which includes worksite rules /conduct, procedures, participant responsibilities and
reporting requirements.
J. During the training period, Subcontractor shall expose participants to all customary and
normal requirements of the job. Worksite shall provide enhanced training for
participants, whenever necessary, to enable participants to master the job.
K. Subcontractor shall provide facilities which are adequate to fulfill the requirements of this
Agreement.
L. Subcontractor shall Prepare and submit a bi- weekly evaluation and discuss the
evaluation with participants.
M. Subcontractor shall notify Intermediary Contractor immediately of any changes in
designation of personnel who will be supervising participants. This includes temporary
designations of more than 2 days duration. Additionally Subcontractor shall designate a
qualified alternate supervisor who has received a Work Experience Program Supervisor
Orientation to supervise the participants) if the regular supervisor is absent. The
Worksite must advise Intermediary Contractor if a new supervisor is assigned to the
participants.
N. Subcontractor shall allow release time for counseling, educational training, unsubsidized
job interviews and other related activities only with written authorization from
Intermediary Contractor or County Representative.
O. Subcontractor shall adhere to policies and rules as discussed in the Supervisor
Handbook. The Supervisor Handbook will be provided to Subcontractor upon execution
of this agreement.
P. Subcontractor shall fully cooperate with authorized representatives of the Intermediary
Contractor, County, State and Federal governments including independent auditors. In
particular, cooperation is required with respect to those representatives seeking to
interview any program participant or staff member of the Subcontractor, as well those
representatives who evaluate, inspect and /or monitor facilities and operations of the
Subcontractor that are directly involved in the implementation of programs funded
through this Agreement, including program records.
Q. Subcontractor shall provide an orientation to participants that explains the program's
purpose, applicable procedures, and the right to file a grievance in accordance with
County regulations.
R. Should Subcontractor employ a participant as staff, then said participant shall cease to
be a participant in the WEX/WS /CS programs.
S. Subcontractor shall provide Worksite supervisors with appropriate written materials
describing the tasks necessary for the performance of his /her duties, including a copy of
this Agreement and WEX/WS /CS regulations and policies.
T. Subcontractor shall assist the Worksite supervisor in resolving any problems concerning
the participant's performance on the job.
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U. In the event of injury or death of a GAIN participant in a WEX /WS /CS assignment,
the SUBCONTRACTOR shall immediately contact: South Bay Workforce Investment
board — GAIN Unit, at (310) 970 -7796 within 24 hours of occurrence or knowledge of
occurrence.
SUBCONTRACTOR shall also:
• Provide the injured participant with State Compensation Insurance Form (SCIF)
3301.
• Complete SCIF Form 3367.
• Obtain completed SCIF Form 3301 from participant and submit Forms 3301 and to,
GAIN Intermediary Contractor, SBWIB /City of Inglewood, 11539 Hawthorne Blvd.,
5th Floor, Hawthorne, CA. 90250.
In the event of extreme injury or death of a GAIN participant immediately contact
Tracey Atkins, Program Manager
South Bay Workforce Investment Board
11539 Hawthorne Blvd., Ste. 500
Hawthorne, CA 90250
(310) 970 -7796
and
Lorraine Sinelkoff, CaIWORKs /GAIN/ Program Division
Los Angeles County Department of Public Social Services
12860 Crossroads Parkway South
City of Industry, CA 91746
(562) 908 -5863
In the event of extreme injury or death of a DCFS participant immediately contact:
Tracey Atkins, Program Manager
South Bay Workforce Investment Board
11539 Hawthorne Blvd., Ste. 500
Hawthorne, CA 90250
(310) 970 -7796
and
Harvey Kawasaki, Division Chief
Los Angeles Department of Children and Family Services
3530 Wilshire Blvd., Ste. 400
Los Angeles, CA 90010
(213) 351.0102
During the assigned work period, the SUBCONTRACTOR shall provide each participant
with
-a-
Instruction as well as reasonable and proper supervision regarding duties /work
activities.
2. Safety instructions and equipment necessary for protection against injury and
damage, in accordance with OSHA guidelines.
The same working conditions as employees similarly employed, e.g., coffee
breaks, lunch breaks.
Special Provisions
A. INTERMEDIARY CONTRACTOR has contracted with the COUNTY to serve as
Employer of Record for the Transitional Subsidized Employment project.
SUBCONTRACTOR agrees to provide services specifically related to the Transitional
Subsidized Employment program, including but not limited to the following:
I . Maintain participant Time Sheets and forward them to INTERMEDIARY
CONTRACTOR or other agent on a bi weekly basis.
2. If necessary, Distribute paychecks delivered by INTERMEDIARY
CONTRACTOR to participants participating in the Transitional Subsidized
Employment program.
3. Maintain a signature log recording the distribution of paychecks to participants.
4. Immediately inform referral agency, INTERMEDIARY CONTRACTOR and the
participant's GAIN Service Worker /DCFC Case Worker should the participant
ceases to attend, requires corrective measure, withdraws from, or is terminated
from his /her assignment.
Tracking and Reporting
INTERMEDIARY CONTRACTOR, the COUNTY or authorized referral agent shall supply all
necessary CaIWORKs /GAIN /DCFS forms.
SUBCONTRACTOR shall comply with WEX/WS /CS tracking and reporting requirements and
instructions for completing forms referenced in EXHIBIT 6 hereto.
A. SUBCONTRACTOR shall schedule a WEX/WS /CS enrollment appointment for
GAIN /DCFS participants by telephone when contacted by an authorized referral
agent/GSW. GAIN Participants (only) will be referred by the GSW on Service Provider
Referral Form GN 6006. The referral form will contain the name and telephone number
of the GSW.
B. SUBCONTRACTOR shall complete as appropriate (entering the planned completion
date) the ON 6006 referral form and mail the original completed, signed and dated to the
GSW within eight (8) workdays after the receipt of same.
- 5 -
C. If requested, SUBCONTRACTOR shall mail a copy of the GN 6006 to the
INERMEDIARYY CONTRACTOR, South Bay Workforce Investment Board - GAIN,
11539 Hawthorne Blvd., 5th FI., Hawthorne, CA 90250.
D. Upon enrollment in a WEX/WS /CS assignment, SUBCONTRACTOR shall complete a
Job Specification Sheet. A copy of this Job Specification Sheet shall be mailed to the
GSW attached to the GN 6006, a copy shall be given to the participant, and a copy shall
be retained in the file.
E. SUBCONTRACTOR shall reschedule the enrollment date when requested to do so by the
GAIN participant, GSW or authorized referral agent. If an enrollment date is
rescheduled, confirmation of the new enrollment will be made by a telephone call to the
authorized referral agent/GSW within one (1) workday. SUBCONTRACTOR shall refer
back to the authorized referral agent/GSW any participant who contacts the
SUBCONTRACTOR after SUBCONTRACTOR has reported the participant's failure to
keep the appointment.
F. SUBCONTRACTOR shall notify the authorized referral agent /GSW within five (5)
workdays of any change in circumstances that will affect program participation on the
Notification of Change from Service Provider (GN 6007B for GAIN Participants only),
including, but not limited to the following:
1. Prior to the scheduled start date and time, the participant called and re-
scheduled the appointment.
2. The participant did not keep the scheduled appointment to enroll in or to start the
WEX/WS /CS assignment;
1 The WEXNVS /CS assignment is completed.
4. The participant obtains employment; during or immediately after the
WEX/WS /CS assignment.
5. The participant refuses employment.
6. The participant fails to attend or to satisfactorily progress in his /her WEXNVS /CS
assignment.
7. The participant needs a change in supportive services.
8. Any other change relevant to CalWDRKS, GAIN and /or DCFS case.
G. If SUBCONTRACTOR determines that the given WEX/WS /CS work/training assignment
is inappropriate for a participant, SUBCONTRACTOR's recommendation for change in
assignment must be made within thirty (30) workdays from the program start date.
Recommendations for change must be made via the GN 6007B form (GAIN Participant
only.)
H. SUBCONTRACTOR shall cancel or stop WEX/WS /CS as requested by County on
Service Provider Cancellation /Stop Notice (GN 6011).
M
Each and every quarterly period, or at the midpoint, if the training program is less than
three months, SUBCONTRACTOR is required to complete a Progress /Attendance
Report (GN6070) provided by the GAIN participant. The completed GN6070 shall be
returned to the GSW by either the participant or SUBCONTRACTOR.
_7_
EXHIBIT 2
SUBCONTRACTOR EMPLOYEE
ACKNOWLEDGMENT AND CONFIDENTIALITY AGREEMENT
GENERAL INFORMATION:
Your Community Service (CS)/Work Experience (WEX) Work Study (WS) provider,
, has entered into an agreement with the City of Inglewood /South Bay Workforce Investment Board
(hereinafter referred to as the "Intermediary Contractor ") to provide various services to the Intermediary Contractor and the County of
Los Angeles. As a result, your signature is required on this Subcontractor Employee Acknowledgment and Confidentiality Agreement.
PARTICIPANT ACKNOWLEDGMENT
I understand that
is my sole CS/WEX/WS /CS provider for purposes of this training.
I rely exclusively upon GAIN /C IWORKs /DCFS and Intermediary Contractor for payment of salary and any and all other
benefits payable to me or on my behalf during the period of this CS /WEX/WS /CS training.
I understand and agree that I am not an employee of the CS /WEX /VVS /CS provider, INTERMEDIARY CONTRACTOR or of Los
Angeles County for any purposes other than the CS/WEX/WS /CS program and that I do not have and will not acquire any rights or
benefits of any kind from the CS/WEX/WS /CS provider , INTERMEDIARY CONTRACTOR or the County of Los Angeles during the
period of this CS/VVEXAVS /CS training.
I understand and agree that I do not have nor will I acquire any rights or benefits pursuant to any agreement between my
CSNVEXANS /CS training provider, and the INTERMEDIARY CONTRACTOR or the County of Los Angeles.
CONFIDENTIALITY AGREEMENT
As a CS/WEX/WS /CS participant of you may be involved with work pertaining to County Services and if
so, you may have access to confidential data pertaining to persons and or other entities who receive services from the County of Los
Angeles. The County of Los Angeles and all of its contractors and subcontractors have a legal obligation to protect all confidential data,
especially data concerning welfare recipient records. Since you may be involved with work with welfare recipients, the County must
ensure that you, too, will protect the confidentiality of data. You must sign this confidentiality agreement as a condition of your work
assignment to be provided to for the County of Los Angeles and /or the Intermediary Contractor.
Please read the Contractor /Subcontractor Participant Acknowledgment and Confidentiality Agreement carefully and take your time to
consider it before signing.
I hereby agree that I will not divulge to any unauthorized personal data obtained while assigned at this work site pursuant to the
agreement between and the INTERMEDIARY CONTRACTOR or the County of Los Angeles.
I agree to report any and all violations of the above by any other person and /or by myself to any immediate supervisor and I agree to
ensure that said supervisor reports such violation to the County of Los Angeles Department of Public Social Services. I agree to return
all confidential materials to my immediate supervisor upon termination of my CS/WEX training with or
completion of the presently assigned work tasks, whichever occurs first.
I acknowledge that violation of this acknowledgment and agreement may subject me to civil and /or criminal action and that the County
of Los Angeles will seek all possible legal redress.
CS/WEX/WSICS PARTICIPANT:
Signature Date
Print -Name
EXHIBIT 3
DEPARTMENT OF PUBLIC SOCIAL SERVICES
Welfare -to -Work Division
AGENCY RATING SYSTEM
City of Rosemead
Agency Name
SERVICES OFFERED BY YOUR AGENCY
NO
Job Placements within the organization that are permanent positions.
EYES
X
On -Site classroom education 8 training to supplement working hours.
X
Guidance and Counseling with direct supervision.
Develops individualized leaming plan with the participant.
Site is easily accessible by Public Transportation.
X
Assist with Job Search placements.
X
Intermediate Hard Skills Training (e.g., Data Processing)
X
Advance Hard Skills Training (e.g., Pharmacy Tech, Computer Programmer)
X
Mentonng.
X
Training for a JoWOccupation with a Prevailing Wage of'.
$8 -$8.99
X
$9 -$9.99
X
$10 and above wlspecialized training (specify)
X
Open Saturdays I Sundays.
X
Work with participants in languages other than English.
X
EXHIBIT 4
CERTIFICATION OF NON- DISCRIMINATION
City of Rosemead
Subcontractor's Name
8838E Valley Blvd. Rosemead CA 91770
Address
95- 2079994
Internal Revenue Service Employer Identification Number
GENERAL
In accordance vAth Subchapter VI and VII of the Civil Rights Act of 1964, Section 504 of the
Rehabilitation Act of 1973, as amended, the Age Discrimination Act of 1975, the Food Stamp
Act of 1977, and the Americans with Disabilities Act of 1990, the Contractor, supplier, or
proposer certifies and agrees that all persons serviced by such fine, its affiliates, subsidiaries, or
holding companies are and will be treated equally by the firm without regard to or because of
race, color, religion, ancestry, national origin, age, condition of disability, marital status, political
affiliation or sex and in compliance with all anti - discrimination laws of the United States of
America and the State of California.
SUBCONTRACTOR'S CERTIFICATION
(circle one)
1. The Subcontractor has a written policy statement prohibiting
Yes No
discrimination in providing services and benefits.
2. The Subcontractor periodically monitors the equal provision of
( Yes — No
services to ensure nondiscrimination.
3. Where problem areas are identified in equal provisions of services
as No
and benefits, the Subcontractor has a system for taking reasonable
corrective action within a specified length of time.
MriNyf I�a.i x`Sti A`ls� Ci.\4
Name and Title of Signatory ' (please print
tA,)"v -+,ti --" q -q -j`
Signafure I Date
EXHIBIT 6
GAIN REQUIRED FORMS FOR WEX/WS /CS SUBCONTRACTORS
Sample forms included in this section are to be completed or processed by SUBCONTRACTOR
according to the terms and conditions hereinabove set forth or as directed by INTERMEDIARY
CONTRACTOR or the COUNTY. The forms will be provided by either the INTERMEDIARY
CONTRACTOR, authorized referral agenct, or the COUNTY GAIN service worker.
Forms to be completed or processed by SUBCONTRACTOR include but are not limited to
1. GN 6006 - Service Provider Referral
2. GN 6007B- Notification of Change From Service Provider
3, GN 6070 - Progress /Attendance Report
4, WEX /CS Job Specification Sheet
5. GN 6011, Service Provider Cancellation /Stop Notice
6. State of California Insurance Forms -SCIF 3367 and SCIF 3301
7. Worksite Information Sheet
8. Youth Report to Work Form
CALIFORNIA
J P I A
April 10, 2014
Teresa Akins
South Bay Workforce Investment Board, Inc
11539 Hawthorne Blvd. Suite 500
Hawthorne, CA 90250
Member Name: City of Rosemead
Additional Protected Party: City of Inglewood SBWIB Inc its Employees Officers and Agents
and the County of Los Angeles its Special Districts its Officials t
Officers and FmplOyees
Activit, '. salaried or non - salaried work assignment with a public, private
for - profit or private non -profit organization.
Coverage Period: From 12:01 AM on 4/1/2014 to 11:59 PM on 6/30/2015
This Evidence of Coverage is issued on an annual basis and will be automatically reissued every June until expiration
of the written contract.
The City of Rosemead (Member) along with other California public agencies, is a member of the California Joint
Powers Insurance Authority (California JPIA), and participates in the following self- insurance and commercial
insurance program that is administered by the California JPIA for its members:
Legal Liability Program, Including Automobile Liability
Coverage Limit: $1,000,000 per occurrence
Annual Aggregate Limit: $2,000,000
On behalf of the Member, the California JPIA agrees to include the above -named additional Protected Party as a
Protected Party under the Memorandum of Liability Coverage for the liability protection program, subject to the
above- stated limits, but only for "Occurrences" arising out of the described activity, during the described Coverage
Period, and where required under the terms of a written agreement between the Member and the additional Protected
Party, The Cnlifomia JPIA will endeavor to provide at least thirty (30) days notice of any change in the foregoing
information. If the written agreement requires, coverage shall be primary.
Coverage is subject to all the terms, Definitions, Exclusions, Conditions and Responsibilities of the Memorandum of
Liability Coverage and the Limits of Coverage staled above.
Sincerely,
r i -
Jim Thyden
Insurance Programs Manager
cc'. Su Tan
CALIFORNIA JOINT BOWERS INSURANCE AUTHORITY
8081 MOODY SJRH F, LA VALb9A, CA 90623 'IF[ 0(,2)46787I)0 PAX (562) A6n -4992
_ .... MAYOR;_ .
WILLFM ALARCON
Cit Y/ of 9 Sqa 1 ea
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MAYORPROTEM:
Mexmu.Er CL.�mc
8838 E. VALLEY BOULEVARD P,o BOX 399
ROSEMEAD, CALIFORNIA 917]0
COUNCIL MRMBLRS:
cov,;
I LEPPONE(626)569 -2100
AUwOrA
POLLY 11w
Automobile Insurance Waiver
Participants of W, Vvorks are not authorized to ride, operate or drive a City owned
vehicle or any personal vehicle to conduct any City business. Neither participant
vehicles nor City owned or operated vehicles will be used to perform any of the
services required to be performed under this Agreement.
Sincerely,
Matthew Hawkesworth
Assistant City Manager
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