HomeMy WebLinkAboutContracts & Agreements_55-2012_CCv0001.pdf SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM
MAPRTMENT OF AGING AND ADULT SERVICES (DAAS)
HOST AGENCY AGREEMENT
it is furtber agreed that
1. The.HostAgMcy,6AJlVWiSt and encourage the Participant in seeking and obtaining unsubsidiYed emp1bymen1t:ft4udm&but not limited to,
recognition thattfuirarticipant will use authorized time for appropriate job search activities. The Host Agency acksmo*kdge's that the
P ifficipiritil"-'e--n_gag'eu%-Iobsearchactivities concurrently while they are assigned to the Host Agency for training.
2. The Host Agency sTiall work with,SCSEk to assist the Participant in his/her personal development, Personal develop nentmay include
meeting with staff at the site,or in:a meeting;to be assessed and/or to develop an Individual DevelopmenfPlan,The Host Agency
un4erstAh4 thatlh,4 Participantwill,use authorized time to attend regular meetings of program participants,SMP)v0j*4hops that provide
trail#irigUt-gdal-getfin&Job search,and.related topics,and/or to attend skills classes Identified as appropriate for-dW.-Participanes training.
3. The-Host Agency-shall Mndder-&tt:PattitipAht for all job openings for which the Participant is qgalffed. -7he'MstA&encyAh,4 hire the
Participant;subject tolheliost Agency's personnel procedures,into a position for which thePartkicipant ls qu&-&d-if widwhert possible.
Failure.to consldqr'th4Part icipant for an appropriate opening will result in termination of thlskgfgemimt
4. The-Host Age!-$W recognize that the Participant is assigned to a temporary training position designed to prepare'tht-Parlidpant for
unsuhs4ized.eniprlbyment,that SCSEP may transfer the participant at any time to another site to enable theparticipant to-'receive different
training,and,0*such a.transfer is likely when the Participant has completed training with the Host Agency.
5. The Host Agency ph4p.ro:vide adequate supervision of the Participant,and shall provide orientation and necessary g concerning the
Host Agen;yJt*,acdvJi*'Ahd thL-Participant's day-td-day responsibilities.
6. TheHost Agency-sh4povide a copy of the Participant's Training Assignment Description to the Participant and to SCSEO.7- he Host Agency
shallnotcbaril;etheparticipanfs duties or working conditions without first updating the.;TtainiqgAssignm=tDwa*&n.
7. The kTqAlAgertc_y 414.P -ide a.4*fe#nd sanitary training environment and training pon4itio4ail 4shag give fl t any necessary
safefy`Wtr7:&oA,Fird repo
yt arty accidents immediately to SCSEP staff
S. Tile Participant 4mg work with the Host Agency Supervisor to provide SCSEP with an accurateTime and Attendance(f&A)record on the
Participant by-the time requested-for everypayperiod.
9. The.Hqst Agency.Shaftwmplete and return in a timely manner any reports,evaluations,etc.requested by SCSEP which will include,but not be
limifecl-to, 64
quar . y..ev*=tions of the Participant.
10. The Host Agency:sbWreport to SCSEP the value of the supervisor's time and what percentage of the supervis&s cothoexulAtion is-paid for with
federal funds.The Host Agency shall report,on each.pay period's Time&Attendance Report(MA),the amount of.6me*peAt in direct
suporvisiQii or traininfof the ParticipanL
11. The lipstAgency-*M assure that the.Participant only works the total number of hours authorized by SCSEP,and will ieftbiri from requiring the
Participant to w6k16ove-r-time or volunteer hours.
u The Host Agentr'sh-altnordisploa any employee or volunteer with the Participant,norassign.'theTarticipant.to,perf6xm the tasks of an
employee on layoffnorreplace anon-SctPfeaerally funded position with the Participant.
13. The:Host Agency shall not discriminate on.the basis of'race,color,religion,sex,national origin,h4n
Aic#p,age,political affiliation or opinion,or
ancest'iy.
14. Tbb,;Hdst Agency shall have the Participant's immediate supervisor attend an annuaLmeeting,of Host Agency supervisors as scheduled by the
SCSEP Siaffi':etailtftotthe Host Agency to be represented at such a meeting will result in termination-of the-#greement.
is. The Host Agency-shall imsure that the Participant-does not engage in any partisan or non-partisan political activity,
or.w,,o*p ptomo te a
specific religimq Jwl during work time paid for by SCSEP.
16. The'Host Agency Shall enforce the provisions of the Drug-Free Workplace Act of 1988.
This-agreement.mayU.taulinafedor amended by either party with 30 days written-notice to the other partyorigunpi,Wt,4
y,by the Senior
community Service EmploymehtTrcgramupon-termutation or reduction of funds.
ATES
SCSA
Senior Conunurd ty Service Ern1ployment Pro-, k;trn, EP)
Signature of Authori4ed Official
San l5ernardino,Co.Dept-of Aging&AdultServices(DAAS}
686 Eastlfilt Street
San Bernardino,CA 924154640
Pete Ag
,uilar Sam Irwin
Name.
A,
Mavor J City Clerk
Title Jane Adams
Deputy Director DAAS
April 17, 2012
Date - Date
Rev:9-10-07
San Bernardino County Department ofAging&Adult Services
SENIOR COMMUNITIES SERVICE EMPLOYMENT PROGRAM
Supervisor's Non-Federal In-Kind Contribution
CONFIDENTIAL CONFIDENTIAL
The following information is required so that a dollar value can be assigned to the amount of time a supervisor
spends in direct supervision or training of a SCSEP Participant. The information supplied on this form will be
kept confidential,and will only be seen by those SCSEP staff involved in computing and reporting the SCSEPs
Non-federal in-kind contributions,and the staff persons of funding agencies(CDA)who monitor or audit this
information.
Name of Agency: City of Redlands
Address of Agency: 35 Cajon Street, Redlands CA 92373
Agency Federal Employer Identification Number (FEIN):
Name and Title of Supervisor: Rick Cross, Operations Supervisor
1. Dollar value of one hour of supervisor's time= $— 54.81
The dollar value of one hour of supervisor's time would include the supervisor's hourly wage plus the hourly value
of any fringe benefits received by the supervisor. The hourly value of a monthly benefit package can be computed
by dividing the monthly value of the benefit package by the average number of work hours in a month. (A person
working forty hours per week works 2080 hours per year,or an average of 173.33 hours per month.) For instance,
a supervisor who is paid$10.00 per hour,and receives a benefit package worth$200.00 per month,should enter
$11.15 as the hourly value of their time to reflect a$10.00 per hour wage plus benefits that are worth$1.15 per hour
($200/173.33).
2. Percent of supervisor's salary & fringes paid for with direct federal grant funds= 0 No
Enter the percent of supervisor's salary& fringes that are paid for directly by the federal government or with
direct federal grant funds. If the supervisor's position is funded entirely with direct federal grants enter 100%. If
None of the supervisor's salary& fringes are paid for with direct federal grant funds enter 0%. If the supervisor's
position is funded from a variety of sources estimate what percentage is covered by federal funds. For instance,a
nutrition site supervisor whose position is funded by both the contributions of the nutrition site participants and by
federal grant funds should enter the percentage that is funded by federal grants. Please note that Community
Service Block Grant(CSBG)funds are not considered federal grant funds for this purpose.
I certify that the above information is true and accurate to the best of my knowledge. I agree to inform the SCSEP
of any changes in the above information.
11—N I
Signature:_ Date: April 17., 2012
Pete Aguilar, Mayor
ATTEST:
Sam IrwfrW CAy Clerk
In-Kitid 05-05-10 Page I of 1
San Bernardino Count Department of Aging&Adult Services
SENIOR COMMUNITIES SERVICE EMPLOYMENT PROGRAM
Application to be a Host Agency
Name of Agency: City of Redlands
Address: 35 Cajon Street
Redlands, CA 92373
Telephone: (909) 798-7655 FAX: 4909 798-7697
Contact Person: Rick Cross Title: _Operations Supervisor
Are you a: ® Government Agency ❑ Private, non-profit? If private attach copy of 5016.
Are you a Faith Based organization? ❑ Yes ® No If yes see page 2 for added instructions.
Do you receive United Way Funding? ❑ Yes MNo
Federal Employer Identification Number(FEIN) 95-6000766 (The Department of
Labor now requires that we enter the FEIN number in our database so this is very important.)
Training
I. What is the occupation in which you will train the participant assigned to you?.
Special Program Aide—Recreation Senior Services
2. Approximately how long should it take to train the participant for this occupation? 4-7 months.
3. Name and title of the persons who will be training the participant:
David Jaffe and Derek Schott Recreation Coordinators
4. Describe in detail the training that will be provided: The special program aides will receive training
on the promotion of recreation programs and events offered at the Redlands Senior Center and the
Joslyn Senior Center. They will learn how to maintain records and files related to senior programs and
activities. help provide program information to the public, answer telephones collect fees register
participants and issue receipts.,
COMPLETE THE BACK SIDE,SIGN AND DATE Page I of 2
Unsubsidized Employment
I. If the participant successfully completes the training will you hire them? R Yes Z No.
2. If you are not able to hire them describe in detail what you will do to help the participant
obtain employment that is not subsidized by the SCSEP. The City will provide access to
resources that educate participants on possible jobs offers. At this time the City is unable to
promise eMploylnent to any persons not currently holding a position with the City because of
budget constraints and the need to approve the addition of any positions via City Council Salary
Resolution.
PLEASE REVIEW AND INITIAL THE FOLLOWING ITEMS - I understand that:
I. SCSEP participants may only be in training between the hours of 8:00 a.m. to 5:00 p.m.,
Monday through Friday. (Initials of applicant—authorized official)
2. In order to be a SCSEP Host Agency we must have a supervisor or alternate supervisor on
duty at all times while we have a SCSEP participant in training at our agency.
(Initials of applicant—authorized official)
3. The grant sources have the following restrictions on participants at all Host Agencies: No
lifting in excess of 15# (less if specified by their Doctor); no climbing ladders or step stools;
no use of power tools/equipment or power kitchen tools/equipment; no cooking; no driving
for Host Agency. Safety at Host Agencies is very important for SCSEP participants.
(Initials of applicant—authorized official)
FOR FAITH BASED ORGANIZATIONS ONLY—PLEASE ATTACH A LETTER WITH
YOUR LETTERHEAD ADDRESSING THE FOLLOWING:
Since SCSEP receives government funds, our participants are prohibited from"performing
duties which promote religious views or beliefs during work/training time paid by SCSEP. Our
federal handbook states "we may use Host Agencies if they do not occupy of facility that is used or
will be used as a place for sectarian religious instruction or worship."
Please submit a letterlmemo with your application stating that out SCSEPparticipants at
your training sites would not be 'performing any duties which promote any religious view or
belief, during any work1training time paid by our SCSEP. The training facility will not be used as
a place for sectarian religious instruction or worship."
Acceptance of the application does not guarantee a participant will be placed with your agency.
Signature of Applicant—A uth orized Official. Y", Date: April 17, 2012
Pete AguYlar, Mayor
N
ATTEST:
Application to be a Host Agency Sam Irwin, 4eitClerk Page 2 of 2
12-07-2007