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Item No. 22 CDBG Allocations FY 2021-22
City Council Agenda Report City of Lake Elsinore 130 South Main Street Lake Elsinore, CA 92530 www.lake-elsinore.org File Number: ID# 19-801 Agenda Date: 12/8/2020 Status: Approval FinalVersion: 1 File Type: Council Consent Calendar In Control: City Council / Successor Agency Agenda Number: 22) Community Development Block Grant (CDBG) Allocations for Fiscal Year 2021-22 and Community Support Allocations for Fiscal Year 2020-21 1.Adopt the Community Development Block Grant (CDBG) Program allocations for Fiscal Year 2021- 22; 2.Approve submittal of the City’s program to the County of Riverside; and 3.Approve allocation of Community Support Funds. Page 1 City of Lake Elsinore Printed on 12/3/2020 REPORT TO CITY COUNCIL To: Honorable Mayor and Members of the City Council From: Grant Yates, City Manager Prepared by: Brendan Rafferty, Fiscal Officer Date: December 8, 2020 Subject: Community Development Block Grant (CDBG) Allocations for Fiscal Year 2021-22 and Community Support Allocations for Fiscal Year 2020-21 Recommendation 1. Adopt the Community Development Block Grant (CDBG) Program allocations for Fiscal Year 2021-22; 2. Approve submittal of the City’s program to the County of Riverside; and 3. Approve allocation of Community Support Funds. Background Each year the City of Lake Elsinore receives an allocation of Community Development Block Grant (CDBG) funds. These allocations are based on population and are designed for assistance to low and moderate income residents and areas. On June 23, 2020 the City Council renewed its Joint-Recipient Cooperation Agreement (Metropolitan Cities Agreement) with the County of Riverside. Participation in the Joint-Recipient Cooperation Agreement allows the City of Lake Elsinore to receive its portion of funds allocated by HUD, minus a twelve percent (13%) administration fee by the County of Riverside. To qualify for funding, eligible projects must largely benefit low and moderate income persons, prevent or eliminate slums and blight, or meet a need having a particular urgency. The County of Riverside Housing, Homelessness Prevention, and Workforce Solutions (HHPWS) has stated that “In order to ensure the effective, efficient, and appropriate allocation and use of the County’s CDBG funding, the County may reject any proposed cooperating city CDBG activity in an amount less than $10,000.” The only exceptions to this policy include: traditionally county- wide activities (city/county, multiple city, etc.) or a project or activity serving a very remote location. On October 6, 2020, a Notice of Funding Availability was published and e-mailed to previously funded organizations and other interested persons. Additionally, this notice was published on the City’s website along with information regarding the City’s Community Support Funding CDBG and Community Support Allocations December 8, 2020 Page 2 Program. The organizations were instructed to submit their applications for Community Support Funds along with their CDBG applications due on November 6, 2020. On November 6, 2020, the City received a total of four (4) applications for CDBG Funds and nine (9) applications for Community Support Funds. A list of current and past CDBG and Community Support Funding allocations is attached. Discussion For the Fiscal Year 2021-2022 funding program, the City hopes to receive approximately $596,000 which is slightly less than the total that was awarded to the City for Fiscal Year 2020- 2021 of $603,511. It should be noted that this amount is an estimate and the actual amount of CDBG funds received by the City could fluctuate depending on how the United States Congress approves the national budget. Based on an allocation of $596,000 and CDBG requirements, thirteen percent (13%) or $77,480 would be required by the County of Riverside for administrative costs. Additionally, the City can earmark a maximum of eight percent (8%) or $37,280 towards CDBG program administration costs and fifteen percent (15%) or approximately $89,400 towards public service programs. However, in order to maximize the amount of CDBG funds available for the City projects, Staff is proposing to use none of the CDBG funds for the City’s administrative costs. This will allow a balance of $429,120 for the following City project: 1. Downtown Community Center Rehabilitation ($429,120). The proposed project involves the use of CDBG funds to make much needed repairs to the Community Center located at 310 W. Graham Avenue. As of the filing deadline of November 6, 2020, the City received four (4) outside public service agency applications for a total requested allotment of $139,876. The agencies requesting funds are as follows: 1. Assistance League of Temecula Valley ($50,000). The agency is located in Temecula and the organization’s Operation School Bell provides clothing and shoes to disadvantaged children in the Murrieta, Lake Elsinore, Menifee and Temecula School Districts. The requested CDBG funds would be used to service children in Lake Elsinore. 2. Boys and Girls Club of Southwest Riverside County ($10,000). Located in Lake Elsinore, the organization is requesting funds for Boys & Girls Club Program Scholarships for before and after school programming and transportation to serve underserved youth in the City of Lake Elsinore. The activities are provided at the Boys and Girls Club’s Clubhouse located at 16275 Grand Avenue in the City of Lake Elsinore 3. Helping Our People in Elsinore, Inc. (H.O.P.E) ($57,500). Located in Lake Elsinore, the organization is requesting funds for its Pantry Program that distributes a balanced menu of groceries to low income families, seniors and individuals in Lake Elsinore and the surrounding communities. CDBG and Community Support Allocations December 8, 2020 Page 3 4. Vista Community Clinic ($22,376). This organization’s request for CDBG funds to meet the costs of a Certified Enrollment Counselor who links uninsured low-income residents of Lake Elsinore to health insurance and a medical/dental home, thereby providing access to comprehensive healthcare services. Services would be provided at Vista Community Clinic's health center at 30195 Fraser Drive. The total amount of CDBG funds available is only 64% of the total amount requested. Additionally, as described above, the minimum allocation has been set at $10,000 by County HHPWS. For these reasons, staff is recommending the funding for “Public Service Programs” that allocates only the available funds. A breakdown of CDBG funding requests and proposed allocations for Fiscal Year 2021-2022 are reflected in the following table. FY 2021-2022 CDBG Program Year – Proposed Allocation Agency Requested Amount 2021-2022 Proposed Allocation 2020-2021 Allocation PUBLIC SERVICE PROGRAMS Assistance League of Temecula Valley $50,000 $27,400 $20,000 Boys & Girls Club of Southwest County $10,000 $10,000 $0 Helping Our People in Elsinore, Inc. (H.O.P.E) $57,500 $30,000 $29,000 Vista Community Clinic $22,376 $22,000 $20,812 Subtotal $139,876 $89,400 $69,812 PUBLIC FACILITY PROJECT Public Facility Improvements $429,120 $429,120 $455,243 Subtotal $429,120 $429,120 $455,243 ADMINISTRATIVE COSTS Riverside County EDA $77,480 $77,480 $78,456 Subtotal $77,480 $77,480 $78,456 GRAND TOTAL $646,476 $596,000 $603,511 As of the filing deadline of November 6, 2020, the City received nine (9) Community Support Funding applications for a total requested allotment of $69,700. The agencies requesting funds are as follows: 1. Trauma Intervention Program ($10,000). Located in Murrieta, this agency provides emotional first aid to survivors of tragedy in order to ease their immediate suffering an d facilitate their healing and long-term recovery. 2. Salvation Army ($12,500). Located in Murrieta, the organization provides at risk and needy school age children with the clothing and supplies they need to start school. 3. Boys and Girls Club of Southwest County ($10,000). Located in Lake Elsinore, this agency has a STEM/Computer science program that provides technology and access to computers for youth. CDBG and Community Support Allocations December 8, 2020 Page 4 4. Dream Center ($10,000). Located in Lake Elsinore, the organization’s Dream Projects is a mentorship extension for Ortega High School. Students develop service projects for the community. The goal of this program is to empower these students to move beyond their circumstances and develop their organizational, financial and team work skills. 5. Assistance League of Temecula Valley ($5,000). The agency is located in Temecula and the organization’s Operation School Bell provides clothing and shoes to disadvantaged children in the Murrieta, Lake Elsinore, Menifee and Temecula School Districts. The requested CDBG funds would be used to service children in Lake Elsinore. 6. Elsinore Woman’s Club ($9,800). Located in Lake Elsinore, this organization is requesting funds to repair the roof of their clubhouse to hold future events such as blood drives, Boy Scout meetings, art shows and dance performances from local schools. 7. The Inland Future Foundation FBO KVCR-TV ($5,000). KVCR serves as the PBS television station for the Great Inland California. On the television program "Uncovered in the Archives," unravels some of history's most extraordinary events, all told trough the hidden treasures that they uncover in the archives. 8. Santa Rosa Plateau Nature Education Foundation ($3,400). Located in Murrieta, this organization will produce standard-based nature education distance learning videos to be distributed and made available to Lake Elsinore Unified School District elementary classrooms. 9. Lake Providence Missionary Baptist Church ($4,000). Located in Lake Elsinore, this organization is requesting funds for building repairs that will help continue the services they offer. The Church services the community with food outreach for the needy, a youth program to mentor and build the lives of at-risk young people, and a musical choir. A breakdown of Community Support funding requests and proposed allocations for Fiscal Year 2020-2021 are reflected in the following table. Agency Requested Amount 2020-2021 Proposed Allocation 2019-2020 Allocation Trauma Intervention Program $10,000 $10,000 $10,000 Salvation Army $12,500 $10,000 $10,000 Boys and Girls Club $10,000 $0 $0 Dream Center $10,000 $5,000 $5,000 Assistance League of Temecula Valley $5,000 $5,000 $5,000 Elsinore Woman’s Club $9,800 $0 $0 The Inland Future Foundation FBO KVCR-TV $5,000 $0 $0 Santa Rosa Plateau Nature Education Foundation $3,400 $0 $0 Lake Providence Missionary Baptist Church $4,000 $0 $0 GRAND TOTAL $69,700 $30,000 $30,000 The above recommendations have been shared with the City Council’s Budget Subcommittee. CDBG and Community Support Allocations December 8, 2020 Page 5 Fiscal Impact As indicated above, the City of Lake Elsinore's CDBG allocation is anticipated to be $596,000 for the 2021-2022 Fiscal Year. These funds will be available on or about July 1, 2021. There is $30,000 available in the General Fund for Community Support Funding in the Community Support Budget. Attachments: 1. Summary Matrix of Public Service Requests with Past Awards (CDBG) 2. Summary Matrix of Community Support Funding Requests with Past Awards 3. FY 2021-2022 CDBG Funding Application - Assistance League of Temecula Valley 4. FY 2021-2022 CDBG Funding Application – Boys and Girls Club of Southwest County 5. FY 2021-2022 CDBG Funding Application - Helping Our People in Elsinore, Inc. (H.O.P.E) 6. FY 2021-2022 CDBG Funding Application - Vista Community Clinic 7. FY 2020-2021 Community Support Funding Application – Trauma Intervention Program 8. FY 2020-2021 Community Support Funding Application – Salvation Army 9. FY 2020-2021 Community Support Funding Application – Boys and Girls Club of Southwest County 10. FY 2020-2021 Community Support Funding Application – Dream Center 11. FY 2020-2021 Community Support Funding Application – Assistance League of Temecula Valley 12. FY 2020-2021 Community Support Funding Application – Elsinore Women’s Club 13. FY 2020-2021 Community Support Funding Application – The Inland Future Foundation FBO KVCR-TV 14. FY 2020-2021 Community Support Funding Application – Santa Rosa Plateau Nature Education Foundation 15. FY 2020-2021 Community Support Funding Application – Lake Providence Missionary Baptist Church Past GrantsApplicant Requested Amount Recommended AmountTotal = $89,400Use of CDBG Funds2020‐2021Allocation2019‐2020Allocation2018‐2019Allocation2017‐2018Allocation2016‐2017AllocationAssistance League (Operation School Bell)$50,000$27,400Purchase of new clothing for disadvantaged (low‐income) school children (K‐12, ages 5‐17) within Lake Elsinore Unified School District (USD), Menifee Union School District, Murrieta Valley USD and Temecula USD.$20,000 $17,500 $15,000 $15,000 $12,500Boys & Girls Club of Southwest Riverside County$10,000$10,000Client scholarships for the After School program that empowers youth towards a great future by surrounding them with the opportunities and resources needed to succeed. The After School Program is provided at the Boys and Girls Club’s Clubhouse located at 16275 Grand Avenue in the City of Lake Elsinore. $0 $10,000 $10,000 $10,000 $10,000Helping Our People in Elsinore, Inc. (HOPE)$57,500$30,000Pantry Program that distributes a balanced menu of groceries to low income families, seniors and individuals in Lake Elsinore and the surrounding communities. $29,000 $20,000 $18,150 $18,150 $18,612Vista Community Clinic $22,376$22,000CDBG funds to be used for Linking Low‐Income LakeElsinore Residents to a Medical & Dental Home through Insurance program whose goals are to link uninsured low‐ income residents of Lake Elsinore to health insurance and a medical/dental home, thereby providing access to comprehensive healthcare services. $20,812 $18,110 $15,000 $15,000 $12,500TOTALS$139,876 $89,400$69,812 $65,610 $68,150 $68,150 $63,6122021‐2022 Program YearCommunity Development Block Grant (CDBG) Applicant Requested Amount Recommended AmountUse of Community Support Funds2019‐2020Allocation2018‐2019Allocation2017‐2018Allocation2016‐2017Allocation2015‐2016AllocationTrauma Intervention Program $10,000$10,000Provides emotional first aid to survivors of tragedy in order to ease their immediate suffering and facilitate their healing and long term recovery.$10,000 $10,000 $10,000 $10,000 $10,000Salvation Army $12,500$10,000Back to School Child Spree provides at risk and needy school age children with the clothing and supplies they need to start school.$10,000 $0 $10,000 $8,000 $0Boys and Girls Club of Southwest County$10,000$0The Ultimate STEM/Computer Science program provides technology and access to computers for youth. Through a variety of activities, youth participate in web exploration, media production, robotics, coding and more. $0 $0 $0 $0 $0Dream Center $10,000$5,000Dream Projects is a mentorship extension for Ortega High School. Students develop service projects for the community. The goal of this program is to empower these students to move beyond their circumstances and develop their organizational, financial and team work skills.$5,000 $5,000 $0 $0 $0Assistance League Temecula Valley$5,000$5,000Purchase of new clothing for disadvantaged (low‐income) school children (K‐12, ages 5‐17) within Lake Elsinore Unified School District (USD), Menifee Union School District, Murrieta Valley USD and Temecula USD. $5,000 $5,000 $0 $0 $0Elsinore Woman's Club $9,800$0The Elsinore Woman's Clubhouse has been the location of many events. The club holds blood drives, Boy Scout meetings, art shows, and dance performances from local schools. The clubhouse roof is in need of repair in order to hold future events for the community.$0 $0 $0 $0 $0The Inland Future Foundation F/B/O KVCR‐TV$5,000$0KVCR serves as the PBS television station for the City of Lake Elsinore and all of Great Inland California. On the television program "Uncovered in the Archives," host Brad Pomerance travels to various institutions throughout the region to unravel some of history's most extraordinary events, all told trough the hidden treasures that they uncover in the archives. $0 $0 $0 $0 $0Santa Rosa Plateau Nature Education Foundation$3,400$0The Santa Rosa Plateau Nature Education Foundation will produce standard‐based nature education distance learning videos to be distributed and made available to Lake Elsinore Unified School District elementary classrooms.$0 $0 $0 $0 $0Lake Providence Missionary Baptist Church$4,000$0The Church building and property are 65 years old and in need of upgrading and repairs. The Church services the community with food outreach for the needy, a youth program to mentor and build the lives of at‐risk young people, and a musical choir. $0 $0 $0 $0 $0TOTALS $69,700 $30,000 $30,000 $20,000 $20,000 $23,000 $30,000AMOUNT BUDGETED $30,000 $30,000 $32,000 $32,000 $40,000 $30,000 $30,0002020‐2021 Program YearPast Allocation COUNTY OF RIVERSIDE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION FOR CITY OF LAKE ELSINORE 2021- 2022 CITY CD BG ALLOCATION I. GENERAL INFORMATION: Applying Organization Name: Assistance League of Temecula Valley Type of Organization: Non-Profit Organization Z Faith Based Organization ❑ For-Profit Organization F-1 Institution of Higher Education F-1 Cooperating City ❑ Organization Address: 28720 Via Montezuma City: Temecula Zip Code: 92590-2510 Mailing Address: 28720 Via Montezuma City: Temecula Zip Code: 92590-2510 Telephone Number: 951-970-6034 Fax Number: Executive Director: Dorcas Shaktman Telephone Number: 951-970-6034 E-mail: dshaktman@verizon.net Program Manager: Dorcas Shaktman Telephone Number: 951-970-6034 E-mail: dshaktman@verizon.net Grant Writer: Cheryl Peterson Address (If clifferent from above): 'Telephone Number: 951-719-0213 E-mail: cher-ylpeterson213@gmail6 11. ORGANIZATIONAL HISTORY: (This is applicable ge/y if you are a non-profit organization) Date Organization founded: 6-15-1989 Date Organization incorporated as a non-profit organization: 6-15-1989 Federal identification number.- DUNS Number: Organizatjon Web Address: www.assistanceleague.org/temecula-valley/ Does your Organization expend $750,000 or more: a year in federal funds? Y n or N Number of paid staff: 0 Number of volunteers: 200 Members/Board of Directors(Attach): PROJECT ACTIVITY A. Name of Project: Operation School Bell-clothing and shoes for low income children/youth B, Specific Location of Project (Attach Project Map-include street address;if a street address has riot been assigned provide APN) Street or APN: 28720 Via Montezuma City: Temecula Zip Code: 92590-2510 C. CDBG funds Requested: 50,000 (totol amount for the project only) D. Where will the proposed activity occur (be specific as to the geographic boundaries)? if the project involves a new or existing facility, what is the proposed service/benefit area for the facility? Beneficiaries served are within the Southwest Riverside County Gconornic Development Region in five cities and school districts; Lake Usinore Unified School District, Menifee Union School District, Rornoland Union, Murrieta Valley Unified School District,'Femecula Valley Unified School District.All of the proposed activities occur in Supervisor District 1,3, and 5. L In which City(ies)/Communities does the activity occur? City(ies): Lake Elsinore,Canyon Lake.,Wildomar, Murrieta,Temecula, Menifee, Romoland-northern section of Menifee, Perris-southern area. Community lies): Murrieta riot Springs, French Valley,Sage,Quail Malley,Winchester,Temescul Canyon and incorporated areas NOTE: HHPWS will make the final determination of the appropriate service area of oll proposals. 1, If this project benefits residents of more than one community or jurisdiction, have requests been submitted to those other entitlement jurisdictions? (i.e., County district(s) 1" Z 31`r 0), and/or 5t" City of Palry) Springs, City of Moreno Valley, City of Riverside, etc.) YES 1 G, Check ONLY the applicable category your application represents. []� Public Service [- Homeless Activities ❑ Real Property Acquisition (Must consult with I-IHPWS p_ior to submitting application) F. Housing Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities(construction) Infrastructure (i.e. Streets, Sewer, Sidewalk, etc.) x Other: (provide description) children and youth development program H. Respond to A&B Qqly if this application is for a public service project. (a) Is this a NFW service provided by your agency? Yes ❑ No [A (b) If service is not new, will the existing public service activity level be substantially increased or improved? Yes,increased 1 . PROJECT NARRATIVE A. Provide a detailed pragct Des�fiption. The description should only address or discuss the specific activities, services, or project that is to be assisted with CDBG funds. If CDBG funds will assist the entire program or activity,then provide a description of the entire program or activity: Under the umbrella of Assistance League Temecula Valley"Operation School Bell"program,the following activities are"changing lives of children" in the Southwest Riverside Economic Development Region:(Activity 41)providing shopping opportunities for children/youth (TK-12)for(at least 51%low to moderate income families)to shop for new school clothes and shoes at local retail stores,thereby reducing a barrier to education and promoting school attendance.ALTV maintains service agreements with(5)school districts within the Southwest Riverside Economic Development Region and offers shopping events,providing clothing($125.00 value each)for students TK-12(at least 51%served are low to moderate income families). Parents/Guardians of children and youth register on-line for shopping event eligibility,check-in at designated store locations, provide proof of income and complete self-certification forms.Once qualified each child/youth shops for clothing up to$125.00 value.At check-out,a shopping event exit evaluation fora is completed and signed. In fiscal year June 1,201.9-May 31,2020,ALTV clothed the following number of children/youth: lake Elsinore School District(841); Menifee School District to include Romoland Union school district(706), Murrieta Unified.School District(455)and Temecula Valley Unified School District(578) with a total of 2,580 children/youth served.The five school districts are located in the following service areas of Riverside County District 1,3, 5 and includes cities,communities and unincorporated areas of each district. 2 B. Provide a detailed description of the proposed use of the CDBG funds only (e.g. client scholarships, purchase of specific equipment, rent, supplies, utilities, salaries, etc,): Assistance League of Temecula Valley is requesting$50,000 in CDBG funds from the City of Lake Elsinore,in support of the Operation School Bell activities.The average annual budget for Operation School Bell clothing expense is more than$300,000,benefiting more than 2400 children/youth with the opportunity to shop for new school clothes and shoes.An award of$50,000 will clothe 400 children/youth($3.25.00 each). 100%of CDBG funds awarded are used exclusively for Operation School Bell clothing expenses to allow low to moderate income children/youth the opportunity to purchase new school clothing and shoes.Operation School Bell is supported by the ALTV Thrift Store sales,private and corporate donations,sponsors and grants. *NEED-data from KidsData.org...Children living in Low-income Working Families=United States 24.8%, California 25.4%AND Riverside County 22.6%. Income and well-being are intricately linked. Poverty can alter a child's developmental trajectories in cognitive,socio-emotional,and physical health.Children who face economic hardship when they are young,or who experience deep and prolonged poverty,are at greatest risk of poor outcomes.The effects of poverty and the stress associated with it can be lasting,contributing to increased risks of dropping out of school,poor adult health,poor employment outcomes arnong other adverse consequences. C: What are the goals and objectives of the project, service, or activity? How will you measure and evaluate the success of the project to meet these goals and objectives (measures should be qualitative)? Goals: obtain funding to clothe 2400 children/youth in five school districts,Riverside County Supervisor districts 1,3,and 5,and children/youth residing at domestic violence agencies; Approximately 18 evening shopping events are scheduled for 2021-2022 to provide clothing to 2400(TK-12) children/youth in five school districts and includes dependents of military families, pre-schools,special education and the youth in the foster care system. Objective: (1)obtain funding to clothe 2400 children/youth in five school districts,Riverside County Supervisor districts 1,3,and 5,and domestic violence agencies children/youth residents; (2)train school and agency staff on eligibility requirements and on-line registration process;(3) negotiate retail service agreements and set-up shopping events at retail locations; (4)check proof of income/self-certification at check-in,assist with shopping, hand-out evaluation forms,assist with check-out. Measurements:Quality of service of program is asked on the evaluation form at check-out.99.8% parents respond positively to the entire experience from school outreach,documentation sent home in both English and Spanish,to the actual shopping event and clothes and shoes obtained.Over 95%respond they spend monies saved on basic needs such as food and rent. ALTV tracks the number of children/youth provided with new school clothing and shoes and reports on community impact to Riverside County. D. Please identify the project milestones using an Estimated Timeline for Project Implementation: February 2021-Sept 2021-Planning&Coordination August 2021-Sept 2021-Volunteer Training Sept 2021- October 2021-Fall "Shopping" Events Nov 2021.-Dec 2021- Reporting&Compliance Jan 2022-Feb 2022- Winter"Shopping" Events Feb 2022-Mar 2022-Fallow up&Close-out March 2022 Final Reporting 3 V, PROJECT BENEFIT A. Indicate the number of people or households that: will directly benefit frorn your proposal using CDBG funds: Note: This is based on the expected nurnber of clients to be served if the County funds your project for the requested amount. Assistance League of Temecula is requesting$50,000 in CDBG funds from the CITY of LAKE ELSINORE which will serve 400 children/youth (Equation:400x$125.00=$50,000),with an estimated project total of 2400 children/youth provided new school clothes and shoes in five school districts,Riverside County Supervisor districts 1,3,and 5,and children/youth residing at domestic violence agencies. B. Indicate the nurnber of unduplicated clients that will be served (An unduplicated client is counted only once, no matter how many direct services the client receives during a funding year): 24400 unduplicated children/students(TK-12) in project total within five school districts, Riverside County Supervisorial districts 1,3, 5 and children/youth residing;at domestic violence agencies. C. Length of proposed CDBG-funded activities or service (weeks, months, year): 1 year-June 1,2021 through May 31-2022 D. Service will be provided to (check one or more): ] Men ❑ Seniors Women ❑ Severely Disabled AdUltS Children (Range of children's ages : 4-17 } ❑] Migrant i-arrn Workers ❑ Homeless (Dumber of beds at facility _ ) ❑ Families 4 E What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? Assistance League of Temecula Valley volunteers continue to outreach to communities,government agencies,school districts,collaborations with food pantries,domestic violence and foster family agencies, and love-moderate income parents and students. F. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the CDBG funds are expended? Operation School Bell is beginning its 32nd year of operation.ALTV's Temecula-based Thrift Shop provides a stable and reliable source of funding from thrift shop sales.ALTV Board and Finance Committee diligently seeks to diversify funding by pursuing funding from other reliable sources such as foundations,corporate sponsors,government grants,private donors and fundraising events. 1. NationalO Objective All CDBG-funded activities must meet at least one of the following national Objectives of the CDBG program, Indicate the category of national Objective to be met by your activity. CATEGORY A: Benefit to low-moderate income persons (must be documented), please choose either subcategory 1. or 2: 1. Limited Clientele: The project serves clientele that; will provide documentation of their family_ size, income, _and ethnicit . Identify the procedure you currently have in place to document that at least 51.% of the clientele you serve are low-moderate income persons. Clientele served are determined to be"A" limited clientele.ALTV's[operation School Bell programs serves at least 51%low-moderate children/youth of parents that provide proof of income,family size and designate ethnicity by completing the self-certification form at the shopping event.ALTV volunteers review proof of income.The children/youth attend school in Lake Elsinore USD, Murrieta Valley USD,Temecula Valley USD, Menifee Union SLR and Romoland SCE in Riverside County. 5 2. Clientele presumed to be principally low- and moderate-income persons: The following groups are presumed by HUD to meet this criterion. You will be required to submit a certification from the client(s) that they fall into one of the following presumed categories. The activity will benefit (check one or more) ❑ Abused children ❑ Homeless persons ❑ Battered spouses ❑ Illiterate adults [] Elderly persons Persons living,with AIDS ❑ Severely disabled adults El Migrant Farm workers a. Describe the clientele above to be served by this activity: na b. Discuss how this pr.oject directly benefits low-and moderate- income residents: Operation School Bell changes lives by addressing a human service"meeting basic needs", by providing school clothes and shoes to children and at-riskyouth .At least 51%of children/youth are from low to moderate income families. Recipient children/youth and their parents state that they spend their savings on necessities such as food and rent. CATEGORY 13: Area Benefit-The project or facility serves, or is available to,ALL persons located within an area where at least 51% of the residents are low/moderate-income. (Applicant is welcome to contact a County of Riverside,HHPWS CDRG Program!Manager for Census information) 2010 Census Tr-act and Block Group numbers: (must use 2011-2015 ACS data pursuant to HUD Notice -C&D-19-02 Total population in Census Tract(s) / block Total percentage of low-moderate population in Census Tract(s)/block 6 CATEGORY C. Activities undertaken to create or retain permanent jobs, at least 51% of which will be made available to or held by low/moderate-income persons. Lrpposed Job Creation Retention Total Jobs Expected to Create: 0 Total Jobs Expected to Retain: 0 CATEGORY D: Activities that provide assistance to micro-enterprise owners/developers who are I ow/moderate-i n come. Proposed Assistance to Businesses New Businesses expected to assist: 0 Existing Businesses expected to assist: 0 Enter Total Businesses expected to assist: 0 VIL FINANCIAL INFORMATION --------_-----_-- A. Proposed Project Budget Complete the following annual program budget to begin July 1, 2021. If your proposed CDBG-funded activity will start on a date other than July 1, 2021., please indicate starting date. Provide total B q I gf information and distribution 91CDqG f ynds it) the proposed budget. The budgeted items are for the specific activity for which you are requesting CDBG funding--h!�QT for the budget of the "entire" organization or agency. (Note:CDBG funds requested must match amount requested in Project Activity,C above.) (EXAMPLE: The Valley Senior Center is requesting funding for a new Senior Nutritionol Progrorn. The total cost of the program is$15,000 and$10,000 in CDBG funds is being requested for operating expenses associated with the proposed activity. The totolActivitylProject Budget will include$5,000of other non-CDBGfunding and$10,000in CDBG funds for a Grand Total of$15,000). TOTALACTIVITY/ PROJECT BUDGET CDBG FUNDS (include non-CDBG Funds REQULSLEl3-O!Ily and CQBG Fundsl I. Personnel A. Salaries &Wages $ 0 $ 0 B. Fringe Benefits $ 0 $ 0 C. Consultants& Contract Services $ 3.000 $ 0 PERSONNEL SUB-TOTAL $ 1000 0 7 II. Non-Personnel A. Space Costs $ 1000 $ 0 B. Rental, Lease or Purchase of Equipment $ 200 $ C. Consumable Supplies $ 1500 $ D. Travel $ 300 $ E. Telephone $ 200 $ F. Utilities $ 300 $ G. Other Costs $ 300,000 $ 50,000 NON-PERSONNEL SUB-TOTAL- $ 303,500 $ 50,000 Ill. father A. Architectural/Engineering Design $ 0 $ 0 Q. Acquisition of Real Property $ 0 $ 0 C. Construction/rehabilitation $ 0 $ 0 D. Indirect Costs $ 0 $ 0 E. Other $ 0 $ 0 OTHER SUB-TOTAL: $ 0 $ 0 GRAN®TOTAL: $ 304,500 $ 50,000 B. Leveraging List other funding sources and amounts (commitments or applications) which will assist in the implementation of this activity. Current and pending; evidence of leveraging commitments/applications must be submitted with application. (Attach) Federal: Leveraging is provided from ALTV fiscal year June 1,2019-May 31,2020,however planning for the 2021-2.022 OSB program has already begun with fundraising efforts commencing with the submission of CDBG applications to EDA Riv.County,City of Murrieta,City of Lake Elsinore,Menifee and'Temecula. State/Local: $18,534 from City of Temecula(CSF),City of Lake Elsinore(CSE)and City of Wildomar $3,000 District 3-Riverside County Supervisor Chuck Washington $2,500 District 1-Riverside County Supervisor Kevin Jeffries Private: $18,985 from the foundations of Target, IECF Native Youth(grant,Albertsons Charities,Gunnerson Foundation,Community Foundation Fees: 0 Donations: $113,000 individual and corporate cash donations Other: $431,448-Operation School Bell is 1.00%supported by the ALTV Thrift Store proceeds. $1.9,250(total volunteer hours of 3,850 @ $5.00 an hour 8 C. What type of long-term financial commitment is there to the proposal'? Describe how you plan to continue the work (project) after the CDBG funds are expended? Operation School Bell activities are supported by the ALTV Thrift Store proceeds and fund raising events, sponsors, donors and grants.ALTV has a long history of receiving federal, city and foundation grants along with donor and corporate contributions. Assistance League of Temecula Valley has been producing month ly,quarterly and annual reports that illustrate how and where funds are spent. D. Provide a summary by line item of your organization's previous year's income and expense statement, {Attach/1 E. Does this project benefit residents of more than one community or jurisdiction, have requests been submitted to those other jurisdictions? Yes # No If yes, identify sources and indicate outcome. Yes,CDBG 21-22 requests have been submitted to EDA/Riverside County Board of Supervisors,City of Murrieta, City of Lake Elsinore,Menifee and Temecula If no, please explain, F. Was this project or activity previously funded with CDBG? Yes[0i] No �Y] If yes, when? Fiscal year 20-21 Is this activity a continuation of a previously funded (CDBG) project? Yes 0 No If yes, explain: Yes,Operation school Bell has been a program of Assistance League of Temecula Valley for more than 32 years,as such,funding has been requested since 2010. VM. MANAGEMENT CApACI'i"Y A. Describe your organization's experience in managing and operating project or activities funded with CDBG or other Federal funds. ALTV has operated the OSB program with CDBG funding from both cities and Riverside County for the last 17 years,successfully tracks all activity,completes all required documentation and submits for reimbursement. 9 B. Management Systems Does your organization have written and adopted management systems (i.e., policies and procedures) including personnel, procurement, property management, record keeping, financial management, etc.? ALTV maintains extensive policies and procedures including national organization and local chapter regulations, policies, bylaws,committee rules and detailed job descriptions. Financial policies related to procurement, internal controls,disbursements,deposits and investments are in place.The Board of Directors oversees organizational budgets/expenditures;Treasurer manages daily/monthly/annual financial and CPA conducts audits. C. Capacity Please provide the names and qualifications of the person(s) that will be primarily responsible for the implementation and completion of the proposed project, Denise Lanier,Board President,former VP of Philanthropic Programs,long-time employee of city of Temecula(human Resources),active volunteer; Anette Sheehy-VP of Philanthropic programs,previous chair of operation School Bell and retired educator; Dorcas Shaktman••Past President&Grants Mgr.,retired SVP Financial Industry. 10 IX. APPLICATION CERTIFICATION Undersigned hereby certifies that(check box after reading each statement and digitally sign the document): 1. The information contained in the project application is complete and accurate. 2. The applicant agrees to comply with all Federal and ty policies and requirements imposed upon the project or activity funded by the CDBG program. 3. The applicant acknowledges that the Federal assistance made available through the CDBG program funding will not be used to substant` 1i reduce prior levels of local, (NON-CDBG) financial support for community development activities. 4. The applicant fully understands that any facility built or equipment purchased with CDBG funds shall be maintained a d r operated for the approved use throughout its economic life, pursuant to CDBG regulation. 5. If CDBG funds are approved, the applicant acknowledges that sufficient non-CDBG fund a available or will be available to complete the project as described within a reasonable timeframe. 6. On behalf of the applying organization, i have obtained authorization to submit this application for CDBG funding. (nor-OMENTATION ATTACHED Minute Action and/or written Board Approval signed by the Board President) DATE: & d Signature: Print Name/Title Denise Lanier, President Authorized Representative: 11 CI EC .•-t ST: The following required documents listed below have been attached. Any missing documentation to the application will because for the application to be reviewed as INELIGIBLE. Yes No ATTACHMENT 1XI El 1.. Members/Board of Directors El 2. Articles of Incorporation and Bylaws 1_x] E] 3. Project Activity Map E] C] 4. Project Benefit, Category B, Low Mod Area Maps(Attach if applicable) FIX El 5. Leveraging (Current evidence of commitment) ] ❑ G. Income and Expense Statement [x] ❑ 7. Management Capacity (Detailed organizational chart) 11 S. Board Written Authorization approving submission of application ASSISTANCE LEAGUE OF TEMECULA VALLEY AL BOARD OF DIRECTORS assistance lea * Fememla V. June, 2020— May, 2021 OFFICERS: President: Denise Lanier Sr. Human Resources Mgr. 32232 Corte Coronado Private and Public Sector Temecula, CA 92592-6354 ramm sins msn.com 951-265-8248 VP Membership: Diane Koirth Orange County TA 29633 Pebble Beach Drive Transportation Sun City, CA 92586 Retired dkoirth2000 ahoo.com 949-230-8429 VP Philanthropic Programs: Annette Sheehy Educator 39612 Clos Du Val Elementary School Murrieta, CA 92563 annettebrll(&Iahoo.com 951-852-1822 VP Finance: Michelle Stiles Associate Dean, MBA, EdD 39100 Hidden Creek Lane Finance, Accounting, Budgeting, Temecula, CA 92591 Operations michellestiles46(c�gmail.com_ (714) 501-5339 Secretary: Diana Elizondo Educator 39628 Clos Du Val Elementary School Murrieta, CA 92563 dianaelizondo verizon.net 951-852-3387 Treasurer: Marilyn Rule College/ Career Counselor 38532 Quail Ridge Drive Accounting Manager Murrieta, CA 92562-3063 marilynrule(a)gmail.com 805-368-7521 Page 1 of 2 COUNTY OF RIVERSIDE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION FOR CITY OF LAKE ELSINORE 2021-2022 CITY CDBG ALLOCATION I. GENERAL INFORMATION: Applying Organization Name: Boys & Girls Club of Southwest County Type of Organization: Non-Profit Organization❑✓ Faith Based Organization For-Profit OrganizationEl Institution of Higher Education ❑ Cooperating City 11 Organization Address: 15 C5 16 Jt FFERSbN AvE. ) SU I r5 A City: ow i c-T A Zip Code: 2- Mailing Address: PO Box 892349 City: Temecula Zip Code: 92589 Telephone Number: 951-699-1526 Fax Number: NIA Executive Director: Shelly Anguiano Figueroa Telephone Number: 951-699-1526 E-mail: shellyf@becswc.org Program Manager: Joe Sorenson Telephone Number: 951-699-1526 E-mail: loeS@becswc.org Grant Writer: Carly Bennett-Valle Address (if different from above): Telephone Number: 951-699-1526 E-mail: carlyv@becswc.org 11. ORGANIZATIONAL HISTORY. (This is applicable only if you are a non-profit organization) Date Organization founded: 8/27/1990 Date Organization incorporated as a non-profit organization: 8/27/1990 Federal identification number: DUNS Number: Organization Web Address: www.becswc.org Does your Organization expend$750,000 or more a year in federal funds? Y E❑ or N 0 Number of paid staff: 15 Number of volunteers: 100 Members/Board of Directors(Attach):R III. PROJECT ACTIVITY A. Name of project: After School Scholarship Program B. Specific Location of Project 'Attach Project Map-Include street address•,if a street address has not been assigned provide APIN) Street or APN: 16275 Grand Avenue city:Lake Elsinore zip Code:92530 C. CDBG Funds Requested;$10,000 (total amount for the project only) D. Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility,what is the proposed service/benefit area for the facility? The proposed activity will occur at our Lake Elsinore Clubhouse located in Lakeland Village. E. In which City(ies)/Communities does the activity occur? city(ies): Lake Elsinore Community(ies):Lakeland Village NOTE:HHPWS will make the final determination of the appropriate service area of all proposals. F. If this project benefits residents of more than one community or jurisdiction, have requests been submitted to those other entitlement jurisdictions? (i.e., County district(s) 1", 2"d,3Id 41n, and/or 51h, City of Palm Springs,City of Moreno Valley, City of Riverside,etc.) N/A i G. Check ONLY the applicable category your application represents. ■❑ Public Service ❑ Homeless Activities ❑ Real Property Acquisition (Must consult with HHPwS Rripr to submitting application) ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities(construction) ❑ Infrastructure (i.e.Streets, Sewer,Sidewalk,etc.) ❑ other: (provide description) H. Respond to A&B only if this application its for a public service project. (a) Is this a NEW service provided by your agency? Yes ❑ No 0 (b) If service is not new, will the existing public service activity level be substantially increased or improved? The service will be increased because there is a need for more scholarships. Ill. PROJECT NARRATIVE A. Provide a detailed Project Description. The description should only address or discuss the specific activities, services, or project that is to be assisted with CDBG funds. If CDBG funds will assist the entire program or activity,then provide a description of the entire program or activity: The Boys & Girls Club of Southwest County (BGC) has a 30 year history working with young people, ages 16-18, from all socio-economic backgrounds and family circumstances. CDBG funds will provide scholarships to 20 youth from low-moderate income households, enabling them to participate in the BGC After School program (the Program). The Program has a formula for success that is instilled in every member. Academic Success+Healthy Lifestyles+Character and Lead ershi p=Great Futures. To meet these priority outcomes, trained, professional staff members, supervise, encourage, and implement activities in the following areas: (1) Health & Life Skills, (2) Sports, Fitness, & Recreation, (3) Culture &Art, (4)Academic & Career, (5) Service Learning. The Program runs every school day from 2:30pm to 6:30pm. Additionally, BGC offers a healthy meal and snack every afternoon. The Program empowers youth towards a great future by surrounding them with the oppportunities and resources needed to succeed. 2 B. Provide a detailed description of the proposed use of the CDBG funds only (e.g. client scholarships, purchase of specific equipment, rent,supplies, utilities, salaries,etc.): CDBG funds will be used for 20 scholarships for children from low-moderate income households to help offset the cost of the Program. The full fee for the Program is $180/month per child; however, BGC offers scholarships for up to 75% off the normal fee to families who qualify. For a family receiving a scholarship, the fee may be as little as $45/month. C. What are the goals and objectives of the project, service, or activity? Flow will you measure and evaluate the success of the project to meet these goals and objectives (measures should be qualitative)? The BGC services were developed to assist youth by providing a safe and supervised environment for children who might otherwise be left home alone. The goals of the program are to ensure all youth who walk through our doors are academically successful, exhibit good character and citizenship and are living a healthy lifestyle. Our objective is to provide an average of 150 visits to 20 youth from low-moderate income households with CDBG fund assistance. Each spring a survey is administered to Boys & Girls Club members to measure the impact of Clubs across the country in a consistent manner using a common set of research, informed indicators, and outcomes. BGC uses a data management system recommended by Boys & Girls Clubs of America to track program usage, scholarships, income, age, ethnicity, school, etc. Firsthand accounts from Club kids and parents can also be provided to show how individuals and families benefited from the Program. The above will be used to evaluate the success of the project. D. Please identify the project milestones using an Estimated Timeline for Project Implementation: July 2021-August 2021: Begin recruitment of members and identify 20 youth to receive scholarships for the Program. August 2021-May 2022: Provide BGC After School programming to 20 youth receiving scholarships. 3 V. PROJECT BENEFIT A. Indicate the number of people or households that will directly benefit from your proposal using CDBG funds: (Vote: This is based on the expected number of clients to be served if the County funds your project for the requested amount. 20 youth and their families. B. Indicate the number of unduplicated clients that will be served (An unduplicated client is counted only once, no matter how many direct services the client receives during a funding year): 20 youth members. C. length of proposed CDBG-funded activities or service(weeks, months,year): 36 weeks D. Service will be provided to(check one or more): ❑ Men ❑ Seniors ❑ Women ❑ Severely Disabled Adults ❑� Children (Range of children's ages:6-1 7 } ❑ Migrant Farm Workers ❑ Homeless (Number of beds at facility:-) ❑ Families 4 E. What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? BGC works closely with the Lake Elsinore Unified School District and other nonprofits and community organizations to publicize and recruit members through flyers, print media, group presentations, online newsletters, social media, the organization's website, etc. F. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work(project)after the CDBG funds are expended? BGC has been providing direct service to youth in Southwest Riverside County for 30 years. The fairly new Lakeland Village location opened in 2017 and was serving nearly 100 youth each day (prior to COVID). 57% of these youth are from families earning less than $53,850/year. BGC remains committed to area youth and families and will continue to provide needed services once CDBG funds are expended through ongoing fundraising efforts, grants, and events. Vll. National Objective All CDBG-funded activities must meet at least one of the following National Objectives of the CDBG program.Indicate the category of National Objective to be met by your activity. CATEGORY A: Benefit to low-moderate income persons (must be documented). Please choose either subcategory 1 or 2: 1. Limited Clientele: The project serves clientele that will provide documentation of their family size, income,_and ethnicity,. Identify the procedure you currently have in place to document that at least 51% of the clientele you serve are low-moderate income persons. BGC requires income verification at the time of application for a scholarship. Required documentation includes copies of the last two current pay stubs and bank statements, as well as a copy of the previous year's federal tax, verification of social services benefits and a letter of needs. BGC will use the County of Riverside's financial guidelines for the CDBG program (as prescribed through the EDA) and require current CDBG paperwork to be completed at the time of application. This information will be updated at least annually for all participants. 5 2. Clientele presumed to be principally low-and moderate-income persons: The following groups are presumed by HUD to meet this criterion. You will be required to submit a certification from the client(s)that they fall into one of the following presumed categories. The activity will benefit(check one or more) ❑Abused children ❑ Homeless persons ❑ Battered spouses ❑ Illiterate adults ❑ Elderly persons ❑ Persons living with AIDS ❑Severely disabled adults ❑ Migrant Farm workers a. Describe the clientele above to be served by this activity: b. Discuss how this project directly benefits low-and moderate-income residents: CATEGORY B,Area Benefit-'The project or facility serves,or is available to,ALL persons located within an area where at least 51% of the residents are low/moderate-income. (Applicant is welcome to contact a County of Riverside,HHPWS COBG Program Manager far Census Information) 2010 Census Tract and Block Group numbers: (must use 2011-2015 ACS data pursuant to HUD Notice-C&D-19-02 Total population in Census Tract(s)/block group(s)- Total percentage of low-moderate population in Census Tract(s)/block group(s): 6 CATEGORY C: Activities undertaken to create or retain permanent jobs, at least 51% of which will be made available to or held by low/moderate-income persons. Proposed Job Creation/Retention Total Jobs Expected to Create: Total lobs Expected to Retain: CATEGORY D:Activities that provide assistance to micro-enterprise owners/developers who are low/moderate-income. Proposed Assistance to Businesses New Businesses expected to assist: Existing Businesses expected to assist: Enter Total Businesses expected to assist: VIL FINANCIAL INFORMATION A. Proposed Project Budget Complete the following annual program budget to begin July 1, 2021. If your proposed CDBG-funded activity will start on a date other than July 1, 2021, please indicate starting date. Provide total Budget information and distribution of CDBG funds in the proposed budget. The budgeted items are for the specific activity for which you are requesting CDBG funding- NOT for the budget of the"entire" organization or agency. (Note:CDBG funds requested must match amount requested in Project Activity,C above.) (EXAMPLE:The Valley Senior Center is requesting funding for a new Senior Nutritional Program. The total cost of the program is$15,000 and$10,000 in CDBG funds is being requested for operating expenses associated with the proposed activity. The total Activity/Project Budget will include$5,000 of other non-CDBG funding and$10,000 in CDBG funds for a Grand Total of$15,000). TOTAL ACTIVITY/ PROJECT BUDGET CDBG FUNDS (Include non-CDBG Funds REQUESTED-Only and CDBG Funds I. Personnel A. Salaries &Wages $ $ B. Fringe Benefits $ $ C. Consultants& Contract Services $ $ PERSONNEL SUB-TOTAL $ $ 7 l!. Non-Personnel A. Space Costs $ $ B. Rental, Lease or Purchase of Equipment $ $ C. Consumable Supplies $ $ D. Travel $ $ E. Telephone $ $ F. Utilities $ $ G. Other Costs $ $ NON-PERSONNEL SUB-TOTAL: $ $ III. Other A. Architectural/Engineering Design $ $ B.Acquisition of Real Property $ $ C. Construction/Rehabilitation $ $ D. Indirect Costs $ $ E. other $30,000 $ 10,000 OTHER SUB-TOTAL: $30,000 $10,000 GRAND TOTAL: $30,000 $30,000 B. Leveraging List other funding sources and amounts (commitments or applications) which will assist in the implementation of this activity. Current and pending evidence of leveraging commitments/applications must be submitted with application. (Attach) Federal: State/Local: Private: Fees:$20,000 Donations: Other: C. What type of long-term financial commitment is there to the proposal? Describe how you plan to continue the work(project)after the CDBG funds are expended? BGC has been providing direct service to youth in Southwest Riverside County for 30 years. The Lakeland Village location opened in 2017 and was serving nearly 100 youth each day (prior to COVID). BGC Board and staff are committed to raising funds through ongoing fundraising efforts, grants, and events to assist families in need. D. Provide a summary by line item of your organization's previous year's income and expense statement.(Attach) E. Does this project benefit residents of more than one community or jurisdiction, have requests been submitted to those other jurisdictions? Yes❑ No Q If yes, identify sources and indicate outcome. If no, please explain. Only serves Lake Elsinore residents. F. Was this project or activity previously funded with CDBG? Yes ■❑ No ❑ If yes,when? FY 2019-2020; FY 2018-2019; FY 2016-2017; FY 2010-2011 Is this activity a continuation of a previously funded (CDBG) project? Yes FN] No❑ If yes,explain: There is a continuous need to support low-moderate income households. hill. MANAGEMENT CAPACITY A. Describe your organization's experience in managing and operating project or activities funded with CDBG or other Federal funds. BGC has managed CDBG funds in at least one of its service areas (Temecula, Murrieta, Lake Elsinore) since FY 2006-2007 and currently manages CDBG funds in the city of Temecula. In addition, BGC has currently and for many years managed Federal Office of Justice Program grants. 9 B. Management Systems Does your organization have written and adopted management systems (i.e., policies and procedures) including personnel, procurement, property management, record keeping, financial management, etc.? BGC has Board of approved policies. C. Capacity Please provide the names and qualifications of the person(s) that will be primarily responsible for the implementation and completion of the proposed project. Carly Bennett-Valle,Chief Financial Officer- Carly has 5 years of experience with Boys & Girls Clubs and non-profit management. Carly has experience in managing federal and state funded grants. Joe Sorenson, Chief Operations Officer- Joe has been with BGC since January 2019. Joe has managed CDBG and Federal Office of Justice Programs during his tenure. 10 IX. APPLICATION CERTIFICATION Undersigned hereby certifies that(check box after reading each statement and digitally sign the document): 1. The information contained in the project application is complete and accurate. Z. The applicant agrees to comply with all Federal and County policies and requirements imposed upon the project or activity funded by the CDBG program. 3. The applicant acknowledges that the Federal assistance made available through the CDBG program funding will not be used to substantial) educe prior levels of local, (NON-CDBG) financial support for community development activities. 4. The applicant fully understands that any facility built or equipment purchased with CDBG funds shall be maintained and/ r operated for the approved use throughout its economic life, pursuant to CDBG regulation.-7 5. If CDBG funds are approved, the applicant acknowledges that sufficient non-CDBG funds afe available or will be available to complete the project as described within a reasonable timeframe. V 6. on behalf of the applying organization, I have obtained authorization to submit this application for CDBG funding. (D7MENTATION ATTACHED Minute Action and/or written Board Approval signed by the Board President) DATE: 1 1'5'2O20 Signature: Print Name/Title Carly Bennett-Valle / Chief Financial Officer Authorized Representative: 11 CHECK-LIST: The following required documents listed below have been attached. Any missing documentation to the application will be cause for the application to be reviewed as INELIGIBLE. Yes No ATTACHMENT V ❑ 1. Members/Board of Directors ❑ 2. Articles of Incorporation and Bylaws ❑ [ 3. Project Activity Map iI)PC ❑ [� 4. Project Benefit, Category B, Low Mod Area Maps(Attach if applicable) P!A 1� ❑ 5. Leveraging(Current evidence of commitment) ❑ 6. Income and Expense Statement d ❑ 7. Management Capacity(Detailed organizational chart) ❑ 8. Board Written Authorization approving submission of application 12 BOYS&GIRM CLUE OF SOUTHWEST COUNTY Temecula I Murrieta I Lake Elsinore 2020 Board of Directors Kimberly Freize Uhler, Chair Clear Blue Promotions Tony Berardino, Chair Elect CES Cornerstone E&S Insurance Services 31805 Temecula Parkway Suite 683 Temecula, CA 92592 Al Rubio, 2"d Vice Chair DCH Auto Group 26845 Ynez Rd. Temecula, CA Myrna Crowther, 3rd Vice Chair Prime Lending 41540 Winchester Rd., Ste. 120 Temecula, CA 92591 Bill Cary,Treasurer William Cary, CPA 27349 Jefferson Ave.,Ste 101 Temecula, CA 92590 Ed Miller, Esq., Past Chairman Fabozzi & Miller, APC 38975 Sky Canyon Dr, Suite 104 Murrieta, CA 92563 Steve Amante Amante & Associates 38975 Sky Canyon Dr, Suite 102 Murrieta, CA 92563 Sonia Bravo Kaiser Permanente 10800 Magnolia Avenue Riverside, CA 92505 Cynthia Davis-Medel Docs Legal Prep, Inc. 41690 Ivy Street, B5 Murrieta, CA 92562 Jonathan Evancik REE Mechanical, Inc. 42245 Remington Ave, B10 Temecula, CA 92590 Patrick Fitzgerald Superior Restoration 532 3rd Street Lake Elsinore, CA 92587 Genie Kelley Retired, Lake Elsinore Unified School District Chris Keyson 8bit Brewing Company 26755 Jefferson Ave. Murrieta, CA 92562 Jeff Kurtz Promenade Temecula 40820 Winchester Rd. Ste. 2000 Temecula, CA 92591 Alistair Machoka Corona Regional Medical Center 800 S. Main Street Corona, CA 92882 Erik McLeod Pacific Premier Bank 40723 Murrieta Hot Springs Rd. Murrieta, CA 92562 Mark Nugent Banner Bank 3999 E. Inland Empire Blvd. Ontario, CA 91764 Christian Petersen CarMax 25560 Madison Ave. Murrieta, CA 92562 John Ruff Ruff& Ready Moving, LLC 43169 Via Dos Pico, Suite A Temecula, CA 92590 Alan Winkelstein, OD Temecula Valley Optometry COUNTY OF RIVERSIDE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION FOR CITY OF LAKE ELSINORE 2021-2022 CITY CDBG ALLOCATION I. GENERAL INFORMATION: Applying Organization Name: HOPE (Helping Our People of Elsinore) Type of Organization: Non-Profit Organization ✓] Faith Based Organization For-Profit Organization Institution of Higher Education El Cooperating City Organization Address. 506 Minthorn Street City. Lake Elsinore Zip Code: 92530 Mailing Address: 506 Minthorn Street City: Lake Elsinore Zip Code: 92530 Telephone Number: (951) 245-7510 Fax Number: Executive Director: Brett Masters Telephone Number: (951) 376-3703 E-mail: hrett@dreamcenterle.org Program Manager: Patti Londot Telephone Number: (951) 751-5828 E-mail: patti@dreamcenterie.org Grant Writer: Patti Londot Address (If different from above): Telephone Number: (951) 751-5828 E-mail: patti@dreamcenterle.org II. ORGANIZATIONAL HISTORY: (This is applicable only if you are a non-profit organization) Date Organization founded: 09-09-1990 Date Organization incorporated as a non-profit organization: 02-02-1992 Federal identification number: DUNS Number: Organization Web Address: dreamcenterle.org/hope Does your Organization expend $750,000 or more a year in federal funds? Y❑ or N ❑o Number of paid staff: 1 Number of volunteers: >150 Members/Board of Directors (Attach): ❑ u1. PROJECT ACTIVITY A. Name of Project: Pantry Program B. Specific Location of Project (Attach Project Map-include street address;if a street address has not been assigned provide APN) Street or APN:506 Minthorn Street city: Lake Elsinore zip Code: 92530 C. CDBG Funds Requested-57,500 q (iotal amount for the project only) D. Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? The Pantry Program will be facilitated at the Minthorn address. HOPE mirrors the services of the Lake Elsinore Unified School District. E. In which City (ies)/Communities does the activity occur? City (ies): Lake Elsinore, Canyon Lake, Wildomar. Community(ies):Lakeland Village and Horsethief Canyon NOTE: HHPWS will make the final determination of the appropriate service area of all proposals. F. If this project benefits residents of more than one community or jurisdiction, have requests been submitted to those other entitlement jurisdictions? (i.e., County district(s) 1", 2nd 3ra 41n and/or 5Y", City of Palm Springs, City of Moreno Valley, City of Riverside, etc.) We will be submitting CDBG applications for Program Year 2021-2022 to the City of Canyon Lake and to the County of Riverside. We hope the City of Wildomar will accomodate an additional budget item to supplement the CDBG local funding for the community. 1 G. Check ONLY the applicable category your application represents. 0 Public Service ❑ Homeless Activities ❑ Real Property Acquisition (Must consult with HHPWS r�ior to submitting application) ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities(construction) ❑ Infrastructure (i.e. Streets, Sewer, Sidewalk, etc.) ❑ Other: (provide description) H. Respond to A& B only if this application is for a public service project. (a) Is this a NEW service provided by your agency? Yes ❑ No ❑� (b) If service is not new, will the existing public service activity level be substantially increased or improved? Yes. HOPE is working to improve clients ability to move to independence through mentoring and use of networking with local agencies and their programs. IV. PROJECT NARRATIVE A. Provide a detailed Project Description. The description should only address or discuss the specific activities, services, or project that is to be assisted with CDBG funds. If CDBG funds will assist the entire program or activity,then provide a description of the entire program or activity: Through our Pantry Program, we ensure that those at greatest risk of hunger receive the food they need to alleviate food-related consequences. As a result of the COVID-19 pandemic, we have evolved from providing food to clients on a once-per-month basis to a weekly basis. 2020 year-to-date (as of September) has seen volume of families served grow by 65% compared with full-year 2019, while individuals served YTD through September has seen growth of 104% compared with full-year 2019. A report out of the Food Research and Action Center (FRAC) titled "Food Hardship in America. Households with Children Especially Hard Hit" (Sept. 2016) California was listed as 24th hardest hit among the 50 states. Among the metropolitan statistical areas (MSA) hardest hit, the area served by HOPE (Riverside-San Bernardino-Ontario) was ranked 37th hardest hit out of the 100 MSAs surveyed, with a 20.8% hardship rate for Households with Children. Without access to food, children are more likely to be sick more frequently, experience growth and development impairments, have lower academic achievements, struggle with social and behavioral problems. Seniors without access to healthy and abundant food sources are at a higher risk of illness and loss of independence, resulting in higher rates of depression, chronic disease and suicide. 2 B. Provide a detailed description of the proposed use of the CDBG funds only (e.g. client scholarships, purchase of specific equipment, rent, supplies, utilities, salaries, etc.): CDBG funds will be used to cover our most basic but crucial costs including food, rent, utilities, supplies, the HOPE food director (the only paid position) and any necessary safety repairs for our Pantry Program. This past year we were able to meet our proposed funding goals, which included a lift-gate box truck and walk-in refrigerator that helped us to achieve the ability to provide fresh produce and other goods to our clients. While HOPE celebrates 30 years of serving the community this December, our lift-gate box truck will also become 30 years old, and is in disrepair, along with our other cargo vans, one which remains in service with over 200,000 miles, and one which failed smog and had to be scrapped. This year we would like to replace the lift-gate box truck and both cargo vans to something newer and less prone to breakdown while in the line of service. This would enable adding drivers to affect a greater outreach in the community and close the gaps of the areas we feel are currently underserved. We would also like to add a utility freezer to help keep items longer, eliminate waste and be a more cost-effective means of food preservation. As in the past, we will be utilizing funding from the CDBG program to assist in accomplishing sustainability goals to help us continue serving Lake Elsinore and help us to further expand the areas within and beyond Lake Elsinore that are currently underserved. C. What are the goals and objectives of the project, service, or activity? How will you measure and evaluate the success of the project to meet these goals and objectives (measures should be qualitative)? Goals and Objectives: Our immediate-term goal is to ensure that those in need receive the food necessary to avoid going hungry. Our longer-term goals are laid out in two phases: Phase 1 - Efficiency and effectiveness optimization and Phase 2, Client coverage expansion. Phase 1 addresses improving the processes we employ to drive effective and efficient operations, eliminating unnecessary steps that consume time of volunteers which limits their ability to smoothly execute the primary mission of feeding the hungry. Completion of Phase 1 enables the deployment of Phase 2, which is designed to expand our reach of clients served (or underserved). In parallel to Phase 1 and 2, we are adding mentorship and life-coaching services to help willing clients move to independence. Measurement and Evaluation: Using our client management tools, we log every individual/family who receives services from HOPE, including type of assistance provided to support demographic and other reporting. Phase 1 goals: we are implementing Key Performance Indicators to capture hours by critical task compared with targeted hours, etc. Phase 2 will be measured through the use of community surveys and action plans. D. Please identify the project milestones using an Estimated Timeline for Project Implementation: Phase 1 Milestones - December 2020 through April 2021. 1) Benchmark highly effective food banks, 2) conduct Lean workshop to identify process improvement opportunities, 3) prioritize process improvement areas, 4) deploy process improvements and 5) measure results to ensure success. Phase 2 Milestones - March through December 2021: 1) Develop and deploy survey to help identify underserved families/individuals within the area currently served by HOPE, 2) analyze survey results to identify the 2 to 3 biggest themes emerging out of this activity, 3) develop and deploy action plan to affect reaching the underserved identified through the survey and interview exercises, 4) develop metrics to ensure Phase 2 execution success, 5) document and share lessons learned. 3 v. PROJECT BENEFIT A. Indicate the number of people or households that will directly benefit from your proposal using CDBG funds: Note: This is based on the expected number of clients to be served if the County funds your project for the requested amount. Approximately 12,000 households. B. Indicate the number of unduplicated clients that will be served (An unduplicated client is counted only once, no matter how many direct services the client receives during a funding year): Over 4,000 unique and unduplicated individuals. C. Length of proposed CDBG-funded activities or service(weeks, months,year): 12 months of service. D. Service will be provided to (check one or more): Men 0 Seniors 0 Women ❑■ Severely Disabled Adults Q Children (Range of children's ages :0-17 ElMigrant Farm Workers [] Homeless (Number of beds at facility : ) A Families 4 E. What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? Our Outreach Team regularly goes out into the community to deliver food and spread the word to those in need. We have ambasadors at many of the local churches in the valley. We visit local trailer parks and low-income areas of the city to make food deliveries and work with other agencies for referrals. Local agencies we work with include the Lake Elsinore Unified Schoold District, SWAG, DPSS, City of Wildomar, City of Lake Elsinore and the City of Canyon Lake. We have become a wholly owned subsidiary of the Dream Center to continue our sustainability in the community. Their outreach into the community is weekly with their Adopt-a-Block program. If there is a need, they are able to fill it including providing food. F. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the CDBG funds are expended? HOPE has been meeting the needs of those in desperate need of food for over 29 years. CDBG funds have been instrumental in our ability to serve the needs of the community. To continue works after CDBG funds are expended, we also work with other agencies, pursue other grants, and partner with local markets and other organizations, such as Feeding America, to receive an ongoing source of fresh supplies. We also model the Mission Increase principles to multiply fund-raising efforts. Partnering with the Dream Center-LE has enabled us to provide additional volunteers and access to resources at the intake evaluation for willing participants in the mentoring program. vl. National objective All CDBG-funded activities must meet at least one of the following National Objectives of the CDBG program. Indicate the category of National Objective to be met by your activity. CATEGORY A: Benefit to low-moderate income persons (must be documented). Please choose either subcategory 1 or 2: 1. Limited Clientele: The project serves clientele that will provide documentation of their family size, income, and ethnicity. Identify the procedure you currently have in place to document that at least 51% of the clientele you serve are low-moderate income persons. Through client intake forms we confirm that all clients receiving services through HOPE are low-income persons in accordance with HUD guidelines. 5 2. Clientele presumed to be principally low-and moderate-income persons: The following groups are presumed by HUD to meet this criterion. You will be required to submit a certification from the client (s)that they fall into one of the following presumed categories. The activity will benefit (check one or more) ❑■ Abused children ■❑ Homeless persons Q Battered spouses � Illiterate adults 0 Elderly persons ❑ Persons living with AIDS Severely disabled adults ❑ Migrant Farm workers a. Describe the clientele above to be served by this activity: Among the clientele served by HOPE, which is only those in desperate need, are populations of individuals which includes: Abused children, battered spouses, elderly persons, severely disabled adults, homeless persons and illiterate adults. b. Discuss how this project directly benefits low-and moderate- income residents: HOPE only serves those in desperate need of assistance within our community. It is our commitment to ensure that those most vulnerable receive assistance, particularly those who do not have adequate means to purchase food for themselves or their families. The majority of our clientele are extremely low-income clients as defined by HUD and are living below the poverty line. Food costs could easily equate to 30-40% of their income based on the USDA food cost guidelines. CATEGORY B: Area Benefit-The project or facility serves, or is available to,ALL persons located within an area where at least 51% of the residents are low/moderate-income. (Applicant is welcome to contact a County of Riverside,HHPWS CDBG Program Manager for Census Information) 2010 Census Tract and Block Group numbers: (must use 2011-2015 ACS data pursuant to HUD Notice-C&D-19-02 Total population in Census Tract(s)/block group(s): Total percentage of low-moderate population in Census Tract(s)/ block group(s): 6 CATEGORY C: Activities undertaken to create or retain permanent jobs, at least 51% of which will be made available to or held by low/moderate-income persons. Proposed Job Creation/Retention Total Jobs Expected to Create: Total Jobs Expected to Retain: CATEGORY D: Activities that provide assistance to micro-enterprise owners/developers who are low/moderate-income. Proposed Assistance to Businesses New Businesses expected to assist: Existing Businesses expected to assist: Enter Total Businesses expected to assist: VII. FINANCIAL INFORMATION A. Proposed Project Budget Complete the following annual program budget to begin July 1, 2021. If your proposed CDBG-funded activity will start on a date other than July 1, 2021, please indicate starting date. Provide total Budget information and distribution of CDBG funds in the proposed budget. The budgeted items are for the specific activity for which you are requesting CDBG funding - NOT for the budget of the "entire" organization or agency. (Note:CDBG funds requested must match amount requested in Project Activity,C above.) (EXAMPLE: The Valley Senior Center is requesting funding for a new Senior Nutritional Program. The total cost of the program is$15,000 and$10,000 in CDBG funds is being requested for operating expenses associated with the proposed activity. The total Activity/Project Budget will include$5,000 of other non-CDBG funding and$10,000 in CDBG funds for a Grand Total of$15,000). TOTAL ACTIVITY/ PROJECT BUDGET CDBG FUNDS (Include non-CDBG Funds REQUESTED-Only and CDBG Funds) I. Personnel A, Salaries &Wages $42,000 $16,000 B. Fringe Benefits $0 $ C, Consultants & Contract Services $ 0 $ PERSONNEL SUB-TOTAL $42,000 $ 16,000 7 II. Non-Personnel A. Space Costs $57,000 $21,000 B. Rental, Lease or Purchase of Equipment $47,000 $18000 C. Consumable Supplies $33,000 $15,000 D. Travel $5,000 $2,500 E. Telephone $2,000 $ 1,000 F. Utilities $20,000 $7,500 G. Other Costs $54,000 $ 18,500 NON-PERSONNEL SUB-TOTAL: $218,000 $83,500 III. Other A. Architectural/Engineering Design $0 $ B. Acquisition of Real Property $0 $ C, Construction/Rehabilitation $0 $ D. Indirect Costs $0 $ E, Other $0 $ OTHER SUB-TOTAL: $0 $ GRAND TOTAL: $260,000 $99,500 B. Leveraging List other funding sources and amounts (commitments or applications) which will assist in the implementation of this activity. Current and pending evidence of leveraging commitments/applications must be submitted with application. (Attach) Federal:CDBG: $170,000 State/Local:Bus/Orgs: $36,000 Private: Individuals: $48,000 Fees: Donations: Other:Grants: $6,000 8 C. What type of long-term financial commitment is there to the proposal? Describe how you plan to continue the work (project) after the CDBG funds are expended? HOPE has been meeting the needs of those in desperate need of food for over 29 years. CDBG funds have been instrumental in our ability to leverage other funds and partners, however, it is not our only source of income. We have collaborated with other agencies for referrals and partnered with local markets to receive fresh supplies. It is, however, through CDBG funds that we are able to cover operational costs to serve our clients. D. Provide a summary by line item of your organization's previous year's income and expense statement. (Attach)Fv� E. Does this project benefit residents of more than one community or jurisdiction, have requests been submitted to those other jurisdictions? Yes❑■ No ❑ If yes, identify sources and indicate outcome. We will be submitting CDBG applications for Program Year 2021-2022 to the city of Canyon Lake, and to the County of Riverside. We hope the City of Wildomar will accomodate an additional budget item to supplement the CDBG local funding. if no, please explain. F. Was this project or activity previously funded with CDBG? Yes❑■ No❑ If yes,when? HOPE has been utilizing CDBG funds since July, 1995. CDBG funds have been crucial in our ability to keep our doors open and our Pantry Program running. Is this activity a continuation of a previously funded (CDBG) project? Yes Fil No ❑ If yes, explain: —14.6 of Lake Elsinore residents live in poverty, and food security is a major daily hurdle. At HOPE, we ensure that food is available so residents can concentrate on other important essentials, such as housing, employment, education, daycare and health. Vill. MANAGEMENT CAPACITY A. Describe your organization's experience in managing and operating project or activities funded with CDBG or other Federal funds. Hope has received CDBG funding for the past 25 years and all funds have been spent in accordance with agreements and with no compliance issues. All required reports and statistics have been submitted on time. 9 B. Management Systems Does your organization have written and adopted management systems (Le., policies and procedures) including personnel, procurement, property management, record keeping, financial management, etc.? HOPE's board has adopted policies and procedures regarding personnel, volunteer management, procurement, property management, financial management, records, client intake and other systems required to operate and manage HOPE. C. Capacity Please provide the names and qualifications of the person(s) that will be primarily responsible for the implementation and completion of the proposed project. Brett Masters is the executive responsible for implementation of this project. Brett serves as the main contact for the Dream Center-LE, which includes running the Fresh Food program through HOPE, an activity HOPE has participated in since 2008. In October, 2020, Brett brought on Patti Londot as Director, HOPE Food Pantry. Patti's focus is both on the day-to-day execution of HOPE's mission, while also developing and deploying strategies to improve operations and expand service to all in need. 10 IX. APPLICATION CERTIFICATION Undersigned hereby certifies that(check box after reading each statement and digitally sign the document): 1. The information contained in the project application is complete and accurate.-0 2. The applicant agrees to comply with all Federal and policies and requirements imposed upon the project or activity funded by the CDBG program 1 3. The applicant acknowledges that the Federal assistance made available through the CDBG program funding will not be used to substant duce prior levels of local, (NON-CDBG) financial support for community development activiti 4. The applicant fully understands that any facility built or equipment purchased with CDBG funds shall be maintained a operated for the approved use throughout its economic life, pursuant to CDBG regulation. S. If CDBG funds are approved, the applicant acknowledges that sufficient non-CDBG funds are available or will be available to complete the project as described within a reasonable timeframe. 6. On behalf of the applying organization, I have obtained authorization to submit this application for CDBG funding. IROCUMENTATION ATTACHED Minute Action and/or written Board Approval signed by the Board Pres€den DATE: Signatu Print Name/Title Authorized Representative: 11 CHECK-LIST: The following required documents listed below have been attached. Any missing documentation to the application will be cause for the application to be reviewed as INELIGIBLE. Yes No ATTACHMENT ❑ 1. Members/Board of Directors ❑ 2. Articles of Incorporation and Bylaws ❑ 3. project Activity Map ❑.11 ❑ 4. Project Benefit, Category B, Low Mod Area Maps (Attach if applicable) [� ❑ 5. Leveraging (Current evidence of commitment) ❑ 6. Income and Expense Statement [� ❑ 7. Management Capacity (Detailed organizational chart) ❑ 8. Board Written Authorization approving submission of application 12 ar u c HOPEUI Board of Directors October 91 2020 Brett Masters, Chair Kara Vega, Treasurer Aubrey Masters, Recording Secretary Bob Guilliams, Member David Baker, Member Cathy Cook Templeton, Member-at-Large Chuck Searer, Member-at-Large "We can do all this through Him who gives us strength" Philippians 4:13 COUNTY OF RIVERSIDE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM APPLICATION FOR CITY OF LAKE ELSINORE 2021-2022 CITY CDBG ALLOCATION I. GENERAL INFORMATION: Applying Organization Name; Vista Community Clinic Type of Organization: Non-Profit Organization ✓� Faith Based Organization ❑ For-Profit Organization Institution of Higher Education Cooperating City Organization Address: 1000 Vale Terrace Drive City: Vista Zip Code: 92084-5218 Mailing Address: 1000 Vale Terrace Drive City: Vista Zip Code: 92084-5218 Telephone Number: 760-631-5000 Fax Number: 760-414-3701 Executive Director: Fernando Sanudo Telephone Number: 760-631-5000, x1131 E-mail: ceo@vcc.org Program Manager: Rajni Lopez Telephone Number: 760-631-5000, x8183 E-mail: rajni.lopez@vcc.org Grant Writer: Joshua Lazerson Address (If different from above): Telephone Number: 760-631-5000, x7099 E-mail: Joshua.N.Laze rson@vcc.%g II. ORGANIZATIONAL HISTORY: (This is applicable only if you are a non-profit organization) Date Organization founded: June 15, 1972 Date Organization incorporated as a non-profit organization: October 11, 1972 Federal identification number: DUNS Number: - Organization Web Address: www.vcc.org Does your Organization expend $750,000 or more a year in federal funds? Y❑■ or N ❑ Number of paid staff: 701 Number of volunteers: 197 Members/Board of Directors(Attach):FV III. PROJECT ACTIVITY A. Name of Project: Health insurance application assistance for low-income residents B. Specific Location of Project (Attach Project Map-include street address if a street address has riot been assigned provide APN) Street or APN: 30195 Fraser Drive City: Lake Elsinore zip Code. 92530-7006 C. CDBG Funds Requested: $22,376 (total omountfor the project only) D. Where will the proposed activity occur (be specific as to the geographic boundaries)? if the project involves a new or existing facility,what is the proposed service/benefit area for the facility? Project staff will be housed at the VCC: Lake Elsinore clinic site. 70% of patients are from Lake Elsinore. Outreach will focus on census tracts 430.011.051.06, 464.02-.04. E. In which City(ies)/Communities does the activity occur? City(ies): Lake Elsinore Community(ies): NOTE. HHPWS will make the final determination of the appropriate service area of all proposals. F. If this project benefits residents of more than one community or jurisdiction, have requests been submitted to those other entitlement jurisdictions? (i.e., County district(s) 15t,2"a,3`a 4th, and/or 5th.City of Palm Springs, City of Moreno Valley, City of Riverside,etc.) 1 G.Check ONLY the applicable category your application represents. ❑■ Public Service ❑ Homeless Activities ❑ Real Property Acquisition(Must consult with HHPws ! or to submitting application) ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities(construction) ❑ Infrastructure(i.e.Streets,Sewer,Sidewalk, etc.) ❑ Other: (provide description) H. Respond to A&B o, my if this application is fora public c service project. (a) Is this a NEW service provided by your agency? Yes ❑ No 0 (b) If service is not new,will the existing public service activity level be substantially increased or improved? If funded, VCC will be able to retain the services of a full-time Certified Enrollment Counselor who will help low-income residents apply for/maintain health insurance. IV. PROJECT NARRATIVE A. Provide a detailed Proiect Description__. The description should only address or discuss the specific activities, services, or project that is to be assisted with CDBG funds. If CDBG funds will assist the entire program or activity,then provide a description of the entire program or activity: In the Lake Elsinore zip code of 92530 where VCC: Lake Elsinore is located, 25,000+ residents are low-income. Patient enrollment here has grown substantially (from 705 in 2016 to 5,862 in 2019, an increase of 731%). Nonetheless, the federal UDS Mapper website illustrates that over 18,000 low-income residents in the area remain unserved by the health center program. This project's goal is to connect low-income residents to a medical and dental home. Prior City of Lake Elsinore CDBG support has enabled VCC to hire a Certified Enrollment Counselor (CEC)to screen and enroll new patients into Medi-Cal or Covered California insurance plans. The CEC also assists existing patients in renewing and therefore maintaining their coverage. As of last year, VCC's CEC was the only person providing these services here, and County Health Department staff refer their clients to VCC for application assistance. Requested funds will support the maintenance of this vital service, increasing the number of low-income Lake Elsinore residents acquiring and maintaining health insurance. The CEC is supported by an Outreach Worker who attends community events and visits local non-profits to promote these services and the availability of application assistance. 2 B. Provide a detailed description of the proposed use of the CDBG funds only (e.g. client scholarships, purchase of specific equipment, rent,supplies,utilities,salaries,etc.): VCC will use the $22,376 in City of Lake Elsinore CDBG funding to cover 45% of the Certified Enrollment Counselor's salary and fringe benefits. VCC will utilize federal funding to cover the balance of the position's salary and fringe benefits. The CEC has all of those tools (e.g. laptop computer, office supplies, access to electronic communication devices) needed to perform enrollment duties. Indirect costs, such as space rent, utilities, and communications will be covered by the same federal funding that supported VCC's development of the Lake Elsinore clinic, and which continues to provide core sustaining funding for that site. C. What are the goals and objectives of the project, service, or activity? How will you measure and evaluate the success of the project to meet these goals and objectives (measures should be qualitative)? From July 1, 2019-January 31, 2020, a total of 290 individuals from Lake Elsinore were provided application assistance through CDBG funds. For the entire FY 2019-2020, a total of 1,055 individuals received application assistance, of which 74% were for Medi-Cal, 17% were for CalFresh (food stamps), and 9% were for Covered California. At the time of this application, 80% of Medi-Cal applications submitted by Lake Elsinore residents with a decision had been approved. In FY21-22, VCC: Lake Elsinore anticipates enrolling 300-400 Lake Elsinore residents in health insurance. However, many will not meet the stringent documentation requirements of the CDBG program. For this reason, the objective of our FY21-22 CDBG program will be to successfully enroll a minimum of 100 Lake Elsinore residents in a public health insurance program. Excluded from this tally will be patients that come to the clinic for medical, behavioral health, or dental care without proper application verification documents and those ineligible for Medi-Cal due to income requirements. D. Please identify the project milestones using an Estimated Timeline for Project Implementation: Because this is an ongoing effort, project Implementation will begin immediately on July 1, 2021, and continue through June 30, 2022. The Program Manager, Rajni Lopez, will monitor enrollment outcomes on a monthly basis, with the understanding that enrollments fluctuate month to month. (VCC typically experiences above-average enrollment activity when Covered California promotes its open enrollment season, even though Medi-Cal applications are accepted year-round.)The pandemic crisis also may have an effect on project operations and outcomes. Because enrollment inputs and outcomes are tracked online via CarePoint software, VCC can run current reports for the fonder at any time. 3 V. PROJECT BENEFIT A. Indicate the number of people or households that will directly benefit from your proposal using CDBG funds: !Vote: This is based on the expected number of clients to be served if the County funds your project for the requested amount. The proposed project will assist a minimum of 100 individuals to gain access to medical and dental insurance during the funding year. Those that also choose VCC as their healthcare home will gain access to quality, comprehensive healthcare services including prenatal care and obstetrics, pediatrics, family and internal medicine, women's health and reproductive health care, dental care, behavioral health services, optometry, podiatry, rheumatology, chiropractic care, and preventive services such as hypertension screening, flu and pneumonia innocuiations, childhood immunizations, and COVID-19 testing. Currently 27% of VCC: Lake Elsinore patients are Latinx, 59% are female, and 40% are children under the age of 19. B. Indicate the number of unduplicated clients that will be served (An unduplicated client is counted only once, no motter how many direct services the client receives during o funding year): As noted above, VCC expects to enroll a minimum of 100 persons in health insurance per CDBG verification requirements. As noted earlier, the actual number of Lake Elsinore residents that VCC expects to enroll in health insurance through the work of the CEC during the funding period will be 300 to 400, but many of these individuals will not be counted for the purposes of this award, as they will not have the requisite documentation to be verified per CDBG requirements. C. Length of proposed CDBG-funded activities or service(weeks, months,year): The proposed effort will take place over the course of a full year, with an anticipated funding year period of July 1, 2021 -- June 30, 2022. The service that VCC proposes to provide through this application (health application/re-application assistance) will be provided continuously during the funding period. D. Service will be provided to(check one or more): Q Men ❑■ seniors 0 Women ❑ Severely Disabled Adults Children (Range of children's ages : } X Migrant Farm Workers 0 Homeless(Number of beds at facility:_) Q Families 4 E. What methods will be used for community involvement to assure that all who might Benefit from the project are provided an opportunity to participate? All CECs at VCC are supported by a team of Outreach Workers that spend all of their time conducting community outreach in low-income neighborhoods. They participate in health fairs, visit low-income housing developments, and conduct presentations at non-profit agencies that also serve low-income individuals. In 2019 alone, the Outreach team recorded hundreds of community contacts in Lake Elsinore. It is through these contacts that VCC leadership and clinicians learn more about residents' barriers to care, emerging healthcare needs, and suggestions on how best to address them. With the pandemic, the project will be increasing its outreach through social media to reach those in need. In fact, as a result of the pandemic, the number of persons in the target area and population who require application assistance has increased with the number of persons losing employment. F. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work(project) after the CDBG funds are expended? VCC's commitment to the long-term provision of healthcare in Lake Elsinore is confirmed by the following: (1) VCC wrote for and was awarded base funding to operate VCC: Lake Elsinore from the federal Health Resources and Services Administration, so guaranteeing the long-term sustenance of this clinic facility; (2) VCC invested significant funds to improve the Fraser Drive property to meet state OSHPD requirements and fulfill its comprehensive care mandate; and (3) VCC continues to seek grant funding from government and foundation sources to support multiple primary care, mental health, and dental programs for the benefit of Lake Elsinore residents. Insurance enrollment assistance remains a priority activity in Lake Elsinore because the rate of uninsurance among VCC: Lake Elsinore patients is 25.4%, above the national average of 22.7% among community health centers nationwide. VI. NationalObie_ctive All CDBG-funded activities must meet at least one of the following National Objectives of the CDBG program. Indicate the category of National Objective to be met by your activity. CATEGORY A: Benefit to low-moderate income persons (must be documented). Please choose either subcategory 1 or Z: 1. Limited Clientele: The project serves clientele that will provide documentation of their family size, income, and ethnicity. Identify the procedure you currently have in place to document that at least 51% of the clientele you serve are low-moderate income persons. Across VCC sites, 96% of patients are low income - they have household incomes at or below 200% of the federal poverty level. During enrollment, VCC collects applicants' demographic information and reviews income verification documents such as paycheck stubs. It is important to note that many patients come to the clinic for care without all of their paperwork in hand. For example, newly unemployed persons often have not received paperwork from the State EDD office. Only those patients with proper paperwork, and who sign attestations regarding family size, income, and ethnicity, will be counted on the CDBG report. Patients without proper documentation will be seen, but will not be counted. 5 2. Clientele presumed to be principally low-and moderate-income persons: The following groups are presumed by HUD to meet this criterion. You will be required to submit a certification from the client(s)that they fall into one of the following presumed categories. The activity will benefit(check one or more) ❑Abused children ❑ Homeless persons ❑ Battered spouses ❑ Illiterate adults ❑ Elderly persons ❑ Persons living with AIDS ❑Severely disabled adults ❑ Migrant Farm►workers a. Describe the clientele above to be served by this activity: Many clinic patients live in CTs 430.01 and 430.06. Of these residents, 27%+ are living in poverty compared to under 16% in 92530, of which these CTs are a part; 58% of these tracts' residents are impoverished or low-income, compared to 44% in the zip code; and where the median household income in 92530 is $57,428, it is below $40,000 in these CTs. Life expectancy in these CTs is below that in Riverside County generally; home ownership is well below the County average (37% & 32% vs. 56% in the County); while adults with a BA in these CTs (5.3% & 8.5% respectively) is just a fraction of the County rate (21.2%). VCC: Lake Elsinore serves families of modest means who need healthcare assistance. b. Discuss how this project directly benefits low-and moderate-income residents: This CEC-driven project provides high-need residents access to health insurance and other resources, making it possible for those involved to develop a long-term relationship with a healthcare provider and to establish a medical home. Residents of 92530 fare worse than Riverside residents generally in the context of 27 significant health related indicators, including ER rate due to diabetes and uncontrolled diabetes, and to related long-term complications; adult obesity; ER rate due to heart failure and hypertension; babies with low birth weight; adults with serious psychological distress; hospitalization rate related to alcohol abuse; and quite a flew others. By engaging in the outreach and application assistance described here, low-income Lake Elsinore residents can access the care they require to maintain health, recover from illness, and ideally reduce the negative indicators above. CATEGORY 8:Area Benefit-The project or facility serves,or is available to,ALL persons located within an area where at least 51% of the residents are low/moderate-income. (Applicant is welcome to contact a County of Riverside,MNPWS CDBG Program Manager for Census information) 2010 Census Tract and Block Group numbers: (must use 2011-2015 ACS data pursuant to HUD Notice.-C&D-19-02 Total population in Census Tract(s)/block group(s):_ Total percentage of low-moderate population in Census Tract(s)/block group(s): 6 CATEGORY C: Activities undertaken to create or retain permanent jobs, at least 51% of which will be made available to or held by low/moderate-income persons. Proposed Job Creation/Retention Total Jobs Expected to Create: Total Jobs Expected to Retain: CATEGORY D:Activities that provide assistance to micro-enterprise owners/developers who are low/moderate-income. Proposed Assistance to Businesses New Businesses expected to assist: Existing Businesses expected to assist: Enter Total Businesses expected to assist: VII. FINANCIAL INFORMATION A. Proposed Project Budget Complete the following annual program budget to begin July 1, 2021. If your proposed CDBG-funded activity will start on a date other than July 1, 2021, please indicate starting date. Provide total Budget information and distribution of CDBG funds in the proposed budget. The budgeted items are for the specific activity for which you are requesting CDBG funding-NOT for the budget of the"entire"organization or agency. ([Vote:CDBG funds requested must match amount requested in Project Activity,C above.} (EXAMPLE. The Valley.Senior Center is requesting funding for a new Senior Nutritional Program. The total cost of the program is$15,000 and$10,000 in CDBG funds is being requested for operating expenses associated with the proposed activity. The total Activity/Project Budget will include$5,000 of other non-CDBG funding and$10,000 in CDBG funds for a Grand Total of$15,000). TOTAL ACTIVITY/ PROJECT BUDGET CDBG FUNDS (Include non-CDBG Funds REQUESTED-Only and CDBG Funds) I. Personnel A. Salaries&Wages $41,927 $ 18,867 B. Fringe Benefits $ 7,798 $3,509 C. Consultants&Contract Services $ $ PERSONNEL SUB-TOTAL $ 49,725 $ 22,376 7 It. Non-Personnel A. Space Costs $2,082 $ B. Rental, Lease or Purchase of Equipment $ $ C. Consumable Supplies $950 $ D. Travel $ $ E. Telephone $540 $ F. Utilities $ $ G. Other Costs $ $ NON-PERSONNEL SUB-TOTAL: $3,572 $ M. Other A. Architectural/Engineering Design $ $ B.Acquisition of Real Property $ $ C.Construction/Rehabilitation $ $ D. Indirect Costs $8,752 $ E. Other $ $ OTHER SUB-TOTAL: $8,752 $ GRAND TOTAL: $ 62,049 $ 22,376 B. Leveraging List other funding sources and amounts (commitments or applications) which will assist in the implementation of this activity. Current and pending evidence of leveraging commitments/applications must be submitted with application. (Attach) Federal: Health Resources & Services Administration (committed), $39,673. State/Local: Private: Fees: Donations: Other: 8 C. What type of long-term financial commitment is there to the proposal? Describe how you plan to continue the work(project) after the CDBG funds are expended? VCC has made a commitment to Lake Elsinore through the development of its current clinic and the fielding of its mobile dental unit. As alluded to earlier, a high rate of uninsurance persists among VCC's target population in Lake Elsinore and environs - VCC has found that many of those residents accessing services via the mobile dental unit are uninsured. For these reasons, VCC is dedicated to maintaining these CEC services and we want to ensure that this capacity is used by those who need it. D. Provide a summary by line item of your organization's previous year's income and expense statement. (Attach)® E. Does this project benefit residents of more than one community or jurisdiction, have requests been submitted to those other jurisdictions? Yes[] No If yes,identify sources and indicate outcome. If no, please explain. F. Was this project or activity previously funded with CDBG? Yes❑ No ❑ If yes,when? VCC has received funding for the CEC project in the last four years (2017-18 through 2020-21) is this activity a continuation of a previously funded (CDBG)project? Yes ❑ No❑ If yes,explain: The proposed project continues the insurance enrollment activities of the current project year. We believe that the project has helped to drive the clinic's continuous growth in service population over these years. VIII. MANAGEMENT CAPACITY A. Describe your organization's experience in managing and operating project or activities funded with CDBG or other Federal funds. VCC is a long-time government grantee. In the last five years alone, VCC has received over $200,000 in CDBG funding from the Health Resources & Services Administration (primary funder), the Substance Abuse & Mental Health Services Administration, and other federal agencies. These latter funds support or have supported general health center operations and programmatic work related to needs such as HIV prevention and development of access to services. 9 B. Management Systems Does your organization have written and adopted management systems (i.e., policies and procedures) including personnel, procurement, property management, record keeping, financial management,etc.? VCC's Financial Policies and Procedures Mannual provides guidelines on financial topics such as maintenance of accounting records; records retention; cash receipts procedures; cash disbursements; requisitioning; purchasing and receiving procedures; accounts payable procedures; standard journal entries; grants and contracts services revenue and receivable procedures; payroll procedures; accounting for fixed assets, gifts, and donations; and allocation of administrative (indirect) costs. The Finance Department ensures that funds from all revenue sources, including grants and cooperative agreements, are invoiced, documented, allocated, and reported. Led by VCC's Human Resources Department, all newly hired VCC staff participates in a minimum of 12 hours or orientation training on HIPAA compliance; workplace safety; customer service; policies and procedures; harassment and ethnics, and emergency codes and responses. Staff also receives regular cultural competency training. All of this information is maintained within VCC's intranet policy and procedure management system. Policies are organized into 19 categories. Key policies (e.g. those related to HIPAA, compliance, risk management, referrals, confidentiality/information release, patient grievance, and others) are routed to all staff via email annually. C. Capacity Please provide the names and qualifications of the person(s) that will be primarily responsible for the implementation and completion of the proposed project. Rajni Lopez, Program Manager--Ms. Lopez oversees VCC's existing CDBG grant in Lake Elsinore. She has co-managed VCC's HIV Program for the past seven months, along with managing a number of Clinical Programs. In addition, Ms. Lopez previously managed a number of HIV Programs at VCC for six years, from 2008-2014. Her experience provides for continuity and a depth of knowledge about VCC and the target population of low-income residents in take Elsinore. Ms. Lopez will ensure that all contract requirements are met; she will attend contract meetings with the funder,; manage contract files; oversee the work of the Program Supervisors and CEC; and serve as a liaison between the project and the City of Lake Elsinore. Lisa Barrera, Program Supervisor- Ms. Barrera trains, supports, and directly supervises the CEC, collects and reviews applications completed by the CEC, and completes the funder's Cost Benefit Report. Teresa Garcia - Ms. Garcia is the Certified Enrollment Counselor providing direct services to Lake Elsinore residents as described in this proposal. 10 It(. APPLICATION CERTIFICATION Undersigned hereby certifies that(check box after reading each statement and digitally sign the document): 1. The information contained in the project application is complete and accurate. X 2. The applicant agrees to comply with all Federal and County policies and requirements imposed upon the project or activity funded by the CDBG program. X 3. The applicant acknowledges that the Federal assistance made available through the CDBG program funding will not be used to substantially reduce prior levels of local, (NON-CDBG) financial support for community development activities. X 4. The applicant fully understands that any facility built or equipment purchased with CDBG funds shall be maintained and/or operated for the approved use throughout its economic life, pursuant to CDBG regulation. X 5. If CDBG funds are approved, the applicant acknowledges that sufficient non-CDBG funds are available or will be available to complete the project as described within a reasonable timeframe. X _ 6. On behaif of the applying organization, I have obtained authorization to submit this application for CDBG funding. (DOCUMENTATION ATTACHED Minute Action and/or written Board Approval signed by the Board President) X DATE: 10/23/20 Signature: GONE- Print Name/Title Fernando Sanudo, Chief Executive Officer Authorized Representative: _ 11 CHECK-LIST: The following required documents listed below have been attached. Any missing documentation to the application will be cause for the application to be reviewed as INELIGIBLE. Yes No ATTACHMENT ❑ 1. Members/Board of Directors [� ❑ 2. Articles of Incorporation and Bylaws FJ ❑ 3. Project Activity Map ❑ ❑ 4. Project Benefit,Category B, Low Mod Area Maps(Attach if applicable) El ❑ 5. Leveraging(Current evidence of commitment) ❑ ❑ 6. Income and Expense Statement [� ❑ 7. Management Capacity(Detailed organizational chart) ❑ $. Board Written Authorization approving submission of application 12 Vista b Community Clinic 2020-2021 VCC Board of Directors Title Name Job Title,Affiliation President Kwan Lee President, Martplan Insurance Agency Vice President Angela Perez, R.N. Registered Nurse, Tri-City Medical Center Treasurer Michael Hire Director, Navy-Marine Corps Relief Society Secretary Frieda Brands, Ed.D. Director of Children and Family Services, Lake Elsinore Unified School District Member Jose Aponte Director, San Diego County Library (retired) Member Raye Clendening Educational Consultant, Oceanside Unified School District (retired) Member Dionicia Dzwigalski, R.N. Sr. Manager of Employee Wellness, Watkins Manufacturing Member James Hagar, Esq. Attorney, Hagar& Cotten Member Antonio Mora Director of Assessment,Accountability, and Evaluation, San Diego County Office of Education Member Monica Nava Senior Director of Migrant Education, San Diego County Office of Education Member Mark Phillipi Insurance Agent, State Farm Insurance Member Joseph Troya Principal. Consolidated Contracting Services Member Ed Vivanco President Beckman Coulter Diagnostics (retired) City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: Trauma Intervention Programs Organization Address: PO Box 585 City: Murrieta Zip Code: 92564 Mailing Address: PO Box 585 City: Murrieta Zip Code: 92564 Website: www.tipswrc.org Telephone Number: 951-698-2453 Fax Number: 866-304-2141 Executive Director: Magda Stewart Telephone Number: 951-609-5068 E-mail: Magdaoftipswrc@gmail.corr Program Manager: Magda Stewart Telephone Number: 951-609-5068 E-mail: magdaoftipswrc@gmail.corr Is your Organization: Non-Profit Organization Yes 0 No Faith Based Organization 0 Yes No II. ORGANIZATIONAL HISTORY: Date Organization founded: 1993 Date Organization incorporated as a non-profit organization: 7/12/2007 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c )(3) charities may be found at GuideStar www.guidestar.org. 1 Federal identification number:— State Identification Number: Members/Board of Directors: (Attach) Mission Statement— Briefly describe the goals and objectives of your organization and community services it provides. Our citizen volunteers will provide emotional first aid to survivors of tragedy in order to ease their immediate suffering and facilitate their healing and long-term recovery. Volunteers are requested by police, fire and emergency room nurses and doctors. Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over$500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization; Natasha Johnson- Board Member This application has been authorized by the organization's: Executive Committee Board of Directors 0 Members-at-Large III. PROJECT ACTIVITY: Name of Project. TIP Amount Requested: $10,000.00 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? The city of Lake Elsinore and it's un-incorporated communities. 2 Check ONLY the applicable category your application represents, ❑✓ Public Service ❑ Homeless Activities ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities (construction) ❑ Other: (provide description) Respond to A & B only if this application is for a public service project. (a) Is this a NEW service provided by your agency? 0 Yes No (b) If service is not new, will the existing public service activity level be substantially increased or improved? (�)YesoNo V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. Our specially trained volunteers provide emotional and practical support to survivors of traumatic events inmediatly after the trauma occurs. Volunteers are called out to these events by police officers,firefighters, and emergency room nurses and doctors. Volunteers are available on a 24/7/365. 3 Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. Funds awarded will be used to help train volunteers, roll out new support programs supplies, and operating expenses such as Liability insurance, etc. Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. All of Lake Elsinore's residents as well as city's First responders benifit from our program dirctly or indirectly. Volunteers are always available to respond at the request of First Respinders. By being on scene our First Responder partners are able to focus on their job, get the job done quickly without worrying about the survivors needs, and on many events clear the scene sooner than they would have without a volunteer. This allows them to get back into service faster which is a benifit to everyone. Also in today's climate it let's citizens know our men & women in uniform care. 4 What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? We bring awareness of our program and services to the community through social media, fund raising events, public speaking, and participating in community events such as fairs, National Night Out, etc. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? We have been providing support to the valley for almost 28 years. Our funding comes from fundraising, donations, and funding from out partner agencies and communities. Our commitment is not only to continue to provide support but also to expand the types of support we offer as well as increase our call volume. VI. FINANCIAL INFORMATION: PLEASE ATTACH COPIES OF THE CURRENT BUDGET AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT) OF THE ORGANIZATION. It does not require a CPA's audit, but please submit if available. 6 SIGNATURE PAGE The applicant acknowledges and agrees to the following. • Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Support Funding application is considered individually and on its own merit, • Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. • Funding is not immediately available to the recipient. Please allow time for checks to be processed. • The awarding of Community Support Funding does not constitute an automatic annual allocation. • The recognition for Community Support Funding should accrue to the City of Lake Elsinore. • Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED NAME and TITLE(Please Print or Type) SIGNATURE: _40REENEw- PRESIDENT or AUTHORIZED OFFICER: 1411E and TITLE (Please Print or Type) SIGNATURE: ORGANIZATION NAME: TELEPHONE: S2/_&0 _ Sb�1 EMAIL ADDRESS:/- DATE: (M nth, Day,Year) City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: The Salvation Army, Murrieta Corp Organization Address: 40270 Los Alamos Road City: Murrieta Zip Code: 92562 Mailing Address: 40270 Los Alamos Road City: Murrieta Zip Code: 92562 Website: www.murrieta.salvationarmy.org Telephone Number: 951-677-1324 Fax Number: NIA Executive Director: Capts. John and Mysti Birks Telephone Number: 951-677-1324 E-mail: john.birks@usw.salvationari my.orc Program Manager: Capts. John and Mysti Birks Telephone Number: 951-677-1324 E-mail: john.birks@usw.salvationarimy.org Is your Organization: Non-Profit Organization O Yes 0 No Faith Based Organization 0 Yes Q No II. ORGANIZATIONAL HISTORY: Date Organization founded: 1865 Date Organization incorporated as a non-profit organization: 1865 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c )(3) charities may be found at GuideStar www,guidestar.org. 1 Federal identification number: State Identification Number: Members/Board of Directors: (Attach) Mission Statement-- Briefly describe the goals and objectives of your organization and community services it provides. The Salvation Army, an international movement, is a evangelical part of the universal Christian Church. It's mesage is based on the Bible. It's ministry is motivated by the love of God. It's mission is to preach the gospel of Jesus Christ and to meet human needs in His name without discrimination. Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: No Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization: No This application has been authorized by the organization's: OExecutive Committee OBoard of Directors O Members-at-Large III. PROJECT ACTIVITY: Name of Project: ChildSpree Amount Requested: $ 12,500 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? Walmart: 31700 Grape Street. Lake Elsinore, CA 92532 z Check ONLY the applicable category your application represents. Public Service ❑ Homeless Activities ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities (construction) ❑ Other: (provide description) Respond to A & B only if this application is for a public service project. (a) Is this a NEW service provided by your agency? O Yes No (b) If service is not new, will the existing public service activity level be substantially increased or improved? OYesONo V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. Since 1997, the Salvation Army has provided low income children of Southwest Riverside County with a $125 shopping spree through our ChildSpree Back to School program. At Walmart in Lake Elsinore, once again we would like to partner with the City of Lake Elsinore to help these children purchase new school clothes and start their new school year off right.This years ChildSpree will be in August 2021. We will be contacting Walmart to partner with us again this year and set a date for our ChildSpree event. The Salvation Army has a goal of assisting 100 needy children from Lake Elsinore.We firmly believe in the value of this program and know first hand that a child who feels special will do much better in school and new school clothes are an integral part of that process. I have witnessed personall over the years the hundreds of smiles from the children and the look of gratitude int he misty eyes of their parents.The City of Lake Elsinore has been extremely generous in their support of the ChildSpree Program in past years. We are requesting $12,500 this year to help The Salvation Army provide new school clothing to 100 Lake Elsinore needy youth in the community. We have seen the growth of need during this time of the Coronavirus and many Lake Elsinore residents have reached out to us for assistance. We appreciate your time and consideration for this grant request. 3 Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. With funds granted from the City of Lake Elsinore, The Salvation Army of Murrieta will provide 100 needy youth with much needed school clothing for the upcoming school year with the support of Walmart at 31700 Grape St. Lake Elsinore, CA 92532 location. We will be able to provide each child with a ChildSpree in the amount of$125. We will be serving needy children in Lake Elsinore with this grant funding. We have a second Child Spree that also serves the Southwest Riverside County with other funds we use to serve an additional 250 need children in our other communities. Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. Our goal is to provide 100 ChildSpree opportunities for children in Lake Elsinore. Each child will receive $125 to shop for their clothes. Due to the COVID-19 pandemic and restrictions we will not be able to have many volunteers assist, however parents will be able to shop with their child. 4 What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? We work hand in hand with Denine Diaz who serves as the Social Service Linkage Specialist for the Lake Elsinore Unified School District. Every year, her team has been able to connect us with the most needy families in the Lake Elsinore community. We have also promote our programs on Social Media such as group outlets for Lake Elsinore residents. We also communicate with our current Lake Elsinore clients by word of mouth to help expand the knowledge of our programs. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? Our ChildSpree has been an ongoing program since 1997 and continues to grow with the support of grant like yours. Each donation provides us with an additional opportunity to make a difference in the life of a child here in the community of Lake Elsinore and neighboring communities. Our goal is to grow this program every year and to be able to support our youth every year when needed. This upcoming year, we plan to see an increase in families needing assistance due to the financial struggles that the Coronavirus has placed on many of our families. 5 VI. FINANCIAL INFORMATION: PLEASE ATTACH COPIES OF THE CURRENT BUDGET AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT) OF THE ORGANIZATION. It does not require a CPA's audit, but please submit it available. 6 SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Support Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. • Funding is not immediately available to the recipient. Please allow time for checks to be processed. • The awarding of Community Support Funding does not constitute an automatic annual allocation. The recognition for Community Support Funding should accrue to the City of Lake Elsinore. Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. Community Support Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: Priscilla Gutierrez, Administrative Assistant NAME and TITLE(Please Print or Type) SIGNATURE: - 0 PRESIDENT or J. KOEBEL, CAPTAIN AUTHORIZED OFFICER: DIVISIONAL SECRETARY FOR BUSINESS pe) SIGNATURE: ORGANIZATION NAME: oration TELEPHONE: 562 264-3620 EMAIL ADDRESS: j•koebel@usw.salvationarmy.org DATE: �lt (Month, Day, Year 7 City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: Boys & Girls Club of Southwest C� Organization Address: 16275 Grand Avenue City: Lake Elsinore Zip Code: 92530 Mailing Address: ' ,"-A AW 992314q City: Temecula Zip Code: 92590 Website: www.boysgidsclubswc.org Telephone Number: 951.699.1526 Fax Number: Executive Director: Shelly Anguiano Figueroa Telephone Number: 951.699.1526 E-mail: shellyf@becswc.org Program Manager: Joe Sorenson Telephone Number: 951.699.1526 E-mail: joes@becswc.org Is your Organization: Non-Profit Organization Yes © No Faith Based Organization © Yes No H. ORGANIZATIONAL HISTORY: Date Organization founded: 1990 Date Organization incorporated as a non-profit organization: 1990 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c )(3) charities may be found at GuideStar www.guidestar.org. 3 Federal identification number: State Identification Number: — Members/Board of Directors: (Attach) Mission Statement— Briefly describe the goals and objectives of your organization and community services it provides. Mission:To inspire, enable and support all youth to realize their full potential as successful, responsible and impactful members of the community.The Club provides youth, ages 6 to 18, with a tangible measure of hope. The Club offers youth what they need and want most:adults who respect, mentor and listen to them and a safe environment where they can have fun and be themselves. Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over$500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: No Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization: No This application has been authorized by the organization's: Executive Committee ®Board of Directors O Members-at-Large III. PROJECT ACTIVITY: Name of Project: Ultimate STEM/Computer Amount Requested: $10,000 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? Lakeland Village; program offered to all youth ages 6-17 in the City of Lake Elsinore 2 Check ONLY the applicable category your application represents. ❑✓ Public Service ❑ Homeless Activities ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities (construction) 0 Other: (provide description) education/child care Respond to A& B only if this application is fora Lublic service project. (a) Is this a NEW service provided by your agency? ©Yes No (b) If service is not new, will the existing public service activity level be substantially increased or improved? @Yes©No V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. The Ultimate STEM/Computer Science Program will provide significant opportunities to advance STEM education and increase interest in STEM fields for youth. Technology and access to computers for youth is the foundation for this program.Through a variety of activities,youth will participate In web exploration,media production, robotics,coding and more.The program will teach youth the importance of the digital world and ignite their passion for technology. The labor force in the United States has changed dramatically over the past few decades, driven by a shift from industry to services and ever-increasing technological advances. Many young people are leaving school without the preparation needed for good jobs and many are not graduating from high school at all. Our local communities, our nation and our world face big challenges from ensuring clean air and water, to bolstering the global food supply, to building infrastructure for growing populations.The next generation of STEM professionals will be the innovators who find cures, solve problems, invent products and generate ideas that can transform life as we know it.The Boys&Girls Club recognizes STEM education is critical to the future success of America and young people. 3 Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. The Boys&Girls Club of Southwest County will utilize grant funds to support programming efforts for the Ultimate STEM Program during out-of-school time and Day Camp Programs for youth ages 6-17. Funds awarded will be used for membership and program fees, internet access expenses, STEM program supplies and technology, including computers and accessories. Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. Grant funding for this program will benefit youth members ages 6-17 in Lake Elsinore;several hundred youth will participate.The program will provide access to computers to complete homework and increase youth member knowledge and experience with technology. It will also help prepare youth for the 21 st Century workforce. 4 What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? Since 1990,the Boys&Girls Club of Southwest County has been in the forefront of youth development, working with young people whom need us most. The organization is dedicated to ensuring that our community's youth have greater access to quality programs and services that will enhance their lives and shape their futures. The organization will continue to work with the Lake Elsinore Valley Unified School District,local schools and other youth serving organizations. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? The Boys&Girls Clubs of Southwest County is committed to ensuring youth members stay in school and that they are prepared for adulthood by developing the skills and competencies necessary to be successful in the workplace.The organization believes that the Ultimate STEM program will make a difference in the lives of Club members and will help to reinforce the importance of staying in school and preparing for their career and future.The Ultimate STEM program is a priority program offered daily and the organization contiunes to raise funds via events,grants,corporations and indiviudals to ensure this program continues. 5 VI. FINANCIAL INFORMATION: PLEASE ATTACH COPIES OF THE CURRENT BUDGET AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT) OF THE ORGANIZATION. It does not require a CPA's audit, but please submit if available. s SIGNATURE PAGE The applicant acknowledges and agrees to the following: ■ Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. ■ Every Community Support Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. • Funding is not immediately available to the recipient. Please allow time for checks to be processed. • The awarding of Community Support Funding does not constitute an automatic annual allocation. • The recognition for Community Support Funding should accrue to the City of Lake Elsinore. ' Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. ' Community Support Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. BREPARED ease Print or Type) SIGNATURE: PRESIDENT or � ,,� �" /1 AUTHORIZED OFFICER: (A iGt,i�"�[� L{ �► �f OC.�if ECGC� Please Print or Typey SIGNATURE: ORGANIZATION NA TELEPHONE: ��. i, 1 , y S L EMAIL ADDRESS: DATE: 2,0 Z(7 (11fonth,Day,Year) 7 City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: Dream Center Lake Elsinore Organization Address: 114 East Peck Street City: Lake Elsinore Zip Code: 92530 Mailing Address: 114 East Peck Street City: Lake Elsinore Zip Code: 92530 Website: https://www.dreamcenterle.org Telephone Number: 951.376.3703 Fax Number: Executive Director: Brett Masters Telephone Number: 951.376.3703 E-mail: brett@dreamcenterLE.org Program Manager: Telephone Number: 951.376.3703 E-mail: Is your Organization: Non-Profit Organization Yes 0 No Faith Based Organization Yes 0 No II. ORGANIZATIONAL HISTORY: Date Organization founded: 2014 Date Organization incorporated as a non-profit organization: 2014 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c)(3) charities may be found at GuideStar www.guidestar.org. 1 Federal identification number: State Identification Number: — Members/Board of Directors: (Attach) Mission Statement— Briefly describe the goals and objectives of your organization and community services it provides. The Dream Center is a volunteer-driven organization that finds and fills the needs of individuals and families in Lake Elsinore. We do this by connecting isolated people to God and a community of support through regular service projects & neighborhood events. We work to meet people where they are at, to bring them hope and a way off the streets, out of Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over$500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: No. Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization: No This application has been authorized by the organization's: *Executive Committee OBoard of Directors O Members-at-Large III. PROJECT ACTIVITY: Name of Project: Pathways Project Amount Requested: $ 10,000 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? The Dream Center will facilitate this program out of the existing HOPE facility on Minthron and will serve Lake Elsinore residents. z Check ONLY the applicable category your application represents. ✓0 Public Service ✓ Homeless Activities ✓ Housing Rehabilitation/Preservation (please provide picture of structure) Public Facilities (construction) ✓�Other: (provide description) Program Planning Respond to A & B only if this application is for a public service project. (a) Is this a NEW service provided by your agency?O YesO No (b) If service is not new, will the existing public service activity level be substantially increased or improved? O Yeso No V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. The Dream Center is launching a case management & mentorship program for Lake Elsinore residents, called "Pathways Project" to help come along side residents who are struggling in our community. During COVD-19, our food pantry is seeing a 100% increase in clients from 2000 people to 4000 people per month. We know that community members who need help with food and hygiene often need help in other areas of life. Our case management program will be a voluntary program that community members can participate in based on need. The Pathways Project objectives will be to help residents meet tangible needs. Our case managers will help participants who are on the verge of homelessness identity rental assistance, those who are looking to re-enter the work force prepare a resume and identify potential jobs. Additionally this program will help participants with drug and alcohol addition, single parents, etc. We will help individuals with things as simple as securing important government documents, drug, alcohol and family counseling, etc. Our goal is to work with individuals and families to identify areas they are struggling and help them with those specific items. Every community member is different and the struggles they endure differ from person to person. We want to be able to provide them resources to be a helping hand up regardless of their situation. 3 We believe by meeting immediate physical needs, our program will provide people with a connection to a community of support and an on-ramp to a transformational process toward self-sufficiency. Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. Funding will be used to plan and facilitate the Pathways Project Program to benefit Lake Elsinore residents. The funding awarded will be utilized for planning, training as well a supplies, equipment such as desks, computers and other office supplies essential to executing this program. Additionally, we will use funds to purchase and develop training material for our case managers. We will hire at least one program director to facilitate and oversee our case management program and manage and train our case managers/mentors. Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. The Pathways Project will serve Lake Elsinore residents as well as families in the LEUSD school district. Our target areas are lower income areas of Lake Elsinore as well as residents who utilize the HOPE food Pantry in Lake Elsinore. With nearly 4000 HOPE clients we would like to see 50% of those take part in our case management and mentorship program. We will partner with The SWAG and LEUSD to help us identify families and/or individuals in need of assistance. 4 What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? The Dream Center Board of Directors approved the Pathways Project case managment program. We have committed volunteers to serve as mentors and case managers and leaders who will help train and equip the case managers. We have partner organization: who are interested in partnering with us to offer counseling services to our participants. We will work with the City of Lake Elsinore, other non-profits such as The SWAG, Habitat for Humanity, the Lake Elsinore Chamber of Commerce and Helping Our People In Elsinore to ensure residents are informed and aware of our program. The Dream Center Lake Elsinore will work with these partners to make sure residents are aware of these services and how to participate in our program. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? We have a dedicated and passionate group of volunteers to serve as mentors and case managers and leaders with mentorship experience willing to help train and equip our case managers to help Lake Elsinore residents. We have a Board of Directors who have voted to approve this program and staff at the Dream Center LE to help execute this program. Additionally, we have non-profit partners who will help connect us to those in need as well as non-profit partners have offered counseling services to our program participants. 5 VI. FINANCIAL INFORMATION: PLEASE ATTACH COPIES OF THE CURRENT BUDGET AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT) OF THE ORGANIZATION. It does not require a CPA's audit, but please submit if available. s SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Support Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. • Funding is not immediately available to the recipient. Please allow time for checks to be processed. • The awarding of Community Support Funding does not constitute an automatic annual allocation. • The recognition for Community Support Funding should accrue to the City of Lake Elsinore. ' Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. ' Community Support Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARE BY: e,N1I4J,I pe) SIGNATUR PRESIDENT or AUTHORIZED OFFICER: ��� L'� t �' ase Print or Type) SIGNATURE ORGANIZATIO e y TELEPHONE: EMAIL ADDRESS: DATE: ' �O (Month, Day, Year) 7 City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: Assistance League Temecula Va� Organization Address: 28720 Via Montezuma City: Temecula, CA Zip Code: 92590 Mailing Address: 28720 Via Montezuma City: Temecula Zip Code: 92590 Website: https://www.assistanceleague.org/temecula-valled Telephone Number: 951-970-6034 Fax Number: Executive Director: Dorcas Shaktman Telephone Number: 951-970-6034 E-mail: dshaktman@verizon.net Program Manager: Dorcase Shaktman Telephone Number: 951-970-6034 E-mail- dshaktman@verizon.net Is your Organization: Non-Profit Organization Yes ® No Faith Based Organization © Yes No II. ORGANIZATIONAL HISTORY: Date Organization founded: 6-15-1989 Date Organization incorporated as a non-profit organization: 6-15-1989 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c )(3) charities may be found at GuideStar www.guidestar.org. Federal identification number: State Identification Number: — Members/Board of Directors: (Attach) Mission Statement— Briefly describe the goals and objectives of your organization and community services it provides. Assistance League of Temecula Valley, a chapter of National Assistance League, is a nonprofit volunteer philanthropic organization dedicated to serving the needs of families, children and youth in Southwest Riverside County. Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: no Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization: This application has been authorized by the organization's: OExecutive Committee @Board of Directors O Members-at-Large III. PROJECT ACTIVITY: Name of Project: OSB-New Shoes Amount Requested: $5000 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? City of Lake Elsinore, specifically children/youth referred by LEUSD SAFER representatives and HOPE liaisons. 2 Check ONLY the applicable category your application represents. ❑✓ Public Service ❑ Homeless Activities ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities (construction) ❑✓ Other: (provide description) children and youth Respond to A & B only if this application is for a public service project. (a) Is this a NEW service provided by your agency? O Yes@ No (b) If service is not new, will the existing public service activity level be substantially increased or improved? OYesONo V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. Assistance League of Temecula Valley's Operation School Bell program is committed to "changing lives" of students and families in the City of Lake Elsinore service area. If awarded, the City of Lake Elsinore grant funding will be used to provide new shoes to approximately 150 children/youth referred by Lake Elsinore Unified School District SAFER representatives and HOPE liaisons. Each child/youth will receive a $35.00 gift card to be used at Famous Footwear retail stores. New shoes for children/youth is a preventative health and safety measure during the cold weather season months. 3 Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. If awarded, ALTV will spend the grant funds for the purchase of Famous Footwear gift cards to be provided to children/youth residing the City of Lake Elsinore and referred by LEUSD SAFER representatives and HOPE liaisons(health technicians).Gift cards will be purchased directly from the Famous Footwear corporate office allowing ALTV to take advantage of the bulk discount offered through National Assistance League. Gift cards may only be used to buy shoes at Famous Footwear retail stores, ensuring that the purchases will be for shoes only. Having appropriate shoes, especially for children/youth is a preventative health and safety measure, especially during the cold weather months. Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. Grant funding will specifically benefit City of Lake Elsinore families by "changing lives"of approximately 150 children/youth with new shoes. Children and youth referred by Lake Elsinore Unified School District SAFER representatives and HOPE(health technicians), are from at least 51% low to moderate income families and may include at-risk youth, foster youth, socio-economically disadvantaged and English language learners. ALTV volunteers are assigned to work with each agency for student selection and distribution of gift cards. 4 What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? Assistance League of Temecula Valley volunteers continue to outreach to communities, government agencies, school districts, collaborations with food pantries, domestic violence and foster family agencies, including low to moderate income parents and students. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? Operation School Bell is in its 33rd year of operation. ALTV's Temecula based thrift store provides a stable and reliable source of funding from thrift shop sales. ALTV Board & Finance committee diligently seeks to diversify funding by pursuing funding from other reliable sources such as foundations, corporate sponsors, government agencies, private donors and fundraising events. During the past several years, ALTV has undertaken an effort to seek corporate and foundational financial support to supplement current OSB expenses and enable the program to serve a growing population of low to moderate income children/youth within Southwest Riverside Economic Development Region. 5 VI. FINANCIAL INFORMATION: PLEASE ATTACH COPIES OF THE CURRENT BUDGET AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT) OF THE ORGANIZATION. It does not require a CPA's audit, but please submit if available. 6 SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Support Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. • Funding is not immediately available to the recipient. Please allow time for checks to be processed. • The awarding of Community Support Funding does not constitute an automatic annual allocation. • The recognition for Community Support Funding should accrue to the City of Lake Elsinore. • Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED Cheryl Peterson, Grant Writer BY: NAME and TITLE(Please Print or Type) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER:Denise Lanier, President e Print or Type) SIGNATURE: ORGANIZATION Temecula Valley TELEPHONE.951 -265 8248 EMAIL ADDRESS:grammysings@msn.com DATE: ZL ( onth,l3ay,Year) City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: Elsinore Woman's Club Organization Address:CP. O. Box 507 > ,( O LLq, 4;,^a-�a r A A VP City: Lake Elsinore Zip Code: 92530 Mailing Address: P. O. Box 507 City: Lake Elsinore Zip Code: 92531 Website: Telephone Number: (951)674-3445 Fax Number: Executive Director: Lynda Krisco, President Telephone Number: (951) 674-6082 E-mail: LyndaKris@@aol.com Program Manager: Sonya Matthies, Past Pres. Telephone Number: (951) 236-0116 E-mail: shmatthies@verizon.net Is your Organization: Non-Profit Organization T Yes O No Faith Based Organization O Yes No II. ORGANIZATIONAL HISTORY: Date Organization founded: 1906 Date Organization incorporated as a non-profit organization: 1924 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c )(3) charities may be found at GuideStar www.guidestar.org. 1 Federal identification number: MM -W State Identification Number: SJOCIV \ e� LS--' Members/Board of Directors: (Attach) Mission Statement— Briefly describe the goals and objectives of your organization an community services it provides. For 114 years EWC has supported the education and welfare of our community. Members work to raise funds for scholarships for local graduates; provide funds for Elsinore School District Sophomore students to attend Hugh O'brien Yourth Leadership Seminars: provide meals & gifts to needy families during holidays; hold blood drives. Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: NO Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization: NO This application has been authorized by the organization's: Executive Committee OBoard of Directors O Members-at-Large III. PROJECT ACTIVITY: Name of Project: Roofing due to rain damaq@ Amount Requested: $9,800.00 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? 710 West Graham Avenue, Lake Elsinore, California 2 + LSIN RC WOMAYS CLUB 2020 QFFICER5 PRESIDENT Lynda Krisko 951-674-5800 FIRST VICE PRESIDENT Sue Myberger 951- 329-1736 SECOND VICE PRESIDENT Kimberly Ryan 909-263- 8332 THIRD VICE PRESIDENT Darlene Wharton 951-943- 7608 RECORDING SECRETARY Dixie Pravettone 951-245- 1211 CORRESPONDING SECTY. Judy Guglielmana 951-318- 6820 FINANCIAL SECRETARY Amy Hickman 951- 245-7729 TREASURER Pat Miller 951-285-8856 PARLIAMENTARIAN Heidi Dodd 951-288-6441 Check ONLY the applicable category your application represents. 0 Public Service ❑ Homeless Activities ❑ Housing 0✓ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities (construction) ❑Other: (provide description) Respond to A & B only if this application is for a public service project. (a) Is this a NEW service provided by your agency? O Yes@ No (b) If service is not new, will the existing public service activity level be substantially increased or improved? OYesONo V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. The Elsinore Woman's Clubhouse has been the location of many events. We hold Blood Drives, Boy Scout Meetings, Art Shows, offer locations for students to perform artistically on the stage from Kindergarten children from Elsinore Elementary to high school song and dance performances. Over the years the Red Cross has used the clubhouse, the EWC has cosponsored with the library to have an author's forum, has had Political Candidates forum, City of Lake Elsinore speakers and the Lake Elsinore School District Superintendant as featured programs for members and the community. The Elsinore Woman's Clubhouse roof will need the necessary repairs to be able to hold events for the community when regulations due to Covid-19 allow. The Spanish tiles will have to be removed and the tar paper replaced on the exterior. The ceiling in the north parlor will need to be patched and painted. 3 Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. The clubhouse was completed in December of 1925. The building has been kept in good repair over the years. Presently, a ceiling leak came to the attention of the Executive Board. It was in the North Parlor and caused damage to the ceiling area. The area on the roof will need to be repaired which will involved removing the Spanish Tiles and the tar paper needs to be replaced. The ceiling in the North Parlor will have to be repaired and repainted. It is absolutely necessary for these repairs for the safety of our members and in order for EWC to rent the building, when regulations allow due to Covid-19. The rental of the building allows members to hold events to raise money to continue helping the needy during the holidays and other times during the year and present scholarships to graduating senior in our Valley and support Elsinore Elementary School special needs, and a stage for schools performing arts to share their talents, and Boy Scouts to meet. Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. The grant funding is to be used to repair the clubhouse roof will benefit the City of Lake Elsinore. It is absolutely necessary that the roof be repaired in order for our members to meet and continue with their efforts in volunteer hours to meaningful causes in our community. The Target population is from the very young into the 90's and above. Our members are a representation of ages, beliefs, and backgrounds and our events are open to all to attend. When we are able to meet again under the guidelines of Covid-19 we will benefit many people. Our 4 membership is at 90. Volunteers:50/with 100's benefiting. We hold Art Shows that bring in at least 100 with a Artist Reception that is well received. We hold at least two rummage sales each year. Our rummage sales offer items collected by members during the year that are offered very reasonably to members of our community. It is a win/win as our clubhouse is in a low income area and residents can get warm coats for a few dollars. What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? When the Elsinore Woman's Club is allowed to hold meetings again following direction under the Covid-19 regulations, our clubhouse will again be open to having Boy Scout Meetings, Church Meetings, Woman's Clubs Meetings, location for school events, Art Shows for adults and children, Flower Shows, Blood Drives, Author Forums, Political Candidate Forums, Library Author events. Having a roof in good repair that does not leak would allow us to move forward with events and rentals that are open to all members of our community to attend. Our members initiate projects which support participation in the arts, promote education, preserve natural resources, stress good citizenship, encourage healthy life styes, contribute to world peace and international understandings and resolve problems unique to our community. Our members volunteer 24,892 hours to meaningful causes in our community. Ours doors are open to everyone! What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? The Elsinore Woman's Club has been in existence since 1906. We have a member who is the fourth member of her family to belong to the club. We are committed to our presence in the community and plan to be here at least another 114 years. Our member range in ages from the 30's to 90 plus all working for the betterment of our community and beyond. When the necessary roof repairs are done to our clubhouse we will be in a position to continue to offer locations for the Boy Scouts to meet, hold fund raising events to allow continued presentations of scholarships, support to Elsinore Elementary. 5 SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Support Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. • Funding is not immediately available to the recipient. Please allow time for checks to be processed. • The awarding of Community Support Funding does not constitute an automatic annual allocation. • The recognition for Community Support Funding should accrue to the City of Lake Elsinore. • Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: AME and TITL5(Plea a Print or Ty e) -ANN PRESIDENT or AUTHORIZED OFFICER: SC b NAME and TITLE(Please Print or Type) SIGNATURE: In::ORGANIZATION CI wb TELEPHONE: CI�1 } �� 1 - �� �f EMAIL ADDRESS: DATE: _ �004"ef (Month,Day,Year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¶VZHEVLWHZZZDJFDJRY 7KHZHEVLWHDOVRRIIHUVDVHDUFKDEOHGDWDEDVHRI&DOLIRUQLDFKDULWLHV)RUP VIRU F FKDULWLHVPD\EHIRXQGDW*XLGH6WDUZZZJXLGHVWDURUJ The Inland Future Foundation, f/b/o KVCR-TV’s “Uncovered in the Archives” 701 S. Mt. Vernon Ave. San Bernardino 92410 701 S. Mt. Vernon Ave. San Bernardino 92410 www.kvcr.org/uncoveredinthearchives 909/384-4444 909/885-2116 Alfredo Cruz 909/384-4444 acruz@sbccd.cc.ca.us Brad Pomerance 310/266-4437 brad@bigmistproduction.com )HGHUDOLGHQWLILFDWLRQQXPEHU 6WDWH,GHQWLILFDWLRQ1XPEHU 0HPEHUV%RDUGRI'LUHFWRUV (Attach) 0LVVLRQ6WDWHPHQW±%ULHIO\GHVFULEHWKHJRDOVDQGREMHFWLYHVRI\RXURUJDQL]DWLRQDQG FRPPXQLW\VHUYLFHVLWSURYLGHV BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB +DVWKHRUJDQL]DWLRQRUDQ\PHPEHUVRIWKH%RDUGRI'LUHFWRUVRIWKHRUJDQL]DWLRQEHHQ LQYROYHGZLWKDQ\SHUVRQDOEXVLQHVVWUDQVDFWLRQVYDOXHGRYHULQFOXGLQJDQ\EXVLQHVV WUDQVDFWLRQVQHJRWLDWLRQVLQYHVWPHQWVRULQWHUHVWVLQUHDOSURSHUW\ZLWKD/DNH(OVLQRUH &LW\&RXQFLO0HPEHUGXULQJWKHSDVWPRQWKV",I<HVEULHIO\GHVFULEH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB ,VD/DNH(OVLQRUH&LW\&RXQFLO0HPEHUDPHPEHURIWKH%RDUGRI'LUHFWRUVRUDQ2IILFHURI WKHRUJDQL]DWLRQ",I<HVSURYLGH&RXQFLO0HPEHU¶V1DPHDQGWLWOHZLWKLQWKHRUJDQL]DWLRQ BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 7KLVDSSOLFDWLRQKDVEHHQDXWKRUL]HGE\WKHRUJDQL]DWLRQ¶V ([HFXWLYH&RPPLWWHH %RDUGRI'LUHFWRUV 0HPEHUVDW/DUJH ,,, 352-(&7$&7,9,7< 1DPHRI3URMHFW $PRXQW5HTXHVWHG :KHUHZLOOWKHSURSRVHGDFWLYLW\RFFXU EHVSHFLILFDVWRWKHJHRJUDSKLFERXQGDULHV ",IWKH SURMHFWLQYROYHVDQHZRUH[LVWLQJIDFLOLW\ZKDWLVWKHSURSRVHGVHUYLFHEHQHILWDUHDIRUWKH IDFLOLW\" BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 47-1803579 3292840131 In 1962, KVCR launched as the first PBS affiliate in Southern California. Today, KVCR serves the City of Lake Elsinore and Greater Inland California. KVCR’s mission is to serve as a beacon for cultural and educational media that informs and transforms the entire region. KVCR promotes and cultivates discovery and engagement with educational, entertaining and thought-provoking programs. KVCR aims to reflect the many cultures and interests that make Lake Elsinore and Inland California so unique and vibrant. KVCR works to nourish strong communities by celebrating the diverse, inclusive and resilient nature of the region. No No “Uncovered in the Archives” (broadcasting on PBS affiliate KVCR-TV) 5,000 The producers of “Uncovered in the Archives” look forward to working with the City of Lake Elsinore to uncover stories about the history of this legendary city. Once such a story is selected, the crew of “Uncovered in the Archives” will have the opportunity to film on location in Lake Elsinore and ultimately produce and broadcast an episode featuring the City, giving Lake Elsinore residents as well as the millions of viewers throughout Southern California who receive KVCR-TV, the opportunity to see Lake Elsinore shine. 47-1803579 3292840131 &KHFN21/<WKHDSSOLFDEOHFDWHJRU\\RXUDSSOLFDWLRQUHSUHVHQWV 3XEOLF6HUYLFH +RPHOHVV$FWLYLWLHV +RXVLQJ 5HKDELOLWDWLRQ3UHVHUYDWLRQ SOHDVHSURYLGHSLFWXUHRIVWUXFWXUH 3XEOLF)DFLOLWLHV FRQVWUXFWLRQ 2WKHU SURYLGHGHVFULSWLRQ BBBBBBBBBBBBBBBBBB 5HVSRQGWR$ %RQO\LIWKLVDSSOLFDWLRQLVIRUDpublic service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rts & Culture 365 days a year, 24 hours a day, KVCR serves as the PBS television station for the City of Lake Elsinore and all of Greater Inland California. On the television program "Uncovered in the Archives," Host Brad Pomerance travels to various institutions throughout the region to unravel some of history's most extraordinary events - known and unknown, remembered and forgotten - all told through the hidden treasures that we uncover in the archives. This 30-minute television program airs in daytime and primetime on a weekly basis on PBS- affiliate KVCR. You can watch all twelve episodes from the first season of the program by signing onto www.kvcr.org/uncoveredinthearchives. In connection with its recently-concluded first season (a recap of Season 1 is attached), “Uncovered in the Archives” was honored to receive two highly-coveted awards for its work – from the Los Angeles Area Press Club and the Society of American Archivists. Based upon the success of “Uncovered in the Archives” first season, KVCR recently committed to a second season of the series. As a result, the producers, who are solely responsible to raise all the funding necessary to produce this public television program, have begun to seek out sponsors for the second season of “Uncovered in the Archives,” whose total budget has been set at $200,000, for approximately ten total episodes. A generous grant from the City of Lake Elsinore will provide “Uncovered in the Archives” with critical funds needed to produce this historically-based public television program by and about Lake Elsinore and communities throughout Greater Inland California. The overlapping Los Angeles and San Diego media markets ignore Inland California. No other television program in Southern California is dedicated to telling stories about Inland California. Only “Uncovered in the Archives” features the storied history of this storied region. Only through the support of municipal governments, public agencies, charitable foundations, philanthropists and private entities can the producers of “Uncovered in the Archives” present the history of this region to the area’s loyal public television audience. 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In Season 2, that budget totals $200,000. $75,000 of that $200,000 includes hard costs (costs which are not salaries). These costs include the purchase and/or rental of all filming equipments — cameras, lights, audio, monitors, power supplies and batteries, computers, media storage and more. Those expenses also include personnel costs - food, transportation, lodging, wardrobe, make- up and more. Currently, “Uncovered in the Archives” is the only originally-produced program airing on KVCR that focuses exclusively on Greater Inland California. Through a generous grant from the City of Lake Elsinore, the producers of “Uncovered” will be able to continue producing this public television program. Equipment: $30,000 Supplies: $15,000 Facilities: $10,000 Transportation/Lodging: $5,000 Food: $5,000 Marketing: $5,000 Other: $5,000 Total Hard Costs: $75,000 Text The City of Lake Elsinore and its residents will benefit in three tangible ways: 1) The production team films on location, eats in restaurants, frequents businesses, pays parking fees and fills their gas tanks – all supporting economic growth in Lake Elsinore, 2) “Uncovered in the Archives” tells stories based exclusively in Lake Elsinore and Inland California. Given this unflinching goal, viewers living in Lake Elsinore directly benefit through the sustained opportunity to watch consistent television programming that features stories about their hometowns, building civic pride in their communities, and 3) KVCR is carried not only in Riverside and San Bernardino Counties, but in significant portions of Inyo, Kern, Los Angeles, Orange, Santa Barbara and Ventura Counties. Viewers outside the region learn about even more places to visit in Lake Elsinore and Greater Inland California, increasing potential tourism and other business opportunities to the area. We would be honored to call the City of Lake Elsinore a sponsor of “Uncovered in the Archives.” And like all sponsors, the City of Lake Elsinore would receive on-screen and oral recognition of its sponsorship at the beginning and end of each episode of “Uncovered in the Archives” during the sponsored period. 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Of those 700,000 households, 42.5% are found in Riverside and San Bernardino Counties or 297,000 Riverside and San Bernardino Counties households tune into KVCR on a monthly basis. The City of Lake Elsinore (with approximately 16,956 households) comprises 1.25% of the combined Riverside and San Bernardino Counties (1,358,000 households). By extrapolation, in City of Lake Elsinore, 3,713 households tune into KVCR on a monthly basis. The U.S. Census Bureau states that each Lake Elsinore household includes 3.77 individuals. By extrapolation, 13,998 individuals living in the City of Lake Elsinore are watching KVCR on a monthly basis. Finally, “Uncovered in the Archives” regularly works with student interns, both at the high school and college level. We would welcome the opportunity to work with student interns from Lake Elsinore. KVCR serves as the primary PBS television station for the City of Lake Elsinore and Greater Inland California. KVCR is carried by virtually every television provider in Lake Elsinore – on cable (i.e., Spectrum), on satellite (i.e., DirectTV and Dish) and on the telcos (Frontier and U-Verse). “Uncovered in the Archives” produces all of its episodes to be supremely focused on Inland California. “Uncovered in the Archives” airs on KVCR on a weekly basis in both daytime and primetime. “Uncovered in the Archives” has two dedicated webpages — nationally through PBS (www.pbs.org/show/uncovered-archives/) and locally through KVCR (www.kvcr.org/ uncoveredinthearchives). Accordingly, viewers in the City of Lake Elsinore enjoy multiple avenues and opportunities to watch episodes of KVCR’s public television series “Uncovered in the Archives” — be it live, recorded or on demand. “Uncovered in the Archives” recently concluded a very successful first season. In connection with this season, “Uncovered in the Archives” was honored to receive two highly-coveted awards for its work – from the Los Angeles Area Press Club and the Society of American Archivists. You can watch all twelve episodes from the first season of the program by signing onto www.kvcr.org/uncoveredinthearchives. Based upon the success of “Uncovered in the Archives” first season, KVCR recently committed to a second season of the series, a copy of the commitment letter is attached. After receipt of that news, we recently learned that that the Cities of La Quinta and Riverside both renewed their grants for the second season of our public television series, seeding the season with over $20,000. 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(' " ! ! % x ! ! % " " % PREPARED BY:_______________________________________________________________________________ NAME and TITLE (Please Print or Type) SIGNATURE:_______________________________________________________________________ PRESIDENT or AUTHORIZED OFFICER:_____________________________________________________________ NAME and TITLE (Please Print or Type) SIGNATURE:_______________________________________________________________________ ORGANIZATION NAME:______________________________________________________________ TELEPHONE:____________________________EMAIL ADDRESS:___________________________ DATE: ______________________________ (Month, Day, Year) SIGNATURE PAGE Brad Pomerance, Host/Co-Executive Producer, “Uncovered in the Archives” Brad Pomerance Inland Futures Foundation, f/b/o KVCR-TV’s “Uncovered in the Archives” 310/266-4437 brad@bigmistproductions.com October 30, 2020 99999 99999 NAME and TITLE (Please Prin _______________________9999999999 ( _______________________9999999999 City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: Santa Rosa Plateau Nature Educd Organization Address: P. O. Box 941 City: Murrieta, CA Zip Code: 92562 Mailing Address: P. O. Box 941 City: Murrieta, CA Zip Code: 92564 Website: srpnef.org Telephone Number: 909-732-2209 Fax Number: Executive Director: Ginger Greaves Telephone Number: 909-732-2209 E-mail: execdirector@srpnef.org Program Manager: Jamie Parsley Telephone Number: 949-290-7700 E-mail: jamie@srpnef.org Is your Organization: Non-Profit Organization Yes 0 No Faith Based Organization 0 Yes No II. ORGANIZATIONAL HISTORY: Date Organization founded: May, 2003 Date Organization incorporated as a non-profit organization: May 2003 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c )(3) charities may be found at GuideStar www.guidestar.org. I Federal identification number: State Identification Number: — Members/Board of Directors: (Attach) Mission Statement— Briefly describe the goals and objectives of your organization and community services it provides. To educate and empower youth to appreciate, preserve and protect nature. Simply described, SRPNEF funds, develops, and implements projects and programs to help guide our young citizens towards a life of of environmental stewardship. We do this by providing environmental education resources to teachers, students and environmental education providers in the community. Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: No. Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization: No This application has been authorized by the organization's: Executive Committee ®Board of Directors 0 Members-at-Large III. PROJECT ACTIVITY: Name of Project: LEUSD Nature Educ D6 Amount Requested: $3,400.00 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? Videos will support LEUSD elementary classrooms. All filming takes place at the Santa Rosa Plateau Ecological Reserve and other open space, protected properties in the community. 2 Check ONLY the applicable category your application represents. ❑✓ Public Service ❑ Homeless Activities ❑ Housing ❑ Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities (construction) ❑Other: (provide description) Respond to A & B only if this application is for a public service project. (a) Is this a NEW service provided by your agency? 0 Yes No (b) If service is not new, will the existing public service activity level be substantially increased or improved? &YesoNo V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. field work t ies prov ided to LE at the s9anta_Rosa_Pleteau.Ecological Reserve (Reservve h_ye„bgM capgefIed for the unforseen future. To continue SRPNEF's nature and science education curriculum and prouram support to elementary (grades 3-6) classrooms, SRPNEF will produce standard-based nature education distance learning videos to be distributed and made available to LEUSD elementary classrooms. The need to provide distance learning resources for teachers and classrooms was recently validated by a survey of 30,000 K-12 California teachers by various education alliances including the Alliance for Climate Changed. When asked what resources teachers need the most at this point in time (aside from more hours in the day), 51% rated video resources as most needed, followed by lesson plans for a virtual classroom (46%) and live educational events (37%). Although SRPNEF is pivoting from on-site, hands-on programs for now, the development of virtual resources will not just support the immediate needs of teachers and their students but will become a long-term program resource even as on-site support returns. As such, SRPNEF has included distance learning resources as a major new component of its education program strategic plan. t 3 Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. Funds will be used to cover costs of consultants to help us produce, film and write distance learning videos; purchase Wexternal hard drive to safely store all film footage. Budget: Consultant Videographer $1,000 Consultant Writer/Editor $ 600 External Hard Drives $1,800 TOTAL $3,400 Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. Videos will be made available to LEUSD teachers and district resource departments to help augment their environmental and science requirements made more difficult with the current necessity for increased online and home schooling formats. The target population is the 12 LEUSD elementary schools and classrooms with approximately 7,000 elementary students. 4 What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? SRPNEF will work with LEUSD personnel to announce the availability and distribution of the education videos. They will also be posted on SRPNEF's youtube channel "Hawks, Rocks and Nature Talks". We will also post and distribute to the general public via email blasts and newsletter postings. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? The on-going production of distance-learning videos is now a critical component within SRPNEF's education strategic plan. SRPNEF has established the NERF Network (Nature Education Resource Forum) to build a network of resource agencies for teachers, and conducts an annual Nature Education Resource Forum specifically for teachers, administrators and environmental education providers. The distance learning videos will become an important part of the SRPNEF library of nature education resources for the community and local school districts. 5 VI. FINANCIAL INFORMATION: PLEASE ATTACH COPIES OF THE CURRENT BUDGET AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT) OF THE ORGANIZATION. It does not require a CPA's audit, but please submit if available. 6 SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Support Funding application is considered individually and on its own merit. ■ Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. • Funding is not immediately available to the recipient. Please allow time for checks to be processed. ■ The awarding of Community Support Funding does not constitute an automatic annual allocation. • The recognition for Community Support Funding should accrue to the City of Lake Elsinore. ' Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. ' Community Support Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPAREDBY: e-7 CC �4 or Type) SIGNATURE: PRESIDENT or A U S r?11 1J v Cj L- , 5 en AUTHORIZED OFFICER: SIGNATURE: �7 ORGANIZATION NAME: V �� �l C�• rDGP�7� TELEPHONE: 999? 732--ZZD EMAIL ADDRESS: exeod lree/i9r e, crone DATE: II/j�1,2-0.;?-C� (Month, Day,Year) 7 City of Lake Elsinore Community Support Program Fiscal Year 2020-21 Funding Application I. GENERAL INFORMATION: Applying Organization Name: L A ke, lTVDviJehce, M(6e,1'mm(V & C4" -5 Cfiu(X-1 Organization Address: '7jc� w. 9L)vrYLe'C AV-e City: LAKE ELSINORE Zip Code: 92530 Mailing Address: ?p -60/_ r3 4(P City: LAKE ELSINORE Zip Code: 92531 Website: www•LakeProvidenceMBC.org Telephone Number: (951) 674-4311 Fax Number: Executive Director: Daniel Jordan Telephone Number: (714) 889-9519 E-mail: L q( e 'f pv',Ae jja H 6e , ot-G� Program Manager: Daniel Jordan J Telephone Number: (714) 889-9519 E-mail: JOV11'e,( P'LAW f�txlokev�C,2 Is your Organization: Non-Profit Organization Yes C) Na Faith Based Organization Yes 0 No II. ORGANIZATIONAL HISTORY: Date Organization founded: 06/23/1955 Date Organization incorporated as a non-profit organization: 06/23/1955 Provide a copy of your statement of non-profit status from the State of California and Most Recent IRS Form 990. IRS Form 990 is a public record. Form 990s for all charities registered in California are posted on the Attorney General's web site www.ag.ca.gov. The web site also offers a searchable database of California charities. Form 990s for 501(c )(3) charities may be found at GuideStar www.guidestar.org. 1 Federal identification number: State Identification Number: Members/Board of Directors: (Attach) Dol)L Mission Statement— Briefly describe the goals and objectives of your organization and community services it provides. Lake Providence Missionary Baptist Church was founded in 1955 and our mission is to achieve ministry outreach through sound biblical teaching and preaching. Our active membership is dedicated to helping young people, low income families and to assist the elderly of Lake Elsinore. Has the organization or any members of the Board of Directors of the organization been involved with any personal business transactions valued over $500 including any business transactions, negotiations, investments, or interests in real property with a Lake Elsinore City Council Member during the past 12 months? If Yes, briefly describe: NO Is a Lake Elsinore City Council Member a member of the Board of Directors or an Officer of the organization? If Yes, provide Council Member's Name and title within the organization: NO This application has been authorized by the organization's: Executive Committee QBoard of Directors 0 Members-at-Large III. PROJECT ACTIVITY: Name of Project: Property Refurbishment Amount Requested: $4,000.00 Where will the proposed activity occur (be specific as to the geographic boundaries)? If the project involves a new or existing facility, what is the proposed service/benefit area for the facility? 301 W. Sumner Ave, Lake Elsinore, CA 92530 z Check ONLY the applicable category your application represents. ❑ Public Service ❑ Homeless Activities ❑ Housing 0 Rehabilitation/Preservation (please provide picture of structure) ❑ Public Facilities (construction) ❑Other: (provide description) Respond to A & B only if this application is for a public service project. (a) Is this a NEW service provided by your agency? O Yes No (b) If service is not new, will the existing public service activity level be substantially increased or improved? eYes®No V. PROJECT NARRATIVE: Provide a detailed Project Description of the project/program (and its objectives) that the City of Lake Elsinore grant funding will be used to support. The church building and property in Lake Elsinore is now 65 years old and in need of upgrading and repairs. We have been serving the community with programs such as, Food Outreach for the needy and a youth program to help mentor and build the lives of at-risk young people through fellowship and a musical choir. We have an active membership that is dedicated to helping the young people in the community and to assist the elderly of Lake Elsinore. This grant request is for improvement and beautification of the outdoor area. Currently, there is limited parking and there is need for exterior lighting. The landscaping is in need of refreshing with low maintenance perennial shrubs and plants, a low-water efficient irrigation system and pest control. The exterior lighting will be increased with outdoor solar powered lights. Resurface the dirt portion of the parking lot with rocks to provide additional parking. 3 Describe how your organization will use the funding awarded? Include equipment or services that would be purchased and why. The funding awarded will be used to purchase, install and maintain: - Outdoor solar powered lights to improve curb appeal and the safety and security of the property. - Low maintenance perennial shrubs and plants. - A low-water efficient irrigation system. - Resurface approximately 500 sq. feet of the dirt in the parking lot with rocks to add additional parking. This will also help with pest control and cover the gopher holes for safety. - Fix the cracks in the existing parking lot asphalt for safety. - Add mulch to the landscaping to reduce weeds. Explain how the grant funding will specifically benefit City of Lake Elsinore residents. Also, who is the target population and provide the estimated number of people expected to benefit from this project/program plus the number of volunteers involved. The City of Lake Elsinore has many historical landmark buildings and our church is on Sumner Ave, near the Historical Downtown Main Street. As the city has future plans for the downtown area, this grant will help contribute to the development and beautification of Lake Elsinore. The estimated number of people expected to benefit is approximately 1,800 people in need, young families, at-risk youth and the elderly. There are about 15-20 volunteers available for this project. 4 What methods will be used for community involvement to assure that all who might benefit from the project are provided an opportunity to participate? The volunteer program will assure the participation of the beneficiaries by developing relationships and continuing to build upon the existing relationships with the neighbors and families in the surrounding community. Lake Providence has been serving the community with programs such as, Food Outreach for the needy and a youth program to help mentor and build the lives of at-risk young people through fellowship and a musical choir. We keep the community informed through social media, flyers, outreach and presentations to local churches and organizations. What evidence is there of a long-term commitment to the proposal? Describe how you plan to continue the work (project) after the Community Support funds are expended? After the funds are expended our commitment to the refurbishment of the church is to refurbish the Soup Kitchen, dining area, bathrooms and the sanctuary. The areas are in need of new flooring and the main sanctuary is in need of new carpet. The existing pews are run down and in need of replacement. We have chosen to replace the pews with 188 new chairs. Musical instruments (keyboard and drums) needed for the youth program and we are in the process of fund raising for these additional projects to refurbish and beautify Lake Providence Missionary Baptist Church. s VI. FINANCIAL INFORMATION: PLEASE ATTACH COPIES OF THE CURRENT BUDGET AND FINANCIAL STATEMENTS (BALANCE STATEMENT AND INCOME STATEMENT) OF THE ORGANIZATION. It does not require a CPA's audit, but please submit if available. 6 SIGNATURE PAGE The applicant acknowledges and agrees to the following: • Is Subject to all Community Support Funding Program requirements including submittal deadlines and payment disbursements. • Every Community Support Funding application is considered individually and on its own merit. • Awards will be given to organizations and activities that directly benefit the residents of Lake Elsinore. ■ Funding is not immediately available to the recipient. Please allow time for checks to be processed. • The awarding of Community Support Funding does not constitute an automatic annual allocation. • The recognition for Community Support Funding should accrue to the City of Lake Elsinore. ' Community Support Funding must be spent as specified on the application and records may be requested by the City of Lake Elsinore to ensure the funds were used appropriately. ' Community Support Funding grants will not be awarded or announced within the 60 days before an election in which an awarding Council Member is on the ballot. • The recipient shall provide a full accounting with documentation on the use of awarded funds. The recipient shall return to the City any funds not spent or documented per the signed agreement. We hereby certify the information contained in this application is true to the best of our knowledge and belief. PREPARED BY: l Jo�l t Y C ype) SIGNATURE: PRESIDENT or AUTHORIZED OFFICER: OnV)Q l �G'r AA 0 [_ �a kf M4 n Int or Type) SIGNATURE: i ORGANIZATION NAME: L-� �Cr7Vi Y� (55( �G Yl./ 5�~ '� f�/1 TELEPHONE: ��I� (��]�I- � I I EMAIL ADDRESS: In -0 L'a LeJrw;hh&e We og DATE: /1 ,�)(-) Q O Month Day,Year) 7