HomeMy WebLinkAbout900873.tiff *--e*H mEMORAnDurii
Elk Weld County
Board of Commissioners Date Sept. 25, 1990
I jai
COLORADO From Walt Speckman t;i C '
subject: Migrant Head Start Expansion
Presented before the Board for approval is a request for $160,285.00
for Migrant Expansion. The Expansion will add 50 new children, to be
served on the Western Slope, to include the counties of Mesa, Delta
and Montrose. The aforementioned funds include start up costs, as
well as, costs for the operation of the program.
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0 900873
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CMS Approval Na 0346-0
II FEDERAL.ASSTS .ICE 2� I`� 3.
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APPU- CA
1. TYPE CARTON 90CM0136 OE-
I SUBMISSIONOTICE OF en cent aAu 'De I• 0.DATE Nor
❑ N �NOF FIER m Si 0. DATE
Gawk PREAPPUCATION The mask dap Assn ASSIGN Dar sae slap
y° M•` APPLICATION 19 90 09 25 "'i n 19
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a. LEGAL APPLICANT/REOFIENT 5. EMPLOYER IDENTIFICATION NUMBER IDT9
KAPPIcen"Name • Weld County Division of Human Resources 184-6000813A1
b•dSWIlsaaon Una . Family Educational Network of Weld County I.
a Straa/P.O.Boa . P.O. Box 1805 PRO' a NUMBER I 1 13 I • 16 10 I t
a Off' • Greeley tears Weld GRAM
L Stall • Colorado 9.Meg a80632 (^`"CFA4) MULIIKE❑
n.carat Palm/Nona Walter SDeckman b. TITLE
A Taapas Nal . (303) 353-3816 Miarant Head Start
17. TRLE OF APPUCANPS PROJECT Mss maim IV of this loon t9 prove■sway daaon own el as d TYPE OF APPUCANT/RECIPENt
'i 1991 Migrant Head Start Expansion C-4.1111•• M-0•••••••r
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c.7 9-411,` I�anaWY J:araPy,ayaralNar Ei 9. AREA OF PROJECT IMPACT/Naves Wawa canna seas mar
i OF ESTIMATED NUMBER 11. TYPE OF ASSISTANCE
o Delta, Mesa P1 Montrose Counties oFPERBON31lEN61TINGsc�`� Ea B
50 �""" ( i nip SS
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a 12 PROPOSED FUNDING i 13. CONORESSICWAL DISTRICTS OF. 14. TYPE OF APPUCAT10N
Aar. LI Etilraailatas
a FEDERAL S 160,285 .00 a APPLE a PROJECT s—P1.nn. D-.c m..nrim Lee ape SSP
0.APPUrANr I 39,697 m 4 17.TYPE OF MANGE(Pr bk r MO
A-0rares s-ora rIbb
p.STATE no 15. PROJECT START Id PROJECT
a DURATION e-4.44.4a4see
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r. Tae I S 199,982 .09 FEDERAL AGSM,/. 19
lV 19. FEDERAL AGENCY TO RECE REQUEST 120.EXISTING FEDERAL GRANT
IDENTIFICATION NUMBER
a. ORGANIZATIONAL UNIT(IF APPROPRIATE?"' - -•C b.ADNSSTRATIVE CONTACT(IF KNOWN) 9OCMO136
i==�" =vi'^"'crazr= .r? M Betty Kel son
a ADDRESS - .. ---• - . r
21. REMARKS ADDED
Yea N0
t 22 tr To Ito eat no lawsee 9s and base, a YES.THIS NOTICE OF I / Ni TION WAS MADE AVAILABLE TO THE STATE
Q THE des n sin weappsateavappsu99n1 EXECUTIVE ORDER 12372 PROCESS FOR REVIEW ON:
b
r APpucANr Ara aaa ar0 ewe*tllieexultant 11as
Jrb�slay asltatlsd 09 the yaratagl DATE -
`¢ THAT. body df eft ipaaIt and Ma app46rd
1 aimntpMaeENIEN ENIESOINICEN 0. NO.PROGRAM IS NOT COVERED BY Eo.12372 121
T 7 the INENEIres a OPPIaAI OR PROGRAM HAS NOT BEER SELECTED BY STATE FOR REVIEW ❑
s
a TV AND TITLE 0. 9AiNATUREX
t CE
G% REPRE George Ke F�oPem e Kennedy Chairman
&MAME hield County Board of County Commissione `�-"edd
24. TAB 7o asnY -b 2d FEDERAL APPLICATION IDENTI TION NUM 26 FEDERAL GRANT ICE TFICA710N (/
RECEIVED 19
27. ACTION TAI(EI 26 FUNDING Yo maga dap 30. Yo d 4s
STARTING
j ❑a AWARDED 29. ACTION DATE,. 19 DATE 19
o 0 b. RETURNED
a 0 c RR FOR a FEDERAL I S .00 31. CONTACT FOR ADDITIONAL WFORMA- 32 Yo ask Sr
1. AMENDMENT a APPLIOAlTr TION(Name at rApAwa aaa lse0 ENDING
y 0 a RETURNED FOR .00 DATE to
�3 E0.17372 suetas ION a STATE .00 33. REMARKS ADDED
STATE i ay APPI.KJ to To a LOCAL 00
Si
0 a DEFERRED a OTHER GO
0 L WITHDRAWN L TOTAL S .00 ❑ Yes ❑ No
•
NM 7540-01-005-8182 2I- A/b100 STANDARD F'ORIIIINP AGE 1(Rea a-9a)
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B_� r'�Nt/7C,c_- ( Wit[ </
Clerk to the Board T orwr., rl arv� - R....—A
IOM NO.ONe0..-
PANT In-BUDGE! INFORMATION
SECTION A-BUDGET SUMMARY
G Function Fedsnnl-_ F_sfirrnated Urnobfigated Funds New or Revised Budget
or Activity Cahbg No. Federal Non.Federal .. Federal
(a) (b) (l (d) (N Non-Federal - Total
1•PA 23 EXP 13.600 $ $ - $ 109,654 i 27,414 i 137,068
2.PA 23 St.up _ 13.600 38,500 2,658 41 ,158
3•PA 26 Hcp. 13.600 10,631 9,625 20,256
4.P.4 20 Ta 13.600 — 1,500 1,500
5. TOTALS $ $
$ 160,285 $ 39,69 7 $199,982
SECTION B-BUDGET CATEGORIES
8. Object Class Categories Grant Program:Funetlorr a Activity
Total
0) PA 23 Exp (2) PA 23 St.uo(3) PA 26 Hco. (4) PA 20 Ta (5)
a. Personnel $ 73,143 $ $ 3,222 $ - $
76,365
b. Fringe Benefits 16,091 709
16,800
c. Travel 1,000
- 1,000
d• Ernalmint & vehicles 25,000 — 25,000
e. Supplies 5,000 2,000 7,000
t. Contractual
Nepal 5,000 5,000
9. Q9t1Mtenlin Maintenance 10,000 10,000
h. Other 14,420 1,500 1,700 1,500 19,120
i. Total Direct Charges
j. Indirect Charges
It TOTALS $109,654 $ 38,500 '$10,631 $ 1,500 $160,285
7. Program Income $ $ i $ $
r
PART 11 OMe NO
0341°°°°
PROJECT APPROVAL INFORMATION
Item 1
Goes this assistance request require Name of Governing Body
State. local regional, or other priority rating? Priority Rating
Yes_No
Item 2.
�oes this assistance request require State. Or local Name of Agency or
advisory, educational or health clearances? Board
_Yes_No (Attach Documentation(
Item 3.
/� _lC.a:- b r-J , D
I�hrs assistance request require State, local. Name of Approving Agandv- ° e-22_�s¢-w / cc
regional or other planning approval? Date Q---)44— A OO
Yes_No
Item a.
lireproposed project covered by an approved compre• Check one: State ❑
hensive plan? Local ❑
Regional ❑
Yes_No Location of Plan
Item 5.
it the assistance requested serve a Federal Name of Federal Installation _
installation? _Yea_No Federal Po
pulation benefiting from Project
Item 6.
Ellice assistance requested be on Federal land or Name of Federal Installation
installation? Location of Federal Land
_Yes_No Percent of Project
Item 7.
Mir).assistance requested have an impact or effect See instructions for additional information to be
on the environment provided.
_Yes_No
Item B. Number of:
WirFt a assistance requested cause the displacement Individuals
of individuals,families, businesses, or farms? Families
Businesses
Yes_No Farms
hem 9.
S tMri other related assistance on this project previous, See instructions for additional information to be
pending,or anticipated provided.
_Yes_NO
PART V
ASSURANCES
The Applicant hereby assures and certifies that he will comply with the regulations, policies, guidelines
and requirements, including 45 CFR Part 74, and OMB Circulars No. A-102 and A-110, as they relate
to the application;acceptance and Use of Federal funds for this federally-assisted project.Also the Appli-
cant assures and certifies to the grant that:
1. It possesses legal authority to apply for the 5. lt will comply with the provisions of the Haigh
grant:that a resolution, motion or similar ac- Act which limit the political activity of
Hon has been duly adopted or passed as an employees,
official act of the applicant's governing body,
authorizing the filing of the application, in- 6. It will comply with the minimum wage and
cluding all understandings and assurances maximum hours provisions of the Federal Fair
contained therein,and directing and authoriz- Labor Standards Act,as they apply to hospital
ing the person identified as the official and educational institution em
ployees- of
representative of the
applicant to act in con- State and local governments.
nection with the application and to provide
such additional information as may be 7. It will establish safeguards to prohibit
required.
employees from using their positions for a
2. It will comply with Title VI of the Civil Rights being motivated b a desire that is or gives for
prvate g of
n9 by private gain
Act of 1964(P.L. 88352)and in accordance for themselves or others, particularly those
with Title VI of that Act, no person in the with whom they have family, business, or
United States shall, on the ground of race, other ties.
color,or national origin,be excluded from par-
ticipation in, be denied the benefits of, or be 8. It will give the sponsoring agency or the
otherwise subjected to discrimination under Comptroller General through any authorized
any program or activity for which the appli- representative the access to and the right to
cant receives Federal financial assistance examine all records, books, papers, or
and will immediately take any measures documents related to the grant.
necessary to effectuate this agreement.
9. It will comply with all requirements imposed
3. It will comply with Title VI of the Civil Rights by the Federal sponsoring agency concerrt-
Act of 1964 (42 USC 2000d) prohibiting ing special requirements of law, program re-
employment discrimination where (1)the quirements, and other administrative
primary purpose of a grant is to provide requirements.
employment or(2)discriminatory employment
practices will result in unequal treatment of 10. It will insure that the facilities under its owner
Persons who are or should be benefiting from ship, lease or supervision which shall be
the grant-aided activity. utilized in the accomplishment of the project
4. lt will corn with are not listed on tiro Environmental Protec-
ply requirements of the provi- lion Agency's(EPA)list of Violating Facilities
sions of the Uniform Relocation Assistance and that It will notify the Federal grantor
and Real Property Acquisition Act of 1970 agertcy of the receipt of any communication
(P.L. 91-648) which provides for fair and from the Director of the EPA Office of Federal
equitable treatment of peraons displaced as Activities indicating that a facility to be used
a result of Federal and federally-assisted in the project is under consideration for listing
programs- by the EPA.
MIGRANT HEAD START EXPANSION PA23
PY 1991-92
PERSONNEL TOTAL COST
.5 b"IB Director $13,259
2 FTE teachers $12,632
3 FTE Teacher Aides $15,222
.5 FTE Education Coordinator $8,007
.5 FTE PI/SS Coordinator $6,007
.5 FTE Health Coordinator $8,007
.5 FTE Office Manager $8,007
Subtotal
$73, 143
FRINGE BENEFITS
FICA $5,500
Workman's Compensation $1,774
Sick leave and vacation $4,694
Health and life insurance $4, 124
Subtotal
$16,091
SUPPLIES
Classroom Supplies $4,000
Medical/Dental Supplies $1,000
Subtotal $5,000
OTHER
Transportation $2,500
Parent Activities $800
Insurance $1,470
Medical/Dental Services $5,900
Training $1,500
Building Rental $1,500
Utilities $750
Travel $1,000
Subtotal
$15,420
TOTAL COSTS $109,654
START-UP COSTS BUDGET PA23
PY 1991-92
TOTAL COSTS
Outdoor Equipment $5,000
Classroom Equipment and Supplies $2,000
Facility Repair and Maintenance $10,000
Vehicles $20,000
Office Equipment and Supplies $1,500
TOTAL
$38,500
MIGRANT HEAD START EXPANSION PA26
PY 1991-92
PERSONNEL TOTAL COST
.25 PTE Special Needs Tech $3,222
FRINGE BENEFITS
FICA $242
Workman's Compensation $78
Sick leave and vacation $207
Health and life insurance $182
Subtotal $709
CONTRACTS $5,000
OTHER
Supplies $1,000
Training $500
Travel $200
Subtotal $1,700
TOTAL COSTS $10,631
MIGRANT HEAD START EXPANSION PA20
PY 1991-92
CDA Training and Certificates for Teachers $1,500
LOCAL INRIND MATCH BUDGET
PY 1991-92
GRANT $160,285
LESS: T & TA ($1,500)
SUBTOTAL $158,785
Times 25%
NON-FEDERAL $39,697
ALLOCATION
EXPANSION = $27,414
START UP = $2,658
HANDICAP = $9,625
$39,697
Part IV Program Narrative
Table of Contents
I. Objectives and Need for Assistance
II. Results or Benefits Expected
III. Approach
A. Start-up
B. Information
1. General Information
2. Administration
3. Education
4. Health
5. Parent Involvement
6. Social Services
7. Career Development & Recruitment
IV. Geographic Location
V. Program Specific Information
A. Program Progress
B. Statewide needs assessment
I. Objectives & Need Assistance
The purpose of a Migrant Head Start Program to be operated on
the western slope (Mesa, Delta & Montrose Counties) is to provide
the following services to eligible Migrant families: 1) to
enchance self sufficiency, 2) educational services, 3) health
services, 4) nutritional services, 5) social services, 6)
parental services and support, 7) enhance children's self-esteem
and cultural price.
Another purpose is to provide a safe, healthy and nurtiring
environment for children of migrant families. Migrant children
accompanying their parents to the fields are placed in a
potentially dangerous situation. It is the intent of the Family
Educational Network of Weld County to provide migrant families with
the assurance that their children are being provided with the best
possible educational and health services as well as being free from
the hazards of being in the fields and orchards.
The Western Slope is Colorado's producer of orchard crops as
well as onions, corn and other table produce. The area in need is
comprised of Mesa, Delta and Montrose Counties (see attached map) .
Orchard crops require fewer migrants than do other crops in
Colorado. According to data obtained from the Colorado Department
of Education, Colorado Department of Migrant Health and Colorado
Employment Services the estimated number of seasonal and migrant
farmworkers is 2,500 (including dependent family members). It was
reported that between 75 to 100 in need of Migrant Head Start
Services were in the orchards. As of this date there are no day
care services available to this population other than care by
relatives (at times as young as 8 years old) or day care centers
costing the migrant families a minimum of $11.00 per day.
It is the intent of the F.E.N.W.C. to provide much needed
Migrant Head Start Services to the migrant families on the Western
Slope via a delegate agency.
II. Results of Benefits Expected
The family Educational Network of Weld County proposes to
expand services to eligible Migrant children on the Western Slope,
with a targeted enrollment of 50 children with a minimum
enrollment of 5 handicapped children.
We are proposing to enter into a delegate agency agreement
with a local service provider all ready established in the area.
The Family Educational Network of Weld County has been approached
by various agencies interested in providing services to the
migrant children to included: Rocky Mountain S.E.R. , Jobs for
Progress and Hilltop Inc. (a local service agency). To determine
the agency best suited to deliver services to the migrant
population the Family Educational Network of Weld County will send
out Requests for Proposals in December of 1990. R.F.P's for a
delegate agency will be reviewed by a selection team to include:
staff, parents and community agencies and the agency best suited
for service delivery will be selected.
The Family Educational Network of Weld County proposes the
following options:
P.A. 23 - to provide services for Migrant children ages 0-5.
P.A. 26 - to provide handicapped services to migrant children.
III. Approach
A. Start-Up
Recruitment of Delegate Agency
The Family Educational Network of Weld County will
send out Request for Proposals (RFP"S) to local service
agencies on the Western Slope in December of 1990. Request
for Proposals will be submitted in January of 1991 and will
meet the following criteria:
1. An ability to comply with and adhere to the Head
Start Performance Standards especially the Parents
I-30 and establish an effective Parent Policy
Committee.
2. An established networking system with local
community agencies and businesses.
3. An ability to meet all of the goals and objectives
as mandated by the grantee.
4. A proven track record in working with low-income/migrant
families and knowledge of the needs specific to the
migrant population and ability to recruit and serve
eligible families.
5. An ability to meet the needs of the migrant families.
6. Have adequate licensing facilities for operation.
The Request of Proposals will be reviewed by a team to
consist of grantee staff, parents and community agencies. The
agency best suited to deliver Migrant Head Start Services will be
selected.
Training of Delegate Agency
After careful selection of a delegate agency, intensive
training will commence. Training will include:
1. Head Start Performance Standards
2. Developmentally Appropriate Early Childhood Practices for
children 0-5 (as established by Y.A.E.Y.C.)
3. Nutrition
4. Health
5. Special Needs/Mental Health
6. Parent Involvement/Establishing an effective Policy
Committee
7. Recruitment and Eligibility
8. Cultural Awareness - Migrant Specific
9. Fiscal and Administrative Responsibilities
10. S.A.V.I.
11. Career Development
The trainings will be conducted by staff from the Family
Educational Network of Weld County. Interstate Research
Associates (I.R.A. the T/TA vendor for The Migrant Programs
Branch) and consultants deemed necessary.
Delegate Agency Monitoring
The delegate agency will be monitored annually be the Grantee
utilizing the Self Assessment Validation Instrument (SAVI) as a
guide. The delegate agency will also conduct a annual Self
Assessment Validation Instrument to be submitted to the Grantee.
The Grantee will also require monthly reports from the delegate
agency to include: fiscal reports, recruitment/enrollment
reports, staff reports, Policy Committee minutes, staff meeting
minutes, etc.
It is the intention of Family Educational Network of Weld
County to select a delegate agency who is committed to run an
effective comprehensive early childhood program and provide
quality services to meet the needs of eligible children and their
families.
B. Statistical Information
1. General Information
a. Number of children to be enrolled: 50
b. Number of handicapped children to be enrolled: No
less five (5).
c. Number of families above and below the poverty
income level whose children will be enrolled.
1. No more than ten (10%) percent of families
with income above poverty level will be
enrolled?
2. No less than ninety (90%) percent of the
families with income below the poverty level
will be enrolled. Families in the category
will be given priority for placement.
d. Number of hours per week of operation: 45
e. Number of weeks per year that the program will
operate:
1. One (1) center for a minimum of twenty (20)
weeks
f. Number of teachers: 3
g. Number of paid teacher aides: 5
h. Number of classes: 3
1. Number of Infant Classrooms: 1
2. Number of Toddler Classrooms: 1
3. Number of Preschool Classrooms; 1
2. Administration
The Family Educational Network of Weld County
(FENWC) Grant Application for the Migrant Head Start
Program was developed by staff, parents, and the
community. The Community Needs Assessment, was
instrumental in preparing the grant, making necessary
changes and establishing the goals and objectives for
program expansion on the Western Slope for program
year 1991-92.
FENWC's Migrant Head Start Program will operate a
Head Start Program on the Western Slope, adhering to
the following specifications.
Western Slope Center
The Center on the Western Slope serves children from the Mesa, Delta and
Montrose Counties including the towns of Palisade, Fruita and Delta.
Number of children to be served: 50
Number of handicapped children to be enrolled 5 (minimum)
Length of program operation: 16 weeks (minimum)
(June 11, 1990 - September 28, 1990)
Number of Teachers to be hired: 3
Number of Teacher Aides to be hired: 5
Number of Infants to be served: 10-15
Number of Toddlers to be served: 15-20
Number of Preschool age children to be served: 20
Number of home visits per year: 2 (minimum)
Average time of home visits: 1 hour
Number of classes: 3
Number of days per week of service: 5
Number of hours per day of service: 9
Number of days per year of service: 80
The Weld County Department of Human Resources provides administrative
services to include: fiscal , personnel and contracts. The Delegate
Agency representing the Family Educational Network of Weld County will
purchase services to ensure quality services to migrant families and
their children.
Health Services to include: well child checks, physical examinations,
immunizations, sick child visits and prescriptions and emergency ser-
vices.
Dental Services to include: screening and examinations, dental repair
and work (excluding orthodenture) , cleanings and flouride, if needed.
Special Needs Services to include: developmental screenings and exams,
speech diagnostics and therapy, physical Therapy, Occupational Therapy,
hearing screenings and any other testing or services a child may need.
The aforementioned Services will be purchased from local agencies and
the Colorado Migrant Health Department. A local pharmacy will be
contacted with to provide pharmaceutical to include: local clinics,
community center boards, schools, doctors and dentists.
All contracts will be open for bid on a yearly basis to ensure fair
competition, quality and cost of effective services.
CALENDAR OF ACTIVITIES
Time Responsible Staff Date
Request for Proposals Executive Director December 5, 1990
to be disseminated
Request for proposals due Executive Director January 30, 1991
Selection of Delegate Agency Executive Director February 28, 1991
Delegate Agency Training Director March, 1991
Start up of Operations Delegate, Director May, 1991
Closing of Operations Delegate, Director October, 1991
3. Education
The Delegate Agency representing FENWC will implement a
developmentally appropriate High/Scope Curriculum for children 3-5
years of age. This curriculum is based on the therapy of Jean
Piaget's cognitive development. The frame work for the curriculum
is based on Active Learning around key experiences: Language,
Classification, Seriation, Number, Spatial Relations, Time, A Plan
Do Review Process is used to help the child to think, problem solve
and make decisions. Language is used in a developmentally
appropriate manner to extend conversation in the child's dominant
language. The children's physical , social and emotional development
is also supported through a nuturing environment, using the child's
dominant language.
In the Infant/Toddler Program the use of the Small Wonder Curriculum
will be implemented. This curriculum addresses cognitive, physical ,
social and emotional development and is also implemented using the
child's dominant language.
All children will be screened using the DDST (Denver Developmental
Screening Test) within 30 days of enrollment. Progress of
development is recorded on the CAR (Child Assessment Record).
4. Health Component
The following, outlines the procedures that will be implemented in
the delivery of medical , dental , special needs, mental health, and
nutritional services to migrant children and their families:
Medical
A local Health Clinic in conjunction with the Migrant Health
Department will provide services to the migrant centers on the
western slope.
The Social Services Component will collect medical and health
histories on every child during the enrollment process. The nurse
will review this information and conduct a health screening on
children as they are enrolled. The screenings will consist of
weight and height measurements and a hematocrit. The physical
examinations are conducted by migrant health or the local health
vendor.
A physician from 2 local clinics will visit the center three times
weekly to examine sick children and prescribe medication. The
clinic provides open slots for migrant children throughout the week
so sick children can be seen on those days when the doctor does not
visit. The Centers will be serviced by Health Care Providers from
the Plan de Salud del Valle Health Clinic. The Head Start Center
will have a nurse who is responsible for the coordination of health
and medical services provided to the children enrolled in the
Migrant Head Start Program.
Vision
All enrolled children have their vision tested by qualified
personnel . Children who fail the vision test or have 20/40 vision
or worse in either eye will be retested. If a child fails the test
a second time, they will be referred to an optometrist. Fees are
paid for by Title XIX, Lions Club, community donations, or Migrant
Head Start funds.
Hearing
Hearing screenings will be conducted in cooperation with local
school districts. A Puretone Audiometer Test will be done in sound
proof booths by professional staff. Abnormal hearing will be
failure to respond in either ear below 15 db. at 500 cps. , 1000
cps. , 2000 cps. , and 4000 cps. Children failing this test will
receive further testing. Children who fail the second test will be
referred to an ear, nose, and throat specialist. Possible treatment
may include, myringatomy with tube placement, removal of impacted
cerumen, and implantation of a selective hearing aid device. Funds
for the services are obtained from Title XIX funds , private
community donations, ana Migrant Head Start funds.
Immunizations
Immunization records and information are obtained during the
enrollment process. Parents are informed of their child's
immunization status. If parents do not have records and they can be
located in another state, the Health Component will strive to obtain
the information. If the child needs immunizations, parents are
asked to sign a consent form to have the nurse make arrangements for
the child to receive them. These children receive updated
immunizations at the Migrant Head Start Centers.
Dental
Dental screenings are done on all enrolled children (age
appropriate). Children identified with possible dental problems are
then examined further by a dental hygienist. Examinations include,
x-rays, and fluoride application. All needed dental treatment,
identified during the examination process is provided by local
community health clinics and dentists.
Mental Health
The Mental Health Plan will provide for the prevention of,
the identification of, and early intervention in problems that
interfere with a child's overall emotions development. A
consultant from a Mental Health Center will provide the
following services: assessment of child's emotional needs;
service recommendations; direct services, such as parenting
classes, family counseling, play therapy, and psychological
testing. Booklets and information regarding the availability
for services, workshops and inservices for Head Start staff are
disseminated to staff and parents.
Nutrition
The delegate agency representative for the FENWC, Migrant H.S.
Program must recognize the importance of nutrition for healthy,
social , emotional and intellectual development. A balanced diet
plays an important role in a child's ability to interact
successfully, learn, achieve, have good relationships with other
children his/her own age, and develop a good parallel play routine.
Nutrition is an important part of FENWC's program. A substantial
breakfast, lunch, and snack will be provided to all children
participating in the program. All menus will include the four basic
food groups, proper nutritional values for infants, toddlers, and
pre-school age children. All meals provided will be nutritionally
sound and prepared appropriately for the different age groups
served. No limitations are set on the amount of food any child can
eat and food is not used a punishment or reward. The delegate
agency will comply with USDA guidelines as established by the
Child/Adult Care Food Program.
Cooking experiences for the children are conducted in the classroom
(age appropriate) . Food projects are conducted on a monthly basis
and assistance is given by the cooking staff, whenever possible.
There will be in-depth training for the cooking staff in meal
preparation, use of equipment, ordering supplies, record keeping,
and the adequate use of time and surroundings. Training includes
information on the following:
* four basic food groups
* food preparation
* use of commodity supplemental foods
* any concerns expressed by Migrant Head Start parents and staff
* Child/ Adult Care Food Program
Handicap/ Special Needs
The FENWC Migrant Head Start Program delegate agency will provide
services to handicapped children, 10 percent of the total number of
funded slots. The following services will be provided to special
needs children to mainstream them into the program.
a. Instructional Services
The program provides special needs children with opportunities
to improve their communication skills, assist them to function
successfully in a school environment by providing them with
positive preschool experiences. Specially designed activities
increase their social growth, give them a positive
self-concept, and interaction skills. Utilizing every
available appropriate federal , state, and local resource,
through coordinated funding, state, and local resource will
improve mutual understanding and appreciation of differences
among children.
b. Supportive Services
FENWC's Migrant Head Start makes every effort to establish an
intrastate and interstate communication program for the
exchange of students records, methods, concepts and materials
to assure that sequence and continuity will be an inherent part
of the migrant handicapped children's total educational program.
Communication is developed and established among the FENWC
Migrant Head Start Programs, the community and its agencies to
ensure coordination of all available resources for the benefit
of migrant handicapped children. Early and Periodic Screening
Diagnosis and Treatment (EPSDT) funds for medical services will
be used whenever possible to cover medical , dental , and
handicapped services.
Pre-service and in-service will be conducted to increase
staff's awareness of their personal biases and possible
prejudices toward handicapped persons by upgrading staff's
skills for teaching migrant handicapped children.
Lines of communication are established among the Migrant Head
Start staff and migrant families to encourage parental support
of their handicapped child.
5. Parent Involvement
The importance of parent involvement in Migrant Head Start is
unquestionable. For the past twenty-five years , the success of
Migrant Head Start, as a comprehensive early childhood program,
has been due to extensive parent involvement.
FENWC Migrant Head Start Program is committed to the principle
that parents, with adequate support, can provide a home
environment that will stimulate children to be successful in
their educational endeavors. Migrant Head Start encourages
parents to take advantage of opportunities offered to them by
the Migrant Head Start experience.
Parent participation includes:
. Involving them in decision making
. Involvement as paid staff, volunteers, and observers in the
classroom
. Working at home with their child(ren) , in cooperation with
Migrant Head Start staff, to support the child(ren) 's
experiences.
. Involvement in the development of a parent education plan
The plan by the delegate agency to involve parents in center
activities includes:
Open House/Family Nights - Four (minimum) open house/family
nights to be conducted during the summer program. Parents will
have the opportunity to visit their child(ren) 's center, visit
with their child(ren) 's teacher(s) , visit their child(ren) 's
classroom(s), and discuss any concerns with the staff. Also,
the parents will have the opportunity to meet and socialize
with other families. Each Family Night will consist of: a
dinner provided by the program; speakers; film presentations;
and distribution of educational materials regarding health,
parenting, services available in the community, etc. All the
materials and presentations will be provided in Spanish and
English. Parent Policy Council - Parents will be encouraged to
participate in the Parent Policy Council (PPC).
Each classroom will select one (1) parent as a representative
and parent as an alternate to the Parent Policy Council . The
Parent Policy Council will meet three (3) times during the
summer months.
The Migrant Policy Council works in conjunction with the Family
Educational Network of Weld County Policy Council to ensure
that their needs are specifically addressed and represented in
overall program planning. Parents living out of state will
receive minutes from all meetings and correspondence regarding
all programmatic planning to ensure their representation and
input. If necessary and if budget allows parents will be
provided with transportation and lodging to attend meetings.
Parents are encouraged to visit the center/classroom when they
are not working because of weather or unavailability work.
Visiting the classrooms offers parents the opportunity to
become better acquainted with their child(ren) 's teacher.
Teachers also learn much about the child(ren) from the parents,
in order to enhance the quality of care that each individual
child receives while in the program.
Parent Education - Agencies such as Community Colleges, Health
Centers and Migrant Health Department offer adult classes for
families. Classes are offered in nutrition, child development,
birth control , first aid, GED, English and other topics in
which the families show interest. The delegate agency will
assist in the coordination of these educational efforts by
disseminating information; participating as presenters; and
encouraging parents to attend, by offering free childcare and
transportation as when needed.
6. Social Services
An outreach and recruitment process will systematically ensure
enrollment of eligible children. Recruitment activities
include: networking with community agencies; advertising in
newspapers and on radio stations , in both English and Spanish;
visiting migrant labor camps; and placing posters in migrant
health centers , food stamp office, Job Service officers, etc.
A family needs assessment will be conducted for every family
participating in the program. The needs assessment identifies
the interests, desires, goals, needs and strengths of the
family. A Case Management approach is used after completion of
the Family Needs Assessment to ensure that families needs are
met. The Family Services component provides direct services
and advocates for Migrant families by networking with local
social service agencies, community organizations, volunteer
organizations, etc. The main goal is to determine how Migrant
Head Start can help families to attain self-sufficiency. Close
relationships have been established with local employment and
training programs, such as JTPA, Employment Services and Rocky
Mountain SER's Jobs For Progress, those programs target
low-income migrant families for employment and training. Rocky
Mountain SER receives federal funds to training, job search,
relocation assistance, etc.
Direct services that Migrant Head Start will provide to migrant
families include: free child care while family members attend
workshops and GED classes; transportation to the center, so
parents may attend meetings, volunteer in the classroom, etc. ,
clothing for Migrant Head Start family members, and food
vouchers. These and other direct services will be provided in
part or all be fundraising efforts and local business
donations. families are also referred to other agencies in an
effort to meet their needs.
7. Career Development and Recruitment
Career Development is a vital and necessary part of the FENWC
Migrant Head Start Program. Without well trained and strongly
motivated Migrant Head Start staff, the services provided to the
Migrant Head Start child and family cannot attain the quality
necessary for the successful operation of the program.
The delegate agencies, Migrant Head Start Program's Career
Development Plan must provide the following:
A part-time CDA Advisor - The CDA Advisor completes observations,
gives feedback, fills out advisor report forms, follows up on any
recommendations given as to how to help candidates improve and
acquire needed skills, assists candidates in portfolio development,
assists candidates in the LAT preparation, conducts a mock LAT for
candidates, and assists parent representatives in completing
observations and report forms.
A Career Development Committee (CDA) - This committee is composed of
professionals, para-professionals, and representatives from each of
the Migrant Head Start component areas.
A plan for job development which includes:
. Recruitment
. Selection Criteria
. Job Descriptions
. Career Ladder
. Employee Evaluation
. Professional Growth and Development
An appraisal-counseling-evaluation system - Staff evaluations are
completed on a quarterly basis during the summer program. This is
necessary given the short period of time that the staff works for
the program (Approximately 5 months). Based on assessment, training
and technical assistance is planned and delivered to staff to
address identified weak areas.
8. Training
Since there is a high turn over of staff working for the summer
program each year, a generic, intensive training is delivered to all
staff before the centers initiate their operations, and continues
for the duration of the program. Staff members who desire to
continue training throughout the year will be provided with support
and the opportunity to participate in training to be offered year
round. An approved training plan must be submitted yearly by the
delegate agency.
Education
Special emphasis will be devoted to infant and toddler training.
Trainers will be the Education Coordinator and additional consultants
from local Universities, Community Colleges, Community Center Boards,
Migrant Head Start T/TA provider; IRA and any local resources identified.
Training will take place at the Center and will be in the format of
lectures, films, role playing, video taping, and hands-on activities.
On-the-job follow up is imperative for successful demonstration of the
functional areas.
"Overview and Goals for Infant/Toddler Child Care Programs, and the
Early Childhood Education." This training will be provided by the
grantee participants with an understanding of the importance of their
role as child care providers.
"Understanding of Principals of Child Growth and Development/" This
training will teach participants to identify and understand the different
stages of child development, how young children learn best at their
developmental levels, which is at the sensory-motor, and pre-operational
levels, how over-and under-expectations can have an effect on the
child's later learning and self concept. Topics will include child
development principals, studies of child growth and development, the
developmental areas--physical , social , emotional , and cognitive, recognizing
children with special needs, observation and recording techniques,
balancing caregiving and direct instruction, discipline and changing
behavior techniques, How to Talk So Children Will Listen, and List So
Children Will Talk, INREAL strategies, and language development.
"Classroom Management Principles." This training involves teaching
participants how to set up a classroom learning environment. The
classroom will be set up into functional areas labeled and organized for
optimal usage. A daily routine will be established to meet the developmental
needs of each of the age groups. All areas of this daily routine will
be thoroughly discussed to ensure that a program of the desired quality
is being provided. The subject of health and safety of each age group
will be addressed, its importance will be stressed, not only for the
children in care but for the adult caregivers as well . Since play
equipment and materials can often be a mystery to a novice caregiver,
time will be devoted to the use of play equipment and how it effects
development. Other subjects which will be studied and discussed are:
the curriculum, use of training and educational kits, lesson planning,
record keeping (children's files, progress reports, screening devices,
etc. ) , bilingual and multicultural issues and materials will be studied
and discussed. Participants will have an opportunity to make materials
for their age groups and practice filling out forms, reports, etc.
The Teaching staff will have a variety of aides and assistants to
supervise and work with (summer youth workers, volunteers, UNC/Aims
students, parents, support staff, and aides). They will need to know
how to work well with others, give clear and concise directions, delegate
work, accomplish program goals, and document and report incidents that
need to be brought to the attention of the Director or Education
Coordinator.
They will also need to know what equipment, supplies and materials are
available, and how to use them. In addition, they must understand the
policies, procedures, and regulations (local , state, and federal )
associated with the program.
Health
Red Cross classes will be offered as well as Infant/Toddler CPR classes.
Classroom staff will attend these classes.
The Health Coordinator will offer training on:
. The Importance of Using Good Hand-Washing Skills
. Prevention of Spreading Infection By Properly Disinfecting the
Classroom
. Appropriate Infants and Toddler Feeding Practices (i.e. , soft,
liquid, special diet)
. Disease Control
. Nutrition
. Family Style Meals
Parent Involvement/Social Services
. Setting up the files
. Eligibility guidelines
. Record keeping (forms, etc. )
. Emergency assistance and referrals
. Community resources for migrants
. Monitoring absenteeism and meeting the 85% ADA
. Maintaining confidentiality
4. Geographic Location
Map Attached.
Budget Narrative PA 26
Personnel
Pays the salary for the special needs technician.
Fringe Benefits
The fringe benefits are based on a uniform rate applied to all Weld
County Personnel as per County Policies and Procedures.
Prescriptions
Covers costs of prescriptions for children with chronic/severe illnesses
which require special medication.
Medical/Dental Supplies
Covers cost of special equipment needed to test and or assist children
with special needs ie: special spoons, chairs, etc.
Contractual
University of Northern Colorado Speech and Language:
Pays for the direct services of speech diagnostics for children and
individual and group speech therapy. Also pays for consultation fees
for case review meetings with other staff and teachers as necessary.
Pays for physical/occupational therapy for children, as well as consultation
fees. The provider for these services is yet to be determined.
T/TA Budget Narrative
Pre-Service Training Consultants
All staff will participate in pre-service training. Consultants from
Centennial Developmental Services, University of Northern Colorado, and
Aims Community College will make presentations in the areas of handicap
and special needs, infant and toddler physical and emotional development,
parent involvement, and health.
Parent Training
Funds will be utilized to provide supportive services such as: child
care, transportation, and books and supplies for parents participating
in training (Parent Policy Council Training, GED Classes, ESL Classes,
etc. ).
CDA Training
The program will contract with a CDA Advisor who will train the teaching
staff and help them to obtain their CDA Certification. The Advisor will
complete observation, give feedback, fill out advisor report forms, and
follow up on any recommendations given to help candidates to improve and
acquire needed skills. He/she will also assist candidates in portfolio
development, and preparation of the L.A.T. , and assist the parent
representatives in completing observations and report forms.
It is expected that 3 to 4 teachers will be CDA Certified by May 31,
1991.
Travel
Travel includes expenses to send staff to approved local and national
trainings, ie: Infant/Toddler Conference, Health Coordinators Conference,
etc.
Budget Narrative for Expansion Costs PA 23
Personnel
Staff Salaries Full-Time Salaries
1 Director .5 FTE 13,259
4 Teachers .5 FTE 12,632
6 Teacher Aides .5 FTE 15,222
1 Health Coordinator .5 FTE 8,007
1 PI/SS Coordinator .5 FTE 8,007
1 Education Coordinator .5 FTE 8,007
1 Office Manager .5 FTE 8.007
Total $73,143
Fringe Benefits
The fringe benefits are based on a uniform rate applied to all Personnel
as per Policies and Procedures.
Classroom Supplies
Classroom supplies include teaching materials, construction paper,
paint, scissors, etc.
Medical/Dental Supplies
Medical/Dental supplies include first aid kits, thermometers, ice packs,
disinfectant, band aides, cotton balls, etc.
Other
Transportation Costs
Transportation includes gas and oil , repair and maintenance and or
contracts relating to transportation services.
Parent Activities
Include costs incurred for Parent Policy Council meetings, parent
trainings and activities.
Insurance
Insurance costs cover expenditures for liability insurance for children
attending the program.
Medical/Dental Services
Medical/Dental services include the costs incurred for physical and
dental screenings and examinations for children attending the program.
These costs also include costs for contracts for health and special
needs children, i .e. , speech services.
Training
These costs include the costs incurred for training all new staff for
staff development, as well as, parent training.
Building Rental
Covers the costs of space rental for 4 additional classrooms.
Utilities
Covers costs incurred for gas, electricity, and telephone services.
Travel
Covers the costs for out of town travel related to trainings, conferences
and meetings with grantee.
Budget Narrative for Start Up Costs PA 23
Outdoor Equipment/Supplies
Consists of equipment used outdoors for children's gross motor development
to include tricycles, climbing apparatus, strollers, sand and gravel ,
etc.
Classroom Equipment/Supplies
Includes costs incurred for classroom set-up which consists of child
size tables and chairs, bookcases, manipulative, easels, etc.
Facility Repair and Maintenance
Costs to upgrade and repair the facilities to ensure a safe environment
for the children. Costs include paint, building materials, playground
upgrade, shelving, new alarm system, etc.
Children's Books and Resources
Multi-cultural materials to include books, records, film strips activity
books, etc.
Office Equipment/Supplies
Includes the purchase of typewriters, file cabinets, calculators, etc.
Miscellaneous expenditures
To cover any incidental costs which will be incurred, i .e. , car seats,
refrigerator, microwave, etc.
Budget Narrative PA 26
Personnel
Staff Salary
Special Needs Technician .5 PTE
Fringe Benefits
Fringe benefits are based on a uniform rate applied to all Personnel as
per Policies and Procedures.
Contracts
Covers the costs for services provided to special needs children to
include but not limited to speech therapy, occupational therapy, hearing
evaluations, etc.
Other
Supplies
Includes any special apparatus needed for children in the classroom,
testing materials, and special toys, etc.
Training
To cover the costs of training needs pertaining to special needs of
children for staff and parents.
Travel
Covers the cost for travel related to special needs trainings, workshops,
meetings, conferences, etc.
Budget Narrative PA 20
CDA Training Certificates
Covers the costs incurred for the training of teachers to become certified
with their CDA's.
:XECLTII E ORDER 12372
STATE POINT OF CONTACT PROJECT NOTIFICATION CERTIFICATION
Family Educational Network of Weld County
Legal Organization Name
Has
XX Has Not Submitted This Application To The State Point of Contact Office.
NOT APPLICABLE
Date Submitted to the State Point of Contact Office
Address of State Point of Contact
Nfrti
ale
Cerotem
>411tr Chairman, Weld County Board
Alof Commissioners 9/26/90
Sighaturaf Authorized Official Date
n iii
ATTEST: , 1 l B :
v-/ ✓ "`''� Deputy Clerk to he Board
Weld Count Clerk to the Board
Comments:
(THIS FORM MUST BE COMPLETED AND ATTACHED TO THE SF-424 APPLICATION).
IIDS GRANTS MANAGEMENT
CERTIFICATION OF HEAD ST/ C
ADMINISTRATIVE COSTS
We The Weld=tthrit r%artf efl)CbuntJ PrIimn ccinnare • , have reviewed
OisseWOmme
45 CFR Part 1301.32 and certify that the development and administrative costs to administer the
Family Educational Network of Weld County Head Start Program for the progranr year
OaofGras
June 1, 1991 dough May 31, 1992 will not exceed 13 percent of S
(total Federal and non-Federal costs for program accounts 22 through 267.
Documents substantiating administrative costs are available in our files for review by auditor and
Office of Human Development Services/Health and Human Services Personnel.
Protean
• Chairman, Board of
County Commissioners 9/26/90
S$irnrs, ugh Bus Gyre
ATTEST �'� / /
77
i�el��County C1 k tff��o the Board
$yam /�'�LLc-r� ��.L���c% -
De uty Clerk to t e Board
•
HDS GRANTS MANAGEMENT
ASSURANCE OF COMPLIANCE WITH THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES REGULATION UNDER
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964
Family Educational Network of Weld County hereinafter called the "Applicant
(Name of Applicant)
HEREBY AGREES THAT it will comply with title VI of the Civil Rights Act of 1964 (P.L. 88-352)
and all requirements imposed by or pursuant to the Regulation of the Department of Health and
Human Services (45 CFR Part 80) issued pursuant to that title, to the end that, in accordance with
title Vi of that Act and the Regulation, no person in the United States shall, on the ground of race,
color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise
subjected to discrimination under any program or activity for which the Applicant receives Federal
financial assistance from the Department; and HEREBY GIVES ASSURANCE THAT it will imme-
diately take any measures necessary to effectuate this agreement.
If any real property or structure thereon is provided or improved with the aid of Federal financial
assistance extended to the Applicant by the Department, this assurance shall obligate the Applicant, or
in the case of any transfer of such property, any transferee, for the period during which the real
property or structure is used for a purpose for which the Federal financial assistance is extended or for
another purpose involving the provision of similar services or benefits. If any personal property is so
provided, this assurance shall obligate the Applicant for the period during which it retains ownership
or possession of the property. In all other cases, this assurance shall obligate the Applicant for the
period during which the Federal financial assistance is extended to it by the Department.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining anv and all Federal
grants, loans, contracts, property, discounts or other Federal financial assistance extended after the
date hereof to the Applicant by the Department, including installment payments after such date on
account of applications for Federal financial assistance which were approved before such date. The
Applicant recognizes and agrees that such Federal financial assistance will be extended in reliance on
the representations and agreements made in this assurance, and that the United States shall have the
right to seek judicial enforcement of this assurance. This assurance is binding on the Applicant, its
successors, transferees, and assignees. and the person or persons whose signatures appear below arc
authorized to sign this assurance on behalf of the Applicant.
Dated September 25, 1990 Family Educational Network of Weld County
(Applicant) ..
4 ChailptfigirBoard of
7e�' � County Commissioners
'. ' t,Chairman of Bo ., Pcdmparable
authq�xed official) l
/ I l r ,/
ATTEST: D {�i /
/
P.O. Box 758 )yy / u �� ' .l
eld County�Cl / k to the Board
Greeley, CO 80632
(Applicant's mailing address) -BY: (.-1J' -4X.4 C
puty Clerk to t Board
HDS GRANTS MANAGEMENT
HHS-441
DL PAR.Vll .MLNI Of IILALIH AND HU :NIA \ SLRNICES
ASSURANCE ., COMPLIANCE WITH SECTIO. 504 OF THE
REHABILITATION ACT OF 1973, AS AMENDED
The undersigned (hereinafter called the "recipient") HEREBY AGREES THAT it will comply with
section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), all requirements im-
posed by the applicable HHS regulation (45 C.F.R. Part 84), and all guidelines and interpretations
issued pursuant thereto.
Pursuant to § 84.5(a) of the regulation [45 C.F.R. 84.5(a)), the recipient gives this Assurance in
consideration of and for the purpose of obtaining any and all federal grants, loans, contracts (ex-
cept procurement contracts and contracts of insurance or guaranty), property, discounts, or other
federal financial assistance extended by the Department of Health and Human Services after the
date of this Assurance, including payments or other assistance made after such date on applica-
tions for federal financial assistance that were approved before such date. The recipient recognizes
and aerees that such federal financial assistance will be extended in reliance on the representations
and agreements made in this Assurance and that the United States will have the right to enforce
this Assurance through lawful means. This Assurance is binding on the recipient, its successors,
transferees, and assienees, and the person or persons whose signatures appear below are author-
ized to sign this Assurance on behalf of the recipient.
This .Assurance obligates the recipient for the period during which federal financial assistance is
extended to it by the Department of Health and Human Services or, where the assistance is in the
form of real or personal property, for the period provided for in § 84.5(b) of the regulation [45
C.F.R. 84.5(b)).
The recipient: [Check (a) or (b))
a• ( ) employs fewer than fifteen persons;
b. ( ) employs fifteen or more persons and, pursuant to § 84.7(a) of the regulation
[45 C.F.R. 84.7(a)], has designated the following person(s) to coordinate its
efforts to comply with the HHS regulation:
Weld County Division of Human Resources
Name of Designee(s) — Type or Print
Weld County Division of Human Resouces 1551 North 17th Avenue, P.O. Box 1805
Name of Recipient — Type or Print Street Address
84-600013 Greeley, Colorado
(IRS) Employer Identification Number City
(303) 353-3816 Colorado 80632
Area Code — Telephone Number State Zip
I certify that the above information is complete and correct to the best of my knowledge.
Prctem
Chairman, Weld County
September 26, 1990 Board of Commissioners
Date / , / / ig at re and Title/o\ thorized Official
ATTEST: L p
/ C.13,Y Deputy Clerk to Board
If there gbeen o a rtit Sits najtte or owners ip within the last year, please PRINT the former
name below:
PLEASE RETURN ORIGINAL TO: GRANTS MANAGEMENT OFFICE
HHS-641 (7/84) REV.)
GPO 9011-7I
HOS GRANTS.NAM1ACEMENT
Certification Regarding Debarment, Suspension, and Other
Responsibility Matters - Primary Covered Transactions
Ey signing and submitting- this grant award or_grant agreement, the
applicant, defined as-the-primary participant-in-accordance-with 15 cn -- -
Part 76,' certifies-to-the:best of _its knowledge and believe-that it and Stirs
principals�>
(a) - are not-presently debarred,:-suspended, -pr '
oposad for-debarmemt;,.., :: a declared ineligible,.orsvoluntarily excluded-frost-covered-transactions_byt_ �
zlZej
any Federal-Department ottagency; -
�>
(b) have not.within a 3-year `:.
Y period.-preceding'-this proposal-been— <
convicted of_or-had_a civil judgment rendereckagainst them for:commissieniz of_fraud or-a -criminal_offense in_connectionvith. obtainin '
obtain, or-performingState e. or-local)obtaining, or og- -- '
contract under-.a public transaction; violatiorof_lederal._oratatei� oc=
antitrust statutes or-commission of embezzlement; theft, forgery; bribery;_
falsification-or -destruction of records, making false-statements, or'-
receiving stolen property;
(c) are not presently indicted or otherwise, criminally or civilly
charged by-a governmental.-entity (Federal, State onlocal) with commissiata of any of_the offenses enumerated .in..paragraph (11(b). ofahis
r; > .r
certifications-. and '
(d) have not within a -3-year period preceding this -
application/proposal had one or more public transactions-(Federal, State,.
or local) terminated for cause or default.
The inability of a person to provide the certification r s
not necessarily result-in denial of squired above rill__
transaction. If necessary, the prospective
in this covered
p participant shall submit an
explanation of why it cannot provide the certification. The certification. -
or explanation will be considered in connection with the Department of
Healt❑ and Human Services' (HHS) determination, whether to enter into this --
transaction. However, failure of the prospective primaryparticipant to--
furnish a certification or-an- explanation shall disqualify -such person from_
participation-in-this transaction._
-
The prospective primary participant agrees that by submitting this
proposal, it.will include the clause entitled "Certification Regarding 4
Debarment, Suspension,- Ineligibility, and Voluntary-Exclusion - Lower Ties-Covered Transactions,' provided below-without modification in all lover—
tier covered transactions and in all solicitations for lower tier covered transactions. _ 3 _
Gene Brantner,, ' Chairman;` Board of Cotinty Commissionarc ,.Name and Titleo Authorized Representative
gna e
x GAS„ car uFY - er to B
_ g wn �r S
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans,
and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief,
that:
(1) No Federal_appropriated funds have been paid or will_be -paid, by or=onT-
behalf of:.the:undersigned, to any person_forinfluencing or attempting
- or-employee-of tgrp s, to_
influence an-officer
_any agency, a Member-of Congress, any
officer or-employer of Congresa,_or-an-employee of a Member_of Congress in-:
connection_with:the awarding. of any Federal_contract;- the-mnNag of any
Federal_.grant; the-ranking ,of-any-Federal-loan, the-entering-into of any-
cooperative=agreement, and the_extension,_ continuation, renewal,
amendment, or_modification of any-Federal_contract, grant, loan, or-
cooperative agreement.
(27 If any funds other than..Federal_appropriated. funds-have been paid or-
will_be paid- to any person for-influencing or-attempting to influence an
officer or employee of any agency, a Member-of-Congress, an officer or -
employee of_Congress, or an employee of-a Member of:Congress in_connection_.
with this Federal..contract, grant, loan or cooperative agreement, the
undersigned shall complete and submit Standard Form-LLL, "Disclosure Fors _
to Report Lobbying," in._accordance. with its instructions.
(3) The undersigned shall require-that the language of:.this certification
be°included in-the award documents for all. subawards at all tiers
(including subcontracts, subgrants, and contracts under grants, loans, and
_._cooperative-agreements) and thatall subrecipients shall- certify and
disclose accordingly.
Ibis certification is a material_representation of fact upon which
reliance was placed when this transaction was made or entered into.
Submission of_this certification is a prerequisite for-making or entering
into this transaction imposed by section 1352, title 31, U.S. Code. Any
person who fails to file the required certification shall be subject to a
civil penalty of not less than $10,000 and not more than 1100,000 for each
such failure.
I 4 n1 I /1
Family Educational Network of Weld County ATTEST:f A '
4/7
Organization � ,.
Prolem Weld"County lerk to Board
Chairman, Hoard of 9/26/90'
County Commissionersce, u ,44-1
Xthotrized ciiplttnre Title Deputy Clerk to e Board
NOTE: If..Disclosure. Forms are required, please contact: Mr: William_
Sexton, Deputy Director, Grants and.Contracts Management Division, Room
341F, HER Building, 200 Independence Avenue, SW, Washington, D.C. ..
" 20201-0001
U.S. DEPARTMENT OF HEALTH AND HUNAN SERVICES
CERTIFICATION REGARDING
DRUG-FREE wORKPLACE REQUIREMENTS
GRANTEES OTHE! THAN INDIVIDUALS
By signing and/or submitting this application or grant agreement, the
grantee is providing the certification set out below.
This certification is required by regulations implementing the
Drug-Free Workplace Act of 1988, 45 CFR Part 76, subpart F. The
regulations, published in the January 31, 1989 Federal Register, iequire
certification by grantees that they will maintain a drug-free workplace.
The certification set out below is a material representation of fact upon
which reliance will be placed when H.S. Department of Health and Human
Services determines to award the grant. False certification or violation
of the certification shall be grounds for suspension of payments,
suspension or termination of grants, or governmentwide suspension or
debarment.
The Grantee certifies that it will provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession or use of a
controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing a drug-free awareness program to inform employees
about:
( 1 ) the dangers of drug abuse in the workplace;
(2 ) the grantee's policy of maintaining a drug-free workplace;
( 3 ) any available drug counseling, rehabilitation, and employee
assistance programs; and
(4 ) the penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace,
(c) Making it a requirement that each employee to be engaged in the
performance of the grant be given a copy of the statement
required by paragraph (a);
•
(d) Notifying the employee in the statement required by paragraph (a)
that, as a condition of employment under the grant, the employee
will:
(1 ) abide by the term of the statement; and
(2) notify the employer of any criminal drug statute conviction
for a violation occurring in the workplace not later than
five days after such conviction;
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(e) Notifying the agency within ten days after receiving notice under
subparagraph (d) (2) froa an employee or otherwise receiving
actual notice of such conviction;
(f) Taking one-of the following actions, within 30 days of .reeeiviag
notice under subparagraph (d)(2), with respect to ley employee
who is so convicted:
(1) taking appropriate personnel action against such an
employee, up to and including terminations or
(2) requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved•fos
such purposes by a federal, state, or local health, law
enforcement, or other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug-free
workplace through implementation of paragraphs (a), (b), (el.
(d), (e), and (f). .
Place of Performance.. The grantee shall insert in the space provided .
below the site(s) for the performance of work done in connection with the
specific grant: (street address, city, county, state, sip code).
WELD COUNTY BOARD OF COMMISSIONERS
Organization Name (Grantee) Award Humbert')
George Kennedy, Chairman Pro-Tem, Board of County Commissioners
Name and Title of Authorized Representative
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ATTEST f!'z`r7YL"rry�/r
Signature
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DEPUTY CLERK 0 THE BOARD
Certification Regarding Debarment, Suspension, and Other
Responsibility Matters - Primary Covered Transactions
By signing and submitting this grant award or grant agreement, the
applicant, defined as the primary participant in accordance with 45 CFR
Part 76, certifies to the best of its knowledge and believe that it and its
principals:
(a) are not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions by
any Federal Department or agency;
(b) have not within a 3-year period preceding this proposal been
convicted of or had a civil judgment rendered against them for commission
of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (Federal, State, or local) transaction or
contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or
receiving stolen property;
(c) are not presently indicted or otherwise criminally or civilly
charged by a governmental entity (Federal, State or local) with commission
of any of the offenses enumerated in paragraph (1)(b) of this
certification; and
(d) have not within a 3-year period preceding this
application/proposal had one or more public transactions (Federal, State,
or local) terminated for cause or default.
The inability of a person to provide the certification required above will
not necessarily result in denial of participation in this covered
transaction. If necessary, the prospective participant shall submit an
explanation of why it cannot provide the certification. The certification
or explanation will be considered in connection with the Department of
Healtn and Human Services ' (HHS) determination whether to enter into this
transaction. However, failure of the prospective primary participant to
furnish a certification or an explanation shall disqualify such person from
participation in this transaction.
The prospective primary participant agrees that by submitting this
proposal, it will include the clause entitled 'Certification Regarding
Debarment, Suspension, Ineligibility, and Voluntary Exclusion - Lower Tier
Covered Transactions,' provided below without modification in all lower
tier covered transactions and in all solicitations for lower tier covered
transactions.
George Kennedy, Chairman Pro-Tem, Board of County Commissioners
Name and Title th4440d Representative- y'/ 41/7/1/
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ATTEST: / Nr!i//1
Signature
7
D puty Clerk to he Board
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