Public Services Program Application Fiscal Year –
San Bernardino County
Fiscal Year -
PublicServices ProgramApplication
The following documents must be submitted in the order listed, please be sure to submit all attachments with your application.
Exhibit 1: Organization Information
Exhibit 2: Project Information
Exhibit 3: Community Needs and Target Population
Exhibit 4: Project Budget & Sources
Exhibit 5: Performance & Outcomes
Exhibit 6: Agency Capacity Narrative
Exhibit 7: Civil Rights Laws Compliance and HUD Good Standing Exhibit 8: Signature and Assurances
Application Checklist
_______________
Log Number
(Office Use Only)
1 2023 2024 2024 BARS23PS-043 2023
Public Services Program Application Fiscal Year –
Exhibit 1: Organization Information
Organization Name:
Organization Address:
City/State/Zip:
Phone:
Fax:
Email:
Applicant Type:
Authorized Person Name:
Authorized Person’s Title:
Address:
City/State/Zip:
Phone:
Fax:
Email:
Application Contact Person’s Name:
Application Contact Person’s Title:
Explain the Agency’s 1) Mission, 2) Purpose, 3) Population Served, 4) Number of years serving population, 5) Supportive Services, their Funding Sources, and Start/End Dates. 2 barstow / CA / 92311Executive Director 2024 7602622620 3232373900 Barstow / CA / 92311 27744 De anza street 1041 w. Main st Executive Director Elizabeth Givens Elizabeth Givens Growing Outreach Growing Opportunities Our mission at G.O.G.O.is to Serve, Assist, Prevent and Educate. We create bridges while removingbarriers that impair the quality of life and access to care forminorities, ensuring they have the tools and support to lead happy, productive, healthy, successful and meaningful lives.2. reach out to the minority residents that do not normallyseek out assistance due to social stigma and fear.3. We serve the citizensin our town of Barstow , CAFt. Irwin.4.
Gogohas served the Barstow communitysince 2017 and is committed togrowing our servicesto the other unserved and underserved cities of Ft. Irwin, Hinkley and needles ,Ca 5.
We offersupportiveservices that include support groups, job training, life skills training, emergency food, clothing, street outreach andcase management. All of ourfunding has come fromfundraising and in-kind donations, volunteers and communitysupport. These projects will continue until 2032.
2023 [email protected] [email protected] non- profit Public Services Program Application Fiscal Year –
Exhibit 2: Project Information
Project Title:
Project Address:
County Supervisorial District where project will be located:
1 st District 2nd District 3
rd District 4th District 5th District
If you are requesting funds for an existing CDBG project, provide prior CDBG project number.
Will this project provide an opportunity to hire minority-owned and women owned businesses? If YES, describe what actions will be completed to implement such subcontracting plans to monitor this component of the proposed project. If NO, discuss why and what actions are being taken to encourage minority-women businesses to apply for this project. 3 If this is an Expansion of Service to previously funded CDBG project, please explain how this is an expansion of service?. (i.e For 2015 we proposed 60 units of service, this year the agency is planning to serve 100 units of service)
Is this a New Public Service Project, or request to expand services to an existing CDBG project? Yes
We have ensured that the company that we use for office space is owned and operated by a certified MBE. We use and subcontract with Black women owned businesses for supplies and needed materials.
2024 Go Go Street Outreach X
N/A
1041 W. Main Street Barstow, CA 92311 /Mobile 2023
Public Services Program Application Fiscal Year –
EXHIBIT 2A: Countywide Vision
Indicate Yes/No in the table below if any of these countywide vision goals are pertinent to the proposed project.
Countywide Vision
Countywide Vision Yes/ No
Implement the Countywide Vision.
Create, Maintain and Grow Jobs and
Economic Value in the County.
Improve County Government Operations.
Operate in a Fiscally-Responsible and
Business-Like Manner.
Ensure Development of a Well-Planned,
Balanced, and Sustainable County.
Maintain Public Safety.
Provide for the Health and Social Services
Needs of County Residents.
Pursue County Goals and Objectives by
Working with Other Governmental
Agencies.
Provide a brief narrative of how your project meets the Countywide Vision:
4 Yes Yes 2024 Yes Yes Yes Yes
Thecountyhas a vision thataligns withGoGo visions andideas for the future of Barstow , Ca.
We firmlybelieve thatif we are in streets and places thatlow income, homeless and others at risk,we canreach and serve citizens who other wise don't know of the services available.Our project directlyaddresses the visionsof San Bernardino county by ensuringthat we include minorities and we offer services thatwill improve their qualityof life , jobpreparedness to ensure they canhave options and access to success.
Yes Yes 2023
Public Services Program Application Fiscal Year –
Exhibit 3: Community Needs and Target Population
Community Needs Target Population
Public Service
Needs:
Yes/No Proposed Community: Yes/No
Senior Services Low and Moderate Persons
Handicapped
Services
Low and Moderate
Households
Youth Services Abused Children
Child Care
Services
Handicapped Persons
Transportation
Services
Illiterate Persons
Substance Abuse
Services
Homeless Persons
Employment
Training
Migrant Farm Workers
Health Services Elderly People
Lead Hazard
Screening
Crime
Awareness
5 City/Target Area of Project Beneficiaries
Participating Cities: (i.e Redlands, Colton, Yucaipa)
Yes
The target area for our services is Barstow, CA. Barstow is severely under-served and has no active street outreach that initiates wrap around services to help the entire city.
NoYes Yes Yes Yes 2024 Yes Yes Yes Yes Yes Yes Yes Yes2023 No Yes Yes Public Services Program Application Fiscal Year –
Exhibit 3: Community Needs and Target Population (continued) Describe the geographic boundaries of the neighborhood, community or area in which clients of the proposed program reside (attach a map if needed):
HUD Demographics: (Yes/No)
Does this project help prevent homelessness?
Does this project help the homeless?
Does this project help those with HIV or AIDS?
Does this project primarily help persons with disabilities? Summarize the description of your project to include 1) priority, 2) sub-activity, 3) population(s) to be served, and 4) accomplishment level, and 5) services to be provided. 6 Yes 2024 Yes
Our priority is to thesections of thecitylisted on the map as 1,3, and 4. Thesearea have the highest crime rates, poverty and un-sheltered residents. Our priorityis toprovide immediate and onsite services that include assessments of their long term needs and start case management for wrap around services.Oursub activities includesupport groups, computer training, skills training, job development,personal care, life skills trainingBarstow has a populations of over 25,000 residentsaccording to welfare info.orgBarstowcurrently has nearly40 percent of it sresidentsliving in poverty, hosing insecure, LGTBQIA+, youth, minorities and seniors.We will be able to access andassist178 residents not including their children and families. This is unduplicated.Our services includeimmediate assessments and case management, our clients are assessed to determine what long term needs are. That includesrehabilitaton, housing relocation, obtaining a career, obtainingchild care , transportation, medicaland mental health needs, therapy, support groups, activitiesfor theirchildren servicesfor their children and teens.
Yes
Barstow has a large sub area Lenwood, the inner city house three public hosing complexes and large mobile home parks. Areas 1,3,4. Map attached. 2023 Yes
Public Services Program Application Fiscal Year –
Describe how this project meets the priority population and activities selected.
Explain why this project is needed and what evidence can you substantiate the need.
Describe what gaps of service in the county this project fills.
What are the critical factors for the success of your project (include both financial and human resources)? For instance, is this the only funding for this project? What happens if funding decreases? Does this project rely on only one source of leveraging? Is there adequate staff involved with the project if there is project turnover? Please address any factor that is critical to project success.
7 The streetoutreach is needed becauseour residents are not aware of what resources are available to them or how to access them. According toACF-HHS reportover40,000 youth and young adultsbenefited from street outreach services in a two year period. LAHSAhasreleased there results for theirStreet outreachefforts andin a six monthperiod they were ableto contact and assist over22,000 people.
2024
This projectwill close that gap onaccess to careand resources. Our city has no other active outreach programs thatcanvasesthe communityto seek out theunserved and assist them with wrap around servicesor any services they may need including but not limited toemergency food, clothing, housing, counseling, medical needs, mental health, domestic violenceand substance abuse. Thisproject will also close the gap on prevention and education for those at risk.
This will not be the onlyfundsfor our street outreach project. These funds will allow us to expand our weekly outreachfrom one day a week to two daysper week for needed supplies and fuel to travel for the year. If funding decreases we willmaintain our one day per week outreach campaign. We do not rely on one single sourcefor leveraging, we have multiple fundraising campaigns, local community support, and in-kind donations of monetary value and supplies. We have a total of 9 volunteers and the executive director to operate and oversee this outreach project.
Alarge part of thesuccess forG.O.G.O.is that we offera streetoutreachprogramthatallowsus to go outto thecommunityandprovide onsite assistance and provide detailed information to reachresidents women that would notseek outassistance otherwise. We reach out to the overlook and not inlcuded with our mobile office and our commitment Serve, Assist, Prevent and Educate.
2023
Public Services Program Application Fiscal Year –
Exhibit 4: Project Budget & Sources
Project Budget
SB County Share: ($) Other Source: ($)
Personnel
Equipment (Rental, Lease or Purchase)
Consultant Services
(Auditing, Accounting or Payroll)
Space Rent
Insurance
Consumable Supplies
Other
Total Costs
Total Project Budget Cost: (CDBG Share + Other Source)
8 $8,640.00 $45,340.00 2024 $4,000.00 $2,000.00 $5,000.00 $0.00 $25,700.00 $8,640.00 $0.00 $600.00 $2,000.00 2023 $5,000.00 $4,000.00 $5,460.00 $19,640.00 Public Services Program Application Fiscal Year –
Exhibit 4A: CDBG Funds Requested and Leveraging Information Indicate the amount being requested by the city.
City Amount Requested ($):
(This amount should match the grand
total requested from CDBG Share)
9 Leveraging items may include any written commitments that will be used towards your cash match requirements in the project, as well as any written commitments for building, equipment, materials, services and volunteer time.
Source of
Funding:
Type of Funding: (Grant Name,
EFSP Money)
Amount ($): Date
Available:
(11/22/2016)
Federal
Funding
State
Funding
County
Funding
Private
Funding
Other:
Total Leveraging Funds
01/04/2023 $5,000.00 2024 Fundraising 01/04/2023 Barstow $25,700.00 $19,640.00 Donations 2023 $20,700.00 Public Services Program Application Fiscal Year –
Exhibit 5: Performance and Outcomes
Definitions:
Unduplicated Clients: The number clients/persons projected to be served during the program year (e.g. 25 clients, 50 seniors):
Duplicated Clients: The estimated yearly units of service (duplicated, e.g. 25 clients x 10 visits=250 units of service):
Complete the chart below with the number of Duplicated and Unduplicated Clients to be served.
• In column 1 identify activities that will be completed (e.g. intervention, counseling, and case management).
• In column 2 indicate the number of Unduplicated Clients to be served. • In column 3 identify the number of Duplicated Clients to be served.
Activities to be Completed (1) Unduplicated
Clients to be
Served (2)
Duplicated Clients
projected to be
served (3)
Performance and Outcomes, answer the following narrative questions using minimum funds request.
Indicate a timeline of services provided to client(s) in order to meet project outcome(s).
Describe how your agency determines client(s) success.
Describe your methodology to evaluate project outcomes. 10 life skills training 2024 Case management
Clients area assessed immediately, emergency housing services within 24 hours and receive case management services with 72 hours, and long term training and resources for 12 months or longer if needed .
768
Case management tracking that shows completion of training or rehabilation, clients securing employment, clients that have been housed, clients enrolled in trade school or college. 384
We have Utilization manager , Karen Brown who oversees and provides internal audits, will ensure our project stays on track and compliant.
192 192 2023 Intake 384 1151
Public Services Program Application Fiscal Year –
Exhibit 5A: Proposed Goals & Milestones
Explain how the project will meet contract goals and milestones and be completed within 12 months (July 1, – June 30, ). For example, project expenditures and performance/ accomplishment goals of 40% by November 30th, 50% by December 31st, 80% by March 31st, and 100% by June 30th.
Fill-in the table below with dates for submission of reimbursement claims and the estimated amount of each.
Date of Reimbursement: Amount ($):
Total Reimbursement:
($)
11 $1,637.00 $1,637.00 $1,636.00 $1,636.00 $1,637.00 2024 2024 10/31/2023 $1,636.00 $1,636.00 05/31/2024 $19,636.00 $1,636.00 02/29/2024 03/31/2024 $1,636.00 $1,637.00 09/30/2023 06/30/2024 04/30/2024 Each month 10 percent of the project will be executed with twice a week street outreach. 30 percent in three months, 60% in 6 months. reaching our goal by the end of April 2024 on going to June 2024. 8 days per month for a total of 96 days of outreach service 50% completion by December 2023. 100% completion By May 2024 and additional events until June 2024.
01/31/2024 07/31/2023 11/30/2023 2023 2023 08/31/2023 $1,636.00 06/30/2023 $1,636.00 Public Services Program Application Fiscal Year –
Exhibit 6: Agency Capacity Narrative
(Non-Profit Organizations Only)
Describe the roles of key administrators, staff members, and volunteers within your agency that will implement the proposed project. In your description include experience, education, and licensing qualifications.
Describe your agency’s experience in administering government and/or public funds.
Describe your method to sustain project viability over the multi-year process if funding decreases.
Instructions: Complete the table below by marking “YES” or “NO” to the questions listed below.
Question:
Example: Have you received federal funds in the past
five years? Yes
In the past ten years, has your organization ever had its nonprofit status revoked or withheld by the IRS, the
Secretary of State, the State Attorney General, or the
Franchise Tax Board?
Has your organization been sued in the last five years? Are any of your managers or staff with fiscal
responsibilities involved in litigation presently that has any bearing on fiduciary trust or employee relations?
Have any unfavorable rulings been handed down by any
court against your organization or Executive Director the last five years?
Does your organization currently have any unresolved
fiscal, reporting, or program issues with any of its funding sources?
YES/ NO
12 No
We have several years of experiencewith administrating funds, we are always compliant, and keep and track all spending with board approval
2024 No
Karen Brown Masters degree in EconomicsJasmine Nelson- Bachelor's Degree in PsychologyElizabeth Givens - AA degree in social services We will continue to offer these servicesthroughin-kind donations, fundraisingand corporategiving. GoGo is actively applying for additional grants and funding with CAL OES and DHHS.
No 2023 No No
Public Services Program Application Fiscal Year –
EXHIBIT 7: Civil Rights Laws Compliance and HUD Good Standing Answer the following questions.
Has your organization been a past recipient of assistance under a HUD McKinney Act program or the HUD Single Family Property Disposition Homeless Program? If you have been a recipient under either of these programs, has your agency experienced any project or construction delay, HUD finding or outstanding audit that HUD deems serious regarding the administration of HUD McKinney Act programs or the HUD Single Family Property Disposition Homeless Program?
If you answered “Yes”, please explain the circumstances and outcome below.
Applicants must be in compliance with applicable civil rights laws and Executive Orders. Applications will be rejected if your agency has any of the following: (1) Any pending civil rights lawsuit instituted by the U.S. Department of Justice; (2) Any noncompliance with civil rights statutes, Executive Orders or regulations as a result of formal administrative proceedings, unless the applicant is operating under a HUD-approved compliance agreement designed to correct the area of noncompliance or is currently negotiating such an agreement; (3) Any unresolved Secretarial charge of discrimination issues under Section 810(g) of the Fair Housing Act, as implemented by 24 CFR 103:400; (4) Any adjudication of a civil rights violation in a civil action brought against the Organization by a private individual, unless the applicant is operating in compliance with a court order designed to correct the area of noncompliance or the applicant has discharged any responsibility arising from such litigation; (5) Any deferral of the processing of applications from the sponsor imposed by HUD under Title VI of the Civil Rights Act of 1964, the Attorney General’s Guidelines (28 CFR 50.3) or the HUD Title VI regulations (24 CFR 1.8) and procedures, or under Section 504 of the Rehabilitation Act of 1973 and HUD Section 504 regulations (24 CFR 8.57). If one or more of these situations exists with your Organization, please attach a brief description.
13 2024 No 2023 No
E-Signature Authorization
San Bernardino County
Community Development and Housing Departmemt
Community Development Block Grant
Martha Zepeda
Deputy Executive Officer
- Application
In order to comply with all applicable federal grant regulations, a hard-copy of this E-Signature Authorization containing an original wet signature must be filed with the San Bernardino County Community Development and Housing (CDH) in order for the applicant to electronically sign the Community Development Block Grant (CDBG) application documents online. This authorization may only be completed by a registered owner, partner, executive officer, or authorized employee (with proof of authorization) of the applicant submitting this form and must contain an original signature to be submitted to the CDH.
Authorization Agreement
I am an owner, partner, executive officer, or duly authorized employee of the below-listed applicant and have authority to enter into agreements on behalf of the below-listed applicant. CDH may rely on the receipt of such agreements executed and delivered by facsimile or other electronic means as if the original had been received. The undersigned agrees that the electronic signatures appearing on documents submitted from the below-listed applicant are the same as handwritten signatures for the purposes of validity, enforceability and admissibility. By signing this Electronic Signature Authorization Agreement, I authorize the CDH to accept, via electronic submission, documents submitted from the below-listed applicant as required by the CDH's CDBG - Funding Application.
I understand that CDH may change the CDBG application system from time to time. I agree that the below-listed applicant will electronically sign all documents requiring a signature related to the CDBG funding application.
My signature on this form certifies that:
I agree that entering my name in the CDBG funding application system constitutes my electronic signature. I understand that any information and documents submitted using my name is electronically certifying my signature. I understand that I am legally bound, obligated, and responsible by use of my electronic signature as much as I would be by my handwritten signature. I agree that I will protect my signature from unauthorized use, and that I will contact CDH immediately, upon discovery that my electronic signature has been compromised. I certify that my electronic signature is for my own use, and that I will not delegate it or share it with any individual.
This request is effective immediately upon receipt by the CDH and will remain in effect until the end of the - CDBG funding cycle or I choose to cancel this request via written notification to the CDH. I understand that it is my responsibility to update and/or cancel this request under all circumstances, including my departure or terminated association with the below-listed applicant.
By signing the E- Signature Authorization Form we certify that this agency will also comply with the following:
Non-discrimination
This organization will, through all possible means, ensure equal opportunity for all persons to receive services, to participate in the volunteer structure, and to be employed regardless of age, handicap, national background, race, religion, or sex. An existing sectarian nature of the agency shall not suffer impairment under this agreement, but participation in religious observances, rituals or services will not be required as a condition of receiving food, services, or shelter paid for by this grant.
Accountability
We commit this organization, if a grant is received, to provide all reports to the County as required; to expend monies only on eligible costs; to keep complete documentation (copies of all canceled checks, invoices, receipts, etc.) on all expenditures for a minimum of three years; to spend all funds and close out the program on the required date; to return any unused funds to the County to cooperate with monitoring or site visits, and; to provide complete documentation of expenses to the County, if requested, by the required date.
We affirm that all information in this application is true and correct to the best of our knowledge and that the applicant under our authority will execute its responsibility under the proposed contract and adhere to all other applicable rules and regulations to the fullest extent possible.
Non-collusion
This proposal is genuine, and not sham or collusive, nor made in the interest or in behalf of any person not herein named; the proposer has not directly induced or solicited any other proposer to put in a sham proposal, or any other person, firm or corporation to refrain from submitting a proposal; the proposer has not in any manner sought by collusion to secure for him/herself an advantage over any other proposer.
Applicant Information
Agency Name: Federal Tax ID No.:
Mailing Address: Phone No.:
Email Address: Fax No:
Authorized Signature
Print Name: Print Title:
Signature: Date:
Please send the signed copy of this one page agreement to:
San Bernardino County Community Development and Housing Department 215 North D Street, Suite 302, San Bernardino, CA 94215-0043 Attn: CDBG Application
14 Growing Outreach Growing Opportunities Elizabeth Givens 2024 2024 2024 12/07/2022 Elizabeth Givens Executive Director Executive Director [email protected] (760) 262-2620 (760) 262-2620 2023 2023 2023 1041 w. Main st Public Services Program Application Fiscal Year –
CDBG Application Checklist
(Non-Profit Organizations Only)
Community-based organizations are required to include one copy of the items listed below. If you are not submitting these items at this time, please notify Community Development and Housing at (909) 387-4705 to make other arrangements. The following information is required before any contract or reimbursement can be completed.
o Summary of agency’s current year General Operating Budget o List of agency’s Board of Directors, including names and addresses o Proof of existing non-profit/tax-exempt status (Letters from the Federal Internal Revenue Service and State Franchise Tax Board) o Current certificate of insurance and amounts covered
o Organizational chart
o Minutes of last Board meeting
o Non- Profit agencies must be Registered in the System of Award Management (SAM) website.
Agency cannot be funded if they have been debarred in the past. o Provide board minutes/letter that authorizes the executive director or program manager to run the project.
If your application is funded you will be required to provide a copy of your last audit and your Articles of Incorporation and Bylaws must be on file. 15 2023 2024