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-053 ✔
✔
✔
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 / California / 92311 Executive Director 2024 760-678-7313 760-718-8396 Barstow / California / 92311 400 S. Second Avenue 400 S. Second Avenue, Suite 103 Executive Director Bushawn Carpenter Bushawn Carpenter Total Restoration Church (Reaching Our Kids) Mission: Reaching Our Kids provides mentoring and academic sponsorships to at-risk Barstow Jr. High and High School students who display academic promise, in order to equip them for leadership, social responsibility, and career preparation. Population Served: At-Risk Jr. High and High School students and their families in the Barstow area and surrounding communities (with a heavy emphasis on minority and economically disadvantaged youth).
Number of Years Serving Population: The program is completing its first year. Supporting Services: STEM Training Workshops, Exposure to new career pathways, Social & Emotional Learning workshops, Group Mentoring, College preparatory workshops (including A-G Requirements), College Tours, Anti-bullying training, Community Service Projects, leadership opportunities, scholarships, and one-on-one mentoring (next phase). Funding Sources:
Private Donations. Start/End Dates: Mar. '22 - Feb. '23 2023 [email protected] [email protected] Public Service 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? No
N/A
2024 Reaching Our Kids X
Not an expansion of a previously funded CDBG project.
400 S. Second Ave, Suite 103 New Public Service Project 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 No 2024 Yes Yes NoYes
The Reaching Our Kids program plans to provide at-risk students (and their parents) with the social and emotional tools to engage in sensitive social conversations that will celebrate diversity while building a true sense of community. We believe that ROK's academic programs (e.g. STEM workshops, college preparatory advising, and career-related networking) will help produce a highly educated, skilled workforce in Barstow and its surrounding areas. We truly believe that our comprehensive program will help build a pipeline to some of our nation's most prestigious universities. Many of these children are destined to become leaders of the next generation and return to San Bernardino County to help build a positive, affirming culture where public safety is enhanced and children are supported in their aspirations.
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
Barstow and surrounding areas.
NoYes No Yes No 2024 No No No Yes No Yes Yes Yes No2023 No NoYes 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 No 2024 Yes
The Reaching Our Kids Program is designed to target at-risk Jr. High and High School students who have dreams of attending a university but have no support system to help them get there. We recognize that some of our community's most gifted students will trade in their lofty dreams and aspirations for temporary gratification that often looks like petty crime and street life. At the age of 13, these children will make decisions that will affect the trajectory of their lives. With the proper support, affirmation, and encouragement some of these children who were once on the borderline of failure will jump on the road to success and change their family stories forever. This program takes the dreams of Jr. High children and builds an educational and community plan to help them get there. Some of the activities that we have already instituted include college visits, interview training, community service projects, mentoring, Mindfulness Training, Social & Emotional Learning, and educational networking.
Although we already engage in a group mentoring model, ROK plans to include one-on-one mentoring and financial literacy in the next year of service. We fully expect all of our ROK Scholars to attend a four-year university. But we also expect our scholars to be leaders and influencers among their peers. We believe that ROK scholars will help shift the culture in our secondary schools and decrease teenage pregnancy and high school dropout rates.
No
The Reaching Our Kids program targets Jr. High and High School students in Barstow and its surrounding areas (includes Barstow Unified School District and Oro Grande School District). 2023 No
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 Barstow non-profit organizations do a great job serving youth. But far too many of our youth fail to realize their post-secondary goals. Although Barstow students graduate at a 94% rate, the percentage of graduates who are proficient in math is 16%; while reading proficiency is 43% (much lower than state averages).1 Only 22% of BHS Graduates are A-G eligible. ROK is needed to help our kids reach college.2(See attached ref.) 2024
The Police Activities League, Barstow Youth Activities League, Noble Fitness, and Barstow Community Football provide great after-school programs. The GIA Program introduces 8thgrade Black males to STEM opportunities, while the EXP Young Fellows Program provides high school boys of color with virtual mentoring sessions. ROK remains the only local program that targets at-risk Jr. High boys and girls, develops a customized plan for each student, provides STEM, community, and leadership training, then walks with them through every step on the way to college.
Many programs wait for grant funding to start offering services, but we were unwilling to lose another class of students to the streets. We enlisted a group of competent, well-trained volunteers, leveraged partnerships with other organizations to maximize resources, and raised over $20,000 in private donations. We are witnessing an incredible impact in our first year. But we recognize the need for paid staff positions to bring this program to its full potential. This funding will help with the administrative support necessary to ensure the sustainability of the program.
Our target population is at-risk Jr. High and High School students in the Barstow area. All of our students will be the first in their families to graduate from a 4-year college or university.
Our program surrounds the ROK Scholars with a variety of services that help them become well-rounded, socially responsible, civically engaged students who look forward to impacting the city of Barstow for years to come.
2023
Public Services Program Application Fiscal Year –
Exhibit 4: Project Budget & Sources
Project Budget
SB County Share: ($) 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 $20,000.00 $48,368.00 2024 $600.00 $0.00 $800.00 $0.00 $27,200.00 $20,000.00 $0.00 $2,000.00 2023 $368.00 $2,400.00 $1,000.00 $1,200.00 $21,168.00 Public Services Program Application Fiscal Year –
Exhibit 4A: CDBG Funds Requested and Leveraging Information Indicate the amount being requested by the city.
City Amount Requested ($):
(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
2024 Private Dontations Barstow $30,000.00 $21,168.00 2023 $30,000.00 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 Accountability/Mentoring 2024 STEM Training
During the 2023/24 year, 90 unduplicated clients will receive monthly SEL training and STEM training; weekly academic advising and family services; and quarterly college field trips, and community service opps.
950
Yearly client success is based on meeting pre-established goals (min. GPA, excellent student discipline & attendance, positive school and community behavior, and serving as a role model at school and at home).
500
Weekly check-ins with students and parents provide documentation of the student's progress, performance, and attendance.
2540 2023 Social & Emotional Learning/ Leadership Training90 250 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 $1,764.00 $1,764.00 $1,764.00 $1,764.00 $1,764.00 2024 2024 10/01/2023 $1,764.00 $1,764.00 04/01/2024 $21,168.00 $1,764.00 01/01/2024 02/01/2024 $1,764.00 $1,764.00 09/01/2023 05/01/2024 03/01/2024 The goals and milestones of the Reaching Our Kids Program will be achieved by ongoing group training, group workshops, and accountability sessions with the students, counselors, teachers, coaches, administrators, and parents. Our job is not done until the student(s) graduate from high school, enroll in a 4-year university, develop a college support team, and circle back to invest in more local kids who aspire to follow in their footsteps. Until then, we expect 25% of expenditures/accomplishments by Sept 30, 50% by Dec. 31, 75% by Mar. 31, 100% by June 30.
12/01/2023 07/01/2024 11/01/2023 2023 2023 08/01/2023 $1,764.00 06/01/2024 $1,764.00 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
Total Restoration Church has administered public funds since October of 2013, but this is our first time seeking government funding.
2024 No
The President, Derrick Delton, has over 27 years of experience helping districts manage multimillion dollar budgets to support students.
Although private donations and business sponsorships will always be a key part of our funding strategy, ROK is looking to diversify by including funding from corporate and government sources.
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 Total Restoration Church (Reaching Our Kids) Bushawn L. Carpenter, Executive Director 46-4064102 2024 2024 2024 12/07/2022 Bushawn L. Carpenter Executive Director Executive Director [email protected] (760) 718-8396 (760) 718-8396 2023 2023 2023 400 S. Second Ave 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