Exhibit E - CDBG Funding Applications.pdf — Rialto City Council, April 25, 2023

EXHIBIT E
FY 2023-2024
CDBG Funding
Requests
CDBG Public Services Funding Requests - FY 2023-2024
(15% : $182,920)
Program Name Organization
FY 2019-20
Approved
FY 2020-21
Approved
FY 2021-22
Approved
FY 2022-23
Approved
FY 2023-24
Requested
Ad-Hoc
Approved
Mobile Food Distribution Sunrise Church of California $ - $ - $ - $ - $ 10,000.00 $ 10,000.00 Legal Aid- Rialto
Legal Aid Society of San
Bernardino $ 11,376.00 $ 21,000.00 $ 13,245.00 $ 23,700.00 $ 28,179.00 $ 28,179.00 Veterans Program
Rialto Family Health Services
Inc. $ 11,376.00 $ 20,000.00 $ 13,244.67 $ 28,700.00 $35,000.00 $35,000.00 Working Dogs for Warriors Working Dogs for Warriors $ - $ - $ - $ - $ 180,000.00 $ 33,500.00 NCNW Bethune Center IE Section NCNW,INC $ 40,417.00 $ 40,417.00 $ 42,000.00 $ 42,000.00 $ 42,000.00 $ 42,000.00 Mobile Recreation City of Rialto $ - $ - $ - $ - $ 33,000.00 $ 33,000.00 $328,179 $181,679
Funded with Admin Set Aside
Fair Housing Services
Inland Fair Housing and
Mediation Board $ 29,061.00 $ 29,061.00 $ 32,478.00 $ 32,000.00 $ 35,000.00 $ 12,000.00

CITY OF RIALTO
FY 2023/2024

CDBG PUBLIC SERVICES APPLICATION
Sunrise Church of California
Mobile Food Distribution

DEADLINE
City of Rialto
Community Development Block Grant
Fiscal Year 2023/2024

PUBLIC SERVICE APPLICATION
The Deadline for returning completed applications is 12:00 p.m., Friday, February 10, 2023. Postmarks and late applications will not be accepted. Alf application must be mailed to:

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https:/iww,.v.hudexchange.info/resource/687 /playing-by-the-rules-a-handbook-for cdbg-subrecioients-on-administrative-systems/

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. 11!!1! Completed and Signed Application - Parts I-VI
11!!1! Articles of Incorporation
11!!1! Non-Profit Determination - 501(c)3 IRS Letter (if applicable) 11!!1! List of Board of Directors
!!!!I Organizational Chart
!!!!I Most Recent Audited Financials
!!!!I Resumes of Key Administrators
!!!!I Job Descriptions for Personnel/Positions Listed in Application � Most Recent Certificates of Insurances.

CONTACT
If you have any questions regarding the City of Rialto's Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
City of Rialto
Aknesa Ananikyan
(909) 816-5623
[email protected]
23/24 Public Ser1ice Application Page 1 of 10
I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
Sunrise Church of California Organization/ Agency
Program/Activity Title flliobile Food Distribution Program Physical Address 2759 Ayala Drive
City, State, ZIP Riallo. CA 92377
Type of Organization � Non-Profit ::J Government □ For-Profit Tax ID 95-2211854
Are you a Women owned, or a ::J Yes � No :::J Decline to state majority Women operated
organization?
Are you a Minority owned, or a =:JYes �No ::J Decline to state majority Minority operated
organization?
If yes, please select which :::J Black Americans :::J Native Americans :::J Hispanic Americans category or categories is most ;::J Asian/Pacific Americans :::J Hasidic Jews applicable.

UEI Number YWXHM5V7U1C9
Name of Workers' Compensation
Brotherhood Mutual Insurance (Government exempt)
Coverage Amount($) 1,000,000
Expiration Date 02/211.1024
Name of General Liability and Brotherhood Mutual Property Damage Insurance (Government exempt)
Coverage Amount($) 2.000,000
Expiration Date 08/13(2023
Name of Applicant Contact David Gomez
Title Communication and Evenls Pastor
Mailing Address 2759 Ayala Drive
City, State, ZIP Riallo. CA 92377
Email [email protected]
Phone 909-904-1022
Amount of CDBG Funds
$10,000 Requested ($)
Approximate Total Number of 500 Unduplicated Beneficiaries (Persons or Households) to be
Served
Type of Beneficiary □ Persons � Households
Groups that the Program/Activity � Youth □ Abused/Neglected Children will Serve � Adults � Households
(Check all that apply) l!!!I Seniors �Community
□ Homeless Persons � Housing Units
□ Disabled Persons D Public Facilities
D Battered Spouses D Businesses
Citv cf kialto 23/24 Public Service Application Pa?," 2 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories l!!!!I Public Service. Improves community public services and facilities, Please choose the CDBG Eligible including but not limited to those concerned with employment, fair Activity Category for your housing and homeownership, homelessness, crime prevention, child proposed project. care, health, drug abuse, education or recreational needs. □ Public Facilities/Improvements
□ Housing/Special Activities by Subrecipients
□ Economic Development
□ Acquisition and/or rehabilitation of real property
D Other. Click to specify
CDBG National Objective l!!!!I Benefits Low and Moderate Income (LMI) Individuals/Households.

Compliance □ Addresses the prevention or elimination of slums or blight.

Your proposed project/activity
must meet at least one of HU D's
CDBG National Objectives.

Please check all that apply to
your proposal.

Meetings National Objectives l!!!!I Low/Moderate Area Benefit - The project serves only a limited area Check all statements that which is proven by current Census data or survey to be a low-income describe how your proposed area. By choosing this category you must be able to prove your project/activity meets one of the project/activity primarily benefits low/moderate income households.

National Objectives above: l!!!!I Low/Moderate Limited Clientele - The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.
□ Slum or Blight on an Area Basis - Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.

City of Rialto 23/24 Public Se! ,,'ice Application Page 3 of 10 Ill. PROJECT NARRATIVE
PROJECT /PROGRAM DESCRIPTION. Briefly describe the proposed service/activity/project to be carried out with the funds requested.

The Sunrise Mobile Food Pantry Program proposes to improve access to healthy foods for low income residents who reside low-mod income neighborhoods. The program will deliver emergency relief boxes, baby items, and senior products to the four targeted communities, once a week for each community. The mobile program will target low income vulnerable populations that are located in low to moderate income designated (LMID) census tracts in which 51% or more of the households earn less than 80 percent of the Area Median Income (AMI). The targeted areas are also located in Opportunity Zones where the average poverty rate is twenty percentage points higher than the statewide average.

The median family income in the Opportunity Zone is also half the statewide average. The project has preliminarily identified the affordable housing communities of the Renaissance Village (220 N.

Glenwood Ave.) in census tract 003510 which has a Low/Mod percent of 62.76, the TELACU La Paz (200 W. Merrill Ave.) and the Crossings (177 W. South St.) 55 + affordable housing communities that are located in census tract 003700 which has a Low/Mod of 73.81 %, the Citrus Grove community (1432 N. Willow Ave.) 55 + affordable housing community located at in census tract 003506 which has a Low/Mod of 55.24%. In total the communities represent 508 total housing units.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

Food ir.seeurly jumped i'I the San Bern21dno-.-Ri..-t10I Counties Me:Io region frnm 9.a•� in 20 IS to t3.4"■ in 2019, driven largely by tho pc:s1demic. SUrvis� Ctx.irch. in p.i.rtnershp iRh the nonpruH SUnris":

Ue De\'tiepment, has betcri distributing rood at tl'le PEA.CE e«iter in Rialto to appt"oXffla.tely 500 to 600 famiies a week sines thii! progum·s ilc-cptkn n 2019. maint, W2 ta thfs ncre.as9d n�ct Ho;nver . ., mk1·2022 program sttvi�» spi(ld t,;, 1ooot.a.-n·•:e-5 a week. and this lncreased traffic has not subsiood evs-n though COVlD-19 condtioos have impro,.--ed The IOlc:• n services rnav be c:orr�aed totne end ol CS tornia.'s rent m0<aloriums. •"Eth U"lt ,e-nt mcralorllm gone, Ria.lo restdetits may choose b5weefl payingfOJ rent and food. In addtioo toth� aive-up traff� 111creasa, there- ha.s been a �o inttease in thenu'nbe, cl famiHeswho •• upto obl:a.nfoodlem5. Some community membefswa"klrom lhe surrOo.Y",tlil'\g neighborhoods: �ith wagons, ._,"h.ledhe<$tak-e the: bus ffetn further k>c�ons -,(I Nall from Kha bus $lop. Th-9 tiW"foCA,lt inctease in w.slk-uptrafflc danoostra:es thi ne!!dlo prow.te ·l"!"lprOled access to fooditQTis for \'Uln,erab-:e communi:ies Mdoop.ht1ons. Those that ar& loodin�cure o.-'tffi suffer s...i.ntly. The mobf• rood prOQla.tn is an opporturu,to reach-Fl Mod se,va s.eniors and tow---fnrome �avid.la!,;; who lack transportation a CM1a1.ol .a!adtunspatatlc:n costs such as gas to dive 10 Stuv.s..;, PEACE Center f<:od clstribl.ltioo sis-:..

The $.rnrise food progam has been galVariUlg oorr.munity voluntee,s and lapping into commun!typ.1rtners to help me-et th� nll!@d of residents. However. a aK:lbt..t iood prog,-am is a need� comm111:ty prcg;.m Iha.I would louch those wt-to eannot get lo the food distribu!:ion locations. The need o.menliy exists:. but we aJso antic:ip..te an Increased ne-ed brought on tiv � wci.al and economic tactu-s that we prqect wi.·1 impact those already vuherilie �d pos"Siix'/ iu:rea.se $erVlce need even mora. Th� factors indudethe Calfrest, emergency atobnef'lts Mdrg in Fecru.uy a 2023, the in.a easing food �s � lo inr'..a!O'I and lhe 1oomfng re-cession
BENEFIT. Discuss how the project/program provides benefit to low-income persons.

The program aims to improve access to healthy loads and other ite ms to low-income residents that reside in affordable housing communrties in the Rialto's LMID areas. Food insecurity is known to cause increased stress, requiring families to choose between food and other essentials such as housing, utilities, transportation and medical care. People who are food insecure are disproportionately affected by diet-sensitive chronic diseases such as diabetes and high blood pressure, and according to research, food insecurity is also linked to many adverse effects to overall health. For children, research shows an association between food insecurity and delayed development: risk of chronic illnesses like asthma and anemia; and behavioral problems like hyperactivity, anxiety and aggression.

The mobile food program has not only an immediate impact on hunger but a long term impact on health.

COLLABORATION. Has your organization/agency developed this project in collaboration with other groups/organizations? If so, please list the groups/organizations and describe their roles in this project.

Sunrise Church has worked in collaboration to support the food distribution program with Sunrise Life Development, Community Action Partnership of San Bernardino County, Rialto Grocery Outlet, Feeding America, and USDA. The partners have provide food and support with volunteers and program support.

City of Rialto 23/24 Pub!!c Se!vice Application Page 1 of 10 SIMILAR RESOURCES. Is a similar service provided by another agency/organization? If so, how will your program/activity differ?
There are two other known food distribution locations in the City of Rialto. Our program will differ by providing a mobile food distribution service to those who have barriers to accessing our location in Rialto in vulnerable communities.

OUTREACH. Discuss outreach efforts for the proposed service/activity/project.

Sunrise Life Development outreach efforts include social media advertising, food distribution information on the website, distribution of food distribution events through partner organizations and community based organizations that serve low income families in need.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
Ramp up Mobile Food Program 03/1512023
Purchase Van 041012023
Hire Part-time Staff 05/0112023
Launch program In targeted communities 06/1512023
OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or Fund Amount($) Current Status
Pending
Sunrise Church Donation Committed S59.530 Allocated
Grocery Slore Sponsorship/Private Donations Pending S15,000 In conversation City of Rialto 23/24 Pub!k Service Application Page S of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column B: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C

BUDGET ITEM COBG REQUEST OTHER SOURCES
($) {$)
··Pei:sonnerf
..

COmmUOCation and Events- Oavki Gomez_ 15 FTE 0 S11.250
Director of HR • Dianna Alvarado .10 FTE 0 S6.240
Personnel Advancement• Mike Story .05 FTE 0 $3.120
Rr.ance Director - Samantha Jones 05 FTE 0 $3.120
Corrvrunlty Engag-ament Repr�sentativ� TBD .50 FTE 0 S20.800 Personnel Total
Nori:Pefso�hel
• ·. ·
Rent/Lease
Supplies
Utilities
Equipment s10,000 ct 1 i:;. (\(\(1
Services
Printing
Admission/Enrollment
Other:

Other:

Non-Personnel Total
TOT:AlPRc>!Ec;T f3UPGE1' ,$�(}.Ol;)O ti:;a ,;_�rr
*For personnel, complete the following CD BG-Funded Personnel Tables.

City of Rialto 23/24 Pub!k Service Application
Column D

NAMES OF

OTHER SOURCES
-
Sunrise Church
Sunrise Church
Sunrise Church
Sunrise Church
Sunrise Church
- .

Priv�tP. F1 mrl�
C, ,_.,.; .... .-. f""I,,, -'
-- II -- - ,-..,v,
. -.. .. --·
Column E

TOT AL BUDGET
($)
s11.250
S6.240
S3.120
S3.120
$20,800
�25 000
$69530 -- - -

Page 6 of 10 ends

CDBG-FUNDED PERSONNEL
� Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted($) Dedicated to
($) CDBG Activity
(%)

PROPOSED PROGRAM STAFF
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is {$) ($) Compensation Budgeted($) Dedicated to
($) CDBG Activity
(%)
KEY PERSONNEL DUTIES. Provide a list of the duties of key personnel listed above.

Job Title Duties
C1tv of Rialto 23/24 Public. Service Application Page 7 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

Sunrise Church has a long history in the City of Rialto and has a large number of supporters. Program costs are minimal because Sunrise has largely been able to secure needed resources through partnerships and volunteer support.

PROGRAM CHANGES. If you received CDBG funding last year, has there been an increase in service that you will provide during FY 2023/2024? Explain why there is a new demand or an unmet need in the community for this service.

Not applicable.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

We would have to delay the launch of the mobile program indefinitely as other funding is identified and secured.

City of Rialto 23/24 Pubtic Service Application Page 8 of 10 V. CONFLICT OF INTEREST QUESTIONNAIRE
Federal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

This questionnaire must be completed and submitted by each applicant for CDBG program funding. The purpose of this questionnaire is to determine if the applicant, or any of the applicant's staff, or any of the applicant's Board of Directors would be in conflict of interest.

1. Is there any member(s) of the applicant's staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or (b) a City Councilmember? □ Yes II No
If Yes please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiliate(s) who is currently or has been, within one year of the date of this questionnaire, (a) a City Employee or Consultant or (b) a City Councilmember? □ Yes II No
If Yes, please list the name(s) and information requested below:

Na me of Person Job Title Relationship City Department

Name of Person Relationship Tie If Family, Indicate
Relationship
Citv of Rialto 23i24 Public Service Application Page 9 of 10 VI. SIGNATURES
Authorized Signature
To the best of my knowledge, the information provided on this application is true, and I am authorized to submit this application on behalf of the applicant agency.

David Gomez
Title
02/09/2023
Signature Date
Authorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.

David Gomez
Title
02/09/2023
Date
Citv of Rialto 23/24 Publrc Service Application Page 10 of 10

REVISED APPLICATION
Sunrise Church of California
Mobile Food Distribution

CITY OF RIALTO
FY 2023/2024

CDBG PUBLIC SERVICES APPLICATION
Legal Aid Society of San Bernardino
Legal Aid - Rialto

DEADLINE
City of Rialto
Community Development Block Grant
Fiscal Year 2023/2024

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https://www.hudexchange.info/resource/687/playing-by-the-rules-a-handbook-for cdbg-subrecipients-on-administrative-systems/

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. � Completed and Signed Application - Parts I-VI
� Articles of Incorporation
� Non-Profit Determination - 501(c)3 IRS Letter (if applicable) � List of Board of Directors
� Organizational Chart
� Most Recent Audited Financials
� Resumes of Key Administrators
� Job Descriptions for Personnel/Positions Listed in Application � Most Recent Certificates of Insurances.

CONTACT
If you have any questions regarding the City of Rialto's Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
City of Rialto
Aknesa Ananikyan
(909) 816-5623
[email protected]
23/24 Public Service Application Page 1 of 10
I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
Legal Aid Society of San Bernardino Organization/ Agency Program/Activity Title Just - Rialto
Physical Address 588 W. Sixth Street
City, State, ZIP San Bernardino, CA 92410
Type of Organization iiiiii Non-Profit D Government □ For-Profit Tax ID
Are you a Women owned, or a D Yes �No D Decline to state majority Women operated
organization?
Are you a Minority owned, or a iiiiii Yes □ No D Decline to state majority Minority operated
organization?
If yes, please select which D Black Americans □ Native Americans iiiiii Hispanic Americans category or categories is most D Asian/Pacific Americans D Hasidic Jews applicable.

UEI Number 618171805
Name of Workers' Compensation
Sequoia Insurance Company Insurance (Government exempt) Coverage Amount($) $1,000,000/event
Expiration Date 1/1/2024
Name of General Liability and Valley Forge Insurance Company Property Damage Insurance (Government exempt)
Coverage Amount($) $2,000,000. per incident; $4,000,000 aggregate Expiration Date 4/8/2024
Name of Applicant Contact
Title
Mailing Address
City, State, ZIP
Email
Phone
Amount of CDBG Funds
Requested($)
Approximate Total Number of
Unduplicated Beneficiaries
(Persons or Households} to be
Served
Type of Beneficiary □ Households
Groups that the Program/Activity I!!! Abused/Neglected Children will Serve □ Households
(Check all that apply) □ Community
□ Housing Units
D Public Facilities
Pablo Ramirez, Esq.

Executive Director
588 W. Sixth Street
San Bernardino, CA 92410
[email protected]
909-406-5302
28,179
150
I!!! Persons
� Youth
I!!! Adults
l!!!J Seniors
I!!! Homeless Persons
l!!!J Disabled Persons
l!!!!I Battered Spouses D Businesses
City of Rialto 23/24 Public Service Application Page 2 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories l!!!I Public Service. Improves community public services and facilities, Please choose the CDBG Eligible including but not limited to those concerned with employment, fair Activity Category for your housing and homeownership, homelessness, crime prevention, child proposed project. care, health, drug abuse, education or recreational needs. □ Public Facilities/Improvements
□ Housing/Special Activities by Subrecipients
□ Economic Development
D Acquisition and/or rehabilitation of real property
D Other. Click to specify
CDBG National Objective I!!! Benefits Low and Moderate Income (LMI} Individuals/Households.

Compliance □ Addresses the prevention or elimination of slums or blight.

Your proposed project/activity
must meet at least one of HU D's
CDBG National Objectives.

Please check all that apply to
your proposal.

Meetings National Objectives □ Low/Moderate Area Benefit-The project serves only a limited area Check all statements that which is proven by current Census data or survey to be a low-income describe how your proposed area. By choosing this category you must be able to prove your project/activity meets one of the project/activity primarily benefits low/moderate income households.

National Objectives above: I!!! Low/Moderate Limited Clientele - The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.
□ Slum or Blight on an Area Basis - Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.

City of Rialto 23/24 Public Service Application Page 3 of 10 Ill. PROJECT NARRATIVE
PROJECT/PROGRAM DESCRIPTION. Briefly describe the proposed service/activity/project to be carried out with the funds requested.

LASSB will be on site at the Rialto Community Center. LASSB provides free legal education and direct legal services to residents of Rialto within the extremely low to low moderate income range. LASSB assists Rialto's vulnerable residents with critical, legal issues regarding survival and basic needs.

LASSB will use legal services to promote stability for Rialto families. This includes eviction defense, obtaining domestic violence restraining orders, addressing habitability issues at rental properties, establishing parental rights, custody orders, obtaining access to health care services, and pursuing income stability by helping with public benefit applications and appeals.

LASSB will help Rialto residents improve employability of residents by expunging old criminal records.

LASSB will verify eligibility for CDBG funded services. We will review client facts, analysis the law, provide legal advice, and strategize to exploit relevant resources. We will prepare legal documents, mediate disputes, and, as appropriate, litigate in court to resolve meritorious cases. LASSB will also address other consumer issues, including employment and labor disputes.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

Rialto's consolidated plan cites a significant need for household preservation, and fair housing services for low-income residents.

According to the 2020 census Rialtos's population is 104,026. The census reports 16.2%, or 16,852 people live in poverty.

Additionally, 36.6%, or 38,073 of homes are rental properties. Seniors make up 9.3%, or 9674. Children make up 28.1%, or 29,231. Disabled residents are 6.7%, or 6969. In 2019 there were 2871 veterans in Rialto. There is a significant number of vulnerable and disadvantaged residents. Data from aspenepic.org shows one in three US households struggle to pay rent.

According to magnifymoney.com 14.2% of California renters risk homelessness. These represent just a portion of the issues facing preople. This partnership offers Ria Ito's residents help to address survival, recovery and stability during this period of crisis.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

Rialto families in the extremely-low to low-to-moderate income groups will improve their home life and self-sufficiency as they assert their rights, and proactively address issues of health and safety within Rialto. LASSB will help families preserve housing, prevent homelessness, improve habitable conditions, obtain protective orders, secure health care services for minors and disabled adults, pursue public benefits, eliminate barriers to employment, and resolve consumer disputes.

COLLABORATION. Has your organization/ agency developed this project in collabor ation with other groups/organizations? If so, please list the groups/organizations and describe their roles in this project.

LASSB collaborates with numerous community par tners. Local bar associations provide volunteer lawyers for legal consultation, advice, and document preparation. Our partnership with Liberia del Pueblo allows families to resolve immigration issues and attend citizenship classes. Echoes of Love helps residents access food banks, clothing, school supplies with climate appropriate attire, emergency shelter, and emotional support. Mary's Mercy Center helps families find long term housing with classes and programs to overcome homelessness. The Vets Center and Inland Behavioral Health Services link residents to veterans services, health care, mental health care, enrollment in MediCal, Cal-SNAP, and WIG benefits. Legal Aid at Work provides legal services for employment and labor disputes.

City of Rialto 23/24 Public Service Application Page 4 of 10 SIMILAR RESOURCES. Is a simil ar service provided by another agency/org anization? If so, how will your program/activity differ?
Limited legal services are available through the court's self-help center and two local legal service providers. Those providers do not address the broad range of legal issues covered by Legal Aid Society of San Bernardino. They offer services on issues such as housing or family law. However, none address guardianship, nor conservatorship, nor the various other issues addressed by LASSB and its partners.

None of them deliver services specialized to Rialto. Nor do they connect needy families to supportive services for food, shelter, citizenship classes, health care, etc. as does LASSB and its partners.

OUTREACH. Discuss outreach efforts for the proposed service/ac tivity/project.

This project is a monthly outreach to the City of Rialto. Monthly clinics are held at the Rialto Resource Center at 141 S Riverside Ave. Rialto, CA. The project is marketed through the Rialto Resource Center, LASSB's website, three statewide legal referral websites, and through our community partners and legal networks. LASSB continues its 65 years of service to the county of San Bernardino and the city of Rialto. Much of our client base is word of mouth referrals. LASSB did not shut down for the COVID-19 pandemic. We found a way to keep operating. In 2022 we served nearly 6000 people. LASSB is committed to expand outreach to more needy and vulnerable people.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/co mpletion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
Continue monthly clinic at Rialto Resource Center start 7 /2023 to 6/2024 Prepare legal case documents for Rialto clients start 7 /2023 to 6/2024 Communicate with Stakeholders and Community Partners start 7/2023 to 6/2024 Conduct Client Surveys start 7 /2023 to 6/2024
Submit Quarterly Performance Reports start 7 /2023 to 6/2024 Submit Annual Performance Reports start 7/2023 to 6/2024 OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or Fund Amount($) Current Status
Pending
State Bar of California Equal Access Funding Committed funded 7/2023 to 6/2024 Stale BarlOLTA Committed funded 7/2023 to 6/2024
State Bar Homeless Prevention Projects Committed funded 7 /2023 to 6/2024 City of Rialto 23/24 Public Service Application Page S of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demon strate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column 8: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D

BUDGET ITEM CDBG REQUEST OTHER SOURCES NAMES OF
($) ($) OTHER SOURCES
Personnel*
Executive Director $1,550 1,692 State Bar IOL TA
Staff Attorney $7,500 6,000 "
Paralegal / Legal Assistant $9,568 3,827 State Bar HP Funds Intake Worker/ Receplionist $1,581 2,000 .

Office Manager $582 150
Deputy Director $1,200 1500
Compliance/Case Director $582 300
Fringe Benefits 5415 $3,712.56
Personnel Total 27979.00 19,181.56
Non-Personnel
Rent/Lease t.()() CA Bar IOLTA
Supplies 7nn
II
Utilities 200
Equipment 1i:;n II
Services n
Printing 1i:.n
Admission/Enrollment 150
Other: Travel 50.00
Other: Project Flyers 1 i:;n on
Other:

Other:

Non-Personnel Total
TOTAL PROJECT BUDGET $28,179 i ?1 011 i:;R
*For personnel, complete the following CDBG-Funded Personnel Tables.

City of Rialto 23/24 Public Service Application
Column E

TOTAL BUDGET
($)
5,064
2,813
7,346
3,897
').11 i:;
1R7
350
49 210.56

Page 6 of 10 ends

CDBG-FUNDED PERSONNEL
□ Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
(%)
Executive Director 155,000 12400 170500 $1.550 .01
Deputy Director 120,000 9600 130800 $1,200 .01
Office Manager 58240 4659.2 63481 $582 .01
Compliance/Case Dir 58240 4659.2 63481 $582 .01

PROPOSED PROGRAM STAFF
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
(%)
Staff Attorney S75,000 $6,750.00 $81,750.00 $7,500 .1
Paralegal/Legal Asst. $47,840 $4,305.60 $52,145.60 $9,568 .2 Intake Worker/Recept $39,520 $3,556.80 $43,076.80 $1,581 .04 KEY PERSONNEL DUTIES Provide a list of the duties of key personnel listed above Job Title Duties
Executive Director Structure project. Train and oversee staff. Oversee compliance, reporting & budget expenditures Deputy Director Structure project. Train and oversee staff. Oversee staff attorneys/paralegals/legal assistants Office Manager Oversee office staff and intake staff
Compliance/Case Direc Audit case work, to ensure RIAL TO compliance and overall organizational compliance Staff Attorney Interview clients. Provide document assistance. Direct Paralegal/Legal Assistance/provide legal assistance Paralegal/Legal Asst. Interview clients. At the direction of an attorney, prepare documents.

Intake Worker/Recepl Conduct eligibility prescreen
City of Rialto 23/24 Public Service Application Page 7 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

Personnel costs are based on staff time for direct services to the Rialto clinic. Staff time includes but is not limited to intake, including preparing CDBG Rialto grant compliance forms and supporting documentation, client interviews, legal advice, document preparation, negotiation, and direct representation. Based on the number and type of cases presented by Rialto clients the grant amount represents .014% of projected agency budget. Thus, the non-personnel costs are calculated at .014% of the total agency costs. Travel is based on the federal mileage rate x the mileage required to staff the Rialto clinic.

PROGRAM CHANGES. If you received CDBG funding last year, has there been an increase in service that you will pr ovide during FY 2023/2024? Explain why there is a new demand or an unmet need in the community for this servi ce.

Yes. We anticipate increased demand and we expanded the nature and extent of services provided in the 2023 to 2024 grant term. The expiration of rental protections during the height of the COVID-19 pandemic produced a tidal wave of eviction filings. Eviction plaintiffs firms report 2-3 times their pre-pandemic caseloads. Consumer debt collection dockets have returned to pre-pandemic levels. Domestic violence spiked during the pandemic and the courts are facing increased filings for protective orders. In response, LASSB is implementing hotline procedures and same day clinics. This was adopted for housing, but will be adopted in Family law, Probate and Expungement as well. The CDBG Rialto eligibility documentation requirements present a challenge to the efficiency of these systems. Therefore. innovative procedures must be developed to speed the eligibility documentation process. This will require training, research, and staff.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

The City of Rialto's CDBG funding allows LASSB and its partners to deliver a broad range of free, legal and social services to extremely to low-moderate income residents.

Partial or no CDBG funding would result in a serious loss of vital legal services to these residents and would contribute to the spread of poverty, homelessness, blight and unsafe conditions throughout the city.

City of Rialto 23/24 Public Service Application Page 8 of 10 V. CONFLICT OF INTEREST QUESTIONNAIRE
Federal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

1. Is there any member(s) of the applicant's staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or (b) a City Councilmember? □ Yes l!!!I No
f I Yes, p ease ist t h e name s an in ormation requested ( ) d f b I eo w:

Name of Person Job Title Relationship City Department

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiliate(s) who is currently or has been, within one year of the date of this questionnaire, (a) a City Employee or Consultant or (b) a City Councilmember? □ Yes l!!!I No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

Name of Person Relationship Tie If Family, Indicate
Relationship
City of Rialto 23/24 Public Service Application Page 9 of 10 VI. SIGNATURES
Authorized Signature
To the best of my knowledge, the information provided on this application is true, and I am authorized to submit this application on behalf of the applicant agency.

Pablo Ramirez Executive Director
Print Name Title
2/9/2023
Date
Authorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.

Greg Armstrong, JD Deputy Director
Print Name Title
2/9/2023
Date
City of Rialto 23/24 Public Service Application Page 10 of 10

CITY OF RIALTO
FY 2023/2024

CDBG PUBLIC SERVICES APPLICATION
Rialto Family Health Services Inc.

Veterans Program

DEADLINE
City of Rialto
Community Development Block Grant
Fiscal Year 2023/2024

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https:ljwww.hudexchange.info/resource/687 /playing-by-the-rules-a-handbook-for cdbg-subrecipients-on-administrative-systems/

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. � Completed and Signed Application - Parts I-VI
■ Articles of Incorporation
■ Non-Profit Determination - 501(c)3 IRS Letter (if applicable) ■ List of Board of Directors
■ Organizational Chart
� Most Recent Audited Financials
� Resumes of Key Administrators
■ Job Descriptions for Personnel/Positions Listed in Application � Most Recent Certificates of Insurances.

CONTACT
If you have any questions regarding the City of Rialto's Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
City of Rialto
Aknesa Ananikyan
(909) 816-5623
[email protected]
23/24 Public Service Application Page 1 of 10
I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
Rialto Family Health Services Inc. Organization/ Agency Program/ Activity Title Veterans Program
Physical Address 214 N. Palm Ave, Suite 504
City, State, ZIP Rialto, CA, 92376
Type of Organization � Non-Profit D Government □ For-Profit Tax ID
Are you a Women owned, or a !!!!I Yes □ No D Decline to state majority Women operated
organization?
Are you a Minority owned, or a � Yes □ No D Decline to state majority Minority operated
organization?
If yes, please select which � Black Americans D Native Americans D Hispanic Americans category or categories is most D Asian/Pacific Americans D Hasidic Jews applicable.

UEI Number EZL TFEZJWGJS
Name of Workers' Compensation
N/A Insurance (Government exempt)
Coverage Amount ($) NIA
Expiration Date NIA
Name of General Liability and Delaney Ins. Property Damage Insurance {Government exempt) Mt. Vernon Fire Ins.

Coverage Amount($) 2,000,000
Expiration Date 11/7/2023
Name of Applicant Contact Estevan Bennett
Title Executive Director
Mailing Address 1444 N. Birch
City, State, ZIP Rialto, CA,92376
Email [email protected]
Phone (909)685-3897
Amount of CDBG Funds
$35,000 Requested($)
Approximate Total Number of 40 Unduplicated Beneficiaries (Persons or Households) to be
Served
Type of Beneficiary l!!I Persons □ Households
Groups that the Program/ Activity □ Youth □ Abused/Neglected Children will Serve l!!I Adults □ Households
(Check all that apply) iii Seniors □ Community
II Homeless Persons □ Housing Units
l!!I Disabled Persons □ Public Facilities
□ Battered Spouses □ Businesses
City of Rialto 23/24 Public Service Application Page 2 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories l!!I Public Service. Improves community public services and facilities, Please choose the CDBG Eligible including but not limited to those concerned with employment, fair Activity Category for your housing and homeownership, homelessness, crime prevention, child proposed project. care, health, drug abuse, education or recreational needs.

D Public Facilities/Improvements
D Housing/Special Activities by Subreciplents
D Economic Development
D Acquisition and/or rehabilitation of real property
D Other. Click to specify
CDBG National Objective l!!I Benefits Low and Moderate Income (LMI) Individuals/Households.

Compliance D Addresses the prevention or elimination of slums or blight.

Your proposed project/activity
must meet at least one of HU D's
CDBG National Objectives.

Please check all that apply to
your proposal.

Meetings National Objectives l!!l low/Moderate Area Benefit -The project serves only a limited area Check all statements that which is proven by current Census data or survey to be a low-income describe how your proposed area. By choosing this category you must be able to prove your project/activity meets one of the project/activity primarily benefits low/moderate income households.

National Objectives above: D Low/Moderate Limited Clientele - The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.

D Slum or Blight on an Area Basis - Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.

The Veterans Assistance Program provides alternative, temporary, and/or permanent living arrangements, job assistance, accessing disability benefits, and discharge upgrades for veterans within the city. Clients are provided with a case manager that assists them in veterans education, counseling, and obtaining health and financial resources that are available to them. It is the goal of the program, that by establishing roots in the community that there is a decreased homeless veteran population, decreased rent burdens and expenses to related shelters, and most of all, provide stability and reduce healthcare complications suffered by most veterans that have served in the United States Military.

COMMUNITY NEED. Does your proposed project/activity address an Identified gap in service or current need in the community? Document the need for the project/program.

The City of Rialto Lacks dedicated Veteran Support programs. Without this support many Veterans find it difficult in accessing benefits that they are entitled to, or may even be aware that they are entitled to those benefits.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

Rialto Family Health Services aids Veterans in the community by providing support for homeless veterans, give guidance in accessing Discharge upgrades, counseling, benefits, navigating bureaucratic channels, as well as acting as an advocate for their needs.

Our agency has collaborated with VFW, Salvation Army, NCNW, and Loma Linda VA.

As these agencies send identified veterans to our agency to service their unique needs.

OUTREACH. Discuss outreach efforts for the proposed service/activity/project.

RFHS takes part in the VA Stand Down Project, Rialto's National Night Out, Memorial Day events and visits Assisted Living facilities to reach out to the Veterans population in the City of Rialto, as well as key social service agencies in order to reach the Homeless Veterans Population
PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
National Night Out 2023 July-Sept
labor Day VFW July-Sept
Holiday Food Give Away Oct-Dec
Veterans Day Oct-Dec
Assisted Living Facility Visit Jan-March
Memorial Day Outreach April-June
OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or Fund Amount ($) Current Status Pending
Donations Pending $6,000
City of Rialto 23/24 Public Service Application Page 5 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column 8: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B ColumnC Column D

BUDGET ITEM CDBG REQUEST OTHER SOURCES NAMES OF
($) ($) OTHER SOURCES
Personnel*
Estevan Bennett $9,700 $1500 leverage
Michael Bennett $6,400 $1500 leverage
Alex Blain $7,800 $1500 leverage
Ila Moodi&-Lee $4,900 $1500 leverage
Personnel Total $28,800
Non-Personnel
Rent/Lease $0
Supplies $1100
Utilities $600
Equipment S600
Services $0
Printing $600
Admission/Enrollment
Other: Insurance !t1000
Other: Subscriptions �1noo
Other: P.O.Box �1�0
Other: Business License i�n
Other: Transportation $500
Other:

Non-Personnel Total $6,200
TOTAL PROJECT BUDGET $35,000 tnnon
*For personnel, complete the following CDBG-Funded Personnel Tables.

City of Rialto 23/24 Public Service Application
Column E

TOTAL BUDGET
($)
$11,200
$7,900
$9,300
$6,400
1$41.000

Page 6 of 10 ends

CDBG-FUNDED PERSONNEL
D Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted($) Dedicated to
($) CDBG Act
ivity
(%)
Program Director $9,700 $9,700 100%
Assistant Case Manager $6,400 $6,400 100%
Administrative Specialist $7,800 $7,800 100%
Payroll Administrator $4,900 $4,900 100%

PROPOSED PROGRAM STAFF
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
(%)
KEY PER ONNEL DUTIES. Prov1 ea 1st o t e s 'd r f h d fk b uties o ey personnel isted a ove.

Job Title Duties
Project Director The Program Director diclates the schedule and what actions the organaation takes to reach clients and collaborations with other agencies Assistant Case Manager Reaching out to potential clients, assisting clients with legal issues, acquiring client information Administrative Specialist The Administrative Specialist catalogs and tracl<s relevant client data and progress throughout their time with the program Payroll Administrator Tracl<s and Reports the time each member of the team dedicates to the program for applicable compensation City of Rialto 23/24 Public Service Application Page 7 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

Personal Case Management requires reasonable compensation in order for team members to invest and dedicate adequate time to address each client and their specific needs.

PROGRAM CHANGES. If you received CDBG funding last year, has there been an Increase in service that you will provide during FY 2023/2024? Explain why there is a new demand or an unmet need in the community for this service.

No significant changes have occurred since last year, however the effects of the US military pulling out of Atganistan are still being felt as many veterans exit the service and are in need of guidance in obtaining benefits and healthcare.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

There are very few Veteran Assistance Program in the City of Rialto, and none that dedicate the time to unhoused clients such as we do. Without CDBG funding there were be no group to adequately advocate on their behalf.

City of Rialto 23/24 Public Service Application Page 8 of 1(; V. CONFLICT OF INTEREST QUESTIONNAIRE
Federal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

1. Is there any member(s) of the applicant's staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or (b) a City Councilmember? D Yes l!!I No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiliate(s) who is currently or has been, within one year of the date of this questionnaire, {a) a City Employee or Consultant or (b) a City Councilmember? D Yes l!!I No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

3. Is there any member(s} of the applicant's staff or member(s) of the applicant's Board of Directors or other governing body who are business partners or family members of (a) a City Employee or (b) a City Councilmember?
□ Yes l!!I No
I Yes, p ease 1st t f r h e name s an in ormation requeste ( ) d f d below:

Print Name
l f3,�
Signature
Authorized Signature
t x-e. c.v-f \ I/ e...

Title
l -[ o
Date
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.

Title
Signature Date
City of Rialto 23/24 Public Service Application Page 10 of 10

CITY OF RIALTO
FY 2023/2024

CDBG PUBLIC SERVICES APPLICATION
Working Dogs for Warriors
Working Dogs for Warriors
City of Rialto 23/24 Public Service Application Page 1 of 10 City of Rialto
Community
Development Block Grant
Fiscal Year 2023/2024

PUBLIC SERVICE APPLICATION

DEADLINE
The Deadline for returning completed applications is 12:00 p.m., Friday, February 10, 2023. Postmarks and late applications will not be accepted. All application must be mailed to:

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376
REQUI

RED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub- recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https://www.hudexchange.info/resource/687/playing-by-the-rules-a-handbook-for- cdbg-subrecipients-on-administrative-systems/
REQUI

RED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. ☐ Comp
leted and Signed Application – Parts I-VI
☐ Articles of Incorporation
☐ Non-Profit Determination – 501(c)3 IRS Letter (if applicable) ☐ List of Board of Directors
☐ Organizational Chart
☐ Most Recent Audited Financials
☐ Resumes of Key Administrators
☐ Job Descriptions for Personnel/Positions Listed in Application ☐ Most Recent Certificates of Insurances.

CONT
ACT
If you have any questions regarding the City of Rialto’s Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
Aknesa Ananikyan
(909) 816-5623
aanani
[email protected]
City of Rialto 23/24 Public Service Application Page 2 of 10 I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
Organization/Agency
Program/Activity Title
Physical Address
City, State, ZIP
Type of Organization ☐ Non-Profit ☐ Government ☐ For-Profit Tax ID
Are you a Women owned, or a
majority Women operated
organization?
☐ Yes ☐ No ☐ Decline to state
Are you a Minority owned, or a
majority Minority operated
organization?
☐ Yes ☐ No ☐ Decline to state
If yes, please select which
category or categories is most
applicable.
☐ Black Americans ☐ Native Americans ☐ Hispanic Americans ☐ Asian/Pacific Americans ☐ Hasidic Jews
UEI Number
Name of Workers’ Compensation
Insurance (Government exempt)
Coverage Amount ($)
Expiration Date
Name of General Liability and
Property Damage Insurance
(Government exempt)
Coverage Amount ($)
Expiration Date
Name of Applicant Contact
Title
Mailing Address
City, State, ZIP
Email
Phone
Amount of CDBG Funds
Requested ($)
Approximate Total Number of
Unduplicated Beneficiaries
(Persons or Households) to be
Served
Type of Beneficiary ☐ Persons ☐ Households
Groups that the Program/Activity
will Serve
(Check all that apply)
☐ Youth
☐ Adults
☐ Seniors
☐ Homeless Persons
☐ Disabled Persons
☐ Battered Spouses
☐ Abused/Neglected Children
☐ Households
☐ Community
☐ Housing Units
☐ Public Facilities
☐ Businesses
City of Rialto 23/24 Public Service Application Page 3 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories
Please choose the CDBG Eligible
Activity Category for your
proposed project.
☐ P ublic Service. Improves community public services and facilities, including but not limited to those concerned with employment, fair housing and homeownership, homelessness, crime prevention, chil d c
are, health, drug abuse, education or recreational needs. ☐ Public Facilities/Improvements
☐ Housing/Special Activities by Subrecipients
☐ Economic Development
☐ Acquisition and/or rehabilitation of real property
☐ Other. Click to specify
CDBG National Objective
Compliance
Your proposed project/activity
must meet at least one of HUD’s
CDBG National Objectives.

Please check all that apply to
your proposal.
☐ Benefits Low and Moderate Income (LMI) Individuals/Households. ☐ Addresses the prevention or elimination of slums or blight.

Meetings National Objectives
Check all statements that
describe how your proposed
project/activity meets one of the
National Objectives above:
☐ Low/Moderate Area Benefit – The project serves only a limited area which is proven by current Census data or survey to be a low-income a
rea. By choosing this category you must be able to prove your project/activity primarily benefits low/moderate income households. ☐ Low/Moderate Limited Clientele – The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Inco me
v
erification for clients must be provided for this category. The following g
roups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.
☐ Slum or Blight on an Area Basis – Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.

City of Rialto 23/24 Public Service Application Page 4 of 10 III. PROJECT NARRATIVE
P
ROJECT/PROGRAM DESCRIPTION. Briefly describe the proposed service/activity/project to be carried out with the funds requested.

CO
MMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

BE
NEFIT. Discuss how the project/program provides benefit to low-income persons.

C
OLLABORATION. Has your organization/agency developed this project in collaboration with other groups/organizations? If so, please list the groups/organizations and describe their roles in this project.

City of Rialto 23/24 Public Service Application Page 5 of 10 SIMILAR RESOURCES. Is a similar service provided by another agency/organization? If so, how will your program/activity differ?
O
UTREACH. Discuss outreach efforts for the proposed service/activity/project.

P
ERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
O
THER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or
Pending
Fund Amount ($) Current Status
City of Rialto 23/24 Public Service Application Page 6 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Sc
ope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low - or moderate-income residents of the City of Rialto . Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled c hecks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Pl
ease use the following format to present your proposed line item budget:

Column A:

Column B:

Column C:

Column D:

Column E:

List the items for which you anticipate the ne ed for CDBG Funds during FY 2023/2024.

Provide the projected request for CDBG funds.

Provide the total of other funds to be used.

List the name of the other funding source.

List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D Column E

BUDGET ITEM CDBG REQUEST
($)

OTHER SOURCES
($)

NAMES OF

OTHER SOURCES

TOTAL BUDGET
($)
Personnel*
Personnel Total
Non-Personnel
Rent/Lease
Supplies
Utilities
Equipment
Services
Printing
Admission/Enrollment
Other:

Other:

Non-Personnel Total

TOTAL PROJECT BUDGET
*Fo
r personnel, complete the following CDBG-Funded Personnel Tables.

City of Rialto 23/24 Public Service Application Page 7 of 10

CDBG-FUNDED PERSONNEL
☐ C
heck this box if CDBG funds will NOT be used to fund personnel.

I
f CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

GENCY ADMINISTRATION
Job Title Annual Salary
($)
Annual Benefits
($)
Total
Compensation
($)
CDBG Funds
Budgeted ($)
Time Position is
Dedicated to
CDBG Activity
(%)
P

ROPOSED PROGRAM STAFF
Job Title Annual Salary
($)
Annual Benefits
($)
Total
Compensation
($)
CDBG Funds
Budgeted ($)
Time Position is
Dedicated to
CDBG Activity
(%)
K
EY PERSONNEL DUTIES. Provide a list of the duties of key personnel listed above.

Job Title Duties
City of Rialto 23/24 Public Service Application Page 8 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

PROGRAM CHANGES. If you received CDBG funding l ast year, has there been an increase i n service that you will provide during FY 2023/2024? Explain why there is a new demand or an unmet need in the community for this service.

IM
PACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

City of Rialto 23/24 Public Service Application Page 9 of 10 V. CONFLICT OF INTEREST QUESTIONNAIRE
F
ederal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

T
his questionnaire must be completed and submitted by each applicant for CDBG program funding. The purpose of this questionnaire is to determine if the applicant, or any of the applicant’s staff, or any of the applicant’s Board of Directors would be in conflict of interest.

1. I
s there any member(s) of the applicant’s staff or governing body who is or has been, within one year of t
he date of this questionnaire, (a) a City Employee or (b) a City Councilmember? ☐ Ye
s ☐ No
I
f Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

2. W
ill the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiliate(s) who is currently or has been, within one year of the date of this questionnaire, (a) a City Employee or Consultant or (b) a City Councilmember? ☐ Ye
s ☐ No
I
f Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

3. I
s there any member(s) of the applicant’s staff or member(s) of the applicant’s Board of Directors or other governing body who are business partners or family members of (a) a City Employee or (b) a City Councilmember?
☐ Ye
s ☐ No
I
f Yes, please list the name(s) and information requested below:

Name of Person Relationship Tie If Family, Indicate
Relationship
City of Rialto 23/24 Public Service Application Page 10 of 10 VI. SIGNATURES
Au
thorized Signature
To the best of my knowledge, the information provided on this application is true , and I am authorized to submit this application on behalf of the applicant agency.

Print Name Title
Signature Date
Au
thorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Syst ems" with special attention to chapters two and five.

Print Name Title
Signature Date

REVISED APPLICATION
Working Dogs for Warriors

CITY OF RIALTO
FY 2023/2024

CDBG PUBLIC SERVICES APPLICATION
Inland Empire Section - National
Council of Negro Women, Inc.

Academic and Job Skills Training

DEADLINE
City of Rialto
Community Development Block Grant
Fiscal Year 2023/2024

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https://www.hudexchange.info/resource/687/playing-by-the-rules-a-handbook-for cdbg-subrecipients-on-administrative-systems/

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. ■ Completed and Signed Application - Parts I-VI
■ Articles of Incorporation
■ Non-Profit Determination - 501(c)3 IRS Letter (if applicable) l!!!I List of Board of Directors
■ Organizational Chart
l!!!I Most Recent Audited Financials
l!!!I Resumes of Key Administrators
l!!!I Job Descriptions for Personnel/Positions Listed in Application l!!!I Most Recent Certificates of Insurances.

CONTACT
If you have any questions regarding the City of Rialto's Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
City of Rialto
Aknesa Ananikyan
(909) 816-5623
[email protected]
23/24 Public Service Application Page 1 of 10
I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
IE Section NCNW, Inc Organization/ Agency
Program/ Activity Title NCNW Bethune Center
Physical Address 1411 S. Riverside Avenue
City, State, ZIP Rialto, CA 92376
Type of Organization ii Non-Profit 0 Government D For-Profit Tax ID 30-1113310
Are you a Women owned, or a ii Yes □ No □ Decline to state majority Women operated
organization?
Are you a Minority owned, or a � Yes 0 No □ Decline to state majority Minority operated
organization?
If yes, please select which ii Black Americans D Native Americans D Hispanic Americans category or categories is most 2 Asian/Pacific Americans D Hasidic Jews applicable.

UEI Number XVBEBPB439C1
Name of Workers' Compensation
State Compensation Insurance Fund Insurance (Government exempt) Coverage Amount($) 1,000,000
Expiration Date 07/06/2023
Name of General Liability and Cornerstone Commerical Insurance Services, Inc Property Damage Insurance
{Government exempt)
Coverage Amount ($) 1,000,000
Expiration Date 06/01/2023
Name of Applicant Contact Barbara Williams
Title Program Director
Mailing Address 1411 S. Riverside Avenue
City, State, ZIP Rialto, CA 92376
Email [email protected]
Phone 909-874-6000
Amount of CDBG Funds
42,000 Requested ($)
Approximate Total Number of 26
Unduplicated Beneficiaries
{Persons or Households) to be
Served
Type of Beneficiary ■ Persons ■ Households
Groups that the Program/Activity l!!I Youth l!!I Abused/Neglected Children will Serve ■ Adults l!!I Households
(Check all that apply) l!!!I Seniors l!!I Community
l!!I Homeless Persons D Housing Units
II Disabled Persons D Public Facilities
l!!!I Battered Spouses D Businesses
City of Rialto 23/24 P ·blic Service Application Page 2 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity categories ■ Public Service. Improves community public services and facilities, Please choose the CDBG Eligible including but not limited to those concerned with employment, fair Activity Category for your housing and homeownership, homelessness, crime prevention, child proposed project. care, health, drug abuse, education or recreational needs.

D Public Facilities/Improvements
D Housing/Special Activities by Subreclpients
□ Economic Development
D Acquisition and/or rehabilitation of real property
D Other. Click to specify
CDBG National Objective l!I Benefits Low and Moderate Income (LMI) Individuals/Households.

Compliance
Your proposed project/activity
D Addresses the prevention or elimination of slums or blight. must meet at least one of HUD's
CDBG National Objectives.

Please check all that apply to
your proposal.

Meetings National Objectives D Low/Moderate Area Benefit - The project serves only a limited area Check all statements that which is proven by current Census data or survey to be a low-income describe how your proposed area. By choosing this category you must be able to prove your project/activity meets one of the project/activity primarily benefits low/moderate income households.

National Objectives above: l!I Low/Moderate Limited Cllentele - The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.

The IE Section NCNW, Inc provides resume writing, customer service training, and job search skills to assist with successful employment. This project will provide a wide range of elements as listed, Academic Enchancement Skills, Soft Skills, Leadership Development Skills, Adult mentoring, Life Skills Training, Volunteerism. The mission of the IE Section National Council of Negro Women, Inc/Bethune Center is to provide pre-employment skills developing and identifying skills, assisting with job search opportunties and follow-up with our clients in the San Bernardino County. Our efforts are to combat high unemployment due to the pandemic and other under developed reasons for unemployment. We have the pleasure of serving the general public in the Rialto Resource Center from referrals and those seeking employment from various city offices. We work with referrals and have now began to get back into the high schools and colleges to present our program to the public. Since the move we have been slow as the public is still trying lo figure out where the new location is so we are hopeful the walk-in traffic will pick up. We have manged to have over 200 people come through the center for various reasons and have found employment for about 31 participants some of those are still employed and doing well in the current postions.

Things are starting to improve as we continue to get the word out post pandemic that we are here to assist with employment needs to those seeking and educational help with those who are seeking educational goals.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

Our targeted population is anyone that was laid off, seeking to change jobs, looking for 2nd jobs and those students who are seeking first time jobs. We also assist those seeking to go to college, military or find the perfect career. Any applicants unemployed or underemployed and need assistance with transisting their lifestyle we are here to help. In the community there are no vendors that I know of to assist with employment needs or just life skills.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

The project serves clients,at least 60% of who are persons whose family income does not exceed 80% of the median income adjusted for household size based on imoome published by the U.S. Department of Housing and Urban Developmen. IE Section NCNW, Inc staff must collect and document each dienfs household income, household composition. size and Income of all adult household members. Documentation can include but not limited to copies of letters from Social Security Administration or public benefit notice showing gross amount recieved by the household, bank statements of direct depoist, pension checks, court decrees of child support, spousal support payments or any other forms of third party source documentation of income. Some of these participants have no documented income.

COLLABORATION. Has your organization/agency developed this project in collabor ation with other groups/organizations? If so, please list the groups/organizations and describe their roles in this project.

O,er the past 33+ years the IE Section NCNW, lno'Belhune Center has provided a oomprehensive youth and young adult development program to foster academic enrichment and employment skills through collaboration wilh the County of Sao Bernardino W1A p<ogram, Prop 47 progtam, City ol Rialto WIA program and lhe Cily of Riallo COBG program. In the past few years we offered worl<shops that addressed frequently asked questions about employment opportunties and the process of employment oppomrnues. Currenay lhe tun.is we request are being used to pay staff payrol Wllile working with lhe day to day operaijons of assisting those Oil! of work with finding employment In vaoous professional and non professional fields. We are currenlly assisting Wi1h resuma preparation, resume updates, intetView prepralion and how to dress for success on any interview that participants are attending. Recenllywe have been successful able lo auend one or the continuation high school in the Rialto area to assist and help p<epare the Senior students looking for employment with some skils and prepration. also assited with higher educaUonal goats and questions.

City of Rialto 23/24 Public Service Application Page 4 of 10 SIMILAR RESOURCES. Is a similar service provided by another agency/organization? If so, how will your program/activity differ?
I'm unaware of any other CBO's or agencies in the Rialto area that is doing the same thing as the IE Section NCNW, Inc/Bethune Center. I collaborate with other CBO's who are working with the same population but doing something slightly different that I collaborate with for assistance and a better understanding of the participants needs. I work with other CBO's on assisting with fine tuning on the skills for any participant.

OUTREACH. Discuss outreach efforts for the proposed service/activity/project.

Current outreach efforts are reaching out to the communtiy at multiple events letting them know we are here and what we offer the community. IE Section NCNW, Inc is working really hard to get into all of the high schools, adult schools and continuation schools here in the Rialto area. Not only to reach the students but to reach the parents and or family members as well. We are also collaborating with many vendors in the areas for jobs, which is allowing us to assist with filling those vacancies with the students, residents and participants in the Rialto area. We also send updates to the variouos high schools on what is available. We will continue to host our Job Fair as the weather gets better for the residents of Rialto.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
OANdl tlNM'4C&V. �.RiltDi-19\Sdv:ls. Booll..rpt:y.UJ,:,..Sa.pa,c:� Sd'rui 0VC. CSVSS Cchg,111 06/30/2024 Continue with community Job Fairs and keep in contact with hiring vendors 06/30/2024 Hosting workshops at the center on computer help, employment access and some job training 06/30/2024 Host events for adults and students for resume writing at convenient times for each 06/30/2024 OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or Fund Amount($) Current Status
Pending
CDBG (This Application) Pending 42,000.00 Applying
IE Seeton NCNW, Inc Committed 5,000.00 On-Going
Olher Grants Pending 5,000.00 Applying
Volunteers (In-Kind) Committed 5,000.00 On-Going
ntv of Rialto 23/24 Public Service Application Page 5 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column B: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D

BUDGET ITEM CDBG REQUEST OTHER SOURCES NAMES OF
($) ($) OTHER SOURCES
Personnel*
Payroll 42,000.00 5.000.00 Grants
Personnel Total 42,000.00
Non-Personnel
Rent/Lease
Supplies 1,000.00 �nn nn nnn JI•-�
Utilities 5,000.00 500.00 r,rants
Equipment
Services
Printing 300.00
Admission/Enrollment
Other:

Other:

Non-Personnel Total 6,300.00
TOTAL PROJECT BUDGET 48,300.00 R nnn nn
*For personnel, complete the following CDBG-Funded Personnel Tables.

City of Rialto 23/24 Public Service Application
Column E

TOTAL BUDGET
($)
47,000.00
i1 ,:;.nn nn
� 500.00

54.300.00

Page 6 of 10 ends

IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column B: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D

BUDGET ITEM CDBG REQUEST OTHER SOURCES NAMES OF
($) ($) OTHER SOURCES
Personnel*
Payroll 42,000.00 5,000.00 Grants
Personnel Total 42,000.00
Non-Personnel , .. ·-
Rent/Lease
Supplies Finn nn Donations
Utilities 500.00 Grants
Equipment
Services
Printing 300.00
Admission/Enrollment
Other:

Other:

Non-Personnel Total
TOTAL PROJECT BUDGET 42,000.00 R '.100 00
*For personnel, complete the following CDBG-Funded Personnel Tables.

City of Rialto 23/24 Public Service Application
Column E

TOTAL BUDGET
($)
47,000.00
fiOO nn
500.00
48 300.00

Page 6 of 10 ends

REVISED BUDGET

CDBG-FUNDED PERSONNEL
D Check this box if CDBG funds will NOT be used to fund personnel.

If COBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with COBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is {$) {$) Compensation Budgeted ($) Dedicated to
($) COBG Activity
(%)
Program Director 42,000.00 0.00 42,000.00 42,000.00 100%

PROPOSED PROGRAM STAFF
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position Is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
(%)
Job Developer 27,000.00 0.00 27,000.00 0 50%
KEY PERSONNEL DUTIES. Provide a list of the duties of key personnel listed above.

Job Title Duties
Program Director Provide financial reporting lo the City of Rialto (COeG) seek and obtain grant opportunlies with the prngram mission. Worlt with various officials, staff and giant administrato,s and payrol repmsentalives. Assist with employment opportunties for the program participants. n.,.w� ... "lltS d�:,;,r-iz1t.o,b�t,t"'oe�c:ll)«"..s"'t'Q�se,el.ir-9�o;:«s1..'"3W.B�lj•"'IJ"U'l9n•.,ual'lo•�..,. ... V'2""i� •411i)"S ardt.opcuceht'titw.-cebhs:.r..c'J)r31 Oversee day lo day activities al the faaoly. sign up participants to assist with seeking jobs, housing and higher education.

Work with the program staff to ensure compliance and monitoring of the program daily activities Communicate elleciiv,,ly with the IE NCNW, Inc Ex=llve Board on program updates along with activiles updates Cc:r.7Ju,aeellM:31d�T«r.tlC.,tdR.-!Ad.COBGIJ'Wll...,$l'alll:n•".d:::thstJOr.mA�tesatdQ'O,r..;d�Mu6Md.y� City of Rialto 23/24 Public Service Application Page 7 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

The cost rationale is for the past 32+ years this program has been in the community assisting with job skills, job placement, higher education or military endeavours. We are seeking to have these funds go toward the staff that will be running the program on a daily basis. Our primary responsibility is to those young adults who are 17 years and older who are considered at risk in the schools and are seeking employment or assistance to further their education. We think that if this program is not in the area what will those who don' t know do with seeking employment. We have had some parents who has come through this program are now referring their children because they know the benefit and how it assisted them.

We have seen a increase in the city with those 17 years old and above seeking out opportunities to be employed and/or upgrading the skins they are now being force to work to assist the household with paying the bills. Therefore we have with training and employment knowlege to assist. We have seen an increase of homelessness for various reasons of families so we are here to assist those who are old enough to work with job opportunties and outreach services to assist with helping them get off the streets and into stable employment and maybe stable housing.

Some of the unmet needs are places to refer those young adults to when we have secured employment and they don't have a stable living enviroment for them to sleep in which has resulted in those participants sleeping in cars or unsafe enviroment. If the family can work together to secure enough income 1t usually leads to them being able to get off the streets and into some form of housing. Income is usually what is the downfall to stablity.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity. lfthls program has no CDBG funding or less it would drastically reduce the days and hours we are able lo assist participants with seelclng employment and educational needs. Thls faciity is open on the days and hours !he participants are seeking lo find employment and attend job fairs. This woold not help with those who walk In and those seeking help Ymen !hey have beeo referred and/or know about the program. The current staff is seeking different g,ant oppo,tunties to assist with funding of this program.

Losing staff or reduci119 hours will not assist the participants in the Rialto area. they wll either tum to another city or r,ot be able to maneuver what to do when seeking cmploymenL We have 11\ose participants who come here seeking employmenl and on- resources and ii wo a,e not here or have lo draslically reduce the hours this would place a burden on other city programs who are not famiiar with assisUng. refeniog 0< where lo refer lo. We receive calls transferred from city offices with par1icpants and lhe caler sa.J the clly personnel did not knowv1here lo send them other tllan the Resource center. We also get a lot or referrals Imm oilier programs to assist with employmenL Wth this program being in the community for 35+ years it has been successful wi1h those who attended in the past now referring their children to the Resource Center because of the experience they had.

1. Is there any member(s) of the applicant's staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or (b) a City Councilmember? D Yes � No
If Yes, please list the name(s) and information requested below:

Name of Person JobTrt:le Relationship City Department

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiliate(s) who is currently or has been, within one year of the date of this questionnaire, (a) a City Employee or Consultant or (b) a City Councilmember? D Yes � No
lfY es, please ist t e name s an m ormatron requeste h ( ) d. f dbl eo w:

Name of Person Job Title Relationship City Department

Name of Person Relationship Tie If Family, Indicate
Relationship
Joanne Gilbert Sister in Law President Sister in Law
Milele Robertson Daughter Treasurer Mayor Daughter
City of Rialto 23/24 Public Service Application Page 9 of 10 VI. SIGNATURES
Authorized Signature
To the best of my knowledge, the information provided on this application is true, and I am authorized to submit this application on behalf of the applicant agency.

Barbara Williams Program Director
Title
02/06/2023
Date
Authorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.

Barbara Williams Program Director
Title
02/06/2023
Date
City of Rialto 23/24 Public Service Application Page 10 of 10

CITY OF RIALTO
FY 2023/2024

CDBG PUBLIC SERVICES APPLICATION
City of Rialto
Mobile Recreation

DEADLINE
City of Rialto
Community Development Block Grant
Fiscal Year 2023/2024

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https:ljwww.hudexchange.info/resource/687 /playing-by-the-rules-a-handbook-for cdbg-subrecipients-on-administrative-systems/

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. □ Completed and Signed Application - Parts I-VI
□ Articles of Incorporation
□ Non-Profit Determination - 501(c)3 IRS Letter (if applicable) □ List of Board of Directors
□ Organizational Chart
□ Most Recent Audited Financials
□ Resumes of Key Administrators
□ Job Descriptions for Personnel/Positions Listed in Application □ Most Recent Certificates of Insurances.

CONTACT
If you have any questions regarding the City of Rialto's Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
City of Rialto
Aknesa Ananikyan
(909) 816-5623
[email protected]
23/24 Public Service Application Pagel of 10
City of Rialto 23/24 Public Service Application Page 2 of 10 I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
Organization/Agency
Program/Activity Title
Physical Address
City, State, ZIP
Type of Organization ☐ Non-Profit ☐ Government ☐ For-Profit Tax ID
Are you a Women owned, or a
majority Women operated
organization?
☐ Yes ☐ No ☐ Decline to state
Are you a Minority owned, or a
majority Minority operated
organization?
☐ Yes ☐ No ☐ Decline to state
If yes, please select which
category or categories is most
applicable.
☐ Black Americans ☐ Native Americans ☐ Hispanic Americans ☐ Asian/Pacific Americans ☐ Hasidic Jews
UEI Number
Name of Workers’ Compensation
Insurance (Government exempt)
Coverage Amount ($)
Expiration Date
Name of General Liability and
Property Damage Insurance
(Government exempt)
Coverage Amount ($)
Expiration Date
Name of Applicant Contact
Title
Mailing Address
City, State, ZIP
Email
Phone
Amount of CDBG Funds
Requested ($)
Approximate Total Number of
Unduplicated Beneficiaries
(Persons or Households) to be
Served
Type of Beneficiary ☐ Persons ☐ Households
Groups that the Program/Activity
will Serve
(Check all that apply)
☐ Youth
☐ Adults
☐ Seniors
☐ Homeless Persons
☐ Disabled Persons
☐ Battered Spouses
☐ Abused/Neglected Children
☐ Households
☐ Community
☐ Housing Units
☐ Public Facilities
☐ Businesses
City of Rialto - Parks, Recreation & Community Services Department Mobile Recreation
214 N Palm Ave
Rialto, CA 92376
95-6000768
N/A
N/A
City of Rialto is self insured.

N/A
N/A
N/A
N/A
Julio Salcedo
Parks, Recreation & Community Services
214 N Palm Ave
Rialto, CA 92376
[email protected]
909-421-4949
$33,000
150

II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories l!!I Public Service. Improves community public services and facilities, Please choose the CDBG Eligible including but not limited to those concerned with employment, fair Activity Category for your housing and homeownership, homelessness, crime prevention, child proposed project. care, health, drug abuse, education or recreational needs. □ Public Facilities/Impr ovements
□ Housing/Special Activities by Subrecipients
D Economic Development
□ Acquisition and/or rehabilitation of real property
□ Other.Click to specify
CDBG National Objective l!!I Benefits Low and Moderate Income (LMI) Individuals/Households.

Compliance □ Addresses the prevention or elimination of slums or blight.

Your proposed project/activity
must meet at least one of HUD's
CDBG National Objectives.

Please check all that apply to
your proposal.

Meetings National Objectives l!!I Low/Moderate Area Benefit - The project serves only a limited area Check all statements that which is proven by current Census data or survey to be a low-income describe how your proposed area. By choosing this category you must be able to prove your project/activity meets one of the project/activity primarily benefits low/moderate income households.

National Objectives above: l!!I Low/Moderate Limited Clientele - The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.
□ Slum or Blight on an Area Basis - Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.

Mobile Recreation is a free program that services families with a range of recreational and enrichment activities at neighborhood city parks where there is no near-by community center. Program participants enjoy a variety of activities which include crafts, painting, board games, and exercise while playing group and individual sports.

This year we hope to be able to branch out and offer these activities directly to apartment buildings in either their court yard or a recreation room. Acquiring an enclosed trailer will allow us to bring Mobile Recreation and a wide variety of equipment needed for the activities to the apartment buildings. The purchase of a trailer will help us be able to service as many persons in their neighborhood as possible.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

The proposed project would assist in bringing Mobile Recreation directly to communities and to individuals who lack the necessary transportation to attend Mobile Recreation at parks.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

Mobile Recreation has a wide range of benefits to low-income persons. Mobile Recreation aims to provide fun, safe, and accessible opportunities to participate in recreational activities. Participating in recreation can lead to a higher quality of life because it leads to persons having a satisfaction within themselves after participating in an activity. Mobile Recreation can also benefit a community and families as a whole by strengthening their unity. Mobile Recreation has the ability to bring neighbors and families together to create a more positive and livelier environment and help in improving their overall relationships.

The Parks, Recreation & Community Services Department has not developed this project in collaboration with other groups or organizations but we will need to collaborate with the managers of the apartment buildings. The managers role will be to look for a date that will be available for us to use their recreation center or courtyard to provide services to residents.

City of Rialto 23/24 Public Service Application Page 4 of 10 • �,....�-SIMILAR RESOURCES. Is a similar service provided by another agency/organization? If so, how will your program/activity differ?
Mobile Recreation or a smiliar service is provided by other cities in Southern California such as Moreno Valley, Chino Hills, and Ontario. Our program will differ because we will bring Mobile Recreation not only to parks but we will be able to host Mobile Recreation directly to low-income apartment buildings that may not be located close enough to walk to a park and participate.

OUTREACH. Discuss outreach efforts for the proposed service/activity/project.

The outreach efforts will include social media programming. We will notify the apartment buildings community members by posting signage at well trafficked locations.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
Contact apartment building Managers and arrange meetings with them July 31, 2023 Finalize social media programming August 11, 2023
Finalize programming for the activities August 18, 2023 Promote Mobile Recreation at the apartment building August31,2023 Hold the first Mobile Recreation event at the first location September 30, 2023 OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or Fund Amount ($) Current Status Pending

N/A N/A N/A NIA
City of Rialto 23/24 Public Service Application Page 5 of 10 City of Rialto 23/24 Public Service Application Page 6 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Sc
ope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low - or moderate-income residents of the City of Rialto . Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled c hecks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Pl
ease use the following format to present your proposed line item budget:

Column A:

Column B:

Column C:

Column D:

Column E:

List the items for which you anticipate the ne ed for CDBG Funds during FY 2023/2024.

Provide the projected request for CDBG funds.

Provide the total of other funds to be used.

List the name of the other funding source.

List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D Column E

BUDGET ITEM CDBG REQUEST
($)

OTHER SOURCES
($)

NAMES OF

OTHER SOURCES

TOTAL BUDGET
($)
Personnel*
Personnel Total
Non-Personnel
Rent/Lease
Supplies
Utilities
Equipment
Services
Printing
Admission/Enrollment
Other:

Other:

Non-Personnel Total

TOTAL PROJECT BUDGET
*Fo
r personnel, complete the following CDBG-Funded Personnel Tables.

N/A
N/A
N/A
N/A
N/A
N/A
$15,000.00
$3,000.00
Enclosed Trailer
$33,000.000
$15,000.00
$15,000
$15,000.00
$33,000.00
N/A
N/A
N/A
$3,000.00

CDBG-FUNDED PERSONNEL
"' Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
(%)

PROPOSED PROGRAM STAFF
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
(%)
KEY PERSONNEL DUTIES Provide a list of the duties of key personnel listed above Job Title Duties
City of Rialto 23/24 Public Service Application Page 7 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

Acquiring an enclosed trailer is simple in its design. Yet, it is customizable to fit our needs. We will need appropriate shelving and storage space for board games, sports balls, outdoor sporting equipment such as volleyball nets, school supplies, and books.

We will be able to store as many tables and benches that we can fit. This will allow for us to have a higher limit to the total number of persons we will be servicing.

Mobile Recreation did not receive CDBG funding last year.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

The number of people, families, and households that can use Mobile Recreation's services will be restricted if it is unable to secure CDBG funding. We won't be able to supply as many tables and chairs, as well as the equipment and materials for the activities that would be required for larger neighborhoods, like apartment buildings, if we are unable to obtain funding.

City of Rialto 23/24 Public Service Application Page 8 of 10 •
V. CONFLICT OF INTEREST QUESTIONNAIRE
Federal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

1. Is there any member(s) of the applicant's staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or (b) a City Councilmember? 11!1 Yes □ No
If Yes, p ease 1st t e name s an m ormation requeste eo w:r h ( ) d . f db I Name of Person Job Title Relationship City Department
This is a City program

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiiiate(s) who is.currently or has been, within one year of the date-of this questionnaife; (a) a City Employee or Consultant or (b) a City Councilmember? □ Yes 11!1 No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

3. Is there any member(s) of the applicant's staff or member(s) of the applicant's Board of Directors or other governing body who are business partners or family members of (a) a City Employee or (b) a City Councilmember?
□ Yes 11!1 No
If Yes please list the name(s) and information requested below: I Name of Person Relationship Tie If Family, Indicate
Relationship
City of Rialto 23/24 Public Service Application Page 9 of 10 VI. SIGNATURES
Authorized Signature
To the best of my knowledge, the information provided on this application is true, and I am authorized to submit this application on behalf of the applicant agency.
� a�. £w1
Date
Authorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.
�IQ
C- �C-£01'
nt Name
City of Rialto 23/24 Public Service Application Page 10 of 10

CITY OF RIALTO
FY 2023/2024

CDBG PUBLIC SERVICES APPLICATION
Inland Fair Housing &
Mediation Board
Fair Housing
City of Rialto 2 ϯ/2ϰ Public Service Application Page 1 of 10 City of Rialto
Community Development Block Grant
Fiscal Year 202ϯ/202ϰ

PUBLIC SERVICE APPLICATION

DEADLINE
The Deadline for returning completed applications is ϭϮ:00 p.m., &ƌŝĚĂǇ, February 1Ϭ, 202ϯ. Postmarks and late applications will not be accepted. All application must be mailed to:

ZŝĂůƚŽWĂƌŬƐ͕ZĞĐƌĞĂƚŝŽŶΘŽŵŵƵŶŝƚǇ^ĞƌǀŝĐĞƐĞƉĂƌƚŵĞŶƚ City of Rialto
ϮϭϰE͘ Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub- recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https://www.hudexchange.info/resource/687/playing-by-the-rules-a-handbook-for- cdbg-subrecipients-on-administrative-systems/

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. տ Completed and Signed Application – Parts I-VI
տ Articles of Incorporation
տ Non-Profit Determination – 501(c)3 IRS Letter (if applicable) տ List of Board of Directors
տ Organizational Chart
տ Most Recent Audited Financials
տ Resumes of Key Administrators
տ Job Descriptions for Personnel/Positions Listed in Application տ Most Recent Certificates of Insurances.

CONTACT
If you have any questions regarding the City of Rialto’s Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
ŬŶĞƐĂŶĂŶŝŬǇĂŶ
(909) 816-ϱϲϮϯ
ĂĂŶĂŶŝŬǇĂŶΛĂŐŝ͘ĐŽŵ͘ĐŽ
City of Rialto 2 ϯ/2ϰ Public Service Application Page 2 of 10 I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
Organization/Agency
Program/Activity Title
Physical Address
City, State, ZIP
Type of Organization܆Non-Profit܆Government տ For-Profit Tax ID
Are you a Women owned, or a
majority Women operated
organization?
܆Yes܆No܆Decline to state
Are you a Minority owned, or a
majority Minority operated
organization?
܆Yes܆No܆Decline to state
If yes, please select which
category or categories is most
applicable.
܆Black Americans ܆Native Americans ܆Hispanic Americans ܆Asian/Pacific Americans ܆Hasidic Jews
h
/ Number
Name of Workers’ Compensation
Insurance (Government exempt)
Coverage Amount ($)
Expiration Date
Name of General Liability and
Property Damage Insurance
(Government exempt)
Coverage Amount ($)
Expiration Date
Name of Applicant Contact
Title
Mailing Address
City, State, ZIP
Email
Phone
Amount of CDBG Funds
Requested ($)
Approximate Total Number of
Unduplicated Beneficiaries
(Persons or Households) to be
Served
Type of Beneficiary տ Persons տ Households
Groups that the Program/Activity
will Serve
(Check all that apply)
տ Youth
տ Adults
տ Seniors
տ Homeless Persons
տ Disabled Persons
տ Battered Spouses
տ Abused/Neglected Children
տ Households
տ Community
տ Housing Units
տ Public Facilities
տ Businesses
Inland Fair Housing and Mediation Board
Fair Housing Services
1500 S Haven Ave., Suite 100
Ontario, CA 91761
95-3639912
PCTMDFBZA5B6
Preferred Employers Insurance
$1,000,000
05/12/2023
Nonprofits Ins. Alliance of California
$1,000,000
05/12/2023
Carmen I. Garcia
President and CEO
1500 S Haven Ave., Suite 100
Ontario, CA 91761
[email protected]
909-984-2254 ext. 153
$35,000
IFHMB's proposed fair housing services program will provide fair housing and landlord-tenant mediation services to 270 residents (20 Fair Housing and 250 Landlord-Tenant) of the City of Rialto.

City of Rialto 2 ϯ/2ϰ Public Service Application Page 3 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories
Please choose the CDBG Eligible
Activity Category for your
proposed project.
տ Public Service. Improves community public services and facilities, including but not limited to those concerned with employment, fair housing and homeownership, homelessness, crime prevention, child care, health, drug abuse, education or recreational needs. տ Public Facilities/Improvements
տ Housing/Special Activities by Subrecipients
տ Economic Development
տ Acquisition and/or rehabilitation of real property
տ Other. Click to specify
CDBG National Objective
Compliance
Your proposed project/activity
must meet at least one of HUD’s
CDBG National Objectives.

Please check all that apply to
your proposal.
տ Benefits Low and Moderate Income (LMI) Individuals/Households. տ Addresses the prevention or elimination of slums or blight.

Meetings National Objectives
Check all statements that
describe how your proposed
project/activity meets one of the
National Objectives above:
տ Low/Moderate Area Benefit – The project serves only a limited area which is proven by current Census data or survey to be a low-income area. By choosing this category you must be able to prove your project/activity primarily benefits low/moderate income households. տ Low/Moderate Limited Clientele – The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.
տ Slum or Blight on an Area Basis – Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.

City of Rialto 2 ϯ/2ϰ Public Service Application Page 4 of 10 III. PROJECT NARRATIVE
PROJECT/PROGRAM DESCRIPTION. Briefly describe the proposed service/activity/project to be carried out with the funds requested.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

IFHMB's proposed fair housing services program will provide fair housing and landlord-tenant mediation services to 270 residents (20 Fair Housing and 250 Landlord-Tenant) of the City of Rialto. Many housing opportunities are lost when individuals experience housing discrimination based on federal and state protected categories. IFHMB's fair housing education, outreach, and mediation activities will address fair housing issues encountered by city residents and assist the City to support and sustain inclusive neighborhoods. This project will : (1) assist persons who have housing discrimination complaints; and (2) conduct education programs to the community to reduce the incidence of housing discrimination associated with the lack of education and enforcement of existing laws. IFHMB provides one-on-one client services through telephone, by email, and by regular mail. Our offices are temporarily closed to the public due to the COVID-19 pandemic, however we are continuing to provide all of our services by phone, email, regular mail, and virtually (through Zoom), and through our website.

To accomplish these goals, the agency conducts intake, investigation, mediation, and enforcement activities regarding fair housing complaints. We also utilize our landlord-tenant mediation program as a means of assisting residents and property owners/managers with housing related disputes. Landlord-tenant disputes may include fair housing issues. IFHMB staff conduct monthly outreach to the community and housing-related organizations utilizing online outreach strategies. Fair Housing virtual workshops are conducted throughout the year to familiarize residents with their housing rights and responsibilities, including federal and state fair housing laws.

In addition, IFHMB's fair housing program will provide data that aligns with Affirmatively Furthering Fair Housing (AFFH) goals. Monthly progress reports will detail the income levels and demographics of city residents who receive services and will assist the city with its AFFH reporting requirements.

There is a current need for the proposed fair housing services. City of Rialto residents need access to education about their fair housing rights and assistance with resolving matters that involve housing discrimination. In the 2021-22 fiscal year, 100% of the City of Rialto residents who received services in our fair housing program had incomes that were in the LMI income categories (25% extremely low, 58% low, 17% low-mod). Additionally, 91% of Rialto residents who received landlord-tenant services were persons with LMI incomes (26% extremely low, 45% low, 19% low-mod). The services to be provided by IFHMB will also assist the city in meeting its AFFH obligations. Fair housing services help ensure that residents are informed of their state and federal fair housing rights. Increased awareness and education results in increased reporting and investigation of fair housing violations. Access to landlord-tenant mediation services will help resolve landlord-tenant disputes.

IFHMB's fair housing services and landlord-tenant services provide benefits to low-income persons. There is a continued need for fair housing and landlord-tenant education, outreach, mediation, and enforcement activities. The proposed programs will help identify and process fair housing complaints. Housing discrimination limits housing opportunities. Fair housing education helps to prevent discrimination that is the result of lack of knowledge of fair housing laws. City residents including low-income persons will benefit from having increased knowledge of housing discrimination laws and access to fair housing enforcement services. The proposed programs will help increase housing choice, and decrease homelessness. In the 2021-22 fiscal year, 100% of the City of Rialto residents who received services in our fair housing program fell into the LMI income categories (26% extremely low, 45% low, 19% low-mod).

IFHMB contracts with several CDBG program participant jurisdictions in three Southern California counties (San Bernardino, Riverside, and Imperial) to provide fair housing services, and landlord-tenant mediation services. IFHMB also receives funding to provide HUD-approved default/foreclosure counseling services. Please see the attached Secured Funders List for additional information.

City of Rialto 2 ϯ/2ϰ Public Service Application Page 5 of 10 SIMILAR RESOURCES. Is a similar service provided by another agency/organization? If so, how will your program/activity differ?
OUTREACH. Discuss outreach efforts for the proposed service/activity/project.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or
Pending
Fund Amount ($) Current Status
IFHMB is the current provider of fair housing services and landlord-tenant mediation services for residents of the City of Rialto. We are not aware of similar services being provided by another agency or organization.

IFHMB conducts various outreach efforts. The services that are provided by our office are advertised through public service channels, through our social media platforms, and by email. Online outreach campaigns provide information on fair housing laws and the services that are provided by our office. Brochures are also distributed as part of our outreach and education efforts.
1st Qtr. - Assist 62.5 residents with landlord-tenant services and 5 residents with fair housing services 9/30/2023 2nd Qtr. - Assist 62.5 residents with landlord-tenant services and 5 residents with fair housing services 12/31/2023 3rd Qtr. - Assist 62.5 residents with landlord-tenant services and 5 residents with fair housing services 3/30/2024 4th Qtr. - Assist 62.5 residents with landlord-tenant services and 5 residents with fair housing services 6/30/2024 This is the minimum number of residents to be assisted. We will provide services to all Rialto residents who seek assistance from our office.

Please see the attached Secured Funders List
City of Rialto 2 ϯ/2ϰ Public Service Application Page 6 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A:

Column B:

Column C:

Column D:

Column E:

List the items for which you anticipate the need for CDBG Funds during FY 202 ϯ/202ϰ.

Provide the projected request for CDBG funds.

Provide the total of other funds to be used.

List the name of the other funding source.

List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D Column E

BUDGET ITEM CDBG REQUEST
($)

OTHER SOURCES
($)

NAMES OF

OTHER SOURCES

TOTAL BUDGET
($)
Personnel*
Personnel Total
Non-Personnel
Rent/Lease
Supplies
Utilities
Equipment
Services
Printing
Admission/Enrollment
Other:

Other:

Non-Personnel Total

TOTAL PROJECT BUDGET
*For personnel, complete the following CDBG-Funded Personnel Tables.

CHIEF EXECUTIVE OFFICER 2,146 31,306 CDBG 33,452
Operations Officer 1,817 26,502 CDBG 28,319
CFO/ Fiscal 2,928 42,704 CDBG 45,632
Grant Analyst/ Supervisor (3) 3,905 56,964 CDBG 60,869 FH Specialist (2) 4,261 62,155 CDBG 66,416
Testing Coordinator (2) 2,286 33,352 CDBG 35,638
FH/ LT Mediator (4) 4,110 59,950 CDBG 64,060
Operator- FH (2) 5,480 79,934 CDBG 85,414
26,933
3,721
Communications
Insurance
Misc
Travel
35,000 510538 545538
54,279 CDBG 58,000
162 2,358 CDBG 2,520
314 4,586 CDBG 4,900
144 2,105 CDBG 2,249
1,607 23,436 CDBG 25,043
1,476 21,524 CDBG 23,000
575 8,392 CDBG 8,967
56 812 CDBG 868
12 180 CDBG 192
8,067 117,672 125,739
392,867 419,800
City of Rialto 2 ϯ/2ϰ Public Service Application Page 7 of 10

CDBG-FUNDED PERSONNEL
տ Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary
($)
Annual Benefits
($)
Total
Compensation
($)
CDBG Funds
Budgeted ($)
Time Position is
Dedicated to
CDBG Activity
(%)

PROPOSED PROGRAM STAFF
Job Title Annual Salary
($)
Annual Benefits
($)
Total
Compensation
($)
CDBG Funds
Budgeted ($)
Time Position is
Dedicated to
CDBG Activity
(%)
KEY PERSONNEL DUTIES. Provide a list of the duties of key personnel listed above.

Job Title Duties
CHIEF EXECUTIVE OFFICER 105,000 18,900 123,898 2,146 1.7 CFO 98,384 17,709 116,093 1,825 1.5
Fiscal/ Office Manger 57,120 10,282 67,402 1,102 1.6
Operations Officer 80,000 14,400 94,400 1,817 1.9
Grant Analyst/ Supervisor (3) 64,480 11,606 228,258 3,905 1.7 FH Specialist (2) 45,760 8,237 107,994 4,261 3.9
Testing Coordinator (2) 45,760 8,237 107,994 2,286 2.1
FH/ LT Mediator (4) 37,440 6,739 176,716 4,110 2.3
Operator- FH 37,440 6,739 44,179 2,835 6.4
Executive Assistant 58,240 10,483 68,723 2,645 3.8
See the attached IFHMB Job Descriptions
City of Rialto 2 ϯ/2ϰ Public Service Application Page 8 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

PROGRAM CHANGES. If you received CDBG funding last year, has there been an increase in service that you will provide during FY 202ϯ/202ϰ? Explain why there is a new demand or an unmet need in the community for this service.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

All program costs are reasonable for the services provided.

Yes, due to the pandemic, there has been an increase in requests for housing related assistance. Novel fair housing issues that are related to COVID ( e.g.- housing discrimination related to loss of income and rental assistance programs, or disability caused by COVID) have required the provision of increased program services. Our fair housing program and landlord-tenant program will provide education, outreach, mediation, and fair housing services related to these matters.

Partial or no CDBG funding for project services will result in a proportionate decrease in the services available to Rialto residents.

City of Rialto 2 ϯ/2ϰ Public Service Application Page 9 of 10 V. CONFLICT OF INTEREST QUESTIONNAIRE
Federal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

This questionnaire must be completed and submitted by each applicant for CDBG program funding. The purpose of this questionnaire is to determine if the applicant, or any of the applicant’s staff, or any of the applicant’s Board of Directors would be in conflict of interest.

1. Is there any member(s) of the app licant’s staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or (b) a City Councilmember? տ Yes տ No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiliate(s) who is currently or has been, within one year of the date of this questionnaire, (a) a City Employee or Consultant or (b) a City Councilmember? տ Yes տ No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

3. Is there any member(s) of the applicant’s staff or me mber(s) of the applicant’s Board of Directors or other governing body who are business partners or family members of (a) a City Employee or (b) a City Councilmember?
տ Yes տ No
If Yes, please list the name(s) and information requested below:

Name of Person Relationship Tie If Family, Indicate
Relationship
■
N/A
■
N/A
■
N/A
City of Rialto 2 ϯ/2ϰ Public Service Application Page 10 of 10 VI. SIGNATURES
Authorized Signature
To the best of my knowledge, the information provided on this application is true, and I am authorized to submit this application on behalf of the applicant agency.

Print Name Title
Signature Date
Authorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.

Print Name Title
Signature Date
e
Carmen I. Garcia President and CEO
2/10/2023
Carmen I. Garcia President and CEO
2/10/2023

REVISED APPLICATION
Inland Fair Housing &
Mediation Board
Fair Housing

CITY OF RIALTO
FY 2023/2024

CDBG NON- PUBLIC SERVICES APPLICATION
City of Rialto
Curb, Gutter, Sidewalks

DEADLINE
City of Rialto
Community Development Block Grant
Fiscal Year 2023/2024

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https:ljwww.hudexchange.info/resource/687 /playing-by-the-rules-a-handbook-for cdbg-subrecipients-on-administrative-systems/

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. □ Completed and Signed Application - Parts I-VI
□ Articles of Incorporation
□ Non-Profit Determination - 501(c}3 IRS Letter (if applicable) □ List of Board of Directors
□ Organizational Chart
□ Most Recent Audited Financials
□ Resumes of Key Administrators
□ Job Descriptions for Personnel/Positions Listed in Application □ Most Recent Certificates of Insurances.

CONTACT
If you have any questions regarding the City of Rialto's Community Development Block Grant (CDBG} funded program, please contact:

Contact
Phone
Email
City of Rialto
Aknesa Ananikyan
(909) 816-5623
[email protected]
23/24 Public Service Application Page 1 of 10
I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
City of Rialto Organization/ Agency
Program/ Activity ntle Engineering Services
Physical Address 335 W. Rialto Ave., West Parking Lot
City, State, ZIP Rialto, CA 92376
Type of Organization D Non-Profit � Government □ For-Profit Tax ID 95-6000768
Are you a Women owned, or a D Yes �No D Decline to state majority Women operated
organization?
Are you a Minority owned, or a □ Yes �No □ Decline to state majority Minority operated
organization?
If yes, please select which □ Black Americans □ Native Americans 0 Hispanic Americans category or categories is most D Asian/Pacific Americans D Hasidic Jews applicable.

UEI Number JSSRWCN 1 S4C7
Name of Workers' Compensation
Exempt Insurance (Government exempt)
Coverage Amount ($) N/A
Expiration Date N/A
Name of General Liability and
Property Damage Insurance
Exempt
{Government exempt)
Coverage Amount ($) N/A
Expiration Date N/A
Name of Applicant Contact Alberto Paiva
Title Director of Engineering Services/City Engineer
Mailing Address 150 S. Palm Avenue
City, State, ZI p Rialto, CA 92376
Email [email protected]
Phone 909-820-8040
Amount of CDBG Funds
$200,000 Requested ($)
Approximate Total Number of
Unduplicated Beneficiaries
(Persons or Households) to be
Served
Type of Beneficiary l!!!!I Persons □ Households
Groups that the Program/Activity l!!!!I Youth □ Abused/Neglected Children will Serve l!!!!I Adults !!!I Households
(Check all that apply) l!!!!I Seniors !!!I Community
□ Homeless Persons □ Housing Units
□ Disabled Persons !!!I Public Facilities
□ Battered Spouses !!!I Businesses
City of Ri;ilto 23/24 Publk Service Application Page 2 of 10 JI. CDBG ELIGIBILITY
CDBG Eligible Activity Categories D Public Service. Improves community public services and facilities, Please choose the CDBG Eligible including but not limited to those concerned with employment, fair Activity Category for your housing and homeownership, homelessness, crime prevention, child proposed project. care, health, drug abuse, education or recreational needs. ""' Public Facilities/Improvements
D Housing/Special Activities by Subrecipients
D Economic Development
D Acquisition and/or rehabilitation of real property
D Other. Click to specify
CDBG National Objective I!!! Benefits Low and Moderate Income {LMI) Individuals/Households.

Compliance D Addresses the prevention or elimination of slums or blight.

Your proposed project/activity
must meet at least one of HUD's
CDBG National Objectives.

Please check all that apply to
your proposal.

Meetings National Objectives ""' Low/Moderate Area Benefit -The project serves only a limited area Check all statements that which is proven by current Census data or survey to be a low-income describe how your proposed area. By choosing this category you must be able to prove your project/activity meets one of the project/activity primarily benefits low/moderate income households.

City of Rialto 23/24 Public Service /\pplication Page 3 of 10 Ill. PROJECT NARRATIVE
PROJECT/PROGRAM DESCRIPTION. Briefly describe the proposed service/activity/project to be carried out with the funds requested.

The Curb, Gutter, and Sidewalk project generally consists of installation of new, removal and/or replacement of curbs, gutters, cross-gutters, driveway approaches, disabled accessible curb ramps, and sidewalks.

The proposed capital improvement projects will install approximately 8,000 square feet of sidewalk, 500 linear feet of curbs and gutters and 5 disabled accessible curb ramps.

The proposed project aims to improve the City's transportation infrastructure, public safety, property values, and storm water runoff control.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

City conducted surveys and resident reporting have aided in identifying deteriorated an damaged curbs, gutters and sidewalk throughout the City. Repair of damaged sidewalks, curb ramps, and drainage facilities improved overall accessibility, reduced hazards to the community, promotes walking, and increase neighborhood property values. With priority give to sidewalk improvements near schools and activity centers, and the extent to damage; CDBG funds will be targeted in areas of low to moderate income to provide higher pedestrian volumes, improved storm water routing, and elevated community aesthetic, and safe pedestrian travel paths.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

The target population for this pro;e<:t are residents and community members of all ages who live, work, and play within the CDBG identified area. This project will serve the target population of approJ<imate!y 100,000 local residents, which according to the City of Rialto 2010 General Plan, have a median household income of $49,593, and 19% are identified as Jiving below the poverty level. The project will serve the target population by providng additional recreational space which will further improve the community's overall quality of life. Additionally, according to American Community Survey 2016, the lowest median household income of this set is S27,857, which is only 44% of the statewide average. The California Healthy Places Index can also be used to identify disadvantaged communities. A threshold of 50% can be used to identify disadvantaged communities based on this index. All 15 census tracts within a mile of the project corridor are considered disadvantaged based on this standard. The lowest recorded percentile. 4.1, is the tract including Downtown Rialto located in the center of the project corridor.

N/A
City of Rialto 23/24 Public Service Application Page 4 of 10 SIMILAR RESOURCES. Is a similar service provided by another agency/organization? If so, how will your program/activity differ?
N/A
OUTREACH. Discuss outreach efforts for the proposed service/activity/project.

The Community Center currently does outreach through the Rialto Progress Magazine, Rialto Network, Social Media and city wide special events.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
Preparation of Bid Documents October 2023
Contract Award March 2024
Construction Completion September 2024
Project Close-out December 2024
OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/prog ram and status of each source.

Source Name Committed or Fund Amount ($) Current Status Pending
City of Rialto 23/24 Public Service Application Page 5 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column B: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D

BUDGET ITEM CDBG REQUEST OTHER SOURCES NAMES OF
($) ($) OTHER SOURCES
Personnel*
Personnel Total
Non-Personnel
Rent/Lease
Supplies
Utilities
Equipment
Services
Printing
Admission/Enrollment
Other: Capital Improvement Cost !h200 000
Other:

Other:

Non-Personnel Total

TOTAL PROJECT BUDGET
*For personnel, complete the following CDBG-Funded Personnel Tables.

City of Rialto 23/24 Public Service /\pplication
Column E

TOTAL BUDGET
($)

Page 6 of 10 ends

CDBG-FUNDED PERSONNEL
l!!!I Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position Is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
{%)

Job Title Duties
City of Rialto 23/24 Public Service Application Page 7 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

Deteriorated curbs, gutters, and sidewalks are safety hazards to pedestrians and motorists, increase liability risks, and allow water to infiltrate into the sub-base causing damage to roadway pavements.

Cost change is primarily due to added locations from FY2022/2023 to this annual project.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

The funds awarded will determine the scope/phase and number of locations within the CDBG area that could be improved. If partial funds are awarded, staff will reduce the scope to the funding availaibity.

City of Rialto 23/24 Public Service /\pplication Page 8 of 10 V. CONFLICT OF INTEREST QUESTIONNAIRE
Federal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

1. Is there any member(s) of the applicant's staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or {b) a City Councilmember? � Yes □ No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department
Alberto Paiva City E"')neerl Director of Eng:ne-cnng Sen."ices Self Engineering

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual{s} or business affiliate(s) who is currently or has been, within one year of the date of this questionnaire, (a) a City Employee or Consultant or (b) a City Councilmember? □ Yes l!!!!I No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

3. Is there any member(s} of the applicant's staff or member(s} of the applicant's Board of Directors or other governing body who are business partners or family members of (a) a City Employee or (b} a City Council member?
□ Yes l!!!!I No
If Yes please list the name(s) and information requested below· , Name of Person Relationship Tie If Family, Indicate
Relationship
City of Rialto 23/24 Public Service Application Page 9 of 10 VI. SIGNATURES
Authorized Signature
To the best of my knowledge, the information provided on this application is true, and I am authorized to submit this application on behalf of the applicant agency.

Alberto Paiva Director of Engineering Services/City Engineer Print Name Title
Signature Date
Authorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.

Alberto Paiva Director of Engineering Services/City Engineer Print Name Title
Signature c_/ Date
City of Rialto 23/24 Public Service Application Page 10 of 10

CITY OF RIALTO
FY 2023/2024

CDBG NON- PUBLIC SERVICES APPLICATION
City of Rialto
Community Center Building 400
ADA Upgrades

DEADLINE
City of Rialto
Community Development Block Grant
Fiscal Vear 2023/2024

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED REVIEW
Prior to submitting a proposal, it is required that you review "Playing by the Rules: A Handbook for CDBG Sub recipients on Administrative Systems". Please pay special attention to chapters two and five. The handbook can be located at the following link: https://www.hudexchange.info/resource/687 /playing-by-the-rules-a-handbook-for cdbg-subrecipients-on-administrative-systems/

CONTACT
If you have any questions regarding the City of Rialto's Community Development Block Grant (CDBG) funded program, please contact:

Contact
Phone
Email
City of Rialto
Aknesa Ananikyan
(909) 816-5623
[email protected]
23/24 Public Service /\pplication Page 1 of 10
I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
City of Rialto Organization/ Agency
Program/ Activity Title Engineering
Physical Address 150 S Palm
City, State, ZIP Rialto, California, 92676
Type of Organization D Non-Profit � Government D For-Profit Tax ID 95-6000768
Are you a Women owned, or a D Yes � No □ Decline to state majority Women operated
organization?
Are you a Minority owned, or a D Yes �No □ Decline to state majority Minority operated
organization?
If yes, please select which D Black Americans D Native Americans □ Hispanic Americans category or categories is most □ Asian/Pacific Americans D Hasidic Jews applicable.

UEI Number JSSRWCN1S4C7
Name of Workers' Compensation
Exempt Insurance {Government exempt)
Coverage Amount($) N/A
Expiration Date N/A
Name of General Liability and
Property Damage Insurance
Exempt
(Government exempt)
Coverage Amount($) NIA
Expiration Date N/A
Name of Applicant Contact Alberto Paiva
Title Director of Engineering Services/City Engineer
Mailing Address 150 S. Palm Avenue
City, State, ZIP Rialto, California 92376
Email [email protected]
Phone 909-820-8040
Amount of CDBG Funds
$600,000 Requested ($)
Approximate Total Number of
Unduplicated Beneficiaries
(Persons or Households) to be
Served
Type of Beneficiary l!!!I Persons D Households
Groups that the Program/Activity l!!!I Youth D Abused/Neglected Children will Serve l!!!I Adults D Households
(Check all that apply) l!!!I Seniors l!!!I Community
D Homeless Persons D Housing Units
D Disabled Persons l!!!I Public Facilities
D Battered Spouses l!!!I Businesses
City of Rialto 23/24 Public Service /\pp!ication Page 2 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories II Public Service. Improves community public services and facilities, Please choose the CDBG Eligible including but not limited to those concerned with employment, fair Activity Category for your housing and homeownership, homelessness, crime prevention, child proposed project. care, health, drug abuse, education or recreational needs.

II Public Facilities/Improvements
□ Housing/Special Activities by Subrec ipients
□ Economic Development
□ Acquisition and/or rehabilitation of real property
D Other. Click to specify
CDBG National Objective II Benefits Low and Moderate Income (LMI) Individuals/Households.

Compliance □ Addresses the prevention or elimination of slums or blight.

Your proposed project/activity The improvement of these facilties will allow us to must meet at least one of HUD's formulate programs that educate and provide recreational CDBG National Objectives. needs for low and moderate income individuals. Please check all that apply to your proposal.

Meetings National Objectives l!!!I Low/Moderate Area Benefit-The project serves only a limited area Check all statements that which is proven by current Census data or survey to be a low-income describe how your proposed area. By choosing this category you must be able to prove your project/activity meets one of the project/activity primarily benefits low/moderate income households.

National Objectives above: l!!!I Low/Moderate Limited Clientele - The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.
□ Slum or Blight on an Area Basis- Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.

City of RicJlto 23/24 Public Service Application Page 3 of 10 Ill. PROJECT NARRATIVE
PROJECT/PROGRAM DESCRIPTION. Briefly describe the proposed service/activity/project to be carried out with the funds requested.

The Parks, Recreation & Community Services Department proposes to renovate the Communrty Center Building in the 400 wing localed al 214 N. Palm Avenue to provide upgraded facilities thal meet Americans with Disabilities Act (ADA) compliance standards; the existing facility hosts Karate and Kung Fu. special events staff, youth, adult, and community-wide City programs.

The buildingstwings are aver 50 years old and consist of approximately 2,570 square feet, each building of office and open classroom space as part of the Rialto Community Center (Johnson Community Center).

Cunentty, patrnns' use of the buildings/wings is c:haUenged by the long overdue remodel and deteriorating condition, and challenging and unsafe, if not lmpossib!e. for Community patrons in wheelchrurs to enter and exit the buildings and use the facilities.

The proposed scope of the project,.,,. include contractor mobilization, mate rials, as well as the following: interior remodel.Ilg to meet ADA building compliance, including ADA accessible doors at building/wing entrances, nemoval of carpet and other floorings, and replacement with upgraded flooring throughout the buildings/wings, conversion ol interior ljghting to energy-efficient LED lighting, repainting the interior of the buikJing, repracing kitchen cabinets, countertops, appliances, windows, ceilings, and mechanical systems as applicable.

Mer completion, the Maintenance and Operations staff will penonn ongoing maintenance to remodel longevity for the patron's future use.

As of the fiscal year 2023, a total budget of $582,343 has been adopted. Design for the facilrty has already taken place; however, additional funds are needed to finish this project.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

The 400 wing houses the department's Special Events Room, Karate/Kung Fu classes, and a multi-purpose room for education/contract classes. The Special Events room is where city employees and community stakeholders plan city-wide events designed to serve Rialto's diversity (socio-economically and linanciaUy). The Karate/Kung Fu classroom setves as a place for peopte from five to ninety•five to receive physical activity and engagement with the community. The additional multi-purpose room wm benefit lhe community with educational and physical activity room. The last room tn the 400s is in poor condition and used for storage because the facility needs to be ADA--comptiant. AJI of these rooms are used to provide services to the community. The Special Events in the 400s are critical lo the community because the rooms welcome city employees, local businesses, the Police Department, Fire Department, School Ois!rict, and mone to plan and organize aclMties and events for all stakeholders in the community. This room is critical because they help the city identify everyone in the community and plan on projects lo provide seNices to the community as a whore, every person, regardless of socio-economic position, Oisabilities, or age.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

The target population for this project is residents and community members of all ages who live, worl<. and play within the CDBG-identified area. This project will serve the target population of approximately 100,000 residents, which, according to the City of Rialto 2010 General Plan, have a median household income of $4!1,593, and 19% are identified as living below the poverty level. The project wilt serve the target population by providing additional recreational space and improving the community's overall quality of life. Additionally, according to American Communrty Survey 2016, this set's lowest median household income is $27,857, which is only 44% of the statewide average. The CaHfomia Healthy Places Index can also be used to identify disadvantaged communities. A threshold of 50% can be used to identify disadvantaged communities based on this index. Based on this standard, all 15 census tracts within a mile of the project corridor are considered disadvantaged. The lowest recorded percentile, 4.1. is the tract, including Downtown Rialto, located in the center of the project corridor.

The Community Center currently does outreach through the Rialto Progress Magazine, Rialto Network, Social Media and city wide special events.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
Preparation of Bid Documents November 2024
Pre-Bid January 2025
Bid Opening April 2025
Contract Award May2025
Construction Completed February 2026
Project Acceptance April 2026
OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or Fund Amount($) Current Status
Pending

N/A N/A NIA NIA
City of Rialto 23/24 Public Service Application Page 5 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly related. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column B: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D

Other:

Non-Personnel Total

TOTAL PROJECT BUDGET
*For personnel, complete the following CDBG-Funded Personnel Tables.

City of Rialto 23/24 Public Service /\pplication
Column E

TOTAL BUDGET
($)

Page 6 of 10 ends

CDBG-FUNDED PERSONNEL
□ Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary Annual Benefits Total CDBG Funds Time Position is ($) ($) Compensation Budgeted ($) Dedicated to
($) CDBG Activity
(%)

Job Title Duties
City of Riillto 23/24 Public Service 1-1.ppliciltion Page 7 of 10 COST RATIONALE. If you consider it necessary, explain why your program/activity costs is reasonable.

The 400 wing caters to a lot of people in the community. The rooms in this region see more activity and diversity than any other area at the community center. The Special Events room is a hub for the department to welcome the community, the Police Department, the Fire Department, the County of San Bernardino, Waste Management, local businesses, and other stakeholders who work together to collaborate on city engagement. Over 150 active com munity members visit the special events room annually to find ways to bring the community together. Everything from planning special activities to planning community events--this room works as a center for the community. Next, is a classroom/mu ltipurpose room currently used by a Kung Fu/Karate class. This class is vital to the community for many reasons. Unlike most activities, the age range is extensive: five to ninety-five, and the class welcomes everyone. This classroom welcomes over 250 kids and adults a year. The area also has a classroom !Ila! is currently vacant due to the poor condition of tile facility and lack of ADA-compliant facilities. Modernizing this room would make this room usable for education, recreation, and resources.

N/A
IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

The funds awarded will determine the scope/phase that could be delivered. If partial funds, staff will work on the design of the proposed improvements to have shelf ready plans and pursue future funding opportunities.

1. Is there any member(s} of the applicant's staff or governing body who is or has been, within one year of the date of this questionnaire, (a} a City Employee or {b) a City Council member? !!!!I Yes □ No
If Yes please list the name(s) and information requested below· , Name of Person Job Title Relationship City Department
Alberto Paiva City Eng'rie:el'/ D:rc!ctorofEng:necting Sa:-.'iees Self Engineering

2. Will the CDBG funds requested by the applicant be used to award a subcontract to any individual(s) or business affiliate(s} who is currently or has been, within one year of the date of this questionnaire, (a) a City Employee or Consultant or {b} a City Councilmember? □ Yes !!!!I No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

3. Is there any member(s) of the applicant's staff or member(s} of the applicant's Board of Directors or other governing body who are business partners or family members of (a} a City Employee or (b) a City Councilmember?
□ Yes !!!!I No
If Yes, please list the name(s) and information requested below:

Alberto Paiva Director of Engineering Services/City Engineer Print Name Title
Date
City of Rialto 23/24 Public Service Application Page 10 of 10

CITY OF RIALTO
FY 2023/2024

CDBG NON- PUBLIC SERVICES APPLICATION
City of Rialto
Mobile Home Repair Program
City of Rialto 23/24 Non-Public Service Application Page 1 of 10 City of Rialto
Community Development Block Grant
Fiscal Year 2023/2024

NON-PUBLIC SERVICE APPLICATION

DEADLINE
The Deadline for returning completed applications is 12: 00 p.m., Friday, February 10, 2023. Postmarks and late applications will not be accepted. All application must be mailed to:

Rialto Parks, Recreation & Community Services Department City of Rialto
214 N. Palm Ave,
Rialto, CA 92376

REQUIRED DOCUMENTS
Please submit the following information along with your completed application by the abovementioned deadline. տ Completed and Signed Application – Parts I-VI

CONTACT
If you have any questions regarding the City of Rialto’s Community Development Block Grant (CDBG) funded program, please contact:

Contact Aknesa Ananikyan
Phone ( 909) 8
16-5623
Email [email protected]
City of Rialto 23/24 Non-Public Service Application Page 2 of 10 I. APPLICANT AND PROJECT/ACTIVITY INFORMATION
Legal Name of
Organization/Agency
Program/Activity Title
Physical Address
City, State, ZIP
Type of Organization տ Non-Profit ܆Government տ For-Profit Tax ID
DUNS Number
Name of Applicant Contact
Title
Mailing Address
City, State, ZIP
Email
Phone
Fax
Amount of CDBG Funds
Requested ($)
Proposed project will serve:܆Units
܆Inspections
܆Square Feet
܆Census Tracts
܆Public Facilities
Estimated number of units
anticipated to be
completed with grant funds:
տ Number of Units:
տ Number of Square Feet:
տ N umber of Inspections:
տ LMI Census Tracts. If yes, please
attach list of census tracts.

Is there a recognized boundary
for the area served, such as
census tracts, block groups,
neighborhoods, street
boundaries, etc.?
տ No.
տ Y
es. If yes, please describe boundaries below:

Will a fee be charged to use the
facility/improvement?
տ Yes. If yes, attach a copy of the fee schedule.
տ No
City of Rialto
Mobile Home Repair Program
150 S Palm Ave
Rialto, CA 92376
95-60000768
Kathy Brann
Economic Development Manager
150 S Palm Ave
Rialto, CA 92376
[email protected]
909-820-2505 x2041
$140,000
City of Rialto 23/24 Non-Public Service Application Page 3 of 10 II. CDBG ELIGIBILITY
CDBG Eligible Activity Categories
Please choose the CDBG Eligible
Activity Category for your
proposed project.
܆Public Service. Improves community public services and facilities, including but not limited to those concerned with employment, fair housing and homeownership, homelessness, crime prevention, child care, health, drug abuse, education or recreational needs. ܆Public Facilities/Improvements
տ Housing/Special Activities by Subrecipients
տ Economic Development
տ Acquisition and/or rehabilitation of real property
տ Other. Click to specify
CDBG National Objective
Compliance
Your proposed project/activity
must meet at least one of HUD’s
CDBG National Objectives. Please
check all that apply to your
proposal.
܈Benefits Low and Moderate Income (LMI) Individuals/Households. տ Addresses the prevention or elimination of slums or blight. տ C
ommunity development needs having a particular urgency.

Meetings National Objectives
Check all statements that
describe how your proposed
project/activity meets one of the
National Objectives above:
տ Low/Moderate Area Benefit – The project serves only a limited area which is proven by current Census data or survey to be a low-income area. By choosing this category you must be able to prove your project/activity primarily benefits low/moderate income households. ܆Low/Moderate Limited Clientele – The project/activity benefits a specific group of people (rather than all areas in a particular area), at least 51% of whom are low/moderate income persons. Income verification for clients must be provided for this category. The following groups are presumed to be low/moderate: abused children, elderly persons (62 or older), battered spouses, homeless persons, adults meeting the Census definition of severely disabled, illiterate adults, persons living with AIDS and migrant farm workers.
տ Slum or Blight on an Area Basis – Area basis activities must be within an officially designated area as defined under State or local law, and addresses one or more of the conditions that contributed to the deterioration of the area.
տ Urgent Needs – Meeting other community development needs having a
parti
cular urgency because existing conditions pose a serious and immediate threat to the health or welfare of the community and other financial resources are not available to meet such needs. (These types of projects are very rare).

City of Rialto 23/24 Non-Public Service Application Page 4 of 10 III. PROJECT NARRATIVE
PROJECT/PROGRAM DESCRIPTION. Briefly describe the proposed service/activity/project to be carried out with the funds requested.

COMMUNITY NEED. Does your proposed project/activity address an identified gap in service or current need in the community? Document the need for the project/program.

BENEFIT. Discuss how the project/program provides benefit to low-income persons.

The Mobile Home Repair Program will assist mobile homeowners with repairs to their residence with a maximum grant award of $20,000 per household. The types of repairs that are addressed include interior/exterior improvements and correcting any Code violations, as well as health and safety issues determined by the California Health and Safety Code.

The program guidelines are as follows: 1. Applicant(s) must reside in the mobile home where repairs are needed for at least one year. 2. Existing mortgage payments, property taxes, utility bills and homeowner’s property insurance must be current and up to date. 3. Applicant(s) must also meet the county median income guidelines not to exceed 80%.

The purpose of this program is to aid those that need additional resources to make vital improvements to their mobile home.

Without the program, owners on a limited and/or fixed income, such as senior citizens, may be forced to live in hazardous conditions. This program serves as one solution in eliminating blight within the City and creating a safe and healthy community.

In order to qualify for the program, interested parties s are required to apply by submitting an application, along with additional documentation, to demonstrate their eligibility for the grant. Once an applicant is approved, City staff will visit the property for evaluation to determine what repairs are necessary. Appropriate City Building permits are required and the fees are accounted for in the grant.

The funding request for the Mobile Home Repair Program is $140,000. This will be used to assist approximately 14 mobile homeowners at a maximum of $20,000 per grant.

The City of Rialto currently has a great need, much like the entire state of California, to address the Housing costs within the city’s low-and-moderate income community. Many of those that fall within the low-and-moderate income bracket, are either on a fixed income or do not have a disposable income to address Building and Safety concerns.

Thus, forcing residents to live in hazardous conditions. The Housing Division for the City of Rialto is prepared to meet this need as we have the proper tools, staff and equipment to prevent our neighborhoods from falling into complete dilapidation and ultimately, averting further residents from homelessness.

The Housing Division for the City of Rialto is prepared to meet this need as we have the proper tools, staff and equipment to prevent our neighborhoods from falling into complete dilapidation and ultimately, averting further residents from homelessness. The target population for this program is up to 14 owner-occupants in mobile home parks that are located within the City of Rialto boundaries. Applicants must own and reside in the mobile home where the repairs are needed and fall within the established income guidelines, which are not to exceed 80% of the county median income.

None
City of Rialto 23/24 Non-Public Service Application Page 5 of 10 SIMILAR RESOURCES. Is a similar service provided by another agency/organization? If so, how will your program/activity differ?
OUTREACH. Discuss outreach efforts for the proposed service/activity/project.

PERFORMANCE SCHEDULE. Prepare a Work Plan for implementation/completion of the services and activities.

Identify activities and completion dates below.

Activity Completion Date
OTHER SOURCES OF FUNDS. List all other funding sources that will be used to undertake the proposed project/program and status of each source.

Source Name Committed or
Pending
Fund Amount ($) Current Status

None.

City Website and other City information services.

City of Rialto 23/24 Non-Public Service Application Page 6 of 10 IV. PROPOSED PUBLIC SERVICE BUDGET
Scope of work and use of CDBG funds must be directly re lated. The CDBG funds requested must be used to provide a direct benefit/service to low- or moderate-income residents of the City of Rialto. Proof of income eligibility and current residence must be acquired from all recipients. Adequate documentation must also be provided by the Agency to support costs associated with the services provided. This includes such support as timesheets to demonstrate the amount of time spent on each service, cancelled checks to demonstrate payment, client intake forms to demonstrate who received the service and any other documentation deemed necessary to show a direct correlation between the service provided and the costs associated with them.

Please use the following format to present your proposed line item budget:

Column A: List the items for which you anticipate the need for CDBG Funds during FY 2023/2024.

Column B: Provide the projected request for CDBG funds.

Column C: Provide the total of other funds to be used.

Column D: List the name of the other funding source.

Column E: List the total line budget. Please round your request to the nearest ten.

Column A Column B Column C Column D Column E

BUDGET ITEM CDBG REQUEST
($)

OTHER SOURCES
($)

NAMES OF

OTHER SOURCES

TOTAL BUDGET
($)
Personnel*
Contract Services
Personnel Total
Non-Personnel
Rent/Lease
Supplies
Utilities
Equipment
Services
Printing
Admission/Enrollment
Other:

Other:

Non-Personnel Total

TOTAL PROJECT BUDGET
*For personnel, complete the following CDBG-Funded Personnel Tables. 140,000
City of Rialto 23/24 Non-Public Service Application Page 7 of 10

CDBG-FUNDED PERSONNEL
܆Check this box if CDBG funds will NOT be used to fund personnel.

If CDBG funds will be used to fund personnel, complete the following tables, as appropriate. Only list personnel that will be paid with CDBG funds.

AGENCY ADMINISTRATION
Job Title Annual Salary
($)
Annual Benefits
($)
Total
Compensation
($)
CDBG Funds
Budgeted ($)
Time Position is
Dedicated to
CDBG Activity
(%)

Job Title Duties
City of Rialto 23/24 Non-Public Service Application Page 8 of 10 COST RATIONALE. If you consider necessary, explain why you consider your program/activity costs to be reasonable.

PROGRAM CHANGES. If you received CDBG funding last year, has there been an increase in service that you will provide during FY 2020/2021? Explain why there is a new demand or an unmet need in the community for this service.

IMPACT OF NO CDBG FUNDING. Describe the effect of partial or no CDBG funding on your project/activity.

Increased cost of material and labor.

City of Rialto 23/24 Non-Public Service Application Page 9 of 10 V. CONFLICT OF INTEREST QUESTIONNAIRE
Federal, State, and City law prohibits employees and public officials of the City of Rialto from participating on behalf of the City in any transaction in which they have a financial interest.

This questionnaire must be completed and submitted by each applicant for CDBG program funding. The purpose of this questionnaire is to determine if the applicant, or any of the applicant’s staff, or any of the applicant’s Board of Directors would be in conflict of interest.

1. Is there any member(s) of the applic ant’s staff or governing body who is or has been, within one year of the date of this questionnaire, (a) a City Employee or (b) a City Councilmember? ܆Yes տ No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

2. Will the CDBG funds requested by the applicant be us ed to award a subcontract to any individual(s) or b
usiness affiliate(s) who is currently or has been, within one year of the date of this questionnaire, (a) a C
ity Employee or Consultant or (b) a City Councilmember? տ Yes տ No
If Yes, please list the name(s) and information requested below:

Name of Person Job Title Relationship City Department

3. Is there any member(s) of the applicant’s staff or me mber(s) of the applicant’s Board of Directors or other g
overning body who are business partners or family members of (a) a City Employee or (b) a City C
ouncilmember?
܆Yes տ No
If Yes, please list the name(s) and information requested below:

Name of Person Relationship Tie If Family, Indicate
Relationship
City of Rialto 23/24 Non-Public Service Application Page 10 of 10 VI. SIGNATURES
Authorized Signature
To the best of my knowledge, the information provided on this application is true, and I am authorized to submit this application on behalf of the applicant agency.

Print Name Title
Signature Date
Authorized Signature
I have read "Playing by the Rules: A Handbook for CDBG Subrecipients on Administrative Systems" with special attention to chapters two and five.

Print Name Title
Signature Date
Colby Cataldi Community Development Manager
Colby Cataldi Community Development Manager

Rialto City CouncilApril 25, 2023

Rialto City Council
April 25, 2023