Attachment A - Grant Applications — City Council and Concurrent Authorities, May 3, 2022 (part 1 of 2)

Printed By: Kayla Martin on 3/30/2022 1 of 2
Program Overview
Completed by [email protected] on 1/18/2022 1:04 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant (CDBG)
Emergency Solutions Grant (ESG) Program
For Fiscal Year 2022-2023
For more guidance, click here to view the full Application Instructions for Funding for CDBG & ESG General Information and Application Instructions For Funding The City of Stockton anticipates receiving federal funds from the U.S. Department of Housing and Urban Development (HUD) to assist low and moderate-income persons, expand economic opportunities, provide decent housing, and/or provide a suitable living environment. As a recipient of Community Development Block Grant (CDBG), Emergency Solutions Grant (ESG), and Home Investment Partnerships (HOME) funds, the City allocates these funds to different activities to meet priority needs and the specific objectives identified in the City’s Consolidated Plan.

For the upcoming 2022-2023 Program Year, the City of Stockton expects to allocate approximately $645,000 to Subrecipients under the CDBG program and $292,000 under the ESG Program. These estimates are based on the City’s 2021-2022 allocations so actual amounts may vary.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Emergency Solutions Grant (ESG) provides funding to assist the homeless or those who are about to be homeless. The program places an emphasis on helping people quickly regain stability in permanent housing after experiencing a housing crisis and/or homelessness.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

The proposed project must meet one of the following goals identified in the City of Stockton’s 2020-2025 Consolidated Plan, which guides efforts to address Stockton’s priority housing and community needs:

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing.

Expand the housing first model to provide permanent housing units with intense wrap-around services on- site.
 Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income levels. Provide homeownership opportunities for low-income first-time buyers.

Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons.
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure.  Community Development Needs: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Applications must be received by 5:00 p.m., Monday, January 24, 2022. Mailed, e-mailed or facsimiles applications will not be accepted. Applications are available online at http://www.stocktonca.gov/housing. For program information or application assistance, contact City of Stockton – Economic Development Department at (209) 937- 8539 or e-mail [email protected].

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
A. Eligibility
Completed by [email protected] on 1/18/2022 1:05 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Service
If using ESG funds
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
B. Contact Information
Completed by [email protected] on 1/18/2022 1:26 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Boys & Girls Clubs of Greater Sacramento FBO: Boys & Girls Club at Sierra Vista-Stockton B.2. Mailing Address
5212 Lemon Hill Ave Sacramento, CA 95824

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Kimberly
B.4. Last Name
Key
B.5. Email
[email protected]
B.6. Phone Number
(916) 392-1350

POINT OF CONTACT INFORMATION
B.7. First Name
Kimberly
B.8. Last Name
Key
B.9. Email
[email protected]
B.10. Phone
(916) 392-1350

ORGANIZATION CONTACT INFORMATION
B.11. Website
https://bgcsac.org/our-clubs/sierra-vista-club-stockton.html B.12. DUNS Number
968,257,741
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
B.13. EIN Number
680,338,324
B.14. Business License Number and Expiration Date
GNB3200944699 expiration 11-1-24
B.15. Type of Agency
501(c)(3)
B.16. Number of Paid Staff
42 B.17. Number of Volunteers
55 Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/21/2022 8:21 AM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
Club Connect 2022-Keeping Kids & Families Connected at Sierra Vista C.2. Project Site Location
1700 E 11th Street Stockton, CA 95206
C.3. Funding Requested in this application
$51,375.00
C.4. Other funds already secured for the project
$56,667.00
C.5. Total Cost to Complete Project
$108,042.00
C.6. Other funds not yet secured
$0.00
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/19/2022 10:40 AM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

Our mission is to inspire and enable all young people, especially those who need us most, to reach their full potential as productive, caring, and responsible citizens. The Club provides a world-class Club Experience that assures success is within reach of every young person who enters our doors, with all members on track to graduate from high school with a plan for the future, demonstrating good character and citizenship, and living a healthy lifestyle.

D.2. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in each category. (For 2021 HUD income limits for the Stockton area, please refer to them here .

Income Limits Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 0
Extremely Low Income (Less than 30%) 300
300
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 125 110
Black/African American 120 0
Asian 35 0
Am. Indian/Alaskan Native 0 0
Native Hawaiian/Other Pacific Islander 0 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 20 0
300 110
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 2
Female Headed Households 50
Seniors 25
Youth 125
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
Homeless 0
202
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
E. Project Funds
Completed by [email protected] on 1/21/2022 5:09 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
E. Project Funds
Please provide the following information.

N/A
E.3. If you are applying for additional funds for a current program/project, provide a status update on the existing funds and when funds will be fully spent. Please list all CDBG and ESG funds received within the last 3 years including funding amount and their status.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
$0.00 $0.00
FY2017/18
ESG
$0.00 $0.00
FY2018/19
CDBG
$0.00 $0.00
FY2018/19
ESG
$0.00 $0.00
FY2019/20
CDBG
$0.00 $0.00
FY2019/20
ESG
$0.00 $0.00
FY2020/21
CDBG
Club Connect city $50,000.00 underway $28,495.21
FY2020/21 ESG $0.00 $0.00
FY2021/22
CDBG
$0.00 $0.00
FY2021/22 ESG $0.00 $0.00
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

City of Stockton-proposed
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
Cal Water- committed
Raymus Foundation-committed
Boys & Girls Clubs of America-committed
Dignity Health-committed
Individual donors-committed
Downtown Sportsmen Club-committed
Community Foundation San Joaquin-committed
E.5. What will be the impact on your agency, program, or project goals be if the program is not funded at the full amount requested? Will your organization have the ability to sustain itself if the funding allocated is less than the amount requested? Please provide detailed information to understand if this is a funding gap and/or funds used to leverage additional sources outside of Stockton i.e. County/State/Federal/Private Funds The Boys & Girls Club at Sierra Vista -Stockton is committed to support the ongoing needs of Sierra Vista youth and families. The Club has remained a reliable source of resources and support during the toughest of times thanks to the financial support of our community partners. The Club continues to leverage funding in an effort to not disrupt critical programs and services to families most in need and 2022 will be no exception. Youth and families in Stockton need the Boys & Girls Club more than ever. As the Club continues to demonstrate the ability to provide direct services to Sierra Vista residents, support from the City of Stockton will allow the Club to keep this critical work going. If funding is less than the requested amount, the Club will work to raise additional revenue and potentially adjust the amount of supplies that are being distributed while doing its best to NOT reduce the number of families that will be supported.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

The Boys & Girls Club at Sierra Vista-Stockton is serving low-income youth and families residing at Sierra Vista's public housing community in South Stockton. There are approximately 350 youth that live at Sierra Vista and the Club currently has 100 registered members. The Club is also supporting youth that attend Aspire Charter School located at Sierra Vista and is looking to expand services to another public housing community in South Stockton (Q4 2022).

E.7. How does (will)your organization verify income eligibility of your clients? Area Benefit Project service area has been identified and determined to be statistically low-income based on the 2010 Census. If you use this method, provide all Census Tracts and Block Groups served by your project and a calculation of the low-income percentage. Please utilize the following web application to confirm eligibility . Area benefit applicants are required to confirm block groups/census tracts are eligible. Map depicting area with low/mod % is required with this application.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents Yes
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents No
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

No
Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Number required at time of assistance). Please attach a blank worksheet under Required Documents No
Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

No
E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

The Boys & Girls Club continues to make health, safety, and education a top priority. The Club is able to serve youth and families throughout the community by providing Club Connect programs and services in all the ways that make it convenient for families. Whether the Club is facilitating in-person programs, community wide events or making home deliveries, the Club is responding to the ongoing needs of kids and families living at Sierra Vista.

In an effort to support families already strained budgets and ensure that families have meals over the weekend, the Club will continue to provide Club Connect Kits to Sierra Vista youth and their families. Kits will contain PPE supplies, food/snack bags, program and school supplies. Kits will be distributed on Thursday and Friday each week so that resources are available he Club will work with Sierra Vista's Resident Council to distribute supplies and determine families most in need of support.

Funding will support the Club Connect program at Sierra Vista to include: community events, staff outreach, home deliveries, and kit supplies.

E.9. Select the common indicator that your agency will use to track clients.

Persons: unit of measurement for public services/ESG
E.10. Define the primary unit of service (e.g. number of classes provided, hours of case management, number of medical visits, number of meals served, etc.) to be used when tracking this program/project, submitting invoices, etc. Note: Do NOT reiterate the number of clients or number of households served.

The Boys & Girls Club will track the number of youth served each week in addition to the number of family members in the household that receive services, supplies, food, and other resources.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 325
Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
Households 0
Other 0
325
E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

The Boys & Girls Club's service delivery methods include; phone calls, emails, flyers, home delivery, in-person programs and meal pick-up, and community wide events. The Club is serving low-income families residing at Sierra Vista.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 3
F. Project Impact
Completed by [email protected] on 1/21/2022 3:39 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
F. Project Impact
Please provide the following information.

F.1. Please list the total client income of Stockton clients your agency PROPOSES to serve through this program/project for each category below in fiscal year 2022-2023. (For current HUD income limits for the Stockton area, please refer to the link here.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 0
Extremely Low Income (Less than 30%) 325
325
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 135 115
Black/African American 130 0
Asian 40 0
Am. Indian/Alaskan Native 0 0
Native Hawaiian/Other Pacific Islander 0 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 20 0
325
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 5
Female Headed Households 50
Seniors 25
Youth 125
Homeless 0
205
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 3
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
0 0 0
2020-2021 (Anticipated) 100 300 300
2021-2022 75 325 325
175 625 625
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

The Boys & Girls Club at Sierra Vista-Stockton will support youth & families via Club Connect weekend meals. In an effort to make sure that the needs of our most at-risk youth and families are being met, the Boys & Girls Club will distribute weekend food and snack boxes each week. Every Thursday and Friday; Club youth, families, and Sierra Vista housing residence will receive a Club Connect Kit that includes meals for the weekend, snack bags, school supplies and PPE supplies. Included with each delivery will be health resources, masks and hand sanitizer for the whole family. The Club will stay connected to families and youth with weekly check-ins and deliveries providing the critical resources necessary to support Sierra Vista families.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

The Boys & Girls Club has established a new charted location at Sierra Vista. The Club is currently serving youth out of a temporary location (at Sierra Vista) while the new Clubhouse is under renovation. The Club serves youth ages 6-18 years old in the after-school hours and summer months; providing academic support and enrichment programs designed to keep kids on track to graduate high school with a plan for their future. While the onset of COVID created challenges and uncertainty, the Club was quick to respond and has successfully developed strong ties in the community. Club Connect has allowed the Boys & Girls Club to build relationships with families while supporting their needs. The Club continues to help youth who are struggling with isolation, food insecurities, and academic challenges.

Club Connect keeps kids excited about school though a weekly incentive program and parents are supported with the resources to help take care of their families; PPE supplies, food, school supplies, and health & wellness resources.

While the Boys & Girls Club is serving hundreds of families, the need for additional support is far and wide. The Club will be collaborating with community partners that are also focused on serving the Sierra Vista community. By teaming up and expanding our reach, our collective efforts will support 325 Stockton youth & families every week.

The Boys & Girls Club, will provide critical resources to help fill the health & wellness gaps created by the ongoing impacts of the pandemic. Resources and support will be focused on health resources, PPE equipment, and fresh food and shelf stable snack boxes to support families over the weekend.

The Club's efforts will help to mitigate food insecurities, strengthen the social and emotional health & well-being of our youth and make sure that there is equitable access to the resources that families rely on. The Boys & Girls Club plays a critical role in the community, adapting and evolving to support kids and families through the most challenging of circumstances. Now the Club will harness the power of our reputation, strength of our relationships in the community, and tremendous experience serving at-risk populations to navigate the evolving nature of COVID-19 and the road to recovery.

Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 3
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
G. Project Narrative
Completed by [email protected] on 1/21/2022 3:48 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

As part of the Club's daily programming, youth participate in Triple Play- a comprehensive health and wellness program that works to improve the overall health of the youth we serve. The Club helps youth increase their daily physical activity, teaches them about good nutrition and making healthy choices. Club Connect 2022 will provide meals for the weekend and critical health resources to youth and families who are struggling to meet their basic needs. The Boys & Girls Club will support the whole child by offering program experiences that promote physical, social and emotional well-being; in addition to the intrinsic motivation to make life-long healthy choices.

Early Intervention:

The Club's focus is to create opportunities where youth can develop, and apply essential skills, with confidence, that will ultimately lead to a sustained desire and the self-efficacy to make healthy lifestyle choices. Programming will be inclusive, culturally- and developmentally- responsive, and adaptable to meet youth and families where they are. The Club understands that there are consequences to household food insecurity for young children as it has detrimental effects on the health and development of young children. Data continues to confirm that ongoing food insecurities increase children’s risk of poor school performance and subsequent health disparities. Club Connect will work to reduce the impacts of food insecurity by providing access to food and education around health and safety.

Maintenance:

Addressing food insecurity is more than just providing an afterschool snack or meal for Club members. We know youth are more likely to make healthy choices when they have access to: activities that encourage them to make healthier choices as they navigate through their day; a safe and supportive relationship with caring adults who models Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
healthy behaviors and attitudes; and access to critical resources that might not be readily available. The Club also understands that youth make choices based on what they learn from others. Given this, the Club has paired youth programming with complementary resources, such as the Club Connect Kit, to support the Club's ability to effectively engage families and the greater Sierra Vista community to maximize impact.

G.3. Provide a detailed description of your proposed project/ activity. Describe the work to be performed, including the activities to be undertaken or the services to be provided, the goals and objectives and the method of approach. Be specific about the days/times of services and the frequency and duration of services received by the average client or participant. A timeline/schedule including activity start date and completion date must be submitted with the application.

The Boys & Girls Club continues to closely monitor the impacts of COVID-19 as it continues to impact youth and families that have headed back to school. There continues to be uncertainty, fear, and helplessness in the communities that we serve. Low income families are struggling to meet their basic needs and while vaccinations are helping to keep families protected, youth positivity rates are increasing causing disruptions in learning, anxiety, and additional financial burdens for the household. The Boys & Girls Club will serve and positively impact 325 individuals each week via its Club Connect program. This program will provide meals for the weekend and critical health resources to youth and families who are struggling to meet their basic needs. Club Connect Kits will provide critical resources and support as families navigate challenges throughout 2022. The Club’s goals are to minimize the difficulties faced by our most at-risk populations by:
• Reducing food insecurities
• Increasing access to PPE supplies
• Reducing financial burdens
• Supporting physical and emotional health
The Club is in a unique position to serve youth and families during this time as Club staff have developed strong relationships with families which allow for a quick determination of the needs of the household. As we navigate beyond this crisis, the Club will be vital to helping kids and families stay healthy while also restoring a sense of safety and rebuilding the community.

Timeline/Schedule
Activity Start Date: February 2022
Program Outreach: Club staff and Sierra Resident Council members will do outreach via emails, flyers, community events and phone calls.

Weekly Club Connect distribution: Kits will distributed on Thursday and Friday from 10:00 AM - 6:30PM (day and time will be coordinated with families)
Distribution will continue through Summer 2023
Project Activity or Program
Service #
Describe the Deliverable
1 Provide Club Connect Kits to 325 Sierra Vista youth and families G.4. Describe your agency’s capacity to implement this program or project (identify agency’s federal grants managed, staff resources, skills and experience, number of years in operation, accomplishments to date, etc.).

The Boys & Girls Club has successfully serving our region's most at-risk youth for over 26 years. With the Club's expansion to Stockton, we have the opportunity to broaden our reach and deepen the impact we have on youth who Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
need us most. The Boys & Girls Club at Sierra Vista-Stockton has been made possible because of our partnership with the Housing Authority. Since the onset of the pandemic, the Club has been providing programs and services to help minimize the academic and health gaps that have been growing over the last 18+ months.

The Club has decades of experience managing and facilitating federal grant programs as the Club has a long history working with the Office of Juvenile Justice on our prevention and intervention programs. The Boys & Girls Club has also been successfully managing CDBG funding in the City of Rancho Cordova for both the 2020 and 2021 funding cycle and was just approved for 2022 funding.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
The Boys & Girls Club at Sierra Vista-Stockton has dedicated staff that will be responsible for the Club Connect program. Sierra Vista youth and families will sign up to participate in the program and the staff at the Club coordinates everything else. Club staff will be responsible for assembling and distributing the Kits each week. The Club ensures the safety of all participants by adhering to all health and safety protocols and for families that have challenges with transportation, the Club will deliver directly to their home.

Project Deliverable # Describe the Deliverable
1 Youth and families will be supported with critical resources to reduce food insecurities and stay healthy
G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? The Boys & Girls Club measures success and effectiveness by the ongoing engagement of each participant in program and by tracking the direct impact of the program in the areas of academic success and health and wellness. Data will be collected in the Club's member tracking system along with surveys, data forms and feedback from the community at large.

The process of measuring impact is a year-round, ongoing effort. The Club will collect and analyze data to identify any needed changes so that program quality is consistent and continues to meet the needs of the community. The Club will utilize a Continuous Improvement Cycle as part of monthly and quarterly reporting. The Continuous Improvement Cycle will be an ongoing feedback loop that will include gathering information, making decisions, implementing strategies, assessing how well they work, and then adjusting or trying new strategies based on the results. The cycle is a team-based process with significant opportunities for all Club staff and program participants to actively participate and contribute input. The cycle includes: 1) assessment, 2) action planning and 3) execution.

For the Club Connect program, the Boys & Girls Club will track and measure the following data:
-Member participation: 100 unduplicated youth will be served (minimum) -Sierra Vista families: 225 additional residents will be supported with Club Connect resources -Parent engagement and feedback of support being received from the Club -Completed program surveys and participation forms from both youth and parents Program Results:
-Families are supported
-Youth develop a sense of belonging
-Reduce household food insecurities
Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
-Increase school attendance
-Youth increase physical activity
-Decrease disparity gaps among residents
-Increase access to critical resources
Deliverable # Task that Support Deliverable
1 The Club will assemble and distribute Club Connect Kits to 325 individuals each week G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
The Boys & Girls Club at Sierra Vista-Stockton is serving youth and families with extremely low incomes; struggling to meet their basic needs. With the help of the Club's program, youth and families will receive resources that help to reduce the challenges that they are currently facing. Participants will benefit from weekly access to food, PPE supplies, and health and wellness resources. The Club has no eligibility requirements and is committed to serving as many youth and family members as possible.

G.8. Briefly explain how this service/activity/project differs from other programs providing similar services in Stockton/San Joaquin County. Also indicate any networking or collaboration which occurs with agencies or programs providing the same or like services AND their role in this specific program/project.

The Boys & Girls Club is partnering with the Housing Authority County of San Joaquin to continue to bring Club programs and services to residents at Sierra Vista. The Club serves youth ages 6-18 years old; providing academic support and enrichment programs designed to keep youth on a positive and productive path. COVID-19 has created challenges and uncertainty for Stockton's most vulnerable communities. The Boys & Girls Club continues to respond quickly by shifting its service delivery model to meet the needs of youth and families during this crisis. Youth are struggling with isolation, food insecurities, and a lack of motivation around their academics. The Club has the unique ability to reach and connect with youth whom other agencies have difficulty reaching. The Club has become a trusted partner in the community and as a result, is well positioned to meet the ongoing needs of youth and families.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

The Club is committed to the long-term sustainability of Club Connect deliveries during these uncertain times. It is important that we continue to provide youth and their families with the resources that they need to stay healthy and connected for as long as it takes. The Club continues to work with the Housing Authority, the Stockton Advisory Council, and local partners to raise funds to support ongoing Club Connect efforts. If awarded funds from the City of Stockton, the Club will continue to leverage support to keep Club Connect deliveries going. The Club has already secured funds to support the project.

G.10. Identify any potential conflict of interest with this application for federal funds. Conflict of interest may exist with employees of the organization who sit on community boards, commission, or committees. Similarly, City of Stockton Council members or City employees who may sit on your board of directors pose possible conflicts of interest.

N/A
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
H. ESG
Completed by [email protected] on 1/20/2022 3:15 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:

H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

COVID-19 has caused numerous disruptions to the lives of our youth. These disruptions can have lasting impacts on progress our members had worked so hard to make before the onset of COVID-19. There is hope. The Boys & Girls Club at Sierra Vista is meeting the needs of Stockton youth and their families with Club Connect. Each week, families will safely receive critical resources that help to minimize the challenges created by COVID-19. 2022 Club Connect Kits include food, PPE supplies, and health & wellness resources. Kits will be distributed specifically for weekend meals as that has been identified as a need in the community.

With the support of our generous community partners we will be able to:
• Provide school supplies throughout the year
• Make wellness calls to ensure that Club kids and their families have what they need (including PPE supplies) • Provide weekend meal boxes to help families’ strained budgets.

We know that our response efforts have been successful; creating lasting impact for our Club kids and families. With continued hard work, we know that recovery is possible too. Building resilience is how we will move forward. We will continue to use the strength of our Club and our community to engage our supporters who care deeply about empowering youth to reach their full potential. We are motivated to keep going, to do whatever it takes to make sure our youth have what they need to build Great Futures. The Club’s response, recovery, and resilience efforts will provide the critical support that under-served families need to navigate the ongoing impacts creates by the COVID-19 pandemic.

H.3. Will the service to be provided with these funds fill a service gap needed to be addressed? Yes
H.4. Duplication of Benefits: Federal finance assistance was provided to my organization to addresses losses resulting from a federally declared emergency or disaster, and my organization has not received (or would receive, by acting reasonably to obtain available assistance) financial assistance for the same costs from any other source (including insurance) and the total amount of funding received does not exceed the total needs for those costs.

No
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/20/2022 3:17 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

I.1. Is your agency requesting funds for a Public Facility project (e.g. construction)? No
I.2. Please describe all planning/predevelopment steps that have been completed to date. (e.g., architectural plans, engineering, land use approvals, permits, funding commitments, etc.) n/a
I.3. Provide a detailed narrative (e.g. rehabilitation or new construction) and a detailed scope of work. n/a
I.4. Does the agency own or lease the property where the project will occur? Who is the legal property owner? If you are leasing, please provide a copy of the lease in the required documents section. If you do not have site control, describe your site control plan.
n/a
I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants). n/a
I.7. Has a market study, property needs assessment and/or other evaluation that identifies the need for the proposed project been completed? If so, describe and upload the project reports and schedule). If no reports have been completed, explain how you plan to proceed.
n/a
I.8. When will construction start and end? Provide a timeline with all critical milestones. n/a
I.9. Is this project a multi-phased activity?
No
I.10. Will this project require implementation of Davis-Bacon/Fair Labor Standard Act requirements? Note: Please contact staff immediately if you have questions regarding Davis-Bacon requirement or for more informationclick Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
here.

N/A
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain. n/a
I.12. For Economic Development activities only. Indicate the number of full-time and part-time jobs you expect to be created and retain, if your application is funded. Also indicate number of jobs likely to be filled by a low-income person:

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/20/2022 3:20 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.1. Identify AT LEAST ONE barrier in implementing your program/project:
 A marketing and publicity campaign that provides consumers with additional education and information about the agency’s programs and services.
 Coordination and collaboration with other service providers.  Accessing and utilizing “un-tapped” resources
 Removing barriers that limit access to services and participation (e.g. language, time, cost, transportation, etc.).

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

The Boys & Girls Club is creating access to critical resources for low-income youth and families. The Club is safely distributing weekly Club Connect Kits (at no cost) to Sierra Vista residents who are struggling to meet their basic needs.

J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients For residents with transportation challenges, Club Connect Kits are delivered directly to the doorsteps of Sierra Vista residence.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
 Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/21/2022 5:18 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Articles of Incorporation/Bylaws
Conflict of Interest Statement (if not included in Bylaws) Organization Chart
Board of Directors Roster – A current roster of the organization’s officers and members of its Board of Directors, which includes their name, position held, address, telephone number, and current employer(s). Please note any conflicts of interest falling under 24 CFR 570.611.

Board of Directors' authorization to request CDBG/ESG/ESG-CV funding Business License Number – The City of Stockton requires all non-profits to maintain a business license. Non-profits may obtain a business license, free of charge, on the 1st floor of City Hall.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Organization Financial Statements – Please submit one of the following:
 For organizations that received City funding in prior years: an audited or reviewed compilation report performed by a Certified Public Accountant for the most recent year.  For all other organizations, an audited report: a compilation report, or the organization’s bookkeeping records in the form outlined above (Balance Sheet, etc.), for the most recent year.

Tax Status – Each applicant must have 501(c)(3) or tax-exempt non-profit status. Please submit one of the following verifying documents:
 A determination letter from the U. S. Internal Revenue Service, confirming 501(c)(3) Tax-exempt status of organization
 A letter from the California State Franchise Tax Board certifying tax-exempt status of organization.

SAM.gov – screen shot of sam.gov registration
Personnel Policies including Affirmative Action Plan and Grievance Procedure Insurance certificate -Type of Insurance Carried, Bonding, Workers ‘Compensation  Project Budget – A copy of the project budget (separate from operational budget) showing all funding sources and uses. Identify specific items that City funds would pay for if approved. For public facility improvement/construction projects; care should be taken in presenting a budget which reflects accurate labor and material costs, including all sources and uses and budget assumption for development phases  Scope of Work including project timeline
 Affirmative Action Plan a written program in which an employer details the steps it has taken and will take to ensure the right of all persons to advance on the basis of merit and ability without regard to race, color, religion, sex, national origin, age, disability.
 Section 504 Handicap Accessibility of the ADA Section 504 states that "no qualified individual with a disability in the United States shall be excluded from or denied the opportunity to receive benefits and services from certain programs.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
Stockton CDBG 22-23 Project Budget.pdf
 Organization Operational Budgets *Required
21-22 FY Budget.pdf
2022-2023projected draft budget.pdf
 Organization Financial Statements *Required
Boys and Girls Final 20.pdf
 Tax Status *Required
BGC SAC IRS Letter.pdf
BGC SAC 501c3 Letter.pdf
 Board of Directors Roster *Required
Stockton Advisory Council Roster.pdf
BGCSAC Board Roster 2021-2022.pdf
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
 Articles of Incorporation/Bylaws *Required
Articles of Incorporation.pdf
BGCSAC ByLaws.pdf
 Conflict of Interest Statement *Required
Conflict of Interest Statement.pdf
 Organization chart *Required
BGCSAC Org Chart.pdf
 Board of Directors’ authorization to request CDBG/ESG funding *Required CDBG Letter of Authorization - Board Chair.pdf
 Business License Number *Required
Business license.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required Certificate (003).pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required Policies.pdf
 Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
 Evidence of Site Control
**No files uploaded
 SAM.gov - screen shot of sam.gov registration *Required SAM.gov registration.pdf
 Key Program Staff Resume *Required
Sierra Vista Branch Manager Resume.pdf
 Title Report
**No files uploaded
 Optional Documents
2021 Sierra Vista Impact Report_to print.pdf
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
Submit
Completed by [email protected] on 1/21/2022 5:24 PM
Case Id: 48634
Name: Boys & Girls Club at Sierra Vista-Stockton -
2022/23Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
Kimberly Key
Title
CEO
Date
01/21/2022
Signature
Kimberly Key
Electronically signed by [email protected] on 1/21/2022 5:19 PM Please download and upload the Certification page here.  Certification Page *Required
certification.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
Program Overview
Completed by [email protected] on 1/24/2022 7:37 AM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
A. Eligibility
Completed by [email protected] on 1/24/2022 7:38 AM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Service
If using ESG funds
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
B. Contact Information
Completed by [email protected] on 1/23/2022 7:28 PM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Bread of Life
B.2. Mailing Address
P.O. Box 446 Stockton, CA 95201

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Chris
B.4. Last Name
Johnson
B.5. Email
[email protected]
B.6. Phone Number
(209) 482-7098

POINT OF CONTACT INFORMATION
B.7. First Name
Gina
B.8. Last Name
Valadez
B.9. Email
[email protected]
B.10. Phone
(209) 471-4991

ORGANIZATION CONTACT INFORMATION
B.11. Website
www.breadoflifeca.org
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
B.12. DUNS Number
71,566,266
B.13. EIN Number
-900,624,281
B.14. Business License Number and Expiration Date
22-001332100 8/31/2022
B.15. Type of Agency
501(c)(3)
B.16. Number of Paid Staff
5 B.17. Number of Volunteers
500
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/21/2022 1:44 PM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
Bread of Life Food Pantry
C.2. Project Site Location
1006 N. Aurora St Stockton, CA 95202
C.3. Funding Requested in this application
$90,000.00
C.4. Other funds already secured for the project
$115,000.00
C.5. Total Cost to Complete Project
$390,000.00
C.6. Other funds not yet secured
$185,000.00
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/19/2022 9:40 PM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

Bread of Life's mission statement is "Bringing hope to families in times of need by providing generous amounts of nutritious, supplemental groceries to all who come regardless of race or religious affiliation. Teaching people to give by showing love and kindness to everyone who comes for food" D.2. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in each category. (For 2021 HUD income limits for the Stockton area, please refer to them here .

Income Limits Clients Served
Moderate Income (More than 80%) 2,007
Low Income (50%-80%) 3,741
Very Low Income (30%-50%) 7,614
Extremely Low Income (Less than 30%) 37,150
50,512
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 24,883 11,031
Black/African American 9,333 212
Asian 192 0
Am. Indian/Alaskan Native 2,035 331
Native Hawaiian/Other Pacific Islander 924 162
Am. Indian/Alaskan Native & White 558 155
Asian & White 236 41
Black/African American & White 885 128
Am. Indian/Alaskan Native & Black/African American 474 20 Other Multi-Racial 10,992 3,321
50,512 15,401
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 13,110
Female Headed Households 20,703
Seniors 12,642
Youth 11,520
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
Homeless 621
58,596
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 3
E. Project Funds
Completed by [email protected] on 1/24/2022 8:21 AM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

N/A No other application is being submitted.

E.2. Please indicate if this application is a request for one-time funding and/or “seed” funding. If not applicable, state “N/A.

N/A Request is not for one-time funding and/or seed funding.

E.3. If you are applying for additional funds for a current program/project, provide a status update on the existing funds and when funds will be fully spent. Please list all CDBG and ESG funds received within the last 3 years including funding amount and their status.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
$0.00 $0.00
FY2017/18
ESG
$0.00 $0.00
FY2018/19
CDBG
$0.00 $0.00
FY2018/19
ESG
$0.00 $0.00
FY2019/20
CDBG
Bread of Life
Food Pantry
City $15,000.00 complete $0.00
FY2019/20
ESG
$0.00 $0.00
FY2020/21
CDBG
Bread of Life
Food Pantry
City $30,000.00 complete $0.00
FY2020/21 ESG $0.00 $0.00
FY2021/22
CDBG
Bread of Life
Food Pantry
City $30,000.00 Underway $30,000.00
FY2021/22 ESG $0.00 $0.00
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 3
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

Current committed funds include: Church/private donations $115,000.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

Although Bread of Life's service area is not strictly defined, we have provided services throughout San Joaquin County and neighboring counties. We began our organization in Stockton to provide the large majority of our services within the city of Stockton (over 90%)
E.7. How does (will)your organization verify income eligibility of your clients? Area Benefit Project service area has been identified and determined to be statistically low-income based on the 2010 Census. If you use this method, provide all Census Tracts and Block Groups served by your project and a calculation of the low-income percentage. Please utilize the following web application to confirm eligibility . Area benefit applicants are required to confirm block groups/census tracts are eligible. Map depicting area with low/mod % is required with this application.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents No
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents No
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

No
Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 3
Number required at time of assistance). Please attach a blank worksheet under Required Documents No
Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

No
E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

Stockton CDBG funds will be used to help cover general costs for Bread of Life's Food Pantry Program, including rent for our warehouse space, wages for managing and implementing day to day operations including deliveries of food donations and running drop off and pick up events, utility costs for the programs warehouse space, insurance, IT, trucking and supplies. All the funds will directly support the day to day operations of our Food Pantry Program.

E.9. Select the common indicator that your agency will use to track clients.

The primary unit of service is the number of food boxes provided to the clients. We will also track the average weight of food provided ( average box weight). This will allow us to calculate total amount of food provided.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 55,000
Households 0
Other 0
55,000
E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

Bread of Life will continue to reach out to the community to inform those in need of our services. Our strategy for 2022 includes social media outreach and digital information including a revised website, and updated client information. We have added staff to increase the number of outreach events held monthly in low income areas within the city of Stockton. Partnering with multiple agencies will allow us to reach more limited English speakers and the disabled population throughout the city. We project an increase of diverse clients by 10%.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
F. Project Impact
Completed by [email protected] on 1/24/2022 8:04 AM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 2,300
Low Income (50%-80%) 4,200
Very Low Income (30%-50%) 7,500
Extremely Low Income (Less than 30%) 41,000
55,000
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 27,250 11,550
Black/African American 9,910 220
Asian 200 0
Am. Indian/Alaskan Native 2,150 340
Native Hawaiian/Other Pacific Islander 800 175
Am. Indian/Alaskan Native & White 590 160
Asian & White 250 50
Black/African American & White 1,000 150
Am. Indian/Alaskan Native & Black/African American 500 30 Other Multi-Racial 12,350 3,200
55,000
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 13,500
Female Headed Households 21,000
Seniors 13,200
Youth 12,000
Homeless 650
60,350
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
90 32,500 30,000
2020-2021 (Anticipated) 140 55,000 50,512
2021-2022 165 65,000 55,000
395 152,500 135,512
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

Bread of Life's Food Pantry provides supplemental food to families and individuals in need of additional food support.

We accomplish this through a basic two-step process of receiving donated food products and then box the items to be distributed at our drop off or pick up events.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

The need for service was determined simply by the response we receive for our services. There is a continued need due to the population growth and the increased housing costs and increased cost of living in Stockton. Stockton's poverty rate at 22.4% continues to be well above the states rate, indicating a higher number of individuals and families struggling to make ends meet.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 3
G. Project Narrative
Completed by [email protected] on 1/24/2022 8:27 AM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

Bread of Life's main activity is a year round food pantry service. We receive estimated 3.5 million pounds of food donation from local food distributors and farming/packing facilities per year. Food donations are received by the truck load, typically several times a week. These donated items are sorted and then stored in our warehouse. Our few employees then work with are large number of volunteers to repack food items into boxes for distribution to individuals and families who either request a drop off or come to one of our food pick up events. Additionally, surplus food supplies are often shared with other local non-profits to distribute in their programs. Bread of Life also works with other support services to assist with food drop off, especially during COVID, a practice that, if possible, will remain in place as a means to service those unable to attend our food pick-up events. Our goal is to provide as much food assistance as possible to those in need. This depends on a number of factors, including food donation availability, Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 3
storage capacity and request for food assistance. Currently, our staff and volunteers drop off food boxes approximately days 5-6 days a week and we run our pick up drive thru events 15-20 times per month between the hours of 8:00am and 1:00pm.

Project Activity or Program
Service #
Describe the Deliverable
1 We have increased our monthly events to multiple drive thru locations (15-20) in social economic areas in Stockton. We average 85-100 families at each event for a total of 1,700 families per month receiving approx. 127,500 lbs of groceries.
2 Our goal is to increase our program by 10%.

G.4. Describe your agency’s capacity to implement this program or project (identify agency’s federal grants managed, staff resources, skills and experience, number of years in operation, accomplishments to date, etc.).

Bread of Life has received grants from both the City and County for numerous years. Through these grants we have worked cooperatively with grantors to follow grant agreement requirements to develop our food pantry program.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
Our dedicated board, staff and volunteers work tirelessly to make our program happen. Our paid staff typically receive and organize donated food product with the help of volunteers. Then the same team, with an even larger set of volunteers, will create the donation boxes and provide them through various drop off and pick up events.

Project Deliverable # Describe the Deliverable
1 The program is overseen by Executive Director Chris Johnson. Chris will reach out to community leaders to identify the populations most in need. 2 We are revamping our website to publish dates and locations of our grocery distribution events. We are active social media to draw attention to low-income Stockton residents. 3 We have an active board that participates at events distributing grocery boxes throughout the month. With 5 paid staff and approx. 40-45 monthly volunteers we plan to increase our program by 10%.

G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? Our measure of success is the people we serve! Our hope and expectation is to be able to run as effectively and efficiently in 2021. We hope to be able to maintain or increase the number of clients served, if the need is there for our services. We hope to increase outreach with both clients and to increase cooperative efforts with other local non- profit organizations.

Deliverable # Task that Support Deliverable
1 We use a mobile app to register clients at each event. We plan to follow up with our clients throughout the year to let them know we care about their needs and to see if we can offer additional assistance.

Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 3
2 Our hope is to develop trusting relationships with our partner locations and clients to ensure people in Stockton are not going hungry.

G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
Our program does not directly target any special group for our program but our general outreach is simply to "people and families in need of assistance" and the large majority of those that receive our services are individuals and families that are in the low to very low income category and self identify as struggling to "make ends meet". We do not have any eligibility requirement to receiving services from our food pantry.

Although Bread of Life's food pantry is similar to other services in our area, we differ in several areas: we do not require an appointment for services, accessibility is free and easy, we do not have any requirements for service, and we provide drop-off service to those that can not make it to one of our pick up event locations.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

At Bread of Life, we strive to utilize our resources to fullest potential. The majority of our labor force are volunteer efforts including that of our main personal running our food pantry services. We also receive the vast majority of our food items through generous donations. Our assurance is providing donated items to those in need has resulted in enormous and continuous donation of products and volunteer efforts. Over the past decade, we have continued to grow as a nonprofit that is supporting our community. We strive to continue in our growth and organizational efforts to continue providing our services to all those in need.

To our knowledge, none of our employees sit on any community boards, commission or committees that would result in a potential conflict of interest. Neither do any of our current board members currently work for the City of Stockton or act as a City of Stockton Council member.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
H. ESG
Completed by [email protected] on 1/24/2022 10:04 AM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:

H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

H.3. Will the service to be provided with these funds fill a service gap needed to be addressed? H.4. Duplication of Benefits: Federal finance assistance was provided to my organization to addresses losses resulting from a federally declared emergency or disaster, and my organization has not received (or would receive, by acting reasonably to obtain available assistance) financial assistance for the same costs from any other source (including insurance) and the total amount of funding received does not exceed the total needs for those costs.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/21/2022 4:54 PM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/24/2022 10:15 AM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.1. Identify AT LEAST ONE barrier in implementing your program/project:
 A marketing and publicity campaign that provides consumers with additional education and information about the agency’s programs and services.
 Coordination and collaboration with other service providers.  Accessing and utilizing “un-tapped” resources
 Removing barriers that limit access to services and participation (e.g. language, time, cost, transportation, etc.).

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

Bread of Life provides information to our consumers through our website and outreach, such as social media and fliers. We are pursuing a more assertive outreach program including increased social media, emails, and coordination with other local nonprofits. We address barriers that may limit access to our services in several ways. We are eliminating barriers by distributing groceries either by direct drop off (as we did during the height of the pandemic) and by transporting boxed groceries to approximately 19 different locations, making our locations easily accessible to our recipients. We are continuing to expand our network of drop off locations to enhance availability to all.

J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients As stated in above (J.2.), Bread of Life's food pantry offers food pick up events at several sites throughout Stockton.

We are always looking to add additional pick up locations, especially if we are able to work with other organizations to provide additional service locations.

J.4. Identify AT LEAST ONE City of Stockton U.S. Department of Housing and Urban Development (HUD) FY 2020- 2025 Consolidated Goal that relates to your program/project:
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing. Expand the housing first model to provide permanent housing units with intense wrap-around services on-site.  Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
very low-income households. Provide homeownership opportunities for low-income-moderate income first-time buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/24/2022 2:34 PM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
2022 CBDG Project Budget.v1.xlsx
 Organization Operational Budgets *Required
2022 Operating Budget.xlsx
 Organization Financial Statements *Required
2022 Profit and Loss Report.pdf
 Tax Status *Required
IRS non profit tax id letter.pdf
 Board of Directors Roster *Required
2022 Directors pg 1.docx
 Articles of Incorporation/Bylaws *Required
Bylaws.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 4
Articles of incorp.pdf
 Conflict of Interest Statement *Required
43689_Conflict-of-Interest-Policy-BOL.docx
 Organization chart *Required
2022 Organizational Chart.docx
 Board of Directors’ authorization to request CDBG/ESG funding *Required 2022 Board of Directors Authorization to Request Funding.docx  Business License Number *Required
2022 business lic.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required 2022 City of Stkn COI A.pdf
2022 City of Stkn COI B.pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required 2022 Bread of Life.Grievance Policy.docx
 Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
Grupe rental agreement.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 4
 Evidence of Site Control
**No files uploaded
 SAM.gov - screen shot of sam.gov registration *Required 2022 Sam registration.pdf
 Key Program Staff Resume *Required
Chris Johnson Resume.doc
 Title Report
**No files uploaded
 Optional Documents
**No files uploaded
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
Submit
Completed by [email protected] on 1/24/2022 2:39 PM
Case Id: 48597
Name: Bread of Life - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
Gina Valadez
Title
President
Date
01/24/2022
Signature
Gina Valadez
Electronically signed by [email protected] on 1/24/2022 2:34 PM Please download and upload the Certification page here.  Certification Page *Required
2022 Signature page.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
Program Overview
Completed by [email protected] on 1/10/2022 4:50 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
A. Eligibility
Completed by [email protected] on 1/21/2022 4:22 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Service
If using ESG funds
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
B. Contact Information
Completed by [email protected] on 1/21/2022 4:24 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Children's Home of Stockton
B.2. Mailing Address
430 N. Pilgrim Street Stockton , CA 95205

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Joelle
B.4. Last Name
Gomez
B.5. Email
[email protected]
B.6. Phone Number
(209) 395-3525

POINT OF CONTACT INFORMATION
B.7. First Name
Joelle
B.8. Last Name
Gomez
B.9. Email
[email protected]
B.10. Phone
(209) 395-3525

ORGANIZATION CONTACT INFORMATION
B.11. Website
www.chstockton.org
B.12. DUNS Number
80,123,839
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
B.13. EIN Number
940,382,320
B.14. Business License Number and Expiration Date
21-00051543
B.15. Type of Agency
501(c)(3)
B.16. Number of Paid Staff
87 B.17. Number of Volunteers
40 Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/21/2022 4:32 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
Children's Home of Stockton's Catalyst Program
C.2. Project Site Location
430 N. Pilgrim Street Stockton, CA 95205
C.3. Funding Requested in this application
$200,000.00
C.4. Other funds already secured for the project
$207,800.00
C.5. Total Cost to Complete Project
$1,217,280.00
C.6. Other funds not yet secured
$1,009,480.00
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/24/2022 12:53 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

For 140 years, Children’s Home of Stockton has provided at-risk youth an opportunity for a productive life through treatment and education in a safe, nurturing environment.

Income Limits Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 0
Extremely Low Income (Less than 30%) 140
140
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 78 35
Black/African American 56 2
Asian 3 0
Am. Indian/Alaskan Native 2 0
Native Hawaiian/Other Pacific Islander 1 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 0 0
140 37
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 0
Female Headed Households 0
Seniors 0
Youth 140
Homeless 0
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
140
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 7
E. Project Funds
Completed by [email protected] on 1/24/2022 1:30 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

E.1. If you are submitting more than one application for Stockton funding, enter the numerical ranking of the priority of this proposal and the total number of proposals your agency is submitting for the coming fiscal year. 1 of 2
E.2. Please indicate if this application is a request for one-time funding and/or “seed” funding. If not applicable, state “N/A.
one-time funding
E.3. If you are applying for additional funds for a current program/project, provide a status update on the existing funds and when funds will be fully spent. Please list all CDBG and ESG funds received within the last 3 years including funding amount and their status.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
N/A N/A $0.00 N/A $0.00
FY2017/18
ESG
N/A N/A $0.00 N/A $0.00
FY2018/19
CDBG
N/A N/A $0.00 N/A $0.00
FY2018/19
ESG
N/A N/A $0.00 N/A $0.00
FY2019/20
CDBG
Purchase of
CHS Cafeteria
Tables/Stools
City $22,497.36 Complete $0.00
FY2019/20
ESG
N/A N/A $0.00 N/A $0.00
FY2020/21
CDBG
N/A N/A $0.00 N/A $0.00
FY2020/21 ESG Catalyst
Program
City $1,500,000.00 Underway $1,416,011.00
FY2021/22
CDBG
N/A N/A $0.00 N/A $0.00
FY2021/22 ESG Catalyst
Program
City $1,500,000.00 Underway $819,544.00
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 7
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

The City of Stockton funded 1.5 million from ESG/CV funding for our Catalyst Program from April 1, 2021, until September 30, 2022. This is an 18-month grant contract. The current City of Stockton contract is attached. We do not have any committed funding sources after September 30, 2022, but will continue to pursue funding and secure donations to support our Catalyst Program. We are applying for the City of Stockton’s ESG funding along with a San Joaquin County CDBG grant funding request for our Catalyst Program.

Private grants and fundraising efforts such as special events and campaigns help to supplement public funding for Catalyst. CHS will apply annually for public and private funding to support Catalyst. However, funding from government sources can fluctuate greatly and be unreliable from year-to-year, pending the federal and state budgets.

The pandemic has resulted in an increased demand for services and the opening of Catalyst has provided immediate shelter and safety for 18 homeless youth. Any loss of funding could affect the core operations for Catalysts, and downsizing the program could be a possibility, leaving at-risk youth homeless and without supportive services. All three Catalyst homes operate 24-hour programs requiring round-the-clock staffing. Over the past year, Catalyst has been operating at capacity. If funded for less than the requested amount, the agency will seek out additional streams of public and private funds to help offset the funding deficit. However, Children’s Home of Stockton may be forced to reduce beds and services at Catalyst. Catalyst (and the safety and services they provide) are often the only thing standing between youth and homelessness. Children’s Home of Stockton Catalyst Program is a necessary resource for the health and safety of homeless youth.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

Children’s Home of Stockton’s Catalyst Program serves homeless youth who are identified and referred from within the City of Stockton. Catalyst will accept you who are from the City of Stockton or from San Joaquin County. A Referral Committee was created to introduce this new resource to the community and help to refer Transition Age Youth to the Catalyst program. The committee is made up of local community-based organizations who serve the Transition Age Youth (TAY) experiencing homelessness in the City of Stockton, law enforcement, city and county departments, system providers, school liaisons to name a few. In addition, we work with local businesses and employment development programs to find employment in Stockton for our youth.

Since the opening of Catalyst, it is the largest housing program for homeless youth in the City of Stockton with 18 beds. Only one other program exists for this specific population with eight beds.

E.7. How does (will)your organization verify income eligibility of your clients? Area Benefit Project service area has been identified and determined to be statistically low-income based on the 2010 Census. If you use this method, provide all Census Tracts and Block Groups served by your project and a calculation of the low-income percentage. Please utilize the following web application to confirm eligibility . Area Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 7
benefit applicants are required to confirm block groups/census tracts are eligible. Map depicting area with low/mod % is required with this application.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents Yes
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents No
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes
Our Catalyst Program serves Transition Age Youth ages 18-24 who have a need of Transitional Housing and are of extremely low-income. Without our programs, these clients would be homeless on the street or at-risk of becoming homeless.

Homeless youth: During the 2021/2022 fiscal year, Children’s Home of Stockton will have served 18 individuals in Catalyst first year of opening the program for homeless youth. Every current Catalyst participant knows at least one homeless youth who is not receiving services, and a waiting list exists at any given time. Homeless youth are often “invisible” to the official entities that track such data and, until recently, no count of homeless youth in the county has been available. The Federal No Child Left Behind Act now requires that schools report the number of homeless students enrolled. In the 2019/2020 school year, San Joaquin County Office of Education reported a total of 2,648 homeless youth enrolled in their schools. It is estimated that there are at least 150 youth on the streets in San Joaquin County every night. Homeless youth have often run away from home due to abuse or neglect, and they are at high risk for substance abuse, poor physical and mental health, sexual abuse and assault, physical abuse and unsafe sexual practices.

Most youth staying at Catalyst have no income, or income from low-income households. Many have run away from home because they were abused or neglected, and many have victimized or forced into prostitution on the streets. At Catalyst, they find a safe place and have their basic and unique needs met. As they learn that there are adults they can trust and they receive supportive services, they begin to see their own potential and have hope for their futures.

Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Number required at time of assistance). Please attach a blank worksheet under Required Documents No
Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

Yes
Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 7
Catalyst participants self-refer or are referred through community partnerships who work with the extremely low- income, at-risk, and homeless Transition Age Youth in our community. We enter data in the Homeless Management Information System (HMIS) which documents their participation in the program and tracks them within the community. In addition, we are members of the Community Care Network (CCN) of San Joaquin County for referrals.

CCN is designed to help address the 80% of non-clinical factors impacting individual’s health. CCN is a product of United Way of San Joaquin County, 211, and Dignity Health who are working on a community-wide technological solution initiative to help address the social determinants of health that are greatly impacting individual’s ability to live their best lives.

E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

CHS intends to use the City of Stockton CDBG/ESG funds to fund a portion of the Catalyst Program. In 2021, Children’s Home of Stockton, in collaboration with United Way of San Joaquin County, and funding provided by the City of Stockton, opened Catalyst, a 12-bed Transitional Housing Program for homeless Transition Age Youth (TAY) ages 18-

24. The purpose is to provide supportive housing, workforce development, mental health services, case management, education, and resources to other services. The goal is to help prevent youth homelessness and establish self- sufficiency and find permanent housing for Participants as they exit Catalyst. Providing a supportive safe place for our TAY participants allows them to focus on continuing their education or finding employment rather than surviving the streets and being vulnerable to risky and dangerous situations. This funding will be applied to sustain our Catalyst Program, which now has the capacity to serve 18 Transition Age Youth concurrently.

Catalyst fills a critical need in our community help prevent and end youth homelessness. It meets the shelter and service needs of Transition Age Youth who are required by circumstance to live on their own. Many have aged out of the foster care system and are still in need of support including a safe place to live with basic needs met so they can focus on their mental health, employment, or education. Many of our Transition Age Youth have experienced childhood trauma, homelessness, couch surfing, or living in their car. They have endured lack of family support, basic needs for survival, food insecurity and community connection. Many are high school dropouts and without this opportunity they are at risk for continuing the cycle of poverty and crime. Often this age group of 18-24 doesn’t qualify for other shelter or housing services. Before the opening of Catalyst, there were only eight beds for homeless youth in the City of Stockton.

Catalyst gives its participants safe and stable accommodations in a family-style setting while surrounding them with the services they need to achieve independence. Transition Age Youth participants take charge of their case management and transition planning in conjunction to being provided access to services, which are facilitated by dedicated staff including the following: Youth Services Director, TAY Coordinators, TAY Clinicians, TAY Coaches, and TAY Outreach Workers. In addition, referrals and contacts for youth are made to agencies that CHS has formal and informal partnerships with throughout the community. CHS operates in a culturally sensitive, trauma informed environment with case management, mental health, vocational and educational services tailored to each participant’s individual needs, strengths, and growth opportunities.

Catalyst uses a Positive Youth Development and a Trauma-Informed approach, in conjunction with Evidence-Based Practices to increase youth safety, well-being and self-sufficiency. With the support of Catalyst staff, TAY participants can build permanent connections with caring adults and build strong ties to their community. Youth play a key role in program planning and work in partnership with staff.

Transition Age Youth participants have opportunities for meaningful community involvement activities as well as Attachment A
Printed By: Kayla Martin on 4/1/2022 5 of 7
support in setting and achieving educational and employment goals. Youth can make positive developmental progress as a result of life skills training, counseling support, and the availability of appropriate services. The TAY Coordinators, TAY Coaches, and TAY Outreach Workers work collaboratively with TAY participants to develop comprehensive written transition plans, enabling youth to successfully exit the shelter and achieve safety and stability. Aftercare services ensure follow-up and ongoing support to help youth maintain independence up to six months after they leave the Catalyst Program. Transition Age Youth participants can stay in the Catalyst Program as long as they need to achieve their personal goals within their individual timelines established upon intake. The end goal is to reduce the percentage of Transition Age Youth who are homeless in the City of Stockton. That is why funding from City of Stockton is so imperative.

We collaborate with community organizations and local employers to assist our Transition Age Youth with finding steady employment. One example of this, is the relationship we have with Food-4-Less, which has become a direct pipeline for our Catalyst TAY participants who need employment.

E.9. Select the common indicator that your agency will use to track clients.

The primary unit of service is hours of case management for the services provided. Our performance indicators are as follows:

1. Percentage of TAY participants served.

2. Percentage of TAY participants receiving Transition Planning and needed Aftercare services.

3. Percentage of TAY participants transitioning to stable and permanent living situations.

4. Percentage of TAY participants who demonstrate improvement in basic life skills and increased self-sufficiency and independence.

Catalyst TAY Program measures success in many ways just as each Transition Age Youth is unique. For all individuals our goal is to provide safety, transitional housing, and more independence through supportive services and resources.

To that end, we measure the effectiveness of our efforts by:

1. Intake Assessment and Exit Survey. We will conduct an initial Intake Assessment and exit satisfaction surveys with TAY participants. Results are used to affirm and to improve practices and services to our Transition Age Youth.

2. Use of the Transition to Independence Process (TIP) Model. The use of the TIP Model will track the effectiveness of services by measuring the participant’s progress in the program and attainment of individual goals.

3. Positive Audits. Completion of successful audits and site visits through the City of Stockton. Reviews will reflect the Catalyst Program’s ability to provide a safe and motivating environment that meets the differing needs of the Transition Age Youth.

If awarded, we will continue to submit invoices for budgetary items along with required data into the Homeless Attachment A
Printed By: Kayla Martin on 4/1/2022 6 of 7
Management Information System (HMIS) for services of case management. All our key program staff have been trained and are experienced in tracking the program and submitting what is necessary.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 18
Households 0
Other 0
18 E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

Children’s Home of Stockton collaborates with other local nonprofits, government entities, medical facilities, law enforcement agencies, service clubs and the business community to conduct outreach, raise awareness, and let those in need know about the services the agency offers. Information about CHS’ services is advertised through print materials handed out at events and distributed in the community, on the agency’s website, in press releases, and radio PSAs.

CHS continues to work to provide trauma informed, culturally sensitive services that are responsive to the growing need of the county’s diverse population.

Catalyst provides housing and supportive services to 18 homeless youth concurrently. Our Catalyst Program is staffed round-the-clock and operates 24 hours a day, 7 days a week, 365 days a year. Catalyst will provide basic necessities, specific services tailored to homeless transition age youth, and case management or exit planning to help participants reach their goals.

Besides providing transitional housing to at least 18 youth aged 18 to 24, Catalyst provides food, clothing and basic necessities; individual therapy, life skills training, vocational learning opportunities, and support groups. Catalyst helps youth work toward their educational goals and secure employment and permanent housing. Clinicians work with youth to identify barriers in their lives and overcome past trauma. TAY Coaches work with youth to take steps toward independence and prepare to exit Catalyst and become self-sufficient.

United Way of San Joaquin County has partnered with Children’s Home of Stockton to assist with the marketing and outreach of the Catalyst Program, which includes assisting CHS in developing ways to showcase the success of the program, highlight TAY participant stories, track outcomes and market the Catalyst Program within the community to increase referrals.

Children’s Home of Stockton created a Catalyst Referral Committee made up of collaborative partners, including the City of Stockton, City of Stockton Police Department, Women’s Center Youth & Family Services, Child Abuse Prevention Council, Delta College, Family Justice Center, Stockton Shelter for the Homeless, and many more, to identify potential Transition Age Youth who are facing homelessness or at risk of becoming homeless. These partners interface on a weekly basis with those in need of shelter and supportive services like the Catalyst Program.

Our Catalyst Program has dedicated TAY Outreach Workers who provide “boots on the ground” work and outreach to those Transition Age Youth ages 18-24 in Stockton who need our program. They collaborate with other community agencies to find information about how TAY homeless youth can be referred to Catalyst.

Attachment A
Printed By: Kayla Martin on 4/1/2022 7 of 7
In addition, Children’s Home of Stockton as a non-profit organization does outreach to the community in several ways. We mail annual campaign letters, an impact report, and holiday cards each year to a donor base of over 8,000 community members. Also, CHS has a website and utilizes social media platforms to bring awareness to its programs and services. Our in-person large community tours are on hiatus due to COVID-19, but we do offer virtual tours.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 3
F. Project Impact
Completed by [email protected] on 1/24/2022 12:54 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 0
Extremely Low Income (Less than 30%) 18
18 F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 10 5
Black/African American 5 0
Asian 0 0
Am. Indian/Alaskan Native 0 0
Native Hawaiian/Other Pacific Islander 1 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 2 0
18 F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 0
Female Headed Households 0
Seniors 0
Youth 0
Homeless 18
18 Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 3
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
145 52 145
2020-2021 (Anticipated) 140 34 140
2021-2022 158 52 158
443 138 443
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

CHS would continue to sustain operations and services for its Catalyst Program which includes providing shelter and supportive services for up to 18 Transition Age Youth age 18-24 who would otherwise be homeless or at-risk of homelessness. Catalyst offers supportive housing, workforce development, job readiness, mental health services, case management, education, and resources to other services so TAY homeless youth can achieve self-sufficiency and permanent housing.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

Children’s Home of Stockton is celebrating its 140th anniversary. CHS has been in existence since 1882. It is the largest licensed Short-Term Residential Therapeutic Program in San Joaquin County, that has been serving at-risk foster youth in San Joaquin County and throughout California. We have remained strong in our mission to provide the highest quality of care to serve the needs of a vulnerable population of youth in our community.

When our Short-Term Residential Therapeutic Program youth leave CHS, we ensure they have a Transition Aftercare plan in place and provide supportive services for our youth and their families for up to six months after they leave our care. But for many high-risk foster youth who age out of the system at age 18, that is not the case. Our Catalyst Program is needed because it addresses San Joaquin County’s growing housing crisis and barriers regarding homeless youth that has only been exacerbated by COVID-19. We formed the Catalyst Referral Committee with local community organizations who serve the TAY homeless population and see a direct need for our program. It serves as a direct way to provide outreach and identify TAY participants who are eligible for our Catalyst Program.

Homelessness in San Joaquin County is an ever-present challenge. According to the 2020 San Joaquin County’s Strategic Plan and the Continuum of Care’s (CoC) Point-in-Time (PIT) Count, from 2015 to 2019, the number of people identified as experiencing homelessness has increased dramatically. It has grown from 1,708 to 2,631 individuals, an increase of 56%. It found that 5.6% of people experiencing homelessness were Transition Age Youth (TAY) between the ages of 18 and 24 years (148 out of 2,631). According to the San Joaquin Continuum of Care, 2019 Homeless Census and Survey, Data Dashboard, the number of people who are experiencing unsheltered homelessness is highest in Stockton (921 individuals). This is not surprising given that Stockton is the largest city in the county and is also the hub for many of the services available in San Joaquin.

The PIT Count may also be an underrepresentation of the young adults facing homelessness. In 2018, San Joaquin County’s Homeless Management Information System (HMIS) tracked a total of 1,000 homeless individuals 18 to 24 Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 3
years old who were provided services. This proves there aren’t enough shelters or beds to accommodate the need.

We opened our Catalyst Program because of the significant need for Transition Age Youth within the community to have continued support which includes immediate housing, case management, counseling, mental health services, life skills training, workforce development, assistance with workforce development, job search and preparation, assistance with continued education, and referrals to substance abuse treatment, or other necessary programs. We understand that in addition to safe housing, Transition Age Youth with extensive histories of homelessness often require comprehensive service engagement and relationship-building with supportive staff to establish a foundation of trust and rapport so they can successfully exit homelessness permanently. Our hope for every Transition Age Youth participant is to establish self-sufficiency and permanent housing as they leave the Catalyst Program.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 5
G. Project Narrative
Completed by [email protected] on 1/24/2022 10:25 AM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

G.1. How would you characterize your program/project based on the continuum of approaches to housing and public service needs listed below: (Select Top Three)
 PREVENTION - Helps prevent a problem before it emerges  EARLY INTERVENTION - Addresses a problem in its early manifestation to keep it from becoming worse  TRANSITION - Helps move clients toward a better situation, lower level of need, etc.  MAINTENANCE - Helps to ensure that clients do not decline, etc.  SELF-SUFFICIENCY - Helps move clients toward a situation in which they will no longer need the program or service
 STABILIZATION - Helps clients attain stability so that they can work toward a better situation G.2. Describe in detail how the program/project will address each of the 3 housing and public service needs selected above (i.e. how it specifically addresses prevention/early intervention etc.) CHS opened its Catalyst Program, a Transitional Housing Program for homeless Transition Age Youth (TAY). We are addressing the homeless crisis for these young adults by preventing them from living on the streets without easy access to services where they remain at-risk of suffering additional trauma, substance abuse, human trafficking, mental health crisis, becoming victims of crime, and poverty in addition to physical health risks.

The Catalyst Program will provide shelter and supportive services for up to 18 Transition Age Youth who are accepted into the program. The purpose of our Catalyst Program is to provide supportive housing with constant staff support, workforce development, mental health services, case management, education, job training, and linkages to other services for unsheltered Transition Age Youth ages 18-24 years old, experiencing homelessness or at-risk of becoming homeless.

By identifying the needs of our at-risk youth and Transition Age Youth participants and offering them direct services or referrals to direct services within our community we are providing early intervention. Our Catalyst Program houses and assists Transition Age Youth ages 18-24 experiencing homelessness or at-risk of becoming homeless. Through early intervention services we are transitioning clients toward a better living situation and providing housing, preventing homelessness, and helping them to build a solid foundation so they can progress to living independently and become self-sufficient.

Our proposed project includes continuing our services and placement for our TAY population in our Catalyst Program.

This program has been in existence since April 2021. There is no implementation time if we receive funding from the City of Stockton. We would begin our grant year on July 1, 2022, and funding would end on June 30, 2023. There are staff on-site to support the TAY participants including a Youth Services Director, TAY Coordinators, TAY Clinicians, TAY Coaches, TAY Outreach Workers. Maximum amount of time a Transition Age Youth could spend in the Catalyst Program is 12 months or by their 25th birthday, whichever occurs first.

Catalyst participants reside in fully furnished 3-bedroom houses (2 per room) which includes a laundry room, two bathrooms, large communal areas, and a secure parking lot. We employ a Resource Officer for security purposes.

Participants are provided food, clothing, hygiene items, have access to computer stations with printers and Wi-Fi, access to an on-campus gym, pool, and community activities. The program services include life skills, mental health counseling, educational assistance, career assistance, and transportation assistance.

We accept referrals from those participants who either self-refer or a who are referred by another organization.

Participants must complete an application and within 24-48 hours our staff will contact the potential TAY participant to set up a time to interview them. During their interview staff will assess the TAY participant to see if the Catalyst Program would be a good fit for them. There is limited space and applications are accepted on a rolling basis. We currently have a waitlist.

The case management they receive includes goal setting in all areas of employment, housing/living situation, education, community involvement/social skills, personal effectiveness/health and wellbeing, and finally, emotional and behavioral wellbeing. We follow an evidence-based model called the Transition to Independence Process (TIP) model which includes future planning based on individual strengths, needs, and goals. Case management begins when they enter the program and receive constant staff support in the home. Strengths, needs, and goals are assessed and updated weekly during case management with their respective TAY Coaches. They learn basic living skills, participate in daily chores, food shopping, financial literacy, and individual/group therapy as they cohabitate with their peers in the house.

Again, Transition Age Youth participants can stay in the Catalyst Program as long as they need to achieve their personal goals within their individual timelines established upon intake. As each TAY participant reaches their goals, they will acquire what is needed to graduate the program successfully. Once their goals are completely met and they are ready to transition, they will receive assistance with Transitional needs for up to six months.

Project Activity or Program
Service #
Describe the Deliverable
1 see above
G.4. Describe your agency’s capacity to implement this program or project (identify agency’s federal grants managed, staff resources, skills and experience, number of years in operation, accomplishments to date, etc.).

CHS has been in existence for 140 years serving at-risk youth. It has a sterling reputation and continues to grow in service provisions to meet the needs presented by an ever-changing population.

We are proud of our accomplishments as the largest 34-bed STRTP in Stockton, licensed by the State of California Department of Social Services, and nationally accredited by the Council on Accreditation. In January 2019, CHS was certified by the San Joaquin County Behavioral Health Services as a Medi-Cal Provider offering Specialty Mental Health Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 5
Services. We have a highly successful Transition Aftercare program that ensures our youth and their families’ individual needs are addressed and that they have a successful transition out of the foster care system.

In 2021, we initiated our HOPE (Healing, Overcoming & Providing Empowerment) Program which provides outreach and coordinated supportive services to foster youth ages 12-18 years old who are identified as Commercial Sexual Exploitation of Children (CSEC) or who are at risk of being trafficked. This program specifically addresses the needs of the upward trending population of CSEC youth we serve and ensure safety and resources while in our care. We can address the high risk needs of this population of youth, by creating a stronger infrastructure of supportive services for our CSEC population.

Our latest accomplishment of 2021 was the creation an implementation of our Catalyst Program which is a partnership with United Way of San Joaquin County and funding provided by the City of Stockton. We were able to staff our Catalyst Program with employees who have longevity working at Children’s Home of Stockton and expertise in working with this population of at-risk individuals. Our staff are Trauma-Informed and provide culturally sensitive care.

Our program leadership team includes a seasoned Youth Services Director with over 13 years of experience working with the at-risk homeless youth population in areas of prevention education and Transition Aftercare support. This is followed by a TAY Transition Coordinator with over 30 years’ experience working with at-risk homeless and foster youth. (We are currently recruiting a second TAY Coordinator.) Our TAY Clinicians combined have over 35 years of experience in providing services to at-risk youth, homeless youth, and foster youth. Our TAY Coaches and Outreach workers have worked within the community and with the at a-risk homeless population for multiple years. All our Catalyst Staff are caring and dedicated advocates for the clients we serve.

Currently, we don’t have any Federal Grants but manage several private and public grants for our programs and services including a San Joaquin County Non-Government County General grant for our Transition Aftercare Program, a City of Stockton HHAP 1 grant and San Joaquin County HHAP 2 grant for our HOPE Program, a San Joaquin County Behavioral Health Services grant to provide Specialty Mental Health Services and City of Stockton’s ESG/CV funding for our Catalyst Program. We serve up to 140 youth per year who reside in our STRTP and up to 18 TAY participants in our Catalyst Program. We employ 87 staff (and growing) and operate on a $8.6 million dollar budget. We have the capacity to continue implementation of this existing program, provide timely quarterly reporting and ensuring the funds will be spent appropriately.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
Our Catalyst Program has been in existence since April 2021 and services have been ongoing. There is no start-up time required. Continuation of this program is facilitated by a Youth Services Director, who oversees the program, TAY Coordinators who provide day-to day house and program supervision, TAY Clinicians who provide clinical services, TAY Coaches who provide mentorship and case management to Transition Age Youth participants, and TAY Outreach Workers, who assist the TAY Coaches but also facilitate marketing and outreach efforts throughout the community.

Our Transition Age Youth participants have full access to each service as part of their stay.

In addition, we have support from United Way of San Joaquin County who helps to disseminate information throughout the community regarding services for Catalyst and how potential participants can gain access to our programs and services. Finally, the Catalyst Referral Committee actively refers TAY participants within the City of Stockton to the Catalyst Program.

Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 5
Project Deliverable # Describe the Deliverable
1 see above
G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? We will measure the effectiveness of our Catalyst Program by the number of TAY participants we are able to provide critical services to and continue to provide Transitional Housing services for. Their success will be measured by tracking the Transition Age Youth’s progress and achievement of their transitional goals. We also look at how they achieve independence and transition to more permanent housing when they leave. Finally, we measure the basic life skills that they improve upon or obtain while in our program. We track their data in the Homeless Management Information System (HMIS) and submit quarterly reports to the City of Stockton. We have attached the Scope of Work to this application explaining the objectives, activities, outputs, outcomes, and impact we expect to track for the Catalyst Program and its TAY participants.

We document their success stories through our social media, marketing pieces, Impact Reports, and website. The results we expect to achieve are to continue operations as we always have and provide needed services for our TAY participants so that each one can succeed in becoming self-sufficient, find permanent housing, and establish employment before they transition out of our Catalyst Program.

Deliverable # Task that Support Deliverable
1 see above
G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
The Transition Age Youth we serve in our Catalyst Program are 18-24, homeless or at-risk of homelessness, and in need of services where they will receive job preparation, assistance with enrolling into college or trade school, strength-based planning services, learn independent living skills, group therapy, mentorship, and guidance in achieving goals for becoming more independent adults and transitioning to more stable living situations. To be eligible for our program they must be 18-24 and experiencing homelessness or at-risk of becoming homeless. They may self- refer or be referred by another agency. We interview applicants to become familiar with their situation and to decide whether the Catalyst Program is the right fit for them.

Based on the San Joaquin County Continuum of Care and Point-in-Time Count regarding homeless youth and young adults, there are very limited resources within the City of Stockton. We are the largest Transition Age Youth (TAY) shelter in the city. In addition to Catalyst (18 bed capacity), only one other provider offers eight beds to homeless TAY youth in the City of Stockton.

Our Catalyst Transitional Housing Program serves male, female, transgender, and LGBTQ TAY clients, ages 18-24. Most places that offer services and shelter for the TAY population are limited to age 21. Our TAY participants have access to a Youth Services Program Director, TAY Coordinators, TAY Clinicians, TAY Coaches, TAY Outreach Workers, and a Resource Officer for safety. They are provided supportive services, vocational opportunities, and referrals for outside Attachment A
Printed By: Kayla Martin on 4/1/2022 5 of 5
community resources.

Catalyst is a partnership with the City of Stockton and United Way of San Joaquin County. The list of agencies that we collaborate and partner with on our Catalyst Referral Committee are the following: City of Stockton Police Department, San Joaquin County Family Justice Center, Child Abuse Prevention Council, Parents-by-Choice, San Joaquin Pride Center, Without Permission, Community Partnership for Families of San Joaquin, San Joaquin County Office of Education, Women’s Center-Youth & Family Services, Housing Authority County of San Joaquin, and many more. In addition, these organizations have been oriented and have agreed to be a source of referrals for outside services.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

Children’s Home of Stockton is committed to maintaining funding and staffing in order to sustain its critical services and shelters for homeless youth in the City of Stockton. In addition to annual renewal applications for local government funding, the agency is aggressively seeking out new funding sources to sustain and grow community support for Catalyst. The agency has been successful in securing new private funding sources to better diversify its funding streams.

Additional funds will be raised through private and public grants and charitable donations. Every year, we research and apply to multiple grants to sustain our vital programs and services. Every Fall, CHS initiates a Major Gifts Campaign to raise awareness and unrestricted funds. CHS continues to seek out new funding sources, form strategic partnerships, and build its endowments to sustain the agency’s annual operating budget to support and grow its services throughout the county.

CHS will continue to look to local businesses, civic groups, and service organizations to help to build a strong foundation to sustain the agency long-term.

There is no conflict of interest.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
H. ESG
Completed by [email protected] on 1/21/2022 5:32 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:

H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

During the pandemic, the Catalyst Program provided 18 homeless Transition Age Youth a safe, warm, and clean place to live, instead of on the streets or at a crowded shelter where they would be more likely to be exposed to COVID-19.

We follow safety protocols including promoting and incentivizing vaccinations, sanitizing our houses, requiring all TAY participants and staff to wear masks, social distancing, and providing COVID-19 testing. Our TAY participants safety is the highest priority. In the event of an outbreak, we have a COVID-19 Emergency Response Plan in place to minimize exposure and prevent the spread of COVID-19 amongst the TAY participants and staff. In addition, we provide clean water, healthy food, clothes, and hygiene products for all our Transition Age Youth. If they need medical care, we assist them with finding that care along with transportation to any medical office.

No
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/24/2022 11:38 AM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

N/A
I.4. Does the agency own or lease the property where the project will occur? Who is the legal property owner? If you are leasing, please provide a copy of the lease in the required documents section. If you do not have site control, describe your site control plan.

We lease the property where we utilize three houses for our Catalyst Program. The Children's Home of Stockton Foundation owns the property. The lease is attached.

I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

N/A
I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

N/A
I.7. Has a market study, property needs assessment and/or other evaluation that identifies the need for the proposed project been completed? If so, describe and upload the project reports and schedule). If no reports have been completed, explain how you plan to proceed.

N/A
I.8. When will construction start and end? Provide a timeline with all critical milestones.

N/A
I.9. Is this project a multi-phased activity?
No
I.10. Will this project require implementation of Davis-Bacon/Fair Labor Standard Act requirements? Note: Please contact staff immediately if you have questions regarding Davis-Bacon requirement or for more informationclick Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
here.

No
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

Catalyst is an existing program and officially opened in April 2021.

I.12. For Economic Development activities only. Indicate the number of full-time and part-time jobs you expect to be created and retain, if your application is funded. Also indicate number of jobs likely to be filled by a low-income person:

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/21/2022 5:36 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.1. Identify AT LEAST ONE barrier in implementing your program/project:
 A marketing and publicity campaign that provides consumers with additional education and information about the agency’s programs and services.
 Coordination and collaboration with other service providers.  Accessing and utilizing “un-tapped” resources
 Removing barriers that limit access to services and participation (e.g. language, time, cost, transportation, etc.).

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

CHS created the Catalyst Referral Committee made up of numerous community organizations within Stockton and San Joaquin County to remove that barrier. We continue to expand participation within the committee to increase our referrals and accept new Transition Age Youth experiencing homelessness or at risk of becoming homeless within our program. Another way we address this barrier is through our TAY Outreach Workers who continue to provide educational and informational presentations throughout the community. CHS’ CEO is the founder and Chair of the San Joaquin County Human Trafficking Task Force which consists of over 40 government and non-government organizations that work rescue, protect, and restore youth involved in human trafficking. CHS is also a member of the Youth Action Committee who is made up of various community-based organizations who serve the target demographic of Transition Age Youth experiencing homelessness or at risk of homelessness.

J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients We are located by RTD bus stations, and we will provide bus passes, Uber transports, or bicycles. If there is a TAY participant in need of immediate transportation, we will do so in our CHS vehicles to remove any existing barriers for our clients. If needed, we also have funds available to assist our TAY participants with car payments, repairs, insurance, etc.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
 Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income households. Provide homeownership opportunities for low-income-moderate income first-time buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/24/2022 2:37 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
CHS Catalyst Program Budget (CDBG).pdf
 Organization Operational Budgets *Required
CHS Operational Budget FY 2021-2022.pdf
CHS Operational Budget FY 2022-2023.pdf
 Organization Financial Statements *Required
CHS Audit 2021.pdf
 Tax Status *Required
CHS_IRS_Determination_Letter.pdf
 Board of Directors Roster *Required
CHS Board Roster 2021-2022.pdf
 Articles of Incorporation/Bylaws *Required
CHS Restated Articles of Incorporation.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 4
CHS Bylaws.pdf
 Conflict of Interest Statement *Required
CHS Conflict of Interest Policy-Employees.pdf
 Organization chart *Required
CHS Organization Chart 2022.pdf
 Board of Directors’ authorization to request CDBG/ESG funding *Required CHS Board Authorization.pdf
 Business License Number *Required
CHS Business License 2021.pdf
CHS Business License Statement 2022.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required CHS Liability & Workers Comp Insurance.pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required CHS-EEO, AA, & Conflict Resolution Personnel Policy.pdf  Use Permit/State License (as applicable)
CHS Use Permit-State License Statement.pdf
 Rental or Lease agreement
CHS-Fdn_Lease.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 4
 Evidence of Site Control
CHS Deed.pdf
 SAM.gov - screen shot of sam.gov registration *Required SAM Statement for Grants.pdf
CHS SAM Screenshot 2022.jpg
 Key Program Staff Resume *Required
Youth Services Director Resume-L.J..pdf
TAY Clinician Resume-M.G..pdf
TAY Clinician Resume-D.S..pdf
TAY Coordinator Resume-D.G..pdf
 Title Report
CHS Title Report Statement.pdf
 Optional Documents
Catalyst TAY Program Scope of Work.pdf
City ESG-CV -Children's Home-United Way-Catalyst Program Contract.pdf Catalyst_TAY_Participant_Policy_and_Procedures.pdf
Catalyst_TAY_Staff_Policy_and_Procedures.pdf
Catalyst_TAY_Intake_Form.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
Submit
Completed by [email protected] on 1/24/2022 3:02 PM
Case Id: 48587
Name: Children's Home of Stockton - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
Joelle Gomez
Title
Chief Executive Officer
Date
01/24/2022
Signature
Joelle Gomez
Electronically signed by [email protected] on 1/24/2022 11:39 AM Please download and upload the Certification page here.  Certification Page *Required
CHS Signed City Certification.pdf
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
Program Overview
Completed by [email protected] on 12/29/2021 8:12 AM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
A. Eligibility
Completed by [email protected] on 12/29/2021 8:13 AM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

If using ESG funds
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
B. Contact Information
Completed by [email protected] on 12/29/2021 8:20 AM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Central Valley Low-Income Housing Corporation
B.2. Mailing Address
2431 W. March Lane #350 Stockton, CA, CA 95207

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Jon
B.4. Last Name
Mendelson
B.5. Email
[email protected]
B.6. Phone Number
(209) 472-7200

POINT OF CONTACT INFORMATION
B.7. First Name
Jon
B.8. Last Name
Mendelson
B.9. Email
[email protected]
B.10. Phone
(209) 472-7200

ORGANIZATION CONTACT INFORMATION
B.11. Website
http:\\cvlihc.org
B.12. DUNS Number
158,901,178
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
B.13. EIN Number
680,256,280
B.14. Business License Number and Expiration Date
2100102851 12/31/2021
B.15. Type of Agency
501(c)(3)
B.16. Number of Paid Staff
29 B.17. Number of Volunteers
0 Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
C. Funding Request
Completed by [email protected] on 12/29/2021 8:22 AM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
CoS ESG RRH-HP 2022-23
C.2. Project Site Location
2431 W. March Lane #350 Stockton, CA, CA 95207
C.3. Funding Requested in this application
$116,000.00
C.4. Other funds already secured for the project
$0.00
C.5. Total Cost to Complete Project
$255,000.00
C.6. Other funds not yet secured
$139,000.00
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
D. Organization Information
Completed by [email protected] on 12/31/2021 1:43 PM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

Central Valley Low Income Housing Corporation provides affordable permanent housing and support services to homeless individuals and families living in San Joaquin County, with core competencies of improving quality of life, reaffirming personal dignity, and enabling self-sufficiency.

Income Limits Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 346
Extremely Low Income (Less than 30%) 849
1,195
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 537 325
Black/African American 514 19
Asian 38 3
Am. Indian/Alaskan Native 13 8
Native Hawaiian/Other Pacific Islander 6 1
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 87 49
1,195 405
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 308
Female Headed Households 378
Seniors 149
Youth 568
Homeless 1,195
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
2,598
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
E. Project Funds
Completed by [email protected] on 1/20/2022 2:48 PM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
n/a $0.00 $0.00
FY2017/18
ESG
RRH/HP/HMIS/Outreach City, County,
State
$245,221.00 complete $0.00
FY2018/19
CDBG
n/a $0.00 $0.00
FY2018/19
ESG
RRH/HP/HMIS/Outreach City, County,
State
$256,398.00 complete $0.00
FY2019/20
CDBG
n/a $0.00 $0.00
FY2019/20
ESG
RRH, HMIS, Outreach City, County,
State
$247,026.00 complete $0.00
FY2020/21
CDBG
$0.00 $0.00
FY2020/21
ESG
RRH/HP/HMIS/Outreach City, County,
State
$284,130.00 186630 $97,500.00
FY2021/22
CDBG
$0.00 $0.00
FY2021/22
ESG
RRH/HP/HMIS/Outreach City, County,
State
$257,500.00 103980 $153,520.00
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

CVLIHC has applied to San Joaquin County for $80,000 in ESG annual award resources toward the same Rapid Re- Housing/Homelessness Prevention project, though that County funding will be used to exclusively serve residents who live outside Stockton City Limits. CVLIHC will also apply to San Joaquin County for at least $59,000 in ESG annual award resources from the State of California toward the same Rapid Re-Housing/Homelessness Prevention project.

E.5. What will be the impact on your agency, program, or project goals be if the program is not funded at the full amount requested? Will your organization have the ability to sustain itself if the funding allocated is less than the amount requested? Please provide detailed information to understand if this is a funding gap and/or funds used to leverage additional sources outside of Stockton i.e. County/State/Federal/Private Funds The ability of this project to provide homelessness prevention services to City of Stockton residents is wholly dependent upon the award from this source of funding. If the funding request is not granted, this project will not be able to provide standard rapid re-housing/homelessness prevention services to City of Stockton residents. Should an award be granted by at an amount less than requested, the project would serve fewer households and fewer unduplicated individuals than expected — a reduced award amount would have to be paired with a reduced expectation of performance and effectiveness. A significant reduction in the award amount compared to the request amount could have an exponential impact on services delivered directly to clients. While the utmost effort is made to ensure the majority of grant money is diverted directly to support of clients, services can only be delivered on behalf of clients if staff and organizational infrastructure are adequately supported. This means that significant reductions in the award amount could result in significant reductions in the amount of funds that can be directed to clients.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

ESG funds that are intended to benefit residents of Stockton will only be used to assist persons who can verify Stockton residency. CVLIHC as an agency serves households throughout San Joaquin County. However, CVLIHC operates several projects that are restricted to residents of certain areas within that geography, including projects that are only available to residents of the City of Stockton. These projects include Emergency Solutions Grants funds and emergency COVID-19 related funds. Individuals must verify residency in the City of Stockton before they are eligible for assistance through projects that are restricted to the City of Stockton.

Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents Yes
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes
Homeless persons and persons at risk of becoming homeless Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Number required at time of assistance). Please attach a blank worksheet under Required Documents Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

CVLIHC will provide deposit assistance and rent assistance in accordance with ESG guidelines to help households exit homelessness and avoid homelessness. This includes payment of rent and utility arrears for households seeking homelessness prevention assistance. Payments will be made directly to landlords, property management companies, or appropriate vendors, not directly to households seeking assistance. This reduces potential for fraud and ensures the assistance is used for its intended purpose.

CVLIHC verifies eligibility and need n compliance with ESG regulations. CVLIHC verifies household income through collection of records provided by households seeking assistance, including passports to service (TANF, CalFresh, etc.), check stubs from employment, bank statements, etc. CVLIHC verifies status of homelessness/at imminent risk of homelessness according to standard practices as described by the federal Housing and Urban Development Department, including verification through the Homeless Management Information System, notices to quit/notices of eviction, self-certification, and direct observation by CVLIHC staff.

All data collected and stored physically and digitally. In addition to physical files kept on the CVLIHC premises, CVLIHC utilizes the Homeless Management Information System as its primary database. The HMIS allows CVLIHC to track demographics, homeless status, household characteristics, and other information; detailed, comprehensive reports on clients served are generated directly from this database. The HMIS also enables efficient referral of households seeking assistance through Coordinated Entry.

E.9. Select the common indicator that your agency will use to track clients.

The number of households and individuals provided assistance will be the primary unit of service tracked by this Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
project. This project is designed to provide direct financial support in order to help households exit homelessness and obtain permanent housing, as well as to help households remain in permanent housing when faced with imminent homelessness. Therefore, it is consistent with the project's design that the number of households provided financial assistance will be the primary unit of service.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 135
Households 50
Other 0
185
E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

CVLIHC's engagement and outreach is specifically designed to target households that are homeless, at imminent risk of homelessness, and are low income. CVLIHC has more than 20 years serving these populations, including a significant number of people who are long-term homeless and permanently disabled. CVLIHC engages in direct outreach to homeless service providers and homeless encampments, and embraces a "no wrong door" approach to applying for its assistance. CVLIHC is a participant in the local Coordinated Entry System, 2-1-1, the Homeless Management Information System, and has strong links to emergency shelters and homeless service providers throughout Stockton and San Joaquin County; many of those seeking assistance with housing contact CVLIHC after learning about CVLIHC's services through CES, 2-1-1, or from other service providers. Service providers also refer individuals through CES, the HMIS, and by direct referrals. Individuals also contact CVLIHC through our website at www.cvlihc.org, where individuals can submit an Initial Contact form that helps us delivery timely assistance for eligible households. CVLIHC also employs numerous individuals with personal experience of homelessness or using public assistance, and employs several individuals who speak other languages, including Spanish, Tagalog, and Mandarin
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
F. Project Impact
Completed by [email protected] on 12/31/2021 3:00 PM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 75
Extremely Low Income (Less than 30%) 75
150
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 60 33
Black/African American 65 5
Asian 6 0
Am. Indian/Alaskan Native 4 0
Native Hawaiian/Other Pacific Islander 3 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 12 2
150
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 25
Female Headed Households 33
Seniors 27
Youth 57
Homeless 150
292
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
43 176 176
2020-2021 (Anticipated) 40 150 150
83 326 326
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

This project will provide rent payments, deposit payments, and other payments necessary for households that are literally homeless and at imminent risk of homelessness to obtain permanent housing or remain in permanent housing. Staff will provide wraparound services including case management, navigation, and landlord advocacy in order to help clients remain housed or obtain housing. Payments are made directly to landlords for qualified households, and all housing will meet Housing Quality Standards.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

This project focuses on rapid re-housing and homelessness prevention. These activities directly align with the San Joaquin Community Response to Homelessness Strategic Plan.

The Plan called to create at least 100 more rapid re-housing opportunities than currently provided for, and for an increase of at least 200 homelessness prevention opportunities to be created throughout San Joaquin County. This project proposed by CVLIHC will allow the City of Stockton to keep pace with the amount of assistance made available in prior years, allowing our community to maintain its baseline operations while we strive to increase capacity in keeping with the Strategic Plan.

Maintaining this baseline by funding this project is critical — because since the Plan was adopted by the City of Stockton, the identified need for rapid re-housing and homelessness prevention has only become greater. This need has been driven in large part by the COVID-19 pandemic. As it has worsened, the San Joaquin Continuum of Care has identified an increasing need among local residents for homeless prevention projects/services. This information has been gained through feedback from service providers and direct input from those in need, as well as through data in the Homeless Management Information system.

The position of the SJCoC regarding maintaining and expanding rapid re-housing and homelessness prevention projects is reflected in the Strategic Plan and in further recommendations to the County and the City, and reflects the real crisis that many people face in being unable to maintain or obtain permanent housing without significant intervention. This project provides those intervention resources and will directly allow those impacted households to exit homelessness or avoid homelessness
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
G. Project Narrative
Completed by [email protected] on 1/14/2022 1:11 PM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

G.1. How would you characterize your program/project based on the continuum of approaches to housing and public service needs listed below: (Select Top Three)
 PREVENTION - Helps prevent a problem before it emerges  EARLY INTERVENTION - Addresses a problem in its early manifestation to keep it from becoming worse  TRANSITION - Helps move clients toward a better situation, lower level of need, etc.  MAINTENANCE - Helps to ensure that clients do not decline, etc.  SELF-SUFFICIENCY - Helps move clients toward a situation in which they will no longer need the program or service
 STABILIZATION - Helps clients attain stability so that they can work toward a better situation G.2. Describe in detail how the program/project will address each of the 3 housing and public service needs selected above (i.e. how it specifically addresses prevention/early intervention etc.) This project is designed to address priority components of the San Joaquin CoC Strategic Plan, and fills need gaps identified in the City's Consolidated Plan:
• PREVENTION: The project is designed to prevent homelessness by addressing an urgent need among households that are at risk of homelessness. This project provides assistance for paying for back rent, current rent, or immediate future rent. This targeted investment is often enough to prevent a household from losing their permanent housing, preventing the problem of homelessness.
• EARLY INTERVENTION: The project's focus on rapid re-housing provides assistance to households that can end their homelessness with timely, limited assistance. These households typically have income and personal resiliencies, but do not have the resources to exit homelessness into permanent housing. This project provides deposit support, rent support, and case management to identify the households' barriers and tailoring the assistance provided to meet those needs to the greatest extent possible. By intervening at the early stages of a household's housing crisis, this project is able to reduce the trauma of associated with homelessness. This intervention also leaves more capacity for emergency shelters to provide shelter and services to other households, and improves our system-wide performance when it comes to addressing homelessness.
• SELF-SUFFICIENCY: This project moves clients from a situation in which they need intervention, to a situation in which they no longer need the intervention. CVLIHC's 12+ years experience in administering rapid re-housing and homeless prevention projects has taught us that households often only need brief, one-time intervention in order to overcome a housing crisis. Rapid re-housing is inherently designed to build self-sufficiency, as it is an intervention type that is meant to be short-term in nature as a bridge between needing assistance and not needing assistance.

Homeless prevention is designed similarly as a short-term bridge between a crisis and stability. CVLIHC helps ensure that self-sufficiency following rapid re-housing and homelessness prevention assistance is part of its projects, as a Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
focus on household sustainability and budgeting is part of the case management services provided to all households that are enrolled in our projects.

The goal is to help households that are homeless quickly exit to permanent housing by providing deposits, tenant- based rental assistance, and case management services or to assist households maintain housing. This project design aligns with priority actions suggested by the San Joaquin CoC Strategic Plan. Rent assistance and other support for households that meet eligibility requirements is provided directly to landlords and appropriate vendors.

Documentation of eligibility and expenditure of funds is maintained in client files. This project will function similarly to the ESG-funded rapid re-housing/homelessness prevention projects that CVLIHC has administered over the past 12 years in the City of Stockton. Four staff are dedicated to CVLIHC’s ESG project components, and have an extensive history assisting households to remain housed and enter housing from homelessness. This staff team is overseen by the CVLIHC management, which has more than 40 combined years’ experience overseeing permanent housing projects. Clients can contact CVLIHC directly, through CES and partner agencies, or via automated assistance tools.

Efforts to identify clients include direct outreach to emergency shelters and other homeless service providers; receipt of referrals from the Coordinated Entry System; referrals from the 2-1-1 system; direct communications with landlords/property managers; by receiving walk-in/phone call self-referrals; and from contacts through the CVLIHC website. CVLIHC also receives referrals via service providers, including mainstream service providers such as the Human Services Agency.

CVLIHC’s office is located at 2431 W. March Lane and is on major bus routes. Regular hours are 9:00 a.m. to 5:00 p.m. , Monday through Friday; extended hours are made available as needed. Clients can also submit applications and paperwork through www.cvlihc.org.

Average assistance usually consists of rental deposits and short term rental assistance, based on the unique household needs. Interaction with clients is sensitive to their schedules. Delivery of checks to landlords and vendors happens as soon as client eligibility is confirmed and all necessary paperwork has been completed according to project standards.

The project will begin serving households as soon as CVLIHC is informed of an award and a sub-recipient contract has been signed. CVLIHC will continue to serve households for the duration of the funding spending window or until funds are exhausted.

Project Activity or Program
Service #
Describe the Deliverable
1 Rapid Re-Housing of homeless households
2 Homelessness Prevention for households at risk of homelessness G.4. Describe your agency’s capacity to implement this program or project (identify agency’s federal grants managed, staff resources, skills and experience, number of years in operation, accomplishments to date, etc.).

CVLIHC has successfully administered ESG projects funded through the State, County, and City of Stockton more than 12 years. Since 1999, CVLIHC has managed Permanent Supportive Housing and Transitional Housing/Rapid Re-Housing projects funded through the HUD’s CoC Program Competition; CVLIHC currently manages 7 CoC funded projects.

CVLIHC has also administered Homeless Emergency Aid Program and California Emergency Solutions and Housing projects funded by the State of California and currently partners with Behavioral Health Services to provide housing to Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
clients. CVLIHC is also the managing partner of Town Center Studios, a Project Homekey partnership with the City of Stockton. CVLIHC has recently implemented ESG-CV rapid re-housing and homelessness prevention projects for the City of Stockton.

CVLIHC is free of findings from any federal or state audit of its practices and finances. CVLIHC staff has significant experience in discharging projects of this type, including the management team, which has more than 40 years experience administering homeless assistance projects with federal and state money.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
Approval of this request will allow for the continuance of a prevention and re-housing program CVLIHC has provided for more than ten years. CVLIHC has an experienced staff team dedicated to providing assistance to Stockton households experiencing homelessness or who are at risk of becoming homeless. Households seeking assistance make contact through the CoC’s "no wrong doors" approach, including 2-1-1, CES, and CVLIHC's website. Households are screened for eligibility based on living situation and income to determine the type and amount of assistance necessary for that household to maintain or obtain housing. CVLIHC staff provide assistance in locating alternate housing as necessary and interact with landlords to assure that housing is safe and decent. Staff contact with clients occurs at regular intervals during and after direct assistance to ensure long-term stability. Staff are also responsible for keeping client files and tracking outcomes through the HMIS.

Project Deliverable # Describe the Deliverable
1 Rapid Re-Housing of homeless households
2 Homelessness Prevention of households at risk of homelessness G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? This project seeks to provide stable permanent housing to all households assisted. CVLIHC expects that at least 90% of the households provided with direct assistance will exit the project to, or retain, permanent housing.

This data will be measured by direct contact with clients and documenting their outcomes. These outcomes will be tracked through the Homeless Management Information System.

Deliverable # Task that Support Deliverable
1 Enrollment of households into RRH project
2 Enrollment of households into HP project
3 Delivery of support to landlords on behalf of clients G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
This project is designed to serve households that are literally homeless or at risk of homelessness as defined by 24 CFR 578. To be eligible, households must meet the criteria for these services as determined by Emergency Solutions Grants regulations as published in the NoFA and in the federal register. This population includes individuals with disabilities, seniors, youth, veterans, and those with other special needs.

Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
G.8. Briefly explain how this service/activity/project differs from other programs providing similar services in Stockton/San Joaquin County. Also indicate any networking or collaboration which occurs with agencies or programs providing the same or like services AND their role in this specific program/project.

CVLIHC is the sole provider of rapid re-housing and homelessness prevention services funded by annual ESG resources. CVLIHC has provided these services for more than 12 years throughout San Joaquin County.

Collaboration with other agencies providing homelessness prevention is not necessary for the successful implementation of this project. This project is designed to offer complete and effective services on its own, and fits a gap in the local system of homeless support services. However, CVLIHC does ensure this project works in concert with services offered by other agencies. CVLIHC utilizes the Homeless Management Information System as its data system, which aids in avoiding duplication of effort and duplication of benefits. CVLIHC also is part of the San Joaquin Continuum of Care Coordinated Entry System and 2-1-1, and collaborates with service providers that routinely refer households to CVLIHC for homeless prevention and other housing services.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

This project is wholly dependent upon the availability of funding to provide the services envisioned, as the project is sustainable only when funding is available to execute the delivery of deposit, rent, and other direct support. However, this project is able to efficiently sustain its efforts if funded by this request, as CVLIHC staff are already engaged in delivering this project to Stockton residents and will be able to effectively continue this project with funding.

No known conflicts of interest exist.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
H. ESG
Completed by [email protected] on 1/20/2022 9:40 AM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:
0 H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

While this is not an ESG-CV application, homeless prevention and re-housing efforts are critical components in a successful response to COVID-19. Prevention and re-housing help connect households with safe and appropriate living space. Prevention eligibility includes providing help to households living in overcrowded situations, which is a high-risk environment in terms of COVID-19 spread; prevention also ensures households do not end up in other high-risk environments such as congregate shelters and homeless encampments. Re-housing also helps households exit congregate shelters (a high-risk environment) and homeless encampments (an unsanitary high-risk environment) H.3. Will the service to be provided with these funds fill a service gap needed to be addressed? Yes
H.4. Duplication of Benefits: Federal finance assistance was provided to my organization to addresses losses resulting from a federally declared emergency or disaster, and my organization has not received (or would receive, by acting reasonably to obtain available assistance) financial assistance for the same costs from any other source (including insurance) and the total amount of funding received does not exceed the total needs for those costs.

No
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 12/29/2021 8:29 AM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

Not applicable
I.4. Does the agency own or lease the property where the project will occur? Who is the legal property owner? If you are leasing, please provide a copy of the lease in the required documents section. If you do not have site control, describe your site control plan.

Not applicable
I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

Not applicable
I.7. Has a market study, property needs assessment and/or other evaluation that identifies the need for the proposed project been completed? If so, describe and upload the project reports and schedule). If no reports have been completed, explain how you plan to proceed.

Not applicable
I.8. When will construction start and end? Provide a timeline with all critical milestones.

Not applicable
I.9. Is this project a multi-phased activity?
No
I.10. Will this project require implementation of Davis-Bacon/Fair Labor Standard Act requirements? Note: Please contact staff immediately if you have questions regarding Davis-Bacon requirement or for more informationclick Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
here.

No
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

Not applicable
I.12. For Economic Development activities only. Indicate the number of full-time and part-time jobs you expect to be created and retain, if your application is funded. Also indicate number of jobs likely to be filled by a low-income person:

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 12/29/2021 8:31 AM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

The population served by rapid re-housing and homelessness prevention projects often has barriers to accessing services, including but not limited to transportation, time, and cost. This project addresses those barriers in a strategic fashion. CVLIHC allows and encourages households to apply for and become qualified for services via a web portal (www.cvlihc.org) , which enables households to overcome barriers to transportation; this also enables individuals to access services while avoiding personal trips that might expose individuals to COVID-19. This virtual-remote approach also enables a quicker turnaround time in processing individual requests for assistance, and reduces costs associated with seeking services (such as gas, bus passes, etc.) CVLIHC has also employed individuals with lived experience as homeless and receiving public assistance, and can effectively meet the individual needs of people who are seeking assistance.

J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients CVLIHC is within one-quarter mile of major bus routes serviced by San Joaquin Rapid Transit District. CVLIHC attempts to
reduce transportation barriers to the population it serves by making it possible to request assistance through a web portal (www.cvlihc.org) or over the phone, and obtain assistance without needing to physically come to the CVLIHC office.

J.4. Identify AT LEAST ONE City of Stockton U.S. Department of Housing and Urban Development (HUD) FY 2020- 2025 Consolidated Goal that relates to your program/project:
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
improve outcomes and stability and promote successful transitions into permanent housing. Expand the housing first model to provide permanent housing units with intense wrap-around services on-site.  Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income households. Provide homeownership opportunities for low-income-moderate income first-time buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/20/2022 2:48 PM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
HP-RP budget.xls
 Organization Operational Budgets *Required
2020-21 CVLIHC agency budget.xlsx
 Organization Financial Statements *Required
2020 CVLIHC - Consolidated FS - signed.pdf
 Tax Status *Required
Nonprofit Status - CVLIHC.pdf
 Board of Directors Roster *Required
CVLIHC Board of Directors bios 11-01-2021.docx
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
 Articles of Incorporation/Bylaws *Required
Bylaws - CVLIHC - Amended 11-29-21.pdf
 Conflict of Interest Statement *Required
Conflict of Interest - 08-20-2020.doc
 Organization chart *Required
Org chart 2022 - CVLIHC.xlsx
 Board of Directors’ authorization to request CDBG/ESG funding *Required Funding Application Authorization - Resolution 2021-22.pdf  Business License Number *Required
Stockton Business License 2022.pdf
Stockton Business License 2021.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required Insurance Certificate - City of Stockton.PDF
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required Policies and Procedures Handbook -11-10-22.DOC
 Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
 Evidence of Site Control
**No files uploaded
 SAM.gov - screen shot of sam.gov registration *Required SAM screen shot.docx
 Key Program Staff Resume *Required
Ferreira, Raul - resume.pdf
Rosenquist, Jennifer - resume.docx
 Title Report
**No files uploaded
 Optional Documents
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
Submit
Completed by [email protected] on 1/20/2022 4:15 PM Case Id: 48551
Name: CoS ESG (Fed) 2022-23 - CVLIHC - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Program Overview
Completed by [email protected] on 1/3/2022 8:48 AM
Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned

Program Overview

Please provide the following information.

Community Development Block Grant (CDBG)
Emergency Solutions Grant (ESG) Program
For Fiscal Year 2022-2023

For more guidance, click here to view the full Application Instructions for Funding for CDBG & ESG

General Information and Application Instructions For Funding

The City of Stockton anticipates receiving federal funds from the U.S. Department of Housing and Urban Development (HUD) to assist low and moderate-income persons, expand economic opportunities, provide decent housing, and/or provide a suitable living environment. As a recipient of Community Development Block Grant (CDBG), Emergency Solutions Grant (ESG), and Home Investment Partnerships (HOME) funds, the City allocates these funds to different activities to meet priority needs and the specific objectives identified in the City’s Consolidated Plan.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 3/29/2022 2 of 2

• Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing.

Expand the housing first model to provide permanent housing units with intense wrap-around services on- site.

• Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income levels. Provide homeownership opportunities for low-income first-time buyers.

Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.

• Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons.

• Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure.

• Community Development Needs: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 3/29/2022 1 of 1

A. Eligibility
Completed by [email protected] on 1/3/2022 8:49 AM
Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned

A. Eligibility

Please provide the following information.

1. CDBG National Objective

 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one

If using CDBG funds:

If using ESG funds
Homeless Management Information System (HMIS)

Attachment A
Printed By: Kayla Martin on 3/29/2022 1 of 2

B. Contact Information
Completed by [email protected] on 1/3/2022 8:55 AM
Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned

B. Contact Information

Please provide the following information.

B.1. Organization Name
Ventral Valley Low Income Housing Corp.

B.2. Mailing Address
2431 W. March Lane #350 Stockton, CA 95207

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Jon

B.4. Last Name
Mendelson

B.5. Email
[email protected]

B.6. Phone Number
(209) 472-7200

POINT OF CONTACT INFORMATION
B.7. First Name
Jon

B.8. Last Name
Mendelson

B.9. Email
[email protected]

B.10. Phone
(209) 472-7200

ORGANIZATION CONTACT INFORMATION
B.11. Website
http:\\cvlihc.org

B.12. DUNS Number
158,901,178
Attachment A
Printed By: Kayla Martin on 3/29/2022 2 of 2

B.13. EIN Number
680,256,280

B.14. Business License Number and Expiration Date
21-00102851

B.15. Type of Agency
501(c)(3)

B.16. Number of Paid Staff
29 B.17. Number of Volunteers
0 Attachment A
Printed By: Kayla Martin on 3/29/2022 1 of 1

C. Funding Request
Completed by [email protected] on 1/3/2022 8:58 AM
Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned

C. Funding Request

Please provide the following information.

C.1. Title of Proposed Project
Homeless Management Information System

C.2. Project Site Location
2431 W. March Lane #350 Stockton, CA, CA 95207

C.3. Funding Requested in this application
$14,500.00

C.4. Other funds already secured for the project
$98,540.00

C.5. Total Cost to Complete Project
$138,040.00

C.6. Other funds not yet secured
$25,000.00

Attachment A
Printed By: Kayla Martin on 3/29/2022 1 of 2

D. Organization Information
Completed by [email protected] on 1/3/2022 9:07 AM
Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned

D. Organization Information

Please provide the following information.

D.1. Please describe your agency’s mission.

Income Limits Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 346
Extremely Low Income (Less than 30%) 849
1,195

D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each race
White 537 325
Black/African American 514 19
Asian 38 3
Am. Indian/Alaskan Native 13 8
Native Hawaiian/Other Pacific Islander 6 1
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 87 49
1,195 405

D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 308
Female Headed Households 278
Seniors 149
Youth 568
Homeless 1,195
Attachment A
Printed By: Kayla Martin on 3/29/2022 2 of 2

2,498

Attachment A
Printed By: Kayla Martin on 3/29/2022 1 of 4

E. Project Funds
Completed by [email protected] on 1/20/2022 2:50 PM Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned

E. Project Funds

Please provide the following information.

E.2. Please indicate if this application is a request for one-time funding and/or “seed” funding. If not applicable, state “N/A.

N/A

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
n/a $0.00 $0.00
FY2017/18
ESG
RRH/HP/HMIS/Outreach City, County,
State
$245,221.00 complete $0.00
FY2018/19
CDBG
n/a $0.00 $0.00
FY2018/19
ESG
RRH/HP/HMIS/Outreach City, County,
State
$256,398.00 complete $0.00
FY2019/20
CDBG
n/a $0.00 $0.00
FY2019/20
ESG
RRH/HP/HMIS/Outreach City, County,
State
$247,026.00 complete $0.00
FY2020/21
CDBG
$0.00 $0.00
FY2020/21
ESG
RRH/HP/HMIS/Outreach City, County,
State
$284,130.00 183630 $97,500.00
FY2021/22
CDBG
$0.00 $0.00
FY2021/22
ESG
RRH/HP/HMIS/Outreach City, County,
State
$257,500.00 103980 $153,520.00

Attachment A
Printed By: Kayla Martin on 3/29/2022 2 of 4

E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

Other sources committed to this project are:

Continuum of Care Project Competition (FY2020 & FY 2021 renewal) Other sources sought for this project are:

San Joaquin County ESG annual allotment
State of California ESG annual allotment to San Joaquin County

E.5. What will be the impact on your agency, program, or project goals be if the program is not funded at the full amount requested? Will your organization have the ability to sustain itself if the funding allocated is less than the amount requested? Please provide detailed information to understand if this is a funding gap and/or funds used to leverage additional sources outside of Stockton i.e. County/State/Federal/Private Funds This funding is important to CVLIHC's ability to provide services as HMIS Lead Agency for the San Joaquin Continuum of Care and to enable other service providers the ability to participate in the HMIS without cost. This funding allows CVLIHC to provide staff to discharge the duties of the HMIS Lead Agency. This funding also helps underwrite software licenses to organizations that provide housing, shelter, and services to the homeless throughout Stockton and would not be able to participate in the HMIS if they were forced to pay for those software licenses. The total annual cost of providing HMIS software licenses to all homeless service providers, a cost that is currently completely borne by CVLIHC, is around $71,000. If this funding is eliminated or reduced, it would impair the organization's ability to operate as HMIS Lead, and would jeopardize the ability of many homeless service providers to participate in the HMIS which is critical to our community's ability to track and measure the effectiveness of our local response to homelessness.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

CVLIHC provides HMIS services as HMIS Lead Agency throughout San Joaquin County. The majority of time and focus, however, is spent upon agencies and upon individuals in Stockton, as the majority of homeless individuals and homeless service providers in this county are located in Stockton.

E.7. How does (will)your organization verify income eligibility of your clients?

Area Benefit Project service area has been identified and determined to be statistically low-income based on the 2010 Census. If you use this method, provide all Census Tracts and Block Groups served by your project and a calculation of the low-income percentage. Please utilize the following web application to confirm eligibility . Area benefit applicants are required to confirm block groups/census tracts are eligible. Map depicting area with low/mod % is required with this application.

S
elf Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents

Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents

Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm Attachment A
Printed By: Kayla Martin on 3/29/2022 3 of 4

workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes

Information is recorded in HMIS for those experiencing homelessness or who may be at risk of experiencing homelessness.

Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

The provider of the software that undergirds the HMIS is named Bitfocus, and charges CVLIHC a $575-per-user annual fee for use of the HMIS software (including license creation). This proposed project will defray that cost for agencies within the City of Stockton; this project will also provide, in part, for continuing local administration to discharge this project and provide support and training to HMIS-participating agencies. This proposed project helps ensure nonprofit and community benefit agencies that use the HMIS are able to do so without incurring a user fee.

E.9. Select the common indicator that your agency will use to track clients.

Persons: unit of measurement for public services/ESG

E.10. Define the primary unit of service (e.g. number of classes provided, hours of case management, number of medical visits, number of meals served, etc.) to be used when tracking this program/project, submitting invoices, etc. Note: Do NOT reiterate the number of clients or number of households served.

The primary units of service in this project are the number of unique persons whose information is entered/used by the number of unique agencies that participate in the HMIS.

In the table below, "Persons" should be interpreted to mean "the number of persons whose information will be tracked via the HMIS"; "Other" should be interpreted to mean "the number of agencies that participate in the HMIS."

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 0
Households 0
Other 0
0 Attachment A
Printed By: Kayla Martin on 3/29/2022 4 of 4

E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

All entities receiving funding through ESG, the Continuum of Care, new State funded projects, Department of Health & Human Services, and Department of Veterans Affairs are required to enter data in HMIS. CVLIHC ensures that contact is made with these agencies, and that individuals are identified at those agencies who are primarily responsible for ensuring compliance with HMIS requirements. Those agencies and individuals receive copies of the HMIS Policies and Procedures approved by the San Joaquin Continuum of Care, sign MOUs regarding the proper use of the HMIS, and receive individual training to ensure understanding and ability to use the HMIS. CVLIHC also reaches out through the San Joaquin Continuum of Care general membership meetings, as well as partners with providers of funds such as City of Stockton and San Joaquin County, to ensure mandated agencies are participating in the HMIS.

CVLIHC ensures that accommodations are made for agencies who need such accommodations to properly learn about and utilize the HMIS, including translation services and disability accommodations.

The population tracked by the HMIS includes almost exclusively low-income individuals, as well as many individuals with disabling conditions and who have limited ability to speak English. Delivery of HMIS services to agencies are not impacted by these realities.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
F. Project Impact
Completed by [email protected] on 1/19/2022 11:48 AM Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 2,000
Extremely Low Income (Less than 30%) 9,000
11,000
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 6,000 3,000
Black/African American 4,000 300
Asian 200 25
Am. Indian/Alaskan Native 50 20
Native Hawaiian/Other Pacific Islander 50 20
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 700 250
11,000
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 2,900
Female Headed Households 1,300
Seniors 700
Youth 4,500
Homeless 10,000
19,400
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
0 14,240 9,975
2020-2021 (Anticipated) 0 12,947 9,075
2021-2022 0 15,000 11,000
0 42,187 30,050
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

This proposed project will enable CVLIHC to fully operate a Homeless Management Information System on behalf of the San Joaquin Continuum of Care and homeless service provider agencies throughout the City of Stockton. CVLIHC has been appointed the HMIS Lead Agency by the San Joaquin Continuum of Care to establish and manage the HMIS for the entire area covered by the Continuum of Care, which includes the City of Stockton. CVLIHC is dedicated through this project to provide agencies throughout Stockton the support and resources needed to effectively implement use of the HMIS and provide the community with reliable, accurate data regarding the scope and nature of homelessness in Stockton.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

Both federal and state governments have determined that local Homeless Management Information Systems are the primary vehicle with which data will be gathered and reported regarding homelessness, and local governments in our community have supported these determinations through additional policies.

Each Continuum of Care throughout the nation is required to have a HMIS in place that meets standards established by the federal Department of Housing and Urban Development (HUD) to collect and report data on services provided to households experiencing homelessness. All recipients/sub-recipients of Emergency Solutions Grant (ESG) funds or HUD Continuum of Care (CoC) funds are required by federal law and regulation to enter data into the HMIS as a condition of receiving funds. Recently, the state of California has also made entering data into the HMIS a legal requirement of many communities that receive state funding to address the issue of homelessness.

Furthermore, the Stockton City Council and San Joaquin County Board of Supervisors have formally adopted policies — including the San Joaquin Community Response to Homelessness Strategic Plan — that support the HMIS as the primary local database that will be relied upon when it comes to answering quantitative questions regarding households that are homeless. This aligns with the general desire to base policies regarding homelessness on reliable, accurate data. A fully supported and functioning HMIS is the most wide-reaching, reliable way to gather information on households experiencing homelessness.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
G. Project Narrative
Completed by [email protected] on 1/19/2022 11:12 AM Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

G.1. How would you characterize your program/project based on the continuum of approaches to housing and public service needs listed below: (Select Top Three)
 PREVENTION - Helps prevent a problem before it emerges  EARLY INTERVENTION - Addresses a problem in its early manifestation to keep it from becoming worse  TRANSITION - Helps move clients toward a better situation, lower level of need, etc.  MAINTENANCE - Helps to ensure that clients do not decline, etc.  SELF-SUFFICIENCY - Helps move clients toward a situation in which they will no longer need the program or service
 STABILIZATION - Helps clients attain stability so that they can work toward a better situation G.2. Describe in detail how the program/project will address each of the 3 housing and public service needs selected above (i.e. how it specifically addresses prevention/early intervention etc.) Early Intervention: The HMIS helps individual service providers accurately collect and, under proper protocols and policies, share information to provide intervention to prevent homelessness and quickly end homelessness for households. Collection of individual data in the HMIS allows easier entry to services/housing that have eligibility standards that require documentation of eligibility, including but not limited to permanent supportive housing.

Accurate data community-wide also helps jurisdictions make better plans for disbursing resources to programs and efforts that show quantifiable results in terms of preventing homelessness and ending homelessness, and focus on productive early intervention strategies.

Transition: Collection of individual data in the HMIS allows easier entry to services/housing that have eligibility standards that require documentation of eligibility, including but not limited to transitional housing, rapid re-housing, and permanent supportive housing. The information recorded in HMIS allows service providers to understand more about the clients they serve, including their barriers to self-sufficiency, and transition clients to better housing situations.

Self-Sufficiency: The HMIS is a critical tool for case managers at all levels of service — prevention, crisis response, support services, transitional housing, rapid re-housing, permanent supportive housing — to track the progress clients make toward self-sufficiency. The HMIS allows case managers and service providers to record services provided, update
household information, and see the broad variety of services/programs the client is accessing to move toward greater independence. Tracking of individual data in the HMIS also allows easier entry to services/housing that have eligibility standards that require documentation of eligibility, including but not limited to permanent supportive housing.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
G.3. Provide a detailed description of your proposed project/ activity. Describe the work to be performed, including the activities to be undertaken or the services to be provided, the goals and objectives and the method of approach. Be specific about the days/times of services and the frequency and duration of services received by the average client or participant. A timeline/schedule including activity start date and completion date must be submitted with the application.

CVLIHC’s office is located at 2431 W. March Lane with regular business hours of 9:00 a.m. to 5:00 p.m., although extended hours are usually made available as needed, Monday through Friday. The HMIS is a web-based system and is
available to users 24 hours per day from any location that has access to the Internet. Administrative support is available
during regular business hours through email, telephone, and virtual contact.

This proposed project will provide support for CVLIHC to operate, administer, and maintain functionality of the local Homeless Management Information System. The project will also allow homeless service provider agencies within the City of Stockton to use the HMIS free of user license fees, and receive training, quality monitoring, and ongoing user support regarding the HMIS.

CVLIHC operates as the HMIS Lead Agency for the San Joaquin Continuum of Care, and is responsible for ensuring the local HMIS is available to all community agencies that are required to enter data in the HMIS. CVLIHC has also committed to help other homeless service providers use the HMIS so the community as a whole can collect and report better, more complete data regarding homelessness. A major responsibility of the HMIS Lead Agency is to ensure agencies such as homeless shelters, housing providers, outreach teams, etc., are trained to use the HMIS and receive ongoing support so that they can gather demographic data, track provision of services, record client outcomes, and issue meaningful reports on data collected.

The provider of the software that undergirds the HMIS is named Bitfocus, and charges CVLIHC a $575-per-user annual fee for use of the HMIS software. This proposed project will defray that cost for agencies within the City of Stockton, ensuring nonprofit and community benefit agencies that use the HMIS are able to do so without incurring a user fee.

Total cost of providing user fees to all HMIS users is about $71,000 annually.

All nonprofit and community benefit organizations within the City of Stockton that utilize the HMIS will be contacted by
CVLIHC. CVLIHC will ensure all agencies understand the HMIS Policies and Procedures and the HMIS Data Quality Plan, will collect and keep signed agency and user agreements for use of the HMIS, will provide training when requested by user agencies or when data collection/quality/accuracy issues are identified, and will provide ongoing support to ensure
agencies are able to fully utilize the HMIS. There are currently thirty (30) agencies based in Stockton, with more than 110 active users, currently entering data in HMIS. Around 130 active users overall currently utilize the HMIS.

As part of a continuing service dating back to 2005, HMIS services will commence immediately upon execution of the agreement with the City and continue until all funds are expended. All funds will be expended prior to the end of the agreement period.

Project Activity or Program
Service #
Describe the Deliverable
1 Provide HMIS users licenses
G.4. Describe your agency’s capacity to implement this program or project (identify agency’s federal grants managed, staff resources, skills and experience, number of years in operation, accomplishments to date, etc.).

CVLIHC has served as the local HMIS Lead Agency for the San Joaquin Continuum of Care since 1999. CVLIHC has received Continuum of Care and Emergency Solutions Grants funds for many years to operate this project. All staff Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
and
administrative procedures are in place to successfully implement this project. Being awarded this grant would represent
a continuation of CVLIHC’s operations. The program funded under this application would be would begin immediately upon the issuance of a contract.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
CVLIHC will continue to implement this project as it currently does. CVLIHC appoints a lead individual to make contact with participating HMIS agencies and to provide outreach, support, and guidance. Agencies will receive this service on a
continuing, ongoing basis throughout the length of the contract with City of Stockton.

Individuals and families who are homeless will be served by this project on a daily basis. Each individual who is assisted
by a shelter or service provider will have their data tracked through the HMIS.

Project Deliverable # Describe the Deliverable
1 Provide HMIS users licenses
G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? CVLIHC will measure effectiveness of this program in several ways. The primary benchmark for success is to continue to have nonprofit and community-based homeless service providers that operate in Stockton and serve Stockton residents be able to use the Homeless Management Information System, without having to pay user fees.

Secondary measures of success include having all HMIS-participating agencies adhere to the standards sought by the HMIS Policies and Procedures and fully implement the HMIS Data Quality Plan adopted by the San Joaquin Continuum of Care.

Deliverable # Task that Support Deliverable
1 Training for HMIS licenses; administration of HMIS system G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
By serving projects that collect information through the Homeless Management Information System and participate in Coordinated Entry, this HMIS project serves: households that are homeless; households at imminent risk of homelessness; households with very low- and extremely low-incomes; individuals with disabilities; special need populations such as those with developmental, mental, or other health conditions; the elderly; youth; and other populations as defined by ESG- and CoC-standard data elements. This program will abide by all mandated eligibility requirements of these funding sources.

The Homeless Management Information System is singular in Stockton and San Joaquin County. There is only one Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
HMIS, and it is overseen and operated by CVLIHC. The San Joaquin Continuum of Care selects the local HMIS Lead Agency, which in this community is CVLIHC. The HMIS is identified by federal and state law, as well as local policy, as the database used to gather and report data regarding homelessness and efforts to end homelessness. Without this system, Stockton and San Joaquin County would not be in compliance with federal and state statues, and would be ineligible for significant sources of funding that are used to address homelessness.

CVLIHC is the only agency in Stockton and San Joaquin County that has operated an HMIS or that has served as the HMIS Lead Agency. No other local agencies provide this service. By its nature, operating the HMIS involves extensive networking and collaboration, including with all active homeless service providers within Stockton and San Joaquin County, to ensure that agencies are aware of the HMIS and properly equipped to participate in the HMIS.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

CVLIHC continues to seek ongoing funding for this project from other sources, and continually strengthens its own internal capacity to implement the HMIS-CES by corresponding with Housing and Urban Development and the creator of the HMIS software. CVLIHC leverages technical assistance from Bitfocus, Housing and Urban Development, a partnership with the San Joaquin Data Co-op, and other community partners.

The San Joaquin Continuum of Care has also prioritized annual CoC Program Competition funding to ensure the long- term viability of the Homeless Management Information System. The SJCoC also engages in a performance review of the HMIS Lead Agency to ensure the HMIS operates in a manner that best supports agencies working to end homelessness, as well as the community’s understanding of homelessness. These activities and priorities have been adopted at the urging of CVLIHC.

No conflicts of interest have been identified.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
H. ESG
Completed by [email protected] on 1/19/2022 11:50 AM Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:
0 H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

This project provides a mechanism to collect data that can be used to respond to COVID-19 H.3. Will the service to be provided with these funds fill a service gap needed to be addressed? Yes
H.4. Duplication of Benefits: Federal finance assistance was provided to my organization to addresses losses resulting from a federally declared emergency or disaster, and my organization has not received (or would receive, by acting reasonably to obtain available assistance) financial assistance for the same costs from any other source (including insurance) and the total amount of funding received does not exceed the total needs for those costs.

No
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/4/2022 2:35 PM
Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

I.3. Provide a detailed narrative (e.g. rehabilitation or new construction) and a detailed scope of work.

Not Applicable.

I.4. Does the agency own or lease the property where the project will occur? Who is the legal property owner? If you are leasing, please provide a copy of the lease in the required documents section. If you do not have site control, describe your site control plan.

Not Applicable.

I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

Not Applicable.

I.7. Has a market study, property needs assessment and/or other evaluation that identifies the need for the proposed project been completed? If so, describe and upload the project reports and schedule). If no reports have been completed, explain how you plan to proceed.

Not Applicable.

I.8. When will construction start and end? Provide a timeline with all critical milestones.

Not Applicable.

I.9. Is this project a multi-phased activity?
No
I.10. Will this project require implementation of Davis-Bacon/Fair Labor Standard Act requirements? Note: Please contact staff immediately if you have questions regarding Davis-Bacon requirement or for more informationclick Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
here.

N/A
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

Not Applicable.

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/18/2022 9:03 PM Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

Agencies that utilize the Homelessness Management Information System regularly face the burden of finding the internal capacity to accurately record client data on an ongoing basis. This project proposal enables the HMIS Lead Agency to provide training and support to help those agencies secure the expertise necessary to enter more accurate and timely data. CVLIHC continually advocates for additional resources so that participating agencies can underwrite staff to perform data-gathering; CVLIHC also researches and implements data-reporting practices with partner agencies that reduce the burden on agencies.

J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients The HMIS is accessible by agencies and users anywhere Internet access is available, eliminating the need for transportation. Trainings can also be done via video and other electronic media.

J.4. Identify AT LEAST ONE City of Stockton U.S. Department of Housing and Urban Development (HUD) FY 2020- 2025 Consolidated Goal that relates to your program/project:
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing. Expand the housing first model to provide permanent housing units with intense wrap-around services on-site.  Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income households. Provide homeownership opportunities for low-income-moderate income first-time Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/18/2022 9:05 PM Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
HMIS project budget.xlsx
 Organization Operational Budgets *Required
CVLIHC agency budget.xlsx
 Organization Financial Statements *Required
2020 Completed audit - signed.pdf
 Tax Status *Required
Nonprofit Status - CVLIHC.pdf
 Board of Directors Roster *Required
CVLIHC Board of Directors bios 11-01-2021.docx
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
 Articles of Incorporation/Bylaws *Required
Bylaws - CVLIHC - Amended 11-29-21.pdf
 Conflict of Interest Statement *Required
Conflict of Interest - 08-20-2020.doc
 Organization chart *Required
CVLIHC org and responsibilities chart.xlsx
 Board of Directors’ authorization to request CDBG/ESG funding *Required Funding Application Authorization - Resolution.pdf
 Business License Number *Required
Stockton Business License 2022.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required Insurance Certificate - City of Stockton.pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required Policies and Procedures Handbook.doc
 Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
**No files uploaded
 Evidence of Site Control
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
 SAM.gov - screen shot of sam.gov registration *Required SAM screen shot.docx
 Key Program Staff Resume *Required
RESUME - 2014.doc
 Title Report
**No files uploaded
 Optional Documents
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
Submit
Completed by [email protected] on 1/20/2022 4:15 PM Case Id: 48564
Name: CoS ESG (Fed) HMIS - 2022-23 - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
Jon Mendelson
Title
Executive Director
Date
01/20/2022
Signature
Jon Mendelson
Electronically signed by [email protected] on 1/20/2022 4:15 PM Please download and upload the Certification page here.  Certification Page *Required
Certification.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
Program Overview
Completed by [email protected] on 1/3/2022 8:31 AM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
A. Eligibility
Completed by [email protected] on 1/7/2022 1:20 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Service
If using ESG funds
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
B. Contact Information
Completed by [email protected] on 1/5/2022 2:13 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Downtown Stockton Alliance
B.2. Mailing Address
PO Box 2375 Stockton, CA 95201

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Michael
B.4. Last Name
Huber
B.5. Email
[email protected]
B.6. Phone Number
(209) 464-5246

POINT OF CONTACT INFORMATION
B.7. First Name
Courtney
B.8. Last Name
Wood
B.9. Email
[email protected]
B.10. Phone
(209) 464-5246

ORGANIZATION CONTACT INFORMATION
B.11. Website
www.downtownstockton.org
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
B.12. DUNS Number
9,285,516
B.13. EIN Number
680,374,511
B.14. Business License Number and Expiration Date
22-00117534 March 31, 2022
B.15. Type of Agency
Other
B.16. Number of Paid Staff
30 B.17. Number of Volunteers
2 Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/10/2022 1:24 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
Downtown Stockton Portable Bathroom & Shower Unit (PBSU) Program C.2. Project Site Location
316 N. El Dorado Street Stockton , CA 95202
C.3. Funding Requested in this application
$51,752.00
C.4. Other funds already secured for the project
$110,000.00
C.5. Total Cost to Complete Project
$161,752.00
C.6. Other funds not yet secured
$0.00
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/6/2022 3:06 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

As a PBID, the DSA’s mission is to promote business, housing, arts and entertainment to help create a vibrant, sustainable, urban
community in Downtown Stockton. We have served our community for 24 years. The Downtown Stockton Alliance supports the downtown community via clean and safe services, such as sidewalk maintenance, safety ambassadors, and the Portable Bathroom and Shower Program; economic development support, which entails connecting property owners and business owners with key resources; business and event marketing support; public policy advocacy on behalf of Downtown’s stakeholders; and hospitality services, such as providing directions, offering tours, and serving as safety escorts.

Income Limits Clients Served
Moderate Income (More than 80%) 278
Low Income (50%-80%) 50
Very Low Income (30%-50%) 50
Extremely Low Income (Less than 30%) 937
1,315
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 557 78
Black/African American 332 4
Asian 55 4
Am. Indian/Alaskan Native 94 69
Native Hawaiian/Other Pacific Islander 14 1
Am. Indian/Alaskan Native & White 2 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 261 64
1,315 220
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
Category Clients Served
Disabled 173
Female Headed Households 312
Seniors 158
Youth 59
Homeless 937
1,639
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 5
E. Project Funds
Completed by [email protected] on 1/12/2022 2:32 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

E.1. If you are submitting more than one application for Stockton funding, enter the numerical ranking of the priority of this proposal and the total number of proposals your agency is submitting for the coming fiscal year. 1 of one for CDBG (our organization will also be submitting an application for ESG - we are planning to submit 1 application in each funding category for the PBSU)
E.2. Please indicate if this application is a request for one-time funding and/or “seed” funding. If not applicable, state “N/A.

This is not a request for one time or "seed funding." N/A E.3. If you are applying for additional funds for a current program/project, provide a status update on the existing funds and when funds will be fully spent. Please list all CDBG and ESG funds received within the last 3 years including funding amount and their status.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
B&M
Entrepreneur
Workshops
City CDBG $10,000.00 Project
cancelled due
to
organizational
transition
$2,392.37
FY2017/18
ESG
$0.00 $0.00
FY2018/19
CDBG
$0.00 $0.00
FY2018/19
ESG
$0.00 $0.00
FY2019/20
CDBG
$0.00 $0.00
FY2019/20
ESG
$0.00 $0.00
FY2020/21
CDBG
Portable
Bathroom &
Shower Unit
(PBSU)
City CDBG $93,422.00 Have
requested
funds to be
rolled into
2021/2022.
$4,732.20
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 5
FY2020/21 ESG $0.00 $0.00
FY2021/22
CDBG
$0.00 $0.00
FY2021/22 ESG Portable
Bathroom &
Shower Unit
City ESG-CV;
SJC ESG-CV; SJC
ESG
$228,809.00 Spending
underway - will
be spent by
Summer 2022
$156,481.14
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

In the 2021/2022 funding year, we received $8,809 from SJC ESG which is on track to be spent by the end of June 2022.

In the 2021/2022 funding year, we received $110,000 of SJC ESG-CV funding, which is on track to be spent by the end of June 2022.

In the 2021/2022 funding year, we received $110,000 of City of Stockton ESG-CV funding, which is on track to be spent by the end of June 2022.

For the 2022/2023 funding year, we have secured $110,000 of funding from SJC ESG-CV funding, thus far. We will begin spending this in July of 2022.

In this application, we are seeking funding of $51,752 of City of Stockton CDBG to complement the SJC ESG-CV funding we already have for the 2022 - 2023 FY, and to allow us to run the PBSU for the full year.

The DSA is seeking $51,752 of COS CDBG funding in this application to fill in a gap between the existing SJC ESG-CV $110,000 and the $161,752 total project cost for 2022/2023.

The $51,752 of COS CDBG funding requested in this application will cover $35,000 of PBSU supply costs (towels, toilet paper, cleaning supplies, masks, soap, sandwich lunches, clean undergarments or other clothing items, etc.), $8,000 of PBSU maintenance costs, and $8,752 of the PBSU supervisor's salary.

We are requesting the same amount from both the COS CDBG and COS ESG programs in the hope that if one denies funding, we may still receive funding from the other, or that if one gives partially, the other may be able to award the remaining balance.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

The PBSU service area is Downtown Stockton and the intended beneficiaries are unsheltered homeless individuals who live in or near Downtown Stockton. The majority of beneficiaries will be homeless individuals who reside in Stockton, though we also expect that a few beneficiaries might be homeless individuals who live in other San Joaquin cities but travel to Downtown Stockton to receive various homeless services.

Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 5
E.7. How does (will)your organization verify income eligibility of your clients? Area Benefit Project service area has been identified and determined to be statistically low-income based on the 2010 Census. If you use this method, provide all Census Tracts and Block Groups served by your project and a calculation of the low-income percentage. Please utilize the following web application to confirm eligibility . Area benefit applicants are required to confirm block groups/census tracts are eligible. Map depicting area with low/mod % is required with this application.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents Yes
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents No
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes
Unsheltered homeless persons.

Yes
We utilize a survey on our tablet through the Fulcrum App, and then ask participants to sign/self-certify using a stylus.

An example of this digital form is attached in the required attachments section.

E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

The CDBG funds requested will be used for 12 months of operation (July 2022 – June 2023) of the Portable Bathroom and Shower Unit (PBSU) Program – which encompasses the maintenance and operation of 1 mobile bathroom unit (with 3 toilets and 3 showers) for homeless individuals which is open from 8:00 AM – 4:30 PM, Monday – Friday, at the parking lot of St. John’s Church (316 N. El Dorado Street in Downtown Stockton). The PBSU is supervised by a DSA ambassador and 2 Ready-to-Work attendants who gather homeless user information for the Homeless Management Information System (HMIS); monitor and remove users if they exceed permitted usage time limit (15 - 20 min.

Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 5
depending on whether they are using the toilet or the shower); purchase and serve sandwich lunches 3 times each week; track restroom usage frequency; provide clean undergarments and other clothing to clients; coordinate homeless service site visits; and provide mental health, physical health, and housing service brochures/information.

The DSA is seeking $51,752 in CDBG funding for the PBSU program FY 2022/2023, which costs $161,752 in total. The CDBG funding will cover PBSU supply (toilet paper, cleaning supplies, masks, towels, soap, sandwich lunches, clothing items, etc.) costs of $35,000; PBSU maintenance costs of $8,000; and $8,752 of the PBSU supervisor's salary.

E.9. Select the common indicator that your agency will use to track clients.

Number of PBSU uses throughout the year.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 800
Households 0
Other 7,000
7,800
E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

In regards to service delivery for the PBSU program, the Portable Bathroom and Shower Unit, which has 3 shower/toilet stalls, will be open and operated Monday – Friday from 8:00 AM – 4:30 PM in the parking lot of St John’s Church located at 316 N. El Dorado Street. Each unit has toilets, sinks, toilet paper, a shower stall, paper towels, seat covers, waste bins, and towels.

The PBSU is supervised by one DSA hospitality ambassador and 2 Ready-to-Work participants, who gather homeless client user information for the HMIS (name, birthday, SSN, housing status, ethnicity, preferred language, length of time homeless, mental health status, and physical health status) prior to bathroom use; monitor and remove users if they exceed permitted usage time limit (15 - 20 min., depending on whether they are using the toilet or shower); track restroom usage frequency; serve sandwich lunches 3 times a week; provide clean undergarments and other clothing to clients; coordinate homeless service site visits; and provide mental health, physical health, and housing service brochures/information.

Clients can use the PBSU at no cost and with no advanced notice - they need only arrive at the PBSU location, answer our questionnaire, and provide their signature in order to access the bathrooms. Additionally, 1 of our bathroom/shower stalls is ADA compliant.

In addition to providing brochures, the DSA coordinates site visits with services agencies to link the homeless directly to homeless support service providers.

In terms of outreach or communicating the existence of the PBSU to the homeless community (the majority of whom Attachment A
Printed By: Kayla Martin on 4/1/2022 5 of 5
are low income), the program has been shared with members of the Continuum of Care; has been shared on the DSA's Facebook page; has been shared with homeless service providers; and has been shared via posters near known homeless camps. Our safety ambassador team also distribute cards that have the location of the PBSU on them to homeless individuals they encounter during their shifts. The marketing materials use bathroom symbols in addition to words in order to reach individuals who may not speak English or who may not be literate.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 4
F. Project Impact
Completed by [email protected] on 1/21/2022 4:14 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 0
Extremely Low Income (Less than 30%) 800
800
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 372 70
Black/African American 242 4
Asian 20 4
Am. Indian/Alaskan Native 85 62
Native Hawaiian/Other Pacific Islander 13 1
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 68 58
800
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 156
Female Headed Households 281
Seniors 115
Youth 35
Homeless 800
1,387
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 4
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
0 0 0
2020-2021 (Anticipated) 4 887 886
2021-2022 4 800 799
8 1,687 1,685
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

The PBSU Program encompasses the maintenance and operation of 1 mobile bathroom unit (with 3 toilets and 3 showers) for homeless individuals which is open from 8:00 AM – 4:30 PM, Monday – Friday, at the parking lot of St.

John’s Church (316 N. El Dorado Street in Downtown Stockton).

The PBSU is supervised by a DSA ambassador and 2 Ready-to-Work attendants who gather homeless user information for the Homeless Management Information System (HMIS); monitor and remove users if they exceed permitted usage time limit (15 - 20 min. depending on whether they are using the toilet or the shower); track restroom usage frequency; provide clean undergarments and other clothing to clients; and provide mental health, physical health, and housing service brochures/information.

In addition to operating the PBSU, the DSA serves lunches 3 times a week and coordinates site visits with service agencies (public health, covid-19 vaccine and test providers, laundry services, donated clothing providers, etc.) to link the homeless directly to housing and other services they need, thus enabling the PBSU to meet the immediate public lavatory needs of unsheltered homeless individuals; connect said individuals with food, housing, mental health, and medical resources; reduce the general public’s exposure to human waste health hazards; and provide employment/experience to low-income individuals.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

The need for the PBSU Program initially arose from a chronic public health issue in the form of public urination and defecation in Downtown Stockton primarily caused by the unsheltered homeless population as a result of a public restroom shortage. As the gateway to our city and the seat of our county, the DSA considered it of paramount importance to address this problem, which endangers the general public – workers and visitors alike – by exposing them to infectious diseases, and is disenfranchising for unsheltered homeless individuals who have nowhere to defecate, urinate, shower, or wash their hands with dignity. Prior to the creation of the PBSU program, the DSA received calls to our maintenance team to pick up 2,000 instances of human waste from public sidewalks and parking lots a year.

The implementation of this Portable Bathroom and Shower Unit at the start of 2021 has begun to address a combination of need gaps in our community. These need gaps and the PBSU's role in addressing them are outlined below.

Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 4

1. A)Need Gap 1: Lack of Accessibility and Availability of Facilities to Address Hygiene Needs of Unsheltered Homeless The 2019 PITC reports 1,558 unsheltered homeless in San Joaquin; 921 (59%) of those were found in the Stockton area, specifically. This demonstrates Stockton’s position as the primary hub for the county’s unsheltered homeless.

Being unsheltered, these individuals have limited access to restrooms – especially since COS Public Works has closed many public ones; they are also frequently turned away by businesses/private restroom owners. The PITC asserts that 72% of the unsheltered homeless have been so for over a year; this long-term lack of restroom access reduces the quality of living conditions for homeless individuals and contributes to public health hazards, which is evidenced by the 2,000 instances of human waste that the Downtown Stockton Alliance (DSA) removed from sidewalks the year before PBSU installation. With the onset of COVID-19, this need gap has become even more critical to address - without a way to clean themselves while living on the streets, the unsheltered homeless are now also facing a greater risk of contracting and spreading COVID-19 within their communities.

B) PBSU As a Solution to Need Gap 1: Improving Accessibility and Availability of Hygiene/Sanitary Needs of Unsheltered Homeless
The PBSU offers the unsheltered homeless much-needed access to restroom facilities 5 days a week, 8.5 hours per day. Because of the PBSU, the unsheltered homeless have an available, secure place to relieve themselves and wash their hands/faces. This helps them retain their dignity; shields them from street dangers while relieving themselves; reduces incidents of indecent exposure/public urination; improves their living conditions; helps reduce the chance of COVID-19 spreading within the unsheltered homeless community; and reduces the general public’s exposure to infectious diseases (including COVID-19). Additionally, we now have COVID vaccinations on site through SJ Public Health, which is helping the homeless community get easy access to COVID-19 protection. Since the launch of the program in January 2021, the PBSU has provided 7,444 total bathroom/shower uses to 887 unique users! In 2021, 46 vaccines were administered by Public Health on site, and 19 COVID-19 tests were administered. We certainly have been filling in these gaps for the homeless community.

2. A) Need Gap 2: HMIS Data Collection Gaps
As discussed in the SJ County Point in Time Count 2019 (PITC), there is an ongoing struggle to collect accurate data about homeless individuals; it is also difficult to establish connections with homeless individuals via typical street outreach programs. This causes a knowledge gap in Stockton and in SJ County at large - the amount of homeless individuals reported does not necessarily mirror the actual amount of homeless in the area. Furthermore, data collected on individuals who are interacted with only once for the purpose of a count may be incomplete, thus hindering aid.

B) PBSU As a Solution to Need Gap 2: Helping with HMIS Data Collection The DSA collaborates with the county via the PBSU to improve the collection of data entered into the HMIS. PBSU monitors engage with homeless individuals using the bathrooms in order to learn about them, including but not limited to SSN, birthdate, housing status, ethnicity, preferred language, length of time on the streets, mental health status, and physical health status. The very nature of the PBSU attracts individuals who are most difficult to track in typical counts - unsheltered individuals. Since bodily functions are daily occurrences - and unsheltered individuals are the most common PBSU
users – the PBSU can build more robust files on unsheltered homeless who live in Downtown Stockton and surrounding areas. Repeat users such as those who use the PBSU contribute to a more detailed HMIS. Since the launch of the program in 2021, DSA has reported all 887 users into the HMIS; of those users, 183 individuals were NEW entries into the HMIS/they were not previously accounted for in the county's system. This proves that our program is contributing to increasing the accuracy of our county's homeless count.

3. A) Need Gap 3: Barriers to Housing – Mental Health and Substance Abuse The 2019 PITC mentions mental illness and drug or alcohol addiction as barriers to housing for the unsheltered homeless population. The 2019 PITC asserts that 63% of the County’s unsheltered homeless struggle with substance Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 4
abuse, and 37% of unsheltered homeless suffer from mental health problems. Having these issues makes it difficult for individuals to successfully enter into or remain in a shelter, without appropriate services. While this data is County-wide, it applies to all SJ cities, including Stockton.

B) PBSU As a Solution to Need Gap 3: Serving as a Hub for Information and Access to Homeless Resources for Mental Health and Substance Abuse
In addition to collecting information about users, the PBSU serves as a hub of information for homeless resources, like mental health services, substance abuse services, medical services, and housing for the unsheltered homeless in the Downtown Stockton area. Literature about these programs is available at the PBSU site; monitors recommend resources; and DSA collaborates with agencies to plan site visits to directly connect individuals with mental health, substance abuse, veteran, and housing programs. 3 PBSU clients have acquired jobs and entered shelters; 5 others have enrolled in the Ready to Work program; and several have accessed medical, drug, or mental health services through referrals from SJ Public Health.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 8
G. Project Narrative
Completed by [email protected] on 1/21/2022 4:16 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

G.1. How would you characterize your program/project based on the continuum of approaches to housing and public service needs listed below: (Select Top Three)
 PREVENTION - Helps prevent a problem before it emerges  EARLY INTERVENTION - Addresses a problem in its early manifestation to keep it from becoming worse  TRANSITION - Helps move clients toward a better situation, lower level of need, etc.  MAINTENANCE - Helps to ensure that clients do not decline, etc.  SELF-SUFFICIENCY - Helps move clients toward a situation in which they will no longer need the program or service
 STABILIZATION - Helps clients attain stability so that they can work toward a better situation G.2. Describe in detail how the program/project will address each of the 3 housing and public service needs selected above (i.e. how it specifically addresses prevention/early intervention etc.) Transition
The PBSU Program helps clients move toward a better situation by giving them a dignified place to use the restroom and also giving them the means to keep their bodies clean. Without the PBSU program, the unsheltered homeless have to try to find a secluded place to relieve themselves and may have no way to bathe apart from trying to wade in the Delta water.

Self-Sufficiency
The PBSU program helps clients gain more control of their lives by giving them the ability to fulfill the very basic needs of personal hygiene. By keeping themselves clean, they are able to better integrate into society, and may even be able to obtain a job. The information we share regarding other homeless service programs also moves clients towards self- sufficiency or a lower level of need by giving them access to mental health, physical health, substance abuse, or housing services, which can help lift them out of their unsheltered state.

Stabilization
The PBSU program provides stabilization for clients by offering them a consistent place to have their hygienic needs met. By having a regular location, M - F, from 8:00 AM - 4:30 PM, clients know they can count on being able to use the toilet or to shower on a regular basis. This consistency offers a way to stabilize their lives on the streets; instead of wondering when or how they will be able to use the restroom or to shower, they can arrange their schedule to have a clean shower and a safe place to use the restroom 5 days a week. This is one small step toward reducing the stress and unpredictable
nature of living on the streets. Having a dependable way to stay clean can lead them closer to the possibility of Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 8
wanting to receive other services and can also make it much easier for them to obtain and hold a job. 3 PBSU clients have entered shelters and found jobs, and 5 others have enrolled in the Ready to Work program.

Timeline
The requested CDBG funding will contribute to the operations of the PBSU from July 1, 2022 to June 30, 2023. An average of $4,313 CDBG funds will be spent on a monthly basis during this 12 month period. The program will continue to operate beyond the requested CDBG funding time period, provided DSA can secure additional funding to do so, or provided that DSA finds a partner who can take over operations at that point in time.

Detailed Description
As mentioned earlier in the application, the PBSU program encompasses the maintenance and operation of 1 mobile bathroom unit (with 3 toilets and 3 showers) for homeless individuals which is open from 8:00 AM – 4:30 PM, Monday –Friday, at the parking lot of St. John’s Church (316 N. El Dorado Street in Downtown Stockton). The PBSU is in operation year round.

The PBSU is supervised by a DSA ambassador and 2 Ready-to-Work attendants who gather homeless user information for the Homeless Management Information System (HMIS); monitor users (who have a 15 - 20 min. time limit depending on whether they are using the toilet or the shower); track restroom usage frequency; distribute sandwich lunches 3 times a week; provide clean undergarments and other clothing to clients; and provide mental health, physical health, and housing service brochures/information. Users can return as often as they want to use the toilet and/or shower.

In addition to operating the PBSU, the DSA coordinates site visits with service agencies to link the homeless directly to housing and service providers, thus enabling the PBSU to meet the immediate public lavatory needs of unsheltered homeless individuals; connect said individuals with food, housing, mental health, COVID-19 vaccinations/testing, and medical resources; reduce the general public’s exposure to human waste health hazards; and provide employment/experience to low-income individuals. This project is a continuation of the PBSU project, which launched at the start of 2021. The project will continue year-round, as long as DSA is able to secure funding or until the DSA finds a partner who is willing to take on operation of the unit.

Activities
The specific tasks/activities which will be undertaken to accomplish our objectives will be:

1. Operation of the portable shower and bathroom unit M – F, 8:00 AM – 4:30 PM, using a supervisor and two bathroom
attendants to interact with users and gather user information; clean the bathrooms; order PBSU supplies; and share information about other homeless services to clients.

2. Provision of lunch 3 times a week to homeless individuals.

3. Entry of collected client information into the HMIS by office staff.

4. Staff review of PBSU data to ensure goals/benchmarks are being met.

5. Coordination with homeless service providers to obtain program marketing materials and to arrange for providers to be on site.

6. Keeping in regular contact with homeless service providers to track whether clients are gaining access to other homeless services.

7. Promotion of the PBSU through social media, posters, and sharing information with strategic organizations to Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 8
increase
the number of users/clients.

All of these activities will help us achieve our aims of providing more available and accessible hygienic services to the unsheltered homeless, of connecting unsheltered homeless with other homeless service providers, and helping to add information/data about our county’s unsheltered homeless population to the HMIS.

PBSU Goals/Benchmarks

1. DSA has set a goal for 30 uses a day on average as a measure of success for the program, with a goal of serving 800 unique clients yearly, and of those we expect 799 of them to be Stockton residents. We also have set a goal for 7,000 total uses. To achieve this goal, we are planning to conduct over 2,000 hours of PBSU operation.

2. DSA has set a goal of helping at least 10% of total PBSU clients (80 individuals) yearly to receive mental health, physical health, or substance abuse services and/or transition into housing.

3. DSA aims for accurate entry of 95% of client user data to be collected and then entered into the HMIS.

For us, success would mean meeting or exceeding our goals for PBSU usage, users, and number of clients getting access to services that can help them transition out of life on the streets; and successful data entry into the HMIS.

Project Activity or Program
Service #
Describe the Deliverable
1 DSA has set a goal for 30 uses a day on average as a measure of success for the program, with a goal of serving 800 unique clients yearly, and of those we expect 799 of them to be Stockton residents.

We also have set a goal for 7,000 total uses. To achieve this goal, we are planning to conduct over 2,000 hours of PBSU operation. 2 DSA has set a goal of helping at least 10% of total PBSU clients (80 individuals) yearly to receive mental health, physical health, or substance abuse services and/or transition into housing. To achieve this goal, we are continuing our coordination with SJ Public Health and other homeless service providers to provide information and/or on site services to our homeless clients.
3 DSA aims for accurate entry of 95% of client user data to be collected and entered into the HMIS. To achieve this, daily, the PBSU supervisor checks her written client records with those the attendants have entered into the Fulcrum app to be sure that 95 – 100% of data is properly recorded. If she notices a mistake or that a client is missing, she coordinates with the attendants to correct a mistake or add the client immediately, if possible. A second ambassador enters this data into the HMIS.

The DSA has sufficient organizational capacity to implement the PBSU program, as evidenced not only by our current management of the PBSU program itself, but also by various teams, programs, grants, and other projects DSA has managed. Our current programs and success are outlined below and demonstrate the capabilities of our organization:

Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 8

1. Downtown Maintenance Team & Equipment
For over 24 years, the Downtown Stockton Alliance has managed a maintenance team within our 123 square block district; they are responsible for picking up trash/human waste/litter on sidewalks, removing graffiti from street- facing buildings, removing weeds on sidewalks, and emptying trash cans within the Downtown area. We also manage a pressure washing team. In our operation of this program, we successfully manage capital equipment in the form of 7 mules, an EV, two trucks, pressure washers, etc., which we keep in our maintenance garage. We currently manage over 20 maintenance crew members. As a part of providing these services, we track the amount of trash they pick up each day, the number of service calls they address, and the number of graffiti instances they remove; this is all compiled in our annual report and demonstrates our ability to effectively manage a team, to collect and report data, and to execute services.

2. Safety Ambassador Program
Since February 2020, DSA has managed the Downtown Safety Ambassador Program, which involves the supervision, training, and hiring of an ambassador team which patrols the Downtown district. These safety ambassadors monitor the district 20 hours a day, 7 days a week and are required to report all incidents using the Fulcrum app. This again demonstrates our ability to manage teams. to track/collect data, and to execute services.

3. Grants Managed
The DSA has also managed several grants in recent years. Grants which were managed in the last few years included a CDBG grant from the City of Stockton for the PBSU in 2020 ($93,442), a CDBG grant for entrepreneur workshops in partnership with Centro Community Partners, a tech incubator grant from PG&E, a SJC ESG-CV grant ($220,000 for 2021 - 2023), a SJC ESG grant ($8,809 for 2021 - 2022) and a 2020/2021 COS ESG-CV grant ($110,000) for the PBSU.

Through the Downtown Stockton Enterprise Loan Fund (DSELF) – a 501(c)3 nonprofit under the DSA’s umbrella - we received over $100,000 from banks in 2006-2007 specifically to use for microlending to small downtown businesses, and have grown that fund to over $200,000. We have effectively managed and submitted reporting for all grants which we have received in the past.

4. PBSU Program
Last year, we began operating the PBSU program. We have one supervisor and 2 attendants managing the program M - F, 8:00 AM - 4:30 PM, and we have been able to successfully gather and track data for 887 unique users and have also collected usage data for 7,444 total uses, using an app called Fulcrum. We have cleaned and maintained the unit, served and ordered lunches 3 times a week, partnered with laundry service providers, coordinated with donated clothing providers, and partnered with SJ Public Health to have COVID-19 vaccinations/testing administered on site.

We have entered our user data into the county's HMIS. Our successful execution and management of this program in 2021 demonstrates our capability to continue managing this program in 2022 and beyond.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
Our agency implements the program as described previously. Our staff (an ambassador/PBSU supervisor and 2 PBSU attendants) operate the mobile bathroom unit (with 3 toilets and 3 showers) for homeless individuals from 8:00 AM – 4:30 PM, Monday – Friday, at the parking lot of St. John’s Church (316 N. El Dorado Street in Downtown Stockton).

The PBSU is in operation year round.

Clients access the unit simply by walking into the parking lot, asking the attendants to use it, and answering our survey/questionnaire.

The PBSU is supervised by a DSA ambassador/PBSU supervisor and 2 Ready-to-Work attendants who gather homeless user information and enter it into the Fulcrum app; monitor and remove users if they exceed permitted usage time limit (15 - 20 min. depending on whether they are using the toilet or the shower); track restroom usage frequency; Attachment A
Printed By: Kayla Martin on 4/1/2022 5 of 8
serve sandwich lunches 3 times a week; provide clean undergarments and other clothing to clients; and provide mental health, physical health, and housing service brochures/information.

The DSA ambassador/PBSU supervisor coordinates site visits with service agencies to link the homeless directly to housing and service providers, thus enabling the PBSU to meet the immediate public lavatory needs of unsheltered homeless individuals; connect said individuals with housing, mental health, and medical resources; reduce the general public’s exposure to human waste health hazards; and provide employment/experience to low-income individuals.

A second DSA ambassador takes the collected user data in Fulcrum and enters it into the HMIS system.

The DSA CEO conducts the ordering of supplies and schedules maintenance of the PBSU, conducts grant reporting, and builds relationships with other homeless service providers to help spread the word about the PBSU.

The DSA Marketing Coordinator promotes the PBSU on social media.

The DSA Economic Development Director compiles information to assist with the quarterly reports and annual report.

Lastly, our Safety Ambassadors distribute informational cards with details about the PBSU's location and hours to homeless individuals they encounter on the streets.

Project Deliverable # Describe the Deliverable
1 DSA has set a goal for 30/day on average as a measure of success for the program, with a goal of serving 800 unique clients yearly, and of those we expect 799 of them to be Stockton residents. We also have set a goal for 7,000 total uses. To achieve this goal, we are planning to conduct over 2,000 hours of PBSU operation through our PBSU supervisor and 2 attendants. Clients access the unit by walking into the parking lot, asking the attendants to use it, and answering our survey/questionnaire.
2 DSA has set a goal of helping at least 10% of total PBSU clients (80 individuals) yearly to receive mental health, physical health, or substance abuse services and/or transition into housing. To achieve this goal, we are continuing our coordination with SJ Public Health and other homeless service providers to provide information and/or on site services to our homeless clients. Our PBSU supervisor and CEO coordinate these services. 3 DSA aims for accurate entry of 95% of client user data to be collected and entered into the HMIS. To achieve this, daily, the PBSU supervisor checks her written client records with those the attendants have entered into the Fulcrum app to be sure that 95 – 100% of data is properly recorded. If she notices a mistake or that a client is missing, she coordinates with the attendants to correct a mistake or add the client immediately, if possible. A second ambassador enters this data into the HMIS.

G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? Goal Criteria 1: DSA aims for 30 uses a day on average as a measure of success for the program, with a goal of serving 800 unique clients yearly, and of those we expect 799 to be Stockton residents. We also have set a goal for 7,000 total uses. To help achieve this goal, we will conduct over 2,000 hours of PBSU operation.

Attachment A
Printed By: Kayla Martin on 4/1/2022 6 of 8
Measuring success: We examine our average daily uses on a monthly totals to see whether we are meeting our goal of 30 uses on average, a day; if we aren’t consistently meeting that goal, then we look to improve marketing efforts and coordination with other service providers to be sure knowledge of our program has permeated the community.

Goal Criteria 2. DSA aims for at least 10% of PBSU clients (80 individuals) yearly to receive mental health, physical health, or substance abuse services and/or transition into housing.

Measuring success: Monthly, we plan to talk with the service providers whose marketing materials are at the PBSU or who have been to the site to promote their services in order to learn whether clients from the PBSU have used their services. We also will talk with regular PBSU clients themselves to learn what changes they have made in their lives. If we don’t see that at least this minimum number is being reached on a monthly basis, then we will examine whether we need to bring additional or different service providers out to the site, or improve our communication to the clients about services available.

Goal Criteria 3. DSA aims for accurate entry of 95% of client user data to be collected and then entered into the HMIS.

Measuring Success: Daily, the PBSU supervisor checks her written client records with those that the attendants have entered into the Fulcrum app to be sure that 95 – 100% of the client data is being properly recorded. If she notices a mistake or that a client is missing from the app, then she coordinates with the attendants to correct a mistake or add the client immediately, if possible. Any mistakes in collection are addressed with the attendants as soon as they occur, so as to prevent repetition of errors. Our data entry staff member then takes that collected information and enters it into the HMIS, checking with the PBSU supervisor if they have any questions, and checking for accuracy. The records from the PBSU will be compared with the HMIS records on a quarterly basis to ensure that all info is correctly matched.

Deliverable # Task that Support Deliverable
1 To achieve the goal of 800 users and 7,000 uses, we will conduct over 2,000 hours of PBSU operation through our PBSU supervisor and 2 attendants, who will operate the PBSU M – F, 8:00 AM – 4:30 PM; gather user information; clean the bathrooms; order PBSU supplies; provide lunch 3 times a week to clients; provide clean undergarments and other clothing items; and share information about other homeless services to clients. DSA staff will also promote the PBSU to the public and review PBSU data.
2 To achieve the goal of helping at least 10% of total PBSU clients to obtain access to other homeless services, DSA staff will coordinate with homeless service providers to obtain program marketing materials and to arrange for providers to be on site, and keep in regular contact with homeless service providers to track whether clients are gaining access to other homeless services.
3 To achieve the goal of accurate entry of 95% of client user data to be collected and entered into the HMIS, DSA staff will collect client data and enter it into Fulcrum; check the accuracy of daily entries; transfer Fulcrum data into the HMIS; and review data regularly to correct any mistakes.

Attachment A
Printed By: Kayla Martin on 4/1/2022 7 of 8
G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
This project will target the unsheltered homeless in and around Downtown Stockton, CA; the unsheltered homeless will benefit by gaining access to a bathroom and shower for no fee, while also gaining access to lunches 3 times a week, public health services such as COVID-19 vaccinations/testing, and information about other homeless services in the community. The eligibility requirements are simply that clients fill out our questionnaire/survey and sign our user agreement.

The PBSU Program differs from similar programs, like Showered With Love (the most similar local program) in a few ways. First, the PBSU offers toilets, whereas Showered With Love only offers showers. Second, the program is in operation Monday - Friday, from 8:00 AM – 4:30 PM in one consistent location, whereas Showered With Love rotates its locations between Stockton and Lodi and only operates a few days/week from 9:00 AM – 1:30 PM. Because our program runs 5 days/week, it offers more opportunities for the unsheltered homeless to wash their hands/faces, use the bathroom, and /or take a shower. We do not currently collaborate with Showered With Love, although we did share space with them at St. John's for part of 2021.

We currently collaborate with St. John’s Episcopal Church; they allow us to place the PBSU in their parking lot and have also allowed us to construct a shed for storage (see our MOU in the additional attachments section). They have also donated hairbrushes, food, clothing, and other items to The PBSU program.

We currently collaborate with Ready-to-Work to recruit the PBSU attendants.

We have also coordinated with Central Valley Low Income Housing in order to gain access to the HMIS.

We currently partner with SJ Public Health to provide health services and COVID-19 vaccines on site.

We partner with laundry service provider Uplift All to provide weekly laundry service to the homeless on site.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

As described earlier in this application, the DSA is seeking gap funding from either the City's CDBG or ESG programs to complement the already secured funding of $110,000 from SJ County's ESG-CV grant for 2022/2023. We plan to continue operation for as long as we are able to obtain funding or until we are able to find a partner organization interested in taking over the project.

Our Executive Director Mike Huber sits on the South Pointe Coalition Board.

Our Executive Director Mike Huber and Economic Development Director Courtney Wood sit in on the EDD's Community Resource calls.

City of Stockton EDD employee Tina McCarty sits on our Board of Directors.

Attachment A
Printed By: Kayla Martin on 4/1/2022 8 of 8
City of Stockton EDD employee Nicole Snyder sits on our Downtown Stockton Enterprise Loan Fund (DSELF) Board of Directors.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
H. ESG
Completed by [email protected] on 1/21/2022 4:12 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:
0 H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

As mentioned earlier in the application, the PBSU program encompasses the maintenance and operation of 1 mobile bathroom unit (with 3 toilets, 3 sinks, and 3 showers) for homeless individuals which is open from 8:00 AM – 4:30 PM, Monday – Friday, at the parking lot of St. John’s Church (316 N. El Dorado Street in Downtown Stockton).

This project is instrumental in directly preventing the spread of COVID-19 by offering the unsheltered homeless a much-needed place to use the restroom/wash their hands/shower. The unsheltered homeless typically do not have bathrooms readily available to them. They could come into contact with COVID-19 and have nowhere to wash their hands/prevent themselves from contracting the virus as a result of their initial contact with it. The PBSU gives them critical access to personal hygiene services which can protect homeless individuals and can also prevent the spread of COVID-19 within the unsheltered homeless community, and the community at large. Additionally, our coordinated site visits by SJ Public Health provide homeless individuals with direct access to COVID-19 vaccinations and testing, further helping to decrease the likelihood that they will contract COVID-19 or become seriously ill from COVID-19. In 2021, 46 vaccines were administered by Public Health on site, and 19 COVID-19 tests were administered.

The PBSU meets the immediate public lavatory needs of unsheltered homeless individuals; prevents the contraction and spread of infectious illnesses like COVID-19; connects said individuals with housing, mental health, and medical resources; reduces the general public’s exposure to human waste health hazards; and provides employment/experience to low-income individuals.

Yes
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/4/2022 1:35 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

N/A - not a Public Facility project
I.4. Does the agency own or lease the property where the project will occur? Who is the legal property owner? If you are leasing, please provide a copy of the lease in the required documents section. If you do not have site control, describe your site control plan.

N/A - not a Public Facility project
I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

N/A - not a Public Facility project
I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

N/A - not a Public Facility project
I.7. Has a market study, property needs assessment and/or other evaluation that identifies the need for the proposed project been completed? If so, describe and upload the project reports and schedule). If no reports have been completed, explain how you plan to proceed.

N/A - not a Public Facility project
I.8. When will construction start and end? Provide a timeline with all critical milestones.

N/A - not a Public Facility project
I.9. Is this project a multi-phased activity?
No
I.10. Will this project require implementation of Davis-Bacon/Fair Labor Standard Act requirements? Note: Please contact staff immediately if you have questions regarding Davis-Bacon requirement or for more informationclick Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
here.

N/A
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

This is a continuation of the existing PBSU program/service described earlier in the application, which we launched in January of 2021.

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/21/2022 4:11 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.1. Identify AT LEAST ONE barrier in implementing your program/project:
 A marketing and publicity campaign that provides consumers with additional education and information about the agency’s programs and services.
 Coordination and collaboration with other service providers.  Accessing and utilizing “un-tapped” resources
 Removing barriers that limit access to services and participation (e.g. language, time, cost, transportation, etc.).

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

1. Coordination and collaboration with other service providers.

When it comes to coordination and collaboration with other service providers, it can be difficult to get everyone working towards a common goal. Additionally, some organizations who provide homeless services don't always enter their data into the HMIS, which means their data is not necessarily shared with the county or other organizations.

Through DSA's relationships with homeless service providers, the PBSU program encourages other service agencies/organizations, like SJ Public Health, Uplift All, etc., to come to the table and set agreed-upon days/times to provide service/visit the PBSU site, which serves as a gateway to their own services. The PBSU encourages collaboration among service providers and helps to build a stronger referral network for homeless services, as evidenced by the number of PBSU clients who accessed vaccines, other medical care, mental health assistance, and shelters after visiting the PBSU. Additionally, the PBSU program's collection of client data and entry of that data into the HMIS increases the sharing of homeless client information among homeless service providers and with SJ County; as mentioned, we helped input data for 887 individuals, of which 183 were brand new entries into the HMIS.

2. Removing barriers that limit access to services and participation Homeless individuals are frequently banned from using business restrooms, and there are few public restrooms available in the Stockton area, since many park restrooms are permanently closed. Unless you are a paying customer at a business, it can be difficult to find a public restroom; similarly, free showers are not readily available to those who are unsheltered.

The PBSU program removes all barriers for unsheltered individuals looking to use the bathroom or to take a shower.

There is no monetary cost to the client to use our service, and the only requirement is that they take our survey/questionnaire. We provide free access to showers and toilets to unsheltered homeless who otherwise may not have access to these services. As mentioned, we served 887 individuals in 2021, with a total of 7,444 bathroom/shower uses for the same year. We also connect the homeless with COVID-19 vaccines and COVID-19 testing through SJ Public Health on site, for free; this helps eliminate barriers they might have been experiencing in terms of COVID-19 prevention and care. In 2021, 46 vaccines were administered by Public Health on site, and 19 COVID-19 tests were administered.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients This program is very accessible to the average ambulatory person via public transportation.

The PBSU is within .1 miles of the El Dorado and Fremont Bus Stop, which equates to a 2 minute, 1.5 block walk.

The PBSU is within .4 miles of the Greyhound bus station on Weber Avenue, which equates to an 9 minute walk that spans 5 blocks.

The PBSU is within .1 miles of the Weber & Center Bus Stop, which equates to a 3 minute walk that spans 1.5 blocks.

The PBSU is within .7 miles of the ACE train station, which equates to a 14 minute walk that spans 10 blocks.

In addition to being accessible via public transit, this location is also walkable for individuals who are receiving assistance
from the Human Services Agency (7 blocks away; .6 miles; 12 minutes walking distance) and the Gospel Center Rescue Mission (10 blocks away; .7 miles; 15 minutes walking distance).

This central location is ideal for the target population of unsheltered homeless, so no additional measures will be taken
to specifically reduce transportation barriers.

J.4. Identify AT LEAST ONE City of Stockton U.S. Department of Housing and Urban Development (HUD) FY 2020- 2025 Consolidated Goal that relates to your program/project:
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing. Expand the housing first model to provide permanent housing units with intense wrap-around services on-site.  Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income households. Provide homeownership opportunities for low-income-moderate income first-time buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/21/2022 9:22 AM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
budget table 2022-2023 final 1.11.2022.pdf
Project Scope and timeline 2022-2023 1.11.2022.pdf
 Organization Operational Budgets *Required
DSA 2021 Budget.pdf
DSA 2022 Budget Draft (3).pdf
 Organization Financial Statements *Required
DSA Financial 12.31.21.pdf
 Tax Status *Required
IRS Tax ID Letter.pdf
 Board of Directors Roster *Required
2022 Full Board Roster.pdf
47337_Conflict of Interest on our Board.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 4
 Articles of Incorporation/Bylaws *Required
DSA Original Articles of Incorporation.pdf
ByLaws.pdf
 Conflict of Interest Statement *Required
Conflict of Interest Statement.png
 Organization chart *Required
Organizational Chart 2022.pdf
 Board of Directors’ authorization to request CDBG/ESG funding *Required resolution to apply for CDBG or ESG money.pdf
 Business License Number *Required
bus license 2022.PDF
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required Insurance Cert.PDF
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required Personnel Policies.pdf
43948_EmployeeIncidentReportForm.png
 Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
St. John's MOU.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 4
 Evidence of Site Control
**No files uploaded
 SAM.gov - screen shot of sam.gov registration *Required sam.gov screenshot.pdf
 Key Program Staff Resume *Required
Shirley's Resume - PBSU Supervisor.pdf
About Resumes or Backgrounds of the Attendants.pdf
 Title Report
**No files uploaded
 Optional Documents
43873_Client Service Map-Intake Process.pdf
43875_Cleaning Procedures for PBSU.pdf
43874_PBSU Intake Survey-Questionnaire.pdf
43876_Pit Stop Protocols - Guidelines for Workers.pdf
SJC ESG CV $220,000 Agreement 2021 Downtown Stockton Alliance (1).pdf SJC ESG $8,809 2021 Down Stockton Alliance (1).pdf
ESG-CV Downtown Stockton Alliance Agreement.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
Submit
Completed by [email protected] on 1/21/2022 4:22 PM
Case Id: 48563
Name: Downtown Stockton Alliance - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
Michael Huber
Title
Executive Director
Date
01/21/2022
Signature
Michael Huber
Electronically signed by [email protected] on 1/21/2022 4:21 PM Please download and upload the Certification page here.  Certification Page *Required
signed -CDBG.ESG Signature.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
Program Overview
Completed by [email protected] on 1/21/2022 9:53 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
A. Eligibility
Completed by [email protected] on 1/20/2022 8:12 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Service
If using ESG funds
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
B. Contact Information
Completed by [email protected] on 1/20/2022 8:21 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
San Joaquin Fair Housing Foundation, Inc.

B.2. Mailing Address
401 S El Dorado Street Suite A Stockton, CA 95203

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Robert
B.4. Last Name
Brooke-Munoz
B.5. Email
[email protected]
B.6. Phone Number
(209) 451-3471

POINT OF CONTACT INFORMATION
B.7. First Name
Robert
B.8. Last Name
Brooke-Munoz
B.9. Email
[email protected]
B.10. Phone
(209) 451-3471

ORGANIZATION CONTACT INFORMATION
B.11. Website
www.sjfairhousing.com
B.12. DUNS Number
965,161,656
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
B.13. EIN Number
843,483,719
B.14. Business License Number and Expiration Date
San Joaquin Fair Housing Foundation, Inc.

B.15. Type of Agency
501(c)(3)
B.16. Number of Paid Staff
7 B.17. Number of Volunteers
1 Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/20/2022 8:24 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
San Joaquin Fair Housing
C.2. Project Site Location
401 S El Dorado Street Suite A Stockton, 95203
C.3. Funding Requested in this application
$174,255.00
C.4. Other funds already secured for the project
$0.00
C.5. Total Cost to Complete Project
$274,828.00
C.6. Other funds not yet secured
$100,573.00
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/20/2022 9:26 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

San Joaquin Fair Housing is a critical partner and community resource for preventing local evictions and increased homelessness. Our role is to provide information, training and counseling services to renters and landlords. San Joaquin Fair Housing has been serving the community since 1983.

Income Limits Clients Served
Moderate Income (More than 80%) 30
Low Income (50%-80%) 79
Very Low Income (30%-50%) 41
Extremely Low Income (Less than 30%) 3,081
3,231
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 1,277 182
Black/African American 1,108 66
Asian 151 17
Am. Indian/Alaskan Native 18 2
Native Hawaiian/Other Pacific Islander 11 0
Am. Indian/Alaskan Native & White 16 1
Asian & White 6 0
Black/African American & White 6 0
Am. Indian/Alaskan Native & Black/African American 6 0
Other Multi-Racial 632 514
3,231 782
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 57
Female Headed Households 1,596
Seniors 13
Youth 0
Homeless 76
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
1,742
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 3
E. Project Funds
Completed by [email protected] on 1/24/2022 1:19 PM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
E. Project Funds
Please provide the following information.

N/A
E.2. Please indicate if this application is a request for one-time funding and/or “seed” funding. If not applicable, state “N/A.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
San Joaquin
Fair Housing
Stockton, Lodi
& SJ County
$226,606.00 Completed $0.00
FY2017/18
ESG
$0.00 $0.00
FY2018/19
CDBG
San Joaquin
Fair Housing
Stockton, Lodi
& SJ County
$250,935.00 Completed $0.00
FY2018/19
ESG
$0.00 $0.00
FY2019/20
CDBG
San Joaquin
Fair Housing
Stockton, Lodi
& SJ County
$239,368.00 Completed $0.00
FY2019/20
ESG
$0.00 $0.00
FY2020/21
CDBG
San Joaquin
Fair Housing
Stockton, Lodi,
SJ County &
HACSJ
$201,368.00 completed $0.00
FY2020/21 ESG $0.00 $0.00
FY2021/22
CDBG
San Joaquin
Fair Housing
Stockton, Lodi
& SJ County
$2,344,225.00 On-going $0.00
FY2021/22 ESG $0.00 $0.00
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 3
Proposed funding:

City of Stockton - $174,255
SJ County - $82,573
City of Lodi - $18,000
E.5. What will be the impact on your agency, program, or project goals be if the program is not funded at the full amount requested? Will your organization have the ability to sustain itself if the funding allocated is less than the amount requested? Please provide detailed information to understand if this is a funding gap and/or funds used to leverage additional sources outside of Stockton i.e. County/State/Federal/Private Funds SJFH will still provide all services but would have to limit the amount of residents that we can work with. This could increase evictions that would be detrimental to tenants trying to secure housing; it will have these individuals living in substandard rentals with dubious owners that only collect rent. As such, the already overloaded court calendar would be impacted with more unlawful detainer actions which lead to homelessness. Less mediation would occur leaving tenants with no voice and owners providing less than minimum requirements under the City code enforcement. Less funding would also increase the possibilities of discrimination practices occurring but left overlooked.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

SJFH will serve the entire City of Stockton. Our major goal is to serve the very low to medium income residents but will have never denied services to anyone. We also provide services to the Cities of Lodi, Escalon, Lathrop, Manteca, Ripon and Tracy as well as all of the unincorporated areas of San Joaquin County.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents Yes
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents Yes
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

No
Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 3
Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Number required at time of assistance). Please attach a blank worksheet under Required Documents No
Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

No
E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

The funding provides a permanent location and a trained staff of Housing Counselors that possess the knowledge of tenant and landlord rights & responsibilities and Fair Housing law. The funds cover all costs involved in keeping the agency in operations.

E.9. Select the common indicator that your agency will use to track clients.

N/A
E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 4,106
Households 0
Other 0
4,106
E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

The program provides outreach to the private and public organizations within this county. The program accomplishes this by conducting seminars at Community centers, Homeless Shelters, Head Start programs, San Joaquin Delta College, City and County Code Enforcement offices, Property Management companies, and in conjunction with the Housing Authority of the County of San Joaquin. We educate the Partnership agencies, public and private organizations on education and responsibilities of each party and where a referral would be made if a party felt that they were a victim of discrimination. Our service delivery methods include telephone contacts, in-office face to face contact, referrals to code enforcement and law enforcement. We also mail, fax and e-mail information to anyone that requests it.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
F. Project Impact
Completed by [email protected] on 1/24/2022 2:02 PM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 33
Low Income (50%-80%) 115
Very Low Income (30%-50%) 35
Extremely Low Income (Less than 30%) 3,923
4,106
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 1,676 265
Black/African American 1,338 100
Asian 177 24
Am. Indian/Alaskan Native 35 2
Native Hawaiian/Other Pacific Islander 11 0
Am. Indian/Alaskan Native & White 21 2
Asian & White 17 3
Black/African American & White 12 1
Am. Indian/Alaskan Native & Black/African American 7 1
Other Multi-Racial 812 633
4,106
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 29
Female Headed Households 1,717
Seniors 8
Youth 0
Homeless 153
1,907
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
17 4,084 4,084
2020-2021 (Anticipated) 14 3,231 3,231
2021-2022 19 4,491 4,491
50 11,806 11,806
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

Mandated by HUD, this program is designed to further fair housing practices in the rental properties of Stockton. SJFH does this by providing education, mediation and discrimination complaints from residents that believe their rights have been violated under State and Federal law.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

The origin of this program was incorporated as a non-profit in 1983 to fulfill the HUD requirement for the City of Stockton to receive CDBG funding. The CDBG funding requirement indicates that there must be a component to further fair housing practices within the City of Stockton. SJFH has had the privilege and honor in providing these services for the past 39 years.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 4
G. Project Narrative
Completed by [email protected] on 1/24/2022 2:34 PM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

Early Intervention: Our agency works to assists tenants with the information needed to handle such issues as repair requests, referrals to other agencies that can assists with legal or financial issues, as well as communication assistance with their housing provider in order to remedy the situation before it escalates to a situation that cannot be remedied.

Stabilization: Our agency assists clients through seminars, workshops, community events, outreach and one on one consultation to educate both tenants and landlords on their rights and responsibilities, current housing laws and correct practices in order to assure that they will improve the quality of their housing environment.

SJFH will provide one-on-one education and mediation to both the tenant and the property owner with rental housing issues within the City of Stockton. We also provide education, medication and investigation on State and Federal Fair Housing laws to the tenant, Property Management and owners. We do conduct outreach in the form of seminars, Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 4
public speaking to interested groups, sending out flyers, informational booths at Community events and outreach to all social service agencies in our area.

There are no other programs within the City of Stockton or San Joaquin County that provide similar services or that fulfill HUD requirements to ensure Fair Housing practices are adhered to. There are no other services that provide comprehensive tenant, property management/owner education and mediation services as an alternative to the legal system. As stated, this program has developed a strong liaison between property management, private owners, the Housing Authority, City Code and other City departments including California Rural Legal Assistance but none of these programs provide the full scope of services we encircle.

Project Activity or Program
Service #
Describe the Deliverable
1 Counseling and mediation are done on a daily basis. Our projected goal is 4106 City of Stockton residents. Office is open to the public Monday to Thursday 9am - 5pm and every other Friday 830am - 430pm
1 Tenant & landlord virtual workshops on rights & responsibilities are scheduled. A total of 4 tenant and 4 landlord workshops will be provided during the fiscal year.
1 SJFH will attend community events where Housing Counselors will be available to answer questions and give guidance.
1 SJFH will send out brochures to all funding entities. City of Stockton, City of Lodi, San Joaquin County, Escalon, Ripon, Tracy, Manteca & Lathrop.
1 SJFH will send our brochures and flyers to community partners and social service agencies in the community.
1 Quarterly meetings with California Rural Legal Assistance to stay updated on current laws and procedures.

SJFH has been in existence for over 39 years and has managed their CDBG funds as mandated. The Executive Director Robert Brooke-Munoz will be monitoring the federal and/or state grants. The Executive Director will oversee all expense. Hilda Maya/Program Manager is responsible in submitting the allocation billings and funding request to the Executive Director for review and approval on a monthly basis. The agency is under contract for accounting services, which will generate a monthly profit & loss statement and a monthly balance sheet. Our annual tax return will be completed by a CPA
San Joaquin Fair Housing staffing for 2022 - 2023
Robert A Brooke-Munoz/Executive Director: over 24 years for housing experience Hilda Maya/Program Manager-Housing Counselor has been with the agency for 13 years Maria Graham/Housing Counselor has been with the agency for 8 years Sonia Carrillo/Housing Counselor has been with the agency for 26 years G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
Our on-going services have been available to the residents of the City of Stockton for 39 years. The funding will allow Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 4
our program to stay in operation. Residents can call our office for assistance, bring in notices for review, email and attend our virtual workshops.

Project Deliverable # Describe the Deliverable
1 The program is on-going for the past 39 years. Continued outreach, community events and community contacts plus word of mouth.
1 The following staff will administer the program and its activities.

Robert A Brooke-Munoz/Executive Director: over 24 years for housing experience Hilda Maya/Program Manager-Housing Counselor has been with the agency for 13 years Maria Graham/Housing Counselor has been with the agency for 8 years Sonia Carrillo/Housing Counselor has been with the agency for 26 years 1 Clients will be able to call in and communicate by email, fax, virtual or US mail. SJFH is located downtown near bus lines and is fully handicapped accessible. 1 Attend regular CAA webinars for regular updates on current housing policy changes 1 Quarterly meetings with California Rural Legal Assistance to stay updated on current laws and procedures.

G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? SJFH currently uses a data base where we log in the work completed on each client. This includes physical location, income, family size, ethnicity and race, disability, veterans, homeless and single female household's.

Deliverable # Task that Support Deliverable
1 SJFH has a data base where all information is tracked on a daily basis. Location, family size, ethnicity, income etc...

Executive Director monitors the data base with staff on a monthly basis. 1 Every 3 months a written quarterly report will be completed so that SJFH can see how well they are preforming.
1 At the end of the fiscal year a year-end report will be completed. The report will show that the agency met or exceeded its projected goals.

G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
This program was designated by HUD to meet the national objective of the CDBG program by directing services in manner, which principally benefit 51% or more persons and families of very low, low and moderate income. San Joaquin Fair Housing has maintained serving the very low/low and moderated income residents of the City of Stockton at an average of over 90% in the last 39 years.

There are no other programs within the City of Stockton or San Joaquin County that provide similar services or that fulfil! HUD requirements to ensure Fair Housing practices are adhered to. There are no other services that provide comprehensive tenant, property management/owner education and mediation services as an alternative to the legal Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 4
system. As stated, this program has developed a strong liaison between property management, private owners, the Housing Authority, City Code and other City departments including California Rural Legal Assistance but none of these programs provide the full scope of services we encircle.

Robert Brooke-Munoz is part of several agency tasks force so he can network in hopes to secure any other funding available.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

San Joaquin Fair Housing has served the City of Stockton and all of San Joaquin County for 39 years. SJFH now has its 501(c)3 status which will enable the agency to see additional funding, collaborate with other 501(c)3's, seek out donations and fundraising. Due to limited funding San Joaquin Fair Housing was going to lay off 1 full-time Housing Counselor during the 2020-2021 fiscal year. SJFH was able to secure funding from the Community Foundation/Stockton Strong agency to retain the full-time Housing Counselor. SJFH applied for CDBG CV funds from the City of Lodi which enable us to hire a part-time receptionist/clerical support till June 30, 2021. SJFH applied and received ESG CV funding in 2021 which enable the agency to hire 2 full time Housing Counselors and 1 full time receptionist. This grant expires March 30, 2022.

We do not have any employees or board members that sit on any community boards, commissions or committees that would be considered a potential conflict of interest with this application for federal funds. Each board member is a volunteer from the community.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
H. ESG
Completed by [email protected] on 1/21/2022 9:54 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:

H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/24/2022 2:05 PM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

N/A
I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

N/A
I.8. When will construction start and end? Provide a timeline with all critical milestones.

N/A
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

N/A
I.12. For Economic Development activities only. Indicate the number of full-time and part-time jobs you expect to be created and retain, if your application is funded. Also indicate number of jobs likely to be filled by a low-income person:

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/20/2022 11:17 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.1. Identify AT LEAST ONE barrier in implementing your program/project:
 A marketing and publicity campaign that provides consumers with additional education and information about the agency’s programs and services.
 Coordination and collaboration with other service providers.  Accessing and utilizing “un-tapped” resources
 Removing barriers that limit access to services and participation (e.g. language, time, cost, transportation, etc.).

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

SJFH will continue to seek and apply for additional funding to add staff. A staffing of 3 full-time Housing Counselors & 1 part-time Housing Counselor is insufficient. SJFH applied and received ESG CV funding from the City of Stockton. The funding enabled SJFH to hire 2 additional full-time Housing Counselors and 1 full-time receptionist. The additional staff has enabled us to serve more individuals/families during the current pandemic. The ESG CV funds expire March 30, 2022 at which time the SJFH staffing will be reduced.

What we learned during the pandemic is that issues can be resolved by phone, emails, conference calls and virtual meetings.

J.4. Identify AT LEAST ONE City of Stockton U.S. Department of Housing and Urban Development (HUD) FY 2020- 2025 Consolidated Goal that relates to your program/project:
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing. Expand the housing first model to provide permanent housing units with intense wrap-around services on-site.  Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income households. Provide homeownership opportunities for low-income-moderate income first-time Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/24/2022 11:53 AM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
SJFH Foundation 2022 2023 operations budget.pdf
 Organization Operational Budgets *Required
SJFH Foundation 2021 2022 Operations budget.pdf
SJFH Foundation 2022 2023 operations budget.pdf
 Organization Financial Statements *Required
SJFH 2020 tax return.pdf
SJFH Foundation P&L balance sheet Jan 2022.pdf
 Tax Status *Required
SJFH Foundation ltr of good standing Jan 2022.pdf
 Board of Directors Roster *Required
Board of Directors SJFH Foundation 2022 2023.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 4
 Articles of Incorporation/Bylaws *Required
SJFH Foundation Bylaws Articles .pdf
 Conflict of Interest Statement *Required
SJFH Foundation Conflict interest Jan 2022.pdf
 Organization chart *Required
SJFH Foundation org chart 2021 2022.docx
SJFH Foundation Org chart 2022 2023.docx
 Board of Directors’ authorization to request CDBG/ESG funding *Required SJFH Foundation CDBG app aproval Jan 2022.pdf
 Business License Number *Required
SJFH Foundation business license May 2022.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required SJFH Foundation Ins Certificate Jan 2022.pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required Personnel plan January 2022.doc
 Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
SJFH Foundation rental space lease agreement.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 4
 Evidence of Site Control
**No files uploaded
 SAM.gov - screen shot of sam.gov registration *Required SAM gov January 2022.pdf
 Key Program Staff Resume *Required
R Brooke Munoz resume.pdf
HMaya resume Jan 2022.pdf
 Title Report
**No files uploaded
 Optional Documents
SJFH Foundation other docs Jan 2022.pdf
SJFH Foundation income verification Jan 2022.pdf
SJFH Foundation self certification Jan 2022.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
Submit
Completed by [email protected] on 1/24/2022 2:35 PM Case Id: 48643
Name: San Joaquin Fair Housing Foundation, Inc -
2022/23Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
Robert A Brooke-Munoz
Title
Executive Director
Date
01/24/2022
Signature
Robert Anthony Brooke-Munoz
Electronically signed by [email protected] on 1/24/2022 2:07 PM Please download and upload the Certification page here.  Certification Page *Required
SJFH Foundation Certification page Jan 2022.pdf
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
Program Overview
Completed by [email protected] on 1/17/2022 1:18 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
A. Eligibility
Completed by [email protected] on 1/17/2022 1:19 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Facility
If using ESG funds
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
B. Contact Information
Completed by [email protected] on 1/18/2022 2:34 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Gospel Center Rescue Mission, Inc.

B.2. Mailing Address
445 S San Joaquin Street Stockton, CA 95203

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Wayne
B.4. Last Name
Richardson
B.5. Email
[email protected]
B.6. Phone Number
(209) 320-2312

POINT OF CONTACT INFORMATION
B.7. First Name
William
B.8. Last Name
Brown
B.9. Email
[email protected]
B.10. Phone
(209) 609-5584

ORGANIZATION CONTACT INFORMATION
B.11. Website
gcrms.org
B.12. DUNS Number
788,079,044
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
B.13. EIN Number
941,375,835
B.14. Business License Number and Expiration Date
18-00038435, Dec. 31, 2022
B.15. Type of Agency
Faith Based
B.16. Number of Paid Staff
46 B.17. Number of Volunteers
14 Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/18/2022 2:36 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
Homeless 211 Navigation Center and Homeless Clothing Room Expansion C.2. Project Site Location
445 S San Joaquin Street Stockton, CA 95203
C.3. Funding Requested in this application
$275,000.00
C.4. Other funds already secured for the project
$100,000.00
C.5. Total Cost to Complete Project
$1,000,000.00
C.6. Other funds not yet secured
$625,000.00
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/17/2022 1:29 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

The Gospel Center Rescue Mission is a ministry to the people of San Joaquin County where the homeless and addicted in our community are presented the opportunity for spiritual, physical and emotional restoration through the love of Jesus Christ.

Income Limits Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 0
Extremely Low Income (Less than 30%) 505
505
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 307 186
Black/African American 144 0
Asian 10 0
Am. Indian/Alaskan Native 14 0
Native Hawaiian/Other Pacific Islander 8 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 22 0
505 186
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 260
Female Headed Households 320
Seniors 53
Youth 58
Homeless 505
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
1,196
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
E. Project Funds
Completed by [email protected] on 1/18/2022 3:56 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

The numerical ranking of this application is one of two.

E.2. Please indicate if this application is a request for one-time funding and/or “seed” funding. If not applicable, state “N/A.

NA
E.3. If you are applying for additional funds for a current program/project, provide a status update on the existing funds and when funds will be fully spent. Please list all CDBG and ESG funds received within the last 3 years including funding amount and their status.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
ESG Stockton $75,575.00 Complete $0.00
FY2017/18
ESG
CDBG San Joaquin
County
$550,000.00 Complete $0.00
FY2018/19
CDBG
CDBG Stockton $118,255.00 Complete $0.00
FY2018/19
ESG
ESG San Joaquin
County
$14,900.00 Complete $0.00
FY2019/20
CDBG
CDBG San Joaquin
County
$1,500,000.00 Complete $0.00
FY2019/20
ESG
ESG San Joaquin
County
$13,000.00 Complete $0.00
FY2020/21
CDBG
CDBG San Joaquin
County
$403,830.00 Complete $0.00
FY2020/21 ESG ESG San Joaquin
County
$14,000.00 Complete $0.00
FY2021/22
CDBG
CDBG Stockton $161,680.00 Complete $0.00
FY2021/22 ESG ESG San Joaquin
County
$12,000.00 Underway $12,000.00
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

Committed : Hazmat demolition $100,000.00
Proposed: Stockton $275,000; San Joaquin County $625,000 E.5. What will be the impact on your agency, program, or project goals be if the program is not funded at the full amount requested? Will your organization have the ability to sustain itself if the funding allocated is less than the amount requested? Please provide detailed information to understand if this is a funding gap and/or funds used to leverage additional sources outside of Stockton i.e. County/State/Federal/Private Funds The project can be scaled to fit the awarded funds. GCRM can sustain itself in the event the proposed project is not fully funded. GCRM is using this request to leverage funds for the same project from San Joaquin County.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

GCRM serves all of San Joaquin County, but 60+% of service units are to residences of Stockton because GCRM is located in Stockton.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents No
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents No
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes
Homeless
Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Number required at time of assistance). Please attach a blank worksheet under Required Documents No
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

No
E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

The requested funds will be used in conjunction with County and private funds to remodel the administration building (445 S San Joaquin Street) to make it ADA compliant. The current restroom facilities are not ADA compliant, and the administration offices are on the second floor making them inaccessible to handicapped persons. The proposed project will reconfigure the restrooms to make them accessible and it will add a handicap lift to a reconfigured stairs to the second floor. The proposed project will also replace two non-energy efficient HVAC systems, expand the existing clothing room to display more clothing and handle the increased number of clients needing clothing. The proposed project will also replace two walk-in non-energy efficient refrigeration units.

E.9. Select the common indicator that your agency will use to track clients.

Emergency Lodging Units of Service: An emergency lodging unit of service includes meals, lodgings and clothing.

Transitional Housing Units of Service: All transitional housing units of service include lodging, meals, clothing, child care, case management, Learning Center and appropriate addiction and life-skills classes for men and women.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 800
Households 100
Other 0
900
E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

Service Deliver: GCRM will provide emergency lodging (food, clothing, shelter and case management to unsheltered homeless men, women and families.

GCRM will provide transitional housing with appropriate wrap-around-services for men, women and families desiring to successfully end addiction and develop necessary life skills to function normally in our community.

Outreach:

GCRM does outreach to the homeless and addicted through word of mouth, a social courtyard for the homeless, emergency lodging, recuperative care and listings in the local 209 system. CPS and the local law enforcement agencies are briefed regularly on the availability of services at GCRM Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
F. Project Impact
Completed by [email protected] on 1/17/2022 3:06 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 0
Very Low Income (30%-50%) 0
Extremely Low Income (Less than 30%) 849
849
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 364 141
Black/African American 151 0
Asian 28 0
Am. Indian/Alaskan Native 25 0
Native Hawaiian/Other Pacific Islander 5 0
Am. Indian/Alaskan Native & White 18 0
Asian & White 3 0
Black/African American & White 22 0
Am. Indian/Alaskan Native & Black/African American 1 0
Other Multi-Racial 91 0
708
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 88
Female Headed Households 215
Seniors 96
Youth 196
Homeless 849
1,444
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
187 1,189 703
2020-2021 (Anticipated) 201 1,129 798
2021-2022 284 1,301 849
672 3,619 2,350
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

The proposed project will make the GCRM administration building fully accessible to homeless, handicapped persons wanting to access services, and it will replace old HVAC and refrigeration equipment that does not meet current energy efficient standards.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

The need was determined by the most recent point-in-time count and the demand for services GCRM experiences daily.

GCRM has been a major provider of emergency lodging services for homeless single men and transitional housing with wrap-around-services for addicted homeless men since 1940. More recently GCRM has added 218 beds for emergency services, addiction treatment and transitional housing with wrap-around-sevices for single women and families; recuperative care for homeless persons who are ready to be discharged from a local hospital, but who have no home or responsible care giver to go to and COVID-19 facilities and services for the the homeless who have been diagnosed with the Virus or have been exposed to it, but don't require hospitalization.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
G. Project Narrative
Completed by [email protected] on 1/18/2022 2:33 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

G.1. How would you characterize your program/project based on the continuum of approaches to housing and public service needs listed below: (Select Top Three)
 PREVENTION - Helps prevent a problem before it emerges  EARLY INTERVENTION - Addresses a problem in its early manifestation to keep it from becoming worse  TRANSITION - Helps move clients toward a better situation, lower level of need, etc.  MAINTENANCE - Helps to ensure that clients do not decline, etc.  SELF-SUFFICIENCY - Helps move clients toward a situation in which they will no longer need the program or service
 STABILIZATION - Helps clients attain stability so that they can work toward a better situation G.2. Describe in detail how the program/project will address each of the 3 housing and public service needs selected above (i.e. how it specifically addresses prevention/early intervention etc.) GCRM's extended programs are designed in length and subject material to transition homeless and addicted men, women and families to function successfully in permanent housing.

TRANSITION: Emergency lodging slows down the degenerative process of homelessness. Transitional housing programs arrest the process and begin to reverse its effects, so that the person establishes a daily routine. The person develops trust in a counselor, dependance on three nutritious meals a day and shelter, gains self-confidence to apply all that is being learned, and in so doing transitions to a state of mind and health consistent with being self-sufficient.

STABILIZATION: Public and private assistance should always lead to an individual or a family achieving stabilization.

Everything that is learned in transition will lead one to personalize it, to become stable in mind, body and action.

SELF-SUFFICIENCY: The ultimate GCRM program goal is always for the client to make progress toward achieving self- sufficiency. To know what constitutes a good decision, have the confidence to make good, sometimes hard decisions; and then to turn those decisions into a history of successful, self-sufficient livingThis request addresses the GCRM "211 Navigation Center" ADA requirements and expands the free clothing thrift store ("Clothing Plus").

The PROJECT is too remodel an existing building constructed before there were ADA regulations and before today's need to use energy efficient mechanical equipment existed into a modern facility that is cost effective and handicap user friendly.

The WORK to be Performed:

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
The work begins with a design phase in which an architect prepares plans and specifications that will consider all of the program use needs in a way that is consistent with current building and fire codes. Next there will be a permitting phase that will seek the approval of the City building department. Then, there will be a demolition phase in which all of the hazardous material is removed and all of the partitions that are to be reconfigured will be removed. Finally, the construction phase begins in which the new design of the space in question is realized and brought to a fruition.

The DAYS/TIMES of SERVICE, FREQUENCY and DURATION of services received by the average client: The average client accessing services through the building in question receives a unit of service equal to a twenty-four hour period during which time the client receives food, clothing, shelter and case management. The client may be accessing emergency lodging service on a day to day basis; or he/she may be accessing transitional housing services for an extended period of time in which case a unit of service includes food, clothing, shelter case management and program appropriate educational services. The frequency and Duration are program specific and may range from day to day for emergency lodging services, recuperative care services and COVID-19 Positive services; or six months to one year for transitional housing services.

TIME LINE/SCHEDULE: Please see the the attached "Time Line." This request addresses the GCRM "211 Navigation Center" ADA requirements and expands the free clothing thrift store ("Clothing Plus").

Project Activity or Program
Service #
Describe the Deliverable
1 The deliverable is a modern administration building that is cost effective to operate and handicap user friendly. A place clients can safely and comfortably access services and staff can safely provide those services.

NUMBER of YEARS in OPERATION: GCRM has been successfully meeting the needs of homeless single men, women and families since 1940.

Over its years of operation GCRM has successfully managed multiple private donations/grants, City, County, State and Federal grants including EHAP, ESG, CDBG, EFSP and Social Security Disability funds.

STAFF RESOURCES: GCRM has an experienced staff of 35 full time and 5 part time employees. Many staff members have personal, former homeless experience. Most staff have been GCRM employees for several years. Four of five administrative staff have graduate and post-graduate degrees.

FEDERAL GRANTS MANAGES & ACCOMPLISHMENTS: GCRM has used public funding in the past including CDBG funds to construct a new 100 bed family shelter on its property. More recently, GCRM has used private funds to purchase and CDBG funds to renovate and currently operate a 17 bed recuperative care facility on its property. And, GCRM has used private and CDBG funds to renovate a former three story hotel into 118 beds for single women and familiesThis request addresses the GCRM "211 Navigation Center" ADA requirements and expands the free clothing thrift store ("Clothing Plus").

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
• The renovation of the administration facility will be managed by an architect and a local, private contractor that has a history of successfully completing projects of similar size and scope. • The successful general contractor will be supervised by GCRM CEO and a Renovation Committee of the board of Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
directors.
• Clients will access the program by self-referral or referral from other community program sources.

Project Deliverable # Describe the Deliverable
1 The deliverable is a modern administration building that is cost effective to operate and handicap user friendly. A place clients can safely and comfortably access services and staff can safely provide those services.

G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? • The ultimate deliverable will be over eight hundred unduplicated, Stockton homeless clients provided with appropriate services in a safe and comfortable environment.

Deliverable # Task that Support Deliverable
1 Program intake and exit processing.
2 Food Services
3 Emergency Lodging
4 Transitional Housing (Life Skills Program, Addiction Treatment, Recuperative Care, COVID-19 Positive Care and Representative Payee Program)
G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
• The project will serve homeless single men, women and families • They will benefit by moving from the street to a safe, clean, supportive environment where they will receive appropriate services to ultimately become self-sufficient. • The applicable eligibility requirements are program specific. The requirements are "Low-barrier," and they are non- discriminatory based on age, gender, race, ethnicity etc.

The renovation needs of the building in question are specific to the services GCRM provides its homeless clients.

GCRM collaborates with all other homeless services providers through the local C of C and other opportunities as they arise.

The role of other similar homeless services providers in the community is mutual support, client referral for more appropriate services and finding available services during maximum capacity seasons.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

GCRM has a full services development department utilizing direct mail, grant writing, social media and public relations to achieve overall financial sustainability. Additionally, when possible and practical client programs are self-sustaining through client fees.

Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
G.10. Identify any potential conflict of interest with this application for federal funds. Conflict of interest may exist with employees of the organization who sit on community boards, commission, or committees. Similarly, City of Stockton Council members or City employees who may sit on your board of directors pose possible conflicts of interest.

There are no known conflicts of interest.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
H. ESG
Completed by [email protected] on 1/18/2022 4:50 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:

H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

The proposed project is emergency lodging and transitional housing services to homeless men, women and families that will prepare for and respond to the COVID-19 Pandemic by providing all homeless services in an environment consistent with all San Joaquin County Board of Health COVID-19 best practices.

No
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/18/2022 11:25 AM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

I.1. Is your agency requesting funds for a Public Facility project (e.g. construction)? Yes
I.2. Please describe all planning/predevelopment steps that have been completed to date. (e.g., architectural plans, engineering, land use approvals, permits, funding commitments, etc.) The only planning/predevelopment steps to date are preliminary discussions with an architect concerning the necessity and viability of the project.

I.3. Provide a detailed narrative (e.g. rehabilitation or new construction) and a detailed scope of work. • Narrative: This project is a complete renovation of an existing facility owned by GCRM. The renovation includes reconfiguring existing restrooms and a stairs to the second floor to make them ADA compliant; replacing two HVAC units and two refrigeration units to make them energy efficient and the expansion of the clothing room facilities. • Detailed Scope of Work:
i. Demolition
i. Involves relocation and addition of some walls.
ii. Involves relocation and addition of clothing room area. iii. Includes new and larger refrigeration space.
iv. Involves addressing ADA requirements in all first and second floor office and restroom areas and one exterior door. v. Relocating and adding new electrical outlets and plumbing water and drain lines vi.Replacing two HVAC units and duct work
.

GCRM owns the building in question.

I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

NA
I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

WMB Architects, Simile Construction as General Contractor I.7. Has a market study, property needs assessment and/or other evaluation that identifies the need for the proposed project been completed? If so, describe and upload the project reports and schedule). If no reports have Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
been completed, explain how you plan to proceed.

No market study or needs assessment has been done, because the need for the facility and related services is well established by recent "Point-in-Time" studies and the demand for services GCRM experiences annually.

I.8. When will construction start and end? Provide a timeline with all critical milestones.

Construction can begin within three months of a signed contract between the City and GCRM. Construction would complete six months after it begins.

Yes
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

This is an expansion of existing services facilities serving homeless persons.

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/18/2022 11:51 AM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.1. Identify AT LEAST ONE barrier in implementing your program/project:
 A marketing and publicity campaign that provides consumers with additional education and information about the agency’s programs and services.
 Coordination and collaboration with other service providers.  Accessing and utilizing “un-tapped” resources
 Removing barriers that limit access to services and participation (e.g. language, time, cost, transportation, etc.).

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

GCRM continues to identify, access and utilize un-tapped financial resources. State and federal grant funds continue to become available for expanding homeless services almost on a monthly basis. We continue to monitor these NOFAs as they become available and will pursue any and all applicable sources.

J.4. Identify AT LEAST ONE City of Stockton U.S. Department of Housing and Urban Development (HUD) FY 2020- 2025 Consolidated Goal that relates to your program/project:
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing. Expand the housing first model to provide permanent housing units with intense wrap-around services on-site.  Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income households. Provide homeownership opportunities for low-income-moderate income first-time buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/20/2022 2:45 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
City 2022-23 ESG Budget.xlsx
 Organization Operational Budgets *Required
2022 Bdgt.xls
 Organization Financial Statements *Required
Combined Financial Statements Dec 31 2019.pdf
 Tax Status *Required
501(c)(3).doc
 Board of Directors Roster *Required
2022 BOARD ROSTER.docx
 Articles of Incorporation/Bylaws *Required
GCRM Articles of INC.pdf
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
signed by-laws.pdf
 Conflict of Interest Statement *Required
GCRM conflict of intrest form.pdf
 Organization chart *Required
Organizational Chart.docx
 Board of Directors’ authorization to request CDBG/ESG funding *Required Board Resolution
 Business License Number *Required
GCRM City Business Lic.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required Crime Ins.pdf
Director's & Officers Liab.pdf
General Liability:Auto.pdf
Workman's Comp Ins.pdf
SGCRM_Scan21012814410.pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required Affirmative Action.docx
Conflict Resolution.docx
EQUAL EMPLOYMENT OPPORTUNITYEqual Pay:Sexual Harassment.docx GCRM Non-discrimination in Employment.docx
Problem & Complaints.docx
WHISTLE BLOWER Policy.docx
Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
 Use Permit/State License (as applicable)
Use Permit.docx
 Rental or Lease agreement
N:A Statement.docx
 Evidence of Site Control
445 Deed of Trust.pdf
 SAM.gov - screen shot of sam.gov registration *Required SAMEntityInformation-20210118-095307.pdf
 Key Program Staff Resume *Required
Wayne's Resume.pdf
 Title Report
445 Title Report.pdf
 Optional Documents
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
Submit
Completed by [email protected] on 1/20/2022 2:48 PM
Case Id: 48629
Name: GCRM 22-23 CDBG Application - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
William R Brown
Title
Director of Foundation & Government Relations
Date
01/20/2022
Signature
William R Brown
Electronically signed by [email protected] on 1/20/2022 2:46 PM Please download and upload the Certification page here.  Certification Page *Required
CDBG.ESG Signature.docx
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
Program Overview
Completed by [email protected] on 1/14/2022 8:49 AM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
A. Eligibility
Completed by [email protected] on 1/24/2022 3:21 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Service
If using ESG funds
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
B. Contact Information
Completed by [email protected] on 1/24/2022 3:22 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
San Joaquin County Aging and Community Services
B.2. Mailing Address
P.O. Box 201056 Stockton, CA 95201

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Chris
B.4. Last Name
Woods
B.5. Email
[email protected]
B.6. Phone Number
(209) 468-1650

POINT OF CONTACT INFORMATION
B.7. First Name
Carmen
B.8. Last Name
Matty-Cervantes
B.9. Email
[email protected]
B.10. Phone
(209) 468-1422

ORGANIZATION CONTACT INFORMATION
B.11. Website
http://www.sjchsa.org/Services/Aging-and-Community-Services B.12. DUNS Number
12,698,423
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
B.13. EIN Number
0 B.14. Business License Number and Expiration Date
B.15. Type of Agency
Gov't/Public
B.16. Number of Paid Staff
5 B.17. Number of Volunteers
0 Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/24/2022 3:23 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
Meals on Wheels
C.2. Project Site Location
Throughout Stockton as meals are delivered at home Stockton , CA C.3. Funding Requested in this application
$15,000.00
C.4. Other funds already secured for the project
$352,843.00
C.5. Total Cost to Complete Project
$367,843.00
C.6. Other funds not yet secured
$0.00
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/24/2022 3:33 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

Aging and Community Services supports older adults, adults with disabilities, family caregivers, and residents in longterm
care facilities. The Department’s services support older and disabled individuals to live as independently as possible in the community; promote healthy aging and community involvement; and assist family members in their vital care giving role.

Income Limits Clients Served
Moderate Income (More than 80%) 33
Low Income (50%-80%) 21
Very Low Income (30%-50%) 44
Extremely Low Income (Less than 30%) 122
220
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 143 24
Black/African American 37 0
Asian 11 1
Am. Indian/Alaskan Native 28 21
Native Hawaiian/Other Pacific Islander 1 1
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 0 0
220 47
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 6
Female Headed Households 88
Seniors 214
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
Youth 0
Homeless 0
308
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 3
E. Project Funds
Completed by [email protected] on 1/24/2022 3:35 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

N/A
E.2. Please indicate if this application is a request for one-time funding and/or “seed” funding. If not applicable, state “N/A.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
Meals on
Wheels
City Of
Stockton
$10,000.00 Complete $0.00
FY2017/18
ESG
$0.00 $0.00
FY2018/19
CDBG
Meals on
Wheels
City of
Stockton
$10,000.00 Complete $0.00
FY2018/19
ESG
$0.00 $0.00
FY2019/20
CDBG
Meals on
Wheels
City of
Stockton
$12,000.00 Complete $0.00
FY2019/20
ESG
$0.00 $0.00
FY2020/21
CDBG
Meals on
Wheels
City of
Stockton
$12,000.00 Complete $0.00
FY2020/21 ESG $0.00 $0.00
FY2021/22
CDBG
Meals on
Wheels
City of
Stockton
$15,000.00 Underway $0.00
FY2021/22 ESG $0.00 $0.00
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 3
Aging and Community Services receives funding from the legislation of the Older Americans’ Act. In addition to this Federal Funding source, the program encourages contributions. The status of each source is ongoing.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

Funds received from the City of Stockton will be used exclusively to provide meals in the City of Stockton.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents No
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents No
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes
Elderly persons (62 years of age or older)
Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Number required at time of assistance). Please attach a blank worksheet under Required Documents No
Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 3
Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

No
E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

San Joaquin County Aging and Community Services will use Stockton CDBG funds to purchase and deliver meals to Stockton residents. The purpose of the Home Delivered Meal Program (Meals on Wheels) is that meal recipients receive a package of five nutritious meals delivered once a week. A program goal is to assist older adults to live independently. Meals meet the nutritional standards by incorporating the Dietary guidelines for Americans and providing a minimum of one third of the USDA dietary requirements.

E.9. Select the common indicator that your agency will use to track clients.

The primary unit of service is the number of meals delivered to Stocktonians.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 0
Households 0
Other 6,000
6,000
E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

The organization uses various outreach strategies. With the reopening of the State, in-person outreach activities have returned although not at the same level as pre-Covid-19. Aging and Community Services staff look forward to attending various community events throughout the city as according to Public Health guidelines ranging from fairs such as Black Family Day, Family Day at The Park, Hmong New Year Festival, Walk to End Alzheimer’s, SALUD Outreach Health Fair, and Medicare Health Fairs among others. Also, there is continued outreach through word of mouth, friends/families, local organizations such as hospice, coordinators of the low income housing who know the program through other residents, hospitals and insurance companies, and 211. In addition, the Meals on Wheels vehicles are marked to publicize the program. Aging & Community Services Information and Assistance 468-1104 receives the referrals and passes them to Meals on Wheels program. Outreach to the low income and disabled persons population is conducted through the aforementioned activities. As Aging & Community Services Department has multilingual staff as well as contracted interpreter services, limited English speakers access the services.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
F. Project Impact
Completed by [email protected] on 1/24/2022 3:36 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 9
Low Income (50%-80%) 21
Very Low Income (30%-50%) 45
Extremely Low Income (Less than 30%) 125
200
F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 110 0
Black/African American 32 0
Asian 15 0
Am. Indian/Alaskan Native 41 38
Native Hawaiian/Other Pacific Islander 2 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 0 0
200
F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 0
Female Headed Households 80
Seniors 200
Youth 0
Homeless 0
280
Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
25 220 220
2020-2021 (Anticipated) 25 200 200
2021-2022 25 200 200
75 620 620
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

Meals on Wheels delivers five nutritious meals once a week to homebound seniors.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

Aging and Community Services conducts a Needs Assessment Survey which indicates there is a need for nutrition services by older adults who are 60 years and older. In addition, yearly and quarterly assessments of nutritional risk document the need. The service gaps Meals on Wheels addresses is providing nutritious meals to homebound seniors with nutrition risk and little or no social support.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 3
G. Project Narrative
Completed by [email protected] on 1/24/2022 3:45 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

In order to have a successful program, the following activities take place Monday through Friday: People call the Information and Assistance (I&A) staff to either asking for themselves for meals to be delivered or to refer people to receive meals at home. Then I&A refers people to Meals on Wheels. A Social Worker calls the referee to conduct an assessment. Once the person is deemed eligible, the person is placed on a route determined by the clients’ geographic proximity for efficiency purposes regarding delivery time and transportation costs. Each route has its day of the week assigned for when the delivery takes place. The clients receive meals that meet a minimum of one third of the dietary guidelines for older adults set forth by the U.S. Department of Health and Human Services and United States Department of Agriculture verified by two Registered Dietitians: San Joaquin County and meal vendor. The clients receive five frozen meals and bread along with fresh milk and fruit. The delivery of meals takes place once a week on an established day of the week between 8am and 5pm. The time frame is all day as people are homebound Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 3
and takes into consideration that due to traffic and clients being added and removed when they no longer need services the delivery time changes. When people have doctor's appointments they call to have the meals delivery before or after their doctor's appointment if possible. Each visit is personalized as each beneficiary is treated as an individual with different needs. Prior to COVID-19, some seniors had their meals put away while others preferred to put their meals away. Drivers follow all of San Joaquin County Public Health protocols. Hence with the delivery of nutritious meals to homebound seniors, the goal to assist older adults to live independently at home while the objective to promote improved nutrition are achieved.

Project Activity or Program
Service #
Describe the Deliverable
1 Weekly delivery of meals
G.4. Describe your agency’s capacity to implement this program or project (identify agency’s federal grants managed, staff resources, skills and experience, number of years in operation, accomplishments to date, etc.).

San Joaquin County Aging and Community Services has provided programs for over four decades. Services provided include a combination of direct and contracted services as well as services provided through collaboration.

Servicesprovided include, but are not limited to: Ombudsman, Elder Abuse Prevention, Adult Day Care, Personal Care, Homemaker, Respite, Falls Prevention, Caregiver Services, Legal Assistance, and Congregate Meals. Aging and Community Services has offered Meals on Wheels program as a direct service since 2008. The staff resources include staff who work directly with the beneficiaries as well as programming and finance administrative staff. During the past five years, over 1900 San Joaquin County residents have received more than 650,000 meals.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
The agency will implement the program by delivering nutritious meals which consists of five frozen meals including bread, milk, and fresh fruit on a weekly basis to the beneficiaries’ homes. Clients will access the program through various ways: a) existing clients who continue to have a need will receive meals; b) clients are referred for services will be assessed for placement; and c) clients who contact the program directly for services will be assessed for placement. Priority placement is given to clients who have a high nutrition risk, homebound and living alone or with another homebound individual. The nutrition risk assessment includes questions such as does the client sometimes does not have enough money to buy food. Access also includes removing English language barrier by having a multilingual staff and contracted interpreter services. Also, transportation is not an access issue for Meals on Wheels as the inquiry and assessment of services takes place through the phone and the service takes place at the beneficiary’s home. As the service is provided free of charge, there is no financial access issue. The staff who administer the activities range from project accountants in the finance department to drivers who deliver the food and staff who assess potential beneficiaries, manage the logistics, and provide supervisory support.

Project Deliverable # Describe the Deliverable
1 Deliver weekly meals
G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? Meals on Wheels will measure the effectiveness of the program through a satisfaction survey. The criterion for success is 75% of the people who responded to the survey will have stated they are satisfied with Meals on Wheels.

The results expected to be achieved at the end of the project is that 75% of the people who responded to the survey Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 3
will have noted that the meals help their food budget, the food is good and nutritious, and/or the home delivery assists people with difficulty to get out of the house.

Deliverable # Task that Support Deliverable
1 Driver will deliver the weekly meals to the clients home G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
The program’s target population prioritizes Stocktonians who are 60 years and older who are homebound, living alone or with another homebound individual, and have a high nutrition risk. The nutrition risk assessment includes if the client sometimes does not have enough money to buy food. The homebound high nutrition risk seniors will benefit by receiving five nutritious meals on a weekly basis with a friendly visit.

While there are resources for food in Stockton, this is the only ongoing service that provides free prepared meals delivered to homebound individuals. The Meals on Wheels program collaborates with the In-Home Supportive Services (IHSS) to ensure that no duplication of services take place by having the clients choose their preference between IHSS homemaker services or Meals on Wheels. Also, Meals on Wheels during the assessment process refers clients to CalFresh to augment their monthly benefits. People who are currently receiving home delivered meals due to COVID-19 through their churches and other non-profits would also not qualify as duplication of services. Once churches and other non-profits stop providing those services, those older adults would be able apply to be assessed for Meals on Wheels.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

Meals on Wheels will continue to be written into the San Joaquin County Aging and Community Services' Area Plan for Older Americans Act funding.

There is no potential conflict of interest with this application for federal funds.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
H. ESG
Completed by [email protected] on 1/24/2022 3:45 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:

H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/24/2022 3:46 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

N/A
I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

N/A
I.8. When will construction start and end? Provide a timeline with all critical milestones.

N/A
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/24/2022 3:46 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.1. Identify AT LEAST ONE barrier in implementing your program/project:
 A marketing and publicity campaign that provides consumers with additional education and information about the agency’s programs and services.
 Coordination and collaboration with other service providers.  Accessing and utilizing “un-tapped” resources
 Removing barriers that limit access to services and participation (e.g. language, time, cost, transportation, etc.).

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

Aging and Community Services is seeking a person with communications expertise to help with the promotion of the Meals on Wheels program at the client and institutional levels.

J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients As Meals on Wheels is a service that begins with a phone call and ends with the delivery of nutritious meals at people’s homes, there is no transportation barrier for clients.

J.4. Identify AT LEAST ONE City of Stockton U.S. Department of Housing and Urban Development (HUD) FY 2020- 2025 Consolidated Goal that relates to your program/project:
 Housing and Services for the Homeless: Provide housing and supportive services for the City’s homeless populations, including emergency, transitional, and permanent supportive shelter, as well as rapid rehousing and homelessness prevention. Increase and maintain transitional housing opportunities with supportive services to improve outcomes and stability and promote successful transitions into permanent housing. Expand the housing first model to provide permanent housing units with intense wrap-around services on-site.  Affordable Housing: Preserve, improve, and expand the supply of decent affordable housing for lower-income households. Increase the supply of affordable multifamily housing units targeting households at extremely low- and very low-income households. Provide homeownership opportunities for low-income-moderate income first-time buyers. Assist existing low-income owner-occupied households keep their homes safe and well maintained by providing rehabilitation funding and other needed assistance.  Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 2
moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/24/2022 3:38 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 4/1/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
HD Meals Budget- 22-23- City.pdf
 Organization Operational Budgets *Required
5054101000 - Organization Operational Budget.pdf
 Organization Financial Statements *Required
2020 county of san joaquin Financials.pdf
 Tax Status *Required
Tax Status.pdf
 Board of Directors Roster *Required
San Joaquin County Board of Supervisors Roster.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 3 of 4
 Articles of Incorporation/Bylaws *Required
Articles of Incorporation.pdf
 Conflict of Interest Statement *Required
Conflict of Interest Statement.pdf
 Organization chart *Required
Organization Chart.pdf
 Board of Directors’ authorization to request CDBG/ESG funding *Required BOS authorization to request funds.pdf
 Business License Number *Required
Business License Number.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required Insurance for FY 23.pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required Personnel policies affirmative action and grievance.pdf  Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
**No files uploaded
 Evidence of Site Control
**No files uploaded
Attachment A
Printed By: Kayla Martin on 4/1/2022 4 of 4
 SAM.gov - screen shot of sam.gov registration *Required DUNS EntityInformation-20220119-011145.pdf
 Key Program Staff Resume *Required
Carmen Matty Cervantes Resume.pdf
Manuel Mendoza Resume.pdf
 Title Report
**No files uploaded
 Optional Documents
Scope of Work including Project Timeline.pdf
county single audit report 2020.pdf
Attachment A
Printed By: Kayla Martin on 4/1/2022 1 of 1
Submit
Completed by [email protected] on 1/24/2022 4:11 PM Case Id: 48594
Name: Meals on Wheels - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name
Elisangela Vigil on behalf of Chris Woods
Title
Deputy Director, ACS
Date
01/24/2022
Signature
Elisangela Vigil
Electronically signed by [email protected] on 1/24/2022 3:48 PM Please download and upload the Certification page here.  Certification Page *Required
CDBG Stockton.msg
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
Program Overview
Completed by [email protected] on 12/30/2021 9:14 AM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
A. Eligibility
Completed by [email protected] on 12/30/2021 9:15 AM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Public Service
If using ESG funds
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
B. Contact Information
Completed by [email protected] on 12/30/2021 2:20 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Kelly's Angels Foundation Inc
B.2. Mailing Address
343 EAST MAIN STREET 305 STOCKTON, CA 95202

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Jamie
B.4. Last Name
Guerrero
B.5. Email
[email protected]
B.6. Phone Number
(209) 242-2493

POINT OF CONTACT INFORMATION
B.7. First Name
JAMIE
B.8. Last Name

GUERRERO
B.9. Email
[email protected]
B.10. Phone
(209) 406-9301

ORGANIZATION CONTACT INFORMATION
B.11. Website
www.kelsangels.org
B.12. DUNS Number
882,271,804
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
B.13. EIN Number
473,382,204
B.14. Business License Number and Expiration Date
B.15. Type of Agency
501(c)(3)
B.16. Number of Paid Staff
2 B.17. Number of Volunteers
12 Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
C. Funding Request
Completed by [email protected] on 12/30/2021 2:46 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
KAF Healthy Solutions
C.2. Project Site Location
343 EAST MAIN STREET 305 STOCKTON, CA 95202
C.3. Funding Requested in this application
$50,000.00
C.4. Other funds already secured for the project
$20,000.00
C.5. Total Cost to Complete Project
$120,000.00
C.6. Other funds not yet secured
$50,000.00
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/19/2022 1:46 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

Kelly's Angels Foundation Inc. provides services for children that have been impacted by homicide.

Income Limits Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 13
Very Low Income (30%-50%) 19
Extremely Low Income (Less than 30%) 16
48 D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 10 10
Black/African American 24 0
Asian 0 0
Am. Indian/Alaskan Native 0 0
Native Hawaiian/Other Pacific Islander 0 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 4 4
Black/African American & White 5 5
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 5 5
48 24
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 0
Female Headed Households 0
Seniors 0
Youth 48
Homeless 0
48 Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
E. Project Funds
Completed by [email protected] on 1/20/2022 7:26 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

One time funding
E.3. If you are applying for additional funds for a current program/project, provide a status update on the existing funds and when funds will be fully spent. Please list all CDBG and ESG funds received within the last 3 years including funding amount and their status.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
city $5,000.00 complete $0.00
FY2017/18
ESG
$0.00 $0.00
FY2018/19
CDBG
city $10,000.00 complete $0.00
FY2018/19
ESG
$0.00 $0.00
FY2019/20
CDBG
city $15,000.00 complete $0.00
FY2019/20
ESG
$0.00 $0.00
FY2020/21
CDBG
city $25,000.00 complete $0.00
FY2020/21 ESG $0.00 $0.00
FY2021/22
CDBG
city $20,000.00 underway $0.00
FY2021/22 ESG $0.00 $0.00
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
Not all funding sources are committed by letters. Funding sources are through yearly grant applications. Crime Survivors for Safety and Justice, Keller Williams, C&S Wholesale Grocers, Central Valley Realtors Association.

Our Executive Director working along, with the board of directors and staff of volunteers that is in place, are passionate about our most harmed and least helped, the children of Stockton. Our team is always working hard to identify continuation funding for our organization.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

The primary geographical focus of Kelly’s Angels is the entire San Joaquin County, though the majority of our youth come from Stockton. However, we do not reject families from outside of that community. We serve all those in need who come to our doors. If approved for CDBG funding, Kelly’s Angels is able to maintain firewalls between its various funding sources to ensure that CDBG funds are limited to clients within the Stockton area if that is a limitation for those funds.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents Yes
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents No
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
Clients are primarily children of homicide or trauma victims.

No
N/A
E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

Kelly’s Angels Foundation provides a variety of services for youth who are experiencing trauma due to the victimization of their parents or care givers from homicide and other violent crimes. Community Development Block Grant (CDBG) funds will be utilized to provide mental and behavioral health programs to assist in the child’s recovery including; safe spaces and mental health therapy services; tutoring and mentoring services; scholarship programs; sports programs; art and music programs.

E.9. Select the common indicator that your agency will use to track clients.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 50
Households 0
Other 0
50 E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

Outreach for Kelly’s Angels is accomplished by community awareness campaign via our website (www.kelsangels.org) and Facebook page, but it also accomplished by referrals through partnering with local agencies such as Table Community Foundation, Community Partnerships for Families of San Joaquin, Reinvent South Stockton, Victim Witness, Victim of Violent Crimes, Child Abuse Prevention Council, Crime Survivors for Safety and Justice, Parents of Murdered Children and Community Hospice of San Joaquin. We start our services by first having a one on one meeting with the client and their family, have them fill out our new client intake forms. During our meeting we find Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
out which of our services the family would like to obtain. Using the information for what services are needed, we then follow up with staff and set up proper appointments, make appropriate phone calls in a timely manner.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
F. Project Impact
Completed by [email protected] on 1/22/2022 1:31 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 12
Very Low Income (30%-50%) 23
Extremely Low Income (Less than 30%) 14
49 F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 12 12
Black/African American 18 0
Asian 2 0
Am. Indian/Alaskan Native 0 0
Native Hawaiian/Other Pacific Islander 0 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 4 2
Black/African American & White 5 5
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 8 8
49 F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 0
Female Headed Households 10
Seniors 0
Youth 48
Homeless 0
58 Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
6 36 51
2020-2021 (Anticipated) 4 32 48
2021-2022 5 30 46
15 98 145
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

Our Executive Director Jamie Guerrero proposed the idea and need of Kelly’s Angels Foundation a few years after his sister was the victim of homicide. It was made painfully aware of just how few resources are available to young victims and survivors of violent crime.

While crime in general in Stockton has been on the decline over the past 15 years, violent crime and homicide has increased as much as 3.4 percent in recent years according to the FBI’s Uniform Crime Reporting Index. An annual average of 52 homicides have occurred in Stockton from 2010-2015 with a spike of 54 in 2017 and 53 in 2018 Stockton currently ranks 2nd in the State of California for homicides and violent crimes per capita according to the previously mentioned FBI statistical source. In 2018 we witnessed a 40 percent decrease in homicides. 2020 seen homicide rise to 56 a 64.7% increase over 2009.
2021 seen an decrease in homicides however overall crime has increased. Survivor lead organizations like Kelly's Angels Foundation, and other on the ground agencies have helped with these statistics.

The need for a program like Kelly’s Angels Foundation is needed with the each murder directly impacting 8-10 immediate family members sons, daughters, sisters, brothers, mothers, fathers, grandparents left to put the broken pieces together again. They need help!
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
G. Project Narrative
Completed by [email protected] on 1/24/2022 11:28 AM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

Tutoring is currently being provided for 2.5 hours, 3 days a week. Tutors are provided from the Latino Community Outreach program. They are paid and we have volunteer college students from the University of Pacific of Stockton.

We set up contracts with the attending school for the volunteer students. CDBG funds will be used to expand tutoring hours and staff to accommodate demand. Currently, tutors must allocate only short amount of time to a limited amount of our clients. Effective tutoring should include an opportunity for children to bond with their tutor on a personal level and establish a rapport. While existing services are beneficial, lack of funding limits our efforts to establish this rapport. Additionally, children are not provided comprehensive tutoring due to limited hours and staff.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
The mentorship program is an existing service that requires expansion. Mentors serve both the children and their families as someone they can rely on to strengthen their family. It is the goal of these mentors to become a friend and ally of the family they work with and a positive influence for the children. Mentorship programs can help to reduce potential negative influence like substance abuse and gang involvement, while creating encouragement and guidance for positive life goals like participating in after school sports or art programs and promoting an interest in higher education. Mentors also serve as a conduit for families to our other services as they establish a rapport with those families and through the mentorship process will identify their needs.

Over the next year we project that the need for mentors will double. Currently our mentors serve 18 families, which means the program will grow to 36 families in 2022. One of the primary efforts with this program will be to provide training for the volunteers who serve as mentors in the program. CDBG funding will fund the possibility of adding 2 or 3 more tutors, making it possible to have tutoring upon request, and increase tutoring to 4 days a week. Additional funding will help by having more staff and enable us to sustain tutors and mentors.

Kelly’s Angels arts and sports scholarship program works to involve the children we serve in after school activities.

Both sports and arts are ideal pathways for youth who have experienced trauma as both activities are documented to serve as a therapeutic self-coping mechanism for children to turn to. These activities help a child focus on positives in their life as opposed to the loss of their family member and helps reorient their energies towards achieving, having fun, and gaining lifelong skills like teamwork at a young age. The scholarship program funds the sport or art activity of their choice, which may be on their school team, paying team enrollment fees, equipment, and competition fees.

Therapy sessions are provided by Kelly’s Angels to provide children with an outlet to work through their trauma with a licensed clinical therapist. Therapy is at the core of our services, and it is a key priority as not addressing these issues immediately can create further complications that can undermine the other services. We also provide hour sessions to parents and care-givers that are also processing their grief, as this helps to support the overall family and improves the support structure in place for the children.

As a core service, we are certain that the need for therapy to grow. CDBG funding will allow for more hours for therapists, which will enable us to serve more clients. We also plan to expand the availability of services to weekends so they are more accessible to working parents and care-givers.

Project Activity or Program
Service #
Describe the Deliverable
1 Kids will stay in school, have better attendance, grades and graduation.
2 Help develop into caring supportive children and adults. 3 Positive peer relations.
4 Stronger kids overcome trauma.

Kelly’s Angels Foundation a survivor led organization, has been working in the trenches battling for the “forgotten children” of San Joaquin County specifically Stockton. With time we have grown to be efficient in developing, implementing and administering the proposed project.

Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
Our team of professional volunteers have been the pillar of our growth, that has propelled us as an agency that has been serving Stockton for the last 6 years. Kelly's Angels Foundation has managed 4 years of City of Stockton's CDBG grants and 3 years of San Joaquin County CDBG grants. With the city of Stockton's CDBG grant our chance for success increases as we continue to cultivate.

We have had several clients graduate our program, high school, and college. We are hopeful that these blooming adults comeback to share their experience with our future and present clients.

G.5. Explain how your agency will implement this program/project and what staff will administer the activities.

How will clients access the program/project?
Outreach for Kelly’s Angels is accomplished by community awareness campaign via our website (www.kelsangels.org) and Facebook page, but it also accomplished by referrals through partnering with local agencies such as Table Community Foundation, Community Partnerships for Families of San Joaquin, Reinvent South Stockton, Victim Witness, Victim of Violent Crimes, Child Abuse Prevention Council, Crime Survivors for Safety and Justice, Parents of Murdered Children and Community Hospice of San Joaquin. We start our services by first having a one on one meeting with the client and their family, have them fill out our new client intake forms. During our meeting we found out which of our services the family would like to obtain. Using the information for what services are needed, we then follow up with staff and set up proper appointments, make appropriate phone calls in a timely manner Project Deliverable # Describe the Deliverable
1 Positive youth development.

G.6 Describe how you will measure the effectiveness of this program/project. Describe your criteria for success.

What results do you expect to have achieved at the end of this grant? To measure effectiveness of positive youth outcomes, we will measure and track change. Pre and post assessments will measure attendance of activities, change, grades, arrest, engagement in sports, truancy, client satisfaction and graduation. These will be assessed every 6 months and we are expecting to achieve, positive engagement by clients.

Deliverable # Task that Support Deliverable
1 Positive youth outcomes
G.7. Describe the population this program/project will serve and how they will benefit. Does your program target a special group (i.e., homeless, special needs, elderly) that benefits or will benefit from your program? What are your eligibility requirements?
The target population for our services is the children and surviving family members of homicides and violent crime, colloquially known as the Forgotten Victims. This is our primary eligibility requirements.

Kelly’s Angels Foundation fills in the gaps of many of the existing or similar services available in Stockton. For example the Stockton Women’s Center Promising Pathways offers therapy and mentorship programs to youth who are experiencing mental and behavioral health issues which is sometimes caused by violent crimes, but their program is limited to ages 16-25. Our mentorship program is open to youth of all ages and also provides those services to family members and care givers. We also provide other services that are unique to our area, such as the sports and arts Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
scholarship programs.

More specifically, Kelly’s Angels is a foundation that focuses and specializes in supporting a specific demographic.

Because of that our organization is especially familiar with the issues that experience can create, and we have familiarized ourselves and have trained to meet those specific goals.

Currently, we work with Table Community Foundation, Community Partnerships for Families of San Joaquin, Reinvent South Stockton, Victim Witness, Victim of Violent Crimes, Child Abuse Prevention Council, Crime Survivors for Safety and Justice, Parents of Murdered Children and Community Hospice of San Joaquin. We still want to make it a point to work with more organizations with similar approaches to violence.

While we suffer from overrepresentation for violent crime, our city lacks services for children traumatized by these crimes. The children of homicide victims are known as the forgotten victims. Our foundation sees a need for services for both the children victimized by these crimes and their families.

G.9. Describe leveraging or sustainability efforts your organization is implementing to ensure the long-term viability of this program/project.

Homicide historically unfortunate will always be a problematic, especially in Stockton. The need for our services will continue, as 8-10 close family members are impacted by each homicide.

Our long term plan, is to guide children through, the devastating generational trauma, that impacts them like a normal day of school. We are hopeful that these “forgotten children” will be receptive to our antidote of support, bringing social and emotional normalcy and a positive impact to their traumatic life.

Activities will be closely monitored after the client’s program completion. We welcome clients, to be involved with our program by participating in activities as mentors, volunteers and future leaders in our community. The tools given, at Kelly’s Angels Foundation, will have a lifelong positive impact on our clients. We will be there to continue to support these young adolescents.

Kelly’s Angels is not currently receiving any federal funds, and none of its employees, volunteers, or board members have any formal affiliation with city employees, including its elected officials.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
H. ESG
Completed by [email protected] on 1/22/2022 1:33 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
H. ESG
Please provide the following information.

H.1. For ESG only Number of Beds:
0 H.2. Provide a concise description of the proposed project and how will directly prevent, prepare for and/or respond to the COVID-19 pandemic.

N/A
H.3. Will the service to be provided with these funds fill a service gap needed to be addressed? No
H.4. Duplication of Benefits: Federal finance assistance was provided to my organization to addresses losses resulting from a federally declared emergency or disaster, and my organization has not received (or would receive, by acting reasonably to obtain available assistance) financial assistance for the same costs from any other source (including insurance) and the total amount of funding received does not exceed the total needs for those costs.

No
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
I. Public Facility Project
Completed by [email protected] on 1/24/2022 11:30 AM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
I. Public Facility Project
Please complete this step if you are applying for a Public Facility project. If not, please mark this step as complete and continue.

N/A
I.5. Will relocation be required if the building is occupied? No
If yes, describe and attach your agency’s relocation plan in the required docs section.

N/A
I.6. Identify the project team. (e.g. architect/engineer/general contractor, and or consultants).

N/A
I.8. When will construction start and end? Provide a timeline with all critical milestones.

N/A
I.11. For Public Service, Public Facility projects and Economic Development activities: Is this a new program/service or an expansion of an existing program/service? Explain.

Job Type Total Full-Time Jobs Total Jobs Full-Time
& Low-Income
Total Part- Time Jobs Percent of Part-Time
Jobs that will be
Low-Income
Expect to Create 0 0 0 0.00 %
Expect to Retain 0 0 0 0.00 %
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
J. Policy Consistency
Completed by [email protected] on 1/24/2022 12:07 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
J. Policy Consistency
Please provide the following information.

J.2. Describe in detail how the program/project will address the barrier selected in question I.1.

Regulations and laws placed by system leaders, have barriers for the very people they are intended to help. Trauma requires immediate help, not 4-6 weeks which if your fortunate to receive services. Centrally located, immediate and free services are 2 of our important values to help relieve and not limit access to our services provided..

J.3. Describe in detail how the program/project is accessible to clients via public transportation, and if applicable, any measures used to specifically reduce the transportation barriers for clients Kelly's Ange;s Foundation is located one block from the downtown RTD bus hub. RTD also donates a limited amount of bus passes yearly and a discount rate for additional passes. Part of our services include in home visits, as many trauma survivors, do not want to leave their home or venture off to other unfamiliar areas.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
 Support Economic Development: Promote economic development activities that create, attract, and retain jobs and promote economic activity and vitality, especially those that provide economic opportunities for low- and moderate-income persons. Prioritize and expand job readiness programs targeting low-income youth, disabled persons, and homeless persons
 Public Services: Ensure the provision of high-quality public services to support ongoing community development, including the provision of funding for fair housing services, among other activities. Actively and faithfully promote fair housing and investigate housing discrimination. Prioritize the maintenance and improvement of municipal services, facilities, and infrastructure  Disaster Response: Support disaster response and recovery activities in the event of a local, state, or national disaster or emergency.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 4
K. Required Documents
Completed by [email protected] on 1/24/2022 2:49 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
K. Required Documents
Please provide the following information.

Please upload the required documents below.

Organization Operational Budgets – A copy of the organization’s operational budget for the current fiscal year and proposed budget for the 2021-2022 fiscal year.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 4
 Procurement Plan (Typically a minimum of 3 bids, quotes, or estimates is required WBE/MBE Outreach, etc.)
 Necessary federal state and local permit and license (as applicable) – For first time applicants, new projects, or expansion of existing facilities. Include date of approval and status, as applicable.  Copy of Rental or Lease agreement (required if applicant is proposing to use CDBG funds to make a portion of lease payments)
 Evidence of Site Control- For public facility/construction projects, provide a copy of the deed trust to project site
 Title Report -For public facility/construction projects/substantial rehabilitation  Include all program policies and procedures for those programs that you are applying for assistance/funding
 Optional Documents
Documentation
 Project Budget *Required
project_22.docx
 Organization Operational Budgets *Required
PROPOSED BUDGET 2022.docx
 Organization Financial Statements *Required
tax_22.pdf
 Tax Status *Required
irs.pdf
 Board of Directors Roster *Required
board.docx
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 4
 Articles of Incorporation/Bylaws *Required
articles.pdf
 Conflict of Interest Statement *Required
conflict_interest.pdf
 Organization chart *Required
organization_chart.jpg
 Board of Directors’ authorization to request CDBG/ESG funding *Required bda_22.pdf
 Business License Number *Required
business_22.pdf
 Type of Insurance Carried, Bonding, Workers ‘Compensation *Required 1697657_CGL_Acord25_1_220124174224924.pdf
 Personnel Policies including Affirmative Action Plan and Grievance Procedure *Required bylaws.pdf
 Use Permit/State License (as applicable)
**No files uploaded
 Rental or Lease agreement
**No files uploaded
 Evidence of Site Control
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 4
 SAM.gov - screen shot of sam.gov registration *Required thumbnail_Screenshot 2022-01-24 at 12.23.06 PM.png
 Key Program Staff Resume *Required
Jamie_Guerrero_Resume_new.pdf
 Title Report
**No files uploaded
 Optional Documents
**No files uploaded
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
Submit
Completed by [email protected] on 1/24/2022 2:57 PM Case Id: 48555
Name: Kelly’s Angels Foundation Inc - 2022/23
Address: *No Address Assigned
Submit
Please provide the following information.
 Applicant certifies that CDBG/ESG funding will not be utilized in a manner that would be considered a duplication of benefits.
 I hereby certify that I have read this application, and the exhibits thereto, and know the contents thereof, and that the statements therein are true, and that I have been authorized by the governing board to submit this application.

Authorized Representative Name

JAMIE GUERRERO
Title

EXECUTIVE DIRECTOR
Date
01/24/2022
Signature

JAMIE GUERRERO
Electronically signed by [email protected] on 1/24/2022 2:50 PM Please download and upload the Certification page here.  Certification Page *Required
signature.pdf
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
Program Overview
Completed by [email protected] on 12/22/2021 4:52 PM
Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
Program Overview
Please provide the following information.

Community Development Block Grant Community Development Block Grant (CDBG) funds are allocated by the U.S.

Department of Housing and Urban Development (HUD) to provide benefits to low- and moderate-income persons, eliminate slums and blight, and meet an urgent community need.

Within this framework, the City of Stockton's Housing Division has also established broad local community development objectives intended to benefit low- and moderate-income households.

EDD Goals and Objectives:

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
A. Eligibility
Completed by [email protected] on 12/22/2021 4:57 PM
Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
A. Eligibility
Please provide the following information.

1. CDBG National Objective
 Benefit low- and moderate- income persons
 Prevent or Eliminate slums or blight
 Fulfill community development needs that have a particular URGENT Need

2. Project Category: Please select one
If using CDBG funds:

Suitable Living Environment
If using ESG funds
Homelessness Prevention
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
B. Contact Information
Completed by [email protected] on 12/22/2021 5:04 PM
Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
B. Contact Information
Please provide the following information.

B.1. Organization Name
Parents by Choice, Inc
B.2. Mailing Address
306 E. Main Street Suite 300 Stockton, CA 95202

EXECUTIVE DIRECTOR INFORMATION
B.3. First Name
Tony
B.4. Last Name
Yadon
B.5. Email
[email protected]
B.6. Phone Number
(209) 275-2487

POINT OF CONTACT INFORMATION
B.7. First Name
Tony
B.8. Last Name
Yadon
B.9. Email
[email protected]
B.10. Phone
(209) 275-2487

ORGANIZATION CONTACT INFORMATION
B.11. Website
parentsbychoice.net
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
B.12. DUNS Number
969,357,156
B.13. EIN Number
352,274,016
B.14. Business License Number and Expiration Date
22-00114819, Expires June 30, 2022
B.15. Type of Agency
501(c)(3)
B.16. Number of Paid Staff
70 B.17. Number of Volunteers
10 Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 1
C. Funding Request
Completed by [email protected] on 1/24/2022 9:06 AM Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
C. Funding Request
Please provide the following information.

C.1. Title of Proposed Project
Safe Step for Youth
C.2. Project Site Location
306 E. Main St Suite 300 Stockton, CA 95202
C.3. Funding Requested in this application
$426,217.09
C.4. Other funds already secured for the project
$0.00
C.5. Total Cost to Complete Project
$568,289.46
C.6. Other funds not yet secured
$142,072.36
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 2
D. Organization Information
Completed by [email protected] on 1/24/2022 10:01 AM
Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
D. Organization Information
Please provide the following information.

D.1. Please describe your agency’s mission.

Parents by Choice exists to bring hope and healing to children, youth and families.

Income Limits Clients Served
Moderate Income (More than 80%) 250
Low Income (50%-80%) 500
Very Low Income (30%-50%) 500
Extremely Low Income (Less than 30%) 250
1,500
D.3. Please list the total number of Stockton clients your agency served in the PRIOR fiscal year (2020-2021) in the race/ethnicity categories below. The total number must match the total number listed in the income categories in question #2 above.

Race Clients Served # Hispanic within each
race
White 900 550
Black/African American 425 80
Asian 100 0
Am. Indian/Alaskan Native 10 0
Native Hawaiian/Other Pacific Islander 10 0
Am. Indian/Alaskan Native & White 0 0
Asian & White 0 0
Black/African American & White 0 0
Am. Indian/Alaskan Native & Black/African American 0 0
Other Multi-Racial 55 20
1,500 650
D.4. In the Prior fiscal year (2020-2021), list the total number of Stockton clients served in each category below:

Category Clients Served
Disabled 50
Female Headed Households 300
Seniors 75
Youth 400
Homeless 25
850
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 2
Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 3
E. Project Funds
Completed by [email protected] on 1/24/2022 9:19 AM Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
E. Project Funds
Please provide the following information.

Years
Requested
Activity Title Source of
Funding (City
and/or
County)
Fund Amount Status of
Project
(Complete,
underway, or
canceled)
Balance
FY2017/18
CDBG
$0.00 $0.00
FY2017/18
ESG
$0.00 $0.00
FY2018/19
CDBG
$0.00 $0.00
FY2018/19
ESG
$0.00 $0.00
FY2019/20
CDBG
$0.00 $0.00
FY2019/20
ESG
$0.00 $0.00
FY2020/21
CDBG
$0.00 $0.00
FY2020/21 ESG $0.00 $0.00
FY2021/22
CDBG
$0.00 $0.00
FY2021/22 ESG $0.00 $0.00
E.4. List all committed and proposed funding sources for your proposed project and indicate the status of each source. Attach copies of any commitment letters you may have in the required documents section.

San Joaquin County request: $142,072.36 to pay for 5 slots per month.

Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 3
E.5. What will be the impact on your agency, program, or project goals be if the program is not funded at the full amount requested? Will your organization have the ability to sustain itself if the funding allocated is less than the amount requested? Please provide detailed information to understand if this is a funding gap and/or funds used to leverage additional sources outside of Stockton i.e. County/State/Federal/Private Funds The funding request is for a defined number of spaces in the project. If the approved amount is less than the request, available slots will be reduced to match the level of approved funding.

E.6. The City’s funding is intended to benefit residents of the City of Stockton. Briefly define your entire service area (e.g., a portion of the city, entire city, county).

The entire City of Stockton will be served by the 15 "Stockton" slots described in this application. An additional five spaces have been proposed to San Joaquin County.

No
Self Certification Clients independently “self-certify” on an intake form, membership form, etc. If you use this method, please upload a blank intake form under Required Documents Yes
Client Document Review Clients provide tax documents, pay stubs, etc., to verify income. Documents are reviewed by staff. If you use this method, please upload a blank worksheet under Required Documents Yes
Presumed Beneficiaries Clients served are primarily and specifically from one of the following groups: abused children, battered spouses, elderly persons (62 years of age or older), special needs/disabled persons, migrant farm workers, handicapped individuals, homeless persons. If you use this method, please indicate which group in the space below.

Yes
Transition-Aged Youth, 18-24 (until their 25th birthday) Economic Development Beneficiaries Financial or Technical Assistance to Businesses. The number of full-time, part- time jobs created or retained; the number of businesses to be provided counseling or technical assistance (DUNS Number required at time of assistance). Please attach a blank worksheet under Required Documents No
Other Survey, other documentation (required documentation for other governmental programs, etc. Please explain in the space below.

Yes
Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 3
Referrals from outside agencies, such as the Women's Center, Children's Home of Stockton, Child Abuse Prevention Council, San Joaquin County Human Services Agency, etc.

E.8. Describe in detail how your agency will use Stockton CDBG/ESG funds in this program/project.

PbC’s Safe Step for Youth program will assist 20 youth in securing stable housing, finding and maintaining employment, furthering their educational goals, and building a solid financial foundation. The program will provide services to youth ages 18 to 24 who are economically and/or emotionally disconnected from their families and are experiencing homelessness or unstable living conditions.

E.9. Select the common indicator that your agency will use to track clients.

Households: unit of measurement for housing activities only E.10. Define the primary unit of service (e.g. number of classes provided, hours of case management, number of medical visits, number of meals served, etc.) to be used when tracking this program/project, submitting invoices, etc. Note: Do NOT reiterate the number of clients or number of households served.

The primary unit of service will be stable housing. This is defined as a private room in a shared apartment, as described in the Project Narrative.

E.11. Provide a numeric GOAL for the units of service to be provided to Stockton clients by this project. Note:
“Other” refers to the unit of service in question #E.10 above.

Total
Persons 0
Households 20
Other 0
20 E.12. Describe the service delivery methods and outreach your agency will conduct towards your target population in question E.11 above, including to low income, limited English speakers, and disabled persons.

Parents by Choice will engage in outreach with community partners to introduce this program to our target population. These partners include, but are not limited to, the Women's Center Youth and Family Services, Child Abuse Prevention Council, the Children's Home of Stockton, Family Resource and Referral, Child Welfare, Probation and others. Agency outreach material will be printed in both English and Spanish.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 3
F. Project Impact
Completed by [email protected] on 1/24/2022 10:10 AM
Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
F. Project Impact
Please provide the following information.

Income Limits Potential Clients Served
Moderate Income (More than 80%) 0
Low Income (50%-80%) 1
Very Low Income (30%-50%) 3
Extremely Low Income (Less than 30%) 16
20 F.2. Please list the total number of Stockton clients your agency PROPOSES to serve through this program/project in the race/ethnicity categories below in fiscal year 2022-2023. The **total number must match the total number listed in the income categories in question F.1 above.

Race Clients Served # Hispanic within each
race
White 10 4
Black/African American 4 0
Asian 0 0
Am. Indian/Alaskan Native 1 0
Native Hawaiian/Other Pacific Islander 0 0
Am. Indian/Alaskan Native & White 1 1
Asian & White 1 0
Black/African American & White 1 1
Am. Indian/Alaskan Native & Black/African American 1 0
Other Multi-Racial 1 1
20 F.3. In the UPCOMING fiscal year 2022-2023, indicate the number of Stockton clients your agency will serve in each category below:

Category Clients Served
Disabled 60
Female Headed Households 325
Seniors 85
Youth 450
Homeless 75
995
Attachment A
Printed By: Kayla Martin on 3/30/2022 2 of 3
F.4. List the average number of unduplicated clients served daily, the total unduplicated number served annually, and the percentage of clients served that reside in Stockton for the current year, as well as the number you anticipate serving in Fiscal Year (FY) 2022-2023.

Reporting Year Average # of Clients
Served Daily
Total Unduplicated # of
Clients Served Annually
Total # of Clients Served
residing in Stockton City
Limits
2019-2020 (Projected- if
currently providing this
service)
0 0 0
2020-2021 (Anticipated) 250 1,600 1,500
2021-2022 280 1,800 1,750
530 3,400 3,250
F.5. Provide a concise description of the proposed project such as work to be performed, services to be provided.

No more than 3 sentences.

Parents by Choice’s Safe Step for Youth program will provide housing, services, and support to 20 at-risk or homeless transition age youth (TAY) ages 18-24. This program utilizes a supportive housing model, which comprises housing made affordable through long-term rental assistance paired with intensive services promoting housing stability.

Program participants will be housed at no cost to them and will receive related services to assist them in obtaining and maintaining independence and self-efficacy.

F.6. How was the need for this service/activity/project determined? Describe the challenges, needs or service gaps in Stockton that your program/projects address.

Youth and families in San Joaquin County (SJC), like in many other California counties, face economic challenges, underemployment, and limited access to education and training. Over the past decade, San Joaquin County’s population growth rate has exceeded the statewide average during a time of severe economic instability. The consequences of that instability continue to affect family security and health. 28.3% of children in San Joaquin County are living in poverty. Based on the high levels of poverty and childhood and environmental trauma, SJC children are susceptible to toxic stress and long-term academic, physiological, and emotional impacts. In 2015, 16.4 % of children in SJC had experienced two or more adverse childhood experiences (ACES). The impact of ACEs begins in childhood and continues through adolescence and adulthood. Youth with more ACEs are more likely to experience mental health challenges, developmental delays, negative cognitive and socio-emotional health issues, academic challenges, behavioral health issues, and specialized health needs. ACEs also increase the likelihood that an individual will not complete high school, not obtain a college degree, be unemployed as an adult, live below the poverty line, and experience homelessness. 46% of runaway and homeless youth reported being physically abused, 38 percent reported being emotionally abused, and 17 percent reported being sexually abused by a family or household member. 75% of homeless or runaway youth have dropped out or will drop out of school. Over 50% of youth who go through foster care are unemployed or homeless by age 24.

The 2019 San Joaquin County Homelessness Census and Survey found that nearly 160 youth ages 18-24 were homeless in San Joaquin County, and 66% of those transition age youth (TAY) are unsheltered. By far, the largest concentration of these homeless individuals is in Stockton. Between 20 and 40 percent of homeless youth identify as LGBTQ+. While current housing programs address housing needs and risk of homelessness for current and former foster and probation youth, youth who are not as directly involved in these systems do not have the same access to transitional housing. It is true that youth who are not emancipated foster or probation youth may also be at risk of homelessness due to their histories of trauma, poverty, chronic and toxic stress, lack of connections and stable relationships, or a myriad of other factors. Homelessness is not only a risk for systems-involved youth.

Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 3
The needs of youth, especially those living with a risk of homelessness, are distinct from adults and the support and interventions provided to these youth should reflect their unique needs. Youth facing homelessness experience simultaneous pressure related to earning an income, finding and accessing safe, supportive relationships, completing school, maintaining social connections, healing from and dealing with the impacts of trauma and adverse childhood experiences, and managing the normal stress of this stage of life.

Housing alone does not prevent or end homelessness. Youth must feel connected to the community, have access to their cultural reference group, monetary support, assistance with obtaining and maintaining employment, and ongoing support to manage existing and emerging mental health and trauma-related issues. Services must be provided in tandem with safe, affordable housing.

Other existing area programs offer a shelter environment to Transition Age Youth. Many of the strategies we propose, including a bridge to permanent housing and intensive case management, could not possibly be employed in a short- term shelter environment. There are not any current supported housing programs within Stockton or the larger San Joaquin County outside of the foster care system, and many at-risk or homeless youth do not meet that eligibility criteria.

Effectively responding to and preventing youth homelessness requires coordination across systems and between local service providers. Community-side efforts to address homelessness and issues contributing to it throughout Stockton and San Joaquin must include community-wide planning, coordination, and strategic use of resources and the programming and services tailored to the particular strengths of and challenges facing individuals and families within that community.

Attachment A
Printed By: Kayla Martin on 3/30/2022 1 of 11
G. Project Narrative
Completed by [email protected] on 1/24/2022 10:48 AM
Case Id: 48528
Name: Parents by Choice - 2022/23
Address: *No Address Assigned
G. Project Narrative
Please provide the following information.

Stabilization: PbC’s Safe Step program model is centered on Housing First, an evidence-based, client-centered practice shown to reduce homelessness. Individuals with access to this program will be housed faster than in programs offering a more traditional approaches, will stay housed longer and more stably than other programs, have a high likelihood of retaining housing stability and, in general, access services more often and are less costly to public systems than participants in other types of housing programs. Black, indigenous, and people of color (BIPOC) are disproportionately represented within the unhoused population, the traditional "housing readiness" models can reinforce inequities. Housing First is a model more likely to attain equitable housing and health outcomes.

PbC aims to reduce and prevent homelessness among youth not only by providing housing but through directly addressing unmet needs and underlying issues that are both immediate and long-term contributors homelessness and other poor outcomes. In addition to safe, appropriate, and affordable housing, all youth will also receive support related to employment and/or education, strengthening relationships and developing permanent natural supports, community connections, and addressing trauma-related and mental health challenges.

PbC will work to create knowledge of the program with other agencies and community partners through outreach, online advertising, flyers, and networking. PbC has strong existing community relationships that will support these outreach efforts.

Eligibility and Admission
PbC will accept youth into the program ages 18 to 24 who are economically and/or emotionally disconnected from their families and are experiencing homelessness or unstable living conditions. Youth may self-refer, but we anticipate that most referrals will come directly from shelters, community centers, street outreach, drop-in centers, or other parts of response systems frequented by vulnerable young people experiencing homelessness. Parenting youth will be accepted as space allows. Wherever possible, priority for entry will be given to youth with the greatest need, which can be determined through a combination of factors including, but not limited to, experience with chronic homelessness, current or past issues with mental illness and/or substance use, high utilization of crisis services, and membership in an at-risk sub-populations (i.e. LGBTQ+ youth, BIPOC youth, parenting teens, youth with histories of or current risk of commercial sexual exploitation, etc.). Housing is not conditional on a set of readiness criteria.

Beginning with the admission process and throughout the program, PbC will emphasize youth choice and will encourage youth to bring their own lived expertise, knowledge, and perspectives to the program and its services.

Upon receipt of a referral, the Program Director will arrange an in-person interview with the youth. The Program Director will explain the benefits and expectations of the program, discuss the youth’s goals for the future, and offer the youth time to ask questions. The referred youth’s potential roommate may also participate in this interview process to answer questions from their perspective and to ensure a mutual fit.

During the intake process, youth will be advised of their tenant rights, receive a program handbook, and review and sign a copy of the participant application. PbC offers options for apartment locations and will discuss the move-in schedule with youth. The Program Director will provide any referred youth who are not accepted to the program with specific reasons for the decision, conditions necessary to re-apply, and alternate housing options for consideration.

Program participants must agree to program guidelines outlined in the Safe Step for Youth Handbook. Youth must maintain program eligibility through either (1) maintaining employment at least part time (20 hours per week), (2) attending school at least part time, or (3) participating in an activity that aids in removing barriers to the previous items (e.g., mental health services, Alcoholics Anonymous meetings, etc.).

PbC staff attempt to have as much contact as possible in the first 30 days of placement to ensure that the needs of the youth are being met. Staff are trained to develop strength-based contact strategies with youth to encourage engagement and supportive working relationships. Staff work to build positive, supportive, and nurturing relationships through partnership, positive reinforcement, and by modeling strengths-based, positive adult roles.

Staff partner with youth to create a plan on how they will keep in contact, with a schedule chosen by the youth.

Shared responsibility is an important component of PbC’s service philosophy. Above all, participants are recognized as adults. Once they demonstrate responsibility, youth will receive a minimum of one contact per week throughout the Attachment A
Printed By: Kayla Martin on 3/30/2022 3 of 11
duration of their program. The intensity and frequency of visits will be predicated on their age, the needs of the client, or crisis situations. High risk and high needs youth will receive daily contact either by phone or in-person from program staff while risk persists. PbC emphasizes that this is a “no fail” program built on the strengths of the participants.

Safe Step Staffing
PbC will employ compassionate, creative, and resilient staff members with a strong understanding of adolescent and young adult development and a positive youth development approach to working with at-risk youth. The Safe Step program employs a .5 FTE Program Director with a Bachelor or Master’s Degree, 2 FTE Transition Coaches with Bachelor’s Degrees, and a .25 FTE Administrative Assistant. Transition Coaches spend time with each participant at least weekly to support their goals, provide encouragement, and link them to community resources. Transition Coaches will help youth reach their goals through coaching and mentoring. The Program Director will meet regularly with each staff member and program participant to ensure the goals of the program are being met, and will act as the point-of-contact for referral sources. Program staff will link participants to any additional services necessary to meet their goals, including those provided directly by PbC and those provided by other community providers.

A PbC staff member will be on call 24 hours a day for placements and emergencies. Youth will have access to their Transition Coach and the Program Director as needed. All staff carry cell phones and are trained in how to handle emergency situations. Program staff have access to the Program Director, Clinical Director, and Executive Director to assist with problem-solving and managing crises as needed.

Housing and Basic Needs
Housing is provided via a permanent scattered-site model in affordable housing units leased by PbC. Rental units may include apartments, single family dwellings, or condominiums. Single youth will share a two-bedroom unit with another youth in the program as a built-in support network. Families may have their own apartments or may share a larger unit with other parenting youth for mutual support.

At entry to the program, youth will be provided with all of the furnishings and household accessories needed at no cost to them. Furnishings include a bed, dresser, sofa, dining table, bathroom accessories, wall decorations, and kitchen utensils, among other necessary items. Youth may shop alongside PbC staff so that their apartment furnishings are a reflection of themselves.

Participants will receive housing at no cost for the first year of their participation in the program. During the second year and as long as they remain in the program, they will pay a portion of rent and utilities based on their income.

Youth will receive a grocery voucher each month and small stipends for achieving monthly goals. They will also receive gift cards for personal items.

PbC’s Transition Coaches will help participants learn how to manage money, including budgeting, savings, and balancing a checking account. Staff will also assist the youth in establishing the utilities in their own name.

Program participants have a lease and all the rights and responsibilities of tenancy. PbC will also ensure the personal safety of program participants and will review written safety rules and guidelines, including who to contact in case of problems with gas, electricity, plumbing, window and door locks, smoke detectors, etc. in the apartment, and safety at night when getting to and from the apartment, within the first 30 days of the program. PbC will work with each youth to resolve safety concerns and reduce harm and risk of eviction or housing disruption. There are instances in which youth may need to move units or exit the program due to unwillingness or inability to address safety concerns.

Participants sign an agreement acknowledging that they may be dismissed from the program for reasons related to Attachment A
Printed By: Kayla Martin on 3/30/2022 4 of 11
the following: (1) refusal to meet minimum eligibility requirements of the program; (2) behaving in a manner that is dangerous to themselves or others and/or having weapons in their apartment; (3) particicpating in the exploitation of other PbC youth for the purposes of Commercial Sexual Exploitation and/or gang activity; (4) using their apartment for illegal activity, including but not limited to possession of drugs with the intent to sell, trafficking others, etc.; (5) bringing unsafe guests to their apartment and/or tell unsafe people where their apartment is located (note: “unsafe" may include violent or abusive individuals, drug dealers, etc.); (6) breaking the rules of lease/apartment complex and/or if the Apartment Management requests their removal; (7) prolonged unexplained absences from the apartment/program. The program is voluntary and youth may exit if they decide they no longer want to be a part of the program. If a client is arrested and detained, PbC will discuss this situation on a case by case basis to determine whether to reserve their space in the program. The use of alcohol or drugs in and of itself, without other lease violations, is not a reason for eviction.

Support with Permanent Housing
PbC will help participants who want to remain in their units to do so. Participants who complete the program may choose to remain in their unit, and PbC staff will work to ensure that the lease transfers to the participant. PbC currently has apartments in desirable neighborhoods near shopping, schools and employment opportunities. PbC nurtures effective relationships with landlords, providing information about the program and considering them as part of the support for youth working toward a goal of reducing homelessness. Our current THP+FC program has a strong relationship with the Venetian Bridges and Riverwood complexes in Stockton. During the program, we will have regular Roommate Meetings to ensure a comfortable and effective living situation. Regular and random apartment checks will also take place to ensure cleanliness and to check for health and safety concerns. As participants near the final quarter in the program, or if a need for a housing change arises during the program, PbC staff will assist with housing locator services, show participants how to fill out an application for rent, and provide advocacy on the participant’s behalf with landlords as needed.

There may be times when a youth needs to be rehoused because their housing is not a good fit or because of eviction.

In these cases, PbC will work with the youth to find alternative housing within or outside the Safe Step program, depending on the needs and preferences of the youth and availability of housing. Transition Coaches will continue to support youth through these transitions, emphasizing that a loss of housing is not a personal failure, treating the situation like a learning opportunity, and engaging the youth and providing support until they are housed again.

Case Management
Case management is youth-centered and driven by the youth’s individual goals. Case management comprises a number of different interventions intended to promote housing stability, build life and independent living skills, enhance engagement with family, friends, and community, and achieve educational and employment goals. Transition Coaches are trained in and actively employ evidence-based practices for engagement, including motivational interviewing and client-centered counseling. Transition Coaches develop relationships with program participants and use a variety of strategies and approaches to help them achieve their goals, including: assessment, goal setting, referrals and linkage, building life skills, problem solving, mediation and communication skill building, advocacy, and support navigating systems. Services are informed by a harm-reduction philosophy, where participants are engaged in nonjudgmental communication regarding any high risk behaviors and offered education regarding how to avoid risky behaviors and engage in safer practices. Transition Coaches will connect youth to evidence-based treatment the youth chooses.

Mental Health and Medical Care
We recognize that youth may come to this program with underlying mental health and trauma-related issues that impact their behavior, relationships, and functioning in work or school. At the time of admission, PbC completes an Attachment A
Printed By: Kayla Martin on 3/30/2022 5 of 11
assessment of each youth to ensure that their individual needs are met through the program. PbC considers physical, emotional, social, cultural, cultural, and spiritual well-being in promoting positive youth development. Services are individualized, needs-driven, and centered around the youth’s ideas of the support they need. PbC’s framework is geared toward positive youth development that emphasizes the youth’s assets and strengths as much as their needs and vulnerabilities. We work to enhance health, confidence, and resilience.

PbC provides individual and group counseling in accordance with the identified needs of the youth. PbC has a range of regular therapeutic groups available for transition age youth, which will be expanded and adapted to the Safe Step program. Mental health services are a core component of PbC’s services, and we have a licensed therapist on staff.

PbC will refer youth to outside mental health and medical providers as needed. PbC has strong referral relationships with San Joaquin County Behavioral Health Services, the Child Abuse Prevention Council, and the Women’s Center Youth and Family Services.

Educational Advocacy and Support
Youth will receive support to obtain educational goals. PbC will assist youth who do not have a high school diploma or GED with enrolling in a GED program. PbC will provide weekly check ins on the status of the youth’s progress in the GED program and will provide additional tutoring and support as needed. The PbC team will support each youth in pursuing post-secondary education or vocational training depending on their interests. Support services include completing college applications, applying for financial aid, and accessing other school resources.

Job Readiness
Helping youth obtain employment is a core component of the THP Plus program, to ensure that youth obtain independence and permanency. Youth not enrolled in a college or vocational program are expected to work at least 20 hours per week. The PbC team will support each youth in developing a resume, filling out job applications, preparing for interviews, learning job skills, and accessing employment opportunities. We work with the Stockton WorkNet Center, as well as the JobCorps Center in Sacramento (funded through the Job Training and Partnership Act and overseen by the San Francisco Regional Office of Job Corps), to provide training and job opportunities to youth participating in the Safe Step program.

PbC will provide employment opportunities through the businesses we own: Plaza Perks, a coffee shop opened in 2020, Main Street Gifts, a retail gift shop coming to downtown Stockton in July 2022, and a commercial restaurant coming to downtown Stockton in the Fall of 2022. The sole purpose of these small businesses is to provide job opportunities for vulnerable youth, in a compassionate, supportive environment. More information about the coffee shop can be found at the following link: https://youtu.be/YBV-kecvi7s.

PbC requires parenting youth to attend our Positive Parenting Program (Triple P) as part of their program participation. Triple P consists of six weekly small groups focusing on topics such as understanding children’s growth and needs, training on positive discipline, and the development of parenting skills. These groups provide an opportunity for parents to connect with one another, share resources and lessons learned, and also to create community through informal mutual support. PbC provides nearly 50 different Triple P groups each year, involving a diverse population of parents, so TAY parents will be given the opportunity to attend a group of their peers if they choose.

Community Involvement
PbC seeks to help youth develop the skills and relationships they need to integrate and participate into the community. PbC will assist youth in establishing and maintaining healthy personal relationships. The program includes a monthly one hour community meeting in which participants are able to talk about how things are going for them Attachment A
Printed By: Kayla Martin on 3/30/2022 6 of 11
living on their own, their struggles, and their inspirations. The focus is on improving life skills, social skills, and emotional wellbeing. Attendance at community meetings is voluntary but strongly encouraged. Approximately once each month there will be a planned community activity by program staff for all youth. Activities will be voluntary and will focus on life skills and/or building community. Youth will be encouraged but not required to attend. Examples of past activities include bowling, laser tag, museum trips, beach outings, and paintball. Youth will be able to participate in interviewing staff as a way to observe and practice interviewing for future employment themselves. They may also be asked to participate in interviews with potential program participants.

Participants will also be empowered to give back to the community at large through participation in outreach and training programs provided by PbC to the community. This will not only empower program youth, but help to improve the lives of other youth facing homelessness.

Exit-Planning and After-Program Care
In support of the goal to develop permanent, positive adult relationships, PbC will start exit planning on day one and will make program staff available to youth after their exit. The PbC Transitional Housing program will remain in contact with “alumni” youth who have exited the PbC program. Agency staff will be available for 180 days post exit.

Some of the aftercare services provided by the agency include a detailed exit plan that documents the services needed and how participants can access them and a road map of future goals in place so both the team and the youth are in sync. Youth and program staff will exchange contact information, including contacts for family, friends, employers, teachers, mentors, etc. Continued staff-client contact will be approved by a supervisor. Management will be aware that a staff person is in contact with a former client to ensure professional boundaries and avoid conflicts of interest. PbC will support periodic alumni get-togethers.

Peer support groups are offered to former clients as well as the opportunity for them to mentor/support current clients. Those that have completed the program successfully can help those in the program; Most importantly, participants will be aided in transitioning from program dependency and creating community-based support systems.

Youth will be given a gift card for food or movies if they check in every six months. PbC will hold an annual holiday party so alumni and current clients can touch base with peers they may have lost contact with. Youth will be encouraged to use social networking to stay in touch with other youth and PbC.

We will measure the following outcome objectives:

1. The program will assist participants in securing stable housing during program participation and upon exit.

2. The program will assist youth in obtaining education and employment goals.

3. Program participants will address mental health or trauma-related issues that impact housing stability.

4. The program will assist youth in establishing a solid financial foundation.

5. The program will encourage social inclusion/community involvement.

Project Activity or Program
Service #
Describe the Deliverable
1 Annually, 80% of program participants will successfully maintain stable housing and will exit the program to stable housing. 2 Of the program participants not employed at time of entry, 70% will obtain employment or will enter a vocational training program, internship or will volunteer within six months of program entry. 3 75% of program participants will have obtained their HS diploma or equivalent upon exit.

Attachment A
Printed By: Kayla Martin on 3/30/2022 7 of 11
4 80% of program participants will exit with a positive balance in their personal savings account.
4 95% of youth will access the necessary services and support related to achieving at least one (1) personal goal related to improved physical and/or mental health, reduced substance use, enhanced personal safety, improved self-esteem, and/or enhanced resilience.

Parents by Choice (PbC) was established in June 2006 by Tony Yadon, MA, a social worker with a wealth of experience and a deep understanding of California’s foster care system, with the mission to bring hope and healing to children, youth, and their families. PbC began with one staff member, a small office, and the vision for an organization committed to ensuring that all children have the resources they need to grow up healthy and whole.

Over the past 15+ years, PbC has grown into an established, well-respected organization. PbC is governed by an active, community-based Board of Directors and is led by the founder and Executive Director. PbC’s leadership and culture center children as the “big deal” of the organization. With support from the state of California, San Joaquin, Stanislaus and Solano counties, private grants, annual community fundraisers, and donor contributions, PbC is financially stable and its budget has grown substantially and safely during its 15-year history. PbC’s $5.5 million annual budget and staff of more than 70 employees support four core programs: Foster Care and Adoption Support, Transitional Housing for Foster Youth, Mental Health Services, and the Positive Parenting Program (Triple P). PbC services are provided in a warm, welcoming, safe, and child-friendly environment in its offices in Stockton, Modesto, and Fairfield, and in other community spaces in Lodi, Manteca, and Tracy through longstanding partnerships with other community organizations. PbC is a fully licensed Foster Family Agency with national accreditation from the Council on Accreditation (COA).

PbC also has a strong relationship with The Housing Authority of San Joaquin and is a partner in a Project Homekey application, which will renovate a Motel 6 property into 128 one bedroom units. PbC will have use of approximately nine of the units for the TAY population. This project hopes to bring $26 million in State support to San Joaquin County for the hotel renovation, and has received a matching pledge of $6 million from the City of Stockton.

PbC has developed responsive, innovative services that meet the unique, diverse, and evolving needs of at-risk San Joaquin children and families. PbC serves more than 1,000 individuals annually through an array of direct and outreach services that include orientation, training, and ongoing support to foster families, independent housing and comprehensive support services to foster youth aged 18-21, adoption support, outpatient and school based mental health services and parenting groups and classes. Services are provided in both English and Spanish by a passionate and qualified staff who hold associate, bachelor’s, or master’s degrees in applied practice fields including counseling, marriage and family therapy, social work, and other social and behavioral sciences. PbC staff have extensive training and experience in preventing child abuse and neglect and teaching healthy, safe parenting techniques and are committed to partnering with San Joaquin children, families and the community to protect and invest in children’s futures.

PbC has proven experience and expertise partnering with San Joaquin County Human Services Agency, Children's Services, and other county departments and community agencies to contribute to safety net services for San Joaquin County’s most vulnerable children and families. PbC provides Intensive Services Foster Care (ISFC) services, which are short-term treatment interventions to promote healing, child stabilization, and to facilitate the permanent transition into a home. In partnership with San Joaquin County, PbC operates a Transitional Housing Program that provides safe Attachment A
Printed By: Kayla Martin on 3/30/2022 8 of 11
and supportive housing to youth who are aging-out of foster care. PbC provides mental health services in San Joaquin county and began providing school-based mental health services at four high schools in Stockton through a contract with San Joaquin Behavioral Health in 2020.

City Council and Concurrent AuthoritiesMay 3, 2022

City Council and Concurrent Authorities
May 3, 2022