HomeMy WebLinkAboutCC Resolution 9577 (Child Development Contract)RESOLUTION NO. 9577
A RESOLUTION AUTHORIZING THE SIGNING OF A
CONTRACT. LEASE OR AGREEMENT
THE CITY COUNCIL OF THE CITY OF SAN RAFAEL RESOLVES as follows:
The MAYOR and CITY CLERK are authorized to execute, on behalf of
the City of San Rafael a contract, lease or agreement with :
State Department of Education for 1995-96 Child Development Contract for
a State Preschool Program for $29,457
a copy of which is hereby attached and by this reference made a part hereof.
I, JEANNE M. LEONCINI, Clerk of the City of San Rafael,
hereby certify that the foregoing resolution was duly and regularly
introduced and adopted at a Regular meeting of the City Council of said City
held on Moil mthe lst day of APRIL 1996 by the following
vote, to wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Phillips, Zappetini &
Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
A.
JEANN \M. LEONCINI, CITY CLERK
ORIG.IiIHLas1'
%I.- CALIFORMA DEPAR" ENT O_FEDU TION
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Expansion DATE: January 1, 1996
LOCAL AGREEMENT FOR CHILD DEVELOPMENT SERVICES CONTRACT NUMBER GPRE-5295
PROGRAM TYPE: Preschool
PROJECT NUMBER: 21-N916-00-03038-5
CONTRACTOR'S NAME: CITY OF SAN RAFAEL
By signing this contract and returning it to the State, you are agreeing to provide services in accordance with the FUNDING TERMS
and CONDITIONS (FT&C) and APPLICATION which are attached and by this reference incorporated into this contract. The FT&C and
Requirements specify the contractual responsibilities of the State and the contractor.
Funding of this contract is contingent upon appropriation and availability of funds. This contract is effective from January 1. 1996
through June 30.1996. For satisfactory performance of the required services, the contractor shall be reimbursed in accordance with
page 16 of the FT&C, ata rate not to exceed $13.87 per child per day of full-time enrollment and. a Maximum Reimbursable Amount
(MRA) of $ 29.457.
Any provision of this contractfound to be in violation of Federal or State statute or regulation shall be invalid but such a finding shall
not affect the remaining provisions of this contract.
SERVICE REQUIREMENTS
Minimum Child Days of Enrollment (CDE) Requirement 2.123.8
Minimum Days of Operation (MDO) Requirement 105
Up to $3,837 of the MRA may be expended as one -time -only start-up costs in accordance with Education Code Section 8275 and
the Funding Terms and Conditions.
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BY o D r ATTEST:
PRINTED NAME OF PERSON SIGNING &Y,&M VA'MI AN OF PEPAN SjahNo / AAWNE M. *EZITI—,
Donna Salai ALBERT J. ORO, Mayor City Clerk
`�” ADDR= 1400 FIFTH AVENUE, W.O. BOX 151560
Manager Contracts Office SAN RAFAL, . CA 94.11 g4PI S-1- 6C
AMOUNT ENCUMBERED BYTHM PROORAMICATEOORY (CODE AND TITLE) FUNDTTTLE 1Dep�nme of Qtx]es� 5wrrice�
DOCUMENT
Child Develooment Proarams General met only
(OPTIONAL USE)
PRIOR AMOUNT ENCUMBERED FOR TIiL4
�TRAC' 03038-N916 30.10.020.001
REM CHAPTER STA7UTE FISCAL YR
TOTAL AMOUNT kTfCUM BE TIP G TO DATE
6100-196-001 (a) 303 ' 1995 1995/96
OBTECI. OF EXPENDITURE (CODE AND TME)
709
Ihaeity t Cy upon m} awn peraatal Iatowledge thu budgeled frond wm milable for She period and ptapow T. BA NO. BA NO. .
'=e�eeTds up11,edabwe-
SIGNATURE OFACCOUNTIND OFFICER DATE
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1. The Contractor agrees to indemnify, defend and save harmless the State, its officers, agents and employees from any and all claims and losses accruing or resulting to any
and all contractors, subcontractors, materialmen, laborers and any other person, firm or corporation furnishing or supplying work, services, materials or supplies in connection
with the performance of this contract, and from any and all claims and losses accruing or resulting to any person, firm or corporation who may be injured or damaged by the
Contractor in the performance of this contract.
2. The Contractor, and the agents and employees of the Contractor, in the performance of this contract, shall act in an independent capacity and not as officers or employees
or agents of the State of California.
3. The Slate mayterminate this contract and be relieved of the payment of any consideration to Contractor should Contractor fail to perform the covenants herein contained at
the time and in the manner herein provided. In the event of such termination, the State may proceed with the work in any manner deemed proper by the State. The cost to
the State shall be deducted from any sum due the Contractor under this contract, and the balance, if any shall be paid the Contractor upon demand,
4. Without the written consent of the State, this contract is not assignable by Contractor either in whole or in part.
5. Time is the essence of this contracL
6. No alteration or variation of the terms of this contract shall be valid unless made in writing and signed by the parties hereto, and no oral understanding or agreement not
incorporated herein, shall be binding on any of the parties hereto.
7. The consideration to be paid Contractor, as provided herein, shall be in compensation for all of Contractor's expenses incurred in the performance hereof, including travel
and per diem, unless otherwise expressly so provided.
B. Contractors entering into a contract funded wholly or in part with funds from the United States Government agree to amendments in funding to reflect any reduction in funds
if the Congress does not appropriate sufficient funds. In addition, the contract is subject to any restrictions, limitations or enactments of Congress which affect the provisions,
terms or funding of this contract in any manner. The State shall have the option to terminate the contract without cost to the State in the event the Congress does not
appropriate funds or a United States agency withholds or fails to allocate funds.
1. During the performance of this contract, contractor and its subcontractors shall not unlawfully discriminate, harass or allow harassment, against any employee or applicant
for employment because of sex, race, color, ancestry, religious creed, national origin, disability (including HIV and AIDS), medical condition (cancer), age, marital status, and
denial of family and medical care leave and denial of pregnancy disability leave. Contractors and subcontractors shall insure that the evaluation and treatment of their employees
and applicants for employment are free from such discrimination and harassment. Contractor and subcontractors shall comply with the provisions of the Fair Employment
and Housing Act (Government Code, Section 12900 et seq.) and the applicable regulations promulgated thereunder (California Code of Regulations, TiUe 2, Section 7285.0
et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing Government Code, Section 12990 (a -f), set forth in Chapter 5 of Division
4 of Tittle 2 of the California Code of Regulations are incorporated into this contract by reference and made a part hereof as If set forth in full. Contractor and its subcontractors
shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement.
2. This contractor shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to perform work under the contract.
By signing this contract, the contractor hereby certifies under penalty of perjury under the laws of the State of California that the contractor will comply with the requirements
of the Drug -Free Workplace Act of 1990 (Government Code Section 8350 et seq.) and will provide a drug-free workplace by taking the following actions:
A. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance is prohibited and
specifying actions to be taken against employees for violations, as required by Government Code Section 8355(a).
B. Establish a Drug -Free Awareness Program as required by Government Code Section 8355(b) to inform employees about all of the following:
1. the dangers of drug abuse in the workplace;
2. the person's or organization's policy of maintaining a drug-free workplace;
3. any available counseling, rehabilitation and employee assistance programs; and
4. penalties that may be imposed upon employees for drug abuse violations.
C. Provide, as required by Government Code Section 8355(c), that every employee who works on the proposed contract:
will receive a copy of the company's drug -tree policy statement; and
will agree to abide by the terms of the company's statement as a condition of employment on the contract.
Failure to comply with these requirements may result in suspension of payments under the contract or termination of the contract or both and the contractor may be ineligible
for award of any future state contracts if the CDE determines that any of the following has occurred: (1) the contractor has made false certification or (2) the contractor violates
the certification by failing to carry out the requirements as noted above.
"I/k?V
California Department of Education Management Bulletin # Q� i7
Child Development Division fN C Q E} V C D LATE APPLICATIONS
COMPETITIVE APPLICATION (CD -3002A RIrV.. VI -LC..,- WILL NOT BE ACCEPTED
PROGRAM INFORMATION 1 ' "U
I
95 1101 CoRT)WE
Legal Status of Agency Headquartered
Return to: Check one: Check one:
Child Development Division X city or city agency
560 J Street, Room 220 _ college or university YES ER
Sacramento, California 95814 _ county or county agency
_ county office of education NO ❑
CDD Use only (CDS# 1
[ ] New [X] Competitve _ private non-profit organization
[ ] Revised [ ] Renewal _ private profit organization
[ ] Continuing _ school district
Please complete the following information: (CDs# 1
' Legal Name of Applicant Agency Amount Requested (12 months)
City of San Rafael $ 58,914.00
I
= Address City County Zip
P.O.Box 151560 San Rafael Marin 94901
Projected Dates of Operation (12 months) Federal Identification Number (9 digits)
From July to June // 19 I 4 1 6 1 0 10 10 1 4 1 2 14 ! ///
Contact person for this application: Telephone Number Fax Number
Bill Scharf (415) 485-3386 (415)485-3046
EXECUTIVE OFFICER/SUPERINTENDENT Address P. o .Box 151560 Telephone 4 8 5- 3 0 7 0
Suzanne Golt, Acting City Man.
City San Rafael Zip 94915-1560
I PROGRAM DIRECTOR Address Telephone 4 8 5- 3 3 8 6
Bill Scharf Same as above
Child Care Manager City Zip
BOARD CHAIRPERSON Address Telephone 485-3070
Al Boro, Mayor same as above
City Zip
Certification: I hereby certify that all applicable state and federal rules and regulations will be observed; that to
the best of my knowledge, the information contained in this application is correct and complete.
i
Bill Scharf Child Care Manager
Typed Name of A thorized Agent Title
Child Care Manager
D o thorized Agent Title
i
Calitoma Department of Education
Cn,m Development Division
COMPETITIVE APPLICATION
PROGRAM INFORMATION
PART II
PROGRAM SECTION
A. PROGRAM PROFILE (not scored): Based on the program type described in the Management Bulletin, describe
the program proposed in this application. (Note: This will be considered in other areas of this application.):
1. Number of children to be served:
Through this application
Infants (0 - 18 months)
Toddlers (18 - 36 months)
Preschoolers (3 - 5 years) 24
School-age (5 - 14 years)
2. Daily hours of operation:
Morning program 8:00 am to 11 :30 am
Afternoon program to
Full day program to
Evening program to
Weekend program to
3. Proposed number of days of operation (full program year): 177
4. Is facility (ies) located in the service delivery area in which the applicant is headquartered? xx Yes No
5. Identify your service delivery area.
The service delivery area is the Canal neighborhood of
the city of San Rafael in Marin county.
1
Ca jMM DgMUMe crfdw.rm
Chu D"dopo" Dniim
caVFMM Ar CATION
PROGRAM DnWAiAr4N
B. FACILITY(IES) (15 points): Please check one:
✓ Facility (es) is (are) licensed/exempt for the proposed ape group to be
served is (are) will be available for services on January 2, 1996.
Facility (es) licensing application has been submitted to and accepted
by the Community Care Ucensing Division.
Facility (les) licensing application has been submitted to the Community
Care Ucensing Division but not yet accepted.
No license application has been submitted to the Community Care
Ucensing Division.
If two or more facilities are involved, identify the licensed status for each facility:
Our Short Preschool is currently licensed for eighty 3 to 5 year olds.
Our Pickleweed Children's Center is currently licensed for forty-
eight 5 to 12 year olds. We are in the process of adding a preschool
license to the Pickleweed facility. If this licensing process is not
completed by January 2nd, which seems unlikely, we would serve the
preschoolers(to begin with at Short Preschool until the Pickleweed
licensing process is completed. Our intent is to serve children at
Pickleweed because that center is located in the neighborhood where
the need is the greatest.
California Depanmem of Education
Child De%clopmrm Dmmnn
COMPETITIVE APPLICATION
PROGRAM INFORMATION
C. TARGET POPULATION (not scored): Describe the target population of children and families to be served, including:
Families economic levels:
The Canal area of San Rafael has an average household income of
$32,286, while the average income in the County is $90,563 for a
two income family. There are 287 families, with 194 children
under 5 years old, living below the poverty level in this area of San
R (aQI.
Ethnici ies):
The Canal area has the fastest growing, densest population and the
highest ethnic diversity in San Rafael. The breakdown, is as follows:
White 37%, Hispanic 43.5%, African-American 7.25%,
Asian/Pacific Islanders 11.75%, Other 0.5%
One must also take into account the high number of undocumented
residents living in this area, which are primarily Hispanic.
Language other than English spoken in the home:
The dominate language for this area is Spanish. There is a growing
population from Eastern Asia, with a number of languages and
dialects represented.
Special needs of families:
The greatest need of families in the area would be economic. There
is a high percentage of families living at or below the poverty level,
with all of the special needs associated with poverty. Language
would be the nest barrier for families that would be addressed.
Geographic boundaries of the agency's service area (i.e., school attendance area, county, city, zip codes):
While the preschool is located in the East San Rafael area and would
draw primarily from the Bahia Vista Elementary School attendance
area. The Canal also has an industrial area. The preschool could also
serve the employees of these businesses. Also, we are near the
Office of Employment and Training and could serve their clients.
3
Cddoems De{vnmem of Edueauoo
C'mW Development Divuion
COMPSTME APPLICATION
PROGRAM INPOR.MATION
D. 'Mission Statement (not scored): Summarize the agencys mission statement regarding child development. Briefly
describe the overall program provided to children and how it reflects the agency's core values for the target
population.
Our mission is to offer a program focused on the whole child. We
offer developmentally age-appropriate curriculum, providing the
opportunity for social, physical, cognitive, emotional and linguistic
growth. We provide a balance of child initiated and teacher directed
activities. The classroom environment follows a child -centered
design, with a range of experiences in activity centers which
encourage and foster children's play and independence. During play
children are free to creatively experiment, and develop personal
experience in the physical and social world in which they live. The
children have access to numerous educational material for both
inside and outside play. They will participate in movement
activities, receive academic support, enjoy special guests and field
trips, learn practical life skills, play and socialize. Through each of
these activities the teachers will focus on the individual
development of the child and follow that child's developmental
profile. We will offer opportunities to meet challenges, face
success, and build confidence within a safe, nurturing and
wholesome environment. The core of our philosophy is, time spent in
the child development program will be quality time. Each child will
be given every opportunity to mature and develop at their own pace
and to their highest potential.
n
Caldomu Depon—ni of Edunnon
CIu1d De,009MM MUlon
COMPMUVE APPLICKMN
PROGRAM INFORMATON
E. GOALS AND OBJECTIVES (15 points): Describe the agency's major goals and objectives for the program in
accordance with the following instructions. Goals and objectives should be developmentally and linguistically
appropriate for each child..
Goals should be broad and comprehensive and should encompass overall program operation.
Objectives should be specific and indicate outcomes for the following subjects and should indicate timelines and
methods of measurement.
1. Administration (staffing, recruitment, orientation, staff development, ratios, etc.)
Goals:
To
provide
a qualified,
well trained staff
that
reflects the cultural
and
ethnic
diversity of
the community we
are
serving.
Objectives:
1. Our program will ensure satisfactory staffing levels at all times
by meeting and exceeding State licensing requirements.
2. We will provide staff development and training through local
community colleges, workshops and in-house activities based on
staffing needs and current trends in child development.
3. Our administrative personnel will provide orientations to new
staff that ensures a proper and positive introduction to the position.
4. We will ensure that staff are trained and qualified for the
position to which they are assigned. This will include language
training as well as training in child development.
5. To provide opportunities and a positive environment in which
staff advance their careers within the division through the
availability of promotional opportunities.
6. To recruit and hire within the community to ensure a staff that
reflects the diversity of the community.
5
CaIiform Depnmem of Edunuon
Ould Desdopmem Division
COMPEMNE APPLICATION
PROGRAM INFORMATION
2. Program activities (developmentally appropriate, meets needs of age groups to be served, nutrition, etc.):
Goals:
To provide a developmentally appropriate, experiential and
integrated program that meets the individual needs of children
served.
Objectives:
1. Develop a child's cognitive abilities through games and activities
that acquire and reinforce thinking skills and concepts.
2. Develop and reinforce a child's primary and secondary language
skills through activities.
3. Prepare children for Kindergarten in partnership with the
elementary school and Kindergarten teachers through a readiness
program.
4. Provide nutritional lessons, snacks and meals that reflect the
diversity of the community.
5. To provide developmentally appropriate nutrition education.
R
California Department of Edumoo
mild Developnrnt Division
COMPEITITVE APPLICATION
PROGRAM INFORMATION
3. Family and community involvement (.community resources, referrals, parent participation, parent education, support
services, social services, etc.):
Goals:
The program will form partnerships with parents, family and
community that acknowledges and reinforces the joint
responsibility for the education and caring of children.
Objectives:
1. The curriculum will be enriched through the use of community
resources.
2. Parents will be actively engaged in the program by providing
opportunities in which they can participate.
3. The program will provide parenting education to help parents
understand how children learn.
4. The program will encourage parents to extend and reinforce
learning at home through activities such as: reading with children at
home, sharing family history and traditions and having children
participate in practical life skills.
5. The program will hold monthly parent meetings, at convenient
times and places in which they can discuss interesting topics, learn
about available social services and discuss the curriculum.
6. The program will hold parent conferences at least biannually that
reinforces the school/parent partnership.
7. The program will use occasional social events to strengthen
rapport, respect and friendship between the families and staff.
7
C&Wonul Depm m of of Eduadao
Child Development Division
COMPETMVE APPLCATION
PROGRAM INFORMATION
F. PROGRAM EVALUATION (10 points): All programs must be evaluated. The evaluation plan must include the
processes for assessing the agencys progress in meeting the goals and objectives on an annual basis.
1. Describe the plan and identify who will be involved in the process:
An evaluation of the program through a self -study process by using
the California Department of Education's Exemplary Program
Standards for Child Development Programs (EPS). The self -study
team will include teaching staff, program administration, parent
representatives and community members. This evaluation will be
used to assess the progress the quality of the program and to review
policies, practices and procedures.
2. Describe how the evaluation results will be used to modify area identified as needing improvement:
The EPS process identifies "gaps" and "matches" in the program
against standards that have been developed for centers. Gaps are
findings by the site study team as areas needing improvement. Gaps
are identified and prioritized, and addressed in an action plan,
including who is responsible for improvement activities and when
the improvement activities will be accomplished. The EPS is based
on improvement, not compliance. It is a continual process.
8
r.rroma Department of EA,ndon
Child Development Division
COMAE irRVE APPLICATION
PROGRAM INFORMATION
G. STAFF DEVELOPMENT (10 points): All programs must have a staff development plan. Describe the plan for the
following areas:
1. Orientation for new staff (handbook, observation, training, etc.):
All staff are given a general orientation at the main administration
office by the program coordinator where the staff handbook, job
description, and philosophy are reviewed. At the center, new staff
are given an orientation specific to their assignment, including
introductions to staff, children and parents, an overview of the local
neighborhood and specific job assignments. An orientation checklist
is followed for all employees to insure consistency and fairness.
2. Annual performance evaluation:
The Memorandum of Understanding between the city and the public
employees union requires a performance evaluation review, at least
annually. The object of this review and evaluation is to provide the
staff with opportunities to continue to grow, improve and receive
feedback on their job performance.
3. How staffs needs will be determined:
Staff needs will be determined through the performance review
process, informal observations, surveys and staff meetings. Staff
needs are also identified by the assessing current trends and the
larger needs of the center and the community. Staff will also be
encouraged to seek and be given opportunities for professional
development.
4. Opportunities for upward mobility/professional development:
The City of San Rafael offers promotional opportunities to staff.
Upper level vacancies were filled from within the Child Care
Division. We have an annual professional development day for the
staff and three days for teacher preparation. The budget provides
funds for staff development and training. Staff are encouraged to
seek opportunities for professional growth by offering them low-
cost workshops and training, and professional organizations.
0
c,Y, & D Pu=ut Of E&=d-
(hib Dgvcloprract D viu00
COMPETTrra APPLICATION
pRoC,RAM UMRMAMON
IDENTIFICATION OF CHILDREN'S NEEDS (10 points): Describe the process by which each child's developmental
H. major strategies or
strengths, skills, and interests will be determined t within
utilized, eda how ther identified ed needsyand linterests will be
approaches, including the developmental profile(s)
addressed, inclusion of teacher observations and sharing the information with parents.
The site personnel will assess each preschool child using formal and
informal evaluation processes to ascertain a child's needs, interests
and language skills upon entering the program. The staff will be
sure that the assessment is appropriate for the level of
development, language, individual needs and interests of the child.
The assessment tools will be free from biases. While proper
assessment is accumulated continuously and over a long period of
time, a developmental profile of the child will be established within
the first month to make sure that materials and activities are
appropriate for the age, language, needs and interests of each child.
Teacher observations and anecdotal information will be recorded and
become part of the child's overall assessment. Information is
shared with parents regarding their child's development on a
continuous and regular basis. The goal of ongoing assessment is for
planning curriculum appropriate to the each child's growth, at all
levels of development. To that end a portfolio of the child's work
will be continuously accrued. No single method of assessment can
give an accurate and well-rounded picture of a child. Using a
assortment of methods will produce a full, comprehensive
assessment of each child. Information about children will be shared
with parents through informal discussions and twice a year, formal
parent -teacher conferences.
10
Califoma Dcpuumnt of Eduotion
Child Devebpmenl Division
COMPETITIVE APPLCAMON
PROGRAM INPORMATION
{. DEVELOPMENTAL PROGRAM (50 points): Describe how the program will address the following developmental
areas for each age group served including special needs and lanauaoe minority children. Include major activities,
strategies or approaches, and curriculum materials utilized in each of the developmental areas:
1. Social/Emotional Development (self-awareness, emotions, interaction with peerstaduhs, etc.):
Our program holds dear the importance of childhood, joy and
laughter. We strive to stimulate a child to want to seek and love
learning through an increased awareness of the world and those
around themselves. We will provide opportunities for children to
enhance their self-image and feel good about themselves. Teaching
staff will not have all the answers or make everything perfect,
instead they will encourage exploration, growth and self-worth.
They will not be "referees" or "judges" but will guide children to
work out their own social issues. Free choice time will encourage
children to enter learning activities they feel confident in doing.
Teachers will help children realize their accomplishments thereby
creating a positive environment to foster their self-image. The
schedule, environment and staff will present opportunities for
children to work and play together to promote cooperation and
socialization. For example: in one area of the room, two children
building a structure with blocks, in another four children are playing
bakery in the sandbox. Use of the block area encourages children to
solve problems such as: enclosing an area, leaving an opening,
balance and proportion and motor development. Playing in the
sandbox involves dramatic play, and the daily sharing which occurs
is an important aspect of social growth. Adults will enter into
games with children. They will follow children's leads, ask key
questions, act out roles and seize opportunities for language
development. We will support the cultural social mores and
respectful of family differences held important by the families of
the children we serve to build each child's feeling of self worth. Our
teachers will be careful to support each child's daily choices of
activities and actions during free choice time. Keeping in close
contact and following through with our families will help insure
that the child's social/emotional needs are met. Teachers will
continually encourage and effect a joyous atmosphere in which
children can enjoy life & it's opportunities.
1 11
Ca mw pepncmm of Em=U-
03iW Developerot MY000
COMPETITM APPUCAMON
PROGRAM INFORMATION
2. Physical Development (large and small muscle activities, eye/hand coordination, etc.):
Physical development is an area where there is often room for
children of varying abilities and levels; from children with special
needs to the extremely capable to work together for the benefit of
all. Open ended, multi-level activities can take place
simultaneously with the same equipment. For example: a child at
one end of the water table may simply and repeatedly pour with a
cup, while another may grasp the concept of measurement by pouring
water into pitchers of increasing size. A special needs child may
only be able to enjoy the texture and warmth of sand in the sandbox,
while another child can build a series of canals for water to run
through. One group of children will be completely involved in
imaginative play with little or no equipment, while in another area
some children are setting up a complex dinner table by rearranging
the furniture, setting the table and clearing away dishes when they
are finished with their imaginary meal. The availability of many
manipulative will be an integral part of the program. Buttons and
beans to sort, parquetry blocks and puzzles to match together,
various shapes and textures to be manipulated, a variety of
materials will be integrated into the curriculum.
The program will have access to both indoor and outdoor facilities
for physical activities. Indoor mats for rolling, tumbling, hopping,
skipping and rolling will be available. A playground with age-
appropriate equipment where climbing, swinging, balancing, sliding,
and free play can take place will be part of the daily. activities.
Group games which require skipping, running, walking forward and
back, hopping, skipping, jumping and rolling will help children
develop physically. Music used to differentiate movement with
given rhythms will be integrated into the curriculum.
12
Cafdaaia Dgmwwm of Education
Child Development Division
COMPETITIVE APPUCATION
PROGRAM WPORMATTON
3. Cognitive Development (conceptualization, classification, seriation, problem solving, etc.):
Play is a child's most important and natural activity. It is through
play that children acquire knowledge about their world. Cognitive
development is a complex process resulting from the interaction of
children's thinking and their experiences. An experiential, thematic
based program, where children's immediate needs are integrated
into an emergent curriculum. Each theme will have built into it
activities for classification, conceptualizing and problem solving.
The environment will be divided into clearly defined areas and
interest centers; with an easel area for painting, a large block area
for building, a dress up area and home center for dramatic play and
so on. The teachers will prepare the environment so there will be
stimulating and challenging materials. The schedule will balance the
teacher directed with child initiated. Laminated animal pictures may
be sorted into groups based on land and water; wild and domestic or
by size. Spontaneity and imagination will be accepted and
encouraged. Games such as Color Bingo will be used to build
language skills, or color and shape recognition. Age-appropriate
activities will be accessible at the center computer station. A
teacher directed art lesson will take into account the development
of left to right. The teachers will be pro -active. They will ask key
questions, while children are at work in play, to push children's
thinking further. Whether problem solving with two children trying
to ride the same tricycle or guiding a group building a structure with
the blocks that is getting too high, the adults are actively engaged
with the children. Teachers will be more interested in what kind of
thinking is going on, than in right or wrong answers. They will lead
large and small group games such as "Who's under the blanket?" to
encourage children to concentrate, remember and listen discerningly
to discover the answer. A simple game can be quite a complex
cognitive activity for a four year old. As the child approaches
Kindergarten, readiness activities will be introduced. Children will
visit their school on occasion. The Kindergarten teachers will come
for a Teddy -bear tea party at the preschool. A' child's preschool
experiences are the building blocks for their future' successes.
11 13
Cahforoia Depa,ptmnt of EAuntion
ChiW DeveVopnmt t Divimn
COMPHI777VE AFFUCA71ON
PROGRAM INFORMATION
4. Language Development (understanding and use of words and sentences, etc.):
Language development activities to foster the development of each
child's ability to acquire, use and interpret the elements of language
through listening to and dictating stories, imaginative play, and
carrying on meaningful conversations with other children and the
adults in the preschool setting. Teachers will use open ended
questions that encourage children to "use their words" as well as
forming sentences and thinking about their responses. Small and
large group circle times will take place daily that includes music
and singing in the child's primary and secondary languages. Acting
out simple stories, such as: Three Bears. or Billv Goats Gruff with
repetitive language sequences wirl provide opportunities for
language development and memory retention. Circle time will also
present activities that include the naming of simple and familiar
items and naming them in the child's primary and secondary
languages. Circle times will include the reading of language and
age- appropriate stories with interesting, self-explanatory pictures.
"Show and tell" times will encourage children to speak about
familiar events * and things they know. Puppetry will be used for
primary and secondary language acquisition. To meet the children's
needs best in the preschool we will provide many and varied
opportunities for language interaction. Children will learn language
through speaking experiences. The language that the each child
brings to the program will be valued and, when possible, utilized in
learning .basic concepts while the child acquire English. Since a long
term goal is the acquisition and facility in English, the teachers
should be able to communicate in the child's native tongue. Language
development must be seen a continual and gradual, so as to not
inhibit the child. A child's self-image is tied to his or her primary
language and culture, therefore staff training should also include,
bilingual, multi -cultural education.
14
California pepntment of Education
Child Development Divuioo
OOMPE1777VE APPL]CATDON
PROGRAM INFORMATION
5. Creative Development (art, music, dramatic play, etc.):
Creative activities encourage children to express themselves in
open, unprogrammed, imaginative ways by drawing inspiration from
their imaginations rather than external models or directions.
Creative activities often involve visual and performing arts. The
staff will encourage and creativity through the use of open ended
questions and by providing materials with varied uses. Creative new
uses for familiar media will be offered: What shapes can be torn
from this tissue paper? What happens when we glue it over this
color? Simple materials, like the large furniture box can keep
children's imaginations occupied for hours. The classroom
environment is integral in the implementation of creative
development. . The environment will include areas for free
expression, including a block area, a painting easel area and a home
center. The classroom should encourage and not inhibit free
expression. The playground should provide, not only equipment for
physical development, but large areas for children to play and
express themselves. There should be a variety of equipment and toys
also provided, including equipment for sand and water play. Access
to a large, open indoor area is essential for the program to offer
dance activities, so children can run and play with their shoes off
and roll around on mats. Music activities through the use of and
rhythm instruments in a structured manner will take place. Musical
instruments will be used to enhance and during the acting out of
stories. Children will be introduced to various kinds of music,
including music from different cultures. The child's portfolio will
be rich with examples of the child's creative work. The creative
aspect of the program is so important, because it is where children
can have positive results since there are not right and wrong
answers, and self-expression is encouraged.
15
C4Vom, Depi,tment of Educw o
Cbild Devetoptmnt Division
CotaMSVE AMCATION
PROGRAM UffORMATION
J. NUTRITION (1 o points): All programs are to provide nutrition that is developmentally appropriate for each age groip
served. In addition, all programs are required to provide nutrition education.
Indicate which of the following meaWsnacks will be served:
X Breakfast
X Morning snack
Lunch
~_ Afternoon snack
Other:
1. Describe how the meals/snacks will be developmentally appropriate. Describe how children will be exposed tc a van ---y
of foods to be served:
The meals/snacks will take into account the children's age, culture
and community. Parents will be asked to assist in special cultural
activities that include food. We will participate in the food service
program at the elementary school and work with their nutritionist.
Through daily meals and snacktime, the children will be introduced
to: foods from other cultures, healthy and nutritious foods and meal
preparation. The program at Pickleweed also participates in the
Community Garden, which is adjacent to the center.
2. Describe the nutrition education program.
The nutrition education program will be provided through age-
appropriate activities, as well as integrated into the daily
curriculum. The children will be introduced to balanced meals
through an experiential approach, including growing vegetables and
edible flowers in the community garden. The program will also
include field trips to the local farmer's market, the grocery store
and a local restaurant.
16
11
Cawoma Depammat of Education
Child De,eloprxni Divixi=
COhpET rME APPLCATION
PROGRAM INFORMATION
K. PARENT EDUCATION AND INVOLVEMENT (10 points): Programs must provide parent education and encourage
parental involvement. Include strategies or approaches to be implemented regarding how parents' needs and
interests will be identified and addressed in the following areas:
1. Parent orientations
Parent orientations will take place through "open houses" and
"back -to -school nights" during the school year. Individual
orientations will take place during registration time. This
orientation will include a review of the parent handbook, including
programs philosophy and goals, a review of a typical day at school,
suggestions on how the parent can participate in the program. The
parents will fill out of a parent intake form. This form will include
questions on meeting the child's needs, likes and dislikes and
special considerations, etc.
2. Parent conferences (at least twice a year):
Formal parent/teacher conferences will be held in October and May
to discuss the child's progress in the program, how the parent can
assist in the child's education and how the parent can participate in
the school program. Parents will also be informed that teachers are
always available to discuss their child's progress whenever the need
arises. Teachers will also use daily communications with the parent
to informally conference with the parents.
3. Parent meetings (on a regular basis):
The goals and objectives of the program should reflect the values
and aspirations of the parents. To that end, parent participation is
imperative. Our program will encourage parent participation through
regular (monthly, or quarterly) parent meetings. Parent meetings
will center around a special topic or project. The center will bring
in special guests for parenting education. The staff will also use
less formal "pot -luck" type events to encourage parents to become
involved in the center.
17
CaVoms Depucrcot of EAteati00
Child Develo nt Divimoo
ODMPFi1TNE A" JCA110N
PROGRAM INPORMATION
4. Ongoing communication with parents:
Ongoing communication is oneof the most important aspects of the
relationship between parents and the preschool program. Since the
program sees many of the parents on a daily basis, they are able to
build continuous, positive relationships and communicate about
many issues and concerns. The staff will acknowledge parents by
name and great them when they bring in their child in and pick them
up. The program will also provide parents with a monthly
newsletter and calendar of activities.
5. Parent Advisory Committee and its role:
The program will form a Parent Advisory Committee, which will
take an active -role in the program. It will advise and help evaluate
the goals and objectives, help with special events and projects. It
will represent the program in the larger community. The PAC will
be advocates for children. They will help staff volunteer activities
and keep be informed of the important issues facing the lives of
children living in the neighborhood. This committee will be a vital
link between the daily lives of children and families, and the school.
18
Ca ffa is Depument of EA=don
Quld Development Drvuion
COMPETITIVE APPLICATION
PROGRAM INFORMATION
L. COMMUNITY RESOURCES AND INVOLVEMENT (10 points): Indicate how the agency will generate community
awareness and will utilize community resources and involvement to enrich the program or expand services to children
and their families:
The Child Care Division is actively involved in many community
activities that would help promote the program and expand services
to children and their families. The Program Manager is on the Board
of Directors of the county Resource and Referral Agency, as well as
being a member of the county appointed child care commission. The
director of Pickleweed Children's Center is on the executive of the
local A.E.Y.C. chapter and a member of the Canal Children's Task
Force. Since the program is located at the neighborhood community
center, it also provides child care services in the evening and on
weekends during community meetings and school parent nights. The
agency maintains an up-to-date list of community referral sources
for parents needing counseling, medical services, legal aid, shelters,
child care, adult education and community recreational
opportunities. The Child Care Division is part of the City of San
Rafael Recreation Department. We publish a quarterly newsletter,
with program highlights, that reaches every household in San Rafael.
Our division is not only a visible entity in San Rafael, but also a
highly respected organization in the county.
Because the program is part of a larger community have already
establish links with the neighboring community. The program will
survey of local businesses and contact them about ways they can
help the program. The agency will identify and contact prominent
community leaders to visit and support the program.
19
CsWomia Depamteat of EtStntion
CWW Developnteot Division
COMPETUIVE APPLICA71ON
PROGRAM INFORMAnON
M. FISCAL (opinion rendered):
1. All applicants are required to submit financial information with this application. Such information will be reviewed by
a CDE auditor.
Government agencies must submit an organization -wide audit (single audit).
Private non-profit agencies must submit an organization -wide audit (single audit). In the absence of an organization -
wide audit, a non-profit agency shall submit a contractor audit. In the absence of a contractor audit, an IRS tax return
is acceptable. Indicate type of financial information attached:
-a Organization -wide Audit (single audit]
O Contractor Audit
0 IRS Tax Return
0 New agency, no audit or tax return completed (submit financial documentationrnformation that shows the
applicant has the necessary financial resources to start and operate a contract, i.e., line of credit, financial
planning documents, etc.)
Private for profit agencies (partnerships or personal) must submit the most recent tax retum. Indicate the type of
financial information attached:
O IRS Tax Return (corporate or partnership)
0 IRS Tax Return (Schedule C for personal)
0 New agency, no audit or tax return completed (submit financial documentation/information that shows the
applicant has the necessary financial resources to start and operate a contract, i.e., line of credit, financial
planning documents, etc.)
2. Has the agency experienced a loss of funding within the past 12 months?
XX No
Yes, please explain:
20
PART III
CERTIFICATIONS
PROGRAM CERTIFICATIONS
I certify that the applicant agency will comply with all applicable local, state and federal requirements including, but not limited
to, California Education Code, Section 8200-8499.8; California Code of Regulations, Title 5, Section 18000-18308; Califomia
Code of Regulations, Title 22, Division 12.
I certify that the applicant agency will maintain a current personnel roster which will identify each employee working in the
child development program; the employee's position; the type and date of expiration of credentiaWpermits for those
employees required to possess credentialstpermits; transcripts of all college units completed and years of experience.
I certify that the applicant agency will have sufficient qualified staff to perform all administrative, support, auxiliary and
instruction functions required in the administration of a child development program.
I certify that the applicant agency will comply with requirements which include, but are not limited to, a process for assessing
the health and social service needs of the children and families being served and for referring children and families for health
and social services. I further certify that the applicant agency will develop and implement a follow-up process regarding such
referrals. Documentation on referral and follow-up will be maintained in the family's basic data file.
I certify that the applicant agency will have adequate equipment and supplies for the children prior to the first day of service.
certify that the applicant agency will have sufficient fiscal resources (cash, line of credit, emergency loans, etc.) to cover
initial start-up costs for the first ninety (90) days of operation.
certify that the applicant agency will establish, or will have established, a child development funds as required by Education
Code, Section 8328 and California Code of Regulations, Title 5, Section 18064.
Bill Scharf
Type Name of Authorized Agent
Si Xe'& u orizedAgen
21
Child Care Manaqer
Title
4V7,16, ,
Date
STATE OF CAUFMNIA
NONDISCRIMINATION COMPLIANCE STATEMENT
STD. 19 (REV. }95) FMC
COMPANY NAME
City of San Rafael
The company named above (hereinafter referred to as "prospective contractor") hereby certifies, unless
specifically exempted, compliance with Government Code Section 12990 (a -f) and California Code of
Regulations, Title 2, Division 4, Chapter 5 in matters relating to reporting requirements and the
development, implementation and maintenance of allondisc amination Program. Prospective contractor
agrees not to unlawfully discriminate, harass or allow harassment against any employee or applicant for
employment because of sex, race, color, ancestry, religious creed, national origin, disability (including
HIV andAIDS), medical condition (cancer), age, marital status, denial of family and medical care leave
and denial of pregnancy disability leave.
CERTIFICATION
1, the official named below, hereby swear that 1 am duly authorized to legally bind the prospective
contractor to the above described certification. l am fully aware that this certification, executed on the
date and in the county below, is made under penalty of perjury under the laws of the State of California.
OFFICIAL'S NAME
Bill Scharf
DATE EXECUTED EXECUTED IN THE COUNTY OF
October 31, 1995 I Marin
PROSPECTIVE CONTRACTORS SIGNATURE
PROSPECTIVE CONTRACTORS TITLE
Child Care Manaqer
PROSPECTIVE CONTRACTOR'S LEGAL BUSINESS NAME
City of San Rafael
22
seri aroma:a
ait� nep.ftnft o[EAmmb=
csTeD II In.Wm
MUTMIVE APPUCMM
DRUM= WORKPLACE CERTUICOM (97D.2104EW I I -M
ALL APPLICANTS MUST
COMPLETE THIS FORM.
SECTION III - PART C
DRUG-FREE WORKPLACE CERTIFICATION
COMPANY I ORGANIZATION NAME
City of San Rafael
The contractor or grant recipient named above hereby certifies compliance with Government Code Section 8355 in
matters relating to providing a drug-free workplace. The above named contractor or grant recipient will:
I. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession, or use
of a controlled substance is prohibited and specifying actions to be taken against employees for violations, as
required by Government Code Section 8355(a).
2. Establish a Drug -Free Awareness Program as required by Government Code Section 8355(b), to inform
employees about all of the following:
(a) The dangers of drug abuse in the workplace,
(b) The person's or organization's policy of maintaining a drug-free workplace,
(c) Any available counseling, rehabilitation and employee assistance programs, and
(d) Penalties that may be imposed upon employees for drug abuse violations.
3. Provide as required by Government Code Section 8355(c), that every employee who works on the proposed
contract or grant:
(a) Will receive*a copy of the company's drug-free policy statement, and
(b) Will agree to abide by the terns of the company's statement as a condition of employment on the contract
or grant.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized legally to bind the contractor or grant recipient to
the above described certification. I am fully aware that this certification, executed on the date and in the county below,
is made under penalty of perjury under the laws of the State of California.
OFFICIAL'S NAME
Bill Scharf, Child Care Manager
DATE EXECUTED October 31, 1995 / EXECUTED IN THE COUNTY OF M a r i n
CONTRACTOR OR G CIP ATURE
T= Child Care Manager
FEDERAL I.D. NUMBER 94-6000424
23
CWW= D*m m t of Edmttion
Cold DmMPMmt DOW=
COMPERHVE APPIICAMON
MC-FREE WORKPLACE CEtrUXATM M. tl (NEW 11-M
INSTRUCTIONS FOR DRUG-FREE WORKPLACE CERTIFICATION
Page 2 of 2
Chapter 1170 (1990), the Drug -Free Workplace Act of 1990, added Chapter 5.5 (commencing with Section 8350) to
Division 1, of Title 2 of the Government Code. This law requires every person or organization awarded a contract or
grant for the procurement of any property or services from any state agency to certify that it will provide a drug-free
workplace by doing things specified in Section 8355.
The law further provides that each such contract or grant may be subject to suspension of payments or its termination,
and the contractor subject to debarment from future contracting, if the contractor or grantee has either (1) made a false
certification, or (2) violated the certification by failing to carry out its requirements. The Department of General
Services will publish a list of individuals and organizations whose contracts and grants have been cancelled for failure
to comply with the law.
The law does not require any contractor (or grantee) to ensure that other businesses with which it subcontracts also
provide drug-free workplaces.
For the purposes of ibis law, some applicable terms are defined as follows:
"Drug-free workplace" means a site for the performance of work at which the employees of the contractor or grantee
are prohibited from engaging in the unlawful manufacture, distribution, dispensation, possession or use of a controlled
substance.
"Employee" means the employee of a contractor or grantee directly engaged in the performance of work pursuant to a
contract or grant with a state agency.
"Controlled Substance" means a controlled substance in schedules I through V of Section 202 of the Controlled
Substances Act (21 U.S.C. Sec. 812).
"Grantee" means the department, division or other unit of a person or organization responsible for the performance
under the grant.
"Contractor" means the department, division or other unit of a person or organization responsible for the performance
under the contract.
24
STATE OF CALFORNIA
VENDOR DATA RECORD
• (Required in lieu of IRS W-9 when doing business with the State of California)
STD 2W (REV &9Z
DEPARTMENT)OFFCE PURPOSE: Information contained in this form
Child Development Division will be used by State agencies to prepare Infor-
PLEASE STREETADORESS
-RETURN 560 J Street, Ste. 220
TO:
CITY, STATE. ZP CODE
Sacramento, CA 95814
mation Returns (Form 1099) and forwithhokang
on payments to nonresident vendors.
(See Privacy Statement on reverse.)
VENDORS BUSINESS NAME OWNERS FULL NAME gmt Fist ALU
City of ,San RafhPl n/a
STREET ADDRESS • ARE YOU SLOACT TD FEDERAL LAMV
P.O.Box 151560 "Wh"
Is...kee�seRoa+.,e► its Fwm w -a)
CRY, STATE, MIO ZIP CODE
San Rafael, CA, 94915-1560 YES ❑ No
INSTRUCTIONS: (1). Check box indicating type of business entity and provide taxpayer Identification number.
(2). Check box Indicating resident or nonresident. (See reverse for addidonalInformation).
(3). Check one or more VENDOR ACTIVITY boxes specifying vendor activity.
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❑CORPORATION
(Enrr idrra/ EeeobT+r drelTeesl'on lMnb•rJ
Resident - Oualltied to do business in CA /
❑ Permanent place of business In CA
Non Resident (See Reverse)
INDIVIDUALJSOLE PROPRIETOR
�EnwSndslSvoviryAaexdAi•ebwerJy. NOTfFNN)
❑ Resident ❑ Non Resident (See Reverse)
❑PARTNERSHIP
Fnw Fedww Effobyer Idreeiaion d
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❑ Resident ❑ Non Resident (See Reverse)
❑ESTATE OR TRUST
(EMM Fed" En*6yw AvreBi�es Nmbv)
I t I- I ► I I I I 'I
Resident me of e) -Decadent was a CA resident at
❑ ath
Resident (frust) a. At least one trustee Is a CA
resident
MEDICAL BEAVICESrWhi nS,1 i•ty,
vodrh: Os1�NsPr. vocal:
❑
❑RyC£S pm MmCA�
eh}sp ec de)
EOUPMENT/SUPPLES
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aNON EMPLOYEE COMPENSATION rrc&A*V
EOUPMENT/SIPPLES
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(&Oro hm Saab wwowid v)
MEDICAL sERVCESAvixft dwe iay,
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❑ INTEREST jEwwo hers Skk w0ftie V
❑ RENT
❑ ROYALTIES
❑ FAIZES AND AWARDS
❑ OTNER gpmW
`
n_ Non Resident (See Reverse)
I hereby artily under penally of perjury that the Information provided on this document Is true and correct
X my residency status should chance, I will promptly Inform you,
AIli:IORJgD VENDOR REPRESENTATIVES NAME (rfln wP" TITLE
Bill Sr,haChild Carp ManAap
t1ONA7URE DATE TELEPHONE NUYGEA
�+ 1 , 5 — — 1 -
October 3 199 415 485 AFi—
tOFFI55 $TATE"EJSE ONLY :
CONTRACULEASE NI MBENONRESIDENTWITHHOLDING
I, )NCUPLOYEE❑ USDICAL ❑ � ❑ OTHER 11STANDARD RATE
COMPENSATION SERVICES ` J
IREPORTAW INCOME CODE PER STA E ADMINISTRATIVE MANUAL SECTION Un If KAsrt 0u)I INITIALS DATE INITIALED❑ WAIVED
❑1 ❑2 ❑❑
3 ❑I �S 6 ❑7 ^
' _ J REDUCED RATE . _ _
California Department of Education
Child Development Division SIX MONTH
FOAM CD -9730 (8,94) CALENDAR
Zia" N OF AG II=
City of San Rafael
PLUGS AN 'X• ON sysRY MY YOUR PROORM WnZ = DPW FOR BMWICs.
JANUARY 1996
IOU K TU M TH F 8A
*16
7 SES 11., 12 13
14 *15 rl �L-7 20
21 ~ Ji 27
28
Days of operation:
APRIL 1996
�SU M.1 TU N THI F 8A
6
7 8 9 10 112 13
14 P�6V1< �1$ 20
21 2� ..Z3...2t, 72t, 12 ! 27
28 ;S� 30.
FEBRUARY 1996
IOU I J" I TUI N, TS Jr 9A
3
4 9 10
11 * 12 `i' 17
18 *19 _2� 24
25 21� 2-7< '29 29:"
Days of Operation: IF
MAY 1996
SU I M I TU K Ts F 6A
4
5 �yfl 10 . 11
12 ;5 X16' i:r 18
19 ZO '21. 22 -2 -4" -Xe 25
26 *27^���r-�0
Days of Operation: 1'7- Days of Operation: 2.1
* Legal Holiday
26
NOTE: same print or type clearly.
PROJZM NUImER
94-34 (mb)
MARCH 1996
I8U1 MITUI NITIF F SA
2
3 9
1011' 16
17 $ 23
24 g28,
29_ 30
31
Days of Operation: 2-0 TOTAL
JUNE 1996
ISUI M ITUI N IrHI r SI
11
2 8
9 14 15
116 17 18 19 20 21 22
123 24 25 26 27 28 29
30
Days of Operation: 7 TOTAL: 1
U�
OVIt71i+T+ TOTWa: J
California Department of Education
Child Development Division
FORM CD -9730 (8/95)
City of San Rafael
1996-97
CALENDAR
V"Ci Rm R• as VVERY lay YOWL MOM" in= Ss OPM FOR ff=vICE. I
Days of Operation: 0
OCTOBER 1996
SUI M TU w Ta F SA�
XX 5
SECOND 6 � 11J 12
QUARTER 13 14 * � 19
20 2� 26
27
Days of operation: 121
JANUARY 1997
SUI X I TU N W F SAI
5 >-.' X '10 11
THIRD 12 13 * ?!� 181
QUARTER 19 xx 25 1
26 ',CK
AUGUST 1996
JULY 1996
SUI
SU
M
TU N r8 F
SA 1
1
2 3 4* 5.
6
1 7
8
9 10 11 12
13
FIRST 14
15
16 17 18 19
20
QUARTER 21
22
23 24 25 26
27
28
29
30 31
24
Days of Operation: 0
OCTOBER 1996
SUI M TU w Ta F SA�
XX 5
SECOND 6 � 11J 12
QUARTER 13 14 * � 19
20 2� 26
27
Days of operation: 121
JANUARY 1997
SUI X I TU N W F SAI
5 >-.' X '10 11
THIRD 12 13 * ?!� 181
QUARTER 19 xx 25 1
26 ',CK
Days of Operation: 0
NOVEMBER 1996
ISUI MITUI WI= F SAI
�< 2I
1130 15 � 16
117
J3,
26� ' 23
124 28* 29 30
r
Days of Operation: /'-
FEBRUARY 1997
1SU1 XITUI WI=I F SAI
11
1 2 �7 8
9 10* 15
1 16 17 * 22
123 X ;6,
Days of Operation: ZO Days of Operation: /7
APRIL 1997
SU1 x rU N W 7 SA
>i
" J -C 5
6 7 8 9 10 11 12
FOURTH 13 19
QUARTER 26
27
Days of Operation: / +
* Legal Holiday
MAY 1997
IOU1 YIrUI N rs F SA
3
4 9 10
11 _ 17
18 24
25 26* 31
Days of Operation: Id
27
ROTE: lase print or type clearly.
PROJZCT MUNI R
94-34(mb)
SEPTEMBER 1996
IOU s TU w rs F SA
1 2 �%l 7
i 8 2 14
115 %s✓ 19 , 121
122 4, .25` 2�, 281
29
Days of Operation: 2-�) TOTAL: 0`0
DECEMBER 1996
IOU M TU_ W Ta r SA I
8 �Q` Vii. T3 14
115 21 1
122 23 24 25* 26 27 28
129 30 31
Days of Operation: !'+ TOTAL:
MARCH 1997
SU I x I rU I W I Ta i F SA
u 1
2 > 8
9 10'� 15
16 19, 20 '2I! 22
123 0,,2& ;26. ,29._,28 29
130
Days of Operation: 7-0 TOTAL: S 7
JUNE 1997
SUN rU M rB F SA
8 ��13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30
Days of Operation: / TOTAL: /
OM1►ERLLL TOTAL: /;E T
AUGUST 1996
SUI
x I TUI a
W
F
SA
1
2
3
4
5 6 7
8
9
10
11
12 13' 14
15
16
17
18
19 20 21
22
23
24
25
26 27 28
29
30
31
Days of Operation: 0
NOVEMBER 1996
ISUI MITUI WI= F SAI
�< 2I
1130 15 � 16
117
J3,
26� ' 23
124 28* 29 30
r
Days of Operation: /'-
FEBRUARY 1997
1SU1 XITUI WI=I F SAI
11
1 2 �7 8
9 10* 15
1 16 17 * 22
123 X ;6,
Days of Operation: ZO Days of Operation: /7
APRIL 1997
SU1 x rU N W 7 SA
>i
" J -C 5
6 7 8 9 10 11 12
FOURTH 13 19
QUARTER 26
27
Days of Operation: / +
* Legal Holiday
MAY 1997
IOU1 YIrUI N rs F SA
3
4 9 10
11 _ 17
18 24
25 26* 31
Days of Operation: Id
27
ROTE: lase print or type clearly.
PROJZCT MUNI R
94-34(mb)
SEPTEMBER 1996
IOU s TU w rs F SA
1 2 �%l 7
i 8 2 14
115 %s✓ 19 , 121
122 4, .25` 2�, 281
29
Days of Operation: 2-�) TOTAL: 0`0
DECEMBER 1996
IOU M TU_ W Ta r SA I
8 �Q` Vii. T3 14
115 21 1
122 23 24 25* 26 27 28
129 30 31
Days of Operation: !'+ TOTAL:
MARCH 1997
SU I x I rU I W I Ta i F SA
u 1
2 > 8
9 10'� 15
16 19, 20 '2I! 22
123 0,,2& ;26. ,29._,28 29
130
Days of Operation: 7-0 TOTAL: S 7
JUNE 1997
SUN rU M rB F SA
8 ��13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30
Days of Operation: / TOTAL: /
OM1►ERLLL TOTAL: /;E T
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Child Dsvelopmrnt Division
COMPETITIVE APPLICATION (CD -3002A REV.
CENTER -EASED (PRESCHOOL)
APPLICATION FOR FUNDING
FINANCIAL SCHEDULE -6 PACE 1 OF 2
Instruction for Completino
Financial Schedule 6 (CD -3002A Rev. 3/92)
Finareiol Schedule 6 (CO -30026) details the aoaneyla planrnsd expanditures for specific object clesaffications. If the applicant Mo
no plana expo diturea in the items detailed on this for* write Ornot applicable• in the first line.
In column (A), report plana Child Developmet contract expenditures for each specified object u:lassification. in column (t) throuo
(E), report planned expenditures that will be Load to support the child development program: column (6) subsidized parent fees; (C)
non -subsidized parent fear; (D) other restricted funds; and (E) other unrestricted funds. The total of all plsmad axpsndituras is
reported in column (F).
these�(�m
Explain in detail expenditures plarm for each specified object classification. Approval of the application and budoet does not
constitute approaI of airy subcontract, equipment, travel, or renovation and repair expenditures for which prior written approval war
be rWrad from the Child Development Division. If an object classification or fading source is not applicable, leave the appropriate
columns and description blank.
Fudfno Source I Legal Name of Applicant
Gild DDevel2Wnr (' f -.v of. San RafaP1
Child
Line Acct. Development Subsidized Nona bsidized Other Other Un -
No. No. Classification Division parent fees parent fees restricted restricted TOTAL
(A) (6) (C) (D) (E) (F)
3 3900 Other employee
benefits $4417 s = s : :4417
Description:
Medical/dental insurance, medicare and retirement.
5 5100 Personal services
of consultants,
etc. is n/ a Is Is Is Is Is n/ a
Description:
5 5200 Travel mrd
conference
expono"s ate. * 2.5 0 s s s s 1$250
Description:
C.A.E.Y.0 conference attendance
5 5610 Contracts 161950 Is is I S i6 161950
Description:
Custodial contract and bisses for field trips.
5 5620 Rents, leases is n./ a Is
Description:
'Indicate pmyamnts to FCCN providers, if applicable.
'13
cWLM=nWM�dEft=m PART V
c.eo..mp�D. + REQUEST FOR APPLICATION (RFA)
C=p,vmAW.ca=(MMA k..V") COMPLETENESS CHECKLIST
Agency Nam- n 4 L. ]' c f 21.-1
Date- n r't nbP r in. i g q 5 Management Bulletin # C15 -4 A
Prior to submitting the four completed copies of the application to the Child Development Division, review the applications for the
following contents. Indicate "completeness" by writing "YES" in the space provided Return ONE copy of this completed Checklist
with the application package.
1. Cover Page has been completed and signed by the authorized agency representative. One copy has an original
signature.
2. All components (A through M) of the Program Section are complete.
✓ 3. All forms are complete and attached:
�L Calendars
✓ Site Information
Staffing Worksheet
4.
All certificates are complete, includes an original signature and is attached
Program Certification
✓
Statement of Compliance
Certification Regarding Provision of a Drug -Free Workplace
/
Vendor Data Report
V,
Financial Schedule A
✓
Financial Schedule B
� 5. ONE copy of the agency's Financial Audit (or other required documentation) is attached to the application.
✓ 6. The application does not include covers, binders, or other attachments which were not requested in the RFA
_,,L 7. The application print has not been reduced to have more than 15 characters/spaces per inch.
✓ 8. The application has not been modified to secure more space than was provided
Vol 9. All four copies of the application are complete.
T1 1 1 qt-h;%rF �
Type or Print Name of Person Completing Form Si/Mi6yPerso netingFor�n