HomeMy WebLinkAboutHRC Homeless Prevention 2021AGREEMENT FOR 2021-22 GRANTS-IN-AID AWARD
THIS AGREEMENT, dated ___________________________ for the convenience of the
parties hereto, is between the City of San Luis Obispo, a chartered municipal corporation
(referred to herein as CITY) and Community Action Partnership of San Luis Obispo County
Inc. (referred to herein as CONTRACTOR).
WITNESSETH:
WHEREAS, CONTRACTOR, has requested CITY to contribute to the Homeless Prevention
and Stable Housing program to provide the services described in the 2021-22 Human Relations
Commission Grants-in-Aid Application dated submitted to the CITY by January 31, 2021
(“Application”) and stored in the Community Development Department office at 919 Palm St.
San Luis Obispo, CA 93401, and
WHEREAS, said services will be available to residents of the City, thereby serving both a
public and municipal purpose.
NOW, THEREFORE, CITY and CONTRACTOR for and in consideration of the mutual
benefits, promises and agreements set forth herein, do agree as follows:
1. CONTRACTOR will make its services, as described in its application,
incorporated by reference and attached as “Exhibit A”, available to CITY
residents on a regular basis for the period of July 1, 2021 through June 30,
2022.
2. CONTRACTOR will provide CITY with a mid-year report, due
January 31, 2022, and final program report, due July 31, 2022, summarizing
administrative, financial, and client service activities. Said reports shall be in
the form of "Exhibit B", attached hereto.
3. CONTRACTOR and all its agents, representatives, or participants in any
manner in the performance of its obligations and duties hereunder, shall be
employees, independent contractors, or volunteers for CONTRACTOR. They
shall not for any purpose be considered employees or agents of the CITY.
4. CONTRACTOR agrees to hold CITY harmless, and to defend CITY against,
from, and in any claim, action, proceeding, or hearing wherein there is an
allegation charging liability on the part of the CITY as a result of any act or
omission, negligent or otherwise, by CONTRACTOR.
5. CITY agrees to pay CONTRACTOR a one-time only grant, in the sum of
$20,000 to be used as described in the Application. The grant will be paid in
one installment when a signed contract is received.
6. The Community Development Director may terminate this agreement at his
sole discretion, after a public hearing and upon ten (10) days written notice to
CONTRACTOR. Said termination shall be effective thirty (30) days after
CITY mails notice of termination of agreement to CONTRACTOR. Any
funds not paid pursuant to paragraph 5 above shall revert to CITY upon said
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termination.
7. CONTRACTOR hereby certifies and agrees that it will comply with the
Human Relations Commission’s “Bylaws” which creates an environment
within the City in which all persons can enjoy equal rights and opportunities
regardless of race, religion, sex, national origin, sexual orientation, age,
physical, mental, or economic status.
8. For purposes of notice under this agreement, all notices shall be considered
effective upon being sent by certified mail to the following addresses:
CITY:
City of San Luis Obispo
919 Palm Street
San Luis Obispo, CA 93401
Attn: Michael Codron, Community Development Director
GRANTEE:
Community Action Partnership of San Luis Obispo County Inc.
1030 Southwood Drive,
San Luis Obispo, CA 93401
Attn: Grace McIntosh
IN WITNESS WHEREOF, the parties hereto have executed this agreement by their proper
officers duly authorized:
Community Action Partnership of San Luis Obispo County Inc.
By: ______________________________
Signature
Its: ______________________________
Title
CITY OF SAN LUIS OBISPO, A MUNICIPAL CORPORATION
By: ________________________________
Michael Codron, Community Development Director
APPROVED AS TO FORM:
By: ________________________________
Christine Dietrick, City Attorney
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
EXHIBIT A
Grants‐In‐Aid Application
[attached]
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
City of San Luis Obispo HRC Grants-in-Aid 2021-22
2021-22 Grants-in-Aid
Application Checklist
Use this checklist as a tool to ensure all required components are submitted with your final application.
Applications must satisfy all of the eligibility criteria in order to be considered. Please verify by
checking boxes below that this application satisfies each eligibility criteria:
❑X I have used a standard typeface of 11 points or larger in every document submitted.
❑X I did not attach materials other than those requested.
❑X I did not use staples, binders, or covers (Paperclips or binder clips suggested).
❑X I have answered all questions and provided all required attachments.
I have included all of the following documents, both in hard copy and in a complete, signed scanned
and emailed packet in .pdf format:
❑X Completed Grant Application
❑X List of Organization’s Board Members
❑X Organizational Chart
❑X Copy of Document Certifying Federal Tax-Exempt Status
❑X Estimated Itemized Project Budget
❑X Copy of Organization’s most recent complete fiscal year financial statement (for the
previous year because it is the middle of the current fiscal year) including a statement of
financial position/balance sheet, statement of revenue & expenses/income statement,
profit & loss.
❑X My Final Application includes all documents listed above, submitted by 5:00 pm on
January 29, 2021, including:
❑X One (1) single-sided hard copy submitted by mail to:
Community Development Department
919 Palm St.
San Luis Obispo, CA 93401
Attn: Cara Vereschagin
Postmarks will not be accepted.
❑X One (1) signed application, including all attachments as a complete
package, in PDF format, submitted via email to housing@slocity.org.
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
City of San Luis Obispo HRC Grants-in-Aid 2021-22
HUMAN RELATIONS COMMISSION
2021-22 GRANTS-IN-AID APPLICATION
Community Action Partnership of San Luis Obispo County, Inc. (CAPSLO) AGENCY:
PROJECT/PROGRAM NAME: Homeless Prevention/Housing Stability
ADDRESS: 1030 Southwood Drive, San Luis Obispo CA 93401
CONTACT: Elizabeth "Biz" Steinberg PHONE: (805) 544-4355
esteinberg@capslo.org E-MAIL ADDRESS: WEBSITE:
(This person will receive notifications regarding grant decisions, contract execution, and reporting requirements)
WHO PREPARED THIS APPLICATION: Grace McIntosh PHONE: (805)544-4355
95-2410253 FEDERAL TAX ID NUMBER: DATE AGENCY ESTABLISHED:
AMOUNT OF GRANT REQUEST: $20,000
1. Please provide your agency’s core mission statement on one attached page (maximum 50 words)
labeled Attachment 1.
2. Please answer the following questions on one attached page labeled Attachment 2:
a. Briefly describe the program/project or reason you are requesting funds (max 150 words).
b. Please describe your grant request in detail (max 250 words).
c. Itemize how your agency would use the GIA award (refer back to “Funding Decisions”
Section on page 1 on the directions).
3. Please answer the following questions on one attached page labeled Attachment 3:
a. Please describe creative approaches your agency takes to achieve the Agency’s mission.
b. Please describe the interaction or collaboration between your Agency and other local
non-profits who serve similar clientele.
c. How will your program and the citizens of San Luis Obispo benefit as a result of this
grant?
www.capslo.org
12/9/1965
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
City of San Luis Obispo HRC Grants-in-Aid 2021-22
4. The HRC has identified their main funding priority as: Homeless prevention including affordable
and alternative housing, supportive services and transitional housing. Does your grant request
meet this funding priority? □ Yes
□ No
5. Which other priority of the non-ranked HRC funding priorities does your request support? Please
check the appropriate boxes: □ Hunger and malnutrition prevention □ Supportive physical and mental health services for those in need □ Services for seniors and/or people with disabilities in need
□ Supportive and developmental services for children and youth in need
□ Services encouraging diversity, equity, and inclusivity in marginalized communities
6. What is the project’s total budget? $20,000
7. What is your agency’s entire total annual budget? CAPSLO Homeless Services Division - $1,295,472
(for the local chapter if a widespread organization)
8. What percentage of your agency’s entire total annual budget comes from private (non-
governmental) donations? 46%
a. What are those private funding sources? Friends of 40 Prado (a nonprofit organization that raises funds for 40 Prado)
CenCal Health, Dignity Health, Tenet Health (for Homeless Services Division), fundraising appeals _
9. What percentage of your agency’s entire total annual budget comes from public
(governmental) donations? 54%
a. What are those public funding sources? County of San Luis Obispo, City of San Luis Obispo
City of Pismo Beach, State of CA: CSBG. _
10. Have you seen growth or decline in your funding sources over the past year?
a. If so, how much? From what type of sources? Decline in federal funding for SAMHSA as grant enters
final year, increase in federal funding for COVID-19 relief (but only for those affected by COVID-19, and related expenses).
b. Did you receive any funds to mitigate financial impacts associated with COVID-19? If so,
how much? From what type of sources? _T_o_d_at_e_, n_o_f_un_d_in_g_h_a_s_b_e_en_r_e_ce_i_ve_d_, _al_th_o_ug_h_a_w_a_rd_e_d_.
11. Will this grant satisfy a match grant requirement, or leverage funding from another grantor?
Yes, it will partially satisfy the match requirement for the Coordinated Entry Program.
a. If so, how much? From what funding sources? GIA funding will be used to contribute to satisfy the $40,639
match requirement for the HUD Coordinated Entry Program grant
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
City of San Luis Obispo HRC Grants-in-Aid 2021-22
12. Is this grant request for a new program, or continuation of an existing program?
Existing program, previously funded by GIA.
13. In the table below briefly list 1-3 methods of evaluation and indicators of success.
Methods of Evaluation Indicators of Success
Tracking Attendance (Sample answer) 100 Attendees Per Session (Sample answer)
Document # of individuals able to retain/obtain stable housing & receive case mgmt srvcs. 15 individuals will retain/obtain housing & receive case mgmt srvcs using GIA funds.
Follow up with households 3 months after financial assistance was provided 90% of households who receive financial assistance will have retained housing after 3 months
14. Using the chart below briefly explain if your agency plans to collaborate with other agencies
and partners on this project. Give specific examples and specify other collaborators:
Name of Partner Activity/Service They Provide for This Project
ABC Dance Club (Sample answer) Free Use of Dance Hall (Sample answer)
5Cities Homeless Coalition; ECHO coordinate eviction prevention services to co-manage client services
Transitions Mental Health Association Meets weekly to discuss services; cross-refers for client services
County of SLO Department of Social Services Meets weekly to discuss services; cross-refers for client services
SLO Legal Assistance Foundation cross-refers for client services
15. What is the total number of residents served by your agency and program?
# of residents served
by your program
July 2019-
June 2020
# of residents served
by your agency
July 2019-
June 2020
Projected # of residents
your program will serve
July 2020-
June 2021
Projected # of
residents your agency
will serve July 2020-
June 2021
City of San Luis Obispo 7 3,873 7 7,950
Outside City limits 0 30,700 0 31,000
Total Served
16. If your agency is submitting more than one application for a grant, please rank the
applications in the order of priority.
a. _N_/A
b.
c.
d.
17. Eligibility Checklist: (Please review the checklist at the beginning of this application and make
sure you have followed all guidelines and included all required documents)
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
City of San Luis Obispo HRC Grants-in-Aid 2021-22
Signatures:
I certify that the information contained in this application is, to the best of my knowledge, true and accurate; that our agency
subscribes to the Human Relations Commission’s “Statement of Purpose and Bylaws” which creates an environment within
the City in which all persons can enjoy equal rights and opportunities regardless of race, religion, sex, national origin, sexual
orientation, age, physical, mental or economic status; and that this application is submitted with the Board of Director’s full
knowledge and endorsement.
Dee Lacey Board President
Print Name Title (Board President or Designee)
January 25, 2021
Signature Date
Elizabeth "Biz" Steinberg Chief Executive Officer
Print Name Title (Executive Director/CEO or Designee)
January 25, 2021
Signature Date
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Attachment 1 City of San Luis Obispo Grants in Aid | 2021-22
CAPSLO – Homeless Prevention/Stable Housing Program
Mission Statement:
Community Action Partnership of San Luis Obispo County addresses the causes of poverty,
empowering low-income people to achieve self-sufficiency through community-based
collaborations and programs.
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Attachment 2 City of San Luis Obispo Grants in Aid 2021-22
CAPSLO - Homeless Prevention/Stable Housing Program
a. Briefly describe the program, project or other reason you are requesting funds (100 – 150 words
or less).
The Homeless Prevention/Stable Housing Program provides emergency financial assistance to City
of San Luis Obispo households that are at risk of being evicted and need assistance with a rental
payment, or who need assistance securing housing with first month’s rent and/or a security deposit.
Only those assessed individuals who can demonstrate their ability to maintain rent beyond the
assistance and are willing to participate in case management for 6 months (to further ensure
continued success) are accepted into the program. Case managers work with candidates to develop
and maintain a realistic post-housed budget and connect them to community resources to obtain
additional assistance (i.e., food, clothing, job training). In addition, individuals are encouraged to
stretch their dollars further by utilizing services at 40 Prado, including free laundry, meals, primary
medical care and other supportive services offered during the day.
b. Please describe your grant request in detail (250 words or less).
This program is part of the existing Case Management program and provides immediate
financial assistance to prevent individuals from falling into homelessness or assist them out
of homelessness and into secure housing. Since rents continue to increase and more
landlords are requiring up to three month’s rent to move in, additional funding is needed.
Also, this program is primarily helping individuals as families are increasingly able to be
housed quickly through county programs like HSP and Bringing Families Home.
Clients are screened to establish which individuals have the greatest need. For example,
individuals who experience unexpected setbacks caused by illness, loss of a job, or other
sudden circumstances beyond their control are considered qualified if they are also income-
eligible (under 120% of the Federal Poverty Income Guidelines). For eviction prevention
assistance (one month’s rent), clients must provide proof of emergency need: either their
rent payment is in arrears or due within five days, or they must provide an eviction notice
from the landlord. To secure housing through a first month’s rent or security deposit, the
household is living in an emergency shelter, a car, or a motel. They must participate in the
Case Management program and must show that they can afford the monthly rent once
housed. Checks are mailed directly to the landlord or given to the case manager to
personally deliver to the landlord.
c. Itemize how your agency would use the GIA award.
The majority of the funding ($18,400) will be used for financial assistance payments to
cover rent or security deposits for low-income City of San Luis Obispo households. As
mentioned above, payments will be made directly to the landlord. The remaining funds
($1,600) will be used for indirect costs at the federally approved 8% rate.
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Attachment 3 City of San Luis Obispo Grants in Aid 2021-22
CAPSLO - Homeless Prevention/Stable Housing Program
a. Please describe any creative approaches your agency takes to achieve the Agency’s mission.
CAPSLO’s 40 Prado Homeless Services Center in San Luis Obispo achieves the agency’s mission of
empowering individuals to attain self-sufficiency through strategic programming to meet community
needs, integrated services and collaboration. 40 Prado offers 24/7 emergency shelter services, meals,
showers, health screenings at the CHC on-site clinic, services to dual diagnosed individuals, recuperative
care for those recently released from the hospital, a warming center, animal kennels, a community
garden, internet access, a mail and message center to facilitate job and housing searches, and safe
parking to homeless individuals and families. CAPSLO’s Head Start program offers the “Home Based”
family education and support program for parents of toddlers. Case managers and staff assist clients in
creating individualized plans with set goals and objectives to obtain housing and self-sufficiency. These
comprehensive on-site services are provided by agency staff, volunteers (pandemic guidelines
permitting), and community partners through extensive collaborations.
b. Please describe the interaction or collaboration between your Agency and other local nonprofits
who serve similar clientele.
An example of collaboration that exists with CAPSLO’s Homeless Services Case Management program is
the Coordinated Entry Program, with 5Cities Homeless Coalition (5CHC) and El Camino Homeless
Organization (ECHO). CAPSLO focuses on serving individuals and families in the City of San Luis Obispo,
while 5CHC serves the South County and ECHO serves the North County. The three agencies enter client
data into CAPSLO’s shared database using a common screening form to avoid service duplication. The
entire county is covered through this partnership, and homeless individuals and those at risk of
homelessness have access to services regardless of their location, and are appropriately referred. Other
local agencies collaborating with CAPSLO at 40 Prado are Dignity Health, Tenet Health, Community
Counseling Center, CenCal Health, Restorative Partners, Legal Assistance Foundation, Middlehouse, and
Casa Solana.
c. How will your program and the citizens of San Luis Obispo benefit as a result of this grant?
Benefits to Homeless Prevention/Stable Housing Program:
Grants-in-Aid (GIA) is essential to house or keep housed individuals and families who would otherwise
end up on the street. GIA funds will be used to provide rental assistance to individuals and families at
immediate risk of losing their housing, or those who are ready to obtain housing but don’t have the
funds needed for a security deposit and/or first month’s rent, through case management. Although
CARES Act funding is expected to be available for those who have been directly affected by the COVID-
19 virus, there are individuals and families whose imminent homelessness was not caused by COVID-19,
and who will not be eligible for federal relief. Additionally, funding from the City of San Luis Obispo is
utilized to leverage grants and donations from other cities within the county, private foundations,
businesses, individual donations, and the County of SLO.
Benefits to Citizens of San Luis Obispo:
GIA funds will only be used for residents of the City of San Luis Obispo who are at imminent risk of
homelessness. Last year, over 450 individuals who were residents of the City of San Luis Obispo
obtained services through 40 Prado. Although participants come to 40 Prado Homeless Services Center
from all areas of the county, the majority are residents of the City of San Luis Obispo.
CAPSLO is currently responding to increased numbers of positive COVID-19 individuals arriving at 40
Prado, as well as increased numbers of individuals and families now in economic crisis because of job
loss and job reduction caused by the pandemic. Funding for homeless prevention to keep individuals
and families stably housed has never been more crucial to the health and quality of life for all residents
of the City of San Luis Obispo.
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
COMMUNITY ACTON PARTNERSHIP BOARD OF DIRECTORS and TERMS DATES -2020
Dee Lacey - President
Private Representative - Director A
1195 Beaver Creek Lane
(12/2020) Lan George
City of Arroyo Grande
300 E. Branch Street
(12/2020) Erica A. Stewart, Public Representative (N/A)
City of San Luis Obispo
990 Palm Street
Paso Robles, CA 93446 Arroyo Grande, CA 93420 San Luis Obispo, CA 93401
(H) 238-1482 (C) (805) 440-4977 (PC) (805) 459-6212 (PC) (805) 540-1154
jdlacey1963@gmail.com lgeorge@arroyogrande.org estewart@slocity.org
Carlos Sosa - Vice President
(12/2020) Gary Jordan (12/2020) Board Consultants
Low Income Representative - Coast Low-Income Representative - North County
433 Manzanita Drive District II 208 Cardinal Way District I
Los Osos, CA 93402 Paso Robles, CA 93446 (O) 528-5098 (C) (805) 550-4747 (H) 239-3798 (O) 451-3841
csosa1950@aol.com gdajordan@yahoo.com
Mical W. Bovee, Secretary/Treasurer
Private Representative - Director B
(12/2020) Diane "Dee" Limon
Low-Income Representative - North County
(12/2021)
1150 Palm Street 22410 J Street
San Luis Obispo, CA 93401 Santa Margarita, CA 93453
(O) 544-1441 (F) 593-1231 (C) 464-9999
mical.bovee@glennburdette.com dlimon@cuesta.edu
Debbie Arnold, Public Representative (N/A) Sandee Menge (12/2022) Early Head Start/Head Start Policy Council
County Government Center/Board of Supervisors
1055 Monterey Street, Room D430
Low-Income Representative - South County
P.O. Box 2228 District III
Wendy Morales (10/2020)
HS/EHS PC President
San Luis Obispo, CA 93408 Avila Beach, CA 93424 648 Felton Way, Apt. B-3
(O) 781-5450 (F) 781-1350 (H) 595-7315 (C) (661) 203-6030 San Luis Obispo, CA 93405
darnold@co.slo.ca.us sandeemng@gmail.com (C) (760) 670-9173
Chuck Cesena
Public Representative
(12/2022) Margie Perez-Sesser
Private Representative - Director D
(12/2022) Pamela McKiernan (10/2020)
HS/EHS PC Vice President
2122 9th Street, Suite 102 5495 Oakhurst 1845 El Cajon Ln.
Los Osos, CA 93402 Cambria, CA 93428 Ramona, CA 92065
(O) 528-9435 (C) (805) 801-8183 (F) 528-9377 (H) 927-4998 (C) (805) 909-7298 (C) (760) 822-1047
clcesena@charter.net margiesesser@sbcglobal.net
Maria Garcia (12/2022) Anneka Scranton (12/2021) Migrant & Seasonal Head Start Policy Council
City of Paso Robles Private Representative - Director C Blanca Arroyo (6/2020)
1000 Spring Street 2590 San Dominico MSHS President
Paso Robles, CA 93446 Los Osos, CA 93402 261 Natividad Road
(O) 237-3888 (C) (310) 872-9088 Salinas, CA 93906
mgarcia@prcity.com annekamarina@gmail.com (C) (831) 613-2714
Rob Garcia
Private Representative - Director E
(12/2022) Lisa Sperow
Low-Income Representative - South County
(12/2021) Angeles Bustamante (6/2020)
MSHS Vice President
613 South Main Street 370 Canyon Way District IV 309 Cypress Street #B
Templeton, CA 93465 Arroyo Grande, CA 93420 Lodi, CA 95240
(O) 434-2608 (H) 489-8844 (C) (805) 709-9299 (C) (209) 747-6030
rob@garciawealth.com esperow@calpoly.edu
Updated: January 27, 2020 by: RA
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Chief Executive Officer
Elizabeth “Biz” Steinberg
Child and Family Services Interim: Melinda Sokolowski
Human Resources Director
Ron Torres
Outreach and Development Director
Loren Leidinger
Child Care Resource Connection
Sheri Wilson
Head Start/ Early Head Start State Child Development
Facilities
Jason Lal
Finance
Joan Limov
Adult Day Center
Mara Whitten
Energy
Jim McNamara
Branding
Laura Mountain‐ Tuller
Front Office
Rosa Avila Carlotta Herbstreit
Migrant and Seasonal Head Start
Flora Chacon
Health & Prevention Education
Raye Fleming
Volunteer Program
Hollie Wogan
Homeless Services
Program Design and Environmental Management
Debra Welch
SSVF
Brandy Graham
Ad Hoc Committees
CAPSLO
Board of Directors Board Selection Committee
Board Nomination Committee
Migrant and Seasonal Head Start Policy Council
Head Start Policy Council
Finance Committee
Liaison Committees
Chief Operations Officer Deputy Director
Grace McIntosh
Executive Administrator
Marci Sperlo
Human Resources and Payroll
Brendan McMahon
Planning and Program Development
Information Technology
Brian Crawford
Family and Community Support Services
Melinda Sokolowski
Wellness Coordinator Alina Hagar
Audit Committee
Planning Committee
Executive Committee
Human Resources
Committee
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
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CO M MU N IT Y ACTION PA RT N ERS H IP OF SAN
LUIS OBISPO COUNTY I N C
1030 SOUTHWOOD DR
SN LUIS OBISP CA 93401 -58 13
l9993
Employer Identification Number: 95-2410253
Person to Contact: Ms. K. Hilson
Toll Free Tele p h one Number: l -8 77-8 29 -5500
Dear Taxpayer:
This is in response to your request of Aug. 07, 2009, regarding your
tax-exempt status.
Our records indicate that a determination letter was issued in ,
May 1966, that recognized you as exempt from Federal income tax,
and discloses that you are currently exempt under section 50l(c)(3)
of the Internal R eve n u e Code.
Our records also indicate you are not a private foundation within the
meaning of section 509(a) of the Code because you are described in
section(s) 509(a)(l) and 170(b)(l)CA)Cvi).
Donors may deduct contributions to you as provided in section 170 of
the Code. Bequests, legacies, devises, transfers, or gifts to you or
for your use are d ed u cti bl e for Federal estate and gift tax purposes
if t h ey m e et t h e ap p l i c a ble pro vis ion s of s ec t ion s 2055, 2106 , a n d
2522 of the Co d e.
I f y o u ha ve a n y q u es t i o n s , please c a l l u s at t h e t ele p ho n e n u m be r
s ho w n i n the he ad i n g o f t hi s l et t er .
Si n cer ely you rs ,
M ic h ele M . S u l l i v a n , O pe r . Mg r .
Ac c o u n t s M a na g e m e nt O p e ra t ions I
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
COMMUNITY ACTION PARTNERSHIP OF SAN LUIS OBISPO COUNTY, INC.
City of San Luis Obispo - Human Relations Commission
2021 - 2022 Grants-In-Aid Application
Case Management Homeless Prevention/Stable Housing Project
Total
REVENUE
City of San Luis Obispo GIA $ 20,000
TOTAL REVENUE $ 20,000
EXPENSES
NON-PERSONNEL
Financial Assistance Payments $ 18,400
Total Non-Personnel $ 18,400
OTHER PROGRAM EXPENSES
Indirect Expense @ 8% $ 1,600
Total Other $ 1,600
TOTAL EXPENSES
$ 20,000
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
EXHIBIT B
Mid‐Year and Year‐End Report Templates
[attached]
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Human Relations Commission Grants-In-Aid Program
MID-YEAR REPORT
Due: January 31st, 2022
Organization: _______________________________________________
Program: _______________________________________________
Administrator’s Report: (A brief synopsis of the activities of the reporting period, including a
statement of the activities, service or programs provided as described in Exhibit B (your grant application)
using the Grants-In-Aid provided, and any changes that have occurred during the reporting period. If
operations have changed due to COVID-19, please disclose briefly here.)
Statistical Report: (This section should include the number of clients served, their cities of origin, the
nature of services provided, as well as any other statistics which are kept by the agency. The total number
of clients served also should be broken down by the type of service received.)
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Financial report: (A financial statement detailing how the City’s grant money has been expended or
plan to be expended.)
___________________________ ________________ ___________________
Name Title Phone
___________________________ ________________ ___________________
Signature Date E-mail
Please limit to no more than 2 pages. Once signed, please scan and e-mail to housing@slocity.org and
mail a hard copy to: City of San Luis Obispo, Attn: Community Development Department, 919 Palm St.
San Luis Obispo, CA 93401.
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Human Relations Commission Grants-In-Aid (GIA) Program
YEAR-END REPORT
Due: July 31, 2022
Organization: ___________________________________________________________________________
Program: _______________________________________________________________________________
Administrator’s Report: (A brief synopsis of the activities of the reporting period, including a statement of
the activities, service or programs provided as described in Exhibit B (your grant application) using the Grants-
In-Aid provided, and any changes that have occurred during the reporting period.)
Statistical Report: (This section should include the number of clients served, their cities of origin, the nature
of services provided, as well as any other statistics which are kept by the agency. The total number of clients
served also should be broken down by the type of service received.)
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00
Financial report: (A financial statement detailing how the City’s grant money has been expended.)
___________________________ ________________ ___________________
Name Title Phone
___________________________ ________________ ___________________
Signature Date E-mail
Please limit to no more than 2 pages. Once signed, please scan and e-mail to housing@slocity.org and mail
a hard copy to: City of San Luis Obispo, Attn: Community Development Department, 919 Palm St. San Luis
Obispo, CA 93401.
DocuSign Envelope ID: BBB77474-69F9-439D-AD12-DF3412418C00