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HomeMy WebLinkAbout2007-308L a2r 7 - 30 L , i Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this day of r 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 Street , Vero Beach FL , 32960 ("County" ) and Exchange Club Center for the Prevention of Child Abuse of the Treasure Coast, Inc. , (Recipient); of: P . O . Box 12908 , Fort Pierce , Florida 34979 For: Safe Families Program Background Recitals A. The County has determined that it is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance' ) and established the Children's Services Advisory Committee to promote healthy children in a healthy community and to provide a unified system of planning and delivery within which children's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling its purpose. D . The proposals submitted to the Children 's Services Advisory Committee and the recommendation of the Children 's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant" ) for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals . The background recitals are true and correct and form a material part of this Contract. 2 . Purpose of Grant. The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes" ) . - 1 - a2r 7 - 30 L , i Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this day of r 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 Street , Vero Beach FL , 32960 ("County" ) and Exchange Club Center for the Prevention of Child Abuse of the Treasure Coast, Inc. , (Recipient); of: P . O . Box 12908 , Fort Pierce , Florida 34979 For: Safe Families Program Background Recitals A. The County has determined that it is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance' ) and established the Children's Services Advisory Committee to promote healthy children in a healthy community and to provide a unified system of planning and delivery within which children's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling its purpose. D . The proposals submitted to the Children 's Services Advisory Committee and the recommendation of the Children 's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant" ) for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals . The background recitals are true and correct and form a material part of this Contract. 2 . Purpose of Grant. The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes" ) . - 1 - 4 . Grant Funds and Payment The approved Grant for the Grant Period is Forty Seven Thousand Dollars ($47 ,000) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for Grant Purposes provided in accordance with this Contract. Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit "B" attached hereto and incorporated herein by this reference . All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate . 5 . Additional Obligations of Recipient. 5 . 1 Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant. In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period . The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5 ) days prior written notice . 5 . 2 Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws , rules, and regulations. 5 . 3 Quarterly Performance Reports . The Recipient shall submit quarterly, cumulative , Performance Reports to the Human Services Department of the County within fifteen ( 15) business days following : December 31 , March 31 , June 30 , and September 30 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program 's performance throughout the Grant Period . 5 .4 Audit Requirements . If Recipient receives $25 ,000 or more in the aggregate from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget. The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for a prior fiscal year is past due and has not been submitted by May 1 . 5 .4 . 1 The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from it's independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate this Contract. - 2 - 4 . Grant Funds and Payment The approved Grant for the Grant Period is Forty Seven Thousand Dollars ($47 ,000) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for Grant Purposes provided in accordance with this Contract. Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit "B" attached hereto and incorporated herein by this reference . All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate . 5 . Additional Obligations of Recipient. 5 . 1 Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant. In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period . The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5 ) days prior written notice . 5 . 2 Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws , rules, and regulations. 5 . 3 Quarterly Performance Reports . The Recipient shall submit quarterly, cumulative , Performance Reports to the Human Services Department of the County within fifteen ( 15) business days following : December 31 , March 31 , June 30 , and September 30 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program 's performance throughout the Grant Period . 5 .4 Audit Requirements . If Recipient receives $25 ,000 or more in the aggregate from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget. The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for a prior fiscal year is past due and has not been submitted by May 1 . 5 .4 . 1 The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from it's independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate this Contract. - 2 - 5 .4 . 2 The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5. 5 Insurance Requirements . Recipient shall , no later than October 21 , 2006 , provide to the Indian River County Risk Management Division a certificate or certificates issued by an insurer or insurers authorized to conduct business in Florida that is rated not less than category A-: VII by A. M . Best, subject to approval by Indian River County' s risk manager, of the following types and amounts of insurance : (i ) Commercial General Liability Insurance in an amount not less than $ 1 ,000 , 000 combined single limit for bodily injury and property damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; (ii ) Business Auto Liability Insurance in an amount not less than $ 1 ,000 , 000 per occurrence combined single limit for bodily injury and property damage, including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and (iii ) Workers' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract , except Workers' Compensation insurance. The Recipient shall , upon ten ( 10) days' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business, of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract. 5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses, damage , or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. - 3 - 5 .8 Public Records. The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes (Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this Contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY Attest: J . K. Bartn , Clerk BOARD OF COUNTY COMMISSIONERS By / eputy Cler r7r By c C w GaryX. Wheeler, Chairman BCC Approved : l Approved : seph A. Baird C unty Administrator A ed// as to form andle al sufficiency: C� rian E . Fell , Assi County Attorney RECIPIEN By EXCHANGE CLUB CE/EFR THE PREVENTION OF CHIE OF THE TREASURE COA - 4 - 5 .4 . 2 The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5. 5 Insurance Requirements . Recipient shall , no later than October 21 , 2006 , provide to the Indian River County Risk Management Division a certificate or certificates issued by an insurer or insurers authorized to conduct business in Florida that is rated not less than category A-: VII by A. M . Best, subject to approval by Indian River County' s risk manager, of the following types and amounts of insurance : (i ) Commercial General Liability Insurance in an amount not less than $ 1 ,000 , 000 combined single limit for bodily injury and property damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; (ii ) Business Auto Liability Insurance in an amount not less than $ 1 ,000 , 000 per occurrence combined single limit for bodily injury and property damage, including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and (iii ) Workers' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract , except Workers' Compensation insurance. The Recipient shall , upon ten ( 10) days' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business, of any and all insurance policies that are required in this Contract. If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract. 5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses, damage , or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. - 3 - EXHIBIT A [Copy of complete proposal/application] Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 PROGRAM COVER PAGE Organization Name: Exchange Club CASTLE C C1 FVl Executive Director: Theresa Garbarino -May E-m 1: tgm ,exchangecastle org Address : PO Box 12908 Telephone: 772-465-6011 Fort Pierce FL 34979 Fax: 772-465-6013 Program Director : Ruth Orenstein E-mail: rorensteinastle org Address : 1275 Old Dixie Highway Telephone : 772-567-5700 Vero Beach FL 32960 Fax : 772-567-713 Program Title: Safe Families Priority Need Area Addressed: Parental Support and Education Brief Description of the Program : Taxonomy 4 PH-610 . 330 - Horne based parent education and support designed to prevent child abuse and neglect and help families remain intact Through long term (up to one year) intensive (at least weekly) visits from a counselor, families learn to reduce risk factors associated with abuse and neglect, and increase the protective factors associated with non- abusive, caring and stable families SUMNVIARY REPORT — (Enter Information In The Black Cells Only) FnRt Requested from Funder for 2007 /08 : $ 57 , 531 . 00 oposed Program Budget for 2007 /08 : $ 353 , 602 . 00 of Total Program Budget : 16 . 3 % Program Funding (2006 /07 ) : $ 47 , 080 ncrease/( decrease ) in request : 10 ,451 increase /( decrease ) in reques222 % cated Number of Children to be served Individually : 260 cated Number of Adults to be served Individually : 160 cated Number to be served via Group settings : 60 Total Program Cost per Client : 736 . 67 * *If request increased 5% or more, briefly explain why: The demand for Safe Families continues to grow. More families were seen last vear than ever before We continue to receive more referrals than we can accommodate. The cost for insurance travel and professional fees continue to rise. If these funds are being used to match another source, name the source and the $ amount: United for Families : $ 128 , 500 : United Wav of Indian River County : $95,451 . The Organization 's Board of Directors has approved this applicatlo on " da e)-1 23/07 Dr. Robert Gehrig Name of of President/Chair of the Board Signature =' Theresa Garbarino-May Name of Executive Director/CPO Signature 1 J j" 2 5 .8 Public Records. The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes (Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this Contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY Attest: J . K. Bartn , Clerk BOARD OF COUNTY COMMISSIONERS By / eputy Cler r7r By c C w GaryX. Wheeler, Chairman BCC Approved : l Approved : seph A. Baird C unty Administrator A ed// as to form andle al sufficiency: C� rian E . Fell , Assi County Attorney RECIPIEN By EXCHANGE CLUB CE/EFR THE PREVENTION OF CHIE OF THE TREASURE COA - 4 - Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 92007043 ORGANIZATION: Exchange Club CASTLE PROGRAM: Safe Families 2007/2008 CORE APPLICATION TABLE OF CONTENTS `X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located. X Section of the Proposal Pa e # TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 A. ORGANIZATION CAPABILITY (one page maximum) 1 . Mission and Vision of organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 B. PROGRAM NEED STATEMENT (one page maximum) _ 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 . Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 4 . Staffing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 6. Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 7- 10 E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 F. UNDUPLICATED CLIENTS 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 2. Projections by Age Group . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . . . . . . . . . . . 12 G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 H. FUNDER SPECIFIC REQUIREMENTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 20 I. REFERENCES 22 J.. TESTING/EVALUATION MATERIALS . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 23 1 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page). 1 . Provide the mission statement and vision of your organization. The mission of the Exchange Club CASTLE is to improve the quality of family life while preventing child abuse and neglect, by providing community education, support and resources for families in need of assistance. The CASTLE envisions a community where each child is allowed to grow to his or her full potential, free from abuse and neglect, and families have access to the supports they need to create healthy living and learning environments for children. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. This year, the CASTLE is celebrating its 26"' year of providing child abuse prevention services to families on the Treasure Coast, and Okeechobee. Starting in 1981 with one program and a staff of three, the CASTLE has grown, and now offers an array of prevention services which have been added as the needs of the community change and develop . The CASTLE' s core program, Safe Families, remains an industry leader, and has set the benchmark for quality in- home services that produce results and keeps families together. More than 100 child abuse centers in 27 states utilize the Safe Families model that was implemented in Fort Pierce in 1981 , by those three CASTLE employees . CASTLE services are accredited by the national Council on Accreditation. All CASTLE services utilize a continuous quality improvement (CQI) model to monitor and improve the delivery of services . This model includes peer reviews, client satisfaction surveys, measurements of program effectiveness, and the use of this information to make improvements . This year the CASTLE won its second "Best Places to Work" award. The CASTLE ' s core program, Safe Families, offers long term, home based, parenting education. Other programs offered include : Families First, a training seminar for divorcing parents; High Hopes for Kids, offering support to children whose parents have divorced; Positive Parenting, a support group for parents facing difficulties raising their children; Valued Visits, a supervised visitation center; Strengthening Families, a five agency collaborative that utilizes a group setting to build family skills ; and most recently, Strong Fathers/Strong Families, which works with incarcerated fathers and their families. The population served : Families who are at risk for abusing or neglecting their children; families who have had a reported incident of abuse or neglect, but who, with support and education, can eliminate further episodes of abuse; families with children 0- 17 . This year' s demographics indicate that 64% of enrolled families are single parents ; 63 % are White, 14% are Hispanic, and 23% are Black. Seventy-three percent of families earn less than $25 , 000 per year. The CASTLE projects a 16% increase in demand for services next year, based on local growth projections, and CASTLE services trends over the past three years. 3 EXHIBIT A [Copy of complete proposal/application] Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one age) 1 . a) What is the unacceptable condition requiring change? b) Who has the need? c) Where do they live? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. What: The unacceptable condition addressed is child abuse and neglect. Child abuse and neglect has well-documented, long term, harmful effects on children, including: an increased risk for adverse health effects such as smoking, alcoholism, drug abuse, eating disorders, severe obesity, depression, suicide and sexual promiscuity. ' Maltreatment in early infancy can cause regions of the brain to form improperly. " Direct financial costs are estimated at $24 billion each year, and indirect costs are estimated to exceed $69 billion a year. '" Who : Parents who pose a risk to their children, because of identifiable risk factors such as poverty, a lack of parenting knowledge/skills, or a parent' s own history of abuse or addiction. Research indicates that as many as one-third of all individuals who were abused or neglected as children will subject their children to maltreatment. `° Where: Last year, parents were served in all parts of Indian River County. Provide Data: While there is no "silver bullet" easy solution to the mistreatment of children, child abuse is very preventable . The overwhelming majority of families that abuse or neglect their children can learn to parent in a manner that is non-abusive when home base parent education is provided. Despite this record of success, only 45% of children who are abused in Florida receive such services, which may be why Florida has the highest child abuse rate in the county (32 children out of every 1 ,000) . Locally, the Treasure Coast has an abuse rate of 29 children per 1 ,000, better than the Florida rate, but well above the national rate of 12 children per thousand. " Clearly, Florida can do more to protect its children. The CASTLE' s Safe Families program maintains its own program data. Safe Families has a retention rate of 94% (once enrolled, only 6% drop out early) . The national average for similar programs is 69%. Safe Families completes 92% of its scheduled visits . The national average is 65% . The average rate of re-abuse for families enrolled in home visiting services is 12-20%. The rate of re-abuse for families in the Safe Families program is 3 % "' v""x 2. a) Identify similar programs that are currently serving the needs of your targeted population ; b) Explain how these existing programs are under-serving the targeted population of your program. Safe Families serves a population that is not served by the other abuse prevention programs in Indian River County. However, in concert with two other programs, there is a seamless system of prevention efforts that spans all age levels and all risk levels : * CASTLE' s Safe Families serves : Children ages 0- 17, primary and secondary risk levels. Accepts referrals from all agencies and accepts self-referrals. *Healthy Families serves : Pregnant mothers and newborns (up to 15 days old) . *Hibiscus (Hope) program serves : Families who are at imminent risk of having their children removed (tertiary risk level) . Accepts only DC&F referrals. These eligibility differences help each program specialize in a particular target population. 4 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages). 1 . List Priority Needs area addressed. Parental Support and Education 2. Briefly describe program activities including location of services. 1 . Upon receiving a referral, a counselor visits the family, and assesses the need for home- based parent education (Safe Families). This is accomplished through interview, observation, and completion of an initial needs assessment. To avoid duplication or overlap with other service providers, a review is done of all services being offered to the family. If eligible for Safe Families, the family will begin a program of regular visits, and a family plan, including specific goals, will be developed. The family is an active participant in this process, collaborating on the initial plan for services. 2 . Once a family plan is developed, the counselor makes weekly visits to address the family plan goals. Weekly visits take place for up to one year, with the visits taking place in the family' s home, thus increasing the counselor' s ability to assess the safety of the children, and evaluate improvements made by the family. 3 . During the weekly visits, counselors use a multifaceted approach to teaching, including utilizing parenting videos, working through parenting programs, creating behavior management plans, and establishing family meetings, or other formalized methods to improve family communication. Positive discipline and family stability are two over-arching goals . 4. All weekly visits are geared toward reducing risk factors (characteristics that increase the likelihood that abuse will occur), and increasing protective factors (characteristics that decrease the likelihood that abuse will occur). Safe Families has identified risk and protective factors that are closely correlated with abuse and neglect, for example : Parents history of abuse as a child (risk factor; and, delay ofsubsequentpregnancy (protectivefactor). All risk and protective factors are listed on the assessment form attached as an appendix. 5 . Frequent supervisory review and a regular peer review ensure that each family is continually evaluated for the frequency and intensity of services needed. 6. Parent Education Groups — Positive Parenting will augment the Safe Families home based intervention. Positive Parenting will consist of 15- 16 hours of parenting education classes. Enrollment in the class will be available to 1 ) those on a waiting list for Safe Families; 2) parents who do not need the intensity of in-home services ; and 3) parents who have completed Safe Families, but continue to need follow-up services . Parenting groups are held at the CASTLE office in Indian River County during day, evening or weekend hours, on a rotating basis . 7. Follow-up occurs for three months after closure of the case. Monthly visits are paid to the family to ensure the continued use of techniques learned. In addition, the Department of Children and Families tracks families for one year after completion of services to determine if re- abuse has occurred. 3. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" and provide evidence that indicates proposed strategies are effective with target population. The stated need or problem is child abuse and neglect. Safe Families prevents child abuse and neglect by replacing patterns of abusive behaviors with non-violent, positive approaches to parenting; and by establishing long term supports so that families remain abuse free long after 5 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 PROGRAM COVER PAGE Organization Name: Exchange Club CASTLE C C1 FVl Executive Director: Theresa Garbarino -May E-m 1: tgm ,exchangecastle org Address : PO Box 12908 Telephone: 772-465-6011 Fort Pierce FL 34979 Fax: 772-465-6013 Program Director : Ruth Orenstein E-mail: rorensteinastle org Address : 1275 Old Dixie Highway Telephone : 772-567-5700 Vero Beach FL 32960 Fax : 772-567-713 Program Title: Safe Families Priority Need Area Addressed: Parental Support and Education Brief Description of the Program : Taxonomy 4 PH-610 . 330 - Horne based parent education and support designed to prevent child abuse and neglect and help families remain intact Through long term (up to one year) intensive (at least weekly) visits from a counselor, families learn to reduce risk factors associated with abuse and neglect, and increase the protective factors associated with non- abusive, caring and stable families SUMNVIARY REPORT — (Enter Information In The Black Cells Only) FnRt Requested from Funder for 2007 /08 : $ 57 , 531 . 00 oposed Program Budget for 2007 /08 : $ 353 , 602 . 00 of Total Program Budget : 16 . 3 % Program Funding (2006 /07 ) : $ 47 , 080 ncrease/( decrease ) in request : 10 ,451 increase /( decrease ) in reques222 % cated Number of Children to be served Individually : 260 cated Number of Adults to be served Individually : 160 cated Number to be served via Group settings : 60 Total Program Cost per Client : 736 . 67 * *If request increased 5% or more, briefly explain why: The demand for Safe Families continues to grow. More families were seen last vear than ever before We continue to receive more referrals than we can accommodate. The cost for insurance travel and professional fees continue to rise. If these funds are being used to match another source, name the source and the $ amount: United for Families : $ 128 , 500 : United Wav of Indian River County : $95,451 . The Organization 's Board of Directors has approved this applicatlo on " da e)-1 23/07 Dr. Robert Gehrig Name of of President/Chair of the Board Signature =' Theresa Garbarino-May Name of Executive Director/CPO Signature 1 J j" 2 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 92007043 involvement with the program ends. The family' s relationship with their counselor is a critical element to the success of the program. Over the course of the program, the counselor guides, supports, and teaches the parent to create a nurturing, healthy environment for their children. Best practices for home visiting programs include intensive services over a long period of time, a focus on parenting skills, frequent observation of the home situation, and frequent review of the family to determine the need for and intensity of the service." Safe Families incorporates all of these best practices . In addition, there is a wide body of research that supports home visiting as the method of choice to make changes in families at risk of abuse and neglect. Here are conclusions from six independent studies that demonstrate the effectiveness of the home-based model of preventing child abuse and neglect: "There is strong evidence to recommend home visitation to reduce child maltreatment"" "The positive effects of early home visitation re-emerge when the children reach age 8"x" "In Pinellas County Florida, parents enrolled in a home visiting program had abuse rates of 1 .6% as opposed to non-enrollees who had a rate of 4. 9%"Xii' "Home visiting programs that target high risk and/or low income mothers and children are effective and return from $6 ,000 to $ 17,200 per youthiX1° "Home visiting is an effective method to prevent the re- abuse of children"%° "Home visiting has demonstrated positive outcomes in the areas of parenting knowledge and attitudes, nutrition, preventative health, and unintentional injury. 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform to the Position Listing on the Budget Narrative Worksheet). Safe Families Program Manager — 91ars/wk. - MA/2yrs. supervisory experience in field. Safe Families Supervisor — 10 hrs ./wk. - BA/ lyr. supervisory exp. in field. Safe Families counselors (3 .0 FTE) — 40 hrs ./wk. - BA/2 years exp . in services to families. Parent Ed. Program. Mgr. 6 hrs ./wk. MA/2yrs . supervisory experience in field. Parent Ed. Facilitator — 5hrs ./ wk.2yrs. teaching exp. Secretary/Receptionist — (3 ) 7hrs . , 6 hrs. , and 15hrs. wk. I year secretarial experience. HR Specialist — 5 hrs./wk. BA — 2 years HR exp. Bookkeeper — 4 hrs ./wk. 2 yrs. Bkkpp. exp. Development/Comm. Relations — (3 ) 15 hrs./wk. 2 yrs . exp. Fundraising/Development. 5. How will the target population be made aware of the program? Families are made aware of the program through referrals from agencies, schools, parents, the Dept. of Children and Families, churches, the CASTLE web site, and United for Families . In addition, the CASTLE participates in local outreach/networking efforts including school events, health fairs, and community booths ; the CASTLE participates in National Child Abuse Prevention Month; and the CASTLE affiliates with many local businesses through fund raising. 6. How will the program be accessible to target population (i. e., location, transportation, hours of operation)? Families are visited in their homes, with no required visits to the CASTLE administrative offices . To enroll in the program, all a parent must do is call the office. An intake screening is done over the phone. If the family seems appropriate for Safe Families, a home visit is scheduled within the next 48 hours . Referrals from other sources are accepted by fax or by mail. CASTLE offices are open from 8 : 00am - 5 : 00pm. Home visits are scheduled weekdays, and weekday evenings . In addition, the CASTLE now has on-line registration for all programs. Services are provided in English, Spanish and Creole. 6 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RPP #2007043 D. MEASURABLE OUTCOMES & ACTIVITIES MATIRX (four outcomes maximum) Outcome # 1 : Reduce the risk factors associated with child abuse for families enrolled in Safe Families by at least two for 95% of families who have been enrolled for at least 3 months. One of the risk factors reduced must be the same one as stated in the reason for referral. 2005/06 baseline: 100% . Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5 -7) I 0 3 4 5 © 7 Program Frequency Responsible Parties Expected Indicator Data Source Time of Activities (how often) (who) Outcomes/change (why) Measurements (where) Measurement (when) (what) (evidence) Provide in-home 1 -3 hours, once Home based Reduce the risk of 1) Risk assessment Family case Upon enrollment and family visitation to per week for at counselor abuse/neglect to children in tool; 2) Completion of files at least quarterly identify and least 12 weeks homes where risk factors family plan goals. thereafter. eliminate identified and at most 52 are present. Eliminate the risk factors to weeks. risk associated with the (risk assessment tool children, utilizing reason for tlfe referral. attached) parent education, support, safety planning, and linkage to needed services. All risk factors must be addressed. 7 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 92007043 ORGANIZATION: Exchange Club CASTLE PROGRAM: Safe Families 2007/2008 CORE APPLICATION TABLE OF CONTENTS `X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located. X Section of the Proposal Pa e # TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 A. ORGANIZATION CAPABILITY (one page maximum) 1 . Mission and Vision of organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 B. PROGRAM NEED STATEMENT (one page maximum) _ 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 . Programs that address need and gaps in service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 2. Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 4 . Staffing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 5 . Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 6. Accessibility of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 7- 10 E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 F. UNDUPLICATED CLIENTS 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 2. Projections by Age Group . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . . . . . . . . . . . 12 G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 H. FUNDER SPECIFIC REQUIREMENTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 20 I. REFERENCES 22 J.. TESTING/EVALUATION MATERIALS . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 23 1 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page). 1 . Provide the mission statement and vision of your organization. The mission of the Exchange Club CASTLE is to improve the quality of family life while preventing child abuse and neglect, by providing community education, support and resources for families in need of assistance. The CASTLE envisions a community where each child is allowed to grow to his or her full potential, free from abuse and neglect, and families have access to the supports they need to create healthy living and learning environments for children. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. This year, the CASTLE is celebrating its 26"' year of providing child abuse prevention services to families on the Treasure Coast, and Okeechobee. Starting in 1981 with one program and a staff of three, the CASTLE has grown, and now offers an array of prevention services which have been added as the needs of the community change and develop . The CASTLE' s core program, Safe Families, remains an industry leader, and has set the benchmark for quality in- home services that produce results and keeps families together. More than 100 child abuse centers in 27 states utilize the Safe Families model that was implemented in Fort Pierce in 1981 , by those three CASTLE employees . CASTLE services are accredited by the national Council on Accreditation. All CASTLE services utilize a continuous quality improvement (CQI) model to monitor and improve the delivery of services . This model includes peer reviews, client satisfaction surveys, measurements of program effectiveness, and the use of this information to make improvements . This year the CASTLE won its second "Best Places to Work" award. The CASTLE ' s core program, Safe Families, offers long term, home based, parenting education. Other programs offered include : Families First, a training seminar for divorcing parents; High Hopes for Kids, offering support to children whose parents have divorced; Positive Parenting, a support group for parents facing difficulties raising their children; Valued Visits, a supervised visitation center; Strengthening Families, a five agency collaborative that utilizes a group setting to build family skills ; and most recently, Strong Fathers/Strong Families, which works with incarcerated fathers and their families. The population served : Families who are at risk for abusing or neglecting their children; families who have had a reported incident of abuse or neglect, but who, with support and education, can eliminate further episodes of abuse; families with children 0- 17 . This year' s demographics indicate that 64% of enrolled families are single parents ; 63 % are White, 14% are Hispanic, and 23% are Black. Seventy-three percent of families earn less than $25 , 000 per year. The CASTLE projects a 16% increase in demand for services next year, based on local growth projections, and CASTLE services trends over the past three years. 3 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 Outcome 4 2 : Increase the protective factors associated with healthy, stable, resilient families, for families enrolled in the Safe Families program by at least one for 95 % of families who have been enrolled for at least 3 months. 2005/06 baseline: 97% . Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 1 4 6 7 Program Activities Frequency FR-es po­ns­ib_1e____7 Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) Provide in-home family 1 -3 hours, once Home based Help families 1 ) Protective factor Family case files Upon enrollment and visitation to identify and per week for at counselor stabilize their lives assessment tool; 2) at least quarterly increase protective factors least 12 weeks and households, so Completion of thereafter. utilizing parent education, and at most 52 that children remain family plan goals. support, stability weeks. abuse and neglect planning, and linkage to free. (assessment tool needed services. attached) 8 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 Outcome 43 : 94% of families who successfully complete the Safe Families program will have no confirmed reports or re-reports of abuse for up to one year after completing services. 2005/06 baseline : 94.3 % . Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns�5-7) I 00 4 Ol " I 7 Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) Provide parenting 1 -3 hours, once Home based Families will Confirmed reports The state database One year after case education including per week for at counselor effectively raise and of abuse. on abuse. closure. positive discipline least 12 weeks discipline their strategies, behavioral and at most 52 children without interventions, choices and weeks. physical or consequences and emotional abuse. communication skills to at risk parents. 9 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 B. PROGRAM NEED STATEMENT (Entire Section B not to exceed one age) 1 . a) What is the unacceptable condition requiring change? b) Who has the need? c) Where do they live? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. What: The unacceptable condition addressed is child abuse and neglect. Child abuse and neglect has well-documented, long term, harmful effects on children, including: an increased risk for adverse health effects such as smoking, alcoholism, drug abuse, eating disorders, severe obesity, depression, suicide and sexual promiscuity. ' Maltreatment in early infancy can cause regions of the brain to form improperly. " Direct financial costs are estimated at $24 billion each year, and indirect costs are estimated to exceed $69 billion a year. '" Who : Parents who pose a risk to their children, because of identifiable risk factors such as poverty, a lack of parenting knowledge/skills, or a parent' s own history of abuse or addiction. Research indicates that as many as one-third of all individuals who were abused or neglected as children will subject their children to maltreatment. `° Where: Last year, parents were served in all parts of Indian River County. Provide Data: While there is no "silver bullet" easy solution to the mistreatment of children, child abuse is very preventable . The overwhelming majority of families that abuse or neglect their children can learn to parent in a manner that is non-abusive when home base parent education is provided. Despite this record of success, only 45% of children who are abused in Florida receive such services, which may be why Florida has the highest child abuse rate in the county (32 children out of every 1 ,000) . Locally, the Treasure Coast has an abuse rate of 29 children per 1 ,000, better than the Florida rate, but well above the national rate of 12 children per thousand. " Clearly, Florida can do more to protect its children. The CASTLE' s Safe Families program maintains its own program data. Safe Families has a retention rate of 94% (once enrolled, only 6% drop out early) . The national average for similar programs is 69%. Safe Families completes 92% of its scheduled visits . The national average is 65% . The average rate of re-abuse for families enrolled in home visiting services is 12-20%. The rate of re-abuse for families in the Safe Families program is 3 % "' v""x 2. a) Identify similar programs that are currently serving the needs of your targeted population ; b) Explain how these existing programs are under-serving the targeted population of your program. Safe Families serves a population that is not served by the other abuse prevention programs in Indian River County. However, in concert with two other programs, there is a seamless system of prevention efforts that spans all age levels and all risk levels : * CASTLE' s Safe Families serves : Children ages 0- 17, primary and secondary risk levels. Accepts referrals from all agencies and accepts self-referrals. *Healthy Families serves : Pregnant mothers and newborns (up to 15 days old) . *Hibiscus (Hope) program serves : Families who are at imminent risk of having their children removed (tertiary risk level) . Accepts only DC&F referrals. These eligibility differences help each program specialize in a particular target population. 4 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages). 1 . List Priority Needs area addressed. Parental Support and Education 2. Briefly describe program activities including location of services. 1 . Upon receiving a referral, a counselor visits the family, and assesses the need for home- based parent education (Safe Families). This is accomplished through interview, observation, and completion of an initial needs assessment. To avoid duplication or overlap with other service providers, a review is done of all services being offered to the family. If eligible for Safe Families, the family will begin a program of regular visits, and a family plan, including specific goals, will be developed. The family is an active participant in this process, collaborating on the initial plan for services. 2 . Once a family plan is developed, the counselor makes weekly visits to address the family plan goals. Weekly visits take place for up to one year, with the visits taking place in the family' s home, thus increasing the counselor' s ability to assess the safety of the children, and evaluate improvements made by the family. 3 . During the weekly visits, counselors use a multifaceted approach to teaching, including utilizing parenting videos, working through parenting programs, creating behavior management plans, and establishing family meetings, or other formalized methods to improve family communication. Positive discipline and family stability are two over-arching goals . 4. All weekly visits are geared toward reducing risk factors (characteristics that increase the likelihood that abuse will occur), and increasing protective factors (characteristics that decrease the likelihood that abuse will occur). Safe Families has identified risk and protective factors that are closely correlated with abuse and neglect, for example : Parents history of abuse as a child (risk factor; and, delay ofsubsequentpregnancy (protectivefactor). All risk and protective factors are listed on the assessment form attached as an appendix. 5 . Frequent supervisory review and a regular peer review ensure that each family is continually evaluated for the frequency and intensity of services needed. 6. Parent Education Groups — Positive Parenting will augment the Safe Families home based intervention. Positive Parenting will consist of 15- 16 hours of parenting education classes. Enrollment in the class will be available to 1 ) those on a waiting list for Safe Families; 2) parents who do not need the intensity of in-home services ; and 3) parents who have completed Safe Families, but continue to need follow-up services . Parenting groups are held at the CASTLE office in Indian River County during day, evening or weekend hours, on a rotating basis . 7. Follow-up occurs for three months after closure of the case. Monthly visits are paid to the family to ensure the continued use of techniques learned. In addition, the Department of Children and Families tracks families for one year after completion of services to determine if re- abuse has occurred. 3. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" and provide evidence that indicates proposed strategies are effective with target population. The stated need or problem is child abuse and neglect. Safe Families prevents child abuse and neglect by replacing patterns of abusive behaviors with non-violent, positive approaches to parenting; and by establishing long term supports so that families remain abuse free long after 5 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 42007043 Outcome 94 : 96% of families will, after successfully completing Safe Families, show improvement on the AAPI test. 2005/06 baseline : 100%. Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 3 i 1 � I F____4: I � 6 7 Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) Provide parent education 1 -3 hours, once IIome based Families will create Post-test score on AAPI Upon enrollment, that reduces risk factors, per week for at counselor safe, stable, and the AAPI as (A standardized and at the end of increases protective least 12 weeks resilient households compared to a pre- parenting test) services. factors and teaches and at most 52 for children. test score positive discipline. weeks. 10 Organization : Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 E. COLLABORATION (Entire Section E not to exceed one page) 1. List your program ' s collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters .) Collaborative Agency Resources provided to the program United For Families Agencies jointly advocate for adequate funding ; CASTLE assists in the on-going implementation of the utilization management system developed by UFF. Children' s Home Society/Family Share relevant case information when necessary to assist Preservation Services . families; ensure that there is no dual enrollment through intake/assessment process and information sharing. Healthy Families Share relevant case information when necessary to assist families; ensure that there is no dual enrollment through intake/assessment process and information sharing; participate jointly in advocacy efforts to support child abuse prevention programs. Department of Children and Share relevant case information when necessary to assist Families families; ensure that there is no dual enrollment through intake/assessment process and information sharing. Provide a list of families where abuse or re-abuse has occurred. 4-C club CASTLE will distribute 4-C club vouchers for clothes and shoes to clients in need. Hibiscus Children' s Center Share relevant case information when necessary to assist families; ensure that there is no dual enrollment through intake/assessment process and information sharing; participate jointly in advocacy efforts to support child abuse prevention programs. Funder Specific Request : Community awareness of children' s issues The CASTLE performed 48 outreach efforts last year on the Treasure Coast. These outreach efforts included speeches to civic groups, information booths at community events, and participation at CASTLE and other agency fund raising events . 11 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 92007043 involvement with the program ends. The family' s relationship with their counselor is a critical element to the success of the program. Over the course of the program, the counselor guides, supports, and teaches the parent to create a nurturing, healthy environment for their children. Best practices for home visiting programs include intensive services over a long period of time, a focus on parenting skills, frequent observation of the home situation, and frequent review of the family to determine the need for and intensity of the service." Safe Families incorporates all of these best practices . In addition, there is a wide body of research that supports home visiting as the method of choice to make changes in families at risk of abuse and neglect. Here are conclusions from six independent studies that demonstrate the effectiveness of the home-based model of preventing child abuse and neglect: "There is strong evidence to recommend home visitation to reduce child maltreatment"" "The positive effects of early home visitation re-emerge when the children reach age 8"x" "In Pinellas County Florida, parents enrolled in a home visiting program had abuse rates of 1 .6% as opposed to non-enrollees who had a rate of 4. 9%"Xii' "Home visiting programs that target high risk and/or low income mothers and children are effective and return from $6 ,000 to $ 17,200 per youthiX1° "Home visiting is an effective method to prevent the re- abuse of children"%° "Home visiting has demonstrated positive outcomes in the areas of parenting knowledge and attitudes, nutrition, preventative health, and unintentional injury. 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform to the Position Listing on the Budget Narrative Worksheet). Safe Families Program Manager — 91ars/wk. - MA/2yrs. supervisory experience in field. Safe Families Supervisor — 10 hrs ./wk. - BA/ lyr. supervisory exp. in field. Safe Families counselors (3 .0 FTE) — 40 hrs ./wk. - BA/2 years exp . in services to families. Parent Ed. Program. Mgr. 6 hrs ./wk. MA/2yrs . supervisory experience in field. Parent Ed. Facilitator — 5hrs ./ wk.2yrs. teaching exp. Secretary/Receptionist — (3 ) 7hrs . , 6 hrs. , and 15hrs. wk. I year secretarial experience. HR Specialist — 5 hrs./wk. BA — 2 years HR exp. Bookkeeper — 4 hrs ./wk. 2 yrs. Bkkpp. exp. Development/Comm. Relations — (3 ) 15 hrs./wk. 2 yrs . exp. Fundraising/Development. 5. How will the target population be made aware of the program? Families are made aware of the program through referrals from agencies, schools, parents, the Dept. of Children and Families, churches, the CASTLE web site, and United for Families . In addition, the CASTLE participates in local outreach/networking efforts including school events, health fairs, and community booths ; the CASTLE participates in National Child Abuse Prevention Month; and the CASTLE affiliates with many local businesses through fund raising. 6. How will the program be accessible to target population (i. e., location, transportation, hours of operation)? Families are visited in their homes, with no required visits to the CASTLE administrative offices . To enroll in the program, all a parent must do is call the office. An intake screening is done over the phone. If the family seems appropriate for Safe Families, a home visit is scheduled within the next 48 hours . Referrals from other sources are accepted by fax or by mail. CASTLE offices are open from 8 : 00am - 5 : 00pm. Home visits are scheduled weekdays, and weekday evenings . In addition, the CASTLE now has on-line registration for all programs. Services are provided in English, Spanish and Creole. 6 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RPP #2007043 D. MEASURABLE OUTCOMES & ACTIVITIES MATIRX (four outcomes maximum) Outcome # 1 : Reduce the risk factors associated with child abuse for families enrolled in Safe Families by at least two for 95% of families who have been enrolled for at least 3 months. One of the risk factors reduced must be the same one as stated in the reason for referral. 2005/06 baseline: 100% . Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5 -7) I 0 3 4 5 © 7 Program Frequency Responsible Parties Expected Indicator Data Source Time of Activities (how often) (who) Outcomes/change (why) Measurements (where) Measurement (when) (what) (evidence) Provide in-home 1 -3 hours, once Home based Reduce the risk of 1) Risk assessment Family case Upon enrollment and family visitation to per week for at counselor abuse/neglect to children in tool; 2) Completion of files at least quarterly identify and least 12 weeks homes where risk factors family plan goals. thereafter. eliminate identified and at most 52 are present. Eliminate the risk factors to weeks. risk associated with the (risk assessment tool children, utilizing reason for tlfe referral. attached) parent education, support, safety planning, and linkage to needed services. All risk factors must be addressed. 7 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 F. UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location Current Fiscal Year Location - _ . Budget 2006/07 Unduplicated Clients Unduplicated Clients Unduplicated Clients North Indian River Co. 88 128 125 South Indian River Co. 361 259 355 Indian River Co Total 449 387 480 Greater Stuart - - - Hobe Sound - - Indiantown - - Jensen Beach - - - Palm City - - Martin County Total - Fort Pierce - Port Saint Lucie - - St. Lucie Co. Total - Other Locations - - - TOTAL SERVED 1 449 1 387 1 480 We ended the 05/06 year seeing many more families than predicted. The 06/07 numbers appear low as we made the prediction before the 05/06 year ended. Number of Unduplicated Clients by Age Current Fiscal Year Location Budget 2006/07 r ff I Ii Individual Group 0 to 4 - (Pre-school) 96 75 95 5 to 10 - (Elementary) 79 55 80 11 to 14 - (Middle) 63 45 65 15 to 18 - (High School) 9 25 20 - Total Children 247 200 260 - 19 to 59 - (Adults) 136 44 123 54 140 60- 60 + (Seniors) 22 1 10 20 - Total Adults 158 44 133 54 160 60 TOTAL SERVED 405 44 333 54 420 60 12 Exchange Club CASTLE Safe Families 2007-2008 2007-2008 CORE APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCYIPROGRAM NAME : Exchange Club CASTLE I Safe Families FUNDER: CSAC-IRC CAUTION : Do not enter any figures where a cell is colored in dark blue Formulas and/or links are in place. Garay areas should : be used for providing information and calculations only. pa � - nc E +` ose =o Program 8u gefiner ped + o a dge $¢dgef ' e 1 Children's Services CouncilSt Lucie 450, 906.00 2 Children's Services Council-Martin - 204,932 .00 3 Advisory Committee-Indian River 57,531 .00 57, 531 .00 73,694 .00 4 United Way-St. Lucie County 70 ,678.00 5 United Way-Martin County 43,810.00 6 United Way-Indian River County 95,451 . 00 144 ,610.00 7 Department of Children & Families 128,500 .00 538,225.00 8 County Funds 9 Contributions-Cash 26,800.00 125,550. 00 10 Program Fees 2, 750.00 - 60, 000.00 11 Fund Raising Events-Net 31 , 750.00 - 245,000.00 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 2,500.00 30 ,000.00 15 Miscellaneous 900. 00 8,500.00 16 Legacies & Bequests 17 Funds from Other Sources 7,419.80 667,417.00 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not Included In total)_ 20 TOTAL REVENUES (doesn`t include line 19) $353,601 . 80 $57 , 531 .00 $2,663,322.00 • _^ �:�.. ,m, - o'f o �' , t`pr � ; $ e ,otaf a . 4 - ,�-. � - - _ . _ 21 Salaries - (must complete chart on next page) 171 ,997.00 32,200.00 1 ,333,724.00 22 FICA - Total salaries x 0.0765 13, 157.77 2,463.30 102 , 029 . 89 Retirement - Annual pension orqual le 23 staff 7,200.00 1 ,750.00 52 ,800.00 I e eat - Medical/Dental/Short-term 24 Disab. 12, 100 . 00 2 ,400.00 96,741 .00 O; ers ompensatlon - emp oyees x 25 rate 2 , 133. 06 399. 00 16,538. 18 Irlurida nemp oymen - prolec e 26 employees x $7,000 x UCT-6 rate 1 ,719.97 322. 70 13, 337 . 24 5/412007 e-i 13 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 Outcome 4 2 : Increase the protective factors associated with healthy, stable, resilient families, for families enrolled in the Safe Families program by at least one for 95 % of families who have been enrolled for at least 3 months. 2005/06 baseline: 97% . Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 1 4 6 7 Program Activities Frequency FR-es po­ns­ib_1e____7 Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) Provide in-home family 1 -3 hours, once Home based Help families 1 ) Protective factor Family case files Upon enrollment and visitation to identify and per week for at counselor stabilize their lives assessment tool; 2) at least quarterly increase protective factors least 12 weeks and households, so Completion of thereafter. utilizing parent education, and at most 52 that children remain family plan goals. support, stability weeks. abuse and neglect planning, and linkage to free. (assessment tool needed services. attached) 8 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 Outcome 43 : 94% of families who successfully complete the Safe Families program will have no confirmed reports or re-reports of abuse for up to one year after completing services. 2005/06 baseline : 94.3 % . Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns�5-7) I 00 4 Ol " I 7 Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) Provide parenting 1 -3 hours, once Home based Families will Confirmed reports The state database One year after case education including per week for at counselor effectively raise and of abuse. on abuse. closure. positive discipline least 12 weeks discipline their strategies, behavioral and at most 52 children without interventions, choices and weeks. physical or consequences and emotional abuse. communication skills to at risk parents. 9 t Exchange Club CASTLE Safe Familles 2007-2008 r wn fl fo .Grd Mnuat OS (SFlA1 �AoAuaE f rho o Sad on Prapo ed '# a�-v. -r un eS ecltic Budge atery '"'� c=-=�- '•"' _ Agencyj` E'x`am jei '�^`:ecut -eDtrecFoi 4b'¢_ t �fl 000 00 L ' ._ g rte„ -?'. ,. - ria .� i �.. ,. ..a..,. , �.a.�.�,s',a�' .- ,. .�,,,-:1000U 00M,OT° rr.°4�€.*` _ - S,QOO,QO, �=: ' ` 7`14/'. Secretary, Madden 28, 348.00 - 51000. 00 0.00% Receptionist, Lewis 25, 160.00 41080 . 00 0.00% Human Resources, Cleveland 35,598.001 4 , 750 . 00 0.00% Dir. of Development, Gibbs 50,400.00 6,750 . 00 0.00% Comm. Relations, Scottaline 38, 850.00 4, 100. 00 0.00% Comm. Relations, Hargraves 40,000.00 3,600. 00 0.00% Bookkeeper, Pickerill 30,576.00 2,900.00 0 .00% Receptionist-IRC, M.Lewis 34,934. 00 13,370.00 0.00% Prog . Manager, Orenstein 45,732. 00 10,200.00 0. 00% Supervisor, Machado 34,000.00 8,800.00 2,500.00 7.35% Counselor, Sudbrock 32,445 . 00 32 ,445.00 10,000.00 30.82% Counselor, Pachon 26, 162 . 00 26, 162.00 10,000.00 38.22% Counselor, Shottland 35452 .00 . 35,452.00 4 ,500.00 12.69% Parent Ed Prog.Mngr. Landry 34 ,934. 00 6,428.00 0.00% Facilitator, Clete 91460. 00 7, 960.00 5 ,200.00 54.97% #DIV/01 #DIV/0 ! #DIV/0 ! #DIV/O ! #DIV/O ! Remaining positions throughout the agency 831 ,673.00 Total Salaries $ 171 ,997.00 $32 , 200.001 2 .41 % gnolicel` ; :nempio » oyes ensro car to woe s " �fr �8z6� , . Secretary, Madden 0. 00 0. 00 0. 00 Receptionist, Lewis 0. 00 0. 00 0.00 Human Resources, Cleveland 0. 00 0.00 0.00 Dir.of Development, Gibbs 0.00 0.00 0.00 Comm. Relations, Scottaline 0.00 0.00 0.00 Comm. Relations, Hargraves 0.00 0.00 0.00 Bookkeeper, Pickerill 0.00 0.00 0.00 Receptionist-IRC, M . Lewis 0. 00 0.00 0.00 Prog.Manager,Orenstein 0.00 0.00 0.06 Supervisor, Machado 2 ,500. 00 191 .25 100.00 31 .00 25. 00 347.25 Counselor, Sudbrock 10,000.001 765.00 500.001 800. 00 124.001 100. 00 2,289.00 Counselor, Pachon 10 ,000. 00 765.00 500.00 800.00 124. 001 100. 00 2,289.00 Counselor, Shottland 4 ,500.00 344.25 300.00 800. 00 56. 00 45. 00 1 ,545.25 Parent Ed Prog. Mngr. Landry 0. 00 0.00 0.00 Facilitator, Clete 5,200. 00 397. 80 350.00 64.00 52. 00 863.80 0 0. 00 0.00 0.00 0 0.00 0.00 0.00 0 0. 00 0.00 0.00 0 0. 00 0.00 0.00 0 0.00 0,0010 00 Total Funder Request Fringe Senetits $32,200. 00 $2,463.30 $1 ,750.00 � $399.00 . $322.00 $7,334.30 5/412007 6-1 14 ' Exchange Club CASTLE Safe Families 2007-2008 r G o#a enc 27 Travel-Daily 17, 144.00 74,720 00 NOW tl,x. Irp, to .�ll3r 7 g Idt ea .gni-, .. 8_ml es, pec�veek=���Pe rmle , 52 wee 28 Travel/Conferences/Training 2,375 .00 28 ,000.00 _..,. €�:_ ;,�. �vrifeeeRGes$ tra€rtrrtgfar�mpio" ees InciZ�des:Yrauet n ;nl,a se and HR confereirc�y;, , _ ,.u, ., ,� �. , _., 29 Office Supplies 5,880.00 1 ,750. 00 33 ,000.00 9- 1 30 Telephone 61600. 00 1 ,000.00 42 ,000. 00 FE s115 _ ...._�. 'Pa -mon amc Cis, anq Ones cetl pw6n� , gUMWN �`" 31 Postage/Ship-piing 2,300.00 10, 000 . 00 X518 9E :y"•. 0 4y I „mss me e a # »-'a, ay, .-FW_l �t . +i 32Utilities 6,600.00 1 ,000.00 32,200.00 IWIN 11, Doi 01 110 _ - t _ 5ta _ate $ . � ..; far; alai. d'e nc€CS?' i. M�� V� 33 Occupancy (Building & Grounds) 25, 092.001 052 . 00 zn6 Taa5 .. � ., 1t - MEN 01 EN 1. v - �- NMI nleanA4 6Pest:conlrbSeCua ti5a'S.rdnmarntenance` `,� ice' 34 Printing & Publications 3 ,800.001 1 ,000.00 26,000. 00 € - u '- ' � ead,e o �e.SanfE,`s �caLevents_emaieara 67,; 35 Subscription/Dues/Memberships 400.001 , 100. 00 bn3"gi a ,� 4 - -s -saf .... �' ; € Fll Mem.. e tt}�"�hi3F.P1?f�s-ztSmagaz€ne5`anet organlzahons- a,�..- e 3 -€ � 36 Insurance 4 500 00 1 500 00 31 800 00 MM 37 Equipment Rental & Maintenance 6,408. 001 1 ,000 . 001 22, 000.00 RAe as � o e aln e an months wY r _,.�..kq 38 Advertising 21375.001 17 800 00 Nispaer$a . .� 2F�a�smg � , , � k ( ay11-13,11W j H,e` p tvanfed atlds,,#und raisings and- pronioti"ons evenksadds, service adds„,,, _ ,, . __. 391 Equipment Purchases: Capital Expense 4,300.00 2 000 00 20, 000 .00 .1E.�annfec'�o ( s' �r nFd- Fx.i 's'.�% ,€;.� e_ e'- t a ' ., -+- f 'x r tt; ., x •r _ip rl_f ,... rr _ +- Update cpmp'hter`s' 5`@-$Y,OOd,update routersaddR€onal aseilicenses, neri4ork upgrades :andsw€tcFss-,etc 5/4/2007 e-i 15 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 42007043 Outcome 94 : 96% of families will, after successfully completing Safe Families, show improvement on the AAPI test. 2005/06 baseline : 100%. Program Design & Task Management Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) 3 i 1 � I F____4: I � 6 7 Program Activities Frequency Responsible Expected Indicator Data Source Time of (what) (how often) Parties (who) Outcomes/change Measurements (where) Measurement (why) (evidence) (when) Provide parent education 1 -3 hours, once IIome based Families will create Post-test score on AAPI Upon enrollment, that reduces risk factors, per week for at counselor safe, stable, and the AAPI as (A standardized and at the end of increases protective least 12 weeks resilient households compared to a pre- parenting test) services. factors and teaches and at most 52 for children. test score positive discipline. weeks. 10 Organization : Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP #2007043 E. COLLABORATION (Entire Section E not to exceed one page) 1. List your program ' s collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters .) Collaborative Agency Resources provided to the program United For Families Agencies jointly advocate for adequate funding ; CASTLE assists in the on-going implementation of the utilization management system developed by UFF. Children' s Home Society/Family Share relevant case information when necessary to assist Preservation Services . families; ensure that there is no dual enrollment through intake/assessment process and information sharing. Healthy Families Share relevant case information when necessary to assist families; ensure that there is no dual enrollment through intake/assessment process and information sharing; participate jointly in advocacy efforts to support child abuse prevention programs. Department of Children and Share relevant case information when necessary to assist Families families; ensure that there is no dual enrollment through intake/assessment process and information sharing. Provide a list of families where abuse or re-abuse has occurred. 4-C club CASTLE will distribute 4-C club vouchers for clothes and shoes to clients in need. Hibiscus Children' s Center Share relevant case information when necessary to assist families; ensure that there is no dual enrollment through intake/assessment process and information sharing; participate jointly in advocacy efforts to support child abuse prevention programs. Funder Specific Request : Community awareness of children' s issues The CASTLE performed 48 outreach efforts last year on the Treasure Coast. These outreach efforts included speeches to civic groups, information booths at community events, and participation at CASTLE and other agency fund raising events . 11 ' Exchange Club CASTLE Safe Families 2007-2008 40 Professional Fees (Legal, Consulting) 5,385 . 00 49,489 .00 F m s s t "' Iff d - om dMEW r # i Q_ ?_ gW apyt Moab fss..,admm Fees;S1 B8,LS pa'�'�o� n03 - d m ,. x ..� � c 41 Books/Educational Materials 1 ,200.001 11030.00 22,000 . 00 it Rn- Tiw iwr -1131 �:,aa »- 't �. �r � Nay .>; l e� _ - M'a e .- cS�sta, . „ ,; �.,�. . .,,a � P a„e:=_oo forsa.acd c(fenfse:. parenf�edu'c�Ylona{ matenats, .-r ,, .,, t .,r = 42 Food & Nutrition 1 1 3,640 . 00 lie e e cllen�t Sda SDV _ Iwo ---. - ` jvi �¢ s. .Fs, 'tea• �, -,. . '""'. e. IN m :. n.� OWNER ri ¢ �r� . szu .� . a-�,�.- ._,. .,c.%. ._:,de'� ,-a�,e -�..,.,�m m y- 'CR-P,,... .�� .ra+,M _," 'a 43 Administrative Costs 45,635.001 1 233 ,840 .69 I 11A W, WON ' WI? `tea=- ' ,, ,.. ...»--. m ... .. _ _� 44 Audit Expense 1 , 100 . 001 16,000.00 �JMY� V ne, ttda . FQIdt eug, . _ �;F1'" u- . = i''�-' 3crrra , = v.:� _: '' rzu IMINT 45 Specific Assistance to Individuals 11000 . 00 _ 10,070. 00 a 5 d � arc � i� � u � ' ?P ..- :. t'illyas is afaadF ,a 1c a ,�, . },$`� '�,., � � s' ... a `Md .. ....,.,.. e _ .. " >a 46 Other/Miscellaneous 450.00 5 ,500. 00 B3 kOS1t141^ '.. . [ �t -5 . '- ,3. _ ' --. .' $ I`°§, k.!-=a. .2' r. ,:. ' +.i' s $ . . MMY t'=` 7 ¢ j ,R„ �a`.,,� . �"'- .. *."'` ', ,�-, Eac"�`9r n Igras �. . = .� _ � ..�"s �, �_ -, 47 Other/Contract 2 , 750-001 1 ,000. 001 231 ,940 . 00 ONE fes. 11EP ME 1c' '-_., ,. rc :,o L ' servaces_ NtlScdra . m,_ , ......;:?? ':'.. ,, . ._, - 48 TOTAL EXPENSES - $353,601 .80 $57,531 .00 $2,663 , 322 . 00 5/48007 B-1 16 • El=,W CIPC ETLE AR Flm�ll 7A 2007-2008 CORE GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME: Exchange Club CASTLE / Safe Families FY 05/06 FY 06/07 FY VMS % INCREASE FYE 9130/06 FYE 9/30/07 FYE 9/30/08 CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. G 01. Bycol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 199,952.00 414,226.00 450,906.00 8.86% 2 Children's Services Council-Martin 142,774.00 170,358.00 204,932.00 20.29% 3 Advisowy Committee-Indian River 56,529.00 56,517.00 73,694.00 30.39% 4 United Way-St Lucie County 55,000.00 65,330.00 70,678.00 8.19% 5 United Way-Martin County 39,509.00 40,229.00 43,810.00 8.907 6 United Way-Indian River County 124,500.00 132,839.00 144,610.00 8.86% 7 Department of Children & Families 677,396.00 535,468.00 538,225.00 0.510/. e County Funds 0.00 9 Contributions-Cash 97,641.00 92,954.00 125,550.00 35.07% 10 Program Fees 47,880.00 55,200.00 60,000.00 8.70% 11 Fund Raising Events-Net 209,480.00 200,000.00 245,000.00 22.50% 12 Sales to Public-Net 0.00 13 Membership Dues 0.00 14 Investment Income 44,345.00 10,000.00 30,000.00 200.000/6 15 Miscellaneous 9,307.00 7,500.00 8,500.00 - 13.33% 16 Legacies & Bequests 0.00 17 Funds from Other Sources 222,073.00 402,478.78 667,417.00 65.83% 18 Reserve Funds Used for Operating 0.00 is In-Kind Donations (Not maudeam loran 7,880.00 0.00 20 TOTAL 1 ,926,386.00 2,183,099.76 2,663,322.00 22.00% EXPENDITURES 21 Salaries 1 ,005,101 .00 1 ,146,814.00 1 ,333,724.00 16.30% 22 FICA 82 834.00 87,731.27 102,029.89 16.30% 23 Retirement 50,000.00 40,000.00 52,800.00 32.00% 24 LifeMealth 93,392.00 40,000.00 96,741 .00 141.85% 25 Workers Compensation 46,554.00 41 ,300.59 16,538.18 -59.96% 26 Florida Unemployment 1 ,372.00 5,508.00 13.337.24 142.14% 27 Travel-Daily 55,294.00 42,320.00 74,720.00 76.56% 28 Travel/Conferences/Training 11 ,240.00 25,044.00 28,000.00 11 .80% 29 Office Supplies 28,186.00 25,000.00 33,000.00 32.00% 3o Telephone 36,103.00 46,800.00 42,000.00 -10.267 31 Postage/Shipping 7,225.00 8,460.00 10,000.00 18.20% 32 Utilities 21 576.00 34,120.00 32,200.00 -5.63% 33 Occupancy (Building & Grounds 135,875.00 126,972.00 135,052.00 6.36% 34 Printing & Publications 12 106.00 21 ,966.00 26.000.00 18.36% 35 Subscri tion/DueslMembershi s 3,954.00 2,929.00 3,100.00 5.84 /0 . 36 Insurance 27,767.00 19,171.00 31,800.00 65.88% 37 E ui ment:Rental & Maintenance 39,133.00 37,260.00 22,000.00 40.96% 3s Advertising - 29,488.00 15 312.00 17,800.00 16.2501. 39 Equipment Purchases:Ca ital Expense 7,165.00 12,000.00 20,000.00 66.67% 40 Professional Fees (Legal, Consulting) 3,583.00 3,940.00 49,489.00 1156.071! 41 Books/Educational Materials 12487.00 25144.00 22.000.00 -12.50% 42 Food & Nutrition 3,993.00 3,640.00 43 Administrative Costs 124,226.00 199,650.92 233,840.69 17.12% 44 Audit Expense 22,595.00 5,500.00 16,000.00 190.91% 45 Specific Assistance to Individuals 4,958.00 8,518.00 10,070.00 18.22% 46 Other/Miscellaneous 2,9%00 5,479.00 5,500.00 0.38% 47 Other/Contract 161 ,816.00 156,160.00 231,940.00 48.53% 48 TOTAL 2,030,937.00 2,183,099.78 2,663,322.00 22.00% 49 REVENUES OVER/ UNDER EXPENDITURES -104,551 .00 0.001 0.00 17 v4=7 Es Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 F. UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location Current Fiscal Year Location - _ . Budget 2006/07 Unduplicated Clients Unduplicated Clients Unduplicated Clients North Indian River Co. 88 128 125 South Indian River Co. 361 259 355 Indian River Co Total 449 387 480 Greater Stuart - - - Hobe Sound - - Indiantown - - Jensen Beach - - - Palm City - - Martin County Total - Fort Pierce - Port Saint Lucie - - St. Lucie Co. Total - Other Locations - - - TOTAL SERVED 1 449 1 387 1 480 We ended the 05/06 year seeing many more families than predicted. The 06/07 numbers appear low as we made the prediction before the 05/06 year ended. Number of Unduplicated Clients by Age Current Fiscal Year Location Budget 2006/07 r ff I Ii Individual Group 0 to 4 - (Pre-school) 96 75 95 5 to 10 - (Elementary) 79 55 80 11 to 14 - (Middle) 63 45 65 15 to 18 - (High School) 9 25 20 - Total Children 247 200 260 - 19 to 59 - (Adults) 136 44 123 54 140 60- 60 + (Seniors) 22 1 10 20 - Total Adults 158 44 133 54 160 60 TOTAL SERVED 405 44 333 54 420 60 12 Exchange Club CASTLE Safe Families 2007-2008 2007-2008 CORE APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCYIPROGRAM NAME : Exchange Club CASTLE I Safe Families FUNDER: CSAC-IRC CAUTION : Do not enter any figures where a cell is colored in dark blue Formulas and/or links are in place. Garay areas should : be used for providing information and calculations only. pa � - nc E +` ose =o Program 8u gefiner ped + o a dge $¢dgef ' e 1 Children's Services CouncilSt Lucie 450, 906.00 2 Children's Services Council-Martin - 204,932 .00 3 Advisory Committee-Indian River 57,531 .00 57, 531 .00 73,694 .00 4 United Way-St. Lucie County 70 ,678.00 5 United Way-Martin County 43,810.00 6 United Way-Indian River County 95,451 . 00 144 ,610.00 7 Department of Children & Families 128,500 .00 538,225.00 8 County Funds 9 Contributions-Cash 26,800.00 125,550. 00 10 Program Fees 2, 750.00 - 60, 000.00 11 Fund Raising Events-Net 31 , 750.00 - 245,000.00 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 2,500.00 30 ,000.00 15 Miscellaneous 900. 00 8,500.00 16 Legacies & Bequests 17 Funds from Other Sources 7,419.80 667,417.00 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not Included In total)_ 20 TOTAL REVENUES (doesn`t include line 19) $353,601 . 80 $57 , 531 .00 $2,663,322.00 • _^ �:�.. ,m, - o'f o �' , t`pr � ; $ e ,otaf a . 4 - ,�-. � - - _ . _ 21 Salaries - (must complete chart on next page) 171 ,997.00 32,200.00 1 ,333,724.00 22 FICA - Total salaries x 0.0765 13, 157.77 2,463.30 102 , 029 . 89 Retirement - Annual pension orqual le 23 staff 7,200.00 1 ,750.00 52 ,800.00 I e eat - Medical/Dental/Short-term 24 Disab. 12, 100 . 00 2 ,400.00 96,741 .00 O; ers ompensatlon - emp oyees x 25 rate 2 , 133. 06 399. 00 16,538. 18 Irlurida nemp oymen - prolec e 26 employees x $7,000 x UCT-6 rate 1 ,719.97 322. 70 13, 337 . 24 5/412007 e-i 13 EA&aye CU CASTLE ' Sa:e FaM n2W .08 2007-2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE / Safe Families FY 05/06 FY 06/07 FY 07/08 % INCREASE FYE 9130106 FYE 9130107 FYE 9130/08 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. Ccol. B)rcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 2 Children's Services Council-Martin 0.00 3 Advisory Committee-Indian River 40,619.00 47,080.48 67,531 .00 22.20% 4 United Way-St. Lucie County 0.00 5 United Way-Martin County 0.00 6 United Way-Indian River County 85,000.00 89,663.25 %,451 .00 6.45% 7 Department of Children & Families 116,661 .00 120,000.00 128,500.00 7.08% 8 County Funds 0.00 9 Contributions-Cash 22,800.00 25,000.00 26,800.00 7.20% to Program Fees 2,200.00 2,500.00 2,750.00 10.00% 11 Fund Raising Events-Net 28,200.00 30,000.00 31 ,750.00 5.83% 12 Sales to Public-Net 0.00 13 Membership Dues 0.00 14 Investment Income 2,500.00 15 Miscellaneous 900.00 16 Legacies & Bequests 0.00 17 Funds from Other Sources 7,350.00 15,124. 15 7,419.80 -50.941a is Reserve Funds Used for Operating 0.00 is In-Kind Donations (Notinciu a mroup 0.00 20 TOTAL 302,830.00 329,367.88 353,601 .80 7.36% EXPENDITURES 21 Salaries 151,962.00 161,521.00 171,997.00 6.49% zz FICA- 11,625.00 12,356.00 13,157.77 6.49% 23 Retirement 6,600.00 6,508.82 7.200.00 10.627/. 24 Life/Nealth--- , 11,750.00 10,895.40 12,100.00 11.06% 25 Workers Compensation 4,559.00 5,463.78 2,133.06 -60.96% 26 Florida Unemployment 178.00 577.80 - 1,719.97 197.68% 27 Travel-Daily 12,188.00 12,636.00 17,144.00 35.68% 2a Travel/Confemncesfrrainin 2,255.00 2,174.88 2.375.00 9.20% 29 Office Su lies 5,527.00 5,438.00 5,880.1301 8.137 - 3o Telephone 5,375.00 8,604.00 6,600.00 -23.29% 31 Postage/Shipping 2,075.00 2,214.40 2,300.00 3.87% 32 Utilities 6,130.00 8,400.00 6.600.00 -21.43% 33 Occupancy (Building & Grounds 23,968.00 23,676.00 25,092.00 6.98% 34 Printing & Publications - 3,762.00 3,739.92 3,800.00 1 .61 35 Subscription/Dues/Memberships 377.00 381 .48 400.00 4.85% 36 Insurance - 4,200.00 4,038.12 4,50040 11.44% 37 Eui ment:Rental & Maintenance 5,690.00 7,164.00 6,408.00 -10.55% 38 Advertising 2,330.00 2,356.24 2,37540 0.80% 39 Equipment Purchases:Ca itai Expense 1 ,255.00 4,000.00 4,300.00 7.50% w Professional Fees (Legal, Consulting) 0.00 5,385.00 41 Books/Educational Materials 1,200.00 1,108.16 1 ,200.00 8.29% 42 Food & Nutrition 0.00 as Administrative Costs 42,165.00 41 ,297.00 45.635.001 10.50% 44 Audit Expense 1,000.00 978.80 1,100.00 92.38% 45 Specific Assistance to Individuals 925.00 919.60 1 ,000.00 8.740/a 46 Other/Miscellaneous 422.00 418.48 450.00 7.53% 47 Other/Contract 2,380.00 2,500.00 2,750.00 10.00% - 48 TOTAL 309,898.00 329,367.88 353.601.80 7.36% 49 REVENUES OVER! UNDER EXPENDITURES -7,068.00 0.00 0.00 seac� 18 B4 Exchange Club CASTLE Safe Families 2007-08 2007-2008 CORE GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME: Exchange Club CASTLE / Safe Families FUNDER: CSAC-IRC A B C FY 07108 FY 07108 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A) EXPENDITURES 21 Salaries 1715997.00 32,200.00 18 .72%9 22 FICA 13, 157 .77 2,463.30 18.72% 23 Retirement 7,200 .00 1 ,750.00 24.31 % 24 Life/Health 12 , 100.00 25400 .00 19.83% 25 Workers Compensation 21133.06 399 .00 18.71 % 26 Florida Unemployment 1 ,719.97 322 .70 18.76% 27 Travel-Daily 17,144.00 0.00 0.00%9 26 Travel/Conferences/Training 25375.00 0.00 0.00%9 29 Office Supplies 59880.00 1 ,750.00 29.76%9 30 Telephone 6,600.00 1 ,000.00 15. 15%9 31 Postage/Shipping 2,300 .00 0.00 0 .00% 32 Utilities 6,600 .00 1 ,000. 00 15.15%9 33 Occupancy (Building & Grounds) 25,092.00 6,716.00 26 .77%9 34 Printing & Publications 31800.00 12000 .00 26.32%9 35 Subscription/Dues/Memberships 400.00 0 .00 0.00%9 36 Insurance 4,500.00 1 , 500 .00 33.33%9 37 Equipment: Rental & Maintenance 61408.00 1 ,000.00 15.61 % 38 Advertising 2,375.00 0.00 0.00% 39 Equipment Purchases :Capital Expense 4,300 .00 21000.00 46.51 %9 40 Professional Fees (Legal, Consulting) 5 ,385 .00 0. 00 0.00%9 41 Books/Educational Materials 15200.00 13030 .00 85.83% 42 Food & Nutrition 0. 00 0.00 #DIV/0 ! 43 Administrative Costs 45,635.00 0 .00 0.00%9 44 Audit Expense 1 ,100.00 0.00 0.00%9 45 Specific Assistance to Individuals 1 ,000.00 0.00 0.00% 46 Other/Miscellaneous 45000 0. 001 0.00%9 47 Other/Contract 25750.00 1 ,000.00 36.36% 48 TOTAL $353,601 .80 $57,531 .00 16.27%9 W0007 e-a 19 t Exchange Club CASTLE Safe Familles 2007-2008 r wn fl fo .Grd Mnuat OS (SFlA1 �AoAuaE f rho o Sad on Prapo ed '# a�-v. -r un eS ecltic Budge atery '"'� c=-=�- '•"' _ Agencyj` E'x`am jei '�^`:ecut -eDtrecFoi 4b'¢_ t �fl 000 00 L ' ._ g rte„ -?'. ,. - ria .� i �.. ,. ..a..,. , �.a.�.�,s',a�' .- ,. .�,,,-:1000U 00M,OT° rr.°4�€.*` _ - S,QOO,QO, �=: ' ` 7`14/'. Secretary, Madden 28, 348.00 - 51000. 00 0.00% Receptionist, Lewis 25, 160.00 41080 . 00 0.00% Human Resources, Cleveland 35,598.001 4 , 750 . 00 0.00% Dir. of Development, Gibbs 50,400.00 6,750 . 00 0.00% Comm. Relations, Scottaline 38, 850.00 4, 100. 00 0.00% Comm. Relations, Hargraves 40,000.00 3,600. 00 0.00% Bookkeeper, Pickerill 30,576.00 2,900.00 0 .00% Receptionist-IRC, M.Lewis 34,934. 00 13,370.00 0.00% Prog . Manager, Orenstein 45,732. 00 10,200.00 0. 00% Supervisor, Machado 34,000.00 8,800.00 2,500.00 7.35% Counselor, Sudbrock 32,445 . 00 32 ,445.00 10,000.00 30.82% Counselor, Pachon 26, 162 . 00 26, 162.00 10,000.00 38.22% Counselor, Shottland 35452 .00 . 35,452.00 4 ,500.00 12.69% Parent Ed Prog.Mngr. Landry 34 ,934. 00 6,428.00 0.00% Facilitator, Clete 91460. 00 7, 960.00 5 ,200.00 54.97% #DIV/01 #DIV/0 ! #DIV/0 ! #DIV/O ! #DIV/O ! Remaining positions throughout the agency 831 ,673.00 Total Salaries $ 171 ,997.00 $32 , 200.001 2 .41 % gnolicel` ; :nempio » oyes ensro car to woe s " �fr �8z6� , . Secretary, Madden 0. 00 0. 00 0. 00 Receptionist, Lewis 0. 00 0. 00 0.00 Human Resources, Cleveland 0. 00 0.00 0.00 Dir.of Development, Gibbs 0.00 0.00 0.00 Comm. Relations, Scottaline 0.00 0.00 0.00 Comm. Relations, Hargraves 0.00 0.00 0.00 Bookkeeper, Pickerill 0.00 0.00 0.00 Receptionist-IRC, M . Lewis 0. 00 0.00 0.00 Prog.Manager,Orenstein 0.00 0.00 0.06 Supervisor, Machado 2 ,500. 00 191 .25 100.00 31 .00 25. 00 347.25 Counselor, Sudbrock 10,000.001 765.00 500.001 800. 00 124.001 100. 00 2,289.00 Counselor, Pachon 10 ,000. 00 765.00 500.00 800.00 124. 001 100. 00 2,289.00 Counselor, Shottland 4 ,500.00 344.25 300.00 800. 00 56. 00 45. 00 1 ,545.25 Parent Ed Prog. Mngr. Landry 0. 00 0.00 0.00 Facilitator, Clete 5,200. 00 397. 80 350.00 64.00 52. 00 863.80 0 0. 00 0.00 0.00 0 0.00 0.00 0.00 0 0. 00 0.00 0.00 0 0. 00 0.00 0.00 0 0.00 0,0010 00 Total Funder Request Fringe Senetits $32,200. 00 $2,463.30 $1 ,750.00 � $399.00 . $322.00 $7,334.30 5/412007 6-1 14 ' Exchange Club CASTLE Safe Families 2007-2008 r G o#a enc 27 Travel-Daily 17, 144.00 74,720 00 NOW tl,x. Irp, to .�ll3r 7 g Idt ea .gni-, .. 8_ml es, pec�veek=���Pe rmle , 52 wee 28 Travel/Conferences/Training 2,375 .00 28 ,000.00 _..,. €�:_ ;,�. �vrifeeeRGes$ tra€rtrrtgfar�mpio" ees InciZ�des:Yrauet n ;nl,a se and HR confereirc�y;, , _ ,.u, ., ,� �. , _., 29 Office Supplies 5,880.00 1 ,750. 00 33 ,000.00 9- 1 30 Telephone 61600. 00 1 ,000.00 42 ,000. 00 FE s115 _ ...._�. 'Pa -mon amc Cis, anq Ones cetl pw6n� , gUMWN �`" 31 Postage/Ship-piing 2,300.00 10, 000 . 00 X518 9E :y"•. 0 4y I „mss me e a # »-'a, ay, .-FW_l �t . +i 32Utilities 6,600.00 1 ,000.00 32,200.00 IWIN 11, Doi 01 110 _ - t _ 5ta _ate $ . � ..; far; alai. d'e nc€CS?' i. M�� V� 33 Occupancy (Building & Grounds) 25, 092.001 052 . 00 zn6 Taa5 .. � ., 1t - MEN 01 EN 1. v - �- NMI nleanA4 6Pest:conlrbSeCua ti5a'S.rdnmarntenance` `,� ice' 34 Printing & Publications 3 ,800.001 1 ,000.00 26,000. 00 € - u '- ' � ead,e o �e.SanfE,`s �caLevents_emaieara 67,; 35 Subscription/Dues/Memberships 400.001 , 100. 00 bn3"gi a ,� 4 - -s -saf .... �' ; € Fll Mem.. e tt}�"�hi3F.P1?f�s-ztSmagaz€ne5`anet organlzahons- a,�..- e 3 -€ � 36 Insurance 4 500 00 1 500 00 31 800 00 MM 37 Equipment Rental & Maintenance 6,408. 001 1 ,000 . 001 22, 000.00 RAe as � o e aln e an months wY r _,.�..kq 38 Advertising 21375.001 17 800 00 Nispaer$a . .� 2F�a�smg � , , � k ( ay11-13,11W j H,e` p tvanfed atlds,,#und raisings and- pronioti"ons evenksadds, service adds„,,, _ ,, . __. 391 Equipment Purchases: Capital Expense 4,300.00 2 000 00 20, 000 .00 .1E.�annfec'�o ( s' �r nFd- Fx.i 's'.�% ,€;.� e_ e'- t a ' ., -+- f 'x r tt; ., x •r _ip rl_f ,... rr _ +- Update cpmp'hter`s' 5`@-$Y,OOd,update routersaddR€onal aseilicenses, neri4ork upgrades :andsw€tcFss-,etc 5/4/2007 e-i 15 ochange Club CASTLE ` Sa Faml1 zco7200M 2007-2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE / Safe Families FUNDER: CSAC-IRC Children's Services Council-St. Lucie NIA Children's Services Council-Martin NIA The demand for Safe Families continue to grow. More families were seen last yearthan ever before. We continue receiving more AdvisoEy Committee-Indian River referrals than we can accommodate. The cost for insurance, travel and professional fees continue to rise. United Way-St. Lucie Coun NIA United Way-Martin County N/A Coun Funds ' NIA Sales to Pu bllo-Nel INA Membershi Dues Investment Inca me Miscellaneous Le acles & Be uests Reserve Funds Used for O eratinIn-Kind Donations of included In total 15M Florida Unemployment Same as professional fees, we are now paying unemployment fees as we go. 7ravel-Dally Gas prices continue to rise and our program keeps growing. In order to lower our workers compensation cost we had to contract aur payroll with an employee leasing company; however we have to pay an administration fee fortheir services with combine with their workers compensation charges they are still 35% lowerthan our Professional Fees Le al Consulting) normal workers compensation cost would have been. Food & Nutrition NA Y2DOi 65 19a Ewha,ge Club CASTLE Sale Fatllks 200720DOS 2007=2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE I Safe Families FUNDER: CSAC-IRC INSAWSrAW 4W Salaries The demand for Safe Families continue to grow and we need to spend more time and resources in the program FICA Increases with salaries Retirement Increases with salaries Life/Health Increases with salaries Workers Compensation Increases with salaries Florida Unemployment Increases with salaries Ofnce Su lies Increses in the cost of supplies, ink cartridges, paper, folders, tonner, etc Telephone More people are contacting us and we need to them as well. Utilities - Cost of electocity/water are higher. Occupancy Buildin & Grounds iWe are using more space for this program in ourfacilities Printing & Publications iWe need to update and create new literature this year. Insurance Increase in insurance rates/program growth E ui ment:Rental & Maintenance Increase in use of equipment due to program growth Equipment Purchases:Ca ital Expense Update computers, network equipment, routers, switches and web page Books/Educatlonal Materials Update books and materials #DIVfU! Other/Contract Contracts for computer repair maintenance 19b rzrzcw es ' Exchange Club CASTLE Safe Families 2007-2008 40 Professional Fees (Legal, Consulting) 5,385 . 00 49,489 .00 F m s s t "' Iff d - om dMEW r # i Q_ ?_ gW apyt Moab fss..,admm Fees;S1 B8,LS pa'�'�o� n03 - d m ,. x ..� � c 41 Books/Educational Materials 1 ,200.001 11030.00 22,000 . 00 it Rn- Tiw iwr -1131 �:,aa »- 't �. �r � Nay .>; l e� _ - M'a e .- cS�sta, . „ ,; �.,�. . .,,a � P a„e:=_oo forsa.acd c(fenfse:. parenf�edu'c�Ylona{ matenats, .-r ,, .,, t .,r = 42 Food & Nutrition 1 1 3,640 . 00 lie e e cllen�t Sda SDV _ Iwo ---. - ` jvi �¢ s. .Fs, 'tea• �, -,. . '""'. e. IN m :. n.� OWNER ri ¢ �r� . szu .� . a-�,�.- ._,. .,c.%. ._:,de'� ,-a�,e -�..,.,�m m y- 'CR-P,,... .�� .ra+,M _," 'a 43 Administrative Costs 45,635.001 1 233 ,840 .69 I 11A W, WON ' WI? `tea=- ' ,, ,.. ...»--. m ... .. _ _� 44 Audit Expense 1 , 100 . 001 16,000.00 �JMY� V ne, ttda . FQIdt eug, . _ �;F1'" u- . = i''�-' 3crrra , = v.:� _: '' rzu IMINT 45 Specific Assistance to Individuals 11000 . 00 _ 10,070. 00 a 5 d � arc � i� � u � ' ?P ..- :. t'illyas is afaadF ,a 1c a ,�, . },$`� '�,., � � s' ... a `Md .. ....,.,.. e _ .. " >a 46 Other/Miscellaneous 450.00 5 ,500. 00 B3 kOS1t141^ '.. . [ �t -5 . '- ,3. _ ' --. .' $ I`°§, k.!-=a. .2' r. ,:. ' +.i' s $ . . MMY t'=` 7 ¢ j ,R„ �a`.,,� . �"'- .. *."'` ', ,�-, Eac"�`9r n Igras �. . = .� _ � ..�"s �, �_ -, 47 Other/Contract 2 , 750-001 1 ,000. 001 231 ,940 . 00 ONE fes. 11EP ME 1c' '-_., ,. rc :,o L ' servaces_ NtlScdra . m,_ , ......;:?? ':'.. ,, . ._, - 48 TOTAL EXPENSES - $353,601 .80 $57,531 .00 $2,663 , 322 . 00 5/48007 B-1 16 • El=,W CIPC ETLE AR Flm�ll 7A 2007-2008 CORE GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME: Exchange Club CASTLE / Safe Families FY 05/06 FY 06/07 FY VMS % INCREASE FYE 9130/06 FYE 9/30/07 FYE 9/30/08 CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. G 01. Bycol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 199,952.00 414,226.00 450,906.00 8.86% 2 Children's Services Council-Martin 142,774.00 170,358.00 204,932.00 20.29% 3 Advisowy Committee-Indian River 56,529.00 56,517.00 73,694.00 30.39% 4 United Way-St Lucie County 55,000.00 65,330.00 70,678.00 8.19% 5 United Way-Martin County 39,509.00 40,229.00 43,810.00 8.907 6 United Way-Indian River County 124,500.00 132,839.00 144,610.00 8.86% 7 Department of Children & Families 677,396.00 535,468.00 538,225.00 0.510/. e County Funds 0.00 9 Contributions-Cash 97,641.00 92,954.00 125,550.00 35.07% 10 Program Fees 47,880.00 55,200.00 60,000.00 8.70% 11 Fund Raising Events-Net 209,480.00 200,000.00 245,000.00 22.50% 12 Sales to Public-Net 0.00 13 Membership Dues 0.00 14 Investment Income 44,345.00 10,000.00 30,000.00 200.000/6 15 Miscellaneous 9,307.00 7,500.00 8,500.00 - 13.33% 16 Legacies & Bequests 0.00 17 Funds from Other Sources 222,073.00 402,478.78 667,417.00 65.83% 18 Reserve Funds Used for Operating 0.00 is In-Kind Donations (Not maudeam loran 7,880.00 0.00 20 TOTAL 1 ,926,386.00 2,183,099.76 2,663,322.00 22.00% EXPENDITURES 21 Salaries 1 ,005,101 .00 1 ,146,814.00 1 ,333,724.00 16.30% 22 FICA 82 834.00 87,731.27 102,029.89 16.30% 23 Retirement 50,000.00 40,000.00 52,800.00 32.00% 24 LifeMealth 93,392.00 40,000.00 96,741 .00 141.85% 25 Workers Compensation 46,554.00 41 ,300.59 16,538.18 -59.96% 26 Florida Unemployment 1 ,372.00 5,508.00 13.337.24 142.14% 27 Travel-Daily 55,294.00 42,320.00 74,720.00 76.56% 28 Travel/Conferences/Training 11 ,240.00 25,044.00 28,000.00 11 .80% 29 Office Supplies 28,186.00 25,000.00 33,000.00 32.00% 3o Telephone 36,103.00 46,800.00 42,000.00 -10.267 31 Postage/Shipping 7,225.00 8,460.00 10,000.00 18.20% 32 Utilities 21 576.00 34,120.00 32,200.00 -5.63% 33 Occupancy (Building & Grounds 135,875.00 126,972.00 135,052.00 6.36% 34 Printing & Publications 12 106.00 21 ,966.00 26.000.00 18.36% 35 Subscri tion/DueslMembershi s 3,954.00 2,929.00 3,100.00 5.84 /0 . 36 Insurance 27,767.00 19,171.00 31,800.00 65.88% 37 E ui ment:Rental & Maintenance 39,133.00 37,260.00 22,000.00 40.96% 3s Advertising - 29,488.00 15 312.00 17,800.00 16.2501. 39 Equipment Purchases:Ca ital Expense 7,165.00 12,000.00 20,000.00 66.67% 40 Professional Fees (Legal, Consulting) 3,583.00 3,940.00 49,489.00 1156.071! 41 Books/Educational Materials 12487.00 25144.00 22.000.00 -12.50% 42 Food & Nutrition 3,993.00 3,640.00 43 Administrative Costs 124,226.00 199,650.92 233,840.69 17.12% 44 Audit Expense 22,595.00 5,500.00 16,000.00 190.91% 45 Specific Assistance to Individuals 4,958.00 8,518.00 10,070.00 18.22% 46 Other/Miscellaneous 2,9%00 5,479.00 5,500.00 0.38% 47 Other/Contract 161 ,816.00 156,160.00 231,940.00 48.53% 48 TOTAL 2,030,937.00 2,183,099.78 2,663,322.00 22.00% 49 REVENUES OVER/ UNDER EXPENDITURES -104,551 .00 0.001 0.00 17 v4=7 Es Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 H. FUNDER SPECIFIC REQUIREMENTS MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages) Note period outcomes/results reflect : 7/1/05 to 6/30/06. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut and paste from last years application. 1 . Reduce the risk factors associated with child 1 . 100% of families reduced at least one risk abuse for families in the Safe Families program factor during enrollment in Safe Families. by at least one, during enrollment in the program and /or at the conclusion of the program, for 95% of families who have been enrolled at least 3 months, as measured by a risk assessment tool (see appendix) . No more than 5% of families who have been enrolled for 3 months or more will show no (zero) risk factor reduction. 2004/2005 baseline: 97. 6% of families reduced at least one risk factor. 2 .4% showed no risk factor reduction. 2. Maintain the reduction in risk factors (by at 2. 100% of families maintained their reduction least one) for a period of 90 days after in risk factors for 90 days. enrollment, for families who have successfully completed the program, as measured by a risk assessment tool (see appendix) in 95% of families. No more than 5 % of families who have successfully completed the program will fail to maintain a risk factor reduction. 2004/2005 baseline : 100% of families maintained their risk factor reduction. 3 . Increase the protective factors associated 3 . 97% of families increased at least one with a reduction in the risk of child abuse for protective factor during enrollment in Safe families in the Safe Families program by at Families. least one, during enrollment in the program and /or at the conclusion of the program, for 95 % of families who have been enrolled for at least 3 months, as measured by a protective factor assessment tool (see appendix) . No more than 5% of families who have been enrolled for at least 3 months will fail to increase at least one protective factor. 2004/2005 baseline 100% of families increased at least one protective factor. 20 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed hvo pages) Note period outcomes/results reflect: 7/1/05 to 6/30/06. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut andpastefrom lastyears application. 4 . Maintain the increase in protective factors 4. 100% of families who increased at least one (by at least one) for a period of 90 days after protective factor maintained the increase for 90 enrollment for families who have successfully days. completed the program, as measured by a protective factor assessment tool (see appendix) in 95% of families. No more than 2004/2005 baseline : 100% of families maintained their protective factor improvement. 5 . 94%, of families who complete the Safe 5 . 94.3 % of families who completed Safe Families program will have no confirmed Families had no confirmed reports or re-reports reports or re-reports of abuse for up to two of abuse for up to two years after completion year after completing services as measured by of the program. the state data base on abuse. 2004/2005 baseline : 97.6% of families were not reported or re-reported for abuse . (Longer follow-up recommended by UW panel last year) . 6 . 96% of families, after successfully 6. 100% of families who completed the Safe completing the Safe Families program, will Families program showed improvement on show improvement on the AAPI test, as their AAPI post test score. measured by comparing their pre-test score to their post-test score. 2004/2005 baseline: 98 . 8% of families who successfully completed the program improved on their post test AAPI scores. 1 .2% did not improve. 7 . Ninety percent of parents participating in 7. 100% of families who participated in parent the parenting education services (groups) will education classes demonstrated improved demonstrate an improved knowledge of knowledge of parenting issues. parenting issues, as measured by a survey after each group session. Baseline: This is a new goal, baseline to be determined. 21 EA&aye CU CASTLE ' Sa:e FaM n2W .08 2007-2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE / Safe Families FY 05/06 FY 06/07 FY 07/08 % INCREASE FYE 9130106 FYE 9130107 FYE 9130/08 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. Ccol. B)rcol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 2 Children's Services Council-Martin 0.00 3 Advisory Committee-Indian River 40,619.00 47,080.48 67,531 .00 22.20% 4 United Way-St. Lucie County 0.00 5 United Way-Martin County 0.00 6 United Way-Indian River County 85,000.00 89,663.25 %,451 .00 6.45% 7 Department of Children & Families 116,661 .00 120,000.00 128,500.00 7.08% 8 County Funds 0.00 9 Contributions-Cash 22,800.00 25,000.00 26,800.00 7.20% to Program Fees 2,200.00 2,500.00 2,750.00 10.00% 11 Fund Raising Events-Net 28,200.00 30,000.00 31 ,750.00 5.83% 12 Sales to Public-Net 0.00 13 Membership Dues 0.00 14 Investment Income 2,500.00 15 Miscellaneous 900.00 16 Legacies & Bequests 0.00 17 Funds from Other Sources 7,350.00 15,124. 15 7,419.80 -50.941a is Reserve Funds Used for Operating 0.00 is In-Kind Donations (Notinciu a mroup 0.00 20 TOTAL 302,830.00 329,367.88 353,601 .80 7.36% EXPENDITURES 21 Salaries 151,962.00 161,521.00 171,997.00 6.49% zz FICA- 11,625.00 12,356.00 13,157.77 6.49% 23 Retirement 6,600.00 6,508.82 7.200.00 10.627/. 24 Life/Nealth--- , 11,750.00 10,895.40 12,100.00 11.06% 25 Workers Compensation 4,559.00 5,463.78 2,133.06 -60.96% 26 Florida Unemployment 178.00 577.80 - 1,719.97 197.68% 27 Travel-Daily 12,188.00 12,636.00 17,144.00 35.68% 2a Travel/Confemncesfrrainin 2,255.00 2,174.88 2.375.00 9.20% 29 Office Su lies 5,527.00 5,438.00 5,880.1301 8.137 - 3o Telephone 5,375.00 8,604.00 6,600.00 -23.29% 31 Postage/Shipping 2,075.00 2,214.40 2,300.00 3.87% 32 Utilities 6,130.00 8,400.00 6.600.00 -21.43% 33 Occupancy (Building & Grounds 23,968.00 23,676.00 25,092.00 6.98% 34 Printing & Publications - 3,762.00 3,739.92 3,800.00 1 .61 35 Subscription/Dues/Memberships 377.00 381 .48 400.00 4.85% 36 Insurance - 4,200.00 4,038.12 4,50040 11.44% 37 Eui ment:Rental & Maintenance 5,690.00 7,164.00 6,408.00 -10.55% 38 Advertising 2,330.00 2,356.24 2,37540 0.80% 39 Equipment Purchases:Ca itai Expense 1 ,255.00 4,000.00 4,300.00 7.50% w Professional Fees (Legal, Consulting) 0.00 5,385.00 41 Books/Educational Materials 1,200.00 1,108.16 1 ,200.00 8.29% 42 Food & Nutrition 0.00 as Administrative Costs 42,165.00 41 ,297.00 45.635.001 10.50% 44 Audit Expense 1,000.00 978.80 1,100.00 92.38% 45 Specific Assistance to Individuals 925.00 919.60 1 ,000.00 8.740/a 46 Other/Miscellaneous 422.00 418.48 450.00 7.53% 47 Other/Contract 2,380.00 2,500.00 2,750.00 10.00% - 48 TOTAL 309,898.00 329,367.88 353.601.80 7.36% 49 REVENUES OVER! UNDER EXPENDITURES -7,068.00 0.00 0.00 seac� 18 B4 Exchange Club CASTLE Safe Families 2007-08 2007-2008 CORE GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME: Exchange Club CASTLE / Safe Families FUNDER: CSAC-IRC A B C FY 07108 FY 07108 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A) EXPENDITURES 21 Salaries 1715997.00 32,200.00 18 .72%9 22 FICA 13, 157 .77 2,463.30 18.72% 23 Retirement 7,200 .00 1 ,750.00 24.31 % 24 Life/Health 12 , 100.00 25400 .00 19.83% 25 Workers Compensation 21133.06 399 .00 18.71 % 26 Florida Unemployment 1 ,719.97 322 .70 18.76% 27 Travel-Daily 17,144.00 0.00 0.00%9 26 Travel/Conferences/Training 25375.00 0.00 0.00%9 29 Office Supplies 59880.00 1 ,750.00 29.76%9 30 Telephone 6,600.00 1 ,000.00 15. 15%9 31 Postage/Shipping 2,300 .00 0.00 0 .00% 32 Utilities 6,600 .00 1 ,000. 00 15.15%9 33 Occupancy (Building & Grounds) 25,092.00 6,716.00 26 .77%9 34 Printing & Publications 31800.00 12000 .00 26.32%9 35 Subscription/Dues/Memberships 400.00 0 .00 0.00%9 36 Insurance 4,500.00 1 , 500 .00 33.33%9 37 Equipment: Rental & Maintenance 61408.00 1 ,000.00 15.61 % 38 Advertising 2,375.00 0.00 0.00% 39 Equipment Purchases :Capital Expense 4,300 .00 21000.00 46.51 %9 40 Professional Fees (Legal, Consulting) 5 ,385 .00 0. 00 0.00%9 41 Books/Educational Materials 15200.00 13030 .00 85.83% 42 Food & Nutrition 0. 00 0.00 #DIV/0 ! 43 Administrative Costs 45,635.00 0 .00 0.00%9 44 Audit Expense 1 ,100.00 0.00 0.00%9 45 Specific Assistance to Individuals 1 ,000.00 0.00 0.00% 46 Other/Miscellaneous 45000 0. 001 0.00%9 47 Other/Contract 25750.00 1 ,000.00 36.36% 48 TOTAL $353,601 .80 $57,531 .00 16.27%9 W0007 e-a 19 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 42007043 References ' US Department of Health and Human Services: Center for Disease Control and Prevention, National Center for Injury Prevention and Control (2005). Child Maltreatment: Fact Sheet. " Ibid. "' Ibid. '" Child Welfare information Gateway @childwelfare.gov: cycle of abuse, 2001 . " Child Maltreatment 2005 US Dept. of Health and Human Services, Administration for Children and Families , 2007. Florida Department of Children and Families-dashboard indicators, 2004-2005 . Florida Department of Children and Families-dashboard indicators, 2003-2004. Viii National Data Analysis System Issue Brief: see above. " Healthy Families Florida Evaluation Report, February 2005; Williams, Stem, and Associates, Miami, FL. Thomas, David, et. al, Emerging Practices in the Prevention of Child abuse and Neglect; Department of Health and Human Services, Washington DC, 2001 . Center for Disease Control and Prevention Task Force: First Reports Evaluating the Effectiveness of Strategies for Preventing Violence (a meta-analysis of 25 studies), 2003 . " U. S. Department of Health and Human Services, Report on Child Abuse and Neglect, 2002. U.S. Department of Health and Human Services, April 2003 , vol. 4, no. 3. Benefits and Costs of Prevention and Earlv Intervention Programs for Youth; Washington State Institute for Public Policy, Olympia, WA, 2004. See reference iii. Xvl A Meta-Analytic Review of Programs for the Promotion of Family Wellness and the Prevention of Child Maltreatment, MacLeod, Jennifer; Nelson, Geoffrey, Wilfrid Laurier University Press, 2003 . 22 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP 42007043 FAMILY RISK/PROTECTWE FACTORS Instructions: When a risk/protective factor is assessed, place a checkmark in the box if the factor needs to be addressed. Upon completion (a risk factor that is no longer a risk, or a protective factor that has been enhanced) write, "completed" in the appropriate box. (If a risk/protectivefactor does not need to be addressed, the box will be blank) RISK FACTOR INITIAL 3 MONTH 6 MONTH 9 MONTH ASSESS. AT ASSESS. ASSESS. ASSESS. ASSESS. COMPLETIO DATE: DATE: DATE: DATE: N 1. Additional parentingknowledge/ skills needed 2. Parentis history of abuse as a child 3. Parent/s history of substance abuse 4. Parentis history ofinental health issues _ 5. Domestic Violence — PosbPresent (VictmVPer etrator) 6. Inability to meet basic needs 7. Teen, young or non-traditional parent S. Lack ofsupport system 9. Parents/Children with physical handicaps or other diagnosable conditions 10. Other PROTECTIVE FACTOR INITIAL 3 MONTH 6 MONTH 9 MONTH ASSESS. AT ASSESS. ASSESS. ASSESS. ASSESS. COMPLETIO DATE: DATE: DATE: DATE: N 1.11ousing stability 2.Delay o subse uent pregnancy 3.Enrollment in childcare 4.Enrollment in healthcare 5. Child receives routine medical care 6. Livable wage employment 7. Active participation in child's school S.Positive Family Communication 9. Constructive use of time. 10. Supportive adults outside offamily AAPI SCORES AAPI-A (Pre) AAPI-B (Post) A B C D E A B C D E A B C D E A B C D E 23 ochange Club CASTLE ` Sa Faml1 zco7200M 2007-2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE / Safe Families FUNDER: CSAC-IRC Children's Services Council-St. Lucie NIA Children's Services Council-Martin NIA The demand for Safe Families continue to grow. More families were seen last yearthan ever before. We continue receiving more AdvisoEy Committee-Indian River referrals than we can accommodate. The cost for insurance, travel and professional fees continue to rise. United Way-St. Lucie Coun NIA United Way-Martin County N/A Coun Funds ' NIA Sales to Pu bllo-Nel INA Membershi Dues Investment Inca me Miscellaneous Le acles & Be uests Reserve Funds Used for O eratinIn-Kind Donations of included In total 15M Florida Unemployment Same as professional fees, we are now paying unemployment fees as we go. 7ravel-Dally Gas prices continue to rise and our program keeps growing. In order to lower our workers compensation cost we had to contract aur payroll with an employee leasing company; however we have to pay an administration fee fortheir services with combine with their workers compensation charges they are still 35% lowerthan our Professional Fees Le al Consulting) normal workers compensation cost would have been. Food & Nutrition NA Y2DOi 65 19a Ewha,ge Club CASTLE Sale Fatllks 200720DOS 2007=2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCYIPROGRAM NAME: Exchange Club CASTLE I Safe Families FUNDER: CSAC-IRC INSAWSrAW 4W Salaries The demand for Safe Families continue to grow and we need to spend more time and resources in the program FICA Increases with salaries Retirement Increases with salaries Life/Health Increases with salaries Workers Compensation Increases with salaries Florida Unemployment Increases with salaries Ofnce Su lies Increses in the cost of supplies, ink cartridges, paper, folders, tonner, etc Telephone More people are contacting us and we need to them as well. Utilities - Cost of electocity/water are higher. Occupancy Buildin & Grounds iWe are using more space for this program in ourfacilities Printing & Publications iWe need to update and create new literature this year. Insurance Increase in insurance rates/program growth E ui ment:Rental & Maintenance Increase in use of equipment due to program growth Equipment Purchases:Ca ital Expense Update computers, network equipment, routers, switches and web page Books/Educatlonal Materials Update books and materials #DIVfU! Other/Contract Contracts for computer repair maintenance 19b rzrzcw es Adult-Adolescent Parenting Inventory FF AAPI - 2 Form A Stephen 1. Bavolek, Ph. D, and Richard G. Keene, Ph, D. Name Date ID',# State/City Sex (circle one) Male Female Age years Race ( circle one) White Black Asian Hispanic Native American Pacific Islander Other INSTRUCTIONS: There are 40 statements in this booklet. They are statements about parenting and raising children. You decide the degree to which you agree or disagree with each statement by circling one of the responses. STRONGLY AGREE — Circle SA if you strongly support the statement, or feel the statement is true most or all the time. AGREE — Circle A if you support the statement, or feet this statement is true some of the time. STRONGLY DISAGREE — Circle SD if you feel strongly against the statement or feel the statement is not true. DISAGREE — Circle D if you feel you cannot support the statement or that the statement is not true some of the time. UNCERTAIN — Circle U only when it is impossible to decide on one of the other choices. When you are told to turn the page, begin with Number 1 and go on until you finish all the statements. In answering them, please keep these four points in mind : 1 . Respond to the statements truthfully. There is no advantage in giving an untrue response because you think it is the right thing to say. There really is no right or wrong answer — only your opinion . 2. Respond to the statements as quickly as you can . Give the first natural response that comes to mind. 3 . Circle only one response for each statement. 4. Although some statements may seem much like others , no two statements are exactly alike. Make sure you respond to every statement. If there is anything you don 't understand, please ask your questions now. If you come across a word you don 't know while responding to a statement, ask the examiner for help When you finish , please feel free to write any comments you have on the back page. Turn the Page and Begin Q1999 Family Development Resources, Inc. All rights reserved. This test or parts thereof may not be reproduced in any form without permission of the publisher. (800) 688-5822 www. nurturingparenting .com fdr&nurturing parenting .com (email) s AATA-2 24 Form A Strongly Strongly Agree Agree Uncertain Disagree Disagree 1 . Children should keep their feelings to themselves. SA A U D SD 2. Children should do what they're told to do, when they're told to SA A U D SD do it. It's that simple. 3 . Parents should be able to confide in their children. SA A U D SD 4. Children need to be allowed freedom to explore their world in SA A U D SD safety. 5. Spanking teaches children right from wrong. SA A U D SD 6. The sooner children learn to feed and dress themselves and SA A U 0 SD use the toilet, the better off they will be as adults. 7. Children who are one year old should be able to stay away SA A U D SD from things that could harm them . 8. Children should be potty trained when they are ready and not SA A U D SD before. 9. A certain amount of fear is necessary for children to respect SA A U D SD their parents. 10 . Good children always obey their parents. SA A U D SD 11 . Children should know what their parents need without being SA A U D SD told. 12. Children should be taught to obey their parents at all times. SA A U D SD 13. Children should be aware of ways to comfort their parents after SA A U D SD a hard days work. 14. Parents who nurture themselves make better parents. SA A U D SD 15 . It 's OK to spank as a last resort. SA A U D SD 16. "Because I said so! " is the only reason parents need to give. SA A U D SD 17. Parents need to push their children to do better. SA A U D SD 18. Time-out is an effective way to discipline children. SA A U D SD 19. Children have a responsibility to please their parents. SA A U D SD Please go to next page. © 1999 Family Development Resources, Inc. All Rights Reserved. 25 x '93 Rrs test or parts thereof may not be reproduced in any form without permission of the publisher. AAT A:2 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 H. FUNDER SPECIFIC REQUIREMENTS MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages) Note period outcomes/results reflect : 7/1/05 to 6/30/06. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut and paste from last years application. 1 . Reduce the risk factors associated with child 1 . 100% of families reduced at least one risk abuse for families in the Safe Families program factor during enrollment in Safe Families. by at least one, during enrollment in the program and /or at the conclusion of the program, for 95% of families who have been enrolled at least 3 months, as measured by a risk assessment tool (see appendix) . No more than 5% of families who have been enrolled for 3 months or more will show no (zero) risk factor reduction. 2004/2005 baseline: 97. 6% of families reduced at least one risk factor. 2 .4% showed no risk factor reduction. 2. Maintain the reduction in risk factors (by at 2. 100% of families maintained their reduction least one) for a period of 90 days after in risk factors for 90 days. enrollment, for families who have successfully completed the program, as measured by a risk assessment tool (see appendix) in 95% of families. No more than 5 % of families who have successfully completed the program will fail to maintain a risk factor reduction. 2004/2005 baseline : 100% of families maintained their risk factor reduction. 3 . Increase the protective factors associated 3 . 97% of families increased at least one with a reduction in the risk of child abuse for protective factor during enrollment in Safe families in the Safe Families program by at Families. least one, during enrollment in the program and /or at the conclusion of the program, for 95 % of families who have been enrolled for at least 3 months, as measured by a protective factor assessment tool (see appendix) . No more than 5% of families who have been enrolled for at least 3 months will fail to increase at least one protective factor. 2004/2005 baseline 100% of families increased at least one protective factor. 20 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP #2007043 MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed hvo pages) Note period outcomes/results reflect: 7/1/05 to 6/30/06. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut andpastefrom lastyears application. 4 . Maintain the increase in protective factors 4. 100% of families who increased at least one (by at least one) for a period of 90 days after protective factor maintained the increase for 90 enrollment for families who have successfully days. completed the program, as measured by a protective factor assessment tool (see appendix) in 95% of families. No more than 2004/2005 baseline : 100% of families maintained their protective factor improvement. 5 . 94%, of families who complete the Safe 5 . 94.3 % of families who completed Safe Families program will have no confirmed Families had no confirmed reports or re-reports reports or re-reports of abuse for up to two of abuse for up to two years after completion year after completing services as measured by of the program. the state data base on abuse. 2004/2005 baseline : 97.6% of families were not reported or re-reported for abuse . (Longer follow-up recommended by UW panel last year) . 6 . 96% of families, after successfully 6. 100% of families who completed the Safe completing the Safe Families program, will Families program showed improvement on show improvement on the AAPI test, as their AAPI post test score. measured by comparing their pre-test score to their post-test score. 2004/2005 baseline: 98 . 8% of families who successfully completed the program improved on their post test AAPI scores. 1 .2% did not improve. 7 . Ninety percent of parents participating in 7. 100% of families who participated in parent the parenting education services (groups) will education classes demonstrated improved demonstrate an improved knowledge of knowledge of parenting issues. parenting issues, as measured by a survey after each group session. Baseline: This is a new goal, baseline to be determined. 21 Form A Strongly Strongly Agree Agree Uncertain Disagree Disagree 20. There is nothing worse than a strong-willed two year old. SA A U D SD - 21 . D -21 . Children learn respect through strict discipline. SA A U D SD 22. Children who feel secure often grow up expecting too much. SA A U D SD 23 . Sometimes spanking is the only thing that will work. SA A U D SD 24. Children tan learn good discipline without being spanked. SA A U D SD 25. A good spanking lets children know parents mean business. SA A U D SD 26. Spanking teaches children it's alright to hit others. SA A U D SD 27 . Children should be responsible for the well-being of their SA A U D SD parents. 28. Strict discipline is the best way to raise children. SA A U D SD 29. Children should be their parents ' best friend. SA A U D SD 30. Children who receive praise will think too much of themselves. SA A U D SD 31 . Children need discipline, not spanking. SA A U D SD 32. Hitting a child out of love is different than hitting a child out of SA A U D SD anger. 33 , In father's absence, the son needs to become the man of the SA A U D SD house. 34 . Strong-willed children must be taught to mind their parents. SA A U D SD 35. A good child will comfort both parents after they have argued. SA A U D SD 36 . Parents who encourage their children to talk to them only end SA A U D SD up listening to complaints. 37. A good spanking never hurt anyone. SA A U D SD 38. Babies need to learn how to be considerate of the needs of SA A U D SD their mother. 39 , Letting a child sleep in the parent's bed every now and then is SA A U D SD a bad idea. 40. A good child sleeps through the night . SA A U D SD ©1999 Family Development Resources, Inc. All Rights Reserved. I-59 This test or parts thereof may not be reproduced in any form without permisicn or the publisher. 26 AA7A-z r Adult-Adolescent Parenting lnven ,,jry - 2 Stephen J. Bavolek, PhD and Richard G. Keene, PhD AAPI -2 Parenting Profile Name: ID or SS#: Date: City: State: Sex: Norm table used Notes: Parenting Raw Score Sten Score I STEN ConstructLOW SCORE DESCRIPTION HIGH SCORE DESCRIPTION A�BA B 1 1 2 3 4 5 6 7 8 9 10 z � ga INAPPROPRIATE EXPECTATIONS Expectations exceed developmental qi APPROPRIATE EXPECTA TIONS Capabilities of children. s: Understands growth and development. A Lacks understanding of normal child Children are allowed to exhibit normal growth and development. 1 '. 2 3 8 i 9 i 10 developmental behaviors. Selfconcept as a parent is weak and Self-concept as a caregiver and provider is easily threatened. positive. Tends to be demanding and controlling. Tends to be supportive of children I LOW LEVEL Of EMPATHY - APPROPRIATE LEVEL OF EMPATHY Fears spoiling children. Understands and values children's needs. Children's normal developmental needs Children are allowed to display normal B not understood or valued. 1 ' 2 ` 3 z developmental behaviors. Children most act right and be good. 8 9 10 i ! Nurture children and encourages positive Lacks nurturing skills p growth Maybe unable to handle parenting _ Communicates with children. stresses. vxi Recognizes feelings of children. STRONG BELIEF INVALUEOF VALUES ALTERNATIVES TO CORPORAL CORPORAL PUNISHMENT PUNISHMENT Hitting, spanking, slapping children is Understands alternatives to physical fords. appropriate and required. Uthatmt alternatives to corporal C asks knowledge of alternatives to ' 2 ' 3 8 j 9 j 10 punishment. corporal punishment. Tends to be democratic in rule making. Lacks ability to use allematives to I - Rules for family, not just for children. corporal punishment. Tends to have respect for children and Strong disciplinarian, rigid. - [heir needs. Tends to be controlling, authoritarian. t i Values mutual parent-child relationship. REVERSES FAMILY ROLES Tends to use children to meet self-needs. APPROPRIATE FAMILY ROLES Children perceived as objects for adult Tends to have needs met app-opdately. gratiFcatioa Finds comfort, support, companionship D Tends to treat children as confidant and t' from peers. peer. 1 2 3 _ 8 9 10 Children are allowed to express Expects children to make life better by develop mental'needs. providing love, assurance, and comfort. Takes ownership of behavior. Tends to exhibit low self-esteem, poor sell Tends to feel worthwhile as a person, good awareness, and poor social life. awareness of self. RESTRICTS POWER - INDEPENDENCE Tends to hew chi:dren with power as VALUE'S POWER - INDEPENDENCE threatening. - Places high value on children's ability to E lzxpects strict obedience to demands. ' 2 3 ` probleresolve. Devalues negotiation and compromise as 8 ± 9 ' 10 Encourages children to express views but a means of solving problemso expects cooperation. Tends to New independent thinking as Empowers children to make good choices. disrespectful. A sten of 1 2 3 ' 4 5 6 7 a 9 10 is obtained by byabout 2.3 4.4 92 15 19-1 19.1 15 9.2 44 2.3 percent of the population. A sten of 1 2 3 4 5 6 7 8 9 10 or less is obtained by byabout 2.3 6.7 15.9 30.9 50 69.1 e4A 93.3 97.7 100 percentofth a population. Copyright O 1999 Family Development Resources, Inc. All Rights Reserved. This test or parts thereof may not be reproduced in any form without written permission of the publisher. Family Development Resources, Inc. 800-688-5822 27 .tet-2 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children' s Services Advisory Committee RFP 42007043 References ' US Department of Health and Human Services: Center for Disease Control and Prevention, National Center for Injury Prevention and Control (2005). Child Maltreatment: Fact Sheet. " Ibid. "' Ibid. '" Child Welfare information Gateway @childwelfare.gov: cycle of abuse, 2001 . " Child Maltreatment 2005 US Dept. of Health and Human Services, Administration for Children and Families , 2007. Florida Department of Children and Families-dashboard indicators, 2004-2005 . Florida Department of Children and Families-dashboard indicators, 2003-2004. Viii National Data Analysis System Issue Brief: see above. " Healthy Families Florida Evaluation Report, February 2005; Williams, Stem, and Associates, Miami, FL. Thomas, David, et. al, Emerging Practices in the Prevention of Child abuse and Neglect; Department of Health and Human Services, Washington DC, 2001 . Center for Disease Control and Prevention Task Force: First Reports Evaluating the Effectiveness of Strategies for Preventing Violence (a meta-analysis of 25 studies), 2003 . " U. S. Department of Health and Human Services, Report on Child Abuse and Neglect, 2002. U.S. Department of Health and Human Services, April 2003 , vol. 4, no. 3. Benefits and Costs of Prevention and Earlv Intervention Programs for Youth; Washington State Institute for Public Policy, Olympia, WA, 2004. See reference iii. Xvl A Meta-Analytic Review of Programs for the Promotion of Family Wellness and the Prevention of Child Maltreatment, MacLeod, Jennifer; Nelson, Geoffrey, Wilfrid Laurier University Press, 2003 . 22 Organization: Exchange Club CASTLE Program Name: Safe Families Funder: Children's Services Advisory Committee RFP 42007043 FAMILY RISK/PROTECTWE FACTORS Instructions: When a risk/protective factor is assessed, place a checkmark in the box if the factor needs to be addressed. Upon completion (a risk factor that is no longer a risk, or a protective factor that has been enhanced) write, "completed" in the appropriate box. (If a risk/protectivefactor does not need to be addressed, the box will be blank) RISK FACTOR INITIAL 3 MONTH 6 MONTH 9 MONTH ASSESS. AT ASSESS. ASSESS. ASSESS. ASSESS. COMPLETIO DATE: DATE: DATE: DATE: N 1. Additional parentingknowledge/ skills needed 2. Parentis history of abuse as a child 3. Parent/s history of substance abuse 4. Parentis history ofinental health issues _ 5. Domestic Violence — PosbPresent (VictmVPer etrator) 6. Inability to meet basic needs 7. Teen, young or non-traditional parent S. Lack ofsupport system 9. Parents/Children with physical handicaps or other diagnosable conditions 10. Other PROTECTIVE FACTOR INITIAL 3 MONTH 6 MONTH 9 MONTH ASSESS. AT ASSESS. ASSESS. ASSESS. ASSESS. COMPLETIO DATE: DATE: DATE: DATE: N 1.11ousing stability 2.Delay o subse uent pregnancy 3.Enrollment in childcare 4.Enrollment in healthcare 5. Child receives routine medical care 6. Livable wage employment 7. Active participation in child's school S.Positive Family Communication 9. Constructive use of time. 10. Supportive adults outside offamily AAPI SCORES AAPI-A (Pre) AAPI-B (Post) A B C D E A B C D E A B C D E A B C D E 23 EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices : Any notice , request, demand , consent, approval or other communication required or permitted by this Contract shall be given or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service; or mailed by registered or certified mail (postage prepaid ), return receipt requested at the addresses of the parties shown below: County: Brad E . Bernauer, Indian River County Human Services Director 1801 27`" Street, Vero Beach , Florida 32960 . Recipient: Exchange Club CASTLE , P . O . Box 12908 , Fort Pierce , FL 34979 ; Attention : Theresa Garbarino-May. 2. Venue: Choice of Law: The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida , only. The location for settlement of any and all claims , controversies, or disputes, arising out of or relating to any part of this Contract, or any breach hereof, as well as any litigation between the parties , shall be Indian River County, Florida for claims brought in state court, and the Southern District of Florida for those claims justifiable in federal court. 3 . Entirety of Agreement: This Contract incorporates and includes all prior and contemporaneous negotiations, correspondence , conversations, agreements , and understandings applicable to the matters contained herein and the parties agree that there are no commitments, agreements, or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements , whether oral or written . It is further agreed that no modification , amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4. Severability: In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other term and provision of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable . 5 . Captions and Interpretations : Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions. Unless the context indicates otherwise, words importing the singular number include the plural number, and vice versa. Words of any gender include the correlative words of the other genders , unless the sense indicates otherwise. 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract. The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision , and control . 7. Assignment. This Contract may not be assigned by the Recipient without the prior written consent of the County. 1 EXHIBIT B [From policy adopted by Indian River County Board of County Commissioners on February 19 , 2002] " D. Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check. Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis, funding may be discontinued immediately. Additionally, this may adversely affect future funding requests. Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example, no expenditures prior to October 1s' may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners. All requests for reimbursement at fiscal year end (September 30'") must be submitted on a timely basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point. Each reimbursement request must include a summary of expenses by type . These summaries should be broken down into salaries , benefits , supplies , contractual services, etc. If Indian River County is reimbursing an agency for only a portion of an expense (e .g . salary of an employee) , then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available . Indian River County will not reimburse certain types of expenditures. These expenditure types are listed below. a . Travel expenses for travel outside the County including but not limited to; mileage reimbursement, hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel (within Indian River County) is allowable. b. Sick or Vacation payments for employees . Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c. Any expenses not associated with the provision of the program for which the County has awarded funding . d . Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary. " 1 Adult-Adolescent Parenting Inventory FF AAPI - 2 Form A Stephen 1. Bavolek, Ph. D, and Richard G. Keene, Ph, D. Name Date ID',# State/City Sex (circle one) Male Female Age years Race ( circle one) White Black Asian Hispanic Native American Pacific Islander Other INSTRUCTIONS: There are 40 statements in this booklet. They are statements about parenting and raising children. You decide the degree to which you agree or disagree with each statement by circling one of the responses. STRONGLY AGREE — Circle SA if you strongly support the statement, or feel the statement is true most or all the time. AGREE — Circle A if you support the statement, or feet this statement is true some of the time. STRONGLY DISAGREE — Circle SD if you feel strongly against the statement or feel the statement is not true. DISAGREE — Circle D if you feel you cannot support the statement or that the statement is not true some of the time. UNCERTAIN — Circle U only when it is impossible to decide on one of the other choices. When you are told to turn the page, begin with Number 1 and go on until you finish all the statements. In answering them, please keep these four points in mind : 1 . Respond to the statements truthfully. There is no advantage in giving an untrue response because you think it is the right thing to say. There really is no right or wrong answer — only your opinion . 2. Respond to the statements as quickly as you can . Give the first natural response that comes to mind. 3 . Circle only one response for each statement. 4. Although some statements may seem much like others , no two statements are exactly alike. Make sure you respond to every statement. If there is anything you don 't understand, please ask your questions now. If you come across a word you don 't know while responding to a statement, ask the examiner for help When you finish , please feel free to write any comments you have on the back page. Turn the Page and Begin Q1999 Family Development Resources, Inc. All rights reserved. This test or parts thereof may not be reproduced in any form without permission of the publisher. (800) 688-5822 www. nurturingparenting .com fdr&nurturing parenting .com (email) s AATA-2 24 Form A Strongly Strongly Agree Agree Uncertain Disagree Disagree 1 . Children should keep their feelings to themselves. SA A U D SD 2. Children should do what they're told to do, when they're told to SA A U D SD do it. It's that simple. 3 . Parents should be able to confide in their children. SA A U D SD 4. Children need to be allowed freedom to explore their world in SA A U D SD safety. 5. Spanking teaches children right from wrong. SA A U D SD 6. The sooner children learn to feed and dress themselves and SA A U 0 SD use the toilet, the better off they will be as adults. 7. Children who are one year old should be able to stay away SA A U D SD from things that could harm them . 8. Children should be potty trained when they are ready and not SA A U D SD before. 9. A certain amount of fear is necessary for children to respect SA A U D SD their parents. 10 . Good children always obey their parents. SA A U D SD 11 . Children should know what their parents need without being SA A U D SD told. 12. Children should be taught to obey their parents at all times. SA A U D SD 13. Children should be aware of ways to comfort their parents after SA A U D SD a hard days work. 14. Parents who nurture themselves make better parents. SA A U D SD 15 . It 's OK to spank as a last resort. SA A U D SD 16. "Because I said so! " is the only reason parents need to give. SA A U D SD 17. Parents need to push their children to do better. SA A U D SD 18. Time-out is an effective way to discipline children. SA A U D SD 19. Children have a responsibility to please their parents. SA A U D SD Please go to next page. © 1999 Family Development Resources, Inc. All Rights Reserved. 25 x '93 Rrs test or parts thereof may not be reproduced in any form without permission of the publisher. AAT A:2 11 / 28 / 2007 13 : 32 FAX 772 4656013 EXCHANGE CLUB CASTLE 002 ,, CORD CERTIFICATE OF LIABILITY INSURANCE Op ID L LATE (MMIPOM'YY) PRODUCER EXCFA' I 03122 / 07 NATIONAL C2TY INSURANCE THIS CERTIFICATE IS ISSDED AB A MATTER OF INFORMATION f/k/a Hu Harbor Insurance Agency ONLY AND CONFERS NO RIGHTS U?ONTXe CERTIFICATE 2222 Colonial Road , Suite 100 HOLDER. THI5CERTIFICATEDOE3NOTAMFND, EKTENDOR Fort Pierce FL 34950 =5309 ALTER THE COVERAGE AFFORD ED 6Y THE POLICIES BELOW. PPaones772 - 461 - 6040 Fax : 772 - 460 - 2315 INSURED INSURERS AFFORDING COVcRACyE NAIC # The 8xchA�ga Cluh Ce_ ter INSURER A; F .Laccipn" for the Prevention Or ~ Child Abuse DHA INSURERS: Exchauga Club C . A . S . T _ y _ F , INSURER 0; PO Box 12906 Ft Pierce PL 34979 INSURER D: COVERAGES INSURER E: THE POLICIES Df INSURANCE LIS-M BELOW HAVE@FEN ISSUED TO THEINSUp pNAMEp A90VE FOR TiE POLICYpERIOp INDICATED. NpTWCH$`AlDi ANY REQUIREKENT, TERM OR CONORION O.^ ANY CONTRACT OR OTHER OOCUME4T VJfI:' RESPECTTO WHICH THIS CERTIFICATE MAY 3E 156UED OR MAY PERTAIN, .TWE h'SURANCEAFFORDED 9YTHE POLICIES DESCRIEEO Hmmr4ISSL'OJECTTO ALL THE TERMS, E%CL'JSION$ ANp COWOIiIOh'S O= N POLICIES. AGGREGATE LIMfiSSHOWN MAYRAVE BEEN REDUCED W pAID CLAIMS. LTR NS TYPE OF INSURANCE POLICY ,NJMEER CY EF E PC EJjf T N DENS SAL LMSfur( - DATE MM1D DATE MWPO LMRS A X X COLIMERCU.LGENERALLIASIUTY papg219509 i EACY, OCCURB_,CE DE � OCCUR ccr=w s1 , 000 , 000 03 /26 /07 03 /26 / 08 PREMISES -e 5100 000 CLAIMS MA MWIOIPfA =re pew , 55 , 000 PERSONALMAOVIILRV s1 , 00C , 000. GP'LAGGPFGATE UMR APPLIES PER' GENERALAGGRE, 0 = 33 , 00 , 000 POLICY R jILOC PRODUCTS - CONPG? Ak3O 33 , 000 , 000 ALROMOtyLE UAe11-ftY ANYAUTO COMEINEC SINGLE L NI- ALL OWNED AUTOS SCHEOULEDAUTOS I SODILYINJU'RY 3 HIRED AUTOS (Per perm) NON,OWN`_DAVTOS I - 5001LYIN,IURY 3 (Par am dcg0 PROPERTY LAMA== 3 (Pa, amdentl GARAGE LIABILITY ANYAUTO AUTO ONLY - E; .AC- ^?•,-i 5 OtyER TIM N AUTO ONLY. BOG S IXCESSNMERELL4 LL{SILfTY OOGUR 0CLnIMS MADE EACH OCCURRE••CE 3 AGGRECviTE 3 DEDUCTIBLE 5 RETENTION $ g WORNER9 OOMPENSATTON AND S EMPLpYERS' URFfY gSI J A � 4 -- I7CRY LI,u,^a ANYPROPR1/ME 0FOFARTNER/EXECUTNE .I. EACH ACOICE\- VM1 g OFFICEREMBcR EXCLUDED? - IfYee. deaglhFunder E.L. DISEASE -E< =Vi'Y== g SPECIAL PROVISIONS Dolow - ` OTHER E.L. OISEASE - = v_ T + _ arc s L Professional Liab . P11PR219509 03 /26 / 07 03 /26 /08 OccurrenC $ 1 , 000 , 000 L Sexual /Ph Abuse P14PX219509 03 /26/ 07 03/26/08 A re ate 'SCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / IXC"WMS ADnEO SY ENDORSEMENT/ SPECp L FROVISIONS +82 x000 , 000 10 days non -payment of premium , certificate ' Holder is nerfed as an dditi, aaal Insured for General Liability coverage . `RTIFICATE HOLDER CAN INDIA-2 SHCULDANYOF TNEASOVEDEECRI2E0 pogcIES BE CAHCELLEO CEFORETHC EXFIRATIOW DATE THEREOF, THE ISSUIND Wl URER WILL ENDEAVOR W L 3 .0 * DAY3WRITTEH Sndi,aa River County Attics Marion Masterson NOTIOETO THE CERTIFICATE HOLDER NAMED TOTHE LET, GU FAILURE TO DO SO SHALL 1840 25th Street IMPOSE No 09USATI0N OR LABILITY OF ANY KIND UPON THE f.NSURER, ITS AGENTS OR Vero Beach FL 329CC) REPRESENTATIVES, A1ITHORRED REFRESENTATIYE .)RD 25 (2001108) © ACORD CORPORATIOfj i988 11 / 28 / 2007 13 : 33 FAX 772 4656013 EXCHANGE CLUB CASTLE Z003 Workere Compensation and Employers Liability Insurance Fa4ey Arilox 88806 Preferred Insurance Co. :fi x::: :..: « ►.: :::::,:;:y::::, .`. ....:::::::::::::.-::::::::::::::>;::.�i=;rxirn. y; :ci#:: "is,:s:> . Or>sia : 'r;: PI- Porth PamBea WCV 7072216 07 / 01 / 2007 07 / 01 /2000 .North Palm Beach, F1 33408-8806 tam .vN. sma ime ai iha add mw of tho I `0)226-1898 Ina�ed w =wiian:in .; I.. .I . . n Yljstt POLICY DECLARATION Effective : 07 / 01 / 2007 Yreflatn •:f : ,.•. ed tis ar tH7ad.. .A. . ; ;;:;; < ;;<ck: : : : :+:.::::::::::::: : :.:::.:: +;;;;: :_;:::afiIs:;: :;a•;:.;:ss;: t; i : ;:;: _....._................................. ...I............;I:I:I -::::......-.. ..._: ::.. EXCHANGE CLUB CENTER FOR THE BROWNING CORPORA^_ ION 0769010 PREVENTION OF CHILD ABU9Z OF 100 AVENUE A SUITE 1F P O BOX 12908 FT - PIERCE , FL 3 .4950 FORT PIERCE FL 34979 Telephone: 772 -465 - 8425 Customer # Carrier # FEIN # Risk ID # Entity of Inaured 31283 592094472 091190907 1 CORPORATION Additional Locations: 2- The Policy Period is from 07 / 01 / 2007 to 07 / 01 / 2008 12:01 a.m. Standard Time at the Insuredrs mailing address. 3. A. Workers Compensation Insurance: : Part Pr ONE of the policy applies to the Workers Compensation Law of the states fisted here: Florida B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ 1 , 000 , 000 each accident Bodily Injury by Disease $ 1 , 000 , 000 policy limit Bodily Injury by Disease $ 1 , 000 , 000 each employee C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: AL,DC, PL,GA, IN ,KS,KY, MD, MN, SC,TN,TX,VA 4 D. This policy includes these endorsements and schedules: See attached schedule. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTSNISIOfd MJF INFORKPATION P.AGE Minimum Premium $ 695 Expense Constant $ 200 Premium Discount $ - 1 , 753 Assessments and Taxes $ Total Estimated AnnualPromium $ 28 , 075 ❑ This is a Three Year Fixed Rate Policy l Premium Adjustment Period: 0 Annual; ❑ Semiannual; 0 Quarterly; ❑ Monthly Countersigned this Day of PIP Issued Date: 08 / :LG / 07 Authorized Representative Issuing Office Am=W Preferred Insurance Co . INSURED Form A Strongly Strongly Agree Agree Uncertain Disagree Disagree 20. There is nothing worse than a strong-willed two year old. SA A U D SD - 21 . D -21 . Children learn respect through strict discipline. SA A U D SD 22. Children who feel secure often grow up expecting too much. SA A U D SD 23 . Sometimes spanking is the only thing that will work. SA A U D SD 24. Children tan learn good discipline without being spanked. SA A U D SD 25. A good spanking lets children know parents mean business. SA A U D SD 26. Spanking teaches children it's alright to hit others. SA A U D SD 27 . Children should be responsible for the well-being of their SA A U D SD parents. 28. Strict discipline is the best way to raise children. SA A U D SD 29. Children should be their parents ' best friend. SA A U D SD 30. Children who receive praise will think too much of themselves. SA A U D SD 31 . Children need discipline, not spanking. SA A U D SD 32. Hitting a child out of love is different than hitting a child out of SA A U D SD anger. 33 , In father's absence, the son needs to become the man of the SA A U D SD house. 34 . Strong-willed children must be taught to mind their parents. SA A U D SD 35. A good child will comfort both parents after they have argued. SA A U D SD 36 . Parents who encourage their children to talk to them only end SA A U D SD up listening to complaints. 37. A good spanking never hurt anyone. SA A U D SD 38. Babies need to learn how to be considerate of the needs of SA A U D SD their mother. 39 , Letting a child sleep in the parent's bed every now and then is SA A U D SD a bad idea. 40. A good child sleeps through the night . SA A U D SD ©1999 Family Development Resources, Inc. All Rights Reserved. I-59 This test or parts thereof may not be reproduced in any form without permisicn or the publisher. 26 AA7A-z r Adult-Adolescent Parenting lnven ,,jry - 2 Stephen J. Bavolek, PhD and Richard G. Keene, PhD AAPI -2 Parenting Profile Name: ID or SS#: Date: City: State: Sex: Norm table used Notes: Parenting Raw Score Sten Score I STEN ConstructLOW SCORE DESCRIPTION HIGH SCORE DESCRIPTION A�BA B 1 1 2 3 4 5 6 7 8 9 10 z � ga INAPPROPRIATE EXPECTATIONS Expectations exceed developmental qi APPROPRIATE EXPECTA TIONS Capabilities of children. s: Understands growth and development. A Lacks understanding of normal child Children are allowed to exhibit normal growth and development. 1 '. 2 3 8 i 9 i 10 developmental behaviors. Selfconcept as a parent is weak and Self-concept as a caregiver and provider is easily threatened. positive. Tends to be demanding and controlling. Tends to be supportive of children I LOW LEVEL Of EMPATHY - APPROPRIATE LEVEL OF EMPATHY Fears spoiling children. Understands and values children's needs. Children's normal developmental needs Children are allowed to display normal B not understood or valued. 1 ' 2 ` 3 z developmental behaviors. Children most act right and be good. 8 9 10 i ! Nurture children and encourages positive Lacks nurturing skills p growth Maybe unable to handle parenting _ Communicates with children. stresses. vxi Recognizes feelings of children. STRONG BELIEF INVALUEOF VALUES ALTERNATIVES TO CORPORAL CORPORAL PUNISHMENT PUNISHMENT Hitting, spanking, slapping children is Understands alternatives to physical fords. appropriate and required. Uthatmt alternatives to corporal C asks knowledge of alternatives to ' 2 ' 3 8 j 9 j 10 punishment. corporal punishment. Tends to be democratic in rule making. Lacks ability to use allematives to I - Rules for family, not just for children. corporal punishment. Tends to have respect for children and Strong disciplinarian, rigid. - [heir needs. Tends to be controlling, authoritarian. t i Values mutual parent-child relationship. REVERSES FAMILY ROLES Tends to use children to meet self-needs. APPROPRIATE FAMILY ROLES Children perceived as objects for adult Tends to have needs met app-opdately. gratiFcatioa Finds comfort, support, companionship D Tends to treat children as confidant and t' from peers. peer. 1 2 3 _ 8 9 10 Children are allowed to express Expects children to make life better by develop mental'needs. providing love, assurance, and comfort. Takes ownership of behavior. Tends to exhibit low self-esteem, poor sell Tends to feel worthwhile as a person, good awareness, and poor social life. awareness of self. RESTRICTS POWER - INDEPENDENCE Tends to hew chi:dren with power as VALUE'S POWER - INDEPENDENCE threatening. - Places high value on children's ability to E lzxpects strict obedience to demands. ' 2 3 ` probleresolve. Devalues negotiation and compromise as 8 ± 9 ' 10 Encourages children to express views but a means of solving problemso expects cooperation. Tends to New independent thinking as Empowers children to make good choices. disrespectful. A sten of 1 2 3 ' 4 5 6 7 a 9 10 is obtained by byabout 2.3 4.4 92 15 19-1 19.1 15 9.2 44 2.3 percent of the population. A sten of 1 2 3 4 5 6 7 8 9 10 or less is obtained by byabout 2.3 6.7 15.9 30.9 50 69.1 e4A 93.3 97.7 100 percentofth a population. Copyright O 1999 Family Development Resources, Inc. All Rights Reserved. This test or parts thereof may not be reproduced in any form without written permission of the publisher. Family Development Resources, Inc. 800-688-5822 27 .tet-2 11 / 28 / 2007 13 : 33 FAX 772 4656019 EXCHANGE CLUB CASTLE 1� 004 The CASTLE does not Use an agency vehicle to transport clients. Doug Boni Assistant Diredor Mailing Address: P.D. Box 12908, Port Pierce, FL 34979 Main Office: 3525 W. Midway Road, For. Pierce, FL 34987 ' Phone 772465-807 7 * Far 772-065-6013 St. Lucie County: 800 Virginia Avenue Ste 34 & 35, Fort Plerce, FL 34582 t Phone: 772-461 -0863 s Fax:772-468-0690 Indian River County. 1275 Old Dixie Highway,Vero Beach, FL 32962 ' Phone- 772-567-5700 * Fax 772-567-7133 Martin County- 38245.E. Dixie Highway, Stuart FL 34997 ` Phone: 772.7874570 ' Fax: 772-2T9-0791 . Sponsored in part by the State of Rorids, United for Famllles, Children§ 5ervloes Councils of Marin, 5L Lucie and Olaechobee Countes, the children's Services Advisory Committee of Indian River Cdurfty and the EsehanSe Clubs. CASTLE 7s a United Way member acienEv. EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices : Any notice , request, demand , consent, approval or other communication required or permitted by this Contract shall be given or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service; or mailed by registered or certified mail (postage prepaid ), return receipt requested at the addresses of the parties shown below: County: Brad E . Bernauer, Indian River County Human Services Director 1801 27`" Street, Vero Beach , Florida 32960 . Recipient: Exchange Club CASTLE , P . O . Box 12908 , Fort Pierce , FL 34979 ; Attention : Theresa Garbarino-May. 2. Venue: Choice of Law: The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida , only. The location for settlement of any and all claims , controversies, or disputes, arising out of or relating to any part of this Contract, or any breach hereof, as well as any litigation between the parties , shall be Indian River County, Florida for claims brought in state court, and the Southern District of Florida for those claims justifiable in federal court. 3 . Entirety of Agreement: This Contract incorporates and includes all prior and contemporaneous negotiations, correspondence , conversations, agreements , and understandings applicable to the matters contained herein and the parties agree that there are no commitments, agreements, or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements , whether oral or written . It is further agreed that no modification , amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4. Severability: In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other term and provision of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable . 5 . Captions and Interpretations : Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions. Unless the context indicates otherwise, words importing the singular number include the plural number, and vice versa. Words of any gender include the correlative words of the other genders , unless the sense indicates otherwise. 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract. The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision , and control . 7. Assignment. This Contract may not be assigned by the Recipient without the prior written consent of the County. 1 EXHIBIT B [From policy adopted by Indian River County Board of County Commissioners on February 19 , 2002] " D. Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check. Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis, funding may be discontinued immediately. Additionally, this may adversely affect future funding requests. Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example, no expenditures prior to October 1s' may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners. All requests for reimbursement at fiscal year end (September 30'") must be submitted on a timely basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point. Each reimbursement request must include a summary of expenses by type . These summaries should be broken down into salaries , benefits , supplies , contractual services, etc. If Indian River County is reimbursing an agency for only a portion of an expense (e .g . salary of an employee) , then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available . Indian River County will not reimburse certain types of expenditures. These expenditure types are listed below. a . Travel expenses for travel outside the County including but not limited to; mileage reimbursement, hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel (within Indian River County) is allowable. b. Sick or Vacation payments for employees . Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c. Any expenses not associated with the provision of the program for which the County has awarded funding . d . Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary. " 1 11 / 28 / 2007 13 : 32 FAX 772 4656013 EXCHANGE CLUB CASTLE 002 ,, CORD CERTIFICATE OF LIABILITY INSURANCE Op ID L LATE (MMIPOM'YY) PRODUCER EXCFA' I 03122 / 07 NATIONAL C2TY INSURANCE THIS CERTIFICATE IS ISSDED AB A MATTER OF INFORMATION f/k/a Hu Harbor Insurance Agency ONLY AND CONFERS NO RIGHTS U?ONTXe CERTIFICATE 2222 Colonial Road , Suite 100 HOLDER. THI5CERTIFICATEDOE3NOTAMFND, EKTENDOR Fort Pierce FL 34950 =5309 ALTER THE COVERAGE AFFORD ED 6Y THE POLICIES BELOW. PPaones772 - 461 - 6040 Fax : 772 - 460 - 2315 INSURED INSURERS AFFORDING COVcRACyE NAIC # The 8xchA�ga Cluh Ce_ ter INSURER A; F .Laccipn" for the Prevention Or ~ Child Abuse DHA INSURERS: Exchauga Club C . A . S . T _ y _ F , INSURER 0; PO Box 12906 Ft Pierce PL 34979 INSURER D: COVERAGES INSURER E: THE POLICIES Df INSURANCE LIS-M BELOW HAVE@FEN ISSUED TO THEINSUp pNAMEp A90VE FOR TiE POLICYpERIOp INDICATED. NpTWCH$`AlDi ANY REQUIREKENT, TERM OR CONORION O.^ ANY CONTRACT OR OTHER OOCUME4T VJfI:' RESPECTTO WHICH THIS CERTIFICATE MAY 3E 156UED OR MAY PERTAIN, .TWE h'SURANCEAFFORDED 9YTHE POLICIES DESCRIEEO Hmmr4ISSL'OJECTTO ALL THE TERMS, E%CL'JSION$ ANp COWOIiIOh'S O= N POLICIES. AGGREGATE LIMfiSSHOWN MAYRAVE BEEN REDUCED W pAID CLAIMS. LTR NS TYPE OF INSURANCE POLICY ,NJMEER CY EF E PC EJjf T N DENS SAL LMSfur( - DATE MM1D DATE MWPO LMRS A X X COLIMERCU.LGENERALLIASIUTY papg219509 i EACY, OCCURB_,CE DE � OCCUR ccr=w s1 , 000 , 000 03 /26 /07 03 /26 / 08 PREMISES -e 5100 000 CLAIMS MA MWIOIPfA =re pew , 55 , 000 PERSONALMAOVIILRV s1 , 00C , 000. GP'LAGGPFGATE UMR APPLIES PER' GENERALAGGRE, 0 = 33 , 00 , 000 POLICY R jILOC PRODUCTS - CONPG? Ak3O 33 , 000 , 000 ALROMOtyLE UAe11-ftY ANYAUTO COMEINEC SINGLE L NI- ALL OWNED AUTOS SCHEOULEDAUTOS I SODILYINJU'RY 3 HIRED AUTOS (Per perm) NON,OWN`_DAVTOS I - 5001LYIN,IURY 3 (Par am dcg0 PROPERTY LAMA== 3 (Pa, amdentl GARAGE LIABILITY ANYAUTO AUTO ONLY - E; .AC- ^?•,-i 5 OtyER TIM N AUTO ONLY. BOG S IXCESSNMERELL4 LL{SILfTY OOGUR 0CLnIMS MADE EACH OCCURRE••CE 3 AGGRECviTE 3 DEDUCTIBLE 5 RETENTION $ g WORNER9 OOMPENSATTON AND S EMPLpYERS' URFfY gSI J A � 4 -- I7CRY LI,u,^a ANYPROPR1/ME 0FOFARTNER/EXECUTNE .I. EACH ACOICE\- VM1 g OFFICEREMBcR EXCLUDED? - IfYee. deaglhFunder E.L. DISEASE -E< =Vi'Y== g SPECIAL PROVISIONS Dolow - ` OTHER E.L. OISEASE - = v_ T + _ arc s L Professional Liab . P11PR219509 03 /26 / 07 03 /26 /08 OccurrenC $ 1 , 000 , 000 L Sexual /Ph Abuse P14PX219509 03 /26/ 07 03/26/08 A re ate 'SCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / IXC"WMS ADnEO SY ENDORSEMENT/ SPECp L FROVISIONS +82 x000 , 000 10 days non -payment of premium , certificate ' Holder is nerfed as an dditi, aaal Insured for General Liability coverage . `RTIFICATE HOLDER CAN INDIA-2 SHCULDANYOF TNEASOVEDEECRI2E0 pogcIES BE CAHCELLEO CEFORETHC EXFIRATIOW DATE THEREOF, THE ISSUIND Wl URER WILL ENDEAVOR W L 3 .0 * DAY3WRITTEH Sndi,aa River County Attics Marion Masterson NOTIOETO THE CERTIFICATE HOLDER NAMED TOTHE LET, GU FAILURE TO DO SO SHALL 1840 25th Street IMPOSE No 09USATI0N OR LABILITY OF ANY KIND UPON THE f.NSURER, ITS AGENTS OR Vero Beach FL 329CC) REPRESENTATIVES, A1ITHORRED REFRESENTATIYE .)RD 25 (2001108) © ACORD CORPORATIOfj i988 11 / 28 / 2007 13 : 33 FAX 772 4656013 EXCHANGE CLUB CASTLE Z003 Workere Compensation and Employers Liability Insurance Fa4ey Arilox 88806 Preferred Insurance Co. :fi x::: :..: « ►.: :::::,:;:y::::, .`. ....:::::::::::::.-::::::::::::::>;::.�i=;rxirn. y; :ci#:: "is,:s:> . Or>sia : 'r;: PI- Porth PamBea WCV 7072216 07 / 01 / 2007 07 / 01 /2000 .North Palm Beach, F1 33408-8806 tam .vN. sma ime ai iha add mw of tho I `0)226-1898 Ina�ed w =wiian:in .; I.. .I . . n Yljstt POLICY DECLARATION Effective : 07 / 01 / 2007 Yreflatn •:f : ,.•. ed tis ar tH7ad.. .A. . ; ;;:;; < ;;<ck: : : : :+:.::::::::::::: : :.:::.:: +;;;;: :_;:::afiIs:;: :;a•;:.;:ss;: t; i : ;:;: _....._................................. ...I............;I:I:I -::::......-.. ..._: ::.. EXCHANGE CLUB CENTER FOR THE BROWNING CORPORA^_ ION 0769010 PREVENTION OF CHILD ABU9Z OF 100 AVENUE A SUITE 1F P O BOX 12908 FT - PIERCE , FL 3 .4950 FORT PIERCE FL 34979 Telephone: 772 -465 - 8425 Customer # Carrier # FEIN # Risk ID # Entity of Inaured 31283 592094472 091190907 1 CORPORATION Additional Locations: 2- The Policy Period is from 07 / 01 / 2007 to 07 / 01 / 2008 12:01 a.m. Standard Time at the Insuredrs mailing address. 3. A. Workers Compensation Insurance: : Part Pr ONE of the policy applies to the Workers Compensation Law of the states fisted here: Florida B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ 1 , 000 , 000 each accident Bodily Injury by Disease $ 1 , 000 , 000 policy limit Bodily Injury by Disease $ 1 , 000 , 000 each employee C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: AL,DC, PL,GA, IN ,KS,KY, MD, MN, SC,TN,TX,VA 4 D. This policy includes these endorsements and schedules: See attached schedule. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTSNISIOfd MJF INFORKPATION P.AGE Minimum Premium $ 695 Expense Constant $ 200 Premium Discount $ - 1 , 753 Assessments and Taxes $ Total Estimated AnnualPromium $ 28 , 075 ❑ This is a Three Year Fixed Rate Policy l Premium Adjustment Period: 0 Annual; ❑ Semiannual; 0 Quarterly; ❑ Monthly Countersigned this Day of PIP Issued Date: 08 / :LG / 07 Authorized Representative Issuing Office Am=W Preferred Insurance Co . INSURED 11 / 28 / 2007 13 : 33 FAX 772 4656019 EXCHANGE CLUB CASTLE 1� 004 The CASTLE does not Use an agency vehicle to transport clients. Doug Boni Assistant Diredor Mailing Address: P.D. Box 12908, Port Pierce, FL 34979 Main Office: 3525 W. Midway Road, For. Pierce, FL 34987 ' Phone 772465-807 7 * Far 772-065-6013 St. Lucie County: 800 Virginia Avenue Ste 34 & 35, Fort Plerce, FL 34582 t Phone: 772-461 -0863 s Fax:772-468-0690 Indian River County. 1275 Old Dixie Highway,Vero Beach, FL 32962 ' Phone- 772-567-5700 * Fax 772-567-7133 Martin County- 38245.E. Dixie Highway, Stuart FL 34997 ` Phone: 772.7874570 ' Fax: 772-2T9-0791 . Sponsored in part by the State of Rorids, United for Famllles, Children§ 5ervloes Councils of Marin, 5L Lucie and Olaechobee Countes, the children's Services Advisory Committee of Indian River Cdurfty and the EsehanSe Clubs. CASTLE 7s a United Way member acienEv.