HomeMy WebLinkAboutR-2014-011 Accepted Grant known as 21st CCLC for $265,085.00 to execute agreement with After School Programs, Inc. for the Time 4 Kids 2013-2014 Program for $26,508.00 which includes Summer Program RESOLUTION NO. 2014-011
A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF DANIA
BEACH, FLORIDA, AUTHORIZING THE PROPER CITY OFFICIALS TO
ACCEPT A GRANT FROM THE FLORIDA DEPARTMENT OF EDUCATION
KNOWN AS THE 21ST CENTURY COMMUNITY LEARNING CENTERS
("21 ST CCLC") IN THE AMOUNT OF $265,085.00; AUTHORIZING THE
PROPER CITY OFFICIALS TO EXECUTE AN AGREEMENT BETWEEN
AFTER SCHOOL PROGRAMS, INC. AND THE CITY OF DANIA BEACH,
FLORIDA, IN AN AMOUNT NOT TO EXCEED $26,508.00 TO
ADMINISTER THE TIME 4 KIDS PROGRAM FOR THE 2013-2014 SCHOOL
YEAR, INCLUDING THE 2013/2014 SUMMER PROGRAMS; CONFIRMING
THAT SPECIAL CONDITIONS EXIST IN ORDER TO SECURE SUCH
SERVICES WITH AFTER SCHOOL PROGRAMS, INC., WITHOUT
COMPETITIVE BIDDING AND WITHOUT ADVERTISEMENT FOR BIDS;
PROVIDING FOR CONFLICTS; FURTHER, PROVIDING FOR AN
EFFECTIVE DATE.
WHEREAS, the Charter of the City of Dania Beach, Part III, Article 3, Section 4,
Subsection 0), authorizes the City Manager to purchase supplies, services, equipment and
materials for the city government in amounts in excess of the established monetary threshold
without competitive bidding and without advertisement for bids if he is authorized to do so in
advance by a resolution adopted by the city commission; and
WHEREAS, the Dania Beach Code of Ordinances, Chapter 2, Article 1, Section 2-10,
"Monetary thresholds for certain purchases and payment disbursement authorizations",
Subsection(a), sets the monetary threshold or limitation at$25,000.00; and
WHEREAS, the TIME 4 Kids Program is funded by a grant known as the 21 st Century
Community Learning Centers ("CCLC")from the Florida Department of Education in an amount
of Two Hundred Sixty Five Thousand Eighty-Five Dollars ($265,085.00) for the 2013-2014
TIME 4 Kids Program after school tutoring program, including the 2013 and 2014 summer
programs; and
WHEREAS, After School Programs, Inc., a Florida non-profit corporation, located in
Deerfield Beach, Florida, has submitted a proposal to administer the grant for an added cost
equal to ten percent (10%) of the approved expenses of the grant amount expended from August
1, 2013 through July 31, 2014, in an amount not to exceed Twenty-Six Thousand Five Hundred
Eight Dollars ($26,508.00); and
WHEREAS, After School Programs, Inc. has provided this service continuously to the
City for several years, and the Administration has found its past performance to be acceptable
and therefore recommends waiving the bidding process and continuation of this service using
this firm;
NOW,THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF DANIA BEACH,FLORIDA:
Section 1. That the City Commission of the City of Dania Beach, Florida, authorizes
the proper City officials to execute the 21 st CCLC application and accept award of the
$265,085.00 21s' Century Community Learning Centers ("CCLC") grant from the Florida
Department of Education,requiring no matching City funds.
Section 2. That the City Commission further approves a waiver for bidding the
contracting of this service and authorizes proper City officials to execute an agreement on behalf
of the City with After School Programs, Inc., which Agreement is attached as Exhibit"A"to this
Resolution and made a part of it by this reference, for an amount not to exceed Twenty-Six
Thousand Five Hundred Eight Dollars($26,508.00).
Section 3. That the Administration is authorized to create and appropriate new grant
revenue and expenses in the City Grant Fund — Summer Program 2013/14 and further to use
planned, approved and appropriated funds in the amount of$26,508.00 available General Fund,
Recreation Administration Professional Services Consulting Account, Account No. 001-72-01-
572-31-10 to pay for administration of the grant with After School Programs, Inc.
Section 4. That the City Manager and City Attorney are authorized to make minor
revisions to such Agreement as are deemed necessary and proper and in the best interest of the
City.
Section 5. That all resolutions or parts of resolutions in conflict with this Resolution
are repealed to the extent of such conflict.
2 RESOLUTION#2014-011
Section 6. That this Resolution shall be in force and take effect immediately upon its
passage and adoption.
PASSED and ADOPTED on February 25,2014.
ATTEST:
LOUISE STILSON, CMC WAL R B. DUKE,III
CITY CLERK MAYOR
APPROVED T1 FORM AND CORRECTNESS: �p�'S FIftr
O y
Q� -
C
THOMAS J. S O
CITY ATTORNEY
3 RESOLUTION#2014-011
EXHIBIT `A"
CONTRACT FOR SERVICES
AFTER SCHOOL PROGRAMS, INC., a Florida non-profit corporation ("ASP") with a
business address located at 1520 South Powerline Road, Deerfield Beach, Florida 33442, and the
CITY OF DANIA BEACH, FLORIDA, a Municipal corporation(the "City"), with an address of
100 West Dania Beach Boulevard, Dania Beach, Florida 33004, wish to enter into this Contract
for Services(the"Contract")dated and effective retroactive to August 1, 2013.
WHEREAS, the City has entered into an Agreement with the Florida Department of
Education 21" Century Community Learning Center (the "CCLC"), identified as the approved
21" CCLC grant application under the guidance of Part B of Title IV —21 st Century Community
Learning Centers No Child Left Behind Act(the"NCLB") of 2001 Public Law 107-110. A copy
of the Agreement is attached as Exhibit "A", and is made a part of and incorporated into this
Contract by this reference.
WHEREAS, City has requested ASP to supply staffing, supplies and services to
implement the TIME 4 Kids 21" CCLC Program at Collins Elementary School as identified in
this Contract;
NOW THEREFORE, in consideration of the mutual promises and covenants contained
in this Contract, and for other good and valuable consideration, the receipt, adequacy and
sufficiency of which are acknowledged, the Parties, intending to be legally bound, agree as
follows:
1. OBLIGATIONS OF ASP
1.1 ASP shall supply the necessary staff and personnel to comply with the
requirements of the approved 21" CCLC grant application awarded to the City in which ASP is
specifically designated by the City, during the Broward County School Year for 2013-2014, and
for summer camp, which combined time period commenced on August 1,2013, and ends on July
31, 2014.
1.2 ASP shall provide academic enrichment and remedial education activities in the
areas of reading, math, and science, enrichment and recreational activities to a daily average of
eighty (80) kindergarten through fifth (K-5d) grade students for one hundred eighty (180) after-
school days, which shall include an additional ten (10) non-school days. ASP shall provide a
summer camp program for one hundred (100) first through fifth (1 st-5d) graders for thirty-four
(34) summer days at Collins Elementary School.
1.3 ASP shall provide transportation as specified in Exhibit`B", which is made a part
of and incorporated into this Contract by this reference.
1.4 ASP shall monitor program progress toward meeting approved goals and
objectives outlined in this Contract.
4 RESOLUTION#2014-011
1.5 ASP will assist the City to develop all reports required by CCLC, the Florida
Department of Education, and the United States Federal Government.
1.6 ASP will provide a progress report to the City detailing the activities
accomplished, that at a minimum shall include those items described as Project Deliverables; a
copy is attached as Exhibit "C", and it is made a part of and incorporated into this Contract by
this reference. The report and Deliverables are due to the City ten(10) days after the end of each
month of service.
1.7 ASP will prepare with each payment request a DOE 399 Form; a copy is attached
as Exhibit "D", and it is made a part of and incorporated into this Contract by this reference,
along with required Deliverables.
1.8 ASP agrees to assist the City at no cost in the preparation and collection of
documentation that may be required to meet financial and program audits that are conducted by
state and federal authorities in relation to expended grant funds under this Contract.
2. COMPENSATION AND METHOD OF PAYMENT
2.1 This Contract is for an amount not to exceed Two Hundred Ninety One Thousand
Five Hundred Ninety-Three Dollars ($291,593.00). ASP will bill the City on the tenth (loth)
day of each month for the preceding afterschool days for the cost incurred to administer the
TIME 4 KIDS Program. Payment for costs is to be based upon the program budget as approved
and amended from time to time by the Florida Department of Education. Any additional costs
exclusive of the program budget and the administrative fees must be approved in writing in
advance by the City. Payment is due within thirty (30) days of the billing date. A late charge of
ten percent (10%) of the payment due shall be charged for each payment received by ASP after
more than twenty-one (21) days after the billing date in which no federal funds will be used. If
payment is not received within thirty (30) days of its due date, the City shall be in default and
ASP may terminate this Contract.
3. OBLIGATIONS OF THE CITY
3.1 The City agrees to pay ASP promptly as set forth in this Contract.
3.2 The City will oversee all services provided by ASP to ensure the terms of this
Contract are being implemented as approved, and that the terms are in compliance with
applicable federal and state laws,policies, and regulations.
4. DEFAULT
4.1 For other than monetary default by the City, in the event either party defaults in
the terms or provisions of this Contract, the other party shall give the defaulting party ten (10)
days' written notice of the default, and an opportunity to cure the default within the ten (10) day
period. In the event the default is not so cured, the other party may terminate this Contract by
giving written notice to that effect to the other party.
5 RESOLUTION#2014-011
4.2 In the event of default, the non-defaulting party may sue for damages. The
prevailing party shall be entitled to recover its attorney fees and costs. The City will not use
federal funds to pay for damages.
4.3 City shall obtain approval from CCLC for the assignment of responsibility to ASP
as set forth and required in this Contract.
5. INSURANCE
5.1 The Contractor shall not commence work under this Contract until it has obtained
all insurance coverages required under it, and not until they have been approved by the Risk
Manager for the City.
5.2 The Contractor shall not allow any subcontractor to commence work on any
subcontract until the subcontractor has all of the insurance coverages required under it, and not
until they have been approved by Risk Manager for the City. In addition, Contractor shall be
responsible for any policy deductibles and self-insured retentions.
5.3 Contractor shall file Certificates of Insurance with the City, reflecting evidence of
the required coverages under this Contract. They shall be filed with the City's Risk Manager
within ten (10) days of the date first above written. All Certificates of Insurance shall contain a
provision that coverages afforded under these policies will not be canceled until at least thirty
(30) days' prior written notice has been given to the City. Policies for coverages shall be issued
by companies authorized to do business under the laws of the State of Florida, and any such
companies' financial ratings must be no less than "A" in the latest edition of the `BEST'S KEY
RATING GUIDE",published by A.M. Best Guide.
5.4 Coverages shall be in force until all work required to be performed under the
terms of this Contract is satisfactorily completed as evidenced by the formal acceptance by the
City. In the event insurance certificates provided to City indicate that the insurance shall
terminate and lapse during the period of this Contract, then in that event, the Contractor shall
furnish, at least thirty (30) days prior to the expiration date of such insurance, a renewed
Certificate of Insurance as proof that equal and like coverages for the balance of the period of the
Contract and any extension of it, is in effect. THE CONTRACTOR SHALL NOT
PERFORM OR CONTINUE TO WORK PURSUANT TO THE TERMS AND
CONDITIONS OF THIS CONTRACT, UNLESS ALL COVERAGES REMAIN IN FULL
FORCE AND EFFECT.
INSURANCE REQUIREMENTS
5.5 Contractor shall provide, pay for and maintain in force at all times during the term
of this Agreement, such insurance, including Professional Liability, Workers' Compensation
Insurance and Comprehensive General Liability insurance as stated below:
A. Commercial General Liability insurance to include the following:
RESOLUTION#2014-011
1. Broad form property damage with limits of no less than
One Hundred Thousand Dollars($100,000.00),per occurrence;
2. Bodily injury, contractual liability with limits of no less
than One Million Dollars($1,000,000.00),per occurrence;
3. Medical expenses of no less than Five Thousand Dollars
($5,000.00)for any one person,per occurrence;
4. Coverage for products and completed operations with
limits of no less than Three Million Dollars ($3,000,000.00) with
an annual aggregate of Three Million Dollars ($3,000,000.00). The
City shall be an additional "named" insured under this policy, and
Owner shall be provided a certificate of insurance evidencing
coverage and named insured status, and the policy shall also reflect
the named insured.
B. Comprehensive Automobile Liability insurance shall be maintained with
no less than One Million Dollars ($1,000,000.00) per person, per accident,
and coverage is to include coverage for hired and non-owned vehicles.
The City shall be an additional "named" insured under this policy, and
Owner shall be provided a certificate of insurance evidencing coverage
and a named insured status on the policy.
C. Workers' Compensation insurance to apply for all employees in
compliance with the "Workers' Compensation Law" of the State of
Florida and all applicable federal laws, for the benefit of the Contractor or
its employees and Employer's Liability coverage to include a minimum
limit of Five Hundred Thousand Dollars ($500,000.00) per occurrence,
including a disease policy with a limit of no less than Five Hundred
Thousand Dollars($500.000.00)per employee.
D. Professional liability insurance with minimum limits of no less than One
Million Dollars ($1,000,000.00) with Three Million Dollars
($3,000,000.00) annual aggregate to assure the City of coverage of the
indemnification specified in this Agreement. The City shall be an
additional "named" insured under this policy, and Owner shall be
provided a certificate of insurance evidencing coverage and named insured
status on the policy.
E. The Contractor shall provide the Risk Manager of the City Certificates of
Insurance for coverages and policies required by this Agreement within
fourteen (14) days of all parties signing it. All certificates shall state that
the City shall be given thirty (30) days' advance notice prior to expiration
or cancellation of any policy. Such policies and coverages shall not be
7 RESOLUTION#2014-011
affected by any other policy of insurance which the City may carry in its
own name. All certificates (of insurance) must clearly identify the contract
to which they pertain, including a brief description of the subject matter of
the contract.
6. MISCELLANEOUS
6.1 Both ASP and City agree to comply with their respective requirements as set forth
in this Contract.
6.2 Notices: All notices, requests, demands and other communications pertaining to
this Contract, shall be in writing and deemed duly given when delivered either personally with a
receipt, by an overnight courier service with a signed receipt, or mailed by certified mail, return
receipt requested,postage prepaid, addressed as follows:
To ASP: David Wolnek,President
After School Programs, Inc.
1520 South Powerline Road
Deerfield Beach, Florida 33442
Telephone: (954) 596-9000
Facsimile: (954) 596-9880
To CITY: Robert Baldwin, City Manager
City of Dania Beach, Florida
100 West Dania Beach Boulevard
Dania Beach, Florida 33004
Telephone: (954)924-6800
Facsimile: (954) 921-2604
To CITY: Mark Bates, Finance Director
City of Dania Beach, Florida
100 West Dania Beach Boulevard
Dania Beach, Florida 33004
Telephone: (954) 924-6800
Facsimile: (954) 921-2604
To CITY: Thomas Ansbro, City Attorney
City of Dania Beach, Florida
100 West Dania Beach Boulevard
Dania Beach, Florida 33004
Telephone: (954) 924-6800
Facsimile: (954) 921-2604
Either Party may change its address for Notices by written notice to the other Party, given
pursuant to this paragraph.
8 RESOLUTION#2014-011
6.3 All Prior Agreements Superseded. This document incorporates and includes all
prior negotiations, correspondence, conversations, agreements and understandings applicable to
the matters contained in this Contract, and both Parties agree that there are no commitments,
agreements or understandings concerning the subject matter in it that are not contained in this
document. Accordingly, it is agreed to by the Parties that no deviation from the terms of this
Contract shall be predicated upon any prior representations or agreements, whether oral or
written.
6.4 Entire Contract. This Contract and all Exhibits to it set forth the entire
understanding between the Parties in connection with the matters specified in it. Neither this
Contract, nor any terms or provisions of it, may be altered or amended in any manner, except in
writing and signed by both Parties.
6.5 Severability. If any provision of this Contract or the application of it, to any
person or situation shall to any extent be held invalid or unenforceable, the remainder of this
Contract and the application of such provisions to persons or situations other than those as to
which it shall have been held invalid or unenforceable, shall not be affected and shall continue in
full force and effect, and shall be enforced to the fullest extent permitted by law.
6.6 Waiver. Unless otherwise specifically agreed in writing to the contrary: (i) the
failure of either Party at any time to require performance by the other of any provision of this
Contract shall not affect such Party's right thereafter to enforce the same; (ii)no waiver by either
Party of any default by the other shall be taken or held to be a waiver by such Party of any other
preceding or subsequent default; and (iii) no extension of time granted by either Party for the
performance of any obligations or acts by the other shall be deemed to be an extension of time
for the performance of any other obligation or act under it.
6.7 Number and Gender. Whenever the context so requires, words used in the
singular shall be construed to mean or include the plural and vice-versa, and pronouns of any
gender shall be construed to mean or include any other gender or genders.
6.8 Headings and Cross-references. The headings of this Contract are included for
convenience of reference only, and shall in no way limit or affect the meaning or interpretation
of the specific provisions in it. All cross-references to paragraphs shall mean the paragraphs in
this Contract, unless otherwise stated or clearly required by the context.
6.9 Counsel. Each Party has been represented by its own counsel in connection with
the negotiations and preparation of this Contract and, consequently, each Party waives the
application of any rule or law that would otherwise be applicable in connection with the
interpretation of it, including, but not limited to, any rule of law to the effect that any provision
of it shall be interpreted or construed against the Party which drafted its provisions.
6.10 Consent to Jurisdiction. The Parties agree that the jurisdiction for any legal action
arising out of or pertaining to this Contract, shall be the Circuit Court for the Seventeenth
Judicial Circuit in and for Broward County, Florida, or the federal District Court in the Southern
9 RESOLUTION#2014-011
District of the United States. Each Party further agrees that venue of any action to enforce this
Contract shall be in Broward County, Florida.
6.11 Successors. This Contract shall be binding upon and inure to the benefit of and be
enforceable by the Parties to it, and their respective successors and assigns.
6.12 Counterparts. This Contract may be signed in counterparts with the same effect as
if the signature on each counterpart was on the same instrument. Each of the counterparts, when
signed, shall be deemed to be one and the same instrument. A legible facsimile copy of this
Contract as executed by either Party shall be considered an original of it.
6.13 Effective Date. This Contract will be effective upon its complete execution by all
Parties to it and effective retroactive to August 1,2013.
6.14 Suspension and Debarment. The City has verified through the Excluded Parties
List System (www.epls.gov) that ASP is not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from transactions with a federal
department or agency.
IN WITNESS OF FOREGOING, the Parties have caused this Contract to be executed by their
duly authorized officers.
CITY OF DANIA BEACH,FLORIDA
ATTEST: a Florida municipal corporation
Louise Stilson, CMC Robert Baldwin, City Manager
City Clerk
Date: , 2014.
APPROVED AS TO FORM AND CORRECTNESS:
Thomas J. Ansbro
City Attorney
10 RESOLUTION#2014-011
AFTER SCHOOL PROGRAMS,INC.,
WITNESSES: a Florida non-profit corporation
Signature David Wolnek, President
PRINT Name
Signature
PRINT Name
STATE OF FLORIDA
COUNTY OF BROWARD
BEFORE me on , 2014, personally appeared David Wolnek, as President
of After Schools Program, Inc., a Florida non-profit corporation, on behalf of the corporation, who
acknowledged execution of the foregoing Contract for the use and purposes mentioned in it. Such
person is personally known to me or who produced as identification.
Signature of Notary Public
PRINTED Name of Notary Public,
State of Florida
My Commission Expires:
11 RESOLUTION#2014-011
i
Florida Department of Education
Project Award Notification
1 PROJECT RECIPIENT 2 PROJECT NUMBER
The City of Dania Beach 06E-2444A-4PCC 1
3 PROJECT/PROGRAM TITLE 4 AUTHORITY
21 st Century Community Leanring Center 84.287C 21st CCLC NCLB,Title IV,Part B
TAPS 14BO31
5 AMENDMENT INFORMATION 6 PROJECT PERIODS
Amendment Number:
Type of Amendment: Budget Period: 08/01/2013 -07/31/2014
Effective Date: Program Period: 08/01/2013 -07/31/2014
7 AUTHORIZED FUNDING 8 REIMBURSEMENT OPTION
Current Approved Budget: $265,085.00 Reimbursement with Performance
Amendment Amount:
Estimated Roll Forward:
Certified Roll Amount:
Total Project Amount: $265,085.00
9 TIMELINES
• Last date for incurring expenditures and issuing purchase orders: 07/31/2014
• Date that all obligations are to be liquidated and final disbursement reports submitted: 09/20/2014
• Last date for receipt of proposed budget and program amendments: 07/31/2014
• Refund date of unexpended funds;mail to DOE Comptroller,325 W.Gaines Street,
944 Turlington Building,Tallahassee,Florida 32399-0400:
• Date(s)for program reports:
• Last date for receipt of invoice: 07/31/2014
10 DOE CONTACTS 11 DOE FISCAL DATA
Program: Lingo,Lani Comptrollers Office
Phone: (850)245-0852 (850)245-0401 DBS: 40 90 60
Email: Lani.Ling2 fldoe.org EO: 45
Grants Management: Unit B(850)245-04% Object: 790000
12 TERMS AND SPECUL CONDITIONS
• This project and any amendments are subject to the procedures outlined in the Pmjgct Application and Amendment Procedures
for Federal and State Programs(Green Book)and the General Assurances for Participation in Federal and State Programs.
• For federal cash advance projects,monthly expenditures must be submitted to the Comptrollers Office by the 20te of each month
for the preceding month's disbursements utilizing the On-Line Disbursement Reporting System.
• See page 2
13 APPROVED:
Authorized cial on behalf of Pam Stewart Date of Signing
Commissioner of Education
DOE-200
Revised 02/05
Page l of 2
i
INSTRUCTIONS
PROJECT AWARD NOTIFICATION i
1 Project Recipient: Agency,Institution or Non-Governmental entity to which the project is awarded.
2 Project Number. This is the agency number,grant number,and project code that must be used in all communication.(Projects
with multiple project numbers will have a separate DOE-200 for each project number).
3 Project Description: Title of program and/or project. TAPS#: Departmental tracking number.
4 Authority: Federal Grants-Public Law or authority and CFDA number. State Grants-Appropriation Line Item Number and/or
applicable statute and state identifier number.
5 Amendment Information:Amendment number(consecutively numbered),type(programmatic,budgeting,time extension or
others)in accordance with the Project Application and Amendment Procedures for Federal and State Pmgo=(Green Book),and
effective date.
6 Project Periods:The periods for which the project budget and program are in effect.
7 Authorized Funding:Current Approved Project(total dollars available prior to any amendments);Amendment Amount(total
amount of increase or decrease in project funding);Estimated Roll Forward(roll forward funds which have been estimated into
this project);and Total Project Amount(total dollars awarded for this project).
8 Reimbursement Options:
Federal Cash Advance—On-Line Reporting required monthly to record expenditures.
Advance Payment—Upon receipt of the Project Award Notification,up to 25%of the total award may be advanced for the first
paymentperiod. To receive subsequent payments,.90%of previous expendittires must be documented mid approved
by the Department.
Quarterly Advance to Public Entity—For quarterly advances of non-federal funding to state agencies and LEAs made in
accordance within the authority of the General Appropriations Act.Expenditures must be documented and reported to
DOE at the end of the project period.If audited,the recipient must have expenditure detail documentation supporting
the requested advances.
Reimbursement of Expenditures—Payment made upon submission of documented allowable expenditures.
Reimbursement with Performance-Payment made upon submission of documented allowable expenditures,plus
documentation of completion of specified performance objectives.
9 Timelines: Date requirements for financial and program reporting/requests to the Department of Education.
10 DOE Contacts: Program contact for program issues,Grams Management Unit for processing issues,and Comptroller's Office
number for payment information.
11 DOE Fiscal Data: A unique payment number assigned by the Department of Education.
12 Terms and Special Conditions: Listed items apply to this project.(Additional space provided on Page 2 of 2 if needed.)
13 Approved: Approval signature from the Florida Department of Education and the date signature was affixed.
Terms and Special Conditions continued
"To ensure compliance with the Florida Department of Financial Services,Comptroller/Chief Financial Officer Memoranda Number(s)
CFOM#01 &02,2012-2013 the department will initiate amendments for project products and services as necessary. Please contact Lani
Lingo 850-245-0852,Lani.Lingo(a f1doe.org.^
Reauired Deliverables
All agencies are required to upload all deliverables and evidence of activities as required to the 21"CCLC website
(b=://www.fldoe.org/curriculum/2Icent=)for submission to the FDOE by the 15 of each month.
Financial Conseauences
The Florida Department of Education's 21"CCLC Program Office shall periodically review the progress made on the activities and
deliverables listed in the Project Deliverable and Invoice Form.If the applicant fails to meet and comply with the activities/deliverables
(example:daily attendance numbers,amount of days and time of operation,required reporting,required submission of deliverables,
proposed activities and/or proposed goalslobjectives)established in the approved application,or to make appropriate progress on the
activities and/or towards the deliverables,and they are not resolved within two weeks of notification,the 21"CCLC Program Office may
approve a reduced payment,or request the applicant redo and resubmit the work,or terminate the project altogether.
Subsequent award years
Subsequent award years will be contingent upon the following:(1)availability of funding from the USED;(2)satisfactory performance
by the sub-grantee as evaluated by the FDOE and as indicated in the approved application;(3)submission of an annual re-application
through the Request for Application(RFA)process and other required submission such as Evaluation Reports and Performance
Information Collection System(PPICS)reporting,other required reporting and deliverables;(4)compliance with all grant requirements
and conditions set forth within the most current RFP/RFA;and(5)if applicable,child care facility licensure requirements by the Florida
Department of Children and Families(DCF).
DOE-200
Revised 02/05
Page 2 of 2
TAM Number
FLORIDA DEPARTMENT OF EDUCATION
PROJECT APPLICATION da 3
Please return to: A)Program Name: DOE USE ONLY
N
Florida Department of Education Date Received -�-
<; _
Office of Grants Management 2013-14 21"Century Community Learning c_ -�-
Room 332 Turlington Building Centers(CCLC)
325 West Gaines street Request for Application(RFA)
Tallahassee,Florida 32399-0400 ;?'� cy" _
Telephone: (950)245-0496 = -
B)Name and Address of Eligible Applimut: Project Numb-6-(DOE ggned),
City of Dania Beach Oa-244WA-4PCtl
100 W.Dania Beach Blvd
Dania Beach,Florida 33004
C) Total Fonds Requested: D)
Applicant Contact Information
$265,085
Coact Name: Mailing Address:
Robert gak1w1e 100 W.Dania Beech Blvd
Dania Beach,Florida 33004
DOE USE ONLY Telephone Number: SunCom Number.
Total Approved Project: (954)924-6800
$.1OS/085'.Qo Fax Number: E-mail Address:
(954)921-2604 rbaldwin@cLdania-beacULus
CERTIFICATION
11 Robert Baldwin (Please Type Name) do hereby certify that all facts, figures, and
representations made in this application are true, correct, and consistent with the statement of general assurances and specific
programmatic assurances for this project. Furthermore, all applicable statutes, regulations, and procedures; administrative and
programmatic requirements; and procedures for fiscal control and maintenance of records will be implemented to ensure proper
accountability for the expenditure of fiords on this project. All records necessary to substantiate these requirements will be
available for review by appropriate state and federal staff. I further certify that all expenditures will be obligated on or after the
effective date and prior to the termination date of the project. Disbursements will be reported only as appropriate to this project,
and will not be used for matching fiords on this or any special project,where prohibited.
Further, I understand that it is the responsibility of the agency head to obtain from its governing body the authorization for the
submission of this application.
f
tos
E) 14
ignature of Agency Head 5t`
DOE 100A
Revised January 2013 Page 1 of 2 Dr.Tony Bennett,Commissioner
AlW-v
s , FLORIDA
Office of the Mayor and Commission of the City of Dania Beach
August 5, 2013
Florida Department of Education
Office of Grants Management
Room 332 Turlington Building
325 West Gaines Street
Tallahassee, Florida 32399-0400
To Whom It May Concern:
This letter authorizes Robert Baldwin, the City Manager of the City of Dania
Beach, to act as the Agency Head on my behalf, as it relates to the 218t CCLC
grant program Time for Kids ( project# 06E-2444A-4PCC1).
Thank ou or your consideration in this matter.
Sin rel ,
W er B. Duke, III
Mayor
cc: A.S.P., Inc
tom.
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"Broward's First City" Q�
100 West Dania Beach Boulevard,Dania Beach,Florida 33004 • Phone: 954-924-6800 • www.daniabeachfi.gov
Section D
Florida Department of Education
General Assurances,Terms,and Conditions for Participation in Federal and State
Programs
Authority for Data Collection:20 USC 1232e(a)
Planned Use of Data: The requirements established in United States Code Annotated, Title 20,
Education,Chapter 31, Subchapter III, Section 1232(e), stipulate that"[e]ach local education agency
which participates in an applicable program under which federal funds are made available to such
agency through a state agency shall submit, to such an agency, a general application containing the
assurances set forth in subsection [1232e](b)." The application shall cover the participation by the
local education agency and all -other--organizations -participating in state and federal programs
administered by the Florida Department of Education. These assurances are set forth below in the
"General Assurances"section.
Instructions: These general assurances will be in effect for the duration of the project it covers. The
state agencies or boards administering the projects covered by the application shall not require the
submission or amendment of such an application unless required by changes in federal or state law,
or by other significant change in the circumstances affecting an assurance in such application. The
superintendent,agency head,or other authorized officer must sign the certification and return it to the
following address. No payment for project/grant awards will be made by this agency without a
current signed General Assurances form on file. For further information, contact the Florida
Department of Education,Bureau of the Comptroller, at(850)245-0401.
Certification:
I, the undersigned authorized official for the named agency/organization of the State of Florida,
hereby apply for participation in federally funded and/or state-funded education programs on behalf
of the named agency/organization below. I certify that the agency will adhere to and comply with the
General Assurances and all requirements outlined in the "Project Application and Amendment
Procedures for Federal and State Programs"(Green Book).
City of Dania Beach 06E Robert Baldwin,City Manager
Typed Agency Name Agency Number Typed Name and Tide of Authorized Official
(may Head)
I certify that the agency will adhere to each of the assurances contained in this set of General
Assurances, Terms, and Conditions for Participation in Federal and State Programs as applicable to
the project(s)for which this agency is responsible.
July 25, 2013 (954)924-6800
Si a(must be original) Date Area Codefrelephone Number
Florida Department of Education—2013 D-2
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Scope of Serhrfce:
The City of Dania Beach in joint partnership with After School Programs, Inc. is requesting
funding to continue the Time 4 Kids 21"CCLC program at Collins Elementary school located in
the high poverty city of Dania Beach. The Time 4 Kids Program 219t CCLC program initially
received funding through The Turnaround Dania Beach organimtion in 2003. In 2006, the City
of Dania Beach became the program's fiscal agent who then hired After School Programs, Inc.
(ASP)to operate the program based on its successful history of administering educational grant
funded programs and improving student achievement. Under ASP's supervision, the Time 4
Kids program has received excellent scores with minimal growth edges on state evaluation
visits, met or exceeded the program's average daily attendance goals and has submitted all
required data and documents on time.
The Time for Kids program targets 80 students, grades Pre-K-5 aftersdhool and 100 students
during the summer program. Collins Elementary' s school grade dropped from an "A'to a"B' in
the 2012/2013 school year with almost half of the students (47%) not demonstrating proficiency
in reading. The number of students who showed mastery in math (68%) and writing (97%)was
considerably higher. However, only 20% of the students showed proficiency in science
indicating a high need for STEM focused activities and academic enrichment designed to boost
student achievement in the 21"CCLC program.
The afterschool program will operate Monday through Friday between the hours of 2:00 p.m.
and 6:00 p.m. 21"CCLC program services will also be offered on all teacher planning days and
2 days during winter break since both The City of Dania Beach and the Broward County School
district have dosed their facilities on certain days due to fiscal hardship. The summer program
will operate Monday through Friday between the hours of 7:30 a.m. and 6:00 p.m. for 8 weeks.
On Fridays, the program will operate at CW Thomas Park,which is located next to the school.
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The Time 4 [Kids program will continue to offer students at Collies Elementary a wide variety of
project based learning activities that provide opportunities for academic enrichment to help
students meet state and local standards in core academic subjects; offer students a wide variety
of additional services and programs such as physical fitness, health, nutrition, visual and
performing arts, character education, service looming and S.T.E.M activities (Spence,
Technology, Engineering and Math) that are designed to reinforce and complement the regular
academic program of participating students and offer opportunities for literacy and related
educational development to families of students enrolled in the 21at CCLC program.
The Time 4 Kids staff includes a Program Director who is responsible for daily operations,
Certified FDOE teachers and enrichment instructors. ASP's Director of Grant Administration will
continue to work closely with the Assistant City Manager of Dania Beach and city personnel to
ensure that all grant requirements are being met.
Project based looming activities are provided to all Time 4 Kids students for a minimum of 90
minutes per day. Thirty minutes of homework assistance will also be provided daily. To
promote positive youth development the program also provides: STEM (Science, Technology,
Engineering and Math) activities, physical fitness, nutrition, health, visual and performing arts,
drug and violence prevention, and service looming. Project objectives include: 1) Improved
academic achievement in the core subject area such as reading,writing, math and science 2)
Promote positive youth development to help enhance motivation, dedication and academic
performance and 3) enhance parenting skills and literacy to promote family involvement and
enhance parenting skills..
ASP and The City of Dania Beach has used the full school facility at Collins Elementary since
2003. School facilities used by the program include age appropriate classrooms, computer lab,
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media center, cafeteria, playgrounds and outdoor fields. This program is insured and licensed
as required by Broward County Child Care Ucensing and Enforcement.
Principles of E/lecd mess: In the 2012/2013 school year, ASP and the City of Dania Beach
partnered with the Center for Assessment, Strategic Planning, Evaluation and Research
(GASPER) to provide on-going evaluation of its 211 CCLC programs. GASPER conducts
formative evaluations at least twice annually (mid-year and summer) with additional interim
evaluation completed after on-site visits. Summative evaluations will be conducted annually.
The Formative Evaluation conducted in February 2013 provided several recommendations for
enhanclog and refining the Time 4 Kids Program and include: 1)Implement Weekend/Holiday
Programming —ASP is working with the City of Dania Beach and the Broward County School
District to provide services on the holidays proposed in our initial application. As Broward
schools and The City of Dania Beach continue to struggle with tight budgets—providing holiday
programming continues to be a challenge. As a result it may become necessary to adjcust the
original application 2) Increase Student Enrollment and Attendance — Initially a concern in
Febnuary's Formative Evaluation, the program is now exceeding its goal of average daily
attendance (80) by nearly 10% (86). 3) The Time 4 Kids Program has also implemented
Student and Parent Satisfaction Surveys and Teacher Surveys of Academic Progress. All
surveys have been turned into the FDOE. 4) Collect Data for Baseline and Continuous
Improvement — Unit based assessments have been implemented for science and math as
recommended. Assessments have also been implemented for physical fitness, nutrition and
health, service learning and dedication and commitment to education. 5) CASPER helped ASP
establish an electronic database for all student assessments and attendance to facilitate data
collection and reporting.6) Parent involvement & Education Activities were implemented and
Included adult GED and technology classes, a Family Literacy Night, Talent Show, Student
Showcase featuring projects such as solar systems, rock gardens and volcanos.
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The recommendations provided by CASPER will help guide the City of Dania Beach and ASP in
enhancing the program and furthering progress towards stated goals and objectives.
3)Pn#ect Fees:
The City of Dania Beach and After School Programs, Inc. will not charge any fees associated
with participation in the 21't CCLC program at Collins Elementary for the 2013-2014 school
yam-
4) Student Safetw.
The safety of the students and families participating in the 21"CCLC program is of the highest
priority to ASP and The City of Dana Beach. ASP's Human Resource Department is dedicated
to hiring qualified and experienced afterschool personnel. Prospective applicants must complete
an application with references and a drug screening, Applicants selected for employment must
comply with all the requirements of Sections 1012.32 Florida Statutes, The Jessica Lunsford
Ad, and school district policies. All ASP personnel and contracted vendors must successfully
complete a Level 2 FBI background screening prior to employment. All staff members must
obtain and visibly wear an easily readable School District photo Identification badge at all times
when on school district property. All staff hired for the 21' CCLC program will have verified
qualifications to provide the activities for which they are hired. Program teachers will have active
and valid teaching certificates from the FDOE. AN personal enrichment instructors must be
experienced youth development workers and/or demonstrate a high level of expertise in the
enrichment activity provided (e.g., artist, dancer, and engineer). The teacher to student ratio will
be approximately 1:15, but will not exceed 1:20(FAN Standards).When possible, a teacher and
enrichment instructor will be paired to enhance safety and provide more Individualized
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programming. Coordinators will establish, review and maintain safety and security procedures
and communicate with parents,program and school staff.
on- neyfy Site ASP's safety policies are continuously reviewed and are a primary
component of the ASP Operational Manual. All staff members are trained In safety procedures
including CPR and First Aid, Identifying Child Abuse and Neglect, Dispensing Medications,
Emergency Procedures, and Crisis Management. Following school dismissal, students are
escorted to the cafeteria or assigned classroom where attendance Is taken by staff members.
Parent/Guardians are notified immediately of any unexplained absences. ASP adheres to the
following safety procedures for student dismissal: 1) all students must be picked up by an
authorized adult designated by the parent/guardlan; 2) the adult signs the dismissal log; 3)the
adult must present photo identification to be compared to copy on file;4) no student is permitted
to walk/bike home. . Off-site activities will be staffed by a minimum one staff to 10 students,with
all chaperones being 21" CCLC staff. ASP has provided safe and enriching field trips to
thousands of Florida students for the past 20 years. The following procedures are implemented
by ASP personnel both on site and during off-site field trips: 1) no student is ever left alone; 2)
buddy system is always in effect; 3) regular head counts (verbal and documented); 4) radio
communication to track student movement; 5) drinking water always available; and 6) public
bathrooms pre-checked and one staff member present for every four children
Sale Trwmwrtation:The 21"CCLC program is located in Collins Elementary school -a pubic
school facility which is conveniently located and easily accessible to all families. Transportation
to the site is not necessary. Parents/Authorized Adults will be responsible for transportation
home.Due to the lack of crossing guards after the 21'i CCLC program, no child will be permitted
to walk or ride their We home. Buses provided for educational field trips will meet all school
district and local requirements. Parents will receive trip notices several weeks in advance and
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be required to sign a permission slip, 21" CCLC staff will bring each student's emergency
information on the trip. Prior to each trip, 21"CCLC staff will review off site and bus rules. Staff
will be positioned in the front, middle and back of the bus
Proawn Locations: The 21" CCLC program will be located in Collins Elementary School
which Is safe, familliar and easily acoessible for children and parents. The program is licensed
as required by Broward County Child Care Licensing and Enforcement and is fully insured per
Broward School District requirements. Collins Elementary meets all state and local health and
safety ordinances, is handicap-accessible, and complies with the American with Disabilities Act
(ADA). The facilities are maintained by the school district and undergo annual safety
inspections. This school was designed to accommodate more than 500 students, such that
there is ample space for the proposed total of 21"CCLC students. The principal wNI continue to
allow the 21" CCLC program to use the entire school facility (at no cost), including the
cafeteria, age-appropriate classrooms, computer lab, media center, and outdoor grounds and
fields
5. Academic and Personal Enrichment
Goal 1: Improve Academic Achievement and UnderstarWng in Core Academic Subjects
• Objective 1.1) 75% of actively participating 21" CCLC students (attending at least 30
days will improve reading comprehension skills, as demonstrated by such measures as
FCAT 2.0, report card grades and formative measures such as Florida Assessment for
instruction *in Reading (FAI.R.) district assessments, ore pre-post assessments
Objective 1.2) 75% of actively participating 21"CCLC students will improve in reading
fluency and `reading with expression" skills as demonstrated by such measures as
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standardized test scores, report card grades, Florida Assessment for Instruction in
Reading(F.A.I.R.)),district assessments,or pre-post assessments
• Objective 1.3) 75% of actively participating 21'r CCLC students will show improved
math skills as demonstrated by such mosscres as MAT 2.0 standardized test scores,
report card grades, and program assessments
• Objective 1.4) 75% of actively participating 21" CCLC students will show improved
achievemerd-and/or interest in science, as demonstrated by such measures as standardzed
test scores,diagnostic assessor- ,t 5, report card grades,or program assessments
• Goal 2: Promote Positive Youth Devsiopmatt by providing a wide variety of additional
programs,activities and services
Objective Z9) 75% of actively participating 21't CCLC students will improve their physical
fitness levels and knowledge of nutrition, as demonstrated by such measures as the health
assessmet and/or pre-post assessments.
Objective 12)75%of actively participating 21"CCLC students will improve social skins and
school dedication, as demonstrated by such measures such as pre-post-tests, teach
surveys of progress, student surveys, and/or Report Card grades
Objective 2.3) 75% of actively participating 21"CCLC studenrts will show improvement in
study sktlis and positive academic behaviors, as demonstrated by such measures as report
card grades,teacher surveys, parent surveys, and/or student surveys
Objective 14) 75% of actively participating 21" CCLC students will evidence Increased
dedication to their communities and service,as demonstrated by such measures as specific
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pre-post knowledge assessments, engagement in service learning activities, and/or student
surveys on community commitment.
MeeBna ShKhm Needs:Through on-going collaboration and communication with ASP, The
City of Dania Beach and the Principal of Collins Elementary — the Time 4 Kids program will
continue to address student needs, while correlating directly to the FDOE Funding priorities.All
project-based learning plans are aligned to the academic needs established through the needs
assessment and correlates directly to Common Core Standards.All activities are designed to be
high-interest, Integrate reading, writing, math and science, and created for students who are not
achieving proficiency and failing behind their peers. Instruction will be differentiated to meet
individual need, with 30 minutes of homework assistance provided daily. Service Learning,
Character Eduction, Visual and Performing Arts, and Physical Fitness will be provided
throughout the program to promote positive youth achievement.
Protect Based LearMna Plans:Project-Based Learning Plans for each school were designed
to meet the academic and personal needs of the communities and engage students. They were
developed collaboratively by school and program staff to provide 90 minutes each day of
academically focused project-based Warning activities, delivered by FDOE certified. To ensure
quality and indWualized attention, the program ratio will be 15 students to 1 teacher.
Enrichment instructors will assist the teachers during project-based activities. in Appendix B of
the application, ASP has included four Project Based Learning Plans, though over 10 have
already been created for use in the project over the next year. The Wngth of time for project
components will be increased equitably for the summer program.
Aaademlc Proararnmina: All of the project-based seaming plans (as shown in the four plans
provided) are closely aligned to the Common Core Standards, Next Generation Sunshine State
Standards. and District Pacing Guides. STEM ages are integrated throughout the projects.
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Certified Teachers are fundamental to the design and implementation of all academic and
personal components of the project plans. They ensure that core academic content, proper
academic remediation, and sufficient assistance are integrated Into each project, each day.
They understand how critical the homework assistance and/or small group tutoring is to
ensuring that student's master the underlying skills necessary to gain proficiency in state and
local standards and to meet the 218c CCLC program goals and objectives.
Sams Acadwnkr-/nlusad Prof (Summarized due to Space): 1) Japanese Cuf u e- In
this project based activity studerft will learn the difference between ancient and modem
Japanese culture and integrates reading, language arts, civics and technology. Students will be
divided into small groups based on their interests (mistoms, clothing, customs, business and
products) and create a project. Students will loam how to research their projects using a project
outline, collect pictures and create visuals to be used in their preserrtations. A Japanese
Cultural Night for Families will be scheduled featuring students projects and food and music and
dress from ancient and modem Japanese Cultures. 2) CreadW & IHus&vd g Books -
Student's will write and illustrate their own books to present to other students and their families
during a Family Literacy Evening. This project based activity will teach students about the
various forms of literature (e.g. -fiction, non-fiction, knfonnationaq the mechanics of writing,
Hktstraft a story, writing and editing, assembling the book and about the publishing process.
Students will also be involved in the planning of the Family Literacy Night. A Meet the Author
Event will also be scheduled. 3) Now&etctr Club — Students will begin this project based
learning activity by reading and researching a variety of news services including newspapers,
television and on-line. They will also review and critique all the available news sources. All
students will be divided into small project based learning workgroups to ensure full engagement
and participation. Each group will brainstorm article idea and assign a team of writers for each
topic. Students will also be involved in gathering information and visuals for their articles.
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Student will work cooperatively to draft articles, align the layout and prepare for print Adult
family members will receive the newsletter monthly 4) World Wide STEM Expioradon- This
project based learning activity is a comprehensive science, math and language arts project that
offers students a solid foundation in science concepts, inquiry-based discussion and exploration
and hands-on investigation that encourage learning and concept retention. Students will be
placed in groups according to science levels (based on pre-assessment scores) students will
develop a driving question about one of the following topics: Environment, Weather, Rocks,
Habitats, Life Cycles, Simple Machines, Combining Matter and Light. Projects -will rotate
through an 8 week timeline and include oral reporting presentations with visual aids, journals,
reports and scrapbooks. All projects will be engaging and inquiry- based, integrate reading,
language arts, math, and sconce and utilize technology to research various topics. Families will
be invited to participate in a Family Science Night
Enrkhmmnt Prcorammkw:Personal enrichment includes a broad variety of activities designed to
be appealing and gain a high percentage of participation. Each proposed personal enrichment
actively reinforces the proposed project-based learning activities and assists targeted `at-risk'
students to meet state and local standards. AD acfiVfm are research-based and rooted in best
practices from the Florida After School Alliance, US Department of Education and the C.S. Mott
foundation. Youth development professionals or volunteers with documented experience will
instruct the students during these enrichment sessions.
Service Learning: Through service learning students use what they learn in the classroom to
solve real-life problems. All 21't CCLC students will participate in at least two service learning
projects during the school year and one during the summer. Activities will integrate reading,
writing, math, science, art and family involvement. Lesson plans from FSU Center for
Leadership and Civic Education and Learn & Serve America may be used. Through these
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21*t CCLC Project Plan
Instructions: Understanding that Project Based Learning is student-driven and that some of the
components below may develop and change with student input(e.g., Expected End Result/Product,
details of the Week by Week Timeline, Presentation Methods and Audience), complete a project plan for
each PBL activity which fully integrates academic and personal enrichment.
Each of the PBL Components outlined below are integral to running effective PBL activities and/or 21 sc
CCLC programs. Complete the column on the right of the chart for each component. (See the Sample 21't
CCLC Project Plan below.)
If awarded, the program will complete a Project Plan Implementation Update each month to document
what changes have been made as the project progressed.
Project#1
PBL Component Description
"'Rroject Title # apanese`Culture
Project Idea The program participants will learn about the basic aspects that make
(Discuss the reason behind choosing this up both modern and ancient Japan through research in groups or
issue/question as a beginning point for i pairs.
inquiry.)
Driving 0tuesllion What are the major differences between ancient Japan and modern
(Open ended;employs higher order .japan?
.thinking skills,evokes:curiosity)
Grant Objectives Addressed 75%of regularly attending students will improve reading
comprehension skills as demonstrated by report card grades,
FAIR and FCAT scores.
• 75%of regularly attending students will improve in reading
fluency and "reading with expression"skills as demonstrated
by FCAT and FAIR scores and an interim assessment.
• 75%of regularly attending students will show improvements in
study skills and positive academic behavior as demonstrated
by pre/post tests and/or student surveys.
Academic`Subjects Technology, Social Studies, Language Arts
Common Core State Standards Research Process:The student uses a systematic process for the
to Address collection, processing, and presentation of information. (LA.4.6.2)
(Write out the Domain and Cluster,then (LA.5.6.2)(LA.2.3.7)(LA.3.3.7)(LA.K.L.3.4)
include the numbers of individual Social Studies: Historical inquiry and analysis(SS.4.A.1)(SS.5.A.1)
standards that will be explicitly (LA.2.4.10)(LA.3.4.10)
taughtireinforced by the project.) Technoloav:The student develops the essential technology skills for
using and understanding conventional and current tools, materials,
and processes.(LA.4.6.4)(LA.5.6.4)(LA.3.2.6)
Informative:The student develops and demonstrates expository
writing that provides information related to real world tasks. (LA.4.4.2)
(LA.5.4.2)(LA.K.3.7)(LA.1.2.5)(LA.3.4.1)
Personal Enrichment Categories , 75%of actively participating students will improve social skills
and school dedication as demonstrated by measures such as
pre/post ttests, teacher and student surveys.
• This project will incorporate PATHS curriculum to facilitate
character building,self-expression and problem solving. Final
project will be presented at event recognizing student's
i positive character traits and contributions.
21 Century Skills to be taught • Collaboration(working in groups as designers,engineers,
(Collaboration,Communication,Critical craftsmen)
Thinking/Problem Solving) • Critical Thinking/Problem Solving(groups will have to
overcome challenges in design and development, as well as
Identify and describe how these will be budgetary"hiccups"they will have to overcome.)
utilized. Communication:Teams will have to report back to each other
• at least twice a week to keep progress moving forward on the
main project.
Expected.Duration-of Project 'October 7t"-;November 11" _
Students Involved (#,grades) Grades K-5
Staff-involved(#;specialties) ` One Teacher and One Counselor for each_grade
Frequency of Project 90 minutes per day-, 5 days a week
(#of days/week
#of hours/day)
i
entry Everrt -- - -= -,�IMhy does Japan`iiave some-customs-that`the:United-States-does-not
`(Designed to engage students',attention) . have?.How does their clothing dtf.w.from Westem clothing?
Week by Week Timeline of Key 1 Week 1:Students will be divided into groups based off similar interests
Tasks and Activities, as well as in topic to research. (i.e.,Japanese plants,attire,customs,etc.)
Enrichment Topics/Lessons Groups will brainstorm and come up with a project idea. Once
(Add as many weeks as necessary approved by a teacher, students will be given information on a project
through the duration of the project.) outline.
Week 2:Students will research their topic of focus.They will collect
pictures and information,and will be taught how to site their research.
Week 3: Students will continue their research,following the
instructions of the outline.
Week 4: Using a variety of tools, students will create a rough draft of
their project.
Week 5:Students will finalize their projects.
Week 6:Students present their projects to the teachers, parents, and
fellow classmates.
Presentation Methods and ;"Participants vAH present their group or paired projects to the students
Audience and supervisors.Parents will be invited.
Expected End Result/Product Students will use visual aid to present what they have learned and
acquired through research.
Connection(s).to;Regular School Technology,Social studies, Language Arts
Day
Adult Family Member Literacy Family members will be invited to view the final presentations and read
and Involvement over their child's research.
Educational Research that supports ; Japanese Culture.(md:)-Retrieved from:
the.prajed• 'htto:t/www.insideiaoantours:comraaanese-culture?
Kids Web Japan.(n.d.)Retrieved from:
Please atte.the-source and providea short j htto//web:japan.orci/kidsweb7explore/basic/
description of its relevance.
Project #2
PBL Component Description
Project'title i How to create,illustrate a:book
Project Idea Students will write/create a story and book with illustrations,present to
(Discuss the reason behind choosing this grates(friends and family members)during a literacy night event
issue/question as a beginning point for fOr adult family members
inquiry.)
Driving Question What book would you create if you wanted to tell a story to
(open ended;employs:higher order, Your famil . friends.'and community?
thinking skills.evokes curiosity)
Grant Objectives Addressed
1.1 75%of regularly participating 21 s`CCLC students(attending at
least 30 days)will demonstrate inaeased reading proficiency
1.2)800/6 of regularly participating 21e CCLC shidents will demonstrate
improvement in writing skills based on common core standards.
Academic Subjects 'Leading,Writing,:Lartlguage Arts,and'Soaal Studies
Common Core State Standards
to Address Common Core Standards Addressed:
(write out the Domain and Cluster,and L.K.R1.2.5, L.K.RI.2.5.6, L.K.RI.2.5.7, L.1.SL.2.4.
then include the numbers of individual L.131-.2.5, L.2.SL.2.4, L.2.W.1.2, L.3.1f, L.3.3a, L.4.1f,
standards that will be explicitly L.4.1 g, 1-4.3a, L.4.3b, L.5.1 d, L.5.2a, L.6.1 c, L.6.1 d, L.6.1 e,
taught(reinforced by the project.)
L.6.2a, 1-6.3a, L.6.3b, L.7.1 c, L.7.3a, L.8.1 d; SS.K.A.1.1,
SS.K.A.2.4, SSA.A.1.2, AA.2.A.1.1, SS. 3.A.1.2,
VA.K.C.1.1., VA.K.C.1.1, VA.K.F.3.1, VA 1.C.1.1,
VA.1.F.3.1,VA.2.C.1.1,VA.3.C.1.1, VA.4.C.1.1,
VA.4.C.2.2, VA.5.17.1.1,VA.5.F.2.1
Personal Enrichment-Categories Arts and music educational activities
21' Century Skills to be taught
(Collaboration,Communication,Critical 11. Positive Attitude-Agility and adaptability
Thinking/Problem Solving) 12. Citizenship- Collaboration across networks & leading by
Identify and describe how these will be influence
utilized. 13. Cooperation-Critical thinking&problem-solving;
Collaboration across networks&leading by influence;
Curiosity and imagination
14. Responsibility - Initiative and entrrepreneurialism; Aocessing
and analyzing information
15. Respect-Critical thinking&problem-solving;Collaboration
across networks&leading by influence;Effective oral and
written communication
16. Caring - Critical thinking 8 problem-solving;
Cdlaboration across networks & leading by influence;
Curiosity and imagination
17. Self-Discipline-Agility and adaptability; Initiative and
entrepreneurialism
18. Perseverance-Initiative and entrepr+eneurialism
19. Trustworthy-Collaboration across networks&leading by
infhJence
20. Integrity- Critical thinking and problem solving;
Collaboration across networks; Leading by influence 8 weeks
E> pee ted Duration of -mect B Mleeks
Students Involved(#,grades) All students will participate;students will be broken into small project-
based leaming work groups to ensure full engagement and
--- "
partcipation.
- -llh� erO-s—cyisStaffl�nV6
Frequency of Project 90 minutes 5 days a week
(#of daysMreek
#of hours/day)
lraAtrj►f ant r: Meet The AutitorEvent to allow stt,dernts to ask Ynsal authors znf
JDes'gired46-engage students`attention] .I publisher#gooks uestions about xhe nmtrng wind ibl fling
Week by Week Timeline of Key ` Week 1:The Mechanics of Writing—Vocabulary and writing
Tasks and Activities, as well as ! foundations
Enrichment Topics/Lessons Week 3: illustrating a story 101 —Working with an artist and
(Add as many weeks as necessary book illustrator to illustrate the story
through the duration of the project.) Week 4: Writing and editing the story
Week 5: Illustrating each page
Week 6: Putting it all together
Week 7: Beginning the publishing process
Week 8: Preparing and hosting the 'Literacy Night'event
fiction lAiFeitirods and' Boole readings and question.and answer session aivith the
audience a student authors
Expected End Result/Product Reading the books to classmates and parents during 'Literacy Night'
hosted for adult family members
Connecbon(s)yto Regular School Reading iA ting,and,language-arts;iessons;Wil.;e reinfioned
pay 1 throughout the pro/ect thrxtugh:<the mechanics of�witing,editing,
.,
,and hands-on jearriing opporturffts:usrng the eki!!s"taught
Adult Family Member Literacy j 'Literacy Night'hosted for adult family members, peers, staff,and
and Involvement stakeholders
;Educational,Research t m supports ;:Lintor Make A_Book
the project• http./twww.lititovpublisNng.cO.m/
125Ways.to Make a Book By Hand
Tease site the"soures and provide a short h#tn:J/meetrneatmlkes,�com/20D9/09/25ways-to-m2ikebook-by-
description of Its•reievance,
:hand/
PressBooks Publishing
httn://Dtessbooks.com/how to-make-a=book=wlthnressbooks
Project#3
i
PBL Component Description
:Project T166 Forming A'Newsletter Club
Project Idea Students will create a newsletter for their peers and the CCLC
(Discuss the reason behind choosing this program parents & staff.
issue/question as a beginning point for
inquiry.)
Drhring Question Mat Events and Activities Will Take Place at Collins Elementary
(Open ended;:employs higherorder -School's After School`'Program?
thinking skills,evokes curiosity)
Grant Objectives Addressed 1.1)750/6 of regularly participating 21 st CCLC students(attending at
least 30 days)will demonstrate increased reading proficiency
4cademic Subjects E Leading,Writing, Language Arts,and Social Studies
Common Core State Standards Common Core Standards Addressed:
to Address i L.K.L.1.2., L.K.L.3.5, L.1.L.1.1, L.1.L.1.2, L.1,RF.1.1, L.2.L.1.2,
(Write out the Domain and Cluster,and L.21.3.4, L.2.L.3.6, L.3.1f, L.3.3a, LAM, L.4.1g, L.4.3a, L.4.3b,
then include the numbers of individual L.5.1 d, L.5.2a, L.6.1 c, L.6.1 d, L.6.1 e, L.6.2a, L.6.3a, L.6.3b,
standards that will be explicitly L.7.1 c, L.7.3a, L.8.1 d, N.Q.1-3, A.REL.1-3, F.I F.1-6, G.CO.12-
taught/reuiforced by the protect.) 13, R1.1-5 and 10, W.2 and 4-7, SL.1-2 and 4-6
Personal:Enrichment Cate_godes Arts and music educational activities(not arts and crafts)
21'Century Skills to be taught Positive Attitude-Agility and adaptability
(Collaboration,Communication,Critical Citizenship-Collaboration across networks&leading by influence
Thinking/Problem Solving) t -Critical think) blerrl-so
Cooperation ng&pro Mng;Collaboration
Identify and describe how these win be across networks&leading by influence; Curiosity and
utilized. imagination
Responsibility-Initiative and entrepreneunaksm;
Acoessing and analyang information
Respect-Critical thinking&problem-solving;Collaboration
across networks&leading by influence; Effective oral and
written communication
Caring-Critical thinking&problem-solving;Collaboration across
networks&leading by influenoe;Curiosity and imagination
Self-Discipline-Agility and adaptability; Initiative and
entrepreneurialism
Perseverance-Initiative and entrepreneurialism
Trustworthy-Collaboration across networks&leading by influence
Integrity-Critical thinking and problem solving;Collaboration
across networks; Leading by influence
.Expected Duration of Project 4'WEEKS
Students Involved (#,grades) All students will participate; students will be broken into small
project-based learning work groups to ensure full engagement and
participation from k-5
Staff-Involved{#.,specialties) I Teacher 1 Enrichment Staff -
Frequency of Project 90 minutes a day 5 Days a week
(#of days/week
#of hourstday)
Entry Event Review an array of newsletters written in different styles
i
(Designed to engage students'attention)
Week by Week Timeline of Key Week 1: Brainstorm article topics;assign writers for each topic
Tasks and Activities,as well as Week 2: Gather information and artwork or pictures for the
Enrichment Topics/Lessons articles
(Add as many weeks as necessary Week 3: Draft articles, align layout, design,and prepare
through the duration of the project.) for print
Week 4: Finalize articles, print, and distribute
Presentalfron hllethods and Newsletter distributed'to peers,parents,and Afterschool program
Audience
Expected End Resulb?roduct Newsletter
Connectfon(s):toRe.ViarSchool Reading,writing;language:arts,:and English lessonswill be
psy rainforced throughout the projectthrough creative,writimg`basics,
warkstiops,editing,and hands-on learning Wporhuirtiss using tMe
skills taught
Adult Family Member Literacy Adult family members will receive newsletters monthly
and Involvement
:Educational Research#Wt supports Sun-Sentinel
the project
h :/hnrwwsun-sentinel.cont/
Please site the souroe.and provide a short Read.Wnte.Think.Creating;a Classroom Newspaper ,
; h
description fits relevance. :/twww: think.oro/c!a m-
resources/lesson- lams/creation-classroom-news apex-
249_html
Pro ect#4
PBL Component Description
!'P-roiect"Title ; WORLD WIDE EXPLORATION OF STEM
Project Idea Comprehensive science, math, and language arts modules offer
(Discuss the reason behind choosing this children a solid foundation in science concepts. Inquiry-based
issue/question as a beginning point for discussion and exploration and hands-on investigation
inquiry.) encourage leaming and concept retention.
Driving Question Students will be engaged in conversations regarding Physical,Earth
(Open ended;employs higher osier and Life:SclenOE..After being.pjaoed in groups acccording'.to science
thinking skills,;evokes curiosity)
<levels<jbasedon assessrnent`nr+e-test`soores);students will:establish
driving-questions that peak their interests in one of the categories. A
_ ZULAproject will be selected based on the student's driving
-question.
Grant Objectives Addressed 1.3)750/6 of actively participating istudents,will show improved math
skills as demonstrated by such measures as FCAT 2.0,report cards
and Pro9mm assessments.
1.4)750/6 of regularly participating 21 a CCLC students(attending at
least 30 days)will demonstrate iincreased science proficiency as
measured best scores,diagnostic and/or ram assessrneft
by �9 Prop
Academic Subjects Science
Earth Science
Math
Common Core State Standards S.ID.1-9, A.SSE.1-3, A.APR.1, A.CED.1-4, G.00.1-13,
to Address S.CP.1-9, S.MD.6 and 7, F.IF.1-9
i
(Write out the Domain and Cluster,and M.K.1.3, M.K.2.4, M.1.01.1.2, M.1.OA.3.5, M.2.MD.1.3,
then include the numbers of individual M.2.MD.1.4, M.3.0.A.4.8, M.3.0.A.4.9, M.4.OA.1.2,
standards that will be explicitly M.4.OA.1.3 and M.5.MD.3.4
taught/reinforced by the project.)
Personal Enrichment Categories A Expanded library service hours
218'Century Skills to be taught Positive Attitude-Agility and adaptability
(Collaboration,Communication,Critical C&-enghip-Collaboration across networks&leading by influence
Thinking/Problem Solving) ICooperation-Critical thinking&problem-solving;C 1aboration
Identify and describe how these will be across networks&leading by influence;Curiosity and imagination
utilized. Responsibility-Initiative and entrepreneurialism;Accessing
and analyzing information
Respect-Critical thinking&problem-solving;Collaboration
across networks&leading by influence; Effective oral and written
communication
Caring-Critical thinking&problem-solving;Collaboration across
networks&leadinginfluence and by ,Curiosity uaginaton
Self-Discipline-Agility and adaptability; Initiative and
entrepreneurialism
Perseverance-Initiative and entrepreneurialism
Trustworthy-Collaboration across networks&leading by influence
Integrity-Critical thinking and problem solving; Collaboration
across networks; Leading by influence
-Expected Duratiomof Project 8°WEEKS
Students Involved(#,grades)
STAFF K-5 GRADE
Staff lnvoived.j#,specialties) 1'TEACHER A ENRICHMENT
i
Frequency of Project 90 MINUTES A DAY 5 DAY A WEEK
(#of days/week
#of hoursiday)
-Entry Event ZULA intro CD's;'Exploring the.ZULA Patrol
(resigned to engage students'attention)
6
Week by Week Timeline of Key Projects vA rotate ttuough this 8 week cycle of activity.
Tasks and Activities, as well as
Enrichment Topics/Lessons Week 1:Read and discuss background information using guiding
(Add as many weeks as necessary questions
through the duration of the project.)
Week 2:Complete Mission activity
Week 3:Watch video and complete graphic organizer on the
scientific properties
Week 4:Review illustrations of actual properties,complete mission,
analyze or observe and doc urTw t findi
Week 5: Begin and complete "Mission Blast
Ofr Week 6: Research career connections
Week 7: Create/Pnesent,PowerPoint
Week 8: Newsletter connections
Preserrlationilethods and Varies - Ocal Reports/presentations with visual `aids,
Audience ;written reports;=scrapbooks,journals
Expected End ResuIVProduct
Actual projects completed
Connection(s)to Regular School Math: : measuring;" collecting. data, . volume, mass, weight
Day ; Language Arts Informative wrjting
Science:Collecting data,Earth and-Space, natural
:resources
Technology-Technology.newsletter,PowerPoint,research skills
Adult Family Member Literacy
and Involvement Adult family members will be invited to participate in Mission
projects.
Educational Research that supports 1 '#rttlyj)uv zula corn/
the project"
Please site the source and provide a shortf�1lUVmrlti/'TiS�.OrO�rTllddkSdiOOV
description of its reievance.
21"CCLC COST AND PRICE ANALYSIS WORKSHEET—THE PURPOSE OF THIS WORKSHEET IS
TO PROVIDE THE APPLICANT WITH GUIDANCE ON HOW TO CONDUCT COST ANALYSIS.
Pages 1 and 3 of this document should be completed and submitted,along with all required
supporting documentation.
Name of Agency City of Dania Beach, Florida
Project Number 06E-2445A-lPCC1
The following worksheet is provided to ensure that appropriate documentation is obtained to support the
proposed budget or quotation. Cost analysis must be completed for each line item. FAILURE TO
PROVIDE THIS INFORMATION WILL DELAY ISSUANCE OF THE AWARD NOTIFICATION. Simply re-
stating a budget in detail is not sufficient.
COST ANALYSIS:Agencies are required to maintain records to support a cost analysis for any
agreement. Detailed budgets are-required.to be submitted by the person or entity awarded funding in
excess of Category Two and must be reviewed by the agency. The agency must document its review of
the individual cost elements from the submitted budget for allowability, reasonableness, and necessity.
The cost analysis form to be used by the agencies begins on page 5 of this document.
Price Analysis is conducted based on one or more of the following (check those that apply)
❑ Written quotations from 3 or more vendors; fax acceptable.
0 Documented phone quotations; indicate the name of the contact person, phone number and other
pertinent information.
❑ Published price lists form 3 or more vendors;fax acceptable.
❑ Previous purchases by the agency of same or similar item(s)from this or another vendor(attach
copies of applicable quotations, bids, or purchase orders).
Previous purchases by others of same or similar item(s)from this vendor(attach copies of
applicable quotations, bids, or purchase orders).
❑ Comparison to in-house estimate(attach estimate).
Salaries/Wages: supporting documentation of the individual's actual base rate. If the proposed rate
includes an escalation factor, identify that factor and attach the subcontractor's justification for its
inclusion. Attach the subcontractor's justification for direct charging of administrative or clerical personnel.
Support documentation for salaries and wages may include copies of payroll forms or reports. If such
documentation is not available, the following certification signed by an authorized representative of the
subcontractor will be required: "The salary and wage information provided is true and correct and
represents the current and actual base rate of each individual proposed.'
Fringe Benefits:Attach supporting documentation for fringe benefits. Support documentation for fringe
benefits may include a copy of the federally-negotiated fringe benefit rate agreement or a copy of the
published rates. If such documentation is not available,the following certification signed by an authorized
representative of the subcontractor will be required: "The fringe benefit information provided is true and
correct and represents the current and actual fringe benefits of each individual proposed."
Procurement Services(Contracts): In accordance with Florida statutes and federal regulations,
applicants must comply with the state and their agency procurement requirements. Applicants must
ensure that the vendor(e.g., contractor, consultant) is not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from transactions with a federal department or
1
agency.Verification may be accomplished through the Excluded Parties List System and one or both of
the following: (1)collecting a certification from the vendor, or(2)adding a clause or condition to the
contract with the vendor. See the Expenditure Guidance
hftr)://www.mvfioridacfo.com/aadir/reference -guide
See page 4445
Additional information regarding financial responsibilities:
Excluded Parties List System:www.epls.aov
Reference Guide for State Expenditures:http.lAvww.Wis.corn/aadir/
Florida Statutes:http:llvvww.lea.state.19.us
Florida Administrative Code:http:/Avww.flru/es.ora
Travel: For each trip,provide the cost elements proposed for air fare, hotel, per diem, etc., as well as the
purpose of the trip. Attach supporting documentation. Support documentation for travel costs may include
a copy of the subcontractor's current travel policy and procedures or a statement signed by an authorized
representative that states that the costs or rates proposed for travel do not exceed current State of Florida
Travel Regulations—See tWExpenditure Guidance..htto:/Iww-w.mvfloridarfo.com/aadir/reference guide
Materials and Supplies:Attach supporting documentation for items with unit costs of$500 or more.
Attach justification for direct charging items such as office supplies, postage, local telephone costs, and
memberships,which are normally treated as indirect costs. Support documentation for materials and
supplies with unit costs exceeding$500 may include copies of published catalog prices or copies of
previous expense vouchers.
Equipment: Equipment means an article of nonexpendable,tangible personal property having useful life
of more than two years and an acquisition cost that equals or exceeds$1,000.Attach supporting
documentation for each item. Support documentation for equipment may include copies of published
catalog prices or copies of previous expense vouchers.
Other Direct Costs: Examples are computing services or time, communications, student fees, etc. Attach
supporting documentation for rates and costs used. Verify the need, and attach a justification for direct
charging an item, if necessary.
Administrative Cost: Attach a copy of the subcontractor's federally-negotiated indirect cost rate
agreement. Support documentation for indirect costs is the federally-negotiated indirect cost rate
agreement. If the subcontractor does not have a rate agreement, (1)sufficient information should be
attached indicating how the rate used was determined and (2) if the rate was accepted and paid
previously by either a federal agency or agency of the State of Florida, documentation to that affect
j should be provided
2
I
COST ANALYSIS FORM
Line Item Total % Allocated to
Budget Category Amount this Agreement Allowable Reasonable Necessary
Salaries/Wages $188,437 100% yes yes yes
Fringe Benefits $18,399 100% yes yes yes i
Procurement $19,500 100% yes yes yes
Services
Contracts
Travel $3,138 100% yes yes yes
Materials and S i 4,$S`6 19w/o yes- yes— yes
Supplies .. .
Equipment
0 N/A i N/A N/A N/A
Other Direct Costs $20,725 100% yes yes yes
Indirect cost '1�d6 l4�lk COO )TWA yA* NtA MIA r—
Administrative 0 N/A N/A N/A N/A
TOTAL $265,085 100% Yes Yes yes
CERTIFICATION
I certify that the cost for each line item budget category has been evaluated and determined to be
allowable,reasonable, and necessary as required by Section 216.3475, Florida Statutes.
Documentation is on file evidencing the methodology used and the conclusions reached.
Robert Baldwin
Nam
ignature
City Manager
Title
City of Dania Beach
Agency
06E-2445A-1 PCC 1
Project Number
August 23, 2013
Date
3
COST ANALYSIS INSTRUCTIONS
1. Agencies must complete a cost analysis worksheet for the original contract and any
amendment that affects the amount of compensation and/or the level of services
provided.
2. Each separate line item must be evaluated to determine whether the cost is allowable,
reasonable and necessary. Each miscellaneous cost must be specifically identified.
3. To be allocated to a program, a cost must be related to the services provided. If the cost
benefits more than one program, a determination must be made that the cost is distributed
in a reasonable and consistent manner across all benefiting programs.
4. To be allowable, a cost must be allowable pursuant to state and federal expenditure laws,
rules and regulations and authorized by the agreement between the state and the provider.
5. To_be reasonable,a cost must be evaluated to determine that the amount does not exceed
what a prudent person would incur given the specific circumstances.
6. To be necessary, a cost must be essential to the successful completion of the program.
7. Indirect costs/overhead should be evaluated to determine that the rate is reasonable.
8. Agencies must retain documentation in agency files to support the conclusions reached as
shown on the Cost Analysis form.
4
The City of Dania Beach
216'CCLC Request For Application(2013-2014)
General Education Provisions Act (GEPA)
After School Programs,Inc.,(ASP)serves an academically,culturally,socio-economically,and racially
diverse population and is committed to equal access and treatment for all students, employees, and the general
public. ASP's nondiscrimination policies guide and govern decision-making at all levels for students and
employees. No individual will be excluded from participation in the 21'CCLC Program on any basis, including
gender,race,national origin,color,disability,sexual orientation,and age.
The proposed 21 Century Community Learning Centers (CCLC) program will provide equal
opportunities for participation among all program beneficiaries in the targeted schools. To increase awareness of
the opportunities for all beneficiaries of the program,project management will actively promote awareness of the
project and the benefits of participation, distribute project communications in all appropriate languages, and
obtain feedback through surveys and informal interviews. Data will be monitored to gauge the project's
effectiveness in reaching underrepresented groups, and steps will be taken, if necessary, to maximize
participation. ASP has successfully provided out of school time programs to thousands of students with varying
exceptionalities in an inclusive educational setting since 1993. To ensure that "best practices" for inclusion are
being implemented in ASP programs, ASP adheres to all school district policies and uses the following
procedures: Upon enrollment of a special needs child, a conference is scheduled at the school. The goal of this
meeting is to review the child's Individual Education Plan(IEP)to ensure that the child's needs are being met in
the least restrictive environment and to support the child's academic,physical and social growth. Obtaining input
and strategies from all stakeholders is critical to understanding the child's special needs and creating a positive,
beneficial and successful out of school time experience.
In accordance with the Americans with Disabilities Act, school sites and other selected professional
development venues will provide reasonable accommodations so that the2lst CCLC program is fully accessible
to those with disabilities. Accommodations will be made as needed to meet the needs of individuals with
disabilities. All facilities used for 21'CCLC programming are fully accessible to individuals with special needs
and disabilities,in accordance with school district policies governing said facilities.
Well trained staff is also critical to the success of an inclusion program. Staff members are specially
selected who have had prior experience working with special needs children and show willingness, sensitivity and
understanding. State mandated training and professional development workshops are also required. "Best practice"
recognizes that children with special needs attending an inclusion program may require more adult supervision and
staff our program lower as needed. Accommodations may be made to the curriculum, activities,material and/or to
the physical learning environment to address the special needs of children in the areas of hearing, speech/language,
visual, intellectual, physical/motor, adaptive, self-help, health, safety and nutrition. ASP has found the following
"best practice"used in all of our programs to also be the keys to a successful inclusion program: 1)Students need to
be active not passive learners;2)encouraging children to snake choices as often as possible,3)parental involvement,
4)Students with special needs must be free to learn at their own pace,and 5)special accommodations must be made
if needed 6)give students the opportunity to experience success. It is also critical that all team members collaborate
and communicate frequently. Inclusive programs teach all children team work and how to interrelate and work
together with others of different abilities.
Date .0 Z �r Zc. I3
�A,1 iAv,^1ne-r Ar
Appendix A
21'0 CCLC Program Assurances
❑ Program Operations
21a'CCLC program will be fully operational and providing services to students within 30 calendar
days of receiving the DOE 200 award notification or within 14 calendar days from the first day of
incurring 21 a CCLC expenditures, whichever is earlier.
❑ Proiect Deliverables
All sub-grantees(Cash Advanced and Performance-based)must collect, submit online, and keep
copies on file, all required deliverables for each performance period.
❑ Academic Focus
All 21 CCLC programs are required to operate in a manner that will maximize the program's
impact on the academic performance of participating students. Programs should provide a breadth
of project based activities and services that offer opportunities for students to loam new skills,
develop creative ways to approach challenges, and achieve acaderinic success.
All academic services must be aligned with the curriculum in core subject areas of each school
whose students are participating in the program. In addition, applicants may propose enrichment or
youth development activities that will attract and retain program participants. Lesson and/or unit
plans for academic enrichment activities will be required as part of the deliverables. Each shxhW
in the program mast be afforded a minimum of 12 full hours of programming each week
Services and benefits provided must be secular, neutral, and non-ideological. No funds provided
pursuant to this program shall be expended to support religious practices,es, such as religious
instruction, worship, or prayer. Faith-based organizations (FBOs)may offer such practices, but not
as part of the program receiving assistance and FBOs should comply with generally applicable cost
accounting requirements to ensure that funds are not used to support these activities.
❑ Scientific Research
Implementing Activities Based on Rigorous Scientific Research—The authorizing statute
provides principles of effectiveness to guide applicants in successfully identifying and implementing
programs and activities that can directly enhance student leaming, one of which includes activities
based on scientific research.As defined in ESEA, Title IX, Section 9101 (37), scientifically-based
research:
• employs systematic, empirical methods that draw on observation and experiment;
• involves rigorous data analyses that are adequate to test the stated hypotheses and justify
the general conclusions drawn;
• relies on measurements or observational methods that provide reliable and valid data across
evaluators and observers, across multiple measurements and observations, and across
studies by the same or different investigators;
• is evaluated using experimental or quasi-experimental designs in which individuals, entities,
programs, or activities are assigned to different conditions and with appropriate controls to
evaluate the effects of the condition of interest, with a preference for random-assignment,
experiments, or other designs to the extent that those designs contain within-condition or
across-condition controls;
• ensures that experimental studies are presented in sufficient detail and clarity to allow for
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replication or, at a minimum, offer the opportunity to build systematically on their findings;
and has been accepted by a peer-reviewed journal or approved by a panel of independent
experts through a comparably rigorous, objective, and scientific review.
• Applicants should base proposed strategies on such research, particularly when providing
services in core academic areas where scientifically-based research has been conducted
and is available, such as reading, mathematics and science.
❑ Supplement Not Suoolant
Funds under this part will be used to increase the level of state, local, and/or other non-federal
funds that would, in the absence of funds under this part, be made available for programs and
activities authorized under this part, and in no case supplant federal, state, local, or non-federal
funds. (ESEA, Title IV, Part B, Section 4203(a)(9) and Section 4204(2)(G).)
Programs are prohibited from using 21 g CCLC funds to pay for existing levels of service; rather,
grant funds must supplement, not supplant, existing services (21't CCLC Non-Regulatory
Guidance, Section G-7). Funds may be used to expand or enhance current activities, or to
establish programs in non-participating schools within a local education agency(LEA)that has a
21``CCLC grant.
❑ Facilities
21 d CCLC programs are not required to operate in a public school. However, if an alternative
facility is proposed, it must be as available and accessible to participants as the students' local
school. The facility must have sufficient resources to provide all proposed and required
activities, such as a computer lab, library, eating facility, safe recreational area, and study area.
The program must maintain equipment, security, resources, and a clear strategy for the safe
transportation of students to and from the center and home. The program will take place in a
safe and easily accessible facility as outlined in the RFP/RFA and in Florida's child care law
([§402.301-319 or regulations for School-Age Child Care[6A-6.0910, Florida Administrative
Code]).
❑ Supplemental Meals
The program must offer nutritious snacks and/or meals that meet the requirements of the United
States Department of Agriculture (USDA)guidelines for afterschool snacks and summer meal
supplements. Depending on when the 21 st CCLC program operates, a supplemental snack
and/or meal must be offered to each student, each day. Snackstmeals cannot be purchased
with 21'CCLC funds and must come from other resources. Students shall not be charged for
costs associated with supplemental snacks/meals. Documentation of meeting supplemental
snack/meal requirements will be required as part of the deliverables.
• The program must provide supplemental meals when program is open as follows:
• Afterschool (daily, nutritious snack; dinner must be served if programs run past 6:00
P.M.)
• Before school (daily, nutritious breakfast)
• Non-school days (daily, nutritious breakfast, lunch and/or snack, depending on hours of
operation)
❑ Students with Special Needs
In accordance with state and federal laws, children with special needs must be afforded the
same opportunities as children in the general population. Students with special needs include
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those who may be identified as limited-English proficient(LEP); homeless; migrant; or with
physical, developmental, psychological, sensory or leaming disabilities that result in significant
difficulties in communication, self-care, attention or behavior, and are in need of more
structured, intense supervision. Children with special needs shall not be excluded from the 21"
CCLC program, regardless of the level or severity of need, provided that they can be safely
accommodated. Description of services to students with special needs will be required as part of
the deliverables.
Title X, Part C: Homeless Education Program: htfn lAvww ildoe.ora&safte Milex.asv
Council for Exceptional Children:httaJAvww.cec.sped,orcr
Bureau of Exceptional Education and Student Services.httn:/Avww.11doe.ordese
For Federal Proarams-General Education Provisions Act 1GEPA1
Provide a concise description of the process to ensure equitable access to, and participation of
students, teachers, and other program beneficiaries with special needs. For details refer to URL:
httcJ/www.ed.00vMund/orant/apply/aoo formaloeca427.adf
❑ Professional Development
Each program must have a professional development plan that is responsive to the needs of its
staff, and identifies the program plans for professional development for staff delivering program
activities. Conferences and trainings must be linked to the 21't CCLC funding purpose as
outlined in the application. 21 a CCLC orientation/professional development and evidence of
staff training will be required as part of the deliverables.
❑ Evuitable Services for Private School Participation
In accordance with P.L. 107-110, No Child Left Behind (NCLB), Trtie IX, Part E Uniform
Provisions, Subpart 1, Section 9501, the applicant must complete the Private School Assurance
form indicating how the agency has and will continue to ensure timely and meaningful
consultation for equitable services to private school children and teachers within the local
education agency(ies) (LEA) service areas. Documentation supporting private school
consultation will be requested as part of the deliverables.
USED Private School Participation:httnJ/www.ed.00v/nolice/elsea4ea/esea02/na111.html
❑ Collaboration with Schools
Adequate communication between the 21'CCLC program staff and the students'regular school
day teachers, school administrators, and family members is critical to ensure student needs are
addressed in the 21't CCLC program. Each program must develop a written communication
plan to identify how these groups will share information about the needs and performance of
213t CCLC students. Communication plans must include how the regular school lessons will be
identified and reinforced during the 21"CCLC program. The program developed and carried out
in active collaboration with the schools attended by participating students (ESEA, Section
4204(b)(2)(D))as outlined in the RFP/RFA.
❑ 21f CCLC Advisory Board
21�CCLC grantees are required to establish a local 21"CCLC Advisory Board comprised of
students, teachers, parents, and members of community agencies and businesses. Sub-
grantees are required to retain documentation of board meetings, such as minutes and
attendance lists. Advisory meetings should consider such topics as program needs and
concerns, operations, and sustainability. It is suggested that the approximate size should be 10
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to 15 members, which must include at least two parents and two students. Documentation
supporting 21"CCLC advisory board meetings will be required as part of the deliverables.
❑ Community Awareness
The federal statute requires each applicant to give notice to the community of its intent to
submit an application and to provide for public availability and review of the application and
any waiver request after submission.The applicant must give notice of intent to submit an
application to the community, and state that the application and waiver request(s)will be
available for public review after submission of the application (ESEA, Section 4204(b)(2)(L)).
❑ Property Under the 210 CCLC
Property acquired(e.g., computers, classroom desks and tables) under the 21"Century
Community Learning Centers program will remain within the appropriate facility for continued
use in the 21"CCLC program after the funding period has expired. If the 21m CCLC program
at the facility(ies) is not maintained after federal funding expires, all equipment will be used
and/or-distributed in accordance with EDGAR,34 CFR, Subpart C,Sections 74.30-74.37 and
80.31-80.33.
❑ Record Retention
Programs must retain all records relating to a program for which federal funds are received for a
period of five(5) years after the completion of the activity for which the funds are used or until
such time as all pending reviews or audits have been completed and resolved. (EDGAR,
34CFR, Subpart C, Section 80.42.)
❑ Monhadno and Evaluation Activities
The grantee agrees to fully cooperate with all monitoring, audit, evaluation, and reporting
requirements established by the FDOE and/or authorized representatives.
The grantee agrees to participate in all statewide evaluation activities (e.g., cooperate with site
visits, responding to data requests, submitting accurate data).
The program will submit all required data and reports, as required and/or requested, to the
State of Florida (Florida Department of Financial Services and the Florida Department of
Education) and the USED.
The program understands that the formative and summative evaluation report are required of
all 21"t CCLC programs, that the reports will be compared to all data submitted to the FDOE
and USED, that this report may be used to determine continuation of funding, and that
adequate progress has been defined as achieving 85% of approved objectives.
❑ Student Safety
Ensure that all procedures and regulations for health, fire, safety, pick-ups, parental/guardian
consents, transportation, field trips, food, medical and other emergency procedures, etc.will
be clearly fisted and widely disseminated, and that they will conform to applicable local and
state standards.
❑ Suspension of the Grant
The FDOE may suspend or terminate the grant with 30 days notice, in whole or in part, if federal
funds supporting the grant are reduced or withdrawn, or for nonperformance by the grantee at
any time during the term of the grant. The FDOE and the grantee may suspend or terminate the
agreement, in whole or in part, upon mutual agreement.
Pegs 4 of 5
The undersigned hereby assures and agrees that, in accordance with statues
and regulations, the funded proposal shall comply with the program assurances
listed above. In addition, we have read, understand, and fully accept the rules,
requirements, and expectations contained in the Request for Proposal
(RFP)/Request for Application (RFA) by checking each box.
Robert Baldwin, City Manager
Printed Name of Agency Head Title
f
Signatu of A cy Head Date
City of Dania Beach
Applicant Organization (Please print)
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PROJECT DELIVERABLE ASSURANCE FORM
Federal Cash Advance(Public Entities Only)
Federal cash advances will be made by state warrant or electronic funds transfer(EFT)to a recipient for
disbursements. For federally funded projects, requests for federal cash advance must be made on the
CARDS-Cash Advance and Reporting of Disbursements System. If at times it is determined that
disbursements are going to exceed the amount of cash on hand plus cash in transit, an on-line
amendment can be made prior to the due date of the next Federal Cash Advance distribution on the
CARDS System.
Supporting documentation for expenditures is required for all funding methods. Examples of such
documentation include, but are not limited to: payroll records,contracts, invoices with check numbers
verifying payment, and/or bank statements.All or any of these items must be available upon request.
Reimbursement with Performance(Community-Based, Faith-Based Organizations, Non-School
District Entities and others)
Payment is rendered upon submission of documented allowable disbursements, plus documented
- completion of specified-performance-objectives. Requests for reimbursement with#he-appropriate backup
documentation must be submitted. Examples of such documentation include, but are not limited to:
payroll records,timesheets, contracts, invoices with service dates and student attendance, check
numbers verifying payment, and/or bank statements, as well as evidence of activities.
Required Deliverables
All agencies are required to upload all deliverables and evidence of activities as required by the
Reporting Outcomes section of this RFP to the 21't CCLC website(http://2lstccic.fichild.com)for
submission to the FDOE by the 15t"of each month.
Financial Consequences
The Florida Department of Education, 21"'CCLC Program Office, shall periodically review the progress
made on the activities and deliverables listed. If the applicant fails to meet and comply with the
activities/deliverables(example: daily attendance numbers, amount of days and time of operation,
required reporting, required submission of deliverable, proposed activities and/or proposed
goals/objectives)established in the approved application or to make appropriate progress on the activities
and/or towards the deliverables and they are not resolved within two weeks of notification, the 21st CCLC
Program Office may(1)approve a reduced payment, (2) request the applicant redo the work and/or(3)
terminate the project.
By accepting grant funds, the agency agrees to submit the required project deliverables for
Florida 21`t CCLC program.
I understand that/must submit the required project deliverables as outlined in the 2013-2014
Project Deliverables and Invoice Form
I understand that if the deliverables do not support program progress as required, the FDOE may
reduce and/or terminate future funding.
Name of Agency City of Dania Beach
Robert Baldwin, City Manager
Print Name of the en Hea r Authorized Agency Representative
July 25, 013
Signature of the Ag cy Head or Authorized Agency Representative Date
A.PP>~NHt,1R.A:AssuRAmCI
AssuRANcE or ftcltvmwc EQuirABLE SERviczs l
PRivATE ScHom Swammi6.TEAcw t,%Alm 0imR EDucATioluL PERsomaL.
Florida Department of Education
Title IV Part B,21st Century Community Learning Centers(21st CCLC)
FY2013-14
The FLDOE Project Application and Amendment Procedures for Federal and State Programs (Green Book)
General Assurances states: "After timely and meaningful consultation, the recipient will provide the
opportunity for children enrolled in private,non-profit schools,and the educational personnel of such schools,
equitable participation in the activities and services provided by these federal funds, and will notify the
officials of the private schools of said opportunity." For the 21' CCLC Program, programs must, at a
minimum,consult with officials from those private school located in the specific geographic area(s)served by
program sites.
Please complete the following form related to consultation and participation of eligible private schools
in Title IV,Part B,21st CCLC.
❑ There are NO private schools located within the geographic area(s) of the sites where the 21" CCLC
program is located.If you check this statement,you do not need to complete the remainder of the form.
There are private schools located within the geographic area(s)of the 21'CCLC sites.
School Name(s): Brauser Maimonides Academy
❑ The private schools listed above were consulted(or attempts were made to consult with)
such schools prior to the development of the Title IV,Part B,21'CCLC application.
The private schools listed above were provided (or will be provided)with the opportunity to
enroll their students in the 21'CCLC program.
❑ Teachers and other educational personnel of private school students attending the 21-1 CCLC
program were offered(or will be offered)services that are equitable to those provided to
public school teachers and other educational personnel.
Method(s)of Contact-Applicant Initiated(check all that apply)
❑ Letters or facsimile documents
❑ Meetings
Documented telephone calls
E-mail
Other(please list):
7�Zs/Zoi3
Signa re of A ncy Head Date
Florida 21't Century Community Learning Center(21't CCLC)
Statement of Assurance for Evaluation Data
While the 212' CCLC grant may include up to five (5) years of funding, the years following the
initial year are dependent upon the evaluation of data supporting successful program
implementation aligned with the components of the Request for Proposal (RFP) and Request for
Application (RFA) submitted.
By accepting grant funds, sub-grantees agree to participate in both the federal and state
evaluation of the Florida 21"CCLC program.
I understand that I must submit the Objective and Performance Indicator data and the Year End
Progress Report to the Florida Department of Education (FDOE); and program data to the
Profile and Performance Information Collection System (PPICS), as required and outlined in the
RFP/RFA.
1 understand that if evaluation data does not support program progress as required, the
FDOE may reduce and/or terminate future funding.
City of Dania Beach
Applicant Organization
''-- Cqy Manager
Sighature of Authorized Certifying Official Title
July 25, 2013
Date Signed
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Exhibit C—Project Deliverables
2014 Performance Goals
Amount
Amount Approved
Requested (FDOE Use
Only)
Required Performance Deliverables $ 0 0 % $0
REQUIRED DELIVERABLES (ALL MONTHS) Instructions
August 2013 Instructions
August 2013 Uploads
W Summative Evaluation Report(Continuation
• Grantees ONLY)checked on, 12/6/13
o City of Dania Summ. Report.pdf(10/23/13
10:06am)
• Dissemination of Summative Evaluation Results
to Stakeholders(Continuation Grantees ONLY)
checked on, 12/6/13
o summative dissm. email Collins.pdf(10/30/13
9:45am)
o sum eval signatures Collins.pdf(10/30/13
9:44am)
• Documentation Supporting Private School
Consultation(Continuation Grantees ONLY)
o Private School Letter(St.Marks)2 (c).docx
(9/27/13 11:15am) 0 0% F
o Private School Letter(SAINT
JEROME)(C).docx (9/27/13 11:16am)
o Private School Letterl (C).docx (9/27/13
11:16am)
• r Documentation of Meeting Supplemental
Snack/Meal Requirements(Continuation Grantees
ONLY)
o Menu.pdf(9/23/13 11:34am)
• 21 st CCLC Orientation/Professional Development
(New and/or Existing Staff) (Continuation Grantees
ONLY)
o Staff Training.pdf(9/23/13 11:34am)
r Project-Based Learning Plans for Academic and
• Personal Enrichment(Continuation Grantees ONLY)
o PBL AUG 3rd 4th Collins.pdf(9/27/13
10:44am)
Exhibit C-1
Exhibit C—Project Deliverables
o PBL AUG Collins.pdf(9/27/13 10:44am)
o PBL AUG 3 Collins.pdf(9/27/13 10:44am)
o PBL AUG 5TH Collins.pdf(9/27/13 10:45am)
r Grant Activity Report(if no children served
• during this month due to start-up) (Continuation
Grantees ONLY)
o NA Serving Children.docx(10/23/13 9:29am)
Florida Department of Health(DOH)
• Food/Sanitation Certificate (Continuation Grantees
ONLY)
o Collins Food Inspection.pdf(9/27/13 10:5lam)
• A copy of the current and approved annual fire
inspection report by a certified fire inspector(or
exemption) Form(Continuation Grantees ONLY)
o Collins Safely Inspection.pdf(9/27/13
10:51am)
Background Check FOR SCHOOL DISTRICTS
ONLY-ALL Staff
• r Affidavit of Compliance for Child Care Personnel
(For all sites exempt from DCF licensing or currently
working on DCF licensing) (ALL STAFF)
o Collins Deliverable Form (4).docx(9/27/13
11:56am)
r Affidavit of Good Moral Character(For all sites
• exempt from DCF licensing or currently working on
DCF licensing) (ALL STAFF)
o Collins Deliverable Form (5).docx(9/27/13
11:56am)
• Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (ALL STAFF)
o Collins Deliverable Form(6).docx (9/27/13
11:57am)
F Child Abuse&Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (ALL STAFF)
o Collins Deliverable Form (7).docx(9/27/13
11:57am)
Student Attendance Lists(each site, if applicable)
• o City of Dania Aug List.xlsx(10/23/13 9:5lam)
Student Sign-Out Sheets (each site, if applicable)
Exhibit C-2
Exhibit C—Project Deliverables
o Collins Sign Outs Aug 19.pdf(9/27/13
10:52am)
o Collins Signout Aug 26.pdf(9/27/13 10:53am)
• Website Monthly Attendance Submission
Confirmation E-mail (each site if applicable)
o Aug City Of Dania Email Confirm..docx
(10/16/13 11:20am)
• F Completed and Signed Project Deliverables and
Invoice Form-
o Project Deliv. Augpdf(10/16/13 11:35am)
Narrative of Progress on Licensing(if pursuing
• licensing)
o Deliverables Form Not Pur Lic Collins.docx
(10/23/13 9:50am)
September 2013 Instructions
September 2013 Uploads
• r Program Changes Based on Summative
Evaluation(Continuation Grantees ONLY) checked
on, 11/12/13
o Summative Evaluation Narrative.docx (11/6/13
10:23am)
F Student Enrollment Packet(Continuation Grantees
ONLY)
o application page.pdf(10/23/13 3:33pm)
o Enrollment Packet.pdf(10/18/13 11:21am)
Program/Student Handbook(Continuation
• Grantees ONLY) F—O 0 % �—
o Hand Book AFTER SCHOOL
PROGRAMS.doc(10/18/13 10:23am)
Implementation Update for Academic Project
• Plans for Academic and Personal Enrichment
(Continuation Grantees ONLY)
o collins picture updates.im(10/30/13 11:26am)
o collins insect update 2 jpjz(10/30/13 11:27am)
o collins Insect update l.jpg(10/30/13 11:27am)
o collins insect update 5.jpg(10/30/13 11:26am)
o collins insect update3.W(10/30/13 11:26am)
o collins insect update4.bg(10/30/13 11:26am)
F Student Attendance Lists(each site, if applicable)
• o City of Dania Sept List.xlsx (10/23/13
Exhibit C-3
Exhibit C—Project Deliverables
10:20am)
fi Student Sign-Out Sheets(each site, if applicable)
• o Sign In and Out Procedures.docx (11/20/13
11:56am)
o Sign out week 1 sept.pdf(10/18/13 10:24am)
o Sign out week 2 Sept.pdf(10/18/13 10:24am)
o sign out week 3 Sept.pdf(10/18/13 10:24am)
o Sign out week 4 Sept.pdf(10/18/13 10:25am)
o Sept 30 Sign out Collins.pdf(10/18/13
10:25am)
F Website Monthly Attendance Submission
• Confirmation E-mail (each site if applicable)
o City of Dania Sept Confirmation.docx
(10/18/13 10:30am)
r Completed and Signed Project Deliverables and
• Invoice Form-
o Project Deliv. Sept.pdf(11/1/13 10:44am)
New Project-Based Learning Plans for Academic
• and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
o Deliverables Form No new PBL Collins.docx
(10/18/13 10:33am)
Affidavit of Compliance for Child Care
• Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONL)
o Deliverables Form No New Staff Collins.docx
(10/23/13 10:11 am)
• F Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONL9
o Deliverables Form No New Staff Collins
1 .docx (10/23/13 10:1lam)
• Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONLY)
o Deliverables Form No New Staff Collins
2 .docx(10/23/13 10:1lam)
Child Abuse&Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONL19
Exhibit C-4
Exhibit C—Project Deliverables
o Deliverables Form No New Staff Collins
3 .docx (10/23/13 10:1lam)
• Narrative of Progress on Licensing (if pursuing
licensing)
o Deliverables Form Not Pur Lic Sent
Collins.docx (10/23/13 10:12am)
• F Background Check FOR SCHOOL DISTRICTS
ONLY-New Staff ONLY
October 2013 Instructions
October 2013 Uploads
r' Documentation Supporting Private School
• Consultation(New Grantees ONLY)
o Deliverables Form NA.docx(11/15/13
11:33am)
• Documentation of Meeting Supplemental
Snack/Meal Requirements (New Grantees ONLY)
o Deliverables Form NA(1).docx (11/15/13
11:33am)
21 st CCLC Orientation/Professional Development
• (New and/or Existing Staff) (New Grantees ONLY)
o Deliverables Form NA(2).docx (11/15/13
11:33am)
Project-Based Learning Plans for Academic and
Personal Enrichment(New Grantees ONLY) 0 0% F o
o Deliverables Form NA(3).docx (11/15/13
11:33am)
Student Enrollment Packet(New Grantees ONLY)
• o Deliverables Form NA(4).docx (11/15/13
11:34am)
Program/Student Handbook(New Grantees
• ONLY)
o Deliverables Form NA(5).docx (11/15/13
11:34am)
• r Grant Activity Report(if no children served
during this month due to start-up) (New Grantees
ONLY)
o Deliverables Form NA (6).docx (11/15/13
11:34am)
Affidavit of Compliance for Child Care
Exhibit C-5
Exhibit C—Project Deliverables
Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing)ALL STAFF
(New Grantees ONLY)
o Deliverables Form NA(7).docx (11/15/13
11:34am)
• Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing)ALL STAFF(New Grantees ONLY)
o Deliverables Form NA(8).docx (11/15/13
11:34am)
F Volunteer Affidavit (For all sites exempt from
• DCF licensing or currently working on DCF
licensing)ALL STAFF(New Grantees ONLY)
o Deliverables Form NA(9).docx (11/15/13
11:35am)
F Child Abuse &Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) ALL STAFF
(New Grantees ONLY)
o Deliverables Form NA(10).docx(11/15/13
11:35am)
• A copy of the current and approved annual fire
inspection report by a certified fire inspector(or
exemption)Form(New Grantees ONLY)
o Deliverables Form NA(11).docx (11/15/13
11:35am)
Florida Department of Health(DOH)
• Food/Sanitation Certificate (New Grantees ONLY)
o Deliverables Form NA(12).docx(11/15/13
11:35am)
F Family Literacy Plan and Schedule(Continuation
• Grantees ONLY)
o Parent Engagement Tally Collins.xlsx
(11/20/13 11:56am)
o Family Involvement Event Calendar
(Collins).docx (11/20/13 11:5lam)
Website and Documentation Supporting the
Dissemination of Information about the 21 st CCLC
program(Continuation Grantees ONLY)
o Summative Evaluation Narrative.docx
(12/26/13 10:32am)
o sum eval signatures Collins.pdf(11/15/13
11:37am)
Exhibit C-6
Exhibit C—Project Deliverables
!_ Documentation of Florida Certified Teachers
• (Continuation Grantees ONLY)
o Collins Teachers Cert..pdf(11/20/13 11:49am)
!' New Project-Based Learning Plans for Academic
• and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
(Continuation Grantees ONLY) checked on, 12/6/13
o Collins PBL Oct.pdf(11/15/13 11:38am)
Implementation Update for Academic Project
• Plans for Academic and Personal Enrichment
(Continuation Grantees ONLY)
i✓ PPICS Data Submission Verification
• (Continuation Grantees ONLY)checked on, 11/20/13
o !ASP (City of Dania Beach) - PPICS
Submission Complete.pdf(11/15/13 11:39am)
• Affidavit of Compliance for Child Care
Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing)NEW Staff Only
(Continuation Grantees ONLY)
o Deliverables Form Oct Not Pur Lic Sept
Collins (1).docx(11/15/13 11:52am)
Affidavit of Good Moral Character (For all sites
• exempt from DCF licensing or currently working on
DCF licensing) NEW Staff Only(Continuation
Grantees ONLY)
o Deliverables Form Oct Not Pur Lic Sept
Collins (2).docx(I 1/15/13 11:52am)
Volunteer Affidavit (For all sites exempt from
• DCF licensing or currently working on DCF
licensing)NEW Staff Only(Continuation Grantees
ONLY)
o Deliverables Form Oct Not Pur Lic Sept
Collins (3).docx(11/15/13 11:52am)
Child Abuse &Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) New Staff Only
(Continuation Grantees ONLY)
o Deliverables Form Oct Not Pur Lic Sept
Collins 4 .docx (11/15/13 11:52am)
r gn-Si In/Sign-Out Procedures
•
o Sign In and Out Procedures.docx (11/15/13
12:36pm)
Exhibit C-7
Exhibit C—Project Deliverables
F Student Attendance Lists (each site, if applicable)
• o Oct2013 Collins.xls (11/15/13 11:41am)
o Stud list Oct City of Dania.xlsx(11/15/13
11:45am)
Student Sign-Out Sheets(each site, if applicable)
• o Collins Oct 21-25 Sign Outs.pdf(11/15/13
11:47am)
Website Monthly Attendance Submission
• Confirmation E-mail (each site if applicable)
o city of Dania Oct Email Conf..docx (11/15/13
12:40pm)
F Completed and Signed Project Deliverables and
• Invoice Form-
o Project Deli. Oct.pdf(11/15/13 1:14pm)
• Narrative of Progress on Licensing(if pursuing
licensing)
o Deliverables Form Oct Not Pur Lic Sept
Collins.docx (I1/15/13 11:5lam)
r Background Check FOR SCHOOL DISTRICTS
• ONLY-New Staff ONLY
November 2013 Instructions
November 2013 Uploads
Proof of Collaboration with Regular Day Staff
• o Collaboration with School Day.docx(12/24/13
10:38am)
o Homework FeedBack Form.pdf(12/24/13
10:38am)
• r Evidence of Professional Development(to date)
o Staff Training Collins l.pdf(12/24/13
10:39am) r" 0 % F
• Attendance Sheets and Documentation to Support
Adult Family Literacy or Parental Involvement
Activities (each site,to date)
o Parent Meeting Sept Collins.pdf(12/24/13
10:39am)
Family Literacy Plan and Schedule (New Grantees
ONLY)
o Deliverables Form Cont. Nov Collins.docx
(12/24/13 10:50am)
Exhibit C-8
Exhibit C—Project Deliverables
Documentation of Collected Baseline Data
• checked on, 1/9/14
o Collins-l st Qtr. Master Student Database-Time
4 Kids-13-14_(1).xls(12/24/13 10:51am)
Website and Documentation Supporting the
Dissemination of Information about the 21 st CCLC
program(New Grantees ONLY)
F_ Documentation of Florida Certified Teachers
• (New Grantees ONLY)
o Deliverables Form Cont. Nov Collins (1).docx
(12/24/13 10:51am)
Documentation of Support from Partners (21 st
• CCLC Partner's Table)
o Collins -Partners Table.docx(12/24/13
11:02am)
o Dania- Partners Table.docx(12/24/13
11:01am)
Implementation Update for Academic Project
• Plans for Academic and Personal Enrichment checked
on, 1/31/14
o Collins PBL Oct.pdf(12/24/13 10:54am)
Student Attendance Lists (each site, if applicable)
• o Student List Nov Collins.xlsx(12/24/13
10:43am)
Student Sign-Out Sheets (each site, if applicable)
• o SignOuts Nov 4-8 Collins.pdf(12/24/13
10:42am)
o SignOuts Nov 4-8 Collins.pdf(12/24/13
10:41am)
Website Monthly Attendance Submission
• Confirmation E-mail (each site if applicable)
o Florida 21 st CCLC Attendance Confirmation
Nov Collins.docx(12/24/13 10:43am)
Completed and Signed Project Deliverables and
• Invoice Form-
o Pro Deliv Nov.pdf(12/24/13 10:24am)
r New Project-Based Learning Plans for Academic
• and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
checked on, 1/31/14
o Deliverables Form No PBL Nov Collins.docx
Exhibit C-9
Exhibit C—Project Deliverables
(12/24/13 10:23am)
• Affidavit of Compliance for Child Care
Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
o Deliverables Form No new Nov Collins.docx
(12/24/13 10:19am)
• r Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONL19
o Deliverables Form No new Nov Collins
1 .docx(12/24/13 10:19am)
• r Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONL19
o Deliverables Form No new Nov Collins
2 .docx(12/24/13 10:19am)
Child Abuse&Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLI)
o Deliverables Form No new Nov Collins
3 .docx(12/24/13 10:19am)
• F Narrative of Progress on Licensing (if pursuing
licensing)
o Deliverables Form Not Pur Nov Collins.docx
(12/24/13 10:22am)
F Background Check FOR SCHOOL DISTRICTS
• ONLY-New Staff ONLY
o Deliverables Form No new Nov Collins
4 .docx (12/24/13 10:19am)
December 2013 Instructions
December 2013 Uploads
r- 21 st CCLC Advisory Board Meeting(s)Minutes
• and Attendance
F I0 0% I0
• Implementation Update for Academic Project
Plans for Academic and Personal Enrichment
r Student Attendance Lists(each site, if applicable)
• o Collins Dec List.xlsx(1/16/14 9:59am)
Exhibit C-10
Exhibit C—Project Deliverables
1
• Student Sign-Out Sheets(each site, if applicable)e)
o Dec 2 Sianouts Collins.pdf(1/16/14 9:56am)
• F Website Monthly Attendance Submission
Confirmation E-mail (each site if applicable)
o Dec City of Dania Email Conference.docx
(1/16/14 9:59am)
• F Completed and Signed Project Deliverables and
Invoice Form-
o December Deland Invoice Form.pdf(1/16/14
9:56am)
F, New Project-Based Learning Plans for Academic
• and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
o Deliverables Form No new PBL Dec
Collins.docx (1/16/14 10:04am)
Affidavit of Compliance for Child Care
• Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
o Deliverables Form No new Dec Collins.docx
(1/16/14 10:01am)
r Affidavit of Good Moral Character (For all sites
• exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONLY)
o Deliverables Form No new Dec Collins
1 .docx (1/16/14 10:O1am)
• Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONLY)
o Deliverables Form No new Dec Collins
2 .docx(1/16/14 10:02am)
• r Child Abuse&Neglect Reporting Requirements
Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
o Deliverables Form No new Dec Collins
3 .docx (1/16/14 10:02am)
Narrative of Progress on Licensing (if pursuing
• licensing)
o Deliverables Form Lie. Dec Collins.docx
(1/16/14 10:06am)
Exhibit C-11
Exhibit C—Project Deliverables
Background Check FOR SCHOOL DISTRICTS
• ONLY-New Staff ONLY
o Deliverables Form No new Dec Collins
4 .docx(1/16/14 10:02am)
January 2014 Instructions
January 2014 Uploads
• r- Sign-in Sheets and Documentation to Support
Adult Family Literacy or Parental Involvement
Activities (each site,November to pre
o Parent Meeting Sept Collins.pdf(2/17/14
11:44am)
o Collins Parent Night Aug.pdf(2/17/14
11:42am)
o Collins Parent Night Sept.pdf(2/17/14
11:43am)
FV Mid-year Data Reporting Spreadsheet checked on,
2/4/14
o City of Dania Collins- Mid Year Review
2014.xlsm(1/29/14 10:11am)
r Student Attendance Lists(each site, if applicable)
• o Collins Dec List.xlsx(2/17/14 11:48am)
• Student Sign-Out Sheets(each site, if applicable) F 0% F
o Collins Sign Outs Jan 27.pdf(2/17/14
11:49am)
Website Monthly Attendance Submission
• Confirmation E-mail(each site if applicable)
o Collins Email Confirm Jan.docx(2/17/14
11:54am)
Completed and Signed Project Deliverables and
• Invoice Form-
o Pro Deliv Jan.pdf(2/17/14 11:55am)
New Project-Based Learning Plans for Academic
• and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
o PBL BlackHistory Collins.pdf(2/17/14
11:56am)
Affidavit of Compliance for Child Care
• Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
Exhibit C-12
Exhibit C—Project Deliverables
ONL19
o Deliverables Form No new Dec Collins.docx
(2/17/14 11:56am)
o Deliverables Form No new Jan Collins.docx
(2/17/14 11:57am)
o Deliverables Form No new Jan Collins.docx
(2/17/14 11:58am)
r Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONLY)
o Deliverables Form No new Jan Collins
1 .docx (2/17/14 11:58am)
• Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONLY)
o Deliverables Form No new Jan Collins
2 .docx(2/17/14 11:59am)
• Child Abuse&Neglect Reporting Requirements
Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
o Deliverables Form No new Jan Collins
3 .docx (2/17/14 11:59am)
Narrative of Progress on Licensing (if pursuing
• licensing)
o Deliverables Form Not Pur Lic Jan
Collins.docx (2/17/14 12:00pm)
• Background Check FOR SCHOOL DISTRICTS
ONLY-New Staff ONLY
o Deliverables Form No new Jan Collins
4 .docx(2/17/14 11:59am)
February 2014 Instructions
February 2014 Uploads
r Written Formative Evaluation Report
• Analysis of Year-to-Date Expenditures
• Implementation Update for Academic Project
Plans for Academic and Personal Enrichment
r Student Attendance Lists (each site, if applicable)
r
• Student Sign-Out Sheets (each site, if applicable)
Exhibit C-13
Exhibit C—Project Deliverables
• Website Monthly Attendance Submission
Confirmation E-mail(each site if applicable)
• r Completed and Signed Project Deliverables and
Invoice Form-
• New Project-Based Learning Plans for Academic
and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
• r Affidavit of Compliance for Child Care
Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
• Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONLY)
r Volunteer Affidavit (For all sites exempt from
• DCF licensing or currently working on DCF
licensing) (NEW STAFF ONL1)
• F Child Abuse&Neglect Reporting Requirements
Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
• r Narrative of Progress on Licensing(if pursuing
licensing)
• r Background Check FOR SCHOOL DISTRICTS
ONLY-New Staff ONLY
March 2014 Instructions
March 2014 Uploads
• r Evidence of Program Modification Based on
Formative Evaluation Report
• Public Notice of Formative Evaluation Results
r Evidence of Professional Development(December F-0 0% I 0
• to present)
• r Summer Student Enrollment Packet(if applicable)
r Implementation Update for Academic Project
• Plans for Academic and Personal Enrichment
r" Student Attendance Lists(each site, if applicable)
Exhibit C-14
Exhibit C—Project Deliverables
Student Sign-Out Sheets (each site, if applicable)
• Website Monthly Attendance Submission
Confirmation E-mail (each site if applicable)
• Completed and Signed Project Deliverables and
Invoice Form-
r- New Project-Based Learning Plans for Academic
and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
F Affidavit of Compliance for Child Care
• Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
• r- Affidavit of Good Moral Character (For all sites
exemPt om DCF licensing or currently working on
DCF licensing) (NEW STAFF ONLY)
Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONL19
• Child Abuse&Neglect Reporting Requirements
Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONL19
• Narrative of Progress on Licensing (if pursuing
licensing)
Background Check FOR SCHOOL DISTRICTS
ONLY-New Staff ONLY
April 2014 Instructions
April 2014 Uploads
• r- Summary of Site Visits/Quality Improvement
Activities (to date)
1— 2013 Summer Program Schedule(each site) (if
• applicable) F 0 % F
r- Website and Documentation Supporting the
• Dissemination of Information about the 21 st CCLC
Program
• r- Implementation Update for Academic Project
Plans for Academic and Personal Enrichment
Exhibit C-15
Exhibit C—Project Deliverables
F Student Attendance Lists (each site, if applicable)
F_
• Student Sign-Out Sheets(each site, if applicable)
• f= Website Monthly Attendance Submission
Confirmation E-mail(each site if applicable)
r- Completed and Signed Project Deliverables and
• Invoice Form-
r- New Project-Based Learning Plans for Academic
and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
• r- Affidavit of Compliance for Child Care
Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONL19
• r Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONLY)
• F Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONLY)
F Child Abuse&Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
• r- Narrative of Progress on Licensing (if pursuing
licensing)
F Background Check FOR SCHOOL DISTRICTS
• ONLY-New Staff ONLY
May 2014 Instructions
May 2014 Uploads
r 21 st CCLC Advisory Board Meeting(s)Minutes
and Attendance �—
• f' Notification of End-of-Year Teacher and Adult I " 0% t "
Family Members Survey
F Attendance Sheets and Documentation to Support
• Adult Family Literacy or Parental Involvement
Activities (each site,to date)
Exhibit C-16
Exhibit C—Project Deliverables
F Implementation Update for Academic Project
Plans for Academic and Personal Enrichment
• r- Student Attendance Lists(each site, if applicable)
r Student Sign-Out Sheets (each site, if applicable)
r Website Monthly Attendance Submission
• Confirmation E-mail (each site if applicable)
• r- Completed and Signed Project Deliverables and
Invoice Form-
• r- New Project-Based Learning Plans for Academic
and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
• F Affidavit of Compliance for Child Care
Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONL19
• F Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONL19
• Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONL19
• Child Abuse&Neglect Reporting Requirements
Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONL19
• Narrative of Progress on Licensing (if pursuing
licensing)
• r- Background Check FOR SCHOOL DISTRICTS
ONLY-New Staff ONLY
June 2014 Instructions
June 2014 Uploads
r Listing of Physical Tangible Personal Inventory
• Inventory (if received as In-Kind,please list 0 0
accordingly)
End-of-Year Data Reporting Spreadsheet
• Evidence of Professional Development(April to
Exhibit C-17
Exhibit C—Project Deliverables
present)
r Grant Activity Report
• r- Implementation Update for Academic Project
Plans for Academic and Personal Enrichment
F Student Attendance Lists(each site, if applicable)
Student Sign-Out Sheets (each site, if applicable)
• r Website Monthly Attendance Submission
Confirmation E-mail (each site if applicable)
F Completed and Signed Project Deliverables and
• Invoice Form-
• r- New Project-Based Learning Plans for Academic
and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
• r Affidavit of Compliance for Child Care
Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
• r Affidavit of Good Moral Character (For all sites
exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONLY)
• 1— Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONLY)
r Child Abuse&Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
F Narrative of Progress on Licensing(if pursuing
licensing)
F Background Check FOR SCHOOL DISTRICTS
ONLY-New Staff ONLY
July 2014 Instructions
July 2014 Uploads
Grant Activity Report
Implementation Update for Academic Project
• Plans for Academic and Personal Enrichment
Exhibit C-18
Exhibit C—Project Deliverables
r- Student Attendance Lists(each site, if applicable)
F Student Sign-Out Sheets (each site, if applicable)
• r- Website Monthly Attendance Submission
Confirmation E-mail (each site if applicable)
r Completed and Signed Project Deliverables and
• Invoice Form-
r- New Project-Based Learning Plans for Academic
and Personal Enrichment(if new plans are being
implemented that have not been previously uploaded)
r- Affidavit of Compliance for Child Care
• Personnel(For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLI)
r Affidavit of Good Moral Character (For all sites
• exempt from DCF licensing or currently working on
DCF licensing) (NEW STAFF ONLY)
• r Volunteer Affidavit (For all sites exempt from
DCF licensing or currently working on DCF
licensing) (NEW STAFF ONLY)
r- Child Abuse&Neglect Reporting Requirements
• Form (For all sites exempt from DCF licensing or
currently working on DCF licensing) (NEW STAFF
ONLY)
r Narrative of Progress on Licensing(if pursuing
• licensing)
F Background Check FOR SCHOOL DISTRICTS
ONLY-New Staff ONLY
Exhibit C-19