REQUEST FOR PROPOSALS FOR PROVIDING VISITATION …

RFP – Visitation Services-Parenting Classes 1 of 29

REQUEST FOR PROPOSALS FOR PROVIDING

VISITATION SERVICES AND PARENTING CLASSES CTS 2031

Shasta County Health and Human Services Agency Business and Support Services

1810 Market Street Redding, CA 96001

Timeline

Release of the RFP: Wednesday, February 1, 2012

Proposal Conference RSVP Deadline: Wednesday, February 15, 2012

Proposal Conference: Thursday, February 16, 2012

Notice of Intent deadline: Tuesday, February 21, 2012

Deadline for Written Questions: Friday, February 24, 2012

County issues Written Responses to Written Questions: Thursday, March 1, 2012

Proposal submission deadline: Thursday, March 8, 2012

Tentative start date for Contract: July 1, 2012

The above dates are subject to change as deemed necessary by the County.

RFP – Visitation Services/Parenting Classes (CTS 2031) 2 of 29

I. INTRODUCTION

The County of Shasta (“County”), Health and Human Services Agency (“HHSA”), invites responses to a Request for Proposals (“RFP”) to provide Visitation Services and Parenting classes to HHSA clients.

A. DEFINITIONS

For the purposes of this RFP process, the following definitions apply:

Assessment means a written evaluation, using interviews, questionnaires/self-rating forms, testing, observations, and other information gathering methods, of a Parent’s overall functioning, including strengths and needs as it relates to Parenting Skills.

Center(s) means a Visitation and Parenting Services Center(s) that will provide a safe and secure setting for visits between County referred children subject to the jurisdiction of the juvenile dependency court and placed out-of-home, or children who are at risk of becoming dependent children of the juvenile court and placed out-of-home; their parents, siblings, relatives and/or caretakers, as well as a place where parenting classes will be conducted for County referred parent(s) of children who are under the jurisdiction of the juvenile dependency court or who are at risk of becoming dependent children of the juvenile court.

Contract means the written agreement between the County and Responder(s) selected to provide visitation services and parenting classes.

Contractor means the successful Responder(s) selected to provide Visitation Services and Parenting Classes under Contract to the County.

County Social Worker means an individual employed by County who provides or arranges for reunification, family maintenance, visitation, respite childcare, and related services to the families of dependent children of the juvenile court or the families of children who are at risk of becoming dependent children of the juvenile court.

County’s Scoring Application means a web-based electronic application which stores and manages Triple P data as input by Triple P trained practitioners. The County’s Scoring Application is available to all Triple P trained practitioners for the level(s) at which individual practitioners have been trained. Triple P trained practitioners are required to register as users on the Triple P Provider Network and are provided with individual user log in details during Triple P training course(s).

Family Reunification means the process of returning children in temporary out-of-home care to their families of origin.

Metrix Form means a form in the County’s Scoring Application used for collecting Triple P data.

Parent means those Parent(s) of children who are under the jurisdiction of the juvenile dependency court or who are at risk of dependency.

Parenting Skills means those methods of interaction that are initiated by a Parent with the Parent’s child(ren) that provide parent/child relationship development, safety, nurturance, age appropriate discipline, and positive learning experiences for the Parent’s child(ren) and promote age appropriate child development.

Parent Visitation Status Report means a written report prepared by Contractor and sent to County that describes and evaluates the behaviors and interaction between a


Parent and the Parent’s child(ren) during a visitation ordered or approved by the juvenile dependency court or County. Report will utilize format established by the County.

Parenting Class Status Report means a written report prepared by Contractor and sent to the County that describes and evaluates a Parent’s progress and attendance at Parenting Classes. Report will utilize format established by the County.

Parental Interview means a face-to-face interaction for the purpose of gathering information about a Parent such as, but not limited to, the way the Parent provides guidance and discipline to his/her child(ren), the challenges the Parent faces, and the ways in which the Parent has been successful in raising the Parent’s child(ren) in the past.

Permanent Plan means a plan ensuring a legally permanent, nurturing family for every child in out-of-home care through family reunification, adoption from foster care, guardianship, or permanent placement with relatives.

Positive Parenting Program (“Triple P”) means an evidence-based multi-level parenting and family-support program. The aims of the program are to: (1) promote the independence and health of families by enhancing Parent’s knowledge, skills and confidence; (2) promote the development of non-violent, protective and nurturing environments for children; (3) reduce the incidence of child abuse, mental illness, behavioral problems, delinquency and school failure; and (4) enhance the competence, resourcefulness and self-sufficiency of parents in raising their children. Some of the distinguishing features of Triple P are multiple levels of program intensity based on need, a public health approach, evidence-based intervention strategies, and assessment and outcome monitoring tools.

Proposal means a formal, written response to this RFP submitted by a Responder.

Request for Proposal (“RFP”) means this invitation to submit a Proposal to provide visitation services and parenting classes.

Responder means any person or organization who submits a Proposal in response to this RFP.

Strengthening Families Initiative means a nationally recognized approach to facilitating and supporting families who need and want to make changes that allow their children to grow, learn and thrive in safe, nurturing environments.

Strengthening Families Protective Factors (“Protective Factors”) means the five Protective Factors that are the foundation of the Strengthening Families approach. Research from the Center for the Study of Social Policy supports the common-sense notion that the likelihood of child abuse and neglect diminishes when these Protective Factors are present and robust in a family. The five Protective Factors are: (1) Parental resilience: The ability to cope with and bounce back from all types of challenges; (2) Social connections: Friends, family members, neighbors, and other members of a community providing emotional support and concrete assistance to parents; (3) Knowledge of parenting and child development: Accurate information about raising young children, appropriate expectations for their behavior, and knowledge of alternative discipline techniques; (4) Concrete supports in times of need: Financial security to cover day-to-day expenses and unexpected costs; formal supports like CalWORKs, Medi-Cal, or job training; and informal support from social networks; and


(5) Children’s social and emotional development: A child’s ability to interact positively with others and communicate his or her emotions effectively.

B. FUNDING

1. Although funding for this program is contingent upon the availability of local, State and/or Federal funding, the County anticipates funding approximately $337,000 per County Fiscal Year (July 1 – June 30) for the provision of visitation services and parenting classes. The initial funding period will be from July 1, 2012, through June 30, 2013. Should funding continue to be available, the provision of the visitation services and parenting classes, at the discretion of the County, may be extended for up to two additional one-year periods.

2. Depending on the number and type of Proposals received, County may elect to Contract the entire program with one Responder, or negotiate contracts with multiple Responders.

C. PROPOSAL CONFERENCE

1. Those intending to submit a Proposal are invited to attend a Proposal Conference. The Proposal Conference for this RFP will be held on Thursday, February 16, 2012 at 8:30 a.m. at Howell Hall, 1604 Market Street, Redding, California.

2. Responders intending to attend the Proposal Conference are requested to R.S.V.P. by Wednesday, February 15, 2012 at 4:00 p.m. to Dina Talison at (530) 229-8033 or [email protected].

D. NOTICE OF INTENT

Those intending to submit a Proposal must notify by email the County Contact, listed in paragraph E of this Section by Tuesday, February 21, 2012 at 4:00 p.m., of their intent to submit a Proposal. The Notice of Intent does not compel submission of a Proposal. However, only those Responders who submit a timely Notice of Intent will have their Proposal considered. If the Responder has not received confirmation within 24-hours of submission of their Notice of Intent, it is the responsibility of the Responder to verify receipt of the Notice of Intent with the County Contact.

E. CORRESPONDENCE

1. All correspondence, including Proposals, shall be submitted to:

Dina Talison - Visitation Services/Parenting Classes RFP (CTS 2031) Shasta County Health and Human Services Agency 1810 Market Street Redding, CA 96001

Phone: (530) 229-8033 Fax: (530) 225-5555 E-Mail: [email protected]

2. Responders may contact only the individual identified above and are specifically directed not to contact other County personnel for meetings, conferences, or technical discussions related to this RFP. Failure to comply may result in a Responder being barred from consideration under this RFP. No questions regarding this RFP will be answered by other County staff.


3. Questions regarding this RFP will only be received in written format and Responders may submit written questions to the County contact listed in Paragraph D of this section, no later than Friday, February 24, 2012 at 4:00 p.m.

4. County’s written responses to timely questions will be sent to all Responders who/that submitted a Notice of Intent and will be posted on the County website at: http://www.shastahhsa.net no later than Thursday, March 1, 2012 at 4:00 p.m.

F. PROPOSAL SUBMISSION DEADLINE

All Proposals must be received, at the address listed in Paragraph E. of this Section 1, no later than Thursday, March 8, 2012. Facsimile or electronically transmitted Proposals will not be accepted. Postmarks will not be accepted in lieu of actual receipt. Late Proposals will not be considered.

II. PROGRAM REQUIREMENTS

A. BACKGROUND

1. A comprehensive visitation and parenting services program preserves family ties, provides education to the parent and helps the parents meet the child’s needs so that they may successfully maintain and/or reunify with their children. Typically, Centers offer:

a. Family-centered programs/services within the local community;

b. An integrated approach to services and activities that educate and develop skills; and

c. Support and encouragement for children and families

2. To improve outcomes for families, Centers work towards creating environments that help increase Protective Factors. These Protective Factors have been described and studied as part of the Strengthening Families Initiative. This RFP seeks to support the provision of Protective Factors in the context of a Center environment.

3. Visitation and parenting services are central to reunification, providing education and support for families who have been separated due to child safety issues. Section 16507.7 of the Welfare and Institutions Code establishes specific criteria and requirements with respect to parenting classes. Visitation can be either unsupervised or supervised and can include typical parenting activities such as attending doctor’s appointments, school presentations or sporting events.

4. Research on visitation demonstrates that:

a. Frequent, purposeful visitation contributes to successful placement and reunification and reduces the time to reunification

b. Children who receive more frequent visits have fewer behavioral problems

c. Children who have more consistent and frequent contact with their biological parents have stronger attachments than children who have less contact

d. Children with higher levels of attachment had fewer behavioral problems, were less likely to require psychiatric medication, and were less likely to be termed “developmentally delayed” than were children with negative levels of attachment.


B. PURPOSE

1. The County of Shasta is seeking to provide HHSA clients with: (1) visitation services, which will allow parents to visit safely and comfortably with their child(ren); and (2) parenting classes to improve Parenting Skills. Proposers must keep in mind that the available funding, identified in Paragraph B of Section I of this RFP, is the aggregate amount available for the provision of visitation services and parenting classes.

2. The purpose of combining parenting classes with visitation services is for the parents to learn a skill and then apply and demonstrate that skill with their children. The location for these services will allow parents to visit safely and comfortably with their child(ren) and receive parenting classes, direct observation, skills modeling, training and support to improve Parenting Skills. A successful visitation and parenting services program first meets the child’s developmental and attachment needs through maintaining and promoting the child’s connections to parents and significant others. Secondly, a visitation and parenting services program assesses a parent’s ability to safely parent, teaches Parenting Skills, and assists with determining the final Permanent Plan.

3. Through visitation and parenting services, the following outcomes are expected:

a. Increasing the number of children and families who reunify through Family Reunification;

b. Reducing the length of time to safely reunify parents and children;

c. Reducing the number of children who reenter foster care; and

d. Reducing the length of time to Permanent Plan.

C. POPULATIONS TO BE SERVED

1. Visitation Services must be directed toward County referred children who are under the jurisdiction of the juvenile dependency court and placed out-of-home, or who are at risk of dependency and placed out of home; their parents, siblings, relatives and/or caretakers.

2. Parenting Classes must be provided to the County referred parent(s) of children who are under the jurisdiction of the juvenile dependency court, or who are at risk of becoming dependent children.

3. All services provided shall be culturally, developmentally, and linguistically appropriate to the population served.

D. SCOPE OF WORK.

1. The Contractor must possess and maintain a working knowledge of the current best practices in Visitation and Parenting services and a comprehensive understanding of the issues related to reducing child abuse and neglect through the Protective Factors.

2. Each response to this RFP must include detailed strategies, including but not limited to:

a. Partnering with the County, and other community service providers;

b. Connecting the Parents to the best available services; and

c. Making referrals for clients to additional community services/supports to meet the needs of the clients.


3. Each response to this RFP must include detailed strategies, and a plan of action to obtain and achieve the following goals and outcomes:

a. Required Content: In addition to visitation and parent education program content required by the state, the program at the Center must also offer instruction to parents and feedback on appropriate Parenting Skills utilizing Triple P “Level 4”, at a minimum, and other Triple P levels as appropriate.

b. Increasing parental resilience: Parental resilience developed within the context of healthy, caring relationships through programs that offer a variety of preventive services to families. Encouraging self-efficacy of vulnerable families by supporting active roles in family activities, services and through connection with other community resources.

c. Building the social connection of parents for mutual support: Developing and strengthening the positive social connections of parents that are trusting, reciprocal, flexible, protective, and embody pro-social, child-friendly values through relationships with staff; and/or helping them to access the services that they need.

d. Increasing the knowledge of parenting and child development: Parenting education programs that focus on improving parents’ strengths and emphasize knowledge of child development and parenting skills.

e. Providing support in times of need: The linkage of parents to needed assistance, resources and/or support that may involve the temporary emergency provision of basic material resources and/or access to needed behavioral/mental health services to help families cope with stresses and develop effective problem solving – particularly in times of crisis.

4. Visitation Services: Responders to this RFP must include detailed strategies (i.e., a plan of action) to achieve the following goals and objectives:

a. Providing visitation services for Parents and their children referred to the Contractor by County. Services at the Center must be directed toward the children under the jurisdiction of the juvenile dependency court and their parents, siblings, relatives and caretakers including foster parents.

b. Implementing an individualized purposeful and progressive visitation plan for each Parent in collaboration with the case-carrying County Social Worker. Each individualized visitation plan shall take into consideration:

(1) Child development and parenting skills;

(2) Types of maltreatment;

(3) Time in care / case plan goals; and

(4) Other factors (e.g., cultural background, substance abuse, domestic violence, child’s special needs, parents’ special needs, etc.)

c. Delivering Visitation services, including:

(1) Preparing Parents and children for visits

(2) Structuring of visits according to the Parent’s parenting capabilities and children’s ages, development and interests;

(3) Teaching parenting and communication skills focusing on Parents’ interaction with their children;


(4) Providing feedback to the parents as to his/her demonstrated strengths and areas for future improvement;

(5) Recognizing issues of grief and separation which affect both Parents and children during visits;

(6) Establishing and facilitating relationships between biological parents and foster parents so they are working together for the best interest of the child; and

(7) Providing ongoing review and modification of visits as part of the shared planning process.

d. Required Visitation Staffing will accommodate an average of 142 scheduled visit hours per week, 52-weeks per year, in a central location or collectively in multiple locations, as well as the following at each service site:

(1) A minimum of two or more staff persons present at all times during regular visiting hours.

(2) Supervision of the visitation program by a social worker with a Master’s Degree in Social Work or a closely related field.

(3) Additional staff with sufficient education and training to carry out their assigned functions.

(4) Additional support may be provided by volunteers to assist with visits, transportation, and other program functions.

(5) Testimony by the Contractor’s staff in court when requested by the County or when required by the court to do so.

(6) Contractor’s staff and volunteers shall undergo and successfully complete background checks as directed by the County prior to contact with children and families.

e. Facility for Visitation Services includes providing a safe and, when needed or required, supervised facility for the children to visit their parents. Specific elements of the Center to be provided must include, but not necessarily be limited to, the following:

(1) The location of the Center must be within a reasonable walking distance of a RABA bus stop. Responders may propose a plan offering multiple sites to provide services to different areas of Shasta County, (i.e. Redding, Enterprise, Anderson, Inter-mountain region, etc.)

(2) Parking for at least 10 – 15 cars and handicapped parking for one of more cars.

(3) A kitchen area with the supplies necessary for simple preparation of food and drinks.

(4) One visitation room designated for infants and medically fragile small children.

(5) A fully-fenced and shaded outside play area with controlled access that is equipped with safe toys and a picnic table.

(6) Visitation room environments that are welcoming and family-friendly.

(7) Availability of the Center for visits Monday through Friday, from 8:00 a.m. to 5:00 p.m. and every Saturday from 9:00 a.m. to 1:00 p.m.,


except County holidays. Consideration should be given to working parents.

(8) Compliance with the visitation terms and conditions as set by the juvenile dependency court or the County for each parent.

(9) Availability of the Center to visits monitored by County Social Workers, County Mental Health Clinicians or other persons approved by County and mutually agreed to by the client.

(10) Any visit location outside of the Visitation Center needs to be pre-approved by the County Social Worker or Supervisor to determine appropriateness for the child(ren) taking into consideration the specifics of the case and the safety of the child (e.g., home of the parent, home of the relative, foster home, park or public location.)

(11) The levels of supervision as required by the juvenile dependency court of County as follows:

(a) Supervised Visits: These visits must be closely supervised with a staff person within hearing and visual distance at all times. Care must be taken to make sure that the child is safe and not subjected to abuse or undue pressure from parents or others allowed visitation. When necessary, staff must intercede for the protection of the child. Staff must also provide instruction to parents on parenting and other topics deemed necessary. Children must not be allowed to leave the building with parents or other non-custodians.

(b) Monitored Visits: These visits are less structured, but a considerable degree of control is still needed for the protection and safety of the child. Staff check on the progress of visits, monitor interaction, and when necessary, intercede and/or provide instruction.

(c) Unsupervised Visits: These visits may take place at the Center, or offsite with the permission of the Contractor’s staff and case carrying County Social Worker(s). While monitoring is not required throughout these visits, the Contractor’s staff must be present to begin and end each visit.

(12) Assistance to parents in making their visit with their children as productive and as comfortable as possible. The Contractor must provide, initially and on an emergency basis, supplies for changing diapers, formula for infants, and snacks for children. The Contractor must supply games, books, and arts and crafts supplies at the center to assist in providing activities for the families. The Contractor must be prepared to provide direction, guidance, modeling, and encouragement to help families understand how the Center can best meet their needs to provide positive parent/child interaction.

(13) Provision for furnishing to each participant utilizing visitation services at the Center, a client satisfaction survey form to be completed voluntarily. The Contractor must encourage the completion of the survey.

(14) Contractor shall provide to County Social Workers, in a timely manner, not less than monthly, written progress reports summarizing parent/child interactions that occurred during the visits.


(15) Contractor shall utilize written referral procedures and written progress report formats provided by County.

5. Parenting Classes: Responders to this RFP must include detailed strategies, i.e., a plan of action to achieve the following goals and objectives:

a. Providing parenting classes to individuals referred to the Contractor by County (hereafter the “Parenting Class” or “Parenting Classes”). Parenting Classes will comply with all criteria and requirements set fourth in Welfare and Institutions Code Section 16507.7. Parenting Classes will utilize the “Level 4” curriculum of Triple P as part of the class curriculum. Contractor shall determine each Parent’s strengths and needs by consulting with the case-carrying County Social Worker and by using the assessment tools as prescribed in the Triple P training to develop a clear strategy for improving the parent’s knowledge, understanding and application of Parenting Skills. Contractor shall be responsible to provide staff trained and accredited to provide Triple P “Level 4” services to clients.

(1) A curriculum for the Parent Classes including, but not be limited to, the following components:

(a) Building self-esteem, including parents’ building both a positive parental identity and the self-esteem of their child.

(b) Handling stress and anger.

(c) The growth and development of children, including, but not limited to, safety, nutrition, and health.

(d) Developing and increasing communication skills in order that a parent may learn to listen to and speak with their child in an age appropriate manner.

(e) Learning to use positive disciplinary mechanisms as alternatives to the physical punishment of a child, including learning what constitutes abuse and neglect.

(f) Learning the boundaries of permissible sexual conduct by adults with regard to children.

(g) Respect for, and sensitivity to, cultural differences in child rearing practices in addressing all of the topics listed in paragraphs (a) through (f), above.

(h) A substance use educational component, regarding the effects on the family when the parent(s) is engaged in substance use.

(i) Review of the definitions and dynamics of child abuse, neglect, and domestic violence and its effects on children.

(2) A maximum parent-to-teacher ratio of 15 parents for each teacher for each parenting class.

(3) Provision for conducting an initial Assessment and Parental Interview of each parent enrolled for each parenting course.

(4) For each Parenting Class participant, an assessment to measure parental attitudes and knowledge prior to the start of the Parenting Class and an examination at the conclusion of the Parenting Class to measure changes in parental attitudes and knowledge.


(5) For each Parenting Class participant a written agreement that outlines the responsibilities a parent must satisfy in order to pass the Parenting Class.

(6) For each Parenting Class, staff will be trained and accredited to provide Triple P “Level 4” services to clients and will have training in the prevention of child abuse and neglect, domestic violence, and child development.

(7) Each Parenting Class consists of at least 32-hours of classroom time, staggered so that a new Parenting Class begins every 8 weeks.

(8) Provision for at least 11, staggered 16-week Parenting Classes provided annually. The goal is to have at least six parents attending each Parenting Class. The Contractor must provide both morning and evening Parenting Classes. The Contractor must also have childcare available for all the Parenting Classes offered.

(9) Utilization of a written referral procedure developed by County.

(10) Availability for court appearances as necessary.

(11) Contractor shall provide written reports about client attendance, participation, and curriculum integration with visitation utilizing format developed by County.

(12) Contractor shall provide each participant utilizing parenting classes a client satisfaction survey form to be completed voluntarily. Contractor shall encourage completion of the survey.

E. PROGRAM RELATED INTERNET SITES.

The following Internet sites may provide Responders with information relevant to this RFP: 1. Welfare and Institutions Code Section 16507.7:

(http://www.leginfo.ca.gov/calaw.html)

2. Center for the Study of Social Policy: Strengthening Families: (http://www.strengtheningfamilies.net/index.php/about)

3. California Department of Social Services (“CDSS”), Manual of Policies and Procedures (“MPP”): (http://www.dss.cahwnet.gov/ord/entres/getinfo/pdf/opsman4.pdf)

4. “Visiting: Planned, Purposeful, and Progressive” Participant’s Guide and related materials, Wentz, Rose October, 2008: (http://www.cfstc.und.edu/09confhandouts/Planned_Visits_Wentz.ppt)

5. “Visitation – The Key to Children’s Safety, Permanency and Well-Being” Wentz, Rose, May 3, 2007: (http://www.chhs.ca.gov/initiatives/CAChildWelfareCouncil/Documents/Visitation.doc)

6. Visitation/Family Access Guide: A Best Practice Model for Social Workers and Agencies,” Ohio Caseload Analysis Initiative in Partnership with ProtectOhio Initiative, 2005: (http://www.pcsao.org/CLA/VisitationGuidefinal.pdf)

7. “Visitation/Family Access Guidelines: A Practice Model for Social Workers,” Olmstead County Community Social Services Department, January 1, 2005: (http://www.dhs.state.mn.us/main/groups/county_access/documents/pub/dhs_id_048528.pdf)


F. PERFORMANCE /OUTCOME MEASURES AND EVALUATION.

1. As part of the process used to select the Contractor, the County will assess the methods whereby a Responder intends to measure and evaluate the extent to which the services to be provided have actually been delivered and the success of achieving the following objectives:

a. Services are utilized at the required level;

b. Services are utilized by the target populations;

c. Parent participants are building Protective Factors;

d. Parent participants are satisfied with the level of service they are receiving;

e. Parent participants are reporting an increased confidence with parenting skills.

2. The methodologies must be included in the Proposal.

G. REPORTING REQUIREMENTS.

The Contract will require, among other duties and responsibilities, the submission of monthly, quarterly, and annual reports, which must include at least the following:

1. Monthly Reports.

a. Visitation Services: Provision of a Parent Visitation Status Report to County on each Parent referred to Contractor for Visitation Services, and shall include a description and evaluation of the behaviors and interactions between a Parent and Parent’s Child(ren).

b. Parenting Classes: (1) Provision of a Parenting Class Status Report to County on each

Parent referred to Contractor for Parenting Classes, and shall include the following information for each Parent:

(a) Level of participation by each Parent (active/passive/absent);

(b) Number of course hours completed by each Parent;

(c) Whether a Parent has graduated (yes/no);

(d) Topics covered during attendance in the Parenting Class by the Parent and topics covered during each Parent’s absence from the Parenting Class;

(e) Weekly attendance statistics for the Parenting Classes; and

(f) Assessment of the Parent’s attainment of knowledge about Parenting Skills as demonstrated by written tests prior to and after the Parenting Classes.

(2) Triple P services will require:

(a) Participation in the countywide evaluation of Triple P as prescribed by County, including administering assessment and outcome tools and entering data in the County’s Scoring Application. Contractor shall obtain written consent and last 4 digits of Social Security number from Participants on a form approved by County in order to enter Participant data in the County’s Scoring Application; and


(b) Daily tracking and monthly submission to County of the Triple P Metrix Form provided by County to Contractor.

2. Quarterly Reports.

a. Visitation Services: (1) Data report of satisfaction surveys completed by Parents receiving

visitation services provided by Contractor;

(2) A narrative of progress toward program goals and outcomes, established jointly by the Contractor and County including discussion of program activities, identified potential problem areas, and suggestions for program improvement; and

(3) Budgetary tracking, including, but not limited to, specific documentation of time spent providing required services.

b. Parenting Classes:

(1) Data report of satisfaction surveys completed by Parents receiving parenting classes services provided by Contractor;

(2) A narrative of progress toward program goals and outcomes, established jointly by the Contractor and County including discussion of program activities, identified potential problem areas, and suggestions for program improvement; and

(3) Budgetary tracking, including, but not limited to, specific documentation of:

(a) Time spent providing required services;

(b) Hours and fractions of hours providing Triple P parent education training in a classroom setting;

(c) Hours and fractions of hours providing non-Triple P parent education training in a classroom setting;

(d) Hours or fractions of hours completing County’s Scoring Application, Metrix Form, and data entry.

3. Annual Reports.

a. Visitation Services: (1) Number of unduplicated parents and children served, including a

breakdown of children by age;

(2) Ethnicity of parents and children served; and

(3) Disability (yes/no) of parents and children served.

b. Parenting Classes: (1) Number of unduplicated clients served, including a breakdown of

children by age;

(2) Ethnicity of clients served; and

(3) Disability (yes/no) of clients served.


III. PROPOSAL SUBMISSION

A. GENERAL

1. Proposal Submission - To be considered, all Proposals must be submitted in the manner set forth in this RFP. It is the Responder’s responsibility to ensure that its Proposal arrives on or before the specified time.

2. All interested and qualified Responders are invited to submit a Proposal for consideration. A Responder may submit more than one Proposal. Submission of a Proposal indicates that the Responder has read and understands this entire RFP, to include all appendices attachments, exhibits, schedules, and addendum (as applicable) and agrees that all requirements of this RFP have been satisfied.

3. Proposals must be submitted in the format described in this Section. Proposals are to be prepared in such a way as to provide a straightforward, concise description of capabilities to satisfy the requirements of this RFP. Expensive bindings, colored displays, promotional materials, etc., are not necessary or desired. Emphasis should be concentrated on conformance to the RFP instructions, responsiveness to the RFP requirements, and on completeness and clarity of content.

4. Proposals must be complete in all respects as required in this Section. A Proposal may not be considered if it is conditional or incomplete.

5. Proposals must be received at the designated location, specified in Paragraph D. of Section I., no later than the date and time specified in Paragraph E. of Section I. Proposal Submission Deadline.

6. All Proposals and materials submitted become the property of the County.

B. PROPOSAL PRESENTATION

One unbound original of each Proposal is required. Additionally, each Proposal must be submitted in a separate sealed envelope, plainly marked “Response to RFP for Visitation Services and Parenting Classes”. Failure to submit the Proposal as requested may result in rejection of the Proposal. No facsimiles or emails will be accepted.

C. PROPOSAL FORMAT

Each Proposal must be submitted as a single document and arranged in the following sequence and using the specified attachments:

1. Statement of Experience, see Attachment A. 2. For Proposals by individuals, a current resume or curriculum vitae for each

individual.

3. A description of the proposed Visitation Services and Parenting Classes, including but not limited to:

a. Detail of each service to be provided;

b. The personnel/positions to be used in providing each of the services; including full-time or part-time status, education, training, a current resume or curriculum vitae for each individual, and any special expertise or experience in providing the proposed services. This is in addition to Statement of Experience, Attachment A;

4. A schedule/timeline for the implementation of each element of the services to be provided as identified in the Proposal.


5. An outline of the research conducted in drafting the Proposal.

6. A description of the methods to be used to evaluate the proposed Visitation Services and Parenting Classes.

7. A description of the Responder’s current community involvement and collaborative efforts that support the provision of the proposed Visitation Services and Parenting Classes.

8. A description of the Responder’s current capacity to meet the Visitation Services and Parenting classes reporting and data reporting requirements, including, but not limited to, equipment and staff support available to collect and enter data.

9. An itemized budget including: (1) a budget for July 1, 2012 through June 30, 2013; (2) a budget from July 1, 2013 through June 30, 2014; (3) a budget from July 1, 2014 through June 30, 2015,and (4) a budget narrative, including an explanation of how the amount of each budget line item was determined. The required format for the budget is included with this RFP as Attachment B. An electronic format of Attachment B will be provided upon request.

10. Copies of insurance policies, binders, or certificates evidencing the following insurance coverage:

a. Comprehensive general liability (including auto and non-owned auto, bodily injury and property damage): $1,000,000 combined single limit; and

b. Workers’ Compensation: Statutory levels.

11. A certification that all statements in the Proposal are true, and an acknowledgment that if the Proposal contains any false statements, the County may declare the Contract made as a result of the Proposal to be void.

IV. PROPOSAL EVALUATION AND SELECTION

A. EVALUATION PROCESS

1. If only one Responder submits a Notice of Intent, the County may, at its sole discretion, enter into negotiations with that Responder to provide the Services, without requiring the submission of a Proposal.

2. Should more than one Responder submit a Proposal, the following evaluation process will be used to select the Contractor.

B. EVALUATION CRITERIA

1. Initial Review - All Proposals will be initially evaluated to determine if they meet the following minimum requirements:

a. The Proposal must be complete, in the required format, and be in compliance with all the requirements of this RFP.

b. Proposers must meet the requirements as stated in the Minimum Proposer Requirements as outlined in Paragraph C. of Section V.

c. Failure to fully comply with all the requirements of this RFP and to provide all requested information may result in the Proposal being rejected and given no consideration. The determination of compliance with the terms and conditions of this RFP shall be in County’s sole judgment and its judgment shall be final and conclusive.


2. Evaluation - While cost is a major consideration in the evaluation process, selection will be based on the determination of which Proposal(s) best meet(s) the needs of the County and the requirements of this RFP for both Visitation Services, and Parenting Classes. The factors to be considered in the evaluation of the Proposal(s) is(are) as follows:

Points

Technical Approach / Understanding of Visitation Services 12

Technical Approach / Understanding of Parenting Classes 12

Originality / Effectiveness of Responder’s Approach to Providing Visitation Services 13

Originality / Effectiveness of Responder’s Approach to Providing Parenting Classes 13

Responder’s Background and Experience in Working Performing Similar Projects and/or Utilizing Strengthening Families as a Framework for Building Community Based Activities 12

Performance Measures / Program Evaluation 11

Community Partnerships / Collaboration / Community Involvement 11

Budget and Budget Narrative/ Any Cash or In-Kind Contribution Proposed to be Included as Part of the Project 16

Total Points 100

3. As part of the evaluation process, the County may schedule interviews with some or all of the Responders, and will, in any event, establish a list of the Responders evaluated.

C. CONTRACT AWARD

1. The Contract, if awarded, will be awarded to the Responder submitting the Proposal deemed by the County, in its sole discretion, to be experienced and fiscally responsible and whose Proposal is determined to be the most cost effective and advantageous to the County. The Responder submitting the Proposal deemed by the County, in its sole discretion, to be the most advantageous will be asked to enter into the Contract negotiation stage.

2. County is not required to award the contract to the Responder that submits the least costly Proposal. Furthermore, County reserves the right to award one or more contracts to one or more Responders as a result of this RFP.

3. If an agreement to enter into a Contract cannot be reached with the selected Responder, then the negotiations with that Responder will be terminated. At the sole discretion of the County, negotiations may then be opened with another Responder and the process repeated, or the County may elect to reject all submitted Proposals and terminate this RFP process. Once negotiations with a particular Responder are terminated, the County will not reopen negotiations with that Responder.

4. County may elect at any time to terminate the RFP process, including rejecting all submitted Proposals.

5. A Notice of Award will be mailed to all Responders at the address specified in Attachment A, Statement of Experience, advising if they were selected to enter


into Contract negotiations with County and shall be deemed received three business days after mailing.

D. USE AND DISCLOSURE OF PROPOSALS

1. The County reserves the right to retain all Proposals that are submitted and to use any ideas in a Proposal regardless of whether a Proposal results in a Contract.

2. This RFP process shall extend until the date stated on the County’s written Notice of Award or the date stated on the County’s written notice of cancellation of this RFP process that will be issued to all Responders and posted on the County website at: http://www.shastahhsa.net.

3. Unless the Responder provides all information required by this RFP process, the Proposal may, at the sole discretion of the County, be rejected and given no consideration. Any Responder attempting to influence this RFP process by interfering or colluding with other Responders or with any County employee may be disqualified.

4. Any Responder submitting a Proposal understands and agrees that submission of his/her/its Proposal shall constitute acknowledgment and acceptance of, and intent to comply with, all the terms and conditions contained in this RFP. The determination of the compliance with the terms and conditions of this RFP shall be in the County’s sole judgment and its judgment shall be final and conclusive.

E. PROTESTS

1. The County shall consider any protest or objection regarding the selected Responder pursuant to this RFP, whether submitted before or after receipt of the Notice of Award, provided that it is submitted and received by the Health and Human Services Agency within 10 calendar days of receipt of the Notice of Award.

a. Any Responder wishing to protest the RFP process must submit a written letter of protest within 10 calendar days of receipt of the Notice of Award by 4:00 p.m. of the final date. Oral protests shall not be accepted.

b. The written letter of protest must reference the title of this RFP.

c. All written protests must be submitted to the address specified in Paragraph D. of Section I.

d. Postmarks will not be accepted as meeting the deadline requirement for protest submission.

e. All protest must be in writing. No facsimile, email, or oral protests shall be accepted.

f. Protest letters must clearly explain the failure of the County to follow the rules of this RFP.

g. It is the responsibility of the Responder to ensure delivery of protests in accordance with this Section. Protests submitted later than 10 calendar days after receipt of the Notice of Award by 4:00 p.m. on the final date shall not be accepted or considered.

2. All written protests shall be reviewed by Shasta County Health and Human Services Agency Director, or his or her designee, who at their sole discretion shall make a final finding regarding any protest within 10 business days of receipt of the protest.


3. Written notification of the final finding explaining the basis for the decision shall be mailed to the protesting Responder within 3 business days of the final finding of the protest.

V. PROCUREMENT CONDITIONS

A. CONTINGENCIES

1. Initiation of this RFP process does not commit the County to finalize a Contract or to pay any costs associated with the preparation of any Proposal, nor to enter into a Contract with the Responder submitting the least costly Proposal.

2. The County reserves the right, in its sole discretion to:

a. Accept or reject any or all Proposals, or any part thereof;

b. Reject any Proposal for failure to submit the Proposal in conformity with the requirements, or the terms and conditions, of this RFP;

c. Waive informalities and irregularities in a Proposal, or to waive any deviations from the requirements or specifications of this RFP that are included in any Proposal, if deemed to be in the best interest of the County;

d. Negotiate with qualified Responders; or

e. Cancel in part or in its entirety this RFP process, at any time.

B. MODIFICATIONS

In the event this RFP process is amended, cancelled, or terminated prior to entering into contract with the selected Responder, County’s written notice of amendment, cancellation, or termination of this RFP process will be sent to all Responders who/that submitted a Notice of Intent and posted on the County website at: http://www.shastahhsa.net.

C. MINIMUM RESPONDER REQUIREMENTS

Responders must:

1. Have no record of unsatisfactory contract performance. Contractors who are or have been seriously deficient in current or recent contract performance, in the absence of circumstances properly beyond the control of the Contractor, shall be presumed to be unable to meet this requirement;

2. Have the ability to maintain adequate files and records and meet statistical reporting requirements;

3. Have the administrative and fiscal capability to provide and manage the proposed services and to ensure an adequate audit trail; and

4. Meet other presentation and participation requirements listed in this RFP.

D. INACCURACIES OR MISREPRESENTATIONS

If in the course of the RFP process or in the administration of a resulting contract, the County determines that the Proposer has made a material misstatement or misrepresentation or that materially inaccurate information has been provided to the County, the Proposer may be terminated from the RFP process or in the event a contract has been awarded, the contract may be terminated.


E. INCURRED COSTS

The County shall not be liable for any costs of work performed in the preparation and production of a Proposal, or for any work performed prior to the effective date of a Contract. By submitting a Proposal, the Responder agrees not to make any claims for, or have any right to, damages because of any misunderstanding or misrepresentation of the terms and conditions of this RFP, or because of any misinformation, or lack of information.

F. PROPOSAL CONFIDENTIALITY

1. All Proposals will become the sole property of the County. At such time as a Responder agrees to enter into a Contract with the County, or the County decides to terminate this RFP process without entering into a Contract, all Proposals and related documents become a matter of public record, with the exception of those parts of a Proposal which are trade secrets, as that term is defined by statute.

2. If any part of a Proposal contains any trade secrets that the Responder does not want disclosed to the public, the Responder shall mark that part of the Proposal as a “trade secret.” The County, however, shall not in any way be liable or responsible for the disclosure of any Proposal or any part thereof if disclosure is required under the Public Records Act (Government Code, Section 6250 et seq.) or pursuant to law or legal process.

3. In addition, by submitting a Proposal, a Responder agrees to save, defend, keep, bear harmless, and fully indemnify the County, its elected officials, officers, employees, agents, and volunteers from all damages, claims for damages, costs, or expenses, whether in law or in equity, that may at any time arise or be set up for not disclosing a trade secret pursuant to the Public Records Act.

G. NEGOTIATIONS

The County may require the potential Contractor(s) selected to participate in negotiations, and to submit revisions to pricing, technical information, and/or other items from their Proposal(s) as may result from these negotiations.

VI. CONTRACT INFORMATION

A. CONTRACT DEVELOPMENT

If the County chooses to fund and proceed with the provision of Visitation Services and Parenting Classes, it will enter into a Contract with the selected Responder(s). NOTE: The County will work with the selected Responder(s) to develop a Contract. Revisions to the budget and/or scope of work may be necessary.

B. STANDARD CONTRACT LANGUAGE A sample of the standard County contract to be used for these services shall be provided upon request. The final contract will include additional terms and conditions as agreed upon by the parties. At a minimum, the Contract will comply with the County’s requirements and Section 23-604 of the Manual of Policies and Procedures of the California Department of Social Services. The Contract may include the following components:

1. Provisions relating to insurance and indemnification, reporting, and record keeping.

2. A provision that the Contractor may be required to obtain and maintain continuously a policy of Errors and Omissions coverage with limits of liability of not less than $1 million.


3. A provision that the Contractor will indemnify the County of Shasta and maintain insurance with certain specified coverage limits and naming the County, its elected officials, its officers, agents, employees, and volunteers as additional insureds.

4. A reporting provision requiring inclusion of a description of individual client characteristics, demographic information, services description, and outcome information.

5. A negotiated, detailed budget and budget narrative. The budget will indicate direct and indirect costs and profit, if applicable.

6. A provision requiring that any submitted budget must comply with, and conform to, the Office of Management and Budget of the Executive Office of the President of the United States (“OMB”) Circulars No. A-21, No. A-87, and No. A-122, as well as the Code of Federal Regulations, as applicable.

7. A provision stating that the Contractor shall be construed to be an independent contractor and nothing in the Contract is intended nor shall be construed to create an employer-employee relationship, a joint venture relationship, or to allow the County to exercise discretion or control over the professional manner in which the Contractor performs the services which are the subject matter of the Contract, provided however, that the services to be provided must be provided in a manner consistent with the professional standards applicable to such services. In addition, the Contract may provide that the Responder shall be fully responsible for payment of all taxes due which would be withheld from compensation if the Responder were a County employee, and that the County shall not be liable for deductions for any amount for any purpose from the Responder's compensation. Furthermore, the Contract may provide that the Responder shall not be eligible for coverage under the County workers’ compensation insurance plan nor shall the Responder be eligible for any other County Benefit.

8. A provision that the Contractor shall ensure, and provide written verification thereof to County, that all staff and volunteers working or providing services under this agreement receive appropriate clearance following a federal and state criminal records check and a California Department of Motor Vehicles record check.

9. A provision that the Contractor comply with all applicable federal and state laws, including the Social Security Act, the Civil Rights Act, the Clean Air Act, applicable federal regulations, the State Energy Efficiency Plan, the Welfare and Institution Code, Section 508 of the Clean Water Act (33 O.K. §1368), Executive Order 11738, Environmental Protection Agency Regulations (40 I.E. Part 15), and the confidentiality provisions of Section 10850 of the Welfare and Institutions.

10. A provision that the Contractor not discriminate in employment practices or in the delivery of services on the basis of race, color, creed, national origin, religion, sex, age, marital status, sexual orientation, medical condition (including cancer, HIV and AIDS) physical or mental disability or use of family care leave.

11. A provision that the Contractor not subcontract any services without the prior written consent of the County.

VII. CONTRACT INDEMNIFICATION AND INSURANCE REQUIREMENTS

The Contract will include indemnification and insurance provisions similar to the following:

A. INDEMNIFICATION 1. Contractor shall indemnify and hold harmless County, its elected officials, officers,

employees, agents, and volunteers against all claims, suits, actions, costs,


expenses, audit exceptions (including, but not limited to, reasonable attorney's fees of County Counsel and counsel retained by County, expert fees, litigation costs, and investigation costs), damages, judgments, or decrees by reason of any person’s or persons’ loss or injury, including death, or property loss or damage (including property of County) arising from the negligent acts, willful acts, or errors or omissions of Contractor or any of Contractor's subcontractors, any person employed under Contractor, or under any subcontractor, or in any capacity during the progress of the work or the provision of services undertaken pursuant to this agreement, except when the injury or loss is caused by the sole negligence or intentional wrongdoing of County. Contractor shall also, at Contractor’s own expense, defend the County against any suit or action brought against County founded upon any claim, action or proceeding which is based upon the work or the provision of services undertaken pursuant to this agreement. Contractor shall also defend and indemnify County for any adverse determination made by the Internal Revenue Service or the State Franchise Tax Board and/or any other taxing or regulatory agency and shall defend, indemnify, and hold harmless County with respect to Contractor’s “independent contractor” status that would establish a liability on County for failure to make social security deductions or contributions or income tax withholding payments, or any other legally mandated payment. This provision shall survive the termination, expiration, or cancellation of this agreement.

2. For professional services provided under this agreement, Contractor shall indemnify, defend, and hold harmless County, its elected officials, officers, employees, agents, and volunteers from and against any and all claims, demands, actions, losses, liabilities, damage, and costs, including reasonable attorneys’ fees, arising out of or resulting from the negligent performance of the professional services provided under this agreement or from recklessness or willful misconduct.

B. INSURANCE

1. Without limiting Contractor’s duty of indemnification, Contractor and any subcontractor shall obtain, from an insurance carrier authorized to transact business in the State of California, and maintain continuously during the term of this agreement Commercial General Liability Insurance, including coverage for owned and non-owned automobiles, and other insurance necessary to protect the County and the public with limits of liability of not less than $1 million combined single limit bodily injury and property damage; such insurance shall be primary as to any other insurance maintained by County.

2. Contractor and any subcontractor shall obtain and maintain continuously required Workers' Compensation and Employer's Liability Insurance to cover Contractor, subcontractor, Contractor's partner(s), subcontractor's partner(s), Contractor's employees, and subcontractor’(s’) employees with an insurance carrier authorized to transact business in the State of California covering the full liability for compensation for injury to those employed by Contractor or subcontractor. Each such policy shall be endorsed to state that the Workers’ Compensation carrier waives its right of subrogation against the County, its elected officials, officers, employees, agents, and volunteers which might arise in connection with this agreement. Contractor hereby certifies that Contractor is aware of the provisions of section 3700 of the Labor Code, which requires every employer to insure against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of the Labor Code, and Contractor shall comply with such provisions before commencing the performance of the work or the provision of services pursuant to this agreement.


3. Contractor shall obtain and maintain continuously a policy of Errors and Omissions coverage with limits of liability of not less than $1 million.”

4. Contractor shall require subcontractors to furnish satisfactory proof to County that liability and workers' compensation and other required types of insurance have been obtained and are maintained similar to that required of Contractor pursuant to this agreement.

5. With regard to all insurance coverage required by this agreement:

a. Any deductible or self-insured retention exceeding $25,000 for Contractor or subcontractor shall be disclosed to and be subject to approval by the County Risk Manager prior to the effective date of this agreement.

b. If any insurance coverage required hereunder is provided on a “claims made” rather than “occurrence” form, Contractor or subcontractor shall maintain such insurance coverage with an effective date earlier or equal to the effective date of this agreement and continue coverage for a period of three years after the expiration of this agreement and any extensions thereof. In lieu of maintaining post-agreement expiration coverage as specified above, Contractor or subcontractor may satisfy this provision by purchasing tail coverage for the claims-made policy. Such tail coverage shall, at a minimum, provide the insurance coverage required hereunder for claims received and reported three years after the expiration date of this agreement.

c. All insurance (except workers' compensation and professional liability) shall include an endorsement or an amendment to the policy of insurance which names Shasta County, its elected officials, officers, employees, agents, and volunteers as additional insureds and provides that coverage shall not be reduced or canceled without 30 days written prior notice certain to the County. The additional insureds coverage shall be equal to Insurance Service Office endorsement CG 20 10 for on-going operations, and CG 20 37 for completed operations.

d. Each insurance policy (except for workers' compensation and professional liability policies), or an endorsement thereto, shall contain a “separation of insureds” clause which shall read:

“Separation of Insureds.

Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies:

a. As if each Named Insured were the only Named Insured; and

b. Separately to each suit insured against whom a claim is made or suit is brought.”

e. Contractor shall provide the County with an endorsement or amendment to Contractor’s policy of insurance as evidence of insurance protection before the effective date of this agreement.

f. The insurance coverage required herein shall be in effect at all times during the term of this agreement. In the event any insurance coverage expires at any time during the term of this agreement, Contractor shall provide, at least 20 days prior to said expiration date, a new endorsement or policy amendment evidencing insurance coverage as provided for herein for not


less than the remainder of the term of this agreement or for a period of not less than one year. In the event Contractor fails to keep in effect at all times insurance coverage as herein provided and a renewal endorsement or policy amendment is not provided within 10 days of the expiration of the endorsement or policy amendment in effect at inception of this agreement, County may, in addition to any other remedies it may have, terminate this agreement upon the occurrence of such event.

g. If the endorsement or amendment does not reflect the limits of liability provided by the policy of insurance, Contractor shall provide County a certificate of insurance reflecting those limits.


Attachment A

STATEMENT OF EXPERIENCE SECTION A

Business Name: ___________________________________________ Phone: Physical Address: City: State: ZIP: Mailing Address (if different from above): City: State: ZIP: Legal Entity:

Corporation (Is the Corporation considered a nonprofit organization? Yes No)

General Partnership Limited Partnership Sole Proprietorship Other: Name(s) and title(s) of officer(s) or owner authorized to sign this Proposal and any contract with the county that may result. Name: Title:

Name: Title: SECTION B Number of years in business under present business name: Prior Business Name(s): Number of years under prior name: SECTION C Number of years experience providing required, equivalent, or related services: SECTION D Contracts completed during the last five years

Year Services $ Amount Location Contracting Agency 1. 2. 3.

(Add additional pages if needed)


SECTION E Have you, or your business failed or refused to complete a contract? Yes No If yes, explain: (Add additional pages if needed) SECTION F Do you or your business hold a controlling interest in any other organization, or is this business owned or controlled by another organization, individual or business? Yes No If yes, explain: (Add additional pages if needed. Section F does not apply to government agencies.) SECTION G Do you, or does your business, hold or have a financial interest in any other business? Yes No If yes, explain (unless you are the individual personally performing contracted services or a governmental agency): (Add additional pages if needed) SECTION H Names, titles and contact information of persons with whom you or your business has been associated in business as partners or business associates in the last five years. (Governmental agencies are exempt) (Add additional pages if needed) SECTION I Explain any litigation involving you, your business, or any officer(s) thereof. If none, so state: (Add additional pages if needed)


SECTION J Provide a description of experience in the services to be provided, or the experience of principal individuals who will be performing services: (Add additional pages if needed) SECTION K If equipment is to be purchased, please provide a list of major equipment to be purchased over $3,000 for the direct provision of services related to this RFP: (Add additional pages if needed) SECTION L Please attach a copy of your most recent audited financial statement, for a fiscal period not more than 18 months old at time of submission, by an independent certified public accountant. See California Department of Social Services, Manual of Policies and Procedures, Section 23-610 (c)(15)(L) for full details of this requirement. Also attach IRS Form 990 and all supporting schedules (Non-Profit Corporations only). SECTION M Please attach a copy of the most current financial statement. Do you or your business agree, at the request of the County, to provide letters of credit, and guarantor letters from related entities? Yes No SECTION N Please provide a list of commitments, and potential commitments, including tax obligations, which may impact assets, lines of credit, guarantors letters, or otherwise affect your or your business’s ability to perform. (Add additional pages if needed)


SECTION O If the nature of the services your business provides requires business or professional licenses, are such licenses held by you and/or your business and its staff? Yes No Please list each required business or professional license: License Number Type Expiration Date (Add additional pages if needed) SECTION P Do you and your business agree to provide additional information, including references, as required by the County to make an informed determination of qualifications? Yes No SECTION Q Do you and your business agree to permit the County, State and Federal governments to audit financial and other records pertinent to the services to be provided? Yes No SECTION R By signing this Statement of Experience, I am certifying that:

1, I understand and agree (upon submission of a Proposal) to abide by the terms and conditions of this RFP and represent that I have the authority to bind the Entity/Individual specified herein to the terms and conditions of this RFP; and

2. All information provided on or attached to this form and contained within this Proposal are true, and I acknowledge that if the Proposal contains any false statements, the County may declare any Contract made as a result of the Proposal to be void.

Name (please print): Signature: Date: Title:

Attachment B


ORGANIZATION NAME BUDGET

Shasta County Health & Human Services Agency ORGANIZATION NAME 1810 Market Street ADDRESS Redding, CA 96001 Multi-Year Service Budgets

Budget Budget Period Budget Period Budget Period Total Category Budgeted Costs

07/12 – 06/13 07/13 – 06/14 07/14 – 06/15

Personnel/Position FTE 0.00 0.00 0.00 0.00 0.00

Fringe Benefits 0.00

Total Salary and Benefits 0.00 0.00 0.00 0.00

Operating Expenses

Office Expenses/Supplies 0.00 Equipment 0.00 Rents/Leases 0.00 Utilities/Communications 0.00 Travel 0.00 Software 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00

Total Operating Expenses 0.00 0.00 0.00 0.00

Other Expenses

Fixed Assets 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00

Total Other Expenses 0.00 0.00 0.00 0.00

Total Expenses 0.00 0.00 0.00 0.00

Administrative Cost 0.00 0.00 (Not to exceed 10% of Salaries)

Totals $0.00 $0.00 $0.00 $0.00

FOR COUNTY USE ONLY: Cost Center Account Code Project Code Activity Code

Attachment B


ORGANIZATION NAME BUDGET

Shasta County Health & Human Services Agency ORGANIZATION NAME 1810 Market Street ADDRESS Redding, CA 96001 Multi-Year Service Budgets

Budget Budget Period Budget Period Budget Period Total Category Budgeted Costs

07/12 – 06/13 07/13 – 06/14 07/14 – 06/15

Personnel/Position FTE 0.00 0.00 0.00 0.00 0.00

Fringe Benefits 0.00

Total Salary and Benefits 0.00 0.00 0.00 0.00

Operating Expenses

Office Expenses/Supplies 0.00 Equipment 0.00 Rents/Leases 0.00 Utilities/Communications 0.00 Travel 0.00 Software 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00

Total Operating Expenses 0.00 0.00 0.00 0.00

Other Expenses

Fixed Assets 0.00 (OTHER - Please Specify) 0.00 (OTHER - Please Specify) 0.00

Total Other Expenses 0.00 0.00 0.00 0.00

Total Expenses 0.00 0.00 0.00 0.00

Administrative Cost 0.00 0.00 (Not to exceed 10% of Salaries)

Totals $0.00 $0.00 $0.00 $0.00

FOR COUNTY USE ONLY: Cost Center Account Code Project Code Activity Code