Att A Application - revised 4.6.2022.xlsx
XLSX spreadsheet 96 KB Posted
- Attached to
- RFA - Start up and Expansion grants
- Solicitation number
- S-58100-00002659
- Issued by
- Marion County, Oregon
About this file
This document is an application for the 2021-2023 Biennium Start-Up and Expansion Grant for At-Risk Afterschool and Summer Meal Programs, issued by the Oregon Department of Education Child Nutrition Programs (ODE CNP). The grant provides approximately $518,000 in funding for sponsors and partners to start up or expand their at-risk afterschool and summer meal programs. The application covers strategies such as adding meal types, sites, hot meals, days of operation, outreach, and enrichment activities to increase program participation. Eligible applicants must complete the application and submit it to ODE CNP by the stated deadline.
The application provides detailed budget forms for expenses related to food service equipment, sanitation, transportation, outreach, enrichment, and labor costs. Applicants must adhere to the allowable expenses outlined in the Request for Application (RFA) and demonstrate how the grant funds will be used to address the program's needs and result in increased participation. Successful applicants will need to describe how the program will continue to be funded after the grant period ends.
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Other files
| File | Type | Posted |
|---|---|---|
| Att B Certification Sheet.pdf | ||
| Att C Sample Grant.pdf | ||
| Att D Uses of Funds.pdf | ||
| RFA - Startup and Expansion Grants.pdf | ||
| 2022-39 Insurance Notice.pdf |
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Coversheet
| 2021-2023 Biennium | |
| Start-Up and Expansion Grant for | |
| At-Risk Afterschool and Summer Meal Programs | |
| State funds are available for Start-up and Expansion Grants for At-Risk Afterschool and Summer Meal programs. Approximately, $518,000 in Grant Funds is available to Sponsors and Partners during the 2021-2023 biennium. These funds are awarded through the Oregon Department of Education Child Nutrition Programs (ODE CNP). | |
| The Grant application is designed to be completed electronically. Send the completed Application and documents to: | |
| jeanie.stuntzner@ode.oregon.gov | |
| If you have questions concerning this form, please contact either: | |
| ode.communitynutrition@ode.state.or.us | kaitlin.skreen@ode.oregon.gov |
For additional information, please visit: http://www.oregon.gov/ode/students-and-family/childnutrition/cacfp/Pages/SpecialGrants.aspx
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: How to File a Complaint, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
| Mail: U.S. Department of Agriculture |
| Office of the Assistant Secretary for Civil Rights |
| 1400 Independence Avenue, SW |
| Washington, D.C. 20250-9410; |
| Fax: (202) 690-7442; or |
| Email: program.intake@usda.gov |
| This institution is an equal opportunity provider. |
End of sheet
&"-,Bold"Oregon Department of Education - Start up and Expansion Grant&"-,Regular"
Operation Plan #'Operation%20Plan'!A1Budget #Budget!A1Operation Plan cont.
#'Operation%20Plan%20cont.'!A1Application Summary #'Application%20Summary'!A1Applicant Information #'Organization%20Information'!A1Evaluation Questions #'Evaluation%20Questions'!A1mailto:jeanie.stuntzner@ode.oregon.govhttp://www.oregon.gov/ode/students-and-family/childnutrition/cacfp/Pages/SpecialGrants.aspxmailto:kaitlin.skreen@ode.oregon.govmailto:%22ODE%20CommunityNutrition%22%20%3code.communitynutrition@ode.state.or.us%3e Applicant Information
| Applicant Information | |
| Red starred items are required. | |
| FALSE | |
| Full and Legal Business Name of Entity ("Applicant")* |
Doing Business As Name*
Sponsor Agreement Number if Applicable*
DUNS Number or Unique Entity ID*
Mailing Address*
City*
State*
Zip*
| County* | Baker |
| Benton | |
| Does your organization have access to either CNPweb and/or EGMS? Yes/No* | Clackamas |
| Clatsop | |
| Primary Contact/Grant Project Director Information | Columbia |
| Must be an employee of the organization applying for grant funds. | Coos |
| First Name* | Crook |
| Curry | |
| Last Name* | Deschutes |
| Douglas | |
| Title* | Gilliam |
| Grant | |
| Phone Number* | Harney |
| Hood River | |
| Email Address* | Jackson |
| Jefferson | |
| Individual Completing the Application *If different than the Primary Contact | Josephine |
| First Name | Klamath |
| Lake | |
| Last Name | Lane |
| Lincoln | |
| Name of Organization | Linn |
| Malheur | |
| Title | Marion |
| Morrow | |
| Phone Number | Multnomah |
| Polk | |
| Email Address | Sherman |
| Tillamook | |
| Authorized Representative or Executive Contact Information | Umatilla |
| Must be authorized to sign contracts on behalf of the applying organization and should match CNPweb | Union |
| First Name* | Wallowa |
| Wasco | |
| Last Name* | Washington |
| Wheeler | |
| Title* | Yamhill |
Phone Number*
Email Address*
| Financial Office Contact Information |
| First Name* |
Last Name*
Title*
Phone Number*
Email Address*
| Food Service Management Company Contact *If applicable |
| First Name |
Last Name
Food Service Management Company
Title
Phone Number
Email Address
| Additional Individual To Include When Communicating |
| First Name |
Last Name
Name of Organization
Title
Phone Number
Email Address
| End of sheet |
| End of sheet |
Oregon Department of Education - Start up and Expansion Grant
CNP Sponsor Partnering Organization Applying to be a CNP Sponsor
PREVIOUS
#Coversheet!A1NEXT #'Operation%20Plan'!A1 Operation Plan
| Operational Plan |
| 1. Which best describes entity's status in relation to the Oregon Department of Education Child Nutrition Programs?* Choose from the drop down options |
| 2. ODE CNP State-Sponsor Agreement Number (if applicable)* |
| Please put N/A if it does not apply. |
3. Has the entity been awarded a Start-up/Expansion grant in the past?* Yes/No: If yes, when?
| 4. Applicant currently participates in which Programs as a CNP Sponsor or Partner?* | |
| Please check all that apply. | |
| FALSE | |
| FALSE | |
| FALSE | |
| 5. Applicant is submitting this application for Grant Funds to Start-Up or Expand which program(s)?* | |
| Please check all that apply. | |
| FALSE | |
| FALSE | |
| FALSE |
| 6. What strategies will Applicant employ to increase participation in this program(s)?* | |
| Please check all that apply. | |
| FALSE | |
| FALSE | |
| FALSE | |
| FALSE | |
| FALSE | |
| FALSE | |
| 7. How many total sites does Applicant currently operate for the Program requesting grant funds?* |
8. How many sites will Applicant add to the Program requesting grant funds?*
RFA 0001-ODE-2021 Oregon Department of Education - Start up and Expansion Grant Application
Add Meal Type(s) (Example: adding breakfast when it is not currently being served) Add Site(s) (Example: increasing from 5 sites to 6 sites) Add Hot Meals (Example: changing to a hot supper when currently only serving cold suppers) Add Days of Operation (Example: adding one day per week or additional weeks to current operations) Outreach (Example: printing and distributing flyers) Enrichment (Example: providing arts and crafts activities in coordination with the meal service) National School Lunch Program Child and Adult Food Care Program CACFP At-Risk Afterschool Seamless Summer Option (SSO) Summer Food Service Program Summer Food Service Program
PREVIOUS
#'Applicant%20Information'!A1NEXT #'Operation%20Plan%20cont.'!A1 Operation Plan cont.
| Operational Plan cont. | |||
| NOTE: Add new rows, as needed. | |||
| 9. If the strategy "Add Meal Type(s)" was selected, please complete the table below. | |||
| Site name, address | Anticipated increase in total meals served per month | Meal type being added | List all meal types served at site |
| 10. If the strategy "Add Days of Operation" was selected, please complete the table below. | |||
| Site name, address | Anticipated increase in total meals served per month | Additional days per week, or weeks of program? | Number of service days being added |
| 11. If the strategy "Add Site(s)" was selected, please complete the table below. | ||
| Site name, address | Anticipated daily participation at site | Reasoning for Site Selection |
End of Sheet
Oregon Department of Education - Start up and Expansion Grant
PREVIOUS
#'Operation%20Plan'!A1NEXT #Budget!A1 Budget
| Budget | |||
| For Use of Funds information please see RFA Attachment D. Allocation guidance can be founds on ODE's Start Up and Expansion Grant webpage. | |||
| Food Service | |||
| Food Service Equipment | Estimated Full Cost | Grant Funds | Please list items/services |
| Small Wares | $ - 0 | $ - 0 | |
| Small Appliances | $ - 0 | $ - 0 | |
| Large Appliances | $ - 0 | $ - 0 | |
| Service Equipment | $ - 0 | $ - 0 | |
| Other (describe): | $ - 0 | $ - 0 | |
| Food Service Equipment | $ - 0 | $ - 0 | |
| Sanitation Inspection related repairs/fees | Estimated Cost | Please list items/services | |
| Inspections | $ - 0 | ||
| Repairs/parts | $ - 0 | ||
| Contracted labor | $ - 0 | ||
| Other (describe): | $ - 0 | ||
| Total Sanitation Inspection related repairs/fees | $ - 0 | ||
| Transportation | |||
| Transportation Related Purchases | |||
| Please note: Motorized vehicles may not be purchased with these funds, nor can the vehicle benefiting from these funds be used to transport children. | Estimated Full Cost | Grant Funds | Please list items/services |
| Food transport equipment | $ - 0 | $ - 0 | |
| Safety features | $ - 0 | $ - 0 | |
| Repairs | $ - 0 | $ - 0 | |
| Paint/wraps | $ - 0 | $ - 0 | |
| Other (describe): | $ - 0 | $ - 0 | |
| Total Transportation Related Purchases | $ - 0 | $ - 0 | |
| Vehicle Mileage Reimbursement | Estimated Cost | ||
| Estimated number of miles traveled per day for program operation. | |||
| Number of days of operation | |||
| Mileage rate (Applicant's standard rate, up to $0.58.5 per mile for 2022) | $ 0.585 | ||
| Total Gas and Mileage Reimbursement | $ - 0 | ||
| Outreach and Enrichment | |||
| Enrichment/Educational Activities Equipment & Supplies | |||
| Please note: Funds may not be used to purchase equipmentor supplies considered high risk to students'/childrens' safety. If you have questions about high risk items contact Agency's Grant Manager. | Estimated Full Cost | Grant Funds | Please list items/services |
| Guest Speaker/Activities | $ - 0 | $ - 0 | |
| Equipment | $ - 0 | $ - 0 | |
| Supplies | $ - 0 | $ - 0 | |
| Other (describe): | $ - 0 | $ - 0 | |
| Total Enrichment/Educational Activities Equipment & Supplies | $ - 0 | $ - 0 | |
| Outreach Materials/activities | Estimated Cost | Remember to check out ODE's free summer meals promotional materials | |
| Print media (flyers, postcards, | $ - 0 | ||
| Ads (newspaper/radio/video) | $ - 0 | ||
| External displays | $ - 0 | ||
| Events | $ - 0 | ||
| Other (describe): | $ - 0 | ||
| Total Outreach Materials/activities | $ - 0 | ||
| Labor Costs | cell intentionally left blank | cell intentionally left blank | |
| Labor Costs for Enrichment/Educational Activities | Estimated Cost | Please list activities | |
| Please list staff postion | |||
| $ - 0 | |||
| $ - 0 | |||
| Total Labor Costs - Enrichment/Educational Activities | $ - 0 | ||
| Labor Costs for Outreach Activities | Estimated Cost | Please list activities | |
| Please list staff postion | |||
| $ - 0 | |||
| $ - 0 | |||
| Total Labor Cost for Outreach Activities | $ - 0 | ||
| Labor Costs for Food Service | Estimated Cost | Please list activities | |
| Please list staff postion | |||
| $ - 0 | |||
| $ - 0 | |||
| Total Labor Cost for CACFP Food Service | $ - 0 | ||
| Total Labor Costs | $ - 0 | ||
| cell intentionally left blank | cell intentionally left blank | ||
| Total Grant funds requested | $ - 0 |
Oregon Department of Education - Start up and Expansion Grant
#'Operation%20Plan%20cont.'!A1NEXT #'Budget%20Narrative'!A1https://docs.google.com/forms/d/154o-oTtgYvAdgqABQqL0CEmWOKsLcwflF1fGuBxnO8A/viewform?edit_requested=true ODE CNP Approved Budget
| ODE CNP Approved Budget | |||
| This budget has been approved by ODE CNP for the Start-Up and Expansion Grant | |||
| Food Service | |||
| Food Service Equipment | Estimated Full Cost | Grant Allocation | Please list items/services |
| Small Wares | $ - 0 | $ - 0 | |
| Small Appliances | $ - 0 | $ - 0 | |
| Large Appliances | $ - 0 | $ - 0 | |
| Service Equipment | $ - 0 | $ - 0 | |
| Other (describe): | $ - 0 | $ - 0 | |
| Food Service Equipment | $ - 0 | $ - 0 | |
| Sanitation Inspection related repairs/fees | Estimated Cost | Please list items/services | |
| Inspections | $ - 0 | ||
| Repairs/parts | $ - 0 | ||
| Contracted labor | $ - 0 | ||
| Other (describe): | $ - 0 | ||
| Total Sanitation Inspection related repairs/fees | $ - 0 | ||
| Transportation | |||
| Transportation Related Purchases | |||
| Please note: Motorized vehicles may not be purchased with these funds, nor can the vehicle benefiting from these funds be used to transport children. | Estimated Full Cost | Grant Allocation | Please list items/services |
| Food transport equipment | $ - 0 | $ - 0 | |
| Safety features | $ - 0 | $ - 0 | |
| Repairs | $ - 0 | $ - 0 | |
| Paint/wraps | $ - 0 | $ - 0 | |
| Other (describe): | $ - 0 | $ - 0 | |
| Total Transportation Related Purchases | $ - 0 | $ - 0 | |
| Vehicle Mileage Reimbursement | Estimated Cost | ||
| Estimated number of miles traveled per day for program operation. | 0 | ||
| Number of days of operation | 0 | ||
| Mileage rate (Organization's standard rate, up to $0.575 per mile) | $ 0.575 | ||
| Total Gas and Mileage Reimbursement | $ - 0 | ||
| Outreach and Enrichment | |||
| Enrichment/Educational Activities Equipment & Supplies | |||
| Please note: Funds may not be used to purchase equipmentor supplies considered high risk to students'/childrens' safety. If you have questions about high risk items contact Grant Manager. | Estimated Full Cost | Grant Allocation | Please list items/services |
| Guest Speaker/Activities | $ - 0 | $ - 0 | |
| Equipment | $ - 0 | $ - 0 | |
| Supplies | $ - 0 | $ - 0 | |
| Other (describe): | $ - 0 | $ - 0 | |
| Total Enrichment/Educational Activities Equipment & Supplies | $ - 0 | $ - 0 | |
| Outreach Materials/activities | Estimated Cost | Remember to check out ODE's free summer meals promotional materials | |
| Print media (flyers, postcards, | $ - 0 | ||
| Ads (newspaper/radio/video) | $ - 0 | ||
| External displays | $ - 0 | ||
| Events | $ - 0 | ||
| Other (describe): | $ - 0 | ||
| Total Outreach Materials/activities | $ - 0 | ||
| Labor Costs | cell intentionally left blank | cell intentionally left blank | |
| Labor Costs for Enrichment/Educational Activities | Estimated Cost | Please list activities | |
| Please list staff postion | |||
| $ - 0 | |||
| $ - 0 | |||
| Total Labor Costs - Enrichment/Educational Activities | $ - 0 | ||
| Labor Costs for Outreach Activities | Estimated Cost | Please list activities | |
| Please list staff postion | $ - 0 | ||
| $ - 0 | |||
| $ - 0 | |||
| Total Labor Cost for Outreach Activities | $ - 0 | ||
| Labor Costs for Food Service | Estimated Cost | Please list activities | |
| Please list staff postion | |||
| $ - 0 | |||
| $ - 0 | |||
| Total Labor Cost for CACFP Food Service | $ - 0 | ||
| Total Labor Costs | $ - 0 | ||
| cell intentionally left blank | cell intentionally left blank | ||
| Total Grant funds awarded | $ - 0 |
Oregon Department of Education - Start up and Expansion Grant
#'Operation%20Plan%20cont.'!A1NEXT #'Budget%20Narrative'!A1https://docs.google.com/forms/d/154o-oTtgYvAdgqABQqL0CEmWOKsLcwflF1fGuBxnO8A/viewform?edit_requested=true Evaluation Questions
| Evaluation Questions |
| 1a. Describe how the Applicant will use Grant Funds in adherence to both the policies and rules associated with the type of Program funds that are requested for and Attachment D allowable expenses. 1b. Describe how the Applicant will use Grant Funds to address its Program need(s) and expenses. |
2. Describe how the proposed Use of Funds will result in increased participation within the Summer and/or the Afterschool At-Risk Meals Program.
3. Describe how the start up or expansion of the Applicant’s program will continue to be funded if the program is successful. Once the grant award period has ended, how will the Applicant continue to fund the program without Agency Grant Funds?
Oregon Department of Education - Start up and Expansion Grant
Application Summary Application Summary
| Applicant's Legal Business Name |
| 0 |
| Child Nutrition Program(s) requesting funds to increase participation |
Strategies for increasing participation
"riosn": "riosn":
how does this work?
KS: It pulls strategies checked on the Operation plan sheet
| Food Service Equipment | $ - 0 |
| Sanitation Inspection related repairs / fees | $ - 0 |
| Transportation Related Purchases | $ - 0 |
| Vehichle Milage Reimbursement | $ - 0 |
| Enrichment/Educational Activities Equipment & Supplies | $ - 0 |
| Outreach Materials/activities | $ - 0 |
| Labor Costs for Enrichment/Educational Activities | $ - 0 |
| Labor Costs for Outreach Activities | $ - 0 |
| Labor Costs for Food Service | $ - 0 |
| Total Amount of Grant Funds Requested | $ - 0 |
Submit this application by email to Noemi.Rios@ode.state.or.us as an MS Excel document and attach all required additional application documents identified above separately.
Oregon Department of Education - Start up and Expansion Grant
ODE CNP Approved Summary ODE CNP Approved Summary
| Organization Name |
| 0 |
| Program(s) requesting funds to increase participation |
Strategies for increasing participation
| Food Service Equipment | $ - 0 |
| Sanitation Inspection related repairs / fees | $ - 0 |
| Transportation Related Purchases | $ - 0 |
| Vehichle Milage Reimbursement | $ - 0 |
| Enrichment/Educational Activities Equipment & Supplies | $ - 0 |
| Outreach Materials/activities | $ - 0 |
| Labor Costs for Enrichment/Educational Activities | $ - 0 |
| Labor Costs for Outreach Activities | $ - 0 |
| Labor Costs for Food Service | $ - 0 |
| Total Grant Funds Awarded | $ - 0 |
Oregon Department of Education - Start up and Expansion Grant
Tracking
| Oregon Department of Education - Summer Food Service Program (SFSP) | Version: 2/19/2020 |
| Revision Tracking |
This page is a tool for the ODE CNP Grant Manager(s) to track progress and communicate pertinent information to Sponsors to facilitate the approval process.
| APPLICATION APPROVAL | |
| Budget Status | |
| 1. Each time this document is returned to the applicant unapproved, increase the step number by one. | |
| 2. Once approved, do not change the step number. | |
| 3. If a revision is requested by the applicant, the Grant Manager will update the revision number. |
| Date Last Reviewed | |
| Revision Number | 0 |
| Step Number | 0 |
| Grant Manager Assigned | |
| CNP Manager Approval | |
| Budget Status |
| CNP Specialist Version Tracking | |
| 1. All budget activity must be tracked. Enter the revision and step number below as well as the date the email was received or sent. | |
| 2. Save the email in the Sponsor's Application folder. |
| Revision - Step | Date Email was Sent | Description/Notes |
| rev0-step0 | Application Received From Applicant | |
| rev0-step1 |
ODE Use only
| Agreement # | CACFP/ SFSP/SSO | Sponsor/Partnering Organization | Mailing Address | City, State, Zip | Primary Contact Name | Primary Contact Number | Primary Contact Email | Individual Completing the Application Name | Individual Completing the Application Number | Individual Completing the Application Email | Authorized Representative Name | Authorized Representative Number | Authorized Representative Email | Financial Contact Name | Financial Contact Number | Financial Contact Email | FSMC Contact Name | FSMC Contact Number | FSMC Contact Email | Additional Individual to Include Name | Additional Individual to Include Number | Additional Individual to Include Email |
| 0 | 0 | 0 | , | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Agreement # | CACFP/ SFSP/SSO | Sponsor/Partnering Organization | Total Grant Amount Requested |
| 0 | 0 | $ - 0 |
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