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Backup Documents 02/27/2024 Item #16D 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 5 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. ** ROUTING SLIP** Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attomey Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. 2. (Enter your Dept here) 3. County Attorney Office County Attorney Office �-• & 2 4. BCC Office Board of County CH by MB Commissioners [s] 3/3( Y 5. Minutes and Records Clerk of Court's Office r or:?(P PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above may need to contact staff for additiona or missing information. Name of Primary Staff Madison Bird Phone Number 2939 Contact/Department Agenda Date Item was 2g24 Agenda Item Number 16.D.5 Approved by the BCC Type of Document(s) Memorandum Number of Original 1 Attached Documents Attached PO number or account number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's signature?(stamped unless otherwise stated) MB 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legality. (All documents to be signed by MB the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney.) 4. All handwritten strike-through and revisions have been initialed by the County Attorney MB Office and all other parties except the BCC Chairman and the Clerk to the Board. 5. The Chairman's signature line date has been entered as the date of BCC approval of the MB document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MB signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is uploaded to the agenda. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on_244/24 and all changes made l - , e during the meeting have been incorporated in the attached document. The County &' ;__ + - Attorney Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made,and the document is ready for the 4 + s • Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04;Revised 1.26.05;2.24.05; 11/30/12;4/22/16;9/10/21 1 6D 5 0AmeriCorps DR . PIPER CENTER Seniors Memorandum of Understanding between the DR . PIPER CENTER' 2607 Dr. Ella Piper Way Fort Myers,FL. 33916 239-332-5346 or 239-332-7815 fax drpipercenter.org and Volunteer Station: Collier County Parks& Recreations hereinafter referred to as "Volunteer Station". Address: 418 School Drive, Immokalee, FL 34142 Telephone: 239-252-4677 E-mail: Randi.Swindennan@colliercountyfl.gov Volunteer Station Executive Director: Randi Swinderman Period Covered: 2/27/2024—2/27/2027 FEIN: A. The Dr. Piper Center for Social Services, Inc. Foster Grandparent Project under the oversight of the Corporation for National and Community Service (CNCS),a Federal Government agency, and the Foster Grandparent Project Community Advisory Group, will: 1. Designate a staff member to serve as a liaison with the Volunteer Station: NAME: Margaret Baugher TITLE: Program Director TELEPHONE: 239-332-5346 X102 EMAIL: margaret@drpipercenter.org 2. Recruit, interview, select, and enroll volunteers in the program. The volunteers will meet the criteria in the Foster Grandparent Program (FGP) Federal Regulations for enrollment in the program. 3. Unless otherwise specified herein, conduct and document a criminal history check for all Foster Grandparents in accordance with the requirements established for a National Service Criminal History Check by the Corporation for National and Community Service. 4. Arrange for pre-service physical examinations for new Foster Grandparents assigned to the Volunteer Station. 5 Provide accident and liability insurance coverage as required by the program. CA© 1 Updated 8/12/2021 1 6 D 5 Nu) AmeriCorps DR . PIPER CENTE Seniors 6. Responsible for the management and fiscal control of the program. 7. Provide orientation to volunteers and provide in-service training on an ongoing basis. 8. Provide orientation to Volunteer Station staff. 9. Permit and encourage the Volunteer Station to screen Foster Grandparents pursuant to the established criteria of the Volunteer Station. 10. Provide a Level 2 background check and a N.S.O.P. check before enrolling Foster Grandparents volunteers. B. The Volunteer Station will: 1. Designate a staff member to serve as the liaison with the Foster Grandparent Project Director and to supervise the Foster Grandparents. NAME: Randi Swinderman, Regional Manager TITLE: Parks and Recreation Division TELEPHONE: 239-252-4677 EMAIL: Rand i.S indermanidjco Ili ercouno:fl.gov 2. For each Foster Grandparent and for each child served, develop and obtain the Sponsor's approval, of a written Child Care Plan that identifies the child(ren) to be served and the role and activities of the volunteer activities,the expected outcomes for each child, and that addresses the period of time each child should receive such services. This Child Care Plan will be signed by the Volunteer Station liaison and the volunteer and will be used to review the Foster Grandparent's services as well as the impact of the assignment on the child's development. 3. Investigate incidents, accidents, and injuries involving volunteers and notify the Foster Grandparent Project on a timely basis. 4. Assign children with designated special or exceptional needs to each volunteer. 5. Provide site-specific orientation and training to the volunteers. 6. Submit required completed paperwork to the Foster Grandparent Project on a timely basis, i.e., individual Volunteer Child Care Plans prior to assignment, Volunteer Impact Evaluations, and Volunteer Performance Evaluations. 7. Designate space for use by volunteers in their activities with their assigned children and project-related activities. /cAG 2 Updated 8/12/2021 16D 5 AmeriCorps DR . PIPER CENTER\ Seniors 8. Ensure that Foster Grandparents serve in a volunteer capacity. The Station will verify that Foster Grandparents will not: displace nor replace paid or contracted employees, relieve staff of their routine duties, or infringe upon the site supervisor's supervisory role with the children. 9. Exclude Foster Grandparents as supervising adults when calculating state-mandated adult- to-child ratios. 10. Supervise Foster Grandparents at all times while they are performing as volunteers and not leave the Foster Grandparent alone with children. 11. Track and report volunteer hours served. 12. Ensure that any screening processes required of other volunteers at the station are required for the Foster Grandparent volunteers including county-required screening. 13. Provide training for all Foster Grandparents in accordance with station policies and procedures subject to Ch. 119, Fla.Stat., Florida's Public Record Law. 14. Adhere to the National Performance Measures at the volunteer placement site(s), as described in the Child Care Plan, in order to assist the Foster Grandparent Project in evaluating the impact Foster Grandparents have on the children served and the community. 15. Periodically review each child's continuing need for a Foster Grandparent and recommend phase-out or reassignment of the assigned Foster Grandparent, as necessary. 16. Maintain the programs and activities to which Foster Grandparent volunteers are assigned accessible to persons with disabilities (including mobility, hearing, vision, mental, and cognitive impairments or addictions and diseases) and/or limited English language proficiency and provide reasonable accommodation to allow persons with disabilities to participate in programs and activities. 17. The Volunteer Station will not discriminate against FGP volunteers or in the operation of FGP on the basis of race; color; national origin, gender; sexual orientation;religion; age; disability; political affiliation; marital or parental status; or military service. C. The Dr. Piper Center for Social Services,Inc., in conjunction with the Volunteer Station, will: 1. Recognize the Foster Grandparents for their volunteer service. 2. Arrange and deliver monthly in-service training. 3. Work together in developing appropriate activities for Foster Grandparents to carry out with their assigned children. Cpp 3 Updated 8/12/2021 16D 5 � �.�� AmeriCorps DR . PIPER CENTER Seniors 4. Provide all reasonable resources and make every effort to ensure the success of the Foster Grandparent Project and the programs of the Volunteer Station to which Foster Grandparents are assigned. D. This agreement may be amended at any time with mutual consent of both parties. Per the FGP Federal regulations, it must be reviewed and renegotiated at least every three years. E. Either party may terminate this agreement on 15 days written notice to the address listed above. By signing this MOU, the Volunteer Station Representative certifies that the volunteer station is a public agency, secular or faith-based private non-profit organization, or proprietary health care organization that accepts the responsibility for assignment and supervision of Foster Grandparents. Each volunteer station must be licensed or otherwise certified, when required, by the appropriate t' a or local government. Signed: Date: 2 27/2 Y BOARD 0 0 NTY COMMISSI ERS COLLIER COUNTY, FLORIDA . ' iSigned: / f�-CJ!I O1 LL_--L�.ific Date: l/ 0 "7.tJ Z 11 Melissa Bonner (Title) CEO and President Dr. Piper Center for Social Services, Inc. PLEASE ATTACH THE IRS LETTER OF DETERMINATION 501©3 -\ p as o legality cy___ QALQ--,i ounty A orney g {f � CR "T iiiFRIC 13Y. _ r / / . c C A-0) Attest= t Cha rman s 4 Updated 8/12/2021 signet re only