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Backup Documents 09/09/2014 Item #16D 1 b ORIGINAL DOCUMENTS CHECKLIST & ROUTI G SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SEN THE BOARD,OF COUNTY COMMISSIONERS OFFICE FOR VA RI Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forvearded 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. **NEW** 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 Attorney Office. Route to Addressee(s)..(List in routing order) Office Initials Date 1. 2. 3. Colleen Greene County Attorney Office Ctill 91(.111 4. BCC Office Board of County TT\l Commissioners \/ (/&( c\`∎z \ 5. Minutes and Records Clerk of Court's Office cl?in (12111 t 12-5D PRIMARY CONTACT INFORMATION l 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 additional or missing information. Name of Primary Staff Natali Betanc Phone Number 239-252-40 Contact/ Department Agenda Date Item was 09/09/14 Agenda Item Number 16D I Approved by the BCC Type of Document MOU Number of Original l'' Attached Documents Attached PO number or account O number if document is ` 4L_. 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 original signature? NB 2. Does the document need to be sent to another agency for additional signatures? If yes, -VA— provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. S e�'r-..rr1Ca✓ 3. Original document has been signed/initialed for legal sufficiency. (All documents to be NB , signed by 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's -NB' . Office and all other parties except the BCC Chairman and the Clerk to the Board W/ 5. The Chairman's signature line date has been entered as the date of BCC approval of the NB document or the fmal negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's NB signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip B should be provided to the County Attorney Office at the time the item is input into SIRE. r //L Some documents are time sensitive and require forwarding to Tallahassee within a certain �l time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC onA-7188nTand all changes made during NB :`+` the meeting have been incorporated in the attached documenhhe County l iptio,: Attorney's Office has reviewed the changes,if applicable. ) ''1 - � -1 ( 'f L ii. 9. Initials of attorney verifying that the attached document is the version approved by the NB i . BCC,all changes directed by the BCC have been made,and the document is ready for e CH' 3 II 4. Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05, - ised 2.24.05;Revise, 11/30/12 16D1 MEMORANDUM Date: September 16, 2014 To: Natali Betancur, Operations Analyst Park & Recreation Department From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Memorandum of Understanding with Dr. Piper Center for Social Services, Inc. to provide volunteer services Attached for your records is a copy of the document referenced above, (Item #16D1) approved by the Board of County Commissioners on Tuesday, September 9, 2014. Per request, two original copies of the MOU were returned to the Center and our department has retained the third original for the Board's Official Record. If you have any questions, please contact me at 252-8406. Thank you. Attachment 16D1 County of Collier CLERK OF THE;CIRUIT COURT Dwight E. Brock COLLIER COUI 1, 'Y COLD THOUSE Clerk of Courts Clerk of Courts 3315 TAMIAMI TRL E STE 102 t,, P.O. BOX 413044 Accountant NAPLES,FLORIDA �r NAPLES, FLORIDA Auditor 34112-5324 _I 34101-3044 Custodian of County Funds September 16, 2014 Joan Willoughby, Program Director Dr. Piper Center for Social Services, Inc. 2607 Dr. Ella Piper Way Fort Myers, FL 33916 Re: Memorandum of Understanding between Collier County and the Dr. Piper Center for participation in the Foster Grandparent Project with the County's Parks and Recreation the designated volunteer station Ms. Willoughby, Attached for further administration are two original copies of the Memorandum of Understanding referenced above, approved by the Collier County Board of County Commissioners during their meeting held on Tuesday, September 9, 2014. Please feel free to contact our office if you have questions or need any further information regarding this item at 239-252-8406. Thank you. DWIGHT E. BROCK, CLERK Ann Je '! • -i411111, eputy Clerk Attachment Phone- (239) 252-2646 Fax- (239) 252-2755 Website- www.CollierClerk.com Email- CollierClerk @collierclerk.com _ _ 1601 Memorandum of Understanding between the Dr. e)Center for. Social Services, Inc. 2607 Dr. Ella Piper Way Fort Myers,FL.33916 239-332-5346 or 239-332-7815 fax drpipercenter.org and Volunteer Station: COLLIER COUNTY c/o Collier County PARKS AND RECREATION hereinafter referred to as "Volunteer Station". Address: 15000 LIVINGSTON ROAD,NAPLES,FL 34109 Telephone: 239-252-4000 Fax:_ E-mail: barrywilliams @colliergov.net Volunteer Station Executive Director: Barry Williams Period Covered: September 9,2014 TO September 8,2017 E1N: 59-6000558 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: Joan Willoughby TITLE: Program Director TELEPHONE: 239-332-5346 EMAIL: joan@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. Conduct and document a Level 2 FBI fingerprint background 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. 1 � i 1601 5. Provide accident and liability insurance coverage as required by the program. 6. Responsible for the management and fiscal control of the program. 7. Provide orientation to volunteers and provide in-service training on an on-going basis. 8. Provide orientation to Volunteer Station staff. 9. Permit and encourage the Volunteer Station to screen Foster Grandparents pursuant to established criteria of Volunteer Station. 10. To the maximum extent permitted by Florida law, The Dr. Piper Center for Social Services, Inc. shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of The Dr. Piper Center for Social Services, Inc. or anyone employed or utilized by The Dr. Piper Center for Social Services, Inc. in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. Collier County's limits are subject to Section 768.28,Fla. Stat. B. The Volunteer Station will: 1. Designate a staff member to serve as liaison with the Foster Grandparent Project Director and to supervise the Foster Grandparents. NAME: Annie Alvarez TITLE: Regional Manager TELEPHONE: 239-252-4449 1(a). Collier County Parks and Recreation will pay for any background screening that is required by Collier County, and volunteers must successfully complete the background screening process required by the County. 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. 2 �,P 1601 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 for project-related activities. 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. 13 Provide training for all Foster Grandparents in accordance with station policies and procedures subject to Ch.119, Fla.Stat., Florida's Public Records Law. 14. Implement Programming for Impact 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 Foster Grandparent volunteers or in the operation of its program on the basis of race; color;national origin; limited English language proficiency; sex; age; political affiliation; religion; or on the basis of disability, if the volunteer is a qualified individual with a disability. 18. The Volunteer Station will refrain from discussing personal religious beliefs, GQ' 3 1613 1 preaching, singing religious songs or praying out loud, and refrain from participating in religious education classes,prayer services,mass or religious retreats. 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 trainings. 3. Work together in developing appropriate activities for Foster Grandparents to carry out with their assigned children. 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 state or local government. Sign-e. A; ; Date: r � ` \`1 (Title) • HENNING, CH: RMAN COLLIER COUNT ill ARD OF COUNTY COMMISSIONERS Signed :�/i, lI /w •ate: D 5// (Title) Fo•I-r randparent Program 11 -ctor a D iper Center for Social Services, Inc. Please attach the IRS Letter of Determination 501(c)3 ATTEST . ' . � ppmv as to form , k DWIGHT E. BR .. terk gality CK CI)) 111 -��9 • Assistant County Attorney Attest as to - -�-� _-�6 4 c�- sIgnature:c ugly.