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99-23154 RESO RESOLUTION NUMBER 99-23154 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE SUBMISSION OF AN APPLICATION, IN THE AMOUNT OF $444,380, TO THE STATE OF FLORIDA, DEPARTMENT OF CHILDREN AND FAMILIES SERVICES (CFS), FOR CONTINUATION OF FUNDING OF THE LOG CABIN TRAINING CENTER, FOR THE FOLLOWING PROGRAMS: THE DEVELOPMENTAL TRAINING PROGRAM, CONSISTING OF AN INDEPENDENT LIVING SKILLS PROGRAM; SUPPORTED EMPLOYMENT TRAINING PROGRAM; TRANSPORTATION SERVICES; AND THE SUPPORTED INDEPENDENT LIVING PROGRAM; ALL PROGRAMS DESIGNED TO BENEFIT DEVELOPMENT ALLY DISABLED ADULTS; AND APPROPRIATING SAID FUNDS, IF AMENDED; AND AUTHORIZING BY THE CITY MANAGER TO EXECUTE ANY AND ALL CONTRACT(S), INCLUDING AMENDMENTS, FOR THE FINAL GRANT A W ARD(S), FROM THE PERIOD OF JULY 1, 1999, TO JUNE 30, 2000. WHEREAS, the State of Florida, Department of Children and Families Services (CFS) is desirous of having the City apply for continued funding to provide independent living skills training, supported employment training, and transportation services for developmentally disabled adults; and WHEREAS, the City has been successfully operating these programs since 1983 and wishes to continue to provide these essential services; and WHEREAS, the City of Miami Beach Log Cabin Training Center is currently serving Medicaid-eligible clients, and the Log Cabin Training Center is a certified Medicaid provider; and WHEREAS, the City is desirous of submitting a grant application for continued funding, in order to provide essential support and services to developmentally disabled adults, in the estimated amount of $444,380, for the period from July 1, 1999, through June 30,2000; and WHEREAS, the City will prepare the budget in accordance with the applicable grant period and the amount negotiated with CFS; and WHEREAS, it is necessary that such funds be appropriated for the final grant award, indluding amendments. NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City Commission herein authorize the submission of an application, in the amount of $444,380, to the State of Florida, Department of Children and Family Services (CFS), for continuation of funding of the Log Cabin Training Center for the following programs: the Developmental Training Program, consisting of an independent living skills program; Supported Employment Training Program; Transportation Services; and the Supported Independent Living Program; all designed to benefit developmentally disabled adults; and appropriating said funds if awarded; and authorizing the City Manager to execute any and all contract(s), including amendments, for the final grant award(s), from the period of July 1, 1999 to June 30, 2000. PASSED AND ADOPTED THIS 12th day of May , 1999. /1/1 MAYOR ATTEST: ~re~ CITY CLERK APPROVED AS TO FORM & LANGUAGE & FOR EXECUTION ~ Alto",.., ~ CITY HALL 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139 http:\\ci.miami-beach.f1.us CITY OF MIAMI BEACH TO: FROM: SUBJECT: COMMISSION MEMORANDUM NO. "3 2..~ - 9 ~ Mayor Neisen O. Kasdin and Members of the City C .ssion DATE: May 12, 1999 Sergio Rodriguez City Manager A RESOL I OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, AUTHORIZING THE SUBMISSION OF AN APPLICATION, IN THE AMOUNT OF $444,380, TO THE STATE OF FLORIDA, DEPARTMENT OF CHILDREN AND FAMILIES SERVICES (CFS), FOR CONTINUATION OF FUNDING OF THE LOG CABIN TRAINING CENTER, FOR THE FOLLOWING PROGRAMS: THE DEVELOPMENTAL TRAINING PROGRAM, CONSISTING OF AN INDEPENDENT LIVING SKILLS PROGRAM; SUPPORTED EMPLOYMENT TRAINING PROGRAM; TRANSPORTATION SERVICES; AND THE SUPPORTED INDEPENDENT LIVING PROGRAM; ALL PROGRAMS DESIGNED TO BENEFIT DEVELOPMENTALLY DISABLED ADULTS; AND APPROPRIATING SAID FUNDS, IF AMENDED; AND AUTHORIZING THE CITY MANAGER TO EXECUTE ANY AND ALL CONTRACT(S), INCLUDING AMENDMENTS, FOR THE FINAL GRANT A W ARD(S), FROM THE PERIOD OF JULY 1, 1999, TO JUNE 30, 2000. ADMINISTRATION RECOMMENDATION Adopt the Resolution. BACKGROUND This is an application for grant funding to the State of Florida, Department of Children and Families Services (CFS) designed to benefit up to fifty-two (52) developmentally disabled adults. The City's Log Cabin Training Center (LCTC), located at 8128 Collins Avenue, contiguous to the Log Cabin Plant Nursery since 1983, has operated a State of Florida, Department of Children and Families Services (CFS) program entitled Adult Day Training Program (ADT). The program consists of a training center for Independent Living Skills and Vocational Skills Training and it is administered by the City's Community 1 Economic Development Department. 41 AGENDA ITEM C []) DATE 5-[2:-91 Clients participating in this program are referred from either the State of Florida, Department of Children and Families Services, or are sponsored by their own families. There is a limit of thirty-nine (39) participants to this program. The program strives to teach clients basic living skills, such as housekeeping, cooking, horticulture, and interviewing techniques. The Program's goal is to teach the participants to become self-reliant. Daily transportation is also provided to and from the program. The successful graduates of the program are then able to maintain a household and engage in meaningful employment. In 1989, the City's LCTC became involved in another CFS program for developmentally disabled adults entitled Supported Employment. There is a limit of fifteen (15) participants to this program. The program focuses exclusively on preparing and training clients to assume jobs utilizing the skills already learned under the Developmental Training Program, detailed above. (Both of these programs, while funded separately, are intricately linked together.) A counselor makes the initial contact with a prospective employer to secure potential positions for graduates of the program and then matches a client's skills and abilities with the job duties and responsibilities required by the position. Follow-up and progress reviews are conducted by the counselor to ensure that the client is able to perform the job effectively. On July 1, 1993, the Log Cabin Training Center started to operate a program entitled Supported Independent Living (SIL) Services. The purpose of that program is to provide an independent living environment for three (3) clients currently served through the City's Program(s). Matching funds are required for the Developmental Training Program and for the Supported Employment Program. Through this grant, component clients are being provided with appropriate rental housing. Specific support services and supervision are being provided by present staff and a Supported Living Coach, in order to ensure the clients' health and safety in their new environment. ANALYSIS Presently, the City provides services for up to fifty-seven (57) developmentally disabled adults of which all are funded through these CFS Grants. The City must apply annually to the State of Florida, Department of CFS for funding for the Developmental Training programs, as the grant awards are not guaranteed from year to year, nor are funds automatically allocated to the City. As such, a grant application has been prepared which includes narrative program descriptions and proposed operating budgets for each program: Independent Living Skills Training, Supported Employment Training, and Transportation Services. The City of Miami Beach Log Cabin Training Center is a medicaid provider and is currently serving medicaid eligible clients. The State of Florida, Department of CFS has tentatively informed the City that it will consider the same grant requests under the Independent Living Skills Training (Developmental Training) Program (which include the Supported Employment Training Program and transportation services) and for the Supported Independent Living Program. Combining these programs results in a total grant request of $444,380 for Fiscal Year 1999-00 to fund the Log Cabin Training Center's Program(s); this will provide over one-half of the Center's operating budget with the remainder to be funded by the City. 42 Funding at this level will allow the Log Cabin Training Center to continue providing services for up to fifty-two (52) developmentally disabled adults. The program period begins on July 1, 1999 and ends on June 30, 2000, in order to coincide with the State ofFlorida1s fiscal year. The State of Florida, Department of CFS requires that the City adopt resolutions which demonstrate the Commission's authorization to apply to the State of Florida, Department of CFS, for funding ofthese essential programs. CONCLUSION The Administration recommends adoption of the attached resolution which authorizes the preparation and submission of a grant application in the amount of $444,380 to the State of Florida, Department of CFS; authorizing the continuation of the Supported Independent Living Program; the appropriation of funds for the :final grant awards, including amendments; and authorization for the Mayor and City Clerk to execute the two (2) corresponding contracts. After the City's grant application has been negotiated and approved by State of Florida, Department of CFS, a final contract for each program, similar in form to the contract attached hereto, will be executed by the Mayor and City Clerk. ~. SR/8t-/RM/ AL;bmc Attachments 43 City of Miami Beach's Log Cabin Training Center Name Position Title Percentage of Compensation AgiLong Program Director -100% Glenna Higginbotham Education Coordinator 100% Nelson Padin Social Worker 100% Brenda Carbonell Administrative Assistant 100% Patrice Lawrence Instructor 100% Javier Aguayo Instructor 100% Leslie Reed Empl. Specialist/Job Coordinator 100% Lawrence Roth SIL Coach (part-time) 100% Lawrence Roth Instructor (part-time) -0- Michael Gibson Instructor (part-time) -0- Bruce Morris Job Coach (part-time) -0- 46 ~'"$.~'#.'#.?fe~ ~ ~~ 0 OOO....OO~ N 0 Ww 0001t)001t) M u..z >0 OOONOOIri <<l Oz 0 .... N ..1- .... I ~~O .,e~ . W e ZOM WO.... 0..1.. ....NO CIl 6)0 0 NOO;::::- 0 0 ;::::- ....MZ CIl CIl CIl 0 0 Olt)- wO CCo ~ ~ CD 00 (.)::::l 0 .. .. Z .... .... 0 . 'W zco :::. :::. 000 < . 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FAMILIES CIVIL RIGHTS COMPLIANCE CHECKLIST Program/Facility Name Tra1.n1.ng cente County I District City of Miami Beach's Log Cabin Dade XI Address Completed By 8128 Collins Avenue Nelson Padin City, Stale, Zip Code Dale 1 Telephone . Miami Beach, FL 33141 04/23/99 (305 ) 993-2008 READ THE REVERSE SIDE FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN COMPLJ:TION .OF THIS FORM. PART I. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: D 1. S tr 1. ct XI, Dade County & the City of Miami Beach. Th proaram provides services to ADA developmentally disabled(mentally retarded) Day Training Center. 2. POPULATION OF AREA SERVED. Source of data: Total # % White % Black % Hispanic 92,000 42 4 53 3. STAFF CURRENTLY EMPLOYED. Effective date: Total # % White % Black % Hispanic 7 43 14 43 4. CLIENTS CURRENTLY ENROLLED OR REGISTERED. Effective date: Total # % White % Black % Hispanic % Other 52 38 27 35 5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. Total # % White % Black % Hispanic % Other 1 % Female % Other % Female 05 % Handicap % Female 35 % Handicap 100 % Over 40 Yrs. 35 % Other % Female PART II. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with the Department of Children and Families? If NA or NO, explain. NA YES NO o ~ 0 NA YES o ~ NO o 7. Compare staff composition to the population. Are staff representative of the population? If NA or NO, explain. NA YES o ~ NO o 8. Compare the client composition to the population. Are race arid sex characteristics representative of the population? If NA or NO. explain. NA YES o ~ NO o 9. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or handicap? If NA or NO. explain. 10. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of NA YES NO race. sex, color, age. national origin. religion or handicap? If NA or NO, explain. t[J 0 0 We are not a residential or intermediate care facility. However, all clients provided the services such as educational/vocational and counselinq without reqard to rase, sex, color, national origin, reliaion. aae or handicap. 11. For in-patient services, are room assignments made without regard to race, color, national origin or handicap? If NA or NO. NA YES NO explain. KJ 0 0 We are not a residential facility. 59 Distribution of Copies: White - District Program Office Yellow - Facility Page 1 of 2 CF 946A. Jan 98 (Replaces Oct 96 edition which may be used) (Slock Number: 5740-00A-0946-0) PART II.. USE A SEPARATE SHEET OF PAPER FQR ANY EXPLANATIONS REQUIRING MORE SPACE. 12. Is the program/facility accessible to non-English speaking clients? If NA or NO. explain. NA YES NO o GI 0 13. Are employees. applicants and participants informed of their protection against discrimination? If YES, how? Verbal _ Written _ Poster _ If NA or NO, explain. 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. 15. Is the program/facility physically accessible to mobility. hearing and sight impaired individuals? If NA or NO, explain. NA YES NO o Ii] 0 NA NUMBER [] I I NA YES NO ~ 0 0 PART III. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. 16. Has a self-evaluation been conducted to identify any barriers to serving handicapped individuals, and to make any necessary YES NO modifications? If NO, explain. 0 0 17. Is there an established grievance procedure that incorporates due process into the resolution of complaints? If NO, explain. 18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain. 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of handicap? If NO. explain. 20. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired individuals? If NO. explain. YES NO o 0 YES NO o 0 YES NO o 0 YES NO o 0 PART IV. FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000 OR MORE. 21. Does the program/facility have a written affirmative action program? If NO, explain. YES o NO o DEPARTMENT OF CHILDREN AND FAMILIES USE ONLY Reviewed By In Compliance: YES 0 NO 0 Program Office *Notice of Corrective Action Sent -1-1_ Date I Telephone 1-1- Response Due On-Site D Desk Review D Response Received '-1- 6U CF 9468. Jan 98 (Replaces Oct 96 edition which may be used) (Stock Number: 5740-008-0946-4) Page 2 of 2 Attachment ..B. 1999-2000 DEVELOPMENTAL SERVICES BUDGET REQUEST A. AGENCY PROFILE: Agency Name: AGI FODOR-LONG CITY OF MIAMI BEACH'S LOG CABIN TRAINING CENTER Executive Director: Address: 8128 COLLINS AVENUE MIAMI BEACH, FL 33141 Telephone: (305) 993-2008 AGENCY TYPE: X Governmental Agency Not-For-Profit (Please provide documentation) For Profit BU0199912000 61 1999-2000 DEVELOPMENTAL SERVICES Information Page: BUDGET REQUEST WHAT IS THE COST ALLOCATION METHODOLOGY USED BY YOUR AGENCY? (Please attach a separate sheet if necessary) DOES YOUR AGENCY KEEP SEPARATE ACCOUNTING LEDGERS REPRESENTING FOR EACH FUNDING SOURC YES_X_ NO .- (IF NO PLEASE EXPLAIN, Attach extra page if necessary) IF YES DOES THIS REQUEST REPRESENT THE COMBINATION OF ALL YOUR FUNDING SOURCES? YES X NO DOES THE AGENCY PROPOSAL FORM D (pages 1 & 2) REFLECT ALL SOURCES OF INCOME? (IF NO, PLEASE EXPALlN, Attach extra page if necessary) YES ATTACH YOUR AGENCY'S LIST OF ALL EMPLOYEES INDICATING POSITION TITLES, DEPARTMENT AND ALLOCATION PERCENTAGE. (FOR LOG CABIN ONLY). SEE ATTACHED. ATTACH TO THE BUDGET REQUEST YOUR AGENCY'S PAYROLL MASTER CONTROL REPORT FOR THE MONTH OF FEBRUARY, 1999. (FOR LOG CABIN ONLY) SEE ATTACHED. BUD1999/2000 62 1999-2000 DEVELOPMENTAL SERVICES Proposal Form A: BUDGET REQUEST Agency Name: CITY OF MIAMI BEACH'S - LOG CABIN TRAINING CENTER Service Name: HOW MANY NON-MEDICAID WAIVER CUSTOMERS WILL BE SERVED 7/1/1999 - 613012000? 8 HOW MANY MEDICAID WAIVER CUSTOMERS WILL BE SERVED 7/1/1999 - 6130/2000? 39 HOW MANY PRIVATE PAID CUSTOMERS WILL BE SERVED 7/1/1999 - 6130/2000? 5 TOTAL NUMBER OF CUSTOMERS THAT WILL BE SERVED 7/1/1999 - 6130/2000? 52 HOW MANY D.S. CUSTOMERS ARE ON YOUR WAITING LIST FOR THIS SERVICE? 42 WHAT IS YOUR FISCAL YEAR? _10_/_01~_99_ THROUGH _09_/_30~_00_ SIL-15 SIL-3 HOW MANY TOTAL EMPLOYEES WILL YOUR AGENCY HAVE? FULL TIME 7 WHAT GEOGRAPHIC AREA(S) IN MIAMI-DADE COUNTY WILL YOU SERVE? FULL TIME 7 NORTH CENTRAL SOUTH EAST WEST ALL OF THE ABOVE x PART TIME 4 HOW MANY EMPLOYEES WILL BE FUNDED BY D. S.? PART TIME 4 PROGRAM EXPANSION 7/1/1999 - 613012ooo? F PR YES (IF YES PLEASE EXPLAIN, Attach Extra Page if Necessary) BUD 199912000 63 Attachment ..B 1999-2000 DEVELOPMENTAL SERVICES BUDGET REQUEST Please list all program location, program names and person(s) in charge: B. PROGRAM LOCA TION(S) BUD1999/2000 Lead Person for The Program: Program Name: Address: Telephone: Fax Number: GLENNA HIGGINBOTHAM CITY OF MIAMI BEACH'S LOG CABIN TRAINING CENTER 8128 COLLINS AVENUE MIAMI BEACH, FL 33141 (305) 993-2008 (305) 993-2012 64 N - o ..- Q) C) m c.. to- UJ w ::) G w 0:: to- W C) C m ::) m :E UJ 0:: w 0 o ~ ~ ti w w UJ ::) ....G < w to- 0:: Z to- W w :E C) Q. C o ::) id m > w C CI CI CI N . eft G) eft ... UJ (i) ~ < Z < to- W C) C ::) m 0:: W to- Z W U C> z z <c 0:: to- Z CD < u C> o .... 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PROGRAM LOCA TION(S) Lead Person for The Program: Program Name: LESLIE REED CITY OF MIAMI BEACH'S LOG CABIN TRAINING CENTER Address: 8128 COLLINS AVENUE MIAMI BEACH, FL 33141 Telephone: (305) 993-2008 Fax Number: (305) 993-2012 BUD199912000 82 Q) Ol m 0.. c u. 0 0 0 0 0 0 0 0 0 w t) - ...... ...... 0 0 0 0 0 0 0 ~ cO , , . , , I cO .0 . .0 ci , ci I . ci ci ci en c 5: w 10 10 M M 0 0 0 0 0 :::> ::E )( ... 1'-. 1'-. "It "It N N N O. 10 0 0 ...... CD ...... w 0:: ~ cD 0:: u. tit tit tit tit tit tit tit tit tit tit tit tit tit tit tit tit tit tit tit C ~ ~ ~ '# '# ~ ~ ~ ~ C 0 0 0 0 0 0 0 W 0 0 0 0 0 0 C 0 0 C ~ ::E 0 M 0 0 0 0 0 0 0 C ~ en 0 LL ci C"i ci ci ci ci ci ci ci N W t) ~ 0 Cl'l 0 0 0 0 0 0 0 ~ 0:: 0 I :::> C ...... ...... ...... ...... ...... ...... ...... ...... en 0 LL en en w """ 0:: ~ ~ ~ ~ I w 0 0 0 0 t) ~ 0 0 0 0 N M M M g z N en en N <l: ~ a: - 0 ...... ~ ~ ~ W ~ 10 M M 0 (/) U Cl'l co co I'- W Z cO cO , , I , cO ci , I , , , , , , I , , , , , w ::) ~ 0:: , ... 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III 52 0 0 c w 0 ~ 0 ..j a: ~ 0 ~ c a: a: a: c w I- 0 Cl w w w W ll.. ::::- 0 > z o. 0 l- X X CI) W 0 ..: N a: c ~ Z l- I- ..j CI) ::> 13 ~ w CD c 0 ll.. ::l 0 0 0 c( a:i 0 ci u.i Ii :r 0 x I- W LOG CABIN ENTERPRISES, INC. LOG CABIN NURSERY PAYROLL NAME: /11, 'c.I-M€ L 6-Jg~o~ WEEKENDING: ~J 119 I DATE IN OUT TOTAL HOURS A C- 'i"}V I rr-; / ~ROSS Si\l.iS 7. I b 1 '14 &j:OD )O! sa I . S; T,E~ c tfI"..! (i- ( IS IE en\...lN'Jt.- 6- 2/g - /\fEN /J. /~f - f)/') p/f 1:0, m-<lt:.H. ~~ fft i)(.)~( , - ......... (\ ~ ~ D. ere'M( /' ............. ......... TOTAL )(5X7.iJ"= , ) ?n~ i lQ!~~ SIGNATURE :2-/,,/17 DATE riL~~ AUTHOIUZAT~ON fJp :Apt /'f1 ~J... 3 l, t. ) ~ 1"55 (? Y;Lc( d.<;)-1 vjs. ...~.~.~.__"_...,~ c. -r- 812.8 COLUNS AVENUE Mlft.MI BEACH. Fl.ORIDA 33141 (305)~3'2008 LOG CABIN ENTERPRISES, INC. LOG CABIN NURSERY PAYROLL NAME: Lo..\DR.e.NC..e.. ~C\+, WEEKENDING: ~"?S}~~ DATE IN OUT TOTAL HOURS GROSS SALES aJ 5)90.. q:oo \O',~C) LS \' ea...c..h. ~)151~ ~ G\ '.00 10 ~-30 t. ~ . ;;;Vo,; ~ 0, 9:.oC) I CJ~ 3(1) (.-S- \\ all (!); a.. '1 q-~OO t ('J ~ 30 f . --s- l( ~', Jq~ ~'...OO lCl:30 4.-S- ~ d/t:21 0., ~ '1~~ 10 ~ ~C> l.~ ,\ ::1h~ I~~ q '..(')(1 ,(}1~30 I.S: " ::2h -, /0, ~ q~oCJ }Cl ~ .3 0 LS- '- ~/\"3)9 '" q:oo \ 0 ~3D i.~ ************* ********* TOTAL \ ~..5 x;;u) -::: :$ a~o'- '" --- . C/XV'" U ~/6 SIGNATURE ;;2jr8')~9 DATE ~C12 ~ AUTHORIZAiT:0N f7J ::/..; 15 ft '-*- It / ;J1tJ F f) CbvC. ~d IPS- ~--5. ~j 8128 COLLINS AVENUE ~.~fAMI 8E:r'\C~:gCP.!D,t\ 33141 (3051 -2008 LOG CABIN ENTERPRISES, INC. LOG CABIN NURSERY PAYROLL NAME: I'h/C/~ J- C?n~~tfrv' WEEK ENDING: 2.! '-I - :2. ) I FJ '1 ~ DATE IN OUT -TOTAL HOURS Acriv lory -~ROSS ~'-I ~ -.---- !J-.J'f I I '3!t1~ . S-: sO 7.,6' TtVP b€l/vEtVE~ 2-/S- 1'2...~CO I : ()~ f I IJ p;t>m S/'rE.€7' 'LIS- If:t/Il .5' /tJ~ I,t) DE t../ IIE,ec.., 2./~ ~!go u, ,'.:? () /tJ,tJ M.A!...,'[; r .s.A LES "2-1 g /2.:&Jd l!ctJ I, (J c.;::~~p,v' Pt/9r1/~ 2./~ ~!t)&' Lf!vp I, () Pit (,'v&€. Lt 7.. J'1 , 1.'&10 Lf-!d() J I () /:)~ t/ v/E,e.1.1 '7-1 If) ~:()O S'".' .g 6 2.S S 17J1=,c "'" e E/ - 01- pI!!!: { . 77J .si:Jt1TE- .11 it; ~# rz../'I !rClCI 'I .. tJ4 /,0 p~LIII~ . 2/ ,.z. /Z.'ctD l!cJtJ J, () [),4 774 s i'fEtEn 'i-I , (, I Z : &'0 1.( tJl) I, P Ic~Sil~ LV LJS ?./ I 7 1 ! C/() Lf: tiP 1,0 $714rr prtf 1:7; /;~LM ;ey .- ^V" ~ -, ...*...*..... ..*.*.*** TOTAL Q.. 'I.. r1 (iJ ! (J- ,2 'f(/, uj ff . ?JJJQ'#..-~ SIGNATURE ,-11~Jtf7 DATE UU-v (JCIi-~ AUTH. OIUZATION J.. ff :J-/I J' /'1 tt/( !~~/ 8128 COLLINS AVENUE MIAMI BEACH. Fl.ORIDA 33141 (305) e!b-Z008 - _____..a ___ __ __.._.._......, n.c..""'.....,... -'''\.....1.. TC:: EUGENE H. LEON~RD. C.P.~ 3058932032 p.e1 LOG CABIN ENTERPRISES, INC I i I I ' I Ni~1E: J i , I , , LOG CABIN NURSERY FA YROLL BRUCE MORRIS TOTAL Ji? .b~ z' ~.,<<; , ~ DATE I I I 1 I I I . I , ,.0 ~i~d I . I er?8 COI..WNG AVENU:: MIAMI 8 EAC:H , FLORIDA 33141 (3o!5l 993'ZOOB .s- Hr.-H,P_FIT ~TIO"&1. TlIAlN'NG ,.AOc;"",," r'OfI OIE\lI\.QP",<."",TAI.I.' Ols"a~tc ADLI.. 15 9'~INI';;'~l tIHi\1:) ~'J'1 nOZ;-t.:E,E-;;I)~ .31 ~ 8~:~T 86St/Qr/~1 jJf' ';'j;f/1r 94 LOG CABIN ENTERPRISES, INC. LOG CABIN NURSERY PAYROLL NAME: L~Q...~c...e. ~~ WEEK ENDING: QIJ3)0, 7 DATE IN OUT TOTAL HOURS GROSS SALES ';;;2 )?;S Jot ~ I \ ~'.OO ) '.00 I \ rJ U()ch. a/q J ~<4 l ~ '.00 ) :.CO I 't .;,,AOJOt C, ~:oa N~CO , ~~ QJ < } /'10, ~ ~'.CO \',00 I -J.. v (")(~\ 1:2)( 7 )0,0, ~ ~CJO 3~30 ~~ ~~~ *...........* *...**... TOTAL d--.I.5' )( ~ IO:.~ 45. 00 /Jv7 ..~ '/1 yY " U ~~~ ;;l/18/99 DATE ~~&r AUTHORIZATION L ~ cJ-1/ J /99' tl.;(" J bS ;;2- SIGNATURE 81Z8 COLLINS AVENUE MIAMI BEACH. FLORIDA 33141 (305) 99lfiZ008 ...__.0......._._ .,__._.........,". '""'nA.......,_ Qr--~d..... IC"'nD n=-\/c;-, _..............,.....,... {"....C.D. c..... ;'\t"'" " '""c: LOG CABIN ENTERPRISES, INC. LOG CABIN NURSERY PAYROLL NAME: /h I 'c. ffA.c L 6-J gS'Cl~ WEEK ENDING: :L / I 1 - '1 It.{ /'11 DATE IN OUT TOTALIIOURS A criV/'1'1 ffltOSS SALES :1-//1 /2../!1> / ,r 00 /. () I/A-rn S I+EE75 2.//1 ~ ~ &J~ 5"": '? 0 2..S glEUE XSi..C- j)tFtill ~, rr- i...vs ;,o,.-aplh-/ p"J 2/ "La g~so 5"""~' .1 0 q, () M,,4lWr~;- SME,f 2. /2.. '2.. l. 2 ~o 0 / ..'dO I. () L E r s ~....J PL,1-,vS' 2/2.0/ J~(}P S-! 0 (j '2.. I 0 TWd I>EI./IIE/lI€<: 2. /2..S- 3:01/ S" :t10 21 () T/.t.I 0 DEi.lv~/ES 2. /2.(P JZ~pu /-:vP /.0 ".A-;-A ~ J+E E'7S' 2/2." ?~po S-: Of) Z,t) TWIJ /.)/E{/V€;2/ES 1 I, S",tJ If+;vP~C.;t+pE. w~ - - P/E12... """' .A.rE/vf~ 1/, /2 ~tlP I.'po I, tJ LErs();oJ P~5 !13 1~tJl ~.' dO 1,0 ~'T'A;r=f= ,..,,€Er. I~AI..iE. (' . !t. ~{i; - ............. ......... TOTAL 2 '1. S- ffrJV~1 ~/II- := 1;2 Cj.".tnI~ , ~ .. > ~5 ~~ SIGNATURE :l /~ /7''1 DATE ~ ~/mo::- AUTHOIUZAT N r!..i( 81- 0 s- jJ jJ .3j; f'l 81Z8 COLWNS AVENUE MIAMI 81:=:.ACH Fl.ORIDA 33141 {30S} 9m3:Z008 _ n...........-!C...... C-,..,C n'-..r-. .....ro......::."'-'Tal I Y nlC;:ARI t="r"l AnlJl T~ .,~' EUGENE H. ~EON~RD, C.P.~ 3058932032 IJOG CABIN ENTERPRISES, INC LOG CABIN NURSERY PAYROLL WEEK ENDINf;: 'q9- . ! ' '-. ......;~S..:.. _.~ _.- -. -------- _.- ------ '""""~~ TOTAL / () ;:; lt2Jj{. --I zk~ I 81:'.8 COLl..IN~ AVENUE MIAMi E:iEACH. F'LORIO.6. 33141 (:!IOS} 993-2008 -<f tJtJ - o j.:<.-d 30- Ii () S.1.: :-:rl 011,',,' l "'<;;'N.r'~n" VOCAl1ON." 'nIA'....NCO F"A(lo;.""" ~Olll OEV(I,Q......:",....., · OIi:J.Ol.l;O 'AOU..r:. "11 IT! I r'.:.':'11 : 'T!:1\1:-1 r:,r'l ".!t. : ,- i ~:F.('l ,/ ;1'[.'.: r ~ rfCoO :-,',r .1:0:: 3&1:~ ~ 97 P.01 I I I f , . ~ ! . I i i I f f r I LOG CABIN ENTERPRISES, INC. LOG CABIN NURSERY PAYROLL NAME: l (J..Lv~R-.l\.J <'-.Q.. ~C \1'"\. WEEK ENDING: 3)J-.f 19 7 DATE IN OUT TOTAL HOURS GROSS SALES \0',30 l.~ IC-CN ' q' ~ Cl () 'O~ 3 {.-:s- I' C1 ~ GO lO : 30 l.~ \ \ ~ '_00 t -"':S q'.CC L"5 . \ q~oo to'.30 \. '"S 1'/ -- II ~:OCJ l cr -=?:C I. -S- \\ '" ~ . \ Q)~ ~CJ Ls l( L5 I, ************* ********* TOTAL ,s )( Q .oc:.:. $300."" . 06.5 SIGNATURE 3/~/9 t; DATE liAv 4?lL r.;, AUTHORIZATION ~/( 8128 COLLINS AVENU~ MIAMI 8E.~CH. FLORIDA:::'':': ,3051 sg@.2008 l/ ~';j /0 IF 3/r/11 :3 f.-' () ?f\ t's-,j I) !Jj{ -i cl 2J. fst- 55 ---- ......-:-- ,~ .--...." .-..,. I - -... --~; ~ ~ '"'- .'J("\""l,~C''''''rr'!" '.'-oc;. r:nNAl. ~.AJN1"',;\;->:"""'.:;f~A"-4 n'")R r::;E'.,' '__ LOG CABIN ENTERPRISES, INC. LOG CABIN NURSERY PAYROLL NAME: La.wn~.NCe..- <no\-h WEEK ENDING; '3/-4/9 c; DATE IN OUT TOTAL HOURS GROSS SALES IWIQ)9'1 \Q:ao \ ~co I cL. UN cJL ~I ;)~/~ 0., 1 :;)~oo t ~ 0<:; { " ;V :::U, I q 0, I ~:co 1...00 t ''- 3/1. /0. df I( IP-: 00 ( '-Oel l 3iaJotC, \~:OO I ~ : "3(:) _S- '?o.pR,S we<=..( 3i~ )'1~ 'a~OO 3: -so _ -s- I, 3/3)0,'1 1 St ~c'O ~.:2. '. 3C., ~5 ~~ I\..... 3/~ /C;~ 3..co ~~)4~ .'1~ ~ '" c; 31.H ) ~c:; ).;l', CO , : 00 \ ~ L~c),l ............. ......... TOTAL t-t . ~-5'" x:& 10 ~~ ;: -.Jt'1:l ;'50 11 (J _ U 5 SIGNA TURE 5/~/'l9 DATE (LGE~ AUTHORIZATION t-Z 3 7- / I /J7 3/!r~ .~~ 8128 COLLlNS AVENUE MIAMI BEACH F'n<riR10A 33141 1305) 99:?2008 CI;R11FICATlON REGAROING LOBRVlNG CERTIFICATION FOR CONTRACTS, GRANTS, LOANS ANO COOPERATIVE AGREEMENTS Attachment The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contrad, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connedion with this federal contrad, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instrudions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontrads, subgrants, and contrads under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fad upon which reliance was placed when this transadion was made or entered into. Submission of this certification is a prerequisite for making or entering into this transadion imposed by sedion 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subjed to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. o '~ d'- ~ Signature 04/22/99 Date AGI FODOR-LONG Name of Authorized Individual Application or Contrad Number CITY OF MIAMI BEACH'S LOG CABIN TRAINING CENTER Name of Organization 8128 COLLINS AVENUE, MIAMI BEACH, FL 33141 100 Address of Oraanization Page _ Contract No. . Cf;RTlFlCA nON Rf;GARDING . [)f;BARM~NT, SUSPf;NSIONr INf;UGIBllITY AND VOLUNTARY f;XClUSION CONTRACTS/SUBCONTRACTS This certification is required by the regulations implementing Executive Order 12549, Debarment _and Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987 Federal Register (52 Fed. Reg., pages 20360 - 20369). . INSTRUCTIONS 1. Each provider whose contract/subcontract equals or exceeds $25,000 in federal monies must sign this certification prior to execution of each contract/subcontract. Additionally, providers who audit federal programs must also sign, regardless of the contract amount Children & Families cannot contract with these types of providers if they are debarred or suspended by the federal government 2. This certification is a material representation of fact upon which reliance is placed when this contract/subcontract is entered into. If it is later determined that the signer knowingly rendered an erroneous certification, the Federal Govemment may pursue available remedies, including suspension and/or debarment 3. The provider shall provide immediate written notice to the contract manager at any time the provider learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. . 4. The tenns "debarred", "suspended", "ineligible", "person", "principal", and ''voluntarily excluded", as used in this certification, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the contract manager for assistance in obtaining a copy of those regulations. 5. The provider agrees by submitting this certification that, it shall not knowingly enter into any subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this contract/subcontract unless authorized by the Federal Government. 6. The provider further agrees by submitting this certification that it will require each subcontractor of this contract/subcontract, whose payment will equal or exceed $25,000 in federal monies, to subm it a signed copy of this certification. 7. The Department of Children and Families may rely upon a certification of a provider that it is not debarred, suspended, ineligible, or voluntarily excluded from contracting/subcontracting unless it knows that the certification is erroneous. 8. This signed certification must be kept in the contract manager's contract file. Subcontractors certifications must be keet at the contractor's business location. I :..... ~ ..-,v_IIUN (1) The prospective provider certifies, by signing this certification, that neither it nor its principals is presently debarred, suspended, proposed for debannent, declared ineligible, or voluntarily excluded from participation in this contract/subcontract by any federal department or agency. (2) Where the prospective provider is unable to certify to any of the statements in this certification, such prospective provider shall attach an explanation to this certification. ..~,' Q.. ~ 04/22/99 S ature Date Name AGI FODOR-LONG 101 Title PROGRAM ADMINISTRATOR ~LCHliDREN . " FAMILIES SECURITY AGREEMENT_ FORM The Department of Children and Families has authorized you: Javier Aguayo / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer aimes are a violation of the department's discipJinary standards and, in agdition to departmental discipline, the commission of computer crimes may result in felony criminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. ,- . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Infonnation is not to be obtained for my ow Javier Aguayo Print Employee Name 4/2 ~LCfCJ ~/;Li ~'1 Date Agi Fodor- Long Print Supervisor Name CF 114, JF 12198 Distribution of Copies: Personnel File/Contract File Security File Employee l~f(HILDREN . & FAMILIES SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Brenda M. Carbonell / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer aimes are a violation of the department's disciplinary standards and, in agdition to departmental discipline, the commission of computer aimes may result in felony aiminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. ." . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.g. . By my signature, I acknowledge that I have received, read and understand Chapter 815. F.g., and have received any necessary clarification from my supervisor. I understand that a security violation may result in aiminal prosecution according to the provisions of Chapter 815, F.g., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Print Employee Name ulz? fa9 ~ Brenda M. Carbonell Agi Fodor-Long Print Supervisor Name Ot~ 0 L~;t; Sig ture of Sup . or ~ff):2fa~ ~ CF 114, JF 12198 Distribution of Copies: Personnel File/Contract File Security File Employee r ~lORIDA DEPARTMENT OF In CHILDREN . " & FAMILIES SECURITY AGREEMENT_ fORM The Department of Children and Families has authorized you: Lonna Cohen I City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer aimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer aimes may result in felony criminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. .- . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Infonnation is not to be obtained for my own or another person's personal use. Lonna Cohen ~y~ Print Employee Name Signature of Employee - lI>>1en ./ O~te Agi Fodor-Long Print Supervisor Name C't' (), Z'\'. Sig tu~ of Supervisor -if<) -1-! 9~ Date ~ - . CF 114. JF 12198 Distribution of Copies: Personnel File/Contract File Security File Employee I ~L('HliDREN . & FAMILIES SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Michael Foth / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, miaofiche, system inquiry, on-line update, or any magnetic media). Computer aimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer aimes may result in felony aiminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. .- . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in aiminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Print Employee Name -dd:-~~'i/llif1 Signature of Employee 0 te Michael Foth Agi Fodor-Long Print Supervisor Name Ct'~i~ . S' ature of sup~or L( /0 2/ a ~ ~ CF 114, JF 12198 105 Distribution ot Copies: Personnel File/Contract File Security File Employee f~f('HiLDREN . &. FAMILIES SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Michael D. Gibson / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer crimes may result in felony criminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. " . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Michael D. Gibson Print Employee Name Jno~ LP.9-1~4Zrf;1 Signature of Employee Date Aqi Fodor-Lonq Print Supervisor Name ~ Date CF 114, JF 12/96 Distribution of Copies: Personnel File/Contract File Security File EmplOyee '~f(IHILDREN . & FAMILIES SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Glenna J. Higginbotham / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer crimes may result in felony criminal charges. The Flonda Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. .' . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Glenna J. Higginbotham Print Employee Name AQi Fodor-LonQ Print Supervisor Name r Lr ilL/ f11 l Date ( CF 114. JF 12196 Distribution of Copies: Personnel File/Contract File Security File Employee .,Gfc'if .iDREN & FAMILIES SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Patrice A. Lawrence / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer aimes may result in felony criminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. " . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in aiminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Infonnation is not to be obtained for my own or another person's personal use. Patrice A. Lawrence Print Employee Name Up "t~ Signature of Employee Aqi Fodor- Long Print Supervisor Name ~.~ Sign ure of Supervisor Lt!6-~'91 { Date CF 114, JF 12/98 Distribution of Copies: Personnel File/Contract File Security File Employee 1~{('HiLDREN & FAMILIES SECURITY AGREEMENT FORM The Department of Children and Famifies has authorized you: Agi Fodor-Long / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-Hne update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in aGidition to departmental discipline, the commission of computer crimes may result in felony criminal charges. The Florida Computer Crimes Ad, Chapter 815, Florida Statutes, addresses the unauthorized modification, destrudion, disclosure, or taking of information resources. .' . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary adion against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Aqi Fodor-Long Print Employee Name C) "~~ sigfi;ture of Employee 4J~:) )99 f Dale Joanna Revelo Print Supervisor Name 4/zz( qq Date CF 114, JF 12/96 109 Distribution of Copies: Personnel Ale/Contract File Security File Employee ~lORIDA DEPARTMENT OF rn CHILDREN. ~ & FAMILIES SECURITY AGREEMENT_ fORM The Department of Children and Families has authorized you: Bruce Morris / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in aG:ldition to departmental discipline, the commission of computer aimes may result in felony criminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. .' . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in aiminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Bruce Morris Print Employee Name ~~ Signature of oyee 122-7'1 Date Aqi Fodor-Long Print Supervisor Name O'~ Signtre of Supervis Lr /.~21 ~~ ( Date CF 114. JF 12/98 (IV Distribution of Copies: Personnel File/Contract File Security File Employee ~L(HILDREN ~ & FAMILIES . SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Nelson Padin / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer aimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer crimes may result in felony criminal charges. The Florida Computer Crimes Act, Chapter 815, Florida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. ,- . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Infonnation is not to be obtained for my own or another person's personal use. Nelson Padin Print Employee Name Aqi Fodor- Lonq Print Supervisor Name ~ CF 114, JF 12/98 111 Distribution of Copies: Personnel File/Contract File Security File Employee ~LORIDA DEPARTMENT. OF rn CHILDREN. "V & FAMILIES SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: .~ Ann Derby-Pincus / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, miaofiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer crimes may result in felony criminal charges. The Florida Computer Crimes Act, Chapter 815, Rorida Statutes, addresses the unauthorized modification, destruction, disclosure, or taking of information resources. .- . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, J acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Ann Derby-Pincus Print Employee Name ~~(!u~w Aqi Fodor-Long Print Supervisor Name O;t' (h ~,. . Sign ure at supervisOV It I ~l/q~ ~ CF 114. JF 12198 112 Distribution of Copies: Personnel File/Contract File Security File Employee ~lORIDA DEPARTMENT OF "., CHILDREN- 'V "FAMILIES SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Leslie Reed / City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed. reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer aimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer aimes may result in felony criminal charges. The Florida Computer Crimes Ad, Chapter 815, Rorida Statutes, addresses the unauthorized modification, destrudion, disclosure, or taking of information resources. .- . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.S., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.S., and may also result in disciplinary adion against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Infonnation is not to be obtained for my own or another person's personal use. Leslie Reed Print Employee Name ~. L'41M Signature of Employee ifL~t1 Agi Fodor-Long Print Supervisor Name ~~~s~ ~9 Date ........ CF 114, JF 12198 Distribution of Copies: Personnel File/Contract File Security File "'__1_.._- f~f(H,iDREN & FAMILIES SECURITY AGREEMENT. FORM The Department of Children and Families has authorized you: Lawrence Roth I City Of Miami Beach's Log Cabin Training Center Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g. printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer aimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer aimes may result in felony aiminal charges. The Rorida Computer Crimes Ad, Chapter 815, Rorida Statutes, addresses the unauthorized modification, destrudion, disclosure, or taking of information resources. ,- . I have read the above statements and have been provided a copy of the Computer Related Crimes Act, Chapter 815, F.g. . By my signature, I acknowledge that I have received, read and understand Chapter 815, F.g., and have received any necessary clarification from my supervisor. I understand that a security violation may result in criminal prosecution according to the provisions of Chapter 815, F.g., and may also result in disciplinary adion against me according to the provisions in the Employee Handbook. The minimum security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Lawrence Roth ~ ,/~ ~a !tf?!:-I- ~ Date Print Employee Name Signature of Employee Agi Fodor-Long Print Supervisor Name ~.t'of~ CF 114. JF 12198 114 Distribution of Copies: Personnel File/Contract File Security File Employee CITY OF MJ:AMJ: BEACH LOG CABIN TRAINING CENTER PROGRAM SUMMARY The City of Miami Beach Log Cabin Training Center serves developmentally disabled citizens throughout our community. We stri ve to equip these individuals with the job and life skills needed to live more independent and personally satisfying lives. Our comprehensive training programs are designed to provide marketable job skills to handicapped adults, as well as to enhance their personal self-esteem. Concepts such as punctuality, cooperativeness, and how to follow directions are taught in conjunction with practical plant nursery skills weeding, fertilizing, propagation and other tasks. The educational component includes money management, cooking skills, financial awareness, survival and safety skills, and other independent living skills. We maintain an ongoing Supported Employment Program in which handicapped adults go out into community based employment. Our Supported Independent Living Program makes apartment living accessible to those individuals whose have been significantly enhanced, mostly through our support programs. independent capabilities training and 115 B. SERVICES TO BE PROVIDED The City of Miami Beach Log Cabin Training Center Program will provide habili tati ve programming for up to 57 developmentally disabled adults. This program operates at the~iami Beach Log Cabin Training Center, Monday through Friday, from 8:30 A.M. to 4:30 P.M. The City's day training program (Independent Living Skills training) provides programs in areas that are considered to be critical to their independent functioning. We offer programs in the following areas: 1. Basic Academics - Remedial/Maintenance 1. Basic 2. Intermediate 3. Advanced 2. Payroll The clients calculate their own payroll derived from services rendered in the Plant Nursery and other related areas. 3. Health Basic health practices and concerns are concentrated on in this class. Self care skills are strengthened, as well as precautionary practices to common problems. 4. Survival Skills Instruction is offered to promote safety and independence in the community. 5. Cooking- Clientele who are determined in need of these skills, are included in this class. 116 6. Cleaning Our clientele are taught basic to advanced janitorial skills for their own personal use, and also as a precursor to job placement. 1. Basic 2. Intermediate 3. Advanced 7. Communications This class offers skills in expressive/receptive communication skills training for those determined to require this instruction. 8. Exercise and Nutrition This class is offered to clientele who are determined to be in need of instruction regarding weight control. 9. Resource A general class offered to certain clients who require instruction in varying specific areas. 10. film This class is offered as a "jumping off" point that encourages certain clients to discuss areas that concern them, while viewing certain selected films. 11. Recycling Intense instruction in the area of recycling skills for client's own personal use and also as a precursor for job placement. 12. Current Events Instruction and discussions regarding major events happening in our society and the world. 13. Job Placement This is done utilizing supported employment methodology. 117 14. Transportation Our clientele are transported to and from home, and/or are transported to various community site job. sites, etc. as necessary. 15. Social Work .- Our caseworker provides all related activities which include: 1. Reviewing referrals 2. Counseling clients 3. Counseling families 4. Developing behavior plans 5. Travel training 6. Client advocacy Our clientele all carry a primary diagnosis of mental retardation. In addition, some are also handicapped by epilepsy, cerebral palsy, mental illness, hearing impairments, and autism. StaffinQ Our program is staffed with the following personnel: Program Administrator Education Coordinator Social Worker Employment Specialist Agricultural Instructor Instructor Driver/Instructor Aide Administrative Aide II 118 C. MANNER OF SERVICE PROVISION All programs listed in Section B take place at the Miami Beach Log Cabin Training Center, located at 8128 Collins Avenue, Miami Beach, Florida, 33141. The exceptions to this include: 1. Survival Skills This occurs in the surrounding neighborhood. 2. Job Placement Site specific. The remainder of our classes take place in classroom settings located at our site. Each client receives a schedule of classes twice per year. Clients are assigned specific classes based on their needs at the habilitation planning meeting (see attachment) . Classes are from 50 to 75 minutes long. Each instructor is responsible for implementing the client's program as specified in the Habilitation Plan. The Education Coordinator supervises the class content and evaluation. Upon entering the program all clientele are assessed using one or all of the following instruments: 1. Functional Living Skills Assessment 2. Becoming Independent 3. Brigance 4. Critical Skills Assessment 5. Plant Nursery Assessment An individual Habilitation Plan (HAB) is developed for each client within 30 days of their admittance to the program. All clientele receive a quarterly review of their progress. The primary curriculum utilized in the program is "Becoming Independent." Additional curriculum include sex education materials, AIDS training materials, materials utilized for meditation/relaxation, counseling, and supplies for cooking and cleaning classes. 119 ELIGIBILITY All clientele must be referred by C.F.S. Following receipt of the referral packet, the following process occurs: 1. Review of referred by agency caseworker 2. Clients must be Title XX eligible 3. Must be a Dade County resident 4. Client must have diagnosis of developmeptal disability (primary) 5. Interdisciplinary team review 6. Final determination INTAKE PROCEDURE 1. Referred from C.F.S. 2. If appropriate, client is accepted. 3. If space is unavailable, client is placed on waiting list. 4. At thirty days, a habilitation plan is developed with C.F.S. coordination. 5. Clients found to be inappropriate are referred back to C.F.S., with explanation. Also additional referrals may be given, such as to vocational rehabilitation. 6. All referrals are followed-up by an agency caseworker for a one-year period. 120 D. EVALUATION The goals of the program are all directed toward increasing the independence of the clientele that we serve. Listed below are the goals for FY 99-00 for our program. 1. GOAL: To provide Habilitative Services MEASURABLE OBJECTIVE: This contract will provide services for up to 35 clients for up to 230 days of service. See section B for description of services. STEPS: The program will comply with C.F.S., Developmental Training Program standards, and will implement programs. TIMETABLE: July 1, 1999 to June 30, 2000. 2. GOAL: Placement of Employment Individuals into Competitive MEASURABLE OBJECTIVE: Up to 15% of our population will be placed/retained into competitive employment for a minimum of 20 hours per week. STEPS: A. Apply to C. F. S. to grant funding for one additional position. B. Identify appropriate work dates. C. Present candidates to C.F.S./V.R. screening committee. D. Proceed with supported employment methodology. TIMETABLE: July 1, 1999 to June 30, 2000. 121 3. GOAL: Increase the independent clientele served functioning of the MEASURABLE OBJECTIVE: All clients will meet a minimum of 50% of stated objectives on their habilitation plans. STEPS: A. The program will implement the classes described in Section B, five days a week. B. Each client will be assessed at least annually. A new individual habilitation plan will be developed annually. c. Each client will receive a quarterly review of progress. D. The program will utilize "Becoming Independent" as the primary curriculum guide. TIMETABLE: July 1, 1999 to June 30, 2000. 4 . GOAL: Increase independent transportation skills of the clientele served. MEASURABLE OBJECTIVE: Increase the number of clients by 20% traveling independently to and from the program. STEPS: A. Travel train and encourage clients taking public transportation and special transportation services. TIMETABLE: July 1, 1999 to June 30, 2000. 5. GOAL: Increase varies vocational skills of the clientele served. MEASURABLE OBJECTIVE: At least 20 clients will learn new vocational skills, besides nursery plant maintenance, in order to acquire jobs within the community. 122 STEPS: A. The program will implement intensive training in cleaning, recycling and community awareness. TIMETABLE: July 1, 1999 to June 30, 2000. 123 CITY OF MIAMI BEACH LOG CABIN TRAINING CENTER SUPPORTED EMPLOYMENT PROGRAM 1. The City of Miami Beach will administer its supported employment program at the Miami Beach Log Cabin Training Center, which typically operates Monday through Friday from 8:30 A.M. to 4: 30 P. M. The program will provide up to fifteen (15) client placements utilizing one of the three supported employment models approved by the State of Florida and Developmental Services, District 11. We will provide services to developmentally disabled clients referred to the agency by HRS. Most of these clients have been vocationally trained by us under the Independent Living Skills training program and are ready to move on to Supported Employment. 2. The goals of this program are focused on increased independence and the achievement of self support for the persons served by providing employment opportunities and the necessary support services, utilizing the Supported Employment models approved by Developmental Services. A goal is placement of up to fifteen (15) individuals in the Supported Employment program increasing their chances of obtaining employment within the community. The measurable objective is that 85% of the clients enrolled in supported employment will obtain or retain community based employment for a minimum of 20 hours per week. STEPS: A. Assess consumer and review case files of potential candidates. B. Present appropriate candidates to HRS/VR screening committee. C. Proceed with Supported Employment methodology which includes job development, job site analysis, task analysis, training and follow up. A second goal is to increase independent functioning of the clients served. The measurable objective is that 85% of the clients enrolled in the Supported Employment program will have progressed to the next level if supervision which includes 20% of a job coach intervention time per week within a twelve-month contract period. STEPS: A. The program will assess, train and provide support services described in section B. 124 B. Each consumers progress will be reviewed monthly and quarterly. C. A reassessment of the habilitation plan will be performed annually and will include an individual employment/follow-along plan. D. Consumers job-related skills will increase to an acceptable level, decreasing the need for job coach intervention. Another measurable objective is that 70% of the Supported Employment consumers will take public transportation to/from their work site and that 70% of Supported Employment consumers will reach employment/follow-along plan objectives within each consumers contract period. STEPS: A. Job coach, caseworker and employer will develop individual employment/follow-up plan objectives. B. Consumer obj ecti ves are presented at reassessment of habilitation plan annually. C. Implemented through Supported Employment guidelines. 3. Services provided include the following: individual asessments; training and career development (vocational and pre- vocational classes, career counseling, work adjustment classes and seminars); job development (finding, creating, analyzing and identifying available positions in the competitive labor market, conducting a diagnostic interview to pre-determine consumers preferences, interests and motivation, matching candidates to specific jobs, teaching consumers to become acquainted with a variety of occupations and work demands); follow-along/maintenance (assisting the placed worker during the initial phase of employment to adjust, meeting periodically with the worker to determine continued job progress and satisfaction); additional services (counseling, client advocacy, coordination of services, follow up and trouble-shooting, documentation of systematic progression) . The services to be provided will be based at our site, 8128 Collins Avenue, Miami Beach, Florida, 33141. Each supported employment candidate will be assessed by using one or more of the following: work skills assessment, outside agency evaluations, becoming Independent curriculum/assessment, critical skills assessment, functional living skills assessment. 125 Supported Employment consumers will receive individual counseling and support services. Eligible candidates receive pre-vocational and/or vocational training, a tailor-made employment/follow along plan which is supplemental to the individual habilitation plan. As required by Developmental Services, there will be a quarterly review of progress reports and monthly evaluations. A pre-placement service is also available as this service ensures a successful placement. Pre-placement may include the following: pre-interview counseling, job skills instruction,- supervision and counseling. The position secured by each consumer will be evaluated according to location, work habits and abilities of specific candidates, and the needs and desires of each individual. Transportation and/or training on travel independence is provided for those eligible. Specific job skills training is provided at the work site. To date all clients who attended our program have retained their jobs a minimum of six (6) months and a maximum of three (3) years. Therefore, our success rates are extremely impressive. 4. The individual responsible for the daily operation of the Program is Agi Long, Program Administrator. 126 Staffing Program Administrator Education Coordinator Social Worker Employment Specialist Instructor/Job Coach Driver/Instructor Aide Administrative Aide II 127 CITY OF MJ:ANJ: BEACH LOG CABIN TRAINING CENTER DEVELOPMENTAL TRAINING PROGRAM 1. The Log Cabin Training Center Program will provide habilitative programming for up to 53 developmentally disabled adults who are referred by CFS. These clients must be Title XX eligible, must reside in Dade County, Florida and must have a diagnosis of developmental disability (primary). In addition, some are handicapped by elipepsy, cerebral palsy, mental illness, hearing impairments, and autism. The Training Program (Independent Living Skills training) provides programs in areas that are considered to be critical to the clients' independent functioning such as basic academics, money and budgeting skills, health, survival and travel skills, cooking, cleaning, communication, exercise and nutrition, and current events. 2. (a) Short Term: stated objectives on will improve his/her learn new vocational community. All clients will meet a minimum of 50% of their individual support plan. Each client independent travelling skills. Clients will skills in order to acquire jobs within the (b) Long Term: Up to 15% of the clients will be placed into competitive employment for a minumum of 20 hours per week. These clients will be able to be retained in their employment using skills developed/learned through the program. In addition, the clients will develop survival living skills that will enable them to live their lives as independently as possible. 3. Services provided include: basic academics, primarily reading and math - beginning, intermediate and advanced; vocational skills, i. e. punctuality, reliability, producti vi ty, general good work habits; financial awareness (money skills) and payroll calculation; self care skills including health, cooking and cleaning; survival skills which promote safety and independence in the community i.e. expressive and receptive communication skills training and independent travel training. For personal enhancement and benefit of each client we provide classes in current events, recycling, exercise and nutrition. We also provide counseling in behavioral management, which includes sexual awareness. Through these services the clients will develop the skills necessary to live their lives as independently as possible and to obtain/retain community based employment. Our program setting is very special. It is a plant nursery in which the clients learn through hands-on daily experience. They are constantly monitored by their instructors in the areas of "on-task" skills, cooperativeness, self and equipment care in addition to other related vocational skills. 128 4. The individual responsible for the daily operation of the Program is Agi Long, Program Administrator. 129 CITY OF MIAMI BEACH LOG CABIN TRAINING CENTER SUPPORTED INDEPENDENT LIVING PROGRAM 1. The City of Miami Beach Log Cabin Training Center is helping to open the doors of community life for developmentally disabled clients from the Miami Beach area. Presently we are providing Supported Independent Living Services to two (2) - soon to be three (3) clients. Our obj ecti ve is to make available homes in the community where our clients can feel accepted and valued by others around them and thus increase self-confidence, self-esteem and independence. 2. Our agency is committed to provide a long term supervised Supported Living Program for developmentally disabled adults who have been identified as being "at risk" due to poor quality of life. We provide training in community living skills which will enable the person to live independently in the community. 3. "Supported Living Services" means the provision of assistance and training to individuals in supported living, including teaching new skills, providing assistance in tasks the client cannot compete independently, and facilitating and coordinating the provision of such interventions through natural non-paid sources. A supportive Living Coach is assigned to each client. The coach provides assistance with tasks, training skills, or performance of activities with and on behalf of the person, which are necessary to maintain an autonomous household and participate in community life to the fullest extent. Coaching includes the coordination of generic resources and informal supports provided by community members and the individual's support team. The" Support Team" means the family coach, friends, neighbors, and significant others selected by the person participating in the Supported Living Services. We also ensure that the person lives wi thin the neighborhood of the "Log Cabin Training Center", thus providing the extra support necessary. 4. The person responsible for the daily operation of the Program is Agi Long, Program Administrator. 130