First 5 Fresno County

Administrative

• Final Project Evaluation Report
  

  Documents the impact a program has had on children and families in Fresno County

• Scope of Work
  

  Describes the scope of services each contractor will provide

Consent Forms

• Client Consent
  

  An agreement between First 5 Fresno County and clients’ parents/legal guardians to use client specific information in First 5 Fresno County studies and research (Spanish Form)

• Consent to Release Information about Teenage Child
  

  An agreement between First 5 Fresno County and teenage clients’ parents/legal guardians to use client specific information in First 5 Fresno County studies and research (Spanish Form)

• The Client Assent for Minor Parents of Children 0 to 5 Years
  

  Seeks permission from minor parents to include information in First 5 Fresno County studies about the child(ren) they care for as parent, guardian, or person with legal custody (Spanish Form)

• Evaluation Consent Form Process & Procedures
  

Financial Forms

• Electronic Funds Transfer (EFT) Policy and Form- NEW!
  

  Form must be submitted by Service Provider/Vendor to receive payment.

• Service Provider Budget Template
  

  Provides a written explanation, justification, and calculation for each expense line-item

• Budget/Financial Reporting PowerPoint Training
  Provides Service Provider an overview of First 5 financial and budget reporting expectations
• Operational Budget Definitions
  

  Provides a line by line definition of each expense line item

• Professional Services SOW/Budget Template
  

  Budget template that provides a breakdown of cost based on a service and/or deliverable

• Contract Amendment Request (CAR) Form
  

  Service Provider is required to submit this form to make any changes to the contract budget and SOW revision, or both

• Cost Allocation PowerPoint Training
  

  Provides an overview of cost allocation methodology. All Service Providers operating multiple programs, or a program funded by multiple funding streams, must have a Cost Allocation Plan (CAP).  Review a CAP sample. 

• Cost Allocation Plan Definition/Methodology
  

  Basic definitions of cost allocation methodology

• W-9
  Request for taxpayer identification number and certification
• Finance Variance Form
  

  Should accompany the Monthly or Quarterly Financial Report when a 10% variance occurs in the year to date expenditures for the reporting period

• Examples of Disallowed Costs
  

  Provides a list of disallowed costs

• Program Cost Allocation Plan Spreadsheet
  

  A guide for non-profit organizations for assigning two or more programs the cost of an item shared by the programs

• Finance Deadlines for Fiscal Year 2011-2012
  

  Provides all finance deadlines for fiscal year 2011-2012

• Finance Deadlines for Fiscal Year 2012-2013
  

  Provides all finance deadlines for fiscal year 2012-2013.

Intake Forms

• Provider Registration
  

  To be filled out by all provider clients prior to receiving direct services (Spanish Form)

• Client Intake
  

  To be filled out by all clients prior to receiving direct services. The form collects client demographic information.
  (Spanish Form) 

Service Provider Information

• FY2011-2012 Outcome Indicator Guidance
  

  Information and guidance for tracking Individual Program Outcome Indicators

• FY2011-2012 Service Provider Meetings
  
• FY2011-2012 Persimmony Training Manual
  
  • Fiscal
  • Performance/Data Entry
• Client Type and Relationship Matrix
  
• FY2011-2012 Outcome Indicator Questions
  

  Outcome Indicator Questions (Spanish Form)

• FY2011-2012 Strategies Training Flyer
  
• FY2012-2013 Service Provider Meetings
  

Tools for Tracking Services

• Community Services Form
  Tracks aggregate information for community services
• The Direct Services Worksheet
  Tracks client data for direct services
• The Home Visitation Worksheet
  Tracks home visit service information
• Provider Capacity Form
  The Community Services form
• The Workshop Roster
  Track aggregate data for workshop attendees
• Breastfeeding Friendly (BFF) Policy