HomeMy WebLinkAboutCC_2023_12_12_C-1 CDGB Draft Recs
2024 CDBG DRAFT
RECOMMENDATIONS
Staff Report
City Program Administration
ITEM NUMBER: C-1
DATE: 12/12/23
Atascadero City Council
Staff Report – Public Works Department
2024 Community Development Block Grant Draft Recommendations
RECOMMENDATION:
Council develop and adopt draft recommendations for the 2024 Community Development
Block Grant (CDBG) funds.
DISCUSSION:
Background
The award process for the 2024 cycle of Community Development Block Grants (CDBG)
began in the fall of 2023. Workshops were held throughout the County to solicit public
comment on community needs. The County published a request for CDBG proposals
and the City received four applications. The City of Atascadero’s total available funding
for the 2024 cycle, based on previous levels, is anticipated to be approximately $134,205.
Final funding amounts are anticipated to be released by the Department of Housing and
Community Development (HUD) in Spring 2024.
CDBG funds are available for community development activities, which meet at least one
of the three national objectives:
1. A benefit to low and moderate-income persons;
2. Aid in the prevention or elimination of blight;
3. Address urgent needs that pose a serious and immediate threat to the health or
welfare of the community.
In order for a program to qualify under the low and moderate income objective, at least
51% of the persons benefiting from the project or program must earn no more than 80%
of the area median. Additionally, at least 70% of the CDBG funds must be spent toward
this objective.
The following criteria should also be used to guide selection of CDBG programs:
1. The proposal is consistent with the national objectives and eligibility criteria of
the HUD CDBG program;
2. The proposal is consistent with the Urban County Consolidated Plan;
3. The proposal is consistent with the General Plan and other City
codes/ordinances.
4. The proposal will achieve multiple community development objectives;
ITEM NUMBER: C-1
DATE: 12/12/23
5. The proposal can be implemented in a timely manner, without significant
environmental, policy, procedural, legal, or fiscal obstacles to overcome; and
6. The project is not financially feasible without CDBG funding.
CDBG funding is broken into three categories: Public Facilities and Housing Projects,
Public Services, and Administration. Award allocations for Public Services and
Administration cannot exceed 15% and 20%, respectively, of the total CDBG funding
amount. The Public Facilities and Housing Projects category does not have any cap
limitations. Council can increase CDBG funding to Public Facilities and Housing Projects
while reducing the funding to Public Services and/or Administration to an amount less
than the category cap limits. It should be noted that the County Administrative costs are
set to 13% of the total CDBG amount to cover their estimated costs to administer the
program.
There is a minimum award threshold of $8,000 per project (application), meaning the City
can allocate less than $8,000 for a particular public service activity if another agency in
the County commits to programming the remainder to equal a Countywide cumulative
total of at least $8,000. Furthermore, Council may recommend a CDBG award more than
or less than the amounts requested on the applications. Council can only make award
recommendations to those applications received for the funding cycle.
Analysis
The City received the following applications for the 2024 funding cycle:
Public Facilities (PF) and Housing Projects (HP) – Estimated 2024 Allocation
$87,233
City of Atascadero – ADA Accessibility Barrier Removal Projects (Viejo Camino) $90,000
Public Services – Limited to 15% of 2024 Allocation ($20,131)
El Camino Homeless Organization (ECHO) – Operation of Homeless Shelter 6,000
5 Cities Homeless Coalition – Subsistence Payments, Homeless Assistance & Security
Deposits 4,667
City of Atascadero – Youth Activity Scholarships 12,000
Administration – Limited to 20% of 2024 Allocation ($26,841)
City Program Administration Costs 9,394
County Program Administration Costs 17,447
Total Funds Requested $139,508
Estimated Funds Available $134,205
Net Difference ($5,303)
One application was received for the Public Facilities/Housing Projects category totaling
$90,000, which exceeds the estimated category allocation of $87,233 by $2,767. Three
applicants were received for the Public Services category totaling $22,667, which
exceeds the estimated category allocation of $20,131 by $2,536. As part of the CDBG
process, Council must develop a draft recommendation for the 2024 grant year that meets
the funding criteria while adhering to the categorical limits.
Upon approval, the draft funding recommendations will be forwarded to the County for
publishing along with recommendations from all participating agencies. A minimum of 30
ITEM NUMBER: C-1
DATE: 12/12/23
days after publication, a second workshop will be held to allow questions from applicants
regarding the draft recommendations, after which the draft allocations will be forwarded
to City Council, with comments from the workshop, for final approval and forwarded to the
County Board of Supervisors. The following is a brief explanation of the funding groups
and applications within each:
PUBLIC FACILITIES (PF) & HOUSING PROJECTS (HP) 2024 Funds Available: $87,233
Public Facilities are defined as activities relating to real property, including the acquisition,
construction, rehabilitation or installation of public improvements.
City of Atascadero –ADA Accessibility Barrier Removal Project Viejo Camino
Funds Requested: $90,000
Viejo Camino Sidewalk Accessibility Project
The City of Atascadero submitted an CDBG application this cycle for the Viejo Camino
Sidewalk Accessibility Project. This project proposes to construct approximately 450
linear feet of new ADA compliant sidewalk, and curb ramps at two locations on Viejo
Camino between El Camino Real and Halcon Road. The sidewalk infill will also provide
connection to a regional bus stop which will provide a new bench and shelter for riders.
RTA has provided a letter of support for this project. This project warrants improvements
to increase accessibility for the traveling public due to its dilapidated and non-compliant
condition. The infrastructure improvements providing wheelchair ramps and ADA
compliant sidewalks will aid those with mobility impairments.
In 2021 Council approved $68,683 for partial funding of for the Viejo Camino Sidewalk
Project. The estimated total project cost is now estimated at $160,000, which requires
$91,317 in additional funding to complete.
PUBLIC SERVICES – (15% cap) 2024 Funds Available: $20,131
CDBG regulations allow for a wide range of public service activities, including, but not
limited to: employment services, crime prevention, childcare, health services, substance
abuse services, fair housing counseling and recreational services.
El Camino Homeless Organization (ECHO) Navigation Centers – Operation of Homeless
Shelter and Meals
Funds Requested: $6,000
ECHO operates Navigation Centers with overnight shelters in Atascadero and Paso
Robles. This program provides funding for operational costs at both Navigation Centers,
including utilities, food for meal programs, shelter supplies, insurance, and maintenance,
as well as for staff positions. The project also supports all or a portion of the following staff
salaries at the two sites: four case managers, two overnight shelter coordinators, a
volunteer coordinator, a shelter manager, a client services manager, and a daytime
program manager.
ECHO’s Atascadero Navigator Center has a 60-bed shelter serving all county residents,
and providing care for medically fragile clients. Through a partnership with People’s Self-
ITEM NUMBER: C-1
DATE: 12/12/23
Help Housing and Housing Authority SLO, ECHO added 50 beds in 2020 by purchasing
a Motel 6 property in Paso Robles with a state Project Homekey grant.
At the Navigation Centers, shelter clients and the unsheltered access case management,
employment and benefits resources, and housing resources. ECHO helps clients to
connect with agencies providing health and mental health services, recovery programs,
educational assistance, and other services that will help clients reach their goals of stable
housing and physical and mental well-being. The public shower program provides access
to showers and donated clothing five times weekly for those not staying in a shelter.
5 Cities Homeless Coalition (5CHC) – Homeless Services: Shelter, Outreach &
Homeless Prevention
Funds Requested: $4,667
Rapid re-housing involves case management targeted at identifying displaced clients’
most essential needs and connecting them to community resources. Homeless
Prevention Services are provided to those at immediate risk of homelessness based on
need and qualification. Clients receive targeted case management services per their
individual circumstance, in addition to direct financial assistance to enable them to remain
in their housing, or deposit assistance needed to re-house them to prevent
homelessness. The goal is to assist participants to secure long-term stable housing that
they can afford to retain. By connecting people with a home, they are in a better position
to address other challenges that may have led to their homelessness, such as obtaining
employment or addressing substance abuse issues.
City of Atascadero – Youth Activity Scholarship Fund
Funds Requested: $12,000
The City administers the Youth Activity Scholarship Fund to allow the children of very low
and low-income families to participate in recreational and social activities, to keep children
active and engaged. Because this program is limited to very-low and
low-income families, the benefit criteria will be met.
ADMINISTRATION – (20% cap) 2024 Funds Available: $26,841
City of Atascadero – CDBG Program Administration - (7% cap)
Allocated Funds: $9,394
Significant City staff time from Public Works and Administrative Services is required for
CDBG administration, and coordination with County Planning staff. The City’s
administrative portion of the funding cannot exceed 7%, or $9,394 of the total
administrative grant amount.
If administration costs exceed the funding allocation, the remaining cost of administering
the program will need to be paid from the general fund.
County of San Luis Obispo – CDBG Program Administration- (13% cap)
Allocated Funds: $17,447
ITEM NUMBER: C-1
DATE: 12/12/23
Due to the complexity of grant administration responsibilities and the consequences of
non-compliance, HUD recommends that the County provide all monitoring and oversight
for all CDBG grants. The County assumes the duties of project oversight, and receives
a required 13% of the total grant funds for administration services for Atascadero in the
amount of $17,447.
Conclusion
The City received funding requests for approximately $5,303 more than the anticipated
2024 available CDBG funding. In addition, there are limits related to categories of funding
for Public Services and Administration. As part of the CDBG process, Council must
develop a draft recommendation for the 2024 grant year that meets the funding criteria
while adhering to the category limits. A final recommendation will be made by Council in
March 2024.
FISCAL IMPACT:
Approval of Atascadero’s total 2024 CDBG allocation would result in the estimated
revenue and expenditure of $134,205 of CDBG funds.
ALTERNATIVES:
CDBG allocation awards must meet program requirements, providing a minimum of 70%
of funding to benefit low- and moderate-income persons, and no more than 15% may be
allocated to the public service category.
ATTACHMENTS:
None; a complete packet of submitted applications is available for public review at the
City of Atascadero City Clerk’s Office, 6500 Palma Avenue.
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City of Atascadero
J4ZKW85KJ1H8
Ryan Hayes/ Deputy Director/ Principal Civil Engineer
Jeri Rangel/ Administrative Services/Finance Director
(805) 470-3424
Rhayes@atascadero.org
6500 Palma Ave.
Atascadero CA 93422
07/02/1979
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CDBG administration and oversight is necessary for the award and execution of CDBG projects.
2024 CDBG APPLICATION FORM
FEDERAL REQUIREMENTS ACKNOWLEDGEMENTS
Every person or Agency awarded a CDBG Contract or grant by San Luis Obispo County for the provision of
services shall be required to certify to the County that they will comply with federal and local requirements
including,but not limited to,those listed below.Please initial each certification listed to indicate you or your
agency can and will comply with these requirements if funded.
Federal Requirements Initials
Americans with Certify that the applicant agency has reviewed its projects,programs,
Disabilities Act and services for compliance with all applicable regulations contained zHinTitleIl,Americans with Disabilities Act of 1990.
Audits Agrees to have an annual audit conducted in accordance with
current San Luis Obispo County policy regarding audits and 2 CFR
200.501 audit requirements.Shall comply with current San Luis
Obispo County policy concerning the purchase of equipment and
shall maintain inventory records of all non-expendable personal
property as defined by such policy as may be procured with funds
provided through the grant.
2H
Conflict of Interest (2 CFR 200.112, 200.318,and 570.611)Certify and agree that no
covered persons who exercise or have exercised any functions or
responsibilities with respect to CDBG-assisted activity,or who are in
a position to participate in a decision-making process or gain inside
information with regard to such activities,may obtain a financial
interest in any contract,or have a financial interest in any contract,
subcontract,or agreement with respect to the CDBG-assisted
activity,either for themselves or those with whom they have
business or immediate family ties,during their tenure or for a period
of one (1)year thereafter.A “covered person”includes any person
who is an employee,agent,consultant,officer,or elected or
appointed official of the agency
Civil Rights Act Certify that the applicant agency complies with and prohibits
discrimination in accordance with Title VI of the Civil Rights Act of 1964.
Debarment Status of
Contractors
Certify to the best of its knowledge and belief,that the applicant or
applicant agency principals will not knowingly enter into any
subcontract with a person who is,or organization that is,debarred,
suspended, proposed for debarment,or declared ineligible from
award of contracts by any Federal agency
(https://www.sam.gov/portal/public/SAM/)
Drug-Free Workplace Certify that it will provide a drug-free workplace.¥Financial
Management
Accounting Standards:Agree to comply with 2 CFR 200(E)(F)and
agrees to adhere to the accounting principles and procedures
required therein,utilize adequate internal controls,and maintain
necessary source documentation for all costs incurred.
County of San Luis Obispo Department of Social Services
P.O. BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 5 OF 8
2024 CDBG APPLICATION FORM
Cost Principles:Shall administer its program in conformance with 2
|CFR 200(E),“Cost Principles for Non-Profit Organizations,”or 2 CFR
225,“Cost Principles for State and Local Governments,”as applicable.
These principles shall be applied for all costs incurred whether
charged on a direct or indirect basis.I
Procurement Policies:Certify and agree to procure all materials,
property,or services in accordance with the requirements of 2 CFR
200.320-326.
Lobbying Activities Certify that no Federal appropriated funds have been paid or will be
paid, by or on behalf of the agency,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 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 contract,grant,loan or cooperative
agreement.
‘Minority Business
Enterprise (MBE),
Women's Business
Enterprise (WBE),
Small Business
Contracting
Certify that it will comply with 2 CFR 200.321 to take all necessary
affirmative steps to assure that minority firms,women business
enterprises,and labor surplus area firms are used when possible.
Further certify that it will submit to San Luis Obispo County at the
time of project completion a report of the MBE and WBE status of all
subcontractors to be paid with CDBG funds with contracts of $10,000
or greater,in a format that will be provided by the County.
Real Property Certify that it will comply with real property standards (24 CFR Part
570.505)applicable to any property within the owner's control that is
acquired or improved in whole or in part using CDBG funds in excess
of $25,000.
Religious Activities Certify and agree that funds provided to the agency will not be
utilized for inherently religious activities prohibited by 24 CFR
570.200(j),such as worship,religious instruction,or proselytization.
Section 3 Certify and agree to ensure that opportunities for training and
employment arising in connection with contracts or subcontracts for
a housing rehabilitation (including reduction and abatement of lead-
based paint hazards),housing construction,or other public
construction project are given to low-and very low-income persons
residing within the metropolitan area in which the CDBG-funded
project is located;where feasible,priority should be given to low-
and very low-income persons within the service area of the project
or the neighborhood in which the project is located,and to low-and
very low-income participants in other HUD programs;and award
contracts for work undertaken in connection with a housing
County of San Luis Obispo Department of Social Services
P.O. BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 6 OF §
2024 CDBG APPLICATION FORM
rehabilitation (including reduction and abatement of lead-based
paint hazards),housing construction,or other public construction
project to business concerns that provide economic opportunities
for low-and very low-income persons residing within the
metropolitan area in which the CDBG-funded project is located.
Where feasible,priority should be given to business concerns that
provide economic opportunities to low-and very low-income
residents within the service area or the neighborhood in which the
project is located,and to low-and very low-income participants in
other HUD programs.
Section 504 Section 504 of the Rehabilitation Act of 1973:Certify that it has read
and understands all its obligations under Section 504 to prohibit =Hdiscriminationagainstpersonswithdisabilitiesintheoperationof
programs receiving federal financial assistance.
Liability The County and cities require all grant recipients to maintain general
liability,automobile,and workman's compensation insurance with
limits of not less than $1 million (may vary by jurisdiction).If you are
successful in obtaining a reward,you will be asked to provide
documentation regarding your ability to provide the required
coverage.
+H
Environmental
Review
Prior to HUD's release of grant conditions and/or funds for the
CDBG-funded project,a review of the project's potential impact on
the environment must be conducted and approved by the County of
San Luis Obispo prior to obligating or incurring project costs.The
County must certify to HUD that it has complied with all applicable
environmental procedures and requirements.Should project costs
be obligated or incurred prior to the completion of the necessary
environmental review,the project shall not benefit from the federal
funds.The level of environmental review required depends on the
nature of the project.24 CFR Part 58 is available at
http://www.hud.gov/offices/pih/ih/codetalk/onap/docs/24cfr58.pdf.
Relocation Any project that involves the acquisition of property,construction,
and/or rehabilitation and that is funded in whole or in part with
federal CDBG funds is subject to federal relocation requirements.In
general,any property owner,commercial business,or residential
occupant who is displaced by a HUD-funded project may be eligible
for relocation benefits.A project cannot be broken into separate
“projects”in order to avoid the federal requirements connected with
property acquisition and relocation.Any questions concerning the
relocation regulations for a specific property acquisition project
should be directed to the Homeless Services Division Grant Unit
staff before any action is taken on the project.
HMIS Reporting All homeless service providers applying for CDBG funds to assist,
house,or shelter the homeless must identify and demonstrate the
capacity to participate in the County of San Luis Obispo Homeless =H
County of San Luis Obispo Department of Social Services
P.O. BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 7 OF 8
2024 CDBG APPLICATION FORM
Management Information System (HMIS)to provide personnel fordataentry,user licensing,and hardware and software necessary for
compatibility with HMIS.HMIS is an electronic data collection systemthatstoresclient level information about persons who access the
homeless services system in a Continuum of Care and reports
aggregate data for the County as per HUD's Data Standards.
Affirmative Marketing Quarterly and annual reports shall be submitted by the
project/program manager to the County for CDBG-funded publicservices and housing projects.Each report shall include the totalnumberofproject/program applicants and clients served with
respect to race,ethnicity,gender,and disability status.Affirmative
marketing efforts shall be taken to increase the participation of anyunderservedgroups.
County of San Luis Obispo Department of Social Services
P.O.BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 8 OF 8
Public Facilities/Housing Project Applications
• Viejo Camino – City of Atascadero
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City of Atascadero
J4ZKW85KJ1H8
Ryan Hayes/ Deputy Director/ Principal Civil Engineer
Jeri Rangel/ Administrative Services/ Finance Director
(805) 470-3424
Rhayes@atascadero.org
6500 Palma Ave.
Atascadero, CA, 93422
07/02/1979
32,811,120
160
25
90,000.00
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An independent auditing firm conducts an annual audit of all City funds, including the Community
Development Block Grant (CDBG) fund. An independent audit firm also conducts the Single Audit per OMB
Circular A-133, Schedule of Expenditures of Federal Awards, which includes all CDBG funding information.
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Section 3 requirements are included in all Capital Project bid documents and construction contracts.
The City of Atascadero administers its CDBG program in conformance with 2 CFR 200 (e)(F), adhering to the
accounting principles and procedures, utilizing adequate internal controls and maintaining required source
documentation for all costs incurred.
All staff members involved with this CDBG project will track/log their CDBG activities and time spent. Our
Administrative Services department keeps copies of the time tracking sheets and payroll records.
Award of 2021 CDBF funds of $68,683.00. $78.02 expended in 2023 leaving a current balance of
$68,604.98 available.
Any remaining funds not fully expended on the upcoming Santa Rosa project will be reallocated to the
Viejo Camino project. The availability of additional funding is unknown until the Santa Rosa project is
complete.
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Operation and maintenance of public facilities is included in the City budget for Public Works facilities.
Viejo Camino Barrier Removal Project
The project is located on Viejo Camino in Atascadero, CA. A map of
the specific locations are included with this application.
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The project consists of approximately 450 linear feet of sidewalk, curb and gutter infill at two locations on
Viejo Camino between El Camino Real and Halcon Road. The sidewalk infill will also provide an ADA
compliant connection to a regional bus stop which will provide a new bench and shelter for riders.
This project will improve two locations within the public right-of-way on Viejo Camino between El Camino
Real and Halcon Road.
1. Location 1 proposes approximately 300 linear feet of 5' wide concrete sidewalk, curb & gutter, and a bus
pullout, bench and cover.
2. Location 2 proposes to construct approximately 150 linear feet of 5' wide concrete walkway, connecting
the existing sidewalk on the eastern edge of Viejo Camino, with the parking lot and walkway surrounding
Paloma Park. Walkway would be at grade.
Project will be within public road right-of-way.
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Yes, the project is subject to prevailing wage requirements. All contractors and sub-contractors working on
this project will be required to pay prevailing wages.
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This project complements City efforts to provide residents with outdoor recreational areas (Paloma Park),
and alternative transportation options. This project will remove physical barriers, resulting in a direct
connection between multiple apartment buildings and low-income housing areas to Paloma Park and the
southbound RTA bus stop. Letter of support from RTA is included with this application.
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Included with this application is a letter of support from the San Luis Obispo Regional Transit Authority
(RTA) for the improvements it will bring to a heavily used bus stop located directly across the street from
Atascadero's largest apartment complex.
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This project provides benefits to residents of nearby senior and low income farmworker housing, providing
significantly increased opportunities for pedestrian usage of the regional bus stop and City park.
Currently, there is no sidewalk, only a dirt shoulder for pedestrians and the mobility impared to access the
regional bus stop. Access for the elderly and mobility impaired traveling along this path is currently
extremely difficult. Subsequently, the elderly and mobility impaired will continue to have limited
transportation options, which has financial, health and efficiency impacts.
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This project meets all the requirements for the Benefit to Low and Moderate Income Persons or
Households, National Objective One.
Location: The project will benefit the nearby senior and low income farmworker housing, providing
significantly increased opportunities for pedestrian usage of the regional bus stop and City park.
Accessibility Issues: Currently, there is no sidewalk, only a dirt shoulder for pedestrians and the mobility
impaired to access the regional bus stop. Access for the elderly and mobility impaired traveling along this
path is currently extremely difficult. Subsequently, the elderly and mobility impaired will continue to have
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CITY OF ATASCADERO
PUBLIC WORKS DEPARTMENT
6500 Palma Avenue, Atascadero CA 93422
(805) 470-3456 | publicworks@atascadero.org
2024 Viejo Camino Sidewalk CDBG Barrier Removal Project
Estimated Timeline of Expenditures
November-January 24-25: PS&E Design $ 12,000
February 2025: Advertise Bid: $ 300
May-July 2025: Construction $ 145,000
CITY OF ATASCADERO
PUBLIC WORKS DEPARTMENT
6500 Palma Avenue, Atascadero CA 93422
(805) 470-3456 | publicworks@atascadero.org
2024 Viejo Camino Sidewalk CDBG Barrier Removal Project
Estimated Timeline of Project Milestones
Project Approved by City Council: March 9, 2024
Project/Environmental Begins: August 2024
SHPO Determination: October 2024
NEPA Determination (CE): October 2024
PS&E Design Begins: November 2024
Complete Project Design/CEQA (CE): February 2025
Advertise Bid: February 2025
Bid Opening: March 2025
Contract Executed April 2025
Notice to Proceed: April 2025
Construction Begin: May 2025
Construction Complete: July 2025
Notice of Completion: July 2025
CITY OF ATASCADEROCOMMUNITY DEVELOPMENT BLOCK GRANT FUNDSCHEDULE OF REVENUES, EXPENDITURES, AND CHANGES IN FUND BALANCEBUDGET AND ACTUALFor the Fiscal Year Ended June 30, 2022OriginalFinalActual AmountsRevenues:Community Development Block Grant 156,660$ 246,280$ 69,008$ (177,272)$ Total revenues156,660 246,280 69,008 (177,272) Expenditures:Administration:CDBG general administration- 10,300 10,295 5 Special projects and studies:Youth scholarships- 10,700 8,820 1,880 Capital outlay:Traffic Way and El Camino Real barrier removal40,720 40,720 15,852 24,868 Santa Rosa barrier removal115,940 115,940 34,041 81,899 Viejo Camino barrier removal- 68,620 - 68,620 Total expenditures156,660 246,280 69,008 177,272 Net change in fund balance-$ -$ - -$ Fund balance, June 30, 2021- Fund balance, June 30, 2022-$ BudgetVariance with Final Budget Positive (Negative)118
Attachment E – Incorporation Documents
The City of Atascadero is a government entity.
2024 CDBG APPLICATION FORM
FEDERAL REQUIREMENTS ACKNOWLEDGEMENTS
Every person or Agency awarded a CDBG Contract or grant by San Luis Obispo County for the provision of
services shall be required to certify to the County that they will comply with federal and local requirements
including,but not limited to,those listed below.Please initial each certification listed to indicate you or your
agency can and will comply with these requirements if funded.
Federal Requirements Initials
Americans with Certify that the applicant agency has reviewed its projects,programs,
Disabilities Act and services for compliance with all applicable regulations contained zHinTitleIl,Americans with Disabilities Act of 1990.
Audits Agrees to have an annual audit conducted in accordance with
current San Luis Obispo County policy regarding audits and 2 CFR
200.501 audit requirements.Shall comply with current San Luis
Obispo County policy concerning the purchase of equipment and
shall maintain inventory records of all non-expendable personal
property as defined by such policy as may be procured with funds
provided through the grant.
2H
Conflict of Interest (2 CFR 200.112, 200.318,and 570.611)Certify and agree that no
covered persons who exercise or have exercised any functions or
responsibilities with respect to CDBG-assisted activity,or who are in
a position to participate in a decision-making process or gain inside
information with regard to such activities,may obtain a financial
interest in any contract,or have a financial interest in any contract,
subcontract,or agreement with respect to the CDBG-assisted
activity,either for themselves or those with whom they have
business or immediate family ties,during their tenure or for a period
of one (1)year thereafter.A “covered person”includes any person
who is an employee,agent,consultant,officer,or elected or
appointed official of the agency
Civil Rights Act Certify that the applicant agency complies with and prohibits
discrimination in accordance with Title VI of the Civil Rights Act of 1964.
Debarment Status of
Contractors
Certify to the best of its knowledge and belief,that the applicant or
applicant agency principals will not knowingly enter into any
subcontract with a person who is,or organization that is,debarred,
suspended, proposed for debarment,or declared ineligible from
award of contracts by any Federal agency
(https://www.sam.gov/portal/public/SAM/)
Drug-Free Workplace Certify that it will provide a drug-free workplace.¥Financial
Management
Accounting Standards:Agree to comply with 2 CFR 200(E)(F)and
agrees to adhere to the accounting principles and procedures
required therein,utilize adequate internal controls,and maintain
necessary source documentation for all costs incurred.
County of San Luis Obispo Department of Social Services
P.O. BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 5 OF 8
2024 CDBG APPLICATION FORM
Cost Principles:Shall administer its program in conformance with 2
|CFR 200(E),“Cost Principles for Non-Profit Organizations,”or 2 CFR
225,“Cost Principles for State and Local Governments,”as applicable.
These principles shall be applied for all costs incurred whether
charged on a direct or indirect basis.I
Procurement Policies:Certify and agree to procure all materials,
property,or services in accordance with the requirements of 2 CFR
200.320-326.
Lobbying Activities Certify that no Federal appropriated funds have been paid or will be
paid, by or on behalf of the agency,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 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 contract,grant,loan or cooperative
agreement.
‘Minority Business
Enterprise (MBE),
Women's Business
Enterprise (WBE),
Small Business
Contracting
Certify that it will comply with 2 CFR 200.321 to take all necessary
affirmative steps to assure that minority firms,women business
enterprises,and labor surplus area firms are used when possible.
Further certify that it will submit to San Luis Obispo County at the
time of project completion a report of the MBE and WBE status of all
subcontractors to be paid with CDBG funds with contracts of $10,000
or greater,in a format that will be provided by the County.
Real Property Certify that it will comply with real property standards (24 CFR Part
570.505)applicable to any property within the owner's control that is
acquired or improved in whole or in part using CDBG funds in excess
of $25,000.
Religious Activities Certify and agree that funds provided to the agency will not be
utilized for inherently religious activities prohibited by 24 CFR
570.200(j),such as worship,religious instruction,or proselytization.
Section 3 Certify and agree to ensure that opportunities for training and
employment arising in connection with contracts or subcontracts for
a housing rehabilitation (including reduction and abatement of lead-
based paint hazards),housing construction,or other public
construction project are given to low-and very low-income persons
residing within the metropolitan area in which the CDBG-funded
project is located;where feasible,priority should be given to low-
and very low-income persons within the service area of the project
or the neighborhood in which the project is located,and to low-and
very low-income participants in other HUD programs;and award
contracts for work undertaken in connection with a housing
County of San Luis Obispo Department of Social Services
P.O. BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 6 OF §
2024 CDBG APPLICATION FORM
rehabilitation (including reduction and abatement of lead-based
paint hazards),housing construction,or other public construction
project to business concerns that provide economic opportunities
for low-and very low-income persons residing within the
metropolitan area in which the CDBG-funded project is located.
Where feasible,priority should be given to business concerns that
provide economic opportunities to low-and very low-income
residents within the service area or the neighborhood in which the
project is located,and to low-and very low-income participants in
other HUD programs.
Section 504 Section 504 of the Rehabilitation Act of 1973:Certify that it has read
and understands all its obligations under Section 504 to prohibit =Hdiscriminationagainstpersonswithdisabilitiesintheoperationof
programs receiving federal financial assistance.
Liability The County and cities require all grant recipients to maintain general
liability,automobile,and workman's compensation insurance with
limits of not less than $1 million (may vary by jurisdiction).If you are
successful in obtaining a reward,you will be asked to provide
documentation regarding your ability to provide the required
coverage.
+H
Environmental
Review
Prior to HUD's release of grant conditions and/or funds for the
CDBG-funded project,a review of the project's potential impact on
the environment must be conducted and approved by the County of
San Luis Obispo prior to obligating or incurring project costs.The
County must certify to HUD that it has complied with all applicable
environmental procedures and requirements.Should project costs
be obligated or incurred prior to the completion of the necessary
environmental review,the project shall not benefit from the federal
funds.The level of environmental review required depends on the
nature of the project.24 CFR Part 58 is available at
http://www.hud.gov/offices/pih/ih/codetalk/onap/docs/24cfr58.pdf.
Relocation Any project that involves the acquisition of property,construction,
and/or rehabilitation and that is funded in whole or in part with
federal CDBG funds is subject to federal relocation requirements.In
general,any property owner,commercial business,or residential
occupant who is displaced by a HUD-funded project may be eligible
for relocation benefits.A project cannot be broken into separate
“projects”in order to avoid the federal requirements connected with
property acquisition and relocation.Any questions concerning the
relocation regulations for a specific property acquisition project
should be directed to the Homeless Services Division Grant Unit
staff before any action is taken on the project.
HMIS Reporting All homeless service providers applying for CDBG funds to assist,
house,or shelter the homeless must identify and demonstrate the
capacity to participate in the County of San Luis Obispo Homeless =H
County of San Luis Obispo Department of Social Services
P.O. BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 7 OF 8
2024 CDBG APPLICATION FORM
Management Information System (HMIS)to provide personnel fordataentry,user licensing,and hardware and software necessary for
compatibility with HMIS.HMIS is an electronic data collection systemthatstoresclient level information about persons who access the
homeless services system in a Continuum of Care and reports
aggregate data for the County as per HUD's Data Standards.
Affirmative Marketing Quarterly and annual reports shall be submitted by the
project/program manager to the County for CDBG-funded publicservices and housing projects.Each report shall include the totalnumberofproject/program applicants and clients served with
respect to race,ethnicity,gender,and disability status.Affirmative
marketing efforts shall be taken to increase the participation of anyunderservedgroups.
County of San Luis Obispo Department of Social Services
P.O.BOX 8119,San Luis Obispo,CA 93403-8119
www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx
PAGE 8 OF 8
VIEJO CAMINO CDBG PROJECT
EXHIBIT
LOCATION EXHIBIT
DRAWN BY:
DATE:
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11355 VIEJO
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11405 VIEJO
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11450 VIEJO
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11505 VIEJO
CAMINO LAPALOMA COURT
11300 VIEJO
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Grocery Market
Public Service Applications
• El Camino Homeless Organization (ECHO)
• 5 Cities Homeless Coalition
• Youth Activity Scholarships – City of Atascadero
COUNTY OF SAN LUIS OBISPO
DEPARTMENT OF SOCIAL SERVICES
HOMELESS SERVICES DIVISION
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 1 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
Please submit Application by email to SS_HomelessGrants@co.slo.ca.us. All submissions
must be made electronically, no paper applications will be accepted. Application must be
received no later than Sunday, November 5, 2023, at 9 pm.
I. PRIMARY APPLICANT INFORMATION (LEAD AGENCY)
Organization Name
Type of Organization Non-Profit For Profit Gov’t/Public Other:
UEI Number
Contact Person/Title
Finance Contact (if different)
Phone Number
Email
Address
City, State, Zip
Date of Incorporation
Is the organization faith-
based? Yes No
Annual Operating Budget
Number of Paid Staff
Number of Volunteers
II. FUNDING DETAILS
Please identify all funding
sources being requested:
Select all that apply; you will be
required to fill out additional
details for each source requested.
Community Development Block Grants (CDBG)
Emergency Solutions Grants (ESG)
Permanent Local Housing Allocation (PLHA)
HOME Investment Partnership Program (TBRA ONLY)
County General Funds Support (GFS)
Total Funding Requested $______________________
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 2 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
III. APPLICANT CAPACITY
1. Describe the applicant’s history of receiving and managing grants from
County/State/Federal sources.
2. Briefly describe your organization’s auditing requirements, including those for the
proposed project. (As outlined in 2 CFR § 200.500)
3. Describe how the organization participates in HMIS, Coordinated Entry, and the San Luis
Obispo County Continuum of Care.
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 3 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
4. Briefly describe your agency’s record keeping system with relevance to the proposed
project.
5. Describe the organization’s experience delivering related programs/projects.
6. Identify all budgeted funds for homelessness-related services and housing opportunities.
Include leveraged funding in the budget attachment to exhibit financial sustainability of the project beyond the
grant term if awarded.
Does your organization comply
with the Generally Accepted
Accounting Principles?
Yes No
IV. PROPOSED PROJECT and PROJECT DETAILS
Name of proposed
project
Project/Program
address(es)
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 4 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
Areas served City of Arroyo Grande City of Atascadero
City of Pismo Beach City of Paso Robles
City of Morro Bay City of Grover Beach
City of San Luis Obispo Countywide
Unincorporated communities of
7. Provide a brief narrative of the proposed project including projected outcomes. How would
you describe your project to the public in one paragraph?
8. Is this effort new, continuing, or expanding? Please describe.
9. Describe how the project will align with the Lines of Effort to support the San Luis Obispo
Countywide Plan to Address Homelessness (2022-2027). List and describe as many that are
applicable.
Check any specific
population(s)
expected to be
served through this
project:
Adults with children
Adults without children
Elderly/Senior
Parenting Youth
Chronically Homeless
Veterans
Domestic Violence Survivors
Persons with Disabilities
Unaccompanied Youth (under 25 years of age)
Individuals with Co-occurring Disorders (Substance Use and Mental Health)
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 5 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
10. How does your program/service complement and collaborate with existing efforts in the
County? Describe how the program/project will increase capacity of services/housing for
persons experiencing homelessness and at-risk persons in the County.
11. Describe any consultation with local jurisdictions to gain support for the project. Describe
any support you have from local jurisdictions.
12. Name partner agencies as applicable and describe how they will be participating in the
delivery of the proposed activity.
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 6 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
13. Describe how you will ensure that the proposed project is accessible to communities of
color which are disproportionately impacted by homelessness, particularly Black, Latinx,
Asian, Pacific Islander, and Native and Indigenous communities. If you have previously
received a grant to serve any of the affected communities, please provide a brief
description of those grant activities and the outcomes you achieved.
Indicate the predicted performance outcomes listed below.
If not applicable, mark N/A or zero.
Number of unsheltered persons to become sheltered:
Number of people experiencing homelessness to be entering permanent housing:
Number of people experiencing Chronic Homelessness served:
Number of persons At-Risk of Homelessness served:
Number of Unaccompanied Youth served:
Number of Youth At-Risk of Homelessness served:
Number of persons in families with children served:
Total:
Number of persons to be served by facility or program during
the program year:
V. CDBG – if requesting CDBG funds
Amount of CDBG Funds
Requested $______________________
Please indicate the amount
you are requesting for each
jurisdiction
Arroyo Grande $________________
Atascadero $________________
Morro Bay $________________
Paso Robles $________________
Pismo Beach $________________
San Luis Obispo $________________
County $________________
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 7 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
Estimated number of
unduplicated persons or
households to benefit from
CDBG funds
Persons: ________
Households: __________
Please select the national
objective that best applies to
the proposed project.
Low/Moderate Income
Urgent Need (e.g., after a natural disaster)
LOW/MODERATE INCOME
Select which criteria the
proposed project intends
to qualify under to meet the
Low/Moderate Income objective
Area Benefit
Low/Moderate Income Clientele
Limited Clientele
Housing
Jobs/Micro-Enterprises
N/A – Low Moderate Income NOT Selected
Identify all eligible activities
that apply to the proposed
project.
Public Services (General)
Operating Costs of Homeless/AIDS Patients Programs
Senior Services
Handicapped Services
Legal Services
Youth Services
Transportation Services
Substance Abuse Services
Services for Battered and Abused Spouses
Crime Awareness or Neighborhood Cleanups
Fair Housing Activities
Tenant/Landlord/Housing Counseling
Child Care Services
Health Services
Services for Abused and Neglected Children
Mental Health Services
Subsistence Payments, Homeless Assistance, Rental Housing
Subsidies or Security Deposits
Job Training and Job Placement Services
Assistance to microenterprises (technical assistance, business
support services, and other similar services to owners of
microenterprises or persons developing microenterprises)
14. Explain how the proposed project meets the selected National Objective.
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 8 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
15. Will the services offered by your organization increase or expand as a result of CDBG
assistance? If yes, explain.
16. If your project serves any of the presumed benefit populations under the Low/Moderate
Income national objective, please describe how the project will directly benefit the
populations identified.
VI. ESG – if requesting ESG funds
Amount of ESG Funds
Requested $______________________
Identify all eligible activities and their amounts that apply to the proposed project
Emergency Shelter $________________ Approximate Persons Served: _____________
Street Outreach $________________ Approximate Persons Served: _____________
Rapid Re-Housing $________________ Approximate Persons Served: _____________
Homeless Prevention $________________ Approximate Persons Served: _____________
HMIS $________________
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 9 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
17. ESG Matching Funds (1:1 match required)
Sources:
$
$
$
$
$
$
$
$
Total $
VII. PLHA – if requesting PLHA funds
Amount of PLHA Funds
Requested $______________________
Estimated number of
unduplicated persons or
households to benefit from
PLHA funds
Persons: ________
Households: __________
Identify all eligible activities
that apply to the proposed
project.
Rapid Re-housing
Rental Assistance
Supportive/Case Management
Operating and Capital Costs for Navigation Centers
Operating and Capital Costs for Emergency Shelters
Operating and Capital Costs for New Construction, Rehabilitation,
and Preservation of Permanent and Transitional Housing
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 10 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
18. Describe all eligible activities that apply to the proposed project.
Must provide rapid rehousing, rental assistance, navigation centers, emergency shelter, and transitional housing
activities in a manner consistent with the Housing First practices described in 25 CCR, Section 8409, subdivision
(b)(1)-(6) and in compliance with WIC Section 8255(b)(8). An applicant allocated funds for the new construction,
rehabilitation, and preservation of permanent supportive housing shall incorporate the core components of
Housing First, as provided in WIC Section 8255, subdivision (b).
VIII. HOME – if requesting HOME funds (TBRA ONLY)
Amount of HOME Funds
Requested $______________________
Estimated number of
unduplicated persons or
households to benefit from
HOME funds
Persons: ________
Households: __________
Provide proposed funding amounts and approximate number of households to be served:
Rental Subsidy $________________ Approximate Persons Served: _____________
Utility Subsidy $________________ Approximate Persons Served: _____________
Security and Utility Deposits $________________ Approximate Persons Served: _____________
19. Please describe your organization’s client application, intake, and preliminary assessment
process.
Please provide a sample of client intake documents, as applicable, in the attachments section.
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 11 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
20. Describe your organizational collaboration with other local organizations to assist TBRA
income eligible households.
HOME Matching Funds (25% match required)
Sources:
$
$
$
$
$
$
$
$
Total $
IX. GFS – if requesting GFS funds
Amount of GFS Funds
Requested $______________________
Estimated number of
unduplicated persons or
households to benefit from
GFS funds
Persons: ________
Households: __________
Identify all eligible activities
that apply to the proposed
project.
Emergency Shelters
Warming Centers
Safe Parking
Street Outreach
Essential Services for Persons Experiencing Homelessness
Tenant Based Rental Assistance (TBRA)
2024 NOFA – Public Services Application
DEPT OF SOCIAL SERVICES - P.O. BOX 8119 | SAN LUIS OBISPO, CA 93403 | PAGE 12 OF 12 www.slocounty.ca.gov/Departments/Social-Services/Homeless-Services.aspx | SS_HomelessServices@co.slo.ca.us
21. Describe all eligible activities that apply to the proposed project.
X. Attachments
Attachment A – Budget, Leveraged-Funds, and Budget Narrative (Required)
Please attach a Budget and Budget Narrative for the project for which you are applying. The budget narrative
should include FTEs to be provided. Please include the value of any matching funding.
Attachment B – Timeline (Required)
Attach a timeline for key steps of project implementation.
Attachment C - Most Recent Audit (Required)
Attachment D - Proof of Active SAM.gov Registration (Required)
Attachment E – Incorporation Documents (Required)
Attachment F – CDBG Acknowledgements (Required if Applicable)
Attachment G – Organization Mission Statement (Required)
Attachment H – Match Certification Letter (if applicable)
1:1 match required for ESG; 25% match required for HOME TBRA
Attachment I – Client Intake Forms (if applicable)
Attachment J – Letters of Support (Optional)
Please attach any letters of support or commitment from local governments or community partners.
Attachment K – Supplemental Answers to Questions (Optional)
If you need more room to answer any of the application questions, please attach additional information here.
Include the question number for each question being answered.
For other additional or optional attachments, please label them clearly (e.g. Attachment L – “Title”).
XI. APPLICATION SUBMISSION:
Applications and accompanying documents are due to Homeless Services Division, Department of
Social Services by 9:00 pm on November 5, 2023.
Electronic Copy – email to SS_HomelessGrants@co.slo.ca.us
Subject line: 2024 NOFA Public Services Application – (Applicant Name)
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Larisse Lopez
Jeri Rangel
805-470-3362
llopez@atascadero.org
6500 Palma Ave
Atascadero, CA 93422
07/02/1979
32,811,120
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The City of Atascadero has used funding from the CDBG Program in effort to offer scholarships to local
low/moderatly low income families in an effort to make youth sports and activities accessible to all the
youth in our community.
An independent auditing firm conducts an annual audit of all City funds, including the CDBG fund. An
independent audit firm also conducts the Single Audit per OMB Circular A-133, Schedule of Expenditures
of Federal Awards, which includes all CDBG funding information.
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The City has a fund solely for the purpose of CDBG expenditures and reimbursuements.
The City of Atascadero's Recreation team has provided youth sports, youth special interest classes and
activities for many years. The City of Atascadero's Youth Scholarship fund has been used to support youth
in paying for other classes and activities separate from just city ran activities. Helping to provide access to
the broad range of classes and activities throughout our community for youth and families who would not
be able to afford such activities otherwise.
N/A
Youth Scholarships
6500 Palma Avenue
Atascadero, CA 93422
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The City of Atascadero has established a youth scholarship fund designed to assist low income families to
allow children to participate in organized reacreation, social and cultural activities. The population served
would be otherwise unable to afford the activity fees to participate in the activities of choice without the
scholarship. The city applies the income guidelines published by HUD adjusted for family size, as qualifying
criteria to decide scholarship awards.
This is a continuing effort to offer youth scholarships to low/moderate income families.
N/A
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The City partners with outside businesses for support such as non-profits and service groups, as well as
contracted intsructors.
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Registration forms are available in Spanish as well as work with local school counselors to be sure they
have current activity information to share with families they work with who's parents only speak Spanish.
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Most youth serving organizations in Atascadero have received requests for assistance in paying
registrations or enrollment fees for their activities. Many families are unable to afford fees that usually
range from $35 to $300 per child. Applications have grown dramatically over the past several years, but the
need has been more acute in the last few years. These children would not be able to participate in the
activities that promote self-esteem, feelings of community, friendship, health, etc. if they are not provided
with financial aid.
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The program will be serving children who are 2.5 years old up to 18 years old and are considered
extremely low to moderately low income households. It would allow children to participate in organized
recreation, social and cultural activities. It would promote self esteem, feelings of community, friendships,
health, etc.
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CITY OF ATASCADERO
TIMELINE: Funds will be expended within 4 quarters.
(October 1st, January 1st, April 1st, and June 30th.
CITY OF ATASCADEROCOMMUNITY DEVELOPMENT BLOCK GRANT FUNDSCHEDULE OF REVENUES, EXPENDITURES, AND CHANGES IN FUND BALANCEBUDGET AND ACTUALFor the Fiscal Year Ended June 30, 2022OriginalFinalActual AmountsRevenues:Community Development Block Grant 156,660$ 246,280$ 69,008$ (177,272)$ Total revenues156,660 246,280 69,008 (177,272) Expenditures:Administration:CDBG general administration- 10,300 10,295 5 Special projects and studies:Youth scholarships- 10,700 8,820 1,880 Capital outlay:Traffic Way and El Camino Real barrier removal40,720 40,720 15,852 24,868 Santa Rosa barrier removal115,940 115,940 34,041 81,899 Viejo Camino barrier removal- 68,620 - 68,620 Total expenditures156,660 246,280 69,008 177,272 Net change in fund balance-$ -$ - -$ Fund balance, June 30, 2021- Fund balance, June 30, 2022-$ BudgetVariance with Final Budget Positive (Negative)118
Attachment E – Incorporation Documents
The City of Atascadero is a government entity.
YOUTH ACTIVITY
SCHOLARSHIP FUND APPLICATION
The City of Atascadero’s goal is to improve the quality of life in Atascadero and the
surrounding community. The City supports a scholarship fund for eligible youth to provide
access to recreational, cultural and social opportunities. Scholarship support is offered to
local low-income families on an “as needed and available basis.” All eligible applications
will be considered. The application fiscal year runs July 1st through June 30th.
Limit:
$250 per child per fiscal year,
UP TO $500 per family per fiscal year (based on availability of funds)
Please Note: *50% of the registration fee is due immediately upon scholarship
application submittal for City of Atascadero activities.
**“Extremely Low Income” families qualify for a 100% scholarship
with proof of 1040 Tax Return OR Current Pay Stub ONLY**
(Late registration fees are NOT covered)
Proof of eligibility (REQUIRED-must show proof of at least one):
• CalFresh/Food Stamps
• MediCal
• CalWorks
• Section 8 Voucher
• 1040 Tax Return (from previous year)
• Free or Reduced School Lunch
• Unemployment (check stub-current)
Scholarships Will Be Awarded to Eligible Youth 2-17 Years of Age who
LIVE in the Atascadero School District
City of Atascadero Scholarship Program
SCHOLARSHIP FUND APPLICATION
PLEASE MAKE SURE TO PRINT LEGIBLY.
Please submit one scholarship form per child. Youth must be 2-17 years of age & live in the
Atascadero School District. Return to: City of Atascadero, 5599 Traffic Way, Atascadero, CA 93422 or
walk in location is 5599 Traffic Way Atascadero. 805-470-3360
Race: ___________
Applicant (Child)_________________________ Age: ____ Gender: ____ Ethnicity: ________
Street Address ____________________________City_______________St____Zip__________
Email Address:_______________________________________________________________
Name of Applicant’s School__________________________________ Grade________________
Mother/Guardian:___________________Employed? YES NO Head of Household? YES NO
Father/Guardian:___________________ Employed? YES NO Head of Household? YES NO
Address of Requesting Party______________________City____________St___Zip__________
Phone (Day): _____________________________ (Evening) ___________________________
ACTIVITY:______________________ ACTIVITY # (City Activities Only):_______________________
REGISTRATION FEE: _____________ 100%/50 % AMOUNT REQUESTED:___________
PLEASE CIRCLE PERSONS IN FAMILY & GROSS COMBINED YEARLY INCOME:
HOUSEHOLD SIZE A - Extremely Low B - Very Low C - Low
1 Person $23,000 max $38,300 max $61,250 max
2 Persons $26,250 max $43,800 max $70,000 max
3 Persons $29,550 max $49,250 max $78,750 max
4 Persons $32,800 max $54,700 max $87,500 max
5 Persons $35,450 max $59,100 max $94,500 max
6 Persons $38,050 max $63,500 max $101,500 max
7 Persons $41,910 max $67,850 max $108,500 max
8 Persons $46,630 max $72,250 max $115,500 max
PLEASE CIRCLE ONE (Documentation REQUIRED):
CalFresh/
Food Stamps
1040 Tax
Return
Free/Reduced
School Lunch
Unemployment
Check (current) MediCal CalWorks Section 8
Voucher
YOU MUST ATTACH PROOF OF ELIGIBILITY REGARDING THE ITEMS ABOVE
I certify that all of the information provided above is true and correct. I further attest that the family meets the income
criteria stated above.
________________________________ ________________
Signature Date
-------------------------------------------------------CITY USE ONLY-------------------------------------------------------
Date Received: ___________ By:______Date Reviewed: ________ Amount Approved: _________ Funds:__________
Good
Until___6/30/2024__
_
ACTIVIDAD JUVENIL
Aplicación de Beca Recreacional
La misión de la Ciudad de Atascadero es mejorar la calidad de vida en la ciudad y en la comunidad
alrededor. La Ciudad apoya un fondo de becas para proveer acceso a los menores de edad al recreo,
eventos culturales y oportunidades del desarrollo social. Se ofrece becas a las familias de bajos recursos
si los fondos son “necesarios y están disponibles”. Todas las aplicaciones serán consideradas. El año
fiscal es 1 julio al 30 junio. (plazo para aplicar/ recibir una beca).
Límite máximo:
$250 cada niño/ niña por cada año fiscal,
HASTA $500 por familia por año fiscal (si hay fondos disponibles)
*Tome en Cuenta: el 50% de la cuota del registro se debe pagar en la hora de hacer
su aplicación de beca a la Ciudad de Atascadero
**Las familias de “muy bajos recursos” califican por una beca del 100% de la cuota,
PERO SE REQUIRE comprobante de ingreso (Forma 1040 del reporte de impuestos
del IRS o un talón de cheque) **
(NO SE CUBREN cargos de registros ATRASADOS)
Comprobante de elegibilidad: (SE REQUIERE- UNO de los siguientes):
• CalFresh
• 1040 REPORTE DE IMPUESTOS (del año pasado)
• Comprobante de que el niño/niña recibe comidas gratis o precio reducido en la escuela
• Talón de cheque del Departamento de Desempleo (UIB)
• Sección 8 de Vivienda
• Tarjeta de Medi-Cal
• Tarjeta de CalWorks
Las Becas son Para los Niños/as de 2 a 17 años de edad que VIVEN EN el distrito
escolar de Atascadero.
Programa de Becas de la Ciudad de Atascadero
Aplicación para Fondo de Becas
Favor de imprimir legiblemente
Favor de someter una aplicación por niño. Los jóvenes deben tener 2 - 17 años y vivir en el Distrito
Escolar de Atascadero. Favor de enviar aplicaciones a/ o caminar en el registro City of Atascadero, 5599
Traffic Way, Atascadero, CA. 93422. Preguntas? 805-470-3360.
Raza: ___________
Nombre del niño:__________________________Edad: ____ Genero: ____ Etnicidad: ______________
Dirección:___________________________Ciudad:____________Estado:____ Código Postal: _________
Nombre de la Escuela del niño:_____________________________________Grado:____________
Madre (no el joven) _______________________________Empleado?: si no Jefe de hogar?: si no
Padre (no el joven) _______________________________ Empleado?: si no Jefe de hogar?: si no
Dirección del Solicitante________________Ciudad: ____________Estado: ____Código Postal: ________
Número de teléfono(día): _____________________________ (Noche) ____________________________
ACTIVIDAD:_____________________________ACTIVIDAD # (solo actividades de la cuidad):____________________________
Cuota: _____________________ 100% / 50 % Cantidad solicitada: _____________
Indique cuantas personas en la familia y la cantidad de ingresos combinados antes
de deducir impuestos:
Tamaño de la casa
A -
Extremadamente bajo B - Muy Bajo C - Bajo
1 Persona $23,000 max $38,300 max $61,250 max
2 Personas $26,250 max $43,800 max $70,000 max
3 Personas $29,550 max $49,250 max $78,750 max
4 Personas $32,800 max $54,700 max $87,500 max
5 Personas $35,450 max $59,100 max $94,500 max
6 Personas $38,050 max $63,500 max $101,500 max
7 Personas $41,910 max $67,850 max $108,500 max
8 Personas $46,630 max $72,250 max $115,500 max
Indique que tipos de ingreso recibe y adjunta comprobante.
Reporte de
impuestos
Sección 8 de
Vivienda
Comprobante de
que recibe
almuerzo gratis o
reducido en la
escuela
Comprobante de que
recibe beneficios del
desempleo
Tarjeta de MediCal Tarjeta de CalWorks
o CalFresh
Se debe adjuntar prueba de elegibilidad en referencia a los elementos ya listados
Certifico que toda la información proporcionada es correcta y la verdad. Además, certifico que la familia
cumple con los criterios de ingresos establecidos anteriormente.
_____________________________________ ________________
Firma Fecha
----------------------------------------------------Para el uso solamente por la Ciudad --------------------------------------------------
Date Received: ____________ By:_________Date Reviewed: __________Amount Approved: __________ Funds:__________
válido
hasta_____6/30/24_______
_
Application Spreadsheet