HomeMy WebLinkAboutResolutions - 2022.03.10 - 35353•
BOARD OF COMMISSIONERS
March 10, 2022
MISCELLANEOUS RESOLUTION #22-074
Sponsored By: Penny Luebs
IN RE: Public Services - Children's Village - Grant Acceptance from the Michigan Department of
Education for Child and Adult Care Food Program
Chairperson and Members of the Board:
WHEREAS Oakland County Children's Village has applied for and been awarded the Child and Adult Care
Food Program Grant from the Office of Health and Nutrition Services, Michigan Department of Education for
reimbursement of meals to Mandy's Place residents at Children's Village for the period October 1, 2021
through September 30, 2022; and
WHEREAS the Office of Health and Nutrition Services, Michigan Department of Education administers the
United States Department of Agriculture National School Lunch/Commodity Distribution, Child and Adult
Care Food Program; and
WHEREAS the purpose of the program is to make nutritionally balanced low-cost meals and milk available
statewide to children at emergency shelters; and
WHEREAS Mandy's Place at Oakland County Children's Village is registered as an emergency shelter; and
WHEREAS Mandy's Place residents qualify for free breakfasts, free lunches, and free dinners seven days a
week and are reimbursed based on rates provided in the Child Care Centers Reimbursement Rates July 1, 2021
— June 30, 2022; and
WHEREAS the grant amount is unknown at the time of acceptance; however, it is based on the attached per
meal reimbursement rates; and
WHEREAS for the previous fiscal year, October 1, 2020 through September 30, 2021, the total cost of meals
and snacks was approximately $602,820, of which Children's Village was reimbursed $34,922 from the
Michigan Department of Education for the Child and Adult Care Food Program; and
WHEREAS meal provision expenditures are not recorded by program due to cost-efficient bulk purchases that
cover food services for the entire campus; and
WHEREAS there is no grant match requirement; and
WHEREAS the grant agreement has completed the Grant Review Process in accordance with the Board of
Commissioners Grant Acceptance Procedures approved by the Board at their January 21, 2021 meeting.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners authorizes and
accepts the attached FY 2022 Child and Adult Care Food Program Institution Agreement and Certification
Statement for grant meal reimbursements for the period October 1, 2021 through September 30, 2022.
BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to execute
the grant agreement and to approve any grant extensions or changes, within fifteen percent (15%) of the original
award, which are consistent with the original agreement as approved.
BE IT FURTHER RESOLVED that acceptance of this grant does not obligate the County to any future
commitment and continuation of this program is contingent upon continued future levels of grant funding.
BE IT FURTHER RESOLVED a budget amendment is not required at this time.
Chairperson, the following Commissioners are sponsoring the foregoing Resolution: Penny Luebs.
Date: March 10, 2022
David Woodward, Commissioner
o�-- Date: March 21, 2022
Lisa Brown, County Clerk / Register of Deeds
COMMITTEE TRACKING
2022-03-01 Public Health & Safety - Recommend to Board
2022-03-10 Full Board
VOTE TRACKING
Motioned by Commissioner Penny Luebs seconded by Commissioner Charles Cavell to adopt the attached
Grant Acceptance: from the Michigan Department of Education for Child and Adult Care Food Program.
Yes: David Woodward, Michael Spisz, Karen Joliat, Kristen Nelson, Eileen Kowall, Christine Long, Philip
Weipert, Gwen Markham, Angela Powell, Thomas Kuhn, Chuck Moss, Marcia Gershenson, William Miller
III, Yolanda Smith Charles, Charles Cavell, Penny Luebs, Janet Jackson, Gary McGillivray, Robert
Hoffman, Adam Kochenderfer (20)
No: None (0)
Abstain: None (0)
Absent: (0)
The Motion Passed.
ATTACHMENTS
1. FY2022 CACFP Grant Review Sign -Off (1)
2. FY2022 CACFP Approved Application
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and
accurate copy of a resolution adopted by the Oakland County Board of Commissioners on March 10, 2022, with
the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the Circuit Court at Pontiac,
Michigan on Thursday, March 10, 2022.
Lisa Brown, Oakland County Clerk�7 Register of Deeds
GRANT REVIEW SIGN -OFF — Public Services/Children's Village
GRANT NAME: FY 2022 Child and Adult Care Food Program
FUNDING AGENCY: Michigan Department of Education
DEPARTMENT CONTACT PERSON: Heather Calcaterra 248-858-t 160/Lori Strong 248-858-1317
STATUS: Grant Acceptance (Greater than $10,000)
DATE: 02/04/2022
Please be advised the captioned grant materials have completed internal grant review. Below are the returned comments.
The Board of Commissioners' liaison committee resolution and grant acceptance package (which should include this sign -
off and the grant agreement/contract with related documentation) may be requested to be placed on the agenda(s) of the
appropriate Board of Commissioners' committee(s) for grant acceptance by Board resolution.
DEPARTMENT REVIEW
Management and Budget;
Approved by M & B — Lynn Sonkiss 2/4/2022.
The draft resolution is to be updated to include budgetary impact language and the applicable
budget amendment (Schedule A budget amendment).
Human Resources:
Approved by Human Resources. No position implications, so HR action is not needed. — Heather Mason 1/31/2022
Risk Management:
Approved by Risk Management. — R.E. 1/31/22
Corporation Counsel:
Approved by Corporation Counsel (no legal issues). — Sharon Kessler 2/1 /2022
— A911,091=-Home Page
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Oakland County Childrens Village - 630008006 - Status History
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Application: FY 2022 - CNP: Child And Adult rare Fond Proaam - Cartels I Status: Approved I Security Level: biEGS—: Level 4 A:,plicaticn
rdmiristator
Below• are the details for the status histor•v of this document.
Document Status History
Status
Date/Time
By Notes
In Progress
11,'112021 3:19:3: PM
alessi, Mr. grog
Application Submitted
W29j2021 3:21:11 PM
alessi, Mr. greg
Review to Progress
12j7/2021 11':53 :1 AM
Grcoth:uie, Pis, Mich
Approved
12/7/20211:08:29 PPI
Groothuis, Hs. Michelle Object Process Step Option
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6H.no> ' riFuS� hr+t� � Ccr� � t I Ps�ie•_s
°^tA I Gn,plianr-�
Ccp,';ah'. '_C_� State of 'd:[h�nan
Michigan Department of Education
Child and Adult Care Food Program
Reimbursement Rates
July 1, 2021 - June 30, 2022
CHILD AND ADULT CARE CENTERS
CATEGORY ( BREAKFAST LUNCH/SUPPERI SNACK
Category A (Free) $1.97 I $3.66 $1.00
Category B (Reduced) $1.67 $3.26 $ .50
Category C (Paid) $ .33 $ .35 $. 09
i
An additional .26 cash -in -lieu of commodities is paid for each lunch
commod and supper served.
Rate is for each meal, meeting CACFP requirements, served to each participating child.
MICHZ1%N
"""'Education
Rev 8/2021
MICHIG}!�iN
C��IOtl Child and Adult Care Food Program
Institution/Michigan Department of Education
PERMANENT AGREEMENT
Child Nutrition Program Aoencv/Subagency CFDA # Program Title
Child and Adult Care Food program USDA/Food and Nutrition Service 10.558 Child and Adult Care Food Program
To carry out the purpose of Section 17 of the Richard B. Russell National School Lunch Act, as
amended, the regulations governing the Child and Adult Care Food Program (CACFP) set forth in Title
42 of the United States Code § 1766, and 7 CFR Part 226 and the Child Nutrition Act of 1966, as
amended, the Michigan Department of Education (State Agency) and the institution enter into the
following agreement.
A. The Institution agrees:
To accept final administrative and financial responsibility for management of a proper,
efficient, and effective non-profit food service program for CACFP operations as an
institution, centers or facilities listed in the institution's annual approved application. In
addition, the institution agrees to submit an amended application as changes occur.
2. To comply with and meet all responsibilities and requirements set forth in
7 CFR Part 226, handbooks, instructions, guidance, and policies issued by Food and
Nutrition Services (FNS) and/or the State Agency.
To comply with all requirements of Title VI of the Civil Rights Act of 1964 (P.L. 88-352),
Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of
1973, the Age Discrimination Act of 1975, and the U.S. Department of Agriculture (USDA)
regulations concerning non-discrimination (7 CFR parts 15, 15a and 15b), including
requirements for:
racial and ethnic participation data collection
public notification of non-discrimination policy
reviews to assure compliance with such policy, to the end that no person may, on the
bases of race, color, national origin, age, disability, sex, gender identity, religion,
reprisal, and where applicable, political beliefs, marital status, familial or parental
status, sexual orientation, or all or part of an individual's income is derived from any
public assistance program, or protected genetic information in employment, or in any
program or activity conducted or funded by the Department. (Not all prohibited bases
will apply to all programs and/or employment activities.)
4. To comply with FNS Instruction 796.2, Revision 4 for the Financial Management Guidance
of the Child and Adult Care Food Program (CACFP), and the Uniform Guidance (UG) as
outlined in 2 CFR Part 200. These documents provide detailed requirements on allowable
and unallowable costs, direct and indirect costs, depreciation, leases, and other regulatory
requirements.
5. To retain CACFP records and ensure that sponsored centers or providers maintain such
records, for three years plus the current fiscal year or until audit findings have been
resolved, and to maintain twelve (12) months of records on -site at sponsored centers or
provider's homes for immediate review.
6. If the institution utilizes electronic retention, they must have a contingency back-up system
in place. The institution must have a written policy of retention for CACFP records to
ensure integrity and compliance with federal regulations.
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7. That records will not be recreated after the fact.
8. To obtain State Agency approval for any new center or facility (provider) prior to claiming
CACFP reimbursement, and only claim reimbursement for the meal types approved by the
State Agency for the center or facility.
9. To maintain dated menus for meals/snacks claimed.
10. To maintain daily attendance records for participants. Attendance is taken daily as
participants arrive and depart.
11. To claim only those meals served to participant(s) in attendance supported by daily
attendance records and enrolled at the time of the meal.
12. Emergency shelters may only claim meals served to eligible resident children. Emergency
shelters are not required to collect enrollment information for participating children.
However, emergency shelters must maintain, at a minimum, a list of children by name,
date of birth, and dates of residency in the shelter.
13. At -risk programs are not required to collect enrollment information for participating
children. At -risk programs may use sign -in sheets as the daily roster.
14. If the institution is a sponsoring organization of facilities, they are fiscally responsible for
monthly claims for all facilities.
15. If the institution is a sponsoring organization and has allowed a facility to claim without an
active license the institution will repay MDE for the monthly claim. It will be up to the
discretion of the institution to try and collect the claim amount from the facility without an
active license for the month in question.
16. That meal attendance will be dated and recorded at the time the meal/snack is served, at
point of service (POS):
• Except for at -risk programs and emergency shelters, meal attendance must be
recorded by each participant's complete name.
• For at -risk programs and emergency shelters, a meal count is acceptable along with a
daily roster of children receiving meals.
• For day care homes, meal attendance may be recorded up until midnight on the day
the meal/snack was served unless the home serves more than 12 children in a day, or
if the provider has been seriously deficient.
17. To permit state or federal officials to make announced, unannounced, or virtual reviews of
their operations and records during the institution's normal hours of child or adult care
operations. If requested, provide state and federal officials access to paperless
documentation. State or federal officials making such reviews must show photo
identification that demonstrates that they are employees of one of these entities.
18. To obtain and submit to MDE by November 1 each year a Single Audit if your institution
expends more than $750,000 in federal funds per year.
19. Claim no more than two meals and one snack or two snacks and one meal per participant
daily:
• At -risk afterschool programs may claim a maximum of one meal and one snack per
participant, per day.
• Emergency shelters may claim a maximum of three meals per participant, per day.
• Family day care home providers may claim no more than two meals and one snack per
participant, daily.
2of4
20. If operating an at -risk afterschool care program, the institution will:
• provide children with daily, regularly scheduled activities in an organized, structured,
and supervised environment
• include daily educational or enrichment activities
• be in a geographical area served by a school in which 50% or more of the children
enrolled are eligible for free or reduced -price school meals
• meet state or local health safety standards
• claim no more than one afterschool snack and/or supper, per child, per day
• only claim snacks/suppers served to eligible children after school hours during the
regular school year (except holidays and weekends during the regular school year when
snacks may be served at any time of the day and suppers may be served at the
traditional "supper hour")
• not charge or collect payments for CACFP at -risk snacks/suppers served to eligible
children
21. If operating an emergency shelter serving homeless children, the institution will:
• not charge or collect for payments for CACFP meals and snacks served to eligible
children in emergency shelters
• claim no more than three meals (breakfast, lunch, supper) or two meals and one snack
per child per day
• only claim meals served in congregate meal settings. Meals consumed in private family
quarters in an emergency shelter are not reimbursable. Exception: Meals served to
infants from birth through age 11 months in private family quarters that are part of the
emergency shelter may be claimed for reimbursement if the shelter provides all the
required components to the infant's parent or guardian and maintains records
documenting that sufficient food had been provided to meet the meal pattern
requirements
• not claim a program meal under more than one federal program. However, an
institution may use other funding sources to supplement the CACFP reimbursement for
the same meal.
22. If operating an Adult Day Services program, the institution will:
• provide a community -based group program designed to meet the needs of functionally
impaired adults through an individual plan of care. Such a program shall be a
structured, comprehensive program that provides a variety of health, social and related
support services to enrolled adult participants.
• serve one or more of the following meal types - breakfast, lunch, supper, and snack.
Reimbursement may not be claimed for more than two meals and one snack, or one
snack and two meals, provided daily to each adult participant.
• not claim CACFP reimbursement for meals claimed under Part C of Title III of the Older
Americans Act of 1965. Reimbursement may not be claimed for meals served to
persons who are not reenrolled or for meals served to participants at any one time
more than the center's authorized capacity or for any meal served at a for -profit center
during a calendar month when less than 25 percent of enrolled participants were Title
XIX or Title XX beneficiaries.
• maintain daily records of time -of -service meal counts by type (breakfast, lunch, supper,
and snack) served to enrolled participants and to adults performing labor necessary to
the food service.
• meet state or local health safety standards.
• if receiving vended meals, ensure that the facility providing the meals does not receive
Title III funds for the meals delivered.
• keep enrollment records and age of enrolled participants under the age of 60.
• keep records that demonstrate each enrolled participant under the age of 60 meets the
functional impairment eligibility requirements.
• maintain records that qualified adult day services participants reside in their own home
(whether alone or with spouses, children, or guardian), or in group living arrangements
(not a group home)
3 of 4
B. The State Agency will:
1. To the extent of funds available, reimburse the institution in connection with approved
meals to eligible participants at the centers and/or homes listed in the application during
the period hereinafter stated.
2. During any fiscal year, the amount of reimbursement for meals on behalf of each center or
facility shall not exceed an amount equal to the number of meals, by types, served to
participants, multiplied by the rates established by the USDA. Homes will be paid the per
meal rate established by the USDA.
3. During any fiscal year, family day care home sponsors will be paid based on the number of
day care homes participating by the applicable rates specified in federal regulation.
4. Submit on behalf of all institutions a statewide media press release announcing the
availability of meals to eligible participants and that the meals are available to all
participants in attendance regardless of race, color, national origin, age, disability, sex,
gender identity, religion, reprisal, and where applicable, political beliefs, marital status,
familial or parental status, sexual orientation, or all or part of an individual's income is
derived from any public assistance program, or protected genetic information in
employment or participation in any program or activity conducted or funded by the
Department. (Not all prohibited bases will apply to all programs and/or employment
activities.)
C. Termination of Agreement
This Agreement may be terminated on the part of either party and the State Agency may begin
proceedings to terminate or suspend this Agreement immediately after receipt of evidence that the
terms and conditions of this Agreement and of the regulations governing CACFP have not been fully
complied with by the institution.
No termination, suspension, or expiration of this Agreement, however, shall affect the obligation of the
institution to maintain and retain records and to make such records available for audit.
MDE may agree to terminate this agreement upon an institution's notification to the State of Michigan's
Licensing Agency that the institution is voluntarily closing or closing for other reasons not related to
program deficiencies and has no pending action with the Child Care Licensing Division.
The CACFP Agreement will only be terminated for voluntary closure or closure for reasons not related to
program deficiencies if the institution is in good standing with CACFP and has no pending actions, such
as but not limited to serious deficiency, corrective action, suspension, proposal to terminate/proposal to
disqualify, and does not owe any outstanding debt to the MDE or the United States Department of
Agriculture's Food and Nutrition Service.
No additional notification will be sent to institutions that are terminated due to the voluntary closure or
closure due to other reasons not related to program deficiencies.
Rev. 10/01/2021
4of4
MICHIGI iN
... tlCa 10[l„
CACFP Centers Certification - Fiscal Year 2022
The authorized official listed below certifies and understands the following:
• I am the authorized official who is designated as the person in authority who is financially
and administratively responsible for the administration and operation of the institution.
• I have read and agree to the Terms of the Permanent Agreement and this certification.
• This facility does not limit admission of accessibility due to race, color, national origin, age,
disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs,
marital status, familial or parental status, sexual orientation, or all or part of an individual's
income is derived from any public assistance program or protected genetic information in
employment or in any program or activity conducted or funded by the Department.
• Neither this institution nor any of its principals have been convicted of any activity that
indicated a lack of business integrity in the past seven years.
• Neither this institution nor any of its principals have been declared ineligible to participate in
any other publicly funded program by reason of violating that program's requirements in the
past seven years.
• The Child and Adult Care Food Program (CACFP) News Media Release was made available to
the local media (Michigan Department of Education (MDE) distributes- see CACFP's website
under Centers - Annual Administrative Forms).
• Key staff as well as responsible person(s) for each site has been trained in program
requirements prior to assuming CACFP duties and at least annually up to their level of
responsibility in the program, including Civil Rights requirements.
• All information on the application is true and correct.
• This institution has a screening system to scrutinize any criminal convictions of program
staff as well prior management of not -for -profit or government supported programs.
• A screening system is in place to scrutinize any criminal convictions of board members
which may disqualify them from performing program administrative functions.
• The CACFP will be administered in accordance with the Agreement, Policy Statement and
CACFP Regulation (7 CFR, Part 226).
• Information on the application is given in connection with receipt of federal funds.
Officials of the U.S. Department of Agriculture (USDA) and MDE may verify this information.
• Deliberate misrepresentation may subject me to prosecution under applicable state and
federal criminal statutes and placement on the National Disqualification List.
• If any information on this certification form or program application changes, I will amend
my application and submit it to MDE CACFP immediately.
• The names, mailing addresses, and dates of birth of all current institution principals
including Chairman of the Board have been submitted to MDE.
• The institution and the institution's principals, site directors, board of directors, contact
persons, and other responsible principals are not currently on the National Disqualification
List.
The list of any publicly funded programs that the institution and its principals have
participated in during the past seven years, is current.
• The institution is currently compliant with the required performance standards of financial
viability and management, administrative capability, and program accountability as
described in 7 CFR §226.6(b)(2)(vii).
• The institution has not unreported less -than -arms -length transactions or other potential
conflicts of interest in the upcoming year; all such conflicts have been disclosed to MDE.
• I agree to obtain and submit to MDE no later than November 1 each calendar year a Single
Audit if my institution expends more than $750,000 in federal funds per year.
• MDE may agree to terminate this agreement upon an institution's notification to the State of
Michigan's Licensing Agency that the institution is voluntarily closing or closing for other
reasons not related to program deficiencies and has no pending action with the Child Care
Licensing Division. The CACFP Agreement will only be terminated for voluntary closure or
closure for reasons not related to program deficiencies if the institution is in good standing
with CACFP and has no pending actions, such as but not limited to serious deficiency,
corrective action, suspension, proposal to terminate/proposal to disqualify, and does not
owe any outstanding debt to the MDE or the USDA's Food and Nutrition Service. No
additional notification will be sent to institutions that are terminated due to the voluntary
closure or closure due to other reasons not related to program deficiencies.
Additional certifications for Sponsoring organizations:
(Administrative Institutions that oversee multiple sites)
• The management plan on file with the MDE is complete and up to date.
• No sponsored facility, responsible principal, or responsible individual of a sponsored facility
is currently on the National Disqualified List.
• The outside employment policy most recently submitted to MDE remains current and in
effect.
• All sponsored sites are licensed or not subject to licensing.
Each time this application is submitted, I certify that any of the above information that has
changed since the initial application has already been submitted to MDE is being submitted with
this certification.
I certify that the above information is true and correct.
Rev. 10/010/2021
CNP: Child And Adult Care Food Program - Centers - Sponsor Information
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
1.
Agreement #:
630008006
2.
Sponsor Name:
Oakland County
Childrens Village
3.
a.
Address Line 1:
1200 NORTH
TELEGRAPH RD
DEPT 63
b.
Address Line 2:
C.
City:
PONTIAC
d.
State:
MI
e.
Zip:
483411032
4.
a.
Federal Employer ID Number:
386004876
b.
School District Code:
63030
C.
School Building Code:
00000
d.
County Code and Name:
Oakland County - 063
e.
DUNS Number:
136200362
f.
Activity Status and Effective Month:
Active OCT
5.
Is this institution a multi -purpose agency?
0 Yes ❑ No
a.
If yes, list the other programs operating with the agency:
Long term non -secure treatment programming; short term secure treatment programming; fully
accredited on grounds school. Services delivered in multple separate cottages and buildings on
fifty acres.
6.
Does this institution operate in more than
❑ Yes Z No
one state?
a.
List the other states the institution operates in:
Generated 11/12/2021 Page 1 of
CNP: Child And Adult Care Food Program - Centers - Sponsor Information
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
b.
Who is financially and/or administratively responsible for the organization:
Heather Calcaterra, Manager
C.
Does the local affiliate send money from the non-profit food service account
or money from the
CACFP to the parent organization:
No.
7, a.
Contact Person
aA.
Honorific:
Mr.
a.2.
Name:
Greg Alessi
a.3.
Title:
Administrator,Childre
n's Village
a.4.
Telephone Number:
(248) 858-1135 -
a.5.
Fax number:
(248) 858-5222
a.6.
E-mail Address:
alessig@oakgov.com
a.7.
Date of birth:
b.
List additional person to receive MDE email notifications
13.1
Honorific:
Ms.
b.2
Name:
Karla Jensen
b.3.
Title:
Food Service
Supervisor
b.3
Email Address:
jensenk@oakgov.co
m
b.4
Telephone Number:
248-858-1163 -
8.
Type of Institution
1. Educational
Institution (EDU)
9.
Sponsor or Independent Center
Sponsor of Centers
0 Independent
Center
10
Authorized Officials:
Generated 11/12/2021 Page 2 of 4
CNP: Child And Adult Care Food Program - Centers - Sponsor Information
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
Authorized Official 1:
a.1
Honorific:
a.2
Name:
a.3
Date of Birth:
a.4
Title:
a.5 Address:
a.6
City:
a.7
State:
a.8
Zip:
Authorized Official 2:
b.1
Honorific:
b.2
Name:
b.3
Date of Birth:
b.4
Title:
b.5 Address:
b.6 City:
b.7 State:
b.8 Zip:
11. Select your commodity preference:
Ms.
Barb Hankey
Director,Public
Services
2100 Pontiac Lake
Rd
Waterford
MI
48328
Ms.
Heather Calcaterra
Manager,Children's
Village
1200 N. Telegraph 63
West
Pontiac
MI
48341
Cash in lieu of
Commodities
Generated 11/12/2021
Page 3 of 4
CNP: Child And Adult Care Food Program - Centers - Sponsor Information
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
12. Does this organization have a Board of
Yes
Directors?
13. Chairman of the Board/Owner
a. Name
David T, Woodward
b. Date of Birth
14. Executive Director/Owner
a. Name
Barb Hankey
b. Date of birth
I certify that the above data is complete and correct:
lZ
Generated 11/12/2021 Page 4 of 4
CNP: Child And Adult Care Food Program - Centers - Site Information: 63CA00090 Oakland County
Children's Village Mandy's Place
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
Site Information
1. Site Number:
63CAC0090
a. License Tag
UnlicensedRC
b. License Number of Location
63CAC0090
2. Site Name:
Oakland County Children's Village Mandy's Place
a. "New" or "Renewal" tag
Renewal
3. a. Address Line 1:
1200 N Telegraph Rd 83 West
b. Address Line 2:
C. City:
Pontiac
d. State:
MI
e. Zip:
48341-0444
4. a. School District Code:
b. School Building Code:
C. County Code and Name: Oakland County - 063
d. Activity Status and Effective Month: A - OCT
5. License Expiration date 6/18/2022
a. If no DHHS license, Type of license:
❑ Military
❑ Tribal
❑ VIDE Alternate Approval
b. Exempt from DHHS Licensing
❑ Afterschool Supper/Snack Program in At -risk area
0 Emergency/Homeless Shelter
❑Adult Day Services Center
❑ Residential Child Care Institution
6. Is this site located in an active school building? ❑ Yes Z No
License Capacity 44
7. Type(s) of Program(s)
❑ Head Start
❑ Child Care Center (Child Care)
❑ Migrant Program (Migrant)
❑ Latch -Key Program (Latch -Key)
❑ Great Start School Readiness Program (GSRP)
❑ At -Risk Afterschool Program (At -Risk)
Z Emergency Shelter Serving Homeless (Emergency Shelters)
❑ Adult Day Services (Adult Care)
❑ Residential Child Care Institutions (RCCIs)
7. a. At -Risk Afterschool Program:
Generated 11/12/2021 Page 1 of 4
CNP: Child And Adult Care Food Program - Centers - Site Information: 63CAC0090 Oakland County
Children's Village Mandy's Place
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
Eligibility Date
What is the closest school?
7. b. Provide a brief description of your afterschool enrichment program.
8. Operating months:
2 JAN Q FEB RI MAR 0 APR
Q MAY 2 JUN 0 JUL 121 AUG
Q SEP Q OCT 0 NOV Z DEC
9. Operating Months for At -Risk Afterschool Program:
❑ JAN ❑ FEB ❑ MAR ❑ APR
❑ MAY ❑ JUN ❑ JUL ❑ AUG
❑ SEP ❑ OCT ❑ NOV ❑ DEC
10. Days food is served:
Sunday:
Monday:
Tuesday: C�J
Wednesday: d
Thursday:
Friday:
Saturday: d
a. Do days of service vary? ❑
b. If yes, please provide explanation:
11. Hours of operation: (Example: 8:25 am to 3:25 pm)
From
To
or 24 Hours 0
12. Age range of participants in care:
From: birth
To: 18 years
13. Are you an School Food Authority (SFA) currently participating in the National School Lunch Program
(NSLP)? Z Yes ❑ NO
Section I
a. Self -Operation Q
b. Food Service Management Company ❑
b.1 Company Name:
C. Vended Food Contract ❑
Generated 11/12/2021 Page 2 of 4
CNP: Child And Adult Care Food Program - Centers - Site Information: 63CAC0090 Oakland County
Children's Village Mandy's Place
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
c.1 Company or Caterer Name:
Section II
Meals provided by:
a. Center Staff W
a.1. If providing Adult Day Services, are you ensuring that this facility does not receive Title III
funds for the meals claimed under CACFP? ❑ Yes ❑ NO 121 N/A
b. Contract with a Vendor or Caterer ❑
b.1. Company or Caterer Name
b.2 If providing Adult Day Services, are you ensuring that the facility providing meals does not
receive Title III funds for the meals delivered ❑Yes ❑No ZN/A
b.3 Are the meals/snacks served in this program included in the Food Service Management
contract? ❑Yes ❑No QN/A
C. Educational Agency ❑
c.1. Name of the Educational Agency
d. Another Department within your agency ❑
d.1. Please Specify
14. Payment System for Participant's Meals:
Do you charge separately for meals? ❑ Yes 2 No
15. Facility Information:
15. a. Check type of facility:
Q Non -Profit
Q Public
❑ For -Profit
b. Is the program you are applying for at this site a part of your Institution? (If 'No' is selected, the
agency will be treated as "Sponsor of Centers")
ZYes ❑No
C. If for -profit check all that apply:
c.1. 25% or more of the license capacity or the enrolled participants receive Title XX benefits for
children paid by the Department of Health & Human Services. ❑
c.2. 25% or more of license capacity or enrolled participants are eligible for free/reduced price meals.
c.3. 25% or more of license capacity or enrolled participants are eligible for Title XIX benefits and /or
Title XX benefits from the Social Security Act. ❑
16. Is this a new site that is a part of a sponsor of centers or facilities? ❑ Yes 21 No
a. If yes, list the date that staff received training on CACFP program duties and responsibilities prior
to the beginning of program operations at this site:
17. a. Name of the Center Director Heather Calcaterra
Generated 11/12/2021 Page 3 of 4
CNP: Child And Adult Care Food Program - Centers - Site Information: 63CA00090 Oakland County
Children's Village Mandy's Place
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
b. Date of Birth -
c. Email calcaterrah@oakgov.com
d. Site Phone Number 248-858-1160
I certify that the above data is complete and correct:0
Generated 11/12/2021 Page 4 of 4
CNP: Child And Adult Care Food Program - Centers - Certification Statements
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
Please print a copy of this page for your records.
Please note that this application cannot be modified and/or amended in MEGS+ until it has been reviewed by the
Office of Health and Nutrition Staff. If you have any questions or concerns regarding your application, please contact
the Office of Health and Nutrition office. If you would like to exit the system, please click the logout button at the top of
this page. CACFP Centers Certification — Fiscal Year 2022
The authorized official listed below certifies and understands the following:
I am the authorized official who is designated as the person in authority who is financially and administratively
responsible for the administration and operation of the institution.
I have read and agree to the Terms of the Permanent Agreement and this certification .
This facility does not limit admission of accessibility due to race, color, national origin, age, disability, sex, gender
Identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual
orientation, or all or part of an individual's income is derived from any public assistance program or protected genetic
information in employment or in any program or activity conducted or funded by the Department.
Neither this institution nor any of its principals have been convicted of any activity that indicated a lack of business
integrity in the past seven years.
Neither this institution nor any of its principals have been declared ineligible to participate in any other publicly
funded program by reason of violating that program's requirements in the past seven years.
The Child and Adult Care Food Program (CACFP) News Media Release was made available to the local media
(Michigan Department of Education (MDE) distributes- see CACFP's website under Centers - Annual Administrative
Forms).
Key staff as well as responsible person (s) for each site has been trained in program requirements prior to
assuming CACFP duties and at least annually up to their level of responsibility in the program, including Civil Rights
requirements.
-All information on the application Is true and correct.
This institution has a screening system to scrutinize any criminal convictions of program staff as well prior
management of not -for -profit or government supported programs.
•A screening system is in place to scrutinize any criminal convictions of board members which may disqualify them
from performing program administrative functions.
-The CACFP will be administered In accordance with the Agreement, Policy Statement and CACFP Regulation (7
Generated 11/12/2021 Page 1 of 3
CNP: Child And Adult Care Food Program - Centers - Certification Statements
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
CFR, Part 226).
Information on the application is given in connection with receipt of federal funds.
Officials of the U.S. Department of Agriculture (USDA) and MDE may verify this information.
Deliberate misrepresentation may subject me to prosecution under applicable state and federal criminal statutes
and placement on the National Disqualification List.
-If any information on this certification form or program application changes, I will amend my application and submit
it to MDE CACFP immediately.
The names, mailing addresses, and dates of birth of all current institution principals including Chairman of the
Board have been submitted to MDE.
-The institution and the institution's principals, site directors, board of directors, contact persons, and other
responsible principals are not currently on the National Disqualification List.
-The list of any publicly funded programs that the institution and its principals have participated in during the past
seven years, is current.
The institution is currently compliant with the required performance standards of financial viability and management,
administrative capability, and program accountability as described in 7 CFR §226.6(b)(2)(vii).
-The institution has not unreported less -than -arms -length transactions or other potential conflicts of interest in the
upcoming year; all such conflicts have been disclosed to MDE.
I agree to obtain and submit to MDE no later than November 1 each calendar year a Single Audit if my institution
expends more than $750,000 in federal funds per year.
MDE may agree to terminate this agreement upon an institution's notification to the State of Michigan's Licensing
Agency that the institution is voluntarily closing or closing for other reasons not related to program deficiencies and
has no pending action with the Child Care Licensing Division. The CACFP Agreement will only be terminated for
voluntary closure or closure for reasons not related to program deficiencies if the institution is in good standing with
CACFP and has no pending actions, such as but not limited to serious deficiency, corrective action, suspension,
proposal to terminate/proposal to disqualify, and does not owe any outstanding debt to the MDE or the USDA's Food
and Nutrition Service. No additional notification will be sent to institutions that are terminated due to the voluntary
closure or closure due to other reasons not related to program deficiencies.
Additional certifications for Sponsoring organizations:
(Administrative Institutions that oversee multiple sites)
The management plan on file with the MDE is complete and up to date.
-No sponsored facility, responsible principal, or responsible individual of a sponsored facility is currently on the
National Disqualified List.
Generated 11/12/2021 Page 2 of 3
CNP: Child And Adult Care Food Program - Centers - Certification Statements
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
The outside employment policy most recently submitted to MDE remains current and in effect.
All sponsored sites are licensed or not subject to licensing.
Each time this application is submitted, I certify that any of the above information that has changed since the initial
application has already been submitted to MDE is being submitted with this certification.
I certify that the above Information Is true and correct.
Rev. 10101012021
✓QI Agree
Su bm ission/Certification
Person
Date
MDE Approval
Person
Date
Generated 11/12/2021 Page 3 of 3
CNP: Child And Adult Care Food Program - Centers - Policy Statement
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
I. No Separate Charge for Meals (Non -pricing Program) 0
II. Separate Charge for Meals (Pricing Program) ❑
If II is selected, complete items 1-4 in the fields below.
1. Agrees to designate the following person to review applications and make determinations of eligibility.
(Name and Title of person to make determinations of eligibility):
Name ALL MEALS ARE FREE
Title Administrator Greg Alessi
2. When an application is denied, the parent or guardian will be informed of the reason for denial and of the hearing procedure. The
designated hearing official is:
Name
ALL MEALS ARE FREE
Title
Manager Heather Calcaterra
Address
1200 N Telegraph Rd 83 West, Pontiac, MI 48341
3. Describe in detail the payment collection method(s) used which will protect the anonymity of the free/reduced price participants.
Meals are provided at no charge to all the children who reside at the facility.
4. Category B meals must be provided. Prices charged for Category B meals are as follows:
Breakfast: (No more than $0.30) $0
Lunch: (No more than $0.40) $0
Snack: (No more than $0.15) $0
Supper: (No more than $0.40) $0
Q I certify that the above data is complete and correct,
Generated 11/12/2021 Page 1 of 1
CNP: Child And Adult Care Food Program - Centers - Management Plan - Board of Directors: David
T. Woodward
Agency: Oakland County Childrens Village 2021 - 2022 Recipient Code: 630008006
Board Member Information:
1. Honorific
2.Name
3. Position
4. Address
5. City
6. State
7. Zip with Extension
8. Telephone Number
Mr.
David T. Woodward
Chairperson
1200 N Telegraph Rd
Pontiac
MI
48341
248-858-0100
Z You must certify that the above data is complete and correct
Generated 11/12/2021
Page 1 of 1
Main Menu > Reports > Report
roc,"A nIP flirnrFnr-r
For more detailed Instructions, select the Show Help button.
SEARCH
Export Results to Screen � Results Per Page 20 V Sort By --SELECT-- m ASC <
Results (21)
Sponsor Name / Number FV Honorific Name Position Address
Oakland County Childrens Village 2022 Mr.
-63030
Oakland County Childrens Village 2022 Mc
- 63030
Oakland County Childrens Village 2022 Mr.
-63030
Oakland County Childrens Village 2022 Mr.
- 63030
Oakland County Childrens Village 2022 Ms,
- 63030
Oakland County Childrens Village 2022 Ms.
- 63030
Oakland County Childrens Village 2022 Ms.
- 63030
Oakland County Childrens Village 2022 Mr.
- 63030
Oakland County Childrens Village 2022 Ms.
- 63030
Oakland County Childrens Village 2022 Ms,
- 63030
Oakland County Childrens Village 2022 Mr.
- 63030
Oakland County Childrens Village 2022 Ms.
- 63030
Oakland County Childrens Village 2022 Ms.
- 63030
Oakland County Childrens Village 2022 Mc
- 63030
Oakland County Childrens Village 2022 Mr.
- 63030
Oakland County Childrens Village 2022 Ms.
- 63030
Oakland County Childrens Village 2022 Mr.
- 63030
Oakland County Childrens Village 2022 Ms,
- 63030
Oakland County Childrens Village �022 Mr.
- 63030
Oakland County Childrens Village 2022 Ms.
- 63030
1 2
David T.
Chairperson 1200 N
Woodward
Telegraph Rd
Robert
Hoffman
1200 N
Commissioner Telegraph Rd
Michael Spisz
Commissioner 1200 N
Telegraph Rd
Charles Cavell
Commissioner 1200 N
Telegraph Rd.
Kristen Nelson
Commissioner 1200 N
Telegraph Rd.
Eileen Kowall
Commissioner 1200 N
Telegraph Rd.
Christine Long
Commissioner 1200 N
Telegraph Rd.
Philip Weipert
Commissioner 1200 N
Telegraph Rd,
Gwen Markham
Commissioner T200 N
elegraph Rd.
Angela Powell
Commissioner 1200 N
Telegraph Rd.
Thomas Kuhn
Commissioner 1200 N
Telegraph Rd
Yolanda S.
Commissioner 1200 N
Charles
Telegraph Rd.
Marcia
Commissioner 1200 N
Gershenson
Telegraph Rd.
William Miller
Commissioner 1200 N
Telegraph
Adam
Kochenderfer
1200 A
Commissioner Telegraph Rd.
Penny Lusts;
Commissioner 1200 N
Telegraph Rd.
Chuck Moss
Commissioner 1200 N
Telegraph Rd.
Karen loliat
Commissioner 1200 N
Telegraph Rd.
Gary
McGillivray
commissioner 120014
Telegraph Rd.
3anet Jackson
Commissioner 1200 N
Telegraph
SEARCH SHOW HELP
City State Zip Telephone
Code Number
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248 858
0100
Pontiac MI 48341 248-858
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248 858
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858
0100
Pontiac MI 48341 248 858
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248.858-
0100
Pontiac MI 48341 248-858-
0100
Pontiac MI 48341 248-858-
0100
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Board Of Directors
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Export Results to Screen v Results Per Page 20 v Sort By -- SELECT-- v ASC V
Results (21)
{Sponsor Name
I J Number a=y Honorific Name Position Address City State Zip Telephone
Code Number
Oakland County Childrens Village - 2022 Mr. Michael Commissioner 1200 N Pontiac NlI 48341 248-858-
63030 Gingell Telegraph Rd 0100
12
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hU.goa I VfEGS+ Horne I Contact I Potties
FO/A I Compliance
CopVrlght 2015 smhP of Michigan
SAVE FRWT VERSION I GLOBAL ERRORS I I REVIEW COMMENTS I SHOW @ELF
Main Menu > Application Memr > Wewlt<dit > Management plan - Meal Service Times
Oakland County Childrens Village - 630008006
Quick Links: V'ew/fdtt I Cirrange Status I Management Tools I Examme rdLgtad-]toms I View Commenl5
Application: hY 2022 - CNP: Child And Adult Care Food Program - Centers I Status: In Progress 1 Security Level: MEGS+. Level 4 Application
Administrator
Modified By: alossl, Mr. grog on 11/1/2021 4:21:01 PM
MANAGEMENT PLAN - MEAL SERVICE TIMES
Instructions: List beginning and ending meal service times and maximum number of participants to be served dunng each serving time.
63CAC0090 Oakiagd CdIfinty C iiidrpn5 Vflipge Mar,.dy's place.- Artive
gc ohgr
i am requesting special meal times that do not match the suggested timeframes: l 1
Explanation for special meal times
u of 2500
Centers
View Consolidated Most limes R,+nnrt
Site Capacity:
44
breakfast 6:00 am - 9:30 am
AM Snack 9:30 am - 10:30 am
Lunch 10 30 am - 120 pm
N . of
Start
End
mblpa of
Number
Start
End
Number of
No, of
Start
End
Nu
Shifts
particpants
Par
�
UhiKs
O
0
1
_�
PM Snack 1 30 pm - 4:30 pm
Supper 4:30 pm - 6:30 pm
Evening Snack (.:.90 pm - 90) on
No. of
Start
End
Number of
Plo. of
Start
Fnd
Number of
No. of
Start
_
hod
Nu
Sf ffts
patt'd Cis
Shifts
Part�<ip0nts
5Who
fay
U
0
0
If the meal service times vary from day to day, provide an explanation:
0 of 2500
_.. _. __._--------
I After -School At -Risk Snack and Suppers
(Check here If the At -Fisk Capacity is Included in the overall Site Capocity� 17
If Not, enter the AI-usl: Capacity here:
Breakfast 6:00 am - 9:36 am
AM Snack 9; 30 am - 10:30 am
Lunch 10:30 am 1:30 pm
M
£taft End Number of
Participants
No. of
Shifts
NumberofNo,oP5cart
rticipantsShifts,Part
End t�°'
0
0
0 f
I
0
0
`
i
PM Snack 1:30 pm - 4:30 on,
Supper 4;°0
pill - 6:30 pm
Evening Snack 6:30 pm - 9;00 pn
No, of
Number of
Start End
No. of
star
Number of
EndStart
No. ofI
Nm
End
Shifts
Participants
Shifts
Particpants
-<hifts
Part
IO
i
0
0
If the meal service times vary from day to day, provide an explanation:
it of 2500
{ Shelters Serving Homeless Participants
Check here if the Pomeless Capacity is included in the OVv xall Site Capacrtr r"a
if not, enter the Homeless Capacity here: 44
breakfast 6MD am , 9:30 am ! AM Snack 9130 am - 19:30 am , Lunch tit am - 1:30 pm
Vn. of Number of N0. of _ Number of No. at Nm
Start End Start End Star( End
I shi Participants 4 Sh,fts participants Shifts Pan
,l li;iu AM r2 lopto 144
1 7:15 AM R36 A6i Mi 6 1-11,
.a----�,. ...._.i-__
PM Snack 1:30 pm - 4r30 pm l Supper 4:30 not - 6:30 pm Evening Snack 6:30 pm - 9:00 pn
Nn. o` Number of No, of NO of No. of ` { Ilui
Start Ear! Start: Cntl Startl f LnC
..-.- � 5:00 PM S. t6 PM 44 1i Pari
Sh It _Pm tics ants Shifts Pariopanis Shifts
1 3:25 PM1t i:40 PM 44 1 8.00 phi $:3^ Phi 44
h a
if thn meal sarmco times vnry lrorn day t0 day, provide an explanation;
0 of 2506
Adult Care Services
I an requesting aprdal meal hides that du not match the required hmRsr
Site Capacity: 44
Breakfast 6:00 am - 9:30 am AM Snack 9 30 am - 10:30 am ( Limch 10:30 am - 1:90 pm
S'taK ( hod I Number of No. of Start End NlltnOct of No, if Star; ( End No
Na, off
ShlftS_
PaOldriants
� Participants
shifts
j0
_
_
No,
0
10
PM Snack
2:30 pm � �};g0 pm
Supper 4:30 pm - 6:30 pre
Evening Snack 6:30 pro - 9:00 n
p
No. of
Shifts
Start
End
Number of
No. of
Start
End
Number of No, of�
Start
End
No
participants
Shifts
Particrpanis Shifts
par+
10
f
0
0
0
0
If the meal service times vary from day to day, provide an explanation
0 of 2500
. 0 1 certify that the above date Is complete and correct
Related Pages
Status Page Name
Comments Created By Last Modified By
Manaaement Plan - Meal Spo ire Times
Mr, grog alessr
1 i/i/2021 3:19.34 PM 110 /2021 4;21:01 PM
Paliry 5[alemenY
Mr, greg aless7
—
11/1/2021 3:19:34 PM 1111/2021 4:41:43 PM
Manaaement Plan - E3oard of No
Mr. grog Alessi
11/1/2021 3:19,34 PM 11/4/2021 9 30:34 AM
' 7np of the Page
NII gcv ; MEG5+- l+orre I Contort I PnUCia
`vih I Combbe�lcc
Conyi ight 201 � Erato of M,irMoan
r