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Home My WebLink AboutCommunity Health Center/Primary Dental • ' (0 levt bUil-iti 41e6',/t,'14- (.. efi'. ' 'kir/ 131114t) r Rating Tool for 2009/2010 Funding Applications SECTION 1. Mary Ann: Pass/Fail: If all answers are yes, the application goes forward. If any answer no, the application review stops. Ye No ❑ Submitted before deadline? 1E ❑ I-questions answered on City supplemental application? ❑ [Common Application Checklist-all items "yes"? 0 /(_ il 4_,,,,...-- (bcd COMMON APPLICATION CHECKLIST Yeso- Cover pages E 0 Agency Information and Questions 1-7. Jam❑ Question 8 Organizational Experience'(2 page maximum) 0--El Question 9 Need for Your Program (2 page maximum) 0�❑ Question 10 Proposed Program/Service (6 page maximum). CI Question 11 Long Range Plan (1 page maximum) k❑ Question 12 Budget (2 page maximum)„, Data Tables Ern Question 13 Number of individuals/Households Served [1❑ Question 14a-c Performance Measures and Average Cost of Service E''-'-� Question 15 Demographics (from ati funding sources) IT ❑ Question 16 Program Staff ;- I- --T❑ Question 1:7 Program Revenue:& Expense Budgets [ ❑ Question 18 Subcontracts Required Documents ❑'❑ Proof of non-profit status : V1 ❑"Organizational Chart Er;❑Agency/Organization Mission Statement ❑ :.❑ Board resolution,.authorizing submittal of the application (may be submitted up to 60 days after application). R' ❑ List of the currentgoverning board and local board, if applicable, (include name, position/title, City residence, length of time on the Board, and expiration of terms. Note any'vacancies) Er El Board Meeting Minutes of last three board meetings of governing board and local Dboard as applicable" ❑ Annual Budget"" "z 1❑ Fin cial Audit Cover Letter ❑ inancial Audit Management Letter () l V`'' ❑ Financial Statement IZI::❑ Verification of Non-Discrimination Policy U • Program Intake Form GI ❑ Sliding Fee Scale 'ASS FAIL R=ljing T• p. 1 Dr-- • 4/15/08 H:\MS 08\09-10 Funding cycle\Rating Tool414financeupdate.doc SECTION 2. Karen & Dianne: All Passed pre-applications • • No Score Rating Tool p. 2 Draft of 4/15/08 H:\HS 08\09-10 Funding cycle\Rating TooI414financeupdate.doc SECTION 3. Dianne: For informational purposes this year: Agency's Past Performance Past Funding History for last two funding cycles 2005-2008 (Circle CDBG or GF) Amount Allocated: 2005-2006 CDBG /GF 2007-2008 CDBG /GF Yes No ❑ ❑ Were quarterly reports on time in '07? ❑ ❑ Was first quarter report in '08 submitted on time? ❑ ❑ Did agency meet 100% of all the performance measures in 2007? If not— which ones did they not meet? ❑ ❑ Did agency submit an annual outcome:report, on time for '07? El ❑ Was a monitoring visit done? If yes, were there any findings? Yes No__ ❑ ❑ Did agency staff respond to staff requests for information:.in a timely manner? (looking for a pattern, not one-time occurrences)in 2007? ❑ ❑ Did agency staff attend-the City of Renton contract workshop;in 07? F ' ❑ ❑ Did agency staff attend theJoint City funding workshop in 2008? ❑ CIWas there key staff turnover in-2007? If so, what position(s) and how many? jy .4.r YY N Score Rating Tool p. 3 Draft of 4/15/08 H:\fIIS 08\09-10 Funding cycle\Rating TooI414financeupdate.doc SECTION 4. Staff check (Mary Ann and Dianne): make sure numbers in tables match. Score based on the number of boxes checked "Yes" Yes No ❑ ❑ #5 Total project costs need to match the totals on #17. ❑ ❑ #6 Total City funds requested for 2008 and requested for 2009 must match ' numbers given in table#17. ❑ ❑ Last column of#6 must match first column of#14C. ❑ ❑ Average cost of service per client for Rentodj #12C must match same in #14C ❑ ❑ Last column of#13 must match middle'colurrmn;of#14C. ❑ ❑ In #13 - column two percentages:must add to 100%. ❑ ❑ In #13 - if agency selected individuals or households,should be answered the same in question #15. ❑ ❑ #13 1st column numbers must match:numbers'on the top`of#15. ❑ ❑ Three columns in #17;;p:`�19: (Revenue Source) add correctly? ❑ ❑ Three columns in #17 p 20 (Program Expense) add correctly? ,t SCORE: / 10 Rating Tool p. 4 Draft of 4/15/08 H:\HS 08\09-10 Funding cycle\Rating TooI414financeupdate.doc SECTION 5. Finance Subcommittee of Human Services Advisory Committee: Scores financial health of the agency Originally the thought was that this would be pass/not pass. However, it does not get to the financial health of the organization. 1. Level of Financial Statements without "going concern" noted in Auditor Cover Letter ❑CPA Audited 3 points ❑CPA Other/reviewed 2 points ❑Internally prepared 1 point 2. Program Budget A) Is there a change of over 20% in the total program budget line on Table 17 Revenue Source between 2007 Actual and 2008 Budgeted? . . ❑Yes ❑No If yes, has this been adequately explained in question 12 B,"Changes to budget"? ['Yes 0 Points ❑No -2 Points B) On Question 17, are the:totals for program,budget'Revenue or Expenses off by more than $100? ['Yes -3 points ❑No 0 points 3. Balance Sheet Strength. Does the program/agency have a positive total net asset figure on the balance sheet?.; ❑Yes 1 point ❑No. • '0 points 4. Balance Sheet Liquidity, , Is the current ratio at least 1.10 on the Program /Agency Balance Sheet? (Current assets divided by current liabilities = current ratio). ❑.Yes 2 points ❑ No 0 points 5. Diversified Funding Program has a Mixture of funding sources for 2007 as shown in Question 17, revenue source. ❑ At least 1 each City, Other Government Funds and Private Sources 3 points ❑ Has funding from at least two of the three types listed above. 2 points ❑Only City funding sources, but receives funding from more than one city. 1 point SCORE: / 9 Rating Tool p. 5 Draft of 4/15/08 H:\HS 08\09-10 Funding cycle\Rating Tool414financeupdate.doc 6. Human Services Advisory Committee: Scores quality of the application 0-3 a. Organizational Experience (score 0-3) Agency has track record of providing service (score 0-3) Staff has applicable/related experience in working with proposed program and/or training (score 0-3) Was there an explanation.as':to how the Board stays informed and connected-.'about needs in South King County? b. Is the need in the City supported,by,:data? (score 0—3 Is the data s ecific to Renton or toy South KingCounty? ) P. (score 0 — 3) Is there a quantifiable need? c. How easily can Renton residents access the program? (score 0-3) Does theFproposed outreach fit Renton or show knowledge of (score 0-3) Were the languageryandculturalneeds of the clients • addressed?`' (score 0-3) Does'the agency;,propose to°:have subcontractors or partners? Are services accessible through 1) the organization or 2) the subcontractors/partners? (Circle one) Range Plan::- . .zF d L+a`ngwR (score,0.-3), Is a;long-range plan described, versus a strategic plan? • (score 0-3) ;Does the plan list multiple funding sources for future ',funding ".(score 0-3) Wes evaluation of services mentioned in the plan? �s�z SCORE: / 33 Total Score: / 52 Rating Tool p. 6 Draft of 4/15/08 H:1HS 08\09-10 Funding cycle\Rating TooI414financeupdate.doc