APPLICATION FOR SUPPLIMENTAL FUND.PDF

OMB Number: 4040-0004
Expiration Date: 10/31/2019
Application for Federal Assistance SF-424
* 1. Type of Submission: * 2. Type of Application: *If Revision, select appropriate letter(s):
• Preapplication New Increase Award
X Application 0 Continuation * Other (Specify):
Changed/Corrected Application X Revision
* 3. Date Received: 4. Applicant Identifier:
09CH010385
5a. Federal Entity Identifier: 5b. Federal Award Identifier:
N/A 09CI-1010385
State Use Only:
6. Date Received by State: 7. State Application Identifier:
8. APPLICANT INFORMATION:
* a. Legal Name: MARICOPA, COUNTY OF
* b. Employer/Taxpayer Identification Number (EIN/TIN): * c. Organizational DUNS:
866000472 050391270
d. Address:
* Street1: 234 N Central Ave
Street2: Fl 3
* City: Phoenix
County/Parish: Maricopa County
* State: AZ: Arizona
Province:
*CouMnr USA: UNITED STATES
*Zip / Postal Code: 85004 - 0948
e. Organizational Unit:
Department Name: Division Name:
Human Services Early Education
f. Name and contact information of person to be contacted on matters involving this application:
Prefix: * First Name: Al ec i a
Middle Name:
* Last Name: Jackson
Suffix:
Title: Early Education Director
Organizational Affiliation:
*Telephone Number: (480) 464-9669 x201 Fax Number:
* Email: j acksona002@mail .maricopa . gov

Application for Federal Assistance SF424
* 9. Type of Applicant 1: Select Applicant Type:
County Government
Type of Applicant 2: Select Applicant Type:
Type of Applicant 3: Select Applicant Type:
* Other (specify):
* 10. Name of Federal Agency:
ACE-Head Start
11. Catalog of Federal Domestic Assistance Number:
93.600
CFDA Title:
Head Start
" 12. Funding Opportunity Number:
eGrants -N/A
*TMe:
N/A
13. Competition Identification Number:
Not Applicable
Title:
Not Applicable
14. Areas Affected by Project (Cities, Counties, States, etc.):
East Maricopa County
* 15. Descriptive Title of Applicant's Project:
Head Start and Early Head Start
Attach supporting documents as specified in agency instructions.

Application for Federal Assistance SF424
16. Congressional Districts Of:
* a. Applicant AZ-007 b. Program/Project AZ-005
Attach an additional list of Program/Project Congressional Districts if needed.
17. Proposed Project:
* a. Start Date: 07/01/2018 * b. End Date: 06/30/2019
18. Estimated Funding ($):
*a. Federal 65,603
* b. Applicant 16,401
*c. State 0
*d. Local
* e. Other 0
*f. Program Income
*g. TOTAL 82,004
* 19. Is Application Subject to Review By State Under Executive Order 12372 Process?
a. This application was made available to the State under the Executive Order 12372 Process for review on
b. Program is subject to E.O. 12372 but has not been selected by the State for review.
X c. Program is not covered by E.O. 12372.
*20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.)
Yes X No
If "Yes", provide explanation and attach
I I
21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to
comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
Vr** I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
Prefix: Mr. * First Name: Steve 1
Middle Name:
'Last Name: Chucri
Suffix:
*Title: Chairman, Maricopa County Board of Supervisor
*Telephone Number: (602) 506 - 7431 Fax Number:
* Email: chucris@mail.maricopa.goV..„
* Signature of Authorized Representative: * Date Signed:
Approfed as to form:
illiJUL 0 9 2018
A zi
Deputy aunty Attomei Clerk of the Board °Mit.

0 0 97) 1
4040-0006 01/31/2019 82,004 82,004 7- Page
(Rev. -102)
Number: Date: Total (g) 424A A
OMB Expiration Form (Circular
$ $ Standard OMB
0 0 by
Budget 16,401 16,401
Prescribed
Revised Non-Federal (f)
or
New $ $
0 0
65,603 65,603
Programs
Federal (e)
$ $
Non-Construction SUMMARY o
- BUDGET Non-Federal (d)
Funds
A -
INFORMATION SECTION Unobligated $ $ o
Estimated Federal (c)
BUDGET
$ $
Federal Assistance
of Number (b)
Catalog Domestic
93.600 93.600 93.600 93.600
Program or Operations Start: Operations Start:
Function Activity (a) Start: Start: Head Head Totals
Grant Head Program Head TTA Early Program Early TTA
1. 2. 4. 5.

o o o o 0 o o o 97) 1A
65,603 65,603 65,603 7-
Page
(Rev.
($) A-102)
Total 424A
Form (Circular
$ $ $ $ $
_ Standard OMB
o o o 0 o o o 0 o o o
by
Start:
Prescribed
Head
Early
TTA
(4) $ $ $
o o o o o o o 0 0 o o
ACTIVITY Start: Operations
Head
OR
Program
Early
FUNCTION
Reproduction
(3) $ $ $
o o o 0 o o o 0 0 o 0
CATEGORIES
PROGRAM, Local
for
Start:
BUDGET
GRANT
Head TTA Authorized
-
B (2)
$ $ $
0 o o o o o o o
SECTION 65,603 65,603 65,603
Operations
Start:
Program
Head
)
(1 $ $ $
6a-6h)
of
6j)
(sum
and
6i
Charges of
Categories
Charges (sum
Benefits
Direct
Construction Income
Personnel Equipment Contractual TOTALS
Class Supplies
Fringe Travel Other Indirect
Total
a. b. c. d. e. f. g. h. i. j. k. Program
Object
6. 7.

0 0 0 97) 2
16,401 16,401 16,401 4,101 20,502 7- Page
(Rev. A-102)
(e)TOTALS Quarter Fourth 424A
4th (e) Form (Circular
$ $ $ $ $ $ Standard OMB
0 16,400 4,100 20,500 by
Sources (YEARS) Prescribed
Quarter Third
Other 3rd (d)
(d) PROJECT PERIODS
$ $ $ $ $ $
o 0
16,401 4,100 20,501 THE
OF FUNDING
State Quarter Second
(c) 2nd BALANCE FUTURE (c)
NEEDS Charges:
RESOURCES $ $ $ $ FOR $ $ INFORMATION
16,401 o 16,401 CASH 16,401 4,100 20,501 NEEDED Indirect Reproduction
Applicant Quarter (b)First BUDGET 22.
NON-FEDERAL FORECASTED 1st FUNDS Local
(b)
OTHER for
- C $ $ - D $ $ FEDERAL $ $ -
F Authorized
SECTION SECTION Year 65,603 16,401 82,004 OF
SECTION
1st
for ESTIMATES
Total
$ $ BUDGET
- E
Program Program
Operations 14) SECTION
Grant Operations and Grant 19)
(a) Program 8-11) 13 (a) 16-
TTA lines lines lines
Program ETA Start: Start: of of of
Start: Start: Head Head (sum (sum (sum Charges:
Head Head Early Early TOTAL Federal Non-Federal TOTAL TOTAL Direct Remarks:
8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 23.

Application for Supplemental Funding
Maricopa County Human Services Department
Grant No. 09CH010385
June 27, 2018
The Maricopa County Human Services Head Start Program requests supplemental funding of
$65,603 for Program Improvement to address health and safety concerns at a Head Start
Playground that have resulted in the closure of the playground for children and staff.
The program is requesting supplemental funding for the renovation of playground surface at
Belleview Head Start located at 466 S. Bellview Street Mesa, AZ. The playground was
designed in 2015 to create a natural play-scape for preschool aged children with elements such
as garden space, water tables, and wood chip surfacing. However, this playground has
developed an infestations of fleas in the wood chips. This infestation has resulted in flea bites
on children and staff. The program has received multiple complaints from parents and staff
about the chronic flea bites in the past year. The program has closed the playground to children
for the past month.
The program is aware that there is a serious health threat to children and staff if we continue to
utilize the playground due to the infestation. Fleas are a small jumping parasitic insect that lives
by consuming an animal or human hosts blood. When the flea bites its host, it can transmit the
disease it may be carrying. Diseases such as the plague, bubonic plague, pneumonic plague and
flea-borne typhus have been attributed to flea bites.
The program has worked with a private contractor to have the playground treated by a licensed
pest control company. The entire playground and the surrounding area, including inside the
classroom, has been treated three times during this program year but the treatments have not
eliminated the flea infestation.
The program has obtained an estimate in compliance with County Procurement methods from
the playground vendor who had previously completed work at this playground. The proposed
resolution includes removing the wood chips and sand underneath and replacing with dirt fill,
treated sand, and artificial grass at a cost of $65,603 (Estimate Included). The program has
managed other playgrounds with artificial grass that has been effective and compliant to
Arizona Child Care Licensing Rule, R9-5-603, E, 1-2, Outdoor Activity Area

Application for Supplemental Funding
Maricopa County Human Services Department
Grant No. 09CH010385
June 27, 2018
Budget and Budget Justification:
Funds in the HS program are budgeted to align with the programs approach to ensure
comprehensive services to eligible children and their families in a cost effective manner. The
budget distinguishes operating funds, TTA funds, the requested supplemental funding and the
required Non-Federal Share. The charts below reflect the distribution of requested funds and the
revised NFS amounts.
Category Operations TTA Supplemental S TOTAL
Funds
Personnel $4,715,737 $47,549 0 0 $4,763,286
Fringe $2,476,273 $18,734 0 0 $2,495,007
Benefits
Travel 0 $4,872 0 0 $4,872
Equipment 0 0 0 0 0
Supplies $284,048 0 0 0 $284,048
Contractual 905,124 0 0 $25,000 $930,124
Other $722,060 $21,169 $65,603 $2,705,829 $3,514,661
Indirect $1,646,970 $15,178 0 0 $1,662,148
Income 0 0 0 0 0
TOTAL $10,750,212 $107,502 $65,603 $2,730,829 $13,654,146
*NFS Includes Additional $16,401 for Supplemental Funds
• Personnel- No Increase Requested
• Fringe Benefits- No Increase Requested
• Travel- No Increase Requested
• Equipment- No Increase Requested
• Supplies- No Increase Requested
• Contractual- No Increase Requested
• Other-
o Building Maintenance & Repair - $65,603 (Operations) Covers the
expenditures to address safety & health concerns with playground surfacing.
• Indirect- No Increase Requested
• Non-Federal Share-

Application for Supplemental Funding
Maricopa County Human Services Department
Grant No. 09CH010385
June 27, 2018
o Other: Volunteers- $16,401
The MCHSD's approach and policies for valuing volunteer time is based on the Maricopa
County Human Resources Compensation Plan. In this plan, the County defines market titles
and ranges of pay for positions utilized in the County. In determining the value of volunteer
time, the program determines the type of service provided and assigns the most relevant
Maricopa County Market Rate Title to the service. The program uses the mid-point salary for
the defined positions including the current costs for benefits, retirement, variable employee
related taxes, and the in-direct based on the approve indirect cots rate agreement. The Family
and Community Partnership Manager supports program staff in working with volunteers and
recruits volunteer support or services and supplies from the community.
The program reviewed the current market ranges for the positions most frequently used to value
volunteer time and made adjustment to previous valuations based on revised market rates, and
increased benefits as of February, 2018
In-Home Volunteer time is captured EDUCATOR ASSISTANT $16,401
Curriculum and from parents when engaged MRT Midpoint Salary (Based on
Literacy in In-Horne Curricula tasks $12.58/hr. ($20,832 Part estimate of
Activities and Family Literacy Year) volunteer hours)
Activities (In-Home + 11,856 Benefits
Curricula Tasks are + 19.17% Retirement/
assigned by the EHS Variable
Teacher to enhance a + 22.9% Indirect
child's experience in the TOTAL VALUE: $27.23/hr.
Program). Valued as
Teacher Assistant Rate
The program obtained approval by signature from the Board of Supervisors and approval
from Policy Council at the June 25, 2018 meeting.