GOVT AGRMT RE CHILD CARE HEALTH CONS WITH FTF.PDF

Government Agreement Summary
GRA Number: GRA-STATE-19-0970-01 Region/Funding Source: Statewide
Applicant Information:
Maricopa County Department of Public Health
4041 N. Central Avenue, Ste. 1400
Phoenix, AZ 85012
Primary Strategy: Child Care Health Consultation Funding Available: $1,111,760.00
Target Service Units
Child Care Health Consultation:
Total Number of centers/homes served: 499
 Center-based providers: 450
 Home-based providers: 49
Brief Description:
The purpose of this grant is to provide Child Care Health Consultation services to 450 center-
based providers and 49 home-based providers in the First Things First East Maricopa Region,
Northwest Maricopa Region, Phoenix North Region, Phoenix South Region, Southeast Maricopa
Region, and the Southwest Region. The Child Care Health Consultant (CCHC) provides technical
assistance, health and safety information, conducts training, and provides other direct or referral
services related to health and safety to early childhood providers for children birth to age five.
Services are provided using the 3-tiered service levels.
Required Data Template Training
The grantee is required to participate in data template training. Further instruction will be provided
closer to award.
Grant Term/Estimated Start Date: Contact Information:
The estimated grant term is July 1, 2018 Russell Spencer
through June 30, 2019, unless terminated, Fiscal Specialist
cancelled or extended. First Things First
Email: Rspencer@azftf.gov
Phone: (602) 771-5043
GRA-STATE-19-0970-01 Page 1 of 46

GOVERNMENT AGREEMENT
GRA-STATE-19-0970-01
Between The
Arizona Early Childhood Development and Health Board
(First Things First)
And
Maricopa County Department of Public Health
(Grantee)
I. Purpose
The purpose of this Agreement is to specify the responsibilities and procedures for the Grantee
role in administering Arizona Early Childhood Development and Health Board grant funds.
II. Term, Renewal
The term of this Agreement is July 1, 2018 through June 30, 2019. The parties may
renew this Agreement for up to three (3) additional twelve (12) month extensions
(including lesser parts thereof).
III. Description of Services
Early childhood professionals are entrusted to provide care for children, and they must
keep children safe from injuries and infectious diseases while providing care. Health and
safety related issues directly impact the quality of early care and education programs.
The health and safety standards are based on the Caring for Our Children (Third edition)
standards that are higher than state licensing standards. The Child Care Health
Consultation program is evidence-based and has been shown to promote healthy and
safe improvements in child care environments.
The Child Care Health Consultation Program offers specialized training and technical
assistance to child care staff, and directors of centers and homes enrolled in Quality
First in the East Maricopa Region, Northwest Region, Northwest Maricopa Region,
Phoenix North Region, Phoenix South Region, Southeast Maricopa Region, and the
Southwest Region. The role of the CCHC is to promote the health and development of
children, families, and to ensure a healthy and safe child care environment. Topics of
technical assistance: sanitation, hand-washing, playground safety, medication
management, emergency preparedness, and health and illness management.
The target population for the Child Care Health Consultation program is 450 center-
based providers and 49 home-based providers enrolled in Quality First.
The purpose of this grant is to provide Child Care Health Consultation services to 450
center-based providers and 49 home-based providers in the First Things First East
GRA-STATE-19-0970-01 Page 2 of 46

Maricopa Region, Northwest Maricopa Region, Phoenix North Region, Phoenix South
Region, Southeast Maricopa Region, and the Southwest Region. The Child Care Health
Consultant (CCHC) provides technical assistance, health and safety information,
conducts training, and provides other direct or referral services related to health and
safety to early childhood providers for children birth to age five. Services are provided
using the 3-tiered service levels.
Specify the Strategy Specific Data Requirements
FTF requires grant partners to submit the following types of data for the {Insert strategy
name} strategy:
 Participant level demographic information:
 N/A  Yes, Required for SFY 2019  Yes, Capacity Building in SFY 2019
 Programmatic Outcome Data:
 N/A  Yes, Required for SFY 2019  Yes, Capacity Building in SFY 2019
IV. GRANTEE’S Responsibilities
The Grantee shall:
A. Prior to entering into this Agreement, have completed and submitted to First Things
First for review and approval the following forms and documents:
1. Agency/Organization Profile
2. Personnel - Program Personnel Table and Program Organization Chart
3. Required Narrative Responses
4. Implementation Plan
5. Line-Item Budget and Budget Narrative
6. Fiscal Information - Funding Sources and Financial Controls
7. Program Evaluation Information
The completed forms and documents comprise part of this Agreement.
B. In providing programming described in Section IV.A, the Grantee shall act in
accordance with its Program Questions and Narrative Responses; the approved
budget; and the following First Things First documents: the Scope of Work (Exhibit
A), Guidance Materials (Exhibit B), and the Data Security, Submission and
Suppression Guidelines and Requirements for Collaborators (Exhibit C).
C. Coordinate and collaborate with all First Things First grant recipients, as
collaboration is critical to developing a seamless service delivery system for children
and families.
D. Submit timely the reports described in Section VI.
GRA-STATE-19-0970-01 Page 3 of 46

V. Reimbursement/Payment
A. First Things First shall pay the Grantee on a cost-reimbursement basis for expenses
approved in the budget, up to $1,111,760, on the terms described in this Section.
B. Payment is conditioned upon receipt by First Things First of timely, accurate and
complete (i) reimbursement documents, (ii) Program Narrative Reports and (iii) Data
Submission Reports submitted via the First Things First Partner Grant Management
System (PGMS). Payments shall be made only for those services performed or goods
received.
C. The Grantee shall submit reimbursement requests at least quarterly, though not
more frequently than monthly. The Grantee shall submit a final reimbursement
request marked “final” no more than forty-five (45) days after the Agreement end
date. Expenses eligible for reimbursement must be paid, accrued or obligated by
the Grantee by the Agreement term end date. Final payment shall be contingent
upon receipt of all fiscal, programmatic, and data reports required of the Grantee
under this Agreement. Requests for reimbursement received later than forty-five
(45) days after the Agreement end date will not be paid.
D. Funds provided to the Grantee under this Agreement shall only be used to fulfill the
Grantee’s responsibilities under this Agreement. Any questions regarding the
appropriate use of the funds shall be resolved by mutual agreement between the
parties.
E. If the Grantee receives reimbursement for expenditures that are disallowed by an
audit exception by First Things First, the state or the federal government, the
Grantee shall promptly repay the funds to First Things First.
VI. Quarterly Program Narrative and Data Submission Reporting Requirements
A. At a minimum, the Grantee shall submit quarterly one Program Narrative Report and
one Data Submission Report by the 20th of the month following the quarter via
PGMS. Failure to submit timely reports will result in suspension of reimbursement.
The reports shall contain such information as deemed necessary by First Things First.
B. Program Narrative and Data Submission Reports are due:
1st Quarter (July 1 - September 30) Due: October 20
2nd Quarter (October 1 - December 31) Due: January 20
3rd Quarter (January 1 - March 31) Due: April 20
4th Quarter (April 1 - June 30) Due: July 20
GRA-STATE-19-0970-01 Page 4 of 46

C. If the Grantee provides services to more than one First Things First region (multi-
regional strategies), the Grantee shall collect, store and report the data for the Data
Submission Reports separately for each region served.
VII. General Terms
A. FTF Grants Uniform Terms and Conditions. First Things First’s Grants Uniform Terms
and Conditions (revision date December 2017) are hereby incorporated by reference
into this Agreement as if fully set forth herein. Copies of this document are available
by emailing the First Things First Procurement Specialist, grants@azftf.gov.
B. Working on Tribal Land. If the Grantee performs any work under this Agreement on
sovereign land of a tribe, the Grantee shall comply with any requirements set forth
by the tribal government in relation to essential functions of the grant operation,
including data collection. It is a material requirement of this Agreement that the
Grantee follow all First Things First tribal policies and procedures including the Tribal
Data Policy as applicable, obtain all appropriate parental consents and obtain
appropriate tribal approvals as designated by tribal authorities, which approval may
include a requirement to participate in cultural education and community
orientation classes.
C. Non-Discrimination. The provisions of State Executive Order 2009-09 are
incorporated herein by reference. These provisions mandate, in part, that
contractors will not discriminate against any employee or applicant for employment
because of race, age, color, religion, sex or national origin. The Grantee shall also
comply with all other applicable state and federal statutes, regulations and
executive orders concerning non-discrimination practices, including the Americans
with Disabilities Act and Federal Executive Order No. 13279 – Equal Protection of the
Laws for Faith-Based and Community Organizations.
D. Records. Pursuant to A.R.S. § 8-1174, the Grantee shall retain and shall
contractually require each subcontractor and subgrantee to retain all books,
accounts, reports, files and other records (“records”) relating to the Agreement for a
period of five years after the completion of the Agreement. All records shall be
subject to inspection and audit by the State (including First Things First) and by an
independent auditor at all reasonable times. Upon request, the Grantee shall
produce any or all such records at First Things First’s main office in Phoenix, Arizona.
Notwithstanding the foregoing paragraph, pursuant to 2 C.F.R. § 200.333, if the
grant includes federal pass-through funds, then the Grantee shall retain and shall
contractually require each subcontractor and subgrantee to retain all records
pertaining to the federal pass-through funds for a period of three years from the
date of submission of the final expenditure report and until any litigation, claims or
audit findings involving the records have been resolved and final action taken. All
such records shall be accessible and subject to audit in accordance with 2 C.F.R. §
GRA-STATE-19-0970-01 Page 5 of 46

200.336. This paragraph does not apply to a grantee, subgrantee or subcontractor
that is a federal agency.
E. Non-Availability of Funds. Every payment obligation of First Things First under this
Agreement is conditioned upon the availability of funds appropriated or allocated
for the payment of such obligation. If funds are not allocated and available for the
continuance of this Agreement, this Agreement may be terminated by First Things
First at the end of the period for which funds are available. No liability shall accrue
to First Things First in the event this provision is exercised, and First Things First shall
not be obligated or liable for any future payments or for any damages as a result of
termination under this paragraph.
F. Relationship of Parties. The Grantee under this Agreement is an independent
contractor. Neither party to this Agreement shall be deemed to be the employee or
agent of the other party.
VIII. Agreement Administration and Operations
A. Advertising, Publishing and Promotion of Agreement. The Grantee shall not use,
advertise or promote information for commercial benefit concerning this grant
without the prior written approval of First Things First.
B. Review of Printed Materials. First Things First must review and approve all Grantee
publications and/or media funded or partially funded through this Agreement for
compliance with this Agreement. The Grantee shall submit to First Things First via
PGMS all print and electronic materials related to the programs and services funded
under this Agreement before publicly distributing those materials so that First
Things First may first review and approve prior to release. If deemed necessary by
First Things First, the Grantee shall revise the materials as indicated by First Things
First before publicly distributing the materials. First Things First shall have full and
complete rights to reproduce, duplicate, disclose, perform, and otherwise use all
materials prepared under this Agreement.
C. Acknowledgment of FTF Funding. The Grantee shall recognize First Things First as a
funding source of programs and services funded in whole or part under this
Agreement in all publicly distributed print or electronic materials related to those
programs and services. The Grantee shall make this recognition in a manner
described in First Things First’s most current protocol and style guide. First Things
First will post any updates to the protocol and style guide under the Grantee
Resources section of PGMS. The Grantee shall also recognize First Things First as a
funding source of programs and services funded in whole or part under this
Agreement in all formal oral presentations and media interviews related to those
programs and services.
GRA-STATE-19-0970-01 Page 6 of 46

D. Public Awareness Efforts. The Grantee shall consult with First Things First in the
planning of public awareness/marketing strategies, such as websites, advertising or
media campaigns, related to the programs or services funded under this Agreement.
E. Ownership of Materials and Data. Any materials and data required to be collected,
delivered or created under this Agreement, including but not limited to reports,
computer programs and other deliverables are the sole property of the State (First
Things First). The Grantee shall not use or release these materials or data without
the prior written consent of First Things First. The Grantee is not entitled to a patent
or copyright on these materials and data and may not transfer the patent or
copyright to anyone else.
F. Ownership of Intellectual Property. Any and all intellectual property, including but
not limited to copyright, invention, trademark, trade name, service mark, and/or
trade secrets created or conceived pursuant to or as a result of this Agreement and
any related subcontract or subgrant (“Intellectual Property”), shall be work made for
hire and First Things First shall be considered the creator of such Intellectual
Property. First Things First shall own (for and on behalf of the State) the entire right,
title and interest to the Intellectual Property throughout the world. The Grantee
shall notify First Things First, within thirty (30) days, of the creation of any
Intellectual Property by it or its subcontractor(s) and subgrantee(s). The Grantee, on
behalf of itself and any subcontractor(s) and subgrantee(s), agrees to execute any
and all document(s) necessary to assure ownership of the Intellectual Property vests
in the State and shall take no affirmative actions that might have the effect of
vesting all or part of the Intellectual Property in any entity other than the State. The
Intellectual Property shall not be disclosed by Grantee or its subcontractor(s) and
subgrantee(s) to any entity not the State without the express written authorization
of First Things First.
G. Sectarian Purposes. Funds provided under this Agreement may not be expended for
any sectarian purpose or activity, including religious worship or instruction.
Additionally, the Grantee shall implement the programs or services funded under
this Agreement consistent with the First Amendment of the United States
Constitution. With respect to these programs or services, the Grantee also shall not
discriminate against any program or service beneficiary or applicant on the basis of
religion. First Things First reserves the right to verify or monitor compliance with
this paragraph. The Grantee shall repay any funds awarded under this Agreement
that the Grantee spends in violation of this paragraph.
IX. Indemnification
A. Not State Agency. This paragraph applies if the Grantee is not a department,
agency, board, commission or university of the State. Each party (as “Indemnitor”)
agrees to defend, indemnify, and hold harmless the other party (as “Indemnitee”)
from and against any and all claims, actions, liabilities, damages, losses, costs or
expenses (including reasonable attorneys’ fees) (hereinafter collectively referred to
GRA-STATE-19-0970-01 Page 7 of 46

as “Claims”) arising out of bodily injury of any person (including death) or property
damage, but only to the extent that such Claims which result in vicarious/derivative
liability to the Indemnitee are caused by the act, omission, negligence, misconduct,
or other fault of the Indemnitor including its officers, officials, agents, employees or
volunteers. The State of Arizona, Early Childhood Development and Health Board
(First Things First) is self-insured per A.R.S. § 41-621.
B. Patent and Copyright. The Grantee shall indemnify and hold harmless the State
against any liability, including costs and expenses, for infringement of any patent,
trademark or copyright arising out of grant performance or use by the State of
materials furnished or work performed under this Agreement. The State shall
reasonably notify the Grantee of any claim for which it may be liable under this
paragraph. This paragraph does not apply if the Grantee is insured pursuant to
A.R.S. § 41-621.
C. Subcontractors. The Grantee shall contractually require its subcontractors and
subgrantees, if any, to defend, indemnify and hold harmless the State of Arizona and
its departments, agencies, boards, commissions, universities, officers, officials,
agents and employees (“State”) from and against any and all Claims (including court
costs, attorneys’ fees, and costs of claim processing, investigation and litigation) for
bodily injury or personal injury (including death), or loss or damage to tangible or
intangible property caused, or alleged to be caused, in whole or in part, by the
negligent or willful acts or omissions of the subcontractor or subgrantee or any of its
owners, officers, directors, agents, employees, volunteers, or subcontractors. This
indemnity shall include any claim or amount arising out of or recovered under the
Workers’ Compensation Law or arising out of the failure of the subcontractor or
subgrantee to conform to any federal, state or local law, statute, ordinance, rule,
regulation, or court decree. It is the specific intention of the parties that the State
shall, in all instances, except for Claims arising solely from the negligent or willful
acts or omissions of the State, be indemnified by the subcontractor or subgrantee
from and against any and all Claims. It is agreed that the subcontractor or
subgrantee will be responsible for primary loss investigation, defense and judgment
costs where this indemnification is applicable. The subcontractor or subgrantee
shall agree to waive all rights of subrogation against the State for losses arising from
the work performed by the subcontractor or subgrantee for the State.
X. Insurance.
The Grantee shall provide a Certificate of Self-Insurance. The Certification shall be sent
directly to First Things First, Fiscal Specialist, 4000 N. Central, Suite 800, Phoenix,
Arizona 85012. If the Grantee is a department, agency, board, commission or university
of the State of Arizona, then the Certificate of Self-Insurance requirement does not
apply.
In addition, the Grantee shall contractually require its subcontractors to procure and
maintain until all of its obligations have been discharged or satisfied, including any
GRA-STATE-19-0970-01 Page 8 of 46

warranty periods under this Agreement, insurance against claims for injury to persons or
damage to property which may arise from or in connection with the performance of the
work by the subcontractor and its owners, officers, directors, agents, employees, or
volunteers. The insurance policies shall be in accordance with recommendations of the
Risk Management Division of the Arizona Department of Administration, including its
published Insurance Modules, and in consultation with First Things First.
XI. Termination Upon 30 Days Notice
In addition to the termination provisions incorporated by reference, either party may
terminate the Agreement for any or no reason by giving at least thirty (30) days written
notice of termination to the other party. If the Grantee requests termination under this
provision, the Grantee shall cooperate with reasonable requests from First Things First
to decrease services and costs related to the Agreement.
XII. Notices
The Grantee shall address all notices related to this Agreement to:
First Things First
Finance Division
4000 N. Central Avenue, Suite 800
Phoenix, AZ 85012
First Things First shall address all notices related to this Agreement to:
Maricopa County Department of Public Health
4041 N. Central Avenue, Ste. 1400
Phoenix, AZ 85012
GRA-STATE-19-0970-01 Page 9 of 46

XIII. Grantee Assurances
Grantee's Authorized Official to initial the following:
lERAL
Gg To adhere to the most current version of the PR GRAMMATIC
Standards of Practice documents (available at To use proven, effective and/or evidence based
http://www ,firstthingsfirst,org/grants/strategy- programs.
toolkit)
To maintain the personnel qualifications outlined in
To adhere to the Data Security, Submission and the Standards of Practice with subsequent hires.
Suppression Guidelines and Requirements for
To comply with any applicable federal, state, and
Collaborators, as applicable.
local health and safety requirements that apply to
To review and adhere to the First Things First the facilities used for a program.
Grants Uniform Terms and Conditions. Copies of It
this document are available by emailing To actively participate in the Quality Assurance
process, including assessments.
grants@azftf.gov .
1 Om To coordinate, to the extent possible, with other
To accept funds and administer the programs in
programs in the same geographic area that serve
accordance with all applicable federal and state
statutes and regulations and Grant Agreement similar target populations.
requirements. 1 a To coordinate with First Things First during the
length of the program period.
To maintain internal controls, including policies and
procedures, for assuring compliance with To acknowledge funding from FTF in publicly-
applicable cost principles and other Grant distributed materials in compliance with FTF's
Agreement requirements. brand guidelines and submit such materials in
advance for review.
To follow established personnel policies related to IL
To consult with FTF in the planning of public
salary scales, fringe benefits, and travel
awareness/marketing strategies such as websites,
reimbursement.
advertising or media campaigns.
To use generally accepted accounting principles
EVALUATION
(GAAP).
To provide regular and timely reporting and to
To perform required financial and compliance
participate In all pertinent First Things First
audits in accordance with federal law and
research and evaluation efforts.
guidelines, including the Single Audit Act and 2 CFR
Part 200. If an evaluation study has been conducted on the
proposed program, a copy of the evaluation
To maintain documentation for employees working
report (if available) will be submitted to First
across multiple funding sources to ensure the
Things First.
amount of time charged to each employee does
not exceed 100%. If funds are being requested to conduct an
evaluation study, approval by First Things First
To have fiscal control and fund accounting
Research and Evaluation team will be obtained
procedures in place to ensure proper disbursement
prior to implementation.
of and accounting for any funds paid to
subcontractors. If the evaluation study will include a tribal
community, approval by First Things First Research
To maintain enrollment and participate in &verify,
and Evaluation team and Tribal Affairs division will
if an employer.
be obtained prior to implementation.
To maintain a system of contract administration to
ensure conformance with the Grant Terms and
Conditions.
GRA-STATE-19-0970-01 Page 10 of 46

XIV. Authority to Execute this Agreement
Each individual executing this Agreement represents and warrants that he or she is duly
authorized to do so.
XV. In Witness Whereof
The parties hereto agree to carry out the provisions of this Agreement.
FOR AND ON BEHALF OF FOR AND BEHALF OF THE
MARICOPA COUNTY Arizona Early Childhood Development
And Health Board
Steve Chuchri Josh Allen
Chairman, Maricopa County CFO/COO
Board of Supervisors
Date Date
ATTEST:
_________________________________
Clerk of the Board
_________________________________
Date
APPROVE AS TO FORM:
_________________________________
Attorney for Maricopa County
_________________________________
Date
GRA-STATE-19-0970-01 Page 11 of 46

Government Agreement Attachments and Exhibits
Attachment A Agency/Organization Profile
Attachment B Personnel - Program Personnel Table and Program Organization Chart
Attachment C Required Narrative Responses
Attachment D Implementation Plan
Attachment E Line Item Budget and Budget Narrative
Attachment F Fiscal Information - Funding Sources and Financial Controls
Attachment G Program Evaluation Information
Exhibit A Overview of First Things First and Scope of Work
Exhibit B Guidance Materials
Exhibit C Data Security, Submission and Suppression Guidelines and Requirements
for Collaborators
GRA-STATE-19-0970-01 Page 12 of 46

Attachment A - Profile
Agency/Organization Profile
A. Grantee Information:
Agency/Organization Maricopa County Dept. of Public Health-Community Wellness and Health Promotion-Child
Care Consultation Program Contact Person Machrina Leach
Address 4041 N. Central Avenue Position Program Manager
Address Email MachrinaLeach@mail.maricopa.gov
City, State, Zip Phoenix, AZ 85012
Phone 602-506-6662 Ext County Maricopa
Employer Identification Number:86-6000472
Agency Classification: ____State Agency __X__County Government ____Local Government ____Schools
____Tribal ____Faith Based ____Non Profit ____Private Organization ____Other
Have you conducted business with First Things First using this EIN within the last year? __X__Yes ____No
If not or if there has been address or EIN changes, please go to https://gao.az.gov/sites/default/files/GAO-
W-9_072815-S%26S%26A.pdf, download the State of Arizona Substitute W-9 Form, and submit with your
application.
Congressional district (federal) in which agency provides most services: District # ____4_____
Legislative district (state) in which agency provides most services: District # ____15_____
Go to http://www.azredistricting.org and click on Final Maps to identify your
congressional and legislative district
Approximate federal funding (from a federal source) to be received in current fiscal year? $ 29,458,806
Agency’s fiscal year-end date: June 30, 2018
Agency’s accounting method: ____Cash __X__Accrual
Does your organization undergo an annual independent audit in accordance with 2 CFR Part 200, Subpart F?
(See Attachment A) __X__Yes ____No
Contact information for firm conducting agency audit:
Audit firm: State of Arizona: Office of the Auditor General
Address: 2910 N. 44th Street, Suite 410, Phoenix, AZ 85018
Phone: 602-553-0333
GRA-STATE-19-0970-01 Page 13 of 46

B. Program Details:
Program Name: N/A
(The specific name of the program if different from the name of the strategy, organization, or model. If none, then enter N/A)
Program Model: N/A
(The specific name of the program model that has been proposed. If none, then enter N/A)
Geographic Area and/or Target Population: Child Care Health Consultants-Statewide and Child Care Staff in
Maricopa County
Brief Program Description (250 words or less):
The CCHC Program is comprised of specially trained registered nurses, designated as Child Care Health Consultants (CCHC).
who will provide tiered health consultation services in a culturally competent manner to state regulated child care centers
and homes participating in Quality First and the Quality Improvement and Ratings System developed by the Early
Childhood Development and Health Board . Services may include:
 Health and Safety Checklist Assessments
 Consultation for all health and safety practices in the child care
 Assistance to director and child care staff in implementing a quality improvement plan
 Technical Assistance to child care staff to correct health and safety deficiencies
 Interpretation of national standards to promote best practices in health and safety
 Guidance to child care staff in the prevention of communicable diseases through outbreak and recognition,
control, and reporting
 Assistance with the development and implementation of health and safety policies and procedures
 Education and training on a variety of health and safety topics
Strategy and Proposed Service Units
Child Care Health Consultation
Number of centers/homes served:
 Center-based providers:
o East Maricopa:
o Northwest Maricopa:
o Phoenix North:
o Phoenix South:
o Southeast Maricopa:
o Southwest Maricopa:
 Home-based providers:
o East Maricopa:
o Northwest Maricopa:
o Phoenix North:
o Phoenix South:
o Southeast Maricopa:
o Southwest Maricopa:
GRA-STATE-19-0970-01 Page 14 of 46

C. Contact Information:
The First Things First Partner Grant Management System (PGMS) has four contact slots per contract. The same
person may be assigned to more than one slot.
Main Contact: is responsible for the overall program and will have access to all financial, programmatic, and
data reports in PGMS.
Finance Contact: is responsible for the submission of reimbursement requests through PGMS and will have
access to budget and reimbursement information in PGMS.
Program Contact: is responsible for program implementation and will have access to the program and data
reports in PGMS.
Evaluation Contact: is responsible for the program evaluation and data collection activities and will have
access to only the data reports in PGMS.
PGMS Contacts
Name: Karen Hoffman Email: karenhoffman@mail.maricopa.gov
Main Contact
Title/Position: CCHC Supervisor Phone: 602-506-6358
Physical Address (if different than the agency address):
Name: Doris Householder Email: dorishouseholder@mail.maricopa.gov
Finance Contact
Title/Position: CWHP Accountant Phone: 602-372-2691
Physical Address (if different than the agency address):
Name: Machrina Leach Email: machrinaleach@mail.maricopa.gov
Program Contact
Title/Position: CWHP Program Manager Phone: 602-506-6662
Physical Address (if different than the agency address):
Name: Maricela Arizmendi Email: maricela.arizmendi@mail.maricopa.gov
Title/Position: Office Assistant Specialized Phone: 602-506-6372
Physical Address (if different than the agency address):
GRA-STATE-19-0970-01 Page 15 of 46

Attachment B - Personnel
Program Personnel Table
In the following table, provide a list of all personnel or positions employed by the applicant that will be
fully or partially funded through the program. Expand as needed. For Key Personnel, include the name
and position title; pertinent background/experience that specifically relates to the program, including
degrees, field of study, number of years in the field, and other qualifications that align with the
Standards of Practice requirements; and their roles and responsibilities. If the position is to be hired
(TBH), then describe the desired background/experience/degrees and field of study. For all personnel,
provide the Full Time Equivalent (FTE) for each position.
Key Personnel - those individuals directly responsible for program implementation/services and are fully or partially
funded through the proposed program.
Background/Experience* FTEs funded
Name/
(include qualifications that align with Key Roles and Responsibilities through the
Position Title
the Standards of Practice) program
Karen Hoffman CCHC from 2010 and moved to Supervise and Evaluate 1 CCHC 0.8 FTE
RN/CCHC Supervisor Supervisor position in 2011 for Team Lead, 7 Child Care Health
Community Wellness and Consultants, and one
Health Promotion CWHP Administrative Assistant. Gather
(formally known as Community data from electronic charting
Health Nursing with MCDPH. system in the Extranet, submitting
Twenty Eight (28) years’ information to FTF. Organize
experience in nursing which meetings with staff 2 times a
includes hospital, school health, month. Meet with leadership staff
public health and hospice. to discuss budget, policy,
Bachelor of Arts Degree in programs,etc. Collaborate with FTF
Education, Associate Degree in leaders, coaching supervisors, Child
Nursing. Has completed Care Licensing, Assessor
NTI/CCHC Trainer Training, NTI Supervisors, as well as other
CCHC Training. Resume on file partners in public health.Network
with FTF. with all CCHC’s to create better
ways of improving quality in child
care centers through education and
intervention methods.
Martha Golfen RN/ CCHC with CWHP for Maricopa Acts as a team leader for 8 CCHCs 1.0 FTE
CCHC Team Lead County Dept. of Public monitoring Time cards and calendars
Health(MCDPH). Moved to Team and all day to day issues that can arise.
Lead in February 2017. Thirty Works with staff on curriculum and
Eight(38) years of nursing mentors staff as needed. Monitors
experience primarily focusing on charting of staff. Works with supervisor
nursing care for women and on protocol, input on evaluations and
children. Has worked as a school program growth. Carries a caseload of
nurse, RN in medical office, and in child care centers and provides
hospital. Bachelor of Arts in Art consultation and technical assistance
History and an Associate degree in to centers as needed. Attends various
Nursing. Completed the NTI CCHC FTF meetings, technical assistant
course. Resume on file with FTF. meetings, and other partner meetings
GRA-STATE-19-0970-01 Page 16 of 46

as needed.
Ann Johnson RN/ CCHC with CWHP for MCDPH since Provide assessment, consultation and 1.0 FTE
CCHC January of 2016. Five (5) years’ technical assistance to child care
experience working as a RN providers. Provide education, training
primarily as a school nurse, but and guidance on a variety of health
has also worked in the hospital. and safety topics for child care staff
Bachelor of Science in Nursing. and parents. Documents data and
Completed the NTI CCHC course. activities conducted with child care
Resume on file with FTF. providers, children and families
following charting and reporting
requirements. Provide guidance,
support, and information regarding
available resources for families and
child care providers for up-to-date
immunizations; health, dental, and
developmental screenings; and mental
health services.
Diane LeFevre RN/ CCHC with MCDPH since Provide assessment, consultation and 1.0 FTE
CCHC September of 2009. Thirty Seven technical assistance to child care
(37) years as a public health nurse. providers. Provide education, training
Primarily has worked providing and guidance on a variety of health
newborn intensive care follow-up and safety topics for child care staff
services for families through home and parents. Documents data and
visitation. Completed NTI CCHC activities conducted with child care
Training. Resume on file with FTF. providers, children and families
following charting and reporting
requirements. Provide guidance,
support, and information regarding
available resources for families and
child care providers for up-to-date
immunizations; health, dental, and
developmental screenings; and mental
health services.
Idolinda Khalsa CCHC with MCDPH since 2010. Provide assessment, consultation and
RN/CCHC Thirty years’ experience in nursing, technical assistance to child care
primarily in maternal nursing, but providers. Provide education, training
has worked previously in public and guidance on a variety of health
health working with children. and safety topics for child care staff
Completed the NTI CCHC Class. and parents. Documents data and
Resume on file with FTF. activities conducted with child care
providers, children and families 1.0 FTE
following charting and reporting
requirements. Provide guidance,
support, and information regarding
available resources for families and
child care providers for up-to-date
immunizations; health, dental, and
developmental screenings; and mental
health services.
GRA-STATE-19-0970-01 Page 17 of 46

Kelly Hanson CCHC with MCDPH since Provide assessment, consultation and 1.0 FTE
RN/CCHC September 2016. Twenty one (21) technical assistance to child care
plus years’ experience in nursing. providers. Provide education, training
Public health experience since and guidance on a variety of health
2013, other experience in multiple and safety topics for child care staff
areas including Trauma, Pediatric, and parents. Documents data and
and Medical/Surgical. Completed activities conducted with child care
the NTI Class. Resume on file with providers, children and families
FTF. following charting and reporting
requirements. Provide guidance,
support, and information regarding
available resources for families and
child care providers for up-to-date
immunizations; health, dental, and
developmental screenings; and mental
health services.
Marnie Richardson CCHC with MCDPH since 2009. Provide assessment, consultation and 0.5 FTE
RN/CCHC Twenty five(25) years of nursing technical assistance to child care
experience beginning in pediatric providers. Provide education, training
nursing then moving to school and guidance on a variety of health
nursing for 18 years. Completed and safety topics for child care staff
the NTI CCHC Class. Resume on file and parents. Documents data and
at FTF. activities conducted with child care
providers, children and families
following charting and reporting
requirements. Provide guidance,
support, and information regarding
available resources for families and
child care providers for up-to-date
immunizations; health, dental, and
developmental screenings; and mental
health services.
Michelle Hanson CCHC with MCDPH since Provide assessment, consultation and 1.0 FTE
RN/CCHC November 2015. Nine years’ technical assistance to child care
experience as a nurse in various providers. Provide education, training
areas. Worked in public health for and guidance on a variety of health
4.5 years. Has a Master’s in Public and safety topics for child care staff
Health. Completed the NTI CCHC and parents. Documents data and
Class. Resume on file at FTF. activities conducted with child care
providers, children and families
following charting and reporting
requirements. Provide guidance,
support, and information regarding
available resources for families and
child care providers for up-to-date
immunizations; health, dental, and
developmental screenings; and mental
health services.
Samantha Chapin CCHC with MCDPH since July 2017. Provide consultation and technical 1.0 FTE
RN/CCHC 5 years’ experience as a nurse, assistance to child care providers.
hospital and school nursing. Provide education, training and
Completed NTI CCHC Class. guidance on a variety of health and
Resume on file at FTF. safety topics for child care staff and
parents. Documents data and activities
GRA-STATE-19-0970-01 Page 18 of 46

conducted with child care providers,
children and families following charting
and reporting requirements. Provide
guidance, support, and information
regarding available resources for
families and child care providers for up-
to-date immunizations; health, dental,
and developmental screenings; and
mental health services.
Wendi Borchardt CCHC with MCDPH since February Provide consultation and technical 1.0 FTE
RN/CCHC 2016. Five and a half (5.5) years of assistance to child care providers.
nursing experience primarily in Provide education, training and
School nursing. Completed the NTI guidance on a variety of health and
CCHC Class. Resume on file at FTF. safety topics for child care staff and
parents. Documents data and activities
conducted with child care providers,
children and families following charting
and reporting requirements. Provide
guidance, support, and information
regarding available resources for
families and child care providers for up-
to-date immunizations; health, dental,
and developmental screenings; and
mental health services.
Claudia Corral Experience with the CCHC program Provides administrative and clerical 0.6 FTE
as a hearing screening assistant support to the Child Care Nurse
for the Hearing Screening Program Consultant Program (CCNC),
2011-2014. During this time she supervisors and staff. Performs data
assisted the CCHC program as well entry assisting with the CCNC Database
with administrative duties which is and Online Continuing Education
her position at the present time. classes. Assists with administrative
Experience in the medical field as a tasks of setting up and running the
CNA and Lab Tech. Completed the CCHC Courses and Health and Safety
Train the Trainer for the Hearing Specialist Trainings. Provides support
Screening Program. Completed as trained child safety seat expert to
Medical Translation Course in CCNC program and otherwise assists
2015 and is bilingual in Spanish with a myriad of administrative tasks
and English. Resume on file with as needed.
FTF.
Additional Personnel - those individuals partially funded through the proposed program but who do not directly
implement or have direct oversight of the program.
Total Number of FTEs funded or partially funded through program: 9.9
* Resumes and/or job descriptions for key personnel may be requested at any time but unless otherwise
indicated, they do not need to be submitted.
GRA-STATE-19-0970-01 Page 19 of 46

If awarded and the program undergoes changes in staff, a Staff Change Notification form along with an
updated version of this Program Personnel Table will need to be submitted to First Things First within
14 days of the proposed change.
GRA-STATE-19-0970-01 Page 20 of 46

Section B - Personnel
Community Wellness & Health Promotion
GRA-STATE-19-0970-01 Page 21 of 46

Attachment C - Narrative Responses
Required Narrative Responses
Provide a narrative response that addresses the following items.
A. Provide a description of the Child Care Health Consultation program proposed,
including a description of how the tier system will be implemented.
Child Care Health Consultants provide tiered health consultative services to all
regions of Maricopa County in both regulated child care center and homes who
participate in Quality First, the Quality Improvement and Ratings System
developed by the Early Childhood Development and Health Board. The design of
the child care health consultative program that is utilized is influenced by the work
of the National Training Institute for Child Care Health Consultants out of the
University Of North Carolina at Chapel Hill. The CCHC program is a voluntary,
helping process which takes place between the CCHC and the child care participant.
It is a problem solving process with the intent of addressing immediate concerns in
health and safety areas and developing expertise in the child care provider so that
when a similar concern arises in the future, the provider will be able to handle it
independently. In addition, it is a fully collaborative process which includes not
only the child care program director and staff, but also other QF Technical Advisors,
such as QF coaches, Inclusion coaches, Mental Health Consultants. For the up and
coming fiscal year we have 1 nurse supervisor, 1 Lead Nurse, 7.5 nurses servicing
Tier 1, Tier 2 and 3 programs assigned to them and 1 administrative assistant.
Participating programs can and will be expected to move between these service
levels, as appropriate, based upon multiple factors that might include self-
selection, a coaching referral or an external referral. Programs may only participate
in one level at a time. CCHCs will carry a caseload with varied tier levels. Tier one
centers receive quarterly information via email or phone after initial contact with
the CCHC. Tier one centers can request specific service and it will be provided. Tier
two is a short term service option that can focus on an acute health and safety
issue or problem. Tier three is intensive service with programs receiving at least
quarterly in person visits (Per First Things First Standards of Practice SFY19 Child
Care Health Consultation on FTF website).This level requires a 12-18 month
commitment.
B. Provide a description of the following related to the target population to be served
by the proposed strategy:
 How the program will specifically address the target population identified
in this agreement.
GRA-STATE-19-0970-01 Page 22 of 46

i. The target population is all of Maricopa County divided into 6
regions serving child care centers and homes. Each CCHC received a
caseload of centers and homes and travels as needed to service
these centers and homes. Assignments are given as much as
possible to geographically match the area that the CCHC lives near
however that is not always possible.
 The proposed units of service to reach in alignment with the Target
Services Units stated in this Scope of Work.
ii. As part of the quarterly data submission this grant partner will
submit data on actual services provided during the state fiscal year.
This data will be used to monitor progress on meeting the
contracted service units as well as to inform FTF’s reach and
strategy impact.
 How the program will meet the needs of the targeted population in terms
of being culturally responsive, linguistically appropriate, age appropriate
and gender responsive.
iii. Each CCHC is an RN and is trained in cultural competency in their
nurse training as well as during the CCHC training. Our policy and
procedure requires that staff take a Diversity training annually as
well. They are professionals and communicate effectively with the
centers and the homes. They have knowledge of the existence of
cultural diversity in our communities and are culturally sensitive as
needed.
 How the program will specifically retain and support programs receiving
CCHC services.
iiii. Working with director and staff, the consultant will tailor the
instruction and technical assistance to meet the needs of the
individual client’s circumstances. Using best practice standards as
outlined in Caring For Our Children and The Environmental Rating
Scales, the assigned CCHC will guide the client according to the
individual goals identified by the director. The CCHC program will
provide varied incentive items that can help encourage the clients
to practice and adhere to the health and safety goals that each
center’s members have identified. The program supervisor will
assign Spanish speaking consultants to the center if that is the
preferred language of the director and staff members. Cultural
practices of the clients will be respected and technical assistance
will be given with cultural practices in mind. The CCHC will provide
the tier service level desired by the client.
GRA-STATE-19-0970-01 Page 23 of 46

C. Identify infrastructure or capacity building, which will be needed to provide the
proposed program, including agreements and partnerships with other departments
and agencies, additional resources, and training and technical assistance.
The infrastructure for the CCHC program housed at Maricopa County Department
of Public Health (MCDPH) is and has been in place for a period of eight plus years.
The CCHC program, as part of previously Community Health Nursing and now the
Community of Health and Wellness Promotion, partners with other areas in the
MCDPH Disease Control Division, such as Office of Epidemiology, Office of
Preparedness and Response and Office of Vital Registration. Community Health
Nursing has partners throughout the Department of Public Health in the
Community Health Action Division which houses the WIC program, Office of Family
Health, Office of Oral Health, and Office of Health Promotion and Education. In the
MCDPH Community Transformation Division there is the Office of Tobacco &
Chronic Disease, Office of Nutrition and Physical Activity, Office of Community
Empowerment and the Office of Public Policy. Being part of the MCDPH we also
partner with the nonprofit organizations The Arizona Partnership for Immunization
(TAPI). The Child Care Health Consultation Program also partners with other
agencies under the umbrella of First Things First such as the Valley of the Sun
United Way, Southwest Human Development, and Arizona Association for
Supportive Child Care working side by side with Coaches, Mental Health
Consultants, and Inclusion coaches in a collaborative capacity. Arizona Department
of Health Services is another partner we work with especially the Office of Child
Care Licensing. All CCHC’s go through a National Training Institute (NTI) based CCHC
certification course upon getting hired as a CCHC at MCDPH. They also attend
numerous trainings such as Owner/Director Orientation Workshop sponsored by
ADHS Office of Child Care Licensing and an Arizona Department of Economic
Security Family Child Care recruitment training. There are many
trainings/conferences that focus in on the area of child care that are offered to the
nurses throughout the year (Child Abuse conference, AZ Annual Immunization
conference, The Obesity Symposium, FTF Summit, Strong Families Conference, etc.)
The CCHC’s participate in the Quality First Academy along side other collaborative
partners in Quality First to gain knowledge of the mulit-stage coaching model
identified for use by FTF when offering technical assistance to child care providers.
The QF Academy also promotes professionalism and cultural responsibility.
D. Identify barriers to providing the proposed program and plans for addressing these
barriers.
A barrier or challenge for this grant cycle still remains that there is not enough staff
to handle 500 plus centers in Maricopa County. There are 7.5 nurses doing full time
direct service to centers in all of the Maricopa area. Each nurse carries a case load
of 60-70 child care centers at this time. The way we try to address this barrier is to
move centers on and off Tier services, so that each CCHC is only handling no more
than 25-30 Tier 3 centers which receive intense services and require more visits.
GRA-STATE-19-0970-01 Page 24 of 46

Services will continue to be provided via the CCHC Tiered Services Model. We now
have eight online courses regarding Health and Safety offered on the Maricopa
website that helps us to provide educational material to all centers in a more
timely and advantageous manner.
Another challenge is getting the centers that are on Tier 1 services to reach out if
they need help. We have seen some improvement with trying to contact them on a
regular basis, but it still seems that they do not always understand that they can
call any time if they need help with something in regards to health and safety. The
plan is to continue to contact and try to get a meeting to go and talk to the Tier 1
centers periodically.
E. Describe plans to recruit and locate personnel within the geographical region of the
provided program that meet the staff qualification standards detailed in the
Standards of Practice, and are linguistically appropriate and culturally responsive for
the population to be served. If there is anticipated difficulty in hiring qualified
personnel, include a plan and timeline for supporting staff to meet the qualification
standard.
Currently, the MCDPH Child Care Health Consultant Program is fully staffed with
7.5 FTE CCHC’s and 1 lead nurse, 1 supervisor and an administrative assistant.
Should staffing levels change, due to staff turn-over, MCDPH has hiring
mechanisms in place through our Human Resources office that will ensure that
qualified candidates are selected for the interview process. Job descriptions are
reviewed annually and updates are made according to grant requirements. We do
have three staff members that can speak Spanish for our Spanish speaking clients
which addresses being able to support child care centers in a linguistically
appropriate and cultural responsive way. At this time, MCDPH CCHC Program does
not anticipate difficulty in hiring qualified staff.
F. Describe how collaboration will be approached and the steps that will be taken to
promote collaboration with Quality First technical assistance providers (coaches,
mental health specialists, and inclusion specialists), other government/tribal
departments and partners working with the agency/tribe. Identify partners to
engage with and the current status of these relationships, including how
collaborations will align with the continuum in the Standards of Practice and Scope of
Work.
1) The CCHC program collaborates with the other Quality First technical advisors working
with Quality First Programs on several different levels: Individual program
collaborative efforts to develop the Quality Improvement Plan, CCHC staff attendance
and participation with the Quality First Academy, and Supervisory participation in joint
collaboration meetings and at quarterly VSUW Coaching meetings. In addition,
BASECAMP allows for CCHC staff and supervisors to pose questions to the assessment
team and to clarify the meanings of standards taken from the Environmental Rating
GRA-STATE-19-0970-01 Page 25 of 46

Scales and Caring for Our Children, 3rd Ed. CCHC’s also collaborate with all pertinent
technical advisors to address critical incidents that may arise with a QF program.
2) The CCHC program maintains collaborative relationships with ADHS Office of Child
Care Licensing and DES, with members from those offices invited annually to a CCHC
Statewide meeting. CCHC’s have the capacity to contact ADHS for questions and
clarifications regarding licensing regulations.
3) The MCDPH CCHC program and MCDPH Office of Nutrition and Physical have partnered
with ADHS Bureau of Nutrition and Physical Activity to implement programs aimed at
obesity prevention in the child care setting through the Empower and Empower Plus
Programs. CCHC’s focus on helping child care programs implement policies from the
Empower Program and demonstrate how Empower and Empower Plus concepts can
readily be adapted to their individual programs.
4) The MCDPH CCHC Program collaborates with Pima County CCHC Program to determine
dates/sites of CCHC Training Programs and Health and Safety Specialist Training
Programs. The two programs also meet to discuss overall curriculum of the CCHC and
HSS training programs to ensure that content is standardized for both training
programs.
5) The MCDPH CCHC program also collaborates with our internal MCDPH departments.
Community Health Nursing (CHN) has county funded CCHC’s who help support non-QF
programs in Maricopa County. CHN also provides NTI certified trainers who help
produce CCHC Training that is done by MCDPH CCHC program The CCHC program
partners with the Community Wellness and Health Promotion (CWHP) program to
provide free adult immunizations to child care providers following community training
events. The office of Epidemiology will alert the CCHC program of any reports of
outbreaks in a child care center. If the program is a QF program, then a QF funded
CCHC can contact the program to assist the program in managing their outbreak. The
CCHC program has partnered with our Public Information Office to create on-line
trainings for child care providers on the CCHC section of the MCDPH web site. Plans
are in place to expand this partnership to include additional training offerings as they
can be created.
G. Describe your program data collection process including who will be responsible for
data collection and data submission; what procedures will be in place to ensure
timely, accurate, and secure collection and submission; and how data will be used to
inform and improve programming.
The MCDPH CCHC program already has resources in place that meet the FTF Basic
Reporting Requirements and maintain data securely and confidentially. All the CCHCs are
responsible to enter Data into the Extranet regarding services given child care providers
and are required to chart within 5 business days after seeing the client. CCHC supervisors
submit quarterly reports to FTF via the secured FTF extranet and PGMS system. Maricopa
County Office of Enterprise Technology’s (OET) Information Security division provides the
processes and technology to ensure the confidentiality, integrity and availability of all
County information systems, to include those of MCDPH. The Information Security
organizational unit focuses on information security policies, governance and compliance.
GRA-STATE-19-0970-01 Page 26 of 46

All staff members are required to review Maricopa County and Maricopa County
Department of Public Health Ethics and HIPAA policies. MCDPH has additional polices in
place for HIPAA compliance and for maintenance of hard copy records and storage of
closed records.
GRA-STATE-19-0970-01 Page 27 of 46

Attachment D - Implementation Plan
The purpose of the Implementation Plan is to identify and define the activities, tasks, and timelines for implementation of the proposed program to ensure effective
implementation. The Implementation Plan demonstrates the day-to-day activities and operations of the proposed program that align to and fulfill the strategy
Standards of Practice and/or Scope of Work. If the proposed program will be implemented for the first time, the implementation plan should include the additional
activities required for start-up and the anticipated timelines for the onset of service delivery to the target population.
All applicable activities and timelines for the following components must be addressed in the plan. Note: the date the task will be completed should include a level
of specificity that demonstrates when and how often the activity will take place (e.g. weekly, bi-monthly, quarterly, etc.) Terms such as ongoing, continuous or until
met are not acceptable.
Implementation Plan
July 1, 2018 – June 30, 2019
I. Organizational Infrastructure - including but not limited to the following activities. Add additional rows as needed.
o Recruitment, hiring and training of all staff (supervisors, direct service and administrative support staff) including orientation, initial and ongoing professional
development, certifications, and training on curriculum, assessments and tools.
o The development/updating of policies and procedures for program implementation
o Determination of staff assignments
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
Recruitment of CCHC Staff 1. Review current job descriptions; Karen Hoffman Annually Current org chart, Job Descriptions
(supervisors, direct service, and update and revise when Human
administrative support staff. Resources (HR) asks for revisions.
2.Confer with HR and
Communications department to post
for vacancies
GRA-STATE-19-0970-01 Page 28 of 46

Orientation and training of CCHC staff 1. New staff will attend all new Karen Hoffman Annually Policy and Procedures Maricopa
employee orientation sessions County
required by the Maricopa
County upon hiring.
2. Attend onboarding session
though FTF QF Academy.
3. Complete tasks in CCHC
orientation manual.
4. Mentor to be assigned to new
staff.
5. New staff will make visits
with experienced staff
members.
.
Professional Development for CCHCs 1. Attend at least 3 of the 4 Karen Hoffman Annually Standards of Practice and Maric opa
Quarterly Update meetings. County Policy and Procedure
2. Attend at least 3 of the 4
Community of Learners sessions
through FTF QF Academy and
the Quality First Symposium
held annually
3. CCHCs will take classes on
the Maricopa County HUB as
requested by supervisor.
4. CCHCs are able to attend
webinars as approved by
supervisor
5. CCHCs attend conferences
when funding is available and is
approved by supervisor
GRA-STATE-19-0970-01 Page 29 of 46

Policies and Procedures for program 1.CCHCs follow Standards of Karen Hoffman Annually CCHC Maricopa County Orientation
implementation Practice from FTF QF Manual for CCHC Program
2. CCHCs follow guidelines in
the CCHC Handbook
3. CCHCs are familiar and review
policies for Maricopa County
Determination of staff assignments Assign child care centers / Karen Hoffman Annually CCHC protocols and guidelines
homes to staff as needed.
Attempt to assign child care
providers to staff in a
location/region that is
reasonable to travel to.
GRA-STATE-19-0970-01 Page 30 of 46

II. Outreach and Marketing to the target population and geographic area (including but not limited to the following activities)
o The development and approval of collateral materials - brochures, flyers etc. (refer to FTF Branding Guide, http://www.firstthingsfirst.org/grants/grantee-
resources)
o Media and news releases (refer to FTF Branding Guide, same link)
o Plan and implementation of targeted outreach activities
o Coordination and alignment with partners of outreach to target population to be served
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
Brochure development and updates 1. Brochure on CCHC Program Karen Hoffman Annually CCHC Standards of Practice 2019
used in Meet and Greet packet.
2. FTF branding utilized to
promote CCHC services
Newsletter Development 1. Newsletter created every 6 Lead Nurse/Karen Every 6 months CCHC Standards of Practice 2019
months to be sent out to all Hoffman
centers and homes.
Mass Email Messaging 1. CCHCs will mass email Tier 1 Karen Hoffman Quarterly CCHC Standards of Practice 2019
centers every quarter with
Lead Nurse
pertinent information regarding
health and safety reminding
them that if they need services
to call their CCHC.
GRA-STATE-19-0970-01 Page 31 of 46

III. Service/Program Delivery (including but not limited to the following activities)
o When services/programming will occur (Frequency/duration)
o Implementation of intake, enrollment and referral processes, as applicable
o Implementation of ongoing program elements and activities required in the Standards of Practice and/or Scope of Work (how often and when they are to occur)
- e.g., core model elements, screenings, assessments, surveys, etc.
o Determination and processes for ending the service - e.g., completion or discontinuation of services as determined by type of strategy and target population
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
Tier 3 Services to Centers and Homes 1.Quarterly in person visits, Karen Hoffman Annually CCHC Standards of Practice 2019 and
extensive service lasting 12-18 CCHC Scope of Work
months approximately
2.Assess(Health and Safety
Checklist) whole program with
special attention to the infant
and toddler rooms
3.Use health and safety
standards based on Caring for
our Children and develop goals
using best practice
4.Implement program model
using CCHC Handbook
5. CCHCs will support and
comply with ADHS Licensing
rules and report any observed
violations.
6. Identify child care staff to
serve as Health and Safety
Specialists.
GRA-STATE-19-0970-01 Page 32 of 46

Tier 2 Service 1.CCHC will provide short term Karen Hoffman Annually CCHC Standards of Practice 2019 and
consultation: an acute health CCHC Scope of Work
and safety issue for a short
duration(1-4 visits)
2. Participants will be offered
to enroll in Tier 1 or Tier 3
services upon completion of
Tier2 services.
3. CCHCs will support and
comply with ADHS Licensing
rules and report any observed
violations.
Tier 1 Service 1.Provide Meet and Greet for all Karen Hoffman Annually CCHC Standards of Practice 2019 and
newly enrolled centers CCHC Scope of Work
2. CCHCs will provide quarterly
informational communication
after initial contact via email.
3.CCHCs will communicate any
community trainings offered by
the CCHC program
4. If the participant requests
service from CCHC it must be
provided.
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Health and Safety Checklists 1.CCHCs must administer and Karen Hoffman Annually CCHC Standards of Practice 2019 and
score and document a Health CCHC Scope of Work
and Safety Checklist upon
enrollment and then annually to
determine progress in meeting
standards
2. There must be at least 7 -8
months in between the
assessments and the same
classroom must be assessed if
possible.
3. All participants with a 1-2
star rating must receive an
annual Health and Safety
Checklist assessment.
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IV. Coordination and Collaboration (including but not limited to the following activities)
o Describe the process for and implementation of collaboration efforts:
 Within your organization, across unit/team coordination, as applicable
 With external partners including other organizations that are a part of the early childhood system (FTF grant partners, FTF Regional Partnership Councils, and
FTF regional grant partner meetings, non-profits, community or county-based alliances, coalitions, initiatives, state or tribal government entities, national
model organizations, professional entities, faith communities, etc.),
 With sub-grant partners, consultants, volunteers, etc.
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
Create new and update existing curricula 1.CCHCs collaborate to update Karen Hoffman Annually Maricopa County CCHC Protocol and
for CCHC program and create new curricula Guidelines.
2. CCHCs discuss and assess CCHC Standards of Practice 2019 and
program during meetings held CCHC Scope of Work
twice a month.
Collaborate with other partners in 1. Collaborate with Disease All CCHCs Quarterly Maricopa County Disease Control
Maricopa County Public Health Control when disease outbre aks Protocol
occur in child care centers.
2. Coordinate with other nurses
that are CCHC trained when
child care centers need
education or assistance with
disease outbreak and they are
not on Quality First.
3. Collaborate with
immunization nurses to provide
vaccine for outbreaks or rural
settings that do not have easy
access to vaccine clinics.
QF Collaboration Meetings CCHCs attend collaboration Karen Hoffman Tier 3 Centers- Quarterly CCHC Standards of Practice 2019 and
meetings with QF coaches, other CCHC Scope of Work
Tier 1 or 2- As needed
specialized Technical Assistance
providers, and directors
GRA-STATE-19-0970-01 Page 35 of 46

Collaboration with outside agencies 1.Collaborate/communicate with All CCHCs At least quarterly CCHC Standards of Practice 2019
ADHS Licensing agency
2. Collaborate with SWHD and
ASCC
3.Collaborate with Head Start
organization
4. Collaborate with ADE PDG
Regional Council Meetings 1. Attend Regional Council All CCHCs Two times annually
meeting as time permits
GRA-STATE-19-0970-01 Page 36 of 46

V. Continuous Quality Improvement (CQI)
o Staff supervision including program directors/managers, supervisors, line staff, and administrative staff (e.g. individual supervision, team meetings, staffing, chart
reviews, observation and shadowing, etc.)
o Review of program implementation and current CQI methods (e.g., data collection, surveys, participant feedback, etc.) to inform ongoing work
o Ongoing review and updating of program policies and procedures
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
Conduct one on one Reflective Meet every other month with staff Karen Hoffman Every other month Standards of practice
Supervision meetings with staff individually to reflect on how the work is
going with the case load of child care
providers as needed.
Team Meetings Meet with team the 2 n d and 4 t h Karen Hoffman Two times a month Maricopa County CCHC Protocol
Mondays of the month
Lead Nurse
Review extranet charting Review staff documentation as Karen Hoffman Quarterly Maricopa County CCHC Protocol
needed
Lead Nurse
Policy and Procedure Manual Review and update policy and Karen Hoffman Annually Scope of Work
procedure for CCHC program
Lead Nurse
GRA-STATE-19-0970-01 Page 37 of 46

VI. Data Collection, Reporting and Evaluation
o Ongoing data entry
o Reporting and submission of data and narrative reports to FTF, State and National Offices
o External evaluation, if applicable
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
Documentation on Extranet All CCHCs use the extranet All CCHCs All charting must be Standards of Practice 2019
charting system to document entered within 5 business
CCHC services: days after it has occurred
1.Visits are charted in the CCHC
Activity Log
2. Health and Safety
Assessments are charted.
3. All trainings are charted.
4. All communication is charted
5. Tier Levels are charted and
changed as the levels change
FTF Quarterly CCHC report 1.Complete FTF quarterly Karen Hoffman Quarterly Scope of Practice
narrative report and submit to
FTF through PGMS on Extranet
GRA-STATE-19-0970-01 Page 38 of 46

VII. Financial Oversight and Management
o Review of budget
o Reimbursements
o Modifications
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
Review Budget Keeps track and reviews CCHC Accountant-Doris Monthly Maricopa County Policy
main grant budget Householder
Administrative Grants A2505
Reimbursement of Funds Submits a CER to the budget Accountant- Doris Monthly Maricopa County Policy
listed on the PGMS on the Householder
Administrative grants A2505
Extranet
Submit Budget Modifications Budget modifications are Accountant – Doris Annually Maricopa County Policy -
submitted periodically as Householder Administrative grants A2505and FTF
needed throughout the year requirements
GRA-STATE-19-0970-01 Page 39 of 46

VIII. Other
Include any additional components and activities associated with the proposed program not listed above.
Timeframe Task(s) Will Be
Activity Task(s) Completed
Person(s)/Roles
a major unit of work for strategy set of specific steps or actions to A date, range of dates or Supporting Documentation
Responsible
implementation complete the activity frequency (daily, weekly,
monthly, quarterly, annually)
GRA-STATE-19-0970-01 Page 40 of 46

FY19 Line-Item Budget — Child Care Health Consultation
Budget period: July 1, 2018 June 30, 2019
U.dget:CategO.ili Line Item Description Requested Funds
—PERSONNEL SERVICES Personnel Services Sub Total
Salaries 7.5 FTE Nurse 548,434
1.0 ETE Lead Nurse 86,652
0.8 FTE Supervisor 71,343
0.6 FTE Admin Assistant 19,456
EMPLOYEE RELATED EXPENSES Employee Related Expenses Sub Total
Fringe Benefits or Other ERE Variable at 19.45% 141,845
Fixed at $11,856 x 9.90 FTEs 123,302
PROFESSIONAL AND OUTSIDE SERVICES Professional & Outside Services Sub Total
Contracted Services
TRAVEL
Travel Sub Total $4,942
In-State Travel Mileage 4,942
Out-of-State Travel
AID TO ORGANIZATIONS OR INDIV1DUAIS Aid to Organizations or Individuals Sub Total
Subgrants or Subcontracts to
organizations/agencies/entities
OTHER OPERATING EXPENSES Other Operating Expenses Sub Total $15,577
• Telephones/Communications Services 7,080
• Internet Access
• General Office Supplies
• Food
• Rent/Occupancy 8,297
• Evaluation (non-contracted & non-
personnel expenses)
• Utilities
• Furniture
• Postage
• Software (including IT supplies)
• Dues/Subscriptions
• Advertising
• Printing/Copying
• Equipment Maintenance
• Professional Development (Staff Training,
Conferences, Workshops, Training Fees
for Staff)
• Insurance
• Program Materials
• Program Supplies
• Scholarships
• Program Incentives
'..CAPITALEQUIPMENT
Capital Equipment Sub Total
Equipment $5,000 or greater in value
NON-CAPITAL EQUIPMENT
Non-Capltal Sub Total
Equipment $4,999 or less in value
Subtotal Direct Program Costs:
$1,010,691
ADMINISTRATIVE/INDIRECT cpsT5 :
$101,069.
Indirect/Admin Costs
Total
$1,111,760 I
Authorized Signature
Date 4
GRA-STATE-19-0970-01
Page 41 of 46

FY19 Budget Narrative — Child Care Health Consulations
The budget narrative should provide a clear and concise description of how amounts were determined, including
• calculations, for each proposed line item in the Line-Item Budget. If a budget category does not apply, either leave
blank or delete the category.
Personnel Services: $725,885
Salaries for 7.50 FTF CCHCs, 1.0 CCHC Lead Nurse, 0.60 Program Administrative Assistant, and 0.80 CCHC Supervisor.
Maricopa County Department of Public Health uses a Placement in Range System for determining nursing salaries
using an average rounded salary and salaries are determined based on the number of years on nursing experience.
Most of the nurses are very experienced and earn a salary in the top range, although some of the newer hires earn
less. The 7.50 FTEs are budgeted using an average rounded hourly rate. Please note, average rounded rates are
being utilized to reflect an anticipated average salary increase for Maricopa County employees during FY 2018-19.
The Program Administrative Assistant's salary is shared with another grant for technical assistance and therefore
0.60 FTE in this grant and 0.40 FTE in the TA grant. The Supervisor's salary is shared with the TA grant as well and
there is 0.80 FTE for this grant and 0.20 FTE in the TA grant. Both the Program Assistant and the Supervisor
respectively spend approximately 60% and 80% of time on this grant. The Lead Nurse is an 1.0 FTE on this grant and
is responsible for the day to day supervision of the 7.50 FTEs (time cards, calendars, one-on-ones, technical
assistance to CCHCs) and works on online training modules. The Supervisor is responsible for staff assignments
within the tiered services delivery model, collecting and reporting all data as required to FTF regarding program
activities, providing recommendations for the CCHC system development and fostering collaboration between the
CCHCs and other early child hood coaches and consultants. The Supervisor also creates protocols and
policy/procedure and manages issues that are related to policy and protocols.
Employee Related Expenses: $264,487
Fringe benefits are calculated at 19.45% of salary ($725,885 x 19.45%) for a cost of $141,185 for Medicare, Social
Security, Worker's Compensation, long term disability, life insurance and AZ State Retirement System. Medical,
dental, vision, and prescription drug coverage benefits are calculated @ $11,856 for 9.90 FTEs for $123,302. These
benefits have been calculated using the Maricopa County projected rates for the contract period of July 1, 2018 —
June 30, 2019.
Professional and Outside Services: If professional consultants/services costs are proposed in the budget, define how
the costs for these services were determined and the justification for the services related to the program. Explain
how all contracts will be procured.
Travel: $4,942
Mileage for in-state travel of all staff is budgeted for a total of $4,942. All CCHC staff travel to various locations in
Maricopa County on a regular daily basis to service child care centers and homes. Staff submit mileage sheets
regularly in accordance to the State of Arizona Travel Policy. The CCHCs do not travel out of state.
Aid to Organizations or Individuals: In the event that this application represents collaboration and you will be
utilizing subcontractors (including subgrantees) to perform various components of the program, include a list of
subcontractors, programmatic work each subcontractor will perform, and how costs for each subcontractor are
determined.
Other Operating Expenses: $15,377
Cell phone and communication services is budgeted for $7,080 for 10 CCHCs (including Lead Nurse and Supervisor).
VPN service for teleworking and hotspots so that the staff can gain access to the internet out in the field are also
included in this amount. Rent and occupancy is budgeted for $8,297.
Capital Equipment: If allowable within the scope of the grant - For items that are tangible, non-expendable, and
movable having a useful life of more than one year and a value of $5,000 or greater, explain each item to be
GRA-STATE-19-0970-01 Page 42 of 46

purchased, how the costs were determined and justify the need for the items based on the scope of work and the
benefit to the program. All purchases should be made through competitive bid or using established competitive
purchasing procedures.
Non-Capital Equipment: For items with a unit cost less than $5,000 and an initial estimated useful life beyond a
single year, explain each item to be purchased, how the costs were determined and justify the need for the items. All
purchases should be made through competitive bid or using established purchasing procedures. For example, items
such as computers, printers, projectors, etc. each with a unit cost less than $5,000.
Administrative/Indirect Costs: $101,069
Maricopa County utilizes a cost allocation system which is comprised of two components. The county wide portion
includes those costs allocated entirely to administration; the departmental cost pool consists of costs that benefitted
all Public Health planning services, finance procurement, human resources, grants/contracts, and agency liability
insurance. The indirect rate is derived annually based on the expenditures of the previous year. The indirect rate for
MCDPH is budgeted at 10% which is 101,069
Applicants must list either Option A or Option B and provide proper justification for expenses included:
12l Option B - Federally Approved Indirect Costs: If your agency/organization has a federally approved indirect
cost rate agreement in place, applicants may include an allocation for indirect costs for up to 10% of the
direct costs. Applicants must provide a copy of their federally approved indirect cost rate agreement.
(See Attachment B)
Authorized Signature -""r-------...... Date
GRA-STATE-19-0970-01 Page 43 of 46

Funding Sources and Financial Controls
A. Funding Sources. In the following table, identify other funding/resources (including federal, state, local
and private funding) that the agency/organization will leverage to achieve the objectives of the
proposed program. First Things First (FTF) funding can be used to enhance or expand the program
funded by these additional funds, but FTF funding cannot supplant or be used to replace any existing
state or federal funding for early childhood development and health programs.
Type of Funding (federal,
state, local, private) and Brief Description of How the Funding Helps Achieve the
Agency/Organization Program Objectives Amount
Received From:
N/A 0,0
0.0
B. Financial Controls.
Grantees will be expected to follow generally accepted accounting principles and be consistent with
policies, regulations, and procedures that apply uniformly to all costs charged and expended by their
agency/organization - across all funding sources.
Describe the financial controls and accountability measures the agency/organization will employ for
the use of FTF funding for the proposed program.
Maricopa County Department of Public Health (MCDPH) will use a centralized accounting system to maintain its
fiscal integrity through several levels (Program/Division/Department/County) of financial controls and accountability
measures. MCDPH's Finance and Budget process starts at the program level, using the Maricopa County (MC) Chart
of Accounts. The program accounting specialist will conduct the program's financial processing throughout the grant
period, ensuring proper account classification and adequate documentation for all expenditures. At the Division level,
MCDPH will provide a Division Accountant to monitor all program financial activity and to facilitate Reimbursement
Request Report submissions. Then, at the Department level, the Accounts Payable/Receivable and Procurement units
will process, review, and monitor all financial requests provided by the program accounting specialist. The MCDPH
Finance Manager conducts monthly meetings with the Finance and Budget staff to review the program budget
expenditures and its projections. Finally, at the County level, the MC Finance Department will process issuance and
receipts of all payments. Throughout this entire accounting system, based on Generally Accepted Accounting
Principles (GAAP), there are several checks and balances. Before posting to MC's financial system, all procurement
and financial transactions undergo, at a minimum, 3 levels of reviews and approvals, to ensure fiscal compliance as
defined in provisions of the grant agreement, MC policies and guidelines and State and Federal laws and regulations.
Authorized Signature Date
GRA-STATE-19-0970-01 Page 44 of 46

Attachment G - Program Evaluation Information
Program Evaluation
An evaluation study is a project that is conducted in order to answer questions about the services you
provide. There are several types of evaluations that can be conducted, including the following that are
most relevant in relation to program implementation:
 Process/implementation evaluation: Determines whether program activities have been
implemented as intended. This type of evaluation examines if the program is implemented with
fidelity.
 Outcome/effectiveness evaluation: Measures program effects in the target population by
assessing the progress in the outcomes or outcome objectives, which the program is supposed to
achieve. This type of evaluation examines if the program is achieving these intended outcome(s).
Refer to the Types of Evaluation brochure created by the Centers for Disease Control and Prevention (CDC)
for additional information on program evaluations:
https://www.cdc.gov/std/Program/pupestd/Types%20of%20Evaluation.pdf
The following questions are about whether your organization has or is planning to conduct an evaluation
study (with or without funding from First Things First).
A. Has an evaluation study been conducted on your program? (e.g., process evaluation, outcome or
impact evaluation study)?  Yes  No
If Yes, include:
- One (1) copy of the evaluation report (if available) with your agreement.
- A brief synopsis of the study’s specific aims and results:
B. Are you planning on having an evaluation study conducted on the program proposed in this
agreement?  Yes  No
If YES, please go to C. If No, stop here.
C. Will FTF funds be utilized to conduct the evaluation study?
 Yes (Yes, funds are budgeted in the line-item budget and budget narrative for an evaluation study.)
 No (No, we will be using other sources of funding for an evaluation study)
If YES, provide detailed responses to each of the following items: *, ** If No, stop here.
1. Purpose, Intended Outcomes, and Research Questions
GRA-STATE-19-0970-01 Page 45 of 46

2. Methodology and Design
3. Proposed Timeline and Party Responsible (e.g., external vendor/contractor or grant partner
program staff) to carry out the work
4. Intended Use of Findings and Dissemination Plan
* If FTF funds are being requested for an evaluation study, the study will need approval by FTF’s Research and
Evaluation team prior to implementation. Specifically, the applicant will be required to provide FTF with a detailed
summary of the work proposed (Refer to the Ownership of Intellectual Property section under the Grant Terms and
Conditions in this RFGA.) In those instances when the evaluation proposal is in its preliminary stages and therefore
lacks sufficient detail at the time of submission (e.g., Applicant is planning to get a vendor to determine the method
and design etc.), the grant partner will be required to submit a detailed study proposal when it becomes available.
This study proposal is subject to approval by FTF’s Research and Evaluation division.
** If the data collection requirements or proposed evaluation will include data from a tribal community (e.g., data
gathering in tribal lands), appropriate tribal approvals must be in place prior to commencing data collection. In
instances when tribal data approvals are necessary, FTF’s Research and Evaluation and Tribal Affairs divisions will
work with the grant partner to secure approvals from the tribe(s). (Refer to the Tribal Data Policy and the
Ownership of Intellectual Property sections under the Grant Terms and Conditions in this RFGA).
In instances when data gathering occurs in tribal lands, the applicant shall address how they will ensure a culturally
appropriate methodology (e.g., in- person interviews), and culturally responsive interaction with participants and
other stakeholders.
Revised December 2017
GRA-STATE-19-0970-01 Page 46 of 46