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DocuSign Envelope ID:ADF76E75-8A91-4F91-BD39-9EB44F59669A <br /> EXHIBIT"A" <br /> Scope of Services FY 2015-16 <br /> Outside Agency Performance Agreement <br /> Agency Name: Charles House Association <br /> Pi-ogz•azn Name: Charles House: Center For Community Eldercare <br /> Funding Awai-d: $15,000 <br /> Outline how the agency will spend Orange County's finding award. <br /> Expense Description Amount <br /> Personnel $15,000 <br /> Program Sci-vices <br /> For assistance with this or the following section, please reference the Ezluihit A instructions and example, located within the <br /> contract and reporting memorandum. Outline the major activities the agency will employ to attain the Anticipated Outcomes <br /> below,by June 30,2016. <br /> • The Daytime Eldercare Program provides daytime care and therapeutic programing for 22 elders <br /> each day <br /> • Charles House supports family caregivers with orientation to caregiving, support groups, <br /> information and referral for community services, etc. <br /> Anticipated Outcomes <br /> The Anticipated Results column must include quantifiable results in the form of number of persons/units served within drank <br /> County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants <br /> within that measure's description or for an earlier performance measure. <br /> Performance Measures Anticipated <br /> Results <br /> 50% of enrolled families in the fiinding year will have the capacity to continue providing <br /> care in the home and not require,or delay, residential car <br /> Over 50% of families will report in the annual survey satisfaction with the Charles <br /> House program and will report positive effects of the <br /> Charles House Association will continue to surpass the NC Standards and maintain state <br /> certification to operate as all adult day care program <br /> Units of Service provided to caregiving families in the daytime eldercare program 5,000 <br /> DocuSigned by: <br /> Certified by. Title: Date: <br /> (Provider's Signature) � o <br />