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DocuSign Envelope ID: 3FD37DED-3EFC-49BB-BD08-D6EFCA4FEB76 <br /> EXHIBIT"A" <br /> Scope of Services—FY 2015-16 <br /> Outside Agency Performance Agreement <br /> Agency Name: Senior Care Of Orange County; Inc. <br /> Program Name: Florence Gray Soltys Adult Day Health Program <br /> Funding Award: $25,000 <br /> Outline how the agency will spend Orange County's funding award. <br /> Expense Description Amount <br /> Participant Funding $15,000 <br /> Program Supplies/Snacks $2,000 <br /> Personnel(Salaries,FICA and Fringe Benefits) $6,000 <br /> Marketing/Oufteach/Staff Development $1,000 <br /> Transportation $1,000 <br /> Program Services <br /> For assistance with this or the following section, please reference the Exhibit 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 /> • To continue to provide a therapeutic health model focus to the participants by promoting <br /> independence,wellness, socialization and emotional well being in a community based setting. <br /> • Provide additional respite support services and resources for the families that we serve through <br /> quarterly trainings and inservices <br /> • To support the continuation of additional program supplies when census increases <br /> Anticipated Outcomes <br /> The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange <br /> Coun y,,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 /> To prevent and/or prolong most participants with health conditions from becoming 85 <br /> isolated and/or institutionalized <br /> Continue to increase enrollment maintaining a daily average census of 24 participants 75 <br /> per day <br /> Continuation of respite support for caregivers while supporting the needs of the 100 <br /> participant. <br /> DocuSigned by: <br /> E7B5052B65BB443... <br /> Certified by: I le: I✓e G 74-- Date: 1Z <br /> (Provider's Signature) <br />