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DocuSign Envelope ID:4FFDF545-B8C1-4ABF-A6A5-400656A36357 [ A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> k) Schedule of Positions <br /> Please include program staff positions followed by volunteer positions; these financial figures <br /> should match the personnel figures in your Agency Comparative Budget Excel Form. Similar <br /> positions can be combined. (i.e., 8 Occupational Therapists can be inserted as one line item). <br /> If provided <br /> indicate: <br /> lox <br /> Position Titles FTE* % Actual Estimated Projected °A Total rztirement <br /> Vacant Staff+ - Plan <br /> (H) Health <br /> Plan <br /> Program Director 180 1.0 64,888 64,888 64,888 n/m <br /> Office Manager 1.00 .75 n/a 28,000 28,000 n/a <br /> Registered Nurses 1.00 1.0 38,000 38,000 38,000 n/a <br /> Certified Nursing <br /> Assistants 3.50 I50 81,850 81,050 81,050 n/a <br /> Activity Coordinator 1.00 1.0 17,000 17,000 17,000 nia <br /> Social Worker .50 .50 28/000 23,000 23/000 n/a <br /> $223,938 $251,938 $251,938 <br /> Notes: <br /> = Similar positions can be combined: i.e. 8 Occupational Therapists can be inserted as one line item. <br /> • ^" Full Time Equivalent staff will be noted as 1.00; half time as .50; quarter time as .25, etc. <br /> • + Denotes the percentage of staff time involved with this program. <br /> o Calculate a Full Time Equivalent for all recorded volunteer hours using the following: <br /> Total Volunteer Hours=Volunteer FTE <br /> 1,960 <br /> Main Application 1125/2016 12:26:51 PM Page 14 of 21 <br />