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DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE XHIBIT A <br /> PROVIDER"S OUTSIDE AGENCY APPLICATION <br /> 2. AGENCY INFORMATION (Be Very Brief and Concise) <br /> Please provide the following information about your agency (2 pages OR LESS): <br /> a) Years in Operation, Date of Incorporation (Month/Year): 11/02/16 <br /> b) Agency's Purpose/Mission (no more than a few sentences): <br /> OCRA is part of a community-based alliance that is building awareness of the needs of rural <br /> seniors and supports them with what they need to age in place with independence and <br /> dignity. OCR helps with access to county services, safe homes, nutritious food and friendly <br /> human contact. OCRA delivers hot meals to rural seniors in underserved areas. <br /> c) Types of Services the Agency Provides (bullet format) <br /> • Nutritious meals <br /> • Social contact <br /> • Liaison with county services <br /> d) Agency's History with Providing These Services: <br /> OCRA evolved out of the SALT/Project Engage initiative where 20 volunteers now visit over <br /> 200 vulnerable rural seniors. Through regular visits over the last 18 months, volunteers <br /> created personal relationships and trust with their "clients". Through that relationship, it was <br /> clear that - some clients would benefit from nutritious, hot meals on a regular basis. <br /> OCRA started a formal meal delivery program in Nov, 2016 with volunteers/caterers <br /> donating meals for 40 rural seniors one time per week. In 2 1/2 months we have delivered <br /> over 360 meals. In many cases, SALT/PE volunteers are delivering the meals during their <br /> regular visits. <br /> We are in the process of scaling up and expect to be delivering meals three times a week to <br /> 50 clients by mid-year. <br /> Social visitation is on-going, coordinating OCRA volunteers with volunteers from the SALT <br /> program and Project Engage program. <br /> OCRA informs the seniors of events, services, and information that the County has to offer. <br /> e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes <br /> n the past year? Is there a new Executive Director?Are there new initiatives?) <br /> OCRA is a new initiative evolved out of an 18-month effort of SALT/PE volunteers visiting <br /> seniors. <br /> f) Schedule of Positions (For Entire Agency) <br /> • Full Time Equivalent(FTE)staff will be noted as 1.00; half time as .50; quarter time as .25, etc. <br /> • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: <br /> Total Volunteer Hours=Volunteer FTE <br /> 2,080 <br /> # of FTE - Full-Time Paid Positions: 0 <br /> # of FTE - Paid Part-Time Positions: 0 <br /> # of Volunteers:25 # of FTE -Volunteers: 3.5 <br /> Agency Information 2/8/2017 4:36:09 PM Page 5 • .f I "' ' <br />