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DocuSign Envelope ID: 535BB656- 53CF- 457A- 98B2- D73B9641501D 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): Senior Care of Orange <br />County was incorporated in March of 2004 with 13 Vears of operation. <br />b) Agency's Purpose /Mission (no more than a few sentences): The mission of the Florence Gray <br />Soltys Adult Day Health Program is to provide social and health services to frail, disabled <br />and isolated adults 18 years and older with special needs that will benefit from Adult Day <br />Health programs. Stimulating activities, enriching programs, provision of nutritious meals <br />and snacks as well as rehabilitative services are offered. The program also provides <br />respite and education for family members and caregivers. The primary goal is to prevent or <br />delay the onset of institutionalization of participants. <br />The vision of Senior Care of Orange County, Inc. is to advocate, establish and operate <br />programs that provide services for frail or disabled older adults to remain in their homes <br />with their family as long as possible. The 65 and older adult is the fastest growing <br />population segment. <br />c) Types of Services the Agency Provides (bullet format): <br />• A safe & friendly environment <br />• Qualified Nurses and Therapist for Health Monitoring <br />• Socialization to prevent isolation <br />• Caregiver Respite <br />• Therapeutic Programming <br />• Safe & Stimulating Environment <br />• Quality of Life and meaningful /purposeful programs <br />d) Agency's History with Providing These Services: Over the past 14 years the need for <br />Adult Day Health services continues to increase. The continued growth of the area and <br />cost of healthcare for seniors to attend our program remains a challenge. Through the <br />years, we have made great efforts and will continue to collaborate with the recruitment <br />process to assist participants from the Department of Social Services (Medicaid <br />CAP /DA) and the Veteran's Administration who will financially support the participants <br />with low incomes and/or medical needs to utilize the Day Health Program as an option <br />to in -home care services. This option may also help with the social interaction of each <br />and every participant enrolled in the program. We will reapply for the Home Community <br />Care Block Grant from Triangle J Council of Governments for continued funding to help <br />support days of coverage for Adult Day Care and Health funding options. <br />e) Other Pertinent Agency Information (Ex. Has the agency experienced any major in the <br />past year? Is there a new Executive Director? Are there new initiatives ?) Over the past <br />year their has been an increase in the health component of the program as the <br />acuity levels of the participants requires more staffing to ensure their needs are <br />10 of 26 <br />