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DocuSign Envelope ID: E7784BE7- 82AF- 4AF1- AA11- 944D2300E76D <br />EXHIBIT A: 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): 4/6/1988 <br />b) Agency's Purpose /Mission (no more than a few sentences): <br />The mission of KidSCope is to provide comprehensive early childhood <br />developmental /mental health support to young children, their families, and care <br />providers. Through the use of research and specialized evidence based services, <br />KidSCope aims to give children a healthy start in the early years, when relationships <br />and experiences influence future life success the most. <br />c) Types of Services the Agency Provides (bullet format): <br />KidSCope provides: <br />• inclusive child care <br />• social - emotional health services using evidence -based modalities, including Parent <br />Child Interactive Therapy and Child Parent Psychotherapy, <br />• child care mental health consultation and teacher education <br />• parent education - Incredible Years Basic /Incredible Babies /Toddlers. <br />• a myriad of childhood development and parenting resources <br />• support to medical practices to assess children for developmental /mental health at <br />well child visits and to provide information and referral to local programs and <br />resources. <br />d) Agency's History with Providing These Services: <br />KidSCope was created in 1988 under OPC Mental Health Center, by a coalition of <br />professionals and child advocates, to address a documented need for specialized <br />services to young children who are experiencing social, emotional, and /or behavioral <br />difficulties. KidSCope was divested under state mental health reform to a local non- <br />profit, Chapel Hill Training Outreach Project, Inc. on October 1, 2005. <br />e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes <br />in the past year? Is there a new Executive Director? Are there new initiatives ?) <br />Unfortunately, KidSCope was not able to secure a new Hillsborough location after <br />Orange County Schools did not renew our lease at Hillsborough Elementary. <br />KidSCope provided quality child care to children with and without special needs, as <br />well as mental health therapy and parent education from that site for 23 years. <br />Although those services are still available from KidSCope county wide, proving <br />services has become much more complicated due to distance and location. <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 />Agency Information 1/22/2018 3:23:54 PM R a g e 11 of 2 <br />