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DocuSign Envelope ID:6D51`41 E3-E7E2-4D6C-l3E76-951 E8674450E <br /> ATTACHMENT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services <br /> Federal Tax Id.or SSN 58-1582881 <br /> Contract# 68-2040 <br /> A. CONTRACTOR INFORMATION <br /> 1. Contractor Agency Name: Charles Douse Association <br /> 2. If different from Contract Administrator Information in General Contract: <br /> Address <br /> Telephone Number: Fax Number: Email: <br /> 3. Name of Program(s): Adult Dgy Care <br /> 4. Status: ( )Public (X)Private,Not for Profit ( )Private, For Profit <br /> 5. Contractor's Financial Reporting Year July 1 2018 through June 30,2019 <br /> B. Explanation of Services to be provided and to whom(include SIS Service Code):_The <br /> Contractor will provide Adult Day Health Services(SIS Code 030 and 155)to clients of the <br /> Orange County Department of Social Services. These services will include assistance with <br /> Activities of Daily Livinp, health monitorin b an RN and the eutic recreational pro ams. <br /> These services will be provided in accordance with provisions set forth in Volume IV of the <br /> Adult and Family Services Manual,Chapter II-Adult Day Care Services. The Contractor is <br /> required to meet all goals and outcomes listed in Attachment O. <br /> C. Rate per unit of Service(define the unit): <br /> 1. If Standard Fixed Rate,Maximum Allowable,(See Rates for Services Chart) <br /> Minimum daily rate: $33.07/day_per client <br /> 2.Negotiated County Bate. <br /> D.Number of units to be provided: <br /> E.Details of Billing process and Time Frames;The County will reimburse the Contractor for <br /> services described in this contract up to the budge budgetM limits of the contract allotment. The <br /> County will reimburse the Contractor at a rate of$33.071day for approved services provided. For <br /> reimbursement,the Contractor must submit an original and two copies of an invoice by the fifth <br /> of the month for the preceding month's expenditures to the designated County Administrator. <br /> The County will reimburse the Contractor monthly upon receipt of a complete and correctly filed <br /> report. <br /> Contract-Scope of Work(06/04) Page loft <br />