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<br />Contract-Scope of Work (06/04) Page 1of 2 <br />ATTACHMENT B <br />SCOPE OF WORK <br /> <br />Orange County Department of Social Services and Orange County Department on Aging <br /> <br /> Federal Tax Id. or SSN__58-1582881__________ <br />Contract # _68-2064__________________ <br /> <br />A. CONTRACTOR INFORMATION <br />1. Contractor Agency Name: Charles House Association <br />2. If different from Contract Administrator Information in General Contract: <br />Address <br /> _______ ___ ______ <br />Telephone Number: _ Fax Number: Email: <br />3. Name of Program (s): Adult Day Care <br />4. Status: ( ) Public ( X ) Private, Not for Profit ( ) Private, For Profit <br />5. Contractor's Financial Reporting Year July 1, 2022 through June 30, 2023 <br /> <br />B. Explanation of Services to be provided and to whom (include SIS Service Code): <br /> <br />The North Carolina Division of Social Services (SIS) User’s Manual provides Service Codes and <br />Definitions for the DSS 5027 and 4263. The Contractor will provide Day Care Services for <br />Adults (SIS Code 030) to clients of the Orange County Department of Social Services (DSS) and <br />Department on Aging (DOA). Services will be authorized via the DSS 5027 and the DOA <br />Purchase of Service Authorization form. Such services will include: <br /> <br />030 – Day Care Services for Adults: Daily care means the provision of an organized program of <br />services during the day in a community group setting for the purpose of support adults’ personal <br />independence, and promoting their social, physical, and emotional well-being. Services must <br />include a variety of program activities designed to meet the individual needs and interests of the <br />participants, and referral to and assistance in using appropriate community resources. Also <br />included are medical examinations required for individual participants for admission to day care <br />and periodically thereafter when not otherwise available without cost, and food and food services <br />to provide nutritional meal and snacks as appropriate to the program. Services must be provided <br />in a home or center certified to meet State Standards for such programs. <br /> <br />The Contractor is required to meet all goals and outcomes listed in Attachment O. <br /> <br />C. Rate per unit of Service (define the unit): <br /> <br />1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) <br /> <br />Minimum daily rate: $60.00/day per client, of which the Contractor must pay employees <br />at least the County’s Living Wage (currently $15.85/hour). The County has increased the <br />standard fixed rate to compensate the Contractor for any amount above the Federal <br />Minimum Wage. <br />Note: The Contractor will not be reimbursed for its initial intake assessment. <br />DocuSign Envelope ID: 2BDD55A6-AB10-4CEE-BD64-A15242793F1F