San Joaquin County Public Health
Physical Activity Mini-Grant Application 2013-14
Goal:
To improve physical activity among low-income youth
in San Joaquin County
San Joaquin County Public Health Services
1601 E. Hazelton Ave, Stockton, CA 95205
(209) 468-8637
www.sjcphs.org
This application is also available on the Public Health website.
Childhood Obesity in San Joaquin County:
Childhood obesity has become a growing concern in San Joaquin County and across
the nation. According to Centers for Disease Control’s Pediatric and Pregnancy
Nutrition Surveillance System (CDC PEDNSS) data, over 40% of San Joaquin County
school-aged children (ages 5 to 20) are considered overweight or obese (meaning
above 85th percentile for height and weight). Levels of physical activity among County
youth and teens have fallen below the statewide average. In addition, opportunities for
daily physical activity continue to decline.
In response to the dire need for obesity prevention, San Joaquin County Public Health
Services (SJCPHS) provides a wide range of health promotion and chronic disease
prevention programs and services. The mission of SJCPHS, in partnership with the
community, is to promote a healthy future for San Joaquin County. Programs such as
the Breastfeeding Initiative, Mothers Invested in Baby (MI Baby), and Network for a
Healthy California provide nutrition education and empowerment to parents, caregivers,
educators, providers, and youth through classes, presentations, trainings, and peer-topeer interactions.
In an effort to increase physical activity resources in the community, SJCPHS is
partnering with the Ricky Barnes Foundation to provide physical activity mini-grants for
programs serving low-income children. The mission of the Ricky Barnes Foundation is
to promote the physical and mental well-being of children. The Foundation encourages
active lifestyles and making healthy choices to boost self-esteem and confidence.
Public Health Services Mini-Grant Funding Opportunity
SJCPHS understands that overweight children are more likely to become overweight
adults unless they acquire and maintain healthy eating and physical activity behaviors.
Hence, SJCPHS will provide mini-grant opportunities for eligible youth-serving
agencies, schools, and afterschool programs serving low-income children. At least four
eligible agencies will be selected to receive mini-grants of up to $5,000 each for the
2013-2014 fiscal year (July 1, 2013- June 30, 2014). Mini-grant payment is in arrears.
Mini-grant recipients will receive “train-the-trainer” training and funding to purchase
equipment and to support ongoing physical activities.
The funds will allow the recipient to purchase equipment for the CATCH (Coordinated
Approach to Child Health) education program, an evidence-based physical activity
education curriculum for elementary and middle school-age children. The SJCPHS
Network for a Healthy California Program will provide “train-the-trainer” training to grant
recipients on the use of CATCH curriculum and equipment as well as any technical
assistance needed throughout the grant period. In return, grant recipients will be
required to report use of the curriculum training and submit a semi-annual and final
report to include progress on an action plan describing how physical activity
opportunities will be sustained using the CATCH training and purchased equipment.
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Proposal Guidelines
1. Applicants must be an established school, youth-serving agency, or afterschool
program serving low-income populations in operation for at least one year and
located in San Joaquin County. A completed W-9 Form will be requested from all
successful applicants.
2. Applicants will submit the following items for the application packet. Failure to
submit any of these items may result in delay of the application. (Please be sure
to keep a copy of the application for your own records.):
1) Form 1 (Application Cover Sheet)
2) Form 2 (Project Budget and Budget Narrative)
3) Four-page maximum Project Narrative
Proposal Submission
Proposals for the SJCPHS Physical Activity mini-grant project must submit:
 A typed original application packet (marked “original” on Form 1), and
 Four (4) copies of the packet (marked “copy” on Form 1).
Hand-deliver proposals in-person:
San Joaquin County Public Health Services
Network for Healthy California
420 S. Wilson Way
Stockton, CA 95205
Attn: Holly Stetson
Phone: (209) 468-8637
OR
Mail proposals to address:
San Joaquin County Public Health Services
Network for Healthy California
Attn: Holly Stetson
1601 E. Hazelton Ave.
Stockton, CA 95205
All proposals must be received by 4:00 p.m. on Friday, May 3, 2013.
PROPOSALS SUBMITTED BY FAX OR EMAIL WILL NOT BE ACCEPTED.
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Proposal Scoring
Proposals for the SJCPHS Physical Activity mini-grant must be presented in the correct
format. Handwritten applications will not be accepted.
Application forms must be submitted according to the following guidelines:
1. Must include one (1) original (marked “Original” on Form 1) application, and four
(4) copies (also marked “Copy” on Form 1).
2. Must be single-spaced, with 1-inch margins and no smaller than 12-point font.
3. Must include Forms 1 and 2, and a 4-page maximum Project Narrative.
Additional pages may be used for the Budget Narrative in Form 2 (Budget).
4. Must not be bound, or inserted into folders. A simple clasp, paperclip, or staple is
preferred and all pages must be on 8.5” x 11” paper.
5. Proposals should be submitted in the following order:
a. Page 1: Form 1 (Cover Page) – (5 points) Must include original signature
of an authorized representative of the agency.
b. Page 2: Form 2 (Budget Request Form) – (25 points) May use additional
pages as needed.
c. Application Narrative – (70 points) See below.
6. Application Narrative – Narrative must be no more than four pages. Submittals
must be typed, single-spaced, with no smaller than a 12-point font, and one inch
margins. Hand-printed applications will not be accepted. Applicants are
encouraged to number their answers to correspond with the application narrative
questions so that reviewers may score applications properly. Questions are not
required in the narrative.
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Timeline and Process Overview
All applications must be received by Friday, May 3, 2013 at 4:00pm.
ACTIONS
Release of RFP
Bidders’ Workshop
The non-mandatory Workshop will take place at:
San Joaquin County Purchasing Department
44 N. San Joaquin Street, Suite 540
Stockton, CA 95205
DUE DATE
April 8, 2013
April 18, 2013
1:00 p.m.
(Teleconferencing is available. Please contact Lourdes Piojo at lpiojo@sjgov.org or
call 209-468-3256 by Tuesday, April 16, by 1:00 p.m. for access.)
Application Deadline (All applications must be received by 4:00 p.m.)
Notice of Intent to Award
Contract Commencement Date
*Dates are subject to change.
May 3, 2013
TBD
July 1, 2013
Evaluation, Monitoring and Budget Guidelines
Evaluation
All mini-grant recipients will be required to submit a semi-annual and final progress
report and submit an activity report form after project activities have been implemented.
The activity report form will help track the activities and funding use. The activity report
form and progress reports will be provided to funded organizations during the CATCH
training.
Monitoring
SJCPHS will monitor areas of agreement in compliance, achievement of goals, and
financial expenditure. In addition to the required reports, site visits will be conducted to
verify project compliance and provide any technical assistance as needed. Each minigrant recipient is required to maintain records for a period of three years to ensure that
mini-grant funds are spent as set forth in the agreement.
Budget Guidelines
Applicants are required to provide a summary of anticipated expenses during the grant
term by completing the budget estimate portion of the Application (Form 2). When
determining the project budget, please note that projected expenses should relate
specifically to proposed project activities.
Allowable project expenses may include the following:
 Purchase of CATCH activity equipment (required) (see Attachment A)
 Materials production (i.e. printing, copying, paper, etc.)
 Stipend for a project coordinator
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
Costs for additional educational materials and equipment to enhance learning
environment
Application Narrative and Scope of Work
Application Cover Page (Form 1) (5 points)
The Application Cover Page must be complete and include the original signature of an
authorized representative of the agency.
Application Narrative (70 points)
In the 4-page maximum Narrative, include a brief description of the applicant agency,
including:
1. Related agency mission/goals and a demonstrated organizational commitment to
childhood health promotion, nutrition, and/or physical activity. (10 points)
2. Experience to undertake this project. At a minimum, demonstrate that the agency
possesses one year of experience in conducting nutrition education and/or
physical activity promotion to low-income youth. (10 points)
3. Describe the project coordinator and his/her qualifications. Include any
experience as it relates to physical activity, nutrition, and/or childhood health
promotion. (10 points)
4. Ability to initiate project on start date (e.g., including a timeline of what is required
for obtaining internal or external approvals in an expedient manner). (10 points)
5. Describe how the materials and equipment purchased will increase childhood
health promotion and physical activity at the organization. (10 points)
6. Describe the methods that will be used to sustain project activities beyond the
duration of the grant. (10 points)
7. Describe the methods you will use to evaluate the outcome of the overall project
(e.g., measure changes in the capacity of the program). (10 points)
Application Budget (Form 2) (25 points)
Applicants are asked to complete a Budget and Budget Justification using estimated
expenses in the appropriate categories. The Budget and Budget Justification should
include the following information:
1. Provide sufficient detail in the Budget to support proposed activities.
2. Provide a list of staff in Budget that will ensure completion of activities. If staff is
not included in the Budget, please be sure to address in the Narrative and/or
Budget Justification section(s).
3. Ensure the proposed salary/wage rates for in-house and subcontracted
personnel are reasonable and necessary based on the assigned level of
responsibility, if applicable.
4. Ensure the total Operating, Equipment, Travel, and/or Other Costs are
reasonable and necessary, and kept to a minimum.
5. Make sure Budget calculations are accurate.
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Invoicing
Monthly invoices shall be submitted for payment within fifteen (15) days following the
end of each month in which costs were incurred in the performance of the mini-grant,
unless the mini-grant period has reached the expiration or termination date, or a later or
alternate deadline is agreed to in writing by SJCPHS.
Upon receipt and approval of the invoices along with any reporting as required by the
mini-grant, SJCPHS agrees to compensate the mini-grant recipient for actual
expenditures incurred in accordance with the approved Budget.
Invoice shall:
a. Be prepared on the recipient’s letterhead and be signed by the authorized official,
employee, or agent certifying that the expenditures claimed represent actual
expenses incurred under this mini-grant.
b. Bear the mini-grant recipient’s name as shown on the Application.
c. Show an invoice date reflecting when the invoice was prepared.
d. Show the mini-grant recipient’s remittance address.
e. Itemize costs for the period in the same or greater level of detail as indicated in
this mini-grant. Subject to the terms of this mini-grant, reimbursement may only
be sought for those costs and/or cost categories expressly identified as
allowable.
Acknowledgement of Funding Source
Identify San Joaquin County Public Health Services and the Ricky Barnes Foundation in
any published documents, video presentations, training programs, training material,
brochures, T-shirts, and any other material and/or programs which are developed as a
result of this funding award.
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FORM 1: Project Application Cover Sheet
San Joaquin County
Public Health Services
Physical Activity Mini-Grant
July 1, 2013—June 30, 2014
DUE: Friday, May 3, 2013 by 4:00 p.m.
Agency Name: Click here to enter text.
Applicant Name & Title: Click here to enter text.
Agency Address: Click here to enter text.
City: Click here to enter text.
Zip: Click here to enter text.
Email Address: Click here to enter text.
Phone #: Click here to enter text.
Fax #: Click here to enter text.
Designated Project Coordinator: Click here to enter text.
Information About Organization
Organization Type:
☐School
☐Afterschool Program
☐Youth Serving Agency
☐Other:____________
Project Proposal
Amount requested: $________________
Number of Youth to be Served by Project: ________________
Click here to enter text.
Name of Chair, Board of Directors, or Authorized Representative
Click here to enter text.
Title
Click here to enter text.
Signature and Title (Signature Required)
Date
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FORM 2: Budget Estimate
San Joaquin County
Public Health Services
Physical Activity Mini-Grant
July 1, 2013—June 30, 2014
DUE: Friday, May 3, 2013 by 4:00 p.m.
Budget
A. Personnel Salaries
Name/Title
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Amount
$Click here to enter text.
$Click here to enter text.
$Click here to enter text.
$Click here to enter text.
Subtotal: $Click here to enter text.
B. Fringe Benefits
Details
Click here to enter text.% of Personnel Salaries:
C. Operating Expenses
Details
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Amount
$Click here to enter text.
$Click here to enter text.
$Click here to enter text.
$Click here to enter text.
Subtotal: $Click here to enter text.
D. Equipment Expenses
Details
CATCH Equipment Package (required)
Click here to enter text.
Click here to enter text.
Click here to enter text.
E. Travel
Details
Click here to enter text.
Click here to enter text.
Click here to enter text.
Amount
$Click here to enter text.
Subtotal: $Click here to enter text.
Amount
$Click here to enter text.
$Click here to enter text.
$Click here to enter text.
Subtotal: $Click here to enter text.
Amount
$Click here to enter text.
$Click here to enter text.
$Click here to enter text.
Subtotal: $Click here to enter text.
Direct Costs (A+B+C+D+E) Subtotal: $Click here to enter text.
F. Indirect Costs
Details
Amount
Click here to enter text.% of Total Salaries (A)
$Click here to enter text.
OR
$Click here to enter text. Actual Indirect Cost (Provide cost calculations below)
Subtotal: $Click here to enter text.
Budget (A+B+C+D+E+F) Grand Total: $Click here to enter text.
Budget Justification
For each line item above, detail how the funds will be used for the project.
A. Name/Title of Project Staff (including project time and pay rates)
(e.g., John Doe, Project Coordinator: 5 hrs. per week x 10 weeks @ $12/hr. = $600)
Click here to enter text.
B. Fringe Benefits (% of Personnel Salaries)
(e.g., 15% of salaries ($1000): 15% x $1000 = $150)
Click here to enter text.
C. Operating Expenses (i.e., office supplies, printing, postage, etc.)
(e.g., $100 for printing recruitment fliers: 1000 x $0.10/copy= $100,
$46 for stamps for community mailings: 100 x $0.46/stamp= $46)
Click here to enter text.
D. Equipment Expenses (CATCH equipment and other physical activity items needed)
(e.g., $1,025 for CATCH early childhood kit, $50 for extra set of bean bags, 10 copies of
Instant Recess DVD kit= $19.50)
Click here to enter text.
E. Travel (mileage reimbursement rate @ $0.565 per mile)
(e.g., Project Coordinator mileage reimbursement, 100 miles/year:
$0.565 x 100 = $56.50)
Click here to enter text.
F. Indirect Costs (% of Total Salaries OR Actual Indirect Costs of up to 8% of Salaries)
Indirect costs, including administrative and overhead costs, should be proposed in accordance with the
County’s Indirect Cost Rate Guideline, which can be accessed at www.sjgov.org under “Popular Links”.
Provide details of cost calculations here.
(e.g., 8% of Personnel Salaries ($4000): 8% x $4000 = $320)
Click here to enter text.
ATTACHMENT A: CATCH Physical Education Activity Kits
The following CATCH Physical Education equipment and activity kits are recommended
for the age/grade levels indicated. They may be purchased at:
http://www.flaghouse.com/Catch/Equipment/Equipment-Packages-PN=1&navlink=true
Packages can be customized to fit your needs. Contact the company for more
information.
CATCH Early Childhood [Ages 3-5] Kit (#W17887)
Based on the evidence-based CATCH Coordinated School
Health Program, CATCH Early Childhood (CEC) is
designed to promote physical activity and healthy food
choices among preschool children ages 3-5. Through CEC,
children are motivated to walk, run, jump, dance, and move
their whole bodies while playing and having fun!
This CEC Kit features a Teacher’s Manual with 10 easy-toteach lessons encouraging healthy eating and activity,
English/Spanish parent tips sheets, coloring activities and
hand puppets to use while reading stories in the CATCH
manual; specially selected equipment that is developmentally appropriate, safe, and
gets little ones excited about being active; and the CEC Activity Box with over 500
activity and picture cards providing detailed instruction for fun, non-elimination games
using the equipment included with this kit. These games are aimed at increasing
children’s moderate-to-vigorous physical activity while they are engaged and having a
blast. CATCH Early Childhood Equipment Set with Manual and Activity Box includes all
of the following:
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CEC It’s Fun to Be Healthy
Teacher’s Manual
CEC Hand Puppets – set of 4
CATCH characters
CEC Activity Box with over 500 5" x
8" activity and picture cards and 2
music CDs
Colored Spot Markers
24 CATCH 7" Playground Balls (4
each in red, blue, yellow, and green)
24 Beach Balls 20"-dia.
Price: $1,025.00
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16 CATCH 9" Cones (4 each in red,
blue, green, and yellow)
1 Colorful 24" Parachute with
SuperChute Grip
24 Fleece 3" Balls (4 each in red,
blue, green, yellow, orange, and
purple)
24 Scarves (assorted colors)
16 CATCH Beanbags (4 each in red,
blue, green, and yellow)
24 CATCH 30" Hula H oops
3 White Mesh Bags
CATCH [Grades] K-2 Activity Box—Instructor’s Guide & Equipment Set (#W11345)
Get your students ready for a lifetime of healthy activity
with— CATCH Physical Education Activity Kits! Open up a
CATCH Activity Kit…and you open up a lifetime of
healthful habits for your students! You get equipment
checklists, class organization guidelines, proven class
management techniques, and detailed instructions on how
to implement each and every activity into your current P.E.
program. Your students get P.E. activities that meet
national standards, positive reinforcement of the CATCH
classroom message, and over 50% of their time spent with
you engaged in heart-healthy Moderate-to-Vigorous
Physical Activity (MVPA). So, get them ready with a kit that’s made for your kids! Get
them started right with CATCH K-2. Activities center on the development of movement
skills, fitness—and enjoyment of physical activity! Fun, engaging task cards are geared
to the young child’s sense of fun and make it easy for you to set up effective activity
stations. You also receive easy-to-use assessments based on national standards.
Enough equipment for a class of 20! This set includes:
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1-K-2 Activity Kit
20-CATCH Playground Balls
12-CATCH 7' Jump Ropes
12-CATCH 8' Jump Ropes
2-CATCH Base Sets (8 pieces total)
2-CATCH Batting Tees
32-Plastic Softballs
16-CATCH Foam Softballs
2-Fat Bats & Balls
16-CATCH Beanbags
16-CATCH Cones
32-CATCH Pinnies
3-Music Compact Discs
Price: $1,595.00
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12-CATCH Spot Markers
1-Communication Drum
32-CATCH Flying Discs
1-CATCH Parachute 24'
24-CATCH Floater Volleyballs
24-CATCH Hoops
24-Scarves
20-Lollipop Paddles
12-Shuttlecocks
24-Fleece Balls
144-9" Balloons
12-16" Beach Balls
6-Mesh Storage Bags
CATCH [Grades] 3-5 Activity Box – Instructor’s Guide & Equipment Set (#W11349)
Get your students ready for a lifetime of healthy activity
with— CATCH Physical Education Activity Kits! Open up a
CATCH Activity Kit…and you open up a lifetime of
healthful habits for your students! You get equipment
checklists, class organization guidelines, proven class
management techniques, and detailed instructions on how
to implement each and every activity into your current P.E.
program. Your students get P.E. activities that meet
national standards, positive reinforcement of the CATCH
classroom message, and over 50% of their time spent with
you engaged in heart-healthy Moderate-to-Vigorous
Physical Activity (MVPA). So, get them ready with a kit that’s made for your kids! Keep
them on the road to lifelong fitness with CATCH 3-5! Emphasis shifts toward activities
that help your elementary-school students develop muscular strength, endurance,
flexibility, and a cooperative spirit. You also receive easy-to-use assessments based on
national standards. Enough equipment for a class of 20! This set includes:
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(1) 3-5 Activity Kit
20-CATCH Playground Balls
12-CATCH 7' Jump Ropes
12-CATCH 8' Jump Ropes
12-CATCH Footballs
20-CATCH Basketballs
20-CATCH Soccer Balls
2-CATCH Base Sets (8 pieces total)
2-CATCH Batting Tees
32-Plastic Softballs
32-CATCH Foam Softballs
2-Foam Bats
16-CATCH Cones
Price: $2,295.00
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32-CATCH Pinnies
3-Music Compact Discs
12-CATCH Spot Markers
1-Communication Drum
32-CATCH Flying Discs
1-CATCH Parachute 24'
12-CATCH Floater Volleyballs
8-CATCH Volleyballs
20-Aerobic Steps
24-CATCH Hoops
24-Scarves
10-Mesh Storage Bags
CATCH [Grades] 6-8 Activity Kit & Equipment Package (#W15019)
Get started today! CATCH Equipment Packages make it
easy for PE specialists, classroom teachers, and activity
professionals to provide more opportunities for children to
practice and participate in their classes. You receive the
equipment needed to implement CATCH for each grade
level; each package accommodates a class of up to 20
students. Products are selected to be developmentally
appropriate and come in the signature CATCH colors. The
CATCH 6-8 Activity Kit & Equipment Package includes:
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(1) 6-8 Activity Box
1 PE Guidebook
1-24' Parachute
16 Cones
36 Jump Ropes (7', 8', & 9')
12-30" Hoops
20 Rubber Basketballs
16 Foam Softballs
16 Beanbags
20 Playground Balls
16 Flying Discs
6-Color Football Set
Price: $1,995.00
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6 Thera-Band Rolls (light to superheavy)
24 Badminton Rackets
2 Badminton Nets
24 shuttlecocks
24 Hockey Sticks
1 Keepers! Bucket Set (includes 36
No-Bounce Balls and Numbered
Spot Markers)
2 Z-Balls
8 Colored Fleece Balls
6 Shoulder Strap Carry-All Bags