15-076 Cupertino Union School District (CUSD) and Linda Rios for Contract Services NO. 7/0k—sq
FY 15-16
AGREEMENT BETWEEN THE CITY OF CUPERTINO AND
CUPERTINO UNION SCHOOL DISTRICT AND LINDA RIOS
FOR CONTRACT SERVICES
THIS AGREEMENT,for reference dated July 1, 2015 is by and between CITY OF
CUPERTINO, a municipal corporation(hereinafter referred to as "City"), and LINDA
RIOS, An individual, whose address is 17485 Montoya Circle, Morgan Hill, California,
(hereinafter referred to as."Consultant"), and CUPERTINO_UNION SCHOOL
DISTRICT (hereinafter referred to as "CUSD"); is made with reference to the following:
RECITALS:
A. City is a municipal corporation duly organized and validly existing under
the laws of the State of California with the power to carry on its business as it is now
being conducted under the Constitution and the statutes of the State of California and
the Cupertino Municipal Code.
B. The Cupertino Union School District covers the City of Cupertino,
California and parts of San Jose, Sunnyvale, Saratoga, Santa Clara and Los Altos,
California. The CUSD operates twenty elementary schools (K-5) and five middle
schools (6-8); and
C. Consultant is specially trained, experienced and competent to perform
the special services which will be required by this Agreement; and
D. City, CUSD, and Consultant desire to enter into an agreement for
upon the terms and conditions herein.
NOW, THEREFORE, it is mutually agreed by and between the undersigned
parties as follows:
1. TERM:
The term of this Agreement shall commence on July 1, 2015 and shall terminate
on June 30, 2016,unless terminated earlier as set forth herein.
1
2. SERVICES TO BE PERFORMED:
Consultant shall perform each and.every service set forth in Exhibit"A" which is
attached hereto and incorporated herein by this reference.
3. COMPENSATION TO CONSULTANT:
Consultant shall be compensated for services performed pursuant.to this
Agreement in the amount set forth below and as described in Exhibit"8"which is
attached hereto and incorporated herein by this reference. The total compensation to
the Consultant shall not exceed$100,000. CUSD and City will each compensate
Consultant one-half of the total rate of$100.00 per hour and performing the scope of
services.
4. ACKNOWLEDGEMENT OF MANDATED REPORTING REOURIEMENTS:
Consultant shall comply with the requirements of California Penal Code 11164-
11174.3 and as set forth in Exhibit"C" which is attached hereto and incorporated herein
by this reference.
5. FINGERPRINT AND TUBERCLOSIS (TB) CONSULTANT DECLARATION:
Consultant agrees that she is the only individual who is working under this
Agreement shall provide fingerprints for criminal background test purposes and results
of TB screening, pursuant to the requirements as set forth in Exhibit"D" which is attach
hereto and incorporated herein by this reference. .
6. TIME IS OF THE ESSENCE:
Consultant and City agree that time is of the essence regarding the performance
of this Agreement.
7. STANDARD OF CARE:
Consultant agrees to perform all services hereunder in a manner commensurate
with the prevailing standards of specially trained professionals in the San Francisco Bay
Area and agrees that all services shall be performed by qualified and experienced
personnel who are not employed by the City, CUSD, nor have any contractual
relationship with City or.CUSD.
8. INDEPENDENT PARTIES:
City, CUSD, and Consultant intend that the relationship between them created
by this Agreement is that of anindependent contractor. The manner and means of
conducting the work are.under the control of Consultant, except to the extent they are,
2
limited by statute, rule or regulation and the express terms of this Agreement. No civil
service status or other right of employment will be acquired by virtue of Consultant's
services. None of the benefits provided by City or CUSD to its employees, including
but not limited to, unemployment insurance, workers' compensation plans, vacation
and sick leave are available from City or CUSD to Consultant, its employees or agents.
Deductions shall not be made for any state or federal taxes, FICA payments, PERS
payments, or other purposes normally associated with an employer-employee
relationship from any fees due Consultant. Payments of the above items, if required,
are the responsibility of Consultant.
9. IMMIGRATION REFORM AND CONTROL ACT (IRCA):
Consultant assumes any and all responsibility for verifying the identity and
employment authorization of all of his/her employees performing work hereunder,
pursuant to all applicable IRCA or other federal or state rules and regulations.
Consultant shall indemnify and hold City harmless from and against any loss,'damage,
liability, costs or expenses arising from any noncompliance of this provision by
Consultant.
10. NON-DISCRIMINATION:
Consistent with City and CUSD's policy that harassment and discrimination are
unacceptable employer/employee conduct, Consultant agrees that harassment or
discrimination directed toward a job applicant, a City or CUSD employee, or a citizen
by Consultant or Consultant's employee or subcontractor on the basis of race, religious
creed, color, national origin, ancestry,handicap, disability, marital status, pregnancy,
sex, age, or sexual orientation will not be-tolerated. Consultant agrees that any and all
violations of this provision'shall constitute a material breach of this Agreement.
11. HOLD HARMLESS:
Consultant shall, to the fullest extent allowed by law, with respect to all services
performed in connection with the Agreement, indemnify, defend, and hold harmless
the City and CUSD and their officers, officials, agents, employees and volunteers from
and against any and all liability, claims, actions, causes of action or demands
whatsoever against any of them, including any injury to or death of any person or
damage to property or other liability of any nature, whether physical, emotional,
consequential or otherwise, arising out, pertaining to, or related to the performance of
this Agreement by Consultant or Consultant's employees, officers, officials, agents or
independent contractors. Such costs and expenses shall include reasonable attorneys'
3
fees of counsel of City or CUSD's choice, expert fees and all other costs and fees of
litigation.
Pursuant to Government Code Section 895.4, and in lieu of Government Code Section
895.6 which provides for pro-rata risk allocation, CUSD shall indemnify, defend, and
hold harmless the City, its officers, agents and employees from any loss, liability, claim,
injury or damage arising out of, or in connection with, performance of the duties and
obligations of the County and its employees set forth in this agreement. The City shall
indemnify, defend, and hold harmless the CUSD, its officers, agents and employees
from any loss, liability, claim, injury or damage arising.out of, or in connection with,
performance of the duties and obligations of the City and its employees set forth in this
agreement.
12. INSURANCE:
On or before the commencement of the term of this Agreement, Consultant shall
furnish City and CUSD with certificates showing the type, amount, class of operations
covered, effective dates and dates of expiration of insurance coverage in compliance
with the paragraphs below. Such certificates, which do not limit Consultant's
indemnification, shall also contain substantially the following statement: "Should any
of the above insurance covered by this certificate be canceled.or coverage reduced
before the expiration date thereof, the insurer affording coverage shall provide thirty
(30) days' advance written notice.to the City of Cupertino by certified mail, Attention:
City Manager." It is agreed that Consultant shall maintain in force at all times_during
the performance of this Agreement all appropriate coverage of insurance required by
this.Agreement with an insurance company that is acceptable to City and CUSD .and
licensed to do insurance business in the State of California. Endorsements naming the
City as additional insured shall be submitted with the insurance certificates.
A. COVERAGE:
Consultant shall maintain the following insurance coverage:
(1) Workers' Compensation:
Statutory coverage as required by the State of California.
(2) Liabili :
Commercial general liability coverage, without an exclusion for
sexual abuse and molestation, in the following minimum limits:
Bodily Injury: $500,000
each occurrence
4
$1,000,000'
aggregate-all other
Property Damage: $100,000 each occurrence
$250,000 aggregate
If submitted, combined single limit policy with aggregate limits in
the amounts of$1,000,000 will be considered equivalent to the
required minimum limits shown above.
(3) Automotive:Proof of automobile insurance required at the
California statutory minimums.
B. SUBROGATION WAIVER:
Consultant agrees that in the event of loss. due to' any of the perils for which
he/she has agreed to provide comprehensive general and automotive liability insurance,
Consultant shall look solely to his/her insurance for recovery. Consultant hereby grants
to City and CUSD, on behalf of any insurer providing comprehensive general and
automotive liability insurance to'either Consultant or City or CUSD with respect to the
services of Consultant herein, a waiver of any right to subrogation which any such
insurer of said Consultant may acquire against City or CUSD by virtue of the payment
of any loss under such insurance.
C. FAILURE TO SECURE:
if Consultant at any time during the term hereof should fail to secure or maintain
the foregoing insurance, City and CUSD shall be permitted to obtain such insurance in
the Consultant's name or as an agent of the Consultant and shall be compensated by the
Consultant for the costs of the insurance premiums at the maximum rate permitted by
law and computed from the date written notice is received that the premiums have not
been paid.
D. ADDITIONAL INSURED:
City, CUSD, and their Council,boards and commissions, officers, employees and
volunteers shall be named as an additional insured under all insurance coverages,
except any professional liability insurance, required by this Agreement. The naming of
an additional insured shall not affect any recovery to which such additional insured
would be entitled under this policy if not named as such additional insured. An
additional insured named herein shall not be held liable for any premium, deductible
portion of any loss, or expense of any nature on this policy or any extension thereof.
Any other insurance held by an additional insured shall not be required to contribute
anything toward any loss or expense covered by the insurance provided by this policy.
E. SUFFICIENCY OF INSURANCE:
5
The insurance limits required by this Agreement are not represented as being
sufficient to protect Consultant. Consultant is advised to confer with Consultant's
insurance broker to determine adequate coverage for Consultant.
13. CONFLICT OF INTEREST:
Consultant warrants that it is not a conflict of interest for Consultant to perform
the services required by this Agreement. Consultant may be required to 'fill out a
conflict of interest form if the services provided under this Agreement require
Consultant to make certain governmental decisions or serve in a staff capacity as
defined in Title 2,Division 6, Section 18700 of the California Code of Regulations.
14. PROHIBITION AGAINST TRANSFERS:
Consultant shall not assign, sublease, hypothecate, or.transfer this Agreement, or
any interest therein, directly or indirectly, by operation of law or otherwise, without
prior written consent.of City and CUSD. Any attempt to do so without said consent
shall be null and void, and any assignee, sublessee, hypothecate or transferee shall
acquire no right or interest by reason of such attempted assignment, hypothecation or
transfer. However, claims for money by Consultant from City and CUSD under this
Agreement may be assigned.to a bank, trust company or other financial institution
without prior written consent. Written notice of such assignment shall be promptly
furnished to City and CUSD by Consultant.
The sale, assignment, transfer or other disposition of any of the issued and
outstanding capital stock of Consultant, or of the interest of any general partner or joint
venturer or syndicate member or cotenant, if Consultant is a partnership or joint
venture or syndicate .or cotenancy, which shall result in changing the control of
Consultant, shall be construed as an assignment of this Agreement. Control means fifty
percent(50%) or more of the voting power of the corporation.
15. SUBCONTRACTOR APPROVAL:
Unless prior written consent from City and CUSD.is obtained, only those people
and subcontractors whose names and resumes are attached to this Agreement shall be
used in the performance of this Agreement.
In the event that Consultant employs subcontractors, such subcontractors shall
be required to furnish proof of workers' compensation insurance and shall also be
required to carry general, and professional liability insurance in reasonable conformity
to the insurance carried by Consultant. In addition, any work or services subcontracted
hereunder shall be subject to each provision of this Agreement.
6
16. PERMITS AND LICENSES:
Consultant, at his/her sole expense, shall obtain and maintain during the term of
this Agreement, all appropriate permits, certificates and licenses including, but not
limited to, a City Business License_, that may be required in connection with the
performance of services hereunder.
17. REPORTS:
A. Each and every report, draft, work product, map, record and other
document, hereinafter collectively referred to as "Report", reproduced, prepared or
caused to be prepared by Consultant pi rsuant to or in connection with this Agreement,
shall be the exclusive property of City i and CUSD. Consultant shall not copyright any
Report required by this Agreement an'd shall execute appropriate documents to assign
to City and'CUSD the copyright to Reports created pursuant to this Agreement. Any
Report, information and data acquired or required by this Agreement shall become the
property of City and CUSD, and all publication rights are reserved to City and CUSD.
Consultant may retain a copy of any report furnished to the City and CUSD pursuant to
this Agreement.
B. All Reports prepared by Consultant may be used by City and CUSD in
execution or implementation of:
(1) The original Project for which Consultant was hired;
(2) Completion of the_i riginal Project by others;
(3) Subsequent additions to the original project; and/or
(4) Other City and CUSD projects as appropriate.
C. Consultant shall, at such time and in such form as City and CUSD may
require, furnish reports concerning the status of services required under this
Agreement.
D. All Reports required to be provided by this Agreement shall be printed on
recycled paper. All Reports shall be copied on both sides of the paper except for one
original, which shall be single sided.
E. No Report,information of other data given to or prepared or assembled
by Consultant pursuant to this Agreement shall be made available to any individual or
organization by Consultant without prior approval by City and CUSD.
18. RECORDS:
Consultant shall maintain complete and accurate records with respect to sales,
costs, expenses, receipts and other such information required by City and CUSD that
relate to the performance of services under this Agreement.
Consultant shall maintain adequate records of services provided in sufficient
detail to permit an evaluation of services. All such records shall be maintained in
accordance with generally accepted accounting principles and shall be clearly identified
and readily accessible. Consultant shall provide free access to such books and records
to the representatives of City and CUSD or its designees at all proper times, and gives
City and CUSD the right to examine and audit same, and to make transcripts therefrom
as necessary, and to allow inspection of all work, data, documents, proceedings and
activities related to this Agreement. Such records, together with supporting documents,
shall be kept separate from other documents and records and shall be maintained for a
period of three (3) years after receipt of final payment.
If supplemental examination or audit of the records is necessary due to concerns
raised by City's and CUSD's preliminary examination or audit of records, and the
City's and CUSD's supplemental examination or audit of the records discloses a failure
to adhere to appropriate internal financial controls, or other breach of contract or failure
to act in good faith, then Consultant shall reimburse City and CUSD for all reasonable
costs and expenses, associated with the supplemental examination or audit.
19. NOTICES:
All notices, demands, requests or approvals to be given under this Agreement
shall be given in writing and conclusively shall be deemed served when delivered
personally or on the second business day after the deposit thereof in the United States
Mail, postage prepaid, registered or certified, addressed as hereinafter provided.
All notices, demands, requests, or approvals from Consultant or CUSD to City
shall be addressed to City at:
City of Cupertino
10300 Torre Ave.
Cupertino CA 95014
Attention: Carol A. Atwood, Director of Recreation and Community
Services
All notices, demands, requests, or approvals from City or Consultant to CUSD
shall be addressed to CUSD at:
Cupertino Union School District
1309 S.Mary Avenue
Sunnyvale, CA 94087
All notices, demands, requests, or approvals from City or CUSD to Consultant
shall be addressed to Consultant at:
8
Linda Rios
17485 Montoya Circle
Morgan Hill, CA 95037-3766
20. TERMINATION:
In the event Consultant fails or refuses to perform any of the provisions hereof at
the time and in the manner required hereunder, Consultant shall be deemed in default
in the performance of this Agreement. If such default is not cured within the time
specified after receipt by Consultant from City or CUSD of written notice of default,
specifying the nature of such default and the steps necessary to cure such default, City
or CUSD may terminate the Agreement forthwith by giving to the Consultant written
notice thereof.
City and CUSD shall have the option, at their sole discretion and without cause,
of terminating this Agreement by giving thirty (30) days' 'prior written *notice to
Consultant as provided herein. Upon termination of this Agreement, each party shall
pay to the other party that portion of compensation specified in this Agreement that is
earned and unpaid prior to the effective date of termination.
21. COMPLIANCES:
Consultant shall comply with all state or federal laws and all ordinances, rules
and regulations enacted or issued by City and CUSD.
22. CONFLICT OF LAW:
This Agreement shall be interpreted under, and enforced by the laws of the State
of California excepting any choice of law rules which'may direct the application of laws
of another jurisdiction. The Agreement and obligations of the parties are subject to all
valid laws, orders, rules, and regulations of the authorities having jurisdiction over this
Agreement(or the successors of those authorities.)
Any suits brought pursuant to this Agreement shall be filed with the courts of
the County of Santa Clara, State of California.
23. ADVERTISEMENT:
Consultant shall not post, exhibit, display or allow -to be, posted, exhibited,
displayed any signs; advertising, show bills, lithographs, posters or cards of any kind
pertaining to the services performed under this Agreement unless prior written
approval has been secured from City and CUSD to do otherwise.
24. WAIVER:
9
A waiver by City and CUSD of any breach of any term, covenant, or condition
contained herein shall not be deemed to be a waiver of any subsequent breach of the
same or any other term, covenant, or condition contained herein, whether of the same
or a different character.
25. INTEGRATED CONTRACT.
This Agreement represents the full and complete understanding of every kind or
nature whatsoever between the parties hereto, and all preliminary negotiations and
agreements of whatsoever kind or nature are merged herein. No verbal agreement or
implied covenant shall be held to vary the provisions hereof. Any modification of this
Agreement will be effective only by written execution signed by City, CUSD and
Consultant.
26. INSERTED PROVISIONS:
Each provision and clause required by law to be inserted into the Agreement
shall be deemed to be enacted herein, and the Agreement shall be read and enforced as
though each were included herein. If through mistake or otherwise, any such provision
is not inserted or is not correctly inserted, the Agreement shall be amended to make
such insertion on application by either party.
27. CAPTIONS:
The captions in this Agreement are for convenience only, are not a part of the
Agreement and in no way affect, limit or amplify the terms or provisions of this
Agreement.
IN WITNESS WHEREOF, the parties have caused the Agreement to be executed.
CONSULTANT CITY OF CUPERTINO
} A Mu ipal Corporation
ter,/
By: Linda Rios y: David Brandt
Title: Consultant Title: City Manager
Date: Date:
CUPERTINO UNION SCHOOL RECOMMENDED FOR APPROVAL:
DISTRICT
10
By: W Z By: Carol A. Atwood
Title: Title: Director of Recreation and
Community Services
APPROVED AS TO FORM:
rMUJ-/U
Carol A. Korade,
City Attorney
ATTEST:
Grace Schmidt
City Clerk
EXPENDITURE DISTRIBUTION:
Account No: 100-20-200-600-634
Amount: $50,000
11
EXHIBIT A
CONSULTANT SERVICES TO BE PERFORMED
The-CONSULTANT will provide_education, training, delinquency prevention, and
support services to minors and families residing in the CITY and the CUSD
boundaries. These services include, but are not limited to, the following, provided
agreement is reached by all parties concerned:
➢ Conference with individual school, CUSD, City, Community, Santa Clara County
(SCC) Sheriff's Office/ law enforcement officials to provide prevention and
intervention strategies and resources for at risk students and families. Consultant
will serve as a resource for parents/guardians, and she will meet/conference with
them at a designated school site, City or CUSD facility.
➢ Conduct presentations/mediations for students, school staff, families, and/or
community organizations. Topics. .to include, but not limited to, school
attendance laws/regulations, student safety, student stress, parenting support,
and violence prevention.
➢ Assist School Resource Officers /law enforcement officials in conducting
meetings and/or presentations with school officials and/or families in need of
prevention and intervention services.
➢ Provide truancy prevention/reduction services.
■ Serve as a member of the School Attendance Review Board (S.A.R.B.),
attend regularly scheduled meetings, and provide follow-up support on
case referrals.
■ Conference with school officials, students, and/or families to provide
intervention strategies and services for improving attendance patterns.
■ Make home visits to truant students with law enforcement, school
officials, and/or CUSD credentialed school nurses to assist
students/families in improving attendance patterns.
12
■ Collaborate with the. District Attorney's Office (Truancy Division) to
ensure student/parent compliance with school attendance laws.
➢ Attend meetings/seminars. identified by individual school,_C.U:S.D. and/or City
officials including,but not limited to:
■ A.C.E.S. (Attendance Collaborative For Educational Success), sponsored
by the Office of the District Attorney.
■ I.EY (Individual Education Plan), S.S.T. (Student Study Team), and
M.D.T. (Multi-Disciplinary Team) meetings, as deemed appropriate by on-
site school principals and/or C.U.S.D. officials.
■ Meetings/seminars on -school safety, violence . prevention, truancy
abatement/attendance laws, child abuse prevention, and support services
for parenting/family maintenance,"mental health,' foster. and-homeless
youth, and crime victims.
13
EXHIBIT P
COMPENSATION
City and CUSD shall compensate Consultant for professional services described in this
Agreement in accordance with the terms and conditions of this Agreement based on the
rates and compensation schedule set forth below. Compensation shall be calculated
based on the hourly rates set forth below up to the not to exceed budget amount set
forth below.
The compensation and reimbursable expenses to be paid to Consultant under this
Agreement for all services described in Exhibit "A" by City and CUSD shall be split
equally between City and CUSD, and shall not exceed fifty thousand dollars ($50,000)
for City and fifty thousand dollars ($50,000) for CUSD. Any work performed or
expenses incurred for which payment would result in a total exceeding the maximum
amount of compensation set forth herein shall be at no cost to the City or CUSD. In no
event shall City be responsible for CUSD's share of the compensation, nor shall CUSD
be responsible for City's portion.
Hourly rate: $100.00 per hour, divided equally.
Invoices:
In order to request payment, Consultant shall submit monthly invoices to the City and
CUSD describing the services performed and the applicable charges to each entity
(including, where applicable an identification of personnel who performed the services,
hours worked, task(s) for which work performed, hourly rates and reimbursable
expenses), based upon Consultant's billing rate and reflecting an equal split of
Consultant's charges between City and CUSD.
Reimbursable Expenses:
Administrative, overhead, secretarial time or overtime, work processing, photocopying,
in house printing, insurance and other ordinary business expenses are included within
the scope of payment for services and are not reimbursable expenses. City and CUSD
shall reimburse consultant for reasonable travel. Travel expenses are limited to the
lesser of actual expenses or expenses that would be authorized for City or CUSD
employee travel pursuant to City or CUSD policy, whichever is lower.
Consultant shall provide additional services outside of the services identified in Exhibit
14
A only by advance written authorization from the City and CUSD prior to
commencement of additional services. Consultant shall submit, at the Project
Manager's request, a detailed written proposal including a description of the scope of
additional services, schedule, and proposed maximum compensation.
TASKS SCHEDULE TIMEFRAME
1. Conferencing Daily/Weekly August-June
2. August-
Presentations/Mediations As Requested/Needed June
3. Assist School Resource Officers/Law As Needed August-July
Enforcement officials
4. Provide Truancy Prevention/ Daily August-June
Reduction Services:
Serve on School Attendance Review
Board Bi-Monthly September-June
Collaborate with SARB Chair: Weekly August-June
Discuss case referrals/SARB agenda Weekly August-June
Train CUSD staff on SARB Yearly/As needed August-June
referral process
Update attendance forms/SARB
reports Yearly/As needed August-June
Provide Follow-up on all
SARB/truancy Daily/Weekly August-June
referrals:
Conference with School
officials/parents/ Daily/As needed August-June
students to improve attendance
patterns
Home visits to truant students Daily/As needed August-June
Provide morning wake-up calls Daily/As needed August-June
Collaborate with District Attorney As needed August-July
(Truancy Division)
15
5. Meetings/Seminars
ACES Monthly August-May
SST As needed August-June
IEP As needed August-June
MDT As needed August-June
Educational Seminars Monthly August- ay
16
EXHIBIT C
ACKNOWLEDGEMENT OF MANDATED REPORTING REQUIREMENTS,
RECEIPT OF TRAINING,AND RECEIPT OF PENAL CODES STATUTES
A mandated reporter is an individual who is obligated by law to report
suspected cases of child abuse and neglect. In general, any individual who, in
the ordinary course of their employment, has contact with children is a
mandated reporter. Mandated reporters include child care workers, teachers and
coaches. (California Penal Code 11165.7).
If your job duties as an employee or an independent contractor of include contact
with children,you are a Mandated Reporter. Prior to commencing employment
and as a prerequisite of that employment, California law requires that you sign a
statement to the effect that you have knowledge of the provisions of the
Mandated Reporter Law, and will comply with those provisions. (California
Penal Code 11166.5).
The following are the Mandated Reporter responsibilities under California law.
You are also being provided with a separate informational document which
includes the text of the California Mandated Reporter Law and contact
information for Child Abuse and Neglect Reporting for the County of Santa
Clara. Please review this information carefully and acknowledge your receipt
and understanding where indicated:'If you have questions or concerns about
this form or your Mandated Reporter responsibilities,please contact.the
Recreation Supervisor at 408-777-3120.
I understand that:
• By virtue of my employment or independent contractor status with
City and CUSD,and because my employment requires me to have
contact with children, I am a Mandated Reporter as defined by
California Penal Code 11165.7.
• The following situations trigger mandatory reports: a)Physical
Abuse (willful harming of a child);b)Sexual abuse including sexual
assault, child exploitation, pornography, and trafficking; c) Severe
or General Neglect; and d) Extreme Corporal Punishment
(resulting in injury). (Cal. Pen. Code 11165 et. seq.) I further
understand that I may,but am not required to, report suspected
Emotional Abuse.
• If I reasonably suspect that a child is being abused, I must
immediately make a telephone report. I must follow up with a
written report within 36 hours. This report may be made to local
law enforcement, or County Sheriff's Department, Probation
Department or Child Welfare Agency. (Cal Pen. Code 11166(a)).
• I am not required to,but I may, share information about suspected
abuse with my supervisor or management or the parents of the
alleged..victim.
• When I make a mandated report, I will be required to give my
name. However, my identity will be kept confidential unless I
either consent to disclosure or if the disclosure is made pursuant to
a court order. Further, agencies investigating the mandated report
may disclose my identity to one another. (Cal Pen. Code 11167(d)).
• The following agencies and individuals receiving or investigating
mandated reports may disclose my identity to one another:
o Prosecutors in a criminal prosecuting or in an action
initiated under section 602 of the Welfare and Institutions
Code arising from alleged child abuse;
o Counsel appointed pursuant to subdivision (c) of Section 317
of the Welfare and Institutions Code;
o A licensing agency when abuse or neglect in out-of-home
care is reasonably suspected. (Cal Pen. Code 11167.5)
• I may not be disciplined, dismissed, retaliated against,
discriminated against or harassed for making a mandated report of
reasonably suspected child abuse.
• As a Mandated Reporter, I have civil and criminal immunity when
making a report (Cal Pen. Code 11172).
• As a Mandated Reporter,it is a misdemeanor to fail to comply
with Mandated Reporting laws and I can be held criminally
liable for failing to report suspected abuse. The penalty for this is
up to six months in County jail, a fine of not more than$1000, or
both. I further understand I could be civilly liable for failure to
report. (Cal. Pen. Code 11166(c)).
I have been provided with a copy of California Penal Code sections 11164-
EXHIBIT D
City of Cupertino Consultant Declaration
The undersigned does.hereby certify that:
1. I am familiar with the facts herein and.am-authorized and qualified to
execute this declaration.
2. I declare that I have complied with fingerprinting and criminal
background investigation,requirements with respect to all Consultant's
employees who may have contact with minors in the course of providing
services pursuant to the Agreement, and the California Department of
Justice has determined that none of those employees has been convicted of
a felony, as that term is defined in California Penal Code Section 11105.3.
3. That a complete and accurate list of Consultant's employees,who may
come in contact with minors during the course and scope of the
Agreement, are included below.
4. All of the below mentioned employees have tested negative for TB, or X-
ray results for TB, and have current documentation on file with
Consultant.
5. All of the belowmentioned employees have received training and
understand their responsibilities under the Mandated Reporter laws of
this state and are willing and able to comply.
A List of all Consultant Employees Working for the City of Cupertino Listed:
Linda Rios, only
6. The City of Cupertino will be notified by Consultant in writing of any new
employees and will be added to the above list prior to beginning work at
the City of Cupertino.
I declare under penalty of perjury that the foregoing is true andel correct:
Date Place Consultant Signature Title
11174.3 (Mandated Reporter Law).
I understand that I am a legally Mandated Reporter. I am aware of and
understand my responsibilities under the Mandated Reporter laws of this state
and am willing and able to comply. I understand that a copy of this
Acknowledgement will be kept in my personnel file.
.
ru�l If
N e (Signature) Date
Name (Print)
1�