Request for Qualifications (RFQ) Process NOTE: This format does not allow the user to start, stop, and return to the process. A copy of this form is available on LAHSA's Funding web page for your convenience. The RFQ is a process which will help to ensure that agencies have core documents in place before they apply for initial funding or try to renew existing funding. It also provides a place for agencies to electronically store "legacy" documents to reduce duplicative processes. The RFQ is a three (3) step process outlined below: Step I. Account creation and RFQ completion. Fill in information to create agency user account for File Sharing. Each agency may only create up to Step II. An e-mail w ill be sent to the addresses indicated in the online setup form and w ill lay out the steps required to complete the set-up of the agency FileShare account. Once completed, upload agency core tw o (2) accounts; how ever you may documents into the corresponding 1 reserve one account for multiple 2 folders in your File Share account. 3 users and one account for control Remember, this step is to not purposes. Once the "submit" button is completed here - it is completed on a pushed at the end of the on-line form separate w eb program, File Share. it w ill trigger the set-up of a FileShare You w ill not be able to upload account w ith LAHSAs IT department. documents until you receive the File Share link, user name, and passw ord from LAHSA IT Support. Step III. Once you have uploaded all of the required core documents complete the form titled "Agency Completed and Executed Certification of Core Documents" form. The form can be found on the Funding page of the LAHSA w ebsite under "Related Documents". This certification form must be signed by the person at your agency authorized to enter into legal contracts. Upload the signed and completed form to your FileShare account File Sharing account Each agency may only create up to tw o accounts. Because these accounts are depositories for your agency core documents, w e suggest that one account be a "shared" account for a few key staff and one account be reserved as a control account. The LAHSA IT department w ill need the follow ing information to set up your account: Legal Agency Name * Name of account user #1 * First Last E-mail address of account user #1 * Name of account user #2 First Last E-mail address of account user #2 https://lahsafunding.wufoo.com/forms/request-for-qualifications-rfq-process/ 1/6
RFQ Complete each required section 1. Legal Agency Name * 2. Federal Tax ID (EIN) * 3. Administrative Address * Street Address Address Line 2 City State / Province / Region United States Postal / Zip Code Country 4. Executive Director/CEO/President * 5. Executive Director/CEO/President Phone. * 6. Executive Director/CEO/President Email * 7. Secondary Contact Name and Title * 8. Secondary Contact Phone. * 9. Secondary Contact Email * 10. If your agency has received federal, state, local or private funds in the last 12 months, please select the sources of those funds. If you have never received funding before, select "t previously funded" https://lahsafunding.wufoo.com/forms/request-for-qualifications-rfq-process/ 2/6
Dept. of Housing and Urban Development (Includes CoC Program, ESG, CDBG, etc.) Public Housing Authorities (HACLA, HACoLA, SMHA, PHA, etc.) Los Angeles Housing Department County DMH, DHS, DPSS, DCFS, etc Other t previously funded 11. Does your agency comply with all federal and state workplace laws? * 12. Program type or agency area of expertise? Permanent Housing Supportive Services Only Emergency Shelter Safe Haven Family Solutions Systems/ Coordinated System Transitional Housing Assessment or Access Center Employment Program Outreach Rapid Rehousing 13. How many years has your agency specialized in each type of service? * ne Less than 1 year 1-3 years 3-5 years 5+ years Permanent Housing Transitional Housing Supportive Services Only Assessment or Access Center Emergency Shelter Employment Program Safe Haven Outreach Family Solutions System/ Coordinated System https://lahsafunding.wufoo.com/forms/request-for-qualifications-rfq-process/ 3/6
Rapid Rehousing 14. What is your agency's Direct Services Staff to Client Ratio for the following program types? * 1 to 7 or less 1 to 15 or less 1 to 30 or less 1 to 31+ N/A Permanent Housing Transitional Housing Supportive Services Only Assessment or Access Center Emergency Shelter Employment Program Safe Haven Family Solutions System/ Coordinated System Rapid Rehousing 15. How many staff does your agency employ? * 16. How many sites does your agency have? * 17. What Service Planning Area(s) (SPA) do you serve? SPA 1 - Antelope Valley/ Palmdale/ Lancaster SPA 2 - San Fernando Valley/ Santa Clarita Valley SPA 3 - San Gabriel Valley/ Monrovia/ El Monte/ Pomona SPA 4A - Metro Downtown SPA 4B - Metro West SPA 4C - Metro East SPA 5 - West Los Angeles/ Santa Monica/ Malibu SPA 6 - South Los Angeles/ Compton https://lahsafunding.wufoo.com/forms/request-for-qualifications-rfq-process/ 4/6
SPA 7 - East Los Angeles/ Whittier/ rwalk/ Artesia SPA 8 - South Bay/ Inglewood/ Manhattan Beach/ Torrance/ Rancho Palos Verdes 18. Does your agency utilize the Los Angeles Continuum of Care Homeless Management Information System (HMIS)? * Using another Continuum HMIS system 19. If you are a new provider, is your agency willing to use the Los Angeles Continuum of Care Homeless Management Information System (HMIS)? * t in the LA CoC 20. How many accounting staff does your agency employ? * 21. How is accounting maintained at your agency? Manual Entry Data System Other 22. In either of your last two audits, did your CPA or CPA firm identify a material weakness or deficiency? * t Applicable 23. If you have received funding through LAHSA in the past five (5) years, what are your agency's Programmatic and Fiscal Risk Assessment levels as of the most recent monitoring? This information would have been provided to you at your last monitoring from LAHSA's Compliance Department. * Low Moderate High Programmatic Risk Level Fiscal Risk Level 24. Are you a new provider or a current LAHSA funded agency that has not yet been monitored? * - New Provider - Current LAHSA agency not yet monitored - Experienced agency that has been previously monitored 25. Are all of your agencies in compliance with applicable provisions of the Americans with Disabilities Act? https://lahsafunding.wufoo.com/forms/request-for-qualifications-rfq-process/ 5/6
- but we have a Reasonable Accomodation process 26. Do program staff receive standard training in CPR, Universal Precautions, non-violent crisis intervention techniques, cultural competency, and child/elder abuse reporting? 27. Will your agency agree to sign Business Associate Agreements so that information on HMIS can be shared among collaborating agencies to expedite services to those facing homelessness? Maybe By submitting this survey, I certify that the statements herein are true and accurate to the best of my knowledge. I also certify that the information provided has been approved by the agency's Executive Director, Chief Executive Officer, or legal certifying official. Name of certifying individual * First Last Date MM / DD / YYYY https://lahsafunding.wufoo.com/forms/request-for-qualifications-rfq-process/ 6/6