ࡱ>  M!bjbj .HXqqq8, 6\$;55555557:f5qO{{@OO5h5OpR5O53O"U5 "g^-4550 6C4::,U5:qU5DOOOOOOO55OOO 6OOOO:OOOOOOOOO :  Following are three checklists to assist new grantees develop the infrastructure needed to implement a successful OHHLHC grant program. The three checklists are: Components of a Lead Hazard Control Program. There are many elements to implementing a successful lead program. Use this checklist to ensure that your program has determined how it will address each key program element. Case File Checklist. Maintaining complete files for all program participants is a critical element of program success. Use this checklist to ensure that participant case files are complete and well organized. Written Operational Procedures Checklist. To ensure that program applicants, participants, contractors, and other partners are treated consistently and that key program elements are completed as intended, grantees need to develop a series of written operational procedures. Use this checklist to ensure that your program develops these procedures during the start-up phase of your program. All of these documents are offered as suggestions and recommendations, but are NOT requirements of OHHLHC. A grantee may use these checklists in their current form, but should feel free to tailor the checklists to best meet the specific needs of its program. Components of a Lead Hazard Control Program This checklist identifies the critical components of a lead hazard control program. Program directors should be sure that they have addressed each of the following areas as it relates to their lead program. While some components may be addressed in the work plan, others may require additional documentation. Grantees should tailor this checklist as needed to meet the needs of their specific program. (ComponentComment Goals of the Program Staff/Job Duties  Working Partners Eligible Census Tracts Rules, Guidelines, and Operating Procedures Forms for processing all aspects of the Lead Program Screening of Children Education/Outreach/Training Lead Pollution and Professional Liability Insurance Lead Guide Specifications, Scope of Work, and Computerized Lead Specification Program Historic Review/Special Districts  Flood Plain Review  Lead Inspections/Risk Assessments/EBL Investigations  Relocation Issues Waste Disposal Issues Ten-Day Notification and List of Approved Encapsulants Lead Cleanings/Low-Level Approach Interim Controls and Abatement TechniquesRegistration of Contractors Duties of Lead Monitor Bidding of Lead Hazard Control Work Bid Acceptance Process Bid Award Process Pre-Construction Meeting Lead Hazard Control Work Clearance Examinations/Payments Closeout Process Other_____________ Other_____________  Case File Checklist Place this checklist the front of each participant case file. Use the checkboxes to indicate whether the form is in the file. The comments box can be used to record notes about the form, as appropriate. This checklist includes items that are common to OHHLHC grant program. Grantees should tailor this checklist as needed to meet the needs of their specific program. (FormComments1. Data Collection Form 2. Signed Application 3. Signed Acknowledgement Receipt of Program Policies/Grievance Procedure/Pamphlet4. Signed Acknowledgement Temporary Relocation Form5. Signed Acknowledgment No Guarantee of Funding Form 6. Signed Authorization Sharing Information Form 7. Signed Verification of Employment Form (if applicable)8. Signed Verification of Benefits Form (if applicable)9. Real Estate Summary Sheet 10. Verification of Ownership Form  11. Copy of Deed 12. Copy of Recorded Land Contract (if applicable)13. Verification of Land Contract Payments (if applicable)14. Flood Plain Review 15. Historic Review 16. Birth Certificates of Children Under Six Years of Age17. Blood Levels of Children Under Six Years of Age18. Copy of Medical Cards 19. If Low-Income Landlord, Verification of Income20. If Rental Property, Tenant Package Completed21. If Loan, Signed Truth and Lending and Right of Rescission (Rental Property)22. Income Verifications Received (in accordance with current guidance)23. Signed Stipulations (rental property)24. Certificate of Insurance (lead) 25. Paint Inspection/Risk Assessment 26. Original Specifications Initialed by Owner27. Bid Proposals/Sealed Bids 28. Bid Tabulation Sheet 29. Estimate of Work Specifications 30. Acceptance of Contractor by Owner31. Grant/Matching Funds/Loan Worksheet32. Resolution of Award to Contractor33. Award of Grant/Matching funds/Loan to Owner34. Signed Relocation Forms 35. Required Contractors Bonding 36. Required Permits 37. Pre-Abatement Plan 38. Notification to State  39. Signed/Approved Contract 40. Notice-to-Proceed 41. Signed Final Inspection (Owner and Inspector)42. Lead Monitors Report 43. Waste Disposal Receipt 44. Certificate of Post-Abatement Clearance45. Payment to Contractor 46. Signed On-going Monitoring/Maintenance Acknowledgment Form47. Signed Receipt of Closeout Package48. Other_______________49. Other_______________ Written Operational Procedures Checklist Grantees develop written procedures for each step in their program process. These written procedures can help to ensure communication and consistency among staff. This checklist identifies procedures that most OHHLHC grantees need to develop. This checklist can be used as a management tool to establish a target date for development of each procedure and assign key staff responsible for its development. Grantees should tailor this checklist as needed to meet the needs of their specific program. 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