Sustainability Grant 2
16/12/13 V4
Introductory Notes:
Please do not use copies of previous application forms.
There are changes to the format and the procedures so please check the form carefully before filling it in and read the guidance note.
For office use onlyAmount Applied For £ ______(max £3,000) Date Received ______
Recommended Yes/No (please circle)
Criteria / Score / Maximum possible Score
Match against criteria General / 1
Financial viability of sessions (see section 5) / 3
Clarity of purpose (see Section 5.9) / 3
Scarcity of provision (see Section 6.1) / 3
Level of unrestricted reserves (see Section 5.10) / 3
Evidence of need (see Section 6.1) / 2
Future plans for sustainability (see Section 7.1) / 3
Total Score (a minimum of 9 must be scored to qualify for grant) / 18
Conditions:
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......
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Date Agreed
Signature x2 from Grants Panel:
Name (1) …………………………………………………… Signed ………………………………………......
Name (2) …………………………………………………… Signed ………………………………………......
1 Organisation/Contact Details
1.1 What is the legal name of the organisation?
1.2 What is the name of the organisation, which you use commonly, if different from above?
1.3 Who will be the main contact for this application? We will address all correspondence to this person and he / she should be able to answer detailed questions about the application.
Title / First Name / Surname1.4 What is the position held in the organisation by the main contact?
1.5 Address for correspondence, including full postcode.
We may have to contact you to discuss your application. If you are based somewhere that is likely to be closed during school holidays, e.g. a school, please provide an alternative correspondence address.
Main AddressPost Code
Alternative Address
1.6 What is the main contact’s telephone number? If you have given an alternative address in Q1.5 above, please give an alternative phone number for that address.
Main Telephone Number / Alternative Telephone NumberFax / E-mail address
2 Organisation Status
2.1 What is the legal status of your organisation (tick only one box)
Local Authority / Governing Body(under extended schools)
Further or higher education institution / Independent school
Sole trader / privately owned business / Unincorporated club or association / not for profit organisation
Voluntary contributed group
(please attach a copy) /
Company limited by guarantee / Company number
Company limited by shares / Company number
Charitable Trust / Charity number
Ofsted
registered
number of
places / Actual
Number of places available / Ofsted
registered
number of
places / Actual
Number
of places available
Full daycare
(4hrs or more) / Before and after school
Sessional care (more than 2 hrs, but less than 4) / Holiday
Before school only / Weekend
After school only
2.2 What type of childcare do you provide and how many places?
2.3 Which age range do you currently provide childcare for?
2.4 Is your organisation currently registered with Ofsted to provide childcare?
Yes / No2.5 If yes, what is your Ofsted registration number?
3 Quality Assurance
If your provision is registered under the Children Act please give the date and outcome of the last inspection and of any other inspection e.g. Ofsted.
3.1
Day Care Standards / Ofsted Education Inspection / Ofsted CombinedInspection
Date
Outcome
4 Who have you received advice from to complete this application?
Childcare & Play Development Manager / Independent Business Adviser/BankBusiness Link Adviser / PLA
NCMA
Other (Please state below)
4.1
4.2 Staffing, policies and procedures. If you currently have any paid staff, please complete the following questions:
a / Do you have written policies procedures for recruitment and selection of staff? / Yes / Nob / Do all staff and volunteers/managers appear on a single central record which includes details of the CRB check? / Yes / No
Note: As a minimum, organisations are expected to have procedures which cover the following: advertising, shortlisting and references, selection process, clearance and checks.
c / Do all staff have up-to-date contracts? / Yes / No
d / Do all staff have regular supervision and a named line manager? / Yes / No
Note: Supervision means a planned, regular opportunity to have one-to-one time with their line manager to discuss their workload, performance and any other issues that they need support with.
e / Do all staff have an annual appraisal? / Yes / No
f / Have all staff attended in service training in the last 12 months?
· / · Induction (for new staff) / Yes / No
· / · On going staff development / Yes / No
· / · In-service training / Yes / No
Note: The minimum standard required is that all new staff receive induction training and that you provide further opportunities for staff development. These can include ‘on the job’ training sessions.
g / Do you have a disciplinary, capability and grievance procedure? / Yes / No
Note: As a minimum standard, organisation should have a policy that is in line with the Advisory, Conciliation and Arbitration Services (ACAS) code of practice.
h / Do you have an equal opportunities policy? / Yes / No
If yes, please attach a copy
i / Do you have written a volunteer policy? / Yes / No
If yes, please attach a copy
j / Do you have written procedures in place for staff reporting to trustees / directors / management committee? / Yes / No
k / Do you have written procedures in place for the treasurer to regularly report to trustees / directors / management committee? / Yes / No
l / Have you attended any business/committee management training within the last 12months? / Yes / No
If yes, which training and date?
If you have answered ‘no’ in relation to any of the questions above do you require further assistance with developing your policies? / Yes / No
5 Financial Information
5.1 Which bank account would any grant be paid into?
You must have a bank account into which we can pay any grant. Your bank/building society account should be in the legal name of your organisation. If it is not, please attach a letter explaining why. You must submit
· Either an original bank statement (photocopies are not acceptable). This must not be more than three months old. It will be returned to you. We appreciate that this may prove difficult for statutory authorities to provide and we will accept a letter, signed by the Director of Finance (or equivalent), confirming the details of the bank account into which the grant would be paid.
If your organisation is recently established and/or the bank account is new, we can accept an original, signed letter from the bank confirming details of the account name and number and the bank sort code.
· Or a copy of a building society passbook stamped and signed by the building society.
Account nameBank / Building Society Name
Bank / Building Society Address
Post Code
Sort Code
Account Number
Building Society Roll Number (if applicable)
5.2 Who from your organisation is authorised to sign cheques from this account?
For unincorporated clubs or associations there must be a minimum of two signatures to pay money from the account.
Name / PositionName / Position
Name / Position
5.3 Please provide your most recent annual accounts
Existing organisations. You must provide a copy of your organisation’s latest accounts. If your income was less than £1,000 in the last year, we will accept a copy of your cash book pages for the last three months or original bank statements for the last three months.
Statutory authorities / further education institutions. If the organisation is run by a statutory authority or further education institution, we only need to see accounts, bank statements or projections specifically relating to your project. See 5.1 above for guidance on bank statements.
5.4 Please give an explanation for the surplus / deficit.
5.5 Do you have audited or examined accounts?
Yes (If yes, please provide a copy) / No5.6 Are you in receipt of any other grants, excluding Nursery Education Funding?
Yes (If yes, please provide a copy) / NoIf yes, please give details below.
Grant Name / Amount / Purpose of Grant / Date Grant Ends5.7 How much are you applying for?
£ (max £3,000)
5.8 What will the sustainability funding be used for?
5.9 How much money does your organisation currently have in unrestricted reserves? (see notes)
£ ______
Please provide reasons why your organisation has these reserves
(e.g. contingencies).
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5.10 Summary of typical sessional attendance (this links to the score for the Financial Viability of sessions on page 1)
Charge Per Session / Monday / Tuesday / Wednesday / Thursday / FridayAM / PM / AM / PM / AM / PM / AM / PM / AM / PM
Opening times of the group
Total number of children attending sessions
Full Daycare
Sessional Care
Out of School Care
Crèche
Parent & Toddler
Number of children attending with special educational needs*
Full Daycare
Sessional Care
Out of School Care
Crèche
Parent & Toddler
How many paid staff are there per session
How many voluntary staff are there per session
* For the purpose of this summary SEN will be defined as those children classified as Early Years Action and Early Years Action Plus.
5.11. Sustainability Small Grant Scheme 20011/2012 (this links to the score for the Financial Viability of sessions on page 1) Income & Expenditure Forecast
Name of Setting or Organisation……………………………………………………………………………..
Month 1 / Month 2 / Month 3 / Month 4 / Month 5 / Month 6 / Month 7 / Month 8 / Month 9 / Month 10 / Month 11 / Month 12 / Total for 12 mthsReceipts
1.Fees
2. Nursery Education Funding
3.Fundraising
4.Donations
5.Other Grants
6. Other
B.TOTAL
PAYMENTS
Payments
7.Staff Costs
8.Training
9.Admin
10.Publicity
11.Rent
12.Insurance
13.Loan repayments
14.Equipment/ resources
15.Other
B.TOTAL
PAYMENTS
C. Surplus (deficit) see notes
D.Opening Bank Balance
E.Closing Bank Balance see notes
5.12 Current Staffing Details
Term Holiday
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Job Title / Hourly rate of pay / Hours per week / Number of weeks / Hours per week / Number of weeks / Total costsTotal
NB Please add additional page if necessary
Sustainability Grant 2
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6 Why do you need this grant?
6.1 A summary of why you need this grant. Simply outline what has happened to cause financial hardship e.g. Closure of local business, etc. You must give details of other settings in your immediate area, which offer the same or similar services to that of your group.
7. Future plans and sustainability
Outline the action you plan to take to ensure ongoing sustainability when this grant funding ends. Please Note: You are required to complete the outline cash flow forecast on pages 9 and 10 of this application.
7.1 This section must show how you will sustain your childcare places when the sustainability grant funding ends. You must show how you intend to increase revenue and/or reduce costs, outline a funding strategy, and how you will market your service/s
Information required
You previously received any sustainability funding from Cornwall Council
in the last 12 months
Yes No
If yes, how much and why?
Statement of accounts for previous financial year attached
Bank Statements (see page 6)
Declarations and Signatures
Name ______Position ______
Signed ______Date ______
ÏData Protection Act
Part or all of the information you give us will be held on computer. It will be used for the administration and analysis of applications and grants. We may provide copies of the information in confidence to individuals or organisations that are helping us to assess applications or monitor grants. Your signature on this application form is treated as confirmation that Cornwall Council and its agents may use the information you have supplied to us under the terms of the Data Protection Act 1998.
Locality Manager
Name ______Signature______
Date______
Please send completed and signed forms to:
Barbara Bardsley
Family Information Service
Room 242, 39 Penwinnick Road,
St Austell, PL25 5DR
Email:
If you would like this information in another format please contact:
Cornwall Council, County Hall, Treyew Road, Truro TR1 3AY
Telephone: 0300 1234 100
Email:
Revenue costs
Administration costs. Include all consumable items such as postage, telephone costs and office stationery. Do not include administration staff costs.
Volunteer costs. Include any expenses incurred by volunteers on your project.
Advertising costs. Include the costs of recruitment advertisements for new staff or promotional materials you may use to inform potential users about your project.
Other costs. Include any costs not already listed. If you enter an amount in this box you must specify what the cost is for e.g. uniform, food, training, promotional events etc.
Training costs. Training costs are not covered by the sustainability grant unless there is clear evidence (such as an Ofsted report that demonstrates that the setting would have to close without the provision of such training),
INCOME
Please refer to the following guidance before completing the income budget.
Fees. Include charges made to service users.
Reserves
For the purpose of Sustainability Funding any group applying should demonstrate that they have minimal or no reserves. The only exception to this is in the case of restricted reserves. Restricted reserves are those for which the donor/funder has said the money can only be used for the work they wish to fund (e.g. Lottery) or specific grants to voluntary organisations. They are not restricted if you have decided to put aside some money for a particular purpose e.g. to repair the roof or budget to pay redundancies – these are contingencies.
Notes for income and expenditure forecast
1. Surplus or deficit for the month:- the surplus or deficit for the month will be the total receipts for that month less that months total payments. Where there are more payments than receipts, this figure should be marked in brackets to indicate a deficit.
2. Closing bank balance:- this figure will be the Surplus or deficit for the month added to the opening bank balance for the month
3. As a check for your workings the opening bank balance for the year added to the total receipts for the 12 months less the Total Payments for the 12 months should agree with your Forecast Closing Bank Balance at month 12.
Sustainability Grant 2
16/12/13 V4