PARTNERSHIP FOR CHILDREN OF CUMBERLAND COUNTY, INC.

Contract Monitoring Summary Report

Agency Name:	Contract #:
Date of Visit:
Contract Period:	Contract POC:
Persons Participating in Site Visit:

I.	Contract File Review	Present?	Comments
	a. Contract Development Form, completed by Direct Service provider, with signature of all authorized signers	Yes No
	b. Initial Contract and any subsequent Contract Amendments, signed by authorized signer	Yes No
	c. Attachment I, Contract Activity Description, signed by authorized signer and Project/Activity Coordinator	Yes No
	d. Attachment II, Activity Budget, initial budget and any subsequent revised budgets	Yes No
	e. Attachment II, Activity Budget Narrative, initial budget narrative and any subsequent revised narratives	Yes No
	f. Attachment III, Smart Start Cost Principles	Yes No
	g. Attachment IV, Reporting Requirements	Yes No
	h. Policy/Statement Addressing Conflict of Interest	Yes No
	i. Policy/Statement Addressing Confidentiality of Client Information	Yes No

II.	Federal/State/Local Regulations	In Compliance	Determining Factor	Comments
	a. Reporting Suspected Child Abuse as defined in NC General Statute § 7B-101	Yes No
	b. Compliance with Civil Rights Act of 1964, Titles VI and VII, regarding nondiscrimination in federally assisted programs and equal employment opportunity	Yes No
	c. Compliance with Rehabilitation Act of 1973, Section 504, regarding nondiscrimination under federal grants and programs	Yes No
	d. Compliance with Americans with Disabilities Act of 1990 regarding equal opportunity for individuals with disabilities	Yes No
	e. Compliance with NC General Statute § 143B-168.15(e) regarding the Use of State Funds	Yes No
	f. Certification that Agency has no overdue tax debt as defined in NC General Statute § 105-243.1	Yes No
	g. Making all persons and records, including general & subsidiary ledgers, reports, program documents, etc. available at any reasonable time to LP, NCPC, DCD, DHHS, OSA, etc. as outlined in NC General Statute § 147.67.7	Yes No
	h. Compliance with all other laws, ordinances, codes, rules, regulations, and licensing requirements applicable to the conduct of its business	Yes No