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Lutheran Family Services in the Carolinas <br />ATTACHMENT B -Scope of Work <br />Federal Tax Id. 56-1286323 <br />Contract # <br />A, CONTRACTOR INFORMATION <br />1. Contractor Agency Name: Lutheran Family Services in the Carolinas <br />2. If different from Contract Administrator Information in General Contract: <br />Telephone Number: ((704)940-3324 Fax Number: (704)334-8815 Email; <br />pat.covington@Ifscarolinas.org <br />Name of Program (s): Lutheran Family Services in the Carolinas <br />4. Status: ( )Public (x) Private, Not for Profit ( )Private, For Profit <br />5. Conttactor's Financial Reporting Year July 1, 2007 through June 30, 2008 <br />B. Explanation of Services to be provided and to whom (include SIS Service Code): <br />Lutheran Family Services in the Carolinas shall maintain one around-the-clock home in <br />Concord, North Carolina for the use of Cabarrus county Department of Social Services, <br />hereinafter referred to as CCDSS. The home shall provide adequate care and supervision <br />for not more than four (4) children at all times placed through CCDSS. CCDSS may <br />place such children in the home as CCDSS, in its sole discretion, deems advisable. <br />Lutheran Family Services in the Carolinas shall provide room, board, adequate house <br />patent staff supervision, routine school supplies, and allowances for• the children placed <br />in the home. Lutheran Fancily Services in the Carolinas shall provide transportation for <br />each child to and from school, to medical appointments, and mental health appointments <br />and shall remain with them at said appointments. Lutheran Family Services in the <br />Carolinas will schedule a physical exam for each child within seven (7) days of <br />admission. Lutheran Family Services in the Carolinas will meet with the school at each <br />child's enrollment to discuss his educational plan and will review this plan with the <br />school each month. Lutheran Family Services in the Carolinas will provide written <br />documentation to CCDSS upon request, conduct regular Plan of Care meetings regarding <br />each child in the horzre, and conduct generic meeting with CCDSS as requested to discus <br />the overall services being provided. <br />SIS code will be 109. <br />C. Rate per unit of Service (define the unit): <br />1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) <br />Contact-Scope of Work (06/04) ~_ Lf Page 1of2 <br />