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County of Orange - 2011 CoC Renewal LOi <br />Exhibit 14: HMIS Certification (Domestic Violence Service Providers) <br />HMIS Certification must be submitted for the SHP funded project referenced In this application and will <br />be subject to verification by OC Partnership in its capacity as Orange County's lead HMIS agency. <br />Please rate the Items as Yes or No. NOTE: Domestic Violence providers, while exempt from entering <br />dient level data directly Into HMIS, must still provide aggregate data to OC Partnership and ensure that <br />their agency's data collection system Is compliant with the March 2010 HUD Data and Technical <br />Standards. <br />SHP Project Name Second Steo/Operations <br />? 1. eye OC Partnership has certified that my agency's internal client management system adheres to <br />the March 2010 HUD Data and Technical Standards. <br />2. yo All homeless clients served by the program are accurately recorded in agency's client <br />management Information system. <br />3. M Agency verifies that during the period from October 1, 2010 through present, staff consistently <br />entered demographic data on all clients served by the program Into agency's client <br />management information system within two weeks of the client's intake into the program. <br />4. ems Agency verifies that during the period from October 1, 2010 through present, staff consistently <br />exited clients from agencys client management information system within two weeks of actual <br />program exit date. <br />Other Emergency, Transitional or Permanent Supportive Housing Programs run by your agency <br />(regardless of funding source). <br />1. Project Name Human Options' emergency shelter for victims of domestic violence is currently active in <br />Orange County's HMIS or HUD compliant client management system. Yes /No <br />2, Project Name is currently active in Orange County's HM IS or <br />HUD compliant client management system. Yes/No <br />Please attach additional page If needed, In order to capture all projects captured on the 2011 HIC. <br />I certify that the foregoing Infer ation is true and correct to the best of my knowledge and that the above <br />informatl n accur tely reflects the administrative records at my agency. <br />I -s 1 <br />Authorized Person Signature Date <br />Maricela Rios-Faust Chief Operations Officer <br />Print Name of Authorized Person Title of Authorized Person <br />#! #ANi########aT#?f#Ma#######MN#NfM#M ###fl/Hiff# <br />The above information for #1 has been reviewed and verified with OC Partnership records. <br />Comments: er( -PG{ 41 oC , Q&2 fv'-'?-S <br />O <br />OA VLII? 4127f RIM 5. <br />A-mbor Ki l (i n9?c ?In l s' Pro"ec'(arxi&r- <br />Nameypnd Tie of OC/,Ponyrship Authorized Representative / <br />Signature of OC Partnership Mthorized Representative <br />6/21/2011 ?8