HomeMy WebLinkAboutAppendix Westridge Operations Handbook 10-01-2019 qcl
WARMING CENTER
A PROGRAM OF GHRDC
Westridge Operations
Handbook
OCTOBER 1, 2019
HUMAN RESOURCE DEVELOPMENT COUNCIL IX
32 SOUTH TRACY AVENUE HJDZEMAN, MONTANA 59715
Table of Contents
Tableof Contents.............................................................................................................................I
Introduction......................................................................................................................................3
ProgramEligibility..........................................................................................................................4
Nightly Operational Procedures ......................................................................................................4
Overnight Staff Hourly Schedule ................................................................................................4
NightlySchedule .........................................................................................................................4
IntakeGuidelines.........................................................................................................................4
General Guest Relations & Facility Operations..........................................................................5
GuestConfidentiality...................................................................................................................5
Nighttime Storage, Bedding, & Bunk Room Procedures............................................................6
Accommodating Disabled Persons, Minors, & Youth................................................................6
Capacity, Guests Leaving Premises, & Trespassing ...................................................................7
GuestParking and Shuttle ...........................................................................................................8
Smoke Breaks, TV & Quiet Hours..............................................................................................8
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General Emergency and Evacuation Protocols............................................................................9
Services, Donations, & Miscellaneous..........................................................................................I I
Services......................................................................................................................................I I
Donations...................................................................................................................................13
Service Animal Accommodations.............................................................................................13
Health& Safety.............................................................................................................................15
Behavior.....................................................................................................................................15
Drug, Alcohol, & Tobacco Use Policy......................................................................................15
InfectionControl........................................................................................................................16
Weapons ....................................................................................................................................16
Safety & Police Issues...............................................................................................................17
StaffNightly Checklist..............................................................................................................17
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2
Introduction
The Warming Center is located in Bozeman, Montana and operated by the Human Resource
Development Council, District IX, (HRDC IX) in partnership with the Greater Gallatin Homeless Action
Coalition (GGHAC). HRDC IX is a non-profit community action agency dedicated to helping people and
building a better community. GGHAC is a community network of concerned citizens and service
providers working together to actively prevent and end homelessness in the Greater Gallatin Area.
The Warming Center first opened in 2010 with the goal of providing a safe,warm, and dry place for
individuals experiencing homelessness to sleep at night during the winter months. The Warming Center
is a low-barrier shelter and welcomes all individuals and families who agree to follow the Warming
Center Participant Agreement.The Warming Center operates nightly on a seasonal basis.
The Westridge Drive Warming Center serves women and families experiencing homelessness. It is
located at:
3025 Westridge Drive
Bozeman, Montana 59715
The Warming Center may utilize additional locations as necessary in an effort to accommodate everyone
who seeks shelter.
Warming Center Outreach and Operations Manager:
Adam Poeschl
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warmingcenter@thehrdc.org
Additional services and information available at:
Human Resource Development Council, IX
32 South Tracy Avenue
Bozeman, Montana 59715
406-587-4486
We believe everyone deserves a warm,safe place to sleep.
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Program Eligibility
The Warming Center is a low-barrier emergency shelter.All individuals who are 17 years of age or older
or accompanied by a parent or guardian and who agree to the expectations in the Warming Center
Participant Agreement are welcome.
Nightly Operational Procedures
Overnight Staff Hourly Schedule
There must be at least one staff members and/or volunteers present at all times during Warming Center
operational hours.The center can only open when two staff/volunteers are present.
Nightly Schedule
6:30 PM Staff and volunteer briefing. Preparation for opening.
7:00 PM Bus departs HRDC for Westridge Warming Center.
7:00 PM Doors opened if two staff/volunteers are present. Guests arrive from HRDC,
staff conducts intake &check-in.
8:00 PM Monitored smoke break.Staff walkthrough. Fire watch sheet.
9:00 PM Monitored smoke break. Staff walkthrough. Fire watch sheet.
10:00 PM Monitored smoke break. Staff walkthrough. Fire watch sheet.Television and
lights turned off.
Volunteers depart.
11:00 PM Staff walkthrough. Fire watch sheet. End of check-in time. Mark bedding boxes.
12:00 PM Staff walkthrough. Fire watch sheet.
1:00 AM Shift change and debrief.Staff walkthrough. Fire watch sheet.
2:00 AM Staff walkthrough. Fire watch sheet.
3:00 AM Staff walkthrough. Fire watch sheet.
4:00 AM Staff walkthrough. Fire watch sheet.
5:00 AM Coffee is made. Morning smoke break. Staff walkthrough. Fire watch sheet.
6:00 AM Lights on. First wake-up announcement. Begin cleaning bunk rooms.
6:15 AM Second wake-up announcement.
6:30 AM Final wake-up announcement.
6:45 AM Shuttle bus arrives.
7:00 AM All guests out of building. Doors locked.
7:30 AM All lights off. Heaters turned down. Cleaning completed. Staff depart.
Intake Guidelines
Guests at the Westridge Warming Center will check in at HRDC's offices at 32 South Tracy from 6:00 pm
to 6:45 pm. Any guest vehicles will be parked at HRDC.At 7:00 pm, guests will be transported to the
Westridge Center from HRDC offices.Alternatively, guests may initially check in at the Industrial
Warming Center for their first evening, after which check in will occur at HRDC Main Offices. All new
participants must fill out a Warming Center Adult Registry(and Warming Center Registry:Children
under18 if accompanying children) with a staff person and sign a Participant Agreement(see Appendix
for all referenced documents. All returning participants must date and initial their Participant
Agreement every time they stay at the Westridge Warming Center. Women and family guests arriving
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after check in hours will spend their first evening at the Industrial Warming Center. Guests may not drive
directly to the Westridge Warming Center without prior permission.
All participants are asked for identification when signing their Participant Agreement. A copy of their ID
will be attached to their Participant Agreement. Lack of identification does not impact a participant's
eligibility to receive services.
General Guest Relations & Facility Operations
1. Discrimination against any guest based on race,gender, age, familial status, disability, ethnicity,
sexual orientation, gender identity, or gender expression is prohibited.
2. Do not stay consistently behind counters/desks. Interact with guests.
3. Treat all guests, staff, and volunteers with dignity and respect.
4. Upon request, provide a copy of the Request for Administrative Review Form (See Appendix)to
any guest,volunteer, or staff who requests one. Copies are located at the front desk.
5. Every guest should be requested to provide a photo identification. If they do not have an ID,
they can still be admitted; however,they must be directed to obtain identification, and the
reason they gave for not having an ID must be noted on their Participant Agreement.
6. Guests must understand and sign the Participant Agreement. Staff must go through every line
of the Participant Agreement for all new guests.
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8. Rules and procedures should be posted.
9. Guests may not leave food in the shelter storage. Everything perishable must be thrown away
every morning.
10. Females and families will have separate bunk rooms.
11. All individuals checking in must be 17 and older. 17-year-olds are required to provide their
parents'or guardians' information so that staff can contact parents or guardians regarding the
guest's whereabouts. If they are unable to provide that information, staff must contact the
Bozeman Police Department and inform them that the individual is staying at the Warming
Center.
12. The refrigerator is for staff and volunteer use only.There are NO EXCEPTIONS.
13. Staff must contact the Outreach and Operations Manager if they feel like an exception to the
Operations Manual is warranted.
Guest Confidentiality
Staff and volunteers are to maintain client confidentiality at all times. When a phone call is received or if
an individual enters the Warming Center looking for another person, use the following verbiage, "I
cannot confirm or deny if that person is here; however, I can take a message, and if the individual is
here, I can deliver the message. If the individual is not here, I will throw the message away."This phrase
is located next to the Warming Center phone.
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Exception: We cooperate with law enforcement officers.You may ask for a badge number to confirm. If
there are any questions regarding client confidentiality, staff should contact the Outreach and
Operations Manager.
Nighttime Storage, Bedding, & Bunk Room Procedures
Nighttime Storage
In order to provide a safe and secure environment,guests are asked to protect their belongings in
overnight bins/bedding boxes,to be stored behind desk.
• To ensure that the bins are secure, only the designated volunteer or staff member should have
access to and assist.
• In order to provide a safe, secure, and sanitary environment in the bunk rooms, backpacks,
purses,jackets, hygiene supplies, toiletry bags, and food must be placed in the bins.
• No outside beverages are permitted in the Warming Center facility unless they are stored in a
tub in common area behind the desk.Alcoholic beverages are not allowed on the Warming
Center premises.
Bunk Rooms
Westridge assigns bunks and rooms upon check-in.
• Families with dependent children are assigned to a family bunk room.
• The only items that are allowed in the bunk rooms include silenced cell phones, wallets,
provided bedding, and medically necessary equipment (CPAP machines, inhalers, insulin
monitors,walkers, wheelchairs, etc.).
Bedding
In order to maintain a clean and hospitable environment,guests will receive fresh bedding after every
fourth use or as deemed necessary by staff. Guests are provided bedding and are not allowed to utilize
their own.
• Guests will receive a blanket, sheet, and pillow in a pillowcase in a bedding box. Extra blankets
may be provided upon request.
• After four tally marks,the contents of the bedding box should be laundered. Each clean bedding
box should have one sheet, one blanket, and one pillow in a pillowcase.
• Guests should receive fresh bedding after four tally marks or at the discretion of staff as
necessary.
Accommodating Disabled Persons, Minors, & Youth
Reasonable Accommodations for Persons with Disability
Reasonable Accommodations are provided to guests who have a completed a Verification of Status as a
Person with a Disability Form (See Appendix)or on a two-week temporary basis until documentation
can be acquired. Medical verification needs to indicate an expected duration of the disability as well
specifics about the accommodations or modifications.Accommodations, set by a medical professional,
are intended to offset the limitations of major life activities.
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• Guests may request a reasonable accommodation for a bottom bunk hold.Approval will be
based on medical verification that the guest is an individual with a disability who is unable to
utilize a top bunk.
• When a guest requests a reasonable accommodation, if deemed temporarily reasonable by lead
staff, the accommodation may be granted and honored for two weeks,giving the guest time to
obtain required medical documentation that verifies the status of a person with a disability.At
the time of the request, staff assists the guest in completing Request for Reasonable
Accommodation Form (See Appendix).The guest is then given a Verification of Status as a
Person with a Disability Form. It is the responsibility of the guest to get this form completed by
a medical professional and to turn the completed form into Warming Center Staff two weeks
from the date of the request.
o If the lead staff has a question regarding whether or not a guest's request is temporarily
reasonable, the Warming Center Outreach and Operations Manager should be
contacted.
o Both short-term and long-term reasonable accommodations should be added to the
Guest Progress Tracker located in the Seasonal Google Drive Folder,WC Season 1X.
o A list of bottom bunk holds(See Appendix) will be maintained at the bunk assignment
counter.The number of bottom bunks to be reserved, corresponding with the number
of reasonable accommodation bunk holds plus two bunks for each bunkroom should be
highlighted on The Guest Bunk. Highlighted bottom bunks indicate beds that are
reserved for those who have reasonable accommodations. If a guest has not been
present for seven consecutive nights, a bunk will no longer be reserved.
Laws Regarding Minors and Youth
The Warming Center is a seasonal homeless shelter for individuals age seventeen (17) and older unless
accompanied by a parent or guardian.
Individuals That Are 17 Years Old
• The Warming Center is required by law to attempt to contact an unaccompanied 17-year-old's
parent or legal guardian for permission to stay at the Warming Center.
• If Warming Center staff is unable to contact the parent or legal guardian, staff must contact the
Bozeman Police Department to notify them that a 17-year-old is present at the Warming Center.
After notification, the 17-year-old may participate in nightly shelter services.
Individuals Under 17 Year Old without Parent or Guardian
• The Warming Center is unable to shelter those under the age of 17 unless they are under the
care of a parent or guardian.
• If the Warming Center is unable to contact a parent or guardian to pick up the individual, the
Bozeman Police Department must be contacted to pick up the individual.
Capacity, Guests Leaving Premises, &Trespassing
Capacity
Staff is to call the Outreach and Operations Manager when 36 guests have checked in.
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Guests Leaving Premises and Return
In order to continue to foster an environment where individuals can expect a warm and safe place to
sleep, those who choose to leave the property after checking in will not be able to return until the
following night.
• If a staff or volunteer witness a guest leaving the property,they will need to inform the guest
that they are not permitted to return until the following night.
Trespassing and Vehicles on Property
No loitering or trespassing is allowed outside of the Warming Center in order to protect guest
confidentiality and safety. On-site parking is for volunteers and staff only.Guest vehicles are not allowed
at Westridge Warming Center, and must be parked at the HRDC Main Offices unless an employment
exemption is provided.
If a guest is asked to leave the premises and refuses to do so, contact Bozeman Police Department and
inform them that"an individual has been asked to leave but refuses to do so. Assistance in removing the
individual from the property would be appreciated." If asked,we do not wish to press charges.
Guest Parking and Shuttle
Guest vehicles are not allowed at the Westridge location. Only volunteer and staff vehicles are allowed
during Warming Center operational hours.
Guests of the Westridge location can park at the HRDC Main office at 32 S.Tracy.A shuttle will pick up
from Fork and Spoon at 7:OOpm then HRDC 7:15pm. A secondary shuttle will pick up again at the 32 S.
Tracy Main office at 8:30pm.
Guest vehicles are not to be left on the HRDC main office property outside of the Warming Center
operation hours from 7 PM to 7 AM.Vehicles left on the property for more than 72 hours without
discussing the circumstances with HRDC may result in towing at the owner's expense.
Guests will be provided with transportation to HRDC's main offices at 7:00 am each morning.
Smoke Breaks, TV & Quiet Hours
Smoke Breaks
Given the nature of operating a seasonal homeless shelter with solely evening to morning hours and the
demographic served,there is a designated smoking section with designated smoke breaks.
• Staff or volunteer monitored smoke breaks will occur for fifteen minutes at 8:00 PM, 9:00 PM,
and 10:00 PM. An additional smoke break at 6:00 AM does not require supervision because it
coincides with the first wake up announcement.
TV and Quiet Hours
In the interest of providing a quiet atmosphere for guests, there are quiet hours from 10:00 PM to 6:00
AM.
• The television in the common room is for communal use. PG-13 rated films and under are
permitted; however, if a guest, staff, or volunteer determines a film is inappropriate regardless
of film rating, it should be removed. While the TV is in use,the volume should not exceed 30.
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• Lights in the bunk rooms and television in the common room will be turned off promptly at
10:00 PM.
• After 10:00 PM, cell phones and alarms must be turned off or placed on silent.
o If a guest needs a wake-up call earlier than 6:00 AM,they will need to advise staff.
o Scheduled wake-up calls should be written on the white board located in the common
area.
Emergency Protocols
General Emergency and Evacuation Protocols
In the event of an emergency,your first priority is to ensure the safety of the guests, and your second
priority is to minimize or prevent any further damage. During emergency situations, the lead staff
person will serve as the Evacuation Coordinator; however, all staff are responsible for ensuring that all
guests and volunteers are following proper evacuation procedures while ensuring their own personal
safety.
• There are posted exit routes located within the building. The Warming Center Outreach and
Operations Manager coordinates with the Bozeman Fire Department to conduct fire and
evacuation drills on an annual basis.
Evacuation of Persons with Disabilities
Persons with disabilities, including those with mobility, hearing, or visual impairments, may need
assistance during an evacuation.You need to be aware of guests that may have disabilities and ensure
that they receive assistance during evacuation if needed. When asking a person if they need assistance,
ask what type of assistance they need.
Evacuation of Persons with Hearing Impairments
For people with hearing impairments,gain the person's attention by gesturing or turning the lights on
and off. If needed, write a note indicating an evacuation is necessary and provide directions.
Evacuation of Persons with Visual Impairments
Announce that an evacuation is necessary and offer your arm for guidance.Tell the person where you
are going and about any obstacles that you encounter. When you reach the evacuation point, ask if
further help is needed.
Evacuation of Persons with Mobility Impairments
If there is no evidence of fire, smoke, or other emergency in the area of occupancy, have the guest
remain where they are. Upon arrival, fire department personnel will determine the cause of emergency,
and if there is an actual emergency, people with mobility impairments will be evacuated by fire
department personnel at that time.
• If there is evidence of fire, smoke, or other emergency in the area of occupancy, evacuate all
people from the area to the evacuation point or to another area not affected by the emergency
situation.
Fire or Explosion Emergency Protocols
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In case of a fire,call 911 and evacuate people from the building. Once guests have exited the building,
the group should get as far away from the building as safely possible by walking across the street (East
side Westridge); this will enable the Bozeman Fire Department to access the building without
interference.
• When the building alarm sounds or an evacuation signal is given, do the following:
o If you have been trained and it is safe to do so,you may attempt to extinguish a fire with
a portable fire extinguisher. If you have not been trained to use a fire extinguisher, you
must evacuate the area.
o Staff should ensure that all persons remain calm,exit the building, and take jackets or
other clothing needed for protection from the weather.
o Staff should close but not lock all windows and doors to confine the fire and ensure
lights are left on.
o If you are away from your room when the alarm sounds, you should exit the building
immediately and not return to the room.
o Everyone should make an effort to notify others in the area of the alarm if they did not
hear it.
o Staff must ensure that guests vacate the building.
o Everyone should walk to the nearest safe exit route without opening doors that feel hot
to the touch or attempting to travel through smoke-filled or hazardous areas.
o Everyone should report to the designated evacuation point and wait at the evacuation
point for directions. No one should go back inside even if someone is missing. Going
back into a burning or unstable building can create a second victim.
• If you become trapped due to smoke, heat, flames, or some other hazard, do the following:
o Leave the room door closed and seal door cracks and ventilation grills with wet towels
or clothing if possible.
o Use the telephone to call 911 and let them know your location. Attempt to hang an
article of clothing in or out the window that is large enough for emergency responders
to see.
o If smoke enters the room and there is a window that opens, open the window to let it
out. Close the window if outside smoke enters.Tie a piece of clothing around your nose
and mouth to filter out smoke if needed.
o Stay close to the floor where the air is cleaner.
Medical Emergency Protocols
Call 911 or have someone call for you.
• If it is possible and safe to do so, do the following:
o Protect the victim from further injury by removing any persistent threat to the victim.
Do not move the victim unnecessarily. Do not delay in obtaining trained medical
assistance.
o Provide first aid until help arrives if you have appropriate training and equipment.
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o Send someone outside to escort emergency responders to the appropriate location.
Personal Safety Emergency Protocols
If guests display emotional outbursts, aggressive language, or threats of violence and staff,volunteers,
or other guests feel they are a treat to others of themselves, staff should:
• Remove other guests and self from immediate area to a room or area that is safe.
• Call the police and inform them of the situation.
• If possible, de-escalate individual while remaining safe and calm.
Protocols for After the Emergency
When a fire or other emergency has occurred and after you have called the authorities and accounted
for your guests, call the Outreach and Operations Manager to report the incident. Be prepared to give as
many details as possible including date, time of incident, information about witnesses,the name of the
responding officer, and if there are any injuries;this information is necessary in order to report to the
insurance company and provide for the safety of guests. Your supervisor will need to know if it is safe for
guests to return.
• Do not give any statements to reporters or the public.The Outreach and Operations Manager
will coordinate any necessary public information.
• Take steps to secure the building from any further damage. It may be necessary to board up
windows or turn off water.
• Follow any instructions given by emergency responders and your supervisor.
Services, Donations, & Miscellaneous
Services
Day Storage
Carrying all of one's personal belongings can create a barrier to accessing services, obtaining stable
income and employment, and hinder presentation when attempting to address said barriers.A day
storage program is available at the Warming Center for individuals that are sleeping outside, in a place
not meant for human habitation, or in an emergency shelter. Westridge's day storage is for Westridge
guests exclusively. An individual using the day storage is not required to use the Warming Center;
however, every individual using the day storage should be encouraged to connect with services at HRDC
including Service Navigation, Warming Center Evening Hours, etc.
• Guests will have the opportunity to sign out a day storage tote for a maximum of 30 days when
space is limited. Guests can register during evening Warming Center hours.
o Guests can only register for themselves and must provide a means of contact for
belonging turnover at the end of 30 days or for waiting list purposes.
o Guests should provide a photo identification to obtain a storage tote. A copy of the ID
should be stapled to the contract paperwork. If they do not have an ID, a picture of the
guest may be taken when storage is assigned.The picture should be stapled to the
contract paperwork.
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o After 30 days,the tote will be assigned to the next person on the wait list.An extension
may be given on a case by case basis under the direction of the Outreach and
Operations Manager.
• The Warming Center, HRDC, staff,and volunteers are not responsible for lost or stolen items.
• When registering for a daytime storage tote, guests will need to sign and date the Day Storage
Contract(See Appendix). Prohibited items on the contract include:
o Weapons of Any Kind
o Alcohol, Drugs, or Other Illicit Substances Including Medical Marijuana
o Plants or Animals
o Perishable Items
o Lighters or Lighter Fluid
o Electronics that Are Turned On
o Other Person's Belongings
• While in the common area,guests will be provided a tote where they can place their belongings.
o The tote should be labeled with the guest's name and date of drop off.
o Once the guest has filled the tote, staff should support the guest in placing the storage
tote in the storage closet.
• The registered guest maintains full responsibility for the belongings in their storage tote.
o The registered guest is the only person who can access the storage bin.
o The Warming Center, HRDC, staff, and volunteers are not responsible for lost or stolen
items.
• Items will be left in the storage bin for one week following the thirty day exit of service date.
o Staff must attempt to contact the guest at least three times in one week.
o If guests do not respond within one week,the items should be donated.
o If a guest has been asked to leave the Warming Center due to violations of contract,the
same measures should be taken in an attempt to arrange for the guest to pick up his or
her belongings.
• When a guest has reached the top of the waiting list, he or she will have one week to respond to
staff outreach.
o Staff must attempt to contact the guest at least three times in one week.
o If guests do not respond within one week,the next person on the waiting list will be
contacted.
Mail
Given the seasonal nature of the Warming Center,guests cannot use the Warming Center address for
the purposes of receiving mail. In order to assist the Warming Center guests with housing, income,or
other financial related needs, a post office box is available for temporary use at the HRDC Bozeman
office.
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• Warming Center and shower guests with current service enrollments may register to use the
HRDC post office box at the HRDC main office with a photo identification.
o Once it has been confirmed that a guest is a Housing First, Warming Center, or shower
customer, HRDC staff will assist the guest(s) in completing the HRDC Post Office Box
Agreement Form (See Appendix).
• Mail sent to the Warming Center or HRDC office physical address will not be guaranteed and
may be returned to the sender without delivery to the recipient.
Sock Exchange
Knowing that someone experiencing homelessness typically utilizes their feet as their primary form of
transportation and that winter months result in a higher risk for frostbite and other foot issues, a sock
exchange project has been implemented at the Warming Center.
• A 10-gallon white bucket, located inside or just outside the main bathroom door, should be filled
approximately half to three-quarters full with warm water with one-half of a capful of bleach.The
bucket should be placed outside of the main bathroom.
o A staff member or volunteer should make a call for sock exchange after the 8:00 PM
smoking break.
o A staff member or volunteer should open the supply closet and allow guests to enter to
choose a pair of clean socks.A staff member or volunteer must stay in the closet when
guests are present.
o Guests should place their dirty socks into the bucket of bleach water.
o After all guests have exchanged socks, the supply closet door should be locked.
• Socks should be washed in a timely manner throughout the night or during the morning shower
service as the washer becomes available.The bleach water should be drained into the bathtub in
the basement bathroom before they are placed in the washer.
Services We Do Not Provide
• The Warming Center will not accept any food donations from the public that has not been either
store bought or prepared in a professional kitchen. Guests may share their food if they choose to.
Any parties wanting assistance with obtaining food should contact Gallatin Valley Food Bank.
• The Warming Center is not an emergency clothing provider. Many local agencies, including Salvation
Army and Sacks, exist to provide clothing and supplies to homeless persons, and staff and volunteers
should direct guests to the aforementioned organizations.
Donations
Service Animal Accommodations
Due to the legal liability and for the safety of guests, pets are not allowed at the Warming Center. If a
guest has a service animal it will be accommodated. A service animal is defined as any guide dog, signal
dogs, or other animal individually trained to provide assistance to an individual with a disability. Staff at
the Warming Center reserve the right to require inspection of a dog license from the City of Bozeman
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for dogs over the age of six months and to inquire about whether the animal is a service animal required
because of disability.
• Although an animal that solely provides comfort or emotional support is not classified as a
service animal by the ADA, a guest that arrives with a letter or prescription from a medical
provider stating that there is a medical or mental health need for the individual to have the
animal with them will be allowed to keep their animal with them on the premises.
• Animals must be harnessed, leashed, or tethered unless a device interferes with the service
animal's work or the individual's disability prevents use of a device to restrain the animal. In the
event that the animal must remain unrestrained,the guest must maintain control of the animal
through voice, signal, or other effective controls.
• Per the ADA, you may ask only the following two questions:
1) Is the animal a service animal required because of disability?
• If the guest answers"no," the animal is not allowed in the building.
• If the guest answers"yes,"then you can ask the following:
2) What has the animal been trained to do?
• An animal is considered a service animal when it has been trained to perform work or a
task that is directly related to the person's disability. A service animal can be a dog or a
miniature horse; however, service animals are not pets.
• The law states that we cannot ask what a person's disability is and that we cannot ask
for verification of a disability nor can we ask for verification of a service animal.
• When a guest answers question two with an appropriate answer, please give the guest a
copy of Service Animal Licensing within the City of Bozeman Requirements and Animal
Behavior Expectations(See Appendix).
o If the service animal is licensed within the city, make a copy of the licensing
paperwork of the dog tag that says"Dog License City of Bozeman." Ensure that
you check the expiration date of the licensure.Staple the copy of the paperwork
or tag with the Participant Agreement.
o If the guest cannot show proof that the animal is licensed, the animal may not
be inside the Warming Center. If the guest expressed that they have financial
barriers to obtaining a license for their animal, ask them to call the Outreach
and Operations Manager.
o Whenever in doubt, be the least restrictive at the time and call the Warming
Center Outreach and Operations Manager.
o All encounters with animals should be documented in the Warming Center staff
notes.
• Guests will need to advise staff if there is a pet in their vehicle. Blankets can be provided
and monitored checks will be permitted in fifteen-minute intervals as outlined in the
nightly schedule.
• Service animals are to be treated as a reasonable accommodation and staff may assist
guests in taking the service animal or approved companion animal outside when needed
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prior to 10:00 PM; however, the Warming Center is not responsible for the care of the
guest's service animal during his or her stay, and the care and supervision of the animal
is solely the responsibility of the guest.The Warming Center may charge a guest if a
service animal causes damage to the Warming Center.
o The service animal will be kept in the designated crate next to the guest's bunk
during quiet hours.The guest should clean the crate in the morning after use.
o If the animal is not behaving in accordance with the policies and procedures and
disrupts the fundamental purpose of the Warming Center to provide a safe,
secure, warm, and quiet place for guests to sleep, the guest will be asked to
place the animal inside his or her vehicle. If a vehicle does not exist,the guest
and his or her animal will be asked to leave.The guest may return to stay in the
Warming Center without the service or companion animal.
Health & Safety
Behavior
• The Warming Center exists to provide a safe,secure, and warm environment for individuals and
families experience homelessness.As such, every person (staff,volunteers, and guests) is to be
treated with utmost respect and dignity.
• Inappropriate behavior includes but is not limited to racial or sexual comments and conduct,
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behavior, etc. See Appendix for specific behavior guidelines and procedures for inappropriate
behavior.
• Staff need to document guests who have been asked to leave due to non-compliance with the
Participant Agreement in the "Guest Progress Tracker" located in Appendix and in the Warming
Center staff notes.
• In order to preserve the safe, secure, and quiet conditions of the facility, the Warming Center
reserves the right to require guests with a history of inappropriate behavior to leave the
premises (see Behavioral Expectation Policy for Customers in Appendix).The Warming Center is
not responsible for the health and safety of a guest once they have been asked to leave the
premises.
• In the event that extreme temperatures (below 0°F),the Warming Center staff may inform the
Bozeman Police Department that a guest has been asked to leave and cannot return until [date].
Drug, Alcohol, & Tobacco Use Policy
The Warming Center upholds an environment which is free from the use, possession, or distribution of
any mind altering substance, illicit drugs, and alcohol by its guests, staff, or volunteers.This policy will be
maintained within a reasonable expectation in consideration of the population we serve.
• Prescription and over-the-counter medications will not be held or administered by Warming
Center staff or volunteers.All medications are to be taken as prescribed or suggested. Sharing of
prescription medications is not allowed.
15
• Both paid and volunteer staff will present for work in a sober state free from any signs of
obvious alcohol or drug use.Staff and volunteers are not allowed to bring alcohol or drugs into
the facility.
• The use of tobacco products (smokeless tobacco, cigarettes, electronic cigarettes, etc.) is
prohibited within the facility. Given the nature of operating a seasonal homeless shelter with
solely evening to morning hours and the demographic served, 15-minute monitored smoke
breaks in the designated smoking area will be offered in the evenings during the times outlined
in the nightly schedule.
If a guest demonstrates an inability to control regular bodily functions, difficulty walking and/or standing
on their own, or difficulty speaking in a clear and coherent manner(i.e. slurred speech, delayed
response, etc.), see Behavioral Expectation Policy for Customers for the appropriate response. If guest
is unable to adhere to the Participant Agreement due to impairment as a result of possible substance
use,follow standard protocols:
• IS GUEST DANGER TO HIMSELF OR HERSELF?Contact dispatch at(406) 582-2000 or dial 911
when the guest is a danger to himself or herself and request AMR services. If a guest refuses
medical attention,ensure that they have signed a consent form indicating their refusal. If
possible, staff should make a copy of the refusal form.
• IS GUEST DANGER TO OTHERS OR VIOLATING BEHAVIORAL GUIDELINES?Contact dispatch at
(406) 582-2000 or dial 911 when there has been a behavior breach and/or the safety of others is
a concern and request an officer.
Infection Control
Staff will take every precaution to prevent the spread of infectious diseases at the shelter.Any person
unable to control bodily functions may be, at the discretion of the Warming Center staff,transported by
the local EMS to a hospital. Guests are asked to wear socks and shoes at all times with the exception of
in the showers during shower operational hours.
Latex or latex-type gloves will be available for all staff and volunteers to use as they see fit. Hands must
be washed after bathroom usage. Hand sanitizer will be provided at the front desk.Any bodily fluids or
other potentially contaminated matter must be immediately cleaned up by a volunteer or staff member
wearing latex or latex-type gloves and using a commercial disinfectant cleaning product. Disinfectant
should be used when appropriate. A sharps container should be posted.The sharps container is located
at the front desk.
Weapons
To protect the safety and security of all who utilize the Warming Center,the Warming Center is a
weapon free zone.Absolutely no firearms are allowed on the property which includes guest vehicles
parked in the parking lot.Any other weapons including but not limited to knives, mace, bear spray,
swords, razors,throwing stars, nun chucks, metal knuckles, etc. must be stored by a staff member in a
labeled manila envelope in a secured and locked location; weapons must be returned to guests upon
guest departure in the morning. Signage will be posted throughout the Warming Center to reflect this
policy. See Behavior Expectation Policy for Customers for specific behavior guidelines and procedures to
follow in the event that this policy is violated.
16
Safety & Police Issues
1) If you feel threatened or unsafe or see a situation escalating, do not hesitate to call 911.
If a guest is being unruly or presents a danger to himself or herself, other guest,
volunteers, or staff,the guest should be told to leave. If the guest refuses to leave,
contact local police for assistance in removing the guest.
2) Do not attempt to break up a fight; call 911.
3) Guests are provided warmth and shelter on the terms of the Participant Agreement. If a
guest cannot follow the stipulations of the Participant Agreement, he or she should be
told to leave.
4) If a serious health or safety issue arises with a guest, notify the Outreach and Operations
Manager.
5) If a guest is sick, intoxicated, or under the influence of drugs and there is a concern for
his or her safety or the safety of others, call 911 and allow EMS to assess the individual.
Warming Center Staff and Bozeman Police Department Shared Language
"My name is . I am a staff member of the Westridge Warming Center located at 3025
Westridge Drive. My phone number is 406-585-4896(to be updated when phone line is placed in
service).
• (Guest name) has been asked to leave and is unwilling to do so. I would like an officer to support
the guest --t� - ----1---
LIIC�'UC�L In ICtlVlll� LIIC �.JI CIIII�C�.
• Call BPD back if the guest leaves before the officer arrives.
• 1 am needing to ask a guest to leave the Warming Center. I have safety concerns and would like
to request an officer to support and standby while I communicate this to the guest that he/she
will need to leave.
• I have concerns about a guest. I am requesting medical assistance because (guest name) has
(describe medical concern).
• (Guest name) has been (disruptive, disorderly,violent, aggressive, threatening, destructive of
property, etc.)This has gone beyond just needing support. I need (guest name)to leave, and I
need to press charges.
Staff Nightly Checklist
Opening
6:30pm o Get key, close key box and scramble code, enter the building and let the door lock behind
you.
o Turn on common room, bunk room, and shower area lights.
o Walk through entire building to check that exterior doors and windows are closed,
premise is secure and clean.
o Check bathrooms for soap,toilet paper, paper towels. Fill and set out sock exchange
bucket.
17
o Turn up heaters to 65 degrees.
o Turn on computer and read all Staff Notes and Guest Progress Tracker written since your
last shift.
o Move PA box and weapon locker to Station 1, update and set up Bunk Sheet at Station 2,
make sure there are bedding tags and markers at Station 3.
o Staff and volunteer briefing.Assign volunteer stations and orient new volunteers if
needed.
Intake
7:OOpm o Unlock front door at 7:00.
o New guests complete WC Registry with staff at front desk.
o All guests initial and date Participant Agreement as soon as they arrive.
o Record all bunk& locker assignments on Guest Bunk& Locker Registry Form.
o Begin first loads of guest laundry.
o First smoke break at 8:OOpm and every hour on the hour after that.
o Building walkthroughs hourly or more.
Overnight
10:OOpm o Quiet hours begin. Common room and bunk room lights out,TV off.
11:OOpm o Turn off open sign, lock front door. Returning guests may no longer check in.
o Lead staff enter new guest intakes and attendance services into Caseworthy, update
Staff Notes and Progress Tracker.
o Start pulling expired bedding boxes.
o Begin washing bedding if it has not been started yet.
1:OOam o Shift change. Evening staff updates morning staff on current guests, incidents, and
current status of cleaning, laundry, and data entry.
Morning
S:OOam o Front door is unlocked. Coffee is made. Guests may come and go as they please.
6:OOam o Lights on in bunk rooms and common room.
o First wakeup call. Additional wakeup calls every 15 minutes.
o All bunks wiped down with bleach spray bottle.
o Bunks rooms swept and mopped or vacuumed.
o Any remaining expired bedding boxes are pulled and washed.
Closing
7:OOam o All guests have left the building. Front door is locked.
o Final additions to Staff Notes and Progress Tracker are made.
18
o Common room, hallways, and bathrooms are swept and mopped.
o Toilets, sinks, mirrors, and floors in bathrooms cleaned. Supplies replaced as needed.
o Trash taken to dumpster.Call for trash pickup if needed.
o Bunk rooms and common room checked for forgotten belongings. Clothing placed in
forgotten items box and valuables in locking lost and found drawer.
o Common room and snack area organized.
o Heaters turned down to 60 degrees.
o Building inspected and ready to open again that night.
o All lights are turned off.
o Exterior doors are locked.
o Key is placed back in key box. Key box is locked and code scrambled.
19
D
0
WARMING CENTER
A PROGRAM OF QwHRDC
Appendix
O Warming Center Adult Registry
C7 ❑
❑ o Today's Date:
WARMING CENTER How many are in your household?
FIRST NAME MIDDLE NAME LAST NAME DATE OF SOCIAL SECURITY
BIRTH #
Nickname or Preferred Name:
Mailing Address:
Phone number: Email:
How did you hear about the Warming Center?
ENDER RACE (Check all that apply) ETHNICITY
Female American Indian or Alaska Native - Non-Hispanic/Non-Latino
Male Asian Hispanic/Latino
Transgender male to female Black or African American Do not Know
Transgender female to male Native Hawaiian or Other Pacific Islander Refuse
Other White
Do not know Do not know
Refuse Refuse
MILITARY SERVICE
Have you served in the military? Yes No Do not know Refuse
EMPLOYMENT/INCOME INFORMATION
Are you employed? Yes No Employer: Date Started:
If YES
Are you employed: Full-Time Part-Time Seasonal
Is your hourly wage: Minimum Wage Range($8.05-$11.22) Living Wage Range($11.23+)
Does your employer provide benefits? Yes INo
If NO,are you: Looking for Work Not looking for work
Retired Do not know
Disabled/Unable to Work Refuse
Do you have income from any source? Yes No
Source of Income Gross Monthly Source of Income Gross Monthly
(Employment,Unemployment,SSI,Child Support,TANF,etc) Amount (Employment,Unemployment,SSI,Child Support,TANF,etc) Amount
$ $
$ $
Warming Center Adult Registry
Do you have non-cash benefits from any source! Yes No Do not know Refuse
Check the box for each non-cash benefit source:
Special Supplemental Nutrition Program(SNAP)
Special Supplemental Nutrition Program for Women, Infants, and Children(WIC)
TANF Child Care services(Childcare Connections Best Beginning's Scholarship)
TANF transportation services
Other TANF-Funded Services
Section 8, Public Housing, or other rental assistance
Temporary rental assistance. If yes, specify source:
Other source:
HEALTH INSURANCE
Do you have health insurance? Yes No Do not know Refuse
Check the box for each health care source:
Medicaid
Medicare
State Children's Health Insurance Program(i.e. Healthy Montana Kids)
Veteran's Administration(VA)Medical Services
Employer-Provided Health Insurance
Health insurance obtained through COBRA
Private Pay Health Insurance
State Health Insurance for Adults
DISABLING CONDITIONS
LV •VN MAY V \A111 \.L1 U�.4V 111.1Vv. W l\V ✓v��v.��nv v• .\V.NJV
If NO.skip this section
Do you have any of these disabilities? If YES,are you currently If YES,Do you expect this to be of long duration,
receiving services? impede independence,and be improved by more
suitable housing conditions?
Substance Abuse Yes Yes Yes
Alcohol No No No
Drugs Do not know Do not know Do not know
Both Refuse Refuse Refuse
Mental Health Yes Yes Yes
No No No
Do not know Do not know Do not know
Refuse Refuse Refuse
Developmental Yes Yes Yes
Disability No No No
Do not know Do not know Do not know
Refuse Refuse Refuse
Chronic Health Yes Yes Yes
Condition No No No
Do not know Do not know Do not know
Refuse Refuse Refuse
HIV or AIDS Yes Yes Yes
No No No
Do not know Do not know Do not know
Refuse Refuse Refuse
Physical Yes Yes Yes
Disability No No No
Do not know Do not know Do not know
Refuse Refuse Refuse
Warming Center Adult Registry
LENGTH OF TIME OF HOMELESSNESS
NOTE: Staying with friends or family,couch surfing,or in a hotel paid without an emergency voucher is not defined as homeless for
the following questions:
i
1) Where did you stay last night?
2) If you have been staying on the streets, in an emergency shelter,or any place not meant for habitation,what is the approximate
date you started sleeping there?
Date
3) How many periods of time have you been homeless in the last 3 years (including this time)?
- Never in the last 3 years 1 (only this time) 2 3 4+ Do not know Refuse
4) What is the total number of months you have been homeless in the past 3 years? (any single day or part of a month spent
homeless should be counted as one month)
0 1 - 2 3 - 4 5 6 _ 7 8 9 10 11
12+ Do not know Refuse
DOMESTIC VIOLENCE
Are you a domestic violence victim/survivor? Yes No Do not know Refuse
Are you currently fleeing domestic violence? Yes No Do not know Refuse
If YES, when did the last experience occur?
0-3 Months 3-6 Months 6-12 Months One year ago or more Do not know
MARITAL STATUS
Single Domestic partner Married Separated Divorced Widowed
FAMILY TYPE
Single person Single parent—mate Single parent—female
Two parent household Two or more adults(no children) Extended family
Mixed adults with children Grandparent(s)raising child(ren) Other
EDUCATION
Are you currently in school? Yes No
What is the highest grade you have achieved?
No schooling completed 12th grade, no diploma Cert. of Training or Skilled Artisan
Nursery school to 4th grade High school diploma Doctorate Degree
5th or 6th grade GED Masters Degree
7th or 8th grade Some College Other Graduate/Professional Degree
9th grade Associates Degree Do not know
1 Oth grade Bachelors Degree Refuse
11 th grade
Warming Center Ad tilt Registry
TRANSPORTATION
No vehicle or regular access to public transportation Have vehicle,but no insurance and needs repairs
Have vehicle,but no valid driver's license Have vehicle,with insurance,but needs repairs
Live within 10 blocks from bus stop/or use Galavan Have vehicle, with insurance and needs no repairs
CHILDCARE
Not applicable(All children are over age 12 or there are no Family/friend provides childcare
children in the household) Enrolled in licensed subsidized childcare—limited choice
Enrolled in unlicensed childcare Enrolled in licensed subsidized childcare—of own choice
Not enrolled in any childcare — Enrolled in licensed non-subsidized childcare—of own choice
On childcarc waiting list
How long have you lived in the Bozeman area?
Where did you live before?
Are you in need of any other services?Please explain how we can help you:
I understand that this agency participates in data collection on the Homeless Management Information System (HMIS) in my
community,and that my Personal Protected Information (PPI),which includes Personal Health Information,Non-public Personal
Information, and Personally Identifiable Information will be entered into HMIS,a secure online database. HMIS is used by homeless
service providers to store personal information,track program and client outcomes, and connect me with services.
I hereby certify that all information provided is true and accurate to the best of my knowledge.
Guest Signature: Date:
Warming Center Registry: Children under 18
*To be completed by Parent or Guardian
C� ID
° _ Today's Date:
WARMING CENTER Head of Household's Name:
Child's Relationship to the Head of Household:
FIRST NAME MIDDLE NAME LAST NAME DATE OF SOCIAL SECURITY
BIRTH #
ENDER RACE(Check all that apply) ETHNICITY
Female American Indian or Alaska Native Non-Hispanic/Non-Latino
Male Asian Hispanic/Latino
Transgender male to female Black or African American Do not Know
Transgender female to male Native Hawaiian or Other Pacific Islander Refuse
Other White
Do not know Do not know
Refuse Refuse
DISABLING CONDITIONS
Do you have any disabilities? IN Yes o No 0 Do not know 0 Refuse
If NO.skip this section
Do you have any of these disabilities? If YES,are you currently If YES,Do you expect this to be of long duration,
receiving services? impede independence,and be improved by more
suitable housing conditions?
Substance Abuse M Yes 0 Yes M Yes
M Alcohol 0 No M No 0 No
0 Drugs M Do not know 0 Do not know 0 Do not know
IN Both M Refuse 17 Refuse 0 Refuse
Mental Health 0 Yes 17 Yes Ed Yes
0 No IN No IN No
0 Do not know 0 Do not know 0 Do not know
0 Refuse 0 Refuse 0 Refuse
Developmental 0 Yes 0 Yes 0 Yes
Disability IN No 0 No 0 No
I7 Do not know IN Do not know 0 Do not know
0 Refuse IN Refuse 0 Refuse
Chronic Health 0 Yes M Yes [a Yes
Condition 0 No IN No IN No
0 Do not know 0 Do not know 0 Do not know
0 Refuse M Refuse I7 Refuse
HIV or AIDS 0 Yes 0 Yes M Yes
0 No 0 No 0 No
IN Do not know 0 Do not know 0 Do not know
0 Refuse 0 Refuse 0 Refuse
Physical Disability M Yes IN Yes 0 Yes
0 No M No IN No
0 Do not know M Do not know 0 Do not know
0 Refuse 0 Refuse M Refuse
Warming Center Registry: Children under 18
*To be completed by Parent or Guardian
LENGTH OF TIME OF HOMELESSNESS
NOTE:Staying with friends or family,couch surfing,or in a hotel paid without an emergency voucher is not defined as homeless for
the following questions:
1) Where did you stay last night?
2) If you have been staying on the streets,in an emergency shelter,or any place not meant for habitation,what is the approximate
date you started sleeping there?
Date
3) How many periods of time have you been homeless in the last 3 years (including this time)?
Never in the last 3 years 1 (only this time) -- 2 — 3 -= 4+ _ Do not know - Refuse
4) What is the total number of months you have been homeless in the past 3 years? (any single day or part of a month spent
homeless should be counted as one month)
0 1 2 _ 3 4 5 6 7 _ 8 -, 9 10 11
12+ Do not know Refuse
I understand that this agency participates in data collection on the Homeless Management Information System(HMIS)in my
community,and that my Personal Protected Information(PPI),which includes Personal Health Information,Non-public Personal
Information, and Personally Identifiable Information will be entered into HMIS, a secure online database. HMIS is used by homeless
service providers to store personal information,track program and client outcomes, and connect me with services.
I hereby certify that all information provided is true and accurate to the best of my knowledge.
Parent/Guardian Signature: Date:
Participant Agreement
q
WARMING CENTER The purpose of the Warming Center is to provide seasonal, nightly emergency shelter. Welcome.
A PROGRAM OF QHROC
As a Participant of the Warming Center, I agree to the following:
1. Warming Center participants must abide by the Warming Center Community Expectations at all times.
2. The Warming Center is open 7:OOPM to 7:OOAM, November 1'through March 31'. Check-in is from
7pm to 11pm. Quiet hours are from 10:OOpm to 6:OOam.
3. Participants who depart from the Warming Center after check in will not be allowed to return again
that evening.
4. Use, possession,or distribution of drugs,alcohol,or illicit substances is not allowed anywhere on
Warming Center property. This includes medically prescribed marijuana. Prescription and over the
counter medications must be taken as prescribed or directed. Outside beverages are not permitted
inside the Warming Center.
5. Smoking is allowed during designated smoke breaks. The use of tobacco products is prohibited inside the
Warming Center. This includes electronic devices and smokeless tobacco.
6. The Warming Center is a weapon free zone. Absolutely no firearms are allowed on the Warming Center
property at any time. Knives, pepper spray, multi-tools or other weapons or work tools must be stored
with a staff member upon arrival and will be returned upon departure.
7. Respectful behavior is expected at all times. Disrespectful behavior such as violence, racism, sexism,
bullying, intimidation, harassment, swearing, and aggression are not welcome at the Warming Center.
8. All participants will be provided with bedding. Outside bedding is not allowed.
9. Coats, bags, and other personal items should be secured in a locker/bin at all times when not in use.
These items are not allowed in bunk rooms or bathrooms. Participants are responsible for their
possessions. The Warming Center is not responsible for any lost or stolen items.
10. Warming Center staff have the right to refuse service to anyone at any time for any reason.
By signing this Agreement, I understand that Warming Center staff have the right to share all pertinent information
regarding my stay with other service agencies and organizations and that I shall hold all participating staff and
volunteers —including HRDC Warming Center agents,volunteers, employees, officers, and directors — free and
harmless from any claim or liability that may arise as a result of my stay.
I have read, understand, and agree to the Warming Center's Participant Agreement
Participant Printed Name Participant Signature Date
Staff Printed Name Staff Signature Date
Warming Center Subsequent Visits
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date_ Participant Initials
Today's Date Participant Initials Today's Date_ Participant Initials
Todav's Date Participant Initials Todav's Date Participant Initials
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date_ Participant Initials
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date Participant Initials
Today's Date Participant Initials Today's Date _ Participant Initials
Today's Date Participant Initials _ Today's Date Participant Initials
Today's Date Participant Initials Today's Date Participant Initials_
HUMAN RESOURCE DEVELOPMENT COUNCIL
Request for Administrative Review
IMPORTANT
REQUESTING AN ADMINISTRATIVE REVIEW: If you disagree with the action taken on your case, you
may request an Administrative Review using this form. You have ten (10) days from the date of notice to make
such a request. Your request must be received by the HRDC on or before the date that this time period ends.
You must file your Administrative Review request with the appropriate supervisor and/or program manager.
ADMINISTRATIVE REVIEW STEPS:
1. Contact the specific program for any assistance you feel you need in requesting an Administrative Review.
2. Complete this form and return to HRDC, 32 South Tracy, Bozeman, MT 59715 or fax (406) 585-3538. If
you wish, please keep a copy for your records.
3. The HRDC will schedule an Administrative Review to discuss your case. At that time you will be able to
present your case and the HRDC will explain the reasons for their decision.
4. If an individual wishes to appeal the supervisor/program's decision, a written statement must be presented to
the CEO or the CEO's designee within 10 days after the individual is informed of the supervisor/program's
decision. The written statement will contain the facts the individual believes should be considered and include a
resolution the individual believes is appropriate. The CEO or the CEO's designee shall consider and advise the
individual of the final decision regarding the individual's complaint or grievance within 60 days after the
individual initiates the process. The decision of the CEO and/or his or her Designee for the I-IRDC re ag rding
your request for an Administrative Review is final.
5. If at any time, you wish to withdraw your request for an Administrative Review, you may do so by sending a
written and signed letter to the HRDC.
REQUEST FOR ADMINISTRATIVE REVIEW
NAME: PHONE:
ADDRESS: CITY: ZIP CODE:
This is to request an Administrative Review. I am making this request because:
Signature Date
FOR OFFICE USE ONLY
Reviewed By Signature Date
Outcome:
i
Verification of Status as a Person with a Disability
Housing Provider: Name:
Address:
City/State/Zip:
Name of Tenant/Applicant/Guest Requesting a Reasonable Accommodation or Modification:
The tenant, guest, or applicant listed above needs the reasonable accommodation or modification
described in the attached Request for a Reasonable Accommodation or Modification form. State and
federal laws require housing providers to make reasonable modifications and/or accommodations to
either the dwelling or other parts of the housing community and/or to policies, procedures, services
or regulations when such changes are not unduly burdensome and are necessary because of a
disability of an applicant, a household member, or a guest, so that the applicant, household member
or guest can have an equal opportunity to use and enjoy the housing and/or facilities.
The Fair Housing Amendments Act, Section 504 of the Rehabilitation Act of 1973, the Americans with
Disabilities Act, and the Montana Human Rights Act define "disability" as:
• a physical or mental impairment that substantially limits one or more major life activities;
• a record of having such an impairment;
• being regarded as having such an impairment.
A physical or mental impairment includes, but is not limited to:
any physiological disorder or condition;
cosmetic disfigurement;
anatomical loss affecting one or more of the following body systems: neurological,
musculoskeletal, special sense organs, respiratory, speech organs, cardiovascular,
reproductive, digestive, Benito-urinary, hemic and lymphatic, skin, and endochrine.
Any mental or psychological disorder, such as cognitive delays, organic brain syndrome,
emotional or mental illness, and/or learning disabilities.
Drug addiction and alcoholism are covered by these provisions as are, for example, cancer,
heart disease, HIV, AIDS, and some temporary disabilities (such as broken limbs or
symptoms arising from pregnancy).
The term "major life activity" means those functions such as caring for one's self, performing
manual tasks, walking, seeing, hearing, speaking, breathing, learning and working (24 C.F.R. G 100.201(b)).
The factors considered when determining if a person is substantially limited in a major life activity
are the nature and severity of the impairment, the duration or expected duration of the impairment,
and the expected permanent or long term impact of the impairment �7 i_c�_rt_ Icl,.20a_U).
IMPORTANT: The health care provider certifying the disability and need for an accommodation
and/or modification IS NOT required to reveal the specific nature and/or severity of the individual's
disability, NOR specific information about treatment.
Montana Fair Housing *406-782-2573
10/15/11 *Page 1 of 2
Verification of Status as a Person with a Disability
As a health care provider with the knowledge necessary to make a determination, I am able to
advise that
(name of client)
qualifies as an individual with a disability as defined above and that the following accommodation or
modification is consistent with the needs associated with his/her disability.
Accommodation/Modification Requested:
Expected duration of disability: LIFETIME
Specify Length if Not Lifetime:
Please describe the major life activities limited by the disability that specifically relate to
the need for the request for a reasonable accommodation or modification:
Please describe how this request for a reasonable accommodation or modification will
specifically help ameliorate the limitations of the major life activities referenced above:
Signature of Health Care Provider
Printed Name and Title
Phone Number:
Date:
Montana Fair Housing*406-782-2573
10/15/11 *Page 2 of 2
(Guest Form)
Request for Reasonable Accommodation
If you feel that there is a need for a reasonable accommodation while you are a guest at the Warming
Center, please complete this form and give it to the Lead Staff. If you cannot complete this form
yourself, you may have someone assist you.
Name of Warming Center Guest:
Phone Number:
Date of Request:
***You will need your medical provider to complete a Verification of status as a Person with a Disability Form within one
week of your request.Extensions to this deadline can only be granted through Tonya Horn,Warming Center Outreach and
Operations Manager.
I am requesting the following change or changes in a policy, procedure, rule, service,or regulation:
I need this reasonable accommodation because:
Note: Reasonable Accommodations for lower bunks are determined to be necessary when a guest is
physically unable to climb up onto a top bunk, or there is a safety concern with a guest sleeping on a top
bunk.
Staff Notes on any documentation that has been viewed to support this request:
(Examples... Dr. note,verbal confirmation with provider, or visual confirmation of discharge paperwork
or prescription)
Staff Name:
❑ YES
❑ NO
Reason for Denial:
i
Bunk Holds
Name Dates Reason(Medical, Work, Other)
Valid
i
IV
0
0
Day Storage Contract
WARMING CENTER
FIRST NAME MIDDLE NAME LAST NAME DATE OF BIRTH
Do you have a nickname?
Mailing Address:
Phone Number: Email:
Other Method of Contact:
As a participant in the Day Storage program at the Warming Center, 1 agree to the following:
1. No drugs, alcohol, illicit substances, weapons, hazardous materials, food, or other perishable items
may be stored in a Day Storage Bin.
2. Belongings need to fit inside of the provided tub, with the lid able to close.
3. Electronics must be turned off while stored in the Day Storage Bin.
4. Only the person signing this contract can access the Day Storage Bin. A photo ID may be requested
to identify the person requesting Day Storage access.
5. This initial contract is for 30 days. Participants have the option of renewing their contract if there
are no names on the Waiting List.
6. If this contract expires and staff are unable to contact the contract holder, the contents of the bin
will be removed and donated or discarded.
7. The Warming Center and Warming Center staff and volunteers are not responsible for lost,
damaged, or stolen items.
8. Staff will bring your tub to and from the storage room for you to access.
Guest Signature: Date:
Staff Signature: Date:
Bin Number: Contract Start Date:
HRDC Post Office Box Agreement Form
By using the below named Post Office Box as my address I do hereby agree that to the following rules:
I understand that HRDC will:
1. HRDC staff will retrieve the mail from this PO Box at least once a week.
2. Mail will be stored behind the HRDC reception desk and sorted by name.
3. HRDC staff is not responsible for delivery to me.
4. HRDC will not notify me when mail arrives.
5. HRDC staff will request photo identification if they do not know you.
6. Mail can be retrieved at the HRDC reception desk Monday-Friday 8am-5pm with the exception of public
holidays.
I understand:
1. This PO Box is for Youth Development and any Housing First Program customers in order to aid in the
pursuit of housing, other services, income or other financial related needs.
2. This is a temporary address for me.
3. It is my responsibility to check for incoming mail.
4. 1 may use this address for up to 3 months. If I wish to use this address for longer than 3 months I will
need to renew my agreement with HRDC staff or mail will be returned to sender.
5. It is my responsibility to retrieve my mail from the front desk of HRDC within 30 days. Any mail
that is not retrieved within 30 days will be returned to sender.
6. Due to the limited size, mail to be sent to me via this address must be housing,job or financial
related. This is not a personal address. Packages cannot be accepted unless otherwise arranged.
Personal mail, including magazines,will not be delivered and will be returned to sender.
7. Mail to me must be addressed exactly as stated below or it may not be delivered.
8. Upon expiration of this PO Box Agreement or procurement of permanent housing, I will need to contact
each individual, organization or business to change my address. A USPS change of address form will not
forward mail from this PO Box.
9. Without my written permission, others will not be able to retrieve my mail.
10. I will not share this address with anyone other than those related to the areas listed above. Use of this
address is a privilege offered through the Home to Stay, Youth Development and Warming Center
programs.
11. Repeated abuse of this agreement form will result in the loss of use of this PO Box.
Printed Name:
Signed Name: Date:
Approved by: Date:
I authorize HRDC to release my mail to: until_/_/ or until the
date this agreement expires, whichever comes first.
Agreement Start Date:
Address: Agreement Exp. Date:
Your First and Last Name
C/O HRDC
Phone Number:
P.O. Box 6244
Bozeman, MT 59771 Photo ID visually verified:
Staff Initials
v.10/8/15
Service Animals are welcome in the Warming Center.
Service Animals are required to follow the Bozeman City Ordinance for dogs.The Warming Center
requires proof that your service animal has a dog license from the City of Bozeman, which includes proof
of rabies vaccination. You must show this license to Warming Center Staff who will make a copy of it and
attach it to your occupancy agreement.
The Warming Center is not responsible for the care of your service animal during your stay at the center.
The care and supervision is solely your responsibility.You may be charged for any damages caused by
your service animal.
The American's With Disabilities Act(ADA) requires that service animals be under the control of the
handler at all times.The service animal must be harnessed, leashed, or tethered while in public places,
such as the Warming Center. Please inform our night's Lead Staff if any of these devices interfere with
the service animal's work or if your disability prevents use of such devices.You may not allow your
service animal to wander away from you and you must maintain control of your animal at all times.
Under control also means that your service animal should not be allowed to bark repeatedly and cannot
defecate inside the Warming Center. Per, Warming Center Policy and Procedures, Please notify staff
when your animal needs to go outside for this purpose so that staff can accompany you.
If your service animal is out of control,you have to opportunity to take effective action to control it. If a
service animal is not behaving in accordance with policies and procedures and disrupts the fundamental
purpose of the Warming Center to provide a safe, secure, warm and quiet place for guests to sleep,you
will be asked to remove your service animal from the premises. You may return to stay without your
service animal.
BUILDING A
BETTER Behavior Expectation Policy
COMMUNITY
For Customers
IM
1.0 Human Resource Development Council (HRDC) wishes to provide you with a positive
v customer experience. In an effort to achieve that,we will both need to be committed to
helping you achieve your goal(s). While we want to help everyone,we can only truly help
customers that are committed to positive outcomes.
To ensure that and provide clarity, HRDC has created a Behavior Expectations Policy:
lid
0
• All HRDC services (Fork&Spoon,Warming Center,Gallatin Valley Food Bank, Head
Start, Section 8, LIEAP, Energy Share,Weatherization,Youth Development,Galavan,
Streamline, Headwaters Area Food Bank, Big Sky Community Food Bank, Resource
Property Management, etc.) are designed to provide a safe environment for our
customers and staff.
• Aggressive behavior is not a part of this environment and will not be tolerated at any
HRDC facilities.
• Aggressive behavior is defined as:yelling,pushing,unwanted physical contact, physical
fighting,throwing objects,swearing, or acting in a threatening manner.
If this unwelcome behavior occurs,the following procedure will be enacted. There are
some offenses that will result in immediate removal from services, pending review.
FIRST OFFENSE/LEVEL 1: Asked to leave the program/facility for the day/night.
SECOND OFFENSE/LEVEL 2: Asked to leave the program/facility for one week.
THIRD OFFENSE/LEVEL 3: Asked to leave all programs/facilities for at least 30
days. Safety Committee representatives will then meet
with the customer to evaluate the appropriateness of
continued participation in our programs/facilities.
Opportunities to receive services will be established.
At times, the Program Director may have to exercise discretion in following this procedure
to protect the safety of our customers and staff.
Appeal Process: If you would like to appeal the decision made (only applicable to Level 3
offenses) please do so using the Administrative Review Procedure.
406.587.4486
e hello@thehrdc.org
32 South Tracy
Bozeman, Montana 59715
HRDC
BUILDING A BETTER COMMUNITY
BUILDING A
COMMUNITY
Behavior Expectation Policy Violation
o�
i
This is to inform you that you have violated the HRDC Behavior Expectation Policy.
J
V
i
rThis is a Level violation, meaning you have been asked to leave the
*' program/facility for (period of time).
The unacceptable behavior(s) that warranted this suspension is/are:
0
a,
r
LEVEL 3/SEVERE OFFENSE:
(initials) I acknowledge that I have received the Administrative Review
Process.
(initials) Two members of the Safety Committee will meet with you at a neutral
location agreeable to both parties at the end of the 30 day suspension.
Parameters for re-entry and opportunities to receive services will be
established dependent on offense, behavior since the offense, and the
content of the meeting.
Printed Name:
Signature: Date:
Parameters for Re-Entry/Access to Programs (to be considered on a case by case basis):
406.587.4486
hello@thehrdc.org
boutn i racy
Bozeman, Montana 59715
N 0 0Q nr
BUILDING A BETTER COMMUNITY