Attachment 3: Governor’s Assurance Statement

PI Attachment 3. Governors Assurance_with proposed changes_CLEAN.docx

Community-Based Child Abuse Prevention Program

Attachment 3: Governor’s Assurance Statement

OMB: 0970-0155

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ATTACHMENT 3: Governor’s Assurance Statement


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COMMUNITY-BASED GRANTS FOR THE PREVENTION OF CHILD ABUSE AND NEGLECT PROGRAM

(TITLE II OF THE CAPTA AMENDMENTS OF 2010 (P.L. 111 -320)) GOVERNOR’S ASSURANCE STATEMENT




As Governor of the state of , I am providing the following assurance that I have designated

to be the lead agency, only after giving full and equal consideration to the capacity and expertise of all entities desiring to be the lead agency, to administer the funds, and assume the obligations imposed by the terms and conditions of the Community-Based Grants for the Prevention of Child Abuse and Neglect award. I further assure the lead agency will provide or will be responsible for providing—


  1. Community-based child abuse and neglect prevention programs and activities designed to strengthen and support families to prevent child abuse and neglect composed of local, collaborative, public-private partnerships directed by

interdisciplinary structures with balanced representation from private and public sector members, parents, and public

and private nonprofit service providers and individuals and organizations experienced in working in partnership with families with children with disabilities;


  1. Direction to an interdisciplinary, collaborative, public-private structure with balanced representation from private and public sector members, parents, and public sector and private nonprofit sector service providers;


  1. Direction and oversight to the network through identified goals and objectives, clear lines of communication and accountability, the provision of leveraged or combined funding from federal, state and private sources, centralized assessment and planning activities, the provision of training, technical assistance, evaluation assistance and reporting and evaluation functions.


  1. A demonstrated commitment to parental participation in the development, operation, and oversight of the

community-based and prevention-focused programs and activities designed to strengthen and support families to prevent child abuse and neglect;

  1. A demonstrated ability to work with state and community-based public and private nonprofit organizations to develop a continuum of preventive, family-centered, comprehensive services for children and families;


  1. The capacity to provide operational support (both financial and programmatic) and training, technical assistance,

and evaluation assistance to community-based child abuse and neglect prevention programs and activities designed to strengthen and support families to prevent child abuse and neglect, through innovative, interagency funding and inter-disciplinary service delivery mechanisms; and


  1. Integration of its efforts with individuals and organizations experienced in working in partnership with families with children with disabilities, parents with disabilities and with the child abuse and neglect prevention activities of the state, and demonstrate a financial commitment to those activities.



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(Signature of Governor) (Date)


OMB Control # 0970-0155 (Expires 06/30/2024)

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorStedt, Elaine (ACF)
File Modified0000-00-00
File Created2024-11-25

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