FREE LEAD HAZARD REPAIRS

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5 Lead Hazard Repair Program FREE LEAD HAZARD REPAIRS Lead Hazard Repair Grant Protect Kids Protect Your Investment Lead poisoning may cause damage to the brain and nervous system, and result in behavior, learning and other problems in children. Requirements Home must be in the city of Cleveland Home built before 1978 A child under age 6 must live in or visit the home more than 20 hours each week or Pregnant woman living in home Families must be low income Lead hazards must be identified in the home(all eligible families get a Free Lead Inspection) For more information and application please see contact information below: City of Cleveland Department of Community Development Neighborhood Services Lead Hazard Repair Grant Program *Landlords are required to pay a minimum of $600 towards the cost of project

6 Lead Hazard Repair Program FREE LEAD HAZARD REPAIRS Lead Hazard Repair Grant Program Protect Kids Protect Your Investment HOUSE HOLD SIZE 2016 INCOME GUIDELINES as of 06/06/2016 Tenant Occupied VERY LOW INCOME <50% MONTHLY VERY LOW INCOME <50%- ANNUAL Owner Occupied LOW INCOME <80%- MONTHLY LOW INCOME <80%- ANNUAL 1 $1,946 $23,350 $3,113 $37,350 2 $2,221 $26,650 $3,554 $42,650 3 $2,500 $30,000 $4,000 $48,000 4 $2,775 $33,300 $4,442 $53,300 5 $3,000 $36,000 $4,800 $57,600 6 $3,221 $38,650 $5,154 $61,850 7 $3,442 $41,300 $5,508 $66,100 8 $3,667 $44,000 $5,867 $70,400

7 Lead Hazard Control Program GRANT APPLICATION GRANT APPLICATION- INSTRUCTIONS TO BE ELIGIBLE, THE HOUSEHOLD MUST BE LOW TO MODERATE INCOME (SEE THE ATTACHED CHART, PAGE 3) AND THERE MUST BE A CHILD UNDER AGE 6 LIVING IN THE HOME OR VISITING THE HOME MORE THAN 20 HOURS PER WEEK. 1. APPLICATION: The Application must be filled in completely and the documents below submitted with the application. The Occupant (tenant), if applicable) must sign the Agreement to Conditions, section E (page 4). The Property Owner must sign the Agreement to Conditions, section F, and the Agreement to Maintenance Conditions, Section G (pages 5, 7). 2. REQUIRED DOCUMENTS: A. INCOME: Proof of all Income (Monthly Amount - 60 day period) for all persons over the age of 17 living in the eligible household. Check Stubs Soc Sec/SSI award letter, Pension/VA award letter, AFDC, IRS W2 Unemployment Benefits letter, Workers Comp, Child Support, Alimony, or other Signed Income tax form including all schedules Most recent checking & savings statements for 6 consecutive months B. PROOF OF INSURANCE- The property owner must submit the declaration page of his/her property insurance. C. BIRTH CERTIFICATES OR OFFICIAL BIRTH DOCUMENTS for all children under the age of 6 living in the unit(s) must be attached. D. RECENT BLOOD SCREENING TEST- A recent blood lead test is required for all Children under 6 years of age at time of application before work can begin on the property. (Blood lead tests obtained within 6 months of start of the work are acceptable.) E. IDENTIFICATION- Copies of driver s license or State ID for Owner & Occupants over 17 years of age 3. PROPERTY OWNER CONTRIBUTION REQUIREMENTS The Lead Hazard Reduction grant program requires that a property owner contribute to the lead and environmental safety of his/her home. 1. Rental Property- (all non-owner occupied property shall be considered rental property). The property owner shall contribute at least $ per unit to the project in direct funds or in-kind work on the home to reduce hazards*. 2. Waiver of Contribution The program may waive contribution requirements in hardship cases. * In-kind work is property repair that the property owner completes to make the unit(s) safer for occupants. A list of proposed repairs for the in-kind work will be provided. Such work must be completed before the Lead Hazard Control repairs are started by the Program. Contact Information Main (216) Hotline (216) 263-LEAD (5323) Fax (216) Department of Community Development Lead Hazard Control Program Cleveland City Hall Room Lakeside Avenue Cleveland, Ohio GRANT APPLICATION ver

8 Lead Hazard Control Program Office Use Parcel Number: GRANT APPLICATION Single Double* 3 Units* Other* House Number Street Name Zip Code *Needs extra applications Additional units or properties must be submitted on additional applications. (example: double unit require two applications) A. Who is the Applicant? An eligible property owner or an eligible occupant may apply First Name Initial Last Name Street Address City State Zip Code Cleveland Social Security # Telephone # (best contact number) Date of Birth OH Race: (Check one) Caucasian; African American/Black; Asian; American Indian-Alaskan Native; Native Hawaiian-Other Pacific Islander; American Indian-Alaskan Native & White; Asian & White; Black-African American & White; American Indian-Alaskan Native & Black; Other Multi Racial Ethnicity: (check one) Do you consider yourself to be: Hispanic or Latino; Not Hispanic or Latino B. What Property is to Be Enrolled For Hazard Control? Is this property in violation of a city Code? NO YES HEALTH CODE HOUSING CODE OTHER CODE C. Who stays in the home? Complete the chart below for anyone staying in the eligible person s home (use the back for more space). Name Relationship to Applicant Date Of Birth Sex M/F Race* (See above) Monthly Income Amount $ $ $ $ $ D. Who is the Property Owner? First Name Last Name Street Address City State Zip Code Primary Telephone Number Alternate Phone Number Home Cell Work Home Cell Work Address OFFICE USE: Protect Your Home Pamphlet DATE SENT/INITIAL GRANT APPLICATION ver

9 Lead Hazard Control Program GRANT APPLICATION 2016 INCOME GUIDELINES as of 06/06/2016 HOUSE HOLD SIZE Tenant Occupied VERY LOW INCOME <50% MONTHLY VERY LOW INCOME <50%- ANNUAL Owner Occupied LOW INCOME <80%- MONTHLY LOW INCOME <80%- ANNUAL 1 $1,946 $23,350 $3,113 $37,350 2 $2,221 $26,650 $3,554 $42,650 3 $2,500 $30,000 $4,000 $48,000 4 $2,775 $33,300 $4,442 $53,300 5 $3,000 $36,000 $4,800 $57,600 6 $3,221 $38,650 $5,154 $61,850 7 $3,442 $41,300 $5,508 $66,100 8 $3,667 $44,000 $5,867 $70,400 Please fill out for all people (including yourself) over 17 living in this property with you who are working or receiving financial assistance (attach additional pages if necessary): Family member Employer Name Employer Address Monthly Wages Monthly Social Security Monthly Child support Monthly Pension Monthly Disability Monthly Public Assistance Other Monthly Income Other Monthly Income Total Monthly Income $ $ $ $ $ - Submission and approval of this application does not guarantee project funding. - Processing and approval of complete applications may take 5-10 weeks. - Submission and/or approval of this application does not exempt you from complying with open building code, housing choice voucher program, Cleveland lead hazard control, or any other orders on your property. Remaining in compliance with any open orders is the responsibility of the property owner at all times GRANT APPLICATION ver

10 Lead Hazard Control Program GRANT APPLICATION E. TENANT/OCCUPANT AGREEMENT TO CONDITIONS The current occupant of the property listed in section B above affirms that he/she desires to be enrolled in the City of Cleveland Lead Hazard Control grant program for repair of lead-based paint hazards, and hereby gives permission to the City of Cleveland to provide lead hazard reduction work at the property. As a condition of participation in the Program, the current occupant acknowledges and agrees to the following: That I will maintain the property free from dust, dirt and debris, and inform the property owner of any loose and flaking paint that I am aware of and keep the property free of debris and bare soil to the extent allowed by my agreement with the owner. That the City of Cleveland will determine the specific scope of and extent of work to be performed by the Program at the property. The written specifications will become part of this agreement and provided as a grant to the applicant. That I will follow the instructions in the Lead Hazard Control Occupant Guide. That I will attend a workshop on lead safe home maintenance practices prior to the start of work funded by the Program. That I will indemnify and hold the City of Cleveland, its respective officers, agents, and employees, harmless from any and all liability suits, losses, judgments, damages, or any other demands arising out of the Lead Hazard Control Program or the actions or omissions of the Enrollee while performing its duties under this Agreement. This indemnification shall survive the term of this Agreement. I further certify that the income for all persons in the home stated represents the total income for the past year prior to this application and I understand that my income and employment information is subject to verification by the City of Cleveland, Ohio. I hereby grant permission to the City of Cleveland, Ohio, Lead Hazard Control grant program supervisors, inspectors, employees and contractors employed, to enter the premises listed in the application to perform work under the Lead Hazard Control Program. I do hereby affirm under penalty of perjury that all information contained on the application is true and correct to the best of my knowledge and belief. Tenant/Occupant Signature Date_ GRANT APPLICATION ver

11 Lead Hazard Control Program GRANT APPLICATION NO OWNER OF RENTAL PROPERTY MAY RAISE RENTS AS A DIRECT RESULT OF THE BENEFITS RECEIVED UNDER THIS GRANT. F. PROPERTY OWNER AGREEMENT TO CONDITIONS The Property Owner affirms that he/she owns the property described in section B above, and that he/she desires to be enrolled in the City of Cleveland Lead Hazard control grant program to make the home lead safer, and hereby gives permission to the City of Cleveland to provide lead hazard reduction work at the property. As a condition of participation in the Program, I acknowledge and agree to the following: That I will continue to keep the lead-safe units available to low-income residents for a period of not less than three years and will retain records of occupancy and marketing to low-income residents for not less than five years. That the City of Cleveland will determine the specific scope of and extent of work to be performed at the property. That I received a copy of the City of Cleveland Department of Community Development Lead Hazard Control Occupant Guide and will follow all applicable guidelines listed in it. That I received information on lead safe home maintenance practices. That I am responsible for the non-lead repairs identified by the Lead Hazard Control Program and that lead hazard control will not begin until the repairs are completed and documented (In-kind work). That I will maintain the property free from loose and flaking paint, use lead safe methods for future repairs, and keep the property free of bare soil. That I will indemnify and hold the City of Cleveland, its respective officers, agents, and employees, harmless from any and all liability suits, losses, judgments, damages, or any other demands arising out of the Lead Hazard Control Program or the actions or omissions of the Enrollee while performing its duties under this Agreement. This indemnification shall survive the term of this Agreement. I hereby grant permission to the City of Cleveland, Ohio, Lead Hazard Control grant program its supervisors, inspectors, employees and contractors employed, to enter the premises listed in identified as the premise to undergo lead hazard reduction to perform work under the Lead Hazard Control Program. I, the undersigned, do affirm under penalty of perjury that the information contained in the application is true and correct to the best of my knowledge and belief. Owner s Signature_ Date GRANT APPLICATION ver

12 Lead Hazard Control Program GRANT APPLICATION G. PROPERTY OWNER AGREEMENT TO MAINTENANCE CONDITIONS RECITALS: 1. The City s Department of Community Development, through its Lead Hazard Control Program ( the Program ), its agents and subcontractors, will complete or have completed lead hazard control and/or other associated activities at the address indicated in section B above. 2. By way of receiving the benefits of the Program, the Property Owner has taken on certain continuing obligations. In consideration of the foregoing, and mutual promises contained in this Agreement, the parties agree as follows: ARTICLE: I OBLIGATIONS OF THE PROPERTY OWNER By executing this Agreement, the City and the Property Owner agree to be bound by this Agreement, and the Property Owner agrees to perform the following continuing obligations related to the properties identified in the above recitals: 1. To be responsible for monitoring surfaces with confirmed lead based paint to ensure surfaces do not become defective or hazardous. 2. The Risk Assessment Report previously forwarded to the property owner identifies all surfaces that tested positive for lead and these are subject to this agreement. 3. To monitor any lead based paint surface noted on the Positives Report of the Risk Assessment Report to ensure that the surface does not become deteriorated creating a lead hazard. 4. To monitor the property at least once each Twelve (12) months and to keep written record of such monitoring. 5. To require that anyone performing maintenance on the Property for a fee will, at a minimum, hold a State of Ohio Lead Safe Renovator s certificate or its recognized equivalent. 6. To ensure that any person performing maintenance on any leaded surface is notified in writing that they are working on a lead based paint containing surface and will perform maintenance in a lead safe manner and in compliance with State and Local regulations. 7. Maintain all records of maintenance for a period of three years from the date of this Agreement. ARTICLE: 2 DEFAULT AND REMEDIES: 1. Property Owner shall be in default of this Agreement if the Property Owner fails to comply with the obligations identified in Article 1, above, or otherwise fails to maintain the Property free from lead hazards for a period of three (3) years from the date of this agreement. 2. Upon the City s determination that a default has occurred, and notice is provided pursuant to Article 4 below, the City may file a civil action with a court of competent jurisdiction to recover costs for the lead abatement work including all tenant relocation expenses. 3. Costs for lead abatement work shall include the City s legal fees for enforcement of this agreement, and those costs incurred for Hazard Control according to the specifications contained within the project folder and subsequently paid to the Construction Contractor, and relocation costs, if any GRANT APPLICATION ver

13 Lead Hazard Control Program GRANT APPLICATION ARTICLE: 3 RIGHT TO RE-INSPECT THE PROPERTY In addition to the remedies outlined above, the Property Owner agrees that the City, or its authorized agent, may re-inspect the property and shall, if requested by the City, notify any tenants occupying the Property that the City is authorized to enter and re-inspect the Property. The Property Owner agrees that the City shall have the right to obtain a lawful order of entry. ARTICLE: 4 NOTICES All notices which may be proper or necessary shall be sent by regular mail, postage prepaid, to the following addresses or to such other address as either party may designate for such purpose: To the City Lead Hazard Control Grant Cleveland City Hall Room Lakeside Avenue Cleveland, Ohio To The Owner Name Address City, State Zip ARTICLE: VI CONSTRUCTION OF AGREEMENT All terms used in this Agreement, regardless of number and gender, shall be construed to include any other number and any other gender, as the context or sense of this Agreement may require. This Agreement may be executed in any number of counterparts, each of which, when so executed and delivered, shall be deemed an original, but such counterparts together shall constitute one and the same instrument. IN WITNESS WHEREOF, To the City To The Owner LEAD HAZARD CONTROL PROGRAM Division of Neighborhood Services Department of Community Development Cleveland City Hall Room Lakeside Avenue Cleveland, Ohio Ph: Fax: Date Owner Signature GRANT APPLICATION ver

14 CHILDHOOD LEAD POISONING PREVENTION PROGRAM 75 Eriewview Plaza, 3 rd Floor Cleveland, Ohio (216) 263-LEAD (5323) EASY WAYS TO REDUCE LEAD IN YOUR CHILD'S ENVIRONMENT Keep lead dust and dirt out of your children's mouths! Wash the toys that they put in their mouths. Wash their hands often: before meals, snacks, and bedtime. Bust the lead dust! Wipe down surfaces which children can touch, especially window sills and wells. Use a disposable wet rag or paper towel. Use soapy water and old rags or paper towels. Throw them away after cleaning. (Wear rubber gloves) Leave lead outdoors! Place a long rug at each entrance way. (Replace rug at least two times every year.) Remove shoes at door and use house slippers inside. Provide a lead-safe play space for your children! Outside - play on grass, not dirt. If possible, provide a place with clean sand to play in. Inside - place a clean blanket on the floor or carpet for babies to play on, keeping the same side up, and washing it often. Provide balanced meals and snacks for your children. Include foods rich in vitamin C, iron, and calcium and low in fat! Serve 4-6 small meals to children each day. Include foods high in iron lean meat, liver, prunes, raisins, and cereal. Include foods high in calcium milk, yogurt, cheese, green leafy vegetables. Include foods high in vitamin C oranges, tomatoes, orange juice. Created: 05/31/2011 Revised: 10/06/2017

15 MORE STEPS YOU CAN TAKE TO REDUCE LEAD HAZARDS Keep your children away from chipping, peeling and flaking paint. Do not allow children to suck on or chew painted surfaces or old painted toys. Provide pacifiers for infants to suck. Wash pacifiers often and pin them on a short ribbon to the child's shirt. Change and wash children's clothes daily.(or more often if needed to keep them clean) Always work wet when cleaning. Sponge mops work better than rag or string mops. If you have to sweep, wet the dust and drag it with the broom. Keep window sills and wells free of lead paint chips and dust -- wet wipe using soapy water, old rags or paper towels and discard rags after use. If windows frames are badly chipping, keep the bottom half closed and open the top half for fresh air. Throw out old, soiled carpets or cover with a clean carpet -- machine washable area rugs are good. Shake rugs, pillows, cushions, blankets and change vacuum bags outdoors (not indoors.) If you work with lead, leave it at work! Shower, wash hair and change clothes and shoes before returning home. Wash work clothes in a separate load of laundry! Cover front steps and porch with astro-turf, or use an outdoor mat to wipe shoes or feet before entering the home. (Replace mat twice a year). Cover bare soil with grass, if possible. Otherwise, cover with a thick layer of gravel, wood chips, sand, or other ground cover. Hose down porches, driveways and sidewalks where children play. Build a sandbox with a bottom and fill with clean sand. Keep it covered when not in use. If you have a vegetable garden, plant it away from old painted buildings or busy roads. Avoid growing leafy green vegetables. Use only cold tap water for drinking or preparing meals, drinks, or baby formula. When tap water has not been used for four or more hours, let it run until you feel a change in temperature. Wherever there is loose or flaking lead paint, do not attempt to remove it yourself, except to damp mop it off the floor. Call the Cleveland Health Department or Environmental Health Watch for lead paint removal advice. Cover any loose, peeling or flaking paint with contact paper, duct tape or block it from a child's reach by putting a heavy piece of furniture in the way Created: 05/31/2011 Revised: 10/06/2017

16 City of Cleveland Frank G. Jackson, Mayor March 21, Erieview Plaza, 2 nd Floor Cleveland, Ohio / RE: <PROPERTY ADDRESS> RE: <PROPERTY ADDRESS> has lead hazards; is unsafe for human occupancy Dear Property Owner or Resident: The Cleveland, Division of Environment, is responsible for addressing lead poisonings. We accomplish this by investigating properties where a child younger than 6 years old associated with that home had their blood tested and the results confirm a high concentration of lead in their blood system; the source is often lead based paint or lead contaminated dust. On <RA DATE> a lead investigation was conducted at <Property Address>. As a result of this investigation, it was determined that lead paint hazards were present. A lead hazard control order/violation to remediate these hazards was issued. To date, the Cleveland Department of Public Health does not have documentation that these hazards have been remediated Therefore, per Ohio Revised Code section and Ohio Administrative Code section , a notice of Non-Compliance and Order to Vacate was issued for this property on <NON letter>. According to these codes, the Cleveland is required to post a placard/sign on one or more entrances to the property to warn of the following: 1. The property has lead hazards; and 2. The property is unsafe for human occupancy, especially for children under six years and pregnant women. The placard/sign shall remain posted until the following is completed: 1. All work is completed by a licensed lead abatement contractor, 2. A clearance examination (final inspection) from a licensed lead risk assessor; and 3. The clearance examination report is provided to the Cleveland. Please find enclosed the following: 1. Copy of the lead hazard control order/violations for this property, 2. Copy of the Notice of Non-Compliance and Order to Vacate, 3. Information on ways you can keep you and your family safe from lead; and 4. Information on a grant that you may be eligible for to support remediation efforts. Please contact us to learn more information. We can be reached at (216) Sincerely, Brian Kimball Commissioner, Division of Environment