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ATTACHMENT B—Scope of Work Federal Tax Id. or SSN 27-3721789 Contract# 122/23 A. CONTRACTOR INFORMATION 1. Contractor Agency Name: Empowering Lives Guardianship Services, LLC 2. If different from Contract Administrator Information in General Contract: Address Telephone Number: Fax Number: Email: 3. Name of Program(s): Guardianship 4. Status: 9 Public ❑ Private,Not for Profit ® Private, For Profit 5. Contractor's Financial Reporting Year January through December B. Explanation of Services to be provided and to whom (include SIS Service Code): • Empowering Lives Guardianship Services, LLC shall provide adult guardianship services to incompetent adults as directed by court order. • Empowering Lives Guardianship Services, LLC shall comply with all requirements of the Order of Appointment entered by the Clerk of Court and meet qualification set forth in Chapter 35A of the North Carolina General Statues. Contractor warrants that it has read and understands those duties and qualifications. • Empowering Lives Guardianship Services, LLC shall arrange for the care, comfort and maintenance of each ward, and provide services in the least restrictive living environment. • Empowering Lives Guardianship Services, LLC shall make DSS aware of any terminations of guardianship appointments within five(5)business days of termination. • Ensure that members of staff who provide services to wards attend "Basic Skills Guardianship Training"offered by the NC Division of Adult and Aging Services. • Conduct a minimum of one face-to-face visit with each ward every 90 calendar days and have contact with the ward and/or ward's caregiver at least once each calendar month. • Obtain legal counsel, at its sole expense, when such is required to fulfill its statutory duties pursuant to Chapter 35A of the North Carolina General Statue. • Maintain an individual guardianship record for each ward served, including a current guardianship service plan developed from strengths and needs identified from an assessment of the ward's situation, ongoing notes and documentation of all guardianship contacts and services and other relevant documentation. • Complete and maintain all reports required by the Clerk of Court and maintain a copy of each report in the ward's record. These reports shall include, but are not limited to, any required annual accountings and the yearly status report sent to the Clerk of Court, which includes: Contract-Scope of Work (7-2008) Page lof 2 `�