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LIBRARY BOARD OF TRUSTEES
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AGENDA
CITY OF RANCHO CUCAMONGA
REGULAR MEETING
First Thursday
6 p.m.
January 5, 2012
Council Chambers
City of Rancho Cucamonga
10500 Civic Center Drive
Rancho Cucamonga, California 91730
***
City Councilmembers
L. Dennis Michael, Mayor
Sam Spagnolo, Mayor Pro Tern
William J. Alexander, Councilmember
Chuck Buquet, Councilmember
Diane Williams, Councilmember
***
Boardmembers
Luella Hairston, President
Jackie Amsler, President Pro Tern
Robert Coberly, Member
Scott Haddon, Member
Janet Temkin, Member
DECLARATION OF POSTING OF AGENDA
Vivian Garcia states and declares as follows:
I presently am and at all times mentioned herein have been, the Senior Administrative
Secretary of the Rancho Cucamon a Public Library. Acting in that capacity on
�F
co1 / , at ;*-50 , I posted a true and correct copy of
the Library Foundation Board meeting age a dated Sin S, aU/a to be
held in the Tri-communities Room located at 10500 Civic Center Drive, Rancho
Cucamonga.
I declare under penalty of perjury that the foregoing is true and correct and that this
declaration was executed on /.2-.z0—// , at Rancho Cucamonga.
City of Rancho Cucamonga
By:
Vivian Garcia
Senior Administrative Secretary
City of Rancho Cucamonga
•
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CLIBRARY BOARD OF TRUSTEES AGENDA
L _.J JANUARY 5, 2012 1
RANCHO
CUCAMONGA
I ._
' ` ' ,, _;.; A: CALL'T,O ORDER '
1. Roll Call: Amsler_, Coberly , Haddon ,
Hairston and Temkin .
;.;.4 /, B CONS;ENT,CatNDAR g A t.F _, °.'
The following Consent Calendar items are expected to be routine and
non-controversial. They will be acted upon by the Library Board of
Trustees at one time without discussion. Any item may be removed
by a Member or member of the audience for discussion.
1. Approval of Minutes: November 3, 2011 and December 1, 2011. 4
., C LBRARY'DIRECTORtS,l'STAFFREPORTS '-I ,_ I
The following items do not legally require any public testimony,
although the President may open the meeting for public input.
1. Library Status Report: Oral reports presented by staff.
a. General announcements. Oral report by Robert Karatsu,
Library Director, and Michelle Perera, Assistant Library
Director.
b. Review of Library statistics. Oral report by Robert 11
Karatsu, Library Director.
2. Budget Report: Report presented by Robert Karatsu, Library 19
Director.
3. Children's Services: Oral update by Renee Tobin, Principal
Librarian.
4. Archibald Library: Oral update by Karye Hood, Reference Services
Coordinator.
5. Paul A. Biane Library: Oral update by Cara Vera, Senior Librarian.
ii4l.a dZ1 a-. �
I . . ..F ', ' ,: ` .,.D: BOARD BUSINESS .' , `..� ,..
The following items have been requested by the Library Board of •
Trustees for discussion. They are not public hearing items, although
the President may open the meeting for public input.
1. Revised Accident Reporting Form. Discussion led by President 28
Hairston. Staff report and form attached.
2
LW LIBRARY BOARD OF TRUSTEES AGENDA
Lai JANUARY 5, 2012 2
RANCHO
CUCAMONGA
2. Presentation and Review of 2012 Library Calendar and Annual
Report by Library Foundation. Discussion led by President Hairston,
Michelle Perera, Assistant Library Director and Library Foundation
Vice-President Teresa Akahoshi.
I E. IDENTIFICATION OF ITEMS FOR ItNE%T
MEETING .*F aj a ,t1 , ,.
This is the time for the Library Board of Trustees to identify the items
they wish to discuss at the next meeting. These items will not be
discussed at this meeting,only identified for the next meeting.
19' � 4� ''',1-.. ..k 1 'C . fzflT f CC-,".
=Y_ F A ,PUBLIC_CQNMUNICATIQN ,
This is the time and place for the general public to address the
Library Board of Trustees on any item listed on the agenda. State law
prohibits the Library Board from addressing any issue not previously
included on the Agenda. The Board may receive testimony and set
the matter for a subsequent meeting.
Comments are to be limited to five minutes per individual or less, as
deemed necessary by the Chair, depending upon the number of
individuals desiring to speak. All communications are to be
addressed directly to the Board, not to the members of the audience.
This is a professional business meeting and courtesy and decorum
are expected. Please refrain from any debate between audience and
speaker, making loud noises or engaging in any activity which might
be disruptive to the decorum of the meeting.
'''' , G:, llIQURNIWNT"i y •, _1 a, , ,•
I, Vivian R. Garcia, Library Administrative Secretary of the City of
Rancho Cucamonga, or my designee, hereby certify that a true,
accurate copy of the foregoing agenda was posted on Tuesday,
December 20, 2011, seventy two (72) hours prior to the meeting per
Government Code 54954.2 at 10500 Civic Center Drive.
3
STAFF REPORT
LIBRARY SERVICES DEPARTMENT
b,.
RANCHO
Date: January 5, 2012 CUCAMONGA
To: Rancho Cucamonga Library Board of Trustees
From: Robert Karatsu, Library Director
Subject: APPROVAL OF MINUTES
RECOMMENDATION
Approval of the minutes of the regular and cancelled meetings of November 3 and December 1,
2011.
BACKGROUND/ANALYSIS
Attached, please find the minutes for the regular and cancelled meetings of the Library Board of
Trustees taken and compiled by Library Administrative Secretary, Vivian Garcia.
FISCAL IMPACT
None.
Respectfully submitted,
Robert Karatsu
Library Director
4
CITY OF RANCHO CUCAMONGA
LIBRARY BOARD OF TRUSTEES
A. CALL TO ORDER
An adjourned meeting of the Library Board of Trustees was held on Thursday,November 3,2011,in
the Council Chambers at City Hall, located at 10500 Civic Center Drive, Rancho Cucamonga,
California. The meeting was called to order at 6:02 p.m. by President Hairston. Present were
Members Amsler and Temkin.
Also present were: Robert Karatsu, Library Director, Michelle Perera,Assistant Library Director,
Renee Tobin, Principal Librarian, Cara Vera, Senior Librarian, Karye Hood, Reference Services
Coordinator, Carol Durkel, Office Specialist II and Vivian Garcia, Administrative Secretary.
B. CONSENT CALENDAR
B 1. Approval of Minutes: October 6, 2011.
MOTION: Moved by Member Temkin to approve the minutes, seconded by Member Amster.
Motion carried 3-0-2 (with Coberly and Haddon absent).
******
Member Coberly arrived at 6:06 p.m.
C. LIBRARY DIRECTOR'S STAFF REPORTS
C1. Library Status Report: Oral reports presented by staff.
a. General announcements. Oral report by Robert Karatsu, Library Director.
Robert Karatsu, Library Director,thanked Members for attending the Music Masquerade&Merlot
Event on Friday, October 28 for their support.
b. Review of current statistics. Oral report by Robert Karatsu, Library Director.
Robert Karatsu, Library Director, reviewed the September statistics with the Board.
C2. Budget Report: Report presented by Robert Karatsu, Library Director.
Robert Karatsu, Library Director, reviewed the budget with the Board.
C3. Children's Services: Oral update by Renee Tobin, Principal Librarian.
5
Library Board Minutes
November 3, 2011
Page 2.
Renee Tobin,Principal Librarian,stated that the Big Truck Storytime was held on Saturday,October
22, at 11 a.m. at the Archibald Library. There were approximately ninety attendees. The
Bookmobile, Public Work's Department, Fire Department and Burrtec participated with vehicles
from their departments. Library staff also supported the Furry Friends event at the Animal Shelter
which started at 8 a.m. There were approximately two hundred attendees.
Renee Tobin, Principal Librarian, stated that Hello Kitty Day would be held this coming Saturday,
November 5 at the Biane Library.
C4. Archibald Library: Oral update by Karye Hood, Reference Services Coordinator.
Karye Hood, Reference Services Coordinator, updated the Board on the computer classes being
offered at the Archibald Library. The Microsoft Excel Classes are being offered in November.
There are approximately nineteen to twenty-three attendees at each class. There is a Teen Program
on Creative Writing being held at the Archibald Library this evening
C5. Paul A. Biane Library: Oral update by Cara Vera, Senior Librarian.
Cara Vera, Senior Librarian, stated that on Friday, October 14, MAD (Music, Arts and Dance)
Cultural Arts Night was held at the Biane Library starting at 7 p.m. She wanted to recognize Linda
Engelke and Lorena Paz as coordinators for the event. There were approximately 450 attendees.
President Hairston stated that she really enjoyed the event.
Cara Vera,Senior Librarian,stated that on October 27,the third annual West End Inland Empire Job
Fair was held at the old Ontario Airport. Library staff presented resume classes for attendees.
Library staff also demonstrated how to apply for jobs on-line.
D. BOARD BUSINESS
D 1. Accident Reporting Form. Discussion led by President Hairston. Form attached.
President Hairston suggested removing the word"Incident"to the title of the form. She suggested
listing"Injury Reporting Form." She was interested in knowing what other Libraries list as the term
"injury"or "accident."
Member Coberly requested that the spelling be checked on page 26 for Immediate Action Taken.
6
Library Board Minutes
November 3, 2011
Page 3
Member Amster stated that she did not think staff could give out antiseptic or aspirin to injured
patrons.
Renee Tobin,Principal Librarian,stated that staff would check with the Risk Management Division.
Member Amsler suggested listing at the bottom of the form the departments or division that would
receive the form next. She also suggested that on page 27 remove the word Information after the
word Follow-up. Also, to add under Follow-up, to add the wording Completed By Supervisor or
Supervisor Use Only.
Member Amsler thanked Adam Tuckerman for his help during one of the Technology Classes
offered at the Biane Library.
President Hairston recessed the meeting at 6:30 p.m.
The Library Board of Trustees meeting moved from the Council Chambers to the Rains Room at
City Hall. President Hairston reconvened the meeting at 6:58 p.m.for the following discussion item.
D2. Library Strategic Services Plan. Discussion led by President Hairston and Robert Karatsu,
Library Director.
President Hairston stated that the report was well prepared and well thought out. She loved the
Circle Diagram. She suggested in the front of the SSP plan to list a glossary on the acronyms used in
the Plan.
President Hairston asked about charging residents for Library cards.
Robert Karatsu,Library Director,reviewed the revenues received from the State with the Board. The
revenues may not be there next year. There may be the potential in the future to charge nonresidents
for a card.
President Hairston asked if other cities have implemented fees at their libraries.
Library Director Karatsu stated that Pomona Library had. He stated that on Sunday,November 13,at
the California Library Association Conference,there will be a program in the afternoon on the topic
covering fees for residents and nonresidents.
President Hairston inquired about a dedicated library tax.
Assistant Library Director Perera stated that recently a tax had been passed in Monrovia and Los
Angeles areas.
7
Library Board Minutes
November 3, 2011
Page 4
Library Director Karatsu stated that if there was sufficient reason to pursue a tax staff would like to
have a consultant brought in to review the possibility of one passing.
Member Amsler inquired about the self check out machine.
Assistant Library Director Perera updated the Board on the self check out machine.
Member Amsler inquired about a bookmobile making deliveries at the assisted living centers in
Rancho Cucamonga.
Robert Karatsu, Library Director, stated that the ADA requirements needed for a bookmobile to
deliver to the centers would be costly. He stated that the Housecalls Program is available to assist
with patrons at the centers.
Member Temkin stated that the Library Strategic Services Plan was a comprehensive plan.
However, she did not see any area for professional development for staff.
Michelle Perera, Assistant Library Director, stated that on page 5 under Team RC, professional
development is covered.
President Hairston inquired about the databases and the costs associated with them.
Assistant Library Director Perera stated that each year before renewal, Library staff reviewed the
stats for all of the databases. Currently, the Library subscribes to sixty databases.
Library Director Karatsu stated that stats are kept by the database companies. One of the databases
was dropped last year due to low usage.
President Hairston noticed that the Back to Basics Program is currently free to the public. Does staff
think there might be a charge in the future for the program?
Renee Tobin, Principal Librarian stated that Allen Callaci, Back to Basics Coordinator, oversees
part-time staff and volunteers for the Program. There is a CDBG Grant which pays for some of the
part salaries at this time.
Member Temkin asked about the reality of the second floor of the Biane Library.
8
Library Board Minutes
November 3, 2011
Page 5
Library Director Karatsu stated that the Library did not receive the IMLS Grant this year. The
second floor of the Library is on hold at this time. Library staff continues to look for windows of
opportunity. The City Manager and the present City Council are very supportive of the plan for the
second floor of the Biane Library.
Member Coberly stated that the Library Strategic Services Plan is one of the best, well-thought
documents that he has seen.
E. IDENTIFICATION OF ITEMS FOR NEXT MEETING
El. Accident Form
G. ADJOURNMENT
MOTION: Moved by Member Coberly to adjourn to Thursday, January 5, 2012, seconded by
Member Amster. Motion carried 4-0-1 (with Haddon absent). The meeting adjourned at 7:40 p.m.
Respectfully submitted,
Vivian Garcia
Administrative Secretary
Approved:
9
CITY OF RANCHO CUCAMONGA
RANCHO CUCAMONGA LIBRARY BOARD OF TRUSTEES
Regular Meeting
A. CALL TO ORDER
The regular meeting of the Rancho Cucamonga Library Board of Trustees was scheduled for
Thursday,December 1,2011,at 6 p.m. in the Council Chambers of City Hall,located at 10500 Civic
Center Drive, Rancho Cucamonga, California.
The meeting was canceled due to a lack of business.
Respectfully submitted,
Vivian Garcia
Administrative Secretary
Approved:
10
STAFF REPORT S y
LIBRARY SERVICES DEPARTMENT La
RANCHO
Date: January 5, 2012 CUCAMONGA
To: Rancho Cucamonga Library Board of Trustees
From: Robert Karatsu, Library Director
Subject: LIBRARY STATUS REPORT
RECOMMENDATION
No recommendation. For information only.
BACKGROUND/ANALYSIS
The spreadsheets on the monthly statistics, a snapshot of the measurable activities of the Library
are attached. These reports include a separate sheet for the Archibald Library, Paul A. Biane
Library and a sheet with combined statistics. Reports attached for November.
FISCAL IMPACT
None.
Respectfully submitted,
/72" -
Robert Karatsu
Library Director
11
COMBINED STATISTICS Oct-11 Oct-10 is FY 2011/12 FY 2010/11
Days Open 57 57: 272 272
Items Borrowed(AR,BL,BKM) 103,171 108,690 506,087 526,390
Average Daily 1,810 1,907 1.861 1,935
%Change -5% -4%
Patrons Registered(AR,BL,BKM) 1,236 1,373 6.400 7.107
Average Daily 22 93 24 26
%Change -10% -10%
Information Questions 14,110 15,692 70.805 76.549
Average Daily 248 270 260 281
%Change -10% -8%
Library Visitors 52,004 55,626 . 263.949 275,867
Average Daily 912 976 970 1.014
%Change -7% -4%
r.
Children's Programs 3,115 3,391 14.212 16.738
#of Sessions 80 195`: 354 366
Aver.Per session 39 106 40 46
%Change -8% -15%
Items Classified 2,531 1,825 12.719 10,640
%Change 39% 20%
Volunteer Hours 691 641 3,964 3,657
%Change 8% 8%
TECHNOLOGY CENTER SERVICES
Computer Use Sessions 8,352 8,881 40.676 42,359
%Change -6% -4%
Technology Questions 4,178 4,148 21.687 22.546
%Change 1% -4%
Programs/Classes Attendance 136 135 898 848
#of Sessions 9 9 47 47
Aver.per session 15 15 19 18
ADULT SERVICES
Information Questions 5,865 6,354`'; 28,159 29,563
Average Daily 103 111`? 104 109
%Change -8% -5%
Programs/Classes Attendance 29 35 166 212
#of Sessions 4 4 4 4 21 22
Aver.per session 7 9 7 9 8 10
Teen Programs 46 75 15 4 222 288
#of Sessions 3 4 2 2 16 19
Aver.per session 15 19 8 2 14 15
Tours/Group Visits Attendance 0 0 0 0' 0 52
12
#of Sessions 0 0 - 4..- : 0 3
Aver.per session 0 0 0 17
CHILDRENS SERVICES
Information Questions 4,067 5,190 20.959 24,440
Average Daily 71 91 77 90
%Change -22% -14%
Bouncing Babies! 480 422 1.758 1.852
#of Sessions 14 12 54 52
Aver.Per session 34 35. 33 36
Toddler Time 222 315 1,001 1,310
#of Sessions 8 9 36 37
Aver.Per session 28 35 28 35
Preschool Storytime Attendance 363 404 1.570 1,937
#of Sessions 16 16 74 74
Aver.per session 23 25 21 26
Afterschool Storytime Attendance 287 199 873 723
#of Sessions 8 8 31 35
Aver.per session 36 25 28 21
Family Storytime Attendance 1,128 1,4354: 5.586 5.901
#of Sessions 30 32 140 146
Aver.per session 38 45 40 40
Special Events Program Attendance 565 510 3.309 4,837
#of Sessions 2 6 15 18
Aver.per session 283 85 221 269
Group Visits to Library Attendance 120 111 443 356
#of Sessions 2 4 9 13
Aver.per session 60 0 49 27
1
13
ARCHIBALD Oct-11 Oct-10 Nov-11 Nov-10: FY 2011/12 FY 2010/11
Days Open 31 31 27 27 146 146
items Borrowed(Incl.renewals) 50,948 52,359 47,653 49,023 248,390 254,080
Average Dairy 1,643 1,689 1,765 1,816 1,701 1,740
%Change -3% -3% -2%
Patrons Registered 648 685 457 612 3,367 3.680
Average Daily 21 22 17 23 23 25
%Change -5% -25% -9%
Information Questions 6,899 7,501 6,179 6,056 32,515 33.267
Average Daily 223 242 229 224 223 228
%Change -8% 2% -2%
Library Visitors 22,903 25,682 21,752 23,727 119,413 133,056
Average Daily 739 828 806 879 818 911
%Change -11% -8% -10%
Children's Programs 819 1,091 509 493 3,902 4,195
#of Sessions 25 29 20 16 116 120
Aver.Per session 33 38 25 31 34 35
%Change -25% 3% -3%
Items Classified 1,399 987 808 1,322 7,522 5.745
%Change 42% -39% 31
Volunteer Hours 116 15B 95 116 885 986
%Change -27% -18% -10%
TECHNOLOGY CENTER SERVICES
Computer Use Sessions 5,085 5,412 4,461 4,446 24.729 25.424
%Change -6% 0% -3%
Technology Questions 1,621 1,685 1,408 1,407 7.612 7.614
%Change -4% 0% 0%
7.
ProgramslClasses Attendance 55 57 69 62 362 290
#of Sessions 4 4 4 5 21 22
Aver.per session 14 14 17 12 17 13
ADULT SERVICES
Information Questions 2,695 2,695 2,228 2,237 12.222 11.866
Average Daily 87 87 83 83 84 81
%Change 0% 0% 3%
ProgramslClasses Attendance 12 12 7 12 58 66
#of Sessions 2 2 2 2 10 10
Aver.per session 6 6 4 6 6 7
Teen Programs 12 46 7 4 91 119
#of Sessions 1 2 1 2 7 9
Aver.per session 12 23 7 2 13 13
Tours/Group Visits Attendance 0 0 0 6 0 15
#of Sessions 0 0 0 0 0 1
Aver.per session 0 0 0 0 0 0
CHILDRENS SERVICES
Information Questions 2,583 3,121 2,543 2,412- 12.681 13.787
Average Daily 83 101 94 89 87 94
%Change -17% 5% -8%
Bouncing Babies 139 138 94 90 603 592
#of Sessions 4 4 3 2 18 18
Aver.Per session 35 35 31 45 34 33
Toddler Time 85 156 66 85 467 677
14
#of Sessions 4 4 3 2 18 18
Aver.Per session 21 39 22 43 26 38
Preschool Storytime Attendance 193 204 171 155 864 864
#of Sessions 8 8 6 6 36 36
Aver.per session 24 26 29 26 24 24
Afterschool Storytime Attendance 120 94 73 42 389 372
#of Sessions 4 4 3 2 15 17
Aver.per session 30 24 24 21 26 22
Family Storytime Attendance 192 189 94 121 759 811
#of Sessions 4 4 4 4 20 21
Aver.per session 48 47 24 30 38 39
Special Events Program Attendance 90 310 11 0 820 879
#of Sessions 1 5 1 0 9 10
Aver.per session 90 62 11 91 88
Group Visits to Library Attendance 0 11 0 0 27 57
#of Sessions 0 1 0 0 3 3
•
Aver.per session 0 11 0 0 19
15
BIANE Oct-11 Oct-10 -. - FY 2011/12 FY 2010/11
Days Open 26 26 , 126 126
Items Borrowed 45,179 49,312 43,871 236,462 250,674
Average Daily 1,738 1,8' '` 1,877 1,989
%Change -8% -6%
d.
Patrons Registered 588 68 2,908 3,368
Average Daily 23 2 c 23 27
%Change -15% .. -14%
Information Questions 7,211 rt'-` 38,290 43,282
Average Daily 31 ? 304 344
%Change -12%
Library Visitors 29, .i 144,536 142,811
Average Daily 1,119 1, 4 'u ,059; ' 1,147 1,133
%Change -3°J4 1%
Children's Programs 2,226� `'` -' 10,195 12,365
#of Sessions 53 234 242
Aver.Per session 42 44 51
%Change 1' -18%
Items Classified 1,132 1100 5,197 4.895
%Change 35° 6%
Volunteer Hours 49 `r'■ 1,216 909
%Change -3$ 34%
TECHNOLOGY CENTER SERVICES
Computer Use Sessions 3,267 3,469 ,: " 15,947 16.935 1
%Change -6% -6%
Technology Questions 2,557 2,46' 14,075 14,932
%Change 4%. „-.. -6%
Programs/Classes Attendance 81 7:i 536 558
#of Sessions 5 26 25
Aver.per session :� 16 1:' 21 22
ADULT SERVICES
Information Questions I 15.937 17,697
Average Daily 122 141 121 # 126 140
%Change -10%
Programs/Classes Attendance • s' 108 146
#of Sessions 2 2 2-, 11 12
Aver.per session 9,.;._ 12 10 10 12
i
Teen Programs `29 8 131 169
#of Sessions 1.' 9 10
Aver.per session 17 15 17
16
Tours/Group Visits Attendance 0 0 6 0 37
#of Sessions 0 0 I. 0 2
Aver,per session 0 0 0 ` 0 19
CHILDRENS SERVICES
Information Questions 1,484 2,069 1,49 ` 8,278 10,653
Average Daily 57 80 65 66 85
%Change -28% -22°A.! -22%
Bouncing Babies) 341 284.%' 1,155 1,260
#of Sessions 10 36 34
Aver.Per session 34 36' ` 32 37
Toddler Time 137 159; = 534 633
#of Sessions 4 18 19
Aver.Per session 34 32� T. 30 33
Preschool Storytime Attendance 170 2• 706 1,073
#of Sessions 8 38 38
Aver.per session 21 2 ; 19 28
Afterschool Storytime Attendance 167 10 484 351
#of Sessions 4 16 18
Aver.per session 42 2 30 20
Family Storytime Attendance 936 1 2 4,827 5,090
#of Sessions . 26 2 120 125
Aver.per session 40 41
Special Events Program Attendance r , 2,489 3,958
#of Sessions 1 6 8
Aver.per session e 415 495
Group Visits to Library Attendance t I k 416 299
#of Sessions 2 6 10
Aver.per session 60 69 0
1 7
SERVICES & OUTREACH Oct-11 Oct-10 FY 2011/12 FY 2010111
BOOKMOBILE
items Borrowed(incl.renewals) 7,044 7,019 21,235 21.636
%Change 0% -2%
Patrons Registered 0 4 125 59
0 0
ADULT LITERACY SERVICES 0 0
Tutor Teams Matched 53 44 267 217
%Change 20% 23%
Learners Waiting 5 7 24 47
%Change -29% -49%
Families for Literacy Participants 4 5 20 31
Computer Literacy Participants 75 68 372 334
Storynite 0 23 0 93
Volunteer Hours 203 179 1,049 1,022
BACK 2 BASICS ARCHIBALD 0 0
#of Students 42 33 129 97
#of Sessions 121 106 320 246
#of Volunteer Hours 150 112 379 283
Special Program Att. 23 28 23 52
#of Sessions 1 1 1 2
Aver.Per session 23 28 0 0
BACK 2 BASICS BIANE
#of Students 45 48 135 144
#of Sessions 135 144 351 330
#of Volunteer Hours 174 113 434 458
Special Program Att. 47 68 92 126
#of Sessions 1 1 3 2
Aver.Per session 47 68 0 0
SCHOOL&COMMUNITY OUTREACH 1,415 1,205 2,390 2,530
#of Visits 5 4 11 15
VIRTUAL LIBRARY SERVICES
Searches 12,218 105,019 59,651 490,070
Retrievals 177,006 125,853 547,158 753,615
Remote Access 1,411 85,836 8,663 435,679
Tutor.Com Use 255 262 964 675
Home Access 255 261 964 674
In-Library Use 0 1 0 1
Digital Books 975 559 4.323 2,877
Audio Downloads 465 408 2,213 2,029
eBook Downloads 510 151 2,110 848
Website Hits 43,495 543,704 217,096 2,160.825
HOMEBOUND SERVICES
Patrons Served 20 26 99 124
Materials Loaned 141 219 765 977
Visitor Hours Volunteered 12 19 66 82
18
7>
STAFF REPORT k
LIBRARY SERVICES DEPARTMENT 1.4
RANCHO
Date: January 5, 2012 CUCAMONGA
To: Rancho Cucamonga Library Board of Trustees
From: Robert Karatsu, Library Director
Subject: STATUS OF 2011/2012 BUDGET
RECOMMENDATION
No recommendation. For information only.
BACKGROUND/ANALYSIS
Schedule A, titled "Revenue Report" is a report of all funds earned during the month(s) and is
attached. It includes separate reports for Archibald Library revenue, Paul A. Biane Library revenue
and combined revenues.
Schedule B, titled "Balance Sheet FY 2011/2012" is a report balancing income vs. projections for
the current fiscal year to date and is attached.
Schedule C, titled "Library Expenditures 2011/2012" is an accounting of all funds expended in the
current fiscal year and is attached.
FISCAL IMPACT
None.
Respectfully submitted,
Robert Karatsui/�
Library Director
19
Schedule A
TOTAL LIBRARIES FINES MEDIA REF PHOTO PASSPORTS
REVENUE REPORT & FEES RENTALS SERV. COPY
Nov-11
01-Nov $758.86 $356.80 $11.00 $64.85 $124.00
02-Nov $876.36 $348.91 $0.00 $11.55 $235.00
03-Nov $979.21 $309.07 $0.00 $33.00 $74.00
04-Nov $430.04 $371.26 $0.00 $293.75 $87.00
05-Nov $549.76 $487.71 $0.00 $0.00 $198.00
06-Nov $354.29 $104.88 $0.00 $0.00 $0.00
07-Nov $875.34 $302.45 $0.00 $44.00 $112.00
08-Nov $1,097.41 $320.61 $0.00 $20.00 $112.00
09-Nov $714.01 $400.15 $0.00 $0.00 $224.00
10-Nov $324.61 $389.16 $31.00 $0.00 $111.00
11-Nov $0.00 $0.00 $0.00 $0.00 $0.00
12-Nov $732.96 $557.97 $0.00 $59.00 $0.00
13-Nov $246.35 $120.75 $0.00 $30.00 $0.00
14-Nov $796.79 $365.04 $0.00 $0.00 $162.00
15-Nov $608.68 $308.89 $0.00 $134.50 $62.00
16-Nov $637.88 $367.75 $0.00 $65.00 $50.00
17-Nov $423.81 $313.39 $0.00 $35.35 $50.00
18-Nov $757.03 $390.11 $35.00 $120.45 $136.00 .
19-Nov $487.91 $482.95 $0.00 $57.00 $173.00
20-Nov $139.30 $151.20 $36.00 $0.00 $0.00
21-Nov $546.09 $400.85 $0.00 $0.00 $62.00
22-Nov $461.60 $432.70 $0.00 $0.00 $50.00
23-Nov $535.02 $636.11 $0.00 $0.00 $235.00
24-Nov $0.00 $0.00 $0.00 $0.00 $0.00
25-Nov $0.00 $0.00 $0.00 $0.00 $0.00
26-Nov $439.35 $508.17 $3.00 $0.00 $62.00
27-Nov $240.25 $152.69 $0.00 $0.00 $0.00
28-Nov $916.57 $311.04 $3.00 $0.00 $173.00
29-Nov $786.00 $347.92 $0.00 $162.25 $198.00
30-Nov $774.33 $271.84 $12.50 $377.00 $37.00
TOTALS: $16,489.81 $9,510.37 $131.50 $1,507.70 $2,727.00
Nov 2010 TOTALS $17,471.04 $10,767.87 $73.00 $1,210.28 $2,589.00
20
ARCHIBALD LIBRARY FINES MEDIA REF PHOTO PASSPORTS
REVENUE REPORT & FEES RENTALS SERV. COPY
Nov-11
01-Nov $336.25 $167.19 $0.00 $64.85 $0.00
02-Nov $564.09 $161.69 $0.00 $11.55 $0.00
03-Nov $401.24 $133.58 $0.00 $0.00 $0.00
04-Nov $161.55 $170.93 $0.00 $108.75 $0.00
05-Nov $315.46 $249.52 $0.00 $0.00 $0.00
06-Nov $354.29 $104.88 $0.00 $0:00 $0.00
07-Nov $391.01 $134.27 $0.00 $44.00 $0.00
08-Nov $566.87 $149.73 $0.00 $20.00 $0.00
09-Nov $345.53 $156.17 $0.00 , $0.00 $0.00
10-Nov $132.36 $163.07 $0.00 $0.00 $0.00
11-Nov $0.00 $0.00 $0.00 $0.00 $0.00
12-Nov $343.01 $241.27 $0.00 $57.00 $0.00
13-Nov $246.35 $120.75 $0.00 $30.00 $0.00
14-Nov $483.64 $174.34 $0.00 $0.00 $0.00
15-Nov $287.99 $153.18 $0.00 $134.50 $0.00
16-Nov $317.89 $138.92 $0.00 $0.00 $0.00
17-Nov $219.08 $177.55 $0.00 $35.35 $0.00
18-Nov $477.55 $152.30 $0.00 $120.45 $0.00
19-Nov $263.58 $195.03 $0.00 $57.00 $0.00
20-Nov $139.30 $151.20 $36.00 $0.00 $0.00
21-Nov $261.83 $183.99 $0.00 $0.00 $0.00
22-Nov $226.00 $181.93 $0.00 $0.00 $0.00
23-Nov $307.93 $297.37 $0.00 $0.00 $0.00
24-Nov $0.00 $0.00 $0.00 $0.00 $0.00
25-Nov $0.00 $0.00 $0.00 $0.00 $0.00
26-Nov $197.02 $204.24 $3.00 $0.00 $0.00
27-Nov $240.25 $152.69 $0.00 $0.00 $0.00
28-Nov $383.58 $151.66 $0.00 $0.00 $0.00
29-Nov $353.04 $182.20 $0.00 $162.25 $0.00
30-Nov $463.03 $120.75 $12.50 $0.00 $0.00
TOTALS: $8,779.72 $4,570.40 $51.50 $845.70 $0.00
Nov 2010 TOTALS $9,103.03 $5,239.69 $64.00 $894.15 $0.00
21
BIANE LIBRARY FINES MEDIA REF PHOTO PASSPORTS
REVENUE REPORT & FEES RENTALS SERV. COPY
Nov-11
01-Nov • $422.61 $189.61 $11.00 $0.00 $124.00
02-Nov $312.27 $187.22 $0.00 $0.00 $235.00
03-Nov $577.97 $175.49 $0.00 $33.00 $74.00
04-Nov $268.49 $200.33 $0.00 $185.00 $87.00
05-Nov $234.30 $238.19 $0.00 $0.00 $198.00
06-Nov $0.00 $0.00 $0.00 $0.00 $0.00
07-Nov $484.33 $168.18 $0.00 $0.00 $112.00
08-Nov $530.54 $170.88 $0.00 $0.00 $112.00
09-Nov $368.48 $243.98 $0.00 $0.00 $224.00
10-Nov $192.25 $226.09 $31.00 $0.00 $111.00
11-Nov $0.00 $0.00 $0.00 $0.00 $0.00
12-Nov $389.95 $316.70 $0.00 $2.00 $0.00
13-Nov $0.00 $0.00 $0.00 $0.00 $0.00
14-Nov $313.15 $190.70 $0.00 $0.00 $162.00
15-Nov $320.69 $155.71 $0.00 $0.00 $62.00
16-Nov $319.99 $228.83 $0.00 $65.00 $50.00
17-Nov $204.73 $135.84 $0.00 $0.00 $50.00
18-Nov $279.48 $237.81 $35.00 $0.00 $136.00
19-Nov $224.33 $287.92 $0.00 $0.00 $173.00
20-Nov $0.00 $0.00 $0.00 $0.00 $0.00
21-Nov $284.26 $216.86 $0.00 $0.00 $62.00
22-Nov $235.60 $250.77 $0.00 $0.00 $50.00
23-Nov $227.09 $338.74 $0.00 $0.00 $235.00
24-Nov $0.00 $0.00 $0.00 $0.00 $0.00
25-Nov $0.00 $0.00 $0.00 $0.00 $0.00
26-Nov $242.33 $303.93 $0.00 $0.00 $62.00
27-Nov $0.00 $0.00 $0.00 $0.00 $0.00
28-Nov $532.99 $159.38 $3.00 $0.00 $173.00
29-Nov $432.96 $165.72 $0.00 $0.00 $198.00
30-Nov $311.30 $151.09 $0.00 $377.00 $37.00
TOTALS: $7,710.09 $4,939.97 $80.00 $662.00 $2,727.00
Nov 2010 TOTALS $8,368.01 $5,528.18 $9.00 $316.13 $2,589.00
22
Schedule B
BALANCE SHEET
Thru Nov 2011
FY 2011/2012
Revenues Earned Projected Loss/Gain
Fines & Fees $86,692 $87,500 ($808) -0.9%
Media Rentals $52,237 $60,000 ($7,763) -12.9%
Sales/Services Fees $488 $1,500 ($1,012) -67.5%
Direct Loan $53,725 $1 $53,724 5372400.0%
Passport Services $14,272 $15,000 ($728) -4.9%
Private Contributions $60,000 $50,000 $10,000 20.0%
Totals: $267,414 $214,001 $53,413 25.0%
*Balance for
Year through Nov 2011 $53,413
23
Schedule C
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CITY OF RANCHO CUCAMONGA
Fiscal Year: 2012 GL Budget to Actual with Encumbrances
Report Date: Nov 2011
Remaining
Object Description Budget MTD Actual YTD Actual Encumbrance Balance
Revenue Accounts
Key 1290000-Library Fund
4101 Property Taxes-CY Secured 3,031,060.00 0.00 0.00 0.00 3,031,060.00 100.00
4102 Property Taxes-CY Unsecured 79,020.00 0.00 0.00 0.00 79,020.00 100.00
4103 Property Taxes-PY Sec&Unsec 61,850.00 0.00 0.00 0.00 61,850.00 100.00
4105 Property Taxes-Supplemental 54,340.00 0.00 0.00 0.00 54,340.00 100.00
4312 Library Fines and Fees 175,000.00 16,498.81 86,697.76 0.00 88,302.24 50.45
4401 Interest Earnings 91,970.00 0.00 9,625.35 0.00 82,344.65 89.53
4402 Unrealized Gain 0.00 0.00 -35,250.97 0.00 35,250.97 0.00
4410 Media Rentals 120,000.00 9,510.37 52,237.04 0.00 67,762.96 56.46
4512 Library Card&Merchndse Sales 0.00 0.00 35.00 0.00 -35.00 0.00
4515 Information Service Fees 300.00 96.50 567.90 0.00 -267.90 -89.30
4565 Passport Processing Fees 30,000.00 2,175.00 11,512.72 0.00 18,487.28 61.62
4567 Passport Photo Fees 7,200.00 552.00 2,760.00 0.00 4,440.00 61.66
4570 Sale of Printed Materials 18,000.00 1,586.60 9,363.33 0.00 8,636.67 47.98
4740 Grant Income 8,250.00 10,000.00 16,114.00 0.00 -7,864.00 -95.32
4906 CLSA Direct Loan 0.00 0.00 53,724.79 0.00 -53,724,79 0.00
4907 Private Contributions Library 125,000.00 0.00 25,000.00 0.00 100,000.00 80.00
4909 RC Library Foundation Support 0.00 5,000.00 5,000.00 0.00 -5,000.00 0.00
Total for Org Key 1290000: 3,801,990.00 45,419.28 237,386.92 0.00 3,564,603.08 93.75
Key 1291000-CA State Library
4402 Unrealized Gain 0.00 0.00 -553.15 0.00 553.15 0.00
4740 Grant Income 0.00 7,500.00 29,857.53 0.00 -29.857.53 0.00
Total for Org Key 1291000: 0.00 7,500.00 29,304.38 0.00 -29,304.38 0.00
Key 1292000-Staff Innovatin Fd(Ca St Lib)
4740 Grant Income 20,000.00 18,000.00 18,000.00 0.00 2,000.00 10.00
4909 RC Library Foundation Support 15,000.00 15,000.00 15,000.00 0.00 0.00 0.00
Total for Org Key 1292000: 35,000.00 33,000.00 33,000.00 0.00 2,000.00 5.71
Key 1298000-Calif Literacy Campaign Grant
4909 RC Library Foundation Support 15,000.00 15,000.00 15,000.00 0.00 0.00 0.00
8290 Transfer In-Library Fund 83,000.00 0.00 41,845.00 0.00 41,155.00 49.58
Total for Org Key 1298000: 98,000.00 15,000.00 56,845.00 0.00 41,155.00 41.99
Total for Revenue Accounts: 3,934,990.00 100,919.28 356,536.30 0.00 3,578,45330 90.93
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CITY OF RANCHO CUCAMONGA
Fiscal Year: 2012 GL Budget to Actual with Encumbrances
Report Date: Nov 2011
Remaining
Object Description Budget MTD Actual YTD Actual Encumbrance Balance %
,Expense Accounts
Key 1290601 -Library Fund
5000 Regular Salaries 295,790.00 22,207.59 99,775.47 0.00 196,014.53 66.26
5010 Part Time Salaries 2,000.00 0.00 0.00 0.00 2,000.00 100.00
5030 Fringe Benefits 132,820.00 0.00 132,833.29 0.00 -13.29 -0.01
5100 Travel and Meetings 6,000.00 0.00 883.50 0.00 5,116.50 85.27
5102 Training 2,000.00 0.00 137.43 0.00 1,862.57 93.12
5105 Mileage 1,000.00 59.94 1,991.57 0.00 -991.57 -99.15
5150 Office Supplies&Equipment 2,000.00 15.05 420.79 0.00 1,579,21 78.96
5160 Membership Dues 3,100.00 0.00 845.00 0.00 2,255.00 72.74
5200 Operations&Maintenance 10,250.00 444.00 1,883.63 0.00 8,366.37 81.62
5215 0&M/Computer Equipment 0.00 0.00 70.00 0.00 -70.00 0.00
5220 Cellular Technology 600.00 0.00 195.00 0.00 405.00 67.50
5300 Contract Services 85,500.00 649.95 31,096.99 2,155.14 52,247,87 61.10
5400 Telephone Utilities 12,000.00 962.58 4,109.11 0.00 7,890.89 65.75
5402 . Water Utilities 3,600.00 0.00 1,756.52 0.00 1,843.48 51.20
5403 Electric Utilities 70,950.00 0.00 27,940.30 0.00 43,009.70 60.61
5501 Admin./General Overhead 189,000.00 0.00 94,500.00 0.00 94,500.00 50.00
5503 City Facilities Allocation 11,740.00 0.00 5,870.00 0.00 5,870.00 50.00
9298 Transfer Out-CA Literacy Cmpgn . 83,690.00 0.00 41,845.00 0.00 41,845.00 50.00
Total for Org Key 1290601: 912,040.00 24,339.11 446,153.60 2,155.14 463,731.26 50.84
Key 1290603-After School Learning Prog
5000 Regular Salaries 32,570.00 2,433.08 11,211.93 0.00 21,358.07 65.57
5010 Part Time Salaries 30,000.00 0.00 2,453.19 0.00 27,546.81 91.82
5030 Fringe Benefits 15,910.00 0.00 15,911.59 0.00 -1.59 -0.00
5150 Office Supplies&Equipment 2,500.00 0.00 0.00 0.00 2,500.00 100.00
5200 Operations&Maintenance 4,000.00 0.00 452.19 0.00 3,547.81 88.69
5300 Contract Services 500.00 0.00 0.00 0.00 500.00 100.00
Total for Org Key 1290603: 85,480.00 2,433.08 30,028.90 0.00 55,451.10 64.87
Key 1290604-Bookmobile Services
5000 Regular Salaries 59,170.00 4,551.70 20,960.58 0.00 38,209.42 64.57
5010 Part Time Salaries 20,600.00 1,444.86 6,670.53 0.00 13,929.47 67.61
5030 Fringe Benefits 29,150.00 0.00 29,152.96 0.00 -2.96 -0.01
5105 Mileage 100.00 0.00 0.00 0.00 100.00 100.00
5150 Office Supplies&Equipment 500.00 0.00 0.00 0.00 500.00 100.00
5200 Operations&Maintenance 4,000.00 0.00 498.10 0.00 3,501.90 87.54
5220 Cellular Technology 1,500.00 79.24 316.81 0.00 1,183.19 78.87
Total for Org Key 1290604: 115,020.00 6,075.80 57,598.98 0.00 57,421.02 49.92
Key 1290605-Library Board of Trustees
5100 Travel and Meetings 1,200.00 0.00 220.00 0.00 980.00 81.66
5160 Membership Dues 500.00 0.00 0.00 0.00 500.00 100.00
Total for OrgKey1290605: 1,700.00 0.00 220.00 0.00 1,480.00 87.05
Key 1290606-Archibald Library
5000 Regular Salaries 469,740.00 35,371.18 162,946.17 0.00 306,793.83 65.31
5010 Part Time Salaries 318,130.00 21,892.43 101,916.72 0.00 216,213.28 67.96
5030 Fringe Benefits 239,770.00 0.00 239,793.98 0.00 -23.98 -0.01
5100 Travel and Meetings 2,000.00 18.00 716.21 0.00 1,283.79 64.18
5105 Mileage 200.00 84.36 84.36 0.00 115.64 57.82
5150 Office Supplies&Equipment 7,500.00 340.57 1,261.37 0.00 6,238.63 83.18
5152 Computer Software 1,000.00 0.00 0.00 0.00 1,000.00 100.00
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CITY OF RANCHO CUCAMONGA
Fiscal Year: 2012 GL Budget to Actual with Encumbrances
Report Date: Nov 2011
Remaining
Object Description Budget MTD Actual YTD Actual Encumbrance Balance
5160 Membership Dues 450.00 0.00 240.00 0.00 210.00 46.66
5200 Operations&Maintenance 185,240.00 5,711.84 40,160.57 24,621.07 120,458.36 65.02
5300 Contract Services 93,320.00 4,255.86 33,908.61 32,424.00 26,987.39 28.91
Total for Org Key 1290606: 1,317,350.00 67,674.24 581,027.99 57,045.07 679,276.94 51,56
Key 1290607-Paul A.Slane Library
5000 Regular Salaries 546,370.00 40,653.85 188,651.05 0.00 357,718.95 65.47
5010 Part Time Salaries 344,920.00 26,636.02 119,607.79 0.00 225,312.21 65.32
5030 Fringe Benefits 279,210.00 0.00 279,237.92 0.00 -27.92 -0.01
5100 Travel and Meetings 4,000.00 0.00 1,125.00 0.00 2,875.00 71.87
5105 Mileage 300.00 0.00 0.00 0.00 300.00 100.00
5150 Office Supplies&Equipment 10,000.00 117.56 3,297.68 0.00 6,702.32 67.02
5152 Computer Software 3,000.00 0.00 0.00 0.00 3,000.00 100.00
5160 Membership Dues 730.00 0.00 400.00 0.00 330.00 45.20
5200 Operations&Maintenance 228,240.00 5,674.26 45,471.49 26,234.48 156,534.03 68.58
5300 Contract Services 86,500.00 1,889.74 31,130.57 14,072.92 41,296.51 47.74
Total for Org Key 1290607: 1,503,270.00 74,971.43 668,921.50 40,307.40 794,041.10 52.82
Key 1290608-Virtual Library
5000 Regular Salaries 28,300.00 2,113.64 9,739.86 0.00 18,560.14 65.58
5030 Fringe Benefits 13,300.00 0.00 13,301.33 0.00 -1.33 -0.01
5152 Computer Software 2,000.00 0.00 0.00 0.00 2,000.00 100.00
5300 Contract Services 4,000.00 0.00 0.00 0.00 4,000.00 100.00
Total for Org Key 1290608: 47,600.00 2,113.64 23,041.19 0,00 24,558.81 51.59
Key 1291602-CA STATE LIBRARY
5010 Part Time Salaries 12,730.00 0.00 3,153.87 0.00 9,576.13 75.22
5030 Fringe Benefits 250.00 0.00 250.07 0.00 -0.07 -0.02
5100 Travel and Meetings 8,000.00 0.00 0.00 0.00 8,000.00 100.00
5152 Computer Software 1,294.00 0.00 723.68 0.00 570.32 44.07
5200 Operations&Maintenance 18,000.00 0.00 11,080.62 0.00 6,919.38 38.44
5300 Contract Services 62,542.00 0.00 28,100.00 3,836.00 30,606.00 48.93
Total for Org Key 1291602: 102,816.00 0.00 43,308.24 3,836.00 55,671.76 54.14
Key 1292602-STAFF INNOVATIN FD(CA ST LIB)
5200 Operations&Maintenance 12,500.00 0.00 0.00 0.00 12,500.00 100.00
5300 Contract Services 22,500.00 2,000.00 2,000.00 0.00 20,500.00 91.11
Total for Org Key 1292602: 35,000.00 2,000.00 2,000.00 0.00 33,000.00 94.28
Key 1298601 -Calif Literacy Campaign Grant
5000 Regular Salaries 56,880.00 3,914.30 19,687.54 0.00 37,192.46 65.38
5010 Part Time Salaries 17,190.00 1,348.05 5,673.20 0.00 11,516.80 67.00
5030 Fringe Benefits 26,930.00 0.00 26,932.71 0.00 -2.71 -0.01
5100 Travel and Meetings 500.00 0.00 175.00 0.00 325.00 65.00
5105 Mileage 300.00 0.00 -61.20 0.00 361.20 120.40
5150 Office Supplies&Equipment 1,000.00 0.00 0.00 0.00 1,000.00 100.00
5160 Membership Dues 140.00 0.00 120.00 0.00 20.00 14.28
5200 Operations&Maintenance 1,000.00 0.00 994.68 0.00 5.32 0.53
5300 Contract Services 1,310.00 250.00 1,012.00 23.00 275.00 20.99
Total for Org Key 1298601: 105,250.00 5,512.35 54,533.93 23.00 50,693.07 48.16
Total for Expense Accounts: 4,225,526.00 185,119.65 1,906,834.33 103,366.61 2,215,325.06 52.42
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CITY OF RANCHO CUCAMONGA
Fiscal Year: 2012 GL Budget to Actual with Encumbrances
Report Date: Nov 2011
Remaining
Object Description Budget MTD Actual YTD Actual Encumbrance Balance
Report Summary
Revenue Total: 3,934,990.00 100,919.28 356,536.30 0.00 3,578,453.70 90.93
Expense Total: 4,225,526.00 185,119.65 1,906,834.33 103,366.61 2,215,325.06 52.42
Total Net for Report: -290,536.00 -84,200.37 -1,550,298.03 -103,366.61 1,363,128.64
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STAFF REPORT
desi
LIBRARY SERVICES DEPARTMENT Lj
RANCHO
Date: January 5, 2012 CUCAMONGA
To: Rancho Cucamonga Library Board of Trustees
From: Robert Karatsu, Library Director
Subject: REVISED ACCIDENT REPORTING FORM
RECOMMENDATION
That the Library Board of Trustees review revised accident reporting form and approve.
BACKGROUND/ANALYSIS
At the November 3, 2011 meeting of the Library Board of Trustees, there was further discussion of
Library's accident reporting form. After discussion by the Board, it was recommended that staff
submit revisions to City's Risk Management Division for approval. Staff has incorporated changes
recommended by Risk Management and have brought back to Board for approval.
FISCAL IMPACT
None
Respectfully submitted,
Robert Karatsu
Library Director
28
•
IF THIS INCIDENT/INJURY IS AN EMERGENCY,
CALL 911 ,
•
RANCHO CUCAMONGA LIBRARY SERVICES "
Incident/Iniury Reporting Form -For Internal Use Only- RANCHO
CAMONGA
LIBRARY SERVICES
Please fill out this form and forward a copy to Library management within 24-hours of the incident/injury.]
rINFORMATION ON N
IURED PARTY • • -
I ,
DATE of inddent/injury: I TIME OF DAY:
NAME of injured:
HOME ADDRESS: i CITY: STATE: ZIP:
I i I
TELEPHONE NUMBER(note If cell or home or business number):
MALE FEMALE ❑ AGE:
I NAME OF ADULT(if accompanying child:) I RELATIONSHIP:
i I
LOCATION/DECRIPTION/ACTION
LOCATION where incideni occurred:
Did Injury/incident occur outside? YES ❑ NO ❑
If yes,indicate weather I.e. raining,sunny,cloudy.
DESCRIBE injury:
I �
DESCRIBE what person was doing at time of incident;/injury: --
i
IMMEDIATE ACTION TAKEN: First aid care(name of materials given;e.g.cold pack, bandages,etc...)
I i
Was 911 called? YES U NO I I --
If YES,who called:
29
NOTIFICATION/OUTCOME -- ' -
If applicable,were parents or relatives notified? YES n NO Unable to reach
Time notified: Where notified: HOME 0 WORK 0 OTHER(Specify)
....■■■■HE■■
r Who was notified. MOTR FATHER OTHER(Specify)
PARENT'S NAME:
Disposition of injured: SENT HOME j SENT TO DOCTOR 0 TO HOSPITAL fl STAYED AT LIBRARY [
Transportation: WALKED 0 PERSONAL VEHICLE 0 AMBULANCE 0 OTHER ri
NAME OF STAFF in charge when incident occurred:
' JOB TITLE: TELEPHONE EXTENSION:
Was he/she present at the time of the inddent? YES 111 NOE
[ NAME [ ADDRESS I TELEPHONE I AGE
1.
—J-
r 2.
3.
rSIGNATuRE AND FOLLOW-UP ,T .-7 4:77-tp-t,7,7 7,7 17
[ SIGNATURE of person filling out this reporting form Job title
FOLLOW-UP INFORMATION :
DATE: TIME: I OBTAINED BY:
[ SUPERVISOR: MANAGER:
30