(a) Every participant coming into the senior center on the specified date will sign the daily log. A visitor who is not a bona fide member shall sign a guest log and not be included in the sample.

(b) Their names will then be checked against the participant record files, which will provide the basis for verifying that they are at least 60 years of age, or the spouse of a person at least 60 years of age.

(c) After a brief explanation of why the requested information is being obtained, including the statement that the provision of this information is optional on the part of the participant, the individual will be asked to show any documentation which would identify him as being categorically related, such as a Medicaid card, P.A. ID card, SSI award letter. This information is to be recorded on the validation form for categorically related individuals, and such identification will terminate the validation process for those individuals of the sample group.

(d) Those participants who do not have any of the above documentation or indicate that they are not categorically related would be asked to voluntarily sign a group declaration form that states that their “monthly gross income is less than 90 percent of the then in effect State median income, adjusted for family size,” or if they prefer, an individual declaration form that certifies the same facts. (The actual figures of the State median income adjusted for family size will be published in the current Comprehensive Annual Social Services Program Plan for New York State.) All those participants who signed either the individual or group declaration are then finished with the validation process.

(e) The number in the sample who are categorically related (see subdivision [c] of this section) will be added to the number who sign the group or individual forms (see subdivision [d] of this section) certifying that their income is below the required level.

(f) Every person not validated by the previous steps must be listed on another form “Individuals Not Validated.” This includes anyone who refuses or otherwise fails to participate in the validation process after signing the log, as well as anyone who declare income above the cutoff level. The residue of the sample who fail to show documentation or sign the group or individual declarations as to their level of income, will be run against existing M.A. or P.A. files when determined appropriate to comply with Federal requirements.

(g) The total number of persons recorded on the categorical, group and individual declaration and not validated forms must equal the number in the sample, as listed on the daily log. This reconciliation is to be recorded on the return transmittal form prescribed by the department.

(h) The completed forms from each center in the sample, including the daily log, are to be packed with the return transmittal form and returned to the main office of the local social services district conducting the validation.