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VIEWS: 3 PAGES: 15

									                 Diocese of Austin
                 Office of Ethics and Integrity in Ministry
                 Site Compliance Review
                 School year: 2010-2011

        PARISH NAME: __________________________________________________________
        CITY: ____________________________________________________________________

Thank you for the important role you play in helping maintain compliance with the Ethics and Integrity in Ministry
policies of the Diocese of Austin. The work you are doing is keeping children safe from preventable harm. We would also like to
thank you in advance for providing the information requested below to the EIM Office by June 1 of each year; this ensures
we complete the annual audit conducted for the USCCB accurately and timely.


      SCREENING AND TRAINING
      All Paid Staff/Priests/Deacons/Women & Men            #      Yes No               Comments
          Religious
      1. Every paid staff member working with minors and vulnerable adults must be compliant with
         diocesan EIM policies
           # of paid staff                                        NA NA
           # of part-time paid staff                              NA NA
           # of priests/deacons/women & men                       NA NA
               religious
          Has every person counted above:
           Completed their Application for                NA
               Ministry/had a background check run?
           Attended the EIM workshop?                     NA
           Attended a subsequent EIM Basic or
               Refresher workshop if it has been 3 years+  NA
               since their initial workshop date?
      2. Are those who are restricted (due to a background
          check result or other reason) contacted by the   NA
          pastor/principal in a timely manner to review
          the restricted status?
      3. Does staff in-service reinforce diocesan EIM      NA
          policies?
      All Volunteers serving in ministry to minors and      #      Yes No               Comments
          vulnerable adults – see EIM policies VI.A.
      1. Every volunteer working with minors and vulnerable adults must be compliant with diocesan
          EIM policies. Can you verify each volunteer has:
           # of religious education volunteers                    NA NA
           # of youth ministry volunteers                         NA NA
           # of other youth serving ministry volunteers           NA NA
           # of homebound communion ministers                     NA NA
           # of liturgical ministers                              NA NA
           # of social service organization volunteers            NA NA
           # others required to be EIM compliant as               NA NA
               determined at the parish level
          Has every person counted above:
           Completed their Application for                NA
               Ministry/had a background check run?
           Attended an EIM workshop?                      NA
           Attended a subsequent EIM Basic or             NA
               Refresher workshop if it has been 3 years+
               since their initial workshop date?
2. Are volunteers who are restricted (due to a             NA
     background check result or other reason)
     contacted by the pastor/principal in a timely
     manner to review the restricted status?
3. Are ministry leaders notified if a volunteer in         NA
     their ministry/organization is ineligible to serve
     due to a restricted or non-compliance status?
4. Does ministry specific training reinforce diocesan NA
     EIM policies?
Minors                                                      #      Yes No                  Comments
Each school year, every parish is required to host a Called to Protect for Youth workshop for 6th and 9th grade
students and new students since the prior year’s workshop (it is open to all middle/high school students,
but required for those specified.) As of fall 2009, every parish is required to teach the Called to Protect for
Children program to students in K-5th. For the 2009-2010 school year:
1. Has Called to Protect for Youth been held at your
     site for 6th graders? (and other middle school        NA
     students as needed) If not, please explain under
     comments.
      Have parents been informed about the                NA
          workshop their child will attend?
      Total # of 6th graders that attended                        NA NA
      Total # of new 7 /8 graders since
                             th  th
                                                                   NA NA
          previous year that attended.
2. Has Called to Protect for Youth been held at your
     site for 9th graders? (and other high school          NA
     students as needed) If not, please explain under
     comments.
      Have parents been informed about the                NA
          workshop their child will attend?
      Total # of 9th graders that attended                        NA NA
      Total # of new 10 -12 graders since previous
                              th th
                                                                   NA NA
          year that attended
3. Has Called to Protect for Children been taught for
     each grade at your site? If not, please explain       NA
     under comments.
      Have parents been informed about the                NA
          program their child will be taught?
      Total # of kindergarteners taught                           NA NA
      Total # of 1 graders taught
                       st
                                                                   NA NA
      Total # of 2nd graders taught                               NA NA
      Total # of 3rd graders taught                               NA NA
      Total # of 4th graders taught                               NA NA
      Total # of 5th graders taught                               NA NA
4. Are waivers filed at your site from parents that
     opt out their child(ren) from CTPY or CTPC?           NA
5. Was training/education information provided to
     parents of students that did not attend CTPY or       NA
     CTPC due to waiver or other absence?
All                                                             Yes        No              Comments
1. Does parish literature publicize diocesan EIM
     requirements and clarify which ministries/ programs
     require compliance?
2. Has your site hosted an EIM Basic and or Refresher
     workshop for adults in the past year?
3. Are other workshops in your area publicized in your
     bulletins/newsletters for the benefit of your
     parishioners?
4. Is there a copy of the current EIM policies available in
     the parish office for those wishing to view them?
INTERACTING, MONITORING AND RESPONDING
                                                            Yes   No            Comments
1. Do parish leaders model appropriate forms of
    interaction with minors and vulnerable adults?
2. Is there an atmosphere of support for the diocesan
    EIM policies?
3. Are there two or more adults (at least one of whom is
    EIM compliant) in classrooms or organized meetings
    where minors or vulnerable adults are present? If no,
    see #4 below.
4. If no to #3 above, does a program supervisor drop in
     regularly to monitor the program?
5. Do older minors ever supervise younger minors
     without having adult supervision themselves? If
     yes, see #6 below.
6. If yes to #5 above, is the minor in full compliance
     with diocesan EIM policies as noted under
     SCREENING AND TRAINING?
7. Is there regular publication of the process to make a
     Confidential Notice of Concern?
8. Does parish/school administration know what to
   do if a Confidential Notice of Concern is submitted or
   an incident is reported?

  ADDITIONAL COMMENTS/NOTES (please attach any additional comments to this form)




  Pastor Name: ____________________________________________________________________

  Pastor Signature: ________________________________________________________________

  Date: ___________________________________________________________________________

  EIM Site Administrator Name: _____________________________________________________

  Preferred Site email address for follow up: ___________________________________________




                             Please keep a copy of this review and send original to:
                                   Office of Ethics and Integrity in Ministry
                                               Diocese of Austin
                                                6225 E Hwy 290
                                               Austin, TX 78723



           THANK YOU FOR YOUR CONTINUED SUPPORT FOR THE
            ETHICS AND INTEGRITY IN MINISTRY PROGRAMS OF
                        THE DIOCESE OF AUSTIN
                Diocese of Austin
                Office of Ethics and Integrity in Ministry
                Called to Protect for Youth Site Review Form
                School year: 2010-2011

Parish/City: ____________________________________________________ __________
DRE Name: _______________________________________________________________
Youth Minister Name: ______________________________________________________

Thank you for the important role you play in helping to educate young people about personal safety and sexual abuse
prevention. Because of your work, and especially because of your support of the EIM program, the young people you work
with are more prepared to deal with difficult situations they might encounter. Finally, we’d like to thank you in advance
for providing the information below as soon as all classes for all grades have been taught; by June 1 of each year at the
latest. This will assist the EIM Office complete the annual audit conducted for the USCCB.

At parishes where the Youth Minister is primarily responsible for the catechism of the high school aged students, he/she
should complete #2. Otherwise the DRE should complete all information requested.

 Minors                                                               Yes      No     #              Comments
 Each school year, every parish is required to host a Called to Protect for Youth workshop for 6th and 9th grade
 students and new students since the prior year’s workshop (it is open to all middle/high school students, but
 required for those specified). For the school year identified above:
 1. Called to Protect for Youth – middle school students
      Were parents informed in advance about the                                    NA
          workshop their child attended?
      Total # of 6th graders in RE this current school year.         NA      NA
      Total # of 6th graders that attended at least one              NA      NA
          session of CTPY
      Total # of 7th /8th graders in RE this current school          NA      NA
          year.
      Total # of 7th /8th graders that attended at least one         NA      NA
          session of CTPY
      Total # of waivers – see #3                                    NA      NA
 2. Called to Protect for Youth – high school students
      Were parents informed in advance about the                                    NA
          workshop their child attended?
      Total # of 9th graders in RE/Youth Group                       NA      NA
      Total # of 9th graders that attended at least one              NA      NA
          session of CTPY
      Total # of 10th-12th graders in RE/Youth Group                 NA      NA
      Total # of 10th-12th graders that attended at least one        NA      NA
          session of CTPY
      Total # of waivers – see #3                                    NA      NA
 3. Are signed waivers on file at your site from all parents that                    NA
     opt out their child(ren) from CTPY?
 4. Was information provided to those parents noted in #3,                           NA
     and those of students absent from any sessions, to assist
     them in educating their own child(ren) about abuse
     prevention and safety issues?

  Please provide a copy of this document to your parish EIM Administrator for the parish Site Compliance
  Review, maintain a copy for your records (you may attach attendance lists if kept) and file with your
  waiver forms, and send the original to the EIM Office in one of the following manners:

                FAX: (512) 949-2529
                Postal mail: EIM Office Diocese of Austin               6225 E Hwy 290         Austin, TX 78723
                Email: emily-hurlimann@austindiocese.org
                 Diocese of Austin
                 Office of Ethics and Integrity in Ministry
                 Called to Protect for Children Site Review Form
                 School year: 2010-2011
Parish/City: ____________________________________________________ __________
DRE Name: _______________________________________________________________
Thank you for the important role you play in helping to educate young people about personal safety and sexual abuse
prevention. Because of your work, and especially because of your support of the EIM program, the children you work with
are more prepared to deal with difficult situations they might encounter. Finally, we’d like to thank you in advance for
providing the information below as soon as all classes for all grades have been taught; by June 1 of each year at the latest.
This will assist the EIM Office complete the annual audit conducted for the USCCB.

 Minors                                                                Yes      No       #            Comments
 As of fall 2009, every parish is required to teach the Called to Protect for Children program to students in K-5th each
 school year. For the school year noted above:
 1. Called to Protect for Children - K-5th
      Were parents informed in advance about the program                               NA
          their child was taught?
      Total # of kindergarteners in RE                                NA       NA
      Total # of kindergarteners that attended at least one           NA       NA
          session of CTPC
      Total # of K waivers – see #2                                   NA       NA
      Total # of 1st graders in RE                                    NA       NA
      Total # of 1st graders that attended at least one               NA       NA
          session of CTPC
      Total # of 1st gr waivers – see #2                              NA       NA
      Total # of 2nd graders in RE                                    NA       NA
      Total # of 2nd graders that attended at least one               NA       NA
          session of CTPC
      Total # of 2nd gr waivers – see #2                              NA       NA
      Total # of 3rd graders in RE                                    NA       NA
      Total # of 3rd graders that attended at least one               NA       NA
          session of CTPC
      Total # of 3rd gr waivers – see #2                              NA       NA
      Total # of 4th graders in RE                                    NA       NA
      Total # of 4th graders that attended at least one               NA       NA
          session of CTPC
      Total # of 4th gr waivers – see #2                              NA       NA
      Total # of 5th graders in RE                                    NA       NA
      Total # of 5th graders that attended at least one               NA       NA
          session of CTPC
      Total # of 5th gr waivers – see #2                              NA       NA
 2. Are signed waivers on file at your site from all parents that                       NA
     opt out their child(ren) from CTPC?
 3. Was information provided to those parents noted in #2,                              NA
     and those of students absent from any class, to assist them
     in educating their own child(ren) about abuse prevention
     and safety issues?

  Please provide a copy of this document to your parish EIM Administrator for the parish Site Compliance
  Review, maintain a copy for your records (you may attach attendance lists if kept) and file with your
  waiver forms, and send the original to the EIM Office in one of the following manners:
                 FAX: (512) 949-2529
                 Postal mail: EIM Office Diocese of Austin                6225 E Hwy 290          Austin, TX 78723
                 Email: emily-hurlimann@austindiocese.org
                       Diocese of Austin
                       Office of Ethics and Integrity in Ministry

Called to Protect for Youth provides education to middle school
and high school students on appropriate physical, emotional and
behavioral boundaries, how to stop adults and other teens from
violating those boundaries, and the Catholic Church’s understanding
of the sacredness of human life.
This program was developed at the request of the parents and
teachers of our diocese by Praesidium, Inc., the same company
that developed the Called to Protect materials used in the adult
EIM workshops in our diocesan Ethics and Integrity in Ministry
program.
CTPY is developmentally appropriate for teens in middle school and
high school and promotes the Catholic Church’s teachings regarding
respect for all human life.

Information on the program may be found on the Web at:
http://www.austindiocese.org/dept/eim/youth_parents.php

 [info in parenthesis below is to be used to personalize for your particular site/grade/timeframe, etc]
Our (parish/school) is required to present this program
annually for our (6th/9th) students and all new students. We have
scheduled the Called to Protect for Youth program here
(on/beginning) ___________. Please be sure your (middle/high
school) student is in attendance for this important program.

For more information contact (DRE, Principal, Youth Minister, etc) or
Emily C Hurlimann, LCSW
Coordinator, Office of Ethics and Integrity in Ministry
Diocese of Austin
(512) 949-2447
                                 Diocese of Austin
                        Office of Ethics and Integrity in Ministry

                 Called to Protect for Youth Waiver

I do not give permission for my child ________________________________________
                                                    (name/grade)

to attend the Called to Protect for Youth program that will be held on _____________
                                                                             (date)

at ____________________________________ in _____________________________.
             (parish/school)                             (city)


I understand that by signing this waiver I am assuming the responsibility for teaching my
child this information and that I will receive materials from the diocese to assist me.




_______________________________ ____________________________ _________
Signature of parent/guardian    Printed name of parent/guardian Date




   For parish/school use only:

   ______ date CTPY materials given to parent/guardian. Notes: ______________________________

   UPON COMPLETION OF WORKSHOP, REPORT NUMBER OF WAIVERS TO EIM OFFICE WITH ATTENDEE INFORMATION.
   KEEP WAIVERS ON FILE AT THE SITE.
                      Diocese of Austin
                      Office of Ethics and Integrity in Ministry

Called to Protect for Children is the final safety education piece of
our diocesan Ethics and Integrity in Ministry program, designed
specifically for elementary grade students K-5. CTPC focuses on
understanding rules, appropriate touch, boundaries, how to respond
to uncomfortable situations and introduces technology safety.
Long in the making, this program was also developed at the
request of parents and teachers of our diocese by Praesidium, Inc.
(creators of the adult EIM workshop series and Called to Protect for
Youth).
CTPC sequentially builds on developmentally appropriate topics
each year from Kindergarten thru 5th grade. It has been approved by
the Catholic Church and promotes our teachings regarding respect
for all human life. Religious education and Catholic school teachers
will facilitate these simple lesson plans with their students.

Information on the program may be found on the Web at:
http://www.austindiocese.org/dept/eim/children_parents.php

 [info in parenthesis below is to be used to personalize for your particular site/grade/timeframe, etc]

Our (parish/school) is required to present this program
annually for our (K-5th grade) students. We have scheduled the
Called to Protect for Children program for our grade/class
(on/beginning) ___________. Please be sure yourstudent is in
attendance for this important program.
For more information contact (DRE, Principal, etc) or

Emily C Hurlimann, LCSW
Coordinator, Office of Ethics and Integrity in Ministry
Diocese of Austin
(512) 949-2447
                                 Diocese of Austin
                        Office of Ethics and Integrity in Ministry

               Called to Protect for Children Waiver

I do not give permission for my child _________________________________________
                                                    (name/grade)

to participate in the Called to Protect for Children program that will be held on

______________ at _____________________________ in ______________________.
   (date)              (parish/school)                        (city).



I understand that by signing this waiver I am assuming the responsibility for teaching my
child this information and that I will receive materials to assist me.




_______________________________ _____________________________ _________
Signature of parent/guardian    Printed name of parent/guardian Date




   For parish/school use only:

   ______ date CTPC materials given to parent/guardian. Notes: ______________________________

   UPON COMPLETION OF WORKSHOP, REPORT NUMBER OF WAIVERS TO EIM OFFICE WITH ATTENDEE INFORMATION.
   KEEP WAIVERS ON FILE AT THE SITE.

								
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