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Safe Sanctuary
Policy
PARKER
UNITED
Rev. Richard Jackson, Pastor
SAFE SANCTUARY
POLICY
Code of Conduct
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Table of Contents
Section
Page Code
of Conduct ____________________________________2 Purpose
for this policy ____________________________4 1.
Volunteer Screening Procedures __________________4 2.
Teenage Volunteers ______________________________5 3.
Leadership Development Procedures _______________5 4.
Personal Safety Procedures ______________________6
a. Supervision Ratios _________________________6
b. Nursery ____________________________________6
c. Record Keeping _____________________________7
d. Restrooms __________________________________8
e. Sleepovers/Lock-ins ________________________8
f. Sick Children ______________________________8
g. Emergencies ________________________________8
h. Parties/Field Trips ________________________9
i. Worker Behavior ____________________________9 5.
Staff and Volunteer Support _____________________10 6.
Reporting Accidents/Injuries ____________________10 7.
Child Abuse Prevention and Procedures ___________10 8.
The Responsibility to Report ____________________11 9.
Other Types of Harm _____________________________11 10.
Improper or Inadequate Supervision _____________12 11.
Hazardous Activities ___________________________12
Appendixes Parker
UMC Policy of Sexual Ethics__________________13 Children’s
Ministry Information Form (front) _______14 Children’s
Ministry Information Form (back) ________15 Incident
Report Form (front)________________________16 Incident
Report Form (back)_________________________17 Abuse
Incident Report Form _________________________18 Checklist
for Response to Allegation of Abuse ______19 Church Ministry
Policy and Procedures Regarding Child
Safety This policy is designed to assist church leaders in recruiting volunteers and to provide guidelines for the safety of children and youth under the age of 18, as well as guidelines for the support of staff and volunteers. Purpose
for this policy Churches
need to be prepared! This is the legal reason for creating safety
policies, but there’s a deeper, more significant reason – to protect
the children. Policies are only printed expressions of the value placed
on children. If the only reason for safety policies is to protect the
organization, the Church has missed God's love for children. Some
people may think that our Church is too small or that, our Church
“knows” everyone, to worry about these safety problems. Remember
it’s much easier to make plans and develop safety policies as a means
of prevention, rather than wait until they are needed as a reaction to
an abuse case. Some churches tend to take the biblical concept of
trusting God to an extreme. They think nothing bad can happen to
Christians. We must not be unwise regarding children’s safety. There
is no automatic protection from evil for the faithful. We’re to watch
and be ready. Accidents will always happen. There will always be
unforeseen circumstances that need to be handled. But the Church should
build into its organization sturdy safety-policy fire blocks into the
walls of its ministry to protect children. 1.
Volunteer Screening Procedures If the staff is aware of any reason why a person would not be suitable for a volunteer position, further investigation and discussion will take place and a final approval, or denial, of the name will be made. If there are medical reasons for a potential volunteer to not be suitable as a leader/helper, he/she will be paired with another volunteer. In the case of a potential volunteer who is new to the church family, a confidential dialogue will take place to determine interest, experience, and the children/youth ministry readiness of the individual. This dialogue will be conducted by a member of the Safe Sanctuary Committee or may be done by one of the pastoral staff. A confidential report will be given at the next Pastor/staff-Parish Committee meeting to determine the suitability of the candidate. If required, further dialogues will take place. New potential leaders for any program will not be assigned to work alone, but will be paired with leaders who are familiar with the program. From time to time, parent volunteers are needed to assist in a particular program's event. When a parent who is not an active participant in the church congregation volunteers, he/she is to be screened by the coordinator of the program and teamed up with a leader who has been approved. Under no circumstances is a parent volunteer to be alone with a child or group of children and out of sight of other leaders. The Children’s Ministry Information Form asks for two personal references. These references should be contacted by a member of the Safe Sanctuary Committee or pastoral staff, and asked to comment on their knowledge of the volunteer. A careful record should be kept on file of the person making the contacts, the date of the calls and a summary of the reference’s comments. All hired and volunteer staff of Parker UMC may be asked to have a police check done at the expense of Parker UMC. 2.
Teenage Volunteers a. In an effort to develop new young leaders, junior and senior high school students are encouraged to assist in the leadership of various children's ministries. These young leaders should be approved by the Safe Sanctuary Committee as leaders- in-training. As such, they should be provided with opportunities to develop their unique gifts, abilities and interests. b.
Teenagers under eighteen (18) wanting to serve as teen workers in any
capacity with activities,
studies, or programs for preschoolers or children will need to fill in a
Teen Volunteer Information Form and go through the training. The only
step in the process they are exempt from is the criminal background
check. Teenagers must be assigned in accordance with the Five-Years
Older Rule (see Basic Procedures for Safe Ministry with Children and
Youth). c. Leaders- in-training must be paired up with adult leaders who can assist in the development of their gifts. The Parker UMC Children's Ministry Information Form must be filled out by potential volunteers. 3.
Leadership Development Procedures The methodology implemented in children’s ministry must reflect the physical, social, mental, and spiritual development of children in the age grouping of a particular program. The curriculum content and program development must be familiar to the leaders in that program. The extent to which a leader is familiar with the developmental needs of the group and the goals of the curriculum will determine the effectiveness of the program. We value the volunteers and make every effort to develop their skills as leaders and their knowledge of the developmental needs of the children they serve. Our efforts to develop a leader’s skills and knowledge include, but are not limited to, seeking out appropriate workshops or providing in-house seminars on child/teen developmental issues, curriculum development, creative classroom control, children with special needs issues, and team teaching. Mentors are an effective way to develop one-on-one the leadership skills needed in a position. Where possible leaders- in-training and new leaders should be paired with a veteran leader, who will pass on wisdom, experience and knowledge relevant to the leadership responsibilities of the position. Good resource materials are published and an effort should be made by the Christian Education Board to purchase these materials have them placed in the Resource Centre or church library. Leaders are encouraged to read such resource material to keep current on trends in children’s ministry. 4.
Personal Safety Procedures We are concerned about the safety of the children, families and volunteers we serve. In an effort to lessen the possibility of abuses occurring and to maintain conduct which is above reproach, we have developed the following standards for our children’s ministry. a.
Supervision Ratios Our goal in the classroom is to provide an environment of acceptance and love in which learning can take place. Room allocation is geared to the needs and size of a particular class/group. For
teaching classes: There will be a minimum of 1 adult teacher for every Sunday School class. When the class size goes above the registered size on a given Sunday, an extra volunteer will assist the teacher. These volunteers will be on the Sunday School supply helper list or will be a teacher who is not scheduled to teach on that particular Sunday. Whenever there is only one adult leader in a classroom with children, the door will remain slightly open unless there is a window or closed-circuit camera allowing anyone passing to look in without interrupting the teaching process. For
club programs: There will be no less than 2 adult leaders present in all club group meetings for children in grades 3 - 6. Because of the nature of club programs and the diversity in activities that may be happening at one time, it is suggested that in addition to the minimum of two adult volunteers there be additional adult volunteers for special activities where required. Club programs for junior and senior high school youth will have a minimum of 2 adult volunteers. Additional adult volunteers should be sought as the group grows to spread the needs of the youth program over a greater number of volunteers. b.
Nursery The church nursery is an important aspect of our children’s ministry and as such we seek to provide the best care for our children. The following guidelines are in place to make the nursery a safe place for young children. We have a nursery available downstairs to care for infants and toddlers. However, since we do not have the resources for a children’s church we request that school-age children remain in the sanctuary after the children’s sermon for the worship service. This will allow the nursery to be kept clean and safe for younger children. When there are two nursery workers in the same family there must be another adult present in the nursery. When toddlers require trips to the bathroom, a nursery worker must supervise the children in the washroom. To lessen the work of the nursery workers, parents of children who use the washroom are encouraged to take their child(ren) to the washroom prior to leaving them in the nursery. The change table must be located where the child being changed can be easily seen by another nursery worker, or two workers should be present in the room where the change table is located. Nursery workers are not to let children leave the nursery until a designated adult arrives to get their child(ren). Nursery toys should be inspected and either be replaced or repaired if damaged. Toys should be cleaned at regular intervals. All toys in the nursery rooms must be appropriate for infants and toddlers. Those toys and activities that are appropriate only for toddlers must be kept out of reach from infants. All nursery furniture and toys must be appropriate for infants or toddlers. Furniture and bedding should be cleaned at regular intervals in addition to when they are dirty. There must be a minimum of 2 care givers with the children at all times, one of whom must be an adult. The nursery must be checked by the person responsible for booking the child care prior to the beginning of the event. If there are not enough care givers for the adult-to-child ratio, the person responsible for the booking must stay in the nursery department. Snacks will consist of food which is approved by the parents of each child or that food which is provided by the parent for their child only. Nursery workers for the event must note the names of children and any particular medical information that is needed for a particular child (i.e. food allergies, asthma, etc.). Reminder: Do not let children leave the nursery department until a designated adult arrives to pick them up. c.
Record Keeping Complete records are to be kept for each Sunday School class, club program and nursery. These records are to include the names of children, addresses, phone numbers, parent name(s) and any allergy/medical information including health card numbers, that are important for leaders to know. The records are to be handed into the church office at the end of each class/club season. They will be filed in the office in their original form under the title of each class/group. The files will be kept for a period of 3 years. An accurate sign- in procedure will be maintained for each child in the nursery and preschool department(s), recording the child’s name, parent’s name(s) and parent location during the service or meeting. Special needs of a child should be noted on the sign- in sheet. Lists of classroom/club/nursery attendance are to be maintained each week. The names of leaders/volunteers are to be noted each week as well. d.
Restrooms Parents are encouraged to take their children to the washroom prior to the beginning of the service. Should a child need to go to the washroom during the service, parents are encouraged to go with the child. No child should be sent to the washroom alone. If parents determine a child to be old enough to go to the washroom without an adult, it is recommended that they send two older children together. Parents/Guardians must take the responsibility to monitor their children. When this is not possible, it is recommended that the child use the washrooms located nearest to the sanctuary/meeting room. Sunday School teachers of children under the age of 10 are encouraged to have the whole class stop at the washrooms on the way to the classroom, remain at the washroom area until everyone is finished and then proceed to the classroom. Sunday School teachers of children over the age of 10 are asked to send children in pairs to the washroom, should it be required. e.
Sleepovers Club programs occasionally will hold sleep-over events or camping weekends. These events require additional supervision considerations. Groups which are co-ed must have adequate adult supervisors of both genders. The supervisors should not all be members of the same family. Additional adults may be recruited for the event. A minimum of 2 female adult supervisors and 2 male adult supervisors is suggested. Groups where children are all of the same gender and the leadership is the same gender should provide the same number of adult supervisors as during a club meeting. Groups where children are all of the same gender, but the leadership is comprised of the opposite gender, should provide a minimum of two adult leaders of the same gender as the children. f.
Sick Children Children who are not feeling well should not be received into the nursery department or classroom. Some signs of illness are unusual fatigue or irritability, coughing, sneezing, runny nose and eyes, vomiting, diarrhea, inflamed mouth and throat, complaining of sore ears or throat, and rash (other than diaper rash). Children with these or similar symptoms should be returned to their parent(s) or guardian(s). g.
Emergencies Workers are not to give or apply any medications to children except for bandages for minor cuts/abrasions, or ice packs for bumps. If a child needs medication, the parent must administer it. No medications will be left in the nursery department or any classroom with the following exception: children who carry inhalers for asthma or medication for serious allergies. In the event that an older child who is a diabetic requires sugar, hard candies will be kept on hand in the classroom and when required one can be given to a diabetic child while parents/guardians are called. An older child is defined as over the age of 12. Emergency procedures in the event of a fire will be reviewed semi-annually and when new volunteers are added. Workers will be trained in these procedures. Evacuation procedures are to be posted in each room. First Aid boxes will be kept on hand and all workers are to review their locations and contents monthly. h.
Parties and Field Trips Children’s programs are encouraged to provide opportunities for the group to go outside of the church building and into the community around. The community provides a variety of outing possibilities to enhance the curriculum being taught in a program and to serve the community. The following are procedures for outings and parties which are off the church property. There must be sufficient adult supervision at all outings. This would include the regular leaders within a program and parents of the children or approved volunteers. Parents helping with the outing do not need to fill out a Parker UMC Children’s Ministry Information Form. All outings must have a signed and dated parental waiver from each parent/guardian. The waiver must state the nature of the outing, the time of departure and return, the destination (including the name of the host, address and phone number) the mode of transportation and the cost to the child, if any. When an outing involves transportation, the leaders should leave a list of the drivers’ names, license numbers and children in particular vehicles. This list should be left in the church office on the bulletin board where it can easily be found. Once a child has been assigned to a particular vehicle, he/she is not to switch vehicles. Parties held in homes must provide additional non-related adult supervision when the children are present in the home. i.
Worker Behavior Workers must always be above reproach in their words and conduct. They are to behave in a godly manner demonstrating Christian conduct, respect, honesty and trustworthiness. All
workers must fill out and keep up-to-date a Parker UMC Children’s
Ministry Information Form. This form is to be reviewed annually. Workers must not in any way be involved in any of the following activities with older children: extended hugging, kissing, sitting on a lap, inappropriate touching or being alone with a child. In the event that a child approaches an adult leader with the intent to hug or kiss, or unexpectedly does so, the adult leader should accept the affection, but should as quickly as possible, in a non-rejecting manner, encourage a more appropriate form of physical contact. Appropriate expressions for ages 0 - 3 include picking up the child, comforting the child, holding the hand of child, changing diapers. Appropriate physical contact with children ages 4+ could include a handshake, pat on the back, quick hug of encouragement with hands located in shoulder area, and a ‘high five’. Workers who are not feeling well should not lead a group of children. Notification, if possible, to a team member(s) should happen as soon as possible so that other workers can step in and assist in the supervision of children. When notification is not possible until the last minute, adjustments should be made in the program to allow for doors to be open and the group meeting to take place in a higher traffic area where others can check on the group without interrupting the session. 5.
Staff and Volunteer Support It is our goal, not only to provide for the safety of our children and youth, but also to support and provide, to the best of our ability, a system of procedures that will protect the staff and volunteers from being falsely accused of wrongful acts. This is accomplished by: a) Screening potential leaders to determine where a volunteer would be best suited to use their gifts, abilities, interests and experiences. b) Providing leadership development that will further prepare the volunteer for leadership within a group/class/club. c) Adhere to the Procedures in section 3: Personal Safety Procedures. d) Maintaining the records of groups/classes/clubs for a period of 3 years in their original form. e) Providing coverage for all staff and volunteers under the Parker UMC Insurance Policy with periodic reviews to ensure that the Policy covers all the areas of our church ministry. When a staff person or volunteer is accused of an alleged wrongful act, the church congregation will provide spiritual and moral support to the person(s) involved. 6.
Reporting Accidents/Injuries Occasionally during the course of regular program activities injury occurs. These may be minor or major in nature. After appropriate support and assistance is given to the injured child or leader, a written Incident Investigation Report should be filled out by the program coordinator or appropriate person on the pastoral staff. A description of the incident, contributing factors and the treatment given should be noted. Witnesses to the incident should be listed with addresses and phone numbers for follow-up purposes.
7.
Child Abuse: Prevention and Procedures Definitions Physical Abuse: This is the use of physical force by the caretaker (parent/guardian, babysitters, or foster parent) of the child which results in any injury to the child. This injury is sometimes described as a non-accidental injury by health professionals. Physical Neglect: This is the chronic or episodic withholding of necessary or essential physical care from the child with resulting injury or damage to the child. Necessary physical care can include food, nutrition, shelter, clothing, medical care, safety, supervision, sensory stimulation (particularly to young infants). Emotional Abuse: This is the acting out by the parent or caretaker of the child of their negative or ambiguous feelings towards the child, resulting in some degree of emotional damage to the child. This kind of behavior may consist of constant chastising, belittling, verbal tirades, ridicule, humiliation, or the out and out rejection of the child’s sense of self-worth and dignity. Emotional Neglect: This is the chronic or episodic withholding of necessary emotional care and support from the child which results in some degree of emotional damage to the child. This kind of neglect might consist of withholding affection and love from the child; it might also include the withholding of affirmations of the child’s self-worth, trust and belongingness. In extreme forms, emotional neglect can involve the complete withdrawal of any verbal and/or non-verbal interactions with the child, manifesting the complete rejection of the child. Sexual Abuse: This is the sexual exploitation of a child by a caretaker or other family member, or any adult, resulting in damage or injury to the child sexually, either psychologically or physically. Forms of sexual exploitation include behavior of a sexual nature, touching of a sexual nature and sexual intercourse. 8.
The Responsibility to Report In
the case of an allegation of child/youth sexual abuse, the volunteer or
clergy staff person who observes or to whom the information is given is
required by the Church and by the state law to complete the tasks listed
below. Date and initial as each step is completed. Note: If allegation
is against the Senior Minister, the report should go to the chairperson
of the Staff Parish Relations Committee and the District Superintendent. 9.
Other Types of Harm Most
of us think that liability arise only out of tangible harm, such as
bodily injury or property damage. Unfortunately, increasing numbers of
lawsuits involve situations where physical injury is not involved. These
exposures may arise out of: 1.
Libel and slander – untrue statements about members of the
congregation or other faiths. Emotional distress may be caused because
of statements made or actions taken, even if they are well founded in
truth. 2.
Public demonstrations against individuals, groups, or organizations if
improperly conducted. 3.
Discharge of students or expulsion of members of congregations. 4.
Invasion of privacy – investigations into the private lives of church
members may cause liability, as may acts such as searching lockers,
desks, or personal property of employees or students. 5.
Publications – accuracy of facts should be carefully determined.
Accusations should not be published. Groups or classes of individuals
should not be charged with guilt by association. 6.
Counseling by insufficiently trained or unskilled counselors. 10.
Improper or Inadequate Supervision You
can’t over-supervise. Most states or local governments have specific
requirements on the minimum ratio of supervisors to participants.
Probably more litigation results from “failure to properly
supervise” than any other cause. If negligence cannot be found for any
other reasons, attempts are made to find inadequate supervision. Instances
where improper or inadequate supervision will likely be alleged are: 1.
Accidents on the playground 4.
Sporting events
7. In the classroom 2.
In Sunday School
5. Field trips
8. Lock-in/sleepover 3.
Church outings
6. Swimming Proper
location of supervisors on playgrounds or at swimming pools is as
important as the number of supervisors. Governmental authorities should
be contacted prior to events on public property to determine any safety
requirements and to place authorities on notice of the type of activity
planned. Parents should be informed in writing of the exact nature of
the planned event, describing the supervision to be given church or
school. Parental consent should be obtained in writing of any special
event. Qualifications required for supervisory personnel should be
determined for each event. You need people of mature judgment who are
experienced supervising groups of children or young people. The
supervisor should not have a history of problems with assigned groups. A
thorough check should be made on an individual’s background,
especially where supervisors are employees of the church or school. All
states have standards for hiring employees in charge of children. Church
officials should be informed of state and local requirements. This would
include “certification of teachers”. 11.
Hazardous Activities We
enjoy activities that foster good fellowship. However, in some
activities the dangers outweigh the enjoyment. These are classified as
hazardous and extra hazardous. Hazardous activities should be
stringently supervised with strict limitations. Extra hazardous
activities should not be sponsored by the church unless supervised by
adults highly competent in the specific activity. Water
slides Water-skiing
Mud
Olympics Snow
skiing Dune
buggies Rafting
Snow
tubing Unsupervised
swimming Obstacle courses Canoeing
Haunted
houses Paddle
boating Tackle
football Horseback
riding Snowmobiles Rope
jumping Rodeos Basketball
Rope
swings Volleyball
Monkey
bar equipment Softball
Fireworks displays & stands Sack
races Motorbikes Touch
football Rock
climbing Roller
skating Trampolines Ice
skatin PARKER
UNITED POLICY
ON SEXUAL ETHICS Sexual Abuse Within the Ministerial Relationship and Sexual Harassment Within the Church, which states that sexual abuse within the ministerial relationship and sexual harassment within the church as incompatible with biblical teachings of hospitality, justice and healing. In accordance with the 2000 Book of Discipline, ¶ 161F, all human beings, both male and female, are created in the image of God, and thus have been made equal in Christ. As the promise of Galatians 3:26-29, states all are one in Christ, we support equity among all persons without regard to ethnicity, situation, or gender. Sexual abuse within the ministerial relationship involves a betrayal of sacred trust, a violation of the ministerial role and exploitation of those who are vulnerable. Similarly, sexual harassment must be understood as an exploitation of a power relationship rather than as an exclusively sexual issue. Misconduct of a sexual nature within the life of the Church interferes with its moral mission. Parker UMC Children’s Ministry Information Form A.
Basic Information Name: __________________________________ Address: __________________________________________________________ Telephone Number: Home: ____________________Work: _________________ Best time to call: Home: ____________________Work: ________________ B.
Ministry What area(s) would you like to volunteer to become involved? (Check all that apply.) Teaching
Helping
Other ___ Preschool ___ Babysitting ___ Music - instrument ___ Grades 1 – 3 ___ Nursery ___ Music - vocal ___ Grades 4 – 6 ___ Preschool ___ Storytelling ___ Grades 6 – 8 ___ Grades 1 – 6 ___ Crafts ___ Grades 6 – 8 ___ Games/Activities ___ Girl’s Club ___ Other (specify) ___ Boy’s Club ___ Girl’s Club ___ Other (specify) ___ Teen’s Group ___ Boy’s Club ___ Teen’s Group Why do you want to volunteer in this area? ________________________________________________________________________ _______________________________________________________________ Are you open to attend relevant seminars or workshops and resource materials that our Safe Sanctuary Committee will be offering on working with the children and program materials? yes / no C.
Experience What previous experience have you in children/youth ministry? (Be specific.) ________________________________________________________________________ ________________________________________________________________________ D.
Personal Data Are there any conditions or personal circumstances which would hinder you from performing certain types of activities in the position(s) for which you are volunteering? (e.g. allergies, asthma, diabetes, fainting, seizures, unable to lift children, etc.) ________________________________________________________________________ ________________________________________________________________________ Please read and sign the following statement. I have read and agree to adhere to the best of my ability, the Policy and Procedures Regarding Child Safety. __________________ ___________________________ Date Signature
References: List two persons not related to you who can comment on your suitability for this ministry. Name Address Telephone How long? _________________ _____________________________ ___________ ______ _________________ _____________________________ ___________ ______ Reference
Check For: _______________________________________ Position: __________________ Reference:__________________________________________Phone: ______________ My
name is (reference checker). I am phoning to obtain a reference for
(volunteer’s name) who has expressed an interest in the volunteer
position of ____________________ at ( He/she has given us your name as someone who would be familiar with his/her qualifications for this position. 1. What is your relationship to this person (work, social, volunteer, etc.)?____________ 2. How long have you known him/her______________________________________________________ 3. What knowledge do you have of this person’s commitment to Jesus Christ? ________________________________________________________________________ ________________________________________________________________________ 4. Have you ever worked with this person in ministry? Please specify in what area(s). ________________________________________________________________________ ________________________________________________________________________ 5. What characteristics would enable this person to fulfill this position? ________________________________________________________________________ ________________________________________________________________________ 6. Do you have any concerns relating to this person being involved in this ministry? ________________________________________________________________________ ________________________________________________________________________ 7. Additional comments regarding suitability for ministry: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 8. Do you affirm this person for ministry? __________________________ Reference Checker Name: ____________________________________________ Signature: _________________________________ Date: ________________________ Parker UMC Incident Investigation Report Claimant:
Name:___________________________________________Age: ___________ Date
of Incident: ____________________________________________
Time: __________________ Description
of Incident: ______________________________________________________________________________________
______________________________________________________________________________________ Contributing
Factors : ______________________________________________________________________________________
______________________________________________________________________________________
Medical
Treatment: ______________________________________________________________________________________
______________________________________________________________________________________
Location
of Treatment:
________________________________________________________________ Witness:
_______________________________________________ Age :
______________ Address:
___________________________________________________________________________
_________________________________
Telephone Number: ____________ Witness:
_______________________________________________ Age:
_______________ Address:
___________________________________________________________________________ _________________________________
Telephone Number: ____________ Action
Taken to Prevent Recurrence:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Legal
Counsel: Yes. ____ No.
____ Name
of Counsel: ____________________________________________________________________ Address:
___________________________________________________________________________
Investigated
by: (Name) ____________________________________
Title
: _____________________ Signature
:
_______________________________________________ Date: ____________ Review
by: (Name) ________________________________________ Date:
__________ Further
Comments: ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________ ABUSE INCIDENT
REPORT FORM Reason
for report _______________________________________________________ Date
of incident ____________________________Class _______________________ Title
_______________________ Name(s)
and Age(s) of Minor(s) ____________________________________________ _______________________________________________________________________ Quote
the child’s first words verbatim:
_______________________________________ _______________________________________________________________________ _______________________________________________________________________ Briefly
describe what happened: ____________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ What
action did you take? _________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Has
the incident been resolved? ____yes ____no Explain: ______________________ _______________________________________________________________________ Were
there any witnesses? ____yes ____no Names: ___________________________ _______________________________________________________________________ Signatures
of witnesses (if possible): _________________________________________ _______________________________________________________________________ Report
submitted to: ______________________________________________________
CHECKLIST FOR
RESPONSE TO ALLEGATION
OF SEXUAL ABUSE TO BE
COMPLETED BY CLERGY/PROFESSIONAL STAFF PERSONS Date:
_____ Initial: ______ 1. For clergy and paid professional staff: remove
the accused
from the situation and suspend the accused from duties involving
children/youth. Date:
_____ Initial: ______ For volunteers: Remove the accused from the
situation and
immediately notify the closest available clergy/professional staff person
who will suspend the accused. If the clergy/professional staff person to
whom the allegation is reported is not the direct supervisor of the
accused, the person reporting will inform the supervisor as soon as
possible. Date:
_____ Initial: ______ 2. Make written documentation of everything done and said.
If the person reporting the allegation is a volunteer, both the volunteer
and the clergy/professional staff to whom the volunteer has reported will
document the procedures
taken. The procedures after this point will be administered by ministerial
staff persons only. | |