FCASV Certification Standards Monitoring Report
Attachment B
Florida Council Against Sexual Violence
Certification Monitoring Report
______
Florida Council Against Sexual Violence
Certification Monitoring Report
Agency Information
Name of Agency,
Physical Address:
Mailing Address:
(if different)
Executive Director,
Phone Number,
E-mail Address:
Name/Title of Staff
Participants:
Independent Reviewer(s):
Date of Monitoring:
Type of On-site Review: Initial Biennial
County/Counties
For Which Certification
Is Requested:
Certification Outcome: Approved
Extended; Corrective Action Requirements due:
Denied
Exit Interview Conducted: Yes No
Certification Eligibility Requirements
YES NO
1. Does the program meet the definition of a Rape Crisis Program (RCP)?
(Check all that apply.)
A private, not-for-profit, non-governmental agency or program of a private, not-for-profit,
non-governmental agency that has been incorporated and providing rape crisis services
for at least one year;
N/A (previously certified governmental agency)
Has provided sexual violence services for at least one year;
Has a name or tag line describing the provision of sexual violence services;
Has a mission describing the provision of sexual violence services;
Serves adult and adolescent victims of sexual violence;
Serves both reporting and non-reporting victims; and
Has at least one full-time staff member or full-time equivalent (FTE) dedicated solely to
serving adolescent and adult victims of sexual violence.
Minimum Standards: All of the above.
Best Practice: All of the above.
2. Does the program provide the following services in-house? (Check all that apply)
Crisis Intervention
Advocacy/Accompaniment
System Coordination
Minimum Standards: All of the above.
Best Practice: All of the above.
3. Does the program provide the following services either in-house or through a
Memorandum of Understand (MOU), subcontract or other agreement?
24-Hour Hotline (may not be with a law enforcement agency)
Information & Referral
Community Awareness
Minimum Standards: All of the above.
Best Practice: All of the above.
4. Is the program recognized as the primary rape crisis program serving the county/counties
for which certification is requested?
Minimum Standards: All of the above.
Best Practice: All of the above.
Certification Eligibility Requirements
Comments:
Findings:
Corrective Actions:
Recommendations:
Direct Service 1: HOTLINE
YES NO
1. Does the program operate a telephone hotline? (This does NOT include a pager, an
answering machine, voicemail, or an answering service.)
Yes, and operated fully in-house
Yes, but partially in-house and partially subcontracted (specify agency):
Yes, but fully subcontracted (specify agency):
Minimum Standards: Forwarded to cell phone answered by advocate.
Best Practice: Fully operated in-house at the agency during business hours; forwarded to the
home of and answered by advocate who is not also on call for advocacy and accompaniment.
2. Is the program in operation 24 hours a day, 7 days a week?
Minimum Standards/Best Practice: 24 hours a day, 7 days a week.
3. Do all of the cities and counties in your program’s service area have toll-free access to your
hotline?
Minimum Standards: Victims may access the line toll-free through the 888-956-7273 statewide
hotline.
Best Practice: All of the cities and counties in the program’s service area have direct toll-free
access to the agency’s hotline.
4. Are hearing-impaired callers able to access the hotline? (Check all that apply.)
TTY/TDD device available 24 hours a day, 7 days a week
TTY/TDD device available part of the day (specify):
They can use the Florida Relay Service
Minimum Standards: Hearing-impaired callers use Florida Relay Service.
Best Practice: TTY/TDD device available 24 hours a day, 7 days a week.
5. Does the program document the number of sexual violence calls the hotline receives each
reporting period?
Also documents the total number of all calls received each reporting period.
Minimum Standards: Document total number of sexual violence calls hotline receives each
reporting period. Enter into DOH Sexual Violence Data Registry.
Best Practice: Document total number of all calls and total number of sexual violence calls
hotline receives each reporting period. Enter sexual violence calls into DOH Sexual Violence
Data Registry. Analyze all calls for time of call, type of call and caller, outcome, time spent on
call, etc., for in-house statistical use.
6. Do individuals answer the hotline immediately as the rape crisis hotline, crisis line, helpline,
hotline or rape crisis center?
Minimum Standards/Best Practice: Hotline must be immediately identified as the rape crisis hotline,
crisis line, helpline, hotline or rape crisis center/program. If this is a dual/multiple service agency, a separate
line to address SV hotline calls may need to be added to meet this requirement.
Documentation Checklist:
EOC # / Evidence of Compliance / Review Method / Sources of Evidence / Approved1 / Staffing schedule that demonstrates when telephone crisis intervention services are available. / Mail-in Document Review / Copy of current staffing schedule
2 / Documentation of the number of hotline calls per reporting period. / On-site Document Review / Monthly reports; document listing the number of hotline calls and the number of SV calls in the last reporting period
3 / Per call documentation that standard activities are provided. / On-site Document Review / Policies & procedures manual; call form
4 / Documentation that accessibility services are available for hearing-impaired callers (TTY/TDD device preferred). / On-site Tour / Observation of working TTY/TDD machine
Direct Service 1: Hotline
Comments:
Findings:
Corrective Actions:
Recommendations:
Direct Service 2: INFORMATION AND REFERRAL
YES NO
1. Does the program provide information and referral services as defined in the standards
(“a response to requests or presenting need for information or assistance related to sexual
violence”)?
Minimum Standards/Best Practice: Program provides information and referral services as defined
in the standards: “a response to requests or presenting need for information or assistance related
to sexual violence.”
2. Does the program provide information and referral services to clients 24 hours a day,
7 days a week?
Minimum Standards: Information and referral services are available to clients 24 hours a day, 7
days a week. Persons providing information and referral over the hotline and in person always
carry a resource directory to provide referrals. Client is never asked to call back during regular
business hours for referrals.
Best Practice: All of the above and persons providing information and referral give a minimum of
three different referrals for each need.
3. Are clients able to access information and referral services in person during business hours
and 24 hours per day by telephone?
Minimum Standards: Information and referral services are available in person during
business hours and 24 hours per day by telephone.
Best Practice: Information and referral services are available in person during business
hours, and 24 hours a day by telephone and via website.
4. Does the program contact agencies listed as referrals to perform each of the following activities
all the time? (Check all that apply.)
Confirm that the listing is current
Notify the agencies that they are listed as referrals
Distribute information about the crisis hotline and available sexual violence victim services
Solicit feedback regarding the appropriateness of referrals that have been made
Minimum Standards/Best Practice: All of the above, all the time.
5. Does the program contact agencies listed as referrals at least annually for the purposes
indicated in the previous question?
Minimum Standards: Agencies contacted annually.
Best Practice: Agencies contacted annually, and resource directory updated, reprinted and
distributed to all staff annually. Corrections to resource directory issued to all staff bi-monthly.
Documentation Checklist:
EOC # / Evidence of Compliance / Review Method / Sources of Evidence / Approved6 / Staffing schedule that demonstrates when information and referral services are available. / Mail-in Document Review / Copy of a current staffing schedule
7 / Documentation procedures established for the information and referral service which shows the number of information and referral units provided to each client. / On-Site Document Review / Policies & procedures manual; monthly reports
8 / Written procedures regarding the methods utilized to annually update the community referral manual/file and solicit feedback from agencies regarding appropriateness of referrals made. / Mail-In Document Review / Policies & procedures manual; job descriptions indicating responsibility
10 / Examples of brochures/written materials available that provide current information on sexual violence related issues and agency services. / On-Site Document Review / Brochures, handouts
11 / Evidence of a referral system (e.g., resource directory, list of referrals). / On-Site Document Review / Resource directory, list of referrals
12 / Evidence of interagency agreements. / Mail-In Document Review / Copies of interagency agreements
Direct Service 2: Information and referral
Comments:
Findings:
Corrective Actions:
Recommendations:
Direct Service 3: CRISIS INTERVENTION
YES NO
1. Does the program provide crisis intervention services as defined in the standards (“a timely
response to an individual presenting a crisis related to sexual violence”)?
Minimum Standards: Program provides crisis intervention services as defined in the standards: “a
timely response to an individual presenting a crisis related to sexual violence.”
Best Practice: Agency is able to respond immediately in person during business hours and by phone
24 hours a day to persons in need of crisis intervention services.
2. Are crisis intervention services available to clients 24 hours a day, 7 days a week?
Minimum Standards/Best Practice: 24 hours a day, 7 days a week
3. Is the program able to provide a face-to-face/in-person response to a request for intervention
services within 24 hours?
Minimum Standards/Best Practice: Within 24 hours
4. Does the program provide crisis intervention services to those indicated in the minimum
standards? (Check all that apply.)
Adult victims of sexual violence
Adolescent victims of sexual violence
Adult victims of childhood sexual abuse
Secondary victims of sexual violence (including non-offending parents of child victims)
Victims of domestic violence
All victims
Callers/clients with general mental health issues
Any caller/client
Minimum Standards: Adult victims of sexual violence, adolescent victims of sexual violence,
adult victims of childhood sexual abuse, secondary victims of sexual violence (including non-
offending parents of child victims 12 years of age and older).
Best Practice: All of the above.
Documentation Checklist:
EOC # / Evidence of Compliance / Review Method / Sources of Evidence / Approved13 / Staffing schedule that demonstrates when in-person crisis intervention services are available. / Mail-In Document Review / Copy of a current staffing schedule
14 / Documentation of the number of crisis intervention contacts per reporting period. / On-Site Document Review / Monthly reports
15 / Per contact documentation in the client record that standard activities are provided including activities to alleviate acute stress. / On-Site Document Review / Policies & Procedures Manual; client case notes, intake notes, progress notes
Direct Service 3: crisis intervention
Comments:
Findings:
Corrective Actions:
Recommendations:
Direct Service 4: ADVOCACY/ACCOMPANIMENT
YES NO
1. Does the program provide advocacy/accompaniment services as defined in the standards
(“personal support and/or assistance in accessing sexual violence related services, and acting
on behalf of and in support of victims of sexual violence, ensuring that their interests are
represented and their rights upheld”)?
Minimum Standards/Best Practice: Program provides advocacy/accompaniment services as
defined in the standards: “personal support and/or assistance in accessing sexual violence related
services, and acting on behalf of and in support of victims of sexual violence, ensuring that their
interests are represented and their rights upheld.”
2. Are program advocacy/accompaniment services available to victims for forensic/medical
exams 24 hours a day, 7 days a week?
Minimum Standards/Best Practice: 24 hours a day, 7 days a week
3. All other advocacy services available to clients 24 hours a day, 7 days a week?
Minimum Standards/Best Practice: 24 hours a day, 7 days a week
Documentation Checklist:
EOC # / Evidence of Compliance / Review Method / Sources of Evidence / Approved17 / Documentation of working relationships with the medical, legal, and victim service provider communities. / On-Site Document Review / Copies of interagency agreements and protocols, meeting minutes, policies and procedures manual
18 / Staffing schedule that demonstrates when advocacy services are available. / Mail-In Document Review / Copy of a current staffing schedule
20 / System of record keeping/documentation defined by the agency that identifies clients who received advocacy and what activities were provided. / On-Site Document Review / Policies & Procedures Manual; client case notes, intake notes, progress notes
Direct Service 4: advocacy/accompaniment
Comments:
Findings:
Corrective Actions:
Recommendations:
Direct Service 5: COMMUNITY AWARENESS
YES NO
1. Does the program provide community awareness services as defined in the standards
(“informing the general public about sexual violence and available programs and services
for victims”)?
Minimum Standards/Best Practice: Program provides community awareness services as defined
in the standards: “informing the general public about sexual violence and available programs and
services for victims.”
2. Does the program perform minimum standards activities as part of its community
awareness services? (Check all that apply.)
Community networking
Training for professionals
Training for non-professional community members
Participation in community events
Public speaking
Distribution of materials
Resource libraries
Free media coverage
Paid media campaign
Website
Minimum Standards: Community networking, training, participation in community events, public
speaking, distribution of materials, resource libraries, media coverage.
Best Practice: All listed activities.
3. Are all of the following recipients of community awareness services? (Check all that apply.)
Community agencies and organizations
Clubs
Churches
Local business customers
Educational institutions
Health care professionals
Law enforcement professionals
Youth-serving organizations
Under-served populations
General public
Minimum Standards: All of the above.
Best Practice: All of the above plus additional local organizations.
Documentation Checklist:
EOC # / Evidence of Compliance / Review Method / Sources of Evidence / Approved21 / Evidence that the agency is disseminating information about sexual abuse/assault (e.g., name of brochure, who given to, where distributed). / On-Site Document Review / Presentation log, brochure distribution/request log
22 / Evidence that the agency is reaching out to diverse populations. / On-Site Document Review / Presentation log, letters from organizations that were presented to, event flyers, media coverage
24 / Documentation of informational presentations and samples of printed materials distributed (e.g., list of community awareness activities with date, title, location, and demographics of audience. / On-Site Document Review / Sign-in sheets; presentation logs; etc.
Direct Service 5: community awareness