Академический Документы
Профессиональный Документы
Культура Документы
Table of Contents: I. II. III. IV. V. VI. VII. VIII. IX. X. XI. XII. XIII. XIV. XV. XVI. XVII. XVIII. XIX. XX. XXI. XXII. XXIII. XXIV. XXV. XXVI. XXVII. XXVIII. XXIX. XXX. INTRODUCTION GUIDING PRINCIPLES VOLUNTEER ENGAGEMENT AND RECRUITMENT REGISTRATION AND SCREENING OF VOLUNTEER APPLICANTS VOLUNTEER GROUPS FORMER CLIENTS AS VOLUNTEERS BACKGROUND CHECKS VOLUNTEER SERVICE AGREEMENT AGE OF VOLUNTEERS ORIENTATION CLIENT CONFIDENTIALITY AGENCY CONFIDENTIAL AND PROPRIETARY INFORMATION USE OF COPYRIGHTED MATERIAL E-MAIL AND INTERNET ACCEPTABLE USE POLICY REPORTING INCIDENTS PROHIBITION OF CORPORAL PUNISHMENT AND AVERSIVE PROCEDURES SEXUAL ABUSE PREVENTION AND REPORTING HARASSMENT PROVISION OF SERVICES TO PEOPLE WITH SEXUAL OFFENSE HISTORIES INFECTIOUS DISEASES IN THE WORKPLACE VOLUNTEERS WITH INFECTIOUS DISEASES INSURANCE COVERAGE VOLUNTEER DRIVING POLICY ANONYMOUS TIP LINE VOLUNTEER GRIEVANCES VOLUNTEER FILES FOR INDIVIDUAL VOLUNTEERS VOLUNTEER FILES FOR GROUP VOLUNTEERS RECOGNITION, RETENTION AND TRAINING RECORDS RETENTION FOR VOLUNTEERS ATTACHMENTS 3 3 5 6 6 7 7 11 11 12 13 13 13 14 14 14 15 15 15 16 16 16 17 19 19 19 20 20 20 20
I. INTRODUCTION
Catholic Community Services (CCS) recognizes that volunteers form a critical link with communities. Volunteers provide direct services to clients, help promote the program, assist with events and advise CCS leaders and staff. By integrating volunteers into all levels of our life and work, we are able to provide more services to more people, cultivate and maintain enhanced relationships with communities, and promote increased opportunities for partnerships, donors and collaborations. All CCS staff work to provide a hospitable environment for volunteers. This manual outlines the agencys policies and standards in regards to the use of volunteers in the work of the agency. This manual is for use by Program Managers/Directors and staff who work with volunteers to assist them in various aspects of volunteer management. It is not intended to be given to volunteers. However, Program Managers/Directors may choose to copy some of the sections from this manual into the volunteer manual for their specific program(s). Unless otherwise noted, the policies outlined in this manual refer to individual volunteers and not group volunteers who are volunteering for a specific project. This manual contains the required documents/forms associated with volunteering for CCS. A list of the documents and forms contained in this manual can be found in Section XXX. All documents/forms referenced in this manual are found in the appendix section of this document, online in Public Folders, under Volunteer Manual and through the Regional Human Resources offices. Best Practice Tip: Through-out this manual you will find the Best Practices Tip Box, helpful tools and resources to consider as you manage volunteers in your program.
BELIEF STATEMENT We Believe . . . in every child growing up in a safe, loving and nurturing environment. . . . in elders living in security and dignity. . . . in healthy family life being affirmed and supported in our communities. . . . in every person having the right to a safe, affordable place to call home. . . . in compassion, love and respect for all people, especially those who are poor and vulnerable.
. . . in joining with others to change the systems which oppress, discriminate or otherwise cause human suffering. . . . in volunteers and volunteers working in an environment which offers respect, teamwork and excellence. . . . in all these things for all people, whatever their color, whatever language they speak or however they worship.
VISION STATEMENT Catholic Community Services of Western Washington and Catholic Housing Services are prophetic voices for justice, recognizing the sacredness and dignity of every human person. Rooted in the Gospel message of hope, we will continue to be leaders, advocates, providers and partners serving poor and vulnerable people. CORE VALUES Compassion Providing care, understanding and concern for those we serve in order to honor the Godgiven life and sacredness of each person at every stage and condition of life. Diversity Welcoming the differences of race, culture, faith, and thought with a strong commitment to naming and combating institutional racism and discrimination. Excellence Providing high quality, professionally competent services with integrity, using best practices. Justice Defending and advocating for the rights of poor and vulnerable people while working toward the common good. Stewardship Prudently developing and using the gifts and talents of volunteers and volunteers and the financial resources needed to live out our mission.
STATEMENT OF ETHICAL CONDUCT The Code of Ethics of Catholic Community Services of Western Washington was developed to provide staff and volunteers with broad ethical statements with which to guide their professional lives and to identify relevant considerations when ethical uncertainties arise. It also provides a means for individuals new to the organization to learn about the ethical principles and standards that should guide our work. Catholic Community Services depends not only on the skills, abilities and commitment of all volunteers and volunteers, but also on their integrity and collective common sense. The application of this Code requires good judgment. As an organization that offers a wide range of services provided by persons who may be licensed in their respective professions, we recognize that our core values of Compassion, Diversity, Excellence, Justice and Stewardship provide an overarching service philosophy to clients. Clients is used inclusively to refer to individuals, families, groups, organizations and communities. Although it provides standards, the Code does not provide a set of rules. Reasonable differences of opinion can and do exist with respect to interpretation, and specific application must take into account the context of a given behavior. Principles, values, and standards sometimes conflict, creating the ethical dilemma. Though a problem solving process is used to weigh options and determine solutions, the process of ethical discernment is not linear. Because our work requires us to sort through complex situations and competing values on a daily basis, ethical decision-making requires constant conversation through supervision, training and consultation.
The code of ethics cannot guarantee ethical behavior or resolve all disputes. Rather, it sets forth standards to which we aspire and against which our actions can be judged by ourselves, and others. Ethical behavior results from a personal commitment to engage in ethical practice and an attempt to act always in a manner that assures integrity and reflects our mission to respect the dignity of persons we serve. CODE Compassion: We will provide care, understanding and concern for those we serve in order to honor the God-given life and sacredness of each person at every stage and condition of life. Diversity: We will treat fellow employees and volunteers in a fair and even-handed manner, fostering a culture rich in diversity that is based on trust, mutual respect, teamwork and integrity. Excellence: We will strive to provide excellent client satisfaction by providing people with services that are innovative and responsive to their strengths and needs. Justice: In our communities, we will act ethically as responsible and responsive citizens engaged in defending and advocating for the rights of poor and vulnerable people, working toward the common good. Stewardship: We will prudently develop and use the gifts and talents of employees and volunteers and the financial resources needed to live out our mission.
EQUAL OPPORTUNITY STATEMENT It is the policy of Catholic Community Services of Western Washington to provide equal opportunities for volunteers and applicants for volunteer assignments without regard to race, color, sex, sexual orientation, marital status, families with children, political ideology, age, creed, religion, ancestry, national origin, honorably discharged veteran or military status, the presence of a sensory, medical or physical disability or the use of a trained dog guide or service animal by a disabled person. This policy applies to all areas of volunteer activities, including engagement, recruitment, placement, training, retention, and all other conditions of volunteer management.
Best Practice Tip: When you use volunteer recruitment sites that also include Craigslist, Volunteer Match, your local United Way, your local RSVP site, Volunteer Centers, and College/ University student center sites, remember to keep opportunity listings current with appropriate contact information. If your posting has been up for a month and your program has not received any inquiries, review the description, re-consider your audience and tailor the language so that its geared to your intended group.
Best Practice Tip: Consider your volunteer when conducting your screening; is it an individual volunteer or someone who represents a group of people who want to volunteer? If its an individual volunteer, you will want to talk with them about what theyre interested in and how your opportunity can be the best fit. If its someone representing a group, this is an opportunity to establish a relationship and create a Volunteer Group Leader.
V. VOLUNTEER GROUPS
Group volunteer projects are a vital and important part for many CCS/CHS programs. They allow us to fill requests that are too big in scope or too complex for individuals to complete. The following guidelines apply: 1. The Group Leader must complete and sign the Volunteer Service Agreement (see Attachment E) and each participant should be listed on a Volunteer Roster. This ensures insurance coverage and documentation of their participation in case there is a problem. 2. The Group Project Leader must complete all of the applicable volunteer documentation required of an individual volunteer. 3. It is not necessary to do a WSP background check on group volunteers unless they will be serving as individuals in an unsupervised setting. 4. When using volunteers under 16 years of age in groups or special projects, a ratio of 1 adult supervisor (over the age of 21 or, a National Service Volunteer between the ages of 18-21 years) per 10 volunteers is required. When a group of volunteers under the age of 18 years are participating in a CCS activity that is sponsored by their own organization (church, school, etc.), a copy of the signed permission form for each participant is required 5. An in-person assessment is required to ensure the suitability of the project and to determine any special needs related to equipment or other requirements. 6. Detail carefully with the group what the work is and what their commitment is. 7. Do a mini orientation that includes the scope of the work, confidentiality, insurance, infection control and information about other program guidelines that may apply.
8. Make sure there are no surprises for the group. Be honest about the condition of the project and give them information about special clothing or equipment they may need. 9. Make sure that volunteers in groups are provided information about how to become regular CCS volunteers. 10. Members of a group who want to continue to volunteer with CCS must complete all the necessary procedures and paperwork required of individual volunteers. 11. The documents outlined in each of the following 3 sections will be maintained in a file for each group of volunteers working on a project. i. Group Leaders for volunteers working on a project as a group must complete an application and a background checks at noted in Section V. of this document. In addition, they must also complete the following: a. a Volunteer Service Agreement (see Attachment E) and b. Sexual Abuse Prevention: What CCS Volunteers Should Know Form (See Attachment K). ii. A roster containing the names and contact information for each volunteer in the group. iii. A Parental Acknowledgment and Permission Form (see Attachment F) will be signed for every volunteer between the ages of 16-18 years who is volunteering alone or for any youth who are volunteering without a legal guardian present. One time Volunteer Groups often transition to on-going Volunteer Groups. On-going Volunteer Groups provide services to a designated client or group of clients on an established and/or routine basis, and/or to different clients on a volunteer regular basis (e.g., two or more times in a six-month period). To reduce client risk and vulnerability while providing a safe environment for volunteers, follow the guideline listed below. When the one-time group transitions to an on-going group the following actions must be taken to ensure client and volunteer service integrity. Each member of the on-going group should have an individual volunteer record. The record should contain: A completed and signed Volunteer Application form with drivers license number, auto insurance carrier and three personal references. A completed and signed Disclosure Statement A completed WSP background check At least three completed personal references from non-family members Orientation
Additional Requirement for volunteers with unsupervised access* or limited residency: D. E. F. Volunteers who provide unsupervised services to children who are aged sixteen years and younger will complete an FBI fingerprint check (Effective 2012). All Volunteers who have resided within Washington for less than 3 years are also required to complete the CICS Authorization Form. (see Attachment D) Depending on the program, an Authorization Form for related external entities (e.g., DEL for Childcare workers, DOH, DSHS, DLR, DD, etc.) may be required.
These background checks are to be completed be the Regional Human Resources office. Once processed, the Regional Human Resources office will provide a background check report to the program for placement in the volunteers file. All checks must be successfully completed prior to a volunteer beginning to work in the program. Background checks for volunteers must be renewed every two (2) years or according to specific contract regulations. *In Long Term Care, volunteers who have unsupervised access to vulnerable adults must go through a background check through Division of Developmental Disabilities (DD) and Home and Community Services. In addition, Long Term Care volunteers are subject to a different list of disqualifying crimes than what is noted in the CCSWW Volunteer Disclosure Statement (Attachment C). Handling Negative Background Checks If a background check report that are completed at the program level comes back with a conviction or record, or, there is any question about the report or whether or not the prospective volunteer is eligible to participate as a volunteer, notify your Human Resources Director/Manager and follow their instructions which may include the following: A. Volunteers should be notified in person or by telephone and provided with the opportunity to explain the circumstances related to negative background check or record finding. Do not leave a voice mail as someone other than the volunteer may access the information. Best Practice Tip: When results are returned on a volunteer background check, crimes are often abbreviated. Use this link to access the list of criminal record abbreviations. Checking this list does not preclude contacting your Human Resources department to discuss the background check information. www.amerusa.net/resource_documents/CriminalRecordAbbreviations.pdf
B. If a meeting is preferred, ensure that another staff person is present. Inform the volunteer of the information received and allow him/her an opportunity to correct or explain. If you have determined that the information is accurate and the conviction is for one of the crimes listed below, inform the prospective volunteer that you are unable to place him/her in the program. In compliance with the CCSWW Confidentiality Policy, this information may not be disclosed to anyone outside the agency. C. The following is the list of disqualifying crimes.
DSHS SECRETARY'S LIST OF CRIMES AND NEGATIVE ACTIONS FOR USE BY ALL Programs Administered by DSHS, including DSHS State Employees in Covered Positions w/ Access to Vulnerable People
[EXCEPT programs administered by ADSA Home & Community Services & ADSA Residential Care Services]
Crimes: A person who has a crime listed below is denied unsupervised access to vulnerable adults, juveniles, and children. If "(5 or more years)" appears after a crime, the person is automatically denied unsupervised access unless 5 or more years has passed since the date of conviction. After 5 years, an overall assessment of the person's character, competence, and suitability to have unsupervised access will determine denial. Abandonment of a child Abandonment of a dependent person not against child (5 or more years) Abuse or neglect of a child Arson Assault 1 Assault 2 Assault 3 Domestic Violence Assault 3 not Domestic Violence (5 or more years) Assault 4/simple assault (5 or more years) Assault of a child Bail jumping Burglary (5 or more years) Carnal knowledge Child buying or selling Child molestation Coercion (5 or more years) Commercial sexual abuse of a minor/ Patronizing a juvenile prostitute Communication with a minor for immoral purposes Controlled substance homicide Criminal mistreatment Custodial assault (5 or more years) Custodial interference Custodial sexual misconduct (5 or more years) Dealing in depictions of minor engaged in sexual explicit conduct Domestic Violence (felonies only) Drive-by shooting Endangerment with a controlled substance Extortion 1 Extortion 2 (5 or more years) Forgery (5 or more years) Harassment (5 or more years) Harassment Domestic Violence Homicide by abuse Homicide by watercraft Identity theft (5 or more years) Incendiary devices (possess, manufacture, dispose) Incest Indecent exposure/Public indecency (Felony) Indecent liberties Kidnapping Leading organized crime (5 or more years) Luring Malicious explosion 1 Malicious explosion 2 Malicious explosion 3 (5 or more years) Malicious harassment Malicious mischief (5 or more years) Malicious mischief Domestic Violence Malicious placement of an explosive 1 Malicious placement of an explosive 2 (5 or more years) Malicious placement of an explosive 3 (5 or more years) Malicious placement of imitation device 1 (5 or more years) Manslaughter Murder/Aggravated murder Patronizing a prostitute (5 or more years) Possess depictions minor engaged in sexual conduct Possess explosive device (5 or more years) Promoting pornography (5 or more years) Promoting prostitution 1 (5 or more years) Promoting prostitution 2 (5 or more years) Promoting suicide attempt (5 or more years) Prostitution (5 or more years) Rape Rape of child Reckless endangerment (5 or more years) Registered sex offender Residential burglary (5 or more years) Robbery Selling or distributing erotic material to a minor Sending or bringing into the stats depictions of a minor Sexual exploitation of minors Sexual misconduct with a minor Sexually violating human remains Stalking (5 or more years) Theft (5 or more years) Unlawful imprisonment (5 or more years) Unlawful use of bldg for drug purposes (5 or more years) Use of machine gun in a felony Vehicular assault Vehicular homicide (negligent homicide) Violation of child abuse restraining order Violation of civil anti-harassment protection order Violation of protection/contact/restraining order Violation of the imitation Controlled Substance Act (manufacture/deliver/intent - 5 or more years) Violation of Uniform Controlled Substance Act (manufacture/deliver/intent - 5 or more years) Violation of the Uniform Legend Drug Act (manufacture/deliver/intent - 5 or more years) Violation of the Uniform Precursor Drug Act (manufacture/deliver/intent" 5 or more years Voyeurism Pending Crime - A person who has a pending crime on the Secretary's List is denied unsupervised access while awaiting a decision by a court, administrative entity, or governmental entity, Upon conviction or acquittal by the court, the Secretary's List is applied. Attempt RCW 9A.28.020; Conspiracy RCW 9A.28.030; and Solicitation RCW 9A.28.040 These crimes may appear with a listed crime, such as Burglary. When the crime of attempt, conspiracy, or solicitation appears in conjunction with a crime on this list, it is treated the same as the listed crime. Example: Unsupervised access is denied for Attempted Burglary for 5 years after the conviction. Sexual Motivation - RCW 9.94A.835 -A person who has a court finding of sexual motivation is denied unsupervised access to vulnerable adults, juveniles, or children. Bail Jumping RCW 9A.76.170 - A person who has the crime of bail jumping is denied unsupervised access until a court decision is issued for the original crime that required bail. Upon conviction or acquittal by the court, the Secretary's List is applied. Negative Action: are considered under individual program law and rule and may lead to denial of unsupervised access to vulnerable adults, juveniles, or children. A negative action is an administrative or civil action taken against an individual and may include: A finding that an individual abused, neglected, exploited, or abandoned a vulnerable adult, juvenile or child issued by an agency, an Administrative Law Judge, or a court of law. A finding by an agency is not a negative action if the individual was not given the opportunity to request an administrative hearing to contest the finding. Termination, revocation, suspension, or denial of a license, certification, and/or State or Federal contract. Relinquishment of a license, certification, or contract in lieu of an agency negative action. Revocation, suspension, denial or restriction placed on a professional license. Department of Health disciplining authority finding.
Updated 12/1/2011
DSHS SECRETARY'S LIST OF CRIMES AND NEGATIVE ACTIONS FOR USE BY ADSA Home & Community Services for Individual Providers and Home Care Agencies FOR USE BY ADSA Residential Care Services for Nursing Homes, Assisted Living Facilities & Adult Family Homes Crimes: A person who has a crime listed below is denied unsupervised access to vulnerable adults, juveniles, and children. If "(5 or more years)" or "(3 or more years)" appears after a crime, the person cannot be in a position to be left alone with a vulnerable adult unless 5 or more years or unless 3 or more years has passed since the date of the conviction. After 5 or 3 years has passed, an overall assessment of the person's character, competence, and suitability to have unsupervised access will determine denial. Abandonment of a child Abandonment of a dependent person Abuse or neglect of a child Arson 1 Assault 1 Assault 2 Assault 3 Assault 4/simple assault (3 or more years) Assault of a child Burglary 1 Child buying or selling Child molestation Commercial Sexual Abuse of a Minor/Patronizing a juvenile prostitute Communication with a minor for immoral purposes Criminal mistreatment Custodial assault Custodial interference Custodial sexual misconduct Dealing in depictions of minor engaged in sexual explicit conduct Endangerment with a controlled substance Extortion Forgery (5 or more years) Incest Indecent exposure/Public indecency (Felony) Indecent liberties Kidnapping Malicious harassment Manslaughter Murder/Aggravated murder Promoting pornography Promoting prostitution 1 Prostitution (3 or more years) Rape Rape of child Registered sex offender Robbery Selling or distributing erotic material to a minor Sending or bringing into the state depictions of a minor Sexual exploitation of minors Sexual misconduct with a minor Theft 1
Theft 2 (5 or more years) Theft 3 (3 or more years) Unlawful imprisonment Vehicular homicide (negligent homicide) Violation of child abuse restraining order Violation of the Imitation Controlled Substance Act (manufacture/deliver/intent) Violation of Uniform Controlled Substance Act (manufacture/deliver/intent) Violation of the Uniform Legend Drug Act (manufacture/deliver/intent) Violation of the Uniform Precursor Drug Act (manufacture/deliver/intent) Voyeurism Negative Actions are considered under individual program law and rule and may lead to denial of unsupervised access to vulnerable adults. A negative action is an administrative or civil action taken against an individual and may include: A finding that an individual abused, neglected, exploited, or abandoned a vulnerable adult, juvenile or child issued by an agency, an Administrative Law Judge, or a court of law. A finding by an agency is not a negative action if the individual was not given the opportunity to request an administrative hearing to contest the finding. Termination, revocation, suspension, or denial of a license, certification, and/or State or Federal contract. Relinquishment of a license, certification, or contract in lieu of an agency negative action. Revocation, suspension, denial or restriction placed on a professional license. Department of Health disciplining authority finding. A protection order issued under chapter 74.34 RCW. (A conviction for violation of a protection order issued under chapter 74.34 RCW is evidence that a protection order was issued).
Updated 07/19/2012
10
Court Ordered Community Service Volunteers Programs providing services to children and youth will not utilize court ordered community service volunteers. Following the guidelines listed below, other programs may use court ordered community service volunteers. It is the policy of Catholic Community Services to allow participation of court ordered community service volunteers only when it does not jeopardize the safety of clients and others. Refer to the list of Washington State convictions that disqualify volunteers from serving clients. Before service begins: Refer to the list of disqualifying crimes and make sure that the person has not been convicted of one of them. Provide an in-person interview. Staff should involve their supervisor during the interview or immediately following to review the information gathered and make a determination regarding the suitability of the volunteer applicant. Use your best judgment, in consultation with the probation officer or another officer of the court to determine whether or not you will place the volunteer. Decline to work with a court ordered volunteer who is not forthcoming with all information necessary. Insist on having the name and phone number of the probation officer or other officer of the court designated to supervise the volunteers service. Respect the volunteers right to confidentiality, but have the volunteer sign a release of information which will allow you to discuss the placement with the court. State clearly and specifically your programs policies, guidelines and standards as well as Agency expectations, policies and standards. State clearly how infractions will be addressed and address them the way you said you would. If a problem arises, do not delay addressing the problem. Orient the volunteer thoroughly. During the service period: Be consistent and clear in your interactions MONITOR THE PLACEMENT REGULARLY. Have contact with the volunteer and the client once a week. Have a face-to-face meeting with the volunteer no less than once every 2 weeks. If a problem arises, do not delay addressing the problem.
11
C. Volunteers under 21 years of age cannot provide personal care tasks. Only volunteers over the age of 21 years, who have documented training/licensure and are provided with additional supervision and training by the program, can provide these tasks. D. Volunteers under 21 years of age cannot transport clients by driving them. Volunteer Groups E. When using volunteers under 16 years of age in groups or special projects, a ratio of 1 adult supervisor (over the age of 21 or, a National Service Volunteer between the ages of 18-21 years) per 10 volunteers is required. F. When a group of volunteers under the age of 18 years are participating in a CCS activity that is sponsored by their own organization (church, school, etc.), a copy of the signed permission form for each participant is required.
X. ORIENTATION
Every volunteer must receive an orientation to the program prior to beginning service. The orientation should be documented in the volunteer file. Orientation should include the topics listed below as they apply to your volunteer and the program opportunities. A copy of the Orientation Checklist is included in the Appendix (see Attachment G) and should include, A. The programs scope and intent: who we serve and eligibility guidelines; B. Client Confidentiality; C. HIPAA for Volunteers; D. Confidential and Proprietary Information Owned by CCS; E. Use of Copyrighted Information; F. E-mail and Acceptable Use Policy; G. Safety Orientation appropriate to the program; H. Reporting Incidents; I. J. Prohibition of Corporal Punishment and Aversive Procedures; Sexual Abuse Prevention and Reporting;
K. Harassment; L. Provision of Services to People with Sexual Offense Histories; M. Infectious Diseases in the Workplace; N. Universal Precautions; O. Volunteers with Infectious Diseases; P. Insurance Coverage; Q. Driving Policy (for volunteers transporting clients) R. Fees and Donations; S. Working Guidelines: these are the basic dos and donts that keep volunteers and clients safe; engage in a discussion and encourage volunteers to call if they have questions;
12
T. Emergency Procedures: be sure that volunteers know exactly what to do in an emergency; ask that they notify you as soon as possible; U. Information about setting limits and negotiating tasks with the client; V. Procedures for notifying the client and staff when the volunteer is unable to keep an appointment; W. Information about how to notice changes in a clients condition or situation and what to do when such changes occur; and X. Information about appropriate relationships between volunteers and clients.
Best Practice Tip: Make your orientation relevant to each volunteer. This is another step in engagement and training so that your volunteer understands their role and can be a contributing member of your program There may be items that appear on the Orientation Checklist that do not apply to the volunteer assignment. These items should be marked as N/A and not left blank.
13
Volunteers will receive the entire Volunteer Copyright Policy and sign the agreement entitled Volunteer Agreement to Comply with Copyright Policy (see Attachment I) to indicate their understanding of this policy.
Best Practice Tip: This policy applies to volunteers who assist the Program by writing and producing newsletters, audio and visual materials and any software applications.
2. If an incident occurs that only involves the volunteer (e.g. altercation between volunteers, incidental property damage, volunteer injures self during activity), the volunteer must notify their supervisor immediately. The supervisor will complete a Staff/Volunteer/Visitor Safety/Accident Report (See Attachment J).
14
XVIII. HARASSMENT
In order to insure that neither clients, volunteers nor staff experience harassment of any kind in the course of their involvement with CCS, all client, volunteer and staff orientations will include a clear statement that CCS prohibits verbal or physical behaviors that can be considered threatening, abusive, sexually inappropriate or that make a client, volunteer or staff person uncomfortable. Clients, volunteers and staff will not be harassed and likewise are prohibited from engaging in any harassment towards other clients, volunteers or staff. Harassment is pervasive unwelcome conduct, whether verbal, physical or visual, based on categories including but not limited to race, color, religion, national origin, gender (of a sexual or non-sexual nature), age, disability/medical condition, marital status, or sexual orientation. In the event that a volunteer feels harassed, he/she will immediately notify their supervisor. If this occurs, supervisors must consult their Program/Division Director and the Agency Human Resources Director to determine what steps should be implemented in order to address the harassment issue raised by the volunteer. In the event that a volunteer is accused of harassment, he/she will be suspended from activity with the agency until agency leadership determines the validity of the claim. If the claim against the volunteer is found to be valid, the volunteer will not be allowed to continue to volunteer with the agency. Best Practice Tip: Heres an opportunity to further engage with your volunteer about the population theyll be working with and the potential that a client could harass them. Provide program specific training to volunteers on how to deal effectively with a client who presents in a forceful manner. In all cases where volunteers feel they may be harassed or are questioning the behaviors of clients they are working with, they should consult their supervisor.
Clinical leadership is involved in the determination of the need for safety planning, etc. for clients with known histories of sexual offending. Supervisors will advise volunteers that they should consult staff if they have any questions about this issue as it pertains to their volunteer activity.
16
and other out of pocket expenses. C. Automobile Insurance Volunteers who provide transportation to clients or otherwise use their automobile in the performance of their volunteer duties must have a current and valid driv ers license and carry at least the minimum auto liability insurance coverage as established by the Washington State Legislature, liability per person, $25,000; liability per occurrence, $50,000; property damage per occurrence, $10,000. In the event of an auto accident, a volunteers own auto insurance is the primary coverage. The Archdiocese of Seattle does carry excess liability coverage. This coverage extends only after the volunteers own auto liability limits are exhausted and the volunteer must be acting within the scope of their assigned duties at the time of the accident. D. Accident Insurance Volunteers are not provided coverage by the Archdiocese of Seattle for injuries to themselves in the performance of their assigned duties. Each volunteer needs to seek coverage under his/her personal health and/or accident insurance plan.
17
7. Use of prescribed drugs that may impair driving ability or alcohol is prohibited. 8. Good judgment and discretion is expected if the volunteer is taking over the counter medication that may impair driving ability. 9. Smoking in a personal vehicle with a client present is prohibited. Smoking in any CCS Fleet Vehicle is also prohibited. 10. All volunteers are expected to follow all driving laws and safety rules such as adherence to posted speed limits and directional signs, use of turn signals and avoidance of confrontational or offensive behavior while driving. 11. Volunteers transporting clients must promptly report any accidents to local law enforcement and to their immediate supervisor. A Client Incident Report must be completed by the supervisor. If the volunteer is injured as well, the Staff/Volunteer/Visitor Safety Accident Report must be completed 12. CCS Volunteers must notify their supervisor of any driving infraction including speeding, reckless driving and Driving under the Influence (DUI) convictions. Failure to adhere to any one or more of the above requirements may result in termination of the volunteer position. B. Additional requirements for Volunteers Who Transport Clients and/or Use Agency Owned Vehicles Volunteers in this category are required to submit an annual validation of vehicle registration. Volunteers must immediately notify their supervisor if their drivers license is suspended, their insurance is cancelled, their vehicle registration changes or lapses or any conviction of driving while under the influence of drugs and/or alcohol. Volunteers who do not do so and continue to drive while transporting clients will be subject to termination of their volunteer activities with CCS. Statement of Physical Ability: All volunteers should review and sign this form as good judgment and discretion is expected if the volunteer is taking over the counter medication that may impair driving ability. Volunteers should inform their supervisor if their physical ability to provide transportation services changes at any point in time. Driving Abstract Standards: Initial and annual driving record abstract reviews and validation of vehicle registration will be performed on/required of all volunteers who transport clients in their vehicle as part of their volunteer work with CCS and/or who drive Agency owned vehicles. Volunteers in this category will be subject to the following guidelines: a. A driver is considered unacceptable if any of the following violations are reflected on a drivers abstract during a three year period immediately preceding the date of review: Driving Under the Influence of alcohol or drugs Hit and Run - felony Failure to report an accident Operating a vehicle during a period of license suspension or revocation Permitting an unlicensed person to drive Reckless driving Speed contests Catholic Community Services reserves the right to use discretion when reviewing and evaluating initial and/or ongoing abstracts to determine whether or not a volunteer will be eligible to drive clients and/or fleet vehicles. Immediate termination of volunteer work with CCS may result for any volunteer who is convicted of any of the above crimes while transporting a client.
18
b. Any combination of three accidents and/or moving violations during the previous three year period will be considered unacceptable and subject to the same terms and guidelines stated above. Accidents are defined as at fault and no fault. Accidents where the other party was at fault and the volunteer was not charged will not show on a driving abstract and will not count against them. Moving violations will include but are not limited to speeding, failure to stop, improper lane change, failing to signal, failure to yield, negligent driving, talking on a phone or texting. c. Single or repeated violations that are not covered under A. or B. above will be primarily judged based on the length of time since the violation(s), nature of the violation, etc.
Vehicle Registration, Insurance and Driver Licensing Volunteers who transport clients are required to submit an annual validation of vehicle registration, provide proof of insurance and a current drivers license.
19
L. Sexual Abuse Prevention: What CCS Volunteers Should Know Form (see Attachment K); M. Acceptance of E-mail and Internet Usage Policy, as appropriate. The following information must be maintained in volunteers files for volunteers who drive as part of their volunteer work with CCS: A. B. C. D. E. F. Volunteer Driving Policy, Signature Form and Driving Abstract Standards (see Attachment L); Copy of current drivers license; Copy of current insurance information; Copy of the volunteers annual driving abstract (If the volunteer transports clients); Annual validation of vehicle registration (If the volunteer transports clients); and Volunteer Statement of Physical Ability and Volunteer Acknowledgment (Attachment M).
The following information may be maintained in volunteer files as determined by the program: A. Job Description B. Evaluation/Satisfaction Survey
XXX. ATTACHMENTS
The following is a list of attachments included as part of the Volunteer Manual. Attachment A - Volunteer Application Attachment B - Washington State Patrol Background Check Attachment C - CCSWW Volunteer Disclosure Statement
20
Attachment D - CICS Authorization Form Attachment E - Volunteer Service Agreement Attachment F - Parental Acknowledgment and Permission Form Attachment G - Orientation Checklist Attachment H - HIPAA Information for Volunteers Form Attachment I - Volunteer Copyright Policy and Volunteer Agreement to Comply with Copyright Policy Attachment J - Staff/Volunteer/Visitor Safety/Accident Report Attachment K - Sexual Abuse Prevention: What CCS Volunteers Should Know Form Attachment L - Volunteer Driving Policy and Acknowledgement Form Attachment M - Volunteer Statement of Physical Abilities Each attachment is included in their entirety on the pages that follow and also located in the Public Folders under Volunteer Manual.
21
Volunteer Application
Name: Home ( Cell ( Address: ) ) Work ( City: Age: Gender: Email: Phone: Relationship: Ethnicity: ) Zip:
Please list any special skills or interests you would like to share (i.e. teaching, hobbies):
Are you fluent in another language? Yes If yes, please specify: Do you have any allergies? Yes If yes, please specify: Do you have any physical limitations? Yes If yes, please specify: I am available to volunteer: How often? [ ] Weekly [ ] Twice a month [ ] Monthly Days/Times available: Time of day? [ ] Morning [ ] Afternoon [ ] Evenings Preferred Assignment? [ ] Ongoing (3+ months) [ ] Short-term (1 month or less) [ ] On-call No No No
22
If you will be using your car at any time as a volunteer, it is necessary for us to record the following information. Please note any traffic violations or accidents within the last three years: Do you have: a. Valid drivers license? Yes No If yes, please list drivers license number and state: At least the minimum auto insurance required by the State of Washington ($25,000 liability per person, $50,000 liability and $10,000 property damage per occurrence.) Yes No If yes, please list insurance company name:
b.
Have you ever been convicted of a felony? Yes An affirmative answer does not necessarily bar you from volunteer work. Because our clients are designated by the State as a vulnerable population, all volunteers are required to authorize a records check by the Washington State Patrol. Please complete Section C and the Applicant Information portion of Section D (signature required) on the attached form and return it with your registration . You will be notified of the results of the background check. It is necessary for our office to have three references on file (please do not list relatives): Reference #1 Name: _________________________________ E-mail: _______________________ Address: ___________________________________ City: _____________________ State: ______ Zip Code: __________ Daytime Phone #: _______________________ Reference #2 Name: _________________________________ E-mail: _______________________ Address: ___________________________________ City: _____________________ State: ______ Zip Code: __________ Daytime Phone #: _______________________ Reference #3 Name: _________________________________ E-mail: _______________________ Address: ___________________________________ City: _____________________ State: ______ Zip Code: __________ Daytime Phone #: _______________________ How did you hear about Catholic Community Services volunteer opportunities? (i.e. specific internet site, name of church, friend) No
As a volunteer, I will respect the confidential nature of any verbal or written information about clients, staff or other volunteers, both during and after the course of my volunteer service.
Signed: ________________________________________
Date: __________________
Please return the completed Volunteer Application, Washington State Patrol background check, and HIPAA form in the self-addressed envelope. Thank you.
23
24
25
EMPLOYEE AND VOLUNTEER DISCLOSURE STATEMENT To comply with the requirements of the Revised Code of Washington, we must ask you to complete the following disclosure statement. 1. Have you ever been convicted of a crime against persons?
(See list of applicable convictions on back.)
_____ Yes
____ No
If yes, please describe and provide the date(s) of trial(s), conviction(s) and the sentence(s) imposed, if any.
2.
_____ Yes
_____No
If yes, please describe and provide the date(s) of trial(s), conviction(s) and the sentences(s) imposed, if any.
3.
_____Yes
_____No
If yes, please describe and provide the date(s) of trial(s), conviction(s) and the sentences(s) imposed, if any.
4.
Have you ever been found in a dependency action, domestic relations proceeding, or disciplinary board final decision to have sexually abused, assaulted or exploited any minor, or to have physically abused any minor? ____ Yes ____ No If yes, please explain below:
5.
Have you ever been found in any disciplinary board final decision to have abused a vulnerable adult? ____ Yes ____ No If yes, please explain below:
We may request your fingerprints to obtain from the Washington State Patrol criminal identification system a report of any record of your criminal convictions for offenses listed, civil adjudications of child abuse, and disciplinary board final decisions. If you are hired before that report is available, YOUR EMPLOYMENT/VOLUNTEER WORK WILL BE CONTINGENT UPON THE RECEIPT OF A SATISFACTORY REPORT. If a report is requested from the State Patrol or from DSHS, we will mail you notice of the response and a copy of the report, within ten days after we receive that report. UNDER PENALTY OF PERJURY, I certify that the above information is true, correct and complete. I understand that if I am hired or selected for volunteer work, I can be discharged for any misrepresentation or omission in the above statement. I also understand that if I am hired or selected for volunteer work, my employment/ volunteering is conditioned on receipt of a satisfactory report from the Washington State Patrol. ____________________________________ Signature ______________________________________ Date
26
___________________________________ _______________________________________________ [EXCEPT programs administered by ADSA Home & Community Services & ADSA Residential Care Services] Please print exact legal name Maiden name or any name by which you have been known
Crimes: A person who has a crime listed below is denied unsupervised access to vulnerable adults, juveniles, and children. If "(5 or more years)" appears after a crime, the person is automatically denied unsupervised access unless 5 or more years has passed since the date of conviction. After 5 years, an overall assessment of the person's character, competence, and suitability to have unsupervised access will determine denial. Abandonment of a child Abandonment of a dependent person not against child (5 or more years) Abuse or neglect of a child Arson Assault 1 Assault 2 Assault 3 Domestic Violence Assault 3 not Domestic Violence (5 or more years) Assault 4/simple assault (5 or more years) Assault of a child Bail jumping Burglary (5 or more years) Carnal knowledge Child buying or selling Child molestation Coercion (5 or more years) Commercial sexual abuse of a minor/ Patronizing a juvenile prostitute Communication with a minor for immoral purposes Controlled substance homicide Criminal mistreatment Custodial assault (5 or more years) Custodial interference Custodial sexual misconduct (5 or more years) Dealing in depictions of minor engaged in sexual explicit conduct Domestic Violence (felonies only) Drive-by shooting Endangerment with a controlled substance Extortion 1 Extortion 2 (5 or more years) Forgery (5 or more years) Harassment (5 or more years) Harassment Domestic Violence Homicide by abuse Homicide by watercraft Identity theft (5 or more years) Incendiary devices (possess, manufacture, dispose) Incest Indecent exposure/Public indecency (Felony) Indecent liberties Kidnapping Leading organized crime (5 or more years) Luring Malicious explosion 1 Malicious explosion 2 Malicious explosion 3 (5 or more years) Malicious harassment Malicious mischief (5 or more years) Malicious mischief Domestic Violence Malicious placement of an explosive 1 Malicious placement of an explosive 2 (5 or more years) Malicious placement of an explosive 3 (5 or more years) Malicious placement of imitation device 1 (5 or more years) Manslaughter Murder/Aggravated murder Patronizing a prostitute (5 or more years) Possess depictions minor engaged in sexual conduct Possess explosive device (5 or more years) Promoting pornography (5 or more years) Promoting prostitution 1 (5 or more years) Promoting prostitution 2 (5 or more years)
DSHS SECRETARY'S LIST OF CRIMES AND NEGATIVE ACTIONS FOR USE BY ALL Programs Administered by DSHS, including DSHS State Employees in Covered Positions w/ Access to Vulnerable People
Promoting suicide attempt (5 or more years) Prostitution (5 or more years) Rape Rape of child Reckless endangerment (5 or more years) Registered sex offender Residential burglary (5 or more years) Robbery Selling or distributing erotic material to a minor Sending or bringing into the stats depictions of a minor Sexual exploitation of minors Sexual misconduct with a minor Sexually violating human remains Stalking (5 or more years) Theft (5 or more years) Unlawful imprisonment (5 or more years) Unlawful use of bldg for drug purposes (5 or more years) Use of machine gun in a felony Vehicular assault Vehicular homicide (negligent homicide) Violation of child abuse restraining order Violation of civil anti-harassment protection order Violation of protection/contact/restraining order Violation of the imitation Controlled Substance Act (manufacture/deliver/intent - 5 or more years) Violation of Uniform Controlled Substance Act (manufacture/deliver/intent - 5 or more years) Violation of the Uniform Legend Drug Act (manufacture/deliver/intent - 5 or more years) Violation of the Uniform Precursor Drug Act (manufacture/deliver/intent" 5 or more years Voyeurism Pending Crime - A person who has a pending crime on the Secretary's List is denied unsupervised access while awaiting a decision by a court, administrative entity, or governmental entity, Upon conviction or acquittal by the court, the Secretary's List is applied. Attempt RCW 9A.28.020; Conspiracy RCW 9A.28.030; and Solicitation RCW 9A.28.040 These crimes may appear with a listed crime, such as Burglary. When the crime of attempt, conspiracy, or solicitation appears in conjunction with a crime on this list, it is treated the same as the listed crime. Example: Unsupervised access is denied for Attempted Burglary for 5 years after the conviction. Sexual Motivation - RCW 9.94A.835 -A person who has a court finding of sexual motivation is denied unsupervised access to vulnerable adults, juveniles, or children. Bail Jumping RCW 9A.76.170 - A person who has the crime of bail jumping is denied unsupervised access until a court decision is issued for the original crime that required bail. Upon conviction or acquittal by the court, the Secretary's List is applied. Negative Action: are considered under individual program law and rule and may lead to denial of unsupervised access to vulnerable adults, juveniles, or children. A negative action is an administrative or civil action taken against an individual and may include: A finding that an individual abused, neglected, exploited, or abandoned a vulnerable adult, juvenile or child issued by an agency, an Administrative Law Judge, or a court of law. A finding by an agency is not a negative action if the individual was not given the opportunity to request an administrative hearing to contest the finding. Termination, revocation, suspension, or denial of a license, certification, and/or State or Federal contract. Relinquishment of a license, certification, or contract in lieu of an agency negative action. Revocation, suspension, denial or restriction placed on a professional license. Department of Health disciplining authority finding. (Updated 12/1/2011)
27
FIRST
FULL MIDDLE
STATE
ZIPCODE
Please list other names used and dates of name change in the last ten years: FULL NAME FULL NAME FULL NAME DOB:______/______/______ SSN:____________-______-____________ DATE DATE DATE
DRIVERS LICENSE NUMBER_________________________________ STATE___________________ Have you ever been convicted of a crime? ________ If yes, please provide details of all convictions and locations of all convictions. (A yes answer will not necessarily disqualify you from employment.)
RESIDENCES: Please list residences in the last 10 years State _____ State _____ State _____ State _____ City ____________________________ City ____________________________ City ____________________________ City ____________________________ County_________________ County_________________ County_________________ County_________________ Years: ______ to ______ Years: ______ to ______ Years: ______ to ______ Years: ______ to ______
In connection with my application I understand that an investigative consumer report may be requested that may include information regarding my court records both civil and criminal, my driving records, educational and professional credentials, and personal and professional references. This may come from either public or private sources and may contain information regarding my character, experience, work habits, and reasons for termination from past employers. I understand that this document shall be kept on file and may be used at any time during my employment to procure an investigative report. I hereby release and discharge to the extent permitted by law, ________, its employees, any individual or agency obtaining information for ________, my personal and professional references, and my former employers, from any and all claims known or unknown, damages, losses, liabilities, cost, or other expenses arising from the retrieving, reporting, and/or disclosure of information in connection with this background investigation. I also understand that I may (1) request in writing the nature of the information obtained, and (2) request a written summary of my rights under the Fair Credit Reporting Act. I hereby agree that a photographic copy or a telephonic facsimile of this document shall be valid for all purposes present and future. I have read, understand and agree with the above.
Signed Witnessed
Date Date 28
____________________________________
Volunteer Date
______________________________
Supervisor Date
29
Catholic Community Services I give permission for ________________________________________ to work as a Catholic Community Services volunteer. I understand that she/he is registered, covered by insurance and will attend an orientation before beginning volunteer work.
___________________ Date
___________________ Date
30
Below is a list of items that need to be discussed, reviewed and provided to a new volunteer. Please ensure that all applicable items are completed before a person begins volunteering.
Best Practice Tip: Feel free to add items to the list that are specific to your program.
I. Topics to cover during orientation to the Program: The Programs scope and intent: who we serve and eligibility guidelines; Client Confidentiality; Confidential and Proprietary Information Owned by CCS (if applicable); Use of Copyrighted Information; (if applicable); E-mail and Acceptable Use Policy(if applicable); Safety Orientation appropriate to the Program; Reporting Incidents; Prohibition of Corporal Punishment and Aversive Procedures; Sexual Abuse Prevention and Reporting; Harassment; Provision of Services to People with Sexual Offense Histories; Infectious Diseases in the Workplace; Volunteers with Infectious Diseases; Insurance Coverage; Driving Policy (for volunteers transporting clients); Fees and Donations(if applicable); Working Guidelines: these are the basic dos and donts that keep volunteers and clients safe; Emergency Procedures: be sure that volunteers know exactly what to do in an emergency; ask that they notify you as soon as possible; Information about setting limits and negotiating tasks with the client; Procedures for notifying the client and staff when the volunteer is unable to keep an appointment; Information about how to notice changes in a clients condition or situation and what to do when such changes occur; and Information about appropriate relationships between volunteers and clients.
31
II. Documentation: Volunteer Application Form; Washington State Patrol (WATCH) Authorization Form; CCSWW Volunteer Disclosure Statement; CICS Authorization Form (if applicable); WSP and FBI Fingerprint Check (if needed); Background Authorization Form(s) and results for related external entities (e.g., DEL for Childcare workers, DOH, DSHS, DLR, DD, etc.), as applicable. Volunteer Service Agreement; Parental Acknowledgement and Permission Form (only needed for individual volunteers between 16 and 18 years of age) Volunteer Orientation Checklist; HIPAA Information for Volunteers Form; Volunteer Agreement to Comply with Copyright Policy; (if applicable); Sexual Abuse Prevention: What CCS Volunteers Should Know Form; and Acceptance of E-mail and Internet Usage Policy (if applicable);
The following information must be maintained in volunteers files for volunteers who drive as part of their volunteer work with CCS: Volunteer Driving Policy Signature Form Copy of annual driving abstract; Copy of current drivers license; and Copy of current insurance information Annual validation of vehicle registration Statement of Physical Ability and Volunteer Acknowledgment The following information may be maintained in volunteer files as determined by the program:
32
33
34
CCS/CHS volunteers shall not install or run peer-to-peer file sharing software or operate a peer-to-peer index or server on CCS/CHS systems or equipment, without the IT Director or Associate IT Directors consent. All volunteers are asked to sign an agreement at the beginning of employment that obligates each volunteer to adhere to this Copyright Policy. Any questions as to whether information is confidential or proprietary or whether an volunteer may copy or use copyrighted material should be raised with Corporate General Counsels office before proceeding. Any materials that violate this Copyright Policy are subject to immediate removal, termination and/or forfeiture. CCS/CHS volunteers that violate this Copyright Policy may be subject to the termination of their volunteer assignment.
35
I have read and agree to comply with the CCS/CHS Copyright Policies. I understand that questions regarding the use of copyrighted material should be raised with Corporate General Counsels office before proceeding. I further understand that should I violate any of this policy, I may be subject to disciplinary action, up to and including termination.
____________________ Date
36
Follow-up:
Date: Date:
37
Sexual Abuse Prevention: What CCS Volunteers Should Know When Serving Youth and/or Vulnerable Adults
(Supervised and Potentially Unsupervised Settings)
Thank you for volunteering for Catholic Community Services! Your work is very important to the youth and vulnerable adults we serve, to CCS, and to the entire community. Please take a moment before you begin your service and read this page regarding sexual abuse. With a few simple guidelines you will learn how to recognize and report this problem. Because a one-page summary cant cover everything, please use your common sense: it is the best resource you have! Catholic Community Services Has a Zero Tolerance Policy of Sexual Abuse. Sexual abuse is defined as any sexualized activity(s) with a minor or vulnerable person for the sexual gratification of the abuser. Of course it includes intercourse or any kind of sexual touch, but it can also mean looking at pornography with a youth or vulnerable adult, voyeurism, and sexualized conversation. These activities are never allowed in any service context at CCS. Boundaries are important. Did you know that most sexual abuse does not come from vicious predators, but from wanderers? These are people who do not understand boundaries . This is why having good rules and clear guidelines are so important: Most volunteer work with youth and vulnerable adults is in a supervised setting. If your volunteer work requires you to spend unsupervised time with a youth or vulnerable adult, be sure that the setting is appropriate and others are nearby. Report questions or problems immediately. When in doubt ASK! If a young person or vulnerable adult confides something to you that concerns you, it cannot be confidential. Share it with your volunteer supervisor and ask for advice. Avoid dual relationships. For example, dont develop a special friendship, meet outside of work, or exchange personal gifts with someone you have served. Keep your own good limits, even if the person you are serving has poor ones (If someone tells you a dirty joke, you dont have to tell one in reply). Be on the lookout for situations that make you uncomfortable; your inner warning signals are the best way to identify risky situations or problem areas.
What to do if you have questions about a concern or suspicion of abuse? All CCS staff are trained in handling questions about problem behavior or suspected abuse. If during your service you see something that concerns you, or a problem is informally reported to you, TELL YOUR VOLUNTEER SUPERVISOR IMMEDIATELY. That person is ___________________________, and their phone number is _______________.
Please let us know that you have read and understood this policy and these guidelines by signing _____________________________ on __________.
(Sign Here) (Date)
38
39
Failure to adhere to any one or more of the above requirements may result in termination of the volunteer position. Additional requirements for Volunteers Who Transport Clients and/or Use Agency Owned Vehicles Volunteers in this category are required to submit an annual validation of vehicle registration. Volunteers must immediately notify their supervisor if their drivers license is suspended, their insurance is cancelled, their vehicle registration changes or lapses or any conviction of driving while under the influence of drugs and/or alcohol. Volunteers who do not do so and continue to drive while transporting clients will be subject to termination of their volunteer activities with CCS. Statement of Physical Ability: All volunteers should review and sign this form as good judgment and discretion is expected if the volunteer is taking over the counter medication that may impair driving ability. Volunteers should inform their supervisor if their physical ability to provide transportation services changes at any point in time. Driving Abstract Standards: Initial and annual driving record abstract reviews and validation of vehicle registration will be performed on/required of all volunteers who transport clients in their vehicle as part of their volunteer work with CCS and/or who drive Agency owned vehicles. Volunteers in this category will be subject to the following guidelines: a. A driver is considered unacceptable if any of the following violations are reflected on a drivers abstract during a three year period immediately preceding the date of review: Driving Under the Influence of alcohol or drugs Hit and Run - felony Failure to report an accident Operating a vehicle during a period of license suspension or revocation Permitting an unlicensed person to drive Reckless driving Speed contests Catholic Community Services reserves the right to use discretion when reviewing and evaluating initial and/or ongoing abstracts to determine whether or not a volunteer will be eligible to drive clients and/or fleet vehicles. Immediate termination of volunteer work with CCS may result for any volunteer who is convicted of any of the above crimes while transporting a client. b. Any combination of three accidents and/or moving violations during the previous three year period will be considered unacceptable and subject to the same terms and guidelin es stated above. Accidents are defined as at fault and no fault. Accidents where the other party was at fault and the volunteer was not charged will not show on a driving abstract and will not count against them. Moving violations will include but are not limited to speeding, failure to stop, improper lane change, failing to signal, failure to yield, negligent driving, talking on a phone or texting. c. Single or repeated violations that are not covered under A. or B. above will be primarily judged based on the length of time since the violation(s), nature of the violation, etc.
Vehicle Registration, Insurance and Driver Licensing Volunteers who transport clients are required to submit an annual validation of vehicle registration, provide proof of insurance and a current drivers license.
40
Volunteer Driving Policy Acknowledgement Form I _________________ have read and understand the Catholic Community Services Volunteer Driving Policy. I agree to follow each stipulation as it pertains to my use of my own vehicle or, if applicable, my use of a CCSWW owned vehicle. I further understand that should I violate any requirement of this policy I will be subject to termination of my volunteer activities with CCS.
41
I, , a Volunteer for Catholic Community Services (insert program name) do hereby state that at this time I am physically capable of driving clients to needed appointments and have no restrictions placed on my drivers license. I am not currently taking medication, prescription or non-prescription that affects or impairs my driving ability. If my ability to transport changes I will notify my supervisor within 48 hours.
I further state that my vehicle is mechanically sound and equipped with seat belts which will be used while transporting clients.
I have read and agreed to the policies and procedures for volunteers who transport clients.
Volunteer Signature
Date
Date
42