Part 1: Program Information
Organizations may complete one template for all programs, or a separate template that addresses each program being reviewed under this section. Provide responses in each box provided.
Organizations being accredited for the first time: Please provide information for the last year.
Organizations being reaccredited: Please provide information for the period since the last accreditation review.
1. Describe any significant changes, challenges, awards received, changes in funding, or obstacles faced by the organization with regard to its social advocacy initiatives.
2. Provide an overview of the program(s) being accredited under this section. The overview should describe:
- the programs' service philosophy and approach to delivering services;
- any unique programs or special services provided to specific populations;
- major funding streams; and
- any additional information referenced in the Table of Evidence.
3. If service components are provided through contract in cooperation with other organizations or through a formal, coordinated service delivery system provide a list that identifies the providers and the service components for which they are responsible. Do not include services provided by referral.
4. Provide any other information your organization would like the peer review team to know about these programs.
Attachments
- A list of all program sites, including the following information for each program site: a) name of program/site director; b) address; c) phone number; d) hours of operation; e) number of FTEs; and f) directions or a map to each program site from the main organization office
- If applicable, a demographic profile of stakeholders involved in the initiative(s) being reviewed under this service section with percentages representing the following: a) racial and ethnic characteristics; b) major religious groups; c) major language groups; d) gender; and e) age. Include an explanation of how the program ensures that it is culturally competent
- Two quarterly reports of accidents, incidents, and grievances related to this service (See RPM 2.02)
- All COA-approved NA Requests
- A list of all NAs applicable to your organization provided within the standards
Part 2: Program Outputs and Outcomes
Provide a response in each box describing how the program is making progress toward achieving its aims and promoting positive results.
1. A summary of where the organization is in the development of its program for measuring quality and outcomes, specific to the service.
2. A list or description of outputs and desired outcomes and any outputs and outcomes being measured including measurement tools used.
Note: Outputs may include number of activities or projects implemented, number of partners or other stakeholders engaged, stakeholder satisfaction, etc.
3. An overview of the organization's process for analyzing data.
4. Examples of program improvements made based on the outcomes data.
Attachments
- Outcomes measurement/data collection procedures
- Outcomes results reported for the previous two quarters
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Self-Study Documents |
On-Site Documents |
On-Site Activities |
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SOC 1
Service Philosophy |
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- Program director
- Relevant personnel
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SOC 2
Setting the Agenda |
- Agenda
- Procedures for agenda setting
- Include description of how advocacy efforts relate to the organization’s mission, in Service Narrative Part 1: Program Information
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- Program director
- Relevant personnel
- Governing body or advisory group members, if possible and appropriate
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SOC 3
Advocacy Issue Assessment |
- Advocacy issue assessment
- Procedures for assessing the advocacy issue
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- Program director
- Relevant personnel
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SOC 4
Advocacy Planning |
- Advocacy plan
- Procedures for advocacy planning
- Procedures for periodically reevaluating the advocacy plan
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- Program director
- Relevant personnel
- Governing body or advisory group members, if possible and appropriate
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SOC 5
Civic Engagement |
- Outreach procedures and informational materials
- Procedures for communicating and collaborating with stakeholders, including procedures for collecting stakeholder feedback
- Include description of civic engagement efforts, in Service Narrative Part 1: Program Information
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- Evidence of collaboration with stakeholders
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- Program director
- Relevant personnel
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SOC 6
Partnerships and Collaborations |
- List of partners, including organizations and decision-makers
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- Evidence of collaboration with partners (e.g., meeting notices, meeting agendas, meeting minutes, correspondence, documentation of decisions, etc.)
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- Program director
- Relevant personnel
- Collaborating organizations or other partners, if possible and appropriate
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SOC 7
Advocacy Activities and Interventions |
- Include description of activities implemented, and rationale for how activities promote the goals specified in the advocacy plan, in Service Narrative Part 1: Program Information
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- Documentation that demonstrates implementation of activities (e.g., meeting minutes, research reports, letters, survey results, printed materials, etc.)
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- Program director
- Relevant personnel
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SOC 8
Personnel |
- List of personnel that includes:
- name
- title
- degree held and/or other credentials
- FTE or volunteer
- length of service at the organization
- time in current position
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- Program director
- Relevant personnel
- Governing body or advisory group members, if possible and appropriate
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