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Mental Retardation Services Policies and Procedures Subject Effective Date Review Date Regulations Policy Purpose The

purpose of this policy is to set forth official operational procedures for people to participate as volunteers within the facilities and programs of the Developmental Programs division of Catholic Social Services. Definitions A volunteer is an individual who provides services to or for the benefit of one of the facilities and programs of the Developmental Programs division of Catholic Social Services of the Archdiocese of Philadelphia by free choice and who does not receive compensation, directly or indirectly, for those services. There are three classes of volunteers: 1. Formal volunteers are persons who participate in regularly scheduled activities and may be in a one-on-one unsupervised situation with a client.(not sure about this,
as the CSS policy states that clients cant be left alone with folunteers)EB
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Volunteer Policy July 1, 2011 January 1, 2012 Volunteer Policy

2. 3.

Casual volunteers include persons who participate in occasional volunteer activities and never are in a one-on-one unsupervised situation with a client. Group Volunteers have a minimum of 5 and a maximum of 40 casual volunteers who volunteer under the auspices of an outside organization.

Individuals performing directed service such as court-ordered community service, confirmation projects, etc. are not considered volunteers. An intern who is registered at an educational institution and providing time without monetary compensation in exchange for a class requirement or credit is not considered a volunteer. (However, CSS requires that they provide us with The background checks) A Formal volunteer must be at least 16 years of age unless accompanied by an adult, have completed the volunteer screening and orientation by the site supervisor and obtain signed Young Person Volunteer Authorization form if under 18 years of age. Nondiscrimination Policy The Catholic Social Services nondiscrimination policy extends to all aspects of volunteer service including recruitment, selection, training and termination. Policy for the Protection of Children, Young People, and People with Intellectual Disabilities
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All volunteers are to adhere to the policies and procedures of the Archdiocese of Philadelphia regarding Child and Youth Protection, which are available at: http://archphila.org/protection/DocArchive/Policies/pap_main.htm Scope of Activity The role of the volunteer is to assist, but not replace or assume, the professional or paraprofessional responsibilities or authority of staff of any of the facilities and programs of the Developmental Programs division of Catholic Social Services. Volunteers shall follow all applicable rules, regulations and administrative procedures and guidelines concerning the conduct of the professional and paraprofessional staff of the Developmental Programs division of Catholic Social Services. Procedure The on-site Volunteer Coordinator is responsible for managing the utilization of volunteers. The Volunteer Coordinator responsibilities include: Identifying possible placement opportunities. Recruitment, screening, and placement of volunteers. A Placement Supervisor, identified by the volunteer coordinator, is responsible for the direct supervision of a volunteer. Coordination, with the Director of Training, of orientation and training of volunteers. Record keeping, including monthly reporting of volunteer hours. Recognition and evaluation of volunteers.

Recruitment

Recruitment for volunteers will be coordinated through the Volunteer Coordinator in a thoughtful, planned manner with recruitment strategies suited to community resources and local needs. Methods of recruitment may include, but are not limited to group presentations, mass media, and the involvement of local resources such as private business, volunteer referral centers, schools, churches, senior service programs, and employment offices. To meet affirmative action goals, appropriate media outlets and community organizations that support under-served audiences are to be used. Volunteers from other agencies (VISTA, etc.) may be used as appropriate. In such cases, policies of the agency must not violate policies of Catholic Human Services of the Archdiocese of Philadelphia. Screening Formal volunteers are required to: 1. Volunteer[ Policy Page 2

2. complete a volunteer application form and an initial interview; 3. complete, submit for approval, pay for and file in the Human Resources office of corporation on whose behalf the volunteer renders such services all background checks as required by the Safe Environment requirements of the Archdiocese of Philadelphia: a. Pennsylvania State Police Request for Criminal Records Check (Act 34). b. Department of Public Welfare Child Abuse History Clearance (Act 151). c. Federal Criminal History Record Information (CHRI) in a manner prescribed by either the Department of Public Welfare or the Department of Education. c.d. Effective July 1st, 2008, at the time of hire/recruitment all employees of Catholic Social Services in the job scope defined above, will be required to submit request to the Federal Bureau of Investigation (B) and to the Commonwealth of Pennsylvania for Criminal Background Clearance and Child Abuse clearance. By obtaining FBI fingerprint-based record checks, Catholic Social Services complies with Pennsylvania Act 73 0f 2007 Current residents of states other than Pennsylvania and/or those who have lived outside of Pennsylvania at any time in the past two (2) years will be required to submit a request to the Federal Bureau of Investigation in place of their criminal clearance and to apply to each previous state (s) for their child abuse clearances. d.e. Once the required clearances are on file, the Formal Volunteer will be required, on an annual basis, to sign an affirmation that they have not perpetrated or been convicted of any offense that would preclude their employment by any of the facilities or programs of the Developmental Programs division under Act 34 or Act 151 ("Volunteer Affirmation"). Volunteers will be required to renew their Act 34 Criminal History Report and Act 151 (Child Abuse) Clearance Statement every 5 years. 4. provide evidence that they are free of communicable disease; 5. complete orientation and training; and 6. sign the Volunteer Acknowledgement Form. Casual Volunteers will be required, on an annual basis, to sign the Volunteer Affirmation Form attached to this policy, in the presence of the administrator or administrators designee. Group Volunteers will be required to submit a Group Volunteer Application Form, and, if placed, adhere to policies as outlined on that form. Placement/Supervision Placement of the Formal Volunteer is a negotiated activity involving the Volunteer Coordinator, volunteers, and placement supervisor working together. There should be flexibility for a volunteer to try out a placement and for a supervisor to dismiss or reassign a volunteer. Volunteer[ Policy
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Orientation and Training In order to develop an effective, beneficial, and successful Volunteer Program, preparing volunteers for the kinds of duties and responsibilities they will be asked to assume is critical. Volunteer Coordinators will coordinate an orientation and training for all volunteers with the Director of Training prior to placing them in a work assignment. Orientation and training is a requirement for all volunteers and can be conducted on an individual basis, with small groups, or included with staff. Minimum information should include the mission and vision of the Developmental Programs division of Catholic Social Services, the policies and procedures of the agency and volunteer program that includes liability, confidentiality, attendance, and universal precautions for infectious diseases, conflict management procedures and Safe Environment Training as prescribed by the Archdiocese of Philadelphia. Confidentiality No volunteer shall be permitted to access, review, disclose, or use confidential client information, or participate in conversations in which confidential client information is discussed. Each volunteer shall keep strictly confidential all information he or she may learn, during the course of performing services, about the clients supported in the Developmental Programs division. Prior to placement, volunteers must complete a HIPAA confidentiality pledge. Safety Requirements Except in the case of an emergency, volunteers shall not administer first aid or other medical assistance to clients. Except as specifically authorized by the Administrator on a case by case basis, volunteers shall not be permitted to operate any motor vehicles owned by or under the control of any of the facilities or programs of the Developmental Programs division, and volunteers shall not be permitted to transport clients by motor vehicle. Record Keeping The Volunteer Coordinator will maintain a file on each volunteer that contains the following information: 1. 2. 3. 4. 5. Application and signed release of information to obtain references, background checks, etc. A dated affidavit from the Human Resources office that required clearances for the given volunteer have been received and are on file. Evidence of completion of orientation and training, including completion of Safe Environment Training as prescribed by the Archdiocese of Philadelphia. Volunteer Time Sheets. A record of hours worked will be kept for each formal volunteer. Evaluation. There will be ongoing evaluation of the effectiveness of volunteers to ensure that volunteer services are being delivered consistent with program

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expectations, safety considerations, and the needs of the individual(s) served. All volunteers will have the opportunity to evaluate the placement. 6. Volunteer Expenses. It may also be the responsibility of the Volunteer Coordinator to keep track of expenses incurred for the Volunteer Program including recognition, recruitment, or reimbursement expenses. Separation. Either the volunteer or the agency may terminate the volunteer relationship at will. If the volunteer resigns, there should be an Exit Interview. The purpose is to evaluate the placement to determine how the volunteer felt about it and assess for future reference if any adjustments should be made to improve the Volunteer Program. If a volunteer is terminated, the record must reflect that the person was separated at the decision of the agency and a termination note should be kept on file.

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The Volunteer Coordinator will compile monthly statistical reports with the number of volunteers and the hours worked. These statistical reports will be forwarded to Catholic Social ServicesVolunteer and community relations office. The Volunteer Coordinator will maintain files on groups of volunteers that, at a minimum, contain the group leader contact name, address, telephone number, clearences and any other relevant information that will help in assigning work or contacting them again. Recognition Recognition of volunteer time and contributions is the responsibility of everyone in the Developmental Programs division, but the primary responsibility lies with the Volunteer Coordinator. Recognition should be on an ongoing basis, and at a minimum, all volunteers will be recognized on an annual basis. Acknowledgment Each Volunteer shall affirm in writing that he or she has been provided with a copy of his/her service description plan time line/schedule,benefits and policy, has read, understands and agrees to comply with this policy. Attachments Young Person Volunteer Authorization Form Volunteer Acknowledgement Form Volunteer Affirmation Form Group Volunteer Application Form

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YOUNG PERSON VOLUNTEER AUTHORIZATION


My child, ____________________________________, who is under the age of 18, has requested to perform service as a volunteer for Don Guanella Village / Divine Providence Village / St. Edmonds Home for Children. I understand that the volunteer service may include work with children, other young persons, and individuals with intellectual disabilities. I also understand that my child may need to receive training in order to qualify to perform the volunteer service that is requested or assigned. I authorize my child to receive any necessary training and to perform volunteer service for [one of the facilities or programs of the Developmental Programs division]. I certify that I am not aware of any problem with or past conduct on the part of my child which indicates, to any degree, that my child may pose a risk of harm to himself/herself or to others with whom my child may interact as a volunteer for [one of the facilities or programs of the Developmental Programs division]. I understand that [the facility or program of the Developmental Programs division] retains the right, in its sole discretion, to determine whether my child may perform volunteer service for one of [the facilities or programs of the Developmental Programs division]. PARENT Signature Printed Name Printed Name Date: _____________________________ Date: _____________________________ Address: ______________________________________________________________ Phone Number: _____________________ E-mail: ____________________________ Emergency Contact Name and Telephone Number: __________________________________________________________________ Reviewed and Screened by: ___________________________ Date: ____________ Determination: _______________________ CHILD Signature ________________________________ ________________________________ ________________________________ ________________________________

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VOLUNTEER ACKNOWLEDGMENT FORM


I, ___________________________________________, have signed the following acknowledgment on this the __________day of _____________, to acknowledge my understanding of the conditions of my voluntary service for [the facility or program of the Developmental Services division]. 1. I acknowledge and understand I have entered into a voluntary relationship with the [the facility or program of the Developmental Services division] and that I will not receive payment or remuneration of any kind for my services. I acknowledge and understand that I am not an employee of [the facility or program of the Developmental Services division], and because of this, I am not entitled to any benefits normally associated with employment, including but not limited to Workers Compensation, retirement and leave accrual. I acknowledge and understand that there has been, and will be, no promise of future employment with [the facility or program of the Developmental Services division]. I acknowledge and understand that my commitment to volunteer service varies according to the volunteer role I perform. I acknowledge and understand that I can terminate my volunteer service for any reason. I also understand that the [the facility or program of the Developmental Services division] reserves the right to end my volunteer service if the [the facility or program of the Developmental Services division] deems it to be in the best interests of the organization. I acknowledge and understand that I am not an agent of [the facility or program of the Developmental Services division] and I will not make any commitment on behalf of [the facility or program of the Developmental Services division] to third parties. Under no circumstances may I make any statement to the media (including press, radio or television) concerning [the facility or program of the Developmental Services division] business without the approval of the Director of the division or his nominee. I acknowledge and understand that any material provided for the purpose of my volunteer service shall be returned to the [the facility or program of the Developmental Services division] upon my leaving the Volunteers program. I will maintain the confidentiality of privileged information gained in the course of volunteering. I acknowledge, understand, and promise that I will indemnify and hold harmless [the facility or program of the Developmental Services division] for any loss, harm, or damage experienced by [the facility or program of the Developmental Services division], its employees or any third parties that may be caused by an act of mine, or my failure to act, in the performance of my volunteer or intern services for [the facility or program of the Developmental Services division]. I acknowledge and understand that I will not be permitted to perform any activity involving the actual receipt or handling of money (either cash or readily negotiable documents such as checks, money orders, state warrants, and the like) while performing my volunteer services for [the facility or program of the Developmental Services

2.

3. 4. 5.

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division], and I assure [the facility or program of the Developmental Services division] I shall refrain from engaging in any such activity. 10. I acknowledge that I have received a copy and/or received training regarding the policies and procedures of the Archdiocese of Philadelphia regarding the Protection of Children, Young People, and People with Intellectual Disabilities. I acknowledge that I have reviewed the policy regarding the Standards of Ministerial Behavior and Boundaries and understand its contents. I understand that I should speak with my placement supervisor, the Volunteer Coordinator, the Administrator, or representatives of the Archdiocesan Office of Child and Youth Protection (215-587-2466 or ocyp@adphila.org) with regard to any questions that I may have regarding the Standards of Ministerial Behavior and Boundaries. I acknowledge that I have received a copy and/or read the Mandated Reporting Policy posted on the Archdiocesan website. I have reviewed the Mandated Reporting Policy and understand its contents. I understand that I should speak with my placement supervisor, the Volunteer Coordinator, the Administrator, or representatives of the Archdiocesan Office of Child and Youth Protection (215-587-2466 or ocyp@adphila.org) with regard to any questions that I may have regarding the Mandated Reporting Policy. I acknowledge and understand that the Archdiocese of Philadelphia has issued policies and procedures regarding the Protection of Children, Young People, and People with Intellectual Disabilities for informational or guidance purposes only and that neither the Archdiocese nor any of its related entities intends for the Standards to create a contract of employment or any type of binding obligation on the Archdiocese or any of its related entities. The Archdiocese of Philadelphia may periodically review the policies and procedures regarding the Protection of Children, Young People, and People with Intellectual Disabilities. The Archdiocese of Philadelphia reserves the right to amend or interpret the policies and procedures as it deems appropriate in its sole discretion. A copy of this acknowledgment form shall be placed in my volunteer file. I acknowledge and understand that I must conform to the rules and regulations of [the facility or program of the Developmental Services division] to the best of my ability, including but not limited to providing timely notice if I am sick and cannot be in attendance, and timely arrival at the office to commence my services on the days I have agreed to perform my services.

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I acknowledge that by signing below I agree to abide by the above principles. Signed Name . Date

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VOLUNTEER AFFIRMATION
The undersigned volunteer hereby affirms that (i) s/he has not perpetrated physical or sexual abuse against or engaged in the sexual exploitation of any children, (ii) to his/her knowledge, has not been the subject of any criminal investigation concerning such offenses, and (iii) within the five (5) years immediately preceding the date hereof, has not been convicted of any of the following offenses: 1. An offense under one or more of the following provisions of Title 18 of the Pennsylvania Consolidated Statutes: (a) Chapter 25 (relating to criminal homicide) (b) Section 2702 (relating to aggravated assault) (c) Section 2901 (relating to kidnaping) (d) Section 2902 (relating to unlawful restraint) (e) Section 3121 (relating to rape) (f) Section 3122 (relating to statutory rape) (g) Section 3123 (relating to involuntary deviate sexual intercourse) (h) Section 3126 (relating to indecent assault) (i) Section 3127 (relating to indecent exposure) (j) Section 4303 (relating to concealing death of child born out of wedlock) (k) Section 4304 (relating to endangering welfare of children) (l) Section 4305 (relating to dealing in infant children)
(m) A felony offense under Section 5902(6) (relating to prostitution and related offenses) (n) Section 5903(c) or (d) (relating to obscene and other sexual materials) (o) Section 6301 (relating to corruption of minors) (p) Section 6312 (relating to sexual abuse of children) 2. An offense designated as a felony under the act known as, "The Controlled Substance, Drug, Device and Cosmetic Act", (the Act of April 14, 1972 (P.L. 233 No. 64)).

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An out-of-state or federal offense similar in nature to those crimes listed in paragraphs 1 and 2.

Date: ____________________ Signature: _________________________________ Please print: _______________________________ IN WITNESS WHEREOF, the undersigned has executed and delivered this document as of this _____ day of ________________, 20____. By: _______________________________

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GROUP VOLUNTEER APPLICATION FORM Group/Organization:_________________________________________________ Contact Name:______________________________________________________ Address: ___________________________________________________________ Phone: ______________ FAX________________ E-mail ______________________________ Number of members attending:__________ Approx. Number of Hours:________________ Please describe your group and intent for project:______________________________________ ______________________________________________________________________________ COMMITMENT My group is interested in: On-going Partnership Weekly Monthly Several times per year Start to Finish project Short-term project 1-2 Hours day 1 Day project Several Days

Are there any Physical, Age, or other limitations that we should consider when assigning a project to your group:__________________________________________________________ Please indicate the best days and times for your group:_________________________ GROUP VOLUNTEER POLICY Please make certain you have read and understood the following: Group Volunteer projects have a minimum of 5 and a maximum of 40 individuals. [The facility or program of the Developmental Services division] cannot guarantee Group Volunteer placement. [The facility or program of the Developmental Services division] will, however, make every effort to match Group Volunteer applicants to volunteer opportunities based on the needs of [the facility or program of the Developmental Services division] and the interests and abilities of the Group Volunteers. Group Volunteers must identify a Group Coordinator who is responsible for the safety and well being of group members. The Group Coordinator Provides coordination and supervision for group while volunteering; Ensure all members adhere to policies and procedures of [the facility or program of the Developmental Services division]; Maintains a file containing a completed liability release form for each member of the group; Volunteer[ Policy

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Is responsible for prohibiting members from possessing, consuming, or being under the influence of alcohol or drugs; and Registers with the Volunteer Coordinator prior to beginning work at [the facility or program of the Developmental Services division]. Group Volunteers that include youth under the age of 18: Are governed by applicable child labor laws; Must provide one adult supervisor for every 5 youths; Are not allow to have persons under the age of 10 as members of the group; and Must obtain a signed parental consent form for each group member under the age of 18, which must be on file with the Group Coordinator. If the group does not have its own consent form, it may use the Young Person Volunteer Authorization form available from the Volunteer Coordinator. Group Volunteers agree to comply with all necessary safety, operational and resource regulations of [the facility or program of the Developmental Services division]. [The facility or program of the Developmental Services division] reserves the right to reject a volunteer group for whatever reason which [the facility or program of the Developmental Services division], in its sole judgment, determines will or may affect the best interests of [the facility or program of the Developmental Services division]. Furthermore, [the facility or program of the Developmental Services division] reserves the right to withhold the reason(s) for this refusal. ORGANIZATION: Applicant: __________________________________ By: _________________________ (please print or type) (signature of applicant organizations agent)

Address: __________________________________ Date: _________________________ Telephone: __________________________(Days)___________________________ (Evenings) E-Mail Address: ________________________________________________________________ Internal Use Only Project Accepted: _____Yes ____ No; if No, why not________________________________ Begin date:___________________________ End date:____________________________ Scope and description of work to be performed: _________________________________________________________________________ Volunteer Coordinator:______________________________________________________ Date:_________________________

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