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2021 Safe Environment Audit Form - All Locations

- Safe Environment

Instructions
For Church Parishes and other Entities
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- Section 1: Location Overview
  List the persons assigned to the following groups between May 1, 2020 - May 1, 2021.
- Safe Environment Coordinator Please enter valid data.
- Safe Environment Coordinator Assistants
  List the name of each person who helps with any of your SE responsibilities, including calling references.
- Location Name Please enter valid data.
- Location Description Church School Other
- Pastor, Associate Pastor, Administrator (Principal for School)
- Deacons
- Women and/or Men Religious
- Seminarians
- Acolytes
- Youth Formation, Youth Ministry, Religious Education Leaders
- Section 2: List the TOTAL NUMBER Safe Environment Trained between May 1, 2020 - May 1,2021:
- Employees Please enter valid data.
- Catholic School Educators Please enter valid data.
- Parents/Volunteers between May 1, 2020 - May 1, 2021 Please enter valid data.
- Section 3: Audit Checklist
- Do you have documentation supporting the above Ministry totals? Yes No
- How many times did your location advertise the Diocesan Outreach Number in the Church Parish Bulletin? (July 1, 2020-May 1, 2021; copies should be stored in Safe Environment File) Please enter valid data.
- Do you have "How to Report Abuse" information on your website? Yes No No, I do not have a website
- How many Reporting Posters do you have posted throughout your location? Please enter valid data.
- Are the Mandated Reporting flyer and/or brochure available to all volunteers and staff at your location? (could be on website, emailed or, printed)Include how it is shared.
- Section 4: Circle of Grace
- First and last name and title of the person responsible for providing you with the COG totals. Please enter valid data.
- List the totals provided to you on the COG Tally Sheet:
- How many students were taught COG in the classroom? Please enter valid data.
- How many students were taught COG at home by a parent? Please enter valid data.
- How many students were taught COG in a virtual classroom? Please enter valid data.
- How many parents declined their child being taught COG? Please enter valid data.
- How many students were not taught COG? Please enter valid data.
- 2020-2021 Circle of Grace program implementation description
  Describe any changes made to the curriculum or program format since the previous year.
- If COG was not included in your curriculum, please explain why.
- Section 5: Additional Comments
- Is there anything else you would like share?
Submit

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2021 Safe Environment Audit Form - All Locations

Section 1: Location Overview List the persons assigned to the following groups between May 1, 2020 - May 1, 2021.

Section 2: List the TOTAL NUMBER Safe Environment Trained between May 1, 2020 - May 1,2021:

Section 3: Audit Checklist

Section 4: Circle of Grace

List the totals provided to you on the COG Tally Sheet:

Section 5: Additional Comments

Section 1: Location Overview
List the persons assigned to the following groups between May 1, 2020 - May 1, 2021.