Private Organization Accreditation

Heartland for Children is the not-for-profit agency responsible for the foster care system in Polk, Highlands, and Hardee Counties.


Bonnie Bagley

Volunteer Roles: Evaluator; Lead Evaluator; Peer Reviewer; Team Leader

I have found that being a COA Volunteer builds my professional skills and experience in ways that more traditional workshops do not. The opportunity to learn about best practices through the COA standards and then see how agencies implement them is truly a growth experience.
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Residential Treatment Services provide individualized therapeutic interventions and a range of services, including education for residents to increase productive and pro-social behavior, improve functioning and well-being, and return to a stable living arrangement in the community.

CA-RTX 2: Access to Service

The organization makes every effort to ensure that services are only available to individuals who require and will benefit from a total milieu environment, active psychotherapeutic and psycho-educational interventions, and around-the-clock care for a specified period of time.

Rating Indicators
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations (CA-HR 6.02) and training (CA-TS 2.03); or
  • Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • A number of client records are missing important information  or
  • Client participation is inconsistent; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Admission policy
    • Access, screening, and intake procedures
    • Written materials describing the program
    • Admission materials outlining permitted and prohibited items
No On-Site Evidence
    • Interview:
      1. Program director
      2. Intake personnel
      3. Residents and their families
    • Review case records

  • CA-RTX 2.01

    The organization defines in writing:

    1. eligibility criteria, including age, developmental stage, and immigration status; 
    2. scope of services and supports, special areas of expertise, and range of client issues addressed;
    3. service options and levels of care;
    4. opportunities for active family participation and support;
    5. opportunities for active participation in community activities; and
    6. promotion of housing unit compatibility based on age, interests, and group composition.

    Interpretation: Eligibility criteria states whether the organization accepts individuals with special risks, such as children and youth who engage in fire setting; individuals who exhibit sexually reactive behaviors; victims of physical, psychological or sexual abuse; and youth who have committed a delinquent act or violated a criminal law.

    Interpretation: In regards to element (f), COA recognizes that organizations, particularly those that receive clients by referral only, may have limited control of  group composition. In these instances, organizations should identify the population(s) served, state how residents’ diverse service needs will be met, and include strategies for promoting living unit compatibility.   

  • CA-RTX 2.02

    The organizations screens and informs residents of:

    1. how well the their request matches the organization’s services; and
    2. what services will be available and when.

    Interpretation: The screen is a preliminary test administered to residents to determine whether he/she meets the program’s eligibility criteria. Screenings will vary based the program’s target population and services offered, and can include information to identify any of the following: trauma history, substance use conditions, mental illness, and/or individual’s risk of harm to self or others. 

    NA Another organization is responsible for screening, as defined in a contract.

  • FP
    CA-RTX 2.03

    Prompt, responsive intake practices:

    1. ensure equitable treatment;
    2. give priority to urgent needs and emergency situations;
    3. support timely initiation of appropriate services; and
    4. provide for placement on a waiting list and referrals to interim services, if applicable.

    Interpretation: Vulnerable populations, such as youth that are lesbian, gay, bisexual, transgender, and questioning (LGBTQ), are at high risk of violence and harassment while in residential placement. The organization should ensure these youth are safe and welcomed by staff. 

  • CA-RTX 2.04

    Residents who cannot be served, or cannot be served promptly, are referred or connected to appropriate resources.

    NA The organization accepts all clients.

  • CA-RTX 2.05

    Admission decisions are made by experienced and licensed personnel in collaboration with the resident and his or her family and/or legal guardian.

    Interpretation: When facilities provide activities under contract with a “no reject” provision the interdisciplinary team carefully reviews admission decisions to ensure the organization is prepared to address any special needs or services the resident may require.

    Interpretation: Experienced and licensed personnel can include psychiatrists, qualified medical practitioners, psychologists, educators, and other professionals.

  • CA-RTX 2.06

    During intake, the organization gathers information to identify critical service needs and/or determine when a more intensive service is necessary, including:

    1. personal and identifying information;
    2. emergency health needs; and
    3. safety concerns, including imminent danger or risk of future harm.

  • CA-RTX 2.07

    The resident and his or her family and/or legal guardian are engaged in an informative placement process and are:

    1. apprised of any available options, benefits, and consequences of planned services;
    2. prepared for admission, and given the opportunity for a pre-admission visit, whenever possible; 
    3. informed of how the organization can support the achievement of his or her desired outcomes; and
    4. provided with information on the effectiveness of treatment, when available. 

  • FP
    CA-RTX 2.08

    The organization describes:

    1. personal items residents may bring with them, consistent with a safe, therapeutic setting;
    2. items that are discouraged or prohibited; and
    3. any safety procedures the program follows or consequences that can result when prohibited items are brought to campus.

    Interpretation: Personal items residents might bring with them may include: photos, books, cellphones, computers, or other electronics. 

    Interpretation: Given the rise in information and communication technologies, it is important for organizations to specify in their admission materials what electronic devices are permitted and prohibited.  

    Research Note: Research on trauma-informed systems emphasizes the importance of children not only feeling physically safe, but also psychologically safe. Psychological safety is defined as feeling safe within one’s self and safe from external harm. One way to promote psychological safety in residential facilities is by giving children control and choice, for example, asking a child what personal items will help him or her feel safe while in care. Organizations should allow children to bring the items that provide them with comfort or work with children and their families to determine what can be arranged.

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