WHO IS ACCREDITED?

Private Organization Accreditation

Debt Education and Certification Foundation (DECAF), a private non-profit 501(c)(3) organization, provides high-quality financial education and counseling, with nationwide outreach throughout the U.S. DECAF is HUD-approved, and recognized as one of the 100 Best Companies to Work for in Texas.
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ORGANIZATION TESTIMONIAL

Holy Family Institute

Sister Linda Yankoski, President/CEO

The Council On Accreditation provides all stakeholders involved in the delivery of social services the assurance that the organization is credible, effective, and is committed to quality improvement. The COA process is an important tool for anyone involved in leading an organization to establish best practices and maintaining and updating these practices over time.
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Purpose

Sound administration and management increase program quality and sustainability; promote financial accountability and viability; support transparency and openness; and reduce risk, loss, and liability exposure.

CYD-AM 10: Files of Children and Youth

Files of children and youth contain accurate and sufficient information, and are properly maintained.

Note: In addition to supporting program operations, files are an important risk management tool.  Well-maintained files can help shield the program from allegations of misconduct and negligence, while poorly-maintained files and improper documentation are a known liability. See CYD-AM 8 for more information regarding risk prevention and management.

Rating Indicators
1
The program’s practices fully meet the standard, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards.
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.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Procedures for file content, maintenance, and disposal (CYD-AM 10.01, 10.02, 10.03, 10.04)
    • Policies and procedures for accessing files (CYD-AM 10.05)
    • Procedures for file review (CYD-AM 10.06)
    • Tool or sample form used for file review
    • Data from file reviews for the previous year (i.e. the past two reviews) 
    • Description of file review sampling methodology, if applicable (i.e. if only a portion of files are reviewed)
    • Improvement/corrective action plans, if applicable
    • Interview:
      1. Program Administrator and/or Director
      2. Program Personnel
    • Review files of children and youth

  • CYD-AM 10.01

    The program maintains files for all children and youth.


  • FP
    CYD-AM 10.02

    Files of children and youth comply with any applicable legal requirements and contain relevant information, including:

    1. registration or enrollment forms;
    2. current emergency contact information that is updated at least annually;
    3. attendance records for the current program year;
    4. evidence of ongoing communication with parents or other family members;
    5. information about and consent/authorization forms related to relevant health information and needs, including medication permission forms, if applicable, updated at least annually;
    6. information about and consent/authorization forms related to special needs, if applicable, updated at least annually;
    7. any additional consent forms or permission slips, including authorizations for pick-up, if applicable;
    8. assessments of child learning and development, if applicable;
    9. accident report forms, if applicable;
    10. payment receipts, if applicable; and
    11. relevant school day data, if applicable.

    Interpretation: Applicability will vary based on program type and characteristics, as well as the needs of individual children and youth.  For example, payment receipts will be relevant to any program that charges a fee.  Relevant school day data will only be relevant to out-of-school time programs, while assessments of learning and development will typically only be relevant to early childhood education programs.  In contrast, accident report forms and information about special needs will be relevant across both types of programs, but only for particular children and youth.  Similarly, information about health needs will be relevant to both types of programs, though early childhood education programs will typically request more extensive health information, as addressed in CYD-ECE 4.01.

    Note: See CYD-OST 1.05, 1.06, 11.08, 14.04, and 14.06 for additional details about the information to be collected and maintained by out-of-school time programs.  See CYD-ECE 2.06, 4.01, 12.04, and 12.06 for additional details about the information to be collected and maintained by early childhood education programs.
     

    Note:  See CYD-AM 4.02 and 8.01 for more information regarding compliance with applicable legal requirements.


  • CYD-AM 10.03

    Files of children and youth are maintained by authorized personnel and are:

    1. specific, factual, and legible;
    2. kept up to date; and
    3. signed and dated by personnel, where appropriate.

    Interpretation: Files and signatures can be paper, electronic, or a combination of paper and electronic.


  • CYD-AM 10.04

    Files of children and youth are maintained and disposed of in a manner that protects privacy and confidentiality.

    Note: See CYD-AM 9 for additional expectations regarding the security of information.


  • FP
    CYD-AM 10.05

    Access to confidential files meets legal requirements, and is limited to:

    1. children and youth and/or, as appropriate, their parents or legal guardians or designated legal representatives;
    2. personnel authorized to access specific information on a “need-to-know” basis;
    3. auditors, contractors, and licensing or accrediting personnel, consistent with the program’s confidentiality policy; and
    4. others who are permitted access, as applicable.

    Note: See CYD-AM 4.02 and CYD-AM 8.01 for more information regarding compliance with applicable legal requirements. See CYD-AM 9 for additional expectations regarding the security of information.


  • CYD-AM 10.06

    At least twice a year the program: 

    1. conducts a review of child and youth files to evaluate the presence, clarity, and continuity of required documents and information, using a uniform tool to ensure consistency; and
    2. updates files based on the results of the review, as needed.

    Interpretation: Required documents and information include those specified in CYD-AM 10.02, as appropriate.  

    Rather than conducting a review of all files, programs may review a random sample of the files of children and youth.  For the purpose of identifying trends and patterns, COA suggests programs use the sampling guidelines included below, based on the number of children and youth served per year.  For example, if a program serves 300 children and youth per year, it should review 135 files total per year, across both of the reviews – not 135 files during each of the reviews.  Programs may choose a different sampling method as long as a rationale is provided.  

    When a program chooses to review only a sample of files it will be especially important to: (1) aggregate and analyze the results in order to determine whether there are any overarching issues that may impact the accuracy and completeness of un-reviewed files; and (2) ensure that all files are updated, as needed.  For example, if reviews reveal that many files are lacking emergency contact information, the program should take steps to ensure that emergency contact information is added in to all files, including files that were not part of the sample reviewed.

    SAMPLING GUIDELINES FOR FILE REVIEW
    Number of Children and Youth Served Per Year...................Sample Size for File Review
    1,000 or > … 35% annually
    999 – 500 ... 40% annually
    499 – 400 …45% annually
    399 – 300 … 45% annually
    299 – 200 … 47% annually
    199 – 100 … 48% annually
    99 – 50 … 50% annually
    49 – 25...75% annually
    Less than 25 … 100% annually

     

    Note: File reviews can contribute to and enhance a program’s system for promoting continuous quality improvement (CQI). See CYD-AM 11 for more information on CQI.

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