Table of Contents
Section
Page
Code of Conduct ____________________________________2
Purpose for this policy ____________________________4
1. Volunteer Screening Procedures __________________4
2. Teenage Volunteers ______________________________5
3. Leadership Development Procedures _______________5
4. Personal Safety Procedures ______________________6
a. Supervision Ratios _________________________6
b. Nursery ____________________________________6
c. Record Keeping _____________________________7
d. Restrooms __________________________________8
e. Sleepovers/Lock-ins ________________________8
f. Sick Children ______________________________8
g. Emergencies ________________________________8
h. Parties/Field Trips ________________________9
i. Worker Behavior ____________________________9
5. Staff and Volunteer Support _____________________10
6. Reporting Accidents/Injuries ____________________10
7. Child Abuse Prevention and Procedures ___________10
8. The Responsibility to Report ____________________11
9. Other Types of Harm _____________________________11
10. Improper or Inadequate Supervision _____________12
11. Hazardous Activities ___________________________12
Appendixes
Parker UMC Policy of Sexual Ethics__________________13
Children’s Ministry Information Form (front) _______14
Children’s Ministry Information Form (back) ________15
Incident Report Form (front)________________________16
Incident Report Form (back)_________________________17
Abuse Incident Report Form _________________________18
Checklist for Response to Allegation of Abuse ______19
Church Ministry Policy and
Procedures
Regarding Child Safety
This policy is designed to assist church
leaders in recruiting volunteers and to provide guidelines for the
safety of children and youth under the age of 18, as well as
guidelines for the support of staff and volunteers.
Purpose for
this policy
Churches need
to be prepared! This is the legal reason for creating safety
policies, but there’s a deeper, more significant reason – to protect
the children. Policies are only printed expressions of the value
placed on children. If the only reason for safety policies is to
protect the organization, the Church has missed God's love for
children.
Some people
may think that our Church is too small or that, our Church “knows”
everyone, to worry about these safety problems. Remember it’s much
easier to make plans and develop safety policies as a means of
prevention, rather than wait until they are needed as a reaction to
an abuse case. Some churches tend to take the biblical concept of
trusting God to an extreme. They think nothing bad can happen to
Christians. We must not be unwise regarding children’s safety. There
is no automatic protection from evil for the faithful. We’re to
watch and be ready. Accidents will always happen. There will always
be unforeseen circumstances that need to be handled. But the Church
should build into its organization sturdy safety-policy fire blocks
into the walls of its ministry to protect children.
1. Volunteer
Screening Procedures
If the staff is aware of any reason why a
person would not be suitable for a volunteer position, further
investigation and discussion will take place and a final approval,
or denial, of the name will be made. If there are medical reasons
for a potential volunteer to not be suitable as a leader/helper,
he/she will be paired with another volunteer.
In the case of a potential volunteer who is new
to the church family, a confidential dialogue will take place to
determine interest, experience, and the children/youth ministry
readiness of the individual. This dialogue will be conducted by a
member of the Safe Sanctuary Committee or may be done by one of the
pastoral staff. A confidential report will be given at the next
Pastor/staff-Parish Committee meeting to determine the suitability
of the candidate. If required, further dialogues will take place.
New potential leaders for any program will not be assigned to work
alone, but will be paired with leaders who are familiar with the
program.
From time to time, parent volunteers are needed
to assist in a particular program's event. When a parent who is not
an active participant in the church congregation volunteers, he/she
is to be screened by the coordinator of the program and teamed up
with a leader who has been approved. Under no circumstances is a
parent volunteer to be alone with a child or group of children and
out of sight of other leaders.
It is a vital part of protecting the
church from legal action if a case of an alleged wrongful act is
filed against the church. This form must be completed by the
volunteer prior to being approved by the Safe Sanctuary Committee.
The completed forms are confidential and will be kept on file at the
church. (These forms are necessary to show the court(s) that the
church has done a systematic screening of the volunteers prior to
them being accepted for a ministry. If the screening is not
completed and an alleged wrongful act is filed against a volunteer,
the church could be liable for neglect in allowing a person who has
had allegations of child abuse to be given a leadership role of
trust over children.) By having all persons involved in children and
youth programs fill out a Children’s Ministry Information Form, we
are working to protect our children, guarding the integrity of our
leaders, and reducing the church’s possible exposure to liability.
The Children’s Ministry Information Form asks
for two personal references. These references should be contacted by
a member of the Safe Sanctuary Committee or pastoral staff, and
asked to comment on their knowledge of the volunteer. A careful
record should be kept on file of the person making the contacts, the
date of the calls and a summary of the reference’s comments. All
hired and volunteer staff of Parker UMC may be asked to have a
police check done at the expense of Parker UMC.
2. Teenage
Volunteers
a. In an effort to develop new young leaders,
junior and senior high school students are encouraged to assist in
the leadership of various children's ministries. These young leaders
should be approved by the Safe Sanctuary Committee as leaders-
in-training. As such, they should be provided with opportunities to
develop their unique gifts, abilities and interests.
b. Teenagers
under eighteen (18) wanting to serve as teen workers in any capacity
with activities, studies, or programs for preschoolers or children
will need to fill in a Teen Volunteer Information Form and go
through the training. The only step in the process they are exempt
from is the criminal background check. Teenagers must be assigned in
accordance with the Five-Years Older Rule (see Basic Procedures for
Safe Ministry with Children and Youth).
c. Leaders- in-training must be paired up with
adult leaders who can assist in the development of their gifts. The
Parker UMC Children's Ministry Information Form must be
filled out by potential volunteers.
3.
Leadership Development Procedures
The methodology implemented in children’s
ministry must reflect the physical, social, mental, and spiritual
development of children in the age grouping of a particular program.
The curriculum content and program development must be familiar to
the leaders in that program. The extent to which a leader is
familiar with the developmental needs of the group and the goals of
the curriculum will determine the effectiveness of the program.
We value the volunteers and make every effort
to develop their skills as leaders and their
knowledge of the developmental needs of the
children they serve. Our efforts to develop a leader’s skills and
knowledge include, but are not limited to, seeking out appropriate
workshops or providing in-house seminars on child/teen developmental
issues, curriculum development, creative classroom control, children
with special needs issues, and team teaching. Mentors are an
effective way to develop one-on-one the leadership skills needed in
a position. Where possible leaders- in-training and new leaders
should be paired with a veteran leader, who will pass on wisdom,
experience and knowledge relevant to the leadership responsibilities
of the position.
Good resource materials are published and an
effort should be made by the Christian Education Board to purchase
these materials have them placed in the Resource Centre or church
library. Leaders are encouraged to read such resource material to
keep current on trends in children’s ministry.
4. Personal
Safety Procedures
We are concerned about the safety of the
children, families and volunteers we serve. In an effort to lessen
the possibility of abuses occurring and to maintain conduct which is
above reproach, we have developed the following standards for our
children’s ministry.
a. Supervision Ratios
Our goal in the classroom is to provide an
environment of acceptance and love in which learning can take place.
Room allocation is geared to the needs and size of a particular
class/group.
For teaching classes:
There will be a minimum of 1 adult teacher for
every Sunday School class. When the class size goes above the
registered size on a given Sunday, an extra volunteer will assist
the teacher. These volunteers will be on the Sunday School supply
helper list or will be a teacher who is not scheduled to teach on
that particular Sunday. Whenever there is only one adult leader in
a classroom with children, the door will remain slightly open unless
there is a window or closed-circuit camera allowing anyone passing
to look in without interrupting the teaching process.
For club programs:
There will be no less than 2 adult leaders
present in all club group meetings for children in grades 3 - 6.
Because of the nature of club programs and the diversity in
activities that may be happening at one time, it is suggested that
in addition to the minimum of two adult volunteers there be
additional adult volunteers for special activities where required.
Club programs for junior and senior high school
youth will have a minimum of 2 adult volunteers. Additional adult
volunteers should be sought as the group grows to spread the needs
of the youth program over a greater number of volunteers.
b. Nursery
The church nursery is an important aspect of
our children’s ministry and as such we seek to provide the best care
for our children. The following guidelines are in place to make the
nursery a safe place for young children.
We have a nursery available downstairs to care
for infants and toddlers. However, since we do not have the
resources for a children’s church we request that school-age
children remain in the sanctuary after the children’s sermon for the
worship service. This will allow the nursery to be kept clean and
safe for younger children.
There will be a minimum of two adults in the
nursery when children are in the room. When there are more than 3
infants or 5 toddlers, additional helpers are to be recruited to
assist in the care of the children. When there is only one
baby/toddler in the nursery on a Sunday morning, there will be two
volunteers in the nursery, one of which must be an adult. The second
nursery worker may be a teenager or an adult.
When there are two nursery workers in the same
family there must be another adult present in the nursery.
When toddlers require trips to the bathroom, a
nursery worker must supervise the children in the washroom. To
lessen the work of the nursery workers, parents of children who use
the washroom are encouraged to take their child(ren) to the washroom
prior to leaving them in the nursery.
The change table must be located where the
child being changed can be easily seen by another nursery worker, or
two workers should be present in the room where the change table is
located.
Nursery workers are not to let children leave
the nursery until a designated adult arrives to get their child(ren).
Nursery toys should be inspected and either be
replaced or repaired if damaged. Toys should be cleaned at regular
intervals. All toys in the nursery rooms must be appropriate for
infants and toddlers. Those toys and activities that are appropriate
only for toddlers must be kept out of reach from infants.
All nursery furniture and toys must be
appropriate for infants or toddlers. Furniture and bedding should be
cleaned at regular intervals in addition to when they are dirty.
Occasionally, a nursery ministry is required
for activities in the church other than the regular Sunday morning
service. The following guidelines are for such events, in addition
to the above procedures.
There must be a minimum of 2 care givers with
the children at all times, one of whom must be an adult.
The nursery must be checked by the person
responsible for booking the child care prior to the beginning of the
event. If there are not enough care givers for the adult-to-child
ratio, the person responsible for the booking must stay in the
nursery department.
Snacks will consist of food which is approved
by the parents of each child or that food which is provided by the
parent for their child only.
Nursery workers for the event must note the
names of children and any particular medical information that is
needed for a particular child (i.e. food allergies, asthma, etc.).
Reminder: Do not let children leave the nursery
department until a designated adult arrives to pick them up.
c. Record Keeping
Complete records are to be kept for each Sunday
School class, club program and nursery. These records are to include
the names of children, addresses, phone numbers, parent name(s) and
any allergy/medical information including health card numbers, that
are important for leaders to know. The records are to be handed into
the church office at the end of each class/club season.
They will be filed in the office in their
original form under the title of each class/group. The files will be
kept for a period of 3 years.
An accurate sign- in procedure will be
maintained for each child in the nursery and preschool department(s),
recording the child’s name, parent’s name(s) and parent location
during the service or meeting. Special needs of a child should be
noted on the sign- in sheet.
Lists of classroom/club/nursery attendance are
to be maintained each week. The names of leaders/volunteers are to
be noted each week as well.
d. Restrooms
Parents are encouraged to take their children
to the washroom prior to the beginning of the service. Should a
child need to go to the washroom during the service, parents are
encouraged to go with the child. No child should be sent to the
washroom alone. If parents determine a child to be old enough to go
to the washroom without an adult, it is recommended that they send
two older children together.
Parents/Guardians must take the responsibility
to monitor their children. When this is not possible, it is
recommended that the child use the washrooms located nearest to the
sanctuary/meeting room.
Sunday School teachers of children under the
age of 10 are encouraged to have the whole class stop at the
washrooms on the way to the classroom, remain at the washroom area
until everyone is finished and then proceed to the classroom. Sunday
School teachers of children over the age of 10 are asked to send
children in pairs to the washroom, should it be required.
e. Sleepovers
Club programs occasionally will hold sleep-over
events or camping weekends. These events require additional
supervision considerations.
Groups which are co-ed must have adequate adult
supervisors of both genders. The supervisors should not all be
members of the same family. Additional adults may be recruited for
the event.
A minimum of 2 female adult supervisors and 2
male adult supervisors is suggested.
Groups where children are all of the same
gender and the leadership is the same gender should provide the same
number of adult supervisors as during a club meeting.
Groups where children are all of the same
gender, but the leadership is comprised of the opposite gender,
should provide a minimum of two adult leaders of the same gender as
the children.
f. Sick Children
Children who are not feeling well should not be
received into the nursery department or classroom. Some signs of
illness are unusual fatigue or irritability, coughing, sneezing,
runny nose and eyes, vomiting, diarrhea, inflamed mouth and throat,
complaining of sore ears or throat, and rash (other than diaper
rash). Children with these or similar symptoms should be returned to
their parent(s) or guardian(s).
g. Emergencies
Workers are not to give or apply any
medications to children except for bandages for minor
cuts/abrasions, or ice packs for bumps. If a child needs medication,
the parent must administer it. No medications will be left in the
nursery department or any classroom with the following exception:
children who carry inhalers for asthma or medication for serious
allergies.
In the event that an older child who is a
diabetic requires sugar, hard candies will be kept on hand in the
classroom and when required one can be given to a diabetic child
while parents/guardians are called. An older child is defined as
over the age of 12.
Emergency procedures in the event of a fire
will be reviewed semi-annually and when new volunteers are added.
Workers will be trained in these procedures. Evacuation procedures
are to be posted in each room.
First Aid boxes will be kept on hand and all
workers are to review their locations and contents monthly.
h. Parties and Field Trips
Children’s programs are encouraged to provide
opportunities for the group to go outside of the church building and
into the community around. The community provides a variety of
outing possibilities to enhance the curriculum being taught in a
program and to serve the community.
The following are procedures for outings and
parties which are off the church property.
There must be sufficient adult supervision at
all outings. This would include the regular leaders within a program
and parents of the children or approved volunteers. Parents helping
with the outing do not need to fill out a Parker UMC Children’s
Ministry Information Form.
All outings must have a signed and dated
parental waiver from each parent/guardian. The waiver must state the
nature of the outing, the time of departure and return, the
destination (including the name of the host, address and phone
number) the mode of transportation and the cost to the child, if
any.
When an outing involves transportation, the
leaders should leave a list of the drivers’ names, license numbers
and children in particular vehicles. This list should be left in the
church office on the bulletin board where it can easily be found.
Once a child has been assigned to a particular vehicle, he/she is
not to switch vehicles.
Parties held in homes must provide additional
non-related adult supervision when the children are present in the
home.
i. Worker Behavior
Workers must always be above reproach in their
words and conduct. They are to behave in a godly manner
demonstrating Christian conduct, respect, honesty and
trustworthiness.
All workers must fill out and keep up-to-date a
Parker UMC Children’s Ministry
Information Form. This form is to be
reviewed annually.
Workers must not in any way be involved in any
of the following activities with older children: extended hugging,
kissing, sitting on a lap, inappropriate touching or being alone
with a child.
In the event that a child approaches an adult
leader with the intent to hug or kiss, or unexpectedly does so, the
adult leader should accept the affection, but should as quickly as
possible, in a non-rejecting manner, encourage a more appropriate
form of physical contact.
Appropriate expressions for ages 0 - 3 include
picking up the child, comforting the child, holding the hand of
child, changing diapers.
Appropriate physical contact with children ages
4+ could include a handshake, pat on the back, quick hug of
encouragement with hands located in shoulder area, and a ‘high
five’.
Workers who are not feeling well should not
lead a group of children. Notification, if possible, to a team
member(s) should happen as soon as possible so that other workers
can step in and assist in the supervision of children. When
notification is not possible until the last minute, adjustments
should be made in the program to allow for doors to be open and the
group meeting to take place in a higher traffic area where others
can check on the group without interrupting the session.
5. Staff and
Volunteer Support
It is our goal, not only to provide for the
safety of our children and youth, but also to support and provide,
to the best of our ability, a system of procedures that will protect
the staff and volunteers from being falsely accused of wrongful
acts. This is accomplished by:
a) Screening potential leaders to determine
where a volunteer would be best suited to use their gifts,
abilities, interests and experiences.
b) Providing leadership development that
will further prepare the volunteer for leadership within a
group/class/club.
c) Adhere to the Procedures in section 3:
Personal Safety Procedures.
d) Maintaining the records of
groups/classes/clubs for a period of 3 years in their original form.
e) Providing coverage for all staff and
volunteers under the Parker UMC Insurance Policy with periodic
reviews to ensure that the Policy covers all the areas of our church
ministry.
When a staff person or volunteer is accused of
an alleged wrongful act, the church congregation will provide
spiritual and moral support to the person(s) involved.
6. Reporting
Accidents/Injuries
Occasionally during the course of regular
program activities injury occurs. These may be minor or major in
nature. After appropriate support and assistance is given to the
injured child or leader, a written Incident Investigation Report
should be filled out by the program coordinator or appropriate
person on the pastoral staff. A description of the incident,
contributing factors and the treatment given should be noted.
Witnesses to the incident should be listed with addresses and phone
numbers for follow-up purposes.
The Incident Investigation Reports should be
reviewed by the Safe Sanctuary Committee. A member of the Committee
should be appointed to investigate the incident and bring
recommendations back to the Board to prevent a recurrence of the
accident. These Reports are to be kept in the church office for
future reference.
7. Child
Abuse: Prevention and Procedures
Definitions
Physical Abuse: This is the use of
physical force by the caretaker (parent/guardian, babysitters, or
foster parent) of the child which results in any injury to the
child. This injury is sometimes described as a non-accidental injury
by health professionals.
Physical Neglect: This is the chronic or
episodic withholding of necessary or essential physical care from
the child with resulting injury or damage to the child. Necessary
physical care can include food, nutrition, shelter, clothing,
medical care, safety, supervision, sensory stimulation (particularly
to young infants).
Emotional Abuse: This is the acting out
by the parent or caretaker of the child of their negative or
ambiguous feelings towards the child, resulting in some degree of
emotional damage to the child. This kind of behavior may consist of
constant chastising, belittling, verbal tirades, ridicule,
humiliation, or the out and out rejection of the child’s sense of
self-worth and dignity.
Emotional Neglect: This is the chronic
or episodic withholding of necessary emotional care and support from
the child which results in some degree of emotional damage to the
child. This kind of neglect might consist of withholding affection
and love from the child; it might also include the withholding of
affirmations of the child’s self-worth, trust and belongingness. In
extreme forms, emotional neglect can involve the complete withdrawal
of any verbal and/or non-verbal interactions with the child,
manifesting the complete rejection of the child.
Sexual Abuse: This is the sexual
exploitation of a child by a caretaker or other family member, or
any adult, resulting in damage or injury to the child sexually,
either psychologically or physically. Forms of sexual exploitation
include behavior of a sexual nature, touching of a sexual nature and
sexual intercourse.
8. The
Responsibility to Report
In the case
of an allegation of child/youth sexual abuse, the volunteer or
clergy staff person who observes or to whom the information is given
is required by the Church and by the state law to complete the tasks
listed below. Date and initial as each step is completed. Note: If
allegation is against the Senior Minister, the report should go to
the chairperson of the Staff Parish Relations Committee and the
District Superintendent.
9. Other
Types of Harm
Most of us
think that liability arise only out of tangible harm, such as bodily
injury or property damage. Unfortunately, increasing numbers of
lawsuits involve situations where physical injury is not involved.
These exposures may arise out of:
1. Libel and
slander – untrue statements about members of the congregation or
other faiths. Emotional distress may be caused because of statements
made or actions taken, even if they are well founded in truth.
2. Public
demonstrations against individuals, groups, or organizations if
improperly conducted.
3. Discharge
of students or expulsion of members of congregations.
4. Invasion
of privacy – investigations into the private lives of church members
may cause liability, as may acts such as searching lockers, desks,
or personal property of employees or students.
5.
Publications – accuracy of facts should be carefully determined.
Accusations should not be published. Groups or classes of
individuals should not be charged with guilt by association.
6. Counseling
by insufficiently trained or unskilled counselors.
10. Improper
or Inadequate Supervision
You can’t
over-supervise. Most states or local governments have specific
requirements on the minimum ratio of supervisors to participants.
Probably more litigation results from “failure to properly
supervise” than any other cause. If negligence cannot be found for
any other reasons, attempts are made to find inadequate supervision.
Instances
where improper or inadequate supervision will likely be alleged are:
1. Accidents
on the playground 4. Sporting events 7. In the classroom
2. In Sunday
School 5. Field trips 8.
Lock-in/sleepover
3. Church
outings 6. Swimming
Proper
location of supervisors on playgrounds or at swimming pools is as
important as the number of supervisors. Governmental authorities
should be contacted prior to events on public property to determine
any safety requirements and to place authorities on notice of the
type of activity planned. Parents should be informed in writing of
the exact nature of the planned event, describing the supervision to
be given church or school. Parental consent should be obtained in
writing of any special event. Qualifications required for
supervisory personnel should be determined for each event. You need
people of mature judgment who are experienced supervising groups of
children or young people. The supervisor should not have a history
of problems with assigned groups. A thorough check should be made on
an individual’s background, especially where supervisors are
employees of the church or school. All states have standards for
hiring employees in charge of children. Church officials should be
informed of state and local requirements. This would include
“certification of teachers”.
11.
Hazardous Activities
We enjoy
activities that foster good fellowship. However, in some activities
the dangers outweigh the enjoyment. These are classified as
hazardous and extra hazardous. Hazardous activities should be
stringently supervised with strict limitations. Extra hazardous
activities should not be sponsored by the church unless supervised
by adults highly competent in the specific activity.
Water slides,
Water-skiing, Mud Olympics, Snow skiing, Dune buggies,
Rafting, Snow tubing, Unsupervised swimming Obstacle
courses, Canoeing, Haunted houses, Paddle boating, Tackle football,
Horseback riding Snowmobiles, Rope jumping Rodeos,
Basketball, Rope swings, Volleyball, Monkey bar equipment, Softball,
Fireworks displays & stands,
Sack races,
Motorbikes, Touch football, Rock climbing, Roller skating,
Trampolines, Ice skating
SANDY GROVE METHODIST CHURCH POLICY ON SEXUAL ETHICS
Sandy Grove United Methodist Church affirms the 1996 Book of
Resolution.
Sexual Abuse Within the
Ministerial Relationship and Sexual Harassment Within the Church, which
states that sexual abuse within the ministerial relationship and sexual
harassment within the church as incompatible with biblical teachings of
hospitality, justice and healing. In accordance with the 2000 Book of
Discipline, ¶ 161F, all human beings, both male and female, are created
in the image of God, and thus have been made equal in Christ. As the
promise of Galatians 3:26-29, states all are one in Christ, we support
equity among all persons without regard to ethnicity, situation, or
gender.
Sexual
abuse within the ministerial relationship occurs when a person
within a ministerial role of leadership (pastor, educator,
counselor, youth leader or other position of leadership) engages in
sexual contact or sexualized behavior with a congregant, client,
employee, student, staff member, coworker or volunteer.
Sexual
harassment is any unwanted sexual advance or demand, either verbal
or physical, that is reasonably perceived by the recipient as
demeaning, intimidating, or coercive. Sexual harassment includes,
but is not limited to, the creation of a hostile or abusive working
environment resulting from discrimination on the basis of gender.
Sexual abuse within the ministerial
relationship involves a betrayal of sacred trust, a violation of the
ministerial role and exploitation of those who are vulnerable.
Similarly, sexual harassment must be understood as an exploitation
of a power relationship rather than as an exclusively sexual issue.
Misconduct of a sexual nature within the life of the Church
interferes with its moral mission.
Parker United Methodist Church stands in opposition to the sin of
misconduct of a sexual nature in the Church and society at large and
commits itself to fair and expedient investigation of any charge of
sexual harassment within the church and to take action deemed
appropriate and in compliance with the Book of Discipline. Further, Parker United
Methodist Church bears affirmative responsibility to
create an environment of hospitality for all persons, male or
female, which is free of misconduct of a sexual nature and
encourages respect, equality and kinship in Christ.
Some
instances of sexual harassment can be resolved easily and informally
between the parties. In all other instances, the conduct should be
reported to the chair of the Staff-Parish Relations Committee or the
pastor in charge. If the conduct involves a clergy person, it should
be reported to the district superintendent or the presiding bishop.
Sandy Grove
UMC Children’s Ministry
Information Form
A. Basic Information
Name: __________________________________
Address:
__________________________________________________________
Telephone Number: Home:
____________________Work: _________________
Best time to call: Home:
____________________Work: ________________
B. Ministry
What area(s) would you like to volunteer to
become involved? (Check all that apply.)
Teaching
Helping
Other
____ Preschool
___ Babysitting
___ Music - instrument
___ Grades 1 – 3
___ Nursery
___ Music - vocal
___ Grades 4 – 6
___ Preschool
___ Storytelling
___ Grades 6 – 8
___ Grades 1 – 6
___ Crafts
___ High school
___ Grades 6 – 8
___ Games/Activities
___ Girl’s Club
___ High school
___ Other (specify)
___ Boy’s Club
___ Girl’s Club
___ Other (specify)
___ Teen’s Group
___ Boy’s Club
___ Teen’s Group
Why do you want to volunteer in this area?
________________________________________________________________________
_______________________________________________________________
Are you open to attend relevant seminars or
workshops and resource materials that our Safe Sanctuary Committee will
be offering on working with the children and program materials? yes / no
C. Experience
What previous experience have you in children/youth
ministry? (Be specific.)
________________________________________________________________________
________________________________________________________________________
D. Personal Data
Are there any conditions or personal circumstances
which would hinder you from performing certain types of activities in
the position(s) for which you are volunteering? (e.g. allergies, asthma,
diabetes, fainting, seizures, unable to lift children, etc.)
________________________________________________________________________
________________________________________________________________________
Please read and sign the following statement.
I have read and agree to adhere to the best of my
ability, the Policy and Procedures Regarding Child Safety.
__________________ ___________________________
Date Signature
References:
List two persons not related to you who can comment
on your suitability for this ministry.
Name Address Telephone How long?
_________________ _____________________________
___________ ______
_________________ _____________________________
___________ ______
Reference Check
For: _______________________________________
Position: __________________
Reference:__________________________________________Phone:
______________
My name is (reference checker). I am phoning to
obtain a reference for (volunteer’s name) who has expressed an interest
in the volunteer position of ____________________ at (
Sandy Grove
United Methodist Church) .
He/she has given us your name as someone who would
be familiar with his/her qualifications for this position.
1. What is your relationship to this person (work,
social, volunteer, etc.)?____________
2. How long have you known
him/her______________________________________________________
3. What knowledge do you have of this person’s
commitment to Jesus Christ?
________________________________________________________________________
________________________________________________________________________
4. Have you ever worked with this person in
ministry? Please specify in what area(s).
________________________________________________________________________
________________________________________________________________________
5. What characteristics would enable this person to
fulfill this position?
________________________________________________________________________
________________________________________________________________________
6. Do you have any concerns relating to this person
being involved in this ministry?
________________________________________________________________________
________________________________________________________________________
7. Additional comments regarding suitability for
ministry:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
8. Do you affirm this person for ministry?
__________________________
Reference Checker Name:
____________________________________________
Signature: _________________________________ Date:
________________________
Sandy Grove
UMC Incident Investigation Report
Claimant:
Name:___________________________________________Age: ___________
Date of
Incident: ____________________________________________
Time:
__________________
Description of
Incident:
______________________________________________________________________________________
______________________________________________________________________________________
Contributing
Factors :
______________________________________________________________________________________
______________________________________________________________________________________
Medical
Treatment:
______________________________________________________________________________________
______________________________________________________________________________________
Location of
Treatment:
________________________________________________________________
Witness:
_______________________________________________ Age :
______________
Address:
___________________________________________________________________________
_________________________________ Telephone Number: ____________
Witness:
_______________________________________________ Age:
_______________
Address:
___________________________________________________________________________
_________________________________ Telephone Number: ____________
Action Taken to
Prevent Recurrence:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Legal Counsel:
Yes. ____ No. ____
Name of Counsel:
____________________________________________________________________
Address:
___________________________________________________________________________
Investigated by:
(Name) ____________________________________
Title
: _____________________
Signature
:
_______________________________________________ Date: ____________
Review by:
(Name) ________________________________________ Date: __________
Further
Comments:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
ABUSE INCIDENT REPORT FORM
Reason for report
_______________________________________________________
Date of incident
____________________________Class _______________________
Title
_______________________
Name(s) and Age(s)
of Minor(s) ____________________________________________
_______________________________________________________________________
Quote the child’s
first words verbatim: _______________________________________
_______________________________________________________________________
_______________________________________________________________________
Briefly describe
what happened: ____________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What action did
you take? _________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Has the incident
been resolved? ____yes ____no Explain: ______________________
_______________________________________________________________________
Were there any
witnesses? ____yes ____no Names: ___________________________
_______________________________________________________________________
Signatures of
witnesses (if possible): _________________________________________
_______________________________________________________________________
Report submitted
to: ______________________________________________________
CHECKLIST FOR RESPONSE
TO ALLEGATION OF SEXUAL ABUSE
TO BE COMPLETED BY CLERGY/PROFESSIONAL
STAFF PERSONS
Date: _____
Initial: ______ 1. For clergy and paid professional staff: remove the
accused from the
situation and suspend the accused from duties involving children/youth.
Date: _____
Initial: ______ For volunteers: Remove the accused from the situation
and immediately
notify the closest available clergy/professional staff person who will
suspend the accused. If the clergy/professional staff person to whom the
allegation is reported is not the direct supervisor of the accused, the
person reporting will inform the supervisor as soon as possible.
Date: _____
Initial: ______ 2. Make written documentation of everything done and
said. If the
person reporting the allegation is a volunteer, both the volunteer and
the clergy/professional staff to whom the volunteer has reported will
document the
procedures taken.
The procedures after this point will be administered by ministerial
staff persons only.
Date: _____
Initial: ______ 3. Immediately notify the parents/guardians of the
alleged
victim and
respond to their questions and concerns.
Date: _____
Initial: ______ 4. Determine whether the incident requires immediately
notification of
state authorities.
Date: _____
Initial: ______ 5. Immediately notify the minister in charge.
Date: _____
Initial: ______ 6. Make written documentation of persons contacted and
action taken to
this point.
Date: _____
Initial: ______ 7. The clergy/professional staff person will immediately
establish a small
response team to begin the internal and pastoral care process.
Date: _____
Initial: ______ a. notify the insurance carrier of the incident
immediately and
comply with its investigation, if any;
Date: _____
Initial: ______ b. cooperate with legal and state authorities in their
investigations,
if any;
Date: _____
Initial: ______ c. prepare a written statement and designate a
spokesperson to
respond to media inquiries;
Date: _____
Initial: ______ d. provide assistance to the alleged victim and his/her
family in
obtaining counseling or referral to a mental health professional, if
needed; determine whether the alleged victim’s counseling expenses can
be reimbursed
by the Church or
the insurance carrier;
Date: _____
Initial: ______ e. respond to the needs of the families of the alleged
victim and the
accused to seek a redemptive solution for all involved;
Date: _____
Initial: ______ f. inform the affected volunteer(s) and paid staff
members of the
need for confidentiality, and;
Date: _____
Initial: ______ 8. Consider and respond to the concerns of other
parents.
Date: _____
Initial: ______ 9. The director of the affected ministerial area will
respond to the
pastoral care concerns of persons within the department.
Date: _____
Initial: ______ 10. Make written documentation of persons contacted and
action taken.
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