Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Select date
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Agency:
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Program Name:
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Contact Person
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Persons Interviewed:
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Location:
Administrative
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Assessment Key: Exceeds Requirement (ER); Meets Requirement (MR); Continuous Improvement (CI); Non-Compliant (NC); Not Reviewed (NR)
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Program staffing levels are maintained
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Comments/Documents Reviewed
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Program files quarterly programmatic reports in a timely manner as required by contract
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Comments/Documents Reviewed
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Agency records document and support information submitted on most recent quarterly report
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Comments/Documents Reviewed
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Staff background checks are current
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Comments/Documents Reviewed
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Agency handles staffing changes per contract
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Comments/Documents Reviewed
Program Management & Scope of Services
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Maintains adequate (complete, current, orderly) client service records for planning, report and evaluation purposes
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Comments/Documents Reviewed
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Program and services are accessible and are reponsive to client needs, as documented by satisfaction surveys, client evaluations, or letters of testimony
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Comments/Documents Reviewed
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Services are provided according to date, time, and location specified
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Comments/Documents Reviewed
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Program maintains an adequate data collection system for collecting, recording and reporting performance information.
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Comments/Documents Reviewed
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Program outcome objectives are on target or ahead of target in relation to time of fiscal year
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Comments/Documents Reviewed
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Program is effective in implementing strategies that encourage parental involvement
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Comments/Documents Reviewed
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Comments/Documents Reviewed
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Comments/Documents Reviewed
