2010 self-certification-plus compliance form

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  • 8/14/2019 2010 Self-Certification-Plus Compliance Form

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    Organization: ___________________________________________

    InterAction Office of Membership & Standards

    1400 16 th Street, NW, Suite 210, Washington, DC 20036

    202-667-8227 www.interaction.org

    ACCOUNTABILTY - TRANSPARENCY - EFFECTIVENESS

    InterAction Self-Certification-PlusMember Compliance Reporting Form

    SCP 2010

    http://www.interaction.org/http://www.interaction.org/
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    Organization: ___________________________________________

    COMPLIANCE CERTIFICATION FORMTABLE OF CONTENTS

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    P a g e | 3Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    INTRODUCTION AND DIRECTIONS............................................................................................................................................................................................4

    As we begin 2010 and the third mandatory PVO Standards compliance exercise through Self-Certification-Plus we have made some improvements to this years document

    based on our members feedback from the previous year. We have modified the compliance tick box Yes, have Policy to read Yes, have the required policy,

    documentation, procedures and/or processes in place in order to create more clarity. Standards that are multifaceted we have added a note to instruct you to tick only one

    box and to indicate an action plan if not in compliance. ................................................................................................................................................................. 4

    2010 SELF CERTIFICATION-PLUS COMPLIANCE FORM....................................................................................................................................................3

    2010 SELF CERTIFICATION-PLUS COMPLIANCE FORM....................................................................................................................................................5

    SECTION I: GOVERNANCE AND ADMINISTRATION STANDARDS....................................................................................................................................5

    Component I.A: Board Responsibility................................................................................................................................................................................... ........ 5

    Component I.B: Board Policies..................................................................................................................................................................................................... 7

    Component I.C: Fiscal Management and Accountability................................................................................................................................................................ 9

    Component I.D: Equal Access Rights........................................................................................................................................................................................ ... 10

    Component I.E: Organizational Integrity................................................................................................................................................................................. ..... 11

    Component I.F: Management and Human Resources................................................................................................................................................................. .. 13

    SECTION II: PROGRAM STANDARDS...................................................................................................................................................................................... 14

    Component II.A: Program Development.......................................................................................................................................................................................14

    Component II.B: Fostering Human Rights................................................................................................................................................................................... 17

    Component II.C: Program Quality Monitoring and Evaluation....................................................................................................................................................17

    Component II.D: Accountability................................................................................................................................................................................................ .. 18

    Component II.E: Organizational Security Policy and Plans......................................................................................................................................................... 19

    Component II.F: Fundraising and Commitment to Accurate Disclosure...................................................................................................................................... 20

    SECTION III: ORGANIZATIONAL COMMITMENT STANDARDS.......................................................................................................................................21

    Component III.A: Administrative and Management......................................................................................................................................................... ........... 21

    Component III.B: Advocacy and Public Policy............................................................................................................................................................................. 26

    2010 SELF CERTIFICATION-PLUS COMPLIANCE FORM....................................................................... ......................................... .... ..............................28SIGNATURE PAGE AND QUESTIONNAIR

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    INTRODUCTION AND DIRECTIONS

    This 2010 Self Certification Plus Compliance Form must be submitted to InterAction by each member organization no later than December 31, 2010 . Thiscompliance process is mandatory for all InterAction members every other year and noncompliance will result in suspension from InterAction membership.

    Although compliance with PVO standards is a self-regulatory process, it is an important mechanism for demonstrating the integrity and accountability of the NGO sector with donors, the public, and beneficiaries and also serves as a track record of members internal efforts to improve organizational accountability.

    As we begin 2010 and the third mandatory PVO Standards compliance exercise through Self-Certification-Plus we have made some improvements to thisyears document based on our members feedback from the previous year. We have modified the compliance tick box Yes, have Policy to read Yes,have the required policy, documentation, procedures and/or processes in place in order to create more clarity. Standards that are multifaceted we haveadded a note to instruct you to tick only one box and to indicate an action plan if not in compliance.

    Before you begin completing your compliance document, please write your organizations name on the header section to help us easier identified who the form belongs to. The actual form which follows is in Microsoft Word table format, with boxes designed in a word-wrapping format so that the boxes expand asyou fill them in. For each standard and its related components, the agency must indicate in the third column marked Compliance whether or not the standardand each component of that standard have been met. To check the box, double click on it and a window will open to allow you to change it to a checked box.Should the agency determine that a particular standard does not apply to their work, it must explain (briefly) its reasons for determining the standard is notapplicable in that section.

    The document explains each standard component and proposes documentation to be gathered and reviewed for evidence of compliance. All the sections, I.A.1 through III.B must be completed fully using the information in columns marked Component and Proposed Evidence. Check the appropriate box in columnmarked Compliance and then either indicate your action plan in column four marked Action Plan if not in Compliance to address noncompliance or indicate the documentation you used as evidence of compliance in column five Documentation Gathered. We do not want you to send us the documentationyou used as evidence of compliance, but only to cite that document in the column Documentation Gathered. Each member is required to develop and

    indicate an action plan to address areas of non-conformance. It has always been InterActions policy that a member is given one year to either come intocompliance with non-conformance to a standard or to demonstrate concerted movement toward coming into compliance in order to avoid possible suspensionfrom membership.

    The completed form, including the signature page provided at the end of this compliance document constitutes a completed certification document. We alsoask you to complete the questionnaire to help us evaluate the process.

    We will be using the results of the 2010 process to determine necessary revisions for 2012 and encourage you to give your feedback on the exercise andsuggestions for improving the process. If you have any questions or need additional clarification on how to complete the materials, please [email protected] or [email protected]

    P a g e | 4Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    The parenthetical term Source in these guidelines refers to the current PVO Standard(s) being applied to each standard heading and component under review.Due to the consolidation, the Source standards are not in numeric order.

    SECTION I: GOVERNANCE AND ADMINISTRATION STANDARDSA member Organization shall be governed responsibly by an independent, active and informed Board of Directors and, if applicable, its duly constituted Executive

    Committee. (Source: 2.1, 2.2)

    Component I.A: Board Responsibility

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    I.A.1 The Organizations boardshall act as the organizationsgoverning body, acceptingresponsibility for oversight of allaspects of the organization.

    (Source: 2.1, 2.4)

    Copies of pertinent sections of documents such as bylaws, charter,

    policies and procedures that vest theultimate authority in the board to act asthe organization's governing body with

    responsibility for governing all aspectsof the organization.

    Yes, have therequired policy, documentation,

    procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    I.A.2 The Organizations board policies shall specify thefrequency of board meetings (atleast two meetings per year),adequate attendance by directors(at least a majority of directors on average), and voting

    requirements. Records of themeetings shall be maintained ... (Source: 2.2

    Copies of pertinent sections of the policy or bylaws that specify thefrequency of board meetings, anddefine the required attendance. Alsogather and document evidence that the

    board meetings were held as plannedand that formal records of such

    meetings were permanently maintained.

    Yes, have therequired policy, documentation,

    procedures and/or processes in place.

    Yes, but lack policyNot in compliance

    Not applicable

    I.A.3 Policies and proceduresshall be in place to ensure thatthe activities are conductedwithin applicable laws. (Source: 2.7)

    Document internal policies and procedures that are in place to be usedto demonstrate compliance with allapplicable laws. If legal action has beeninitiated against the organization withinthe last three years, document internal

    Yes, have therequired policy, documentation,

    procedures and/or processes in place.

    Yes, but lack policy

    P a g e | 5Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    policies and procedures followed, andany actions taken, to respond to andresolve legal action.

    Not in complianceNot applicable

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    I.A.4 The Organizations boardshall exercise fiscal oversight of the organization by:

    a) Approving the annual budget;

    b) Appointing an independentCertified Public Accountant

    as auditor;c) Receiving and reviewing the

    annual, audited financialstatements, which complywith Generally AcceptedAccounting Standards andRequirements according tothe AICPA and the FASB;

    d) Requesting and reviewing amanagement letter, if applicable; and

    e) Reviewing the financialstatements and activities of the organization.

    f) Appropriate records shall bemaintained. (Source: 2.5.4.2)

    The names of the board members whoare currently serving on the board'sfinancial oversight committee,including the name of theorganizations treasurer, if applicable.

    Gather additional evidence, asappropriate, to verify the elements of the component.

    Yes, have therequired policy, documentation,

    procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Note: Organizationswith less than $100,000annual incomes are notrequired to use anindependent auditor.(Source: 4.2) The

    board can execute thesefunctions through theuse of variouscommittees, including afinancial oversightcommittee.

    Note: Only tick one box! If non compliantwith any of the sections,Not in compliance

    box must be ticked andaction plan given in theAction Plan column.

    P a g e | 6Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    I.A.5 The Organization shallannually report to the public bymeans of an annual report, or inseparate report formats:

    a) Audited financialstatements,

    b) IRS form 990 if applicable,

    c) List of current boardmembers,

    d) Other information that may be helpful to the public inunderstanding theorganizations purposes,goals, activities and results.(Source: 4.5)

    Copies of all required documents. Yes, have therequired policy, documentation,

    procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Component I.B: Board Policies

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    I.B.1 Documented board policies shall:

    a) Restrict the number of

    employees who are votingmembers of the board,

    b) Provide limits for directors being related to one another,the founder, or the executivedirector or president/chief executive officer,

    c) Establish limited terms of service for directors and

    Copies of the appropriate sections of the organization's policies and

    procedures that address the terms of service, restrictions on board members

    relationships and services byemployees, and board memberscompensation and/or reimbursementfor expenses.

    Yes, have therequired policy, documentation,

    procedures and/or

    processes in place.Yes, but lack policyNot in complianceNot applicable

    Note: This restrictionapplies only to paymentfor services as a director and does not apply tosalaried employees who

    P a g e | 7Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    officers,

    d) Prohibit compensation to board members for service as directors.(Source: 2.2)

    are also directors.Reimbursement for out-of-pocket expenses isnot consideredcompensation.

    Note: Only tick one box! If non compliantwith any of the sections,Not in compliance

    box must be ticked andaction plan given in theAction Plan column.

    I.B.2 Organizations board policy shall prohibit direct and

    indirect conflicts of interest,requiring that members of the board and employees:

    a) Disclose any affiliation theyhave with an actual or

    potential supplier of goodsand services, recipient of grant funds, or organizationwith competing or conflictingobjectives;

    b) Absent themselves fromdiscussion and abstain fromvoting or otherwise

    participating in a decision onany issue in which there is aconflict of interest; and

    c) Refuse large or otherwiseinappropriate gifts for

    personal use.

    Those sections of the organization's policies and procedures that address

    potential conflict of interest situationsaffecting board members or employees,and compile any additional evidencethat the organization is complying withthese policies and procedures.

    Yes, have therequired policy,

    documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Note: This standarddoes not require that theconflict of interest

    policy provide an

    exhaustive list of conflict situations, butthat such a policy

    provides a framework for determining when asituation wouldconstitute a conflict.The management mustreport staff conflicts of interest to the board,report major credibility

    P a g e | 8Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    (Source: 2.3

    Appropriate records shall bemaintained.

    risks to the board, andtrain new boardmembers, employeesand volunteers onconflict of interest

    requirements.

    Note: Only tick one box! If non compliantwith any of the sections,Not in compliance

    box must be ticked andaction plan given in theAction Plan column.

    Component I.C: Fiscal Management and AccountabilityThe Organizations finances are conducted in such a way as to assure appropriate use of funds. Appropriate records shall be maintained. (Source: 4.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    I.C.1 The Organization shall operate according to a budgetapproved by its board.

    (Source: 4.7)

    Copy of the organization's budget for thecurrent year.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in compliance

    Not applicable

    I.C.2 The Organizationscombined fundraising andadministration costs shall be kept to the minimum necessaryto meet the organizationsneeds. (Source: 4.6)

    Note: The organization should

    The ratio or proportion of theorganization's total combined fund-raising and administrative costs to thetotal expenditures for each of the pastthree years.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    P a g e | 9Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    set an internal target for fundraising and administrativeexpense that is appropriate tothe nature of its structure and

    programs. These expenses

    should generally not exceed35% of expenditures . (Source:6)I.C.3 The Organization shall exercise adequate internalcontrols over disbursements toavoid unauthorized payments,

    prohibiting any unauditabletransactions or loans to boardmembers and to staff. This mayinclude descriptions of

    procurement policies and procedures. (Source: 4.7)

    Pertinent materials prepared by theorganization (including managementletters and conflicts of interest policiesin assessing compliance with I.A.4 andI.B.2)

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    I.C.4 The Organization shall file Form 990 annually with theUnited States government.

    Note: Religious organizationsshould seek legal counsel toconfirm that they are exempt bylaw from this component.(Source: 4.3)

    Form 990 filed with the United Statesgovernment during the past three years.If no 990 is filed, annual auditedfinancial statements shall be madeavailable.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Component I.D: Equal Access Rights

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    I.D.1 The Organization shallensure that the fundamentalconcern of the organization isthe well being of those affected,and that its programs assist those

    Copies of the organization's instructions,directives, policies and/or procedureswhich direct personnel to adhere to non-discrimination practices in its eligibilitydecisions, and list the organization's

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policy

    P a g e | 10Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    who are at risk without political,religious, gender or other discrimination. (Source: 7.1.6)

    most recent personnel orientations,trainings and instructional materialaddressing non-discrimination.

    Not in complianceNot applicable

    I.D.2 The agency shall have a

    written policy that affirms itscommitment to gender equity, toethnic and racial diversity, to theinclusion of people withdisabilities in organizationalstructures and in staff and boardcomposition. The policy should

    be fully integrated into anorganizations plans andoperations, with a mechanismmandated by the CEO for

    overseeing implementation.(Source: 2.6.1/2/3 and 7.2.1,7.3.1, 7.4.1)

    Copy of the written policy and relevant

    sections of operational plans.

    Yes, have the required

    policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Component I.E: Organizational IntegrityThe affairs of the Organization are conducted with integrity and truthfulness. (Source: 3.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    I.E.1 Each director andemployee shall follow the

    organizations written standardof conduct that provides that:

    a) The organization opposesand does not act as awilling party towrongdoing, corruption,terrorism, bribery, other financial impropriety, or illegal acts in any of its

    A copy of the organization's writtenstandard of conduct

    A copy of the pertinent section of the organization's policies and

    procedures which address correctiveactions to be taken in response tofounded wrongdoing by Boardmembers, employees, contractorsand volunteers.

    Yes, have the required policy, documentation,

    procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Note: This standardrequires that theorganization hasdocumented policies or

    P a g e | 11Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    activities;

    b) The organization takes prompt and firm correctiveaction whenever and

    wherever wrongdoing of any kind is found amongits board and employees;and

    c) The standard of conduct ismaintained despite possible

    prevailing contrary practiceselsewhere. (Source: 3.2,3.4)

    procedures to guide itsinvestigation of, andcorrective action to,different types of wrongdoing. These

    documented policies or procedures need not beexhaustive, but theyshould provide aframework for investigative andcorrective action.Records of theinvestigations andcorrective actions shall bemaintained.

    Note: Only tick one box!If non compliant with anyof the sections, Not incompliance box must beticked and action plangiven in the Action Plancolumn.

    I.E.2 The organization willhave policies to address

    complaints and prohibitretaliation againstwhistleblowers. (Source: 3.3)

    Copy of the policy that protectsemployees who present evidence of

    misconduct by individuals associatedwith the organization. Verify that policies and procedures have beenfollowed.

    Yes, have the required policy, documentation,

    procedures and/or processes in place.Yes, but lack policyNot in complianceNot applicable

    I.E.3 The organization willhave policies for documentretention and destruction thatensure protection of documentsduring an official investigation.

    Gather and review a copy of policy. Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policy

    P a g e | 12Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    (Source 3.7) Not in complianceNot applicable

    Component I.F: Management and Human ResourcesThe organization shall follow management practices that are appropriate to its mission, operations, and governance structure. (Source: 6.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    I.F.1 The organization shallhave clear, well-defined,documented policies and

    procedures relating to all UnitedStates employees, clearlyoutlining their rights and

    benefits. (Source: 6.3, 6.3.1)

    Personnel policies and procedures or other documents related toorganizational operations.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in compliance

    Not applicable

    I.F.2 The Organizations policies shall prohibit excludingfrom participation, denying

    benefits, or otherwise subjectingto discrimination any person onthe basis of race, color, nationalorigin, age, religion, disabilityor gender in any aspect of service delivery and human

    resource practices. (Source:2.6)

    Note: If an organization claimsexemption under section 702 of the Civil Rights Act of 1984, theorganization may consider religion in its employment

    practices.

    Policy that affirms the organization'scommitment to equal access to theorganization's services and prohibitsdiscrimination by the organization on the

    basis of race, color, national origin, age,religion, handicap or gender.

    Track job applications to make sure allapplicants have been treated equally

    according to policies and procedures.Interview HR staff, if necessary.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    P a g e | 13Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    I.F.3 The Organization shallhave documented policies and

    practices that support equal payfor equal work for women andmen in the United States.

    (Source: 6.4.1.5, 6.4.2.4)

    Copy of the policies that affirm theorganizations commitment to equal payfor equal work.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    SECTION II: PROGRAM STANDARDS

    Component II.A: Program DevelopmentOrganizations field programs should empower institutions and facilitate popular participation and sustainable development. (Source: 7.1.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    II.A.1 The Organizations programs shall facilitate self-reliance, self-help and popular

    participation by empoweringindividuals and communitiesand strengthening capacities of local structures. (Source: 7.1.1, 7.1.8) To this end, theorganization considers such

    things as appropriate includingthe programs potential for individual and communityempowerment;

    a) The potential of planned activities tostrengthen the capacity of local structures;

    b) The capacity of

    Draft a concise but comprehensivedescription of the organizations trainingmanuals and services or gather andreview a copy of material containing thisinformation. The followingtopics/materials should be covered andverified that training was documentedand delivered. Applicable organizational

    policies and standards include:

    Training manuals or guidelines for program design, implementation,monitoring and evaluation

    Gender analysis tools for programming

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Note: To achieve thisstandard, theorganizations program

    planning andimplementation mustreflect efforts to foster mutually beneficialrelationships among

    peoples from variedcultural and economic

    backgrounds. Program and

    P a g e | 14Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    local/regional institutionsto absorb financial andother inputs constructively;

    c) The potential to strengthen

    the capacities of vulnerablegroups, typically women,children, minorities, thedisabled, and the very

    poor;

    d) The potential of localresources to sustain the

    program;

    e) Where resources exceedcapacity, the potential tocreate new structures suchas locally controlledfoundations or funds;

    f) The potential effect uponlocal demand and marketsfor locally produced goodsand services;

    g)The environment impact;

    h)The involvement of

    appropriate stakeholdersfrom affected groups; and

    i) The programs potential toadvance the status of womenand their empowerment.

    (Source: 6.4.1.6; 7.1.7/8)

    senior staff should betrained in gender analysisfor program planning,implementation andevaluation.

    Note: Only tick one box!If non compliant with anyof the sections, Not incompliance box must beticked and action plangiven in the Action Plancolumn.

    P a g e | 15Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    II.A.2 - Where appropriate,awareness of diversity issuesshall be incorporated into eachstage of the program process,from the review of project

    proposals to implementation andevaluation, to ensure that projects foster participation and benefits for all affected groups.The agency will collaborate with

    partner NGO organizations inthe field to integrate diversityissues into their programs.(Source: 7.3.2)

    Program planning, proposal and program evaluation guidelines for review of diversity criteria.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    II.A.3 - Agency programs and

    activities should be held inaccessible locations to the extentfeasible. Organizations will

    provide training and conferencematerials in alternative formatsas applicable (Braille, sign-language interpreters, etc) andshould plan financially toreasonably accommodate peoplewith disabilities in their

    programs and activities.

    (Source: 7.4.3)

    Review training site locations and

    formatting of training materialsdeveloped over the past year to assessand verify that accessibilityconsiderations were followed.

    Yes, have the required

    policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    II.A.4 For those organizationsoperating in the field , theorganization shall give priorityto working with or through localand national institutions andgroups, encouraging their creation where they do notalready exist, strengtheningthem where they do and

    Develop a list of the entities with primary responsibility in each countrywhere the organization operates. Gather organizational policy, guidelines and/or training material about working in

    partnership with local communitygroups and/or instructors.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    P a g e | 16Copyright 2010 InterAction Questions: Email [email protected] or [email protected]

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    developing clearly and publiclystated criteria for establishing

    partnerships with such groupsand for fostering communityempowerment through

    participation in the planning of programs and projects. (Source: 7.1.3)

    Component II.B: Fostering Human Rights

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    II.B.1 - In its programactivities, the organizationrespects and fosters human

    rights, both socio-economic andcivil-political. (Source: 7.1.4)

    The organization's instructions,directives, policies and/or proceduresthat address the privacy and dignity of

    program beneficiaries.

    Yes, have the required policy, documentation, procedures and/or

    processes in place.Yes, but lack policyNot in complianceNot applicable

    Component II.C: Program Quality Monitoring and EvaluationThe organization has established policies and procedures for ongoing monitoring and evaluation of its programs and projects, both qualitatively and quantitatively.(Source: 7.1.9)

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    II.C.1 The organizations procedures for programmonitoring and evaluation shalladdress the effective use of inputs , including human andfinancial resources.(Source: 7.1.9)

    Materials summarizing theorganization's procedures for monitoringand evaluating the effective use of inputs.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    II.D.1 The organization shallexercise management andfinancial controls to provideassurance that the donor contributions are used as

    promised or implied in thefundraising appeal or asrequested by the donor.(Source: 4.8)

    Policies on accounting practices andreporting on the generation and use of restricted and unrestricted funds, anddocument all communications to the

    public and donors on the use of restricted

    and unrestricted funds.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policy

    Not in complianceNot applicable

    Component II.E: Organizational Security Policy and PlansInterAction members shall have policies addressing the key security issues (Source: 7.6.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    II.E .1 Organizational SecurityPolicies and Plans: InterActionmembers shall have policiesaddressing the key securityissues and formal plans at boththe field level and headquarterslevels to address these issues.(Source: 7.6.1)

    Materials recording the organization'srequirements for preparing security

    plans at both the field and headquarterslevels.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    II.E .2- Resources to addresssecurity: InterAction membersshall make available appropriate

    resources to meet theseminimum operating securitystandards. (Source: 7.6.2)

    Materials recording theorganization's security-related resourceallocations and/or budget guidelines

    regarding security related expenditures.

    Yes, have the required policy, documentation, procedures and/or

    processes in place.Yes, but lack policyNot in complianceNot applicable

    II.E.3 Human ResourceManagement: InterActionmembers shall implement hiring

    policies and personnel procedures to prepare staff to

    Materials recording the organization's procedures for preparation and supportof staff prior to, during and after fieldassignments relating to security risks.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policy

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    cope with the security issues attheir posts of assignment,support them during their service, and address postassignment issues. (Source:

    7.6.3)

    Not in complianceNot applicable

    II.E.4 - Accountability: InterAction members shallincorporate accountability for security into their managementsystems at both the field andheadquarters level. (Source: 7.6.4)

    Materials recording the organization'sinstructions for personnel evaluationsrelated to security.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    II.E.5 Sense of Community: InterAction members shall work

    in a collaborative manner withother members of thehumanitarian and developmentcommunity to advance their common security interests.(Source: 7.6.5)

    Materials recording the organization policy regarding sharing of security

    information and other participation inefforts to enhance mutual security withother NGOs.

    Yes, have the required policy, documentation,

    procedures and/or processes in place.Yes, but lack policyNot in complianceNot applicable

    Component II.F: Fundraising and Commitment to Accurate Disclosure

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHEREDII.F.1 The organization shall

    be truthful in marketing andadvertising.

    Note: The organizationscommunications must neither minimize nor overstate thehuman and material needs of those whom it assists. (Source:

    Summarize the methods used to assurethe accuracy of conditions portrayed inthe organization's communications. If no such guidelines exist, summarize themethods used to assure the accuracy of conditions portrayed in theorganization's communications. Gather and review sample-marketing guidelinesthat address the organization's accurate

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    5.3)The organizationscommunications must notcontain any material omissionsor exaggerations of facts,

    misleading photographs, nor anyother communication that wouldcreate a false impression or misunderstanding. (Source: 5.2)The materials must give accurate

    balance to the actual programsfor which solicited funds will beused. (Source: 5.2)

    portrayal of conditions in itscommunications. Survey donors toverify that the organizations intendedmessage is accurately getting through.

    SECTION III: ORGANIZATIONAL COMMITMENT STANDARDSSeveral PVO Standards do not easily lend themselves to clear and objective measurement. More important than defining an absolute measurement is a member's ability to

    provide evidence that internal policies have been adopted/implemented, reflecting an organizational commitment to regular, deliberate progress toward meeting thesebroader institutional objectives.

    Component III.A: Administrative and Management

    COMPONENT PROPOSED EVIDENCE COMPLIANCE ACTION PLANIF NOT IN COMPLIANCE

    DOCUMENTATIONGATHERED

    III.A.1 The organization shall be willing to share programknowledge and experience with

    program participants, other agencies, donors and other constituencies. (Source: 7.1.10)

    Review and summarize theorganization's efforts to share programknowledge and experience with program

    participants, other agencies, donors andother constituents.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    III.A.2 The organization shallhave, or plan to adopt within its

    All policies that affirm the organization'scommitment to gender equity, racial and

    Yes, have the required policy, documentation,

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    next strategic plan, written policies that affirm itscommitment to gender equality,racial and ethnic diversity andinclusion of people with

    disabilities in staff and boardcomposition, in part by adopting policies and procedures toincrease:

    a) The numbers of women insenior decision-making

    positions, where there isunder-representation, atheadquarters and in thefield;

    b) Ethnic and racial diversity,where there is under-representation, and;

    c) The inclusion of peoplewith disabilities, wherethere is under-representation. (Source: 6.4.1.2, 6.4.2.2, 6.4.3.1)

    (Source: 2.6.1, 2.6.2,2.6.3) [compare to text about

    U.S. procedures in I.F.3above]

    ethnic diversity, and inclusion of peoplewith disabilities in organizationalstructures and in staff and boardcomposition. If the organization has notyet adopted such policies, prepare

    written plans to adopt policies, meetingminutes discussing the development andadoption of such policies, or other relevant documentation. Assemblecopies of personnel policies that aredesigned to address any discrepancies in:

    The female/male ratio of the senior staff at headquarters and in the field;

    The female/male ratio of the

    remaining headquarters staff; The percentage of employees with

    disabilities (known to theorganization by the employee'svoluntary disclosure or some other legal means).

    procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    Note: Only tick one box!If non compliant with anyof the sections, Not incompliance box must beticked and action plangiven in the Action Plancolumn.

    III.A.3 The organization shallinstitute family friendly policiesand create an environment thatenables both women and men to

    balance work and family life.(Source 6.4.1.4)

    The organizations personnel policiesshall identify the inclusion of familyfriendly elements, such as parental leave,flexible work hours, telecommuting, etc.Examine personnel records (approvedleaves, individual work schedules, etc.)to examine the extent to which these

    policies are being utilized and the

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    utilization patterns of both female andmale staff.

    III.A.4 The organization shallendeavor to recruit and retain

    staff that combines professionalcompetence with a commitmentto service.

    Note: To assist in therecruitment and retention of staff with the skills, experienceand attitudes that increase the

    probability that service deliverywill meet the industry'sstandards for efficiency andeffectiveness, the organization

    should regularly carry out thefollowing activities:

    a) Define and update objectiveentry qualifications for each

    job category, b) Devise and carry out

    effective advertisingcampaigns for job openings,

    c) Provide adequate andequitable staff orientationand training,

    d) Inform staff of currentopenings, and

    e) Carry out equitableremuneration and

    promotions

    Samples of advertisements of recent job openings from newspapers and

    other media Compile job descriptions

    Compile samples of recent internalannouncements of job openings

    Describe opportunities made availableto staff to upgrade skills

    Compile a list of the organizationsrecruitment outreach (e.g., evidenceof specific efforts being made to reachand attract a more diverse pool of candidates)

    Yes, have the required policy, documentation,

    procedures and/or processes in place.Yes, but lack policyNot in complianceNot applicable

    Note: Only tick one box!If non compliant with anyof the sections, Not incompliance box must be

    ticked and action plangiven in the Action Plancolumn.

    III.A.5 The organizations Samples of job descriptions and Yes, have the required

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    hiring and personnel evaluation policies and practices halldemonstrate commitment togender and diversity issues anda commitment to gender equityand diversity. (Source 6.4.1.3, 6.4.2.3)

    candidate interview questions for criteria/questions that addresscommitment to and experience with

    promoting gender equity, diversity, andinclusion of people with disabilities.Review the organizations performanceassessment form for criteria/questions onelements related to advancing gender equity, diversity, and inclusion of peoplewith disabilities.

    policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    III.A.6 The organizations performance expectations of contractors shall be clearlydefined and communicated.(Source 6.3.3)

    NOTE: Compliance with thiscomponent can be demonstratedthrough agreements between theorganization and contractors,including NGOs and other organizations.

    Standard contracts used between theorganization and its contractors. If thereare any concerns, survey contractors for opinions/experience.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    III.A.7 The organization'shuman resource development

    program for U.S. staff at alllevels shall promote non-discriminatory workingrelationships and respect for diversity in work andmanagement styles byintegrating gender, diversity anddisability sensitization into itsorientation and training

    programs. (Source: 6.4.1.1,6.4.2.1, 6.4.3.2, 6.4.1.6)

    Copies and review of the currentcurricula used for orientation and/or training addressing employment andservice-related diversity issues includinggender, racial, ethnic and physicaldisability.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    III.A.8 The organization shallmake financial arrangements to

    protect its ability to honor itsobligations to employees.

    (Source: 6.3.2)

    Review payroll and benefit plan recordsto determine that the organization:

    Has accurate records

    Pays salaries and benefits when due Properly funds employee retirement plans

    Pays payroll taxes on a timely basis Has corrected any shortcomings in

    these areas, if any, and pointed outin an audit or management letter.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    III.A.9 Staff who is engagedin fundraising and publicrelations shall meet thestandards of the Association of Fundraising Professionals andPublic Relations Society of America, respectively. (Source: 5.7)

    Copies of any policies that address theethical practices expected of staff engaged in fundraising and publicrelations.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    III.A.10 If the organizationengages in fundraising events or cause-related marketing, theamount of funds going to thecharity shall be clearlydescribed prior to, or inconjunction with the effort..(Source: 5.5)

    Samples of advertisements, invitations, brochures, etc., that announce upcomingfundraising events or provide cause-related marketing.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in complianceNot applicable

    III.A.11 Organizations thatcontract for fundraisingactivities shall have written

    Current or anticipated contracts for fund-raising activities with the dates they arein force.

    Yes, have the required policy, documentation, procedures and/or

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    for those engaging in activitiesaimed at influencing legislationor other public regulations. Theorganization is responsible for determining if any of itsadvocacy or "lobbying"activities may be prohibitedunder these laws and/or regulations. (Source: 8.3)

    activities.

    III.B.3 If the organizationundertakes activities intended toinfluence public policy in theUnited States or other countries,it shall do so in accordance withits own established policies.

    (Source: 8.4)

    All of the organization's written procedures for assessing the complianceof its public policy and advocacyactivities with its own policies.

    Yes, have the required policy, documentation, procedures and/or processes in place.

    Yes, but lack policyNot in compliance

    Not applicable

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    INTERACTION

    PVO STANDARDS

    COMPLIANCE CERTIFICATION FORM 2010

    SIGNATURE PAGE

    Name of Organization

    Name of CEO or Board Chairman (Please Print)

    Signature of CEO or Board Chairman Date

    In order to help us improve and structure the SCP process to offer most benefit to the membership,please answer all of the following questions.

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    Name of the organization : _______________________________________________

    Did you find the Self-Certification-Plus process useful for you institutionally? If yes, please explain how.

    Did the process lead to any recognition to strengthen your organizations processes, policies and/or systems? If so, pleasegive examples.

    Who lead the effort and who where the other individuals and divisions engaged in Self-Certification-Plus at your organization?

    Did you discover areas where your organization would benefit from technical assistance?

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    Organization: ___________________________________________ 2010 Self Certification-Plus Compliance Form

    Do you have any recommendations on how Self-Certification-Plus process might be improved for 2012?

    Did you agree with the assumption that all Category I and Category II Standards are mandatory? If not, which Category I andCategory II Standards would you not consider to be mandatory?

    Does your organization verify compliance with any other standards? If so, which one?

    Other Comments

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