Meets Standard (Substantial compliance; complies in all material ways with the standard for the relevant review period) Does Not Meet Standard (Requires Corrective Action) Instructions for Overall Compliance Determination Narrative The narrative must include a comprehensive discussion of all the evidence relied upon in making the compliance or non-compliance determination, the auditor’s analysis and reasoning, and the auditor’s conclusions. This discussion must also include corrective action recommendations where the facility does not meet the standard. These recommendations must be included in the Final Report, accompanied by information on specific corrective actions taken by the facility. DATA COLLECTION AND REVIEW Standard 115.386: Sexual abuse incident reviews All Yes/No Questions Must Be Answered by the Auditor to Complete the Report 115.386 (a) Does the facility conduct a sexual abuse incident review at the conclusion of every sexual abuse investigation, including where the allegation has not been substantiated, unless the allegation has been determined to be unfounded? Yes No 115.386 (b) Does such review ordinarily occur within 30 days of the conclusion of the investigation? Yes No 115.386 (c) Does the review team include upper-level management officials, with input from line supervisors, investigators, and medical or mental health practitioners? Yes No 115.386 (d)
Meets Standard (Substantial compliance; complies in all material ways with the standard for the relevant review period) Does Not Meet Standard (Requires Corrective Action) Instructions for Overall Compliance Determination Narrative The narrative must include a comprehensive discussion of all the evidence relied upon in making the compliance or non-compliance determination, the auditor’s analysis and reasoning, and the auditor’s conclusions. This discussion must also include corrective action recommendations where the facility does not meet the standard. These recommendations must be included in the Final Report, accompanied by information on specific corrective actions taken by the facility. DATA COLLECTION AND REVIEW Standard 115.386: Sexual abuse incident reviews All Yes/No Questions Must Be Answered by the Auditor to Complete the Report 115.386 (a) Does the facility conduct a sexual abuse incident review at the conclusion of every sexual abuse investigation, including where the allegation has not been substantiated, unless the allegation has been determined to be unfounded? Yes No 115.386 (b) Does such review ordinarily occur within 30 days of the conclusion of the investigation? Yes No 115.386 (c) Does the review team include upper-level management officials, with input from line supervisors, investigators, and medical or mental health practitioners? Yes No 115.386 (d)
Carbone%20Hall%202018%20Audit.docx