Monitoring Review Report for

Mediation/Conflict Resolution

PROGRAM INFORMATION
County:	Date of Monitoring:
Sponsoring Agency:
Component Name:	Component ID:

Service Delivery

The program schedules the initial appointment with the referred juvenile and the juvenile’s parent/guardian within 10 business days of receiving the referral. 18. Mediation/Conflict Resolution, 18.4, A

The average optimal weeks and contact hours are within parameters specified for the SPEP Service Type indicated in the program agreement. 18. Mediation/Conflict Resolution, 18.3, B.

The program has a protocol manual that details the structure, format and content through which program services are delivered, evaluated and maintained.

2. Program Operational Requirements, 2.3, A. 2.

Comments:

Staff Recruitment

The program follows all State and Federal workplace rules when recruiting, hiring and supervising full-time and part-time staff, including the recruitment and training of volunteers.

2. Program Operational Requirements, 2.8, A. 2.

The program has employment policies and procedures related to staff employment and supervision responsibilities. These policies include criteria regarding an individual’s eligibility for employment, contracting for services, volunteering and internships which keep in consideration the nature of the services to be delivered and the juveniles served.

2. Program Operational Requirements, 2.8, A. 4.

There is a file for all full-time staff, part-time staff, volunteers, interns, and contractor(s) containing: 2. Program Operational Requirements, 2.8, A. 6. a - j.

A written job description detailing the primary duties and expectations of the position including those specifically related to the delivery of DPS JCPC-funded program services; and stating the minimum education and experience requirement.

NOTE: Contractor files are exempt from this requirement.)

A signed copy of the Contract for Professional Services Template (Form JCPC/PO 001).

NOTE: Applies only to programs utilizing contractors to provide professional services.

A completed Program Volunteer Application Template (Form JCPC/EA 001).

NOTE: Applies only to programs utilizing volunteers.

An annual performance evaluation to measure performance of duties.

NOTE: Interns, volunteers and contractors are exempt from this requirement.

A criminal background check that provides a clear record of any criminal conviction(s).

Reference checks.

A valid driver’s license check is available for all staff, part-time staff, interns, contractors, and volunteers who may transport juveniles or required to drive as

part of their duty assignment.

Proof of education requirements from an accredited institution for the specific position.

Current licensure and/or certification requirements, when applicable.

Signed DPS Policy and Procedures Acknowledgement Statement (Form JCPC/PO 003)

Comments:

General Qualifications

18. Mediation/Conflict Resolution,18.5, A. - B.

The Program Manager has at least a Bachelor’s degree in a human services or related field, or a 4-year degree in any other field with at least 2 years experience as a direct service professional in a juvenile serving agency.

Program Staff have at least an Associate’s degree in a human services field, or a high school diploma with at least 1 year of Human Services experience.

Comments:

Volunteer Program Staff

18. Mediation/Conflict Resolution, 18.5, C. 1. - 4. I-ii

Volunteers providing direct service have at least 1 year of experience working with at-risk youth.

Each volunteer position has a job description.

A completed Program Volunteer Application (Form JCPC/EA 001), including 3 references has been provided, contacted, and documented on the completed form for each volunteer.

Each volunteer has been screened and the program determined that the volunteer possesses credentials/skills/experience commensurate to the requirements of the job description.

For each volunteer who is involved in supervision the program has on file:

A criminal background check.

Additionally, for volunteers providing transportation of juveniles, the program has on file:

A valid driver license (a copy must be annually updated and on file); and

A safe drivers records check.

Comments:

Staff and Volunteer Orientation and Training

18. Mediation/Conflict Resolution, 18.6, A. 1. - 4.

Orientation and training on policies, procedures, rules and regulations of the program and DPS are provided to program staff and volunteers within 30 days of employment.

The program maintains documentation of program orientation and staff trainings.

Program offers training opportunities for on-going development of service specific skills and knowledge.

Volunteers complete pre-service training specific to this program type prior to providing direct service to juveniles.

Staff are appropriately trained and qualified to lead for the specific type of activities utilized by the program.

Direct service staff participated annually in at least 12 hours of professional continuing education in an area related to the service type.

Comments:

Juvenile Records

The program has a hard copy paper record or digital record for each juvenile admitted to the program.

The program complies with JCPC policy, Appendix D. Digital Client Records.

2. Program Operational Requirements, 2.4, A.

Juvenile records are stored in a secure location. 2. Program Operational Requirements, 2.4, C.

Juvenile records are maintained for a period of 5 years after the termination date.

2. Program Operational Requirements, 2.4, C.

The program enters data into client tracking within 7 days of the admission decision.

18. Mediation/Conflict Resolution,18.4, B. 1.

Participation Agreement includes: 18. Mediation/Conflict Resolution, 18.4, C. 1. - 5.

Name of the sponsoring agency and program name.

Program guidelines, requirements, and projected dates of completion.

Signed consent of parent(s)/legal guardian(s), juvenile and program staff for participation in the program.

Specific requirements of the parent(s)/legal guardian(s) and each family member, if applicable

Results of any non-compliance.

Termination Process: 18. Mediation/Conflict Resolution, 18.4, E. 1. -3.

The program enters data into client tracking within 7 days of the termination decision.

The program has submitted a copy of the termination summary for each juvenile within 10 business days of termination from the program to the parent(s)/legal guardian, court services, if applicable and other referring entities as appropriate.

A copy of the termination summary is included in juvenile files.

The termination summary form includes:

Documentation of mediation date(s).

Mediation Outcome

The reason for termination which supports the reasons reported in NCALLIES

Names of persons and agencies receiving the termination form

The name of the program person completing the documentation.

Comments:

A review of 6 active and 6 terminated client records (randomly selected) has been conducted by the monitor. (If a program has less than 6 records in either category, review all records in that category.) The completed record review sheets for this component are attached.

3. Program Oversight and Monitoring, 3.4, A. 2.

Active Client File Review
Client Name	Admission Date (matches client tracking)	Referral Form	Referral Source (matches client tracking)	Referral Reason (matches client tracking)	Risk Assessment (referred by Court Counselors) or Score from Court Counselor (referred by another agency.)	Community Programs Risk Assessment (not referred by Court Services)	Parental Consent to Participate	Medical / Medication Information (if applicable)
ISP shows how progress/changes will be measured	Contact Record with activities, dates, times, duration, results each time the youth and/or family is seen	Hard Copy of Client Tracking Data in Record	Copy of Progress Reports to Juvenile Court Counselors at least every 30 days (if applicable)
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6.

Terminated Client File Review
Client Name	Termination Date (matches client tracking)	Referral Form	Referral Source (matches client tracking)	Referral Reason (matches client tracking)	Risk Assessment (referred by Court Counselors) or Score from Court Counselor (referred by another agency.)	Community Programs Risk Assessment (not referred by Court Services)	Parental Consent to Participate	Medical / Medication Information (if applicable)	Consent for Release of Information (if applicable)	Contact Record with activities, dates, times, duration, results each time the youth and/or family is seen	Hard Copy of Client Tracking Data in Record	Copy of Progress Reports to Juvenile Court Counselors at least every 30 days (if applicable)	Mediation Agreement	Termination Summary with date and reason for termination (matches client tracking)
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6.

Record Review Comments:

Summary of Comments:

Form JCPC/OM 003J Monitoring Review Report Supplement – Mediation/Conflict Resolution	Page 1 of 1

Form structure last revised July 2020

North Carolina Department of Public Safety

Availability of Services

JesseRiggs

2020-07-21

Briggs, Denise

NC DJJDP