Child Protection Policy 2008-2009

Child Protection Policy and Procedures First Presbyterian Church of La Grange I.

Introduction

Child abuse is a serious problem in our society and, unfortunately, within the Christian community. Abuse often occurs in settings where children completely trust adults -- homes, schools, camps, athletic and park programs, retreats and the church. As people entrusted with the lives of children, we believe that we have a profound moral and legal obligation to reduce the possibility of abuse from happening to the children who attend activities of the First Presbyterian Church of La Grange. The purpose of this document is to help make church activities a safer place for our children by instituting policies and procedures that guard against abuse. These policies and procedures are designed to help our church to: •Safeguard the children from abuse. •Provide assurance to families that their children are safe and secure at First Presbyterian Church of La Grange activities. •Provide emotional and spiritual support to children and their families if such abuse takes place. •Assure proper reporting when there is reasonable cause to believe that child abuse or neglect has occurred. II.

Policy Statement

The environment of the First Presbyterian Church of La Grange is to be free from any form of abuse. Violation of this policy shall result in disciplinary action, pastoral counsel, and/or possible legal action. The staff, volunteers and other leaders at First Presbyterian Church of La Grange shall adhere to this policy and its implementing procedures at all times.

III.

Amendment and Legal Review

The Child Protection Policy and Procedures may be amended or modified at any time by the Session of the First Presbyterian Church of La Grange (“Session”). The policy and procedures shall be reviewed at least annually by the Personnel Committee of the First Presbyterian Church of La Grange and by legal counsel to ensure continued compliance with the law, guidelines issued by the Chicago Presbytery or the General Assembly of the Presbyterian Church U.S.A., and the requirements for coverage under the general liability insurance policy obtained by the First Presbyterian Church of La Grange. At the conclusion of this review, the Personnel Committee and legal counsel shall submit any required revisions to the Session for approval. In the event that revisions are not required, the Personnel Committee and legal counsel shall submit a statement to that effect to the Session and request the inclusion of the statement in the Session’s minutes. IV.

Adoption and Revision

The Child Protection Policy and Procedures was adopted by the Session of the First Presbyterian Church of La Grange on April 23, 2008. Implementation of the Policy and Procedures will be complete by October 15, 2008. It was last revised by action of the Session on __________________. 1

V.

Procedures

The Child Protection Policy and procedures consist of five major topics including: 1. Volunteer and Staff Screening & Hiring Procedures 2. Volunteer and Staff Training 3. General Supervision 4. Incident Reporting 5. Confidentiality Each topic is described, defined and detailed as follows: A. Volunteer and Staff Screening & Hiring Procedures: All first-time candidates must complete an application, provide two references and a copy of driver’s license or state identification, be available for an interview if needed, and be willing to provide authorization for a background check. Renewal applications must be completed by all staff and volunteers once each year. All volunteer candidates must be regularly involved with the church for at least six months before they will be considered for any ministry position involving children. Related Definitions: Staff: A person employed or contracted with the First Presbyterian Church of La Grange. Volunteer: A person who provides services for First Presbyterian Church of La Grange and receives no remuneration. Volunteers include persons elected or appointed to serve on boards, committees, and other groups. Children: a person under the age of 18. Activity: a program or event sponsored by or under the control of First Presbyterian Church of La Grange. Parent: a parent or legal guardian of a child participating in an activity. Six Month Rule: No volunteer worker candidate will be considered for any ministry position involving contact with children or youth until the candidate has been regularly involved in our church for six months or more. Details: 1. Candidates for staff positions will complete the usual First Presbyterian Church of La Grange application. Candidates for volunteer positions will complete the application form in Appendix A. 2. Applications will be carefully reviewed by the minister and/or supervisor of the ministry for which the applicant is being considered to ensure the candidate will be appropriate for the ministry position. First Presbyterian Church of La Grange has the right to refuse a candidate. 2

3. If the candidate appears to be appropriate for the ministry work, then references will be checked to confirm the information provided on the application. 4. A criminal background check will be performed with respect to any candidate seeking to work with children. 5. Proof of current auto insurance must be kept on file for anyone providing transportation to children as part of a First Presbyterian Church of La Grange activity. 6. All information gathered in the screening process will be kept in a secure location and will be kept strictly confidential with access permitted only to those few persons (i.e. pastors, personnel moderator) who have a legitimate need to know. 7. Renewal applications must be completed by all staff and volunteers once each year (Appendix I). B. Volunteer and Staff Training: All staff and volunteers coming into contact with children must participate in annual training. The training covers how to identify and report alleged, suspected or confirmed abuse or neglect as well as the policies and procedures outlined in this document. Upon completion of training, all staff and volunteers working with children will be considered Trained Adult Leaders. Related Definitions: Trained Adult Leader: A volunteer or staff member who has fulfilled the requirements of the screening & hiring process as well as the training in accordance with the First Presbyterian Church Child Protection Policy. Abuse: conduct that harms or has the potential to harm a child physically, sexually, or emotionally with inappropriate aggression, sexual content, verbal harassment, or negligence. 

Neglect: the failure of a parent or responsible caretaker to provide adequate supervision, food, clothing, shelter, medical care or other basic necessity to a child.



Sexual Misconduct: conduct that results in or has the potential to result in child sexual abuse.

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Child Sexual Abuse: abuse against a child that is sexual in nature. The behavior may or may not involve touching. Sexual conduct or interaction between an adult and a child is always considered forced and abusive whether or not consented to by the child.

Adult: a person 18 years of age or older. Mandated Reporter: a person required by law to report to the appropriate state agency all suspected incidents of child abuse or neglect that come to their attention. (See Section D(5) and Appendix E for more information on who is considered a mandated reporter.) Person in charge of an activity: the person designated to lead and take responsibility for the activity. This person must be a Trained Adult Leader. 3

Details: 1. A copy of this policy will be provided to all staff and volunteers prior to starting work. All staff and volunteers are required to read the document and sign it prior to starting work. 2. Training will be given to recognize the signs and symptoms of neglect and of abuse prior to working with children. 3. Training will be given regarding procedures to follow when an incident of suspected abuse, neglect, or sexual misconduct is to be reported. 4. Guidelines will be given for acceptable and appropriate behavior. 5. Staff and volunteers who are mandated reporters will be provided with copies of the Illinois Department of Children and Family Services (DCFS) Manual for Mandated Reporters. All must sign the DCFS Acknowledgement of Mandated Reporter Status Form. 6. Training will be under the supervision of the Associate Pastor for Family Life in cooperation with the personnel committee, the Coordinator for Children’s Ministry and the Coordinator for Youth Ministry. 7. Training materials will be reviewed annually before being presented to the staff and volunteers. C. General Supervision: Two Adult Rule: Two Trained Adult Leaders must be present at all church sponsored activities involving children. If only two adults are present, they must be unrelated by marriage or family. In the unusual event that two trained adult leaders are not present, parents will be informed of the exceptional circumstance and given the following options 1.) to leave their child with one trained adult leader or 2.) to forego the child’s participation in that event. Parents opting to leave their child will indicate, via written signature, their awareness of the situation. (Appendix E) Two Years Older Rule: All Trained Adult Leaders must be at least 24 months older than the oldest child participating in the activity. Details: 1. At least two Trained Adult Leaders should be present at every activity. When providing transportation, if unable to have two trained adult leaders in each vehicle, cars should drive in tandem. With a minimum of two Trained Adult Leaders at all times, the following ratios of adults to children must be followed: 4

Age of Children

Adult to Child Ratio

0–2

1 + 1: 4

3–4

1 + 1: 10

5 – 18

1 + 1: 20

2. At no time should an adult and child be alone together. This includes transportation to and from an activity. 3. Trained Adult Leaders shall arrive at least 10 minutes before a scheduled activity and should keep watch over those in their care until one of the following has occurred: • For children 5th grade and lower: an authorized adult has picked them up from the activity. • For children 6th grade and over: the activity has ended and all children have left the location of the activity. 4. If the activity involves sleeping time, the following guidelines should be followed: • At least one male Trained Adult Leader and one female Trained Adult Leader will chaperone and supervise sleeping times. • If sleeping in the same room, girls and boys should be separated in some manner. 5. Parental permission in writing must be secured for participation in off-premises activities sponsored by the church. (Appendix F). 6. Trained Adult Leaders must keep attendance records for all activities involving children that include the names of all children and Trained Adult Leaders present as well as the date of the activity. 7. Communication via e-mail/text messaging between trained adult leaders and children should occur only among all group/event participants, with another trained adult leader cc’d or with the parent of the child cc’d, not on an individual basis. D. Incident Reporting: Any trained adult leader who has reason to believe that abuse has occurred or is occurring should take the following steps: immediately protect the child, notify the person in charge of the activity or a pastoral staff member, and complete an incident report. An adult or a child, in the case of child-on-child abuse, may be the accused.

Related Definitions: Accused: the person against whom a claim of abuse or neglect is made. Accuser: the person claiming knowledge of sexual misconduct, neglect or abuse by a person covered by the policy. The accuser may or may not be the victim of alleged sexual misconduct, neglect or abuse.

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Child-on-Child Abuse: Illinois state law describes this type of sexual abuse as occurring between two children under the age of 18 when one child is five or more years older than the other. Governing body: a representative body composed of elders and ministers of the Word and Sacrament; these are sessions, presbyteries, synods, and the General Assembly. A governing body may have both church members and non-members as employees. Inquiry: term used in the Rules of Discipline (Book of Order) to determine whether charges should be filed based upon allegations of an offense received by a governing body (see Book of Order, D-10.0101, D-10.0102 and D-10.0103). Investigating Committee: a team of people designated by the governing body having jurisdiction over the accused to determine whether charges should be filed. (See Book of Order D-10.0200). Investigation: a term generally used when responding to allegations of an offense, and persons that are to be investigated will be so advised. Reasonable suspicion or reasonable cause to suspect: a belief or opinion based on fact or circumstances that are sufficient for a prudent person to want to inquire further or to take protective action or to report a suspicion to authorities. Response: the action taken by the governing body or entity when a report of sexual misconduct or abuse is received. It may include inquiry into facts and circumstances, or possible disciplinary action up to and including termination. Response Team: consists of the pastoral staff, the Clerk of Session and a session member. If needed, the team may be expanded to include other appointed members. Victim: a child who has allegedly suffered an act of sexual misconduct, abuse or neglect. Details: 1. Immediate Safety: If there is an immediate danger to any person, the Trained Adult Leader shall take all necessary steps to insure the person’s safety. 2. Internal Reporting: A Trained Adult Leader having knowledge of an incident of suspected child abuse or neglect shall report the incident immediately to the person in charge of the activity or a pastoral staff member. If the initial report is made to the person in charge of the activity, the person receiving the report will immediately inform the pastoral staff. If a member of the pastoral staff is the accused or is unavailable to act, references to the pastoral staff shall be referred to the Clerk of Session. If the Clerk of Session is the accused or unavailable to act, references to the Clerk of Session shall be referred to the Moderator of the Personnel Committee. 3. Notification: After receiving the initial report of the incident, the pastoral staff shall inform the child’s parent or guardian of the incident as well as the Clerk of Session. 6

4. Incident Report Form: In addition to any state reporting form that may be required, within 48 hours after the incident, each Trained Adult Leader with knowledge of the incident shall complete a First Presbyterian Church of La Grange Incident Report Form and deliver the form to a member of the pastoral staff. See: Appendix C. 5. External Reporting: a. Report to Child Abuse Hotline: The Response Team will determine if there is reasonable cause to believe that a child participating in a First Presbyterian Church of La Grange activity is an abused or neglected child. If the Response Team has insufficient information to determine whether reasonable cause exists, the team shall make further inquiry sufficient to make the determination. If the Response Team determines that reasonable cause exists to suspect child abuse or neglect, a member of the Response Team will immediately call the Illinois Department of Children and Family Services (DCFS) Hotline or the applicable State or County Child Abuse Hotline. The oral report must be followed by a written report on the applicable state reporting form. If the State authorities determine that the incident should be investigated, they will normally contact the police. b. DCFS Mandated reporters: Under most state child protection statutes, mandated reporters are professionals who may work with children in the course of their professional duties, and are required by law to report suspected child abuse or neglect. Clergy are mandated reporters under the Illinois statutes. See: Appendix D for information on child abuse hotlines and mandated reporters. First Presbyterian Church of La Grange Trained Adult Leaders who are clergy and who have reasonable cause to suspect child abuse or neglect, are required by Illinois law to report directly to the DCFS Hotline. Such clergy, therefore, shall report any incident occurring in Illinois directly to the DCFS Hotline in addition to informing a pastoral staff member as outlined in #2 of this section. If the Response Team determines that reasonable cause to suspect child abuse or neglect does not exist, and fails to make a report, a clergy member who has knowledge of the incident and believes that reasonable cause does exist to suspect child abuse or neglect is required to make a report, notwithstanding the contrary determination by the Response Team. c. DCFS non-mandated reporters: First Presbyterian Church of La Grange Trained Adult Leaders who are neither clergy nor other professionals named in the applicable state statute, are not mandated reporters under the law. Trained Adult Leaders who are not mandated reporters may, nevertheless, report an incident to the State Child Abuse Hotline if they have reasonable cause to suspect that child abuse or neglect may have occurred. d. Book of Order mandated reporters: In addition to the state reporting statutes regarding mandated reporters, Clergy, Certified Christian Educators, Elders and Deacons are required by the Book of Order to report knowledge of harm, or the risk of harm, related to the physical abuse, neglect, and/or sexual molestation or abuse of a minor to ecclesiastical and civil legal authorities. (G-6.0204b; G-6.0304b; G-6.0402b; 7

G-14.0701d) The reporting protocol described in this section is designed to satisfy the Book of Order requirements.” e. The reporting person is not responsible for substantiating any allegations or suspicions. 6. Suspension/Administrative leave: After receiving the initial report, the Response Team shall immediately suspend the accused person from all activities involving contact with children. The suspension shall remain in effect until the Response Team determines that the accused no longer poses a potential threat to children. If the accused is a minister of Word and Sacrament against whom a written statement of alleged offense is filed pursuant to the following subsection #7, the Permanent Judicial Commission shall determine whether the accused shall be placed on paid administrative leave pursuant to the Rules of Discipline and the Presbytery of Chicago Policy on Administrative Leave. In addition, if the accused is a staff member, he or she may be temporarily suspended with pay pursuant to the Personnel Guidelines of the First Presbyterian Church of La Grange. 7. Church Disciplinary Proceedings: If the accused is subject to the jurisdiction of the Presbyterian Church (U.S.A.) and reasonable cause exists to believe that child abuse or neglect may have occurred, a member of the pastoral staff shall commence disciplinary proceedings against the accused under the Rules of Discipline by causing a written statement of alleged offense to be filed with the Clerk of Session. If the accused is subject to the jurisdiction of a governing body other than the Presbytery of Chicago, the Clerk of Session shall submit the written statement to the clerk of session or the stated clerk of the Presbytery having jurisdiction over the accused. In addition to the foregoing, any interested member may file a statement of alleged offense with the Clerk of Session in accordance with the Rules of Discipline. 8. Additional reports: If reasonable cause exists to believe that child abuse or neglect may have occurred, a member of the pastoral staff shall make additional reports as provided in this subsection #8. If the accused is a staff member of the Presbytery of Chicago, the incident shall be reported to the Presbytery’s Staff Personnel Work Group. If the accused is a minister of Word and Sacrament in the Presbyterian Church (U.S.A.) and subject to the jurisdiction of the Presbytery of Chicago, the incident shall be reported to the Committee on Ministry. If the accused is a staff person of another governing body or a volunteer with another governing body the incident shall be reported to the other governing body if not already reported in connection with the commencement of disciplinary proceedings. If the accused is a clergy member of another denomination, the incident shall be reported to the appropriate authorities of the denomination having jurisdiction over that person. A member of the Response Team shall also report the incident to First Presbyterian Church of La Grange’s insurance carrier. 9. Investigation: The person or persons making the initial report to a pastoral staff member shall not conduct an investigation of the incident, but shall take all necessary steps to insure the child’s immediate safety. After receiving the initial report of the incident, the Response Team shall make sufficient inquiry to determine whether there is reasonable cause to believe 8

that a child participating in a First Presbyterian Church of La Grange activity is an abused or neglected child. If reasonable cause exists, the applicable state child protection agency will normally notify law enforcement and investigate the incident after being notified by the Response Team. If church disciplinary procedures are commenced, the investigating committee will conduct its own investigation. The Church’s insurance company may also conduct a separate investigation. The Response Team shall determine to what extent the incident needs to be investigated separately by First Presbyterian Church of La Grange for its own purposes or to provide adequate information to another governing body that may have an interest. Any such separate investigation by First Presbyterian Church of La Grange shall be performed at the direction of and the under the supervision of the Response Team. 10. Pastoral care and professional counseling: A member of the pastoral staff shall report the incident to the moderator of the Response Team created under the Presbytery of Chicago’s True North program. See: Aligning Our Hearts To True North: The Presbytery of Chicago Sexual Misconduct Policy and Procedures. The Presbytery Response Team shall coordinate pastoral care and professional counseling as needed for the alleged victim, those reporting the incident, the accused, others affected by the allegations, and their respective families. 11. Legal counsel: A member of the response team will contact legal counsel for advice and guidance promptly after the organization receives notice of possible abuse in connection with FPCLG activities. Decisions concerning the ministry’s response to the allegations will be made in accordance with such advice. 12. Insurance company: A member of the response team will contact the church’s insurance company promptly after the organization receives notice of possible abuse in connection with FPCLG activities. E. Confidentiality: The identity and all identifying characteristics of all parties involved in an incident must remain confidential. This would include information regarding name, age, gender and the incident itself. Details: 1. In accordance with both civil law and Presbyterian polity, the accused is presumed innocent until proven guilty. 2. All persons with knowledge of the incident shall maintain strict confidentiality and shall share information with others only as requested or permitted by the Response Team. 3. The Response Team and the investigating committee, if any, shall be in exclusive possession of all reports and other written materials pertaining to the incident. No other person shall keep copies of reports or other records concerning the incident without authorization from the Response Team. 4. The Response Team shall share information with the Chicago Presbytery Response Team, and the Church’s Personnel Committee, and others on a strict, need-to-know basis. 9

5. All third party requests for information shall be referred to a member of the pastoral staff. 6. Violations of confidentiality shall be subject to discipline under the employment policies of the First Presbyterian Church of La Grange or as provided in the Rules of Discipline (Book of Order) of the Presbyterian Church U.S.A.

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APPENDIX A First Presbyterian Church of La Grange

VOLUNTEER APPLICATION

Please indicate your areas of interest: _______________________________ Faith Forest, ISAAC Band, TUXIS, Confirmation Mentor, Nursery or other childcare.

Please print all information and answer every question. Name:_______________________________________________________________________ Address:_____________________________________________________________________ Date of Birth: __________ Driver’s License #:_______________________________________ Daytime Phone:_____________ e-mail address: ____________________________________ Employer: _____________________________________Occupation: ____________________ List your children and their ages: ___________________________________________________ ____________________________________________________________________________ How long have you attended services or been involved with First Presbyterian Church of La Grange? ____________________________________________________________________________ ____________________________________________________________________________ Please list any previous work involving children and/or youth: ____________________________________________________________________________ ____________________________________________________________________________ ________________________________________ What qualities do you have that would help you in your volunteer work? ___________________ ____________________________________________________________________________ ____________________________________________________________________________ Have you ever participated in, been accused of, plead guilty/no contest to, or been convicted of abuse or any sexual misconduct? Yes ___ No ___ Have you read and do you agree to abide by the First Presbyterian Church of La Grange Safe Child Policy and Procedures? Yes ___

No___

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References Please list two personal references (people who are not related to you by blood or marriage, with at least one that has no affiliation to the First Presbyterian Church of La Grange) and provide a complete address and phone information for each. References and responses are confidential. 1. Name:____________________________________________________________________ Address: ________________________________________________________________ City, State & Zip: ___________________________________________________________ Daytime & Evening Phone: ___________________________________________________ Relationship to reference: ___________________________________________________ 2. Name: ________________________________________________________________ Address: ________________________________________________________________ City, State & Zip: ___________________________________________________________ Daytime & Evening: _________________________________________________________ Relationship to reference: ___________________________________________________ The information contained in this application is true and complete to the best of my knowledge. I authorize investigation of all information contained in the application. The church may also contact my references and I waive any right to inspect these references. I authorize obtaining information concerning my education, my character and fitness for working with children or youth. I authorize First Presbyterian Church of La Grange to perform a criminal background check now and as needed in the future. I release and hold harmless all parties from all liability for any damage that may result from the release of this information to First Presbyterian Church of La Grange.

Signature _____________________________________________ Date ______________

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APPENDIX B First Presbyterian Church of La Grange Reference Check For Staff or Volunteer Applicant name: ______________________________________________________________ Reference name: ______________________________________________________________ Address:

________________________________________________________________

Phone (h)_______________________(wk)_____________________________ What is your relationship to the applicant? How long have you known the applicant? How would you describe the applicant? How would you describe the applicant’s ability to relate to children or youth?

How would you describe the applicant’s leadership abilities?

How would you feel about having the applicant as a volunteer worker with your child and/or youth? Do you know of any characteristics that would negatively affect the applicant’s ability to work with children and/or youth? If so, please describe.

Do you have any knowledge that the applicant has ever been arrested for any reason? If so, please describe. Please list any other comments you would like to make: Reference inquiry completed by: (Print)___________________Signature ____________________ Date__________________ All responses will be kept confidential and seen only by those who have a legitimate need to know.

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APPENDIX C First Presbyterian Church of La Grange INCIDENT REPORT FORM (Please print all information) Date of incident: _____________________Time of incident: ___________________ Name of child involved: ________________________________________________________ Program:____________________________________________________________________ Location of incident: ____________________________________________________________________________ Describe incident in as much detail as possible, including response to the incident. Feel free to use the reverse side of the paper or additional sheets, if necessary. If another person is involved, please obtain as much contact information about the person as possible i.e. telephone number, address, etc.

Name of person(s) who has/have knowledge of the incident: Name: ________________________________Telephone Number:_______________ ___ Staff/Supervisor ___ Volunteer ___ Participant __ Other

Name: ________________________________ Telephone Number:_______________ ___ Staff/Supervisor ___ Volunteer ___ Participant___ Other

Print Name _________________________________ Phone _________ Signature: ___________________________________ Date:___________ ___Staff/Supervisor ___Volunteer ___Participant ___Other Return this form to a pastoral staff member OR Person In Charge of the Activity

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APPENDIX D First Presbyterian Church of La Grange Child Abuse Hotline Child Protection Statutes Most states have child protection statutes that provide for reporting incidents of child abuse or neglect. The Illinois statute is the Abused and Neglected Child Reporting Act, 325 ILCS 5/1 et seq. administered by the Illinois Department of Children and Family Services (“DCFS”). Mandated Reporters Mandated reporters are professionals who may work with children in the course of their professional duties. Mandated reporters are required by the applicable child protection statute to report to state authorities when they have reasonable cause to suspect that child abuse or neglect may have occurred. The Illinois statute names seven categories of mandated reporters, namely: medical personnel, school personnel, social service/mental health professionals, law enforcement personnel, coroner/medical examiner personnel, child care personnel and members of the clergy. The Illinois statute requires that mandated reporters sign a statement acknowledging their status as mandated reporters before they commence employment. The statement is made on one of two DCFS forms, entitled Acknowledgement of Mandated Reporter Status and Acknowledgement of Mandated Reporter Status (Clergy). The acknowledgement forms must be retained by the employer. First Presbyterian Church of La Grange staff and volunteers who are not clergy and who are not among the categories of professionals listed in the applicable child protection statute are not mandated reporters. Child Abuse Hotline A mandated reporter who has reasonable cause to suspect child abuse or neglect is required to immediately report or cause a report to be made to DCFS, DHS or the applicable child protection agency. In most cases, the reporting requirement will be satisfied if a member of the response team makes the report, but if the response team fails to report, the mandated reporter must nevertheless make the report if he or she has reasonable cause to believe that child abuse or neglect may have occurred. Note, however, that the Illinois statute requires that mandated reporters who are staff members of a medical or other public or private institution, school, facility or agency or a member of the clergy, must make the report personally, and may not rely on the institution, school, facility, agency or church to make the report. First Presbyterian Church of La Grange staff members and volunteers who are clergy, therefore, should make the report themselves and should inform the response team that they have made the report. (Pastors and ordained elders are all defined as mandated reporters in the Book of Order). The initial report is an oral report made by calling the Child Abuse Hotline. Following are hotline numbers: In Illinois, the Department of Children and Family Services: 1-800-252-2873. National Child Abuse Hotline: 1-800-422-4453 1-800-4-A CHILD The oral report to the Child Abuse Hotline must be followed by a written report on the applicable state reporting form. In Illinois, the written report must be made within 48 hours after the initial hotline report. In addition to mandated reporters, persons who are not mandated reporters are also permitted to make reports of suspected child abuse or neglect. Whether or not the person making the report is a mandated reporter, his or her identity is protected by statute, and a person who makes a report in good faith is immune from civil or criminal liability. Criteria needed for a child abuse or neglect investigation:

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• •

• •

The alleged victim is a child under 18 years or person of diminished capacity. The alleged perpetrator is a parent, guardian, foster parent, relative caregiver or any person responsible for the child’s welfare at the time of the alleged abuse or neglect. (This applies only to filing a report with DCFS. Any person who abuses a child must be reported under the other provisions of this policy) There is a specific incident of abuse or neglect or a specific set of circumstances involving suspected abuse or neglect. There is demonstrated harm to the child or a substantial risk of physical or sexual injury to the child.

Information the reporter should have ready to give to the Hotline: • Names, birth dates (or approximate ages), genders, races, etc. for all adult and child subjects. • Addresses for all victims and perpetrators, including current location. • Information about the siblings or other family members, if available. • Specific information about the abusive incident or the circumstances contributing to risk of harm. • When the incident occurred and the extent of the injuries. • How the child says it happened, and any other pertinent information. • Reporters should be prepared to provide phone numbers where they may be reached throughout the day in case the Hotline must call back for more information. Additional information: For additional information on reporting statutes and procedures, check the applicable state child protection website. In Illinois, the website is at http://www.state.il.us/dcfs.

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APPENDIX E First Presbyterian Church of La Grange Parental Consent Form – One Care Provider Present

Child(ren) Name(s): _____________________________________________________ Parent or Guardian Name:________________________________________________ Parent or Guardian Signature: ____________________________________________ Date: _________________________________________________________________ By signing this document, I acknowledge that I have been informed of the exceptional circumstance which involves one care provider being present instead of two. My signature also indicates that I have chosen to leave my child(ren) in the care of one provider.

Care Provider Name: ____________________________________________________ Care Provider Signature: ________________________________________________

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APPENDIX F First Presbyterian Church of La Grange Parental Consent Form

Event: Location: Date: Time:

Participant’s Name: ____________________________________________________________

Parent/Guardian’s Name: ________________________________________________________

Parent/Guardian’s Phone Number (home) ____________________ (cell) __________________

Emergency Contact Name: _______________________________________________________

Emergency Contact Phone Number (home) ___________________(cell) ___________________ PARENT PERMISSION The participant named on this form has my permission to engage in the event described above. In consideration of the benefits derived from participation, I hereby voluntarily waive any claim against First Presbyterian Church, La Grange, Illinois 60525, or its staff or advisors for any and all causes that may arise in connection with this activity. In case of serious accident or illness emergency, we hereby give permission to the adult advisors to secure proper treatment for our child as named above.

DATE: _________________

SIGNED: _________________________________ (one parent or guardian)

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APPENDIX G First Presbyterian Church of La Grange Signature Page – Policy and Procedures

I, _____________________________, acknowledge that I have read and agree to abide by the foregoing Safe Child Policy and Procedures. Signature: ______________________________________________ Date: ________________________

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APPENDIX H First Presbyterian Church of La Grange Signature Page – Training I, _________________________________, acknowledge that I have participated in the Child Protection training conducted on _____________________________ (date). Signature: ________________________________________________________

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APPENDIX I First Presbyterian Church of La Grange Renewal Application – Staff and Volunteers Name:_______________________________________________________________________ Address: ____________________________________________________________________ Age Range:  under 18

 18 – 25

 over 25

In which children/youth program(s), if any, are you currently involved?________________

In what other children/youth program(s), if any, do you plan to become involved? ______

Have you at any time ever: • Been arrested for any reason? • Been convicted of, or pleaded not contest to, any crime? • Engaged in, or been accused of, any child molestation, exploitation, or abuse? Are you aware of: • Having any traits or tendencies that could pose any threat to children, youth or others? • Any reason why you should not work with children, youth, or others?

 Yes  Yes

 No  No

 Yes

 No

 Yes

 No

 Yes

 No

If the answer to any of these questions is “yes,” please explain in detail: ______________ ____________________________________________________________________________ Applicant Verification and Release I recognize that the organization to which this application is being submitted is relying on the information contained herein. Accordingly, I attest and affirm that all of the information that I have provided is absolutely true and correct. I agree to abide by all policies and procedures of the organization, and to protect the health and safety of the children/youth at all times. Printed name: ________________________________________________________________ Signature: _______________________________________________ Date: ______________

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