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2012 Self-Certification-Plus Compliance Form

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  • 8/3/2019 2012 Self-Certification-Plus Compliance Form

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    Organization: ___________________________________________

    InterActionSelf-Certification-Plus

    Member Compliance Reporting F

    ACCOUNTABILTY - TRANSPARENCY - EFFECTIVENESS

    InterAction Office of Membership & Standards

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

    202-667-8227 www.interaction.org

    SCP 2012

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

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    P a g e | 2 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________

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    INTRODUCTION AND DIRECTIONS

    This 2012 Self Certification Plus Compliance Formmust be submitted to InterAction by each member organization no later thanDecember 31, 2012. 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 theNGO sector with donors, the public, and beneficiaries and also serves as a track record of members internal efforts to improve organizational accountability.

    We have made some improvements to this years Self-Certification-Plus document based on our members feedback. We have modified the compliancequestions and the tick boxes in the column Compliance to correspond more accurately with each individual standards component.

    Before you start completing your compliance document, please fill in your organizations name in the header section of the cover page. The name will thenprint out on each page. The actual document is in Microsoft Word word-wrapping format with boxes designed to expand as you fill them in. To check acompliance box, double click on it and a window will open to allow you to change it to a checked box. The completed form, including the signature page

    provided at the end of this compliance form constitutes a completed certification document. We also ask you to complete the questionnaire to help us evaluatethe process.

    The document explains each standard (I.A. through III.B) in the first column, Component, and proposes documentation to be gathered and reviewed forevidence of compliance in column two, Proposed Evidence. For each standard section and its related components, you must indicate in the third columnmarked Compliance whether or not your organization is in compliance with the required standard. If not in compliance you must explain an action plan toaddress areas of non-conformance in column four marked Action Plan if not in compliance. According to InterActions policy a member is given two yearsto either come into compliance with non-conformance to a standard or to demonstrate concerted movement toward coming into compliance in order to avoidpossible suspension from membership.

    You must also annotate the documentation you used as evidence of compliance in column five, Documentation Gathered. We cannot confirm yourcompliance complete unless you indicate what documents you reviewed. Please note that we do not want you to send us the documentation you used asevidence of your compliance, but only to cite the documents in that column.We encourage you to give your feedback on the exercise and suggestions for improving the process. If you have any questions or need additional clarificationon how to complete your report, please contact [email protected] [email protected] .

    P a g e | 1 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    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: ___________________________________________

    2012 Self Certification-Plus Compliance Form

    SECTION I: GOVERNANCE AND ADMINISTRATION STANDARDS

    A member Organization shall be governed responsibly by an independent, active, and informed Board of Directors, and, if applicable, its duly constituted ExecutiveCommittee. (Source: 2.1, 2.2)

    Component I.A: Board Responsibility

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    I.A.1 The Organizationsboard shall act as theorganizations governing body,accepting responsibility foroversight of all aspects of theorganization.(Source: 2.1, 2.4)

    Copies of pertinent sections ofdocuments such as bylaws,charter, policies and proceduresthat vest the ultimate authorityin the board to act as theorganization's governing bodywith responsibility for

    governing all aspects of theorganization.

    Yes, have the required policyand procedures in place.Policy missing, compliant in

    practiceNot in compliance

    I.A.2 The Organizationsboard policies shall specify thefrequency of board meetings(at least two meetings peryear), adequate attendance bydirectors (at least a majority ofdirectors on average), andvoting requirements. Recordsof the meetings shall be

    maintained. (Source: 2.2)

    Copies of pertinent sections ofthe policy or bylaws thatspecify the frequency of boardmeetings, and define therequired attendance. Alsogather and document evidencethat the board meetings wereheld as planned and that formalrecords of such meetings were

    permanently maintained.

    Yes, have the requiredpolicies, procedures andprocesses in place.Not in compliance

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

    Document internal policies andprocedures that are in place tobe used to demonstratecompliance with all applicablelaws. If legal action has beeninitiated against theorganization within the lastthree years, document internal

    policies and proceduresfollowed, and any actionstaken, to respond to and resolve

    Yes, have the required policyand procedures in place.Not in compliance

    P a g e | 2 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________

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    legal action.I.A.4 The Organizations

    board shall exercise fiscaloversight of the organization

    by:

    a) Approving theannual budget;

    b) Appointing anindependentCertified PublicAccountant asauditor;

    c) Receiving andreviewing the

    annual, auditedfinancialstatements, whichcomply withGenerallyAcceptedAccountingStandards andRequirementsaccording to theAICPA and theFASB;

    d) Requesting andreviewing amanagement letter,if applicable; and

    e) Reviewing thefinancialstatements andactivities of theorganization.

    f) Appropriaterecords shall be

    The names of the boardmembers who are currentlyserving on the board's financial

    oversight committee, includingthe name of the organizationstreasurer, if applicable.Gather additional evidence, asappropriate, to verify theelements of the component.

    Yes, have the requireddocumentation, evidence and

    procedures in place.

    Not in compliance

    Note: Organizations with lessthan $100,000 annual incomesare not required to use anindependent auditor. (Source: 4.2) The board can executethese functions through the useof various committees,including a financial oversightcommittee.

    Note: Only tick one box! Ifnon compliant with any of thesections, Not in compliance

    box must be ticked and actionplan given in the Action Plancolumn.

    P a g e | 3 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    maintained.(Source: 2.5, 4.2)

    I.A.5 The Organization shallannually report to the publicby

    means of an annual report, or inseparate report formats:

    a) Audited financialstatements,

    b) IRS form 990 ifapplicable,

    c) List of currentboard members,

    d) Otherinformation that

    may be helpful tothe public inunderstandingtheorganizations

    purposes, goals,activities andresults.(Source: 4.5)

    Copies of all requireddocuments.

    Yes, have the requireddocumentation available to the

    public.Not in compliance

    Component I.B: Board Policies

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    I.B.1 Documented boardpolicies shall:

    a) Restrict thenumber ofemployees whoare votingmembers of the

    board,

    Copies of the appropriatesections of the organization's

    policies and procedures thataddress the terms of service,restrictions on board membersrelationships and services byemployees, and boardmembers compensation and/orreimbursement for expenses.

    Yes, have the required

    policies,documentation,procedures and/or processes inplace.Not in compliance

    Note: This restriction appliesonly to payment for services as

    a director and does not apply toP a g e | 4 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________

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    b) Provide limitsfor directors

    being related toone another, the

    founder, or theexecutivedirector or

    president/chiefexecutive officer,

    c) Establish limitedterms of servicefor directors andofficers.(Source: 2.2)

    salaried employees who arealso directors.Reimbursementfor out-of-pocket expenses isnot considered compensation.

    Note: Only tick one box! Ifnon compliant with any of thesections, Not in compliance

    box must be ticked and actionplan given in the Action Plancolumn.

    I.B.2 Organizations boardpolicy shall prohibit direct andindirect conflicts of interest,requiring that members of the

    board and employees:

    a) Disclose anyaffiliation theyhave with anactual or

    potential supplierof goods andservices,recipient of grantfunds, ororganization withcompeting orconflictingobjectives;

    b) Absentthemselves fromdiscussion and

    Those sections of theorganization's policies and

    procedures that addresspotential conflict of interestsituations affecting boardmembers or employees, andcompile any additionalevidence that the organizationis complying with these

    policies and procedures.

    Yes, have the required policiesand/or procedures in place.Not in compliance

    Note: This standard does notrequire that the conflict ofinterest policy provides anexhaustive list of conflictsituations, but that such a

    policy provides a framework

    for determining when asituation would constitute aconflict. The managementmust report staff conflicts ofinterest to the board, reportmajor credibility risks to the

    board, and train new boardmembers, employees andvolunteers on conflict ofinterest requirements.

    Note: Only tick one box! If

    P a g e | 5 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    abstain fromvoting orotherwise

    participating in a

    decision on anyissue in whichthere is a conflictof interest; and

    c) Refuse large orotherwiseinappropriategifts for personaluse.

    (Source: 2.3)Appropriate records shall be

    maintained.

    non compliant with any of thesections, Not in compliance

    box must be ticked and actionplan given in the Action Plan

    column.

    Component I.C: Fiscal Management and Accountability

    The 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 COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    I.C.1 The Organization shalloperate according to a budgetapproved by its board.(Source: 4.7)

    Copy of the organization'sbudget for the current year.Minutes of board approving the

    budget.

    Yes, have the requireddocumentation.Not in compliance

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

    Note: The organization shouldset an internal target forfundraising and administrativeexpense that is appropriate tothe nature of its structure and

    The ratio or proportion of theorganization's total combinedfund-raising and administrativecosts to the total expendituresfor each of the past three years.

    Yes, meet the required ratioand have the expenditures forthe past three years.Not in compliance

    P a g e | 6 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________

    2012 Self Certification-Plus Compliance Form

    programs. These expensesshould generally not exceed35% of expenditures.(Source: 4.6)

    I.C.3 The Organization shallexercise adequate internalcontrols over disbursements toavoid unauthorized payments,

    prohibiting any unauditabletransactions or loans to boardmembers and to staff. Thismay include descriptions of

    procurement policies andprocedures. (Source: 4.7)

    Pertinent materials prepared bythe organization (includingmanagement letters andconflicts of interest policies inassessing compliance withI.A.4 and I.B.2)

    Yes, have the requiredmaterials, policies and

    processes in place.Not in compliance

    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

    by law from this component.(Source: 4.3)

    Form 990 filed with the United

    States government during thepast three years. If no 990 isfiled, annual audited financialstatements shall be madeavailable.

    Yes, have the required

    documentation.Not in compliance

    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 thoseaffected, and that its programsassist those who are at riskwithout political, religious,gender or other discrimination.(Source: 7.1.6)

    Copies of the organization'sinstructions, directives, policiesand/or procedures which direct

    personnel to adhere to non-discrimination practices in itseligibility decisions, and list theorganization's most recent

    personnel orientations,trainings and instructionalmaterial addressing non-

    Yes, have the requiredpolicies, procedures andmaterial in place.Not in compliance

    P a g e | 7 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    discrimination.I.D.2 The agency shall have awritten policy that affirms itscommitment to gender equity,

    to ethnic and racial diversity, tothe inclusion of people withdisabilities in organizationalstructures and in staff and

    board composition. The policyshould be fully integrated intoan organizations plans andoperations, with a mechanismmandated by the CEO foroverseeing implementation.(Source: 2.6.1/2/3 and 7.2.1,

    7.3.1, 7.4.1)

    Copy of the written policy andrelevant sections of operational

    plans.

    Yes, have the required writtenpolicy and procedures anddocuments.

    Not in compliance

    Component I.E: Organizational Integrity

    The affairs of the Organization are conducted with integrity and truthfulness. (Source: 3.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    I.E.1 Each director andemployee shall follow theorganizations written standardof conduct that provides that:

    a) The organizationopposes and doesnot act as awilling party towrongdoing,corruption,terrorism,

    bribery, otherfinancialimpropriety, orillegal acts in any

    A copy of theorganization's writtenstandard of conduct

    A copy of the pertinent

    section of theorganization's policiesand procedures whichaddress correctiveactions to be taken inresponse to foundedwrongdoing by Boardmembers, employees,contractors andvolunteers.

    Yes, have the requiredpolicies, documentation,procedures and/or processes inplace.

    Not in compliance

    Note: This standard requiresthat the organization hasdocumented policies or

    procedures to guide itsinvestigation of, and correctiveaction to, different types ofwrongdoing. Thesedocumented policies or

    procedures need not beexhaustive, but they should

    P a g e | 8 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    of its activities;b) The organization

    takes prompt andfirm corrective

    action wheneverand whereverwrongdoing ofany kind is foundamong its boardand employees;and

    c) The standard ofconduct ismaintaineddespite possible

    prevailingcontrary

    practiceselsewhere.(Source: 3.2,3.4)

    provide a framework forinvestigative and correctiveaction. Records of theinvestigations and corrective

    actions shall be maintained.

    Note: Only tick one box! Ifnon compliant with any of thesections, Not in compliance

    box must be ticked and actionplan given in the Action Plancolumn.

    I.E.2 The organization willhave policies to addresscomplaints and prohibitretaliation againstwhistleblowers.(Source: 3.3)

    Copy of the policy that protectsemployees who presentevidence of misconduct byindividuals associated with theorganization. Verify that

    policies and procedures havebeen followed.

    Yes, have the required policyand procedures in place.Not in compliance

    I.E.3 The organization willhave policies for documentretention and destruction thatensure protection of documentsduring an official investigation.(Source: 3.7)

    Gather and review a copy ofpolicy.

    Yes, have the required policy.Not in compliance

    P a g e | 9 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Component I.F: Management and Human Resources

    Theorganization shallfollow management practices that are appropriate to its mission, operations, and governance structure. (Source: 6.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

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

    procedures relating to allUnited States employees,clearly outlining their rightsand benefits.(Source: 6.3, 6.3.1)

    Personnel policies andprocedures or other documentsrelated to organizationaloperations.

    Yes, have the requiredpolicies, documentation,procedures and/or processes inplace.Not in compliance

    I.F.2 The Organizations

    policies shall prohibitexcluding from participation,denying benefits, or otherwisesubjecting to discriminationany person on the basis of race,color, national origin, age,religion, disability or gender inany aspect of service deliveryand human resource practices.(Source: 2.6)

    Note: If an organizationclaims exemption under section702 of the Civil Rights Act of1984, the organization mayconsider religion in itsemployment practices.

    Policy that affirms the

    organization's commitment toequal access to theorganization's services and

    prohibits discrimination by theorganization on the basis ofrace, color, national origin,age, religion, handicap orgender.

    Track job applications to makesure all applicants have been

    treated equally according topolicies and procedures.Interview HR staff, ifnecessary.

    Yes, have the required policy

    and procedures in place.Not in compliance

    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 affirmthe organizations commitmentto equal pay for equal work.

    Yes, have the requiredpolicies.Not in compliance

    P a g e | 10 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    SECTION II: PROGRAM STANDARDS (Advocacy campaigns are considered as programs)

    Component II.A: Program Development

    Organizations field programs should empower institutions and facilitate popular participation and sustainable development. (Source: 7.1.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

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

    participation by empoweringindividuals and communitiesand strengthening capacities oflocal structures. (Source:

    7.1.1, 7.1.8) To this end, theorganization considers suchthings as appropriate includingthe programs potential forindividual and communityempowerment;

    a) The potentialof plannedactivities tostrengthen the

    capacity oflocalstructures;

    b) The capacityoflocal/regionalinstitutions toabsorbfinancial andother inputsconstructively;

    c) The potential

    Draft a concise butcomprehensive description ofthe organizations trainingmanuals and services or gatherand review a copy of materialcontaining this information.The following topics/materials

    should be covered andverified that training wasdocumented and delivered.Applicable organizational

    policies and standards include:

    Training manuals orguidelines for programdesign,implementation,monitoring and

    evaluation Gender analysis tools

    for programming

    Yes, have the requiredpolicies, documentation,procedures and/or processes inplace.Not in compliance

    Note: To achieve this

    standard, the organizationsprogram planning andimplementation must reflectefforts to foster mutually

    beneficial relationships amongpeoples from varied culturaland economic backgrounds.Program and senior staffshould be trained in genderanalysis for program planning,implementation and evaluation.

    Note: Only tick one box! Ifnon compliant with any of thesections, Not in compliance

    box must be ticked and actionplan given in the Action Plancolumn. Includes advocacycampaigns/events/programsheld in the U.S.

    P a g e | 11 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    to strengthenthe capacitiesof vulnerablegroups,

    typicallywomen,children,minorities, thedisabled, andthe very poor;

    d) The potentialof localresources tosustain the

    program;

    e) Whereresourcesexceedcapacity, the

    potential tocreate newstructures suchas locallycontrolledfoundations orfunds;

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

    g)The environment impact;h)The involvement ofappropriate stakeholdersfrom affected groups; andi) The programs potentialto advance the status ofwomen and theirempowerment.

    P a g e | 12 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    (Source: 6.4.1.6; .1.7&7/1/8)II.A.2 - Where appropriate,awareness of diversity issuesshall be incorporated into each

    stage of the program process,from the review of project

    proposals to implementationand evaluation, to ensure that

    projects foster participation andbenefits for all affected groups.The agency will collaboratewith partner NGOorganizations in the field tointegrate diversity issues intotheir programs.

    (Source: 7.3.2)

    Program planning, proposaland program evaluationguidelines for review of

    diversity criteria.

    Yes, have the requireddocumentation, proceduresand/or processes in place.

    Not in compliance

    II.A.3 - Agency programs andactivities should be held inaccessible locations to theextent feasible. Organizationswill provide training andconference materials inalternative formats asapplicable (Braille, sign-language interpreters, etc) andshould plan financially toreasonably accommodate

    people with disabilities in theirprograms and activities.(Source: 7.4.3)

    Review training site locationsand formatting of trainingmaterials developed over the

    past year to assess and verifythat accessibilityconsiderations were followed.

    Yes, have the requiredmaterials, procedures and/or

    processes in place.Not in compliance

    II.A.4 For thoseorganizations operating in thefield, the organization shallgive priority to working with orthrough local and nationalinstitutions and groups,encouraging their creationwhere they do not already

    Develop a list of the entitieswith primary responsibility ineach country where theorganization operates. Gatherorganizational policy,guidelines and/or trainingmaterial about working in

    partnership with local

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

    processes in place.Not in complianceNot applicable (if no fieldoperations)

    P a g e | 13 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    exist, strengthening themwhere they do and developingclearly and publicly statedcriteria for establishing

    partnerships with such groupsand for fostering communityempowerment through

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

    community groups and/orinstructors.

    Component II.B: Fostering Human Rights

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    II.B.1 - In its programactivities, the organizationrespects and fosters humanrights, both socio-economicand civil-political.(Source: 7.1.4)

    The organization's instructions,directives, policies and/or

    procedures that address theprivacy and dignity of programbeneficiaries.

    Yes, have the requiredpolicies, procedures and/orprocesses in place.Not in compliance

    Component II.C: Program Quality Monitoring and Evaluation

    The 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 organizationsprocedures for programmonitoring and evaluation shalladdress the effective use ofinputs, including human andfinancial resources.(Source: 7.1.9)

    Materials summarizing theorganization's procedures formonitoring and evaluating theeffective use of inputs.

    Yes, have the requiredprocedures and/or processes inplace.Not in compliance

    II.C.2 The organization shallincorporate relevantmonitoring and evaluation

    Evaluation of completedprograms; meta-evaluation (orsynthesis) of evaluative

    Yes, have the requiredpractices, procedures and/orprocesses in place.

    P a g e | 14 Copyright 2012 InterAction Questions: [email protected]@interaction.org

    mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]
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    Organization: ___________________________________________

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    (M&E) practices in its policy,systems and culture;

    Conduct regular and deliberate

    evaluative activities to examineprogress towards its goals andmission; and apply adequatefinancial and human resourcesfor monitoring and evaluation.

    activities.

    Budget allocation or financialstatements showing allocation

    of resources for project andprogram monitoring andevaluation activities; humanresources (staff/consultant)with primary responsibility forM&E.

    Not in compliance

    II.C.3 For thoseorganizations with fieldoperations, the organizationshall have the capacity to

    provide financial and

    performance oversight at thelocal level, whether through afield office structure or through

    partnerships with local entities.

    Note: This componentaddresses internalorganizational mechanisms thatassure appropriate, ongoingoversight of local/regional

    program performance. Thiscomponent does not addressthe external audits performedannually by an independentcertified auditor.(Source: 7.9.14)

    Gather and review selectionsfrom the following:

    Design monitoring andevaluation standards and

    evaluation policy for programsand projects; documents whichshow adherence to professional

    principles and standards,including encouraging the

    participation of communitiesand partners; an agency-wideM&E system.Material summarizing theorganization's procedures for

    providing oversight of programfinances and performance atthe local level. If any of thisoversight responsibility isoutsourced, gather and review acopy or summary of theresponsibilities to be carriedout by the contractor in thisarea.

    Yes, have the required policy,documentation, proceduresand/or processes in place.Not in complianceNot applicable (if no field

    operations)

    Component II.D: Accountability

    The resources generated are used and accounted for in a manner consistent with the programs and purposes described in appeals.

    P a g e | 15 Copyright 2012 InterAction Questions: [email protected]@interaction.org

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    Organization: ___________________________________________

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    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    II.D.1 The organization shall

    exercise management andfinancial controls to provideassurance that the donorcontributions are used as

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

    Policies on accounting

    practices and reporting on thegeneration and use of restrictedand unrestricted funds, anddocument all communicationsto the public and donors on theuse of restricted andunrestricted funds.

    Yes, have the required

    policies, documentation,procedures and/or processes inplace.Not in compliance

    Component II.E: Organizational Security Policy and Plans

    InterAction members shall have policies addressing the key security issues (Source: 7.6.1)

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    II.E.1OrganizationalSecurity Policies and Plans:

    InterAction members shallhave policies addressing thekey security issues and formal

    plans at both the field level andheadquarters levels to addressthese issues.(Source: 7.6.1)

    Materials recording theorganization's requirements for

    preparing security plans at boththe field and headquarterslevels.

    Yes, have the requiredpolicies, procedures and/orprocesses in place.Not in compliance

    II.E.2Resources to addresssecurity: InterAction membersshall make availableappropriate resources to meetthese minimum operatingsecurity standards.(Source: 7.6.2)

    Materials recording theorganization's security-related resource allocationsand/or budget guidelinesregarding security relatedexpenditures.

    Yes, have the requiredmaterials, procedures and/or

    processes in place.Not in compliance

    II.E.3Human ResourceManagement: InterActionmembers shall implementhiring policies and personnel

    Materials recording theorganization's proceduresto

    prepare staff to cope with thesecurity issues at their posts of

    Yes, have the requiredpolicies, documentation,procedures and/or processes inplace.

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    Organization: ___________________________________________

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    procedures to prepare staff tocope with the security issues attheir posts of assignment,support them during their

    service, and address postassignment issues.(Source: 7.6.3)

    assignment; preparation andsupport of staff prior to, duringand after assignments relatingto security risks.

    Not in compliance

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

    Materials recording theorganization's instructions for

    personnel evaluations related tosecurity.

    Yes, have the requiredmaterials, procedures and/or

    processes in place.Not in compliance

    II.E.5Sense of Community:

    InterAction members shallwork in a collaborative mannerwith other members of thehumanitarian and developmentcommunity to advance theircommon security interests.(Source: 7.6.5)

    Materials recording the

    organization policy regardingsharing of security informationand other participation inefforts to enhance mutualsecurity with other NGOs.

    Yes, have the required policy,

    documentation, proceduresand/or processes in place.Not in compliance

    Component II.F: Fundraising and Commitment to Accurate Disclosure

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    II.F.1 The organization shallbe truthful in marketing andadvertising.

    Note:The organizationscommunications must neitherminimize nor overstate thehuman and material needs ofthose whom it assists.(Source: 5.3)The organizations

    Summarize the methods usedto assure the accuracy ofconditions portrayed in theorganization's communications.If no such guidelines exist,summarize the methods used toassure the accuracy ofconditions portrayed in theorganization's communications.Gather and review sample-marketing guidelines that

    Yes, have the requiredguidelines, methods, and/or

    processes in place.Not in compliance

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    Organization: ___________________________________________

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    communications must notcontain any material omissionsor exaggerations of facts,misleading photographs, nor

    any other communication thatwould create a false impressionor misunderstanding.(Source: 5.2)The materials mustgiveaccurate balance to the actual

    programs for which solicitedfunds will be used.(Source: 5.2)

    address the organization'saccurate portrayal of conditionsin its communications. Surveydonors to verify that the

    organizations intendedmessage is accurately gettingthrough.

    SECTION III: ORGANIZATIONAL COMMITMENT STANDARDS

    Several PVO Standards do not easily lend themselves to clear and objective measurement. More important than defining an absolute measurement is a member's ability toprovide 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 COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    III.A.1 The organizationshall be willing to share

    program knowledge and

    experience with programparticipants, other agencies,donors and otherconstituencies.(Source: 7.1.10)

    Review and summarize theorganization's efforts to share

    program knowledge and

    experience with programparticipants, other agencies,donors and other constituents.

    Yes, have the requiredprocedures and/or processes inplace.

    Not in compliance

    III.A.2 The organizationshall have, or plan to adoptwithin its next strategic plan,written policies that affirm itscommitment to genderequality, racial and ethnic

    All policies that affirm theorganization's commitment togender equity, racial andethnic diversity, and inclusionof people with disabilities inorganizational structures and

    Yes, have the requiredpolicies or plans, proceduresand processes for developingthe policies.Not in compliance

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    Organization: ___________________________________________

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    diversity and inclusion ofpeople with disabilities in staffand board composition, in part

    by adopting policies and

    procedures to increase:

    a) The numbers ofwomen in seniordecision-making

    positions, wherethere is under-representation,at headquartersand in the field;

    b) Ethnic and racial

    diversity, wherethere is under-representation,and;

    c) The inclusion ofpeople withdisabilities,where there isunder-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 textabout U.S. procedures inI.F.3 above]

    in staff and board composition.If the organization has not yetadopted such policies, preparewritten plans to adopt policies,

    meeting minutes discussingthe development and adoptionof such policies, or otherrelevant documentation.Assemble copies of personnel

    policies that are designed toaddress any discrepancies in:

    The female/male ratioof the senior staff atheadquarters and in

    the field; The female/male ratioof the remainingheadquarters staff;

    The percentage ofemployees withdisabilities (known tothe organization by theemployee's voluntarydisclosure or someother legal means).

    Note: Only tick one box! Ifnon compliant with any of thesections, Not in compliance

    box must be ticked and action

    plan given in the Action Plancolumn.

    III.A.3 The organizationshall institute family friendly

    policies and create anenvironment that enables bothwomen and men to balancework and family life.

    The organizations personnelpolicies shall identify theinclusion of family friendlyelements, such as parentalleave, flexible work hours,telecommuting, etc. Examine

    Yes, have the requiredpolicies in place.Not in compliance

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    (Source 6.4.1.4) personnel records (approvedleaves, individual workschedules, etc.) to examine theextent to which these policies

    are being utilized and theutilization patterns of bothfemale and male staff.

    III.A.4 Theorganizationshall endeavor to recruit andretain staff that combines

    professional competence with

    Note: To assist in therecruitment and retention ofstaff with the skills, experience

    and attitudes that increase theprobability that servicedelivery will meet theindustry's standards forefficiency and effectiveness,the organization shouldregularly carry out thefollowing activities:

    a) Define andupdate objectiveentryqualificationsfor each jobcategory,

    b) Devise and carryout effectiveadvertisingcampaigns for

    job openings,c) Provide

    adequate andequitable staff

    Samples ofadvertisements ofrecent job openingsfrom newspapers andother media

    Compile jobdescriptions

    Compile samples of

    recent internalannouncements of jobopenings

    Describe opportunitiesmade available to staffto upgrade skills

    Compile a list of theorganizationsrecruitment outreach(e.g., evidence ofspecific efforts beingmade to reach and

    attract a more diversepool of candidates)

    Yes, have the requiredmaterials, procedures and/or

    processes in place.Not in compliance

    Note: Only tick one box! Ifnon compliant with any of thesections, Not in compliance

    box must be ticked and actionplan given in the Action Plancolumn.

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    Organization: ___________________________________________

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    orientation andtraining,

    d) Inform staff ofcurrent

    openings, ande) Carry out

    equitableremunerationand promotions

    III.A.5 The organizationshiring and personnelevaluation policies and

    practices shall demonstratecommitment to gender anddiversity issues and a

    commitment to gender equityand diversity.(Source 6.4.1.3, 6.4.2.3)

    Samples of job descriptionsand candidate interviewquestions for criteria/questionsthat address commitment toand experience with

    promoting gender equity,

    diversity, and inclusion ofpeople with disabilities.Review the organizations

    performance assessment formfor criteria/questions onelements related to advancinggender equity, diversity, andinclusion of people withdisabilities.

    Yes, have the requiredpolicies and practices in place.Not in compliance

    III.A.6 Theorganizationsperformance expectations ofcontractors shall be clearly

    defined and communicated.(Source 6.3.3)

    Note: Compliance with thiscomponent can bedemonstrated throughagreements between theorganization and contractors,including NGOs and otherorganizations.

    Standard contracts usedbetween the organization andits contractors. If there are any

    concerns, survey contractorsfor opinions/experience.

    Yes, have the requireddocumentation in place.Not in compliance

    Not applicable (if nocontractors)

    III.A.7 The organization's Copies and review of the Yes, have the required

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    Organization: ___________________________________________

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    human resource developmentprogram for U.S. staff at alllevels shall promote non-discriminatory working

    relationships and respect fordiversity in work andmanagement styles byintegrating gender, diversityand disability sensitization intoits orientation and training

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

    current curricula used fororientation and/or trainingaddressing employment andservice-related diversity issues

    including gender, racial, ethnicand physical disability.

    documentation and/orprocesses in place.Not in compliance

    III.A.8 The organizationshall make financial

    arrangements to protect itsability to honor its obligationsto employees.(Source: 6.3.2)

    Review payroll and benefitplan records to determine that

    the organization:

    Has accurate records Pays salaries and

    benefits when due Properly funds

    employee retirementplans

    Pays payroll taxes on atimely basis

    Has corrected anyshortcomings in these

    areas, if any, andpointed out in an auditor management letter.

    Yes, have the requiredrecords, procedures and/or

    processes in place.Not in complianceNot applicable (if no paidemployees)

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

    Copies of any policies thataddress the ethical practicesexpected of staff engaged infundraising and publicrelations.

    Yes, have the requiredpoliciesNot in compliance

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    Organization: ___________________________________________

    2012 Self Certification-Plus Compliance Form

    III.A.10 If the organizationengages in fundraising eventsor cause-related marketing, theamount of funds going to the

    charity 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 requireddocumentation, proceduresand/or processes in place.Not in compliance

    Not applicable (if not engagedin fundraising or cause-relatedmarketing)

    III.A.11 Organizations thatcontract for fundraisingactivities shall have writtencontracts or agreementsoutlining the terms and retaincontrol of all fund-raisingactivities conducted on their

    behalf. (Source: 5.6)

    Current or anticipatedcontracts for fund-raisingactivities with the dates theyare in force.

    Yes, have the requiredcontracts and agreements.Not in complianceNot applicable (if nocontracted fundraisingactivities)

    Component III.B: Advocacy and Public Policy

    COMPONENT PROPOSED EVIDENCE COMPLIANCEACTION PLAN

    IF NOT IN COMPLIANCE

    DOCUMENTATION

    GATHERED

    III.B.1 If engaged inlobbying, the organization shallhave clear policies governingits decisions and activitiesconcerning its advocacy, public

    policy and/or lobbyingactivities, which:

    Describe the criteria orcircumstances in whichit will involve itself;and

    Define the process foradopting andimplementing such

    positions.(Source: 8.1, 8.2)

    Policies that describe thecriteria or circumstances inwhich the organization willinvolve itself in advocacy or

    public policy activities andwhich define the process foradopting and implementingsuch positions.

    Yes, have the required policiesin place.Not in complianceNot applicable (if not engagedin advocacy)

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    III.B.2 If engaged inlobbying, the organization'sadvocacy, public policy andlobbying activities shall

    conform to applicable UnitedStates non-profit law.(Source 8.3)

    The United States non-profitlaw provides strict guidelinesfor those engaging in activitiesaimed at influencing legislationor other public regulations. Theorganization is responsible fordetermining if any of its

    advocacy or "lobbying"activities may be prohibitedunder these laws and/orregulations. (Source: 8.3)

    Written procedures forassessing the compliance of its

    public policy and advocacyactivities with applicable

    United States non-profit law.Prepare a list of public policyand advocacy activities inwhich the organization has

    been engaged during the past24 months, arranged by thecountry that is the object ofthese activities.

    Yes, have the required policiesand procedures in place.Not in complianceNot applicable (if not engaged

    in lobbying)

    III.B.3 If the organizationundertakes activities intendedto influence public policy in theUnited States or othercountries, it shall do so inaccordance with its ownestablished policies.(Source: 8.4)

    All of the organization's writtenprocedures for assessing thecompliance of its public policyand advocacy activities with itsown policies.

    Yes, have the requiredpolicies, documentation,procedures and/or processes inplace.Not in complianceNot applicable (if not engagedin public policy and advocacyactivities)

    INTERACTION

    PVO STANDARDS

    COMPLIANCE CERTIFICATION FORM 2012

    SIGNATURE PAGE

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    Organization: ___________________________________________

    2012 Self Certification-Plus Compliance Form

    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.

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

    Did the process strengthen your organizations processes, policies and/or systems? If so, please give examples.

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

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    Organization: ___________________________________________

    2012 Self Certification-Plus Compliance Form

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

    a. Was it easy and straightforward to select your compliance level in column three?b. Do you have any recommendations on how the Self-Certification-Plus process might be improved for 2014?

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

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    Organization: ___________________________________________

    2012 Self Certification-Plus Compliance Form

    Other Comments

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    Organization: ___________________________________________

    2012 Self Certification-Plus Compliance Form

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