ANNUAL SAFE ENVIRONMENT VERIFICATION LETTER

1 ANNUAL safe ENVIRONMENT VERIFICATION LETTER . Parish: _____. Address: _____. Audit Period (corresponds to fiscal year): _____. Dear Bishop Zubik, The above referenced parish in the Diocese, knowing the policies and practices of the Diocese related to protecting children and young people by establishing a safe ENVIRONMENT , (check one): _____ Is in full or substantial compliance with the policies and practices of the Diocese of Pittsburgh as represented in the attached checklist. _____ Is in partial compliance with the policies and practices of the Diocese of Pittsburgh as represented in the attached checklist.

2 The plans for achieving full or substantial compliance within the next audit period include: _____. _____. _____. _____. _____. _____ Is unable to be in compliance with the policies and practices of the Diocese of Pittsburgh at this time for the following reason(s): _____. _____. _____. _____. _____. Signature of Pastor/Administrator: _____. Printed Name of Pastor/Administrator: _____. Date: _____. Return signed LETTER and completed compliance checklist to: Most Rev. David A. Zubik, DD. c/o The Office for the Protection of Children and Young People 2900 Noblestown Road Pittsburgh, PA 15205.

3 No later than September 30, 2016. Page 1 of 5 revised 7/2016. 2015-16 Compliance Checklist USCCB Charter for the Protection of Children and Young People Parish Name: _____. Parish Address: _____. Pastor/Admin. Initials: _____ Date: _____. Level of Compliance Part I: Parish Checklist for Compliance with the Charter as of June 30, 2016. (check ONE in each row). Area of Compliance Full Substantial Partial Non 1. Copies of the document Promise to Protect, Pledge to Heal: the Charter for the Protection of Children and Young People (revised 2011) by the United States Conference of Catholic Bishops are readily available to the faithful.

4 By being prominently placed in public areas such as the church, school, religious education, youth ministry and parish offices. 2. Copies of the diocesan safe ENVIRONMENT Policy (revised 2015) in booklet form are readily available to the faithful by being prominently placed in public areas such as the church, school, religious education, youth ministry . and parish offices. 3. Copies of the Code of Pastoral Conduct (revised June 2008) are readily available to the faithful by being prominently placed in public areas such as.

5 The church, school, religious education, youth ministry and parish offices. 4. Copies of the Clergy Sexual Misconduct Policy (revised 2014) of the Diocese of Pittsburgh, in both English and Spanish, are readily available to the faithful by being prominently placed in public areas such as the church, . school, religious education, youth ministry and parish offices. 5. A copy of the 2003 diocesan policy and procedures for when an allegation of sexual misconduct is made against Church personnel other than clergy is.

6 Readily available in the parish files. 6. Parish staff is familiar with the diocesan Megan's Law Policy (Revised 7/1/2008) including the LETTER of Agreement (Appendix A) and a copy of . the policy is readily available in the parish files. 7. Copies of the 2015 Diocese of Pittsburgh booklet: Reporting of Child Abuse and the Child Protective Services Law of Pennsylvania are readily available to the faithful by being prominently placed in public areas such as the . church, school, religious education, youth ministry and parish offices.

7 8. The diocesan Victim Assistance Hotline telephone number (1-888-808- 1235) is published routinely in the parish bulletin (at least twice monthly) . and copies are readily available in the parish files. 9. The parish promotes and advertises education sessions for parents, and other adults on safe environments (Protecting God's Children for Adults) . and copies of the advertisements are readily available in the parish files. 10. All church personnel who have regular contact with children as defined in the diocesan safe ENVIRONMENT policy (Appendix A) have participated in the.

8 Protecting God's Children training program. Page 2 of 5 revised 7/2016. 2015-16 Compliance Checklist USCCB Charter for the Protection of Children and Young People Parish Name: _____. Parish Address: _____. Pastor/Admin. Initials: _____ Date: _____. Level of Compliance Part I: Parish Checklist for Compliance with the Charter as of June 30, 2016. (check ONE in each row). Area of Compliance Full Substantial Partial Non 11. Child Protective Services Law (CPSL) posters showing PA's ChildLine toll free number (1-800-932-0313) for reporting suspected child abuse are posted at each entrance of the church & school as.

9 Well as other appropriate places in the parish so that they are clearly visible to staff and to others who enter the premise. 12. A written parish protocol has been developed and published for reporting suspected cases of child abuse, is well known, and is . readily available in the parish files. 13. The parish/school mandated reporters (Appendix D of Policy Book). of suspected child abuse have been trained on the requirements for . reporting and the procedures in the written parish protocol. 14. The signed Acknowledgements of Receipt/Document Review for the Code of Pastoral Conduct and Child Protective Service Law are kept on file for all Church personnel (paid and volunteer) and readily.

10 Available for review. 15. Copies of the PA Criminal Record Check for all church personnel subject to the safe ENVIRONMENT Policy (Appendix A-SE Policy) are . kept on file and readily available for review. 16. Copies of the DHS Child Abuse History for all church personnel subject to the safe ENVIRONMENT Policy (Appendix A-SE Policy) are . kept on file and readily available for review. 17. Copies of the FBI Criminal Clearance or Waiver form for all church personnel subject to the safe ENVIRONMENT Policy (Appendix A-SE.)