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Seeking Safety - Utah Division of Substance Abuse and

Seeking Safety - Utah Division of Substance Abuse and 2026

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The document is an Abuse and Molestation Questionnaire designed for organizations to assess their policies and practices regarding the prevention and reporting of abuse. It includes sections on client demographics, allegations of abuse, written policies, employee and volunteer screening controls, background checks, and record retention. The questionnaire aims to ensure that organizations have adequate measures in place to protect clients and comply with legal requirements.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your organization’s name and FEIN at the top of the form. If you lack a website, attach a brochure detailing your daily activities.
Indicate the number of clients in each age range by filling out the corresponding fields. This helps assess your organization's outreach.
For questions regarding abuse claims, select 'YES' or 'NO' as applicable. If you answer 'YES', provide explanations in the designated area.
Complete sections about your organization's policies on reporting abuse and employee screening controls. Be thorough in your responses to ensure compliance.
Fill out background check information for employees and volunteers, ensuring all checks are documented accurately.
Finally, review all entries for accuracy before signing and dating the application at the bottom.

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