Reporting Potential Abuse

Reporting Potential Abuse
The YMCA of the Virginia Peninsulas believes children, parents, and guardians are the core of our life line and your insight is key. Accordingly, the YMCA of the Virginia Peninsulas encourages children, parents, and guardians to share opinions, suggestions, concerns, questions and/or grievances about our policies, personnel, and/or other matters impacting the organization.

This form is used to document and report any suspected or confirmed cases of abuse, neglect, or misconduct involving staff, volunteers, members, and children within the YMCA. Accurate and timely reporting ensures the safety of individuals and compliance with state and organizational policies.

This procedure provides for a timely, thorough and objective investigation of the following concerns:

• Inappropriate Behavior by Employees/Volunteers/Members;
• Inappropriate Behavior by Consumers;
• Retaliation; and/or;
• Whistleblower complaints.

Thank you for completing this report and helping us uphold our organization’s commitment to safety, accountability, and integrity.

MonthDayYear
Your Name (Not Required to Submit)

First NameLast Name
Phone Number (Not Required to Submit)
Please enter a valid phone number.
Email (Not Required to Submit)
example@example.com
Would you like a YMCA staff member to follow up with you?

YesNo

Details of Event
Center Event occurred in:
Program
Date(s) and Time(s) event occurred
Summary of the incident
Please provide detailed information. Include the behavior complained of and/or the alleged policy or legal violation. Include all individuals involved if applicable. If there are different dates and times, please note them in the summary.
Witnesses (if applicable)
Please provide relevant documentation here

Cancelof
By clicking yes below you indicate that the information you have provided above is truthful.

Yes

THANK YOU

FOR CONTACTING US ABOUT YOUR CONCERNS. SOME ONE WILL BE CONTACTING YOU SOON.
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