PE: 2 Local Agency Self Evaluation

Effective Date: 06/94 Downloads: PDF Version    Revised Date: 03/17


Each Local Agency (LA) is required to perform a Self Evaluation each fiscal year to review clinic operations. This evaluation shall include a review of the following areas: Clinic Environment, Certification, Nutrition Education, Breastfeeding, Participant-Centered Services, Food Delivery, Food Instrument Security, and Civil Rights. The purpose of the review is to ensure that WIC services are provided in accordance with State of Nevada WIC policies and Federal regulations.



  1. Evaluations are to be conducted annually at all LAs and consist of two components: 1) observation of clinic environment and procedures and 2) observations of individual CPA interactions with participants.

Component 1:  This portion is to be done by the LA Director / WIC Manager using the Local Agency Self Evaluation Checklist (see appendix PE: A), and the Quality Assurance Standards in policy PE: 3.


Component 2:  This is to be done by the clinic supervisor (POC).  Each CPA is to be observed conducting an appointment for each of the five participant categories (Prenatal, Breastfeeding, Post-Partum, Infant, and Child).  The POC will also review the related charts using the LA PCS Observation form and the Participant Records Worksheet. (See appendix PE: B and C)


  1. Documentation of the LA Self Evaluation shall be kept on file at the LA for a minimum of three years following the date of the audit.  Documentation must also include the date the records were reviewed, the ID numbers of the participants and the names of the reviewers.  All documentation shall be made available to State personnel upon request and/or for State Program Review purposes.
  2. In areas where deficiencies are found regarding Clinic Environment, Certification, Food Delivery, Food Instrument Security and Civil Rights corrective action shall be made. In areas where deficiencies are found regarding Nutrition Education, Breastfeeding, and Participant-Centered Services, suggestions for improvement, staff mentoring and further observations shall be made to improve staff development.