PE: 3 Quality Assurance Standards

Effective Date: 09/93 Downloads: PDF Version    Revised Date: 06/13


Quality Assurance Standard Procedures are a set of criteria which define excellent performance. In the case of the WIC Program, these standards outline both regulatory requirements (i.e., required by Federal Regulations and State Policies & Procedures) and nutritionally-related requirements (i.e., dictated by professional standards of care).



The following criteria are to be reviewed annually by Local Agency staff to help facilitate review of Standard Procedures by utilizing the Local Agency Self Evaluation Checklist. Included in the review process will be clinic and clinic staff observations, as well as participant file reviews.


Standard Procedures 


Clinic environment clean and uncluttered

Clinic is easily accessible, comfortable, warm and inviting

Promotes healthy eating and activity messages and endorses breastfeeding as the preferred method of infant feeding.

Provides confidentiality and privacy of each applicant and participant. All applicant and participant information is confidential including but not limited to personal and income information, medical forms, information relating to referral services, authorization documents, and any other documentation with identifying information. It is the responsibility of all clinic staff to keep all information confidential, both written and verbal. 



Application list is maintained according to written procedure

Processing Standards are met according to participant category

Waiting List is maintained if necessary

Relatives or family members certified by non-related WIC staff member



Income calculations are shown on Rights & Responsibilities form

Self-declared income is documented

Adjunctive Eligibility documented

Income is within guidelines for family size

ID and residency are documented

Family size is documented

Statement is written and signed by participant for any missing documentation

When applicable, staff has documented that missing information is verified when brought back into clinic within 30 days

Participant is offered voter registration services to register to vote and any assistance requested

Rights & Responsibilities signed by participant and CPA



Weight is measured according to accepted procedures

Height/length is measured according to accepted procedures

Anthropometric measurements are plotted on growth charts accurately and completely; Infants: weight/age, length/age, weight/length; Children: weight/age, length/age and BMI

Prenatal BMI/weight gain/loss is plotted accurately once per pregnancy trimester.



Hemoglobin is taken according to accepted procedure or referral made to Public Health Nurse

Hemoglobin is taken according to appropriate required schedule


Health/Nutrition Assessment 

Physical Presence or exception documented

Health/Nutrition questionnaire completed and signed by CPA

Appropriate nutritional risks completely identified


Nutrition Education 

Appropriate Nutrition Education tailored to a participant’s needs

Appropriate nutrition education contacts documented for each certification period

Nutrition education is given after complete assessment

Staff demonstrates knowledge in the six VENA competency areas during nutrition assessment and education: 1) Principles of life cycle nutrition 2) Nutrition assessment process 3) Anthropometric and hematological data collection 4) Communication 5) Multicultural awareness 6) Critical thinking

Required number of Nutrition Education contacts scheduled/completed

Prenatal women seen once a trimester after certification for weight monitoring and education

Infant Health Assessment completed midway during infant’s first year when possible (see recommended infant appointment schedules in Policy CT: 1, Certification)

Expanded nutrition education appointments are given for Infant and Child Health Assessments

Nutrition Care Plan written for high-risk participant within two months of initial identification of condition

“Graduating” women and 5 year-old children offered Final Nutrition Education Contact



At each trimester contact Prenatal women are encouraged to breastfeed their infant

Post-partum women encouraged to breastfeed at recertification



Lead Screening referral made to health care provider if needed 

Current immunization status of infant/child documented (referral if necessary also documented)

Other appropriate referrals made and documented



OARS (open-ended questions, affirmations, reflections, and summarizes) are used during appointments

Asks for information about participants’ goals, abilities, questions and concerns

Helps participants decide which nutrition/health behaviors are important to change in the context of their goals, culture and personal situation

Helps participants identify barriers to change and ideas to overcome barriers

Staff follows up on previously set goals and assists participants with future goal setting by offering information and ideas with small realistic and doable action steps



Food package prescribed is appropriate and correct for participant category

Participant signature on WIC EBT Card Issuance/Inventory Log for receiving EBT card

EBT cards maintained in locked storage area

WIC Bulk EBT Card Stock Inventory Log complete and accurate to issued and unissued EBT card boxes

Physicians’ Rx in participant file for special formula

Receipt for special formula with participant signature in participant file

Relatives or family members issued Food Instruments by non-related WIC staff member



Staff verbally read/summarized Rights and Responsibilities to participant

Rights and Responsibilities form signed by Competent Professional Authority (CPA) and participant

Participant notified of ineligibility or disqualification

“…And Justice For All” posters displayed in clinic

Discrimination and Fair Hearing Policies are posted in the clinic

Voter Registration Poster displayed in clinic

Clinic appointment schedule does not cause significantly different processing times for different racial/ethnic groups

Racial/ethnic distinction is not made on the following:

a.  Application List

b.  Waiting List

c.  Outside of participant file or MIS

Sufficient resources exist to adequately provide services to non-English-speaking persons

Outreach is being directed to different minority organizations