Culturally & Linguistically Appropriate Services (CLAS) Organization Self-Assessment Tool

CLAS is defined as services that are respectful of and responsive to individual cultural health beliefs, and practices, preferred languages, health literacy levels and communication needs. The CLAS standards provide a guideline with actions steps and strategies to address and eliminate health care disparities. Adopting these standards will help advance better health and health care in the U.S.

The purpose of this assessment is to help your organization evaluate its current status as it relates to CLAS.

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Facility Type --None--Hospital Clinician Practice Nursing Home Home Health Agency Other
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CLAS Standards:
The CLAS Standards consist of 15 Standards. Standard 1 is the Principal Standard because the ultimate aim in adopting the remaining Standards is to achieve Standard 1. The remaining 14 Standards are divided into three main CLAS Standard Areas referred to as themes.

Theme 1: Governance, Leadership and Workforce

1 - Does your organization have a designated CLAS champion who is supported by the leadership and whose responsibilities include (at a minimum) continuous learning about, promoting, and identifying and sharing educational resources about CLAS and the National CLAS Standards throughout the organization? Check one.
--None--Yes No

2 - Does your organization have written policies and procedures that support recruitment, retention, training, and promotion practices that support CLAS? (CLAS Standard 2) Check one.
--None-- Yes, all staff are aware/trained Yes, however not all staff are aware/trained No written diversity practice policies/procedures currently

3 - Does your organization recruit, retain, and promote board and staff that reflect the cultural diversity of the community? (CLAS Standard 3) Check one.
--None--Aprox. 70-100% Aprox. 50% Less than 25%

4 - Do staff members at all levels and disciplines receive training in culturally- and linguistically-appropriate service delivery? (CLAS Standard 4) Check ALL that apply (Press & hold Control key to select more than one value).
Training Provided to New Hires Training Provided Yearly Training not Provided

5-Does the organization’s board of directors receive training in culturally-and linguistically-appropriate service delivery? (CLAS Standard 4) Check ALL that apply (Press & hold Control key to select more than one value).
Standard to Orientation At least Yearly Board Receives no Training

Theme 2: Communication and Language/Assistance

6 - Does your organization provide interpretation services, at no cost, to all patients to include those with Limited English Proficiency (LEP) and who are deaf/hard of hearing? (CLAS Standard 5) Check one.
--None--Always Most of the Time Does not Currently Assess Unknown

7 - Do all LEP and Deaf / Hard of Hearing patients receive verbal and written notices about their right to language assistance services? (CLAS Standard 6) Check ALL that apply (Press & hold Control key to select more than one value).
Verbal Notices Written Notices Does not Provide

8 - Does your organization ensure the competence of the staff providing language assistance services? (CLAS Standard 7) Check one.
--None--Always Most of the Time Does not Currently Assess Unknown

9 - How do you assess the competence of staff providing language assistance services? Check One.
--None--Staff are are trained medical interpreters Uses an Interpreter / Tool Does not Assess Unknown

10 - Does your organization offer written materials in languages that target the diverse cultural groups in your service area/population and are they written in a way that are easy to read and understand? (CLAS Standard 8) Check one.
--None--Materials Offered in to All Groups Materials Offered to Some Groups Does not Currently Offer Materials Unknown

11 - How do you determine the literacy level of the materials you are using? Check one.
--None--Use Software Manually Test Order Materials at a Low Literacy Level Unknown

12 - Does your organization clearly display images / post signage visibly in the health center that shows inclusivity for the diverse cultural groups, including LGBTQ and people with disabilities in your service area/population? (CLAS Standard 8) Check one.
--None--Images / Signage for All Groups Images / Signage for Some Groups No Images / Signage for Any Groups in Area

Theme 3: Engagement, Continuous Improvement, and Accountability

13 - Does your organization have a plan to identify and address CLAS needs for the communities you serve to include underserved populations? (CLAS Standard 9) Check one.
--None--Fully Developed and Implemented In Draft or Partially Implemented Has no Written Plan

14 - Does your organization review your written CLAS plan at least once a year to assess CLAS progress and needs? (CLAS Standard 10) Check one.
--None--Written CLAS Plan is Reviewed Est. Yearly Does not Currently Review Yearly Not Applicable

15 - Does your organization use Race, Ethnicity Language (REL) patient data, LGBTQ data and community/service area, to help design and deliver health care services? (CLAS Standard 11 & 12) Check one.
--None--Used in All Applicable Situations Sometimes Used Never Used

16 - Does your organization partner with other agencies to design, implement, and evaluate services that target the diverse cultural groups in your service area/population? (CLAS Standard 13) Check one.
--None--Target All Target Some Does not Participate

17 - Does your organization have a conflict and grievance resolution process that is culturally and linguistically appropriate? (CLAS Standard 14) Check one.
--None--Yes No Unknown

18 - Does your organization provide communication regarding CLAS activities to all stakeholders, constituents, and the general public via organization website, newsletter or other forms of communication? (CLAS Standard 15) Check one.
--None--Yes No Unknown