This sample checklist is intended to heighten the awareness of personnel to the importance of Cultural and Linguistic Responsiveness in health and human service settings. It provides concrete examples of the kinds of beliefs, attitudes, values and practices that foster Cultural and Linguistic Responsiveness at the individual or practitioner level. 


The following sample of an individual self-assessment can assist health care service providers in identifying areas in which they might improve the quality of their services to culturally diverse populations.  The full assessment will be provided during the implementation of The Mancini Method in your organization.


Promoting Cultural and Linguistic Responsiveness


Sample Self-Assessment Checklist for Personnel Providing Health Care Services


Directions: Please enter A, B or C for each item listed below. 


A = Things I do frequently 

B = Things I do occasionally 

C = Things I do rarely or never 


Physical Environment, Materials & Resources 


____ 2. I ensure that magazines, brochures and other printed materials in reception areas are of interest to and reflect the different cultures of individuals and families served by my program or agency. 


Communication Styles 


____ 6. I use bilingual-bicultural staff and/or personnel and volunteers skilled or certified in the provision of medical interpretation during treatment, interventions, meetings or other events for individuals and families who need or prefer this level of assistance. 


Values & Attitudes 

____ 14. I recognize and accept that individuals from culturally diverse backgrounds may desire varying degrees of acculturation into the dominant culture.