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I. TEAM COMPOSITION AND FORMATION # yes/no WT. ITEM Page/Paragraph Reference 1 4 Was EZRA used by the Leader to prepare the Team? III-12/13 2 4 Were there 4 Team members per Family: 3 seated Team members and 1 Team Family servant? III-27 c.2 3 4 Minimum requirement met for "qualified" clergy? (2 for 4 Families or less, 3 for 5 Families or more) II-24/28 4 1 Did the Team have a reasonable ecumenical balance? II-20, III-4 #1 5 2 Were at least 1/3 of the Team first-time members? III-17 D-1 6 2 Were all the new 2, non-4th Day members properly and constantly mentored? III-19 7 2 Were all Team members worshipping regularly in a Christian church? III-18 8 2 Were all Team members regularly participating in an accountability Prayer & Share group? III-19, III-5 #6 9 2 Are all Team members compliant with the "Three and Out" rule except those on Leadership track? III-5 #3; III-18 D-1 10 4 Was there a minimum of 34 actual hours of Team Formation? III-1, III-6 #6, III-47 H-2 11 3 Did all Team members attend at least 75 Team meetings? III-43 G-1 12 4 Were all talks previewed according to the preview guidelines in the Program Manual? III-20/22 13 1 Were all talk speakers counseled about maintaining outline guidelines and time limits? III-21/23 14 3 Were all of the meditations and homilies rehearsed as part of Team Formation? III-22 15 2 Did the Chaplain have access to and knowledge of the Kairos Penetration Plan? II-4/7 40 0 0 Compliance II. TEAM LEADERSHIP 1 4 Did the Team have a Weekend Leader, Advising Leader, and an Observing Leader? III-15, 26, & 29 2 4 Was the Leader approved by the State Chapter and attend an Advanced Kairos Training? II-22, III-13/14 3 4 Was the Inside Coordinator position filled? III-15, 26, & 29 4 3 Was the Head Servant position filled? III-15, 26, & 29 5 3 Was the Agape Coordinator position filled? III-15, 26, & 29 6 2 Was the Team Music Leader position filled by a volunteer? III-26 & 37-40 20 0 0 Compliance p. 1 of 8 KI Excellence Initiative 03/19/2011

III. TEAM BEHAVIOR # yes/no WT. ITEM Page/Paragraph Reference 1 3 Did the Team comply with all DOC and institutional rules/guidelines, especially the security ones? II-1 A, III-46 #3, III-49 g 2 4 Did the Team avoid activities that divide, e.g. denominationally-specific activities, etc.? III-4 # 2, 3, 4, 6, 7, & 8 3 3 Did members dress according to Program Manual (no logos, rich jewelry, etc.)? III-5 #5 4 3 Did all Team members perform services without rebellion? III-3 # 3 & 8, III-5 #1 & 7 5 3 Did all Team members stay for the entire Weekend, except for personal illness or emergencies? III-5 #2 16 0 0 Compliance IV. CONDUCT OF THE WEEKEND 1 4 Was Weekend conducted over a continuous 3-1/2 Day period, i.e. no avoidable interruptions? I-6 D-1 2 3 Was the Program conducted in sequence as specified in the Program Manual? I-6 D-1, III-9 #6 3 4 Did Leader refrain from rotating or changing seating arrangements at Family Tables after Friday morning? III-54 #15 4 4 Did the Team refrain from adding to, subtracting from, or substituting activities during the Weekend? III-9 # 2,3 5 2 Were Residents supplied with supplies (Notebooks, pens/pencils, colored markers, Posterboard, etc.)? IV-28/32 6 3 Were all Participants selected according to the Kairos Penetration Plan? II-4/7 7 3 Did the Kairos graduates assisting as servants remain in the background when not serving? III-40 C.7 8 4 Were all 4 Forgiveness meditations given by the same Team member? III-24 b.1 27 0 0 Compliance V. MUSIC 1 3 Was the Music Team effective in a manner consistent with the Program Manual? III-37/40 6 a,b,c 2 2 Did the Music Leader select appropriate music? III-37/40 6 a,b,c 3 4 Did the Music Team use a legal songbook or other legal means of providing music? AKT Manual, "Music" 4 1 Did the Music Leader lead an approved Blessing Before / Blessing After for each meal? IV-34, IV-78/79, IV-114 10 0 0 Compliance p. 2 of 8 KI Excellence Initiative 03/19/2011

VI. HOSTING # yes/no WT. ITEM Page/Paragraph Reference 1 4 Was every single Participant hosted by a single Team member to establish a 1-to-1 ratio? III-30/31 d, IV -6, 8/9 2 3 Did all first-time Team members host only one Participant? III-31 3 3 Were the Observing Leader & Inside Coordinator exempt from hosting a Participant? III-29 Team chart & 31 10 0 0 Compliance VII. AGAPE 1 3 Was General agape obtained and displayed throughout the Weekend? III-33/36 2 3 Were General agape items used (placemats, posters, prayer vigil charts/wheels/chains, etc.)? III-35 3 4 Was personal agape provided (letters from Team members)? III-35/36 10 0 0 Compliance VIII. WEEKEND ACTIVITIES: THURSDAY 1 1 Did the Leader hold a Team meeting before departing for or at the prison before the official start? IV-6 & 8 2 3 Did Team hosts greet Participants appropriately upon Participants' arrival? IV-3, 6; III-30/31; IV 8/10 3 3 Were Leader's Opening Talk and Introductions accomplished following the Manual script? IV-11/17 4 3 Were Freedom Guides distributed to all Participants? IV-6 5 3 Did the Clergy giving the meditations follow the Program Manual script? IV-18/26 6 3 Were Leader's Closing talk & Evening prayer according to the Program Manual script? IV-27 7 1 Did the Leader hold a Team meeting at the end of the evening? IV-28/31 8 3 Did Leader and Team maintain inmate confidentiality at evening meeting with Support Team? III-53 #2 and IV-16 20 0 0 Compliance p. 3 of 8 KI Excellence Initiative 03/19/2011

IX. WEEKEND ACTIVITES: FRIDAY # yes/no WT. ITEM Page/Paragraph Reference 1 3 Did Team-member hosts greet Participants appropriately upon Participants' arrival IV-32 2 3 Was the morning chapel service conducted per the script? IV-36/43 3 4 Did speaker for the Choices talk cover the essential points and stay within time limits? IV-46/49 4 1 Did the Inside Coordinator organize the group photo? IV-32 5 4 Did speaker for the You Are Not Alone talk cover the essential points and stay within time limits? IV-50/53 6 4 Did the speaker for the Friendship With God talk cover essential points and stay within time limits? IV-54/56 7 3 Was the noon chapel program conducted per the script? IV-33 8 3 Was the Isaiah 49 Homily presented appropriately by clergy? IV-57/58 9 3 Was the Isaiah 49 Homily followed by the required Isaiah 49 song? IV-33 10 3 Was the Acceptance of Self meditation given? IV-59/60 11 4 Did speaker forthe Church talk cover essential points and stay within time limits? IV-61/65 12 4 Did speaker for the Opening the Door talk cover essential points and stay within time limits? IV-66/69 13 1 Were Spiritual Counseling directions given by a clergy? IV-70 14 3 Did Observing Leader conduct an affirming review of posters and summaries at the Poster Party? IV-34/35 15 3 Was the closing chapel program conducted per the script including Accepting God's Forgiveness? IV-35, 73-74 16 1 Did the Leader hold a Team meeting at the end of the evening? IV-75/76 17 3 Did the the Leader and Team preserve Participant confidentiality among Support Team? III-53 #2, IV-16 50 0 0 Compliance p. 4 of 8 KI Excellence Initiative 03/19/2011

X. WEEKEND ACTIVITIES: SATURDAY 1 3 Did Team member hosts greet Participants appropriately upon Participants' arrival? IV-77 2 3 Was the morning chapel program conducted per the script including Forgiveness of Others Part I? IV-77; IV-81/87 3 4 Did speaker for the Discovery Through Study talk cover essential points and stay within time limits? IV-90/93 4 2 Was the Leader's announcement made after the Discovery Through Study talk? IV-94 5 3 Did Family chapel visits take place? IV-78 6 4 Did speaker for the Christian Action talk cover essential points and within time limits? IV-95/98 7 2 Was the Prayer for Acceptance of Others given? IV-78; Freed. Guide p13 8 4 Did the Participants receive personal agape? IV-99 9 4 Was The Wall meditation conducted per script? IV-100/102 10 3 Did Family discussion occur after The Wall meditation? IV-102 11 3 Did Observing Leader conduct an affirming review of posters and summaries? IV-79 12 3 Did Leader conduct an invitation to the Open Mike with counsel about the "Master Carpenter"? IV-104/105 13 2 Did Observing Leader conduct an Open Mike session? IV-79 14 3 Was the evening chapel service conducted per the script? IV-80 15 3 Were prayers from the Freedom Guide given? IV-80 16 3 Was Forgiveness of Others Part 2 given? IV-106 17 2 Was the Forgiveness Windup Homily given by either a clergy or the chaplain? IV-107 18 4 Was the Forgiveness Windup service conducted by either a clergy or the chaplain? IV-108/110 19 3 Was a Hand-washing ceremony conducted by the additional clergy? IV-109/110 20 4 Did the Leader dismiss Participants in silence, i.e. no hugs, handshakes, or celebrations, etc.? IV-111 21 1 Did the Leader hold a Team meeting at the end of the evening? IV-112 22 3 Did the Leader and the Team preserve Participant confidentiality among the Support Team? III-53 #2, IV-16 66 0 0 Compliance p. 5 of 8 KI Excellence Initiative 03/19/2011

XI. WEEKEND ACTIVITIES: SUNDAY 1 3 Did Team member hosts greet Participants appropriately upon arrival? IV-113 2 3 Was the morning chapel program conducted per the script? IV-113 3 4 Was the Meditation to Heal Past Memories given by a clergy according to the script? IV-116/126 4 2 Was this meditation conducted in the chapel atmosphere? IV-113 5 2 Did the Music Team lead the song Sanctuary immediately after the meditation? IV-113 6 4 Did speaker forthe Rooster Story cover the essential points and stay within time limits? IV-127/128 7 2 WasThe Rooster Story conducted in the chapel atmosphere? IV-113 8 1 Was the discussion for both meditations conducted in the Community Room? IV-113 9 4 Did speaker forobstacles to Accepting God's Grace talk cover essential points and within time limits? IV-129/133 10 4 Did speaker for thewalking in God's Grace talk cover essential points and within time limits? IV-134/141 11 4 Did Weekend Leader's talk Hang in There cover essential points and within time limits? IV-142/147 12 3 Was the Prayer & Share simulation breakout conducted properly? IV-145 13 3 Were Family Affirmation Prayer Circles conducted according to the Program Manual? IV-146/147 14 2 Did the Participants prepare agape posters per the Building the Body exercise? IV-114 15 2 Did the Leader give the Final Talk? IV-148/150 16 1 Were crosses distributed to Weekend Participants in a Cross Ceremony? IV-151 44 0 0 Compliance p. 6 of 8 KI Excellence Initiative 03/19/2011

XII. WEEKEND ACTIVITIES: CLOSING 1 4 Did the Advising Leader greet Outside guests to review proper procedures for Closing? III-51; IV-115 2 4 Did the Advising Leader greet Resident Community to review proper procedures for Closing? 3 2 Were Free-world guests in attendance at the Closing? IV-115 4 3 Did a KO representative speak at Closing? IV-153; III-51 5 4 Was a physical "separation" maintained between Free-world guests and Residents (start to finish)? III-51/52 6 3 Were Participants given an opportunity to share their responses to the three questions? IV-152 7 1 Did the Leader introduce distinguished guests? IV-153 8 3 Did a graduate from a previous Kairos Weekend give the 4th Day address? IV-153 9 2 Was the Chaplain invited to make remarks? IV-153 26 0 0 Compliance XIII. POST WEEKEND ACTIVITIES: THE CONTINUING MINISTRY 1 3 Did Leader conduct the Instructional Reunion according to the script? V-1/35 2 1 Was the Instructional Reunion completed within the necessary timeframe? V-5 3 4 Are previous Prayer & Share fellowship groupings (either formal or informal) consistent w/ Manual? V-1/35; esp. V-4/5 4 4 Do provisions exist to allow sole leadership of Monthly Reunions for the chaplain and Residents? VI-14/15, 19; VI-24 5 3 Are previous Monthly Reunions conducted in a way consistent w/ Program Manual requirements? VI-19/21 6 4 Did the Leader submit an EZRA Weekend Report within a week after the Instructional Reunion? EZRA guidelines 7 3 Was there a 1- or 2-Day Retreat conducted approx. 3 months prior to this Weekend? VI-25/43 22 0 0 Compliance p. 7 of 8 KI Excellence Initiative 03/19/2011

KAIROS INSIDE EXCELLENCE INITIATIVE CHECK LIST TALLY SHEET AREA MAX SCORE REMARKS IF NECESSARY Actual % SCORE I 40 II 20 III 16 IV 27 V 10 VI 10 VII 10 VIII 20 IX 50 X 66 XI 44 XII 26 XIII 22 SIGNED: State Chair or Designee DATE: PRINTED: p. 8 of 8 KI Excellence Initiative 03/19/2011