This thesis explores the process of accreditation within a government contracted social service agency in British Columbia, Canada. The agency is seeking accreditation from the Commission on Accreditation for Rehabilitation Facilities (CARF). Institutional ethnography is used to explicate the social relations of CARF - how it organizes frontline work with clients and how it re-organizes an agency’s relations to government funding and service delivery. Data include the author’s frontline work accounts, interviews with frontline workers and the Director, and textual documents used within frontline work. The research process traces specific reporting documents that connect frontline work to the agency’s funders, Community Living B.C. and the Regional Health Authority, and to CARF. This thesis makes visible how the accreditation discourse of measurement and continuous quality improvement shifts how frontline workers think about and do their work with clients in ways that align their priorities with those of government contract management.