The United States is unique with it non-governmental peer-review based accreditation system for oversight of higher education for quality assurance and improvement. In a triad relationship with federal and state governments for accountability, accreditation associations are the designated gatekeeper for federal financial assistance. Therefore, though voluntary, accreditation status is not an option for most public, private and not for profits institutions (Wolff, 2005). Western Association of Schools and Colleges (WASC) is the only regional accreditation association with different commissions and standards for community colleges, with Accrediting Commission for Community and Junior Colleges (ACCJC) presiding. After revision of its standards in 2002, over 40% of California Community Colleges have been sanctioned, which comprises the majority of colleges within this commission (Beno, 2012; Beno, 2011; Karandjeff, 2011). As of the January 2012 commission hearing, ACCJC has issued adverse actions to 28 colleges (25%) all within the California Community College system (ACCJC, 2012; Beno, 2012). Although an increase in sanctions has been noted among all accrediting commissions, ACCJC far exceeds its peers. Due to the severity of a sanction, this case study examined the effects of accreditation actions through a lens of accountability by examining two colleges one sanctioned and one reaffirmed with recommendations, respectively. An embedded mixed methods case study included semi-structured interviews, document review and analysis and examination of various input, progress and output performance indicators for a time period preceding comprehensive review and after addressing accreditation actions. The results revealed the impacts in areas of organizational, individual and interpersonal phenomena at each of the institutions. Sanction was deemed a strong and effective force for encouraging initial planned change to organizational structure, policies and operations to align with accountability practices, accreditation requirements and standards at the sanctioned institution. Although it may be limited by the performance measures selected, findings revealed a disconnect among effective structure and practices to measures of student outcomes. At least within these two sites studied, there was some context that leadership and an effective shared governance structure may contribute to or influence compliance with ACCJC's expectations and capacity for improvement. In other words, unless explicitly targeted, student progress and achievement may not be a direct result of effective decision making and planning processes; and process improvements may not translate to improvements with academic outcomes. However, leadership and human agency are key factors for managing change and interpreting and shaping collective and individual understanding of quality and external requirements for balancing internal and external accountability for quality assurance and quality improvement. This study suggests implications for practice for both colleges and the accrediting commission to achieve the objective of quality improvement and institutional effectiveness. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]