ࡱ> gi`abcdef bjbj *@ F(((8` ()4!!(!!!"""W(Y(Y(Y(Y(Y(Y($+-X}("""""}(!!)((("j!!W(("W((((!.> -#Z(C()0)(.$.(.((""("""""}(}((""")"""".""""""""" :   PROVIDER REPORT FOR BAY COVE HUMAN SERVICES 66 Canal St Boston, MA 02114 June 19, 2017 Version Provider Web Report Prepared by the Department of Developmental Services OFFICE OF QUALITY ENHANCEMENT  SUMMARY OF OVERALL FINDINGS  Provider BAY COVE HUMAN SERVICES Review Dates 4/3/2017 - 4/7/2017 Service Enhancement Meeting Date 4/20/2017 Survey Team Ed Sutka Mark Boghoian (TL) Sally Hajjar Cheryl Hampton Leslie Hayes Lisa MacPhail Raymond Edi-Osagie   Survey scope and findings for Residential and Individual Home Supports Service Group Type Sample Size Licensure Scope Licensure Level Certification Scope Certification Level Residential and Individual Home Supports 16 location(s) 16 audit (s) Targeted Review DDS 17 / 23 Provider 65 / 65 82 / 88 2 Year License 04/20/2017- 04/20/2019 DDS 38 / 44 Provider 0 / 0 38 / 44 Certified 04/20/2017 - 04/20/2019 Residential Services 12 location(s) 12 audit (s) DDS Targeted Review 34 / 38 Individual Home Supports 4 location(s) 4 audit (s) DDS Targeted Review 36 / 38 Planning and Quality Management (For all service groupings) DDS Targeted Review 11 / 11 Survey scope and findings for Employment and Day Supports Service Group Type Sample Size Licensure Scope Licensure Level Certification Scope Certification Level Employment and Day Supports 2 location(s) 7 audit (s) Targeted Review DDS 13 / 15 Provider 45 / 45 58 / 60 2 Year License 04/20/2017- 04/20/2019 DDS 25 / 26 Provider 15 / 15 40 / 41 Certified 04/20/2017 - 04/20/2019 Community Based Day Services 1 location(s) 4 audit (s) DDS Targeted Review 13 / 13 Employment Support Services 1 location(s) 3 audit (s) DDS Targeted Review 21 / 22 Planning and Quality Management (For all service groupings) DDS Targeted Review 11 / 11  EXECUTIVE SUMMARY: Bay Cove Human Services is a large, private, non-profit, multi-faceted human services agency whose mission is to partner with people to overcome challenges and realize personal potential. The agency prides itself on providing services in urban settings and for its ability to foster positive relationships within the multi-cultural communities in which it provides services and outreach. The agency is contracted with the Department of Developmental Services (DDS) to provide twenty-four hour residential supports and Individual Home Supports to approximately 280 individuals and Community Based Day Supports and Employment Supports to approximately 150 individuals. As a result of the previous DDS Licensing Survey conducted in 2015, the agency achieved Two-Year Licenses for both its Residential Supports and Employment/Day Supports and the agency was deemed for Certification as it had achieved a three year accreditation by CARF. Because the agency received Two-Year Licenses, the agency was afforded and chose the option to conduct its own self-assessment of both service groupings and receive DDS targeted licensing reviews (for each of its two service groupings) in lieu of participating in a Full DDS Licensure Survey. The DDS targeted review was comprised of an evaluation of the eight critical indicators and those licensing indicators determined to have been "Not Met" in the previous survey of 2015. All agencies choosing this option were also evaluated by DDS for all new and revised licensure and certification indicators based on revised Federal (CMS) expectations. The agency conducted its own self-assessment and submitted it to DDS prior to the start of the targeted survey. The findings of the DDS evaluations were then combined with the agency's findings from its self-assessment and used to determine the agency's new Licensure and Certification levels. The DDS targeted review confirmed that the agency's quality management systems provided effective monitoring and oversight. Except for a few delays in timely restraint reporting, all organizational indicators, including agency planning and development were found to be 'Met.' The agency is currently strategizing ways to improve the timeliness of the restraint managers' review. The agency also embraced the new CMS requirements for residential settings. For example, people's privacy was respected by ensuring that bedroom doors may be locked; and, the agency attested that through written agreement, people remained free from arbitrary eviction. An organizational measure that was a noteworthy improvement from the previous survey was agency compliance with mandated membership composition/attendance requirements for its Human Rights Committee. It was also found that the Committee effectively performed its mandated functions. Residentially, the agency supported people to live in well maintained homes in a variety of different communities. In the area of safeguards for individuals, all critical indicators were found to be 'Met.' Individuals were supported to maintain good health including attendance at routine and specialized health care services; and when required, people received nursing care/oversight for specialized needs. Staff support to individuals to take prescribed medication as ordered by their physicians was also a recognized agency strength. Staff were well trained in physician ordered protocols which were well implemented and tracked. An improvement from the previous survey was noted in the agency's ability to maintain hot water temperatures within required limits. Another significant improvement was seen in the agency's Behavior Modifying Medication Treatment Plans. A new form was developed and implemented; and, Plans reviewed contained the required specificity, detail and composition. To fully meet this standard, the agency needs to ensure that data collection occurs as designated in the Plan and is used consistently throughout the agency. Other noted improvements related to requirements for the submission of ISP related assessments and provider support strategies as well as tracking of people's progress towards goal completion. Acknowledging the improvements in these three areas, further efforts are needed to reach the threshold of 80% compliance. In regards to compliance with certification indicators, respect for individualized choices in routines and schedules and support to maximize people's independence were agency strengths. For example, individual's decisions to eat meals and snacks when and with whom they chose were supported. Staff also supported people to decorate and personalize their own personal space and the common areas of their homes. There were a few areas identified, particularly within the new and revised certification indicators that warrant improvement. Individuals could benefit from receiving increased support to develop new social contacts and to increase existing personal relationships. Similarly, individuals may benefit from receiving more support to explore and connect with their personal interests. Therefore, further assessment of people's unique interests and support to actualize findings needs to occur. With regard for the agency's Day/Employment Supports, both service types provided people with ample choices for varied work, educational activities and community access. There was a noted improvement in DDS requirements for the submission of assessments and provider support strategies, and the tracking of people's progress towards goal completion. The CBDS program supported people with various learning activities on-site and provided people with work, volunteer options, and opportunities to participate in various activities and field trips in the community. At the CBDS program, a Participant Advisory Council (PAC) was formed that meets regularly. The individuals who sit on this Council are elected by fellow CBDS participants to represent them and their community interests. They are trusted to bring the ideas for community exploration and any concerns to the PAC meeting. Meeting minutes are taken in a set format at each meeting and follow-up on identified issues are pursued by staff. Staff also completed a Pre-ISP document with or for each individual, which contains specific information on each individual's needs and activity preferences. The agency's Employment Supports Program is recognized for providing supports to people in accordance with their identified needs, as well as the needs of their employer. Agency management/supervisory staff are actively involved in the Greater Boston Employment Collaborative (GBEC) which serves as a partnership between service providers, government agencies, workforce development entities, and employers working towards the common goal of increasing employment opportunities for individuals with disabilities. The agency supported people to remain successfully employed through utilizing of several tools/documents in conjunction with garnering input from individuals and their employers on a consistent and frequent basis. This process served to ensure that people were meeting the expectations of their employers and confirmed that individuals remained interested in continued employment at their current workplace. Staff also remained flexible in their support for individuals to change jobs, acquire promotions, make lateral transfers and in general succeed with their identified employment objectives. Based on the results of these combined evaluations, the agency achieved a Two-Year License for its Residential Supports with 93% of all licensing indicators receiving a rating of 'Met' and is Certified with 86% of all certification indicators receiving a rating of 'Met.' The agency also achieved a Two-Year License for its Employment/Day Supports with 97% of all licensing indicators receiving a rating of 'Met' and is Certified with 98% of all certification indicators receiving a rating of 'Met.' Therefore, the agency will conduct its own licensing follow-up review for each service grouping within 60 days. In preparation for this Licensing review, Bay Cove Human Services has presented the following description of its organization's on-going quality assurance program with special attention to the agency's current evaluation of compliance with DDS Licensing Standards.   Description of Self-Assessment Process: Bay Cove Human Services, Inc.'s Quality Assurance system is designed as a continuous feedback loop with steps to identify individual programmatic issues, identify patterns, trends, and systemic issues, correct issues, follow-up to ensure that individual and systemic correction has occurred, and re-assessment to assure that there are no further problems. The following table outlines how we go about assuring that all DDS licensure and certification standards continue to be met. For purposes of this self-assessment review, we used the Licensure ratings from the last 40 QA Reviews held between January 14 & 16, 2016 through January 26, 2017. Our sample size was as follows: Residential Services - 35 sites; 70 audits of individuals' records; Individual Home Supports - 6 audits of individuals' records; Community Based Day Services - 2 sites; 8 audits of individuals' records; Supported Employment - 2 sites; 2 audits of individuals' records; and an audit of all organizational licensure indicators. A score of "met" meant that the programs/systems audited collectively met 80% or above for that indicator. Applicable Certification indicators were added to the QA Review tools starting September 28, 2016. Topic/what reviewed: Day & Residential: Personal Safety, Environmental Safety, Communication, Health, Human Rights, Competent Workforce, Goal Development & Implementation How reviewed: Comprehensive Quality Assurance Reviews include: A walk-through of all program spaces (including testing of water temperature, testing of fire alarms, and a review of proper documentation of external inspections). A review of incidents, medication occurrences, DPPC reports, and restraint reports for the past year. An audit of the record for at least two individuals (includes reviewing ISP, Assessments, Support Strategies, Progress Notes, Emergency Fact Sheet information, Charges for Care information, and medical appointment information for completeness & if current). A review of Human Rights documentation (behavior plans, medication plans, supports & health related protections) for completeness & if current. A review of required training completed by individuals and staff over the past year. A review of staffs' last evaluation dates submitted to Human Resources. A review of the program's medication system. How often: At least annually By whom: Quality Assurance Coordinator or the Operations Director How corrections are made: Program Directors receive the report and make corrections. Senior Program Directors and Service Directors also provide additional review and follow-up. All results are recorded on the Review. Topic/what reviewed: Residential: Environmental Safety-Includes: Vehicle safety and External property How reviewed: Property Inspections & Vehicle Inspections How often: Property Quarterly, Vehicle Twice a year By whom: The Program Director or a designated staff person How corrections are made: Property - Work orders are generated by the Program Director and the maintenance department schedules a visit to correct. A binder is maintained at the program site by maintenance when they have completed a job. Vehicle - Program staff schedule and follow-up with maintenance or they work with the Agency's Manager of Fleet Operations & Insurance to do so. Topic/what reviewed: Residential: Human Rights-Financial (L67-L69) How reviewed: Audit that includes a review of all client funds held at the program. How often: two times a year By whom: Compliance Coordinator & SPDs How corrections are made; The Program Director is in charge of making corrections based on the Checklist that is sent out by the CC or the SPD. Topic/what reviewed: Human Rights L49-L54, L56 How reviewed: site visit How often: every two years By whom: At least one member of the Human Rights Committee How corrections are made: Program Director follows-up as indicated Topic/what reviewed: Residential: Health How reviewed: Site visits using a standard checklist which includes review of medications, health care, appointments, protocols How often: Annually By whom: Director of Health Services, or Program Nurse Consultants/Managers How corrections are made: Program Director follows-up as indicated Topic/what reviewed: Health How reviewed: All appointment forms are sent to that program's nurse consultant. How often: Ongoing By whom: Program Director How corrections are made: The nurse consultant/manager will call the Program Director for any clarification. Topic/what reviewed: Day: Goal Development & Implementation How reviewed: Each program has a chart that tracks when Assessments and Support Strategies are due to DDS and when they are sent to Service Coordinators. How often: Ongoing/Monthly By whom: Quality Operations Coordinator, SPD's How corrections are made: The SPDs follow-up with Program Managers when timelines are not adhered to.  LICENSURE FINDINGS Met / Rated Not Met / Rated % Met Organizational 9/10 1/10 Residential and Individual Home Supports 73/78 5/78 Residential Services Individual Home Supports Critical Indicators 8/8 0/8 Total 82/88 6/88 93% 2 Year License # indicators for 60 Day Follow-up 6 Met / Rated Not Met / Rated % Met Organizational 9/10 1/10 Employment and Day Supports 49/50 1/50 Community Based Day Services Employment Support Services Critical Indicators 8/8 0/8 Total 58/60 2/60 97% 2 Year License # indicators for 60 Day Follow-up 2 Organizational Areas Needing Improvement on Standards not met/Follow-up to occur: From DDS review: Indicator # Indicator Area Needing Improvement L65 Restraint reports are submitted within required timelines. In seven of sixteen audits, the agency did not submit restraint reports into the HCSIS system within the required timelines. The agency needs to ensure that it submits restraint reports into the HCSIS system within the required timelines.  Residential Areas Needing Improvement on Standards not met/Follow-up to occur: From DDS review: Indicator # Indicator Area Needing Improvement L55 Informed consent is obtained from individuals or their guardians when required; Individuals or their guardians know that they have the right to withdraw consent. The agency had obtained consent for the use of photographs without reference(s) to a particular photograph and/or publication in which it would be used. The agency needs to ensure that all consents for photographs are situation specific. L63 Medication treatment plans are in written format with required components. In three of ten audits, the agency did not ensure that data collection relative to medication treatment plans was collected on a consistent basis and aggregated for use by the prescribing physician. The agency needs to ensure that data collection occurs as per the plan and is made available and presented to the prescribing physician. L86 Required assessments concerning individual needs and abilities are completed in preparation for the ISP. Although there was significant improvement noted, in four out of fourteen audits, the agency did not consistently ensure that required assessments were submitted to DDS within the established timeframes. The agency needs to ensure that it submits all required assessments to DDS within the established timeframes. L87 Support strategies necessary to assist an individual to meet their goals and objectives are completed and submitted as part of the ISP. Although there was significant improvement noted, in five out of fourteen audits, the agency did not consistently ensure that support strategies were submitted to DDS within the established timeframes. The agency needs to ensure that it submits all support strategies to DDS within the established timeframes. L88 Services and support strategies identified and agreed upon in the ISP for which the provider has designated responsibility are being implemented. The agency did not ensure that provider support strategies were consistently implemented in four out of fifteen audits. The agency needs to ensure that it consistently implements provider support strategies and documents their outcomes on a regular basis, for the purpose of supporting individuals to achieve their goals. Employment/Day Areas Needing Improvement on Standards not met/Follow-up to occur: From DDS review: Indicator # Indicator Area Needing Improvement L86 Required assessments concerning individual needs and abilities are completed in preparation for the ISP. In two of four audits, the agency did not consistently ensure that required assessments were submitted to DDS within the established timeframes. The agency needs to ensure that it submits all required assessments to DDS within the established timeframes.   CERTIFICATION FINDINGS Reviewed by Met / Rated Not Met / Rated % Met Certification - Planning and Quality Management DDS 6/6 Provider 5/5 11/11 0/11 Residential and Individual Home Supports DDS 32/38 Provider -5/-5 27/33 6/33 Individual Home Supports DDS 17/19 Provider 19/19 36/38 2/38 Residential Services DDS 15/19 Provider 19/19 34/38 4/38 Total 38/44 6/44 86% Certified Reviewed By Met / Rated Not Met / Rated % Met Certification - Planning and Quality Management DDS 6/6 Provider 5/5 11/11 0/11 Employment and Day Supports DDS 19/20 Provider 10/10 29/30 1/30 Community Based Day Services DDS 11/11 Provider 2/2 13/13 0/13 Employment Support Services DDS 8/9 Provider 13/13 21/22 1/22 Total 40/41 1/41 98% Certified Individual Home Supports- Areas Needing Improvement on Standards not met From DDS Review: Indicator # Indicator Area Needing Improvement C7 Individuals have opportunities to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them. Individuals were generally involved in the hiring of staff that support them; however, it was reported by the agency that this was not routinely documented. In addition, the agency had not routinely solicited and documented information from individuals relative to their input for employee evaluations. The agency needs to ensure that individuals are offered opportunities to provide feedback about those who support them at both the time of hire and on an ongoing basis relative to staff performance evaluations. C16 Staff (Home Providers) support individuals to explore, discover and connect with their interests for cultural, social, recreational and spiritual activities. In two of four audits, the agency did not consistently support individuals to explore, discover and connect with their own personal interests for cultural, social, recreational and spiritual activities. Agency staff need to support individuals to explore, discover and connect with their interests for cultural, social, recreational and spiritual activities. Residential Services- Areas Needing Improvement on Standards not met From DDS Review: Indicator # Indicator Area Needing Improvement C7 Individuals have opportunities to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them. Individuals were generally involved in the hiring of staff that support them; however, it was reported by the agency that this was not routinely documented. In addition, the agency had not routinely solicited and documented information from individuals relative to their input for employee evaluations. The agency needs to ensure that individuals are offered opportunities to provide feedback about those who support them at both the time of hire and on an ongoing basis relative to staff performance evaluations. C9 Staff (Home Providers) provide opportunities to develop and/or increase personal relationships and social contacts. In four of eleven audits, the agency did not consistently support individuals to develop and/or increase personal relationships and social contacts. The agency needs to ensure that staff support people to further develop and/or increase personal relationships and social contacts. C16 Staff (Home Providers) support individuals to explore, discover and connect with their interests for cultural, social, recreational and spiritual activities. In five of eleven audits, the agency did not consistently support individuals to explore, discover and connect with their own personal interests for cultural, social, recreational and spiritual activities. Agency staff need to support individuals to explore, discover and connect with their interests for cultural, social, recreational and spiritual activities. C17 Community activities are based on the individual's preferences and interests. In five of eleven audits, the agency did not consistently support individuals to engage in community based activities that were based on their personal preferences. The agency needs to ensure that it provides individuals with the opportunity to participate in community activities that reflect their own personal preferences and interests. Employment Support Services- Areas Needing Improvement on Standards not met From DDS Review: Indicator # Indicator Area Needing Improvement C7 Individuals have opportunities to provide feedback at the time of hire and on an ongoing basis on the performance of staff that support them. Individuals were generally involved in the hiring of staff that support them; however, it was reported by the agency that this was not routinely documented. In addition, the agency had not routinely solicited and documented information from individuals relative to their input for employee evaluations. The agency needs to ensure that individuals are offered opportunities to provide feedback about those who support them at both the time of hire and on an ongoing basis relative to staff performance evaluations.  MASTER SCORE SHEET LICENSURE Organizational: BAY COVE HUMAN SERVICES  Indicator # Indicator Reviewed by Met/Rated Rating (Met, Not Met, Not Rated) O L2 Abuse/neglect reporting DDS 17/17 Met L3 Immediate Action Provider - Met L4 Action taken Provider - Met L48 HRC DDS 1/1 Met L65 Restraint report submit DDS 9/16 Not Met(56.25 % ) L66 HRC restraint review Provider - Met L74 Screen employees Provider - Met L75 Qualified staff Provider - Met L76 Track trainings Provider - Met L83 HR training Provider - Met Residential and Individual Home Supports:  Ind. # Ind. Loc. or Indiv. Reviewed by Res. Sup. Ind. Home Sup. Place. Resp. ABI-MFP Res. Sup. ABI-MFP Place. Total Met/Rated Rating L1 Abuse/neglect training I Provider - - - - - Met L4 Action taken L Provider - - - - - Met L5 Safety Plan L DDS 11/11 2/2 13/13 Met O L6 Evacuation L DDS 10/11 2/2 12/13 Met (92.31 %) L7 Fire Drills L Provider - - - - - Met L8 Emergency Fact Sheets I Provider - - - - - Met L9 Safe use of equipment L Provider - - - - - Met L10 Reduce risk interventions I Provider - - - - - Met O L11 Required inspections L DDS 10/11 1/1 11/12 Met (91.67 %) O L12 Smoke detectors L DDS 10/11 2/2 12/13 Met (92.31 %) O L13 Clean location L DDS 11/11 1/1 12/12 Met L14 Site in good repair L Provider - - - - - Met L15 Hot water L DDS 9/11 1/1 10/12 Met (83.33 %) L16 Accessibility L Provider - - - - - Met L17 Egress at grade L Provider - - - - - Met L18 Above grade egress L Provider - - - - - Met L19 Bedroom location L Provider - - - - - Met L20 Exit doors L Provider - - - - - Met L21 Safe electrical equipment L Provider - - - - - Met L22 Clean appliances L Provider - - - - - Met L23 Egress door locks L Provider - - - - - Met L24 Locked door access L Provider - - - - - Met L25 Dangerous substances L Provider - - - - - Met L26 Walkway safety L Provider - - - - - Met L28 Flammables L Provider - - - - - Met L29 Rubbish/combustibles L Provider - - - - - Met L30 Protective railings L Provider - - - - - Met L31 Communication method I Provider - - - - - Met L32 Verbal & written I Provider - - - - - Met L33 Physical exam I Provider - - - - - Met L34 Dental exam I Provider - - - - - Met L35 Preventive screenings I Provider - - - - - Met L36 Recommended tests I Provider - - - - - Met L37 Prompt treatment I Provider - - - - - Met O L38 Physician's orders I DDS 9/9 1/1 10/10 Met L39 Dietary requirements I Provider - - - - - Met L40 Nutritional food L Provider - - - - - Met L41 Healthy diet L Provider - - - - - Met L42 Physical activity L Provider - - - - - Met L43 Health Care Record I Provider - - - - - Met L44 MAP registration L Provider - - - - - Met L45 Medication storage L Provider - - - - - Met O L46 Med. Administration I DDS 11/11 11/11 Met L47 Self medication I DDS 11/11 11/11 Met L49 Informed of human rights I DDS 10/11 4/4 14/15 Met (93.33 %) L50 Respectful Comm. L DDS 11/11 2/2 13/13 Met L51 Possessions I Provider - - - - - Met L52 Phone calls I DDS 11/11 4/4 15/15 Met L53 Visitation I Provider - - - - - Met L54 Privacy L DDS 11/11 2/2 13/13 Met L55 Informed consent I DDS 0/1 0/2 0/3 Not Met (0 %) L56 Restrictive practices I Provider - - - - - Met L57 Written behavior plans I Provider - - - - - Met L58 Behavior plan component I Provider - - - - - Met L59 Behavior plan review I Provider - - - - - Met L60 Data maintenance I Provider - - - - - Met L61 Health protection in ISP I Provider - - - - - Met L62 Health protection review I Provider - - - - - Met L63 Med. treatment plan form I DDS 7/10 7/10 Not Met (70.0 %) L64 Med. treatment plan rev. I Provider - - - - - Met L65 Restraint report submit L Provider - - - - - Met L67 Money mgmt. plan I Provider - - - - - Met L68 Funds expenditure I Provider - - - - - Met L69 Expenditure tracking I Provider - - - - - Met L70 Charges for care calc. I Provider - - - - - Met L71 Charges for care appeal I Provider - - - - - Met L77 Unique needs training I Provider - - - - - Met L78 Restrictive Int. Training L Provider - - - - - Met L79 Restraint training L Provider - - - - - Met L80 Symptoms of illness L Provider - - - - - Met L81 Medical emergency L Provider - - - - - Met O L82 Medication admin. L DDS 11/11 11/11 Met L84 Health protect. Training I Provider - - - - - Met L85 Supervision L Provider - - - - - Met L86 Required assessments I DDS 7/11 3/3 10/14 Not Met (71.43 %) L87 Support strategies I DDS 7/11 2/3 9/14 Not Met (64.29 %) L88 Strategies implemented I DDS 7/11 4/4 11/15 Not Met (73.33 %) L90 Personal space/ bedroom privacy I DDS 10/10 4/4 14/14 Met #Std. Met/# 78 Indicator 73/78 Total Score 82/88 93.18% Employment and Day Supports:  Ind. # Ind. Loc. or Indiv. Reviewed by Emp. Sup. Cent. Based Work Com. Based Day Total Met / Rated Rating L1 Abuse/neglect training I Provider - - - Met O L2 Abuse/neglect reporting L Provider - - - Met L4 Action taken L Provider - - - Met L5 Safety Plan L Provider - - - Met O L6 Evacuation L DDS 1/1 1/1 2/2 Met L7 Fire Drills L Provider - - - Met L8 Emergency Fact Sheets I Provider - - - Met L9 Safe use of equipment L Provider - - - Met L10 Reduce risk interventions I Provider - - - Met O L11 Required inspections L DDS 1/1 1/1 2/2 Met O L12 Smoke detectors L DDS 1/1 1/1 2/2 Met O L13 Clean location L DDS 1/1 1/1 2/2 Met L14 Site in good repair L Provider - - - Met L15 Hot water L Provider - - - Met L16 Accessibility L Provider - - - Met L17 Egress at grade L Provider - - - Met L18 Above grade egress L Provider - - - Met L20 Exit doors L Provider - - - Met L21 Safe electrical equipment L Provider - - - Met L22 Clean appliances L Provider - - - Met L25 Dangerous substances L Provider - - - Met L26 Walkway safety L Provider - - - Met L28 Flammables L Provider - - - Met L29 Rubbish/combustibles L Provider - - - Met L31 Communication method I Provider - - - Met L32 Verbal & written I Provider - - - Met O L38 Physician's orders I DDS 4/4 4/4 Met L44 MAP registration L Provider - - - Met L45 Medication storage L Provider - - - Met O L46 Med. Administration I DDS 2/2 2/2 Met L49 Informed of human rights I DDS 3/3 4/4 7/7 Met L50 Respectful Comm. L DDS 1/1 1/1 2/2 Met L51 Possessions I Provider - - - Met L52 Phone calls I DDS 3/3 4/4 7/7 Met L54 Privacy L DDS 1/1 1/1 2/2 Met L55 Informed consent I Provider - - - Met L58 Behavior plan component I Provider - - - Met L59 Behavior plan review I Provider - - - Met L60 Data maintenance I Provider - - - Met L65 Restraint report submit L Provider - - - Met L77 Unique needs training I Provider - - - Met L78 Restrictive Int. Training L Provider - - - Met L79 Restraint training L Provider - - - Met L80 Symptoms of illness L Provider - - - Met L81 Medical emergency L Provider - - - Met O L82 Medication admin. L DDS 1/1 1/1 Met L84 Health protect. Training I Provider - - - Met L85 Supervision L Provider - - - Met L86 Required assessments I DDS 1/2 1/2 2/4 Not Met (50.0 %) L87 Support strategies I Provider - - - Met L88 Strategies implemented I Provider - - - Met #Std. 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$$Ifa$K$$IfK$kdS$IfK$L$rp%p8 62(a }uuujj $$Ifa$K$$IfK$kd$IfK$L$rp%p8 62(a,57;}uuujj $$Ifa$K$$IfK$kdw$IfK$L$rp%p8 62(a;<ASW[_}uuujj $$Ifa$K$$IfK$kd $IfK$L$rp%p8 62(a_`e~}uuujj $$Ifa$K$$IfK$kd$IfK$L$rp%p8 62(a}uuujj $$Ifa$K$$IfK$kd-$IfK$L$rp%p8 62(aĘ}uuujj $$Ifa$K$$IfK$kd$IfK$L$rp%p8 62(aØĘ #%@ABMNWXcdmntvyzЙљٙڙۙܙߙ   34<=>?BDHIghpqrsvx|}Uhw5h]T5B*OJPJQJphh]TB*OJPJQJphh]TU $}uuujj $$Ifa$K$$IfK$kdQ$IfK$L$rp%p8 62(a$%ABNXd}u<uuu8kdu$IfK$L$%%62(aytw5$IfK$kd$IfK$L$rp%p8 62(adnuvzrjjj$IfK$kd$IfK$L$rp%p8 62(a $$Ifa$K$љڙܙ}uuujj $$Ifa$K$$IfK$kdY$IfK$L$rp%p8 62(a  }uuujj $$Ifa$K$$IfK$kd$IfK$L$rp%p8 62(aProvider - Met C23 Assess skills & training needs Provider - Met C24 Job goals & support needs plan Provider - Met C25 Skill development Provider - Met C26 Benefits analysis Provider - Met C27 Job benefit education DDS 3/3 Met C28 Relationships w/businesses DDS 1/1 Met C29 Support to obtain employment Provider - Met C30 Work in integrated settings DDS 2/2 Met C31 Job accommodations Provider - Met C32 At least minimum wages earned Provider - Met C33 Employee benefits explained Provider - Met C34 Support to promote success DDS 2/2 Met C35 Feedback on job performance Provider - Met C36 Supports to enhance retention Provider - Met C37 Interpersonal skills for work Provider - Met C47 Transportation to/ from community DDS 3/3 Met C50 Involvement/ part of the Workplace culture DDS 2/2 Met C51 Ongoing satisfaction with services/ supports DDS 3/3 Met C54 Assistive technology DDS 3/3 Met Individual Home Supports Indicator # Indicator Reviewed By Met/Rated Rating C7 Feedback on staff performance DDS 0/4 Not Met (0 %) C9 Personal relationships DDS 4/4 Met C11 Get together w/family & friends DDS 4/4 Met C12 Intimacy DDS 4/4 Met C13 Skills to maximize independence DDS 4/4 Met C14 Choices in routines & schedules DDS 4/4 Met C15 Personalize living space DDS 2/2 Met C16 Explore interests DDS 2/4 Not Met (50.0 %) C17 Community activities DDS 3/4 Met C18 Purchase personal belongings DDS 4/4 Met C19 Knowledgeable decisions DDS 4/4 Met C46 Use of generic resources DDS 4/4 Met C47 Transportation to/ from community DDS 4/4 Met C48 Neighborhood connections DDS 4/4 Met C49 Physical setting is consistent DDS 2/2 Met C51 Ongoing satisfaction with services/ supports DDS 4/4 Met C52 Leisure activities and free-time choices /control DDS 4/4 Met C53 Food/ dining choices DDS 4/4 Met C54 Assistive technology DDS 4/4 Met Residential Services Indicator # Indicator Reviewed By Met/Rated Rating C7 Feedback on staff performance DDS 1/11 Not Met (9.09 %) C9 Personal relationships DDS 7/11 Not Met (63.64 %) C11 Get together w/family & friends DDS 11/11 Met C12 Intimacy DDS 10/11 Met (90.91 %) C13 Skills to maximize independence DDS 10/11 Met (90.91 %) C14 Choices in routines & schedules DDS 11/11 Met C15 Personalize living space DDS 11/11 Met C16 Explore interests DDS 6/11 Not Met (54.55 %) C17 Community activities DDS 6/11 Not Met (54.55 %) C18 Purchase personal belongings DDS 11/11 Met C19 Knowledgeable decisions DDS 11/11 Met C46 Use of generic resources DDS 11/11 Met C47 Transportation to/ from community DDS 10/11 Met (90.91 %) C48 Neighborhood connections DDS 11/11 Met C49 Physical setting is consistent DDS 10/11 Met (90.91 %) C51 Ongoing satisfaction with services/ supports DDS 11/11 Met C52 Leisure activities and free-time choices /control DDS 11/11 Met C53 Food/ dining choices DDS 10/11 Met (90.91 %) C54 Assistive technology DDS 9/11 Met (81.82 %)       PAGE 23 of  NUMPAGES 23   4=?C}uuujj $$Ifa$K$$IfK$kd}$IfK$L$rp%p8 62(aCDIhqsw}uuujj $$Ifa$K$$IfK$kd$IfK$L$rp%p8 62(awx}}uuujj $$Ifa$K$$IfK$kd$IfK$L$rp%p8 62(a}ĠƠʠˠ  <=EFGHKMQRmnqruvy{šơΡϡСѡԡ֡ڡۡh]T5B*OJPJQJphh]Th]TB*OJPJQJphWŠ}uuujj $$Ifa$K$$IfK$kd3$IfK$L$rp%p8 62(aŠƠˠ}uuujj $$Ifa$K$$IfK$kd$IfK$L$rp%p8 62(a}uuujj $$Ifa$K$$IfK$kdW $IfK$L$rp%p8 62(a =FHL}uuujj $$Ifa$K$$IfK$kd $IfK$L$rp%p8 62(aLMRnrvz}uuujj $$Ifa$K$$IfK$kd{ $IfK$L$rp%p8 62(az{}uuujj $$Ifa$K$$IfK$kd $IfK$L$rp%p8 62(aơϡѡա}uuujj $$Ifa$K$$IfK$kd 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