PROVIDER REPORT FOR	

	

	

	

	

	

	

	

	

	
	
BETTER COMMUNITY LIVING INC
5 Ventura Drive
 Dartmouth, MA 02747    	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

	

Version	

	

	

	

	

	

	

	

	
Provider Web Report
June 27, 2018	

	

	

	

	

	

	

	
Prepared by the Department of Developmental Services
OFFICE OF QUALITY ENHANCEMENT	

	

	

	

	

	

	

				
	SUMMARY OF OVERALL FINDINGS	

				

	

	

Provider	

	
BETTER COMMUNITY LIVING INC	

	

	

	

	
Review Dates	

	
6/7/2018 - 6/13/2018	

	

	

	

	
Service Enhancement 
Meeting Date	

	
6/27/2018	

	

	

	

	

	

	
Survey Team	

	
Laura O'Connor	

Katherine Gregory (TL)	

Scott Nolan	

Ed Sutka	

	

	

	

	

	

	
Citizen Volunteers	

	

	

		

	
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	
11 location(s) 11 audit (s) 	
Full Review	
85 / 86 2 Year License 06/27/2018 -  06/27/2020	
	
67 / 73 Certified 06/27/2018 -  06/27/2020	

Residential Services	
5 location(s) 5 audit (s) 	

Full Review	
20 / 22	

Placement Services	
3 location(s) 3 audit (s) 	

Full Review	
20 / 22	

Individual Home Supports	
3 location(s) 3 audit (s) 	

Full Review	
21 / 23	

Planning and Quality Management (For all service groupings)	

	
Full Review	
6 / 6	

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) 3 audit (s) 	
Full Review	
33 / 35 2 Year License 06/27/2018 -  06/27/2020	
	
40 / 42 Certified 06/27/2018 -  06/27/2020	

Community Based Day Services	
1 location(s) 1 audit (s) 	

Full Review	
13 / 14	

Employment Support Services	
1 location(s) 2 audit (s) 	

Full Review	
21 / 22	

Planning and Quality Management (For all service groupings)	

	
Full Review	
6 / 6	

	

	

EXECUTIVE SUMMARY :	

			
Better Community Living, Inc. a non-profit agency founded in 1998, is celebrating its thirtieth year of providing support for adults and children with disabilities living throughout the Greater New Bedford community. The agency offers a number of service types, including day habilitation, family flexible supports, residential supports, employment/day supports, and recently piloted day services designed to meet the unique needs of individuals with autism. Residential services include twenty four hour supports for 42 people, Placement services for 5 people and 14 people who receive less than 24 hour Individual Supports.  The agency's day supports encompassed approximately 1 individual receiving community based day services (CBDS) and 4 individuals receiving employment services. 

The scope of this survey, conducted by the Office of Quality Enhancement (OQE), was a full review of all licensing and certification indicators of the agency's Residential Services, for those receiving at least 15 hours of supports per week, and Employment Supports.  The agency's Community Based Day Services (CBDS) program is accredited by the Council for the Accreditation of Rehabilitation Facilities (CARF).  For this service, the DDS completed a full licensure review and evaluated the new and revised certification indicators as of August 2016.

Organizationally the agency had systems in place to effectively safeguard individuals in the areas of environmental safety, human rights, and personal safety and health care coordination.  Maintenance personnel visited homes on a quarterly basis to ensure routine and corrective maintenance was completed.  It was evidenced across all homes visited during the survey that systems were effective in ensuring that required inspections were in place; smoke and CO detectors were operational, and that homes were clean and well maintained.   People and their guardians were routinely provided information regarding how to file a grievance or to report to the Disabled Person Protection Commission (DPPC).

Within Residential services there was a variety of practices in place in the area of health care coordination and promoting optimal health.  The agency used a comprehensive electronic healthcare management system to track and monitor that individuals received regular, preventative, and follow up care.  Nursing support was readily available and provided training to staff regarding healthcare case management and promoting healthy lifestyles.  Noted outcomes of these efforts including people were offered healthy diets and exercise was encouraged, with notable positive impact such as one individual losing over sixty pounds. All of the people that had participated in the survey, received recommended routine, preventative and follow up health care.  

Supporting individuals with challenging behaviors to develop more pro-social behaviors was also an area of strength for the agency. Medication Treatment Plans and Positive Behavioral Support Plans contained target behaviors common to both, and interventions were applied consistently. Individuals were also supported to use coping strategies to increase constructive interactions with others, increasing their ability to gain and maintain friendships.   

Staff was observed to be very knowledgeable of the unique needs of each of the individuals they supported and were highly responsive to individuals' personal preferences and clinical needs.  A strategy used by the agency to promote this outcome was the development of a 'Unique Needs' profile for each individual.  In some instances, staff longevity provided long term relationships and understanding of people's unique support needs and preferences.  

A review of licensing indicators related to non-site based CBDS and Employment services identified several positive outcomes. Individuals were supported to increasingly expand their skills in areas such as safe use of equipment, time management, and planning for more efficient delivery of Meals on Wheels. ISP goals were personalized to reflect the assessed interests and strengths of the individuals. 

The review of certification indicators identified several positive outcomes for individuals, across all of the services reviewed.  Electronically centralized information systems enhanced communication with guardians and DDS through the weekly distribution of individual case notes. Individuals were supported to visit frequently with family and friends. One individual had been supported to re-connect with a relative with whom he had grown up and he was making plans to visit her in another state where she lived.

An emphasis was placed on ensuring individuals receiving Residential and Individual Home Supports were supported to explore and participate in activities that matched their interests and cultural preferences. The agency's strategic plan contained an initiative to increase participation in community based activities through the development of a community activity calendar to be distributed to all staff weekly. Events are also emailed to staff daily with the intent of increasing the awareness of the availability of local events. Staff were familiar with the calendars and also the particular interests of the individuals they worked with. The agency tracked the frequency of community outings in in order to determine the effectiveness of their plan. It was evident that individuals enjoyed a rich variety of cultural and recreational experiences in their community. Many activities were tailored to the individual's specific tastes. One individual preferred 3-D movies and was supported to frequently enjoy such movies. 

Individuals were also encouraged to explore new interests, and to connect with others who had shared interests. An individual who had found friends in his neighborhood that enjoyed wrestling was supported to throw a party with them during a special wrestling event. It was evident through observation that discussions regarding the wide array of recreational opportunities offered were a natural part of conversation between staff and individuals. Individuals were active participants in multiple recreational and community activities such as local cultural festivals, trips to casinos, walks in local parks and nature preserves, public exercise sessions on the beach, participation in bowling leagues, attendance of local fitness clubs. One individual who expressed a desire to maintain connections with her Portuguese culture was supported to access resources and activities that represented her cultural heritage, such as spending time at the Portuguese-based library in New Bedford and attending Portuguese Festivals. Individuals readily expressed their satisfaction in the frequency and quality of activities they were involved in, had an increased presence in the community, and had enriched relationships and cultural experiences due to a consistent approach applied towards promoting community inclusion.

Within the CBDS and Employment Services, 95% of the certification indicators were met.  Individuals experienced fully integrated, competitive employment, and job success with both longevity and satisfaction. Individuals were supported to enjoy a variety of employment options and activities in the community. A wide variety of community activities were offered based on individuals' contributions and exploration of what was offered within the local community of each person. For instance, one individual chose to frequent businesses in the community of his childhood, where he had developed relationships with the employees. Another individual, through the providing support CBDS Program, attends integrated art classes and through his community relationships has become an established artist exhibiting in local shows and galleries. 

While a number of strengths were identified within the licensing and certification indicators, there are areas in which further efforts are needed to meet the intended outcomes. For example, one behavior plan was found to have a restrictive practice, without a clearly identified rationale, or a plan to fade this practice. The agency would benefit from strengthening its existing systems of review pertaining to any potentially restrictive practices, to ensure that all required components are in place. The agency has initiated efforts to provide training in intimacy and companionship for individuals through their Safe, Healthy Intimacy Education (S.H.IN.E) Program. An increased focus on assessing all individuals' needs in this area and providing appropriate guidance and education is recommended. Comprehensive assessments were not yet in place and/or strategies to support each individual to become as independent as possible through the use of assistive technology or modifications. 

Another area that an emphasis should be placed is the development of procedures to ensure essential safeguards are in place when people use checking accounts with attached debit cards.  Given that employers may provide direct deposit as a method of payment, strategies should be in place for tracking and monitoring expenditures when people receive assistance with money management.  The agency is encouraged to strengthen training and oversight to ensure that all staff are knowledgeable regarding their roles and responsibilities pertaining to money management needs. 

Based on the findings of this report, Better Community Living has earned a Two Year License for Residential Supports with 99% of all licensing indicators receiving a rating of met and is Certified achieving 92% of the certification indicators The agency also achieved a Two Year license for its Employment/Day Supports with 94% of all licensing indicators receiving a rating of Met and is Certified achieving 95% of all certification indicators.  The agency is responsible for indicators rated Not Met within 60 days in the area of Residential Support.	

LICENSURE FINDINGS	

	

	

	

	

Met / Rated	
Not Met / Rated	
% Met	

Organizational	
9/10	
1/10	

Residential and Individual Home Supports	
76/76	
0/76	

    Residential Services
    Placement Services
    Individual Home Supports

	

Critical Indicators	
8/8	
0/8	

Total	
85/86	
1/86	
99%	

2 Year License	

	

# indicators for 60 Day Follow-up	
	
1	

	

Met / Rated	
Not Met / Rated	
% Met	

Organizational	
9/10	
1/10	

Employment and Day Supports	
24/25	
1/25	

    Community Based Day Services
    Employment Support Services

	

Critical Indicators	
1/1	
0/1	

Total	
33/35	
2/35	
94%	

2 Year License	

	

# indicators for 60 Day Follow-up	
	
2	

	

	
Organizational Areas Needing Improvement on Standards not met/Follow-up to occur:	

Indicator #	
Indicator	
Area Needing Improvement	

 L65	
Restraint reports are submitted within required timelines.	
One of two restraint reports received the Restraint Manager Review past the 5 day deadline. The agency needs to ensure restraint reports are submitted within the required timelines.	

		

	

	
Employment/Day Areas Needing Improvement on Standards not met/Follow-up to occur:	

Indicator #	
Indicator	
Area Needing Improvement	

 L56	
Restrictive practices intended for one individual that affect all individuals served at a location need to have a written rationale that is reviewed as required and have provisions so as not to unduly restrict the rights of others.	
Restrictive practices for one individual served in both CBDS and Employment Services are included in a written plan; a rationale for one practice was not clear nor was there a plan to reduce or eliminate the need for the restriction. The agency needs to determine if this practice is effective, develop clear procedures for staff implementation, and a plan to fade or reduce the need for this restriction.	

			

	CERTIFICATION FINDINGS	

						
		
Met / Rated	
Not Met / Rated	
% Met	

Certification - Planning and Quality Management	
6/6	
0/6	

Residential and Individual Home Supports	
61/67	
6/67	

Individual Home Supports	
21/23	
2/23	

Placement Services	
20/22	
2/22	

Residential Services	
20/22	
2/22	

TOTAL	
67/73	
6/73	
92%	

Certified	

	

Met / Rated	
Not Met / Rated	
% Met	

Certification - Planning and Quality Management	
6/6	
0/6	

Employment and Day Supports	
34/36	
2/36	

Community Based Day Services	
13/14	
1/14	

Employment Support Services	
21/22	
1/22	

TOTAL	
40/42	
2/42	
95%	

Certified	

	

						

Individual Home Supports- Areas Needing Improvement on Standards not met:	

Indicator #	
Indicator	
Area Needing Improvement	

 C12	
Individuals are supported to explore, define, and express their need for intimacy and companionship.	
For one individual, staff had not assessed their interests and need for intimacy and companionship. The agency needs to ensure that staff have an understanding of the individual's interest in the area of companionship, and support them to explore and express those interests and needs.	

 C54	
Individuals have the assistive technology and/or modifications to maximize independence. 	
For two individuals, a plan was not developed to support them to explore and implement the use of assistive devices and/or modify existing technology to maximize their independence.  The agency needs to ensure that all individuals are assessed to determine whether the individual would benefit from any assistive devices to maximize their independence in their home and community	

	

	

Placement Services- Areas Needing Improvement on Standards not met:	

Indicator #	
Indicator	
Area Needing Improvement	

 C12	
Individuals are supported to explore, define, and express their need for intimacy and companionship.	
For two individuals, staff had not assessed their interests and need for intimacy and companionship. The agency needs to ensure that staff have an understanding of the individual's interest in the area of companionship, and support them to explore and express those interests and needs.	

 C54	
Individuals have the assistive technology and/or modifications to maximize independence. 	
For three individuals, plans were not developed to support them to explore and implement the use of assistive devices and/or modify existing technology to maximize their independence. The agency needs to ensure that all individuals are assessed to determine whether the individual would benefit from any assistive devices to maximize their independence in their home and community	

	

	
Residential Services- Areas Needing Improvement on Standards not met:	

Indicator #	
Indicator	
Area Needing Improvement	

 C12	
Individuals are supported to explore, define, and express their need for intimacy and companionship.	
For three individuals, the agency had not assessed their interests and need for intimacy and companionship. The agency needs to ensure that staff have an understanding of the individual's interest in the area of companionship, and support them to explore and express those interests and needs.	

 C54	
Individuals have the assistive technology and/or modifications to maximize independence. 	
For four individuals, plans were not developed to support them to explore and implement the use of assistive devices and/or modify existing technology to maximize their independence.  The agency needs to ensure that all individuals are assessed to determine whether the individual would benefit from any assistive devices to maximize their independence in their home and community	

	

	

Community Based Day Services- Areas Needing Improvement on Standards not met:	

Indicator #	
Indicator	
Area Needing Improvement	

 C54	
Individuals have the assistive technology and/or modifications to maximize independence. 	
For one individual, a plan was not developed to support them to explore and implement the use of assistive devices and/or modify existing technology to maximize their independence. The agency needs to ensure that all individuals are assessed to determine whether the individual would benefit from any assistive devices to maximize their independence in their home and community	

	

	
Employment Support Services- Areas Needing Improvement on Standards not met:	

Indicator #	
Indicator	
Area Needing Improvement	

 C54	
Individuals have the assistive technology and/or modifications to maximize independence. 	
For two individuals, plans were not developed to support them to explore and implement the use of assistive devices and/or modify existing technology to maximize their independence.  The agency needs to ensure that all individuals are assessed to determine whether the individual would benefit from any assistive devices to maximize their independence in their home and community	

	

		

	MASTER SCORE SHEET LICENSURE	

					
	Organizational: BETTER COMMUNITY LIVING INC	

					
	
Indicator #	
Indicator	
Met/Rated	
Rating(Met,Not Met,NotRated)	

O	
 L2	
Abuse/neglect reporting	
12/12	
Met	

 L3	
Immediate Action	
15/15	
Met	

 L4	
Action taken	
12/12	
Met	

 L48	
HRC	
1/1	
Met	

 L65	
Restraint report submit	
1/2	
Not Met(50.0 % )	

 L66	
HRC restraint review	
2/2	
Met	

 L74	
Screen employees	
1/1	
Met	

 L75	
Qualified staff	
2/2	
Met	

 L76	
Track trainings	
17/17	
Met	

 L83	
HR training	
17/17	
Met	

							
	Residential and Individual Home Supports:	

							
	
Ind. #	
Ind.	
Loc. or Indiv.	
Res. Sup.	
Ind. Home Sup.	
Place.	
Resp.	
ABI-MFP Res. Sup.	
ABI-MFP Place.	
Total Met/Rated	
Rating	

 L1	
Abuse/neglect training	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L5	
Safety Plan	
L	
5/5	
3/3	
3/3	

	
11/11	
Met	

O	
 L6	
Evacuation	
L	
5/5	
1/1	
3/3	

	
9/9	
Met	

 L7	
Fire Drills	
L	
5/5	

	

5/5	
Met	

 L8	
Emergency Fact Sheets	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L9	
Safe use of equipment	
L	
5/5	
2/2	

	
	
7/7	
Met	

 L10	
Reduce risk interventions	
I	
2/2	

	

2/2	
Met	

O	
 L11	
Required inspections	
L	
5/5	
	
2/3	

	
7/8	
Met
(87.50 %)	

O	
 L12	
Smoke detectors	
L	
5/5	
1/1	
3/3	

	
9/9	
Met	

O	
 L13	
Clean location	
L	
5/5	
	
3/3	

	
8/8	
Met	

 L14	
Site in good repair	
L	
5/5	
	
2/3	

	
7/8	
Met
(87.50 %)	

 L15	
Hot water	
L	
5/5	
	
3/3	

	
8/8	
Met	

 L16	
Accessibility	
L	
5/5	
1/1	
3/3	

	
9/9	
Met	

 L17	
Egress at grade 	
L	
5/5	
1/1	
3/3	

	
9/9	
Met	

 L18	
Above grade egress	
L	
	
1/1	
1/1	

	
2/2	
Met	

 L19	
Bedroom location	
L	
4/4	

	

4/4	
Met	

 L20	
Exit doors	
L	
5/5	
1/1	

	
	
6/6	
Met	

 L21	
Safe electrical equipment	
L	
5/5	
	
3/3	

	
8/8	
Met	

 L22	
Well-maintained appliances	
L	
5/5	
	
3/3	

	
8/8	
Met	

 L23	
Egress door locks	
L	
5/5	

	

5/5	
Met	

 L24	
Locked door access	
L	
5/5	

	

5/5	
Met	

 L25	
Dangerous substances	
L	
5/5	

	

5/5	
Met	

 L26	
Walkway safety	
L	
5/5	
	
3/3	

	
8/8	
Met	

 L28	
Flammables	
L	
5/5	

	

5/5	
Met	

 L29	
Rubbish/combustibles	
L	
5/5	
	
3/3	

	
8/8	
Met	

 L30	
Protective railings	
L	
2/2	
	
3/3	

	
5/5	
Met	

 L31	
Communication method	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L32	
Verbal & written	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L33	
Physical exam	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L34	
Dental exam	
I	
5/5	
2/2	
3/3	

	
10/10	
Met	

 L35	
Preventive screenings	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L36	
Recommended tests	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L37	
Prompt treatment	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

O	
 L38	
Physician's orders	
I	
5/5	
2/3	

	
	
7/8	
Met
(87.50 %)	

 L39	
Dietary requirements	
I	
3/3	
1/1	

	
	
4/4	
Met	

 L40	
Nutritional food	
L	
5/5	
1/1	

	
	
6/6	
Met	

 L41	
Healthy diet	
L	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L42	
Physical activity	
L	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L43	
Health Care Record	
I	
4/5	
3/3	
2/3	

	
9/11	
Met
(81.82 %)	

 L44	
MAP registration	
L	
5/5	
2/2	

	
	
7/7	
Met	

 L45	
Medication storage	
L	
5/5	
2/2	

	
	
7/7	
Met	

O	
 L46	
Med. Administration	
I	
5/5	
2/2	
1/1	

	
8/8	
Met	

 L47	
Self medication	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L49	
Informed of human rights	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L50	
Respectful Comm.	
L	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L51	
Possessions	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L52	
Phone calls	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L53	
Visitation	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L54	
Privacy	
L	
4/5	
3/3	
3/3	

	
10/11	
Met
(90.91 %)	

 L55	
Informed consent	
I	
1/1	
1/1	

	
	
2/2	
Met	

 L56	
Restrictive practices	
I	
1/1	

	

1/1	
Met	

 L57	
Written behavior plans	
I	
2/2	
2/2	

	
	
4/4	
Met	

 L58	
Behavior plan component	
I	
2/2	
1/1	
1/1	

	
4/4	
Met	

 L59	
Behavior plan review	
I	
2/2	
1/1	
1/1	

	
4/4	
Met	

 L60	
Data maintenance	
I	
2/2	
1/1	
1/1	

	
4/4	
Met	

 L61	
Health protection in ISP	
I	
3/3	
1/1	

	
	
4/4	
Met	

 L62	
Health protection review	
I	
3/3	
1/1	

	
	
4/4	
Met	

 L63	
Med. treatment plan form	
I	
4/4	
	
1/1	

	
5/5	
Met	

 L64	
Med. treatment plan rev.	
I	
4/4	
	
1/1	

	
5/5	
Met	

 L67	
Money mgmt. plan	
I	
5/5	
	
1/2	

	
6/7	
Met
(85.71 %)	

 L68	
Funds expenditure	
I	
5/5	
	
2/2	

	
7/7	
Met	

 L69	
Expenditure tracking	
I	
5/5	
	
1/2	

	
6/7	
Met
(85.71 %)	

 L70	
Charges for care calc.	
I	
5/5	
1/1	
3/3	

	
9/9	
Met	

 L71	
Charges for care appeal	
I	
5/5	
1/1	
3/3	

	
9/9	
Met	

 L77	
Unique needs training	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L78	
Restrictive Int. Training	
L	
3/3	

	

3/3	
Met	

 L79	
Restraint training	
L	
4/4	

	

4/4	
Met	

 L80	
Symptoms of illness	
L	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L81	
Medical emergency	
L	
5/5	
3/3	
3/3	

	
11/11	
Met	

O	
 L82	
Medication admin.	
L	
5/5	
2/2	

	
	
7/7	
Met	

 L84	
Health protect. Training	
I	
3/3	
1/1	

	
	
4/4	
Met	

 L85	
Supervision 	
L	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L86	
Required assessments	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L87	
Support strategies	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

 L88	
Strategies implemented	
I	
4/5	
3/3	
2/3	

	
9/11	
Met
(81.82 %)	

 L90	
Personal space/ bedroom privacy	
I	
5/5	
3/3	
3/3	

	
11/11	
Met	

#Std. Met/# 76 Indicator	

	

	

76/76	

	
Total Score	

	

	

85/86	

	

	

	

	
98.84%	

		
							
Employment and Day Supports:	

							
	
Ind. #	
Ind.	
Loc. or Indiv.	
Emp. Sup.	
Cent. Based Work	
Com. Based Day	
Total Met / Rated	
Rating	

 L1	
Abuse/neglect training	
I	
2/2	
	
1/1	
3/3	
Met	

 L8	
Emergency Fact Sheets	
I	
2/2	
	
1/1	
3/3	
Met	

 L9	
Safe use of equipment	
L	
1/1	
	
1/1	
2/2	
Met	

 L31	
Communication method	
I	
2/2	
	
1/1	
3/3	
Met	

 L32	
Verbal & written	
I	
2/2	
	
1/1	
3/3	
Met	

 L37	
Prompt treatment	
I	
2/2	
	
1/1	
3/3	
Met	

 L39	
Dietary requirements	
I	
1/1	
	
1/1	
2/2	
Met	

 L49	
Informed of human rights	
I	
2/2	
	
1/1	
3/3	
Met	

 L50	
Respectful Comm.	
L	
1/1	
	
1/1	
2/2	
Met	

 L51	
Possessions	
I	
2/2	
	
1/1	
3/3	
Met	

 L52	
Phone calls	
I	
2/2	
	
1/1	
3/3	
Met	

 L54	
Privacy	
L	
1/1	
	
1/1	
2/2	
Met	

 L55	
Informed consent	
I	
1/1	
	
1/1	
2/2	
Met	

 L56	
Restrictive practices	
I	
0/1	
	
0/1	
0/2	
Not Met
(0 %)	

 L57	
Written behavior plans	
I	
1/1	
	
1/1	
2/2	
Met	

 L58	
Behavior plan component	
I	
1/1	
	
1/1	
2/2	
Met	

 L59	
Behavior plan review	
I	
1/1	
	
1/1	
2/2	
Met	

 L60	
Data maintenance	
I	
1/1	
	
1/1	
2/2	
Met	

 L77	
Unique needs training	
I	
2/2	
	
1/1	
3/3	
Met	

 L80	
Symptoms of illness	
L	
1/1	
	
1/1	
2/2	
Met	

 L81	
Medical emergency	
L	
1/1	
	
1/1	
2/2	
Met	

 L85	
Supervision 	
L	
1/1	
	
1/1	
2/2	
Met	

 L86	
Required assessments	
I	
2/2	
	
1/1	
3/3	
Met	

 L87	
Support strategies	
I	
2/2	
	
1/1	
3/3	
Met	

 L88	
Strategies implemented	
I	
2/2	
	
1/1	
3/3	
Met	

#Std. Met/# 25 Indicator	

	

24/25	

	
Total Score	

	

33/35	

	

	

	
94.29%	

		
							
	MASTER SCORE SHEET CERTIFICATION	

							
	
Certification - Planning and Quality Management	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C1	
Provider data collection	
1/1	
Met	

 C2	
Data analysis	
1/1	
Met	

 C3	
Service satisfaction	
1/1	
Met	

 C4	
Utilizes input from stakeholders	
1/1	
Met	

 C5	
Measure progress	
1/1	
Met	

 C6	
Future directions planning	
1/1	
Met	

	

	

							
Community Based Day Services	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff / care provider performance	
1/1	
Met	

 C8	
Family/guardian communication	
1/1	
Met	

 C13	
Skills to maximize independence 	
1/1	
Met	

 C37	
Interpersonal skills for work	
1/1	
Met	

 C40	
Community involvement interest	
1/1	
Met	

 C41	
Activities participation	
1/1	
Met	

 C42	
Connection to others	
1/1	
Met	

 C43	
Maintain & enhance relationship	
1/1	
Met	

 C44	
Job exploration	
1/1	
Met	

 C45	
Revisit decisions	
1/1	
Met	

 C46	
Use of generic resources	
1/1	
Met	

 C47	
Transportation to/ from community	
1/1	
Met	

 C51	
Ongoing satisfaction with services/ supports	
1/1	
Met	

 C54	
Assistive technology	
0/1	
Not Met (0 %)	

Employment Support Services	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff / care provider performance	
2/2	
Met	

 C8	
Family/guardian communication	
2/2	
Met	

 C22	
Explore job interests	
2/2	
Met	

 C23	
Assess skills & training needs	
2/2	
Met	

 C24	
Job goals & support needs plan	
2/2	
Met	

 C25	
Skill development	
2/2	
Met	

 C26	
Benefits analysis	
2/2	
Met	

 C27	
Job benefit education	
2/2	
Met	

 C28	
Relationships w/businesses	
1/1	
Met	

 C29	
Support to obtain employment	
2/2	
Met	

 C30	
Work in integrated settings	
2/2	
Met	

 C31	
Job accommodations	
2/2	
Met	

 C32	
At least minimum wages earned	
2/2	
Met	

 C33	
Employee benefits explained	
2/2	
Met	

 C34	
Support to promote success	
2/2	
Met	

 C35	
Feedback on job performance	
2/2	
Met	

 C36	
Supports to enhance retention	
2/2	
Met	

 C37	
Interpersonal skills for work	
2/2	
Met	

 C47	
Transportation to/ from community	
2/2	
Met	

 C50	
Involvement/ part of the Workplace culture	
2/2	
Met	

 C51	
Ongoing satisfaction with services/ supports	
2/2	
Met	

 C54	
Assistive technology	
0/2	
Not Met (0 %)	

Individual Home Supports	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff / care provider performance	
3/3	
Met	

 C8	
Family/guardian communication	
3/3	
Met	

 C9	
Personal relationships	
3/3	
Met	

 C10	
Social skill development	
3/3	
Met	

 C11	
Get together w/family & friends	
3/3	
Met	

 C12	
Intimacy	
2/3	
Not Met (66.67 %)	

 C13	
Skills to maximize independence 	
3/3	
Met	

 C14	
Choices in routines & schedules	
3/3	
Met	

 C15	
Personalize living space	
1/1	
Met	

 C16	
Explore interests	
3/3	
Met	

 C17	
Community activities	
3/3	
Met	

 C18	
Purchase personal belongings	
3/3	
Met	

 C19	
Knowledgeable decisions	
3/3	
Met	

 C20	
Emergency back-up plans	
3/3	
Met	

 C21	
Coordinate outreach	
3/3	
Met	

 C46	
Use of generic resources	
3/3	
Met	

 C47	
Transportation to/ from community	
3/3	
Met	

 C48	
Neighborhood connections	
3/3	
Met	

 C49	
Physical setting is consistent 	
1/1	
Met	

 C51	
Ongoing satisfaction with services/ supports	
3/3	
Met	

 C52	
Leisure activities and free-time choices /control	
3/3	
Met	

 C53	
Food/ dining choices	
3/3	
Met	

 C54	
Assistive technology	
1/3	
Not Met (33.33 %)	

Placement Services	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff / care provider performance	
3/3	
Met	

 C8	
Family/guardian communication	
2/2	
Met	

 C9	
Personal relationships	
3/3	
Met	

 C10	
Social skill development	
3/3	
Met	

 C11	
Get together w/family & friends	
3/3	
Met	

 C12	
Intimacy	
1/3	
Not Met (33.33 %)	

 C13	
Skills to maximize independence 	
3/3	
Met	

 C14	
Choices in routines & schedules	
3/3	
Met	

 C15	
Personalize living space	
3/3	
Met	

 C16	
Explore interests	
3/3	
Met	

 C17	
Community activities	
3/3	
Met	

 C18	
Purchase personal belongings	
3/3	
Met	

 C19	
Knowledgeable decisions	
3/3	
Met	

 C20	
Emergency back-up plans	
3/3	
Met	

 C46	
Use of generic resources	
3/3	
Met	

 C47	
Transportation to/ from community	
3/3	
Met	

 C48	
Neighborhood connections	
3/3	
Met	

 C49	
Physical setting is consistent 	
3/3	
Met	

 C51	
Ongoing satisfaction with services/ supports	
3/3	
Met	

 C52	
Leisure activities and free-time choices /control	
3/3	
Met	

 C53	
Food/ dining choices	
3/3	
Met	

 C54	
Assistive technology	
0/3	
Not Met (0 %)	

Residential Services	

Indicator #	
Indicator	
Met/Rated	
Rating	

 C7	
Feedback on staff / care provider performance	
5/5	
Met	

 C8	
Family/guardian communication	
5/5	
Met	

 C9	
Personal relationships	
5/5	
Met	

 C10	
Social skill development	
5/5	
Met	

 C11	
Get together w/family & friends	
5/5	
Met	

 C12	
Intimacy	
2/5	
Not Met (40.0 %)	

 C13	
Skills to maximize independence 	
5/5	
Met	

 C14	
Choices in routines & schedules	
5/5	
Met	

 C15	
Personalize living space	
5/5	
Met	

 C16	
Explore interests	
5/5	
Met	

 C17	
Community activities	
4/5	
Met (80.0 %)	

 C18	
Purchase personal belongings	
5/5	
Met	

 C19	
Knowledgeable decisions	
5/5	
Met	

 C20	
Emergency back-up plans	
5/5	
Met	

 C46	
Use of generic resources	
5/5	
Met	

 C47	
Transportation to/ from community	
5/5	
Met	

 C48	
Neighborhood connections	
5/5	
Met	

 C49	
Physical setting is consistent 	
5/5	
Met	

 C51	
Ongoing satisfaction with services/ supports	
5/5	
Met	

 C52	
Leisure activities and free-time choices /control	
5/5	
Met	

 C53	
Food/ dining choices	
5/5	
Met	

 C54	
Assistive technology	
1/5	
Not Met (20.0 %)