PROVIDER REPORT FOR
POLUS CENTER FOR SOCIAL AND ECONOM
134 High St
 Clinton, MA 01510    

 
 
Version
Provider Web Report

 
Prepared by the Department of Developmental Services
OFFICE OF QUALITY ENHANCEMENT	

SUMMARY OF OVERALL FINDINGS
 
Provider	
POLUS CENTER FOR SOCIAL AND ECONOMIC DEVELOPMENT	

Review Dates	
8/8/2012 - 8/14/2012	

Service Enhancement 
Meeting Date	
8/27/2012	

Survey Team	
 
Ken Jones	

Janina Millet (TL)	

Steve Goldberg	

Citizen Volunteers	
 
 NA	

	

 

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	9 location(s) 9 audit (s) 	Full Review	54 / 73 Defer Licensure  - 	 

 
 	
Placement Services	7 location(s) 7 audit (s) 	 

 
 	Full Review	14 / 14 Certified - with all indicators std. met	
Individual Home Supports	2 location(s) 2 audit (s) 	 

 
 	Full Review	15 / 15 Certified - with all indicators std. met	
 
Survey scope and findings for Planning and Quality Management	
Service Group Type	Sample Size	Scope	Licensure Level	Certification Scope	Certification Level	
Planning and Quality Management	N/A	N/A	N/A	Full Review	4/6 Certified	

EXECUTIVE SUMMARY

Established in 1979, the Polus Center for Social and Economic Development is an international, multi-faceted, non-profit organization headquartered in Clinton Massachusetts.  Among its areas of service provision Polus Center coordinates humanitarian efforts to people with disabilities in Central America, and provides planning and development consultation both nationally and internationally. Its community based supports in Massachusetts are located in the Worcester, North Shore and Greater Boston regions of the state.  The agency operates Placement Services and Individual Home Supports, provided to 46 individuals through contractual agreements with Department of Developmental Services. 

Although operating on an international level, organizationally Polus Center strives to create opportunities for people with disabilities by maintaining a small, close team of professionals who focus on providing innovative, person-centered, and flexible supports. The organization's Shared Living Guidelines establishes guiding principles that further promote expectations for services, focusing upon the importance of supporting people's home life, community involvement, human rights, and basic safety.  

Polus Center promoted and achieved highly individualized supports for individuals. The agency utilized processes such as person-centered planning sessions to create good matches for individuals with shared living providers and individual support staff. Types and locations of households and apartments were also considered from the standpoint of how best to support people's needs, while concurrently promoting their abilities and autonomy. The interests of people were well documented, well understood by providers and staff, and regularly engaged through activities of the individuals' own choosing. Program Directors monthly notes on home visits evidenced an ongoing focus on key areas of support, and a concerted effort on the part of providers to respond to the unique needs of all the individuals in the survey sample.
  
Another, strength of the Polus Center was its commitment to helping people develop and maintain relationships.  Polus' commitment in this area was evident in their mission statement and the guiding principles.  Polus Center has also made building these relationships and local community inclusion an intricate part of its orientation and training process.  Survey finding identified solid supports enabling people to pursue community connections consistent with their values and interest. Individuals expressed positive regards for their relationships with care providers.  Care providers also helped them to maintain relationships with family members and significant others. 

The survey team also identified areas in which Polus Center may productively focus its attention. Among these, the agency will need to develop more effective methods of oversight of medication administration practices, i.e. ' obtaining physician's orders, documentation of administration, meeting MAP requirements for site registration and certification of staff.  Measures should also be taken to better monitor service locations to ensure compliance with environmental safety standards such as requirements for water temperature and heating system inspections. Concerns were also noted in aspects of the supports provided to individuals in the management of their funds. The need for service improvement was also seen in survey findings related to rights protection, specifically documentation and review of support related protections, use of behavior modifying medication, and procedures for obtaining informed consent. Lastly, the agency should consider how these critical findings might be addressed through improvements that can be made to existing procedures in place for data collection and analysis. The agency has such systems in place that have demonstrated functionality, and their utility could be further realized.

 

LICENSURE FINDINGS

 	Met / Rated	Not Met / Rated	% Met	
Organizational	7/7	0/7	 	
Residential and Individual Home Supports	47/66	19/66	 

    Placement Services
    Individual Home Supports	 

 

 	
Critical Indicators	4/8	4/8	 	
Total	54/73	19/73	74%	
Defer Licensure	 	 	 	
# indicators for 60 Day Follow-up	 
 	19	 

 
 	Residential Areas Needing Improvement on Standards not met/Follow-up to occur:	
 
 	Indicator #	Indicator	Area Needing Improvement	

 

 
 	 L8	Emergency fact sheets are current and accurate and available on site.	Emergency Fact Sheets must reflect current information regarding individual that includes, current medications, known allergies, medical and psychological diagnosis, name and number for the designated contact person for each provider serving the individual, response to search efforts, ability to protect self and all relevant capabilities, limitations, and preferences.	

 
 
 	 L9	Individuals are able to utilize equipment and machinery safely. 	Where individuals are interested and involved in utilizing household equipment/appliances, an assessment of support needs relative to safety and the relevant supervision/training support needs that are required must be identified.	
O	 L11	All required annual inspections have been conducted. 	The agency needs to ensure that all required inspections (e.g. furnaces, hot water heaters) have occurred in a timely manner.	

 	 L15	Hot water temperature tests between 110 and 130 degrees.	The agency must have a process in place to ensure hot water temperature in homes register between 110-130 degrees.	

 
 
 	 L27	If applicable, swimming pools are safe and secure according to policy. 	The agency will need to develop a pool policy that incorporates consideration of compliance with local ordinances, training of supporters, and assessment of each individual’s water safety skills, as recommended in the DDS Safeguards for Pools.	
O	 L38	Physicians' orders and treatment protocols are followed (when agreement for treatment has been reached by the individual/guardian/team). 	The agency needs to ensure that all physician orders and treatment protocols (e.g. protocol for diabetic blood sugar levels, seizure protocol) are followed as written by the prescribing health care practitioner.	

 	Residential Areas Needing Improvement on Standards not met/Follow-up to occur:	
 
 	Indicator #	Indicator	Area Needing Improvement	

 
 	 L44	The location where MAP certified staff is administering medication is registered by DPH.	The agency needs to ensure that when medications are administered to individuals who are not capable of self medicating (for residential and Individual Home Support services) the location must be registered by DPH.	
O	 L46	 All prescription medications are administered according to the written order of a practitioner and are properly documented on a Medication Treatment Chart. 	The agency must ensure that all prescribed medications are accompanied by written physician orders. Additionally, all prescribed PRN medications must include specific, observable criteria for administration. 	

 
 
 	 L47	Individuals are supported to become self medicating when appropriate. 	For individuals identified as able to become self medicating, the agency must ensure that the individual’s record contain a current self-medication assessment and that procedures are in place to assist the person to learn how to safely self medicate.	

 

 
 	 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 needs to ensure that informed consent for media use and release of personal information includes but not limited to the right to withdraw consent at any time, the name of the person obtaining the consent and the specific reason for which the information is to be used must be completed. The consent form should also include that the consent is valid for one year.	

 
 
 	 L61	Supports and health related protections and supports are included in ISP assessments and the continued need is outlined.	The agency needs to ensure that the use of all supports and health-related protections are documented in the individual’s ISP.	

 
 	 L62	Supports and health related protections are reviewed by the required groups.	The agency needs to ensure that the use of all supports and health-related protections receive the appropriate approvals and authorizations (e.g. prescribing clinician, HRC).	

 

 
 
 	 L63	Medication treatment plans are in written format with required components.	The agency utilized a standardized format to capture information regarding to use of behavior modifying medications. In some instances medication treatment plans did not contain all of the information to satisfy regulatory requirements. Specifically in these instances information regarding procedures to minimize risk and clinical indications for the termination of the medication was absent. Medication treatment plans must contain all of the required components.	

 

 
 	 L67	There is a written plan in place accompanied by a training plan when the agency has shared or delegated money management responsibility.	When the agency has shared or delegated money management responsibilities for individuals¿ funds, a training plan must be identified that will reduce or eliminate the need for assistance in this area, over time.  Additionally, the agency needs to ensure that adequate safeguards are in place to account for and protect individual’s funds. This includes consistent and timely reconciling of funds. 	

 
 
 	 L69	Individual expenditures are documented and tracked.	When a home provider assists an individual in handling personal funds all provider-assisted transactions need to be documented and tracked, and receipts need to be maintained for transactions that exceed $25.00.	
 	Residential Areas Needing Improvement on Standards not met/Follow-up to occur:	
 
 	Indicator #	Indicator	Area Needing Improvement	

 

 
 	 L70	Charges for care are calculated appropriately.	The agency’s Charges for Care (CFC) notification form has a provision that identifies the 75% amount charged to the individual, however in several instances this information was absent and the entire calculations were not fully disclosed. The agency needs to provide full disclosure on the amounts included in the CFC calculations.	

 
 
 	 L71	Individuals are notified of their appeal rights for their charges for care.	The agency needs to ensure that all individuals and guardians are notified of for their charges for care (CFC). The agency CFC notice also needs to include clearly stated language regarding appeal rights and how to process any request for appeal consideration.	

 
 
 	 L80	Support staff are trained to recognize signs and symptoms of illness.	The agency need to provide additional training for staff in recognizing signs and symptoms of illness consistent with the topics outlined in the Health Promotion and Coordination Initiative training manual.	
O	 L82	Medications are administered by licensed professional staff or by MAP certified staff (or by PCAs) for individuals unable to administer their own medications.	The agency needs to ensure that in instances where individuals receive Residential/Individual Home Supports and are not capable of self medication, that MAP certified staff, licensed professionals, or PCA's are administering individual's medications.	

 

CERTIFICATION FINDINGS

 
 	Met / Rated	Not Met / Rated	
Certification - Planning and Quality Management	4/6	2/6	
Residential and Individual Home Supports	 

    Individual Home Supports	15/15	0/15	
    Placement Services	14/14	0/14	
 
 	Planning and Quality Management Areas Needing Improvement on Standards not met:	
 	Indicator #	Indicator	Area Needing Improvement	

 

 

 	 C1	The provider collects data regarding program quality including but not limited to incidents, investigations, restraints, and medication occurrences.	The agency should strengthen the individual-specific, programmatic, and monitoring aspects of services to ensure relevant information is gathered to measure program quality. For example, there did not appear to be an effective process to collect data for a variety of key safeguard areas that include environmental safety, health, and rights protections.	

 
 	 C2	The provider analyzes information gathered from all sources and identifies patterns and trends.	The agency needs to develop a method to document its efforts to collect and analyze data regarding service quality on an on-going basis.	
	Placement Services Commendations on Standards Met:	
 	Indicator #	Indicator	Commendations	

 

 

 

 

 	 C9	Staff (Home Providers) provide opportunities to develop and/or increase personal relationships and social contacts.  	Polus is commended for the attention paid to supporting individuals to cultivate and maintain relationships with families and friends. Staff and home care providers understood the importance of supporting individuals to develop and increase personal relationships and personal contacts. In general, individuals who participated in this review were offered multiple opportunities to connect with their community and other people in meaningful ways such as volunteer work and church activities. Through these activities and others, individuals have made strong, long-lasting relationships that enrich their lives.  	

 

 

 

 	 C11	Staff (Home Providers) support individuals to get together with families and friends when appropriate   	 Polus was very attentive to helping individuals strengthen family ties. On a continuous basis, home care providers were supporting individuals to make connections with family members by phone, scheduling and planning visits, arranging holiday events, and vacations. The agency demonstrated a great sensitivity to unique circumstances, family dynamics and personal preferences, which ensure that gatherings with family members resulted in positive outcomes for everyone. 	

	Placement Services Commendations on Standards Met:	
 	Indicator #	Indicator	Commendations	

 

 

 

 

 

 

 
 
 	 C16	Staff (Home Providers) support individuals to explore their interests for cultural, social, recreational and spiritual activities.  	 Polus is commended for supporting people to explore and engage in a rich variety of cultural, social, recreational and spiritual activities. Providers and staff assisted individuals to experience a rich and active life. People were supported to explore and attend a variety of local recreational activities and events, as well as several offered by Polus such as skiing, barbeques, and activities at Coffeelands. People were supported to explore and engage in spiritual activities and were involved meaningfully in their church well beyond simply attending services. Both the people Polus supports and the providers they employ come from diverse background that had served to expose many to new cultures, languages, celebrations and foods. For example, some people surveyed had become fluent in Spanish, had visited their provider’s country of origin, and had even developed a preference for Dominican cooking. 	

 

 
 	 C17	Community activities are provided and are based on the individual's preferences and interests. 	 The agency is commended for its ability to support individuals to participate in a diverse range of meaningful activities that reflect their interests and personal preferences. In general, individuals were engaged in activities within their respective communities and expressed much satisfaction with their involvement.   	
	Individual Home Supports Commendations on Standards Met:	
 	Indicator #	Indicator	Commendations	

 

 

 

 

 	 C9	Staff (Home Providers) provide opportunities to develop and/or increase personal relationships and social contacts.  	 Polus is commended for the attention paid to supporting individuals to cultivate and maintain relationships with families and friends. Staff and home care providers understood the importance of supporting individuals to develop and increase personal relationships and personal contacts. In general, individuals who participated in this review were offered multiple opportunities to connect with their community and other people in meaningful ways such as volunteer work and church activities. Through these activities and others, individuals have made strong, long-lasting relationships that enrich their lives.  	

 

 

 

 	 C11	Staff (Home Providers) support individuals to get together with families and friends when appropriate   	 Polus was very attentive to helping individuals strengthen family ties. On a continuous basis, home care providers were supporting individuals to make connections with family members by phone, scheduling and planning visits, arranging holiday events, and vacations. The agency demonstrated a great sensitivity to unique circumstances, family dynamics and personal preferences, which ensure that gatherings with family members resulted in positive outcomes for everyone. 

	

	Individual Home Supports Commendations on Standards Met:	
 	Indicator #	Indicator	Commendations	

 

 

 

 

 

 

 
 
 	 C16	Staff (Home Providers) support individuals to explore their interests for cultural, social, recreational and spiritual activities.  	 Polus is commended for supporting people to explore and engage in a rich variety of cultural, social, recreational and spiritual activities. Providers and staff assisted individuals to experience a rich and active life. People were supported to explore and attend a variety of local recreational activities and events, as well as several offered by Polus such as skiing, barbeques, and activities at Coffeelands. People were supported to explore and engage in spiritual activities and were involved meaningfully in their church well beyond simply attending services. Both the people Polus supports and the providers they employ come from diverse background that had served to expose many to new cultures, languages, celebrations and foods. For example, some people surveyed had become fluent in Spanish, had visited their provider’s country of origin, and had even developed a preference for Dominican cooking. 	

 

 
 	 C17	Community activities are provided and are based on the individual's preferences and interests. 	 The agency is commended for its ability to support individuals to participate in a diverse range of meaningful activities that reflect their interests and personal preferences. In general, individuals were engaged in activities within their respective communities and expressed much satisfaction with their involvement.   	

MASTER SCORE SHEET LICENSURE
Organizational: POLUS CENTER FOR SOCIAL AND ECONOM
 
 	Indicator #	Indicator	Met/Rated	Rating(Met, Not Met, Not Rated)	
O	 L2	Abuse/neglect reporting	5/5	Met	
 	 L3	Immediate Action	5/5	Met	
 	 L4	Action taken	5/5	Met	
 	 L48	HRC	1/1	Met	
 	 L74	Screen employees	1/1	Met	
 	 L76	Track trainings	3/3	Met	
 	 L83	HR training	1/1	Met	
 
Residential and Individual Home Supports:

 
 	Indicator #	Indicator	Location or Individual indicator	Residential Supports	Individual Home Support	Placement Support	Respite Support	Total Met/Rated	Rating	

 	 L1	Abuse/neglect training	I	 
 
 	2/2	7/7	 
 
 	9/9	Met	
 
 	 L5	Safety Plan	L	 
 	2/2	7/7	 
 	9/9	Met	
O	 L6	Evacuation	L	 
 	2/2	6/7	 
 	8/9	Met
(88.89 %)	

 	 L8	Emergency Fact Sheets	I	 
 
 	1/2	4/7	 
 
 	5/9	Not Met
(55.56 %)	

 	 L9	Safe use of equipment	L	 
 
 	0/1	0/4	 
 
 	0/5	Not Met
(0 %)	

 
 	 L10	Reduce risk interventions	I	 

 	 

 	1/1	 

 	1/1	Met	
O	 L11	Required inspections	L	 
 
 	1/2	5/7	 
 
 	6/9	Not Met
(66.67 %)	
O	 L12	Smoke detectors	L	 
 	2/2	6/7	 
 	8/9	Met
(88.89 %)	
O	 L13	Clean location	L	 
 	2/2	7/7	 
 	9/9	Met	

 	 L14	Site in good repair	L	 
 
 	1/1	7/7	 
 
 	8/8	Met	
 
 	 L15	Hot water	L	 
 	2/2	5/7	 
 	7/9	Not Met
(77.78 %)	
 
 	 L16	Accessibility	L	 
 	2/2	6/6	 
 	8/8	Met	

 
 	Indicator #	Indicator	Location or Individual indicator	Residential Supports	Individual Home Support	Placement Support	Respite Support	Total Met/Rated	Rating	
 
 	 L17	Egress at grade 	L	 
 	2/2	7/7	 
 	9/9	Met	

 	 L18	Above grade egress	L	 
 
 	1/1	1/1	 
 
 	2/2	Met	
 
 	 L19	Bedroom location	L	 
 	1/1	 
 	 
 	1/1	Met	
 	 L20	Exit doors	L	 	2/2	 	 	2/2	Met	

 	 L21	Safe electrical equipment	L	 
 
 	2/2	7/7	 
 
 	9/9	Met	
 
 	 L22	Clean appliances	L	 
 	2/2	7/7	 
 	9/9	Met	

 	 L25	Dangerous substances	L	 
 
 	2/2	7/7	 
 
 	9/9	Met	
 
 	 L26	Walkway safety	L	 
 	2/2	7/7	 
 	9/9	Met	
 
 	 L27	Swimming pools	L	 
 	 
 	0/2	 
 	0/2	Not Met
(0 %)	
 
 	 L28	Flammables	L	 
 	1/1	6/6	 
 	7/7	Met	

 	 L29	Rubbish/combustibles	L	 
 
 	2/2	7/7	 
 
 	9/9	Met	
 
 	 L30	Protective railings	L	 
 	1/1	3/3	 
 	4/4	Met	

 	 L31	Communication method	I	 
 
 	2/2	7/7	 
 
 	9/9	Met	
 
 	 L32	Verbal & written	I	 
 	2/2	7/7	 
 	9/9	Met	
 
 	 L33	Physical exam	I	 
 	2/2	7/7	 
 	9/9	Met	
 
 	 L34	Dental exam	I	 
 	2/2	7/7	 
 	9/9	Met	
 
 	 L35	Preventive screenings	I	 
 	1/1	7/7	 
 	8/8	Met	
 
 	 L36	Recommended tests	I	 
 	2/2	7/7	 
 	9/9	Met	
 
 	 L37	Prompt treatment	I	 
 	2/2	7/7	 
 	9/9	Met	
O	 L38	Physician's orders	I	 
 	 
 	2/5	 
 	2/5	Not Met
(40.0 %)	

 	 L39	Dietary requirements	I	 

 
 	3/3	 
 
 	3/3	Met	
 
 	 L40	Nutritional food	L	 
 	2/2	7/7	 
 	9/9	Met	

 
 	Indicator #	Indicator	Location or Individual indicator	Residential Supports	Individual Home Support	Placement Support	Respite Support	Total Met/Rated	Rating	
 
 	 L41	Healthy diet	L	 
 	2/2	6/7	 
 	8/9	Met
(88.89 %)	
 
 	 L42	Physical activity	L	 
 	1/1	5/6	 
 	6/7	Met
(85.71 %)	

 	 L43	Health Care Record	I	 
 
 	2/2	6/7	 
 
 	8/9	Met
(88.89 %)	
 
 	 L44	MAP registration	L	 
 	0/1	 
 	 
 	0/1	Not Met
(0 %)	
 
 	 L45	Medication storage	L	 
 	1/1	 
 	 
 	1/1	Met	
O	 L46	Med. Administration	I	 
 
 	1/1	1/7	 
 
 	2/8	Not Met
(25.00 %)	
 
 	 L47	Self medication	I	 
 	1/2	2/3	 
 	3/5	Not Met
(60.0 %)	

 	 L49	Informed of human rights	I	 
 
 	2/2	7/7	 
 
 	9/9	Met	
 
 	 L50	Respectful Comm.	L	 
 	2/2	7/7	 
 	9/9	Met	
 
 	 L51	Possessions	I	 
 	2/2	7/7	 
 	9/9	Met	
 
 	 L52	Phone calls	I	 
 	2/2	7/7	 
 	9/9	Met	
 	 L53	Visitation	I	 	2/2	7/7	 	9/9	Met	
 	 L54	Privacy	L	 	2/2	7/7	 	9/9	Met	
 
 	 L55	Informed consent	I	 
 	0/1	2/6	 
 	2/7	Not Met
(28.57 %)	

 	 L61	Health protection in ISP	I	 
 
 	0/1	1/2	 
 
 	1/3	Not Met
(33.33 %)	

 	 L62	Health protection review	I	 
 
 	0/1	0/2	 
 
 	0/3	Not Met
(0 %)	

 	 L63	Med. treatment plan form	I	 
 
 	0/1	0/5	 
 
 	0/6	Not Met
(0 %)	

 	 L64	Med. treatment plan rev.	I	 
 
 	1/1	4/5	 
 
 	5/6	Met
(83.33 %)	
 
 	 L67	Money mgmt. plan	I	 
 	1/1	1/4	 
 	2/5	Not Met
(40.0 %)	

 	 L68	Funds expenditure	I	 
 
 	1/1	4/4	 
 
 	5/5	Met	
 
 	 L69	Expenditure tracking	I	 
 	 
 	2/4	 
 	2/4	Not Met
(50.0 %)	

 
 	Indicator #	Indicator	Location or Individual indicator	Residential Supports	Individual Home Support	Placement Support	Respite Support	Total Met/Rated	Rating	

 	 L70	Charges for care calc.	I	 

 
 	1/4	 
 
 	1/4	Not Met
(25.00 %)	

 	 L71	Charges for care appeal	I	 
 
 	1/1	2/5	 
 
 	3/6	Not Met
(50.0 %)	

 	 L77	Unique needs training	I	 
 
 	2/2	7/7	 
 
 	9/9	Met	
 
 	 L80	Symptoms of illness	L	 
 	0/2	0/7	 
 	0/9	Not Met
(0 %)	
 
 	 L81	Medical emergency	L	 
 	2/2	7/7	 
 	9/9	Met	
O	 L82	Medication admin.	L	 
 	0/1	 
 	 
 	0/1	Not Met
(0 %)	

 	 L84	Health protect. Training	I	 
 
 	1/1	2/2	 
 
 	3/3	Met	
 
 	 L85	Supervision 	L	 
 	2/2	7/7	 
 	9/9	Met	

 	 L86	Required assessments	I	 

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

 	 L88	Strategies implemented	I	 
 
 	2/2	7/7	 
 
 	9/9	Met	

 	#Std. Met/# 66 Indicator	 

 

 	 

 

 	47/66	 

 
 	Total Score	 

 	 

 	54/73	 

 	 

 	 

 	 
 	73.97%	 

 

MASTER SCORE SHEET CERTIFICATION
 	Certification - Planning and Quality Management	
 	Indicator #	Indicator	Met/Rated	Rating	
 	 C1	Provider data collection	0/1	Not Met (0 %)	
 	 C2	Data analysis	0/1	Not Met (0 %)	
 	 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	
 
Individual Home Supports Reviewed By -DDS	
Indicator #	Indicator	Met/Rated	Rating	
 C7	Feedback on staff performance	2/2	Met	
 C8	Family/guardian communication	1/1	Met	
 C9	Personal relationships	2/2	Met	
 C10	Social skill development	2/2	Met	
 C11	Get together w/family & friends	2/2	Met	
 C12	Intimacy	1/1	Met	
 C13	Skills to maximize independence 	2/2	Met	
 C14	Choices in routines & schedules	2/2	Met	
 C15	Personalize living space	2/2	Met	
 C16	Explore interests	2/2	Met	
 C17	Community activities	2/2	Met	
 C18	Purchase personal belongings	2/2	Met	
 C19	Knowledgeable decisions	2/2	Met	
 C20	Emergency back-up plans	2/2	Met	
 C21	Coordinate outreach	2/2	Met	
Placement Services Reviewed By -DDS	
Indicator #	Indicator	Met/Rated	Rating	
 C7	Feedback on staff performance	7/7	Met	
 C8	Family/guardian communication	7/7	Met	
 C9	Personal relationships	6/6	Met	
 C10	Social skill development	7/7	Met	
 C11	Get together w/family & friends	6/6	Met	
 C12	Intimacy	6/6	Met	
 C13	Skills to maximize independence 	6/6	Met	
 C14	Choices in routines & schedules	6/6	Met	
 C15	Personalize living space	7/7	Met	
 C16	Explore interests	6/6	Met	
 C17	Community activities	6/6	Met	
Placement Services Reviewed By -DDS	
Indicator #	Indicator	Met/Rated	Rating	
 C18	Purchase personal belongings	6/6	Met	
 C19	Knowledgeable decisions	7/7	Met	
 C20	Emergency back-up plans	7/7	Met