Dtes of Review: FY '09 Evluttor(s): S. Crpenter DESK REVIEW: Accredittion: Acredittion is no longer required by the stte contrct. Significnt Events from the Agency: Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc -- HLHP hs gret system in plce for progrm sttisticl dt. Surveys re done nd informtion used to improve services. -- The Annul Performnce Report for Prt C services hs high level of complince this is n indictor of qulity services tht blends into ll progrms HLHP provides. --HLHP hs website: www.hilineprogrms.org. Agency Internl Communictions Systems: -- HLHP hs n internl network with dedicted server. Ech employee hs it's own emil ddress nd much is done through this electronic communictions. Reports re net nd typed. -- HLHP hs severl progrms it dministers in ddition to DDP funded services. Policie nd procedures re vilble nd incorporte DDP's policies. Pge 1
Dtes of Review: FY '09 Evluttor(s): S. Crpenter DESK REVIEW: Fiscl (udits, cost plns, invoices): Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc -- Audit reports indicte complince in mjor progrms with no findings or exceptions. -- HLHP works with the Regionl Office to work through Individul Cost Pln nd invoicing concerns. Licensing: -- HLHP does not operte ny licensced fcilites. Pge 2
Dtes of Review: FY '09 Evluttor(s): S. Crpenter DESK REVIEW: Qulity Assurnce Observtion Sheets: (trends from pst yer) -- no trends to report Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Mediction Errors: (trending from pst yer) -- None to report. Incident Mngement: (summry trends, steps to ddress trends, investigtion summmries) -- HLHP hs fully implemented the DDP IR policy. IR's re few nd re often medicl in nture. IR's re mostly discovered through fmily or self reporting often well fter the fct. Pge 3
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Stff Relted: Evidence Found of Orienttion Trining ("" if present; 'x' if not present) stff initils yes/no Note where evidence found: LK Evidence Found DDCPT or equivlent: stff initils LK yes/no Note where evidence found: Evidence of Criminl Bckground Checks: stff initils LK Note where evidence found: personnell files, stff trining records, gency employment ppliction Evidence of Stff Survey: stff initils LK yes/no Note where evidence found: (regrding stff hiring, screening, trining, supervision) Pge 4
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Stff Relted: Evidence Found of Stff Trining: ("" if present; 'x' if not present) 1st id/cpr Abuse Prevention Client Rights Incident Reporting Stff Initils: Confidentility IP/PSP Process CDS complete w/in 6 months of hire dte? Mediction Cert Note where evidence found: Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc LK n/ Pge 5
Dtes of Review: FY '09 Evluttor(s): S. Crpenter IP Checklist: ("" if evidenced; "x" if not) Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Consumer Initils: SL1 SL2 SL3 Consumer/Fmily Survey PSP/IP Doc Avil to ll Stff IPP/Actions Implemented Dt for IPP/Actions QAOS #1 Dt Internlly Monitored Self Mediction Objective n/ n/ n/ Consumer informed of grievnce procedure SL consumer choice of SL stff Rights Restrictions n/ n/ n/ PSP/IP Checklist PSP nnully Individul Needs Addressed? Assessment Bsed? Qurtery Reports? Incident Reports Addressed? Behviorl Supports Addressed? n/ n/ n/ Functionl Anlysis Needed? n/ n/ n/ Free from Aversive Procedures? (regrding service plnning nd delivery) -- In reviewing progrm dt books, this reviewer ws impressed with the qulity nd qunity of meningful dt. It ws net nd orgnized. Good job! -- Qurterly reporting hs improved. Pge 6
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc IP Checklist: ("" if evidenced; "x" if not) Consumer Initils: CS1 CS2 CS3 CS4 CS5 CS6 Consumer/Fmily Survey PSP/IP Doc Avil to ll Stff n/ n/ n/ IPP/Actions Implemented n/ n/ n/ Dt for IPP/Actions n/ n/ n/ Dt Internlly Monitored Self Mediction Objective n/ n/ n/ n/ n/ n/ Consumer informed of grievnce procedure SL consumer choice of SL stff Rights Restrictions n/ n/ n/ n/ n/ n/ PSP/IP Checklist PSP nnully? Individul Needs Addressed? Assessment Bsed? Qurtery Reports? Incident Reports Addressed? Behviorl Supports Addressed? n/ n/ n/ n/ n/ n/ Functionl Anlysis Needed? n/ n/ n/ n/ n/ n/ Free from Aversive Procedures? (regrding service plnning nd delivery) CS4 nd CS5 hve respite only in their greements. Pge 7
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Residentil Site Checklist: ("" if evidenced; "x" if not) Site Nme: SL1 SL2 SL3 Bthing procedures posted n/ Clen/Snitry Environment Egress Hot Wter Temps 117.4 121.7 n/ Emergency Assistnce Fire Extinguishers/smoke Detectors 1st Aid/CPR Supplies Accessible/Avilble PRN Medictions n/ n/ Mediction Procedures n/ n/ Mediction Locked Storge n/ n/ Mediction Administrtion Records n/ n/ Stff Rtios or ICP Stffing Awke Overnight Stff n/ n/ n/ Adequte Supplies Storge of Supplies Free from versive procedures? Weekly integrted ctivities n/ n/ n/ House or site rules? n/ n/ n/ Opp for choice, self determintion Mel Prep, Meltime Enggement in Dily Life Prticiption in Dily Living Skills Dily Leisure Opportunities n/ Stff Trined in Individul Specifics SL2 nd SL3 live with fmily who re responsible for mediction dministrtion. SL3 hs respite only in his ICP. Pge 8
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Residentil Site Checklist: ("" if evidenced; "x" if not) Site Nme: CS1 CS2 CS3 CS4 CS5 CS6 Bthing procedures posted n/ n/ n/ n/ n/ n/ Clen/Snitry Environment Egress Hot Wter Temps n/ n/ n/ n/ n/ n/ Emergency Assistnce n/ n/ n/ n/ n/ Fire Extinguishers/smoke Detectors n/ n/ n/ n/ n/ 1st Aid/CPR Supplies Accessible/Avilble n/ n/ n/ n/ n/ PRN Medictions n/ n/ n/ n/ n/ n/ Mediction Procedures n/ n/ n/ n/ n/ n/ Mediction Locked Storge n/ n/ n/ n/ n/ n/ Mediction Administrtion Records n/ n/ n/ n/ n/ n/ Stff Rtios or ICP stffing n/ n/ n/ n/ n/ n/ Awke Overnight Stff n/ n/ n/ n/ n/ n/ Adequte Supplies n/ n/ n/ n/ n/ Storge of Supplies n/ n/ n/ n/ n/ Free from versive procedures? Weekly integrted ctivities n/ n/ n/ n/ n/ n/ House or site rules n/ n/ n/ n/ n/ n/ Opp for choice, self determintion Mel Prep, Meltime n/ n/ n/ n/ n/ n/ Enggement in Dily Life Prticiption in Dily Living Skills Dily Leisure Opportunities n/ n/ n/ n/ n/ n/ Stff Trined in Individul Specifics With the exception of CS1, ll consumers live with fmily who meet their helth nd sfety needs. Pge 9
Dtes of Review: FY '09 Evluttor(s): S. Crpenter ("" if evidenced; "x" if not) Site Nme: Driver Orienttion Progrm Wheelchir tie downs Wheelchir Lift Driver's Licenses Emergency Supplies Fire Extinguisher Trnsporttion Log Scheduled Mintennce Progrm Trining--Stff Doing Mintennce Checks MDT inspection on file (MDT vehicles only) Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc -- HLHP does not operted ny lrge cpcity vehicles for trnsporttion. Trnsporttion is done through the use of the gency cr or through privte vehicles. Opertors re required to show proof on insurbility nd vlid driver's license. Pge 10
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Stff Survey: ("" if evidenced; "x" if not) Stff Initils: How long worked: Allegtions re reported to? (APS) Do you notify Supervisor first? (NO) Steps to tke if buse is discovered? Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc BH 2 yers Suspect theft of gloves, steps to tke? IP/PSP requests Doctors ppt No jcket, -25 consumer wnts to leve describe consumer behviors stff response to behviors by pln n/ n/ n/ former employee wnts info wht is consumer informtion? trining to meet helth nd sfety needs? emergency evcution procedures? Pge 11
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Stff Survey: ("" if evidenced; "x" if not) Stff Initils: describe procedure to ssist with meds if med is unvilble? if gve wrong med? if moving to new plce or gets new med? requirement to ssist with meds? describe PRN or OTC is to be given wht constitutes med error? Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Bh how to respond to someone who is upset wht is you strt to lose control? when do you fill out n incident report? notifictions for ER? consumer to consumer incidents who writes the IR? Pge 12
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Stff Survey: ("" if evidenced; "x" if not) Stff Initils: consumer destroying things stff pinches consumer bck how do you know support pln is needed? Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc BB wht is IP/PSP bsed on? you hve n ide for n objective.. why do ssessments? How do you find out wht someone would Pge 13
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Consumer Questionnire (used by QIS). ("" if evidenced; "x" if not) Bolded questions re mndtory. Consumer intils: SL1 SL2 Consumer hs/showsid crd? (if PSP documents this is not pplicble, mrk NA) Do you hve nice stff t home/work? yes yep Is nyone men to you t home/work? n nope Do you like where you live/work? yes yes Are you ever frid of nyone? no nope Someone hits/hurts you, who cn you tell? Rick, Bud Bud, Tn Does nyone tlk to you bout this? yes yes Cn you get help when you need it? yes yes from stff? yes yes from Cse Mnger? yes yes Cn you get your own food/drink? yes yes knocking/permission? no no Do stff ever tke things from you? no nope Cn you get rides to plces you need to go? yes yes Rides to the plces you wnt to go? yes yes Who is your Cse Mnger? keenie keenie Does s/he tlk to you bout wiver services? yes yes yes yes Pge 14
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Consumer Questionnire (used by QIS). Bolded questions re mndtory. Consumer intils: CS1 CS2 CS3 CS4 CS5 CS6 Consumer hs/showsid crd? (if PSP documents this is not pplicble, mrk NA) yes no no yes yes no Do you hve nice stff t home/work? yes yes yes yes yes yes Is nyone men to you t home/work? no no Do you like where you live/work? yes yes Are you ever frid of nyone? no no Someone hits/hurts you, who cn you tell? police sister keenie prents mom mom Does nyone tlk to you bout this? yes yes yes yes yes yes Cn you get help when you need it? yes yes from stff? yes yes from Cse Mnger? yes yes Cn you get your own food/drink? yes yes Do people ever come into your room without knocking? no no Do stff ever tke things from you? no no Cn you get rides to plces you need to go? yes yes/drive Rides to the plces you wnt to go? yes yes Who is your Cse Mnger? PR LW KP GG PR PR Does s/he tlk to you bout wiver services? yes yes yes yes yes yes Does she help you get wht you need? yes yes yes yes yes yes Pge 15
Dtes of Review: FY '09 Evluttor(s): S. Crpenter Developomentl Disbilities Progrm Comprehensive Evlution Hi-Line Home Progrms, Inc Consumer Questionnire (used by QIS). ("" if evidenced; "x" if not) Bolded questions re mndtory. Consumer intils: CS1 CS2 CS3 Who helps this person nd how? Are there some stff/peers they like better? Stff/peers they don't like? Why? Current needs not being met? Helth nd Sfety relted? Who do you tlk to bout these concerns? Does you the hve person n opportunity hve input for to his/her input? life? If you hve concerns, who do you tlk to? re they resolved? Wht re this persons wishes/drems? is the pln moving tht direction? does this person ever seem frid? re you frid for them? Does this person know how or where to report buse? yes yes yes who provided tht trining? keenie keenie keenie Who will the individul cll or report to? who provided tht info? Does the person hve trnsporttion to ll services nd plces s/he would like to go? who is the person's cse mnger? keenie keenie keenie Does CM help the person ccess services? yes yes yes Does the CM explin wiver services? yes yes yes Does the person understnd this info? yes yes yes Pge 16