Community Placement Checklist Parents Coordinating Council - Lanterman Developmental Center As part of the community placement process, families will be asked to visit or contact potential homes for their loved ones. This is an opportunity for families and advocates to evaluate these placements and related services and supports. Regional Centers are required to provide care and services equivalent to that of Developmental Centers. Vital services must be identified and in place before clients move. The following questions are designed to assist and educate families as they consider potential community placements. Questions may vary according to each client's needs and family preferences. The Home 1. Is the home rented or owned? By whom? How long is the lease? 2. How many bedrooms? Are the bedrooms single or double occupancy? Does your client need a special bed for positioning or safety? If side rails are needed, are they properly installed? Can the head and foot of the bed be raised and lowered? Does the bed have rollers to allow for increased open space when not in use? Does the bedroom have sufficient closet/dresser space for your client (and roommate)? 3. Are there smoke alarms or fire sprinklers in every bedroom? How about carbon monoxide alarms? In working condition? 4. Are there at least two emergency exits? How far is the nearest exit from the bedroom where your client will be sleeping? 5. How many bathrooms? Will clients be sharing the bathroom(s)? Does this meet the toileting needs of your client, and the other clients of the home? Does this meet the showering / bathng needs of your client? Are the bathrooms equipped with hand rails, shower chairs with seatbelts, non-skid floors? Is there a separate bathroom for staff and visitors? 6. Are hallways and living spaces large enough to comfortably maneuver a wheelchair? 7. Is the home designed with break-resistant glass, furniture, light and bathroom fixtures? Are there adequate electrical outlets? 8. Are the floors an easy to clean surface? 9. Is the front/back yard properly secured? 10. Are there safety locks on the doors with outside access? 11. Are there alarms on doors with outside access? 12. Are medications and hazardous materials properly locked? 13. Are wheelchair ramps properly installed? 14. Is there the opportunity for regular physical exercise on-site? 15. How far is the home from: the Day Program? Hospital? Recreational facilities? 16. Is transportation headquartered at the residence? PCC Community Placement Checklist 1
Is staff appropriately licensed to operate vans? Does the vehicle(s) have a wheelchair lift? The Home Owner (Provider) 1. Is the owner (provider) a non-profit or for-profit entity? 2. How long has the provider been in business? 3. Does the provider operate any other facilities? 4. How is the home, and care for its clients, funded? What is the per diem per client (the amount paid monthly for each client in the home)? 5. Is the home licensed or certified? By whom? For how many clients? 6. How often is the home inspected? By what agency? What was the date of the last inspection? Are inspection reports available to families? 7. Who is responsible for home maintenance? 8. What insurance (property, liability, etc.) does the owner/operator carry? What is the policy limit? 9. What is the phone number of the home? Of the main office? Group Home Staff 1. What is the client/staff ratio? For night shift? (24-hour awake staff?) For weekends and holidays? 2. What staff is licensed, and in what area? 3. What staff is certified, and in what area? 4. How are staffing needs managed in case of sick days, vacations, or emergencies? 5. How are staffing needs met if client is not able to or does not want to go to Day Program? 6. How often is the Owner/Administrator on site? If they operate multiple homes, how do they divide time between homes? 7. What are the educational/training requirements for staff? How many are licensed or certified to work with persons with DD? Where did they receive their training and experience? How long have they have worked in developmental services? 8. Have all employees had proper health screening? 9. Have all employees, consultants, and volunteers had criminal background checks? 10. Is a staff roster available? Are there any live-in staff? Are hire dates and turnover rate provided? Is back-up staff readily available? Is there a benefit package? 11. Is staff fluent in the primary language of the client and family? Able to use American Sign Language? 12. Is staff properly trained in the following areas: Choking procedures? Seizure control? Administration of medications? Basic nursing care? Behavioral intervention? PCC Community Placement Checklist 2
13. Is staff physically able to perform behavioral interventions? What kind of Behavior Management Training is used? How often is staff re-certified? 14. How often are client-focused "team meetings" and IPPs held? Are families and friends invited to participate? Are sample reports available? 15. Ask for a list of the consultants the provider uses (see Medical Supports section). Write down their names and phone numbers. Call and ask them about the home and how often they work there. Do they work directly with the clients? Neighborhood 1. Is the home in a neighborhood clean and safe? 2. Who are the neighbors, and are they friendly with the clients living in the home? 3. Is there excessive traffic in the neighborhood accessible to ambulatory residents? 4. Is the home in a low-crime residential area? 5. Is there sufficient parking for visitors and staff? Is the home close to Recreational Activities? Parks and open space? A church? A restaurant or cafeteria that would be welcoming? Vending machines? School or employment opportunities? 6. Is the neighborhood wheelchair friendly? Are surrounding facilities accessible to wheelchairs? Are there wheelchair cuts in all surrounding sidewalks? Are neighborhood streets too steep to navigate with a wheelchair? Are there particular areas close by that would make for an enjoyable walk? Are there particular plants in the neighborhood yards that would trigger allergic reactions? 7. Is there a hospital and fire station close by? Where are emergency responders located? How long will it take them to arrive at the home? Other Clients 1. Is there an appropriate matching of: Age? Gender? Medical and behavioral conditions? Sleeping habits and common bedtimes? Similar interests in activities? (noisy vs. quiet, neat vs. messy, smoking vs. non-smoking) 2. Do clients appear to interact well with each other? What are the regular activities around the household where residents interact with each other. Are there certain friendships that may have an impact on your client? If the rooms are shared, how does the Provider plan to address the issue of consumers wanting to watch/listen to different music/movies? 3. Do any of the current residents have a history of aggression towards others? Stealing? Property destruction? Sexual misconduct or acting out? Do any of the other residents require additional staffing to manage their behaviors? If so, is this available around the clock? 4. Do clients have adequate privacy and "personal time"? PCC Community Placement Checklist 3
5. Are clients able to keep/avoid pets? Food Preparation 1. Who controls the menu? Does the home have a dietician or food consultant? Ask for a copy of a typical week s menu. How much variety and personal choice exists? Do other residents appear to be properly fed and in good health? 2. What types of food are regular menu items? How often are fresh, frozen, canned, or "junk" foods served? What foods are present in the refrigerator and cupboards? Can special nutritional needs be accommodated? Does your client have any food allergies? How will this be managed? 3. Is the kitchen and equipment adequate for the size of the home? Is the kitchen clean and well maintained? Are the refrigerator, freezer, and pantry adequately stocked? Is there a food processor available for soft diets? 4. Will your client have a place to store personal food, away from other consumers? 5. Does the staff share food with the clients? Where and when does the staff eat? How frequent are restaurant or fast food visits? 6. How does the staff manage specialty food preparation? Money Management 1. How are client funds handled? Ask the provider to show you the lockbox where client funds are stored (every home is required to have one). 2. Who is the representative payee? Do you wish to allow the provider to manage your child s savings? How and for what do you want it spent? 3. Who is responsible for buying clothing and personal hygiene items? 4. Do clients receive a regular "allowance" for personal shopping? How and when do the clients go shopping? How does the provider track expenditures? 5. Are client account statements regularly sent to families? Human Rights Policies 1. How are family concerns handled and addressed? Is there a typical response time for complaints? What happens if there is a disagreement? Who is the person to contact when a concern arises? Is that person an employee of the home, or an independent overseer? 2. Can families contact other client families, if permission is given by those families? If other residents in the home are verbal, ask them if they are happy there, and what they like (or don t like) about living there. 3. What is the policy for unannounced visits? 4. Is there an Ombudsman notice posted? (How to report abuse) Can the staff tell you all the rights of persons with developmental disabilities (without reading from the chart)? 5. Does the home have an advocacy organization or committee? PCC Community Placement Checklist 4
How often does it meet? Who are the members? Are reports available from the most recent meeting? 6. Are inspection reports from overseeing agencies (Community Care Licensing, Fire, Public Health, etc.) available to the public? 7. If there were any previous violations, how long did it take to correct them? What were these violations? 8. Do the clients have the opportunity to regularly attend church services? Is the church, synagogue, or other place of worship close by? Is transportation available to those services? Do staff or other residents regularly participate? 9. How long can a client be on "furlough" from the home (medical, family vacation)? How often? 10. How does the provider handle home visits? Will they use their staff and transportation to drop off and pick up your client? Will they provide staff to assist with lifting or transfers, or behavior management? Medical Services 1. Who administers medications? Are they a licensed nurse or psych tech? If not, what are their credentials for administering medications? 2. How often are clients given medical, psychiatric, and dental check-ups? 3. What clinic(s) will be used? 4. Are the appropriate specialists (podiatry, psychology) available? 5. How are medical emergencies handled? When was the home s most recent medical emergency, and how was it handled? 6. What is the average response time for the home? 7. If hospital care is needed, which hospital will be used? How far is it from the home? 8. Who will provide convalescent services after surgery or illness? 9. Who will pay for non-eligible Medicaid services? 10. Use the following checklist to identify the professional medical services required by your client: Physician Ophthalmologist (Eyes) Dermatologist Dentist Audiologist (Hearing) Dietician Psychiatrist Orthopedist Podiatrist Psychologist Cardiologist Gynecologist Neurologist Assistive Technology Physical Medicine & Rehabilitation Day, Vocational, and Recreational Programs 1. What Day Programs will your client attend? Is there a choice? Are they in close to the home? Do all residents of the home attend the same program? 2. What is the training / certification of Day Program staff? 3. What is the goal of the Program (new skills, independence, employment, etc)? Was your client assessed to make sure these goals are realistic? How frequently is client progress evaluated? 4. Is there a sufficient range of activities? Are the activities appropriate for your client? PCC Community Placement Checklist 5
Are the other consumers compatible with your client? 5. How is transportation provided? Who transports the clients (the home, day program, or outside agency?) Is it a dependable firm that hires quality staff? Are drivers trained in dealing with developmentally disabled clients? 6. How long is the work day? How many days per week? What breaks or meals are provided throughout the day? 7. Is there an opportunity for paid employment? What is the pay scale? 8. Is there an opportunity for Volunteer activities? 9. What is the staffing ratio? (Please refer to "Group Home Staff" section for additional staffing questions). 10. If your client has medical needs, is there on nurse on shift at the Day Program? 11. Use the following checklist to identify the activities that are important to your client: Physical Therapy Indoor/Outdoor Activities Swimming Special Olympics Dance Special Camps Music Community Outings Personal Tutor Church Services Vocational Training Speech Therapy 12. What are evening activities? 13. What are weekend activities? Discharge Policies 1. For what reason(s) could a client be involuntarily discharged from the home? 2. Who makes decisions on discharge? Does the family have a meaningful role in this process? 3. If the home closes for any reason, what happens to the client? 4. If the client finds a more suitable placement, what is the policy for transfer? 5. Is there a written "due process" policy for the above situations? 6. What happens if client ages out? Provisional Placement Issues 1. Will the client have access to outpatient services at Lanterman? 2. How will these services be continued when Lanterman is closed? 3. In case of emergency, does the nearest hospital offer overnight or short-term respite care for individuals with developmental disabilities? 4. Does your Regional Center have a dedicated crisis intervention team? 5. Is the Crisis Team available 24 hours per day, 7 days per week? 6. Are there sufficient short-term respite beds available to clients of your Regional Center? 7. In the case of a prolonged crisis, where will the client be placed? 8. Have these policies and/or provisions been given to you in writing? The Association for the Mentally Retarded at Agnews (AMRA) developed a very comprehensive and thoughtful Home Review Checklist during the closure of that Center. We are greatly indebted to the families and friends of Agnews Developmental Center residents for their work on the process of choosing a safe and quality placement for our family members. This document has been adapted from that original, with input from PCC members. PCC Community Placement Checklist 6