Critical Skill and Group Living Operational Class (For Licensees, Pre-Licensees and Key Personnel) To assist in compliance with: Administrative Rule R 400.14201 Administrator; Qualifications and Training in AFC Subjects Also Highly Applicable for Direct Care Workers NOTICE DATES, TIMES AND LOCATIONS: Evening and Day Time Classes - $699.95 This price adjusts downward by $100.00 per person when 4 or more attend from one organization. Check on-line for dates and times Livonia, MI 888.432.6813 Registration Line Register and Pay On-Line at: This Class Can be Attended On-Line Utilizing Webinar Format with Exception of Health & Safety items: First Aid and CPR Teach back participation required for Medication Administration. Auxiliary Items Covered During this Class: Foster Care As Defined by the State of Michigan Who Can Attend? This session is open to prospective and existing adult foster care group home licensees and administrators and any direct care staff who need or wish to attend or any persons involved in the support of community care providers EARLY REGISTRATION A MUST! SOME ON-SITE TRNG. AVAILABLE Direct Care Training & Early Registration a Must, Space is Limited! To attend phone: 888.432.6813 or Fax or Mail Registration Form With Payment: Fax: 248.987.4708 or 248.919.5247 $699.95 Per Attendee (Per subject rate applies for those not attending entire event) Send payments to: DCTC: 19500 Middlebelt Rd. Ste. 120-W, Livonia, MI 48152
The Class Outline With Individual Subject Costs for Those Not Attending the Entire Class Critical Skill Class New Curriculum and Adjusted Prices Effective October 2008 Dates and Items Scheduled Subject to Change. Also conducted live on-line with exception of health & safety items. Date Day Subject Day I Monday Introduction and Greetings Day I Monday Adult Foster Care Definition Day I Monday Population Specific Behavioral Characteristics Mentally Ill Developmentally Disabled Traumatic Brain Injury Day II Tuesday Special Section: How a Damaged Brain Can Affect Behavior Day II Tuesday Adult CPR/Infant/Child CPR Day II Tuesday Universal First Aid Day III Wednesday Critical Elements of Program Design-Licensing Requirements Review Day III Wednesday Effective Fire Safety and Prevention Day IV Thursday Person Centered Planning Day IV Thursday Knowing Resident Rights and How to Teach Them to Staff Day V Friday Documentation Integrity and Reporting Requirements A Complete Review of all Adult Foster Care Documentation and a Rule Review of all Required Reporting Affecting Direct Care Workers and Care Administrators in Michigan Day VI Monday Effective Financial and General Management (of a group living program) Day VII Monday Prevention and Containment of Communicable Disease: Blood Borne Pathogens Day VII Tuesday Preparing for Disasters Affecting Group Living Programs How to Compose a Plan in Advance Day VII Tuesday Introduction to Medication Administration Day VIII Wednesday Basic Medication Administration Day VIII Wednesday Review Exam Class Location: 19500 Middlebelt Road, Suite 120-W in Livonia, MI 2
Notes for Prospective Attendees: Seats in this class and all other dates fill-up fast since we make a concerted effort to stick to a maximum of 15 persons per class, 10 for Health & Safety sections. Early registration is a must! Missed sections can be made up for up to one year in future classes Daily schedule and prices subject to change at any time. If only attending for less than the entire session you cannot register on-line, please phone our offices at 248.987.4704. 3
GENERAL WORKSHOP REGISTRATION FORM A B C D Facility Name Major Contact Person (Administrator) License Number (if not licensed write pending) Facility Type (Child Care or AFC) Attendee Name Session No# Session Title 1 Critical Skill Class 2 Critical Skill Class 3 Critical Skill Class 4 5 6 7 Date (s) You Wish to Attend 8. Mailing Address: (Include City, State and Zip Code) 9.. Day Time Telephone: ( ) Evening Telephone: ( ) 10. Fax Number: ( ) E-mail address: This form must either be mailed or faxed at least 2 weeks before any event. Call in advance to check available space. Costs noted below: Monthly CEU workshops - $69.95 Some special sessions are more CPR - $29.95 per person (Renewals are only $15.00 per person) First Aid - $29.95 per person Critical Knowledge Workshop - $699.95 per person for the 5 day session Succeeding in Care Business Workshop - $199.95 per person for 1 day session 2 nd Time Attending is $75.00 Continuing Education, 2-Day Conventions - $295.95+ (August 2007) Special Medication Principles Class - $129.95 (Same price for Resident Rights and Disease Prevention: Blood Borne Pathogens) Child Care Provider Continuing Education - $139.95 for the 10-Hour Session Attendees are expected to arrive 15 minutes before the actual session start time. Session start times will not be delayed for late comers. Payment should be included with the return of this form. Mail to: Direct Care Training & - 26300 Ford Rd. #140-Dearborn Heights, MI 48127. If you wish to fax this form, fax to: 313.557.0101 and send payment within 2 business days. Register by phone by calling: 313.279.4354. Credit cards accepted. Refunds: If a registrant cannot attend due to an unforeseen emergency the amount paid can be credited toward any future workshop or seminar conducted by our company within one year of the cancellation. Cash refunds will not be made. Use multiple sheets if necessary. Prices and dates subject to change with or without notice. Signature of Primary Registrant or Facility Rep. Date Page of 4
Check by Phone Authorization Form Account Holder Information Name on Check in Brackets [ ] Check Number: Bank Name: [ ] Bank City: 1. Pay to the order of: Direct Care Training & 2. The Amount of $ 3. Entity Name: 4. Contact Person: 5. Bank Name: 6. Routing Number: 7. Account Number: By affixing the account holder signature below you authorize our company to create a check for bank deposit resulting in a debit to the identified account. You indicate you are authorized to make this debit for services or products sold by Direct Care Training &, Michigan Community Living, Inc. or any of its affiliates for the exact amount specified above. Authorized Signer: Date: Printed Name: Mail to: 26300 Ford Rd. #140 Dearborn Heights, MI 48127 Fax to: 248.987.4708 Place a Copy of your Check Here Made Payable to DCTC and Fax 5
Date: TO PURCHASE OUR SERVICES USING A CREDIT CARD 1. Name on Credit Card: 2. Business Name: 3. Billing Address of Credit Card: (Make sure zip code is included) 3. Item You Are Paying for: 4. Your Telephone Number: ( ) 5. Card Type: Credit Card Number: / / / / / / / / / / / / / / / 6. Expiration Date: / 7. Security Code: (This is the 3 digit code usually near the signature area on the back of the credit card) 8. Amount You are Authorizing to be Charged to this card: ($ ) 9. Signature of Cardholder: 10. Printed Name: FAX TO: 248.987.4708 6