Verify through interview and documentation the process by which the administrator is overseeing provision of services. 1.006 Does the ICF/IID have policies and procedures regarding vehicle accessibility, vehicle maintenance, and requirements for vehicle drivers? 5123:2-3-04 No set format for policies and procedures 1.007 Does the ICF/IID have general liability insurance? Must be at least $500,000 Section 2 - PERSONNEL Question # Question Guidance/Additional Information Compliant Yes/No Plan of Correction (If not compliant) 2.001 Did the ICF/IID complete a valid initial BCII/FBI check for direct service employees? 5123:2-2-02; 5160-45-07; ORC109.572, 5123:2-3-01 Mark as non-compliant if the initial checks were not completed at all or were completed using the incorrect reason code/reason title FBI check required if employee hasn't been an Ohio resident for 5 yrs. previous to hire 2.002 Did the ICF/IID complete a valid BCII/FBI check every 5 years for direct service employees? 5123:2-2-02; 5160-45-07; ORC109.572, 5123:2-3-01 Mark as non-compliant if the 5 year checks were not completed at all or the incorrect reason code was used BCII recheck not required if employee is enrolled in Rapback; Rapback does NOT include the FBI recheck FBI
check required if employee hasn’t been an Ohio resident for 5 yrs. 2.003 Are all ICF staff enrolled in RAPBACK within 30 days of his or her initial criminal records check by the bureau of criminal investigation 5123:2-2-01, 5123:2-3-01 Effective October 1, 2016 If hired prior to 10/1/16, employee must be enrolled in RAPBACK at time of next 5 year check. If an employee is not able to get a BCII via fingerprints they cannot be enrolled in Rapback. The provider agency must continue to complete the 5 year BCII/FBI 2.004 Did the ICF/IID complete the initial and 5 year BCII/FBI checks in a timely manner? 5123:2-2-02; 5160-45-07; ORC109.572, 5123:2-3-01 Mark as non-compliant if either the initial or 5 year checks were completed late, DO NOT mark non-compliant to this question if the checks were not done at all. 2.005 Did the ICF/IID complete the following initial database checks for employees? Inspector General’s Exclusion List Sex Offender and Child Victim Offenders Database U.S. General Services Administration System for Award Management Database Database of Incarcerated and Supervised Offenders Abuser Registry Nurse Aide Registry Mark as non-compliant if checks were not completed at all Applies to employees hired after 1/1/13 Persons on the data base may not be employed to provide services to individuals For ICF-IIDs, this is not required for staff hired prior to January 1, 2013 until December 31, 2014.
5123:2-2-02, 5123:2-3-01 2.006 Did the ICF/IID complete the following database checks every five years for employees? Inspector General’s Exclusion List Sex Offender and Child Victim Offenders Database U.S. General Services Administration System for Award Management Database Database of Incarcerated and Supervised Offenders Abuser Registry Nurse Aide Registry 5123:2-2-02, 5123:2-3-01 Mark as non-compliant if checks were not completed at all If employees are verified as enrolled in ARCS, the 5 year recheck is not required. Beginning 1/1/13. 2.007 Did the ICF/IID complete the initial and 5 year database checks in a timely manner? Inspector General’s Exclusion List Sex Offender and Child Victim Offenders Database U.S. General Services Administration System for Award Management Database Database of Incarcerated and Supervised Offenders Abuser Registry Nurse Aide Registry 5123:2-2-02, 5123:2-3-01 Mark as non-compliant if either the initial or 5 year checks were completed late Staff hired before 1/1/13 - the first recheck is due 5 years from the date of the last check; as long as the previous check included the BCII, Abuser Registry, Nurse Aide, and FBI as applicable
A Social History Other Evaluations as needed 5123:2-3-03 4.002 Using person centered planning, has the plan been developed based on the results of the Comprehensive Functional Assessment (CFA) as it relates to: Ensure health and welfare, Assist the individual to engage in meaningful activities Support community connections Assist in improving self-advocacy skills Ensure achievement of outcomes Identify risks include supports to prevent or minimize risks Ensure employment services that are consistent with the individual’s identified employment outcome 5123:2-1-11; 5123:2-2-05 ISP promotes: Rights Self-determination/Individual Choice Physical well-being Emotional well-being Material well-being Personal development Interpersonal relationships Community Inclusion Provider has communicated unmet/change in wants/needs Identified risks related to a noted trend of unusual incidents and/or major unusual incidents 4.003 Does the assessment/planning process consider; What is important to the individual What is important for the individual Known and likely risk Place on the path to employment Desired community employment outcome What is working and not working 5123:2-3-03 Assessment considers the individual’s skills The team may prioritize the assessed needs of the individual based on what is important to/important for the individual. Important to promotes satisfaction Including provider/staff selection Important for promotes health and welfare Trends of unusual incidents Major unusual incident review Serious chronic medical conditions There are four places on the path to community employment:
preventive measures to protect the health and welfare of any at-risk individuals. 5123:2-17-02 8.016 Did the ICF/IID maintain a log of unusual incidents which includes: Name of Individual Description of Incident Identification of Injuries Time/Date of Incident Location of Incident Preventative Measures 5123:2-17-02 Sample UI Log Available on Health and Safety Toolkit Required for Agency and Independents 8.017 Did the facility report all allegations of mistreatment, abuse, neglect, as well as injuries of unknown sources to the administrator immediately? 5123:2-17-02 Was administrator or designee notified on the same day the incident was identified? 8.018 Is there evidence that the ICF-IDD completed an Incident Report for all unusual incidents? 5123:2-17-02 Check UI report This applies to all incidents that meet the definition of an unusual incident. SECTION 9 – PERSONAL FUNDS 9.001 Does the ICF-IID ensure that individual funds are made available to the individual as required? 5123:2-2-07 Individual funds must be deposited within 5 days of receipt and made available to the individual within 3 days of request. This includes all monies such as personal allowance, employment, gifts, income tax refunds and food stamps. 9.002 Did someone other than the staff who handle personal funds, complete reconciliations at the frequencies required? 5123:2-2-07 Bank accounts should be reconciled using the most recent bank statement.