Ill. Admin. Code tit. 59, § 108.APPENDIX A – Developmental Aide Training Program Review Check List

DMHDD-1221i

Department of Mental Health & Developmental Disabilities

Rev. 03/91

IL462-0337

DEVELOPMENTAL DISABILITIES AIDE TRAINING PROGRAM REVIEW CHECK LIST

Facility/agency name:

Date:

Address:

Phone:

Program sponsor:*

Contact person:

DPH ID:

Reviewer:

Review date:

PROGRAM CLASSIFICATION

Licensed ICFD

Bed capacity

Community college

Certified ICFDD

No. DD clients

Area vocational college

Other

STATUS

Initial approval

Program change (must be submitted 30 days prior to implementation)

Annual renewal

(must include:

(1)

Master program schedule as outlined in 77 Ill. Adm. Code 395.110(c)(5);

(2)

any clinical site agreements as outlined in 77 Ill. Adm. Code 395.110(c)(7); and

(3)

any other information required in 77 Ill. Adm. Code 395.110(c) which

has been changed since initial approval or previous annual renewal.)

Reviewer

AIDE TRAINING PROGRAM OVERVIEW

Directions: Check reviewer box whenever the program does NOT meet the stated criteria.

TRAINING PROGRAM TITLE

Program rationale (i.e., philosophy, purpose, sponsor, summary, cirriculum coordinator qualifications

Philosophy

Purpose

Summary that identifies sponsoring agency

Qualification(s) of curriculum coordinator (QMRP or at least two years' experience with DD & DMHDD approved)

Other (identify)

COMMENTS:

*If the program sponsor is a private business or vocational school, a copy of the sponsor's certificate of approval issued by the State Board of Education must be included.

II.	Instructor qualifications shall meet one of the following (A-C):
	A.	Verification of successful completion of a DMHDD-approved "train-the-
		trainer" workshop
	B.	DMHDD approved QMRP trainer
	C.	At least one year's experience with DD programs & DMHDD approved
	D.	Resume included
	COMMENTS:




III.	Program Delivery
	A.	Location(s) identified
	B.	Scheduled projected dates given
	C.	Evidence of agency agreements, as appropriate
	COMMENTS:

Reviewer	TRAINING PROGRAM OVERVIEW
Directions: Check reviewer box whenever the program does NOT meet the stated criteria
	TRAINING PROGRAM TITLE
	IV.	Program Schedule
		A.	Basic content presented in a minimum time frame of three (3) weeks, but not to exceed a maximum of 120 days. Educational institutions are exempt.
		B.	If an educational institution, the term, semester or trimester courses submitted must include designated hours for OJT and evidence of any agency agreements.
		COMMENTS:




	V.	Academic Classroom Component (80 hours)
		Outline including:
		A.	Program and course title
		B.	Behavioral objectives learner is expected to know or do
		C.	Content outline
		D.	Teaching methods
		COMMENTS:

VI.	On-the-Job Training Component (40 hours)
	A.	Has a completed itemization of written training tasks (analogous to behavioral objectives)
		1.	Tasks are identified and written specifying training behaviors trainee is required to perform.
		2.	Each task has the required steps for successful completion.
	B.	Task-specified behaviors are taught by a qualified instructor.
	COMMENTS:


VII.	Program Content
	A.	Flows from stated objectives (not mandated)
	B.	Reflects basic, current knowledge in personal care and skills as related
		to the needs of developmentally disabled persons (not mandated)
	C.	Curriculum review findings (pages 3-4)
	D.	Explanation identifying:
		1.	Instructor(s) criteria for pass/fail of trainers (not mandated)
		2.	Methodology
	E.	Audiovisual materials, trainee and trainer texts are identified by title
		(not mandated)
	F.	Training plan received 60 days prior to being implemented
	COMMENTS:


VIII.	Program Hours
	A.	120 hours minimum
	B.	Exceeds minimum 120 hours with additional program content (not mandated)
	C.	Ratio of one (1) hour of on-the-job training (including supervised clinical
		practice to two (2) hours of (theory) classroom experience
	COMMENTS:


IX.	Evaluation Tools
	A.	Copy of evaluation tool(s) included
	B.	Copy of student evaluation of instructor (not mandated)
	C.	Has tools to evaluate:
	1.	Program objectives
	2.	Program content
	3.	On-the-job performance
		a.	Evaluation of tasks by instructor's direct observation
		b.	A recording form is used to indicate the date of successful completion of all OJT tasks; will be filled out and kept on file at the facility
	4.	Instructors (student evaluation of program instructor)
	COMMENTS:

		DEVELOPMENTAL DISABILITIES AIDE TRAINING CURRICULUM REVIEW
		Directions: Designated reviewer should
Program Deficiencies	Anticipated Time		a.	Check Program Deficiencies whenever the program does not meet stated criteria
b.	As appropriate, indicate sponsor's Anticipated Time (i.e., hours, minutes) by the general or specific program title; you may also elect to use this space to identify if the time is for CI (classroom instruction) or OJT (on-the-job training)
c.	As appropriate, state instruction media used
	PROGRAM TITLE
		I.	Orientation
			A.	Functions of long-term care facilities for the developmentally
				disabled
			B.	The health care professions, support services for the develop-
				mentally disabled and community social service agencies
			C.	Philosophy of residential care
			D.	Role of the interdisciplinary team
			E.	Job duties and responsibilities of the DD aide
			COMMENTS:




		II.	Introduction of the Residents
			A.	Communication and interpersonal relationships with residents,
				families and others
			B.	Psychosocial needs of residents and their family
			C.	The growth and development process
			D.	Characteristics and types of developmental disabilities
			E.	Resident's adjustment to death and dying
			COMMENTS:




		III.	Fundamentals of Habilitation Planning
			A.	Philosophy of achieving independent living skills
			B.	Introduction to the individual habilitation plan including the role of the employee in the habilitation process
			C.	Habilitation plan assessment procedures and goal planning
			D.	The role of the employee in the admission, transfer and discharge processes
			E.	The role of the employee in basic resident care planning & procedures
			COMMENTS:

IV.	Techniques of Habilitation Planning and Implementation
	The role of the employee in social habilitation include:
	A.	Activities of daily living (ADL);
	B.	Therapeutic and leisure time activities;
	C.	Education;
	D.	Community living adjustment;
	E.	Behavior development;
	F.	Behavior control;
	G.	Effect of drugs in behavior management;
	H.	Total communication;
	I.	Pre-vocational and vocational training;
	J.	Nutrition and fluid intake;
	K.	Diets and therapeutic diets;
	COMMENTS:

DEVELOPMENTAL DISABILITIES AIDE TRAINING CURRICULUM REVIEW
Program Deficiencies	Anticipated Time	PROGRAM TITLE
V.	Principals of Record Keeping
			A.	History and use of facility records with special emphasis on the role of the employee in the record keeping process
			B.	Content and organization of resident records
			C.	Recording methods for progress notes, universal notes, ADC notes and habilitation news
			D.	Writing effective progress notes
			E.	Confidentiality
			F.	Recording admission, transfer and discharge information
			COMMENTS:



		VI.	Safety
			A.	Basic fire safety
			B.	Emergency and disaster procedures
			C.	Injury prevention techniques
			D.	Household daily safety procedures including body mechanics
			COMMENTS:

VII.	Facility Environment
	A.	Creating normalized environment for daily activities
	B.	Importance of cleanliness of the facility, use of equipment and supplies
	COMMENTS:




VIII.	Principles of Disease Control
	A.	Introduction to micro-organisms causing resident illness and disease
	B.	Teaching of disinfection and sanitation
	COMMENTS:




IX.	Emergency Medical Procedures
	A.	CPR
	B.	Seizures
	C.	Drug reactions
	D.	Traumas
	E.	Heimlich maneuver
	COMMENTS:





X.	Resident Rights
	A.	Basic civil, human and legal rights of residents
	B.	Protection of residents personal property
	COMMENTS:





XI.	Bodily Functions
	A.	Helping residents to understand their bodily functions
	B.	Personal hygiene
	C.	Human sexual behavior
	COMMENTS:

DEVELOPMENTAL DISABILITIES AIDE TRAINING SUMMARY SHEET


Sponsor		Date

I.	Decision:
		A.	Approved.
		B.	Conditionally approved (contingent on the receipt of additional materials,
	or revisions needed to remedy any minor deficiencies in the proposed
	program). Additional materials or revisions requested are as follows:

		C.	Denied for the following reasons:

II.	Additional comments or recommendations:


Title

Signature		Date

(Source: Added at 15 Ill. Reg. 6122, effective April 15, 1991)