Individual Service Plan (Isp) For Individuals With Developmental Disabilities Living In The Community Template Page 16
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17INDIVIDUAL-SPECIFIC TRAINING REQUIREMENTS FOR OTHER SUPPORTS (CONTINUED)
For each targeted area, document the urgency of training, as follows:
For each IDT member who must complete training, specify the type, as follows:
1 – Prior to working with the individual
A – Awareness level (e.g., obtains basic familiarity with the plan)
2 – Prior to working alone with the individual
K – Knowledge level (e.g., learns specifics strategies/techniques)
3 – Within 30 days of working with the individual
S – Skill level (e.g., demonstrates ability to follow procedures)
4 – Other (specify)
TOPIC AREA
WHO RECEIVES TRAINING
URGENCY
TYPE
WHO PROVIDES TRAINING
Case Manager
SEXUALITY AND RELATIONSHIPS
Residential Staff
INFORMED CONSENT
PAST HISTORY
Day Support Staff
SUPPORTS
Ancillary Supports:
OTHER (SPECIFY):
Others:
Case Manager
DECISION MAKING
Residential Staff
INDEPENDENT
GUARDIANSHIP STATUS
Day Support Staff
SURROGATE HEALTH DECISION MAKER
POWER OF ATTORNEY/CONSERVATOR
Ancillary Supports:
OTHER (SPECIFY):
Others:
Case Manager
SPECIAL CONCERNS REGARDING ROUTINES
Residential Staff
WEEKDAYS
EVENINGS
Day Support Staff
WEEKENDS
LEISURE PREFERENCES
Ancillary Supports:
OTHER (SPECIFY):
Others:
Case Manager
Residential Staff
DAILY ORAL CARE SUPPORTS:
Day Support Staff
Ancillary Supports:
Others:
Case Manager
Residential Staff
OTHER (SPECIFY):
Day Support Staff
Ancillary Supports:
Others:
Case Manager
Residential Staff
OTHER (SPECIFY):
Day Support Staff
Ancillary Supports:
Others:
Case Manager
Residential Staff
OTHER (SPECIFY):
Day Support Staff
Ancillary Supports:
Others:
Case Manager
Residential Staff
OTHER (SPECIFY):
Day Support Staff
Ancillary Supports:
Others:
Case Manager
Residential Staff
OTHER (SPECIFY):
Day Support Staff
Ancillary Supports:
Others:
NAME: ______ DOB: ____
EFFECTIVE DATE of ISP: ____
PAGE 16 OF 17
version 3/13
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