CDDP Site Visit File Review Document – ISP Information

DD143 – Children’s Proctor/Foster Services

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IndividualCDDP Date of Review

DOB SE: DD143Service Coord. Reviewer

Individual Support Plan Requirement / Yes / No / NA / Date Noted in File / Comments/Notes
1 / Copy of current DD143 service plan in client file / 0001
2 / Copies of current RTR & PFW, or SIS/IBA in file / 0002
3 / Copies of FA/BSP in file / 0003
4 / Copies of medical and/or other support protocols in file / 0004
5 / Service plan & discussion record addresses support needs, as identified on the RTR, PFW, FA/BSP, and/or other protocols / 0005
6 / Evaluations, assessments, consultant reports, as appropriate, as identified in ISP/annual plan. / 0006
7 / Action plans are present and reflect personal interests and desires as reflected in the ISP / 0007
8 / Service plan includes school/IEP service info, including documentation of a discussion regarding discovery activities that progress the youths readiness for a Path to Employment (if youth is 14 yrs or older) / 0008
9 / For LTD funding, ISP plan is amended to reflect modified supports OAR 411-320-0160(10)(b) / 0014
10 / Service plan documents majority agreement in the plan, Opposition maybe in a discussion record or non-signature of SC / 0009
11 / Service plan or case notes documents reasons preferences not honored (may be seen as no effort to acknowledge preferences) / 0010
12 / Plan contains signature of participants, including the person and/or guardian. / 0011
13 / Plan remains current meaning a new plan is developed within one year (calendar month) of the previous ISP / 0012
14 / Plan extension: In the rare cases where an addendum extends a plan, there are clear reasons why the plan is extended (that are not focused on agency/team convenience. The addendum must specify that the current plan continues to meet the needs of the individual). / 0013

Form:DD143 Version:7 Next Record Key: 0015 Load Date-Time

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