Document Sample
					           Group Living Services – Paragon
               CORE COMPETENCIES
Name:                            Date:
Site:                            Date of Hire:
Trainer:                         Supervisor:

Before working unassisted (without experienced co-worker) employee will:

                                                                                     Training    Staff     Trainer
           COMPETENCY                          DEMONSTRATIONS                         Date      Initials   Initials
S-1   Obtain first aid and CPR    Present current certification card from
      certification.              qualified first aid and CPR training.
S-2   Locate emergency            When presented with hypothetical emergency
      notification information    situation, staff present appropriate phone lists
      including who is to be      and information on individuals.
      informed of an
      emergency, how, and in
      proper order.
S-3   Follow posted emergency         Identifies what is an emergency.
      evacuation procedures.          Locate & follow posted evacuation plan.
                                      Locate emergency exits and safe areas.
                                      Notify appropriate agency and emergency
S-4   Demonstrate appropriate      Correctly identify situation as potentially
      methods of support and           harmful.
      non-physical intervention    Seek assistance from others, if needed
      for individuals.             Use appropriate body language, tone of
                                       voice, listening skills, redirection, etc.
                                   Follow prescribed procedures & protocols
                                       for individuals
S-5   Lift or transfer an         Follow general or individualized protocols
      individual or material      such as:
      using recognized safe        use proper body mechanics
      body mechanics.              keep back straight
                                   bend at the knees
                                   lift using legs
                                   use assistive lifting devices (such as back
                                       belts, slings, etc.)
S-6   Complete documentation       Correctly identify situation as an incident.
      required for incident and    Notify appropriate personnel, as per
      accident reporting               approved procedures.
      process.                     Complete and submit form through
                                       appropriate channels.
S-7   Use safe handling and        State safe handling & storage procedures.
      storage techniques for       Locate and present MSDS (Material
      chemicals and cleaners           Safety Data Sheets) as available.
S-8   Locate safety equipment.    Present first aid kit, fire extinguisher, and
                                  other emergency equipment if any.
S-9   Safely operate any          Demonstrate proper operation of equipment
      equipment or machinery      such as phones, vehicles, tie-downs, lifts,
      used within the work        stoves, production machinery, gas shut-off,
      environment.                fire alarm shut-off, etc.

           COMPETENCY                          DEMONSTRATIONS                        Training    Staff     Trainer
                                                                                      Date      Initials   Initials
H-1   Locate medical               Present appropriate information on
      information for specific     individuals.
H-2   Respond to specific             Describe special dietary, seizure, physical
      medical and health               concerns of individuals.
      concerns of individuals.      Describe staff responsibility in dealing with
      (i.e., diet, exercise,           those concerns.
      seizures, diabetes, g-        Follow established procedures &
      tube, allergies.)                protocols.
                                    Follow menu as developed.
                                    Document in medical progress notes.
                                    Communicate health concerns at work
                                       with appropriate residential support
H-3   Provide personal care        Follow procedures for feeding, dietary needs,
      supports appropriate to      personal hygiene, oral hygiene, care for
      needs of individuals         incontinence, etc. Assure personal care
      (including use of adaptive   aupports are present in work environment.
H-4   Use appropriate              Demonstrate universal precautions for blood
      procedures for dealing       borne pathogens including use and disposal
      with blood and other body    of gloves, disposal of contaminated clothing,
      fluids.                      cleaning & disinfecting, etc.
H-5   Use appropriate infection     Demonstrate proper handwashing
      control techniques.              procedures.
                                    Use approved isolation techniques.
                                    Demonstrate proper use of antibacterial
                                       agent for surface cleaning.
H-6   Demonstrate appropriate       Verify physician’s order.
      medication administration     Follow organization’s approved medication
      and documentation.               administration procedures.
                                    Administer meds according to individual’s
                                       Physician’s Order Sheet.
                                    Complete required documentation.
H-7   Identify situations that      Identify methods individuals may use to
      require immediate                indicate pain.
      medical intervention.         Identify symptoms of acute illness such as
                                       dehydration or constipation.
                                    Seek medical assistance as needed.
                                    Notify appropriate personnel.

Before working unassisted (without experienced co-worker) employee will:
           COMPETENCY                               DEMONSTRATIONS                          Training    Staff     Trainer
                                                                                             Date      Initials   Initials
R-1   Identify basic civil and        Indicate that consumers and staff have the
      human rights are held by        same rights unless restricted through court
      all individuals regardless      action (such as guardianship).
      of ability.
R-2   Identify additional rights of   List (orally or in writing) at least 5 rights of
      people with                     individual receiving services as defined in
      developmental disabilities      OAR 309-49-150 such as:
      who receive service from         adequate food, housing, clothing, medical
      ODDS.                               care, training
                                       visits to and from family, friends,
                                       confidential communication
                                       control and freedom re: personal property
                                       privacy
                                       protection from abuse and neglect
                                       expression of sexuality
                                       access to community resources
                                       transfer within program
                                       choice and ownership of personal affairs
                                       appropriate services
                                       consent to or refuse treatment
                                       choice to participate in community
R-3   Identify examples of            State mandated reporting procedures.
      abuse, neglect; and state       List orally (or in writing) 5 items from definition
      the mandated reporting          of abuse as defined in OAR 309-49-035 such
      requirements and                as:
      process.                         physical assault such as hitting, kicking
                                       neglect of care including medication,
                                          medical care, clothing, personal grooming
                                       denying meals, clothing or aids to physical
                                       use of derogatory names, ridicule,
                                          coercion, threats, cursing, intimidation
                                       sexual exploitation
                                       restrictions on individual freedom by
                                       use of restraints without physician’s order
                                       financial exploitation
                                       punishment of one individual by another
                                       implied or direct threat of termination of
                                          residential services

           COMPETENCY                           DEMONSTRATIONS                           Training    Staff     Trainer
                                                                                          Date      Initials   Initials
R-4   Identify right of consumer   List orally or in writing at least two examples of
      confidentiality and state    confidentiality such as:
      examples of violation of      all individuals’ records are confidential
      confidentiality.                 except as otherwise indicated by
                                       applicable rule or law
                                    individuals have access to own records
                                    individual can authorize release of records
R-5   Locate organization’s        Present applicable grievance protocols.
      grievance procedure for
      individuals supported and
      for the organization’s

Before working unassisted (without experienced co-worker) employee will:

                                    VALUES & PERSONAL REGARD
           COMPETENCY                           DEMONSTRATIONS                           Training    Staff     Trainer
                                                                                          Date      Initials   Initials
V-1   Locate personal              Present files or documentation that contain
      information about            pertinent information such as ISP, summary
      individuals.                 sheets, likes, dislikes, and Essential Lifestyle
V-2   Demonstrate behavior          Use eye contact (as appropriate).
      that indicates respect and    Address people by name.
      courteousness to              Talk to people rather than about them.
      individuals being             Don’t patronize or talk down to people.
      supported.                    Listen and respond with empathy.
                                    Identify how staff’s own moods, attitudes,
                                       and actions impact individuals being
V-3   Use people first language     Speak of person first then the disability (if
      in interactions with staff       necessary).
      and individuals               Emphasize abilities, not limitations.
                                    Do not label people as part of a disability
                                    Encourage person to speak for
V-4   Describe the importance      State orally (or in writing) concepts such as:
      of providing choices to       choice as basic need and protected right
      individuals with              importance of having options
      disabilities.                 importance of choice in achieving
                                       independence and integration
                                    importance of choice in selecting goals &
                                    importance of providing opportunities for
                                       choices in daily activities (i.e., foods, work,
                                       leisure activities)

                                    VALUES & PERSONAL REGARD
           COMPETENCY                          DEMONSTRATIONS                        Training    Staff     Trainer
                                                                                      Date      Initials   Initials
V-5   Describe the importance      State orally (or in writing) concepts such as:
      of supporting                 individuals must have control over their
      independence for                own lives.
      individuals.                  independence does not necessarily mean
                                      doing things alone or without the support
                                      of others.
                                    a person’s level of dependence on the
                                      support of others is not an indication of
                                      individual worth or value.
V-6   Describe the importance      State orally (or in writing) concepts such as:
      of supporting productivity    right to engage in income-producing work
      for individuals.              value of income level, employment status,
                                      and job advancement
                                    value of sharing talent that contributes to a
                                      household or community
                                    productive time spent in alternatives to
V-7   Describe the importance      State orally (or in writing) concepts such as:
      of supporting individuals     use by all people of common community
      in community activities.        resources
                                    participation common community activities
                                    adequate transportation and accessibility
                                      to community resources
                                    community based employment or
                                      alternatives to employment
                                    regular contact with other citizens in their
V-8   Use listening and            Demonstrate:
      confirmation skills that      use of paraphrasing and other effective
      increase communication.         listening skills
                                    use of appropriate eye contact and
                                      individual’s name
                                    allow adequate time for a person to
                                    use of communication techniques
                                      identified to be effective with individual
                                    sensitivity to non-verbal communication

Before working unassisted (without experienced co-worker) employee will:

                              ORGANIZATION MISSION & POLICIES
          COMPETENCY                         DEMONSTRATIONS              Training    Staff     Trainer
                                                                          Date      Initials   Initials
M-1   Locate the mission and     Present mission and values statement.
      values statement of the
M-2   Locate organization policy Present documents.
      and procedure
      documents for behavior
      support management,
      incident reports,
      confidentiality, consumer
      rights, and med

Within 3 months of hire employee will:

          COMPETENCY                           DEMONSTRATIONS                        Training    Staff     Trainer
                                                                                      Date      Initials   Initials
S-   Recommend and make              Identify areas and situations which may
10   suggested modifications          jeopardize safety.
     to environment as             Notify person responsible for residential or
     required for individual’s        business site.
     safety.                       Properly place equipment and objects.
S-   Respond to emergency         When presented with a hypothetical situation
11   by acting to protect         involving a person-to-person or person-to-
     individuals and self from    property emergency, staff will:
     harm.                         correctly identify situation as potentially
                                   seek assistance from others, if needed
                                   use approved non-physical interventions
                                   use appropriate least restrictive
                                      techniques of physical interventions if non-
                                      physical interventions are ineffective
                                   complete required documentation
                                   debrief with appropriate personnel
S-   Properly respond to          When presented with a hypothetical
12   emergency situation (fire,   emergency situation, staff will:
     explosion, accident, or       follow approved emergency procedures
     other emergency,                 (as determined for location or individuals)
     including evacuation of       provide necessary assistance to
     individuals)or drill to          individuals.
     ensure safety of              call for assistance as necessary
     individuals and staff.        report situation to appropriate personnel
S-   Identify and report           Conduct safety check.
13   potential safety hazards.     Report safety hazards to supervisor or
                                      other appropriate personnel.
                                   Suggest modifications to environment.
S-   Use safe handling             Use appropriate handling procedures (i.e.,
14   procedures when                  clean area, clean utensils).
     handling, preparing, and      Prepare foods safely (hot foods hot, cold
     storing food.                    foods cold, etc.)
                                   Use appropriate storage techniques (i.e.,
                                      clean containers, label and date contents.)

Within 3 months of hire employee will:

           COMPETENCY                           DEMONSTRATIONS                      Training    Staff     Trainer
                                                                                     Date      Initials   Initials
H-8   Describe the desired             Identify and locate written information
      therapeutic effects and           about medications used by individuals
      locate information about          being supported.
      possible side effects of         Indicate the effects and side effects of
      medications being used            medications which staff need to monitor.
      by individuals.
H-9   Identify symptoms of             Observe and record changes in activity
      illness or injury for             level, skin color, communication, etc.
      individuals being                Report changes to appropriate personnel.
      supported (i.e.,                 Implement appropriate action to respond
      dehydration, constipation,        to situation.
      chronic or intermittent          Observe and respond appropriately
      condition, seasonal               specific changes as identified for
      allergies, etc.)                  individuals.
                                       Communicate warning signs to others
                                        (employers, friends) as appropriate to
                                        ensure health and safety.

           COMPETENCY                           DEMONSTRATIONS                      Training    Staff     Trainer
                                                                                     Date      Initials   Initials
R-6   Identify actions defined as   List orally (or in writing) examples such as:
      sexual harassment.             offer enticements in exchange for sexual
                                     unwelcome sexual advancements
                                     verbal, graphic or physical conduct of a
                                        sexual nature which creates an offensive
                                        work environment
R-7   Protect the rights of the     Demonstrate behavior that supports
      individuals supported.        individuals in activities relating to:
                                     involvement in decision making and
                                        community involvement
                                     control over finances, including earning
                                        and managing money
                                     Choice of religion, work, clothes,
                                        friendships, etc.
                                     the purchase and maintenance of personal
                                     having privacy
                                     receiving information about rights,
                                        treatment, risks, records,
                                     being free from abuse & neglect.
                                     voting
                                    (Specific measures to be determined by

           COMPETENCY                          DEMONSTRATIONS                        Training    Staff     Trainer
                                                                                      Date      Initials   Initials
R-8   Respect confidentiality in   Demonstrate behavior that supports
      a variety of areas.          individuals in areas such as:
                                    keep medical, financial, and personal
                                       information private
                                    Privacy when communicating by phone or
                                    Appropriate disclosure of individual
                                       information (i.e., consent)
                                    refrains from “gossiping”
                                   (Specific measures to be determined by
R-9   Act to prevent abuse,        Demonstrate methods to prevent abuse such
      neglect, and exploitation    as:
      of individuals.               identify events and circumstances that
                                       could bring about (i.e., responding to an
                                       aggressive situation) staff to be abusive.
                                    assess individuals’ susceptibility to abuse,
                                       including self-abuse.
                                    teach skills to decrease personal
                                    follow any prevention plan in place through
                                       ISP or agency policy/protocol.
R-    Describe the role of the
10    legal guardian.              List orally (or in writing) at least two
                                   responsibilities of a legal guardian such as:
                                    provide consent on behalf of the ward
                                       (individual determined by the court to need
                                       a guardian)
                                    assure the ward receives appropriate
                                       medical care and services
                                    assure ward resides in least restrictive
                                    provide for care, treatment, support, etc.
                                       as designated.

Within 3 months of hire employee will:

                                     VALUES & PERSONAL REGARD
            COMPETENCY                          DEMONSTRATIONS                        Training    Staff     Trainer
                                                                                       Date      Initials   Initials
V-9   Demonstrate behaviors         Measures to be determined based on
      that increase                 preferences and needs of individuals being
      opportunities and             supported, i.e.:
      individual’s ability for to    involve individuals in decision making
      make choices.                  presents opportunities for choice in daily
                                        activities (such as meal preparation,
                                        budget, clothing, break-time activities)
                                     facilitates and respects communication of
V-    Demonstrate behaviors         Measures to be determined based on
10    that increase                 preferences and needs of individuals being
      independence and              supported.
      functional skill levels of     presents choices in everyday activities
      individuals.                   encourages use of demonstrated skills in
                                        all activities
V-    Demonstrate behaviors          Promote involvement of individual in work,
11    that increase productivity        household and environmental duties.
      of individuals.                Support individuals in activities that seen
                                        as a contribution to their community and
                                        society in general.
V-    Participate in activities     Measures to be determined by
12    and processes that            organization...i.e.:
      support community              supports individuals in community
      integration for individuals       activities as directed in ISP
                                     supports indivisuals in community based
                                     supports individuals in a variety of desired
                                        community settings
V-    Describe the purpose and      Identify key factors such as:
13    basic components of the        assess interests and support needs of
      ISP and staff role in its         individual
      implementation.                determine goals & objectives required to
                                        meet needs
                                     identify strategies for achieving goals
                                     collect pertinent information about
                                        achieving those goals
                                     evaluate effectiveness of service plans
                                        and support strategies
                                     modify plans as needed
                                     work with other partners in plan
                                        implementation i.e. members, families,
                                        VR, other providers, and the community
V-    Follow the objectives and      Carry out the program plan as written
14    strategies set forth in the    Document participation in ISP related
      ISP.                              activities
                                     Demonstrate appropriate instructional
                                        procedures in formal and informal settings.

                                     VALUES & PERSONAL REGARD
          COMPETENCY                            DEMONSTRATIONS                        Training    Staff     Trainer
                                                                                       Date      Initials   Initials
V-   Identify elements              List orally or in writing the following:
15   individualized planning         services are organized around the unique
                                        needs of the individual
                                     individual is directly involved in planning
                                        process to the fullest extent possible
                                     services are flexible and responsive to
                                        identified individual needs
V-   Encourage the                  Staff will:
16   participation of individuals    determine individual’s preferences
     in preferred activities         support the scheduling of preferred
                                        activities and jobs
                                     structure jobs and activities to allow for as
                                        much participation as possible
                                     assure that proper materials and
                                        equipment are available for activities and
                                     assist the individual to connect with his or
                                        her community through clubs,
                                        organizations, recreation, business
                                        groups, etc.
V-   Demonstrate effective          Measures to be based on communication
17   communication skills &         strengths and needs of individuals being
     strategies with individuals    supported. Suggestions include:
     being supported.                make recommendation on how to improve
                                        effective communication
                                     structure activities to promote interaction
                                     recognize and respond to various forms of
                                        communication, spoken and unspoken
                                     respond to individual’s level of
V-   Describe key information       List in orally (or in writing) the following
18   and events for individuals     information:
     being supported.                background, dreams, hopes, likes/dislikes,
                                        wants, behavior profile, approved
                                        procedures and support techniques,
                                        personal characteristics

Within 3 months of hire employee will:

                                ORGANIZATION MISSION & POLICIES
          COMPETENCY                SAMPLE DEMONSTRATIONS (May be                    Training    Staff     Trainer
                                                   modified)                          Date      Initials   Initials
M-   Describe the mission and    Paraphrase orally or in writing.
3    value statement of the
M-   Complete documentation      Correctly complete all required documentation
4    according to agency         (i.e., correct content, within timelines, sent to
     policies and procedures.    correct individuals, etc.)
M-   Locate site copy of         Present appropriate OARs upon request.
5    applicable Oregon
     Administrative Rules


Employee Name: _________________________________________________
                                           (please print)

   Note to employee: This form becomes part of your personnel file; read and understand it before signing.

I have received this training and have the opportunity to ask questions and to have those questions answered.

I have:

1) Completed 47 hours of classroom training.
2) Fulfilled all requirements for the initial and three month core competencies, as
   indicated by the completed check lists.

________________________________                                         _________________
Employee Signature                                                       Date

I have provided on-the-job training, and have observed this employee’s progress. This employee
has demonstrated mastery of all core competencies.

________________________________                                         _________________
Trainer / Assistant Manager Signature                                    Date

I have reviewed the core competency checklists. I have reviewed the employee’s performance
with the assistant manager and concur that this employee has fulfilled all requirements as listed

________________________________                                         _________________
House Manager Signature                                                  Date


Shared By: