Zumbro House, Inc.



Lead Counselor Training ManualTable of ContentsEmployeesSchedule – how it should look, staying within standard amount of hours, when it should be completed and available to staff, on-call staff, consistency, overtime, etcChanges in staff hours – who to contact and when (increase or decrease in scheduled hours)Scheduling and Auditing of Employee TimecardsPerformance Coaching; Giving FeedbackPerformance Monitoring Documentation of PerformanceSupervision Meetings and FormsVerbal Counsel/Written WarningsOvernight ChecksTrainingNew Employee Training – checklist, med skills assessment, how to cover each item, how to fill out the form, etc.Ongoing TrainingTraining RequirementsStaff MeetingsWhat Do if a Staff is Injured at WorkLeave of AbsenceFamily Medical Leave (FMLA)Military LeavePersonal leaveOtherPeople Receiving Services from Zumbro House, Inc.Specific Guardian/Case Manager ExpectationsCommunication with guardians, case managers, day placements, etc. – every other week contact requirementCommunicating with difficult team membersPersons served MeetingsDocumentation GuidelinesPerson Served files Where to file documentsWhat/When/How to send things to the office for filingMedical DocumentationMedical Referral Forms (Annual Physical, Medical, Dental, Ophthalmology) Medication Administration Record Sheets (MAR’s)Med ChangesMed ErrorsPerson Served Finances – review ledgers weeklyChecking accounts Limited access to checkbooks, extra checks, where are they secured?Petty cashAsset limitsRent responsibilitiesCompletion of financial paperwork – CAF’s, shelter forms, other financial documentsGeneral billing/funding informationDo not throw anything awayActivities/SchedulePsychotropic Medications Primary Counselor ResponsibilitiesLicensing Requirements-245D and Department of HealthPersons served Appearance – for meetings, for every dayHouseHome Safety ChecklistCredit Card –Purchasing and Recordkeeping, your responsibility/liabilityFire Drills; Severe Weather DrillsMenu – Nutrition GuidelinesHouse Appearance, Safety, and MaintenanceOtherCell Phone Use and Availability Required Postings for the Site (employment posters, PAPP, Emergency Numbers, Persons served Rights)ZH Vehicle Maintenance Lead Counselor ChecklistsScheduleWriting, maintaining, and filling the staff schedule is the responsibility of the Lead. Although the Program Counselor will be as helpful as possible with the schedule if needed, it does remain a Lead responsibility to make sure there is adequate staff coverage at the house. If you are proactive about the schedule, and manage it effectively, you will have fewer emergencies and less stress.Please try to stay within the shifts that have been assigned to the house based on the Person Served needs, scheduling as many appointments and other miscellaneous tasks during those scheduled hours as possible. Also be aware of staff who may be arriving early or staying late for their shifts when it is not necessary. These extra hours – schedule creep – can add up over the week, and is unacceptable. Staff should be working their assigned shifts and getting any variation from that approved by the Lead or by the Program Counselor. Staff hours are scheduled according to the needs of the Person Served and the house – not the financial needs of the staff. The fewest staff hours should be scheduled that still meet the needs of the Person Served and the site. This would include scheduling doctor appointments and other appointments during regularly staffed hours, rather than having staff come in early for a Person Served appointment. This should be done, even if it means that the appointment is scheduled a few days later.There is an example of a house schedule in this manual and a schedule template is available on the Management Only page of the website. The schedule should be typed – all changes must be clear and easy to read. Resident Counselors should only make changes on the schedule when they have been directed to do so by the Lead Counselor or Program Coordinator.The schedule should be completed and available to staff at least one week before it begins. Open shifts should be filled as far in advance as possible. It is the Lead Counselor’s responsibility to look at every shift to be sure the staffing is adequate – meaning having confidence that the quality and abilities of the staff are adequate to offer the needed support to the Person Served on every shift. Every effort should be made to avoid “weak” shifts, as those often result in issues with Person Served and incident reports. Consistency in staff is critical to the success of our Persons Served, so scheduling as few staff for as many of the hours is ideal, rather than having a number of fill-in staff covering shifts. At a typical Zumbro House site, there are 3 primary afternoon positions, one part-time position, and two overnight positions. Just less than 200 staff hours per week should be used, as a general rule. Additional staff hours for Persons Served who stay home during the day, will increase this number.Overtime should be diligently avoided. Only in emergency situations and when all other options have been exhausted should overtime be approved. Lead Counselors as well as Program Coordinators are expected to explain overtime when necessary, so be prepared to do so if you are approving any overtime. Also, expect to specify what measures failed in order to avoid overtime. On call staff is in a separate section on the staff phone list, and staff that may have additional hours available are labeled as “PT”. Be sure to always refer to the staff phone list that is posted on the website, as that is where you should find the most updated information. Please avoid the temptation to print out copies of the staff phone list, as it changes frequently. This will help avoid calling former employees to pick up shifts. If you find that there is an incorrect phone number, please ask the staff to complete an Employee Communication Form, which is located on the employees only page of the website. When you are calling staff to fill in, you should be asking if they will be in overtime if they pick up the shift. Although the employee is also supposed to be informing the Lead when they are asked to pick up shifts, we cannot always count on the employee to pass along that information. Also make sure to inform any on-call staff, who are working in your house for the first time, that they must read and sign the signature page for all of the Person Served Behavior Support Plans, Snapshots, IAPP’s, CSSP/CSSP Addendum.If a staff is requesting a permanent change in hours, please make sure that they complete an Employee Communication Form on the website informing Human Resources of the change. Staff who is working an average of 39 hours per week are eligible for PTO benefits 90 days after they begin working those full time hours. Remember, all permanent changes to the schedule should be approved by the Program Coordinator. This includes the Lead’s schedule. Creating “custom” schedules for employees can create chaos when positions need to be filled.Payroll forms, both blank copies and those being used for the current payroll, should be kept in the Payroll Book. These forms are available on the Employees only page of the website. Having these forms in the same location at all sites makes it easy for staff who are working at multiple sites and also for the supervisors who are gathering forms for payroll. The Lead must inform the Program Coordinator whenever they wish to change their own work schedule – temporarily or permanently. Otherwise the PC will expect the Lead to be on-site when the schedule specifies they are to be on site. Lead Payroll ResponsibilitiesAs a Lead Counselor, you are responsible for performing timecard audits for all of the employees that work at your sites during a given pay period. Here is a step to step guide on how to perform your auditing responsibilities using the EZLaborManager electronic time-keeping program. You must assign recurring schedules to all of your regularly scheduled part-time and primary Resident Counselors. Recurring schedules must be reassigned with position turnover, as new employees are hired. NOTE: Recurring schedules have already been created by HR based on the set positions at your site, you just need to assign them to your employees. To do this, click on the schedules tab on the left side of your home screen. If you are unable to see any employees, you need to create a filter of employees you would like to view. To create a permanent filter, Click the yellow filter button . On the My Filters page, Click New. Under Filter Item, select employee ID and click the arrow to move it into the right box. Then click next. Name your filter (i.e. My Staff, Fremont/Chicago staff). Click the button. Add employees to your filter by checking the box on the left. Add all of your primary and part-time RCs, as well as on-call employees that you commonly use. You should add all of the employees that work at your sites. Then click save. On the My Filters page, click on the blue filter link you just made to begin. At any point in the future, If you’d like to add more employees or delete employees, you may edit your filter, by pressing the button and following the same steps above. Once you are back on the schedules tab and can view the employees that work at your sites, you can begin adding recurring schedules to your regularly scheduled staff. First, press the Recurring Schedules tab, so that it is highlighted green. Select Assign Multiple. Click on the employee’s name you wish to add to a recurring schedule, so that it is highlighted blue. Then, click the button next to the box under Recurring Schedule and choose the corresponding recurring schedule you wish to add to that employee (i.e. Bloomington Primary ON). See that under Description, it states the days associated with that schedule. Under Start Date, choose any past Sunday that begins a pay period (see 2013 Pay Calendar worksheet). The Start Week should be 1 and you do not need to enter in an end date, unless applicable (i.e. they have put in a two week notice). Click Submit. You should now be able to see their recurring schedule to the right of their name. Follow the same steps to add recurring schedules to each employee that is regularly scheduled at your site.Only HR can edit and create recurring schedule assignments. If you notice that one is inaccurate, contact HR to request that it be changed. You must keep all employees scheduled up –to-date by adding daily schedules as needed. For example, if an employee who is assigned a recurring schedule requests a day off and finds coverage with an on-call staff, you will need to edit each employee’s schedule to reflect this change. Anytime you have preapproved a regularly scheduled employee to work hours that vary from their recurring schedule, or schedule employees that do not work regularly at your site (i.e. on-calls), you must update their schedule using the Daily Schedules tab. Under Schedules, select Daily Schedules so that it is highlighted green. Employees in your filter should be listed; however, if you need to adjust a schedule of an employee that you cannot see, you must edit your filter (see instructions above under 1.a). Select Edit Single. In the corresponding row of the employee you wish to edit, highlight the day you wish to edit, create, or delete a schedule. If you need to see a broader view of days, click the button next to the employee’s name. Select the day you wish to edit. If you are deleting a shift, press Delete Selected, then Submit. You will see that the shift disappears. If you are editing a time in/out or adding a shift, add the in time in the corresponding In box and out time in the corresponding Out box. Under Department, press the button and choose the site they will be working. Click Apply, then Submit. The updated schedule should appear below, next to the employee’s name. If the edited schedule was outside of the current week, you can click the button by their name to view it on their monthly schedule. Remember, editing Daily Schedules is a one-time schedule adjustment. The schedule will default to the employee’s recurring schedule (if applicable) for all other days, unless you individually adjust shifts using the Daily Schedules tab. Once you have set up schedules, employee’s timecards will show a next to shifts that match their assigned schedule (this is good!). There will be a exception next to any shifts that do not match the schedule you have assigned them. A exception will appear next to any shifts where an employee has forgotten to punch out or punch in. If a exception appears next to ANY shifts where an employee has worked at your site, you need to write a note on their timecard to explain the deviation. This is the primary role in your auditing process. Employees should be updating an ongoing Timecard Notation Form and Time Edit Request Form for any shifts flagged with or exceptions. These forms should be kept in a designated place at your site (timecard binder). You will be expected to audit timecards once weekly on Sundays. To perform your audit, you will first need to pull up a list of all the employees that worked at your sites during the current pay period. To do this, click the Reports link on the top right of your home screen. Click the Supervisor Reports link. Then, click the corresponding button next to Timecard Report. Name this timecard report “My staff” or enter in your site names. Time frame should be current pay period. Scroll to the bottom of the page to add a current filter for this report. Under Create New Filter, use the scroll down menu to chose “worked department”. This will create a timecard report for all employees that worked only at your sites. Press the button and in the corresponding box, check the sites you manage. They should now appear in the Selected Values table. Click Add Filter. You new filter and filter description show now appear. Click Save and Preview. This will save this report for future use and it will pull up a report of all the employees that have worked at your sites during the current pay period. Either print this report out or write down all the employees that show up in the report. In the EZLabormanager window, click the Reports-Home link at the top of the screen. You will be able to see your customized report link as you named it under My Reports. You can use this report to look up employee timecards that work at your site at any future date.After you have printed out the employee timecard report or written down all the employee names that have worked at your site, you will now need to pull up their timecards to add in timecard notations for exceptions. To look up an employee timecard, click Timecard Manager tab on the left side of your screen. Ensure that the filter is set to default filter. If it is set to your customized filter, you will only be able to look up employee timecards listed under that filter (this may be okay if you’ve added everyone to your filter who worked at your sites). Go through every employee’s timecard on your list by typing in their name in the white box/ drop down menu (located to the right of where the employee name is listed). Write notes on the employee timecards for any shifts marked by . To do this, click the button on the far right of an employee’s timecard for the corresponding shift. Transcribe the employee’s notation that they submitted to you on the Timecard Notation Form. If they did not submit a notation for a shift there is a , indicate that on the employee timecard note. Furthermore, if you know the reason for the exception, you can write it in but you’ll still want to indicate that the employee did not submit a notation to you. Please summarize why the exception occurred (why the employee clocked out late/early, stayed late/early, was absent, went into overtime, etc), and whether or not you approved it. Write your name at the bottom of the note. Employees WILL be able to see any notes you write on their time card; they will NOT be able to edit them. Any time you make edits to a timecard, remember to click Save & Calculate at the bottom of the page!! Also, when you are auditing time cards, ensure that the department listed next to the shift is accurate. Ensure that any Timecard Edit Request Forms, sent in for missed punch in or missed punch outs (indicated by a ) have been corrected. Remember, to change an employee time in/out, you NEED permission from them using this Timecard Edit Request Form. If there is an employee with a next to a shift on their timecard, please follow up with this employee and ask them to fax a Timecard Edit Request Form to the office. On the Sunday at the beginning of every pay period, you must continue to turn in an updated and accurate staff schedule for the previous pay period. Additionally, you must submit all Time Edit Request Form copies kept at your site. FINAL NOTES TO REMEMBERRecurring schedule changes must go through HR. Leads can adjust schedules on a day-to-day basis. Leads are responsible for adjusting employee shifts on a day-to-day basis for preplanned, preapproved schedule changes, under the “Daily Schedules” tab. Otherwise, anytime an employee’s hours deviate from their assigned schedule they must submit an entry on an Ongoing Notation Form. This will be flagged by an exception on their timecard. Your audit responsibilities include writing notes on employee timecards for any shift worked at your site that shows an exception. To look up employees who worked at your site, create a custom timecard report. You must look through each employee’s timecard that shows up on this list and check for exceptions. In the timecard notes for shifts with exceptions, you must state the reason for the exception, whether or not it was approved, etc. Leads must write their name on every note. You must also ensure that the department worked is accurate. You must audit each employee’s timecard that worked at your site(s) at least once every week.You must turn in updated staff schedules at the end of every pay period.Employee PerformanceCoaching and Giving FeedbackThis is one of the most important aspects of the Lead position. The performance of your staff is a direct reflection on your performance. The coaching and performance improvement suggestions that you give to the staff have a substantial effect on the quality of care that is being provided to the Person Served. For that reason, it is absolutely essential that any performance issues are addressed promptly and consistently. Allowing staff performance issues to “slide”, is negligent to the primary duties of Lead Counselor and a disservice to our Person Served. You are not only monitoring staff compliance with internal policies and licensing standards, but you are also expected to provide feedback to your staff regarding interactions with the Persons Served. If you observe a staff’s interaction with a Person Served and feel that an alternate approach would work better, it must be addressed. The Persons Served reflect the behavior of our staff, so helping our staff interact appropriately with the Persons Served is critical to their success and will help minimize behavioral issues. We also have a responsibility to our employees who really want to do a good job. If we are not addressing performance concerns to help them do better, we are taking that opportunity away from them. Even more concerning, missing the opportunity for the Persons Served to have a better staff person.Giving employees feedback is not always easy – you may not have had to do that in the past, you may be unsure of how they are going to react, you may be uncomfortable with the conflict, you may need them to pick up an extra shift so you don’t want to upset them, and you have to work closely with that person at the house! The trick is to be fair and consistent. If you are fair and consistent, employees will expect you to say something to them if their work is not up to standards. As long as they feel like they are treated fairly and that we would like to see them succeed, they probably won’t get too upset with you.Your best tools are the ones that Zumbro House has already provided to you…the Policies and Procedures, Snapshots, job descriptions, Person Served Behavior Support Plans and programs, house rules, etc. Always refer to those documents when talking with the employee. They know then that we are not just making up the rules as we go.What is most important is that you are talking to employees as soon as possible after a performance concern has been found. Feedback that is not given right away is not nearly as effective – if you wait, the employee may not even have a clear recognition of what the situation was.Refer to the Giving and Receiving Feedback documents included in this manual for some additional helpful hints.Performance Monitoring Here is a good motto to live by: INSPECT what you EXPECT!! If staff know you are never going to check on something, they are much less likely to follow through with that task. That doesn’t mean they are a terrible staff; that is just human nature! Spot checks of those Resident Counselor Checklists and the Overnight Checklists must be done regularly – at least twice per week. This doesn’t have to be a time-consuming task, just choose a few items and double check quickly that they have been completed – and completed up to the standard that Zumbro House expects.Always remember, the Lead Counselor has to take accountability for what goes on in their house. Make sure the staff is well trained and that you are addressing and documenting all performance issues. If you overlook incomplete or improperly completed job tasks, then you are communicating to the employee that it is not important. This further creates an atmosphere where rules are considered optional. Enforcing all house rules and company policies consistently will result in a better run house. If the Lead is not holding their staff accountable for their staff’s performance, then they are neglecting a major part of their job. Documentation of PerformanceYou have heard this before – If it is not documented, it did not happen. The same applies to documentation of employee performance. If you give someone a verbal counsel or some coaching on a particular area and do not follow up with documentation, we cannot use that information to move forward in the disciplinary process if needed.When you are documenting performance, it can be done a few different ways, but it must always be kept confidential. There is a form, Record of Verbal Counsel, which is available on the Management Only page of the website. (There is an example of this form included in the manual.) This Record of Verbal Counsel should be completed any time that you speak with a staff about performance or offer them some retraining to increase their level of performance. As you are documenting performance, keep the following tips in mind:Write it all down – although you may mean well, nothing undermines the credibility of an employer more than incorrect or incomplete information created later because we are relying on memory to complete it. You may think a particular situation is so outrageous or unique that you will not forget it, but your information will only be viewed as completely credible if it has been documented.Stick to the facts! – Do not guess, exaggerate, or offer personal opinions. The documentation must be clear and concise and include only the facts. Strictly Business – Only refer to the situation at hand and the facts surrounding it. If you add in any comments such as what another staff person said about their strange choices for recreation on their off time, it may damage the credibility of your documentation and someone could make the case that you were unable to be objective.Use Company Policies and Procedures for support – Most commonly used documents are the Job Description, the Staff Reliability Policy, and the Security Policy. You can use all of the policies in the Personnel and Management policies, House Rules and boundaries, the Medal program, and any other documents that we have trained the employee on.Make sure the staff are aware of those policies and procedures and have access to them – record that in your documentation.Don’t make promises – especially ones that you cannot keep. If you tell an employee that you will address their concerns and then do not follow through, your credibility and your authority is damaged.Be a historian – It is useful to write “this employee was given a verbal counsel on 2-3-08 for attendance, a second verbal counsel on 4-15-08 regarding the staff reliability policy, and a written warning on 5-6-08 also for attendance.” As you can imagine, writing that this employee has been spoken to about this issue “at least three times” is much less informative and credible. Check with Human Resources if you need to check on dates of items that are in the employee’s file.Always be FAIR – treat all employees fairly and consistently to avoid accusations of preferential or discriminatory treatment.Supervision Forms and MeetingsSupervision meetings are expected to take place between the Lead Counselor and the Program Coordinator twice per month in which house documents, staff issues, resident progress and work processes are reviewed. Meetings between the Lead Counselor and the Assistant Lead Counselor will take place weekly and again house documents, staff issues, resident progress and work processes are reviewed. These meetings are designed to ensure that the structures set up in the programs are being done regularly and correctly. These meetings are vital in upholding the quality of services that is expected of ZH Lead Counselors and Assistant Lead Counselors. See the meeting forms below.Assistant Lead Weekly Supervision formItems needed for this meeting: most recent Assistant Lead Checklist, staff meeting minutes, safety checklist, Activity Schedules, Menu’s, House and resident ledgersStaff and Staff Training: Review staff schedulePerformance of staff (RC’s/On-Calls) strengths/issues, interventions/plan for improvementAre all staff completing the following consistently (primary meetings/checklists, staff meetings/attendance, activity and staff schedules, menu postings, staff reading/signing documentation) and if not what is the plan to ensure that these take place as scheduled and staff follow through.c. Shadow Training: Name(s) of staff who shadowed this week?Are Shadow Packets complete and sent to Woodbury?Financial:Review Ledgers for each resident-Do the ledgers balance?Review house ledger-Is the Budget followed?Identify any issues or training needs for Assistant Lead in the area if financeProgramming: Review MARS, Staff meeting minutesReview MAR’s for errors and ensure that documentation is correct:Review Resident books to ensure that documentation is updated and staff are signing off:Staff meeting directive follow up-strengths/issues:Person Centered Plans: Review appointment calendar, Activity Schedules, menu posting, individual programmingIssues and plan to resolve issues/barriers.Health and Safety: Review lead safety checklistSafety of each site (review the lead safety checklist), issues found and plan to resolve:Lead Signature:______________________________________________Date:__________________Assistant Lead Signature:______________________________________ Date:__________________Lead Bi-Monthly Supervision FormName: Date: PC/Supervisor: _______________________Items needed for this meeting: most recent Lead Checklist, Assistant Lead Checklist, Primary Checklists, RC Checklists, staff meeting minutes, safety checklist, and resident ledgersStaff Supervision and Staff Training: Review Lead Checklists, Assistant Lead and RC Checklists, LedgersPerformance of Assistant Leads, strengths/issues, interventions/plan for improvement2.b. Is the staff consistently completing the following: primary meetings/checklists, staff meetings/attendance, activity and staff schedules, menu postings, staff reading/signing documentation, RC checklists? If not the plan to ensure that these take place as scheduled and staff follows through.Other staffing: strengths/issues vacanciestraining needsinterventions/plan for improvement:Programming: Review MARS, Staff meeting minutesReview MAR’s for errors and ensure that documentation is correct:Review Resident books to ensure that documentation is updated and staff are signing off:Staff meeting directive follow up-strengths/issues:Person Centered Plans: Review appointment calendar, Activity Schedules, menu posting, individual programmingIssues and plan to resolve issues/barriers.Health and Safety: Review lead safety checklistSafety of each site (review the lead safety checklist), issues found and plan to resolveAre all the rooms in the site clean and neat? If not what is the plan to ensure that all rooms are clean and neat?Lead Signature:______________________________________________Date:__________________Program Coordinator Signature:_________________________________Date:__________________Verbal/Written WarningsAgain, the trick is to be fair and consistent – and PROMPT! Follow the outline of the form and stick to the facts. There are examples of the Record of Verbal Counsel and the Employee Warning Notice included in the manual.Verbal Counsel should be completed any time that you talk to a staff about improving their performance or doing something differently. You can type up the form and email it to Human Resources and your supervisor. The Record of Verbal Counsel Form does not need to be signed by the employee. It will get passed along to Human Resources so that it can be placed in the employee’s personnel file. These verbal counsel forms provide the foundation for any written warning that we may need to proceed with in the future. If you tell us we have a problem employee, but there is no documentation in their file, the documentation is the problem. Remember, the employee is not going to change or improve their performance if they don’t know they are doing something wrong or if they are not held accountable.Written Warnings should be given for more serious infractions or if the person has been given verbal counsel for the issue in the past and is not improving their performance. They may be written by either the Lead Counselor or the Program Coordinator, but your Program Coordinator should always be involved in the decision to give someone a written warning. The Employee Warning Notice is located on the Management Only page of the website. Each section reflects important information. In order for the warning to be credible, it must be completed thoroughly and accurately. All written warnings must be emailed to Human Resources (and CC your Program Coordinator) for approval before giving them to the employee. All written warnings are delivered at the administrative office where the Program Coordinator and Human Resources are present. Occasionally, it may be appropriate for the Lead Counselor or Director of Program Services to attend. It is important that the employee has an opportunity to respond to the warning and be able to ask any questions that they may have. It is critically important that an employee’s personnel file accurately reflects their performance. An empty personnel file indicates that the employee’s performance is exemplary. If it is possible that an employee may need to be removed, we must have ongoing and thorough documentation of the performance deficits leading up to the removal, including our efforts to improve their performance. Having substandard staff working at your house, who refuse to respond to your coaching and efforts to improve their performance, is a disservice to the persons served. In fact, the persons served success is often directly reflective of the staff who work with them. This is why it is of the utmost importance that we maintain a high standard of care and that we hold our staff accountable for performance that does not meet that expectation. TrainingNew Employee TrainingNew employees are required to shadow another employee (not be alone with any Person Served) for the first 16 hours of their training. We require that the first 8 hours of onsite orientation/shadowing be conducted by the Lead Counselor or the Assistant Lead Counselor if the Lead Counselor is unavailable. On-call and overnight employees must shadow another employee for the first 20 hours of their training. It is only necessary that they are an “extra” staff for the first shift. After that, as long as they are working with a second staff, that meets the shadowing requirement. They will have an Orientation Checklist/Shadow Packet that will need to be completed, signed by the Lead Counselor and the employee, and returned to the office for the employee’s file. The Orientation Checklist/Shadow Packet is available on the website under Misc Employee Documents, labeled New Hire Shadowing Packet. The document included in this training manual is an expanded version of that checklist that explains what should be communicated to the employee for each of the items listed. Take the time to train a new employee well – that will make them a better Resident Counselor and create less problems and headaches for you in the future. Also, encourage your staff to be accepting and helpful to the new employees. They should understand that the more they help train a new employee, the better coworker they are going to have.That new employee is required to have at least 30 hours of new employee training total. On the bottom of the Orientation Checklist is a section to record that training. First, there should be 16 hours of training shadowing another staff, and the other staff (preferably the Lead) signs the sheet verifying that they were working alongside that employee. That leaves 14 additional training hours needed. Those hours can be counted any time that staff is working with another employee or attends a training class such as PIA. These additional 14 hours will be recorded on that Orientation Checklist after it is returned to the office. See the attached form for an example of that documentation of training hours.A new employee will also need to complete a Medication Administration Observed Skills Assessment (example included). Completion of the Medication Administration Observed Skills Assessment is a licensing requirement and must be done before the staff can pass medications independently. After the staff has had an opportunity to watch at least one complete med pass and review all of the medication information sheets, the Lead Counselor or a trusted long-term staff must watch the staff complete an entire med pass. Each type of medication (i.e. oral, topical, eye drops, ear drops, etc) that is used that site should be reviewed. Then the new staff and the staff who is observing them sign the bottom of the form verifying that they are able to pass medications according to the policies and procedures. The form must be faxed to the office.Additional shadowing forms that the employee must fax to the office after review include the ADT Alarm Training and Personnel Policies Checklist. Please review these documents with the employee. Ensure that the new employee knows how to use the ADT alarm key pad and is familiar with the protocols to safeguard the alarm code. SHADOW PACKET: On-Site Orientation (to be completed and faxed to the office at 651-264-1002 within 15 days of hire):_____Do not be alone with any Person Served(s) at any time during 16 hours of shadowing._____ Do not answer the door or the telephone at the house during shadowing._____Do not drive any company vehicle until notified of approval by the agency’s insurance carrier_____ Review all Person Served Individual Abuse Prevention Plans. Sign signature page on each.Discuss emergency intervention histories, Snapshots, etc._____ Review each Person Served Care Plan and sign signature page on each (at Class F programs)_____ Review Person Served ISPs and the plan to implement ISP objectivesDiscuss individual goals and documentation_____ Review Person Served complete files_____ Review the Person Served Information/Snapshots Book_____ Locate the Fire Evacuation Plan and Severe Weather Shelter_____Locate Fire Extinguisher(s)_____ Locate emergency/power outage supplies: corded phone, flashlight, battery-powered radio_____ Locate emergency phone List_____ Identify the location of the first aid kit or first aid supplies_____Locate and learn the operation procedure for ADT alarm system_____Review the employee website, i.e. where to find program/medical forms, submit Incident Reports, complete staff trainingEnsure the employee knows how to log into the webpage. Let the employee browse through each link. Incident Reports, EUCPs, Medication Discrepancies, monthly staff training, communication form, employee of the month are all completed online and submitted electronically to the appropriate supervisor. _____ Review House/Apartment Rules and Boundaries_____ Understand the shoe procedure and the location of the shoe cabinet_____Review the Medal Program and Ticket ProgramMake sure that the staff understands that the Medal Program is the cornerstone of the Zumbro House program and it must be followed accurately. They must convey that importance to the Person Served by following the program and encouraging Persons served to earn their daily rewards as well as earning progression through earning safe days. If it is not part of the culture of the house, it is not going to work and the Persons Served will have more difficulties. _____Access and read through the Management Policies_____Locate and discuss staff scheduleReview all procedures regarding the schedule, such as who to contact with scheduling issues, concerns, or requests and review the Staff Reliability Policy. This is reviewed in initial orientation, but it is very good info to reinforce. _____Review payroll program on computer, identify location of payroll forms, and where to keep Notation Forms and Time Edit Request Forms_____Learn to check phone messages and email and respond or pass on as appropriate_____Become familiar with the staff book/communication bookExplain that this is for communication only- conflicts should not be addressed in this format. Also, the communication book does not ever take the place of documentation in a Person Served file._____Locate and discuss the Resident Counselor checklistsThese checklists should really be discussed point by point and the STANDARD of what is expected should be documented. For example, explain what “clean the refrigerator” means and how we expect it to look when they are finished._____Identify where the keys are for the house are kept when not on your person (at the beginning or the end of your shift)_____Learn how to submit incident reports and emergency use reports/complete a test incident report It is very important that they are able to actually send a test incident report to the supervisor so we are positive that they understand the process and how to do it with the computer. _____ Attend a Community MeetingTalk with the staff about what the general outline for the meeting should be, conducting level vote, how to keep documentation in the notebook for the meeting, homework, etc._____ Review the house schedule/calendar of upcoming eventsReview how things get added to the schedule, responsibility to make sure the things on the schedule are followed through_____ Identify Persons Served laundry days and household choresDiscuss any potential or ongoing conflicts regarding these tasks_____ Observe Persons Served hygiene routinesMake sure to cover times of day they complete their hygiene routines, Person Served preferences, where they keep their supplies_____ Become familiar with menu/meal planning and meal preparationDiscuss not eating/preparing foods outside of the menu, what may be acceptable substitutes for items on the menu, etc._____ Understand portion control requirementsRefer to the Nutrition Policy as well as the USDA guidelines for nutrition, also included in the Lead Counselor Training Manual_____ Discuss snack options_____ Review all Persons Served medication sheets and familiarize yourself with the medications and their usesMake sure the employee knows where to access the medication information sheets. Make sure the employee knows what medication is prescribed for (for example, although Depakote is an anti-convulsing often prescribed for seizure disorder, it may be used for mood or behaviors as well._____ Observe a complete medication passAnswer any questions they may have. Discuss any history of med refusal. Discuss any PRN medication Protocols if applicable. Once they have completed this observation, they should complete a Medication Observation Checklist (see example included)_____ Review Standing Orders Medication List for each Person Served_____ Identify location of standing order medications_____ Administer medications while being observed; complete Medication Administration Observed Skills Checklist FormDo not sign the employee off if you are not comfortable; talk with your supervisor if someone really seems to be having difficulty with this_____Train on medical equipment_____Med appointment procedures, referral formsShow the employee where medical appointment referral forms are located, either online or in a designated place on site. Explain appointment documentation and necessary forms to bring to appointments. Whenever a staff takes a Person Served to an appointment, they must understand what happened at the appointment, any new medication orders or any appointment follow-up that is needed. This must be communicated to the supervisor after the appointment. Record shifts worked shadowing/training with another staff person (Must shadow another staff for at least the first 16 hours of training):Date _________ Hours Worked________ Signature of Staff Shadowed __________________________________Date _________ Hours Worked ________Signature of Staff Shadowed __________________________________Date _________ Hours Worked ________Signature of Staff Shadowed __________________________________Date _________ Hours Worked ________Signature of Staff Shadowed __________________________________Date _________ Hours Worked ________Signature of Staff Shadowed __________________________________Total # onsite Training hours __________ (must be at least 30 hours)My signature below acknowledges that I have had all of the above listed training and have had opportunities to ask questions:_______________________________________________________________________________________________Employee signature DateZumbro House – Policies and ProceduresPlease initial each policy below as you review._______Non-Contract and Employment “At Will” Statement_______Welcome Letter_______Company Goals, Philosophy and Purpose_______Continuity of Policies – Right to Change or Discontinue_______Equal Opportunity Policy_______Recruitment_______Announcement of New Positions_______Transfer Policy_______Employee Selection and Development_______Staff Qualifications_______Staff Orientation_______Staff Training_______Staff Reliability_______Background Studies_______Sexual Harassment_______Drug Abuse/Alcohol Abuse_______Smoking_______Employment Classifications_______Employee Safety_______Employee Work Related Injury or Illness Reporting, Investigation, Prevention_______Return to Work after Serious Injury or Illness_______Performance Improvement_______Separation of Employment_______Grievance Procedure_______Employment Disputes_______Compensation_______Payroll Procedures_______Equal Pay_______Job Description_______Workday_______Pay Advances_______Overtime Compensation_______Rest Periods_______Performance Review_______Salary/Wage Administration_______Payroll DeductionsEmployee Benefits_______Group Medical and Dental Insurance_______Paid Time Off (PTO)_______Holidays_______Leave of Absence and Military Leave_______Medical/Family Leave_______Bereavement Leave_______Jury Duty_______Voting_______Employee-Incurred Expenses and Reimbursement_______Travel Reimbursement_______Relocation of Current or New Employees_______Required Management ApprovalMiscellaneous Policies_______Confidentiality of Company Information_______Confidentiality of Company Information – E-Mail_______Staff Reimbursement for Damaged or Stolen Property_______Conflict of Interest and Non-Compensation_______Gratuities to Government Employees or Officials_______Gratuities or Gifts from Persons Served/Legal Representatives_______Political Activities_______Employee Privacy_______Telephone_______Dress Code_______VisitorsProgram Policies_______ Admission and Service Initiation Policy_______ Service Coordination and Continuity Policy_______ Individual Rights Policy_______ Individual Funds Management Policy_______ Incident Response, Reporting, and Review Policy_______ Emergency Response, Reporting, and Review Policy_______ Emergency Use of Manual Restraint Policy_______ Grievance Policy – Program_______ Maltreatment of Vulnerable Adults Reporting and Internal Review Policy_______ Maltreatment of Minors Reporting and Internal Review Policy_______ Facility Health and Sanitation Policy_______ Safe Medication Assistance and Administration Policy_______ Healthy Living Policy_______ Safe Transportation Policy_______ Data Privacy Policy_______ HIPAA Compliance Policy_______ Record Keeping Policy - Program_______ Quality Improvement Policy_______ Temporary Service Suspension and Termination PolicyBy signing below, I am indicating that I have read and understand the employee policies and procedures of Zumbro House, Inc., and have had the opportunity to have any questions answered. I am aware of how to access the employee policies and procedures.__________________________________________ ___________________________________________________ _____________________________Employee signature Printed NameDateZUMBRO HOUSE, INC.Medication Administration Observed Skill Assessment – Site SpecificStaff members must demonstrate the ability to administer medications through an observed skill assessment. The skill assessment must be completed after the staff member has successfully completed the approved medication administration training and prior to staff members administering medications without supervision. Staff members are only required to have an observed skill assessment for the medication administration skills required for their job.The skill assessment must document:The skill(s) observed,A determination of competency,The date, signature and title of person observing the skill(s).This is to indicate that_______________________________________________________________has successfully demonstrated the (Staff Name)Ability to administer medications at____________________________________________________on_____________.(Name of Site) (Date)CHECKLIST OF RESPONSIBILITIES AND SKILLSPassFailHas observed at least one complete med pass at the site.________Can explain the seven “rights” of medication administration.________Can explain the purpose/action of each medication used at the site.________Can explain the main side effects of each medication used at the site.________Can identify available sources of information regarding side effects.________Can identify location of the Health Care Procedures Manual.________Can explain correct medication error reporting procedures.________Can explain correct medication storage procedures.________Can explain correct medication destruction procedures.________Has demonstrated the CORRECT medication administration procedures for the following:(Check all that apply)____Oral____Vaginal ____Topical____Sublingual ____Eye Drops/Ointment ____Inhalers ____Nose Drops____Enteral Tubes ____Nasal Spray ____Transdermal Patches ____Rectal ____Nebulizer ____Other:__________________________________________________Medical Equipment Training as Applicable:____ Blood Pressure Cuff____ Glucometer____ CPap____ Nebulizer ____ Other: __________________________________________________Comments:_______________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________Signature and title of staff observing the skillsDateMedication Administration AgreementI have successfully completed an approved Medication Administration Training and have been observed administering medications at the site. I agree to follow all company policies and procedures for administering medications. By signing this agreement, I understand and accept the serious responsibility for administering medications to the consumers receiving services from this company._____________________________________________________________________________________Signature of StaffDateADT Alarm TrainingAlarm contacts have been placed on all exterior doors, bedroom windows, and in some houses, bathroom or other accessible windows. For the safety of the Persons Served as well as the surrounding community, the alarm system must be armed at all times. There is a recording device within the system that will allow managers to review and pinpoint any spans of time that the alarm was disarmed for any reason. If the alarm is found to be disarmed, this will be considered a significant infraction of the Security Policy. The infraction will result in disciplinary action up to and including suspension or termination of employment.Alarm InstructionsIt is essential that the four-digit code remain confidential. Under no circumstances can it be shared with any individuals not employed by Zumbro House. Even more importantly, it cannot be discovered by the Persons Served! For this reason, when staff is entering the code on the keypad, you must adhere to the following procedures:Persons Served must remain at a distance of 10 feet from the keypadStaff will place their body between the Person Served and the keypad, to block any viewBefore beginning to the enter the code, staff will look over their shoulder in both directions to ensure that no Person Served is able to see the keypadStaff will cover the keypad with one hand while entering the code with the other handIf there is ever any suspicion that a Person Served is aware of the code, contact a supervisor immediately – a plan will be developed to have the code changed by maintenance and to adjust supervision protocols until that change takes place.Identify the primary door and all secondary doors (if applicable). WE SHOULD BE USING THE PRIMARY DOOR AT ALL TIMES. PLEASE AVOID USING THE SECONDARY DOOR AS MUCH AS POSSIBLE. The primary door is programmed under Zone 1 and is used when Persons Served and staff enter and leave the building. Secondary doors are programmed under Zone 2 and should remain armed at all times and should only be used in emergency situations. When you are leaving the building (even for a short period of time such as for a smoke break or activities in the yard):Enter the Four-digit code, OFF, Four-digit code, AWAY (#2)Once entered, you will have 30 seconds to get out of the building and the alarm will re-arm behind you.When you are returning to the building, or coming onto your shift, enter the house and go right to the key pad:Enter the Four-digit code, OFF, Four-digit code, AWAY (#2)This sequence must be entered on the keypad within 30 seconds of entering the house.At the beginning of every shift, staff must ensure that the secondary door is armed. To do this: Enter the Four-digit code, *2. The panel should read ARMED AWAY. If the panel reads DISARMED: Enter the Four-digit code, *2, Four-digit code, AWAY (#2). This will arm all secondary doors. To disarm the secondary door in an emergency situation ONLY: Enter the Four-digit code, *2, Four-digit code, OFF. Proceed with the steps outlined above to rearm the secondary door.The panel should always show a Ready status. If the light does not indicate a Ready status, ensure all doors and windows are closed and attempt to re-arm the system. If the system continues to indicate a non-Ready status or if the word “CHECK” appears on the touchpad’s display, contact the supervisor immediately.I have been trained on alarm protocols and have demonstrated my ability to complete the tasks outlined above. _____________________________________________________________Staff Signature Date______________________________________Printed NameOngoing TrainingAll training hours are documented and filed at the office and become part of an employee’s personnel file. Completing required training is an expectation of the job as well as a requirement for licensing. Employee’s ability to meet those training requirements will be reflected in performance appraisals and other performance management documents as necessary.There will be a mandatory training posted on the website for all employees to complete each month. This may be in an electronic version that can be submitted through the website, or it may need to be printed off and faxed into the office. The Lead should first set an example and complete the training in a timely manner, and then encourage the staff through staff meetings, written notes in the staff communication log, or whatever it takes to get them to complete the training. Staff who do not complete the training by the end of each month may be subject to disciplinary action. Lists of staff who have not completed the training will be supplied to the supervisors, and Leads will be expected to help communicate expectations for completion with those staff.Ideas for additional training topics should be forwarded to Human Resources, either by email or by phone. We do want to be offering training for employees that is both useful and relevant to their jobs.Training RequirementsFor Direct Service Staff who have:Have been employed less than 12 months:Have been employed more than 12 months:Fewer than 5 years documented experience30 hours required24 hours requiredFive or more years documented experience:30 hours required12 hours requiredAs you can see, the numbers are fairly high for newer employees. House meetings also contribute to the training hours requirement, so attendance at staff meetings is critical! Updates will be given to the supervisors and shared with the leads throughout the year as to how employees are doing on obtaining the required number of hours.Staff/House MeetingsThe House Meeting Minutes form is available on the website. There is an attached example of the House Meeting Minutes form with explanations/suggestions for what should be included in each section of the form. It is the responsibility of the Lead Counselor to take notes at the staff meetings. The Minutes form must be completed and faxed into the office within 24 hours of the meeting. The original form should be stored in a binder so that staff who did not attend the meeting can review and initial those minutes. Please make sure to document in the notes everything that was discussed at the meeting so that the minutes can be used as a reference if needed in the future. For example, if there is a change in a Persons Served program that is discussed at a staff meeting that staff “Jane” attended, and then “Jane” does not follow the new program, she can be held accountable because we have documentation that she was given the information. This is also an example of why it is important to have all staff who did not attend the meeting review the minutes and initial that they have done so.When these minutes are received at the office, training hours are recorded for each staff that attended and they are kept in a file for future use if needed.What to Do if a Staff is Injured at WorkThe Workers Compensation laws require employers to manage employee injuries in a specific way. Employers are required to track injuries, any time missed from work due to an injury, or any time that is worked with restrictions (such as a lifting restriction) as a result of the injury. We are required to file reports with our insurer according to very specific timelines. In order for us to manage claims effectively and get the employee the coverage that they need, we need to gather as much information as possible about the injury and how it occurred. This will also allow us to review that information to see if there is a way to prevent that injury from occurring in the future. There may be penalties against the company if the requirements are not met, so prompt communication is the key to success!If an employee gets injured during their shift, they are going to notify you. It is your responsibility to notify the Program Coordinator right away to determine if a First Report of Injury should be completed. This form is located on the Zumbro House website Employee Page under the Payroll/Personnel forms link. If the employee needs medical treatment, tell them that they must tell the medical provider that they were injured at work and give them the company name and address. The employee should pass along the office address and the phone number for Human Resources (651-264-1004). The employee must provide us with documentation of that appointment and any recommendations from the doctor. The form that they will likely return is called a “Report of Work Ability” and needs to be passed along to the Program Coordinator and Human Resources as soon as it is received. It will contain confidential information regarding the employee’s health status and should be kept private and protected. The information will include if the employee has any restrictions that need to be followed, if they are authorized to be off work, and when, if any, follow up appointment is scheduled. Any work missed due to an injury incurred while at work must be reported by the Lead Counselor or Program Coordinator to Human Resources promptly.If the employee has any physician prescribed restrictions as a result of the injury, those must also be reported to Human Resources – prior to the person returning to work. The Human Resources Representative and the Supervisor will determine if it is safe for the employee to return to work with the restrictions.If the employee is receiving ongoing treatment for their workplace injury, all information from the doctor and Report of Work Ability forms must be turned in promptly to Human Resources or to the Program Coordinator. As mentioned above, we will look closely at all situations where someone is injured to assess if something can be done to lessen the risk for other injuries in the future. Take a look at the First Report of Injury form that is included in this manual to see what kind of information is needed. If you know what is going to be needed, you will be able to ask the employee the right questions about the situation.Leave of AbsenceThere are several types of leaves that are available to our employees. Since the Lead Counselor is responsible for the schedule, it is likely the Lead that will be the first person aware that an employee needs a leave of absence. There are several types of leaves available to Zumbro House employees, but the most important of those for Lead Counselors to be aware of is Family and Medical Leave (FMLA). Family and Medical LeaveThe Family and Medical Leave Act (FMLA), enforced by the US Department of Labor, requires employers to provide up to twelve weeks of unpaid, job-protected leave to eligible employees for the following reasons:For incapacity due to pregnancy, prenatal medical care, or childbirth;To care for the employee’s child after birth, or after placement for adoption or foster care;To care for the employee’s spouse, son or daughter, or parent, who has a serious health condition; orFor a serious health condition that makes the employee unable to perform their job; orMilitary Caregiver Leave to provide care for a covered family member with a serious illness or injury incurred in the line of duty; orQualifying Exigency Leave (Military) See the Leave of Absence Policy for more details. Employees are eligible for FMLA if they have worked for Zumbro House for at least 12 months and have worked at least 1,250 hours in their last 12 months of employment.If an employee talks to you about needing to take a leave for a medical reason or any of those listed above, contact the Program Coordinator and Human Resources. Ask the employee to complete a Request for Leave of Absence form, which can be found on the Employees Only page of the website. Human Resources will make the determination whether the employee is eligible for FMLA. If the employee is not eligible for FMLA, a personal leave will be considered.Employees may not always have the ability to ask for this type of leave in advance. Illnesses can come on unexpectedly. For this reason, it is important that we are always asking ourselves about FMLA if employees are missing work. For example, if an employee calls in sick for more than three shifts in a row, you should be talking with Human Resources to see if the employee and the situation meet the eligibility requirements.The Human Resources Representative will be tracking all time off during a Family and Medical Leave. It is important to communicate to that person any conversations that you have with the employee regarding return to work or their employment/health status.Personal LeavePersonal leave covers all other leaves for personal reasons, for medical reasons when employees do not qualify for FMLA, or any other non-medical reason. Employees must request a Personal Leave of Absence by completing a Request for Leave of Absence form and submitting it to the Program Coordinator. Each Personal Leave will be considered for approval on its own merits, and the following will be taken into consideration:The reason for the request;The amount of time required;The employee’s performance record; and The employee’s length of service.Personal Leaves for medical reasons will require documentation regarding the necessity of the leave form the employee’s physician. Zumbro House may choose to accommodate any temporary restrictions that an employee may have to support them in avoiding a medical leave. Please refer to the Personnel Policies on the website for the most current information regarding Personal Leave. You may direct any employee to contact Human Resources with their questions.Military LeaveMilitary Leave is available to Zumbro House employees, except for temporary employees, who enter military service for active duty. Please refer to the Zumbro House Personnel Policies for more a more detailed description of this leave. You may refer the employee to the Human Resources Representative to answer any questions they may have.OtherFor any leave requests that do not meet the definitions listed above, speak to your supervisor if you have questions. As with all requests for leaves, refer the employee to the Personnel Policies located on the Employees Only section of the website.Off Boarding- Lead CounselorLeading up to a LC’s last day as the Lead Counselor for Zumbro House, the PC and Controller may discuss a transition plan to ensure a smooth transition from one LC to another. The custody of the finances may vary depending on the notice provided by the LC that is leaving the position.Client FinanceOn or before the Lead Counselor’s (LC) last day, their Program Coordinator (PC) must complete a physical count of cash on hand at the house. Both the LC and PC should count together and agree to the cash on hand. The management of the finances is now in the PC’s trust. The LC must provide the ledger and receipts that support the cash balance so that the PC can easily confirm the balance of cash is equal to the ending balance on the ledger. If the LC is unprepared for the count they will have 24 hours to get ledgers and receipts in order. The PC and LC must provide a report of the count and ledger balance to the Accounting Assistant at the Woodbury office. All ledgers provided to the Accounting Assistant will be audited and reconciled to the cash count that was provided by the LC and PC. Outcomes will be reported to the PC and the Controller.When necessary, the PC will collect any missing receipts or cash from the LC prior to the LC’s final sign off. The PC may request assistance from HR as applicable.On or before the LC’s last day of work the PC must collect the following items from the LC: Client financesHouse ledgers and receiptsUS Bank credit card Holiday gas cardLogin/password information used to access paystubs or other dataAny other Zumbro House property, which may include folders, notes, calendars and flash drives.The PC will inform the Director of Operations and the Controller of any unresolved/incomplete items. Guardian/Case Manager ExpectationsGuardians and Case Managers are our customers, along with the Persons Served. You are expected to provide the utmost in service to our customers. Our desire is to have the guardian end every telephone, email and in-person contact, with a positive feeling about Zumbro House, Inc. Guardians and case managers have entrusted their Persons Served to Zumbro House, so it is important that they feel comfortable that we have the best interest of the Person Served, in mind. The Lead is the face of Zumbro House, and it is the Lead’s role to represent the company well and to create good will with guardians and case managers. Leads must always speak to guardians and case managers with the highest degree of respect. It is the expectation of Zumbro House that contact is made with guardians and day placements at least once every other week. We like to touch base and let team members know when things are going well also! Communication is essential to the success of our Persons Served, and we would not ever want someone to feel like our communication with them was not adequate. It is best to document any calls in the Persons Served’ progress notes so they can be referred back to in the future if needed.As you are communicating with those team members, you may on occasion hear about a worry or a concern that they may have. It is expected that the Lead Counselor pass along to the Program Coordinator any complaint, concern, or even a hint that one of those team members has a bad feeling about something. It is important to us that teams are satisfied with our services. If a Lead Counselor withholds information about a concern of any kind, they will subject to disciplinary action.You may experience team members that are challenging to work with. It is okay to refer them to the Program Coordinator if necessary. In fact, your Program Coordinator should take more of the communication responsibilities with those teams.Customer satisfaction surveys are sent to case managers and guardians. They are asked to rate services on a scale from 1-5 in areas such as, house cleanliness, friendliness of the staff, and experience with the Lead Counselor. Zumbro House, Inc. uses this tool in appraising a Lead’s performance.Please speak with your Program Coordinator to discuss any team specific communication needs.Person Served MeetingsYour responsibility as a Lead may vary regarding Person Served meetings, so ask your Program Coordinator for some direction. Many times, the Person Served meeting takes place at the house. It is your responsibility to make sure that the house is in top-notch condition and cleanliness (as it should always be) the day of the meeting. It is also the Lead’s responsibility to be sure that the Person Served looks at their best as well. Persons Served should have a nice haircut, combed hair, and be dressed in their best clothes for a meeting. It impresses guardians and case managers when Persons Served (especially those who have looked disheveled historically) are dressed well and look good. A jacket and tie is appropriate, with pressed dress pants. The Persons Served appearance, fair or not, reflects on the quality of service we provide. If a Person Served looks unclean and disheveled, the Persons Served team may surmise that the services are commensurate. It is never acceptable for Persons Served to wear torn or stained clothing, have messy hair, or have poor hygiene – especially on the day of the meeting. Be sure to contact the overnight staff to let them know exactly what you expect from the Persons Served appearance, since the overnight staff is likely the person involved with helping the Person Served get dressed and ensure appropriate hygiene.Keep in mind…for some of the team members, like the case manager for example, this may be the only chance they get to see our program and the Person Served. If we make a poor impression or the Person Served looks a mess, that person will likely conclude that this meets Zumbro House expectations. We want it to be very apparent that we have high expectations for both our houses and the Persons Served. Also consider that for some of our Persons Served, this meeting can be very stressful. It is difficult to imagine how you would feel to have a group of people sitting around the table discussing all of your most private information. When we help the Person Served look great, chances are they are going to feel better as well – maybe have more confidence and be more proud of what they have accomplished.After a Person Served meeting, there may be changes to a Behavior Support Plan, new guardian expectations, or new programs to be implemented. Any time there is a change to Person Served Snapshot, Behavior Support Plan, IAPP or CSSP/CSSP Addendum; staff must review these documents in the Person Served books and sign the Signature Page. You, along with the Program Coordinator, are responsible for making sure those changes or requests get communicated to the staff. This can be done both verbally with each staff as you see them and in written form in the staff communication log to be sure that everyone gets the information. It should also be covered in your next House Meeting. Communicating this information and documenting it on the House Meeting Minutes form gives us the documentation that is needed to show that staff has been trained on changes as required.Documentation GuidelinesPerson Served FilesThe Table of Contents for the Person Served book is included in this manual. Filing must be done right away to ensure that important documents do not get left out and possibly lost. Pages that are half torn out or falling out of the books must be corrected; use hole-punch reinforcements to repair the sheets if necessary.Central Filing at the OfficeAt the beginning of each month, the following information from the previous month is pulled from the Persons Served program books:Medication Administration RecordsHealth Progress NotesPerson Served Data Tracking SheetsActivity RecordProgress NotesThis information and any other items at the house to be filed at the office such as medical referral forms, etc. should be packaged in that Persons Served envelope (provided by the office), a monthly checklist completed, and turned in at the first Lead Counselor Meeting of each month. Each page sent must have the Persons Served first and last name and a date including the year. What if you need to refer to something that is filed at the office?You can call your supervisor to see if they are going to be at the office. You may also call the main office and speak with the Administrative Assistant. They may be able to help you find what you need and get back to you with the information.Plan ahead – if you know you will need a piece of information for a report later, make a copy or record the information that you need. If you plan ahead, it will save everyone’s time in looking for the information later.Medical DocumentationMedical Referral Forms (Annual Physical, Medical, Psychiatric, Dental, Ophthalmology)Medical referral forms must be filled out completely and accurately. The referral form is our way of documenting that we have given a physician all of the information he or she needs. For example, what if a Person Served is allergic to penicillin and we do not write it on the medical referral form? We may take them in for a sinus infection, the doctor prescribes penicillin and we administer it. The Person Served has an allergic reaction and has to be rushed to the emergency room. We could be held responsible for that error because we did not provide the doctor with complete information. The same goes for accurate completion of the Persons Served current medications section. Many of our Persons Served see multiple doctors, which makes it even more essential to have that information on the referral form. If the prescriptions come from several doctors, they would have to way to consider any contraindications if we did not complete the referral accurately.Because the information on Medical Referral Forms is so critical, the Lead Counselor, or a specific designee for the house, should complete the referral forms in advance whenever possible. Many houses have designated the Sunday overnight to complete all appointment referral forms for the upcoming week. It is still the Lead Counselor’s responsibility to ensure these referral forms are being filled out accurately. If a Resident Counselor is the person who takes a Person Served on an appointment, it is very easy for them just to grab the referral form and go.Please refer to the example of the Medical Referral Form that is included in this manual (below). These referral forms can be found in the ZH Website.All completed medical referral forms should be reviewed by the Lead Counselor to ensure that any necessary follow up is scheduled or completed. If a follow up appointment is needed, it should be scheduled before even leaving the doctor’s office whenever possible. If setting up the appointment is delayed, it is more likely to be forgotten or missed. If there is a medication change or a new prescription on the referral form, it should be faxed to the nurse at the office. (See the section below on Medication Changes.)Completed medical referral forms should be kept in the front pocket of the Person Served program book until the end of the month. These completed referral forms are our documentation that an appointment actually happened, what the outcome was, any treatment recommendations, etc. As you are gathering the past month’s filing to be given to the Program Coordinator at the first Lead Meeting of the following month, include these completed medical referral forms. MEDICAL REFERRAL FORMType of Appointment: .This form to be used for Urgent Care, chiropractic, neurology, dermatology, endocrinology, audiology, urology, etc. – NOT annual physicals. PLEASE write one of these appointments in the space provided above.Resident:_________________________________________Appointment Date: ____________________________Doctor/Location: __________________________________Appointment Time: ____________________________Primary Diagnosis: _________________________________Date of Birth:_________________________________ _________________________________________________Staff Attending Appt: __________________________Diet: ____________________________________________Allergies: ____________________________________Current Medications (including topical and PRN medications): Fill out below OR attach a copy of the MAR’s.Medication/TreatmentDose/Frequency/RouteReason for UseReason for Visit: __________________________________________________________________________________________________________________________________________________________________________________*Above to be completed by Zumbro House staff**Below to be completed by the Physician or Health Care Professional*Summary of examination and lab work completed: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Current findings and Diagnosis: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________New Orders: (Print clearly OR attach electronic appointment summary): __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________MEDICATION CHANGES (fax this form to pharmacy if yes is checked in any box below)Medication Increased? FORMCHECKBOX Yes FORMCHECKBOX No Name of med(s), dose/time):___________________________________Medication Decreased? FORMCHECKBOX Yes FORMCHECKBOX No Name of med(s), dose/time):___________________________________Medication Added? FORMCHECKBOX Yes FORMCHECKBOX No Name of med(s), dose/time):___________________________________Medication Discontinued? FORMCHECKBOX Yes FORMCHECKBOX No Name of med(s), dose/time):___________________________________Next Appointment Date and Time: _____________________________________________________________________Physician’s Printed Name: ____________________________________________________________________________Physician Signature: ___________________________________________Date: ___________________________Medication Administration SheetsMedication sheets will come in the mail each month from Bloomington Drug Pharmacy. Although they are usually very reliable, the sheets must be checked for accuracy each month. The Lead Counselor must double check the accuracy of the med sheets each month before they are put into the Persons Served program book for use. In addition, the staff who received the med sheets when they are delivered and the overnight staff who places them in the books at the beginning of each month should be double checking them for accuracy. You will be checking for any typos, that any new medications have been added, and that any discontinued medications have been deleted.If you find any discrepancies, you should call the pharmacy and get them straightened out. The pharmacy will be able to answer any questions that you have. If there is an error, they can correct it on their end so that the med sheets are accurate for the next month. The number for Bloomington Drug is 952-884-7528. You may also make the correction on the medication lists that accompany the med sheets each month and fax the corrected copy (with the physicians order if applicable) back to the pharmacy.Throughout the month, it is the Lead Counselor’s responsibility to be checking the med sheets frequently to ensure that medications are being passed and documented correctly. You should do a thorough check of all med sheets and med cards at least once each week; it may be helpful to choose a specific day of the week to do your check so that it does not get forgotten. Medication/Treatment Discrepancy Forms must be completed for any errors – including documentation errors or omissions. See below for more information regarding Medication/Treatment Discrepancy Forms.At the end of each month, when the medication sheets are pulled from the books, you are to give them one last thorough check to be sure that all medications are accounted for, that all documentation is in place, and that Medication/Treatment Discrepancy Forms have been completed for any missing documentation or errors. The Lead Counselor will sign and date the sheet in the lower right-hand corner, indicating that they have completed this review. The sheets can then be bundled with the other Person Served information to be sent to the office.Medication ChangesAll changes must be discussed with the Program Coordinator prior to starting the medication. This does not mean delay starting the medication until you see the PC – you must contact them so that the medication can be started as soon as possible. A copy of the prescription or the med referral form with the updated order must be faxed to the nurse at the office.When you are transcribing new medication orders onto the med sheet, you must be extremely careful that the information is exact. The handwriting must be legible and the order must be written in a way that is clear to any staff person reading it. The transcription must include:Name of the medication (as it is listed on the med card or bottle)DosageFrequency to be given (i.e. twice daily). Exact times must also be entered under the “Hour” columnAny special instructions, such as “shake well” or “take with food”The prescription numberIf it is a new medication, the prescribing doctor and start dateUse the other entries already on the med sheet as a guideline. If you have any questions, make sure to contact your supervisor or the nurse for help. If it is a medication that the Person Served is already taking, but there has been an increase or decrease, you must discontinue the current dose on the med sheet and write the new order on a completely new line. You cannot cross out and change dosages once the month has started.Once the medication has been entered on the med sheet, put a note in the Staff Communication Log explaining the change.Medication Administration ErrorsIt is an expectation of all staff, not just Lead Counselors, to complete Medication/Treatment Discrepancy Forms when errors are discovered. Make sure you hold staff accountable for meeting that expectation.As you are checking through the medication administration sheets at least once weekly, you should be completing a Medication/Treatment Discrepancy Form for any errors or omissions in documentation that you find unless it has already been completed by a staff. The form is located on the Zumbro House website Employee page. It is completed electronically and automatically submitted to the appropriate persons. The original Medication/Treatment Discrepancy Form becomes part of the Person Served file. (See section on Documentation Guidelines for filing instructions.)There is an example of a Medication/Treatment Discrepancy Form included in this manual. Please make sure they are filled out thoroughly and that the description section gives a detailed account of what occurred. It is very difficult to look at those forms at a later date and remember what the situation was if they are not completed thoroughly.Medication Treatment/Discrepancy FormWhen a medication or treatment discrepancy occurs, the staff Person discovering the discrepancy must:1. Call the nurse immediately if the medication was missed or given incorrectly.2. Document the discrepancy on the Medication Administration Record as well as in the Health Progress Notes, and 3. Complete this form.This section is to be completed by the staff that discovered the discrepancy.Name of Person Served *Name of Medication or Treatment: *Today's Date: *MM/DD/YYYYHouse *Date discrepancy occurred: *MM/DD/YYYYTime discrepancy occurred: *HH:MMAM/PMDate discrepancy was discovered: *MM/DD/YYYYTime discrepancy was discovered: *HH:MMAM/PMType of Discrepancy (Check all that apply): *Medication/Treatment not givenIncorrect dose givenMedicaton /Treatment given to wrong Person ServedMedication/Treatment given via wrong routeMedication/Treatment given at wrong timeMedication Treatment given on wrong dateMissing/incorrect documentationDescribe the discrepancy: *Was the Nurse Notified *Yes No If Yes, notified on what date,MM/DD/YYYYand what time:HH:MMAM/PMWas Physician Notified: *Yes No If yes, name of Physician notified: (if no put N/A) *Action taken (be sure to document all instruction received from nurse or physician in the Health Progress Notes. Alert other staff of potential problems due to the discrepancy. *Staff who discovered discrepancy: *Name of staff responsible for discrepancy: *Additional Comments: (If none put N/A): *Lead Name: *Date Signed by PCSignature of PCPerson Served FinancesZumbro House has been given the responsibility for managing funds for our Persons Served. This is a serious responsibility and we must keep detailed and accurate records of all Person Served accounts and spending. Person Served cash and checkbooks must be safeguarded from theft or loss. Mismanagement of Person Served funds could be reportable under the Vulnerable Adults Act, so our record keeping has to be meticulous.Checking/Savings AccountsYou may be asked as a Lead to become a signer on a Persons Served account. Your Program Coordinator can tell you how to go about doing this, but only with the direction from your Program Coordinator. You can become a signer on the account, but you cannot become a co-owner on the account. Make sure you specify with the bank personnel that you need to be added as a signer only. Persons Served should be ordering and using duplicate checks. Although they are slightly more expensive, it creates additional documentation of Person Served spending.Person Served checkbooks should be kept in a secure location where only the Lead Counselor and the Program Coordinator can access them. Any extra check blanks or saving account deposit/withdrawal slips must also be kept in this secure location. Transactions from checking or savings accounts must be completed by the Lead Counselor.Persons Served should not have cash/debit cards and should not have access to online banking. Both of these put the Person Served at an increased risk for theft, so they should be avoided. If a Persons Served team feels strongly about a Person Served having access to one of these, it must be discussed and approved by the team. Specific handling and access guidelines must be determined.All transactions must be recorded on the Person Served Checking/Savings Ledger. There is an example of a register included in the manual with some common transactions.Deposits should be always be made in full. For example, imagine you are taking a Person Served to the bank to deposit his Social Security check which is for $725.00 and the Person Served needs to withdraw $20 in cash as well. Deposit the entire $725 into the checking account and then in a separate transaction, write a check to “Cash” for the $20. Writing a check for cash is a better option than using a withdrawal slip from the bank. It creates better documentation and leaves little room for errors. Separating the transactions in this way makes the register clearly show deposits and withdrawals. Also, if you are depositing more than one check in a single transaction – for example a personal needs check and a paycheck from their job – write a detailed description in the checkbook register that reflects the amount of each check. For all deposits, the register should reflect the origin of the check rather than just writing “deposit.” The paystub or check stub from the deposit should be faxed to the office (for monthly reporters only) and then attached to a receipts page behind the ledger. Checks must be deposited within seven days. Choosing a day each week to complete all banking, every Monday, for example, will ensure all transactions are being completed promptly.Person Served bills received at the house must be paid within seven days. It is essential the balance of the Persons Served account is double-checked (also considering any outstanding checks) before writing out the check to avoid any possibility of an overdraft. If the Person Served does not have adequate funds to pay a bill, the Lead should discuss the situation with the Program Coordinator.At the beginning of each month, enter the automatic withdrawals the Person Served will have for the month, if applicable, such as gym membership fees. Adding these to the ledger early in the month will ensure avoidance of overdrafts later in the month.Attach receipts for checking/savings transactions for the current month to blank pages behind the ledger. The receipts should be stapled to the pages without overlapping. If you use tape to fasten the receipts to the page, make sure the tape does not cover any of the ink on the receipt – the tape will cause the ink to fade over time. Do not mix checking receipts with cash receipts – this will make it confusing for you and more difficult to balance the checkbook at the end of the month. When the Persons Served checking statement arrives, put it with your financial documentation and receipts until the end of the month. At the end of the month, the account statement, the receipts for the past month, and the checkbook register must be compiled and balanced. You should begin by going through the checking register and matching the receipts or vouchers for every transaction. Vouchers for checking account purchases should be extremely rare and if receipts are repeatedly being lost or misplaced, this will be addressed as a disciplinary issue. Make sure there are no missing or skipped check numbers. If a check has been voided for some reason, the voided check should be attached to the receipt pages.Next, check that all cash withdrawals have been recorded on the Persons Served petty cash ledger for the month. Balancing the petty cash ledger is discussed in the next section.Now you are ready to reconcile the checkbook register to the bank statement. You can use the Checkbook Balancing Form (found on the Management Only page of the website) and follow these steps to reconcile the checkbook:Reconcile the Checks – Determine if there are checks that have not yet cleared the bank. In the checkbook register, check off each check listed on the statement, making sure the amount you recorded is the amount the statement shows.Reconcile the Deposits – Make sure each deposit shown on the bank statement has been recorded in the checkbook register. Direct deposits of paychecks or social security checks can easily be forgotten. Check off the deposits in the checkbook register as you did for the checks.Record Interest Earned and Bank Fees – Check the bank statement for any fees or any earned interest and record them in the checkbook register.List Outstanding Checks – Now go through the checkbook register and in column 2 of the Checkbook Balancing Form, list any outstanding checks (the checks you did not check off when reviewing the statement). Include any checks from previous months still outstanding. Total the column of outstanding checks.List Outstanding Deposits – Go through the checkbook register and in column one of the Checkbook Balancing Form list the outstanding deposits from current and past months not checked off when reviewing the statement. Total the column of outstanding deposits.Record The Bank’s Ending Balance – On line one of the bottom portion of the Checkbook Balancing Form, enter the ending balance shown on your bank statement.Enter Outstanding Deposits – On line two of the bottom section of the Checkbook Balancing Form, enter the total outstanding deposits from column one. When using the form from the website, this calculation is done automaticallyEnter Outstanding Checks – On line three of the bottom section of the Checkbook Balancing Form, enter the total outstanding checks from column two. The total is entered automatically when using the form from the website.Calculate Your Balance – The form on the website calculates the balance automatically. If not, use a calculator to total lines one through three, as indicated by the plus or minus signs on the form and enter your new total on line four. This should equal the balance in the checkbook register. If it does not balance, go back and check for math errors in the checkbook register, such as reversed, subtracting a deposit rather than adding it, adding a check written rather than subtracting it, automatic payments/deposits we forgot to record, etc.**Tip – If the balance is off, see if the amount it is off divides easily by nine. If it does, the problem may be a transposed number (such as recording a check as $53.94 instead of $53.49).After everything is balanced and accounted for, paper clip together the bank statement, the receipt pages for that month, the Checkbook Balancing Form, and the Person Served Checking/Savings Ledger. This will go in your envelope for Person Served finances, brought to the first Lead Meeting of the following month. (See the section on Documentation Guidelines for more information regarding Person Served filing.) Make sure you keep copies of the statement, the ledgers, and the balancing form for reference as you start the next month’s finances.FYI – Even if there is no activity in an account for the month (which is fairly common with savings accounts) a ledger must be submitted which states “No activity for this month” or something similar. On the bottom of the checking and petty cash ledgers, it asks if the Person Served has another type of account, such as checking or savings. Be sure to answer the question, so the office staff reviewing the finances is aware of what accounts they have and do not have.Person Served Petty CashPerson Served cash must also be safeguarded. As a Lead Counselor, you should only leave out enough cash for Resident Counselors to access for planned activities or other planned expenses. The amount of money left accessible for staff should never exceed $20 for each Person Served unless a larger amount is pre-approved by the Program Coordinator. You must still be sure the cash is in a place where it is not accessible to the Persons Served, and staff should return unused cash to a safe location as well. Persons Served should not have more than $50 to $60 of cash on hand in the house unless there is a specific planned expense coming up that requires them to have more money. Just having that amount of cash in the house makes it more vulnerable to theft. Person Served petty cash should be checked and balanced at least once weekly by the Lead Counselor. When you balance the petty cash each week, you should make an entry indicated that it has been balanced directly on the Person Served Petty Cash Ledger. A cash audit form is available on the website to ease the process of counting the money. Include the forms with the ledgers but do not attach them. If you find there are missing receipts, check with the staff given the responsibility for that purchase or activity right away. If you wait to address this until the end of the month, it is very unlikely you will find missing receipts. If there are missing funds, you must report this to the Program Coordinator immediately. As you know, cash purchases are recorded on the Person Served Petty Cash Ledger. The ledger should begin on the first day of the month and end on the last day of the month. All cash purchases require a receipt and there must be a detailed description of the transaction on the Person Served Petty Cash Ledger. There are only a few instances where using a Petty Cash Voucher would be acceptable in lieu of a receipt. If the cash is spent in a place where it is impossible to get a receipt, such as a vending machine, it is appropriate to use a Petty Cash Voucher. If the Person Served is approved by their IDT for carrying pocket money, such as $5 per week just as an example, it would be appropriate to fill out a Person Served Allowance Voucher when the Person Served is given their allowance. Attach your receipts for cash purchases to blank pages behind the ledger for the current month. The receipts should be stapled to the pages without overlapping. If you use tape to fasten the receipts to the page, make sure the tape does not cover any of the ink on the receipt – the tape will cause the ink to fade over time. Do not mix them with the checking receipts, as this will make it confusing and difficult to balance both accounts.At the end of the month, verify again there is a receipt or voucher for every purchase. Then recheck all of the addition on the ledger. Recount the Person Served cash to be sure it matches with the ending balance. Make a note on the ledger: “Reviewed and Balanced by ___________” and the date. Attach all of the receipt pages to the back of the Person Served Petty Cash Ledger. This will go in your envelope of filing for the main office, to be brought to the first Lead Meeting of the following month. (See the section on Documentation Guidelines for more information regarding Person Served filing.)Asset LimitsMost of our Persons Served has a $2000 asset limit. That means that the total of their checking, savings, and cash on hand should be less than $2000.00 at any given time. Social Security contacts the Persons Served bank every few months to ensure their balance does not exceed $2000 on the last day of the month. Any time a Person Served goes over that asset limit, they are at risk of losing their Medical Assistance and any other benefits they are receiving. Since we are responsible for assisting our Persons Served with their funds, it is also our responsibility to keep an eye on what they have for assets. When a Persons Served total assets reaches $1500, the Lead Counselor must notify the Program Coordinator and work together to develop a plan for spending it down (with approval from the guardian or case manager as needed). Some Persons Served has a higher asset limit for various reasons. If you are not aware of these exceptions, assume the limit is $2000.Unpaid room and board can cause a Person Served to go over the asset limit very easily. See the section below for payment of rent requirements.Rent ResponsibilitiesIf you have ever rented an apartment, a house, condo, etc. you know rent is always due at the beginning of the month. For our Persons Served who are responsible for some of their rent – or Room and Board – it is also due at the beginning of the month. The payments are due at the office by no later than the 10th of the month. The accounts receivable representative from the office will communicate what amount is due for each Person Served either to the Program Coordinator or to the Lead Counselors pletion of Financial PaperworkThere may be several forms of financial paperwork that come to the house for the Persons Served. It is essential you are paying close attention to the mail and passing it along to the Program Coordinator as soon as it is received. If in doubt, fax it to the office. All of our Persons Served are eligible for Medical Assistance and some receive GRH (which is explained below). There is a recertification process for those and the forms will likely be sent to the Person Served at the house. Fax the letter explaining the form to the office along with the color of the form (usually, white, purple, blue or orange). We usually only have about 10 days to get them returned to the county for processing. If those forms are not completed and sent in, the Person Served can lose their medical assistance. That means they lose their medical coverage to see the doctor, they cannot get their medications paid for, and they also cannot get the cost of their placement at Zumbro House or their day placement paid. There are other forms as well, such as the Household Report Form that are required for some Persons Served each month. If you get something that you are not sure about, contact your Program Coordinator right away to make sure we meet any set deadlines.In order for the office to be able to complete those forms, it is essential all Person Served paychecks and bank statements get faxed into the office, along with the cash ledger completed to date no later than the 25th of the month. The original pay stubs and bank statements can be attached to your Person Served funds documentation, but they must be faxed to the office as soon as they are received.General Billing InformationWhat the charges are for a Person Served to live in a facility such as Zumbro House:Room and Board – This is like rent, and for our Persons Served, this dollar amount is designated to cover food, linens, shelter, etc. It is the same amount for every Person Served and the amount is set by the State of MN, not by Zumbro House.Program Rate – This is a rate that is negotiated with the county when a Person Served is placed in one of our programs. This is the dollar amount that pays for staffing and all of the other expenses not covered by Room and Board.What income sources our Persons Served may have:Group Residential Housing (GRH) – If they qualify, this would help pay all or a portion of their Room and Board rate. Social Security (RSDI) – Social Security for disabled adults that qualify under a parent. This is considered earned income and the Person Served is often required to pay all or a portion of their Room and Board out of this check. Supplemental Security Income (SSI) – This is unearned income and it is used to ‘supplement’ their earned income. To qualify, an individual earns below the current rate established by the Federal Government. A formula is used to determine the amount of money received based on their earnings. Typically, the amount received is adjusted according to money earned two months prior. Because of this, a three paycheck month could substantially reduce the amount received from SSI two months later. When this happens, it can be frustrating to an individual having to pay an additional amount toward room and board in a month when they are back to receiving two paychecks.Generally, no matter how much the individual receives from RSDI or SSI, they receive their personal needs money from the total with the remaining being paid toward their room and board or program costs. There are some exceptions to this rule.Earned Income – this would include any income a Person Served earns at a job and their RSDI.What is “Personal Needs”?Personal Needs money is a predetermined amount a Person Served is able to keep out of their unearned income. It is intended to cover the cost of medication co-pays, personal items such as hygiene supplies, and other personal needs. Because this amount is not substantial, it is important we assist the Persons Served with budgeting their money effectively.Do Not Throw ANYTHING Away!Anything that is received from the county or looks even remotely similar to some of the example forms we have included in your manual must be kept and forwarded on to the office. Even if you think you have already sent that exact same thing, please send it again. Sometimes there is such a minor change on one of those reports that it may be easily mistaken as a copy. One of those missed changes could cause Zumbro House to incorrectly bill for or collect for a Person Served. The next several pages are examples of some of those items you may see show up in the mail. These examples are certainly not all-inclusive, so again, make sure to consult with the Program Coordinator if you receive something you do not recognize or are unsure about.Activities/ScheduleAll activities should be planned in advance. It can be a challenge to work everyone’s things into the schedule if you have an active house. Teaching the Persons Served to work together cooperatively is very important. It is also very important to not deviate from the planned activity schedule. It is vital that there are no surprises for the residents as they look to the activity schedule to plan their day/evening and it is disruptive to them is the schedule is not followed. Please reinforce this to all staff during orientation training/shadowing and at staff meetings.When planning other activities, remember that there are many things to do that are very cheap or free. Watch the newspaper for ideas, as many place around the metro offer specific days that are open to the public for free or reduced cost. Lots of the Persons Served enjoy getting together with other houses to do things as well. That is a great way to keep them connected and encourages those friendships to develop. Keeping the Persons Served involved in activities that they enjoy will reduce the number of incidents that occur. Everyone feels better and can deal with stress or frustration a little easier when they have other things to look forward to.Be sure to reinforce to the staff that unplanned activities are not allowed without authorization from the Lead Counselor or program Coordinator. Unplanned activities are a violation of the Security Policy and will be addressed with disciplinary action up to and including termination of employment.Psychotropic MedicationsMany of the Persons Served we support is taking psychotropic medications – medications that are prescribed to alter mood or behavior. These medications (a list of psychotropic medication can be found in this manual) can have some significant effects on someone who takes them, and for that reason, we have some additional requirements to follow.Any time someone is taking a psychotropic medication, we must have an informed consent signed by the guardian. This form shows that we have given the guardian all of the information about that medication(s) and they are giving us permission to go ahead and administer it to the Person Served. For new psychotropic medications, we have to have this in place BEFORE the medication is started (unless it meets the criteria as an “emergency initiation”). This is why it is very important that the Program Coordinator is aware of all new prescriptions before they are started. For this reason, it is the Lead Counselor’s responsibility to attend all of the Persons Served psychiatric med monitoring appointments. We must also have a Behavior Support Plan. This plan should be a training tool for the staff, as it tells how to be proactive with the Person Served, what the behaviors look like, how staff should interact with the Person Served and how staff should react should the behaviors occur or escalate. A copy of this Behavior Support Plan should be kept in the Persons Served program book and accessible to the staff.The next thing that we must do is keep data on the behaviors that we are attempting to reduce or eliminate. That is what your behavior data tracking sheets are for. Ideally, we would like to have some baseline data, meaning how frequently the behaviors are occurring before the medication starts. It is very important that the lead Counselor monitor that behavior data tracking sheet throughout each month to be sure staff are recording behaviors accurately. This is information that will get used to interpret if the medication is having any effect on the Person Served, if the dose needs to be adjusted, etc.Then we have to monitor for side effects. Formal side effects monitoring on the forms to be explained is done by the Lead Counselor each month. If there are possible side effects that you or other staff is noticing, you should discuss them with the Program Coordinator right away. The MOSES (Monitoring of Side Effects Scale) is done per the instructions of the prescriber for anyone taking psychotropic medications. There is a copy of the MOSES included in the manual so that you can review the types of side effects that we must watch for. In addition, if the Person Served is taking a psychotropic medication that is under the “anti-psychotic” classification, another side effect monitoring tool may be completed – the DISCUS (Dyskenisia Identification System: Condensed User Scale). This scale checks for signs of Tardive Dyskinesia and also must be completed at least every month. There is also a copy of the DISCUS included in the manual.The DISCUS must also be completed when an anti-psychotic medication is discontinued, at one, two, and three calendar months after the discontinuation to check for the presence of Tardive Dyskinesia. So, just because a medication has been discontinued, we are still required to complete the side effects monitoring. Please check with your Program Coordinator before you stop completing either of these.If one of the Persons Served at your house takes a psychotropic medication on an as needed or PRN basis, there is additional documentation required besides the Med Sheet. Each Person Served who has a psychiatric PRN, must have a protocol for administration of that medication. That protocol is on a PRN Psychotropic Medication Administration Plan form and also must be available to the staff. It should tell the staff what target behaviors to look for, what interventions should be attempted before giving the PRN, and what exact behaviors the Person Served must be displaying in order to be given the medication. This protocol is approved by the Persons Served team.Any time a PRN psychotropic medication is administered, the PRN Psychotropic Medication Actual Use Report must be completed. As you talk with staff or review medication administration records, you will hear about or see that the medication has been passed. Double check to be sure that the PRN Psychotropic Medication Actual Use Report has been completed. The Program Coordinator should already have been made aware of the need to use that PRN and there is likely a corresponding Incident Report, but they also need to review and sign off on this Actual Use report as well. The PRN Actual Use Forms should be attached to the med sheet when it is turned into the office (by the first Friday following the end of the month).One last thing we must monitor when someone is taking psychotropic medications is that they are not losing any skills or positive characteristics as a result of taking the medication. We do not want Persons Served to be “drugged up” or be like zombies. We want to make sure that they are still able to do as many things independently as possible, that they are still able to participate in activities that they enjoy, that they maintain their positive attributes, etc. Sometimes finding a balance between decreasing the behavior and not slowing them down too much can only be found by trial and error.EXAMPLES OF PSYCHOTROPIC MEDICATION CLASSIFICATION Generic NameTrade NameANTIPSYCHOTIC *acetophenazineTindal *aripiprazole Abilify *chlorpromazineThorazine/Ormazine *chlorprothixeneTaractan *clozapineClozaril *droperidolInapsine *fluphenazineProlixin/Permitil *haloperidolHaldol *loxapineLoxitane *mesoridazineSerentil *molindoneMoban *olanzipineZyprexa *perphenazineTrilafon *pimozideOrap *prochlorperazineCompazine *promazineSparine *quetiapineSeroquel *reserpineSerpasil *risperidoneRisperal *sertindoleSerlect *thioridazineMellaril *thiothixeneNavane *trifluperazineStelazine *triflupromazineVesprin *ziprasidoneZeldox/GeodonSEDATIVE/HYPNOTICamobarbitalAmytalbutabarbitolButisolchloral hydrateNoctecestazolamProSomethchlorvynolPlacidylflurazepamDalmaneglutethimideDoridenpentobarbitalNembutalquazepamDoralsecobarbitalSeconaltemazepamRestoriltriazolamHalcionzaleplon SonatazolpidemAmbieneszopicloneLunestaMOOD STABILIZERcarbamazepineTegretolgabapentinNeurontinlamotrigineLamictallithium carbonateLithobid/Eskalithlithium citrateEskalithnimodipineNimotoptopiramateTopamaxvalproic acidDepakote, DepakeneCLASSIFICATIONGeneric NameTrade NameANTIDEPRESSANTamitriptylineElavil/Endep*amoxapineAsendinbupropionWellbutrincitalopramCelexaclomipramineAnafranildesipraminePertofrane/NorpramindoxepinSinequan/Adapinduloxetine Cymbaltaescitralam LexaprofluoxetineProzac/SarafemfluvoxamineLuvoximipramineTofranil**isocarboxazidMarplanmaprotilineLudiomilmirtazapineRemeronnefazodneSerzonenortriptylineAventyl/PamelorparoxetinePaxil**phenelzineNardilprotriptylineVivactilreboxetine VestrasertralineZoloft**selegelineEldepryl**tranylcypromineParnatetrazadoneDesyreltrimipramineSurmontilvenlafaxineEffexorANTIANXIETYalprazolamXanaxbuspironeBusparchlorazepate dipotassiumTranxenechlordiazepoxide Librium/Librax/Mitranchlormezanone TrancopalclonazepamKlonopindiazepamValiumhalazepamPaxipamhydroxyzineAtarax/VistarillorazepamAtivanmeprobamateEquanil/MiltownoxazepamSeraxprazepamCentraxmeprobamate & premerine PMB 200/400 SIDE EFFECTSamantadine SymmetrelbenztropineCogentinbiperidenAkinetonbromocriptineParlodeldantroleneDantriumdiphenhydramineBenadrylorphenadrineNorflexprocyclidineKemadrintrihexphenidylArtanedoxylamineUnisomCLASSIFICATIONGeneric NameTrade NameSTIMULANTamphetamine sulfate AdderalldextroamphetamineDexedrinedextroamphetamine sulfateObetrolmethylphenidate Ritalin/Concerta/MetadatepemolineCylertmodafinilProvigilCOMBINATIONchlordiazepoxide/amitriptylineLimbitrol*perphanazine/amitriptylineTrivail/Etrafonmeprobamate & benactyzineDeprolMISCELLANEOUS/OTHERSatomoxetine Stratteratenormin AtenololclonadineCatapressdonepezilAriceptdexamphetamineDexedrinegabapentin NeurontingalantamineReminylguanfacineTenexlamotrigine LamictalmephobarbitolMebaral*metoclopramideReglanmemantineNamuindanaltrexoneTrexanoxcarbazepine TrileptalpemolineCylertpropranololInderalrivastismineExelontacrineCognextopiramate TopamaxverapamilCalanThis list is not necessarily complete. New medications may be introduced, other medications may be shown to have psychotropic properties, and listed psychotropic medications may be withdrawn from the market. Some medications listed may have uses in several categories. Additionally, some medications listed have nonbehavioral/nonpsychiatric uses (e.g., carbamazepine for epilepsy).* May cause Tardive Dyskinesia.** MAOI (Monoamine Oxidase Inhibitors)MONITORING OF SIDE-EFFECTS SCALE (MOSES)Individual:I.D.Date:Rater Signature & Title:Instructions: See other side. Bold items are primarily observable. Regular print items are primarily Person Served verbalization, staff input and/or chart review.Scoring: See other side for details0 = None 2 = mild 4 = Severe1 = Minimal3 = ModerateNA = Not AssessableExam Type (check one, if * specify in comments) FORMCHECKBOX 1. Admission FORMCHECKBOX 4. Drug D/C* FORMCHECKBOX 7. Other* FORMCHECKBOX 2. Baseline FORMCHECKBOX 5. Drug Initiation FORMCHECKBOX 3. Dosage Increase FORMCHECKBOX 6. Six Month AssessmentEYES / EARS / HEAD01. Blink Rate: Decreased0 1 2 3 4 NA02. Eyes: Rapid Vert/Horz0 1 2 3 4 NA03. Eyes: Rolled Up0 1 2 3 4 NA04. Face: No Expression/0 1 2 3 4 NA Masked05. Tics/Grimaces0 1 2 3 4 NA06. Blurred/Double Vision0 1 2 3 4 NA07. Ear Ringing0 1 2 3 4 NA08. Headache0 1 2 3 4 NAMOUTH09. Drooling0 1 2 3 4 NA10. Dry Mouth0 1 2 3 4 NA11. Mouth/Tongue0 1 2 3 4 NA Movement12. Speech: Slurred/0 1 2 3 4 NA Difficult/SlowNOSE / THROAT / CHEST13. Nasal Congestion0 1 2 3 4 NA14. Sore Throat/Redness0 1 2 3 4 NA15. Breast: Discharge0 1 2 3 4 NA16. Breast: Swelling0 1 2 3 4 NA17. Labored Breathing0 1 2 3 4 NA18. Swallowing: Difficult0 1 2 3 4 NAGASTROINTESTINAL19. Vomiting/Nausea0 1 2 3 4 NA20. Appetite: Decrease0 1 2 3 4 NA21. Appetite: Increase0 1 2 3 4 NA22. Constipation0 1 2 3 4 NA23. Diarrhea0 1 2 3 4 NA24. Flatulence0 1 2 3 4 NA25. Thirst: Increased0 1 2 3 4 NA26. Abdominal Pain0 1 2 3 4 NA27. Taste Abnormally0 1 2 3 4 NA metallic, etc.MUSCULOSKELETAL / NEUROLOGICAL28. Arm Swing: Decreased0 1 2 3 4 NA29. Contortions/Neck-Back0 1 2 3 4 NA Arching30. Gait: Imbalance/Unsteady0 1 2 3 4 NA31. Gait: Shuffling0 1 2 3 4 NA32. Limb Jerking/Writhing0 1 2 3 4 NA33. Movement: Slowed/0 1 2 3 4 NA Lack of34. Pill Rolling0 1 2 3 4 NA35. Restlessness/Pacing/Can’t0 1 2 3 4 NA Sit Still36. Rigidity0 1 2 3 4 NA37. Tremor/Shakiness0 1 2 3 4 NA38. Fainting/Dizziness/0 1 2 3 4 NA Upon Standing39. Seizures: Increased0 1 2 3 4 NA40. Complaints of Jitteriness0 1 2 3 4 NA Jumpiness41. Tingling/Numbness0 1 2 3 4 NASKIN42. Acne0 1 2 3 4 NA43. Bruising: Easy/0 1 2 3 4 NA Pronounced44. Color: Blue/Coldness0 1 2 3 4 NA45. Color: Pale/Pallor0 1 2 3 4 NA46. Color: Yellow0 1 2 3 4 NA47. Dry/Itchy0 1 2 3 4 NA48. Edema0 1 2 3 4 NA49. Hair: Abnormal Growth0 1 2 3 4 NA50. Hair: Loss0 1 2 3 4 NA51. Rash/Hives0 1 2 3 4 NA52. Sunburns/Redness0 1 2 3 4 NA53. Sweating: Decreased0 1 2 3 4 NA54. Sweating: Increased0 1 2 3 4 NAMEASURES (Enter under OTHER)Temperature Pulse Blood PressureURINARY / GENITAL55. Menstruation: Absent/ Irregular56. Sexual: Continual Erection57. Urinary Retention58. Urination: Decreased59. Urination: Increased60. Urination: Increased (Includes Nocturnal)61. Sexual: Activity Decreased62. Sexual: Erection Inability63. Sexual: Orgasm Difficult64. Urination: Difficult/ PainfulPSYCHOLOGICAL65. Agitated66. Drowsiness/Lethargy/ Sedation67. Attention Difficulty68. Confusion69. Irritability70. Morning “Hangover”71. Perceptual: Hallucinations/Delusions72. Sleep: Excessive73. Sleep: Insomnia74. Withdrawn75. Feelings of Sadness/ Crying76. Nightmares/Vivid DreamsWHILE THE SIDE-EFFECTS IN THESE TWO AREAS ARE OFTEN DIFFICULT TO DETERMINE, PLEASE BE AWARE THEY MAY OCCUR DEPENDING ON THE SPECIFIC DRUG PROFILE. BE CERTAIN TO INQUIRE ABOUT THESE IF THE PERSON SERVED IS VERBAL0 1 2 3 4 NAIF SEEN:CIRCLE ITEMENTER UNDER “OTHER”ASSIGN INTENSITY SCOREOTHER:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Dyskinesia Identification System: Condensed User Scale (DISCUS)Individual:COOPERATION (check one): FORMCHECKBOX 1. None FORMCHECKBOX 3. Full FORMCHECKBOX 2. PartialDate:Rater Signature & Title:Instructions: See other side. Scoring: See other side for details0 = None2 = Mild4 = Severe1 = Minimal3 = ModerateNA = Not AssessableExam Type (check one) FORMCHECKBOX 1. Admission FORMCHECKBOX 3. Annual FORMCHECKBOX 5. D/C – 1 month FORMCHECKBOX 7. D/C – 3 month FORMCHECKBOX 2. Baseline FORMCHECKBOX 4. Semi-Annual FORMCHECKBOX 6. D/C – 2 month FORMCHECKBOX 8. OtherCURRENT PSYCHOTROPICS / ANTICHOLINERGICS AND TOTAL MG/DAY_______________________________ ______mg _______________________________ ______mg ______________________________ ______mg_______________________________ ______mg _______________________________ ______mg ______________________________ ______mgASSESSMENTDISCUS Item and Score (Circle one score for each item)EVALUATION (see other side)1.Greater than 90 day’s neuroleptic exposure? FORMCHECKBOX Yes FORMCHECKBOX No2.Scoring/intensity level met? FORMCHECKBOX Yes FORMCHECKBOX No3.Other diagnostic conditions? FORMCHECKBOX Yes FORMCHECKBOX No(if yes, specify)___________________________________________________________________________________________________________________________________________________________________________________________________4.Last exam date: _______________Last total score:_______________Last conclusion_______________Preparer’s signature and title for item 1-4 if different from Physician._________________________________________________________________5.Conclusion (check one) FORMCHECKBOX No TD (if scoring prerequisite met, list other diagnostic condition or explain in comments) FORMCHECKBOX Probable TD FORMCHECKBOX Masked TD FORMCHECKBOX Withdrawal TD FORMCHECKBOX Persistent TD FORMCHECKBOX Remitted TD FORMCHECKBOX Other (specify in ments______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________FACE1.Tics2.Grimaces0 1 2 3 4 NA0 1 2 3 4 NAEYES3.Blinking0 1 2 3 4 NAORAL4.Chewing/Lip Smacking5.Puckering/Sucking/Thrusting Lower Lip0 1 2 3 4 NA0 1 2 3 4 NALINGUAL6.Tongue Thrusting/Tongue in Cheek7.Tonic Tongue8.Tongue Tremor9.Athetoid/Myokymic/Lateral Tongue0 1 2 3 4 NA0 1 2 3 4 NA0 1 2 3 4 NA0 1 2 3 4 NAHEAD/NECK/TRUNK10.Retrocollis/Torticollis11.Shoulder/Hip Torsion0 1 2 3 4 NA0 1 2 3 4 NAUPPER LIMB12.Athetoid/Myokymic Finger-Wrist-Arm13.Pill Rolling0 1 2 3 4 NA0 1 2 3 4 NALOWER LIMB14.Ankle Flexion/Foot Tapping15.Toe Movement0 1 2 3 4 NA0 1 2 3 4 NACOMMENTS / OTHERTotal Score(items 1-15 only)_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Exam DateRater Signature and TitleNext Exam DatePhysician SignatureDateSimplified Diagnosis for Tardive Dyskinesia (SD-TD)PREREQUISITES – The 3 prerequisites are as follows. Exceptions may occur.A history of at least three months total cumulative neuroleptic exposure. Include amoxapine and metoclopramide in all categories below as well.Scoring/Intensity level. The presence of a TOTAL SCORE OF FIVE OR ABOVE. Also be alert for any change from baseline or scores below five which have at least a “moderate” (3) or “severe” (4) movement on any item or at least two “mild” (2) movements on two items located in different body areas.Other conditions are not responsible for the abnormal involuntary movements.DIAGNOSES – The diagnosis is based upon the current exam and its relation to the last exam. The diagnosis can shift depending upon: (a) whether movements are present or not, (b) whether movements are present for 3 months or more (6 months if on a semi-annual assessment schedule), and (c) whether neuroleptic dosage changes occur and effect movements.NO TD – Movements are not present on this exam or movements are present, but some other condition is responsible for them. The last diagnosis must be NO TD, PROBABLE TD, or WTHDRAWAL TD.PROBABLE TD – Movements are present on this exam. This is the first time they are present or they have never been present for 3 months or more. The last diagnosis must be NO TD or PROBABLE TD.PERSISTENT TD – Movements are present on this exam and they have been present for 3 months or more with this exam or at some point in the past. The last diagnosis can be any except NO TD.MASKED TD – Movements are not present on this exam but this is due to a neuroleptic dosage increase or reinstitution after a prior exam when movements were present. Also use this conclusion if movements are not present due to the addition of a non-neuroleptic medication to treat TD. The last diagnosis must be PROBABLE TD, PERSISTENT TD, WITHDRAWAL TD, or MASKED TD.REMITTED TD – Movements are not present on this exam but PERSISTENT TD has been diagnosed and no neuroleptic dosage increase or reinstitution has occurred. The last diagnoses must be PERSISTENT TD or REMITTED TD. If movements re-emerge, the diagnosis shifts back to PERSISTENT TD.WITHDRAWAL TD – Movements are not seen while receiving neuroleptics or at the last dosage level but are seen within 8 weeks following a neuroleptic reduction or discontinuation. The last diagnosis must be NO TD or WITHDRAWAL TD. If movements continue for 3 months or more after the neuroleptic dosage reduction or discontinuation, the diagnosis shifts to PERSISTANT TD. If movements do not continue for 3 months or more after the reduction or discontinuation, the diagnosis shifts to NO TD.INSTRUCTIONSThe rater completes the assessment according to the standardized exam procedure. If the rater also completes Evaluation items 1-4, he/she must also sign as the preparer. The form is given to the physician. Alternatively, the physician may perform the assessment.The physician completes the Evaluation section. The physician is responsible for the entire Evaluation section and its accuracyIT IS RECOMMENDED THAT THE PHYSICIAN EXAMINE ANY INDIVIDUAL WHO MEETS THE 3 PREREQUISITES OR WHO HAS MOVEMENTS NOT EXPLAINED BY OTHER FACTORS. NEUROLOGICAL ASSESSMENTS OR DIFFERENTIAL DIAGNOSTIC TESTS WHICH MAY BE NECESSARY SHOULD BE OBTAINED.File form according to policy or procedure.OTHER CONDITIONS (partial list)SCORINGNOT PRESENT (0): Movements not observed or some movements observed but not considered abnormal.MINIMAL (1): Abnormal movements are difficult to detect or movements are easy to detect but occur only once or twice in a short non-repetitive mannerMILD (2): abnormal movements occur infrequently and are easy to detect.MODERATE (3): abnormal movements occur frequently and are easy to detect.SEVERE (4): abnormal movements occur almost continuously and are easy to detect.NOT ASSESSED (NA): An assessment for an item is not able to be made.1. Age 2. Blind3. Cerebral Palsy4. Contact Lenses5. Dentures/No Teeth6.Down’s Syndrome7.Drug Intoxication (specify)8.Encephalitis9.Extrapyramidal Side-Effects (specify)10.Fahr’s Syndrome11.Heavy Metal Intoxication (specify)12. Huntington’s Chorea13. Hyperthyroidism14. Hypoglycemia15.Hypoparathyroidism16. Idiopathic Torsion Dystonia17. Meige Syndrome18. Parkinson’s Disease19. Stereotypes20. Sydenham’s Chorea21. Tourette’s Syndrome22. Wilson’s Disease23. Other (specify)Primary Counselor ResponsibilitiesThe Primary Counselor system is a great way to get the Persons Served the connection and support that they need to be successful. It is also a good way to delegate some of the tasks to the Resident Counselors so you are not directly responsible for completing every detail. It is the role of the Primary Counselor to develop a relationship with the Person Served that is encouraging, supportive, and assists the Person Served to function at the highest level possible. The Primary Counselor is to complete the Primary Counselor Checklist weekly and submit them to the Lead Counselor at the staff meetings. A copy of the Primary Counselor Checklist can be found on the Employees Only page of the website. It includes tasks such as having a weekly 1:1 counseling session with the Person Served, reviewing upcoming scheduled activities, ensuring laundry is clean and organized, ensuring hygiene tasks are being completed, communicate concerns to the Lead Counselor, etc.It is important that when you assign a Primary Counselor, they understand what the expectation is with that role. Review the Primary Counselor Checklist with them and have them sign a copy. You also sign and date the copy, making a note that the Resident Counselor was trained on the role of a Primary Counselor. That signed copy should be sent to the office for filing in the employee’s personnel file. This will serve as proof that the Resident Counselor was trained in case there are any concerns in the future.It is the responsibility of the Primary Counselor to give an update on that Person Served at each staff meeting. You must hold the Primary Counselor accountable. The Primary Counselor system will not be successful if staff are not held accountable for the tasks they have been assigned. If the system fails in your house, you end up having more work to do yourself. Even more importantly, the Person Served is missing out on something that has the possibility to make them more successful.Licensing RequirementsWe do really have requirements that dictate most of the programs, forms, reports, etc. that we all have to complete. Everything has a purpose and none of it is just for fun.Zumbro House is licensed to provide services by two governing agencies. The Minnesota Department of Human Services grants us a license to provide what is called “Waivered Services.” Each house has a licensed capacity of three or four Persons Served and we must follow the standards outlined in Rule 245D and by the Department of Health for our Home Care Apartment Programs. The 245D tells us how we should coordinate services with Person Served teams, develop programs, meet with teams, intake and discharge, monitor medications, provide needed health care, communicate with other licensed providers (such as a day placement), prepare for and respond to emergencies, and much more.At least every other year, a licensor from the Department of Human Services comes to Zumbro House, Inc. for the licensing review. They choose a random sampling of about 10% of our Persons Served, making sure to choose someone who is newly admitted and someone who takes psychotropic medications. They review the file, making sure that each required piece has been completed and shared with the appropriate members of the Persons Served team. The DHS licensor is extremely thorough – if there has been a mistake such as a report not completed on time, a guardian signature missing, etc. they will find it. This is why we are very vigilant about making sure to pay attention to all of the details.The DHS licensor will also ask for a sample of staff personnel files. The licensor will check to make sure that the staff meets the minimum training requirements and that the background study was done promptly and has been returned from DHS. This is why we are always bugging to make sure training is completed. As the Lead Counselor, you may get email reminders of which individuals have not completed the required monthly trainings. The office staff will also be contacting staff directly. It is very important that you are reminding staff to complete those trainings during your staff meetings and training new staff how to access those on the company website.If the DHS licensor finds any areas that we have not met the requirements, they can write us a citation. We then may have to change a procedure, put a double check system into place, or somehow demonstrate how we are going to correct the citation going forward. Yes, sometimes that means more new paperwork for us. If we would happen to get the same citation two reviews in a row, the company could be given a fine or other negative action could be taken against our license.Also, if the licensor believes that there may be significant concerns throughout the company and they have found patterns of missing or incorrect information, they can expand to a full review – which means that they would look at files for every Person Served that we have. As you can imagine, that would be very time consuming and stressful for everyone involved. It is very important that every member of the team, the Resident Counselor, Lead Counselor, and Program Coordinator all follow through on their assigned parts of the puzzle so that we are all successful.The second governing agency is the county, who grants us an “Adult Foster Care” license. The licensor from the county comes out once per year and looks at several things. Physical plant and safety is a large portion of what the county licensor is looking at. See the section on the Home Safety Checklist for more information regarding what they will be checking. If the licensor finds any violations, Zumbro House will likely have 30 days to correct them. However, if the violations have an effect on the Persons Served safety, other action may be taken. We should keep our sites in a condition that exceeds the expectations of the county licensor at all times – we should always be ready for an announced visit from the licensor. It is the sole responsibility of the Lead Counselors to ensure that the house is compliant with all of the items listed on the Home Safety Checklist at all times. Extra batteries must be available for the smoke detectors, carbon monoxide detectors, flashlights, and emergency radios. The First Aid kits must include all of the necessary items. There can be no combustible storage near the furnace and no storage under stairwells. The list of requirements is too long to try to remember, and there is no way to ensure all of the requirements are being met besides a thorough completion of that Home Safety Checklist each month.In addition, the licensor will look carefully at the cleanliness of the house. Every corner, behind the door, vents, ceiling fans, blinds, shower curtains, etc, must be clean and maintained. There should be no dust or dirt buildup at all! The Persons Served rooms are deep cleaned each and every week (with staff assistance), so there is no reason for there to be dust and grime under beds, behind doors, or in the closets. If there are items that are not getting cleaned, add them to your overnight checklist and follow up with the overnight staff to be sure they understand the expectations. If there is a performance issue and the cleaning is not being completed or not done well, that issue must be addressed with that individual staff. If there are issues not being addressed or communicated to the Program Coordinator, the Lead Counselor will be held responsible.Any violation of a licensing standard at a single location reflects poorly on the entire organization. The Persons Served deserves a clean and healthy place to live, and it is our responsibility to provide it. Please remember – we should be exceeding the licensing expectations every day.Appearance of Persons Being Served How a Person Served looks is not just a reflection on them, it is a reflection on Zumbro House. It is our responsibility to encourage the Persons Served to take pride in their appearance. When they leave the house to go anywhere – to their day program, to the gas station, to an activity – they should be clean, their hair should be combed, and their clothes should fit, with no stains or holes present. Of course, we also need to set an example for them, so it is important to encourage all staff to also avoid wearing clothes that have holes or are stained. We may not know when a parent or a case manager may be stopping by unexpectedly, so it is important to look acceptable when at home, too.When the Person Served has a team meeting, we want them to be looking their best. They should have a haircut, hygiene should all be taken care of, and wearing clothing that is appropriate for a meeting. This is often the only time that certain team members may see the Person Served. We want them to be able to make a great personal impression, as well as demonstrate the high expectation that Zumbro House has for them. It is the Lead Counselor’s responsibility to plan ahead and make sure the Person Served has a haircut if necessary and has picked out clothes that are appropriate. It is perfectly acceptable to delegate this responsibility to a Primary Counselor; however, the Lead Counselor must check in to make sure the Person Served is prepared for the meeting day.When any person feels like they look good, they are naturally going to feel better about themselves. When a Person Served feels better, they are less likely to be easily irritated and may have less behavioral challenges. It is important for us to support the Persons Served in increasing their self-esteem and taking pride in their successes. The Lead is responsible for ensuring that their Persons Served look good on a day to day basis. If you are not satisfied with the appearance of your Persons Served, then it is your responsibility to ensure that your staff raises their standard to yours. Person Served appearance is the simplest and most obvious way that we can showcase our service.Home Safety ChecklistThe Home Safety Checklist is a tool that the county licensor will use to do your house inspection once a year. It is the standard that the county expects in our houses throughout the year. As a Lead Counselor, you are to complete the Home Safety Checklist once per month. You can find a copy of the form on the Management Only page of the website. In the metro area, it should be turned in at the first Lead Counselor Meeting of the month. When completing the Home Safety Checklist, it is important that you check on each item listed, rather than just assume it is complete. For example, you may remember that you set up a fire drill for last month, but you should double check to be sure that it has been filed in the correct place. There should never be a smoke alarm or a flashlight that does not have working batteries – at least we know if we find one not working, that it has only been not working for less than a month (since your last check).If you find any maintenance issues that need to be addressed, email the Maintenance Coordinator at maintenance@ and cc your supervisor to report the concerns. Make a note right on the checklist that you have notified maintenance. Also make yourself a note to follow up with the Maintenance Coordinator after 1 week (much shorter if it is a safety concern) if the issue has not been addressed or a plan has not been discussed to correct the issue.Included in the manual is a copy of the Home Safety Checklist with some notes included. Under some of the items, it shows exactly what should be checked. We should be ready for the licensor to look at our properties at all times and without prior notice. If this Home Safety Checklist is being completed thoroughly, we should always be ready! Debit Card Purchasing and Record KeepingAs a Lead Counselor, you have been or will be issued a company debit card. With this card, it is the Lead Counselor’s responsibility to ensure the house has all of the needed groceries and supplies. Keeping the house stocked with needed supplies requires some planning ahead and establishing a routine for shopping. Without that established, it will be difficult to stay on top of house needs while staying within your house budget.SECURITY Please ensure the company debit card and gas card is kept secured in a location that will minimize the opportunity for theft or loss. If the card is lost or stolen, please contact your supervisor immediately so that the card can be cancelled, to prevent unauthorized use. Please sign the back of your card to make it more difficult for a person to use, should it be lost. The company debit card should never be given to staff to use to purchase items for the house. The Lead is responsible for all purchases made with the debit card. BUDGET You have $230.00 per Person Served to spend per calendar month. $200.00 of that has to be spent on food for the Person Served; the other $30 should be spent on house supplies. For sites with 4 Persons Served, this totals $920 per month, with $800 on food; $120 on house supplies. For sites with 3 Persons Served, this totals $690.00 per month, with $600 on food; $90 on house supplies. For sites with 2 Persons Served, this totals $460.00 per month, $400 on food; $60 on house supplies. It is critical you stay within this budgetary restriction. If you have a Person Served move into or out of the house in the middle of a month, your budget amount will be pro-rated for the remaining days of the month. You should contact accounting if this occurs to make sure the correct adjustment is made to your budget. Extending beyond the allotted budget will not be tolerated and will result in disciplinary action. RECEIPTS Receipts must accompany every single expenditure, without exception. The employee will be liable for any purchases made with the company credit card that don’t have a corresponding receipt. If you forget to get a receipt, please contact the vendor as most companies can print duplicate receipts. If a missing receipt is requested by Accounting, the Lead will have 2 days to find the receipt or get the duplicate from the vendor.Receipt support submitted should be included in an envelope with the home name reflected. Number the receipts to correspond to the line entry on the house expense ledger. Purchases of edible items should be made separate from non-edible items, to lend for more accurate and efficient tracking of expenses. Approved uses for the company debit card:Groceries All groceries must be purchased at the local Aldi, Wal-Mart or the dollar store which offers exceptional value and allows you to purchase more within the budgeted amount. Avoid buying boneless and skinless meats, since they tend to be priced higher. Buy less expensive cuts of meat also. There are many lean and flavorful cuts of meat that do not cost a lot. Look also for good deals in the frozen food section – turkey roasts and Jenny-O turkey-ham roasts are fairly inexpensive examples of healthy low fat meats your Persons Served will enjoy. Your overall goal is to stretch your grocery budget, so you are buying the most and healthiest food with your allotted budget. Buying bulk and avoiding individually or convenience packaged products (such as yogurts, soda, pudding or chips) will help stretch you budget and allow you to buy more product for the same price. Buying items in bulk also discourages staff pilfering. You should only be purchasing the least expensive of any given item - store brand generics or items that are on sale. Taking the time to comparison shop will help stretch your budget and allow you to purchase more items for the same cost. Prepare ahead by dividing bulk purchases into menu or meal requirements. This will help avoid over-serving of bulk meats. Clean and prepare meats and vegetables, use recipes that are easy and guarantee the satisfaction and health of your Persons Served. Vegetables and fruits are necessary to your diets whether they be canned, frozen or fresh. Please be reminded that Zumbro House adheres to USDA guidelines for appropriate serving sizes. Staff should be serving food according to recommended serving sizes noted on most packaged foods. For meats and produce, please refer to USDA guidelines. Serving more than the prescribed USDA serving sizes, will encourage Person Served overeating, is unhealthy, and will negatively affect your budget. More information on this subject is included in the Menu section of this manual. Household Supplies, Sundries, Office Supplies Please limit your purchasing of these items to Walmart or the Dollar Stores, as these places will provide the best value and will allow you to stretch your budget. Household supplies will include cleaning supplies, paper towels, toilet paper, tablecloths, paper plates, house games, kitchen tools, etc. The best place to shop is at your dollar stores or Wal-Mart. Again, stretch your budget by purchasing the least expensive of every given item, such as generic brands and/or sale items. Sundries will include supplies for your medication cabinet or first aid kits, band aids, antibiotic ointment, med cups and the occasional aspirin or cough syrup. Any items that are used for an extended need and are for a specific Person Served will be purchased by the individual Person Served. Office supplies include pens, paper, and other office items. The purchase of stamps falls into this category. Please secure your stamps in a secure location as this is a common item chosen for theft. Person Served Outings Zumbro House does not pay for staff to participate in Person Served activities, such as bowling or video arcades. If staff wishes to play or participate in the Person Served activity, they must pay for it themselves. Activities which require staff to pay for admission should be avoided, and only in rare instances will be approved. Zumbro House will not pay for staff or Person Served food, drink or snacks during community activities.Please note, Zumbro House does not pay for staff meals on Person Served out to eat night. Staff may eat the prepared dinner with the Persons Served. Staff may not eat house food at other times, including breakfast or lunch. Staff will need to bring in their own food for these meals. Please note that all purchases should fall into one of the above categories. They are also listed on the House Expense Ledger form. Anything outside of the above should be listed as “Misc.” approved by your supervisor, and noted as such on the House Expense Ledger. Gift cards may not be purchased with the company debit card.**Unfortunately… staff pilfering is an all too common problem that will bite into your budget and take food and supplies away from your Persons Served. Whether it is staff taking home a roll of toilet tissue, a ream of paper, or a pork roast, staff pilfering is stealing from the very individuals who we are charged with taking care of – our Persons Served. It is critical that you remain continually aware of this possibility and you store your supplies securely in a locked closet or cabinet and keep available/accessible only the bare minimum of supplies and groceries. You are also encouraged to keep an informal inventory of your supplies and groceries. If you are noticing inordinate amounts of food or supplies missing, staff pilfering may be the culprit. If you suspect staff pilfering, please contact your Program Coordinator or Human Resources, immediately. Completing the House Expense LedgerBegin each month with a blank House Expense Ledger Form. This form is available on the Management only page of the website. Write your budget amount for the month on the first line (labeled “Beginning Balance”). Each purchase should be listed in chronological order, from the 1st of the month through the end of the month. Purchases should be recorded on the House Expense Ledger as they are made, the transaction number should be written on the receipt, and the receipt should be kept in an envelope. Prompt entry of each purchase transaction will be conducive to a smooth month-end process, minimizing the time needed during that more intense portion of the month.The description for each purchase must be specific; including what was purchased (such as groceries, household supplies, etc) rather than just the store where the purchase was made. Use Person Served initials where applicable. Please see the included example of a House Expense Ledger. Writing specific descriptions will allow the accounting department to review the ledgers efficiently without having to make follow up calls to ask about certain expenditures. Balance your ledger after every purchase so you are always aware of your remaining balance.Purchases must be recorded in the month they are made. For example, you cannot make a purchase on February 28th and record it on the ledger for March so you stay under your February budget limit.The House Expense Ledger is for debit card transactions only. If you ever have to make a return, make sure the store credits that money back to the debit card rather than giving you cash. There will also be a receipt for that return to be numbered and recorded (as a deposit). It is never acceptable to buy something with the debit card and then have a Person Served pay the house for it with cash.The House Expense Ledger along with the envelope of receipts organized in chronological order must be mailed to the office or given to your supervisor by the first business day of the following month. Getting them in promptly allows accounting to review the information and get the account reimbursed quickly.The debit card statement is reviewed at the office. Each receipt is matched up to the statement and checked for accuracy. Any variance from the policy as outlined above will require explanation by the employee and may result in disciplinary action. Please contact your supervisor if you are unsure about any aspect of the above outlined expectations or if you are unsure if a specific expenditure is approved.Fire Drills/Severe Weather DrillsThe Zumbro House Fire Drill Form and the Tornado/Severe Weather Drill Form are located on the Management Only page of the website. It is the responsibility of the Lead Counselor to make sure drills are completed as required in order to remain in compliance with licensing. Please follow the Fire Drill/Severe Weather Drill calendar for the current year and communicate scheduled fire drills and severe weather drills to your staff. Best practice is for fire drills and severe weather drills to be run in alternating months. For example, January – fire; February – weather; March – fire; April – weather; etc. These drills are an opportunity not only for Persons Served to learn and practice what to do in case of emergency, but for the staff to learn and practice as well.Drills should be conducted at various times of the day, in varied conditions, and should use all possible exits. When preparing for the drill, decide if you are going to have any of the exits blocked. It is important to help the Persons Served think about what route of evacuation they will take if the fire is in a different area of the house. As you are getting ready to announce the drill, take a look at the time. It is important to pay close attention to how quickly the staff and Persons Served are able to evacuate. Getting out of the house in less than two minutes is the goal for a fire drill. A house fire can become deadly in that small amount of time.Doing drills frequently can seem like a repetitive task; however, when an emergency actually occurs, people may panic. They will not be able to execute a safe evacuation if they have not practiced the skills and know exactly what to do almost without even thinking. It is important to encourage both Persons Served and staff to take the drills pleted drills should be kept in the Drill Notebook. The forms must be completed thoroughly and legibly. If there is ever a Person Served that refuses to evacuate or respond to the drill, you should inform the Program Coordinator. If this is a repeated occurrence, a plan may need to be discussed with the team and added to the Persons Behavior Support Plan in case the refusal would occur in a real emergency situation.Menu – Nutritional GuidelinesHealthy eating habits and getting enough exercise affects how we feel every day – it affects how much energy we have, how tired we are or how easily we get tired, and it affects how we deal with stress or cope with situations that we are faced with. Remembering this, it is easy to see why it is so important that we are encouraging our Persons Served to live a healthy lifestyle. When Persons Served have a healthy lifestyle, they are likely to handle stress more easily, feel better about themselves, have fewer incidents, and of course have less illnesses.There is a BMI (Body Mass Index) calculator at bcm.edu/cnrc/caloriesneed.htm. By just entering someone’s weight, height, age, and level of daily physical activity, you will get a BMI score. With this score, you can see what range that BMI falls in – healthy, overweight, or obese – and you can get a recommended daily calorie intake. This information is approximate and of course does not override any information or recommendations that are in place from a Persons Served physician. Check this out for the Persons Served at your house. Then, keep that information in mind as you plan menus and do the grocery shopping. Don’t forget to factor in any other health conditions or dietary restrictions that a Person Served may have, such as diabetes.As you are planning the menu, keep the following tips in mind:Make smart choices from every food group.In order to get balanced nutrition, you have to eat a variety of nutrient-packed foods every day. A healthy eating plan is one that:Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.Includes lean meats, poultry, fish, beans, eggs, and nuts.Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.Mix up your choices within each food group.Focus on fruits. Eat a variety of fruits – whether fresh, frozen, canned or dried – rather than fruit juice for your most of your fruit choices. For a 2,000 calorie diet, you will need 2 cups of fruit each day.Vary your veggies. Eat more dark green veggies, such as broccoli, kale, and other dark leafy greens; orange veggies, such as carrots, sweet potatoes, pumpkin, and winter squash; and beans and peas such as pinto beans, kidney beans, black beans, garbanzo beans, and lentils.Get your calcium-rich foods. Get 3 cups of low-fat or fat-free milk – or an equivalent amount of low-fat yogurt and/or low-fat cheese (1 ? ounces of cheese = 1 cup of milk) – every day.Make half your grains whole. Eat at least three ounces of whole grain cereals, breads, crackers, rice, or pasta every day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or ? cup of cooked rice or pasta. Look to see that grains such as wheat, rice, oats, or corn, are referred to as whole in the list of ingredients.Go lean with the protein. Choose lean meats and poultry. Bake it, broil it – avoid frying as much as possible. And vary your protein choices – add fish, beans, peas, nuts, and seeds.Read the Nutrition Facts labels on foods. Keep these low: saturated fats, trans fats, cholesterol, and sodium.Get enough of these: potassium, fiber, vitamins A and C, calcium, and iron.Use the % Daily Value (DV) column when possible: 5% DV or less is low; 20% DV or more is high.Check the serving size and the calories per serving.Make your calories count – if a food is high in calories and low in nutrients, you have to decide if it is worth eating.Don’t sugarcoat it. Added sugars add calories with very little nutrients. Some names for those added sugars include sucrose, glucose, high fructose corn syrup, corn syrup, maple syrup, and fructose.Know your fats. Look for foods that are low in saturated fats, trans fats, and cholesterol, to reduce the risk of heart disease (%5 DV is low and 20% DV is high). Most of the fats that you eat should be polyunsaturated or monounsaturated fats. Total fat intake should be about 20% to 35% of your calories.Reduce sodium; Increase potassium. Research shows that eating less than 2,200 milligrams of sodium (about 1 tsp of salt) per day may reduce the risk of high blood pressure. Most of the salt that we eat comes from eating processed foods, not the salt shaker. Potassium counteracts some of sodium’s effect on blood pressure.Let’s not forget about exercise! In order to be healthy, we need to burn off the calories that we are putting in! Consider this: consuming just 100 calories per day more than you burn can make you gain about 1 pound per month! It works out to be 10 – 12 pounds per year. Yikes!About 20-50% of your daily caloric intake depends on how physically active you are. According to the Centers for Disease Control (CDC) and Prevention, adults need at least:2 hours and 30 minutes of moderate-intensity aerobic activity per week and muscle-strengthening activities on 2 or more days per week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, arms);OR1 hour and 15 minutes of vigorous-intensity aerobic activity every week, and muscle-strengthening activities on 2 or more days per week that work all major muscle groups;ORAn equivalent mix of moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities on 2 or more days per week that work all major muscle groups. We should be encouraging our Persons Served to get the needed amount of exercise into their routines. It is okay to exercise in small increments of time – 10 minutes at a time is okay. Aerobic activity gets you breathing harder and gets your heart beating faster. Moderate intensity means that you are working hard enough to get your heart rate up and break a sweat. Vigorous intensity means you are breathing hard and fast, and your heart rate has gone up quite a bit. If you are working at the vigorous level, you will not be able to speak more than a few words without pausing for a breath.Exercise can have the following benefits:Weight ControlBetter sleepReduce your risk of cardiovascular diseaseReduce your risk for Type 2 diabetesReduce your risk of some cancersStrengthen your bones and musclesIncrease your chances of living longer Improve your health and moodBetter mood = less incidents!!Being conscious of Persons Served health is our responsibility. Please refer to the Healthy Living Policy on the Zumbro House website for even more information. House Appearance, Safety, and MaintenanceHow the house looks is very important – it should be in “visitor condition” all of the time. “Visitor condition” means that if anyone should happen to stop by – a guardian, a case manager, a licensor, or anyone else – the house is clean, organized, and presentable. It is all of our responsibility to provide the Persons Served with a clean, healthy, and safe environment. The Lead is responsible for the appearance of the house at all times. This would behoove the Lead to ensure that his/her staff is cleaning the house to a high standard. Further, it is the Lead’s responsibility to ensure that all safety and maintenance needs are attended to at their house. Maintain a high standard. Replace bathroom caulking, paint rusty vent grates, pick up cigarette butts, keep the lawn mowed and hedges trimmed, etc.The expected standard of clean is very high. Since we have awake overnight staff, we are able to expect that a thorough cleaning of the house get done on that shift as well as on other shifts. There should never be visible dirt or mess, floors should be swept and mopped, any marks or dirt on walls should be wiped off. There should be no cobwebs or dust evident – the lower levels of the house may need extra checks for this. Lead counselors are responsible for the way the house looks. As discussed in the earlier section on monitoring employee performance, you must INSPECT what you EXPECT. Be monitoring those Resident counselor and Overnight Checklists closely. Assign additional cleaning responsibilities as you see necessary.If there are maintenance issues, report them to the Maintenance Coordinator and also the Program Coordinator. Never assume that someone has already reported a maintenance concern or that it is being taken care of. Make sure that the Maintenance Coordinator is aware of the issue. Also make sure to report even small maintenance issues so that they can be addressed before they get to be a larger problem. When reporting a maintenance concern to the Maintenance Coordinator, it is important to share what priority it should be assigned. For example, if it is a door alarm not working, a broken lock on a med cabinet or some kind of safety issue that would take priority over a broken piece of trim or a living room that needs paint.Safety The most common workers compensation injury category is slips, trips, and falls. Although these are the most common injuries, they are also the most preventable. We want to reduce the risk of injury for the Persons Served and for the staff. Here are some things that you can do to reduce the risk:Make sure there are no cables or cords near any walkways.Clean up spills immediately, even if the mess is not yours.Pick up anything that is on the floor, even if it is a small item like a pen, paperclip, sheet of paper, etc.When something is out of reach, use a ladder or a step stool. Standing on furniture, boxes, or other potentially unstable items could be dangerous.Make sure that lifting of anything even slightly heavy is done with proper body mechanics, using your legs instead of your back to lift the weight.Before you lift anything, be sure that your pathway is clear and that your view is not blocked.Close drawers and cupboards after every use – don’t leave something open if you are walking away from it for any amount of time.Avoid bending, twisting, and leaning backwards when you are seated. It’s not good for the chair, and you are likely to tip over backwards.Even if you think you know your way around “blindfolded,” look where you are going when you walk.There are many more safety tips that could be included here – these are just some that seem to apply to many of our locations. Lead Counselors as well as Program Coordinators should talk about safety often with employees and at staff meetings. It is everyone’s responsibility to ensure that we are providing a safe environment to live in and to work in. encourage staff to report any safety that they have promptly and report them to the Maintenance Coordinator.Fire HazardsAccording to FEMA, house fires kill more than 4,000 Americans every year and over 25,000 are injured. We would be crazy to believe that there could never be a house fire at a Zumbro House site. House fires can accelerate very quickly. In just two minutes, a fire can become life-threatening and a residence can be engulfed in flames in just five minutes. The following are some common causes of household fires:Dryer lint – According to the Consumer Product Safety Commission, dyers spark almost 16,000 fires annually, resulting in more than $84 million in damages, about a dozen deaths, and around 300 injuries. The lint filter on the dryer should be cleaned off before starting every load. If each staff thinks “It won’t hurt to not clean it off just this one time” then it will never get cleaned out and we have an increased fire hazard. If the lint filter is full or clogged, it also affects the performance of the dryer and it will take longer for each load to get dry.Grease build-up under the range hood – Check out the stove at your site. Bend down and look up under the range hood and you are likely to find a build-up of grease. In the event of a small flame up on the stovetop, that grease build-up could ignite and cause a house fire. It should be checked and cleaned at least once per month.Faulty cords or plug-ins – If you have outlets at the site that are not working, only hold the plugs very loosely, or seem faulty in any other way, report the concern to maintenance. Also, if there are any cords that are frayed or have any wires showing, they must also be repaired. Keep cords tucked away so they are not in areas where they can get stepped on, have things set on top of them, etc. That extra wear can cause the cord to fray or break. Faulty cords and plug-ins can be the cause of an electrical fire. Lamps and light bulbs – An incandescent light bulb burns at between 212 degrees and 572 degrees depending on the wattage. Wool can ignite at 442 degrees; cotton can ignite at 482 degrees. Even a 40 watt bulb can generate enough surface heat to ignite fabric or plastic. All light bulbs need to have some sort of cover – a lampshade, a glass fixture, etc. Lamps should never be placed where they could easily be tipped over. Never put light bulbs in that have higher than the recommended wattage for that particular fixture.Pile up of Stuff – Is there a room at the house or a spot in the garage that collects lots of junk? Stacks of newspapers or recycling can create an increased fire risk. Make sure the recycling and garbage gets taken care of so it does not build up. Clear out clutter from areas. Take advantage of Spring Clean Up days and other city-wide events to get rid of unused or damaged items.Too much plugged in – Extension cords or plug adapters to add more plug-ins are not acceptable in our sites due to the county licensing standards. Plugging too many items in to one outlet can cause the circuit to overload. Make sure that only surge strips are being used, not extension cords – and you cannot plug one surge strip into another.Electrical equipment – Many of the Persons Served have video games, stereos, and other electrical equipment generate lots of heat. They need air space around them to keep them cool. Please check on these items in the Persons Served’ rooms to be sure they are being placed appropriately to allow some air flow so they do not overheat. It’s bad for the equipment, too, so if you explain that to the Person Served they will be more likely to cooperate with moving it if needed.Cell Phone Use and AvailabilityAs a Lead Counselor, you have been assigned a cell phone unless you have chosen to use your personal phone. The Resident Counselors should only be calling the Lead phone when there is an emergency, to notify them of an incident, or other urgent matters. If the staff is calling the phone for matters that are not urgent, you should instruct them to leave you a note at the house about it, talk with you the next day, or otherwise handle the situation. Talk through the situation with them if needed, ask them to tell you how they would handle things, and that may build their confidence and ability to make a decision on their own next time. The better you train the Resident Counselors at your site, the fewer phone calls and urgent matters you will have to address on your time off.Because of the nature of the Persons Served we support and the fact that we are providing a 24 hour service, it is essential that Resident Counselors can reach a supervisory staff when necessary. Lead Counselors are expected to answer the cell phone or return calls (those that require a return call) within 15 minutes. If there is a time when you know you will be unable to answer your phone for a period of time, you must notify the Program Coordinator so we can ensure that someone is available in case of an emergency.Zumbro House allots one hour of time spent answering/returning calls on the Lead Counselor phone outside of your scheduled hours per week. Therefore, the Lead Counselor has to punch for at least 39 hours per week.Zumbro House offers lead counselors a monthly stipend for use of their personal cell phone for work purposes.Contact your Program Coordinator if you are having any trouble with the phone not working correctly.Required Employment PostingsWe are required by law to have several employment information posters up in an area of the house where staff can access them. The required postings are as follows:Employee Rights and Responsibilities Under the Family and Medical Leave ActMinnesota Workers’ Compensation – Employee rights and responsibilitiesSafety and Health Protection on the Job (OSHA)Minimum Wage (Minnesota Department of Labor and Industry)Know Your Rights Under Minnesota Laws Prohibiting Age DiscriminationUnemployed? – You have the right to apply for Unemployment BenefitsJob Safety and Health – It’s the LawEqual Employment Opportunity is The LawEmployee Rights Under the Fair Labor Standards Act (Federal Minimum Wage)If you are missing any of the postings, please contact Human Resources and they can supply you with a new posting. It is your responsibility to ensure that your house has all required postings at all times.Zumbro House Vehicle MaintenanceLead Counselors must pay attention to the general maintenance of the house vehicle. Since you are in the vehicle much more often than your supervisor, it makes sense for the Lead to take responsibility for van maintenance. Be mindful that we need our vehicles to be safe for the Persons Served as well as for the safety of the staff driving them. Do not let van maintenance concerns go unreported or unaddressed.Oil changes are recommended every 5 months or every 5,000 miles, whichever comes first. Please watch for oil change deals or coupons to get the best price possible. Contact your Program Coordinator to let them know when you are taking the van in for any type of maintenance or repair. Any major repairs will be approved by Chris and can likely be paid for over the phone from the office. These major repairs will not count against your monthly house budget. Smaller items, such as wiper blades or a bottle of oil will be purchased with your company credit card and therefore would be part of your monthly budget.For van maintenance questions, it is preferable that you contact the Zumbro House Maintenance Coordinator to get his opinion. Then contact the Program Coordinator if it is determined that repairs are necessary.Lead Counselor ChecklistsThe Lead Counselor Weekly Checklist is to be completed and turned in with the Monthly Paperwork to the Woodbury Office. The form can be found on the Management Only page of the website. This checklist can be used as a reminder of some tasks that need to be completed each week and a way for you to take credit for some of the checking that you do.Regarding the staff schedule section, write down open shifts or staffing needs that you are aware of coming up. For example, maybe you know that three weeks from now you are going to have a full time staff on vacation and need a plan to fill those hours. Take note that writing the shifts down on this checklist does not make them the Program Coordinator’s responsibility to fill. They may be able to offer you some ideas and help, but it is the Lead Counselor’s responsibility to manage the schedule.Under the Medication Errors section, record the dates when you reviewed the medication administration sheets for errors or holes in the documentation. Verify that there is a Medication/Treatment Discrepancy Form completed for any error or any missing documentation.In the Finance section, you are initialing that you have balanced and accounted for all Person Served funds. Any discrepancies must be reported to the Program Coordinator right away. If it is the time of the month for reconciling checkbooks, you should record that as well.For the Resident Counselor Checklists section, you will notice that there are places to record the dates that you have done your spot checks. Remember, Inspect what you Expect. There is also an area to record that you have received the Primary Counselor Checklists. Holding the Resident Counselors accountable for those will make your job easier.Under Miscellaneous Responsibilities, you will notice there is a place to record the date of last drill. Make sure this is filled in when you turn the form in to your Program Coordinator.Please do not wait to communicate problems, questions, or concerns to the Program Coordinator until you turn in this checklist – this form is not meant to take the place of communication. As mentioned above, this checklist can be used as a reminder of some tasks that need to be completed each week and a way for you to take credit for some of the checking that you do.Reviewed: 12-2015 ................
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