"Alf Core Training Provider Monitoring Tool" - Florida

This fillable "Alf Core Training Provider Monitoring Tool" is a document issued by the Florida Department of Elder Affairs specifically for Florida residents.

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Download "Alf Core Training Provider Monitoring Tool" - Florida

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ALF Core Training Provider Monitoring Tool
This monitoring tool is designed to be used in conjunction with DOEA Form ALFCT-001, June 2009; Rule 58T-1.205, F.A.C.;
Section 429.52, F.S.; and Rule 58A-5.0191, F.A.C.
***OBTAIN A LIST OF ALL PRESENT ATTENDEES WITH CONTACT INFO FOR FOLLOW-UP QUESTIONNAIRE***
Provider Name:
Reviewed By:
Registration #:
Date(s):
Location:
Followup Onsite:
PART I: CURRICULUM
Yes/No
Module 1: General License Activity: Curriculum Describes, Defines, and Explains the Following:
1.1
"Assisted Living Facility" (ALF)
1.2
The purpose and intent of ALFs
Difference in standard ALF license and specialty licenses of extended congregate care (ECC), limited
1.3
mental health (LMH), and limited nursing services (LNS)
1.4
How to apply for an initial ALF license
1.5
How often and where to apply for license renewal
1.6
Actions needed in case of transfer/change of ownership, facility closure, or change of administrator
1.7
"Licensed capacity"; The need to operate within established capacity
1.8
ALF advertising regulations
NOTES:
Yes/No
Module 2: Administration of an Assisted Living Facility
Minimum requirements for ALF administrator, maintaining administrator credentials, and
2.1
administrator's responsibilities
2.2
The need for the facility's fiscal stability; actions required in cases of fiscal instability
2.3
Guidelines for handling resident finances and property
2.4
Minimum staffing requirements; how to calculate
2.5
Background screening requirements
Mandatory staff in-service training including, but not limited to, infectious diseases, resident rights
2.6
and abuse, HIV/AIDS, CPR and first aid, and training documentation.
2.7
"Adverse incident" - how to report it
Physical plant standards, including, but not limited to, building code compliance, minimum space,
2.8
temperatuer, and furnishing requirements
Compliance with local regulatory agencies (i.e. health department and dire authority), dire and
2.9
elopement standards and drills, evacuation capability
Components of comprehensive emergency management plan/disaster preparedness, where to submit
2.10
plan, how often to review it
2.11
Uniform fire safety standards for ALFs
NOTES:
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ALF Core Training Provider Monitoring Tool
This monitoring tool is designed to be used in conjunction with DOEA Form ALFCT-001, June 2009; Rule 58T-1.205, F.A.C.;
Section 429.52, F.S.; and Rule 58A-5.0191, F.A.C.
***OBTAIN A LIST OF ALL PRESENT ATTENDEES WITH CONTACT INFO FOR FOLLOW-UP QUESTIONNAIRE***
Provider Name:
Reviewed By:
Registration #:
Date(s):
Location:
Followup Onsite:
PART I: CURRICULUM
Yes/No
Module 1: General License Activity: Curriculum Describes, Defines, and Explains the Following:
1.1
"Assisted Living Facility" (ALF)
1.2
The purpose and intent of ALFs
Difference in standard ALF license and specialty licenses of extended congregate care (ECC), limited
1.3
mental health (LMH), and limited nursing services (LNS)
1.4
How to apply for an initial ALF license
1.5
How often and where to apply for license renewal
1.6
Actions needed in case of transfer/change of ownership, facility closure, or change of administrator
1.7
"Licensed capacity"; The need to operate within established capacity
1.8
ALF advertising regulations
NOTES:
Yes/No
Module 2: Administration of an Assisted Living Facility
Minimum requirements for ALF administrator, maintaining administrator credentials, and
2.1
administrator's responsibilities
2.2
The need for the facility's fiscal stability; actions required in cases of fiscal instability
2.3
Guidelines for handling resident finances and property
2.4
Minimum staffing requirements; how to calculate
2.5
Background screening requirements
Mandatory staff in-service training including, but not limited to, infectious diseases, resident rights
2.6
and abuse, HIV/AIDS, CPR and first aid, and training documentation.
2.7
"Adverse incident" - how to report it
Physical plant standards, including, but not limited to, building code compliance, minimum space,
2.8
temperatuer, and furnishing requirements
Compliance with local regulatory agencies (i.e. health department and dire authority), dire and
2.9
elopement standards and drills, evacuation capability
Components of comprehensive emergency management plan/disaster preparedness, where to submit
2.10
plan, how often to review it
2.11
Uniform fire safety standards for ALFs
NOTES:
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ALF Core Training Provider Monitoring Tool
Yes/No
Module 3: Records
3.1
Components of resident records
3.2
Requirements for staff and facility records; record retention
NOTES:
Yes/No
Module 4: Residency Cycle
4.1
ALF resident admission criteria
Components of admission package (i.e. promotional brochure, copy of contract)
4.2
4.3
Resident health assessment requirements and timeframe
Continued residency and exemptions (i.e. hospice resident)
4.4
4.5
Admission requirements for mental health residents
Requirements for the involuntary examination/hospitalization for mental illness
4.6
4.7
Discharge criteria
4.8
Contribution solicitation prohibition regarding residents supported by state funds
4.9
Facility responsbility in the case of facility closure
NOTES:
Yes/No
Module 5: Food Service
5.1
Responsibilities regarding the appointment of a food services supervisor
5.2
Food services in-service training and continuing education requirements; how to document training
5.3
Dietary standards for regular and special diets, therapeutic diet orders; responsibility to meet resident
dietary needs
5.4
Menu planning and requirements, menu accessibility to residents, and keeping menu records
5.5
Regular and therapeutic menu review process
Meal spacing, food presentation and temperature, assistance with eating, use of catered services and
5.6
availability of snacks
5.7
standards applying to food handling, storage, and sanitation guidelines, including dishwashing
Facility responsibility and requirements when residents refuse therapeutic diets
5.8
5.9
Requirements and the purpose of maintaining a non-perishable food supply
Conditions warranting the services of a dietary consultat and documentation standards
5.10
5.11
Methods to correct deficiencies related to dietary standards
NOTES:
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ALF Core Training Provider Monitoring Tool
Yes/No
Module 6: Medication Management
6.1
Facility responsibility regarding medication
6.2
Medication administration responsibility
6.3
Identification of staff and other persons that are qualified in various medication practices
6.4
Activities in providing assistance with self-administration of medication
Residents experiencing problems with self-administration of medication
6.5
Training requirements for persons providing assistance with self-administered medication and how to
6.6
document this training
6.7
Medication records, record keeping, storage and disposal requirements
Correct medication labeling and medication orders
6.8
6.9
Rules regarding OTC and sample prescription medications
The use of medicines as chemical restraints
6.10
Conditions warranting the services of a licensed pharmacist andnursing consultant; documentation
6.11
standards
6.12
Methods to correct deficiencies in medication practices
NOTES:
Yes/No
Module 7: PERSONAL CARE AND SERVICES
Demonstrate knowledge of the meaning of activities of daily living (ADLs), personal services, and
7.1
assistance with ADLs.
Demonstrate knowledge of the scope of ALF responsibilities in providing personal care services.
7.2
7.3
Demonstrate knowledge of the activities program requirements.
NOTES:
Yes/No
Module 8: SPECIAL NEEDS POPULATION (ALZHEIMER’S DISEASE, MENTAL HEALTH, HOSPICE)
Define mental disorder and mental health resident as applicable to the ALF regulations.
8.1
Demonstrate an understanding of the ALF’s responsibilities for meeting the needs of mental health
8.2
residents.
8.3
Demonstrate knowledge of the special requirements regarding care for hospice residents.
8.4
Demonstrate knowledge of Alzheimer's disease advertising disclosures.
Demonstrate knowledge of the special staffing and training requirements regarding care for
8.5
Alzheimer's residents and how to document this training.
Demonstrate knowledge of the special training requirements for LMH, ECC, and Alzheimer’s disease
8.6
and related disorders (ADRD) staff.
NOTES:
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ALF Core Training Provider Monitoring Tool
Yes/No
Module 9: RESIDENT RIGHTS
9.1
Demonstrate knowledge of the resident bill of rights.
9.2
Identify the ways for residents to file complaints; identify entities available for residents' advocacy and
ways to inform residents about them.
9.3
Demonstrate knowledge of the civil actions that may be taken to enforce rights.
9.4
Demonstrate knowledge of the statutes and rules regarding availability of third party services.
9.5
Demonstrate knowledge of the conditions allowing residents to work in the facility.
Demonstrate knowledge of the mandatory abuse, neglect, and exploitation reporting requirements
9.6
for ALF staff.
9.7
Demonstrate knowledge of the standards applying to the use of physical restraints.
9.8
Demonstrate knowledge and understanding of surrogate decision makers for residents, including
guardianship, in order to protect the health, safety and welfare, including financial resources, of
residents.
9.9
Demonstrate knowledge and understanding of the facilities policies and procedures regarding advance
directives and do not resuscitate orders.
NOTES:
Yes/No
MODULE 10: ENFORCEMENT ACTIVITIES
Demonstrate knowledge of the state departments and other entities that have the authority to
10.1
conduct inspections, the type of inspections, and under what circumstances.
10.2
Demonstrate knowledge of the types of sanctions that could be imposed on the facility.
10.3
Demonstrate knowledge of the penalties for operating without a license.
10.4
Demonstrate knowledge of the penalties for altering facility records.
10.5
Demonstrate knowledge of injunctive proceedings and receivership proceedings.
Demonstrate an understanding of a moratorium on admissions and the facility's responsibilities during
10.6
a moratorium.
Define prohibited advertising and offering of services, as well as demonstrate knowledge of applicable
10.7
penalties.
10.8
Demonstrate knowledge of the penalties for withholding evidence of financial instability.
NOTES:
PART 2: RECORDS
Yes/No
RECORD COMPONENTS
Provider maintains records for minimum of 5 years for each course taught.
Records include title of the training program.
Records include agendas.
Records include the complete curriculum, accompanying documentation, and training aides.
Records include the training provideer's name and registration number.
Records incude the trainees' names, dates of participation, training location,
Records include training evaluations and roster signed by trainees.
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ALF Core Training Provider Monitoring Tool
NOTES:
PART 3: COMPETENCY EXAM
Yes/No
Provider submits names of trainees completing core training to the testing authority within 10 calendar days after
the completion of the course.
PART 4: GUEST SPEAKERS
Yes/No
Provider ensures that guest speakers possess expertise in the specific subject matter.
Provider ensures that guest speakers cover all components of the subject matter if he or she provides the module
or portion of the module instruction.
PART 5: CERTIFICATES
Yes/No
Provider issues certificates to trainees that successfully complete core trianing.
Certificates include title of the training program.
Certificates include subject matter of the training program.
Certificates include training program agenda.
Certificates include number of hours of the training program.
Certificates include trainee's name, dates of participation, and location of the training program.
Certificates include the training provider's name, dated signature, credentials, and professional license number, if
applicale.
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