New Curriculum Form Orientation & Safety, Population Specific, Continuing Education (CE) Use this form when you developed your own curriculum (courses) for DSHS to approve as long-term care worker training. Community instructors, curriculum developers, and facilities use this form. Section 2: Curricula Submitted Total number of courses submitted: Total number of hours submitted: Course Materials: You must document the competencies and learning objectives you plan to meet with these Section 1: Training Program or Facility Information courses. For each learning objective, list where in the student materials it is covered. This may be pages in a student manual or other materials. It is a requirement that you send in a list of competencies and learning Date Submitter’s Name objectives. If you plan to enhance DSHS curriculum indicate where and what you are including as Training Program/ Submitter’s Phone ( ) - enhancements. (Please see example of completed course description below). Facility Name Document the competency expected from the student. Training Program # Submitter’s E-mail List the learning objectives required to meet that competency. AFH/ALF/ESF License # New Applicant Returning Applicant For each learning objective, indicate materials are covered. (You may be requested to submit these materials.) Repeat until you have listed all competencies and learning objectives for the course. . For Orientation and Safety please refer to the Example of Course Description: Course Title: Course Type: Delivery mode/modes: Check all that apply Navigating Challenging Orientation 5.5 Behaviors with the Dementia Classroom Safety Client Online Course Population Specific Webinar CE* No more than 24 class hours may be submitted. Summary Give a brief course description (a few sentences) of the main topic/subject areas to be covered. This course focuses on handling challenging behaviors. We will use the DSHS Navigating Challenging Behaviors curriculum and add a DVD and activities focusing on challenging behaviors and dementia.
New Curriculum Form Orientation & Safety, Population Specific, Continuing Education (CE) Use this form when you developed your own curriculum (courses) for DSHS to approve as long-term care worker training. Community instructors, curriculum developers, and facilities use this form. Section 1: Training Program or Facility Information Date Submitter’s Name Training Program/ Facility Name Submitter’s Phone ( ) - Training Program # Submitter’s E-mail AFH/ALF/ESF License # New Applicant Returning Applicant Section 2: Curricula Submitted Total number of courses submitted: Total number of hours submitted: Course Materials: You must document the competencies and learning objectives you plan to meet with these courses. For each learning objective, list where in the student materials it is covered. This may be pages in a student manual or other materials. It is a requirement that you send in a list of competencies and learning objectives. If you plan to enhance DSHS curriculum indicate where and what you are including as enhancements. (Please see example of completed course description below). Document the competency expected from the student. List the learning objectives required to meet that competency. For each learning objective, indicate materials are covered. (You may be requested to submit these materials.) Repeat until you have listed all competencies and learning objectives for the course. For Orientation and Safety please refer to the . Example of Course Description: Course Title: Navigating Challenging Behaviors with the Dementia Client Course Type: Orientation Safety Population Specific CE* No more than 24 class hours may be submitted. Delivery mode/modes: Check all that apply Classroom Online Course Webinar 5.5 Summary Give a brief course description (a few sentences) of the main topic/subject areas to be covered. This course focuses on handling challenging behaviors. We will use the DSHS Navigating Challenging Behaviors curriculum and add a DVD and activities focusing on challenging behaviors and dementia.
New%20Curriculum%20Request%20Form.docx