23. IM4Q staff do not ask Staff or Family If the interviewer does not have access to the ISP prior to Yes the interview, they should not ask the individual. No Are staff able to identify Interviewer to discuss with Staff/Family: Tell me about any NA, no risk mitigation is needed what risk mitigation special health and safety needs for this person. What is Don’t know, no response, unclear response or person does not strategies should be your role to support these needs? The intent is evaluate if communicate using words – please describe: implemented for each risk staff/family can describe the person's specialized health factor? and safety needs in the ISP and their role in support of Narrative in addition to the initial response: those the needs, if appropriate (e.g., specialized diet; food prep; positioning; medication; mobility; allergies). 24. Do you get to decide your Person and/or Interviewer should as the person who decides your daily Person decides daily schedule (like when staff schedule (like when to get up, what you do each day, when Person has help deciding, to get up, what you do to go sleep)? Someone else decides each day, when to go Don’t know, no response, unclear response or person does not sleep)? Capture staff responses separately- who decides this communicate using words – please describe: person's daily schedule (like when to get up, what you do each day, when to go sleep)? Ask them to provide Capture Staff answer separately examples and note. Ask within the context of the Person decides environment. Person has help deciding, Someone else decides Don’t know, no response, unclear response or person does not communicate using words – please describe: 25. Do you have a place to be Person Interviewer should ask the person if they have alone time if Yes alone in your home (can they want to have time to themselves. No you have time to NA, lives alone or is under 18 yourself)? Here we are looking at privacy (e.g. going in a room and Don’t know, no response, unclear response or person does not closing the door), not the person’s need for supervision communicate using words – please describe: (e.g. staying home alone).
23. IM4Q staff do not ask Are staff able to identify what risk mitigation strategies should be implemented for each risk factor? Staff or Family If the interviewer does not have access to the ISP prior to the interview, they should not ask the individual. Interviewer to discuss with Staff/Family: Tell me about any special health and safety needs for this person. What is your role to support these needs? The intent is evaluate if staff/family can describe the person's specialized health and safety needs in the ISP and their role in support of those the needs, if appropriate (e.g., specialized diet; food prep; positioning; medication; mobility; allergies). Yes No NA, no risk mitigation is needed Don’t know, no response, unclear response or person does not communicate using words – please describe: Narrative in addition to the initial response: 24. Do you get to decide your daily schedule (like when to get up, what you do each day, when to go sleep)? Person and/or staff Interviewer should as the person who decides your daily schedule (like when to get up, what you do each day, when to go sleep)? Capture staff responses separately- who decides this person's daily schedule (like when to get up, what you do each day, when to go sleep)? Ask them to provide examples and note. Ask within the context of the environment. Person decides Person has help deciding, Someone else decides Don’t know, no response, unclear response or person does not communicate using words – please describe: Capture Staff answer separately Person decides Person has help deciding, Someone else decides Don’t know, no response, unclear response or person does not communicate using words – please describe: 25. Do you have a place to be alone in your home (can you have time to yourself)? Person Interviewer should ask the person if they have alone time if they want to have time to themselves. Here we are looking at privacy (e.g. going in a room and closing the door), not the person’s need for supervision (e.g. staying home alone). Yes No NA, lives alone or is under 18 Don’t know, no response, unclear response or person does not communicate using words – please describe:
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