10.002 If the provider is responsible for providing Non-Medical Transportation, does the vehicle have a fire extinguisher? 5123:2-9-18 10.003 If the provider is responsible for providing Non-Medical Transportation, does the vehicle have a first aid kit? 5123:2-9-18 10.004 If the provider is responsible for providing Wheelchair ramp/ties; windshield transportation, do all vehicles used to wipers/washer; mirrors; horns; brakes; transport individuals have all required emergency equipment; and tires inspections? vehicle inspections Annual vehicle inspection by the state highway patrol or certified mechanic. 5123:2-9-18 10.005 If the provider is responsible for providing Per-Trip Billing: Type of Vehicle transportation, are they using the 1) A non-medical vehicle with a capacity correct type of vehicle for the service they are of 9 passengers or more, excluding the billing? driver 5123:2-9-18 OR 2) A modified vehicle designed to transport individuals wheelchairs (with safety restraints for wheelchairs, stable ramp or lift and daily inspection of lift, ramp and restraints 10.006 Does the facility have policies and procedures LICENSED FACILITY ONLY Licensed regarding vehicle accessibility, vehicle No set format for policies and procedures Facility maintenance, and requirements for vehicle Only drivers? 5123:2-3-04 SECTION 11 PHYSICAL ENVIRONMENT – Question # Question Guidance/Additional Information Compliant Plan of Correction
10.002 If the provider is responsible for providing Non-Medical Transportation, does the vehicle have a fire extinguisher? 5123:2-9-18 10.003 If the provider is responsible for providing Non-Medical Transportation, does the vehicle have a first aid kit? 5123:2-9-18 10.004 If the provider is responsible for providing transportation, do all vehicles used to transport individuals have all required inspections? vehicle inspections Annual vehicle inspection by the state highway patrol or certified mechanic. 5123:2-9-18 Wheelchair ramp/ties; windshield wipers/washer; mirrors; horns; brakes; emergency equipment; and tires 10.005 If the provider is responsible for providing transportation, are they using the correct type of vehicle for the service they are billing? 5123:2-9-18 Per-Trip Billing: Type of Vehicle 1) A non-medical vehicle with a capacity of 9 passengers or more, excluding the driver OR 2) A modified vehicle designed to transport individuals wheelchairs (with safety restraints for wheelchairs, stable ramp or lift and daily inspection of lift, ramp and restraints 10.006 Licensed Facility Only Does the facility have policies and procedures regarding vehicle accessibility, vehicle maintenance, and requirements for vehicle drivers? 5123:2-3-04 LICENSED FACILITY ONLY No set format for policies and procedures SECTION 11 – PHYSICAL ENVIRONMENT Question # Question Guidance/Additional Information Compliant Plan of Correction
004-AGENCY-TOOL-10.1.17.docx