Score at this level when 3 of at this level when 2 Score at this level when 1 at this level when 0 0 the components in this of the components in this of the components in this of the components in this Does the goal 1 section are covered. section are covered. section are covered. section are covered. further connect 2 the person to Mark all included in the Community Inclusion Plan: 3 their 1. The individual has opportunities to participate in and contribute to their activity or activities to the community and best of their ability. expand the circle of 2. The individual is supported to expand their circle of support which includes others who are not paid support? to provide support. 3. The individual is supported to pursue multiple opportunities for community connections if desired. The action steps of the plan support this. Action Steps 7 Points 6 Points 5 Points 4 Points 3 Points 2 Points 1 Point 0 Points Score Comments and Supports
Does the goal further connect the person to their community and expand the circle of support? The action steps of the plan support this. Score at this level when 3 of the components in this section are covered. at this level when 2 of the components in this section are covered. Score at this level when 1 of the components in this section are covered. at this level when 0 of the components in this section are covered. 0 1 2 3 Mark all included in the Community Inclusion Plan: 1. The individual has opportunities to participate in and contribute to their activity or activities to the best of their ability. 2. The individual is supported to expand their circle of support which includes others who are not paid to provide support. 3. The individual is supported to pursue multiple opportunities for community connections if desired. Action Steps and Supports 7 Points 6 Points 5 Points 4 Points 3 Points 2 Points 1 Point 0 Points Score Comments
Community%20Inclusion%20Plan%20Quality%20Review%20Tool%202018.docx