1 2 3 0 Standard Satisfactory Excellent Unsatisfactory Does not meet all required / Score Meets current / lasting standards Exceeds current standards Major revision recommended lasting standards - Moderate ACCEPTABLE PRACTICE BEST PRACTICE revision recommended Requirement 0 Points 1 Point 2 Points 3 Points Score Score at this level if missing 2 IISP includes the or more of required Score at this level if missing 1 Score at this level if all individual’s first & last components Score at this level if required of required components required components AND name, legal OR components can be found in (aside from those in blue are included in plan in a clear, representative, date of Required items may be in plan font) easy-to find manner the ISP, date of the IISP another plan, but it was not (must be reviewed at submitted least every 6 months) Mark all that apply: and the preparer’s The individual’s first and last name is listed printed name and date The name of the legal representative (guardian) is listed or it is indicated person does not have guardian The ISP date is listed The preparer’s printed name is listed The date the IISP was developed or revised is listed The date the IISP is no older than 6 months Requirement 0 Points 1 Point 2 Points 3 Points Score Score at this level if the IISP IISP includes a list of includes evidence of the individuals that Score at this level if there is individual’s participation and Score at this level if the plan participated in the IISP evidence that the person involvement (or notes of is missing reference to development, and Score at this level if the plan participated and the plan is attempt to involve) guardian participation of individual written agreement of does not include references to individualized to their (if applicable) and non-agency and guardian, OR missing the individual/legal rep participation or signatures of preferences; AND the plan staff AND includes signatures individual’s / legal individual or guardian. includes signature of individual of individual /legal rep representative’s signature (if and their legal representative Evidence could include a list, applicable) (if applicable) or notes on who contributed AND a plan individualized to the person’s preferences
Score 0 Unsatisfactory Major revision recommended 1 Standard Does not meet all required / lasting standards - Moderate revision recommended 2 Satisfactory Meets current / lasting standards ACCEPTABLE PRACTICE 3 Excellent Exceeds current standards BEST PRACTICE Requirement 0 Points 1 Point 2 Points 3 Points Score IISP includes the individual’s first & last name, legal representative, date of the ISP, date of the IISP (must be reviewed at least every 6 months) and the preparer’s printed name and date Score at this level if missing 2 or more of required components OR Required items may be in another plan, but it was not submitted Score at this level if missing 1 of required components (aside from those in blue font) Score at this level if required components can be found in plan Score at this level if all required components AND are included in plan in a clear, easy-to find manner Mark all that apply: The individual’s first and last name is listed The name of the legal representative (guardian) is listed or it is indicated person does not have guardian The ISP date is listed The preparer’s printed name is listed The date the IISP was developed or revised is listed The date the IISP is no older than 6 months Requirement 0 Points 1 Point 2 Points 3 Points Score IISP includes a list of individuals that participated in the IISP development, and written agreement of individual/legal rep Score at this level if the plan does not include references to participation or signatures of individual or guardian. Score at this level if the plan is missing reference to participation of individual and guardian, OR missing the individual’s / legal representative’s signature (if applicable) Score at this level if there is evidence that the person participated and the plan is individualized to their preferences; AND the plan includes signature of individual and their legal representative (if applicable) Score at this level if the IISP includes evidence of the individual’s participation and involvement (or notes of attempt to involve) guardian (if applicable) and non-agency staff AND includes signatures of individual /legal rep Evidence could include a list, or notes on who contributed AND a plan individualized to the person’s preferences
Draft%20IISP%20Rubric%20for%20Quality%20Review.docx