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["ISSP Initial QA"]
["Consumer Name:"]
["IP Date:"]
["IP Outcome:"]
["Date of Review: "]
[null,null,"N/A"]
["RESET THIS SHEET?"]
[]
["What type of plan is it? (select one from list)"]
["Support ISSP","Training ISSP","Behavioral Support","Behavioral Training"]
["General ISSP Regulations","Yes or no (or N/A)","NOTES/ FOLLOW-UP ACTION","Follow-Up Action Completed?"]
["Does the goal statement on the IP exactly match the outcome on the plan?"]
["Is the agency name listed at the top of the plan?"]
["Is the date of IP correctly listed on the plan?"]
["Does the Start Date of plan match the effective start date of IP?"]
["Does the End Date of plan match the effective end date of IP?"]
["Was the plan written prior to the effective start date of IP?"]
["Was baseline data accumulated over a period of at least 10 days for ISSP or 14 days for IBSSP?"]
["Does the baseline data indicate specific dates data was taken?"]
["Does the baseline accurately relate to Criteria for Effectiveness?"]
["Does the Objective make sense in relation to the goal?"]
["Is the Objective measurable, realistic and achievable with training?"]
["Is the Objective written in the most positive terms possible?"]
["Is the methodology detailed such that it could easily guide support staff in exact steps to take to ensure success for the consumer?"]
["Is a special protocol required to provide this training?"]
["Is the special protocol attached to the plan?"]
["If Extra Supports are identified, are they specific to consumer?"]
["Does the frequency of training/support match the IP?"]
["Is the Criteria for Effectiveness realistic and measurable?"]
[]
["Training Plan (TP)","Yes or no (or N/A)","NOTES/ FOLLOW-UP ACTION","Follow-Up Action Completed?"]
["Does the Objective indicate an increase in skill/ability level?"]
["For ISSP, does the Criteria for Effectiveness indicate that consumer will increase skill/ability?"]
["For IBSSP, does the Criteria for Effectiveness indicate that the Targeted Behavior will decrease?"]
["Does the Baseline data allow for an increase in ability?"]
["Does the current training objective reflect a natural progression of skill/ability, building on previous skill? "]
[]
["Support Plan (SP)","Yes or no (or N/A)","NOTES/ FOLLOW-UP ACTION","Follow-Up Action Completed?"]
["Does the objective indicate that the consumer will maintain ability?"]
["For ISSP, does the Criteria for Effectiveness indicate that consumer will maintain skill/ability level?"]
["For IBSSP, does the Criteria for Effectiveness indicate that the Targeted Behavior will not increase?"]
["Is there no evidence (through tracking, progress notes or observation) to indicate that a Training Plan would be more effective?"]
[]
["Individual Behavioral Service/Support Plan (IBSSP)","Yes or no (or N/A)","NOTES/ FOLLOW-UP ACTION","Follow-Up Action Completed?"]
["Is the Date of CLR or ELP filled in and does it reflect the most recent update?"]
["Is the Date of Functional Analysis (FA) filled in and does it reflect the most recent update?"]
["Do the main points listed from CLR reflect only the behavior being addressed in the Plan?"]
["If the consumer has a Restrictive Procedure or Psychotropic Medications, are Informed consent(s) signed, and are current dates listed on IBSSP?"]
["Is the Psychiatric Diagnosis current (if applicable)?"]
["Are Targeted Behaviors described in objective, observable and measurable terms?"]
["Are only Targeted Behaviors to be addressed in the Plan listed?"]
["Are “Environments Behavior is Most Likely to Occur”  specific and include antecedents (if any are identified)?"]
["Does the Baseline data reflect the consumer’s abilities prior to intervention?"]
["Is baseline data present for each Targeted Behavior?"]
["Do the severity of Behaviors indicate frequency, duration and intensity (if applicable)?"]
["Is the objective written in measurable terms?"]
["Do Replacement Activities indicate what activities may be used to replace a Targeted Behavior when it is exhibited?"]
["Do Proactive Procedures indicate methods that can be used when a Targeted Behavior is not present?"]
["Do Environmental Changes indicate changes, adaptations or additions identified to increase likelihood of consumer success?"]
["Are Environmental Changes to avoid (those that may increase the behavior) described, if applicable?"]
["Do Reactive Methods indicate methods of intervention when a Targeted Behavior is present?"]
["Are Reactive Methods are written in positive, respectful terms?"]
["Are Therapies/Medications used  current?"]
["If applicable, are Restrictive Procedures noted in the IBSSP?"]
["Does the IBSSP indicate criteria for having the Restrictive Procedure(s) removed?"]
["If applicable, are Suspensions of Rights noted in the IBSSP?"]
["Does the IBSSP indicate criteria for having the Suspension(s) of Rights removed?"]
["If applicable, is the Safety Control Procedure noted in the IBSSP?"]
["If applicable, is the Safety Control Procedure itself separate from the IBSSP?"]