Individual Checklists for Course Coordinators

Not for use in Direct Support Person (DSP) training

Checklist G DSP Training Program Letter of Application (pdf) (IL462-1280) - Submitted by agencies adopting, in its entirety, the DHS standardized core training program.
Checklist H DSP Training Program Letter of Application (pdf) (IL462-1281) - Submitted by agencies requesting DHS approval of an agency-written training program or if a modified DHS standardized core training program.
Checklist I DSP Instructor Qualifications (pdf) (IL462-1282) - Submitted by agencies to obtain DHS approval of the qualifications of their DSP training program instructors.
Checklist J DSP Training Two-Year Review (pdf) (IL462-1283) - Submitted by agencies as part of the required two-year review of their DSP training program.
DSP Interventional Competencies Evaluation Form (pdf) (IL462-1284) - Submitted by agencies as part of the DSP training program approval process.
DSP Informational Competencies Evaluation Form (pdf) (IL462-1285) - Submitted by agencies as part of the DSP training program approval process.
DSP Core Competency Area Checklist (pdf) (IL462-1286) - Documentation for each DSP that they have demonstrated competency in all informational and interventional areas required of DSPs. This form is maintained in the individual's personnel or training file.
DSP Core Competency Verification (pdf) (IL462-1290) - Documentation to support assessment tests for each classroom module, completed OJTs and CBTAs or other Division-approved OJT. This form is maintained in the individual's personnel or training file.
Request for Waiver of DSP Training Requirements (pdf) (IL462-1291) - Request 30 day or 120 day waiver.
Illinois Healthcare Registry DSP Application Form (pdf) (IL462-1292) - Completed by agencies at the end of DSP training to add each DSP's training record to the Health Care Worker Registry. This form is maintained in the individual's personnel or training file.
DHS-Approved DSP On-the-Job Training (OJT) Activities and Competency-Based Training Assessments (CBTAs) (pdf) (IL462-1293) - Documentation to support assessment of completed OJTs and CBTAs or other Division-approved OJTs. This form is maintained in the individual's personnel or training file.