Individual Service & Support Advocacy (ISSA) Visiting Notes Interpretive Guidelines

  1. This person's space, privacy and confidentiality appear to be respected.
    • Own/shared room - decorated personally, space in room.
    • Personal possessions are found - TV, VCR, etc., so their room is a retreat (if desired)
    • Individual closet space is available.
    • Privacy in bathing bathroom.
    • Releases in file.
    • Staff knocking if other clients just walked in.
    • Confidentiality - people can open own mail.
    • No discussion of others in front of people.
    • No individual information posted on walls.
    • Any space available to be by themselves.
    • Shower curtains.
    • Enough furniture.
    • Personal property is respected.
  2. The setting of the visit appears to be safe and clean.
    • No dangerous utensils were observed in kitchen area.
    • There appears to be adequate lighting - stairways.
    • There are handrails in bathroom, if needed.
    • Bathroom and kitchen appears to be clean and odor-free, no foul odor, no bugs.
    • Furniture is in good condition.
    • Adaptive equipment is available, if needed.
    • There are clear walkways, lack of clutter.
    • Appropriate staff support per Individual Service Plan (ISP).
    • Smoke alarms, fire extinguishers working.  Fire exits are clear.
    • Cleaning products are stored safely.
    • Electrical outlets are not overloaded.
    • Clean bathrooms, no water on floors.
    • Outside appearance is good, sidewalks are shoveled, yard is kept well.
  3. The person appears to have the opportunity to interact with those he/she chooses and relationships appear to be supported.
    • If there is a boyfriend, girlfriend, friends, family members, they have the opportunity to talk on the phone with them.
    • How often they see family and friends.
    • How often they go with friends into the community.
    • Look at the ISP to see who is involved, records of family contact.
    • Ask: Do you have opportunities to spend time with other people?
    • Ask: What people do you do things with and how do you do it.
    • Ask: Do you call others and visit, do they call you and visit.
    • Ask how an intimate relationship is supported.
    • Look in the ISP for development of friendships and acquaintances.
    • Look for documentation of opportunities for visits.
    • Do people know their neighbors?
    • Do people have opportunities to go to church or other socials groups, if desired.
  4. The person appears to have a positive relationship with those who support and work with him or her.
    • Check done or written material.
    • Observe interactions with support staff, tone of voice, are interactions comfortable and relaxed.
    • Positive interactions, respect, able to joke around, comfortable.
    • Ask: what kinds of things staff do with and for them, are they satisfied.
    • Ask if person is having problems with anyone.
    • Basic casual conversations (not just telling people what to do).
    • Review progress/communication logs and see how people are discussed or referred to.
  5. The person appears to have the opportunity to express opinions and desires and to feel that he or she has been listened to.
    • Are there house meetings with other residents and staff.
    • ISP - look for individual response/documentation.
    • Ask: who do you talk with about problems.
    • Ask staff how they know what people who are nonverbal are telling them.
    • Observations of their interactions.
    • Wants and needs are being met.
    • People are given the opportunity to vent like everyone else.
    • Staffings: do staff ask what peple want and is it put into the ISP.
  6. The person appears to be given the chance to make choices in daily activities.
    • Very difficult if nonverbal, unless there is a specific goal in the ISP.
    • Ask individuals what they want to do and how they decided.
    • Observe what is going on.
    • What happens if you don't want to do something, is it okay to refuse.
    • Choice of job or activity.
    • Who selects what you wear, what time do you get up and what time do you go to bed.
    • With whom do they live and share a room?
  7. The person appears to be provided with opportunities to learn new skills in natural settings.
    • Look at what people are doing and where, does it make sense?
    • Look at programs, i.e., are they diong money skills in a restaurant?
    • Observe if they are doing activities that are new and different.
    • Do people appear to be asked what they want to do, is there an indication that they are taken places or shown things that they currently don't know?
  8. The person appears to be able to access the community with supports as desired.
    • Do you do some of the things you want to do.
    • When you go out, what kinds of things do you do?
    • Do they go on outings alone or in large groups.
    • Adequate transportation appears to be available.
    • Look at documentation of activities.
    • Ask if they like where they are going and if they liked what they were doing.
    • Staff support is available.
    • Record review.  Where are people going?
    • Ask staff and person about what has been done and further plans.
    • People get to take vacations.
    • People appear to have access to stores, banks, doctors of their choice.  These are not outings.
  9. The person appears to have access to spending money available for general purposes.
    • Do they have money in their wallet.
    • Do they have a checking or savings account.
    • Do they take money to workshops.
    • Who monitors the money.
    • Those on budgeting program may want more, but not available.
    • Money is accounted for entirely.
    • Able to purchase their own personal supplies, etc.
    • Own checking or savings account and timely access to the account.  Who are co-signers.
    • Budgeting is available as a choice.
    • Can carry money if they are able, or if not.  How do they get money if they want it.
    • Safe place for money.
    • Where does the spending money com from, SSI, paychecks?
  10. The person appears to be in good health.
    • Health appears to be stable.
    • No complaints voiced by individual.
    • Look at records, consult with staff.
    • Look for new medications or new diagnosis.
    • Ask person who they are feeling.
    • Look at person.
  11. The person's medical issues or concerns appear to be addressed in a respectful and timely fashion.
    • Review records
    • Talk with staff
    • Follow up appears to happen in a timely manner.
    • Ask:  Who do you go to if you don't feel well?
    • Ask:  Do you like your doctor?  How do they treat you?
    • Ask staff how they know if a person is is nonverbal may not feel well.
    • Proper screenings, i.e., women's exams, TD screens.
    • How are medical issues dealt with.
  12. Person appears to be well groomed and appropriately dressed.
    • Observation.
    • Individual is generally clean and well groomed.
    • Clothes are clean, the right size and belong to person.  Clothes are appropriate to weather and location.
    • Clean clothes are available and there is a place for dirty clothes.
    • Hair, nails and teeth are clean.
    • Absence of body odor.
  13. The person appears to be supported to engage in recreation and leisure activities of his or her choice.
    • Have you ever been on vacation?  What did you do?
    • Who chooses activities?
    • Can you watch TV, listen to music of choice, etc., when you wish?
    • Ask: what do you do for fun, how often, with whom?
    • Is there an acdtivity or even that you would really like to explore?
    • Do you visit new places?
    • Hobbies are supported.
  14. The ISP contains outcomes for the person based on his or her identified wants and needs.
    • Is there something identified that the person wants to do.
    • Does the person want to work on this.
    • Does the person want to learn to cook.
  15. It appears that services are being provided in accord with the ISP and progress toward the outcome is evident.
    • Look for documentation.
    • Ask individual if they are doing those things.
    • Ask and observe as to what is going on.
    • Staff are actively involved in activities, etc., aroundd the home in a positive manner.
  16. Overall, the person seems to be satisfied with his or her current plans and setting.
    • Ask:  do you like this house?  Do you like living here?
    • Ask: What goals are you working on?  Do you like the goals?
    • Ask: How do you like the people with whom you are living?
    • Is there anything you would like to change or do differently?