What is Most Important to Me:

Dependable staff

Taking medication as directed

Staff do not talk on their cell phone while working

Making my own choices

Getting a job in the community

Experience and learning job skills

My privacy-Keeping my personal life and home address private

Learn to read and write

What People Like and Admire Most About Me:

Take leadership in my ISP meeting

I stand up for myself and let people know what I want

Hard, dependable worker

Enjoy meeting new people

Let people know how I want to be supported

How to Best Support Me:

I take seizure medication

Provide purpose of medication

Make sure my meds are given correctly

I need help paying bills

Include me in any decisions being made about my life

I don’t trust easily

My Name is Brett

   

  

 

                                          

 

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t Me:

Pag

e 1

of 1

8

SD

S 4

118

(5/2

017)

Perso

n rec

eiving

servi

ces:

Glo

ria L

ouis

e A

mst

erda

mPl

an ef

fectiv

e date

s:06

/01/

2017

-05

/31/

2018

Indi

vidu

al S

uppo

rt P

lan

(ISP)

Perso

n's le

gal n

ame:

Glo

ria L

ouis

e A

mst

erda

mPr

eferre

d nam

e:G

lo Plan

effec

tive d

ates:

06/0

1/20

17–

05/3

1/20

18

One p

age p

rofil

e for

:My

life

Wha

t peo

ple l

ike an

d ad

mire

abou

t Glo

:- G

reat

sens

e of

hum

or, a

ble

to fi

nd th

e hu

mor

in ju

st a

bout

any

situ

atio

n - C

arin

g fr

iend

and

dev

oted

fam

ily m

embe

r, sh

e is

alw

ays t

here

for t

hem

whe

n th

ey n

eed

her

- She

kno

ws w

hat s

he w

ants

and

how

to g

et it

- sh

e in

spire

s us b

y he

r det

erm

inat

ion

and

inne

r stre

ngth

- V

ery

smar

t and

inte

llige

nt

- Her

pas

sion

for j

ustic

e, a

wes

ome

advo

cate

for o

ther

s - E

ye fo

r sty

le! S

he h

as g

reat

fash

ion

sens

e an

d pu

ts to

geth

er st

ylis

h ou

tfits

- S

he is

ver

y se

nsiti

ve a

nd h

as a

big

hea

rt, sh

e al

way

s kno

ws w

hen

som

eone

is n

ot fe

elin

g w

ell a

nd tr

ies t

o ch

eer t

hem

up.

Glo

ria lo

ves t

o se

e ot

hers

hap

py

Wha

t is i

mpo

rtant

to G

lo:

How

to b

est s

uppo

rt Gl

o:- H

er fa

mily

is n

umbe

r 1!

- Spe

ndin

g tim

e an

d re

gula

rly c

heck

ing

in w

ith fr

iend

s and

peo

ple

she

feel

s cl

ose

to

- Not

bei

ng u

nder

estim

ated

by

othe

rs a

nd b

eing

inde

pend

ent

- Bei

ng a

ble

to c

omm

unic

ate

with

oth

ers,

bein

g se

en a

s an

equa

l, be

ing

resp

ecte

d - H

avin

g st

aff w

ho c

an d

o he

r hai

r and

hel

p he

r pic

k m

atch

ing

outfi

ts -

Glo

ha

s to

look

goo

d!

- Fee

ling

safe

with

staf

f, be

ing

able

to tr

ust t

hem

- P

ictu

res o

f fam

ily a

nd fr

iend

s, es

peci

ally

old

pho

tos (

and

look

ing

at th

em

whe

n sh

e is

feel

ing

sad

or d

own)

- C

eleb

ratin

g ho

liday

s and

her

birt

hday

- H

avin

g m

oney

and

tran

spor

tatio

n so

she

can

do th

ings

- S

tayi

ng a

ctiv

e so

she

does

n't g

et b

ored

or d

epre

ssed

Kno

w a

nd fo

llow

Glo

ria's

plan

and

nur

sing

pro

toco

ls.

- Tak

e it

serio

usly

AN

Y T

IME

Glo

ria in

dica

tes s

he fe

els i

ll or

som

ethi

ng

hurts

. - A

lway

s tre

at h

er w

ith re

spec

t, es

peci

ally

with

priv

acy

- Use

her

com

mun

icat

ion

book

-- d

on't

assu

me

wha

t she

mig

ht sa

y,

ALW

AY

S as

k he

r. - B

e aw

are

that

she

is a

frai

d of

bei

ng d

ropp

ed a

nd g

ets n

ervo

us w

hen

she

is

bein

g tra

nsfe

rred

in th

e H

oyer

Lift

. - W

hen

Glo

ria se

ems d

epre

ssed

, lis

ten

with

out p

ress

ure

- In

gen

eral

, off

er h

er o

ptio

ns a

nd le

ave

the

deci

sion

-mak

ing

up to

her

.

Ind

ivid

ual

Su

pp

ort

Pla

n

On

e P

age

Pro

file

-1.1

5.1

5

Per

son

’s N

ame:

P

refe

rred

nam

e:

Ho

w t

o b

est

sup

po

rt

Thi

s se

ctio

n in

clud

es in

form

atio

n on

:

•

Wha

t is

help

ful?

Wha

t is

not?

•

Wha

t oth

ers

can

do to

hel

p th

is p

erso

n ha

ve m

ore

good

day

s an

d av

oid

bad

days

.

•

Spe

cific

are

as th

e pe

rson

wan

ts to

iden

tify

for

supp

ort.

For

exa

mpl

e, s

he m

ay b

e w

orki

ng o

n

bein

g be

tter

orga

nize

d an

d ha

ve s

peci

fic th

ings

that

othe

rs c

an d

o to

sup

port

her

.

•

The

hel

p th

is p

erso

n ne

eds

to c

reat

e th

e be

st

envi

ronm

ent a

nd o

utco

mes

for

her.

•

Be

posi

tive.

On

e P

age

Pro

file

fo

r:

location

A o

ne

pag

e p

rofi

le is

inte

nd

ed t

o o

ffer

a s

um

mar

y th

at p

eop

le in

th

e p

erso

n’s

life

can

u

se t

o g

et t

o k

no

w t

hem

qu

ickl

y o

r en

sure

th

at t

hey

are

pro

vid

ing

co

nsi

sten

t su

pp

ort

in

the

way

th

e p

erso

n w

ants

. T

he

info

rmat

ion

co

mes

fro

m t

he

per

son

’s p

ersp

ecti

ve. C

om

ple

te t

his

pag

e b

ased

on

com

mu

nic

atin

g d

irec

tly

wit

h t

he

per

son

. If

add

itio

nal

info

rmat

ion

is n

eed

ed, i

ncl

ud

e

info

rmat

ion

fro

m p

eop

le w

ho

hav

e d

irec

t kn

ow

led

ge

of

the

per

son

’s p

ersp

ecti

ve.

Wh

at p

eo

ple

like

an

d a

dm

ire

mo

st a

bo

ut

It is

hel

pful

to a

sk th

e pe

rson

, frie

nds,

fam

ily, s

taff,

co

-wor

kers

, or

othe

rs w

ho k

now

and

car

e ab

out

the

pers

on w

hat t

hey

like,

love

, adm

ire, r

espe

ct, a

ppre

ciat

e, e

tc. a

bout

him

/her

.

Mak

e th

is a

pro

ud li

st o

f the

per

son’

s po

sitiv

e qu

aliti

es, s

tren

gths

and

tale

nts.

Onl

y in

clud

e w

hat t

he

pers

on c

hoos

es to

incl

ude—

she

can

add

item

s to

o!

Avo

id ja

rgon

. Thi

nk o

f how

you

wou

ld w

ant t

o be

intr

oduc

ed.

Be

clea

r an

d av

oid

usin

g w

ords

suc

h as

“us

ually

or

“som

etim

es.”

Be

posi

tive.

Wh

at is

mo

st im

po

rtan

t to

Incl

ude

enou

gh d

etai

l tha

t som

eone

who

doe

s no

t kno

w th

e pe

rson

cou

ld u

nder

stan

d w

hat m

atte

rs

mos

t to

him

, and

if y

ou to

ok th

e na

mes

off

the

prof

ile h

e co

uld

still

be

iden

tifie

d.

Add

thin

gs a

bout

the

pers

on’s

who

le li

fe th

at a

re im

port

ant t

o hi

m (

hobb

ies,

inte

rest

s, p

assi

ons)

, as

wel

l as

thin

gs th

at r

elat

e to

wha

t’s im

port

ant a

t wor

k, h

ome,

sch

ool,

or in

the

com

mun

ity.

Add

det

ails

that

will

hel

p gi

ve p

eopl

e an

idea

of w

ho th

e pe

rson

is a

nd w

hat

he v

alue

s m

ost.

Inse

rt th

e pe

rson

’s p

hoto

her

e to

mak

e th

e on

e

page

pro

file

mor

e pe

rson

al.

If th

e pe

rson

wou

ld r

athe

r ha

ve p

ictu

res

of

favo

rite

peop

le, p

lace

s, o

r th

ings

, go

for

it!

Lis

tin

g o

ff f

oo

d, s

hel

ter,

clo

thin

g, s

afet

y, e

tc.

sho

uld

be

avo

ided

un

less

th

ey h

ave

bee

n

abse

nt

in t

he

per

son

’s li

fe.

“Hav

ing

fu

n a

t w

ork

- I

enjo

y h

arm

less

pra

ctic

al jo

kes

and

tim

e

to s

it a

nd

rel

ax w

ith

peo

ple

ove

r lu

nch

or

coff

ee.”

Try

th

is:

Inst

ead

of

this

:

“H

avin

g f

un

”

.

The

loca

tion

whe

re th

e

Pro

file

was

cre

ated

or

will

be

mos

t use

d. T

ry:

“wor

k” o

r “h

ome”

Cre

ati

ve O

ne

Pa

ge

Pro

file

tem

pla

tes

ava

ilab

le a

t:

Ore

go

nis

p.o

rg/1

PP

Co

mm

on

Err

or:

Des

crib

ing

wha

t is

impo

rtan

t to

the

pers

on in

sho

rt, c

rypt

ic p

hras

es th

at g

ive

an

idea

of w

hat’s

impo

rtan

t, bu

t are

eas

ily s

ubje

ct to

mis

inte

rpre

tatio

n by

the

read

er.

Co

mm

on

Err

or:

The

bas

ics

shou

ld b

e as

sum

ed,

unle

ss th

ere

is a

his

tory

of t

heir

bein

g ab

sent

.

Co

mm

on

Err

or:

Ass

umin

g

that

if it

is im

port

ant t

o ot

hers

in

the

pers

on’s

life

(fo

r ex

ampl

e,

staf

f or

fam

ily),

it m

ust

be

imp

ort

ant

to t

he

per

son

.

Provider Risk

 Managem

ent S

trategies –

 ODD

S 1.21.2015 

  

 Page 1 of 1

  Provider Risk Man

agem

ent S

trategies 

Person

’s nam

e: 

Provider/Site

 Nam

e:

List risks ide

ntified

 on the ISP Risk M

anagem

ent P

lan or Service Agreemen

t and

 what sup

port docum

ent(s) are in

 place to

 address e

ach risk. 

Risk 

Title

 of d

ocum

ent

Docum

ent d

ate

Whe

re kep

t 

Does th

is pe

rson

 have a Nursin

g Care Plan at th

is locatio

n? 

 No   

 Yes, w

here fo

und: