DSP Performance Review Form

Employee Name *

Date *

1. Treats residents with dignity and respect in all interactions. Incorporates a person-centered philosophy. Carries out resident programming as directed.

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2. Provides resident supervision and intervention according to their Individual Abuse Prevention Plan (IAPP). Ensures that all areas of the IAPP are followed. Mediates resident crises according to A Helping Hand Senior Care Services policy.

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3. Administers resident medications and completes all related documentation. Ensures that medication is being ordered as needed and receipts of medications are documented.

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4. Ensures that the site activity schedule is followed accurately. Ensures that all appointments and community activities are complete.

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5. Assists residents with budgeting and purchases, ensuring receipts are kept for all transactions. Monitors purchases to ensure budgeting is followed.

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6. Ensures that all necessary documentation is completed, including, but not limited to, incident reports, fire drills, symptom/outcome tracking forms, and any other forms as directed by a supervisor.

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7. Ensures that Shift Report EmailMe Forms are completed accurately and that tasks are completed to A Helping Hand Senior Care Services standard.

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8. Communicates concerns from residents/legal representatives to the Program Director.

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9. Act as a role model for new staff – is disciplined, shows follow-through, maintains a positive attitude, and supports management.

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1. Inform Lead Counselor of potential clinical/behavioral problems. Completes responsibilities of Primary Counselor, if applicable.

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2. Attends and participates in all trainings required, such as annual trainings and/or specified trainings requested by a supervisor.

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3. Facilitate community meetings daily. Supports residents with decision making and problem solving.

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4. Is acutely familiar with the files of each resident they are working with, including, but not limited to, the CSSP, CSSPA, IAPP, and Snapshot.

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5. Maintains professional boundaries with residents and support teams at all times.

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1. Ensures that the house is kept clean and tidy at all times.

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2. Ensures adherence to the A Helping Hand Senior Care Services Nutrition Policy. Encourages residents to be active and make healthy choices.

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3. Ensures that resident hygiene and grooming is attended to – nails trimmed, foot checks done, etc.

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4. Participates in fire and severe weather drills as assigned. Encourages residents to participate and provides positive or corrective feedback when needed.

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5. Reports any maintenance concerns to the Lead Counselor or the Program Director.

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6. Remain awake and alert during all shifts worked; is ready to respond at all times.

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1. Completes and submits an accurate, signed timecard. Works shifts as scheduled.

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2. Ensures that company resources are used efficiently.

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3. Ensures time at work is used to engage with residents and complete work related tasks.

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4. Is familiar with licensing standards and helps ensure compliance.

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5. Is responsive to supervisor or other A Helping Hand Senior Care Services personnel. Shows follow through on designated tasks.

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Goal #1

Plan for Achievement

Goal #2

Plan for Achievement

Supervisor Comments

Employee Comments

Employee Signature

Date

Supervisor Signature

Date

Jama Mohamod, Manager

Date

HR Review

Date