WHO IS ACCREDITED?

Private Organization Accreditation

CSS Healthcare Services provides Community based health services to the young, the elderly and to Individuals with Developmental Disability. Founded in 1997, we have the ability to offer a variety of quality community-based services to our clients, which has greatly contributed to our growth and success.
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ORGANIZATION TESTIMONIAL

Joint Base Charleston School Age Program

Paula B. Matthews, School Age Program Coordinator

Preparing for our after school accreditation was an awesome and very valuable learning experience for the Child and Youth Professionals at Charleston Air Force Base. Becoming familiar with and understanding the After School standards was a breeze because of the training webinars and the great customer service we received from all of the COA staff. Thank you for supporting our military families.
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Purpose

The rights and dignity of clients are respected throughout the organization.

FOC
CR 4: The Rights of Persons with Developmental Disabilities

Children, youth, and adults with developmental disabilities receive services that help them achieve full integration and inclusion in the mainstream, make choices, exert control over their lives, and fully participate in, and contribute to, their communities.

Interpretation: Throughout CR 4 the term "person" is defined to include children, youth, and adults with developmental disabilities. In instances where the person cannot make his or her own decisions, sign documents, or is otherwise limited in his/her ability to provide informed consent, the term, "person" may be understood to also include an advocate or legal guardian, as in "...the person, his/her advocate, or legal guardian..."

NA The organization does not provide any programs or services that are designed to serve persons with developmental disabilities.

NA The organization is implementing the standards for Services for Individuals with Developmental Disabilities (DDS).

Rating Indicators
1
The organization's practices fully meet the standard as indicated by full implementation of the practices outlined in the CR 4 Practice standards.
2
Practices are basically sound but there is room for improvement as noted in the ratings for the CR 4 Practice standards.
3
Practice requires significant improvement as noted in the ratings for the CR 4 Practice standard; and/or
  • One of the CR 4 Fundamental Practice Standards received a 3 or 4 rating.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the CR 1 Practice standards; and/or
  • Two of the CR 4 Fundamental Practice Standards received a 3 or 4 rating.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Include service philosophy in the Narrative of each applicable service section (CR 4.01, CR 4.02, and CR 4.07)
    • Procedures for use of interventions that limit movement, diminish sensory experience, limit personal freedom, or cause personal discomfort
    • Include service planning procedures with the service planning and monitoring evidence of each applicable service section (CR 4.03, CR 4.04, and CR 4.05)
    • Procedures for helping persons access assistive technology
    • Procedures for providing or making referrals for family support services
    • Training curricula, educational material and/or other material provided to persons served regarding sexuality and relationships
    • Interview:
      1. Clinical or program director
      2. Relevant personnel
      3. Persons served
    • Review case records

  • CR 4.01

    Organizations serving persons with developmental disabilities adopt a service philosophy that:

    1. promotes meaningful participation, inclusion, and self-determination;
    2. provides a basis for the implementation of strengths-based, person-centered activities and interventions; and
    3. safeguards the emotional, physical, and psychological well-being of the person.
    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • One of the elements needs strengthening in the organization’s service philosophy.
    3
    Practice requires significant improvement; e.g.,
    • Two of the elements need strengthening ; or
    • One of the elements is not covered.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.

  • FP
    CR 4.02

    The person is the primary source of information about the need for service and the information gathered for assessment.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g.,
    • Practice generally meets the intent of the standard but procedures for documentation are weak; or
    • In a few instances there is no documentation in the case record.
    3
    Practice requires significant improvement; e.g.,
    • While the standard is generally met in practice there are no procedures; or
    • In a significant number of cases there is no documentation in case records.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.

  • CR 4.03

    The organization works in partnership with the person, and his or her team according to the wishes of the person, to develop and implement a service plan that enables the fullest and most independent life possible in the community and promotes self-determination.

    Interpretation: Persons with limited ability to make independent decisions receive help from the team in making choices and/or assuming responsibility for making decisions.

    "Team" is defined to include the person’s family, friends and other natural supports, circle of support, support/service broker, service coordinator, or others chosen by the person. It is essential that members of the person’s team are, to the extent possible, chosen by and the preference of the person.

    Interpretation: Service planning for persons with developmental disabilities can address, as appropriate to the person:

    1. health and safety issues;
    2. degree of supervision needed;
    3. independent living, social, and daily living skills;
    4. nutritional and dietary needs;
    5. leisure and vocational interests, aptitudes, and need for greater social inclusion;
    6. screening and treatment for co-occurring psychiatric disorders or substance use conditions;
    7. the need for assistive technology, auxiliary aids, and other special accommodations;
    8. positive behavior support planning;
    9. medication needs;
    10. issues related to adaptive, behavior, and cognitive functioning, including concrete and abstract reasoning;
    11. specialized supports such as physical, speech, and occupational therapy;
    12. ancillary services;
    13. end of life planning; and
    14. the need for hospice or palliative care.
    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g.,
    • Practice meets the intent of the standard but procedures need strengthening.
    3
    Practice requires significant improvement; e.g.,
    • Procedures need significant strengthening; or
    • The standard has not been met in a few cases.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.

  • CR 4.04

    The service planning process includes a means for resolving conflicts between the person and his/her family, advocate, or others that may be involved in establishing and implementing the person’s plan.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • Staff skills for meeting the intent of this standard need strengthening, and training is being provided to improve staff skills; or
    • The conflict resolution process needs strengthening.
    3
    Practice requires significant improvement; e.g.,
    • Staff are limited in their ability to meet the intent of this standard and there is no effort to improve skills.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.

  • CR 4.05

    If the organization uses interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort, such interventions are implemented only when:

    1. the organization can document its reasons for believing that the intervention will be beneficial to the person served;
    2. the person or his or her guardian has been fully informed about the risks and benefits of the intervention and has consented to it;
    3. the intervention is prescribed by a qualified medial practitioner or recommended by an interdisciplinary team;
    4. the organization periodically reviews the continued need for and effectiveness of the treatment or intervention;
    5. all personnel working with the individual have been trained on their specific treatment plan and its parameters; and
    6. the intervention is not used as a substitute for appropriate staffing patterns, for the convenience of staff, or as punishment.

    Update:

    • Revised Standard - 05/07/18
      Element e) and an interpretation were added.

    Interpretation: Examples of such treatments and interventions are use of splints or poseys to prevent self-injury, use of visual or auditory screens to reduce stimulation, use of distasteful substances, textures, or activities as a consequence for behavior.

    Interpretation: In regards to element (c), the prescription should include the specific parameters of the use of the intervention, including a time limit and specific set of behaviors or circumstances that the intervention should be applied

    NA The organization does not use interventions that limit physical movement, diminish sensory experience, restrict personal freedoms, or cause personal discomfort.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • Procedures, that include well delineated treatments and interventions, guide practices that are basically appropriate to the intent and elements of the standard, but one of the elements needs strengthening; or
    • Documentation related to use of interventions needs minor improvement.
    3
    Practice requires significant improvement; e.g.,
    • Procedures need strengthening for two of the elements; and/or
    • There are a few instances in which procedures for element (a) or (b) were not followed; or
    • Documentation needs significant improvement.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all; e.g.,
    • In a few instances one of the standard's elements was not implemented; or
    • Use of interventions is not documented.

  • FP
    CR 4.06

    The organization provides assistive technology, or helps the person gain access to assistive resources, as needed, and the person is:

    1. involved in the selection of specific technologies;
    2. afforded the opportunity to try the device prior to purchase or assignment; and
    3. trained on the use of specific assistive devices being provided.

    Interpretation: Assistive technology is any tool, device, service, or software that helps persons with disabilities perform tasks that otherwise might be difficult or impossible.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • One of the elements needs strengthening.
    3
    Practice requires significant improvement; e.g.,
    • Two of the elements need strengthening; or
    • One of the elements is not covered; or
    • Assistive technology is sometimes not available.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.
    • Assistive technology is generally not available.

  • CR 4.07

    An intervention is discontinued immediately if it produces adverse side effects, or is deemed unacceptable according to prevailing professional standards, and policy prohibits:

    1. corporal punishment;
    2. the use of aversive stimuli;
    3. interventions that involve withholding nutrition or hydration, or that inflict physical or psychological pain;
    4. the use of demeaning, shaming or degrading language or activities;
    5. unnecessarily punitive restrictions including cancellation of visits as a disciplinary action;
    6. forced physical exercise to eliminate behaviors;
    7. punitive work assignments;
    8. punishment by peers;
    9. group punishment or discipline for individual behavior; and
    10. unwarranted use of invasive procedures and activities as a disciplinary action.
    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g.,
    • All prohibited interventions are included in policy, however, procedures for discontinuing interventions need more specificity.
    3
    Practice requires significant improvement; e.g.,
    • One of the elements is not included in policy; or
    • Procedures need significant improvement; or
    • Documentation related to discontinued procedures needs improvement.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.
    • Policy does not include two or more elements; or
    • In at least one instance a prohibited practice was used.

  • CR 4.08

    The organization supports persons with developmental disabilities to establish meaningful social relationships, build and maintain natural support systems, exercise their rights and responsibilities, and participate in the life of their community by:

    1. identifying and pursuing the types of social roles, as well as family and other relationships, the person wishes to pursue;
    2. providing opportunities for social and physical interaction with persons, in addition to service providers and recipients; and
    3. achieving an optimal level of community involvement and participation.

    Interpretation: Persons with developmental disabilities receive services and supports that are tailored to their individual needs and help them fully interact with the community and achieve maximum independence in the least restrictive environment.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • Procedure or documentation related to one of the elements needs strengthening.
    3
    Practice requires significant improvement; e.g.,
    • Procedure or documentation related to two of the elements needs strengthening, e.g., documentation rarely discusses impact on individual's goals.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.

  • CR 4.09

    Family support services are available to strengthen the family’s ability to provide care, prevent unwanted and inappropriate out-of-home placements, and help maintain family unity.

    Interpretation: Information is available to help caregivers with their caretaking responsibilities and addresses the needs or interests of caregivers, including topics such as early childhood development, behavior, home economics, work-life balance, and nutrition.

    Interpretation: Examples of community support services, include:

    1. behavioral support;
    2. case management;
    3. counseling;
    4. early intervention services;
    5. financial assistance;
    6. in-home support;
    7. public entitlements;
    8. respite services; and
    9. support groups.
    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • Procedure or documentation related to one of the elements needs strengthening.
    3
    Practice requires significant improvement; e.g.,
    • Procedure or documentation related to two of the elements needs strengthening.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.

  • FP
    CR 4.10

    Persons with developmental disabilities receive appropriate support and education regarding sexuality and relationships, including:

    1. sexual health and development;
    2. family planning and pregnancy prevention;
    3. prevention of STDs and HIV/AIDS; and
    4. sexual abuse and exploitation, including giving and receiving sexual consent.

    Interpretation: Support and education regarding sexuality and relationships should be tailored to the assessed needs, capacity, and learning style of the person.

    Research Note: The literature suggests that people with developmental disabilities are far more likely to be victims of sexual and other violence than people in the general population.

    Rating Indicators
    1
    The organization's practices reflect full implementation of the standard.
    2
    Practices are basically sound but there is room for improvement; e.g., 
    • Procedure or documentation for support or education related to one of the elements needs strengthening.
    3
    Practice requires significant improvement; e.g.,
    • Procedure or documentation for support or education related to two of the elements needs strengthening.
    4
    Implementation of the standard is minimal or there is no evidence of implementation at all.
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