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

Nuevo Amanecer Latino Children's Services

Galo A. Rodriguez, M.P.H., President & CEO

Since Nuevo Amanecer Latino Children’s Services pursued its COA accreditation on October 14, 2004, this corporation has sustained a continuous quality improvement process by not looking whom to blame among the involved parties but improving what we have already done well… because good enough is not good enough.
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Purpose

Group Living Services allow individuals who need additional support to regain, maintain, and improve life skills and functioning in a safe, stable, community-based living arrangement.

GLS 15: Care and Supervision

The organization provides 24-hour-a-day supportive care and supervision tailored to each resident’s developmental, educational, clinical, and safety needs and attentive to effects of congregate living.

Rating Indicators
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations (HR 6.02) and training (TS 2.03); or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • A number of client records are missing important information  or
  • Client participation is inconsistent; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Resident/personnel care and supervision ratios
    • Procedures and criteria used for assigning and evaluating workloads
    • Resident/personnel care and supervision ratios and coverage schedules for the past year
    • Documentation of workload assessment and data for workload size for the past six months
    • Interview:
      1. Program director
      2. Relevant personnel
      3. Residents
    • Observe facility

  • GLS 15.01

    Adequate care and supervision are provided at all times according to the developmental level, age, and emotional or behavioral needs of residents.


  • FP
    GLS 15.02

    Adults that provide direct care and supervision offer residents:
    1. a positive role model;
    2. nurturance, structure, support, respect, and active involvement;
    3. predictable limit-setting;
    4. flexibility when appropriate and in the resident’s best interest;
    5. guided practice to learn effective communication, positive social interaction, and problem solving skills; and
    6. education and skills training specific to risk-taking behaviors, including practice with decision making and anger management.

    Interpretation: Regarding element (d), providing individualized care that is tailored to the resident’s needs requires being flexible with codified rules when they contradict what is best for the resident. For example, being flexible with bedtimes for a resident who may have experienced nighttime trauma rather than strictly enforcing a lights out time allows the organization to be responsive to the needs of residents. 

    Interpretation: Problem solving skills per element (e) should enable residents to resolve issues that can occur in both home and community settings. 

    Research Note: Positive features associated with lower AWOL rates include clarity about leadership and how the home should operate, a high level of staff support and morale, agreement on a consistent approach, and involvement of youth in setting acceptable boundaries and patterns of behavior.


  • GLS 15.03

    Adults that provide direct care and supervision communicate to residents and implement on behalf of all residents, policies that promote on site security including the prohibition of weapons and gang activity.


  • FP
    GLS 15.04

    Resident care and supervision is provided by:
    1. at least one on-duty worker for every 8 adults during awake hours and every 12 adults during sleeping hours;
    2. at least one on-duty worker for every 6 children during awake hours and every 8 children during sleeping hours;
    3. a sufficient number of qualified personnel on-site that can respond to emergency/crisis situations or to meet special needs of residents during busy or more stressful periods;
    4. rotating after-hours and holiday coverage when needed; and
    5. same-gender and cross gender supervision when indicated by individual treatment needs.

    Interpretation: Staffing requirements and care ratios can vary depending on the age, developmental level, length of treatment, and the service needs of the population. 

    Interpretation: The organization may use direct care workers or counselors to provide supervision to residents. Personnel must be awake at all times unless convincing evidence demonstrates the resident group does not need awake supervision during sleeping hours. Examples of reasons certain homes or programs might not have awake personnel are: care for a long-term, stable population; majority of unit residents are ready to move to a less restrictive setting; low runaway rates; and low rates of night-time incidents. Electronic supervision is not an acceptable alternative to supervision by personnel.

    Note: Organizations must also meet state licensing requirements for care ratios.

    Research Note: National recommendations for the supervision of children in group homes is that there are no more than six children per worker during waking hours and no more than eight children per worker during overnight hours.  

    Research Note: Research suggests that staffing models impact children’s experience in group care. For example, utilizing live-in staff creates a family-life environment and allows for more consistency in resident’s everyday care compared to rotating shift staff.


  • FP
    GLS 15.05

    Each group living residence is continually supervised by an on-call, professional staff member available on a 24-hour basis.

    Interpretation: This standard addresses supervision for residents by professional clinical workers. The professional clinical staff person is permitted to sleep during sleeping hours. An exception to this standard may occur when planned periods of independence help residents meet their service goals.


  • FP
    GLS 15.06

    Direct care personnel workloads do not exceed 15 residents and are assessed and adjusted according to:
    1. special circumstances, such as multi-need residents;
    2. the needs of the population;
    3. the work and time required to accomplish assigned tasks and job responsibilities;
    4. the qualifications, competencies, and experience of the worker, including the level of supervision needed; and
    5. service volume, accounting for assessed level of needs of new and current clients and referrals.

    Interpretation: Direct care personnel are the residential treatment center’s milieu counselors, case managers, and/or child, youth, adult care workers.

    Research Note: Nationally recognized caseload guidelines recommend that direct care personnel have no more than eight children and their families assigned to their caseload at one time. 

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