Standards for public agencies

2020 Edition

Adult Day Services (PA-AD) 2: Personnel

Program personnel have the competency and support needed to provide services and meet the needs of service recipients.
2020 Edition

Currently viewing: ADULT DAY SERVICES (PA-AD)



Individuals who participate regularly in Adult Day Services achieve and maintain an optimal level of well-being, functioning and health, and remain in their preferred community residence.
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.

Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  

  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Table of contents of training curricula
  • Procedures or other documentation relevant to continuity of care and case assignment
  • Documentation tracking staff completion of required trainings and/or competencies
  • Sample job descriptions from across relevant job categories
  • Training curricula
  • Documentation of current caseload size per worker
  • Interviews may include:
    1. Program director
    2. Relevant personnel
  • Review personnel files

PA-AD 2.01

Personnel are qualified by:
  1. the skill and experience to meet the psychosocial and medical needs of care recipients; and 
  2. the personal characteristics and temperament suitable for working with adults with special needs.

PA-AD 2.02

The program director or administrator is available full time at each site and is qualified:
  1. as a registered nurse; or 
  2. has a bachelor’s degree in a human service field and relevant experience.


If qualified directors or administrators are not employed full-time at every site, a qualified director or administrator should oversee a limited number of sites.

PA-AD 2.03

All direct service personnel are trained on, or demonstrate competency in the following areas, as appropriate to the services provided:
  1. crisis prevention and intervention techniques;
  2. identification of changes in service recipient functioning; 
  3. identification of medical needs or problems;
  4. the agency's plans for handling medical or psychiatric emergencies;
  5. use of adaptive equipment, such as braces and wheelchairs;
  6. providing personal care; and
  7. specific skills necessary to serve the target population.

PA-AD 2.04

Personnel who lead or facilitate group activities have relevant training or experience.

Fundamental Practice

PA-AD 2.05

There is at least one person certified in basic first aid and CPR on duty at each program site, at any time the program is in operation.

PA-AD 2.06

A recreational therapist is on staff or available for consultation.

PA-AD 2.07

Day programs with a health focus employ an RN or LPN.
NA The day program does not have a health focus.

Fundamental Practice

PA-AD 2.08

An agency that serves a high percentage of multiply handicapped or frail individuals obtains the specialized services of dietitians, nurses, physicians, and physical and/or occupational therapists for consultation, evaluation, or training.


If specialized services are provided off-site, support and transportation are arranged.
NA The agency does not serve a high percentage of handicapped or frail individuals.

PA-AD 2.09

The agency minimizes the number of workers assigned to the individual over the course of their contact with the agency by:
  1. assigning a worker at intake or early in the contact; and
  2. avoiding the arbitrary or indiscriminate reassignment of direct service personnel.

PA-AD 2.10

Employee workloads support the achievement of client outcomes and are regularly reviewed.
Examples: Examples of factors that may be considered when determining employee workloads include, but are not limited to:
  1. the qualifications, competencies, and experience of the worker, including the level of supervision needed;
  2. the work and time required to accomplish assigned tasks and job responsibilities; and
  3. service volume, accounting for assessed level of need and frequency of contact with persons served.