Compliance Information

Evaluation is based on the level of supervision; evaluations occur in-session by the staff’s supervisor. The frequency depends on how often the supervisor is required to support the staff member. The basic timeline of such supervision for new staff is as follows:

• First month: Daily
• Second month: Weekly
• Third month: Bi-Weekly
• Fourth month: Monthly

Staff is evaluated on their implementation of Kaleidoscope Interventions procedures during their scheduled client sessions. These may occur based on the schedule of supervision as noted above, as spot checks for maintenance of procedures, or if the need is indicated by either direct observation or permanent products of staff’s work (i.e., data). There are three forms used during sessions:

• Discrete Trial Training Checklist: This checklist allows the supervisor to take a 5-trial probe, checking off correct implementation of trial set-up (how the child was transitioned, how the stimuli were set up, etc.), implementation of the specific prompt delay, and error correction. The supervisor places a check next to procedures implemented correctly and a minus next to procedures implemented incorrectly. The percentage of accuracy is calculated to determine how accurate the Behavior Specialist’s implementation is.
• Mand Training Checklist: This checklist is formatted much like the one described above; however, it covers the implementation of specific mand training protocols (i.e., vocal mand, PECs, or sign). The supervisor collects data, and accuracy is calculated in the same manner.
• Session Evaluation Sheet: This sheet is filled out at the end of a supervision session and covers all aspects of a session. This includes environment, antecedent stimuli, reinforcement and rapport, prompting and correction procedures, mand/echoic behavior, intraverbal behavior, receptive/tact behavior, and behavior/data/miscellaneous information. These forms allow the supervisor to check off all staff behaviors related to session implementation that are being implemented correctly or incorrectly and contains columns for the form to be filled out upon four different supervision sessions.

These forms are used to track a staff member’s individual performance regarding session implementation only; these do not include professionalism, case management, or any other duties related to a staff member’s position. These forms, however, may be used to complete further evaluations that Kaleidoscope Interventions records may require.

The Clinical Director will complete an overall evaluation of a staff member after each semester. This may be to maintain employment for the following semester, to identify areas where improvement is needed. These evaluations are often written and include overall performance, such as:

• A summary of performance based on the previously discussed data sheets
• Attendance in meetings, client sessions, and training
• Punctuality
• Professionalism
• Progress from previous semesters

These performance evaluations are reviewed with the staff and submitted to the Human Resource Department. The staff member is allowed to ask for clarification regarding the performance evaluation and work with the Clinical Director to form performance goals for the next semester. These evaluations are also used as a measure of progress across semesters for each staff member.

If a staff member has a question regarding their performance evaluation, would like to request an evaluation, or find out when their next evaluation will be conducted, they can email the Clinical Director at any time.

Even though the list may seem lengthy, the morning health inspection only requires a few minutes, particularly if you incorporate it during your greeting children in the morning. The inspection is easy to remember if you start at the top and go from head to toe and then from front to back.

Check the following:

• Scalp – Itching, sores, cleanliness, lice. Children are excluded from school if lice are present.
• Face – General appearance, expression, unusual color
• Eyes – Redness of eyelid lining, irritation, puffiness, squinting, frequent rubbing, styles, sensitivity to light, yellowish color
• Ears – Drainage, earache. (There are other observations for hearing impairment.)
• Nose – runny nose, sneezing, frequent rubbing
• Mouth – Inside of mouth for redness, spots, sores
• Throat – Enlarged, red, or irritated tonsils with or without white spots
• Chest – Frequent or severe coughing,      wheezing, rattles (raspy breathing)
• The child gets red or blue in the face.
• The child makes a high-pitched croupy or whooping sound after he coughs.
• Skin – Yellowish skin or eyes, unusual spots, rash, bumps, bruises, unusual injuries; crusty, bright yellow dry or gummy areas of the body. Check both the front and back of the body.
• Fever – Feverish appearance with changes in behavior
• The child is cranky or less active than usual.
• The child cries more than usual.
• The child appears unwell or generally uncomfortable.
• Fever greater than 101°F.

If any of the above is noticed, an incident report must be completed and the parent contacted.

In the event of a minor injury (e.g., small abrasions/cuts with minimal bleeding, small bumps, or bruises), the clinician is responsible for providing the necessary care, then continuing with the session. This means:

• Conducting a visual assessment of the injury after an incident (e.g., client falling, episode of self-injury, aggression from a peer, etc.)
• Providing the appropriate First Aid (i.e., cleaning the wound, supplying Band-Aids, etc.). If the clinician is not currently certified in First Aid, they are responsible for contacting a clinician or the caregiver who can provide care.
• Completing an Incident Report Form, to be signed by the parent/guardian upon the end of the session. Once signed, the Incident Report Form must be given to the immediate case supervisor for review and signature. The case supervisor will then give a copy of the Incident Report to the Clinical Director and the caregiver.

In the event of a moderate to severe injury (e.g., larger cuts/bruises, severe bleeding/bleeding that lasts for more than 3 minutes, swelling of joints/appendages, etc.), the clinician is responsible providing immediate First Aid and contacting the necessary personnel. This means:

• Conducting a visual assessment of the injury after an incident
• Providing the appropriate First Aid. If the clinician is not currently certified in First Aid, they are responsible for contacting a clinician/caregiver who can provide care.
• If the injury requires immediate medical care above and beyond what the clinician can supply: CALL 911, then the parent/guardian.
• If the injury appears to require further medical care; however, it is not an immediate emergency, contact the parent/guardian.
• The Clinical Director, in both cases, must be immediately notified of the event. If the Clinical Director cannot be notified by phone, the clinician MUST email the Clinical Director.
• Completing an Incident Report Form, to be signed by the parent/guardian upon the end of the session. Once signed, the Incident Report Form must be given to the immediate case supervisor for review and signature. The case supervisor will then give a copy of the Incident Report to the Clinical Director and the caregiver.

Kaleidoscope Interventions clinicians must be especially aware of any head injuries that may occur. If a client hits his/her head:

• Without loss of consciousness: Monitor the client for the rest of the session.
• Without loss of consciousness but an immediate indication of injury: This means any immediate bruising, bumps, etc. Contact the parent/guardian; it is then up to their discretion regarding whether the session is terminated. If the client remains, monitor for the rest of the session.
• With the loss of consciousness/any altered appearance, speech, or behavior: CALL 911. Contact the parent/guardian and the Clinical Director of Therapeutic Services.
• NOTE: If at any time while a client is being monitored, they meet the criteria for more intensive care, follow the appropriate guidelines as outlined above.

It is the clinician’s responsibility to provide care for any medical emergency that may occur (i.e., seizures, allergic reactions, etc.). Each client is supplied with an emergency contact form, which lists any medical conditions a clinician should be aware of. In the case of such an emergency:

• Provide the appropriate First Aid. If the clinician is not currently certified in First Aid, they are responsible for contacting a clinician/caregiver who can provide care.
• Notify the parent/guardian immediately. If the medical issue is not an immediate emergency (e.g., an allergic reaction resulting in rash, etc.), it is up to the parent/guardian’s discretion whether the client is picked up or continues with the session. If the parent/guardian elects to continue with the session, monitor the client for the rest of the session.
• If the medical issue requires immediate medical care, or the medical issue has never occurred before (e.g., a seizure occurs when the client has no history), CALL 911, then notify the parent/guardian and campus Security.
• If the client is sent home or 911 is called, notify the Clinical Director by phone or email.
• Fill out an incident report form.

It is expected that clinicians create a supportive work environment in all aspects of their responsibilities. All clinicians are expected to assess and provide care for injuries by themselves based on the severity of the injury, obtain the appropriate medical care, and assist other clinicians as needed. In the case of an injury:

• All minor injuries must be treated by the clinician or a clinician trained in First Aid.
• If a clinician cannot complete the client session, they must first attempt to find another clinician to cover the remainder of the session. If no coverage is found, the clinician is to notify the Clinical Director immediately for recommendations on how to proceed.
• If an injury qualifies as an emergency requiring immediate medical care, CALL 911 and notify the Clinical Director.
• If an injury does not qualify as an immediate emergency, however, the clinician prefers to seek medical care, the clinician must notify the Clinical Director and find a replacement clinician to resume client services.
• An Incident Report Form must be filled out in the event of a clinician injury related to a client (i.e., resulting from client aggression, etc.).
• The employee or a supervisor will contact HR to notify them of the incident. Once the employee and supervisor sign an incident report, a copy must be provided to HR to be added to the employee file.

NOTE: When providing care to any client or clinician, ALL UNIVERSAL PRECAUTIONS MUST BE FOLLOWED. This includes wearing gloves, hand-washing, and the use of spill kits where appropriate. See policy regarding Universal Precautions.

A crisis behavior is defined as when a student is no longer in control of his or her behavior or indicates(by warning signs)that they will lose control of their behavior.

There should always be two staff available during a crisis behavior, and a crisis behavior report needs to be completed. If an injury occurs during the crisis behavior, an injury report must also be completed. Following a crisis behavior:

• Complete the crisis behavior report as applicable to the student in the crisis.
• Conduct a debriefing meeting if the crisis follows an unusual pattern or circumstance.
• Include all classroom staff and administrators as necessary
• Decide as a team what is to be done to prevent the crisis from happening again.
• Have all team members sign the bottom of the form
• Submit the form to Principal
• Inform parents of the incident but don’t send a crisis report home
• Duty to report misconduct:

Once it is suspected or known that abuse is occurring, a report must be made to the Florida DCF Abuse Hotline within 48 hours. There are four methods of contact; please note that the preferred method of contact is by telephone. If you are unable to get through immediately, stay on the line. If it is an emergency and you cannot wait, call 911. Modes of contact are:

• By Telephone 1-800-96-ABUSE(1-800-962-2873)
• By Fax 1-800-914-0004
• Web Reporting http://www.state.fl.us/cf_web

As stated, all staff working at Kaleidoscope Interventions are considered Mandatory Reporters. However, to ensure that the complete reports are given, the Clinical Director must be notified immediately, and documentation of the report be made. Further, due to the intensity of some of the behaviors displayed by clients, it is essential to ensure that if physical injury is present, it is not the result of the client’s behavior (e.g., occurring due to self-injury, property destruction, etc.). Therefore:

• If a physical injury is present that did not occur while at Kaleidoscope Interventions (e.g., the injury was present upon arrival or discovered later in the day, when no incident had occurred that would result in such injury), an incident report form must be filled out describing the injury, its location, and the time of day it was discovered.
• If the client is known to engage in behaviors producing injury, body checks must be conducted at a minimum when the client first arrives and when the client leaves. Any injuries the client arrives with and their location must be documented; any injuries incurred while at Kaleidoscope Interventions must be documented once the client leaves.
• The Clinical Director must be notified immediately if abuse or neglect is suspected, either in person or by phone. If enough evidence is gathered to suspect abuse or neglect has or is occurring, the Clinical Director will make the call with the staff or assist the staff in filling out a form to be faxed. This ensures that the information the clinician has collected is reportable and that all information regarding the client will be provided for the report.
• When making such a report, remember to include all information regarding the who, what, where, when, and whys of the incident. That is who it happened to or is involved, what happened, where it occurred when it occurred, and, if available, why it occurred. If it is suspected that there is a potential risk to those involved in the investigation, this must be reported at the call time. Once having gathered the information, the Abuse Hotline Counselor will decide if it is enough to accept as a formal report and notify the Clinical Director and staff reporting.

Due to the number of clients who receive services at Kaleidoscope Interventions, all staff must be aware of abuse indicators. The company’s annual internal training will be provided to each employee, training the employee to recognize the signs. As Mandatory Reporters, staff should be especially aware of those behavioral changes that may occur as a result of abuse. Staff should be aware of types of abuse that may occur, the associated risks or indicators, and report such indicators when making a report. Types of abuse covered under such reports and the general definition above include:

• Physical abuse: any injury or patterns of injury intentionally inflicted or caused by a parent, legal guardian, or caregiver.
• Sexual abuse: any event of a child being coerced, tricked, or forced into any sexual activity by an adult or older child.
• Psychological maltreatment/emotional or mental abuse: the humiliation, rejection, or intimidation of a child that undermines their emotional or psychological well- being, characterized by a pattern of negative behavior by a parent, legal guardian, or caregiver aimed at a child.

Three basic forms of child maltreatment are recognized: the abuse of a child, the neglect of a child, and the child’s endangering.

• Abuse represents an action against a child. It is an act of commission and is characterized in three categories:
  • Physical abuse – non-accidental injury of a child.
  • Sexual abuse– any act of a sexual nature upon or with a child. The act may be for the sexual gratification of the perpetrator or a third party.
  • Emotional abuse – chronic acts that interfere with the psychological and /or social development of the child.
• Neglect is a failure to act on behalf of a child. It is an act of omission and is generally characterized in two categories:
  • Physical neglect – failure to meet the requirements basic to a child’s physical development, such as supervision, housing, clothing, medical attention, nutrition, and support.
  • Emotional neglect – failure to provide the support and/or affection necessary to the child’s psychological and social development.
  • An additional category that is especially important to the teacher or school authority is:
  • Educational neglect – failure to ensure a child’s opportunity to learn in a school or home environment.
  • Endangering of a Child – creating a substantial risk to the health or safety by violating a duty of care, protection, or support.

• If you have reason to believe that a child is being, or has been, abused and/or
• neglected, you shall immediately make a written report and must verbally report your concern to the Department of Children and Family (DCF) in the county where the child resides.
• Since it is the DCF worker’s responsibility to investigate suspected abuse and/or neglect, you shall not pressure the child to divulge information regarding specific circumstances or the identity of the perpetrator.
• Reports of suspected child abuse and/or neglect are confidential. You should be aware that the reporting person is immune from civil or criminal liability for reporting.