Title Page

  • Document No.

  • Audit Title

  • Client initials / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Rules & Regulations

  • Staff member has passed all location requirements

  • Staff adheres to location dress code

  • Staff can state location rules & regulations

Collaborative/Professional Relationship

  • Talks to staff in respectful and professional manner

  • Does not interact with other children unless it applies to client or is asked to support.

  • Listens to staff both in direct and indirect (is aware of cues given) situations

Shadowing

  • Lets teacher/staff present Sd

  • Uses prompts that encourage responding to staff

  • Prompts used:

  • Asks staff to represent SD

  • Non-vocal prompts

  • If invasive prompts used, fades prompt

  • Provides feedback/suggestions to staff that can support setting

  • Collects data in the moment

  • Uses appropriate reinforcement for setting

Behaviors

  • Behaviors Reported

  • Provides simple data collection or reinforcement systems

  • Provides basic easy to implement suggestions

  • Gathers info from staff

  • Behaviors Observed

  • Collects data

  • Identifies potential function

  • Implements setting appropriate interventions

  • Record interventions used

  • Provides staff with support/suggestions

Direct Instruction

  • Uses all 3-components of DTT

  • Uses all 3-components of NET

  • Uses setting appropriate reinforcement

  • Collects data in the moment

Acknowledgement

  • We have reviewed the results of this assessment.

  • Assessor

  • Assessed Staff

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