Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Medication Procedures
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Written permission from parent/physician on file according to Administrative Regulation FFAC
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Follow up with corrected action will be completed by:
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All permits for medication administration are up-to-date
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Follow up with corrected action will be completed by:
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All medications accounted for and documented on the parent permission form
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Follow up with corrected action will be completed by:
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All out-dated permits for medication are purged and medication is sent home
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Follow up with corrected action will be completed by:
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All medications are organized, kept in a locked cabinet and not accessible to students
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Follow up with corrected action will be completed by:
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All medications are labeled correctly and entered into the Master Schedule for Medication Administration
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Follow up with corrected action will be completed by:
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All self-administered medications are flagged and appropriate permission is on file
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Follow up with corrected action will be completed by:
Office Visit Documentation
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All clinic office visits are logged in on the Clinic Sign In Sheet
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Follow up with corrected action will be completed by:
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All individual student office visit documentation is logged into e-school on a daily basis and no more than 1 day behind
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Follow up with corrected action will be completed by:
Immunization Compliance
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Report of Immunization Compliance is up to date as medically feasible
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Follow up with corrected action will be completed by:
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Documentation to show that Parent Notification of Immunizations Due letters have been sent
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Follow up with corrected action will be completed by:
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Administrators notified of students needing to be excluded due to non-compliance
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Follow up with corrected action will be completed by:
Screening
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Screening of all mandated grades completed by the end of first semester
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Follow up with corrected action will be completed by:
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All new students must be screened as they enter TISD schools
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Follow up with corrected action will be completed by:
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All screening information is entered into e-school in a timely manner and follow up procedures are in place
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Follow up with corrected action will be completed by:
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Audiometer calibration documented and current
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Follow up with corrected action will be completed by:
Organization
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Clinic Environment is neat and orderly with health displays for student and staff education
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Follow up with corrected action will be completed by:
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Clinic supplies are labeled and easily accessible
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Follow up with corrected action will be completed by:
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Substitute Notebook updated, current and well organized
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Follow up with corrected action will be completed by:
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Student health folders organized, coded for special health needs and purged according to records management schedule
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Follow up with corrected action will be completed by:
Specialized Health Care Services
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Nursing care plans/ IHPs written as needed for special needs students
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Follow up with corrected action will be completed by:
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Specialized procedures documentation current.
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Follow up with corrected action will be completed by:
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Action Plans for identified students are availble and easily accesible as needed.
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Diabetic Management Plan
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Follow up with corrected action will be completed by:
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Seizure Action Plan
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Follow up with corrected action will be completed by:Follow up with corrected action will be completed by:
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Allergy Action Plan
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Follow up with corrected action will be completed by:
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Asthma Action Plan
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Follow up with corrected action will be completed by:Follow up with corrected action will be completed by:
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Other IHPs
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Follow up with corrected action will be completed by:
Unlicensed Assistive Personnel
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Principal Medication Designation from is complete and easily accessible
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Follow up with corrected action will be completed by:
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Medication Skills checklists are complete for all designees (initial and return demonstrations documented)
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Follow up with corrected action will be completed by:
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Special Procedures skills checklists complete for all designees (initial and return demonstrations documented)
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Follow up with corrected action will be completed by:
Anaphylaxis
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Identified staff training completed and documented
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Follow up with corrected action will be completed by:
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Notification of need to know persons has been documented (food service, teachers, 504 coordinator/counselors
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Follow up with corrected action will be completed by:
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E-school has been updated to reflect critical alert if appropriate
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Follow up with corrected action will be completed by:
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Epinephrine auto-injectors are kept in an unlocked cabinet
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Follow up with corrected action will be completed by:
Diabetes Care
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UDCA Prinicipal Designee Form is signed
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Follow up with corrected action will be completed by:
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UDCA skills checklist has been completed and return demonstration documented.
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Follow up with corrected action will be completed by:
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Diabetic Management and Treatment plans are current, signed by parent and physician
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Follow up with corrected action will be completed by:
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Student diabetes kit available in the event of a lockdown or evacuation
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Follow up with corrected action will be completed by:
Substitutes
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Current daily medication worksheet available
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Follow up with corrected action will be completed by:
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Current student health condition information is readily available
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Follow up with corrected action will be completed by:
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Emergency procedures and contacts for campus easily accessible
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Follow up with corrected action will be completed by:
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Location of special procedures, emergency supplies, diabetes supplies clearly labeled.
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Follow up with corrected action will be completed by:
Safety, Security, and Emergency Preparedness
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Current Student Emergency form PDF document saved to the desktop on clinic laptop
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Follow up with corrected action will be completed by:
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AED visible, labeled with instructions, monthly checks current
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Follow up with corrected action will be completed by:
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Assists administrator in organization of Emergency Response Team and crisis and safety planning
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Follow up with corrected action will be completed by:
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Red bags prepared and monitored
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Follow up with corrected action will be completed by:
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Evacuation plan in place for medications, special procedures supplies/equipment
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Follow up with corrected action will be completed by:
Signatures
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Director of Health Services
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School Nurse
