OAR 411-325-0180
Individual Summary Sheets


A provider must maintain a current one to two page summary sheet for each individual receiving services from the provider. The record must include:

(1)

The name of the individual and his or her current address, previous address if the individual has lived in the home less than one year, date of entry into the home, date of birth, gender, marital status (for individuals 18 or older), religious preference, preferred hospital, medical prime number and private insurance number (if applicable), and guardianship status; and

(2)

The name, address, and telephone number of the following (if applicable):

(a)

The legal or designated representative, family, and people significant to the individual, and for a child, the parent and educational surrogate;

(b)

The primary care provider and clinic preferred by the individual;

(c)

The dentist preferred by the individual;

(d)

The identified pharmacy preferred by the individual;

(e)

The school, day program, or employer of the individual;

(f)

The case manager of the individual, and for Department direct contracts, the Department representative; and

(g)

Other agencies and representatives providing services and supports to the individual.

(3)

For a child under the age 18, any court-ordered or contacts or limitations authorized by the child’s legal representative must also be included on the individual summary sheet.

Source: Rule 411-325-0180 — Individual Summary Sheets, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=411-325-0180.

411‑325‑0010
Statement of Purpose
411‑325‑0020
Definitions and Acronyms
411‑325‑0025
Program Management
411‑325‑0030
Issuance of License
411‑325‑0040
Application for Initial License
411‑325‑0050
License Expiration, Termination of Operations, License Return
411‑325‑0060
License Conditions
411‑325‑0070
License Renewal
411‑325‑0090
Change of Ownership, Legal Entity, Legal Status, Management Corporation
411‑325‑0110
Variances
411‑325‑0120
Medical Services
411‑325‑0130
Food and Nutrition
411‑325‑0140
Physical Environment
411‑325‑0150
General Safety
411‑325‑0170
Staffing Requirements
411‑325‑0180
Individual Summary Sheets
411‑325‑0185
Emergency Information
411‑325‑0200
Transportation
411‑325‑0220
Individual Furnishings
411‑325‑0230
Emergency Plan and Safety Review
411‑325‑0240
Assessment of Fire Evacuation Assistance
411‑325‑0250
Fire Drill Requirements and Fire Safety
411‑325‑0260
Individual Fire Evacuation Safety Plans
411‑325‑0270
Fire Safety Requirements for Homes on a Single Property or on Contiguous Property Serving Six or More Individuals
411‑325‑0280
Fire Safety Requirements for Homes or Duplexes Serving Five or Fewer Individuals
411‑325‑0290
Fire Safety Requirements for Apartments Serving Five or Fewer Individuals
411‑325‑0300
Residency Agreements, Individual Rights, Complaints, Notification of Planned Action, and Hearings
411‑325‑0350
Behavior Supports and Physical Restraints
411‑325‑0360
Psychotropic Medications and Medications for Behavior
411‑325‑0370
Individuals’ Personal Property
411‑325‑0380
Handling and Managing Individuals’ Money
411‑325‑0390
Entry, Exit, Transfer, and Closure
411‑325‑0410
Community Living Supports
411‑325‑0430
Individual Support Plan
411‑325‑0440
Children’s Direct Contracted Services
411‑325‑0445
Notification of School District - Homes Serving Five or More Children
411‑325‑0460
Civil Penalties
411‑325‑0470
License Denial, Suspension, Revocation, Refusal to Renew
411‑325‑0480
Criminal Penalties
411‑325‑0490
Provider Eligibility for Medicaid Service Payment
Last Updated

Jun. 8, 2021

Rule 411-325-0180’s source at or​.us