OAR 411-348-0180
Individual Summary Sheets

A program provider must maintain a current one to two-page summary sheet for each child receiving services from the program provider. A copy of the summary sheet must be maintained by the program provider and at the Host Home. The record must include all of the following:

(1)

The child’s name, current and previous address, date of entry into the Host Home, date of birth, gender identity, sex, religious preference, current hospital, medical prime number and private insurance number (where applicable), and guardianship information.

(2)

A photo of the child taken within the last year.

(3)

The name, address, and telephone number of the following:

(a)

The child’s family, parent, guardian, advocate, or other significant person.

(b)

The child’s current physician, secondary physician, or clinic.

(c)

The child’s current dentist.

(d)

The child’s current pharmacy.

(e)

The child’s current school and educational surrogate, if applicable.

(f)

The child’s CDDP services coordinator.

(g)

The child’s behavior professional, when professional behavior services are actively involved with the development of a Temporary Emergency Safety Plan, Functional Behavior Assessment, or Positive Behavior Support Plan, or the maintenance of the Positive Behavior Support Plan.

(h)

Other representatives providing services to the child including an attorney or CASA (Court Appointed Special Advocates) representative.

(4)

Any court-ordered, or parent or guardian authorized, contacts or limitations.

Source: Rule 411-348-0180 — Individual Summary Sheets, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=411-348-0180.

411‑348‑0010
Statement of Purpose 411‑348‑0020
Definitions and Acronyms 411‑348‑0025
Program Management, Endorsement, Certification, and Enrollment 411‑348‑0030
Issuance of License 411‑348‑0040
Application for Initial License 411‑348‑0045
In-Residence Caregiver Applicant Study 411‑348‑0050
License Expiration, Termination of Operations, and License Return 411‑348‑0060
License Conditions 411‑348‑0070
License Renewal 411‑348‑0090
Change of Ownership, Legal Entity, Legal Status, Management Corporation, and In-Residence Caregiver 411‑348‑0100
Capacity 411‑348‑0110
Variances 411‑348‑0120
Medical Services 411‑348‑0130
Food and Nutrition 411‑348‑0140
Physical Environment 411‑348‑0150
General Safety 411‑348‑0170
Staffing Requirements 411‑348‑0180
Individual Summary Sheets 411‑348‑0185
Emergency Information 411‑348‑0200
Transportation 411‑348‑0210
Transition Planning and Supporting Families 411‑348‑0220
Required Furnishings 411‑348‑0230
Emergency Plan and Safety Review 411‑348‑0240
Assessment of Fire Evacuation Assistance and Fire Safety Evacuation Plan 411‑348‑0250
Fire Drill Requirements and Fire Safety 411‑348‑0260
Fire Safety Evacuation Plans 411‑348‑0280
Fire Safety Requirements 411‑348‑0300
Rights, Complaints, Notification of Planned Action, and Hearings 411‑348‑0350
Behavior Supports and Physical Restraints 411‑348‑0360
Psychotropic Medications and Medication for Behavior 411‑348‑0370
Personal Property 411‑348‑0380
Financial Records and Managing Money 411‑348‑0390
Entry, Exit, Transfer, and Closure 411‑348‑0410
Alternative Care, Childcare, Camp, and Alternate Caregivers 411‑348‑0430
Individual Support Plan 411‑348‑0460
Civil Penalties 411‑348‑0470
License Denial, Suspension, Revocation, and Refusal to Renew 411‑348‑0480
Criminal Penalties 411‑348‑0490
Provider Eligibility for Medicaid Service Payment
Last Updated

Jun. 8, 2021

Rule 411-348-0180’s source at or​.us