Supervisor Assurance
[To confirm successful completion of training, testing and competency requirements for the DD Waivers]
I, __________________________ (print), recognize that, as a condition of
providing services or consultation under the BI, FIS and CL Waivers, the following requirements must be met. I hereby assure that, as supervisor of these services, the following events have occurred as described.
1) I have reviewed the required training topics (including the characteristics of developmental disabilities and Virginia’s DD Waivers, person-centeredness, positive behavioral supports, effective communication, DBHDS-identified health risks and the appropriate interventions, and best
practices in the support of individuals with developmental disabilities) and
completed the DBHDS online training for supervisors, which details the supervisors’ responsibilities for ensuring DSP training, testing and competency requirements of the BI, FIS and CL waivers.
2) I have obtained a supervisor’s training certificate through the DBHDS Knowledge Center and passed the Orientation Manual test (with a total score of 80% or better).
3) I [or a certified trainer] will ensure that DSPs who will be providing services have received training in the characteristics of developmental disabilities and Virginia’s DD Waivers, person-centeredness, positive behavioral supports, effective communication, DBHDS-identified health risks and the appropriate interventions, and best practices in the support of individuals with developmental disabilities and have passed the Orientation Manual Test (with a total score of 80% or better).
4) I will complete a DBHDS competency checklist(s) that are maintained in agreement with DBHDS requirements including annual updates and the program director’s (or designee’s) signature to include the DSP and Supervisor’s Competencies Checklist (DMAS P241a) and if working in a
DBHDS-licensed service the appropriate additional competencies checklist(s) when supporting individuals at Tier Four based on their completed Supports intensity Scale©.
5) When using the “Orientation Manual for DSPs and Supervisors (July 2016),” I agree NOT to give the manual to DSPs as a self-study tool, but rather to meet with them individually or in small groups to review the content and dialogue about it. I will meet with DSPs who utilize the on-line orientation training for DPSs to facilitate their further understanding of the material and answer questions.
Supervisor’s Signature Date
Director/Manager’s Signature (Optional) Date
Agency Name and Address
Please keep this assurance, your training certificate, and competency checklist(s) on file for viewing during a DBHDS Licensing and DMAS Quality Management Review.
(DMAS P245a)
Name / Title: | Emily McClellan / Regulatory Manager |
Address: |
Division of Policy and Research 600 E. Broad St., Suite 1300 Richmond, 23219 |
Email Address: | Emily.McClellan@dmas.virginia.gov |
Telephone: | (804)371-4300 FAX: (804)786-1680 TDD: (800)343-0634 |