Zenith CSSP Post Tests Make sure the answers correspond exactly with the CSSP. If there are any answers that you need included or changed, email Jason. CSSP for ZenithYour NameProgram and initials of the the personDoes this person need support with hearing or vision? Yes NoWhat kind of supports are needed while the person is eating? None-- the person is independent Needs supervision/verbal prompts Needs food cut up in bite sized pieces Needs food ground up in a food processor Needs food pureed The person cannot have anything by mouthWhat allergies does the person have? Make a list separated by commas. For example: Pollen, Eggs (if none put none) Does this person ambulate independently? Yes No-- the person needs at least some support while walking or in the wheelchairDoes this person need physical assistance with toileting? Yes NoDoes the person have any risks in regards to sexual abuse? (Select all that apply) This person is NOT at risk of sexual abuse. Inability to be assertive. Lack of understanding or sexuality. Likely to seek or cooperate in an abusive situation. Displays sexual behaviorDoes the person have risks in regards to physical abuse? (select all that apply) The person is NOT at risk for physical abuse. Inability to deal with verbally/physically aggressive persons. Inability to identify potentially dangerous situations. “Victim” history exists. Verbally/physically abusive to others. Lack of community orientation skills. Inappropriate interactions with others.Is this person susceptible to self-abuse? (Select all that apply) The person is NOT at risk of self-abuse. Eats non-edible substances. Unsafe conduct in a vehicle. Dresses inappropriately Elopement Refuses to eat. Chooses not to take medications. Lack of self-preservation skills (ignores personal safety). Inability to care for self-help needs. Engages in self-injurious behaviors. Alcohol, tobacco, drug use.Is this person at risk of financial exploitation? Yes NoDoes this person have a history of inaccurate reporting? Yes NoWhat is the staff ratio needed for this person? 1:1 1:2 1:4 1:8Describe the person's receptive communication Hears and understands verbal communication of others well Limited and requires specialized knowledge (sign language, cues that are easy to miss, special phrases) Utilizes hearing aids for assistanceWhich of the following matches the person's safety in being alone?Can be alone in another roomCan be alone with limitations (not when upset or not with others while without staff)Within arm's reachWithin visual rangeWithin hearing rangeDescribe the person's expressive communication Verbally expresses words and phrases well Gestures (body language, facial expression) Communication device or sign languageDoes the person work while at Zenith? Yes NoTransportation Needs (Click all that apply)Specialized (ride along)Wheelchair tie-downCan be dropped off at home aloneMust see staff on premises (not just a car in the driveway)Submit Form
