| Administrative Agency Standards Directives, etc. |
Attachment 1: List of Agency Directives, etc. |
Attachment 2: Board of Director Training Guide |
Directives | Attachments |
100-25-DD | Disaster Preparedness Plan |
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100-29-DD | SCDDSN Medication Error/Event Report |
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101-03-DD | Service Agreement and Permission to Evaluate |
| Greenwood Genetic Services Consent Form |
|
104-01-DD | Request for Exception Form |
| Application to Operate Residential, Day Facility, or Camp |
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104-02-DD | DHEC Health Licensing Inspectors |
|
200-01-DD | Cash Ledger for Funds Maintained At Residential Level |
|
200-02-DD | Attachment A: Statement of Financial Rights |
| Attachment B: Guidelines for Purchases (Personal vs. Dept. Funds) |
| Attachment C: Personal Funds Draft |
| Attachment D: Group Withdrawal Draft |
| Attachment E: Shopping Worksheet |
| Attachment F: Regional Bank Liaison Application |
| Attachment G: Regional Bank Purchasing Card Application |
| Attachment H: Purchasing Card Change Request |
| Attachment I: Purchasing Card Credit Limit Change Request |
| Attachment J: Purchasing Card Request for Purchase |
| Attachment K: Purchasing Card Record for Group Entertainment Purchases (Restaurant/Movie Tickets) |
| Attachment L: Regional Bank Authorized Signatures Record |
| Attachment M: Regional Bank Signature Card |
|
| 200-03-DD | Attachment A: Past Due Payment Agreement |
| Attachment B: ARRC Review Notification Letter |
| Attachment C: ARRC Decision/Appeal Notification Letter |
|
| 200-12-DD | Attachment A: Statement of Financial Rights |
| Attachment B: Fee Schedule |
| Attachment C: Statement of Financial Responsibilities |
| Attachment D: Application for Benefits and Management of Funds Authorization |
|
| 200-14-DD | Schedule 14 to the Capital Application |
| Application for Capital Funds |
| Addendum A |
| Addendum B |
| Addendum C |
| Addendum D |
| Addendum E |
| Addendum F |
| Addendum G |
|
250-05-DD | Attachment A |
| Attachment B |
|
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250-08-DD | Appendix A: Procurement Exemptions |
| Appendix B: Blanket Purchase Agreements |
| Appendix C: Instructions |
| Appendix C: Solicitation Template |
| Appendix C: Amendment Template |
| Appendix C: Verification Sheet |
| Appendix C: Tally Sheet Template |
| Apendix C: Award Template |
| Appendix D: Instructions |
| Appendix D: Solicitation Template |
| Appendix D: Amendment Template |
| Appendix D: Verification Sheet |
| Appendix D: Tally Sheet Template |
| Apendix D: Award Template |
|
250-09-DD | Calculating Room and Board Example |
|
250-10-DD | Statewide Individual Funding Levels |
|
250-11-DD | Attachment A: Initial Request for Outlier Funding |
| Attachment B: Rejustification Request for Outlier Funding |
| Attachment C: Certification of Provision of Services for Residential Outliers |
| Attachment D: Residential Staffing Pattern Spreadsheet |
| Attachment E: Residential Staffing Pattern Examples |
|
250-12-DD | Application |
|
275-01-DD | Missing Property Report |
|
275-04-DD | Sample Financial Statements |
| Independent Accountant's Report on Applying Agreed-Upon Procedures |
|
300-03-DD | Attachment A: Annual Facility Inspection Report-General Building Inspection
Attachment B: Electrical Inspection
Attachment C: Mixing Valve Inspection Check List
Attachment D: Fire Sprinkler Systems-Monthly & Quarterly Inspection Form
Attachment E: Fire Sprinkler Systems-Semi-Annual Waterflow Alarm Test Form
Attachment F: Generator Inspection Check List
Attachment G: HVAC Inspection Check List |
|
334-02-DD | Facility Use Application |
|
334-03-DD | Glossary |
| Vehicle Management Program Manual |
| Appendix A: Request to Purchase/Dispose Vehicle |
| Appendix A-1: Vehicle Disposal Criteria |
| Appendix B: Non-State Employee to Operate a State Vehicle |
| Appendix C: Certificate of Non-Availability of State Vehicle |
| Appendix D: Drive Record Screening Request |
| Appendix E: Drive Corrective Actions |
| Appendix F: Accident Procedures and Report Form |
| Appendix F-1: DDSN Regions and Board Accident Procedures |
| Appendix G: Quarterly Accident Reporting and Information Sheet |
| Appendix H: Accident Review Boards |
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334-04-DD | Employee Acknowledgment of DDSN Drug & Alcohol Testing Policy |
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367-02-DD | Acquiring Information Technology (IT) Products and Services |
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368-01-DD | Record/Document Loss Report |
|
402-01-DD | Employee Performance Management System Policy |
| Employee Performance Characteristics |
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403-01-DD | Nomination Form Completion Instructions |
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406-04-DD | DHEC Form |
| Service Letter |
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413-01-DD | Guidelines for Employee Progressive Disciplinary Action |
| Report of Counseling Conference |
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418-01-DD | TERI/Retiree Employment Interest Form |
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502-01-DD | Community Residential Admission/Discharge/Transfer Report |
| Residential Respite Form |
| Residential Vacancy Form |
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502-05-DD | Report of Critical/Urgent Circumstances |
| Review of Report of Critical/Urgent Circumstances |
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502-10-DD | Regional Center Individual Transition Checklist |
|
505-02-DD | Report of Death |
| Report of Death (Final) |
|
510-01-DD | Balancing the Right of Consumers to Choose with the Responsibility of Agencies to Protect |
| Supervision Guidance |
| Sample Supervision Plans |
| Home Without Staff on Site Guidance |
| Home Without Staff on Site Plan |
|
534-02-DD | Attachment A- Reporting Allegations of Abuse, Neglect or Exploitation |
| Attachment B - Initial Report of Alleged Abuse, Neglect or Exploitation |
| Attachment C - Administrative Review of Alleged Abuse, Neglect or Exploitation – ICF/ID Facilities |
| Attachment D - Administrative Review for Improper Conduct Toward Consumer |
| Attachment E - Management Review for Improper Conduct Toward Consumer |
| Attachment F - Addendum to Management/Administrative Review Report |
| Attachment G - Receipt of Property |
| Attachment H - SCDDSN Acknowledgement of Training on Preventing and Reporting Abuse, Neglect or Exploitation |
| Attachment I - Request for Reinstatement of Employee |
| Attachment J - Decision – making flow chart for type of review provider may undertake for an adult consumer (18+) and when a reinstatement of an employee may be requested to DDSN |
| Attachment K - Same as above but change for a minor consumer (< 17) |
|
535-07-DD | Flow Chart |
| Instruction Sheet for Health Care Consent Form |
| Health Care Consent Form |
|
535-10-DD | SEC Form 2030-201004 Declination to Register to Vote |
|
535-11-DD | Appeal or Request for Reconsideration Form |
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535-12-DD | Declaration of a Desire for a Natural Death |
| Health Care Power of Attorney |
| Your Right to Make Decisions About Your Health Care |
|
567-01-DD | Attachment A - Outline of Minimum Requirements for Curriculum |
|
567-04-DD | Approved Systems/Curricula |
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600-05-DD | Components of Meaningful Environments & Specialized Services |
| Examples of Informal Behavioral Guidelines and Interventions (2) |
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600-10-DD | Personal Property Record |
| Inventory of Personal Property for Overnight Visits |
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603-01-DD | Examples of Psychopharmacologic Medication as of 2011 |
| Tardive Dyskinesia Education Sheet |
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603-02-DD | Infection Control Manual |
|
603-05-DD | Consent for HIV/HBV/HCV Testing |
| Employee Blood/Body Fluid Exposure & Testing Summary |
| Management of Exposure to the Hepatitis B Virus |
| Management of Exposure to the Hepatitis C Virus |
| Management of Exposure to the HIV Virus |
| Situations for Which Expert Consultation for HIV Postexposure Prophylaxis is Advised |
| Health Care Professional's Written Opinion for Employees |
|
603-06-DD | Definition of Terms |
|
603-09-DD | Consent for HIV/HBV/HCV Testing |
| Guidelines for Blood Exposure Management at a Glance |
| Blood/Body Fluid Exposure & Testing Summary |
| Management of Exposure to the Hepatitis B Virus |
| Management of Exposure to the Hepatitis C Virus |
| Management of Exposure to the HIV Virus |
| Situations for which expert consultation for HIV postexposure prophylaxis is advised |
|
603-10-DD | Assessment for Latex Sensitivity/Allergy Risk Factors |
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603-12-DD | S.C. Department of Disabilities and Special Needs Immunization Record |
| Rules of Simultaneous Administration of Vaccines |
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603-13-DD | Curriculum Outline |
|
604-01-DD | Sample Inventory Document (Blank) |
| Instructions for Completing Inventory Document |
| Sample Inventory Document (Completed) |
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700-02-DD | Request for payment for Interpreter Services |
|
700-03-DD | Medicaid Funded Service Options |
| Evaluation for Community Living |
| Resource Information |
|
700-04-DD | Attachment A - Level I/Level II Service Coordination Assessment |
| Attachment B - Service Coordination Levels |
|
734-01-DD | Form 350 - Request Form – Individual and Family Support |
| Form 351 - Individual and Family Support - Request for Payment |
| Attachment A - Means Test for IFS Only |
|
735-02-DD | Statement of Legal Responsibility |
| Guidance to Service Coordinators/Early Interventions for Assisting With the Determination of Legal Responsibility |
|
736-01-DD | Statement of Legal Responsibility |
| Guidance to Service Coordinators/Early Interventions for Assisting With the Determination of Legal Responsibility |
|
738-01-DD | Service Coordination Services |
| Acknowledgement of SC/EI Choice |
| Invoice for Discharge Planning from ICF/ID and Enrolling in the ID Waiver Program |
| ID/RD Waiver Information Sheet |
| CS Waiver Information Sheet |
| HASCI Waiver Information Sheet |
| Community Residential Admission/Discharge Report |