Name: _________________________
Date: _________________________
Procedural Safeguards and Mediation Self Study Examination
2.Families whose children
receive early intervention services must receive and understand procedural safeguards which informs them of:
a) Rules and Regulations
b) Consent
c) Right to Decline Services
d) Right to Examine Records
e) Prior Notice
f) Surrogate Parents
g) Dispute Resolution
h) All of the
above
for the system as well as impartial procedures for
________________ _____________________.
a) The Service Coordinator from the Base Service Unit
b) The family
c) The Program Supervisor
d) The Primary Interventionist
5.
Written consent must be obtained when
a)
An initial evaluation and assessment is being conducted
b)
An at-risk child is being referred for tracking
c)
Determining eligibility for ITF waiver services
d)
When any early intervention services or services are being
initiated or changed
e)
Any or all of the above applies
6. Full information in ____________________________ is necessary to obtain
consent.
7. A parent can determine whether or not to accept or decline any service. True or false
8. Declining a service after first accepting that service may affect the provision
of other early intervention services. True or false
9. In accordance with the confidentiality procedures in federal regulations,
parents have a right to _________________ and _______________ records.
10. __________________ _______________________ __________________ must
be given to the parent(s) prior to the county program proposing, refusing,
initiating or changing the identification, evaluation or placement of the child or the provision of services.
11. In order to ensure the rights of a child receiving services, the county must
appoint a surrogate parent when
a) A parent cannot be identified.
b) The child is in legal custody of a Children and Youth agency and a birth parent cannot be identified.
c) The child is in legal custody of a Children and Youth agency
and parental rights have been
terminated and no other parent can be identified.
d)
The birth parents are deceased.
e) Any of the
above circumstances applies.
development and implementation of the IFSP. True or False
a)
b)
c)
a) May not be used to deny or delay the request for a due
process hearing
b) May be offered first to a parent who is requesting a due
process hearing
c) Is voluntary
on the part of the parents
d)
Must be conducted by a qualified, trained mediator
e) All of the above
a) Mediation promotes a positive
relationship between al parties
b) Mediation helps all parties to understand each other’s
point of
view
c) Builds trust necessary to resolve possible
future disputes
d) Less stressful, less expensive and less time
consuming than a
a hearing
e) All of the above
a) A written conclusion
b) No conclusion
c) Another meeting scheduled
Comments:
A
BARC Early Intervention Department Director or Supervisor will review this
document. I understand that in order to
receive a credit of two hours towards the State Mandated 0-3 annual
professional development requirement, this self-study examination must be
complete and accurate.
________________________________ ___________________________________
(Signature) (Date)
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For Office Use Only
Reviewed by: ________________________________________________________
Title: _______________________________________________________________
Date: _______________________________________________________________