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Program Plan Information and Development

ICF/DD-H and ICF/DD-N

Note: You can download a Full Packet or use the links below to download the specific documents needed.

Full Packet: ICF/DD-H     (75 pages - PDF)

Full Packet: ICF/DD-N     (110 pages - PDF)

1. General Information
Intermediate Care Facility - (ICF/MR) Program Types Information on Navigating the Agencies Required Eight-Hour Provider Training Health and Safety Code 1268.6 Directory of Regional Centers ICF Resources Links DDS - Health Facilities Program Section
2. Health Facility Program Plan Information and Application
Approval and Notification Information   DS 1852 - HFPP Application (PDF)
2a. Program Plan Development for ICF DD-H (Habilitative)	2b. Program Plan Development for ICF-DD-N (Nursing)
Program Plan Format Instructions (PDF) Consultants/Professional Staff (PDF) Staff Schedules (PDF) Checklist: ICF/DD-Habilitative Program Plan (PDF) Checklist: ICF/DD-H Medication Training Program Plan (PDF) California Code of Regulation (Title 22, Division 5, Chapter 8.5, Article 1, Section 76800-76962)	Program Plan Format Instructions (PDF) Changes in Required Staff Hours (PDF) Consultants/Professional Staff (PDF) Staff Schedules (PDF) Checklist: ICF/DD-Nursing Program Plan(PDF) Checklist: ICF/DD-N Medication Training Plan (PDF) DS 1853: Training Program for ICF/DD-N Attendant (PDF) ICF/DD-N Draft and Amended Regulations (PDF) (Source: Title 22, Department of Health Services)
	2c. Attendant Training Program Information Packet
	Attendant Training Program - Specialized Procedures Department Health Services (DHS) Letter PTB 91-42 (PDF) DHS - Title 22 Amended Regulations (PDF) Nursing Practice Act - Attendants and Technicians in Institutions; Supervision (PDF) Unlicensed Assistive Personnel - Board of Registered Nursing (PDF) The RN as Supervisor - Board of Registered Nursing (PDF) Considerations for the Assignment and Performance of Specialized Procedure (PDF) Specialized Procedure Format (PDF) DS 1851: Specialized Procedures Request Cover Sheet (PDF)
3. Qualified Mental Retardation Professional (QMRP) & Consultants/Professional Staff Information
QMRP Requirements Survey Procedures and Interpretive Guidelines for ICF for Persons with Mental Retardation (W159-W180) (PDF) (Source: Code of Federal Regulations, Centers for Medicare and Medicaid Services, State Operations Manual - Appendix J) Role of Registered Nurse (PDF)
4. Task Two Protocol: Key Components of Systemic Approach to Prevent Abuse and Neglect
Development of Facility Policy on Abuse and Neglect Reducing Risks (PDF) Guidelines for Determining Immediate Jeopardy - Seven Components to Abuse Prevention (PDF) (Source: Code of Federal Regulations, Centers for Medicare and Medicaid Services - Appendix Q) Special Incident Reporting Requirements Letter (PDF) Special Incident Reporting Requirements, Quick Guide (PDF) CCR, Title 17, Division 2, Chapter 3, Community Services, SubChapter 2, Vendorization Process, Section 54302 and 54327.