STAFF ADMINISTERING OF MEDICATION Sample Clauses

STAFF ADMINISTERING OF MEDICATION. I hereby request and authorize Roitenberg Family Adult Day Program staff to assist with administration of my medications as prescribed by my doctor. My medication will be secured by staff and administered to me at the indicated time according to the medication schedule provided. I understand that I am responsible for the procedural requirements listed above and that day center staff are not responsible for procuring my medications. PARTICIPANT/RESPONSIBLE PARTY SIGNATURE DATE STAFF SIGNATURE DATE Roitenberg Family Adult Day Program Participant File Participant Medication List Participant Name Admission Date Date Does the participant take any medications? Yes No Is the participant responsible for taking his/her own medications? Yes No Will Roitenberg AD staff be responsible for the administering of medications for the participant at the center? Yes No Medications - Please list ALL current PRESCRIPTION and OVER THE COUNTER medications - Information must be accurate and complete - Medication to be taken at the Roitenberg Adult Day must be marked with an X MEDICATION DOSAGE TIME TAKEN REASON SPECIAL INSTRUCTIONS                    THE ADULT DAY STAFF ARE NOT RESPONSIBLE FOR INACCURATE OR MISSING INFORMATION. IT IS VERY IMPORTANT THAT MEDICATION INFORMATION BE UPDATED REGULARLY FOR PARTICIPANT SAFETY, AND MAY BE DONE AT ANY TIME BY CONTACTING ROITENBERG ADULT DAY AT 000-000-0000. PARTICIPANT/RESPONSIBLE PARTY SIGNATURE DATE STAFF SIGNATURE DATE Roitenberg Family Adult Day Center Participant File Orientation Checklist Participant Name Admit Date BY SIGNING ON THE LINE BELOW I AM ACKNOWLEDGING THAT I HAVE RECEIVED ORIENTATION PRIOR TO AND DURING THE ADMISSION PROCESS, OR WITHIN 24 HOURS AFTER ADMISSION, INCLUDING:  Internal and external reporting procedureContact information for the license holder’s common entry point  ADC abuse prevention plan. I HAVE ALSO RECEIVED THE FOLLOWING INFORMATION IN WRITING DURING THE ADMISSION PROCESS, AND STAFF IN THE ADULT DAY CENTER HAS ANSWERED ALL QUESTIONS TO MY SATISFACTION:  Overview of the program’s services and care provided  Description of the population the ADC serves  Description of individual conditions the ADC is not able to serveProcedure for reporting a grievance  Copy or summary of Minnesota Statute 626.557, Vulnerable Adult Act  Transportation policy and procedure  Provision of meals and snacksProgram fees, billing, payment plans, and options for assistanceSmoking policyIns...
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