Observations
Based on a review of the Staffing Requirements Facility Summary Report (SRFSR) and employee records, the facility failed to document the completion of 30 clock hours of annual training required for counselor assistants, after their first year, in one of five employee records reviewed.
The findings included:
Five employee records and the SRFSR were reviewed on January 7, 2016. One of the employees was a counselor assistant. The facility failed to document at least 30 clock hours of annual training in employee record #5.
Employee #5 was hired as a counselor assistant on February 27, 2013 and was still in the position as of the date of the onsite inspection. The facility's training year that was reviewed was from January 1, 2015 through December 31, 2015. Employee #5's employee record only documented 26.5 hours of annual training for the training year reviewed.
These findings were reviewed with facility staff during the licensing process.
|
Plan of Correction
Counselor Assistant's failure to complete 30 clock hours of training for training year July 1, 2014 -June 30, 2015 was an oversight of project compliance by Clinical Supervisor. Clinical Supervisor discussed the nature of the oversight with licensing agent at the time of inspection as well as Trehab's Executive Director upon completion of the inspection. Clinical Supervisor put the following activities in place to more effectively track employee #5's annual training hours: Clinical Supervisor made Counselor Assistant aware of the oversight, reviewed the regulation and provided a copy of the regulation for Counselor Assistant to keep in his training binder. Further, Counselor Assistant's training hour status for the current year was reviewed. Clinical Supervisor added "training hours tracking" to Counselor Assistant's weekly supervision form/case consult agenda making this a focus area. This will ensure consistent tracking of training hours and time to complete hours if Counselor Assistant becomes off track. Clinical Supervisor will provide 6-12 hours of in-house training within the next five (5) months to assist Counselor Assistant, as well as other clinical staff, with completion of required training hours. |