First Aid and Safety
Tools and Trainings
Privacy and Protection
Compliance and Complaints
Access and Input
Miscellaneous
100

Where are the First Aid kits located?

Billing/reception offices, kitchen, Director's office. *All locations are noted on the evacuation maps

100

What trainings are provided to staff related to privacy, ethics, and compliance? How frequently? 

Code of ethics, CMS Compliance, MENTOR South Bay Compliance, and Privacy and Security. Trainings are provided annually and during orientation. 

100

Where is the Notice of Privacy Practices available?

Summary of Privacy Practices are included in the Person Being Served Orientation Manual, the Notice of Privacy Practices is available to all consumers upon request, copies are maintained in reception, Reminder of Notice of Privacy Practices is posted in the waiting room bulletin board.

100

What Code of Ethics does MENTOR South Bay recognize? Where is this located?

MENTOR Code of Conduct, MENTOR Compliance Plan and the Employee Information Guide are available in Salesforce Libraries .Staff are also required to adhere to any professional code of ethics.

100

How is consumer input obtained by MENTOR South Bay?

Consumer satisfaction calls completed by management, surveys are sent via email, Consumer Councils. Additionally clients/guardians can contact MENTOR South Bay at any time to provide input. During field observations/supervisions when applicable.

100

Who is the Medical Director?

Dr. Killion

200

Where are the fire extinguishers located? 

Kitchen, reception, treatment hallways

*All locations are noted on the evacuation maps

200

What trainings are provided to staff related to cultural competency? How frequently?

Cultural Competency/Humility and Human Rights. Trainings are provided annually and during orientation. 

200

Who is allowed to request medical records? When does MENTOR South Bay release records?

Anyone can request records. MENTOR South Bay releases records only with valid release to do so (signed by client/legal guardian), an access request completed by client/legal guardian for their records, or a court order signed by a judge

200

How can a client/guardian file a complaint? Where is this information available?

Contact a site supervisor, director, QI or MENTORNetwork’s Compliance Hotline, this information is shared during the intake process and reviewed as needed. This information is outlined in Grievance Procedure form. If all internal avenues are exhausted or at any time they choose, clients may also file complaints externally through DPH, licensing board, insurance company.

200

How is employee input obtained by MENTOR South Bay?

Supervision, team meeting, town hall meetings, employee surveys. Senior management also has an open door policy so staff may contact the President and others at any time to provide input.

200

Where is medication stored?

We do not store medication on sites, if a client needs to take medication while on site, they need to inform their clinician and it must be kept on their person. Staff must keep all medication on their person or locked up.

300

Where are rubber gloves located? When would you need to use them?

In the first aid and spill kits. They are used to clean up any bodily fluids/vomit. 

300

What safety related trainings are provided to staff? How frequently?

Health and Safety, Workplace Violence and Crisis Prevention, Community Outreach and Safety. Trainings are provided annually and during orientation. 

Active Shooter training is provided annually. 

300

What are examples of how MENTOR South Bay protects privacy of individuals served?

Administrative, Technical, and Physical Safeguards. Examples include: all records are maintained in locked filing cabinets; electronic records are encrypted; password protection on all devices, EHR, email; HIPAA log in EHR; policies and procedures in place; privacy training provided to all employees.

300

Where are formal complaint/grievance forms located?

The MENTOR Network Employee Information Guide and Employee Code of Conduct

300

How is someone referred to services at MENTOR South Bay?

They can self refer, be referred through family members or other community agencies (hospitals, doctors, DCF, schools, probation)

300

When is an incident report completed?

Any factual occurrence or anticipated event in which a MENTOR client is (or would be) the cause or victim of emotional, physical, or social harm to himself/herself or to others. In the event of an incident which is outlined in the Incident Management Process Procedure, reports are to be completed in 24 hours. Notification requirements are based on Level of crisis.

400

Where are the evacuation plans locted?

By the door of every room, and in the hallways. 

400
How does a clinician develop a person centered treatment plan?

After completing a comprehensive assessment, the clinician collaborates with the client/family to develop appropriate goals and an individualized plan. 

400

When is a client/guardian informed of their rights? How is this done?

   

 During the initial intake session, through the Patient Rights, Privacy Practices or Family Handbook, this information is verbally shared and the client/guardian is provided a copy as requested. Information includes Patient Rights, Privacy Practice, Consent to Treat and can be found in the office in a prominent location.

400

What is MENTOR South Bay’s Compliance Hotline used for? Who can call the hotline? Where is this information available?

A) To report any compliance concerns (billing, privacy, etc)  B) Anyone can call the hotline C) Posters in the team room, Orientation and annual trainings, Person Being Served Orientation Packet

400

How is a person screened for services?

Intake department gathers demographic and insurance information. Director reviews referral and assigns to appropriate clinician, a Masters level clinician completes a biopsychosocial assessment and determines medical necessity, case is further reviewed in supervision.  

400

What are MENTOR South Bay’s values?

Integrity, Respect, Inclusion, Growth

500

Who is First Aid and CPR trained on site? Where is this information available?

Site supervisors and directors must be trained, all EI staff must be trained. 

Names are listed on the first aid kits. 

500

What outcome tools does MENTOR South Bay use?

PHQ-9, CANS, PROMIS

500

Where can staff locate Policy and Procedure Manuals?

Google Drive SBM_Public Folders, which can be accessed through Credible Homepage links then select Policy and Procedure folder. This can also be saved to staff’s drive for quick access.

500

Who is The MENTOR Network’s Compliance Officer? How can this person be reached?

Mary Rodenberg-Roberts, email: Mary.Rodenberg-Roberts@thementornetwork.com    


Please note: This also includes privacy related concerns 

500

If a person is found ineligible for services how are they informed?

By the clinician or management in person or via phone. Person will be notified of reason and staff will refer elsewhere or identify other community supports as appropriate.

500

What is MENTOR South Bay’s mission?

The MENTOR Network’s mission is to offer adults, children, and their families innovative, quality services and supports that lead to growth and independence, regardless of the physical, intellectual or behavioral challenges they face. Our philosophy emphasizes partnerships—with those we serve, their families, our employees, Mentors, payors and the communities in which we work—in an effort to help individuals shape the direction of their own lives in community-based settings.

600

Who is the Evacuation Team Leader? What is their role?

Krista Berardi- ensures authorities and staff are notified during hazard and staff have evacuated. 

600

What is a Consumer Resource Manual? Where is it located?

Available community resources for clients/guardians, it is available in the reception area. 

600

What does HIPAA stand for?

Health Insurance Portability and Accountability Act

600

Where is supervision documentation located?

In Credible employee forms. Prior to 2016, paper supervision records stored in locked cabinets on site.

600

What happens if person-served is in crisis after hours?

They can call the 24 hours on-call number 1-800-244-4691 in order to be connected with a supervisor or director.

600

If a CARF surveyor asks you a question you do not know how should you respond?

I do not know off hand, let me find that for you. Let me speak with my manager to get you that information. I will refer you to the appropriate person to obtain that information. Do NOT make up an answer if you are unsure if is ok to need to look something up or get further assistance.

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