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Embed code for: 3rd Quarterly Report July-Sept 2016 cq
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CLIENT QUARTERLY PROGRESS REPORT
Reporting Period: July August September 2016
Individual’s Name: Cheryl Quassa
D.O.B. (dd/mmm/yy): August 8 1991
Home Community: Igloolik Nunavut
Community of Placement: Oshawa, Ontario
Date of Admission (dd/mmm/yy): December 15, 2015
Assigned Nurse: Trish Mussato
Name of Agency / Service Provider: Lakeview Community Living
Name of Agency Contact: Theresa Crilly
Care Provider Name: Tom and Theresa Crilly
Placement Address: 813 Stone Street, Oshawa, Ont. L1J 1A4
Placement Phone Number: 289 404 2374
Date of Yearly Medical: January 5, 2016
Section 1.0 Physical Health
Purpose of Medication
40 mg ½ tab noon
100mg 1 cap noon
500mg 1 tab am and noon
300mg 1 cap noon
1000 iu 1 tab am
100mg 5 tabs bed
25 mg 1 tab at noon, 5 tabs bed
1.2 Medication Changes
Please provide information on any medication changes since the last Quarterly Progress Report was submitted (name of new and/or discontinued medications and the reason for the changes): September 26, 2016
Nadolol 40 mg ½ tab noon
Soflax 100mg 1 cap noon
Calcium 500mg 1 tab at noon
Euro Fer 1 cap at noon
1.3 Medical Examinations
Type of Exam
Date of Last Exam
Outcome / Recommended Treatment
January 5, 2016
August 18, 2016
Dr. Gajraj Recommended Dentures
August 24, 2016
Dr. Gibbes Ontario Shores, Hearing for disposition order Nunavut Courts
1.4 Known Allergies
1.5 Personal Finance Accounting
300,00 per month
69.00 gst July 2016
Please see Comfort Allowance Records attached
Include client financial account spreadsheet as attachment as required.
Please provide information regarding dietary habits, dietary concerns, and any weight-loss programs the individual is participating in (if there is a rotating menu approved by the agency, please provide a copy with this report):
Metabolic Clinic Ontario Shores Cheryl was referred by Dr. Pytyck to the Metabolic Clinic for weight management and healthier lifestyle choice
Intake August 29, 2016
September 12, 25, 2016
Recommendation cut back on sugar replace with sweetener in coffee and diet pop, add more vegetables to diet.
Cheryl has followed through with the instructions given, she has been using the sweetener in her coffee and is drinking the diet pop.
We decided to go for walks to start for half an hour.
Section 2.0 Behavioural Health
2.1 Historical / Ongoing Behavioural Concerns
Number of Incident/Critical Incidents this Quarter: # 0
2.2 Recent / New Behaviours of Concern
2.3 Psychiatry / Psychology Supports / medical professional
Name of Professional
Date Last Seen
Outcome / Treatment Recommendations
July 28, 2016
September 8, 2016
Medication Review and Renewal
Medication Review and Renewal
July 11 25 2016
August 29 2016
September 12, 26, 2016
Psychologist Ontario Shores
Coping skills for cannabis use
July 6, 2016
August 17, 2016
Depo Provera Injection Next injection October 5, 2016
Foot care nurse, cuts toenails and scraps calluses.
Section 3.0 Individual Programming (SMART GOALS)
S. – Specific, M. – Measurable, A. – Assignable, R. – Realistic, T. – Time based
3.1 Life Skills Training
Please provide information on specific life skills (ie. activities of daily living) the individual is currently developing, the specific activities intended to achieve this goal, and any challenges encountered:
CQ is on a rotation of daily chores at Lakeview Community Living, more consistently with reminders, if not she will not usually complete the chore.
Hygiene- refuses to brush her teeth, reminders to change her clothing daily, generally hygiene is poor.
She will clean her bedroom with assistance and reminders, she will not independently complete the daily expectations making her bed, keeping her bedroom tidy.
SNAP program designed for adults with developmental delay addressing barriers that an adult would encounter on a day to day bases
Fire escape safety reviewed the plans for escape based on the location of the fire determining if they would escape out their window or the main exit door.
Fire safety in the home.
3.2 Social Skills Training
Please provide information on specific social skills (ie. interacting appropriately with others) the individual is currently developing, the specific activities intended to achieve this goal, and any challenges encountered:
CQ is allowed 2 hours twice a week with approved friends that do not use cannabis or drink alcohol. CQ has followed through with the rules and has abstained from any drug use.
CQ is supervised in the community by staff and transported as she would have a difficult time navigating the public transit at this time.
At times CQ has a difficult time interrupting the motives of others, particularly new comers. She will often create scenarios that she believes are true of other’s intentions. Often we will reassure her that the situation was not as she interrupted.
CQ will bully the staff if she does not like the answer given or if limits are placed. Generally if we explain why she will except the reason and calm down and becomes more co-operative.
3.3 Vocational / Academic Training
Please provide information about current vocational / academic activities, and the specific successes and challenges in this area: Not applicable at this time
3.4 Supported Employment / Volunteer Work
Please provide any information about current supported employment and/or volunteer work, and the specific successes and challenges in this area (please include the type of work, hours of work, and how long the individual has worked at this job): We offered the opportunity for CQ to start volunteering at Wind Reach Farms, a vocational community support program. CQ went with the group once and declined returning.
3.5 Leisure / Recreational Activities
Please provide any information about specific leisure / recreational activities the individual engages in, and the frequency of participation:
CQ goes swimming every Wednesday as part of the activity programming at Lakeview.
Brain Fitness CQ has been participating more with the group each week, she engages in the therapeutic games although she does not participate with the relaxation and breathing exercises.
As part of her goals with the Metabolic Clinic she has agreed to exercising each week, we will start with walking.
3.6 Cultural / Spiritual
Please provide information on specific ways the agency / care provider encourages the individual to maintain his/her cultural and spiritual identity (for example, traditional country food is offered; individual is encouraged to speak/learn his/her Inuit dialect, etc.):
Every Tuesday an instructor originating from Iqaluit comes to teach cultural studies. They share traditional food, music, crafts and converse in Inuktitut. The instructor shares stories from the north and cultural traditions.
CQ will be attending the dinners on Wednesday evening at the Aboriginal Centre in Oshawa.
3.7 Emotional Health & Wellness
Please provide a detailed summary of the individual’s ability to relate with others outside the home, coping skills used by the individual, the degree of success the individual has had integrating into the larger community, etc:
CQ has agreed to attend meetings with the psychologist Dr. Levi associated with Ontario Shores. The goals for counselling to learn new coping strategies in order to lessen the temptation to use cannabis. CQ has engaged in the counselling and willingly attends the meeting.
CQ requires supervision and must follow the rules associated with her community time in order to maintain the disposition order in place. To abstain from any illegal substance and alcohol. A urine sample is randomly taken by the nurse at Ontario Shores.
CQ’s sleep is uninterrupted except to use the washroom at night. She eats all scheduled meals and will begin exercising regularly.
3.8 Daily Schedule
Please provide a summary of the individual’s daily schedule (ie. what time meals are eaten, what time is allocated for pursuing personal leisure activities, etc.):
7:00-9:00 am breakfast, hygiene, make bed clean clothing for the day, medication is administered by the caregiver
Tuesday Cultural Studies
Wednesday SNAP life skills
Friday Shopping Allowance Day
12:00 -1:00 Lunch medication administered by caregiver
Monday to Friday Appointments and community time
Thursday Megan Marlowe RN from Ontario Shores visits Lakeview each week at 1:30 pm
Saturday and Sunday Leisure
4:00-6:00 pm Dinner Chores
Monday Community time
Thursday Brain Fitness
Friday Movie night or Nebs fun world
Monday to Sunday Snack, hygiene, medication administered, bed at 10:00 pm
Section 4.0 Advocacy
Is there currently specialized equipment (ie. mobility aids, developmental learning aids, communication aids, etc.) that the individual does not have access to that you feel would benefit the individual and enhance his/her quality of life? Please specify items and identify the potential benefits: None required at this time
4.2Access to Services / Support
Are there currently any services / supports that the individual is not receiving that you feel would enhance the individual’s quality of life? Please specify the services / supports, and identify how such supports would contribute to greater quality of life for the individual: None required at this time.
Please provide information regarding who comprises the individual’s support networks (both formal and informal) including names, relationship / role with the client, and how the agency encourages the individual to continually expand his/her informal support networks:
Dr. Pytyck Psychiatrist Ontario Shores Whitby
Dr. Green Family Doctor
Dr. Gajraj Dentist
Dr. Sud Optometrist
Ontario Shores Outpatient Services
Lakeridge Health Centre Hospital Oshawa
Recreation Centre Cedar Street and Legends
Whitby Library Oshawa Library
Smith House Cooking class
Aboriginal Centre Oshawa
Wind Reach Farms Vocational Training
Cultural Studies Lakeview Community Living Programming
Waterfront trail, exercise
Durham Mental Health Recreation Worker, comes to pick CQ up to do various actives in the community. Cooking class, Aboriginal Dinner, Swimming.
Please provide any information on personal items that the individual currently has, and items the individual has indicated s/he needs or would like to purchase, or you feel is needed (ie. clothing, television, stereo, bicycle, etc.): clothing, television, small stereo,
SECTION 5.0 FINANCIAL
5.1 Sources of Income
Please provide specific information on all sources of income, including personal spending money that has been allocated in the service contract, income assistance, and employment income (including hourly wage, number of hours worked per week, etc.):
Comfort Allowance 300.00 per month managed by caregiver, attached Comfort Allowance Records
GST cheque 69.00 quarterly July 2916
Please provide specific information on the individual’s monthly expenditures, including membership fees:
Swimming 4.25 x 2 per week
Community outings 20.00 per week
Cigarettes 52.00 per month Purchases cigarettes from the Indian reserve.
Cell phone 40.00 per month
5.3 Providing Support on Financial Matters
Please provide specific details regarding how the agency / care provider supports the individual to budget personal money, purchase desired items, pay bills, and complete day-to-day banking: Caregiver keeps a record of Comfort Allowance and disperses 5 dollars per day and 25 dollars each Friday, the remainder of the allowance goes to savings.
The cigarettes are kept in a locked cupboard and CQ receives on average about 15 cigarettes per day.
All of CQ’s personal items are provided by the caregiver.
SECTION 6.0 FAMILY CONTACT
Please indicate dates for any tele-health sessions that occurred between the individual and his/her family members since the last Monthly Progress Report was submitted:
July 28, 2016 Teleconference with CQ family in Igloolik.
Next teleconference scheduled for October 20, 2016 with family in Igloolik
6.2 Family Visits
Please indicate dates for any family visits that occurred (either the individual traveling home to his/her community, or family members visiting the individual’s placement) since the last Monthly Report was submitted:
CQ’s family came to Lakeview to visit with her August 8-15 2016. Her Aunt Veronica and sister Shirley came to visit. The visit went well, there was not any substance abuse and CQ enjoyed her time with her family shopping and visiting at Lakeview.
6.3 Permanency Planning
Please indicate progress toward repatriation and or step down to lover level care, if applicable:
To remain an outpatient at Ontario Shores living at Lakeview Community Living.
SECTION 7.0 RECOMMENDATIONS
Please provide information / suggestions that you feel will enhance the individual’s quality of life, improve the agency’s ability to provide a high quality of service, etc.: No request at this time.
Report Completed by: Theresa Crilly
Date Completed: October 18, 2016
Report Covers July1 ____________ to _September 30 2016______________
Signature of agency representative:______________________
Printed Name: Theresa Crilly__________________
Date report send via email:
10 | Page Revised Sept 2016
Comfort Allowance 300.00 per month managed by caregiver, attached Com