PROGRAM PLAN FORMAT
ICF/DD-NURSING
Instructions
1. To develop your Program Plan use the Program Plan Checklist, Title 22, and the Code of Federal Regulations, Appendix J (Federal Tags) as your guide.
2. Prior to submission to DDS, review your Program Plan against the checklist to ensure that it is complete. Enter the specific page number in the left column of the checklist to coincide with the program plan.
3. Place components of the Program Plan in sequential order to assure approval in a timely manner (see sample Table of Contents below).
4. Language should be clear and concise. We recommend a 12-point font. Please do not use only uppercase letters.
5. The Nurse Consultant will review the Medication Training Program Plan, Attendant Training,
ICF/DD-NURSING
Instructions
1. To develop your Program Plan use the Program Plan Checklist, Title 22, and the Code of Federal Regulations, Appendix J (Federal Tags) as your guide.
2. Prior to submission to DDS, review your Program Plan against the checklist to ensure that it is complete. Enter the specific page number in the left column of the checklist to coincide with the program plan.
3. Place components of the Program Plan in sequential order to assure approval in a timely manner (see sample Table of Contents below).
4. Language should be clear and concise. We recommend a 12-point font. Please do not use only uppercase letters.
5. The Nurse Consultant will review the Medication Training Program Plan, Attendant Training,