Request for Engagement
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Number of people supported | |
---|---|
Service coordination/Case Management for families with young children (0-5) | 0 |
Foster Care for children (ages 0-5) | 0 |
Adoption services for children (ages 0-5) | 0 |
Early Intervention Services (ages 0-5) | 0 |
Other services for families with young children (ages 0-5) | 0 |
Number of people supported | |
---|---|
Service Coordination/Case Management services for children and youth (ages 6-18) | 0 |
Foster Care for children (ages 6-18) | 0 |
Adoption services for children (ages 6-18) | 0 |
Transition services | 0 |
Other services for children and youth (ages 6-18) | 0 |
Number of people supported | |
---|---|
Service Coordination/Case Management services for adults (ages 19 and above) | 0 |
24/7 Residential services | 83 |
Residential Services NOT 24/7 | 7 |
Host Home/Shared Living Services | 1 |
Employment services for people ages 16 and above | 26 |
Day Services/Programming (not employment) (senior or adult day services) | 76 |
Other services for adults with intellectual and developmental disabilities | 0 |
Number of people supported | |
---|---|
Other services for adults with mental health disabilities | 0 |
Other services for adults with substance use disorder | 0 |
I affirm that all people receiving services from Independent Opportunities, Inc. are included in the numbers provided in this section. I understand that CQL will include all services relevant to the accreditation in visit activities.
Organizations new to accreditation with CQL: If the organization wishes to exclude any relevant services from the accreditation process, approval must be requested from and approved from CQL VP of Services and Systems Excellence.
Signature
CQL Certification is a multi-step process that increases the validity and reliability of information-gathering and data collection when conducting POM interviews. After someone takes part in the POM Workshop, conducts practice interviews, goes through the coaching activities, and successfully passes their inter-rater reliability (IRR) assessment, they will achieve CQL Certification and begin their two-year certification term. All of those steps are required to achieve CQL Interviewer Certification. Additional steps are required to achieve CQL Trainer Certification.
Participation in the POM Workshop alone does not mean that the participant has achieved CQL Certification.
Only current CQL staff members are to able conduct the CQL Certification process and grant CQL Certification. Neither Certified Interviewers or Certified Trainers are able to grant CQL Certification – either internally at their organization or externally at other organizations. If someone is currently an active Certified Trainer in the Personal Outcome Measures, they are also a Certified Interviewer.
To maintain CQL Certification status, every two years the Interviewer must pass a new IRR assessment, and have met the current recertification requirements. Those requirements can be found on our website here. If these requirements are not met every two years, they are no longer a current, active Certified Interviewer or Trainer.
If your regulating/licensing body publishes licensure or certification information, please include the website/hyperlink or other means to access that information here: https://www.tn.gov/disability-and-aging.htmlwebsite/hyperlink
With my signature below I agree to provide completed copies of evidence of compliance for any external monitoring reports and if appropriate, approved corrective plans to CQL as requested. I also attest that all information in the section titled "Certification of Compliance" is accurate as of the date submitted.
Signature
AnnFirst Name WilliamsLast Name
Name | Title | Phone | |
---|---|---|---|
Theirl Jarman | 918-744-5067 | tjarman@ioi-tulsa.com | |
Ann Williams | 9316260990 | awilliams@ioi-tn.com |
Hotel/Motel | Street | City | State/Province | Distance (miles) to organization |
---|---|---|---|---|
Hilton Gardin Inn | 412 Royal Parkway | Nashville | TN | 5 |
The undersigned hereby agrees to work with CQL | The Council on Quality and Leadership for CQL Accreditation and/or related activities, agrees to pay the established fee, and grants permission to licensing agencies and any other relevant examining or reviewing entity or group to release official records and information to CQL for its consideration during the accreditation process.
Upon receipt, CQL will process this request and, if accepted upon review of documentation, set dates for the initial accreditation. In the event that the scheduled accreditation is canceled or postponed by the organization, the organization is responsible for payment of any expenses incurred by CQL.
Organization Name: Independent Opportunities, Inc.Organization Name
Signature of Chief Executive Officer/Designee: Signature
Date: 09-12-2024Date
Reminder
Please visit the webpage for Person-Centered Excellence Accreditation, with Distinction (PCE-D), if you are applying for that type of accreditation. It lists additional requirements and evidence that must be submitted with this request for engagement.
The following documentation must be submitted with this Request for Engagement to be considered for Person-Centered Excellence Accreditation, with Distinction.
The total cost for Systems Accreditation is US$5,250.
For all other Accreditation types, the total cost is based on several factors, including the number of people you provide services for, the diversity of services you offer, and the geographical size.
Description | Amount |
---|---|
Quality Assurances, Person Centered Excellence, Person Centered Excellence with Distinction-Engagement Fee $2,500.00 x 1 | $2,500.00 |
Next Steps
You will receive a letter of engagement with the dates and cost of accreditation along with preparation guidance and support (this includes access to the PORTAL Data System, planning meetings, manuals, etc.) once the request has been processed and accepted and your organization has been scheduled.
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