Ongoing Supervision Of The Child Safety Program: Fill & Download for Free

The ketogenic, or keto, diet is a very-low-carb, high-fat diet that has been shown to deliver several health benefits.In recent years, interest in the use of the keto diet to help manage certain health conditions in children, including epilepsy and brain cancer, has increased.While the keto diet is relatively safe for adults, this may not be the case for children and teens unless it’s prescribed by a health professional for medical reasons.This article reviews the safety of the keto diet for children and teens, as well as its potential uses and downsides.Uses of the keto diet in childrenSince the 1920s, the keto diet has been used to treat children and adolescents with refractory epilepsy — a seizure disorder.Epilepsy is defined as refractory when treatment with at least two traditional antiepileptic drugs has failed.In several studies in children with this condition, following a keto diet decreased seizure frequency by up to 50%.The anti-seizure effects of the keto diet are thought to be the result of several factors:reduced brain excitabilityenhanced energy metabolismbrain antioxidant effectsThis way of eating has also been used in conjunction with traditional chemotherapy to help treat certain types of brain cancer in adults and children.Nearly all tumors depend on carbs (glucose) for energy. The keto diet has been said to starve tumor cells of the glucose they need, thus helping reduce tumor size when combined with other forms of treatment.While several animal studies have been conducted and human studies are ongoing, further data is needed to establish the long-term effectiveness of the keto diet for treating brain cancer in children.Over the past 20 years, new versions of the keto diet have emerged, some of which are less restrictive yet provide many of the same benefits. This includes the modified Atkins diet .While the therapeutic keto diet restricts calories, carbs, and protein, the modified Atkins diet is more liberal when it comes to overall calories, fluids, and protein. This allows for more flexibility while offering similar benefits.Keto diet for epilepsy managementWhen implementing the keto diet to help manage epilepsy in children, a specific regimen is followed to ensure consistent results. The diet is typically administered under the supervision of a physician, registered nurse, and registered dietitian.Before starting the diet, a registered dietitian is consulted to determine the child’s nutritional needs and establish a meal plan. Traditionally, the diet comprises 90% fat, 6–8% protein, and 2–4% carbs.The program often begins in a hospital or intensive outpatient setting for the first 1–2 weeks. On day one, one-third of the total calorie goal is achieved, followed by two-thirds on the second day, and 100% on the third day.In a clinical setting, all-in-one formulas containing the necessary nutrients may be used to initiate the keto diet for the first week, after which whole foods are gradually reintroduced.The child and parents are thoroughly educated on the diet, and the necessary resources are provided before they return home.The diet is usually followed for about two years, at which point it’s either discontinued or transitioned to a modified Atkins diet to allow for more flexibility.Studies have also found that the keto diet can be safe and effective for infants and toddlers with refractory epilepsy.Still, as these populations are extremely vulnerable, the decision to use this diet must be made on an individual basis by a physician.Potential adverse effectsAs with any diet that restricts one or more food groups, the keto diet may have certain adverse effects.The risk of side effects increases in children and adolescents, as their growing bodies are more susceptible.The main potential side effects associated with the keto diet in children are:dehydrationelectrolyte imbalancedigestive issues, such as nausea, vomiting, diarrhea, and constipationelevated blood cholesterol levelslow blood sugarimpaired growthvitamin and mineral deficienciesIn a therapeutic setting, proper measures are taken to minimize adverse effects.Medical guidance is mandatory when the keto diet is used to help treat epilepsy or cancer in children and adolescents. Without it, the risk of serious side effects increases, outweighing any potential benefits.Is it safe for growing children?Children are at a phase in their life in which they’re growing at an increased rate, as well as developing their food preferences.During this crucial time, adequate nutrition is important. Overly restricting dietary intake of certain food or micronutrient groups, as is done with the keto diet, may impact growth and overall health.Following a keto diet would also affect your child’s cultural experience when eating with peers and family.Given the high rates of childhood obesity, many children may benefit from a reduced carb intake. However, the keto diet is too restrictive for the average healthy, growing child.Free Ebook Deliciously Easy Keto Recipes - Click Here To Read

This (In a special ed preschool classroom with many adults, what's the hierarchy of instructors in terms of training/experience? ) is a very hard question to answer because each of the staff have their own unique role and they work as a special education team which includes functional behavior analysis and implementation as described in each student's IEP (Individualized Education Program). If the hierarchy and tasks are unclear, a new IEP team meeting can clarify each staff member's responsibilities and provide a framework needed to support the behaviors, services, and special and general education appropriate for the unique needs of each student.The Los Angeles Unified School District, issued a policy bulletin (BUL-6269.0) dated April 7, 2014, from Sharyn Howell, Executive Director, Division of Special Education at this link: http://notebook.lausd.net/pls/ptl/docs/PAGE/CA_LAUSD/FLDR_ORGANIZATIONS/FLDR_SPECIAL_EDUCATION/BUL-6269.0%20MULTI%20TIERED%20BEHAVIOR%20SUPPORT%20SWD%20W%20ATTACHMENTS.PDFIts title, A Multi-Tiered System of Behavior Support for Students with Disabilities, describes its contents. Among its guiding principles:Students with disabilities experiencing behavioral challenges in the school environment must be afforded the opportunity to be supported using the evidencebased practices found in Multi-Tiered Systems of Support (MTSS). It is the responsibility of the IEP team to design a plan to address student behavior through teaching. It is the school staff’s responsibility to implement positive behavior support even if such support is not specified in the IEP. The IEP does not supplant the school’s responsibility for holding all staff accountable for implementing Positive Behavioral Interventions and Supports (PBIS).Please read the entire document linked above; it is very instructive. Regarding the hierarchy, roles, and responsibilities mentioned in the question details:Teacher: In a special ed preschool classroom, as in every gen-ed classroom, the teacher is 'in charge' of everything that goes on in that classroom. It is the teacher's task to coordinate lessons and behavior, and to schedule with the service providers all services for each child, including supervising everyone who works in the classroom as support staff. Here is California's credentialing requirements for a special education teacher: Special Education (Education Specialist Instruction) Credentials and here is what is necessary to get an Education Specialist Instruction Credential: http://www.ctc.ca.gov/credentials/leaflets/cl808ca.pdf which are instructions for teachers to get preliminary and clear teaching credentials.IA (Instructional Aide): Taking cues from the classroom teacher, the instructional aide implements the educational services and accommodations needed for each student to whom s/he is assigned so that such student(s) can access their curriculum according to their IEP.Note: With respect to many aspects of education including behavior education as a 'related service' -- and because we are now using data-driven metrics to determine educational interventions needed, there is a tiered model for intervention which is now being used; I have formatted this quote with bold and paragraphing for your reading convenience on Quora. The original can be found in the link above, on page 6 (of 11 pages):Behavior Intervention Consultation (BIC) is a Tier III data-driven service unique to the Division of Special Education and delivered by certificated and classified staff trained in positive behavior interventions and applied behavior analysis (ABA).This is an indirect service which supports school site staff in delivering behavioral interventions to individual students per the IEP. Using a team approach to build capacity, the BIC provider(s) will train and coach staff to support students with identified behavioral needs. Consultation may focus on the identification and implementation of Tier I, Tier II, or Tier III behavioral supports and/or instructional strategies (e.g., development of a system for collecting and analyzing behavior data, coaching and/or modeling behavioral strategies, providing professional development).Behavior Intervention Development (BID) is a Tier III data-driven behavioral related service. Behavior Intervention Development involves consultation with the student’s educational team to support the student with identified behavioral needs in acquiring appropriate behavior while reducing the student’s need to use the target behavior. Behavior Intervention Development includes the ongoing design, implementation, and evaluation of the instructional and behavioral program as well as environmental accommodations and/or modifications. Through collaboration and consultation with the student’s educational team, the BID provider designs a plan based on appropriate assessment and planned interventions (i.e., Functional Behavior Assessment [FBA] and Positive Behavior Intervention Plan [PBIP]).It is the BID provider’s responsibility to train the educational team, which may include Behavior Intervention Implementation (BII) provider(s), on the implementation of the plan and the collection of data. Based on California Code of Regulations 5 CCR 3065(d) (Attachment E) BID is provided by qualified District staff or a District contracted nonpublic agency (NPA). This service can be delivered as a stand-alone service or in conjunction with Behavior Intervention Implementation (BII) (see below) services.Behavior Intervention Implementation (BII) is a Tier III data-driven behavioral related service that supports an individual student who exhibits significant behaviors in her or his educational environment which require a specialized plan for implementation. This service may be delivered in conjunction with BID services. BII emphasizes direct support of a student’s program through the implementation of the behavior support plan. Under the supervision of a teacher or BID provider, the BII provider also collects behavioral data pertaining to the target behavior, replacement behavior, and behavior goals interventions (e.g. frequency, duration, scatterplot, interval). Based on California Code of Regulations 5 CCR 3065 (e) (Attachment E),BII (Behavior Intervention Implementation): This is the behavior intervention staff member (formerly called 'aide') trained to implement research-validated interventions according to the Functional Behavior Assessment (FBA) as instructed by BID and BIC.SLP (Speech and Language Pathologist): Students requiring SLP interventions sometimes have the intervention services of an SLP in the classroom. In a special ed classroom with BIIs and IAs present, and when there is no behavioral or curricular intervention urgency, speech and language issues will be addressed through intervention in the moment, whenever possible. Usually SLP is the lowest priority in a preschool special ed classroom populated with students with behavior issues, because behavior intervention tends to take first priority (as student safety is the first concern). Training: In the United States, Speech-Language Pathologists obtain a Master's Degree.***After talking with special education teachers over the years, I conclude that having so much staff present is often too difficult for a classroom teacher to manage and coordinate, as each specialist present thinks her/his intervention in the moment takes priority -- and it is hard to prioritize four or five simultaneous needs presented by one student (multiply the many needs of 11 or 12 different students, many of whom have their own Behavior Plan!) -- especially if a crowded and small classroom feels chaotic to the children and to the adults in it.To avoid 'turf wars' with the child as the battlefield, I would urge parents to describe in writing in an IEP any preferences they may have with respect to intervention hierarchy in the classroom.

There could be many ways, one of them is to buy and existing assisted living facility and become its director. For this keep an eye out there in your preferred location for any existing facility looking for buyout opportunities. Among other options, you could apply to through job listings and work for the company.However, to be a successful in this business is not an easy game. You have to be thoroughly prepared to serve as effective administrator, smart executor and strong command over your workforce. To achieve this you could first start working at any existing facility as Director of Operations or as an Assistant to it.If you want to own a assisted living facility and starting from a scratch you would need to own a place or rent a place and decide which services you would like to offer. Assisted living facilities provide variety of services and targeted population age groups can include all adults (18+) or you can limit to more senior age groups (65+). Next you would want to decide about services: Activities of daily living (include feeding, toileting, selecting proper attire, grooming, maintaining continence, putting on clothes, Bathing, walking and transferring such as moving from bed to wheelchair), room and board services include meals, snacks, housekeeping, laundry services, and life enrichment activities. If you like and there is a demand you can also add more ancillary services that would include nursing, PT/OT services, rehab services, physician visits, lab services etc. One of the most sought after program you could add in your programs list is to offer Adult day are services.Assisted living services are mostly licensed by state governments in US. According to individual state regulations you could run as a licensed facility or non-licensed facility and number of services would be limited or determined accordingly. As for example in State of Michigan assisted living facilities are broadly defined as Adult Foster Care and Homes for the Aged.In Michigan, the Department of Human Services (DHS), Bureau of Child and Adult Licensing (BCAL) is charged with the responsibility for licensing and monitoring assisted living facilities that provide a combination of housing and services that require licensure. Information about BCAL and its standards can also be obtained at www.michigan.gov/afchfa.What Needs to be Licensed: An operation needs to be licensed under Act 218 as an adult foster care (AFC) facility if it provides personal care, supervision and protection in addition to room and board to 20 or fewer unrelated persons who are aged, mentally ill, developmentally disabled, or physically disabled, for 24 hours a day, 5 or more days a week, for 2 or more consecutive weeks for compensation.However, if you plan to provide only room and board whereas to deliver care/supervision and protection services to your resident through another company, then you are not required to be licensed or certified by state agency (BCAL in case of MI). These rules may vary from state to state. More details pertaining to MI you can find here: Licensing Rules and Statutes.Supporting above information I would like to add following excerpt derived from Michigan Assisted Living Association :There are two types of licensed facilities in Michigan. They are adult foster care (AFC) homes and homes for the aged (HFAs).Adult Foster Care HomesAdult foster care homes are licensed by BCAL pursuant to the Adult Foster Care Facility Licensing Act, Public Act 218 of 1979. Under Michigan law, an adult foster care facility is defined as a:Governmental or nongovernmental establishment that provides foster care to adults. Adult foster care facility includes facilities and foster care family homes for adults who are aged, mentally ill, developmentally disabled, or physically handicapped who require supervision on an ongoing basis but who do not require continuous nursing care. MCL 400.703(4)The definition of foster care is a key component of the statutory provision. "Foster care" means:The provision of supervision, personal care, and protection in addition to room and board, for 24 hours a day, 5 or more days a week, and for 2 or more consecutive weeks for compensation. MCL 400.704(6)Similarly, the definitions of "personal care," "protection" and "supervision" must be observed:"Personal care" means personal assistance provided by the licensee or an agent or employee of the licensee to a resident who requires assistance with dressing, personal hygiene, grooming, maintenance of a medication schedule as directed and supervised by the resident's physician, or the development of those personal and social skills required to live in the least restrictive environment. MCL 400.706(1)"Protection" means the continual responsibility of the licensee to take reasonable action to insure the health, safety, and well-being of a resident, including protection from physical harm, humiliation, intimidation, and social, moral, financial and personal exploitation while on the premises, while under the supervision of the licensee or an agent or employee of the licensee, or when the resident's assessment plan states that the resident needs continuous supervision. MCL 400.706(4)"Supervision" means guidance of a resident in the activities of daily living, including all of the following:Reminding a resident to maintain his or her medication schedule, as directed by the resident's physician.Reminding a resident of important activities to be carried out.Assisting a resident in keeping appointments.Being aware of a resident's general whereabouts even though the resident may travel independently about the community. MCL 400.707(7)In summary, if all of the following services are provided 24 hours per day, 5 or more days per week for 2 or more consecutive weeks, the facility must be licensed as an adult foster care home:room and boardsupervisionpersonal care andprotectionWhen interpreting and enforcing this statutory basis, BCAL insists on licensure where all of the services are provided by a single entity. When more than one legal entity is involved, licensure may not be required. For example, if ABC, Inc. provides all of the above referenced items other than personal care but the residents contract with a separate legal entity such as XYZ Home Health Care, Inc. for personal care, the setting may not require licensure.There are four types of adult foster care homes:Family homes for 1 to 6 persons: The licensee (the individual who has legal responsibility for the home) is generally the primary caregiver and lives in the home. This is the only category where the licensee is required to live in the home. These homes are typically single family dwellings in residential neighborhoods or rural areas. The homes generally provide private or semi-private bedrooms, semi-private bathrooms and family style common areas for social, dining and recreational activities.Small group homes for 1 to 6 persons: The licensee may be an individual, partnership, corporation or limited liability company. Staffing is provided on a 24-hour basis by the licensee and/or qualified staff. These homes typically are also single family residences as described above.Small group homes for 7 to 12 persons: These larger homes vary greatly in design and accommodations. Many are large single family residences while some are uniquely designed multi-occupancy buildings with private suites or apartment-style living arrangements.Large group homes for 13 to 20 persons: These homes tend to have the greatest number of variations in floor plan and accommodations. A growing number of them offer studios or private apartment-like units. Sometimes the units have kitchen efficiencies and private living areas. Some facilities are part of a community of several large group homes located on one piece of property. For example, some developments have "twin twenties" on one parcel of land. This means that two or more homes licensed for 20 or more are located on one piece of property.These facilities typically serve the elderly, while retaining a home-like environment. For example, one building on the site may serve a more independent older population, while another addresses the needs of individuals with Alzheimer's or the frail elderly. This approach facilitates the compatibility of residents and the availability of specialty services.To locate AFC homes in your area, there is a facility "look up" tool at www.michigan.gov/afchfa.Licensed Homes for the AgedAgain, BCAL also licenses homes for the aged. The statutory authority is the Michigan Public Health Code MCL 333.20106. Size is the single most distinguishing characteristic of a home for the aged in contrast to an adult foster care home. A home for the aged is an assisted living program that serves individuals 60 years of age or older in a setting serving 21 persons or more. (The facility may be smaller only if it is attached to a nursing home.) Younger persons may be admitted to an HFA with BCAL advance approval. There are more than 180 licensed homes for the aged statewide.Pursuant to state law a home for the aged is a:Supervised personal care facility, other than a hotel, adult foster care facility, hospital, nursing home, or county medical care facility that provides room, board, and supervised personal care to 21 or more unrelated nontransient individuals 60 years of age or older. Home for the aged includes a supervised personal care facility for 20 or fewer individuals 60 years of age or older if the facility is operated in conjunction with and as a distinct part of a licensed nursing home. MCL 333.20106(3)In reviewing the HFA statute it is important to note the following definitions developd through administrative rules:"Activities of daily living" means activities associated with eating, toileting, bathing, grooming, dressing, transferring, mobility and medication management. R 325.1901(2)"Assistance" means help provided by a home or an agent or employee of a home to a resident who requires help with activities of daily living. R325.901(4)"Medication management" means assistance with the administration of a resident's medication as prescribed by a licensed health care professional. R325.1901(14)"Room and board" means the provision of housing and meals to meet the needs of the resident. R325.1901(20)"Supervised personal care" means guidance of or assistance with activities of daily living. R325.1901(22)"Supervision" means guidance of a resident in the activities of daily living, and includes all of the following:Reminding a resident to maintain his or her medication schedule in accordance with the instructions of the resident's licensed health care professional as authorized by R333.17708.Reminding a resident of important activities to be carried out.Assisting a resident in keeping appointments.Being aware of a resident's general whereabouts as indicated in the resident's service plan, even though the resident may travel independently about the community.Supporting a resident's personal and social skills. R325.1901(23)Homes for the aged range in design from shared rooms to private bedrooms to suites to fully appointed apartments. To locate HFAs in your area there is a facility "look up" tool at www.michigan.gov/afchfa.BCAL strictly interprets and enforces the provisions of the Public Health Code that govern homes for the aged. In summary, a home for the aged license is required when room, board and supervised personal care is provided to 21 or more unrelated nontransient individuals, 60 years of age or older. Unlike adult foster care, the HFA statute has no requirements regarding the length of time care is provided.Licensing RulesThe state of Michigan has promulgated administrative rules that govern adult foster care homes and homes for the aged. These administrative rules are commonly also referred to as licensing rules and can be located at www.michigan.gov/afchfa.