Supervision Needs Guide Sheet
The Purpose of this Guide is to trigger conversation around the need of supervision of the people we support
Define Supervision: the need to have a person present either within eyesight, the room, the building, in
arms length, by a phone call or page system, etc. during the day, in their home, or in their community.
Define Intensive Supervision: one-to-one supervision within arm’s length
What are the Environments the person needs supervision in?
• Home: activities at the individual's home or the home of a family member
• Community: activities that take place outside of the individual's home
• Day Program: normal daily activities such as volunteering, working, attending an adult training
center, etc.
• Other
-Transportation
-Health Care Situations
-Bathroom (home, community, day program)
What Level of Supervision is needed?
• Vision
• Hearing
• Physical
• Threat
Home Environment:
Visual: 1.) Constant eye sight/line of sight – relevant to specific body part(s) you visually need to
see (hands, face, etc and the physical proximity needed
2.) Visual Checks
3.) Time Frames
4.) Location needed – no visual checks
Hearing: 1.) Within hearing range
-With range of person hearing staff and staff being able to hear the person
-On the same floor
2.) Visual checks / Time Frames (timeframe appropriate for not hearing)
3.) Sounds that would trigger staff’s response (e.g. breaking glass)
Physical: 1.) Intensive supervision (within arm’s reach) with exceptions noted in very specific
terms such as the person’s bedroom or bathroom.
2.) In regards to specific rooms in the home or levels of the home
3.) inside or outside of the home (what does on the property mean?)
Specific or Unique Home situations to think about regarding supervision needs:
1.) Visitors – children visiting, etc
2.) Emergency situation arises with housemates
3.) Does the staffing pattern meet all types of emergency situations?
4.) Can staff delegate their responsibility of supervision to a family member, volunteer staff,
etc?
5.) Use of the Donut Exercise to distinguish responsibility, etc.
Day Program Environment:
Visual: 1.) Constant eye sight/line of sight – relevant to specific body part(s) you visually need to
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see (hands, face, etc and the physical proximity needed)
2.) Visual Checks
3.) Time Frames
4.) Location needed – no visual checks
Hearing: 1.) Within hearing range
-With range of person hearing staff and staff being able to hear the person
-On the same floor
2.) Visual checks / Time Frames (timeframe appropriate for not hearing)
3.) Sounds that would trigger staff’s response (eg. breaking glass)
Physical: 1.) Intensive supervision (within arm’s reach) with exceptions noted in very specific
terms such as the using the bathroom.
2.) Need to be specific such as ‘Is the person a choking risk?’
Specific or Unique Day Program situations to think about regarding supervision needs:
1.) Situations outside of program building such as taking out the trash, neighborhood walks,
pavilions on the property, etc.
2.) Special events at the Day Program
3.) Fire Drills, emergency evacuations, etc
Community Program Environment:
Visual: 1.) Constant eye sight/line of sight – relevant to specific body part(s) you visually need to
see (hands, face, etc and the physical proximity needed
2.) Visual Checks
3.) Time Frames
4.) Location needed – no visual checks
Hearing: 1.) Within hearing range
-With range of person hearing staff and staff being able to hear the person
-On the same floor
2.) Visual checks / Time Frames (timeframe appropriate for not hearing)
3.) Sounds that would trigger staff’s response (e.g. breaking glass)
Physical: 1.) Intensive supervision (within arm’s reach) with exceptions noted in very specific
terms such as the using the bathroom.
Bathroom: (home, community, day program)
Visual: actual eye contact
Hearing: 1.) Able to hear
2.) Unusual noises coming from the bathroom
Physical: 1.) specific bathroom person should use
2.) Staff outside of bathroom
3.) Alarm on bathroom door
Questions to Consider
1.) Should support staff use a specific bathroom?
2.) Protocol needed when 1:1 staffing has to use the bathroom?
3.) Protocol needed to address supervision level and any deviations from it?
Healthcare:
Questions to Consider
1.) Can Supervision Level change during a Doctor visit, ER visit, Hospitalization, etc.?
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2.) Can Nursing Staff take over for direct support professionals
3.) Does the Doctor want the staff present? Think through the transfer of care
*Doctor/Nurse should be made aware of the needs of the person being supported regarding
supervision
Transportation:
Questions to Consider
1.) Are van drivers able to cover level of care needed by people in vehicle, or in an
emergency situation?
2.) Does the person need to sit somewhere specifically in a vehicle?
3.) What type of vehicle does the person need to be transported in?
4.) Does the person need staff sitting with them?
5.) What does the transfer of care look like with transitioning from a vehicle to building
Special Community Activities:
-amusement park rides
-recreational activities such as riding bikes, ATVs, canoeing, etc in the community
Other:
-Clearly defining level of supervision between different programs which can sometimes be
drastically different. (ISP, Behavior Support Plan, etc.)
-Support staff having a clear understanding of what 2:1, 1:1, etc supervision looks like and requires
from them.
-Talking or texting on cell phones/receiving calls/wearing ear buds
-Reviewing Back-up plans and Fade Plans
-Reviewing AIS/Supplemental Hab.
-Wording: mindful of use of words such as typically, usually, sometimes, etc
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