|
Form No. |
Title |
Issue/Reviewed Date |
Responsible Person |
|
Consent to Exchange Information and Use Photos |
30/07/2024 |
Chief Executive Officer | |
|
Kyeema Intake Form |
13/08/2024 |
Admin Assistant | |
|
Dose Administration Container Record Sheet |
26/02/2020 |
Chief Executive Officer | |
|
PRN (as required) Medication Record Sheet |
03/09/2021 |
Team Leader | |
|
CCF-05 |
|
|
|
|
Exit from Service Form |
29/06/2023 |
Chief Executive Officer | |
|
CCF-07 |
|
|
|
|
Medication Original Container Record Sheet |
10/11/2020 |
Team Leader | |
|
Medication Purpose Form - Doctor Approved |
26/05/2025 |
QA Officer | |
|
CCF-10 |
|
|
|
|
Kyeema On Call Records |
11/12/2018 |
Chief Executive Officer | |
|
Contents Page for Participant Files |
08/01/2021 |
Team Leader | |
|
Saline & Citric Acid Flush Recording Form |
21/03/2025 |
Team Leader | |
|
CCF-14 |
|
|
|
|
Participant Survey |
21/06/2024 |
Admin Assistant | |
|
Positive Intervention Framework |
17/01/2020 |
Chief Executive Officer | |
|
Participant Consent & Information for Overnight Activities |
12/01/2023 |
Team Leader | |
|
Community Inclusion Information and Contact Form |
26/09/2024 |
Chief Executive Officer | |
|
Home Risk Assessment Form |
09/03/2022 |
QA Officer | |
|
CCF-20 |
|
|
|
|
Booking Request Form – Activities |
25/02/2022 |
Team Leader | |
|
Participant Transport Costs for Kyeema Services |
06/09/2023 |
Finance Manager | |
|
Kyeema Transport Costs & Agreement |
18/01/2024 |
Team Leader | |
|
Indicators of Violence, Abuse, Neglect, Exploitation and Discrimination |
17/01/2020 |
Chief Executive Officer | |
|
Record of Participant Expenditure Form |
06/03/2023 |
QA Officer | |
|
Participant File Contents Guide |
16/09/2024 |
QA Officer | |
|
Participant Choice to Engage in Risk Eating |
20/05/2024 |
Chief Executive Officer | |
|
Participant Treatment Sheet - Summary of Doctor Approved Medication |
07/11/2024 |
QA Officer | |
|
NDIS Process for Notification of Reportable Incidents for Team Leaders & Managers |
17/01/2020 |
Chief Executive Officer | |
|
Incident Reporting for Support Workers Poster |
23/06/2025 |
QA Officer | |
|
Incident Reporting Chart for Managers/Team Leaders |
28/09/2022 |
QA Officer | |
|
Wheelchair Bus Procedure |
09/03/2017 |
Respite Manager | |
|
Medication Checklist – Daily Medication |
13/12/2022 |
Team Leader | |
|
Administering Medications – 8 R’s Form |
05/06/2019 |
Supports Manager | |
|
Health Support Plan - Asthma |
18/02/2020 |
Team Leader | |
|
Participant Treatment Sheet - Over-the-Counter Medication |
16/09/2024 |
QA Officer | |
|
High Intensity Support Worker Skills Review - Bowel & Catheter |
27/02/2025 |
QA Officer | |
|
Flowchart Child Safety Reporting Process |
17/01/2020 |
Chief Executive Officer | |
|
Terms of Reference – Speaking Up Advocacy Group (Friendly Version) |
28/06/2019 |
Chief Executive Officer | |
|
Participant Information Form |
08/05/2024 |
Team Leader | |
|
Lunch Receipt |
10/02/2022 |
Admin Assistant | |
|
Health Support Plan – Seizure |
21/02/2020 |
Team Leader | |
|
Participant Risk Identification |
10/04/2024 |
QA Officer | |
|
Health Support Plan – General |
25/02/2022 |
QA Officer | |
|
STAR Behaviour Monitoring Chart |
17/01/2020 |
Chief Executive Officer | |
|
Health Support Plan – Epilepsy |
22/11/2023 |
Team Leader | |
|
Epilepsy Medication Management Plan (Midazolam) |
31/01/2020 |
Team Leader | |
|
Seizures Recording Form |
25/07/2017 |
Respite Manager | |
|
Health Support Plan – Enteral Feeding |
28/06/2024 |
QA Officer | |
|
Health Support Plan – Catheter Care |
28/06/2024 |
QA Officer | |
|
Authority for Kyeema Staff Use of a Participant Vehicle |
16/06/2022 |
Chief Executive Officer | |
|
Excursion Activity Checklist |
15/07/2024 |
Team Leader | |
|
Vitamin & Dietary Supplement Record Sheet |
25/07/2017 |
Respite Manager | |
|
High Intensity Support Worker Skills Review - Severe Dysphagia |
27/02/2025 |
QA Officer | |
|
High Intensity Support Worker Skills Review - Enteral |
07/06/2023 |
QA Officer | |
|
Health Support Plan - Diabetes |
05/03/2020 |
Team Leader | |
|
Consent to Share Information - Easy Read |
09/09/2024 |
Administrative Officer | |
|
CCF-58 |
|
|
|
|
Staff Acknowledgement – Health Support Plans |
15/09/2023 |
QA Officer | |
|
CCF-60 |
|
|
|
|
CCF-61 |
|
|
|
|
CCF-62 |
|
|
|
|
Speaking Up Committee Minutes |
11/06/2019 |
Chief Executive Officer | |
|
Participant Survey Letter |
01/06/2023 |
Admin Assistant | |
|
Incident, Complaint, WHS Record Form |
06/05/2025 |
QA Officer | |
|
Kyeema Services Listing |
17/01/2022 |
Admin Assistant | |
|
Receipt for Cooking Program |
21/2/2017 |
Supports Manager | |
|
Receipt for Portland Workskills |
21/2/2017 |
Supports Manager | |
|
Receipt for Riding with the Disabled (RDA) |
21/2/2017 |
Supports Manager | |
|
Generic Receipt for Miscellaneous Purchases |
22/06/2017 |
Supports Manager | |
|
Toileting Assistance Form |
18/09/2024 |
Supports Manager | |
|
Schedule of Supports Form |
07/08/2024 |
Finance Manager | |
|
CCF-73 |
|
|
|
|
Temporary Travel Schedule of Supports |
08/01/2019 |
Chief Executive Officer | |
|
Participant Handbook |
05/12/2023 |
Chief Executive Officer | |
|
Support Goals and Actions |
13/04/2023 |
QA Officer | |
|
Participant Intake Pack & Acknowledgement Form |
16/09/2024 |
QA Officer | |
|
Medication Effects & Side-Effects |
25/08/2022 |
QA Officer | |
|
Day Activities Staff Duty Roster |
26/05/2023 |
QA Officer | |
|
Day Activities Participant Timetable for Families |
20/02/2025 |
Supports Manager | |
|
Health Support Plan - Bowel Care |
28/06/2024 |
QA Officer | |
|
Health Support Plan - Mental Health |
03/08/2020 |
Team Leader | |
|
Health Support Plan – Mealtime Management or Dysphagia Support |
28/06/2024 |
QA Officer | |
|
Support Planning Process – NDIS Documentation Flowchart |
23/03/2022 |
QA Officer | |
|
Support Planning Process – TAC Documentation Flowchart |
23/03/2022 |
QA Officer | |
|
High Risk Activity Assessment |
28/04/2021 |
QA Officer | |
|
Participant Behaviours of Concern Information Sheet |
21/03/2023 |
Chief Executive Officer | |
|
Disability Support for Older Australians Consent to Share Information |
18/06/2021 |
Chief Executive Officer | |
|
Disability Support for Older Australians ISP |
18/06/2021 |
Chief Executive Officer | |
|
Home Alone - Communication, Monitoring and Supervision Plan |
04/11/2021 |
QA Officer | |
|
Day Activities - Staff Meeting Minutes Template |
26/05/2023 |
QA Officer | |
|
Day Activities Timetable Template |
21/02/2025 |
QA Officer | |
|
Urinary Catheter Output Chart |
18/12/2023 |
Team Leader | |
|
Bowel Activity Record Chart |
05/10/2023 |
QA Officer | |
|
Bristol Stool Form Scale |
11/09/2023 |
QA Officer | |
|
Enteral PEG Feeding Record Chart |
12/09/2023 |
QA Officer | |
|
Urinary In-Out Catheter Output Chart |
19/10/2023 |
QA Officer | |
|
Non-Prescription OTC Medication Record Form |
27/11/2024 |
QA Officer | |
|
CCF-99 |
|
|
|