Full SA Binder for Paul Kleit

Paul Kleit

20405 Apple Harvest Circle, Apt. P

Germantown, 20876

EMail: paulharoldkleit@gmail.com

Phone: 814-470-1149

Birthdate: 09/30/1994

GermantownPOD

Residence: Upper Montgomery County

ILO Start Date: 2018

ILO Family Number: 21

DDA: No

IMPORTANT NOTES:

Main Emergency Contact: Susan Kleit

Main Contact Phone#: 814-360-4954

Secondary Emergency Contact: Andrew Kleit

Secondary Contact Phone#: 814-380-2792

Specialist1 Name Dr. Steven Israel

Specialist1 Type Psychiatrist

Specialist1 Address 121 Congressional Lane, 604, Rockville, MD 20862

Specialist1 Phone 301-888-6812

Specialist2 Name

Specialist2 Type

Specialist2 Address

Specialist2 Phone

Aetna, Penn State Insurance

Other

Medicaid Number 43205382600

Medicare Number

Pharmacy Tetnus

Pharmacy

Disability Diagnosis

Disability Diagnosis Autism, Communication Disorder, Intellectually Disabled

Disability Impact Daily Living

Paul needs assistance making good choices, arranging for his medical needs, arranging for transportation other than the

Activity Restrictions

Dietary Restrictions

Allergies

Allergies Additional Notes

Seizures

Seizure Status (Yes or No)

Seizures How Often

Seizures How Long

Seizures Warning Signs

Seizures After Effects

Seizure Medication

Seizure Additional Notes

Chronic Medical Conditions

Chronic Medical Conditions

Chronic Medical Conditions Notes

Psychological Conditions

Psychological Conditions

History of Anxiety/Depression (Yes or No)

History Anxiety Depression Notes

History of Suicide (Yes or No)

History Suicide Info

Additional Notes

public bus at which Paul is quite proficient. Paul's general social skills are quite lacking, he has difficulty retaining friendships.

None

None

None

No

IMPORTANT NOTES

HELPFUL INFORMATION

Paul has issues with keeping calm when routines are disrupted.

Paul responds well to written or picturebased lists. Written lists should be brief and precise.

BE IN THE KNOW!

Neighbors:

Please be considerate of your neighbors. Please do not listen to loud music, television or videos after 10 pm or before 9 am.

Fire Safety

CookingFire-Ifthereisafirewhenyouarecooking (stoveoroven),USEYOURFIREEXTINGUISHER!Puta lidonthepotorpaninwhichyouarecooking.

NEVER USE WATER ON A GREASE FIRE!

SmokeDetectors–Batteriesneedtobechangedbythe maintenancestaff.Donotdisableortamper withthem.

Fire Evacuation Plan

• Whenalarmsounds,oremergencyoccurs-remain calmandassessthesituation.

• ALWAYSassumeitisarealemergencyandproceedto thedesignatedmeetingspot.

• Itisbettertobeinconveniencedbyafalsealarmthan notgettosafety.

• DONOTUSEELEVATORSduringevacuation.

•Calmlybeginevacuationprocedures:

Primary Escape Route:

ExityourapartmentandfollowtheEmergencyExitSignstothe stairwell. Takethestairsdowntothefirstfloor.

IMMEDIATELYEXITTHEBUILDING. MeetILOAdvocatesatthe agreeduponmeetingplaceoutside.

Whereisyouragreeduponmeetingplace?

Drawamapfromyourapartmenttothestairwell.

Drawamapfromthestairwellonthefirstfloortothenearest Exitandthentoyourmeetingspot.

• IfdirectedbyEmergencyPersonnel,crossthestreet andmeetwithotherILOAdvocates.

• Proceedtotheagreeduponmeetinglocationuntil EmergencyPersonnelgivesthe‘all-clear’signalor directsyoutoreturntothebuilding.

Apartment Troubleshooting

Thingstocontactbuildingmaintenancefor:

• Brokenappliances

• Jammedgarbagedisposal

• Leakingpipe,faucetorceiling

• Burnedoutlightbulbsinceiling

• Toiletkeepsrunning

Maintenance or front office phone #:_______________________

Toilet:

• Ifthetoiletoverflows,turnthenozzle(thevalve locatedbehindthetoilet)allthewaytotherightto shutoffthewater.(leftieloosie,rightytightie)

• Plungethetoiletuntilitisnolongerclogged.

• Afterwards,youwillneedtoturnthenozzlebackto thelefttoturnthewaterbackon.

• Usetowels,papertowelsorragstocleanupthe waterandanyotherdebrisfromthefloor.

• Cleanthefloorwithacleaningproduct.

Kitchen:

• Thegarbagedisposalmustbeusedwithrunning waterorthemotormayburnupandcreateafire hazard.

• Makesurealldishesandutensilsareoutofthesink beforeyourunthedisposal.

• Promptlyrefrigerateuneatenfood.Iffoodisunrefrigeratedfor2hours,throwitout.

• TurnstoveandovenoffIMMEDIATELYwhendone cookingsoyouwon’tforget.

• Defrostfoodintherefrigeratorormicrowave,noton thecountertop.

Appliances:

• Removethelintfromthedryeraftereachuse.

• Ifyoudon’tcleanthefilteritbecomesafirehazard.

Sample DAILY Chore List

❑Checkemail

❑Checkphonemessagesandtexts

❑Getmailfrommailboxandsort/recycle

❑Putawaycleandishes

❑Load/rundishwasherasneeded

❑Cleancounters

❑Sweep

❑Takeouttrash/recyclingasneeded

Sample WEEKLY Chore List

❑Cleanbathroom

❑Mopkitchen

❑Vacuum

❑Changesheetsandtowels

❑Laundry(includingfoldingandputtingaway)

❑Grocerylistandshopping

❑Paybills

❑Fillmedicinecontainers

ILO Self-Advocate Agreement

✓ Respect –allmemberswillrespecttheideas,thoughts, personalspaceandpropertyofothers.

✓ Confidentiality -everythingsharedinthegroupis confidential.Thegroupneedstodeveloptrustandbuild workingrelationships.

✓ Responsibility -allmemberssharetheresponsibilityto makethegroupwork.

✓ Acceptance -thegroupacceptsmembersjustastheyare andavoidsmakingjudgments.

✓ One Speaker at a Time -groupsaremostbeneficialwhen allparticipantscanshareanddiscussindividualissuesor concerns.Membersmustbemindfulandgiveeachperson theopportunitytospeak.

✓ Giving Attention -memberswillgivesupportiveattention tothepersonwhoisspeaking.

✓ Sharing -sharingisencouraged.

✓ Questions -groupmembershavetherighttoask questions.

✓ Discussion -thegroupisactivelyinvolvedinthe discussionandplanningofactivities.

Asking Others for Help

Calling 911

1. Try to remain calm.

2. Know your location.

3. Be awareof your surroundings.

4. Don't hang up.

5. Let the 911 dispatcher guide the conversation.

6. Be patient.

7. Follow all directions.

How?

 Bedirect-say,“Canyouhelpme?”

 Bespecificaboutwhatyouneed.

 Askquestionsifyoudon’tunderstand.

 Showrespect–bewillingtolisten.

Always...say,“Thankyou”

Why?

 Sometimesaskingforhelpisthefastestandbestway tofigurethingsout.

 And...mostpeopleliketohelpandwanttohelp.

ILO Self-Advocate Life Skills Exercise

Life Skills Exercise

Safety UsingaFireExtinguisher

1. Watch this YouTubevideo (https://www.youtube.com/watch?v=Hw4uIiXUCY4) and list 2 things you learned from it:

(1) (2)

2. Review the following steps and then walk through the steps (role play):

Steps for Responding to the Initial Stage of a Fire

Step 1:  Pull the fire alarm and call 911.

Step 2:  Identify a safe evacuation path before approaching the fire.

Step 3:  Use the extinguisher using the P.A.S.S. technique (pull, aim, squeeze and sweep).

Step 4:  Evacuate immediately if the extinguisher isn’t working or if it’s a large fire.

3. Examine a real fire extinguisher and makesure you understand this technique:

PASS Fire Extinguisher Technique

 PULL: Pull the pin. This will also break the tamper seal.

 AIM: Aim low, pointing the extinguisher nozzle (or its horn or hose) at the base of the fire.

 SQUEEZE: Squeeze the handle to release the extinguishing agent.

 SWEEP: Sweep from side to side at the base of the fire until it appears to be out. Watch to make sure it doesn’t reignite.

UsingaFireExtinguisher

Self-Advocate Name_____________________________________ Date________________________

ILO Community Builder_______________________________________________

How Well Do You Know This?

1. Where is your fire extinguisher located in your home?__________________________

2. What arethe 4 action steps to take ifa fire breaks out.

(1) ______________________________

(3)

(4)

3. What is the acronym commonly used to help us remember how to use a fire extinguisher?

4. What are the 4 steps for using a fire extinguisher?

(1)____________________________________________

(2)____________________________________________

(3)____________________________________________

(4)____________________________________________

5. Do you feel confident that you could handle an emergency situation that involved a small fire? Yes No

Write Out A Schedule

How I Plan to Deal with My Anxiety, Stress or Worry!

Routines help us feel “normal” – it eases our fears about what’s going to happen next. If we have a schedule, we know what’s going to happen next! It is comforting.

Consider establishing times for:

 Eating

 Sleeping

 Physical Activity

 Connecting with Others

Sample Schedule*

*Be kind to yourself – it’s ok not to always follow the schedule!

 Learning Something New

 Doing Something Fun

 Helping Someone Else

 Talking to a Family Member, Friend or Therapist About Your Anxious Feelings

 9:00-10:00am FixandEatBreakfast

 10:00-11:00am GetDressed,MakeBed

 11:00-12:00pm TakeaWalkOutdoorsorDoYoga

 12:00-1:00pm FixandEatLunch

 1:00-3:00pm ReadaBookorMagazine

 3:00-4:00pm DoaVirtualOnlineSafariwithaZoo(or someotherfunonlineactivity)

 4:00-5:00pm CheckinonaFriend(calloronline)

 5:00-6:00pm FixandEatDinner

 6:00-8:00pm WatchTVorPlayVideoGames

 8:00-9:00pm GiveYourselfaSpaTreatment(thinkwarmbath, lotion,awarmorcoolwashclothoveryoureyes whilelayingdownandlisteningtosoftmusic)

Your Schedule

What’s Your Plan for Staying Healthy in the New Year?

Usethishandychecklist,askfamilyandfriendsforideasorhelp,andthenGODOIT!

 Physical Activity

Example:Takeawalktwiceaweekfor20minutes

 Medical Check-Ups

Example:Scheduleannualcheck-upwithregular doctor;Schedulea6-monthdentalcheck-up

 Nutritious Eating

Example:Eatatleast3vegetablesand3fruitseach day

 Staying in Touch with Family & Friends

Example:Textfunnyjoketodadonceaweek;meet withILOfriendseveryweek;attendILO’sSocialSunday

Use the boxes below or another sheet of paper for your own personal 2020 goals.

Integrated Living Opportunities (ILO) © 2020 All rights reserved. info@ilonow.org | www.ilonow.org

Key things to remember:

Don’t Tell Secrets!

 Once you put it up, it is there forever.

 Respect privacy laws when posting names, photos, and other information.

Most Importantly - Be Respectful!

You are responsible for what you post!

 Consider privacy, slander, harassment, and copyright laws.

 You can be sued.

Be Truthful!

 Never misrepresent yourself or pretend to be someone else.

 Remember EVERYTHING is traceable.

 Don’t send emails that may hurt others or are against the law.

 Don’t be rude or use abusive language in chats or email.

 Don’t send emails when you are angry. Save it as a draft and reread it the next day before sending.

 Don’t share other people’s private information.

My Internet Safety Checklist

 I don’t give out my passwords.

 I have a “checker” friend who helps me keep my privacy safe and could help me if someone is being inappropriate or harmful to me online.

 I set time-limits for myself or try to maintain a fairly low percentage of time online or gaming online.

 I don’t “friend” people I don’t know, and I understand how to “unfriend”, “unfollow” or say “no” in order to manage my online life.

 I don’t click on links or images from people I don’t know.

 I make sure I’m not posting other people’s private information when I share posts.

 I don’t post any personal information online.

 I don’t share information that could allow someone to harm me.

 I am truthful, safe and respectful in all of my online dealings.

Friend or Foe

Brainstorm what makes a person a friend, or a foe. Are you familiar with any of the images below?

Consider Friend or Foe

 Stranger danger.The peopleyou chat and play games with are strangers. Don’t share personal information with them nomatter how nice they are, or what they say.

 Really? A person’s virtual character (a character or name they have created to use inthe game) is not always a true representation of who that person is. Don’t assume a man is aman and a woman is a woman, or that they are who they say they are.

“Stranger Danger” of the Past: Links and Malware

 With Threats. Hackers used to have it so easy. You’d be watching skateboarding or dog videos, and then DING!, a new email would come in. It’d be someone telling youthat you owed money and must pay up or else. But we’ve gotten smart about that kind of thing. So now hackers have a new way of getting personal information from us. How are they doing it?

“Stranger Danger” of Today: Impersonation

 Or Treats! By impersonating a legitimate person with whom the victim has a pre-existing relationship. Maybe the email would be from your friend John, and he’d have a funny videoyou just had tosee.

 Of course, your friend John is actually the victim of a hacker using his identity. They just wanted you to click their link!

ILO Ideas

ILO’s Weekly Ideas for Fun and Adventure for those of us stuck at home for a while.

Home-bound?.............................................Explore the World from home!

Isolated?.........Reach out and touch someone (virtually or by phone)!

Bored?...............................................Get creative and entertain yourself!

This is a great opportunity to do things that stretch your imagination, your knowledge, your creativity and to get your life in order. Here are a few ideas for this week:

Get inspired

❑ Sign-up online for the InspireMore feed: https://www.inspiremore.com/

❑ Take a camera outside and photograph everything that looks beautiful to you.

❑ Practice deep breathing while listening to nature sounds

❑ Draw or paint a scene outside your window.

Expand your mind

Get your life in order

Find your creative side

Stretch your imagination

Do something for someone else

❑ Check out Facebook’s Expand Your Mind Show:

https://www.facebook.com/ExpandYourMindShow/

❑ Shock your mind and your taste buds and try a new food, drink or recipe.

❑ Take a couple of “before” photos of one room in your house (bedroom, kitchen, bathroom).

❑ Then organize and clean that room.

❑ Then, take a photo of it again and share the before and after photos with your family and friends. Ask them to rate you from 1-10.

❑ Enjoy something you created in the past a Facebook post, a video, a drawing, or a project.

❑ Disconnect for a while and write your thoughts in a journal or notebook.

❑ Check out a PBS show you haven’t seen before:

❑

❑

https://www.pbs.org/wgbh/masterpiece/shows/endeavour/

https://www.pbs.org/wgbh/masterpiece/shows/howards-end/

❑ Your choice: ________________________________

❑ Ask 2 or 3 other ILO self-advocates what they’re grateful for and why.

❑ Ask someone to tell you about the thing they love the most in life and why.

Let us know how you did and send us suggestions for next week: jbrown@ilonow.org