CDDP Site Visit File Review Document – CLOSED FILE
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Individual CDDP Date of Review
DOB SE: Closed File Service Coord. Reviewer
/ Requirement / Yes / No / NA / Date Noted in File / Comments/Notes /CDDP to CDDP referral/transfer
OAR 411-320-0070 (6)(a-e) / Needs to be documentation in case notes or copies of the information sent to the CDDP. Transfer must occur within 30 days
1 / Documentation of eligibility for DD services received while enrolled / 0001
2 / Service enrollment and termination forms (CPMS/DHS-0337) / 0002
3 / Waiver eligibility / 0003
4 / CDDP progress notes / 0004
5 / Documentation of services provided to the individual by the CDDP / 0005
6 / Documentation that may be necessary to complete financial settlement with the State / 0006
/ Requirement / Yes / No / NA / Date Noted in File / Comments/Notes /
Terminations - OAR 411-320-0100(3)(a-e)
1 / CDDP terminates from services only when
(circle one):
· Individual/guardian requests
· Individual dies
· Determined ineligible (requires notification)
· Individual moves (except when under 18 and parent remains in county)
· Cannot be located / List reason for termination: / 0007
Form: Closed File Version: 7 Next Record Key: 0008 Load Date-Time
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