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Campus Lead Shift Report
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Client Demographics
Behavioral Level System Form
Campus Lead Shift Report
Campus Lead on Duty Name:
Rotation Shift#:
Date:
Time:
IR/ER’s
None to report at this time:
Medications & Medical Concerns
Campus Lead Medication Administration Check
C1:
C2:
C3:
C4:
MARs Checked for Accuracy of Med Administration
Select
Yes
No
N/A
Are all psychotropic med counts accurate?
Select
Yes
No
N/A
Are there any continued new or changed medications?
Select
Yes
No
N/A
Staff Behavioral Issues
Campus Transportation/Vehicle Issues
Resident Behavioral Follow Up
Cottage 1:
Cottage 2:
Cottage 3:
Cottage 4:
Cottage Meetings
Were bullet points discussed?:
Yes
No
N/A
Was cussing discussed?:
Yes
No
N/A
Was racial slurs discussed? (zero tolerance):
Yes
No
N/A
Was COVID-19 visitations discussed?:
Yes
No
N/A
Was horse play discussed?:
Yes
No
N/A
What cottage parents were involved?:
What was addressed in the meeting?:
What were positives mentioned in the meeting?:
End of Shift Care of Therapeutic Environment
Kitchen/laundry room:
C1:
C2:
C3:
C4:
Describe efforts to correct:
Common Areas
Floors mopped:
C1:
C2:
C3:
C4:
Damages or Concerns in Cottages
C1:
C2:
C3:
C4:
Any Other Information or Concerns
Submit Report