Anyone interested in joining Ivey Ranch Park Association’s (IRPA) Adult Day Program can either contact their SDRC representative or email IRPA’s Care Programs Manager Christina@iveyranch.com. Interested persons will receive a questionnaire to fill-out and return. Once the completed questionnaire is returned, the Care Programs Manager or ADP Lead Teacher will contact you with more information and to schedule a tour.

ALL participants will have a trial period of two weeks. The trial period ensures that we are a good fit for participants, and that participants are a good fit for our program.

- Participants must be able to administer their own medications.

- Physical and Mental Conditions:

• Participants must be able to sit up unattended.

• Participants must be able to participate in Functional Skills Training.

• Participants must be willing to listen and follow directions given to them by staff and volunteers.

• Participants must be willing to participate in daily activities.

• Participants must be able to be in a group setting with a staffing ratio of 1:4. IRPA’s Adult Day Program cannot accommodate participants who require 1:1 staffing due to behaviors. Participants with a history of aggression, violent, or self-injurious behaviors are subject to further review. The program cannot accept participants who currently display these behaviors.

- IRPA’s Adult Day Program accepts participants who rely on others to perform Activities of Daily Living (ADL).

• Ivey Ranch DOES NOT have a licensed professional on staff to provide care to those who have/use: Diabetes; Enemas, or Suppositories; Inhalation-Assistive Devices; Urinary Catheter, etc.

• Participants whose needs cannot be met.

• Conditions or behaviors that are likely to cause physical or mental harm to self or others.

Participants may be enrolled part-time and set which days they would like to attend. However, participants need to be in the program on their scheduled days from 10am-3pm.

• Excused Absence – Notice was given at least 24 hours prior, or the participant was called out sick. (Sick- For 3 consecutive days or more a doctor’s note must be provided. If a participant is in/out 2 or more times in a 2-week period due to illness, then a doctor’s note must be provided.) Participants may be excused for a MAXIMUM of 20 business days in one calendar year (January-December). Any absences beyond that are required to be paid out-of-pocket and are NOT covered by San Diego Regional Center, CDA, YMCA, etc.

• Vacation time – Participants can be excused for up to 10 consecutive business days for a vacation. Participants wishing to take a vacation for longer than 10 consecutive business days may do so, but are required to pay out-of-pocket for additional days PRIOR to leaving. Any participant who does not pay to hold their slot prior to leaving will be removed from our roster and may be added back to the waitlist when they return. Our current rate (as of summer 2024 is $71.51/day). Failure to pay prior to departure (of a vacation longer than the 10 days) will result in a $50 fee plus the fees for additional days the participant was absent. All fees MUST be paid by the time the participant is dropped-off on the day they return to the program. (See excused absence policy above if additional vacation days are needed throughout the year.)

• Unexcused Absence – Notice was provided the day of, or not at all.

• Late Pick-Up (after program closes at 6:00 for ADP or 6:30pm for SAP) – Participants families are charged $5 for the first 5 minutes then $5 per minute after. Payments for late pick-up MUST BE PAID PRIOR to the next day of care and are not the responsibility of Regional Center, YMCA, CDA, etc. Parents/Guardians are held responsible for late pick-up payments.

• Solo Time – Prearranged time when a participant will be alone with 1:1 care outside of normal operating hours.

• Set Hours – The hours a participant/family/caregivers set for care. These hours are used to plan staffing accordingly. A participant who leaves 15 minutes or more prior to their set departure is still responsible for hours of care up to set time. (Ex: if a participant has hours set from 3pm-6pm and leaves at 5pm on any given day without 24-hour advanced notice then he/she is still responsible and charged for the missing hour until 6pm). (Set hours apply to SAP and after care for ADP. ADP participants are required to be on-site from 10am-3pm on their scheduled days.)

• If a participant does NOT have set hours staff must be notified prior to the participant’s arrival. Unannounced drop-offs are prohibited because of our staffing ratios and planned activities. If a participant shows unannounced, then the participant may be turned away at the door or Emergency Staffing rates apply (Rate for payment is double time PER participant PER hour. Payments for emergency staffing MUST BE PAID PRIOR to the next date of care and are not the responsibility of Reginal Center, YMCA, CDA, etc.; Participants/Parents/Guardians are held responsible for emergency staffing payment).

• ADP Community Outings – Community outings will be during set times and any changes to the schedule will be relayed to participants/families/care providers. No participant arrivals/drop-offs will be permitted during community outings unless agreed upon prior with Care Programs Manager.

• Sick participant – if a participant becomes ill during care hours. The participant’s parent/care provider is notified, and the parent/care provider has ONE HOUR to pick-up participant. If a participant is left more than an hour, then Emergency Staffing rates apply (Rate for payment is double time PER participant PER hour. Payments for emergency staffing MUST BE PAID PRIOR to the next date of care and are not the responsibility of Regional Center, YMCA, CDA, etc.; Participants/Parents/Guardians are held responsible for emergency staffing payment.).

• Emergency Staffing – Staff makes emergency staffing plan to care for participant(s). ADP - When participants are left at Ivey during a community outing (example: participant’s arrival was expected at 10am and participant is dropped off, or arrives on transportation, at 11:30am during an outing, WITHOUT prior notice to care staff, care will not be available until ADP returns or emergency staffing arrangements can be made). SAP – (example: If a participant is not picked-up to go to school. Emergency staffing will take effect, and accommodations will have to be made to care for the participant until schools are released or a care provider arrives for pick-up.)

• Rate for payment is double time PER participant PER hour. Payments for emergency staffing MUST BE PAID PRIOR to the next date of care and are not the responsibility of Regional Center, YMCA, CDA, etc.; Participants/Parents/Guardians are held responsible for emergency staffing payment.

• Ivey Ranch reserves the right to increase the emergency staffing rate for any participant who requires emergency staffing 2 or more times per year. Ivey Ranch reserves the right to terminate a participant from the program after their 3rd time.

• If a participant arrives during an outing without notice, the participant/family/guardian may choose to leave and return when ADP returns OR they can choose to not return that day, but their absence will be considered Unexcused.

• Attendance must be regular, with any changes to days and times communicated to staff to remain enrolled.

• If a participant is absent for two consecutive days without notification, then a program staff member will reach out to check in with the participant/family/guardian and discuss when participant will be returning to the program. If a participant is absent/no show for 5 consecutive days, IRPA is required to notify Regional Center.

• Part time enrollment is allowed if days are pre-determined and scheduled with staff. Parents/guardians are responsible for all scheduled days unless otherwise discussed.

​REMINDER – You must call or text the Care Programs Manager the day prior to an absence for it to be excused. Calls or emails to office personnel are NOT a valid callout. Office personnel is not always available or able to notify program staff early enough to excuse an absence and adjust staffing ratios.

Care Programs Manager: Christina Paad

Phone Number: (619) 922-0919

Email: Christina@iveyranch.com

​

Information for Participants and/or Authorized Representatives:

Assisting with Self-Administered Medications

General Information:

All medication bottles must have the participant’s name clearly labeled on them. All medication must be sent in the original bottle with an unaltered label. If the medication is a prescription medication, then the instructions from the physician must be clearly labeled on the bottle or box. Over-the-counter or PRN medications (“pro re nata,”: “as the need arises.”) must have a doctor’s order provided to the Center. A medication permission slip must be completed by a licensed physician and submitted with each medication. The instructions from the participant’s parent/authorized representative cannot conflict with the products label directions or the doctor’s prescription label.

Ivey Ranch DOES NOT have a Licensed Professional on staff to provide care to those who have/use: Diabetes; enemas, suppositories or any medication inserted into a body cavity; inhalation-assistive devices or nebulizer treatments; urinary catheter; feeding tube; IV catheter; or injection, etc. [Ivey Ranch staff will administer an epi-pen / an auto-injector (containing epinephrine). All staff members will have completed epi-pen and anaphylaxis training within 30 days of employment.] We also cannot assist those whose medication requires an assessment before the person can take the medication, such as blood glucose testing and measurements of heart rate, breathing rate, and blood pressure. Ivey Ranch Park does not administer controlled substances / scheduled medications (Schedule I, II, III, IV, V).

- Schedule I: These drugs have a very high physical and psychological abuse potential and do not have any acceptable medical use. These drugs are illegal in the United States. Examples include heroin and LSD

- Schedule II: These medications have high physical and psychological abuse potential but are legal in the United States. Many narcotics (strong pain medication) are Schedule II medications. Examples include Fentanyl, Morphine, Oxycodone, Adderall, Dilaudid, and Ritalin.

- Schedule III: These medications have moderate to low physical abuse potential, but high psychological dependence. Schedule III medications are legal in the United States. Examples include limited dose Codeine, Suboxone, and depo-testosterone.

- Schedule IV: These medications have a low potential for physical or psychological abuse compared to schedule II and III drugs; however, the risk still exists. Examples include Ativan, Xanax, Diazepam, Ambien, Tramadol, and Soma.

- Schedule V: These medications have minimal physical and psychological abuse potential. Examples include Lomotil and some cough syrups containing codeine.

Specialized training by a licensed professional is required to assist with metered dose inhalers, and dry powder inhalers. If a participant needs to use an inhaler on-site then he/she must be able to independently self-administer their inhaler medication. (Title 22 Adult Day Programs; 82075 HEALTH-RELATED SERVICES) The participant’s physician must check the option on his/her medication permission that states…

“The client is able to determine and communicate his/her need for a prescription or nonprescription PRN medication.”

Ivey Ranch Park Association’s Adult Day Program staff can assist with self-administration but CANNOT administer medications.

General Guidelines for Helping with the Self-Administration of Different Types of Medications:

Ivey Ranch Park Association Adult Day Program staff members can…

• assist with gathering all of the necessary supplies.

• read the prescription label to the participant and/or help the participant to understand a prescription label.

• assist with opening a package or taking off a lid.

• remind the participant of the correct time to take his/her medication(s). (Plan to give medications within 1 hour of the scheduled dose or within 30 minutes if a time-critical medication.)

· assist with ensuring the proper route of administration, as needed. eye or ear, buccal or sublingually, orally, skin topical, or transdermal / patch, inhaler.

• measure liquid medications, break scored tablets, and crush tablets as directed.

- The physician’s order on the medication record must clearly state if a capsule can be opened, or a tablet is to be crushed. If the order does not state this, then staff members are only allowed to help with/provide the whole tablet or capsule. A change in the order must be made by Licensed Professional.

- Staff members can assist with mixing a tablet or capsule with food if the medication has special instructions requiring to do so. The crushed tablet or capsule contents may be mixed with a small amount of applesauce, jelly, pudding, or yogurt (if dairy is allowed). If the physician’s order does not state that it is ok to mix the medication with food, then the medication will be given with water only.

• help participants recognize when to clarify an “as needed” prescription order.

• help a participant learn the purpose, common side effects, and potential adverse effects of any medications we assist with.

• safely store medications.

• help participants recognize general signs of adverse reactions to medications.

• check expiration dates

• assist with checking the physician’s instructions for fluid or food intake with certain medications and follow those instructions. If the physician’s order does not state specifics regarding food or drink, then the medication will be given with water only.

• assist with privacy. Everyone has the right to privacy. For example, before helping with the self-administration of a medication in front of another person, staff members will make sure the person taking the medication is comfortable with this.

• assist with seeking professional guidance by a licensed practitioner when judgment or discretion is required.

• hand the medication or enabler to the participant.

- Liquid: A staff member can help remind a participant which method they need to use to take their liquid medication. Liquids are to be taken one of the following ways: swallowed, swished and spit out, or swished and swallowed. A staff member may need to measure liquid medications for a participant to self-administer. If needed a staff member can use an oral syringe designed for medication administration to draw up the desired dose and then place the measured medication into the medication cup. They can hand the medication cup to the participant, and staff can assist them with lifting their hand to their mouth, if needed. The participant must put the medication into his/her mouth on their own.

- Eye drops or ointment: Staff members can assist with eye drops or ointment by: applying gloves and helping the participant into position by tilting their head back comfortably. If they are lying down, staff can assist them with placing a pillow under their shoulders to allow their head to tilt back more easily. If eye crusting or discharge is present, a staff member may help the participant with cleaning their eye. Staff can remove the eye drop bottle or eye ointment tube from its container. Some eye drops need to be gently shaken before use; they may refer to the manufacturer’s instructions. They can hand the bottle or tube of medication to the participant, and have the participant gently pull down the lower lid of the eye needing medication; assist them as needed. For eye drops, have the person point the tip of the bottle downward to prevent germs from flowing into the bottle. An Ivey staff member can instruct the person to instill the number of drops indicated on the order into the lower lid of their eye. For eye ointment, the can instruct them to apply enough pressure to the ointment tube to release a thin line of medication into the lower lid of their eye. A staff member can help hold or guide the person’s hand as needed but the participant must instill the medication. A staff member can ask the person to blink their eyes several times. This helps the medication spread. They may also ask the participant to keep their eye closed for one minute and remind the participant that blurry vision is common after eye ointment is applied. Staff can provide tissue to blot excess medication from around the eye.

- Ear drops: The participant should lie on their side or tilt their head. A staff member can make sure the ear in need of medication is pointing up and exposed. They may also help remove the ear drop bottle from its container, hand the bottle to the participant, and/or help hold or guide the person’s hand as needed, but the participant must instill the medication. Staff can instruct the participant to maintain the side-lying position for at least 2 minutes and remind them to keep their head tilted to keep the drops from leaving the ear. A staff member can also provide tissue to blot excess medication.

- Nasal drops or sprays: Staff members can remind the participant to gently blow their nose to clear their nostrils before nasal drops or sprays are instilled, and they can hand the bottle to the person. When instilling nasal spray, the participant can be reminded to keep their head in a neutral position, and place the tip of the bottle just underneath their nostril. Staff can remind them to gently hold their finger against the opposite nostril and spray the medication while gently sniffing. If instilling nasal drops, a staff member can remind the participant to gently tilt their head back, place the tip of the bottle just above their nostril, and instill the number of ordered nasal drops. A staff member can remind them that they should avoid blowing their nose right after instilling nasal drops or spray.

- Topical medications: Staff members can squeeze a small amount of the medication onto the applicator. The staff member can tell the participant to apply the medication to the affected area until it is absorbed and remind the participant to not allow the medication in the tube to touch the applicator after application to the affected area

- Transdermal medication (absorbed through the skin): A staff member will help to ensure the old patch is removed from the person. Staff will take a moment to search for old patches that should have been removed and the absence of a patch that should have been present. The can help the participant identify a new area for the new patch, clean the new area with a damp cloth, mild soap, and water, and dry the area thoroughly. A staff member may help remove the backing from the patch if needed. A staff member can watch the participant apply the patch according to the package instructions.

- Inhalers: (As stated above in General Information) Specialized training by a licensed professional is required to assist with metered dose inhalers, and dry powder inhalers. If a participant needs to use an inhaler on-site then he/she must be able to independently self-administer their inhaler medication. (Title 22 Adult Day Programs; 82075 HEALTH-RELATED SERVICES) The participant’s physician must check the option on his/her medication permission that states…

“The client is able to determine and communicate his/her need for a prescription or nonprescription PRN medication.”

· mark and separate discontinued medications from the current medications that have not yet expired or been returned to the participant and/or authorized representative.

• dispose of medications that have expired medications or medications that have been left behind by a discharged person.

Information from:

Ivey Ranch Park Association Adult Day Program Policies and Procedures

Title 22 – Adult Day Programs

Relias Academy – Courses for California RCFE Medication Management

Yes. On days a participant attends they will need to be in the program from 10am-3pm. Community outings occur 2-3 times a week during those hours, and participants can not arrive on-site while the program personnel is off-site. If a pick-up needs to be arranged during outing hours, care providers may contact the Care Programs Manager to see if it is possible.

Program hours can be paid for privately, by SDRC, or by Financial Management Services (FMS).

Yes. After care hours are from 3pm-6pm. After program hours can be paid for privately, by SDRC, or by FMS.

During ADP hours (10am-3pm) the ratio is 1:4.

IRPA’s Adult Day Program cannot accommodate participants that require 1:1 staffing.

Our ADP program hopes to have little to no cost for outings for participants/care providers. If a fee is required that is not covered by ADP then participants/care providers will receive a notification at least two weeks in advance. IRPA’s ADP has a recycling program that we hope will offset costs for outings.

Our program will be walking to and/or taking the city bus for all of our community outings. Participants are required to have a city bus pass.

Ivey’s ADP is a 510 program and not a 515. Unfortunately, this means that we are unable to accept participants with behaviors that may cause physical or mental harm to self or others.

Our program’s curriculum and activities can include but are not limited to:

• Socializing: Group activities such as art projects, games/puzzles, gardening, fitness, fundraising, reading/storytelling, music, birthday/holiday celebrations, and dancing.

• Independent Living Skills:

• Laundry - including washing machine and dryer use, folding clothes, and putting away laundry

• Dishes - including rinsing dishes, loading and unloading the dishwasher, and putting dishes away

• Cooking/Baking - including measuring, mixing, prepping food (i.e., washing fruits and vegetables), and use of small appliances

• Shopping including managing money, understanding costs, store etiquette, and following a shopping list

• Access to community resources including generic agencies (colleges, food banks, recreation centers etc.)

• Self-Care

• Understanding doctors’ visits to primary care physicians, therapy appointments, dentists, and specialists / Patient understanding

No. Ivey Ranch Park’s ADP participants must have their own transportation for arrival and pick-up/departure.

• IRPA Skills Training /Working Intern Program (WIP) - Teens and young adults with special needs will learn skills that include animal caregiving, grounds management, riding lesson assistance, store keeping, and event assistance. This program provides on-the-job experience and customized training.

- Contact Cynthia at Cynthia@iveyranch.com for more information. WIP can be paid for by SDRC or The Department of Rehabilitation

• Therapeutic Riding - Visit our website.

- Website: Iveyranch.com

Yes. A teacher from the ADP program will be able to assist participants in getting from one program to another.

Yes. Meals and snacks are provided at set times during programming.

Lunch is at 12PM.

Afternoon snack is at 3:15pm, once ADP has ended for those who have after-care.

Yes. A participant can bring food from home to enjoy during our set meal times.

Please note:

-We are a nut free program (this includes: peanuts and tree nuts)

- We are a junk food free facility except on holidays and birthdays. Participants can bring healthy snacks and foods such as fruits, vegetables, protein, sandwiches, yogurt, cheeses, etc.