Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6475 min / 107.92 hrs

(67.45%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 15 1345 1110 405 1110 590 875 1025

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

outdoor actvites
Date Clients' Codes Settings Systems Age Group

animal therapy
Communicatng
(for confidentiality)

Reportng and

Educaton
Transfers
1 2017-01-04 orientaton Community Mult-System 20 20 30 25 60
2 2017-01-09 J Community Mult-System Paediatric (Newborn - 18 yo) 30 80 25 50 60 20 60
3 2017-01-11 C Community Mult-System Paediatric (Newborn - 5 90 60 30 50 90
4 2017-01-16 J Community Mult-System Paediatric (Newborn - 18 yo) 70 80 50 45 30 60
5 2017-01-18 CM & TB Community Mult-System Paediatric (Newborn - 18 yo) 65 40 60 45 60 45
6 2017-01-23 J Community Mult-System Paediatric (Newborn - 18 yo) 60 60 15 50 40 70
7 2017-01-25 CM & TB Community Mult-System Paediatric (Newborn - 18 yo) 80 45 10 40 60 40
8 2017-01-30 J&E Community Mult-System Paediatric (Newborn - 18 yo) 80 45 10 35 45 60 35
9 2017-02-01 TB & T Community Mult-System Paediatric (Newborn - 18 yo) 60 70 45 60 60 35
10 2017-02-06 J&E Community Mult-System Paediatric (Newborn - 18 yo) 70 60 10 45 45 85 45
11 2017-02-08 CM & TB Community Mult-System Paediatric (Newborn - 18 yo) 60 45 10 60 30 45 45
12 2017-02-13 E Community Mult-System Paediatric (Newborn - 18 yo) 80 45 15 60 50 45
13 2017-02-15 CM Community Mult-System Paediatric (Newborn - 18 yo) 80 60 10 60 45 45 35
14 2017-02-27 S & JF Community Mult-System Adult 10 30 60 65 45 35 45
15 2017-03-01 D Community Mult-System Adult 90 65 85 20 45
16 2017-03-06 JF Community Mult-System Adult 70 55 20 50 45 45 45
17 2017-03-08 D Community Mult-System Adult 90 60 20 45 35 45 60
18 2017-03-13 Spring break Community Mult-System Adult 90 60 35 65 80 60
 Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6475 min / 107.92 hrs

(67.45%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 15 1345 1110 405 1110 590 875 1025

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

outdoor actvites
Date Clients' Codes Settings Systems Age Group

animal therapy
Communicatng
(for confidentiality)

Reportng and

Educaton
Transfers
19 2017-03-15 Spring break Community Mult-System Adult 90 60 35 65 80 60
20 2017-03-20 S Community Mult-System Adult 25 35 45 20
21 2017-03-22 D Community Mult-System Adult 90 45 45 55 25 35 45
 Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6475 min / 107.92 hrs

(67.45%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 15 1345 1110 405 1110 590 875 1025

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

outdoor actvites
Date Clients' Codes Settings Systems Age Group

animal therapy
Communicatng
(for confidentiality)

Reportng and

Educaton
Transfers
 Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6475 min / 107.92 hrs

(67.45%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 15 1345 1110 405 1110 590 875 1025

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

outdoor actvites
Date Clients' Codes Settings Systems Age Group

animal therapy
Communicatng
(for confidentiality)

Reportng and

Educaton
Transfers
 Total Intervention Time = 9,600 min / 160.00 hrs (100.00%)

PRACTICAL SKILLS
PT = 0CHECKLIST
min / 0 hr OT = 870 min / 14.50 hrs Misc = 2255 min / 37.58 hrs
(9.06%) (23.49%)

0 0 College0
Full credit and aknowledgement of this Tool to Pat Lee, Centennial 0 0 0 50 0 0 820 1010 685 0 345 215

Daily Checklist Completon

Measurement / Assembly

W/C Mobility and Skills Training

Meetngs and In-Services

Adaptaton of Assistve devices
Assisted with Splintng and/or
ADL or IADL Training

Cognitve Perceptual
Other Interventon

Indirect Patent Care

Number

Other Interventon
Date Clients' Codes

W/C Seatng and

(for confidentiality)

Documentaton
Stair Climbing

Interventons
Ambulaton

Modalites

lunch
1 2017-01-04 orientaton 60 60 15 10
2 2017-01-09 J 20 60 50 15 10
3 2017-01-11 C 5 35 45 30 30 10
4 2017-01-16 J 45 35 35 20 10
5 2017-01-18 CM & TB 65 35 35 20 10
6 2017-01-23 J 45 60 50 20 10
7 2017-01-25 CM & TB 85 30 60 20 10
8 2017-01-30 J&E 75 30 35 20 10
9 2017-02-01 TB & T 45 30 35 20 20
10 2017-02-06 J&E 45 30 30 10 5
11 2017-02-08 CM & TB 65 65 35 10 10
12 2017-02-13 E 45 65 55 10 10
13 2017-02-15 CM 45 20 60 10 10
14 2017-02-27 S & JF 45 45 60 15 15 10
15 2017-03-01 D 45 75 25 20 10
16 2017-03-06 JF 45 50 25 20 10
17 2017-03-08 D 35 45 25 10 10
18 2017-03-13 Spring break 55 25 10
 Total Intervention Time = 9,600 min / 160.00 hrs (100.00%)

PRACTICAL SKILLS
PT = 0CHECKLIST
min / 0 hr OT = 870 min / 14.50 hrs Misc = 2255 min / 37.58 hrs
(9.06%) (23.49%)

0 0 College0
Full credit and aknowledgement of this Tool to Pat Lee, Centennial 0 0 0 50 0 0 820 1010 685 0 345 215

Daily Checklist Completon

Measurement / Assembly

W/C Mobility and Skills Training

Meetngs and In-Services

Adaptaton of Assistve devices
Assisted with Splintng and/or
ADL or IADL Training

Cognitve Perceptual
Other Interventon

Indirect Patent Care

Number

Other Interventon
Date Clients' Codes

W/C Seatng and

(for confidentiality)

Documentaton
Stair Climbing

Interventons
Ambulaton

Modalites

lunch
19 2017-03-15 Spring break 55 25 10
20 2017-03-20 S 45 10
21 2017-03-22 D 35 60 25 10 10
 Number

Date Clients' Codes

(for confidentiality)
0

Ambulaton
PRACTICAL SKILLS
Full credit and aknowledgement of this Tool to Pat Lee, Centennial

Stair Climbing
0 College0

Modalites
min / 0 hr

Other Interventon
0

ADL or IADL Training

PT = 0CHECKLIST

W/C Seatng and

0

Measurement / Assembly

W/C Mobility and Skills Training

50

Assisted with Splintng and/or

(9.06%)

0
Total Intervention Time = 9,600 min / 160.00 hrs (100.00%)

Adaptaton of Assistve devices

Cognitve Perceptual
0
OT = 870 min / 14.50 hrs

Interventons

Other Interventon
820

Meetngs and In-Services

1010

Documentaton
685
0

Indirect Patent Care

(23.49%)

lunch
345
Misc = 2255 min / 37.58 hrs

Daily Checklist Completon

215
 Number

Date Clients' Codes

(for confidentiality)
0

Ambulaton
PRACTICAL SKILLS
Full credit and aknowledgement of this Tool to Pat Lee, Centennial

Stair Climbing
0 College0

Modalites
min / 0 hr

Other Interventon
0

ADL or IADL Training

PT = 0CHECKLIST

W/C Seatng and

0

Measurement / Assembly

W/C Mobility and Skills Training

50

Assisted with Splintng and/or

(9.06%)

0
Total Intervention Time = 9,600 min / 160.00 hrs (100.00%)

Adaptaton of Assistve devices

Cognitve Perceptual
0
OT = 870 min / 14.50 hrs

Interventons

Other Interventon
820

Meetngs and In-Services

1010

Documentaton
685
0

Indirect Patent Care

(23.49%)

lunch
345
Misc = 2255 min / 37.58 hrs

Daily Checklist Completon

215
 PRACTICAL SKILLS CHECKLIST

9600
Full credit and aknowledgement of this Tool to Pat Lee, Centennial College

Total Minutes Per Client

Number

Date Clients' Codes

(for confidentiality)

1 2017-01-04 orientaton 300

2 2017-01-09 J 480
3 2017-01-11 C 480
4 2017-01-16 J 480
5 2017-01-18 CM & TB 480
6 2017-01-23 J 480
7 2017-01-25 CM & TB 480
8 2017-01-30 J&E 480
9 2017-02-01 TB & T 480
10 2017-02-06 J&E 480
11 2017-02-08 CM & TB 480
12 2017-02-13 E 480
13 2017-02-15 CM 480
14 2017-02-27 S & JF 480
15 2017-03-01 D 480
16 2017-03-06 JF 480
17 2017-03-08 D 480
18 2017-03-13 Spring break 480
 PRACTICAL SKILLS CHECKLIST

9600
Full credit and aknowledgement of this Tool to Pat Lee, Centennial College

Total Minutes Per Client

Number

Date Clients' Codes

(for confidentiality)

19 2017-03-15 Spring break 480

20 2017-03-20 S 180
21 2017-03-22 D 480
 PRACTICAL SKILLS CHECKLIST

9600
Full credit and aknowledgement of this Tool to Pat Lee, Centennial College

Total Minutes Per Client

Number

Date Clients' Codes

(for confidentiality)
 PRACTICAL SKILLS CHECKLIST

9600
Full credit and aknowledgement of this Tool to Pat Lee, Centennial College

Total Minutes Per Client

Number

Date Clients' Codes

(for confidentiality)