Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6645 min / 110.75 hrs

(69.22%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 140 1365 1430 160 950 875 160 1565

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

Clients' Codes

outdoor actvity
Date Settings Systems Age Group

Communicatng
(for confidentiality)

Reportng and

Positoning
Educaton
Transfers
1 2017-01-09 TM Community Mult-System Paediatric (Newborn - 18 yo) 90 60 90 60 90
2 2017-01-11 EM Community Mult-System Adult 30 60 90 70 50
3 2017-01-16 TM Community Mult-System Paediatric (Newborn - 18 yo) 90 60 90 30 90
4 2017-01-18 EM Community Mult-System Adult 30 60 15 30 15 30 30
5 2017-01-18 G Community Mult-System Paediatric (Newborn - 18 yo) 90 30 30 25 20
6 2017-01-23 TM Community Mult-System Paediatric (Newborn - 18 yo) 90 60 90 60 60
7 2017-01-25 EM Community Mult-System Adult 20 15 30 10 30 30 30
8 2017-01-25 G Community Mult-System Paediatric (Newborn - 18 yo) 20 60 30 30 30
9 2017-01-30 TE Community Mult-System Adult 60 60 15 30 30 60
10 2017-02-01 G Community Mult-System Paediatric (Newborn - 18 yo) 90 90 30 60 90
11 2017-02-06 TM Community Mult-System Paediatric (Newborn - 18 yo) 90 60 60 60 90
12 2017-02-08 EM Community Mult-System Adult 30 60 60 60 15 90
13 2017-02-13 TM Community Mult-System Paediatric (Newborn - 18 yo) 90 60 10 60 60 75
14 2017-02-17 EM Community Mult-System Adult 30 30 10 20 30 30
15 2017-02-17 G Community Mult-System Paediatric (Newborn - 18 yo) 30 10 30 60 50
16 2017-02-27 TE Community Mult-System Adult 20 60 15 30 30
17 2017-02-27 TR Community Mult-System Paediatric (Newborn - 18 yo) 20 60 15 30 60
18 2017-03-01 W Community Mult-System Paediatric (Newborn - 18 yo) 60 60 20 30 60 90
 Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6645 min / 110.75 hrs

(69.22%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 140 1365 1430 160 950 875 160 1565

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

Clients' Codes

outdoor actvity
Date Settings Systems Age Group

Communicatng
(for confidentiality)

Reportng and

Positoning
Educaton
Transfers
19 2017-03-06 TE Community Mult-System Adult 60 60 20 30 30 90
20 2017-03-08 W Community Mult-System Paediatric (Newborn - 18 yo) 60 90 20 30 60 90
21 2017-03-13 A Community Mult-System Paediatric (Newborn - 18 yo) 90 50 20 30 30 90
22 2017-03-15 O Community Mult-System Paediatric (Newborn - 18 yo) 90 60 30 20 90
23 2017-03-20 TE Community Mult-System Adult 60 60 20 30
24 2017-03-20 TR Community Mult-System Paediatric (Newborn - 18 yo) 60 60 30 20
25 2017-03-22 W Community Mult-System Paediatric (Newborn - 18 yo) 60 60 10 60 90
 Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6645 min / 110.75 hrs

(69.22%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 140 1365 1430 160 950 875 160 1565

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

Clients' Codes

outdoor actvity
Date Settings Systems Age Group

Communicatng
(for confidentiality)

Reportng and

Positoning
Educaton
Transfers
 Total Intervention Ti

PRACTICAL SKILLS CHECKLIST OT/PT = 6645 min / 110.75 hrs

(69.22%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 140 1365 1430 160 950 875 160 1565

Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /

Other Interventon
Number

Clients' Codes

outdoor actvity
Date Settings Systems Age Group

Communicatng
(for confidentiality)

Reportng and

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

PRACTICAL SKILLS
PT = 0CHECKLIST
min / 0 hr OT = 1755 min / 29.25 hrs Misc = 1200 min / 20.00 hrs
(18.28%) (12.50%)

0 0 College0
Full credit and aknowledgement of this Tool to Pat Lee, Centennial 0 270 0 20 250 190 1025 30 475 0 410 285

Daily Checklist Completon

Measurement / Assembly

W/C Mobility and Skills Training

Meetngs and In-Services

fne motor skill/ coordinaton
Other Interventon

Indirect Patent Care

Number

organizatonal skills

Other Interventon
Date Clients' Codes

W/C Seatng and

(for confidentiality)

Documentaton
Stair Climbing
Ambulaton

LIFE SKILLS
Modalites

Lunch
1 2017-01-09 TM 30 25 20 15
2 2017-01-11 EM 20 60 30 25 30 15
3 2017-01-16 TM 30 30 25 20 15
4 2017-01-18 EM 15 10 5
5 2017-01-18 G 20 10 10 5
6 2017-01-23 TM 30 30 30 20 10
7 2017-01-25 EM 30 25 10 10
8 2017-01-25 G 30 20 10 10
9 2017-01-30 TE 30 60 45 60 20 10
10 2017-02-01 G 60 30 20 10
11 2017-02-06 TM 30 30 20 25 15
12 2017-02-08 EM 60 20 20 30 20 15
13 2017-02-13 TM 30 30 30 20 15
14 2017-02-17 EM 30 30 10 10 10
15 2017-02-17 G 30 10 10 10
16 2017-02-27 TE 30 30 10 10 5
17 2017-02-27 TR 30 10 10 5
18 2017-03-01 W 20 90 20 20 10
 Total Intervention Time = 9,600 min / 160.00 hrs (100.00%)

PRACTICAL SKILLS
PT = 0CHECKLIST
min / 0 hr OT = 1755 min / 29.25 hrs Misc = 1200 min / 20.00 hrs
(18.28%) (12.50%)

0 0 College0
Full credit and aknowledgement of this Tool to Pat Lee, Centennial 0 270 0 20 250 190 1025 30 475 0 410 285

Daily Checklist Completon

Measurement / Assembly

W/C Mobility and Skills Training

Meetngs and In-Services

fne motor skill/ coordinaton
Other Interventon

Indirect Patent Care

Number

organizatonal skills

Other Interventon
Date Clients' Codes

W/C Seatng and

(for confidentiality)

Documentaton
Stair Climbing
Ambulaton

LIFE SKILLS
Modalites

Lunch
19 2017-03-06 TE 60 75 25 20 10
20 2017-03-08 W 90 15 15 10
21 2017-03-13 A 30 90 15 20 15
22 2017-03-15 O 50 90 15 20 15
23 2017-03-20 TE 30 15 10 15
24 2017-03-20 TR 30 15 10 15
25 2017-03-22 W 30 90 30 15 20 15
 Total Intervention Time = 9,600 min / 160.00 hrs (100.00%)

PRACTICAL SKILLS
PT = 0CHECKLIST
min / 0 hr OT = 1755 min / 29.25 hrs Misc = 1200 min / 20.00 hrs
(18.28%) (12.50%)

0 0 College0
Full credit and aknowledgement of this Tool to Pat Lee, Centennial 0 270 0 20 250 190 1025 30 475 0 410 285

Daily Checklist Completon

Measurement / Assembly

W/C Mobility and Skills Training

Meetngs and In-Services

fne motor skill/ coordinaton
Other Interventon

Indirect Patent Care

Number

organizatonal skills

Other Interventon
Date Clients' Codes

W/C Seatng and

(for confidentiality)

Documentaton
Stair Climbing
Ambulaton

LIFE SKILLS
Modalites

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

PRACTICAL SKILLS
PT = 0CHECKLIST
min / 0 hr OT = 1755 min / 29.25 hrs Misc = 1200 min / 20.00 hrs
(18.28%) (12.50%)

0 0 College0
Full credit and aknowledgement of this Tool to Pat Lee, Centennial 0 270 0 20 250 190 1025 30 475 0 410 285

Daily Checklist Completon

Measurement / Assembly

W/C Mobility and Skills Training

Meetngs and In-Services

fne motor skill/ coordinaton
Other Interventon

Indirect Patent Care

Number

organizatonal skills

Other Interventon
Date Clients' Codes

W/C Seatng and

(for confidentiality)

Documentaton
Stair Climbing
Ambulaton

LIFE SKILLS
Modalites

Lunch
 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 2017-01-09 TM 480
2 2017-01-11 EM 480
3 2017-01-16 TM 480
4 2017-01-18 EM 240
5 2017-01-18 G 240
6 2017-01-23 TM 480
7 2017-01-25 EM 240
8 2017-01-25 G 240
9 2017-01-30 TE 480
10 2017-02-01 G 480
11 2017-02-06 TM 480
12 2017-02-08 EM 480
13 2017-02-13 TM 480
14 2017-02-17 EM 240
15 2017-02-17 G 240
16 2017-02-27 TE 240
17 2017-02-27 TR 240
18 2017-03-01 W 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 2017-03-06 TE 480
20 2017-03-08 W 480
21 2017-03-13 A 480
22 2017-03-15 O 480
23 2017-03-20 TE 240
24 2017-03-20 TR 240
25 2017-03-22 W 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)