Assessment/Monitoring Visit Form

This form allows for signatures and affirmations of elements conducted during the visit by both the Assessor and the program administrator on-site at the time of the visit. Each element being endorsed has its own checkbox. The Assessor will note all elements conducted at the visit, and if the program administrator does not agree that a specific element of the visit was followed and/or conducted, a comment should be added to the form describing the nature of the discrepancy. If the program administrator refuses to sign the form, the Assessor should note this and notify his or her supervisor. 

This form must be completed and can be found in the Appendix of the Staff Handbook. Note: the visit form could be revised to incorporate additional items as needed but cannot remove any items.