Total Intervention Time =

PRACTICAL SKILLS CHECKLIST OT/PT = 2445 min / 40.75 hrs PT = 2715 min / 4
(26.65%) (29.59%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 0 0 0 1140 745 300 240 20 0

Reportng and Communicatng

Other Interventon (specify

Ambulaton/ Stair Climbing

routne interventons here)
Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /
Number

Date Clients' Codes Settings Systems Age Group

(for confidentiality)

1:1 Exercises

Positoning
Educaton
Transfers
C 2017-09-11 Orientaton Rehabilitaton Mult-System 30 40 5
2 2017-09-11 SC Rehabilitaton Mult-System Adult 5 10 10 5
3 2017-09-11 AM Rehabilitaton Mult-System Adult 5 10 10 5
4 2017-09-13 OJ Rehabilitaton Mult-System Adult 5
5 2017-09-13 MM Rehabilitaton Mult-System Adult 5
6 2017-09-13 VC Rehabilitaton Mult-System Adult 5
7 2017-09-13 SJ Rehabilitaton Mult-System Adult 5
8 2017-09-13 GS Rehabilitaton Mult-System Adult 5
9 2017-09-13 Documenton Rehabilitaton Mult-System 25 10
10 2017-09-18 SC Rehabilitaton Mult-System Adult 5
11 2017-09-18 MC Rehabilitaton Mult-System Adult 5
12 2017-09-18 BL Rehabilitaton Mult-System Adult 5
13 2017-09-18 AQ Rehabilitaton Mult-System Adult 5
14 2017-09-18 AM Rehabilitaton Mult-System Adult 5
15 2017-09-18 Documenton Rehabilitaton Mult-System 30 25 20
16 2017-09-20 LM Rehabilitaton Mult-System Adult 10 5
17 2017-09-20 MK Rehabilitaton Mult-System Adult 10 10
18 2017-09-20 FS Rehabilitaton Mult-System Adult 5
19 2017-09-20 DB Rehabilitaton Mult-System Adult 5
 Total Intervention Time =

PRACTICAL SKILLS CHECKLIST OT/PT = 2445 min / 40.75 hrs PT = 2715 min / 4
(26.65%) (29.59%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 0 0 0 1140 745 300 240 20 0

Reportng and Communicatng

Other Interventon (specify

Ambulaton/ Stair Climbing

routne interventons here)
Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /
Number

Date Clients' Codes Settings Systems Age Group

(for confidentiality)

1:1 Exercises

Positoning
Educaton
Transfers
20 2017-09-20 PW Rehabilitaton Mult-System Adult 5
21 2017-09-20 MB Rehabilitaton Mult-System Adult 5
22 2017-09-20 Documenton Rehabilitaton Mult-System 35 20
23 2017-09-25 RU Rehabilitaton Mult-System Adult 10
24 2017-09-25 PA Rehabilitaton Mult-System Adult 5
25 2017-09-25 LA Rehabilitaton Mult-System Adult 5
26 2017-09-25 PW Rehabilitaton Mult-System Adult 5
27 2017-09-25 Documenton Rehabilitaton Mult-System 35 45 30
28 2017-09-27 FS Rehabilitaton Mult-System Adult 20 10
29 2017-09-27 PW Rehabilitaton Mult-System Adult
30 2017-09-27 RU Rehabilitaton Mult-System Adult 5
31 2017-09-27 BC Rehabilitaton Mult-System Adult
32 2017-09-27 LP Rehabilitaton Mult-System Adult
33 2017-09-27 OK Rehabilitaton Mult-System Adult 10 10 5
34 2017-09-27 JB Rehabilitaton Mult-System Adult
35 2017-09-27 Documenton Rehabilitaton Mult-System 35 25
36 2017-10-02 SC Rehabilitaton Mult-System Adult 10
37 2017-10-02 PW Rehabilitaton Mult-System Adult 5
38 2017-10-02 MC Rehabilitaton Mult-System Adult 10
 Total Intervention Time =

PRACTICAL SKILLS CHECKLIST OT/PT = 2445 min / 40.75 hrs PT = 2715 min / 4
(26.65%) (29.59%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 0 0 0 1140 745 300 240 20 0

Reportng and Communicatng

Other Interventon (specify

Ambulaton/ Stair Climbing

routne interventons here)
Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /
Number

Date Clients' Codes Settings Systems Age Group

(for confidentiality)

1:1 Exercises

Positoning
Educaton
Transfers
39 2017-10-02 MB Rehabilitaton Mult-System Adult 5
40 2017-10-02 KG Rehabilitaton Mult-System Adult 5
41 2017-10-02 AM Rehabilitaton Mult-System Adult 5
42 2017-10-02 Documenton Rehabilitaton Mult-System 45 30 15
43 2017-10-04 LA Rehabilitaton Mult-System Adult 20 10
44 2017-10-04 FS Rehabilitaton Mult-System Adult 20 5
45 2017-10-04 Documenton Rehabilitaton Mult-System 80 15
46 2017-10-11 LA Rehabilitaton Mult-System Adult 5 5
47 2017-10-11 FS Rehabilitaton Mult-System Adult 5 10 5
48 2017-10-11 SA Rehabilitaton Mult-System Adult 5 10 5
49 2017-10-11 JB Rehabilitaton Mult-System Adult 5 5
50 2017-10-11 Documenton Rehabilitaton Mult-System 45 30 15
51 2017-10-16 SC Rehabilitaton Mult-System Adult 5
52 2017-10-16 BC Rehabilitaton Mult-System Adult 5 5
53 2017-10-16 SY Rehabilitaton Mult-System Adult 5
54 2017-10-16 LG Rehabilitaton Mult-System Adult 5 5
55 2017-10-16 Documenton Rehabilitaton Mult-System 45 30
56 2017-10-18 FS Rehabilitaton Mult-System Adult 5 10
57 2017-10-18 DB Rehabilitaton Mult-System Adult 5
 Total Intervention Time =

PRACTICAL SKILLS CHECKLIST OT/PT = 2445 min / 40.75 hrs PT = 2715 min / 4
(26.65%) (29.59%)

Full credit and aknowledgement of this Tool to Pat Lee, Centennial College 0 0 0 1140 745 300 240 20 0

Reportng and Communicatng

Other Interventon (specify

Ambulaton/ Stair Climbing

routne interventons here)
Environment / Equipment
Group Exercises / Actvity

Preparaton of Client /
Number

Date Clients' Codes Settings Systems Age Group

(for confidentiality)

1:1 Exercises

Positoning
Educaton
Transfers
58 2017-10-18 SY Rehabilitaton Mult-System Adult 5 5
59 2017-10-18 DP Rehabilitaton Mult-System Adult 5
60 2017-10-18 MB Rehabilitaton Mult-System Adult 5 5
61 2017-10-18 Documenton Rehabilitaton Mult-System Adult 45 30
62 2017-10-23 SC Rehabilitaton Mult-System Adult 10 10
63 2017-10-23 PW Rehabilitaton Mult-System Adult 10 10
64 2017-10-23 Documenton Rehabilitaton Mult-System 45 65
65 2017-10-25 GM Rehabilitaton Mult-System Adult 5
66 2017-10-25 FS Rehabilitaton Mult-System Adult 10
 Total Intervention Time = 9,175 min / 152.92 hrs (100.00%)

PRACTICALPTSKILLS CHECKLIST

9175
= 2715 min / 45.25 hrs OT = 0 min / 0 hr Misc = 3725 min / 62.08 hrs
(29.59%) (40.60%)

Full credit and aknowledgement of this Tool to Pat Lee,865 1595College

Centennial 255 0 0 0 0 0 0 365 1265 1900 0 195

Shadowing PT Assessments

Actvity Analysis and Actvity Specifc

Total Minutes Per Client

Other Interventon (specify
routne interventons here)

Daily Checklist Completon

Measurement / Assembly;

Laundry/ Equipment Prep

Equipment Maintenance/
Meetngs and In-Services

Workload Measurement
W/C Mobility and Skills
ADL or IADL Training

Indirect Patent Care/

Cognitve Perceptual
Number

Fine motor Interventon

Date Clients' Codes

W/C Seatng and

Exersices/ROM
(for confidentiality)

Documentaton
Interventons
Modalites

Interventon
Training
C 2017-09-11 Orientaton 15 50 20 20 30 45 20 15 290
2 2017-09-11 SC 20 20 5 20 95
3 2017-09-11 AM 20 20 5 20 95
4 2017-09-13 OJ 40 20 65
5 2017-09-13 MM 40 20 65
6 2017-09-13 VC 10 25 10 20 70
7 2017-09-13 SJ 10 25 10 20 70
8 2017-09-13 GS 50 20 75
9 2017-09-13 Documenton 20 35 30 15 135
10 2017-09-18 SC 10 20 20 55
11 2017-09-18 MC 10 20 20 55
12 2017-09-18 BL 15 20 20 60
13 2017-09-18 AQ 10 20 20 55
14 2017-09-18 AM 15 20 20 60
15 2017-09-18 Documenton 45 20 45 10 195
16 2017-09-20 LM 10 20 10 5 60
17 2017-09-20 MK 20 10 50
18 2017-09-20 FS 10 20 20 55
19 2017-09-20 DB 10 20 20 55
 Total Intervention Time = 9,175 min / 152.92 hrs (100.00%)

PRACTICALPTSKILLS CHECKLIST

9175
= 2715 min / 45.25 hrs OT = 0 min / 0 hr Misc = 3725 min / 62.08 hrs
(29.59%) (40.60%)

Full credit and aknowledgement of this Tool to Pat Lee,865 1595College

Centennial 255 0 0 0 0 0 0 365 1265 1900 0 195

Shadowing PT Assessments

Actvity Analysis and Actvity Specifc

Total Minutes Per Client

Other Interventon (specify
routne interventons here)

Daily Checklist Completon

Measurement / Assembly;

Laundry/ Equipment Prep

Equipment Maintenance/
Meetngs and In-Services

Workload Measurement
W/C Mobility and Skills
ADL or IADL Training

Indirect Patent Care/

Cognitve Perceptual
Number

Fine motor Interventon

Date Clients' Codes

W/C Seatng and

Exersices/ROM
(for confidentiality)

Documentaton
Interventons
Modalites

Interventon
Training
20 2017-09-20 PW 10 20 20 55
21 2017-09-20 MB 10 20 20 55
22 2017-09-20 Documenton 40 45 10 150
23 2017-09-25 RU 10 20 45 85
24 2017-09-25 PA 5 30 20 60
25 2017-09-25 LA 20 10 20 55
26 2017-09-25 PW 5 40 20 70
27 2017-09-25 Documenton 40 50 10 210
28 2017-09-27 FS 20 5 35 30 20 140
29 2017-09-27 PW 5 20 25
30 2017-09-27 RU 10 10 25
31 2017-09-27 BC 5 20 25
32 2017-09-27 LP 5 20 25
33 2017-09-27 OK 20 10 55
34 2017-09-27 JB 5 10 10 25
35 2017-09-27 Documenton 35 25 10 130
36 2017-10-02 SC 25 10 5 10 60
37 2017-10-02 PW 5 20 10 40
38 2017-10-02 MC 25 10 10 10 65
 Total Intervention Time = 9,175 min / 152.92 hrs (100.00%)

PRACTICALPTSKILLS CHECKLIST

9175
= 2715 min / 45.25 hrs OT = 0 min / 0 hr Misc = 3725 min / 62.08 hrs
(29.59%) (40.60%)

Full credit and aknowledgement of this Tool to Pat Lee,865 1595College

Centennial 255 0 0 0 0 0 0 365 1265 1900 0 195

Shadowing PT Assessments

Actvity Analysis and Actvity Specifc

Total Minutes Per Client

Other Interventon (specify
routne interventons here)

Daily Checklist Completon

Measurement / Assembly;

Laundry/ Equipment Prep

Equipment Maintenance/
Meetngs and In-Services

Workload Measurement
W/C Mobility and Skills
ADL or IADL Training

Indirect Patent Care/

Cognitve Perceptual
Number

Fine motor Interventon

Date Clients' Codes

W/C Seatng and

Exersices/ROM
(for confidentiality)

Documentaton
Interventons
Modalites

Interventon
Training
39 2017-10-02 MB 5 20 5 10 45
40 2017-10-02 KG 5 20 5 10 45
41 2017-10-02 AM 5 30 10 50
42 2017-10-02 Documenton 60 15 10 175
43 2017-10-04 LA 25 15 35 105
44 2017-10-04 FS 45 10 15 35 130
45 2017-10-04 Documenton 80 60 10 245
46 2017-10-11 LA 5 20 5 20 60
47 2017-10-11 FS 20 5 10 15 20 90
48 2017-10-11 SA 15 10 10 10 20 85
49 2017-10-11 JB 5 30 5 20 70
50 2017-10-11 Documenton 10 35 30 10 175
51 2017-10-16 SC 10 20 5 10 50
52 2017-10-16 BC 15 20 5 25 75
53 2017-10-16 SY 15 20 5 25 70
54 2017-10-16 LG 10 30 5 10 65
55 2017-10-16 Documenton 10 60 65 10 220
56 2017-10-18 FS 25 5 10 15 20 90
57 2017-10-18 DB 5 20 5 5 40
 Total Intervention Time = 9,175 min / 152.92 hrs (100.00%)

PRACTICALPTSKILLS CHECKLIST

9175
= 2715 min / 45.25 hrs OT = 0 min / 0 hr Misc = 3725 min / 62.08 hrs
(29.59%) (40.60%)

Full credit and aknowledgement of this Tool to Pat Lee,865 1595College

Centennial 255 0 0 0 0 0 0 365 1265 1900 0 195

Shadowing PT Assessments

Actvity Analysis and Actvity Specifc

Total Minutes Per Client

Other Interventon (specify
routne interventons here)

Daily Checklist Completon

Measurement / Assembly;

Laundry/ Equipment Prep

Equipment Maintenance/
Meetngs and In-Services

Workload Measurement
W/C Mobility and Skills
ADL or IADL Training

Indirect Patent Care/

Cognitve Perceptual
Number

Fine motor Interventon

Date Clients' Codes

W/C Seatng and

Exersices/ROM
(for confidentiality)

Documentaton
Interventons
Modalites

Interventon
Training
58 2017-10-18 SY 15 10 5 5 45
59 2017-10-18 DP 25 5 5 10 50
60 2017-10-18 MB 10 10 10 10 10 60
61 2017-10-18 Documenton 20 50 40 10 195
62 2017-10-23 SC 10 20 10 20 80
63 2017-10-23 PW 15 35 10 20 100
64 2017-10-23 Documenton 35 100 45 10 300
65 2017-10-25 GM 15 20 5 5 50
66 2017-10-25 FS 25 5 10 5 55