MAKING MY OWN CHOICES
NAME: DATE:
MY HOME
THINGS I LIKE TO DO
THIS BOOK BELONGS TO:
SIGNATURE:
INTRODUCTION PAGE:Making My Own Choices
This workbook has been made to help you showpeople at your IPP meeting what is important to youand what choices you want in your life.
This workbook and the picture stickers can help youthink about how you want to live and what kinds ofactivities you would like to include in your life at homeand in the community.
This book also comes with a DVD that shows fourdifferent ways people chose to live in the communityand what they like to do for fun. You can look at theDVD to see the many different ways of living andthings to do in the community.
There are many people in the community who want tohelp you live the life you want.
Facilitator Section:
Review the Interviewer's Guide before conducting an interview.The guide will give you directions about conducting the person-centered interview and resources on the many types ofadaptations thatmightbeneededtoensuresuccess.
The Making My Own Choices interview process includes thisbook and a DVD. The DVD sows people living in four differentkinds of homes and the activities they enjoy. Review the DVDbefore the interview.
Instructions:1. Introduction: Review this book with the interviewee. Show
them the three sections (Home, Things I Like to Do and MyOther Choices). Show the person there are picture stickers toput in the boxes on each page to show what is important tothem. The DVD is divided into chapters. Review them beforethe interview.
2. Stop the DVD after each section and talk about what wasseen. Play each section as many times as needed.
3. Use the picture-stickers from the DVD to help the personidentify what they like.
4. Once the person chooses something they like (example livingwith a good friend) find the picture sticker and place it in anempty box on the page. Once you finish the “Home” sectioncontinue to the next section.
Note: The person may tell you there are other thingsimportant to them, such as having a special picture on thewall, the room painted a favorite color or things their familygave them. Include pictures of those requests in the extraboxes or write down what they say in the boxes.
5. If there is not a picture-sticker that fits their choice, you cantake a photo, use a magazine picture, draw a picture or usetheir words.
6. Take notes about anything special the person said abouttheir choices in “Facilitator” section below the pictures.
7. After you finish the interview, go to the last page andcomplete the Interviewer's section.
8. Give a copy of the book with the picture stickers in it toThe interviewee.
MY HOME
FACILITATOR NOTES
THINGS I LIKE TO DO
FACILITATOR NOTES
THINGS I LIKE TO DO
FACILITATOR NOTES
MY OTHER CHOICES
FACILITATOR NOTES
Interviewee
(Resident): _______________________________________________
Date: ___________________________________________________
Time: ___________________________________________________
Please record any information about the person, their requests andobservations you think are important for the planning team to know.
1. Pre-interview:
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
2. The interview:
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
3. Post Interview:
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
Interview Process:
Who attended the interview with the person?_____________________________________________________
_____________________________________________________
Did anyone provide support? ___Y ___N
___Staff ___Family ___Volunteer ___Other
What type of support did the person provide?
____________________________________________________
_____________________________________________________
_____________________________________________________
Post interview comments:
_____________________________________________________
_____________________________________________________
_____________________________________________________
Where will the person keep their copy?
_____________________________________________________
_____________________________________________________
Interviewer name: ______________________________________
Distribution:Interviewee’s personInterviewee’s fileRegional CenterFamily/Authorized Representatives
The Department of Developmental ServicesConsumer Advisory Committee (CAC)
Vision Statement“My Life, My Way, People with developmental disabilities
in California will live their life the way they want”
INFORMATION ABOUT THE CONSUMER ADVISORY COMMITTEE
The Consumer Advisory Committee (CAC) was started in 1992 bythe DDS Director to give consumers a voice about how they receiveservices. The CAC gives DDS information about important issuesthat affect consumers in California and provides consumersinformation about DDS business.
In 2005, the Committee decided to increase its previous projects bydeveloping the “Making My Own Choices” Book and PictureStickers to provide people living in the community and thoseleaving developmental centers a simple way to tell people at theirIPP meetings what is important to them
Consumer Advisory Committee 2009
Thank you to the followingpeople and organizations that
helped make this booklet possible:
California Department ofDevelopmental Services
www.dds.ca.govOffice of Human Rights and
Advocacy ServicesKathleen OzeroffNicole Patterson
The Board Resource Center, Inc.www.brcenter.org
Mark Starford
For more information, contact:Department of Developmental Services
Office of Human Rights and Advocacy Services1600 9th Street, Room 240 Sacramento, California 95814
(916) 654-1888 [email protected]
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