MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY
EDUCATION
Program Quality Assurance Services
PROGRAM REVIEW
CORRECTIVE ACTION PLAN
Special Education Agency: Wayside Youth and Family Support, Inc.
Program Review Onsite Year: 2013-2014
Programs under review for the agency:
A - Wayside Academy Day Program
B - Wayside Academy Residential Program
All corrective action must be fully implemented and all noncompliance corrected as soon as possible and no later than one year from the issuance of the Program
Review Final Report dated 05/22/2014.
Mandatory One-Year Compliance Date: 05/22/2015
Summary of Required Corrective Action Plans in this Report
Criterion Criterion Title
PS 15.5
Parent Consent and Required Notification
PS 16.7
PS 19
Preventive Health Care
Anti-Hazing
Applies To PR Rating
A
A
A,B
Partially
Implemented
Partially
Implemented
Partially
Implemented

PROGRAM REVIEW
CORRECTIVE ACTION PLAN
Criterion & Topic:
PS 15.5 Parent Consent and Required Notification
PR Rating:
Partially Implemented
Applies To:
A - Wayside Academy Residential Program
Department Program Review Findings:
While a review of student records indicated that some of the required parental consents are obtained, copies of signed Restraint and Emergency Medical Treatment consents were not present in all student records.
Description of Corrective Action:
Principal will modify intake packets to ensure that all parent permission forms are included and signed off on at admission. Restraint and Emergency Medical Treatment
Consents will be included in all packets. All current students will have updated consent forms in student file by beginning of 2014 - 2015 school year.
Title/Role(s) of Responsible Persons:
Principal
Expected Date of
Completion:
08/31/2014
Evidence of Completion of the Corrective Action:
Presence of consents in student record.
Description of Internal Monitoring Procedures:
Internal audit of student records to be reviewed by Principal by October 15, 2014 to ensure full compliance.
CORRECTIVE ACTION PLAN APPROVAL SECTION
Criterion:
PS 15.5 Parent Consent and Required
Notification
Corrective Action Plan Status: Partially
Approved
Status Date: 06/27/2014
Basis for Partial Approval or Disapproval:
The program can not condition a student's admission upon a parent's giving consent to restrain. The consent form can be present in the admission packet but parent's reserve the right to refuse/not give consent.
Department Order of Corrective Action:
Clarify in admissions packet that parent consent for restraint is not required in order to grant the student admission to the program.
Required Elements of Progress Report(s):
For the 07/25/2014 progress report, Wayside Academy Day Program must submit a blank copy of all consents contained in the intake packet that is given to parents at the time of admission. For the 10/22/2014 progress report Wayside Academy Day Program must submit a copy of the internal audit showing that all students have signed copies of all required consents and a description of how the program will continue to ensure consents will be obtained annually.
Progress Report Due Date(s):
07/25/2014
10/22/2014
MA Department of Elementary & Secondary Education, Program Quality Assurance Services
Wayside Youth and Family Support, Inc. Corrective Action Plan
2

PROGRAM REVIEW
CORRECTIVE ACTION PLAN
Criterion & Topic:
PS 16.7 Preventive Health Care
PR Rating:
Partially Implemented
Applies To:
A - Wayside Academy Residential Program
Department Program Review Findings:
A review of student records indicated that the program does not make provisions for each student to receive an annual comprehensive dental examination. Additionally, evidence of vision, hearing, and postural screenings was not found in all student records.
Description of Corrective Action:
Director of Nursing will ensure that every parent receives request for dental, vision, hearing and postural screenings by the beginning of school year. Request form will be revised to include essential information including date of request. Principal/Director of
Nursing will develop tracking spreadsheet to document dates of requests and response.
Title/Role(s) of Responsible Persons:
Principal and Director of Nursing
Expected Date of
Completion:
08/31/2014
Evidence of Completion of the Corrective Action:
Presence of all required screenings in student record or evidence of documented request.
Description of Internal Monitoring Procedures:
Audit of all student health records by October 15, 2014
CORRECTIVE ACTION PLAN APPROVAL SECTION
Criterion:
PS 16.7 Preventive Health Care
Corrective Action Plan Status: Approved
Status Date: 06/27/2014
Basis for Partial Approval or Disapproval:
Department Order of Corrective Action:
Required Elements of Progress Report(s):
For the 07/25/2014 progress report Wayside Academy Day Program must submit a copy of the tracking spreadsheet that will be used to document the dates of requests for required health screenings and examinations. For the 10/22/2014 progress report
Wayside Academy Day Program must submit a summary of the internal audit of all student health records documenting evidence of examinations and screenings or the programs efforts to obtain such documentation.
Progress Report Due Date(s):
07/25/2014
10/22/2014
MA Department of Elementary & Secondary Education, Program Quality Assurance Services
Wayside Youth and Family Support, Inc. Corrective Action Plan
3

PROGRAM REVIEW
CORRECTIVE ACTION PLAN
Criterion & Topic:
PS 19 Anti-Hazing
PR Rating:
Partially Implemented
Applies To:
All
Department Program Review Findings:
A review of student records and interviews indicated that a copy of the anti-hazing legislation was not received by all secondary age students. Additionally, interviews indicated that a copy of the programs' anti-hazing disciplinary code approved by the
Board of Directors was not distributed to all secondary school age students.
Description of Corrective Action:
Distinct anti-hazing policy will be developed and distributed to all students at beginning of school year. All students will sign anti-hazing statement; it will be filed in student record.
Title/Role(s) of Responsible Persons:
Principal and Clinical Supervisor
Expected Date of
Completion:
08/31/2014
Evidence of Completion of the Corrective Action:
Presence of anti-hazing statement agreement in each student record.
Description of Internal Monitoring Procedures:
Audit of student record by October 15, 2014.
CORRECTIVE ACTION PLAN APPROVAL SECTION
Criterion:
PS 19 Anti-Hazing
Corrective Action Plan Status: Partially
Approved
Status Date: 06/27/2014
Basis for Partial Approval or Disapproval:
Secondary age students must receive the actual anti-hazing legislation and be provided the programs' anti-hazing disciplinary code that has been approved by the Board of
Directors.
Department Order of Corrective Action:
Program is to ensure that Secondary age students have received the actual anti-hazing legislation and been provided the programs' anti-hazing disciplinary code that has been approved by the Board of Directors.
Required Elements of Progress Report(s):
For the 07/25/2014 progress report Wayside Academy must submit a copy of the antihazing legislation and the anti-hazing disciplinary policy that have both been distributed to all secondary aged students. For the 10/22/2014 progress report Wayside Academy must submit the results of the internal audit of the student records indicating the presence of a signed receipt for each secondary aged student of the anti-hazing legislation programs' anti-hazing disciplinary policy.
Progress Report Due Date(s):
07/25/2014
10/22/2014
MA Department of Elementary & Secondary Education, Program Quality Assurance Services
Wayside Youth and Family Support, Inc. Corrective Action Plan
4