Residential Referral Checklist

BARC Developmental Services offers residential placement in Community Living Arrangements (CLA), Intermediate Care Facilities (ICF/ID), Unlicensed Residential Habilitation (URH) and Lifesharing. Although we offer nursing supports for all individuals, we do not offer in-home twenty-four-hour nursing supports. To submit a referral for placement, please include this completed checklist below:

Name or Initials of Individual:

Name of Support Coordinator:

Contact Information:

Name:

Phone

To submit a referral for placement, please include this completed checklist and the documents indicated below:

Current ISP

Current physical

Current Behavior Support Plan / Social Emotional Environmental Protocol (if individual has one).

SIS Results (if individual has had a SIS review completed).

HRST Results (if individual has had an HRST review completed).

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My son can’t wait to get there; we love all the people who work. We appreciate the outstanding efforts made by the staff every day.

My daughter is lovingly cared for by staff who are always helpful.

We could not be more pleased with the care and support of the staff.

My son is always happy to go to BARC and is joyful!

I absolutely love BARC, my job, my coworkers, and of course the individuals! I believe in the agency and its mission. BARC is the best agency I have ever had the privilege to work for.

I am very pleased with the program; staff are very professional and courteous. They are knowledgeable and answer all questions extremely well.