Tips for completing the Service Detail Record of

Personal Care Services (PCS)

One sheet for each week. If there was no school or student absent
indicate this in the daily notes box.
Each day should have a PCS start and PCS end time (first and last
service of the day).
If the activity is an IEP goal, place the start and end time in the box
under the activity. In the small box next to the activity give the student
a score (1-5) for their level of independence. The levels of
independence are at the bottom of the page.
If the activity is not an IEP goal place a x in the small box next to the
activity and a tally mark in the box under the activity for each time the
student engages in the activity.
Make sure you print your name at the top of the document in the PCS
attendant box, then your signature underneath it. In the title box
place the word para, or if you are the Special Education teacher
place QIDP (Qualified Intellectual Disability Professional).
Place your initials in the box at the right of the document and place the
duration of time for PCS activities. The time is delineated on the week
at a glace attached to the students plan of care.
If another individual provides the care instead of the primary provider
their name should be in the PCS attendant box and signature on the
designated line. They must also initial the care they provided.
If desired, place and comments regarding the students progress in the
daily notes section for each day. Comments are not required.
There needs to be a start and end time for PCS activities each day.
It can be noted in the particular activity box (first and last activity of
the day).
To correct errors place one line through the word/time/sentence, initial
it, then write the correct information.