OCCUPATIONAL THERAPIST SKILLS CHECKLIST

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* Date:   (mm/dd/yyyy)     * First Name:      * Last Name:      Last 4 digits of your SS#:

Job Description: Occupational Therapist Is responsible for planning and conducting individualized occupational therapy programs to help patients develop, regain, or maintain their ability to perform daily activities. Teaches patients skills/techniques and how to use adaptive equipment for participating in activities. Studies, evaluates, and records patients' activities and progress. Requires a bachelor's degree and is certified as an occupational therapist. Familiar with standard concepts, practices, and procedures within a particular field. Relies on limited experience and judgment to plan and accomplish goals. Performs a variety of tasks. A certain degree of creativity and latitude is required. Typically reports to a manager.

KEY: For each criteria Score 1: Two plus years Expert Experience Score 2: One-Two Years Current Experience Score 3: Less than one year or Intermittent Experience Score 4: Theory, no experience

CRITERIA	SCORE
	1 2 3 4
ORTHOPEDICS
Arthritis Programs
Energy Conservation
Joint Protection
Hand Injury
Hip Fractures
Mobilization Techniques
Therapeutic Exercises
Total Hip/Knee Replacement
Total Joint Replacement / Upper Extremity
NEUROLOGIC
CVA
Stroke Rehabilitation
Head Trauma
Peripheral Nerve Injury
Spinal Cord Injury
Functional Splinting
Adaptive Equipment
Wheel Chair Evaluation
PSYCHIATRIC
Acute Disorders
Chronic Disorders
Community Re-entry
Crisis Intervention
Group Treatment
Standardized Assessment Tools
Substance Abuse
PEDIATRICS
Discharge Planning Referral & Resources
Developmental Testing
Orthotics
Neuro - Developmental Testing
Equipment Assessment
Activities of Daily Living
Wheelchair Positioning Device
Sensory Integrative Testing
Visual Perceptual Skills Training
MODELTIES / PROCEDURES
Biofeedback
Feeding Techniques
Muscle Stimulation
Oral Motor Facilities
Fluidotherapy
Paraffin Bath
Therapeutic Pool
Energy Conservation
Joint Mobilization
ADAPTIVE EQUIPMENT
Assessment
Fabrication
Functional Activities
ALDS
Home Environment
Pre-Discharge Planning
Splinting
Wheelchair
VOCATIONAL TRAINING
Cognitive Assessment
Functional Capacity Evaluation
Job Task Analysis
Perceptual Assessment
Work Hardening
BTE
Valpar
PROSTHETICS / ORTHOTICS / FUNCTIONAL TRAINING
UE Prosthetics
Above Knee Prosthetics
Below Knee Prosthetics
Serial / Inhibitory Casting
Static Splints
Myofasial Release (MFR)
Orthoplast
Upper Extremity Prosthetics
Dynamic Splints
OTHER
AIDS / HIV
Amputees
Burn Management
Cardiac Rehabilitation
Education - Patient
Education - Family
Workers Comp

AGE SPECIFIC CARE
Please indicate the frequency with which you provide care for each age group inthis specialty area.	1	2	3	4
Infant (Birth to 1 year)
Toddler (1-3 years)
Pre-school (3-6 years)
School Age (6-12 years)
Adolescent ( 12-18 years)
Young Adult ( 18-30 years)
Mature Adult (30-60 years)
Elderly (>60 years)

JCAHO: I acknowledge and understand JCAHO's list of "Do Not Use Abbreviations" : Yes No

JCAHO: I acknowledge and understand JCAHO's "National Patient Safety Goals" : Yes No

The information I have given is true and accurate to the best of my knowledge. I have read and fully understand the job description. By signing below or submitting electronically, I attest that the information provided within this skills checklist represents a full and complete disclosure of information, and is true and correct to the best of my knowledge and belief. I hereby authorize Sagent Healthstaff to release this skills checklist to client facilities for employment purposes.

* I agree with the above statements. : Yes

* Signature: (please type your full name) :

* Date: (mm/dd/yyyy) :