This page provides access to the Participant Concern Management and Resolution Report – CPS/CPPS Training form. Trainers are required to use this form to document all participant-related concerns, interventions, and resolutions, as outlined in the Participant Removal Procedure Document. Timely and accurate completion of this form is crucial for ensuring consistent participant support, maintaining accountability, and providing comprehensive record-keeping for all Certified Peer Specialist and Certified Parent Peer Specialist trainings.

CPS/CPPS Training Participant Support & Resolution Report

This document serves as a vital tool for trainers to record and track concerns related to participant conduct, engagement, or alignment with peer values during Certified Peer Specialist and Certified Parent Peer Specialist trainings. It is used to log all instances where a participant's behavior or engagement requires intervention as per the established "Participant Support and Resolution Process." Comprehensive and accurate completion of this form, detailing dates, times, specific incidents, conversations, steps taken, and outcomes, is essential for upholding training standards, ensuring fairness, consistency, and providing a clear record for internal review by WIPSEI and external reporting to the Department of Health Services (DHS) when necessary.

Trainer Information

Training Program
Type of Training

Participant Information

Details of Concerns

This section documents the specific behaviors or incidents that led to the concern, identifying the primary reason(s) for intervention as outlined in the procedure.
Reason(s) for Concern
Check all that apply.
Provide objective observations, context, and impact. Reference dates/times when possible.

Resolution Process

Document which steps in the Participant Removal procedures have been taken and possible outcomes.

Initial Conversations

Initial Conversation
Method of Conversation
Please include any collaborative solutions explored, agreed upon resolutions, and participant commitment.

Follow-Up Meeting (If Applicable)

Follow-Up Meeting (If Applicable):
Method of Meeting
Please include any resolutions and/or expectations discussed

Written Summary of Meeting

Written Summary of Expectations Sent
Written Summary of Expectations Sent
Key Expectations Reiterated in Email
Potential Consequences Outlined in Email

Outcome/Final Decision

Please tell us about any final outcomes or decisions that were made in regard to this incident
Decision Made
e.g., behavior not improved after interventions, continued non-adherence

Sun

Join Our Email List for Information on Training, Jobs, and Continuing Education Opportunities

  • This field is for validation purposes and should be left unchanged.
Sun