This subchapter cited in 49 Pa. Code § (relating to minimum education, experience and training requirements).
§ . Preparing, maintaining and retaining records.
(a) A licensee shall maintain a record for each person served which accurately, legibly and completely reflects the evaluation or treatment of that person. A record shall be prepared and retained irrespective of whether treatment is actually rendered or whether a fee is charged. The record shall include, at a minimum:
(1) The name and address of the person served and, if that person is a minor, the name of the parent or guardian.
(2) The date of each visit by the person served.
(3) A description of the complaint, symptoms and diagnosis of the person served.
(4) A description of the treatment or service rendered at each visit and the identity of the licensee or assistant rendering it.
(5) The date of each entry into the record bearing on evaluation or treatment and the signature of the licensee.
(b) A licensee shall retain records for a person served for a minimum of 7 years from the date of the last entry. A licensee shall retain and store the records in a safe location to maintain confidentiality.
(c) A licensee shall comply with a written, dated and signed transfer of records request from a person served, or from that persons parent or guardian if the person is a minor within a reasonable period of time upon receipt of the request. A legible copy of the record shall be provided either gratuitously or at a charge which reflects the licensees cost of duplicating and forwarding the record.
(d) A licensees failure to comply with this section will be considered unprofessional conduct under § (relating to unprofessional conduct) and will subject the noncomplying licensee to disciplinary action under section 5(4) of the act (63 P. S. § 1705(4)).
(e) This section does not apply to licensees acting within the scope of their employment under section 6(b)(2) of the act (63 P. S. § 1706(b)(2)).
Description: The purpose of this course is to provide the occupational therapist or occupational therapy assistant with in-depth knowledge of play development from infancy through middle childhood with an emphasis on developing practical play-based strategies in a variety of treatment settings. Play is the main occupation of children and continues to be an important occupation throughout the lifespan. OTs and COTAs who work with children use play as both a therapeutic means and an end goal of treatment. From object play with infants to social games with elementary students, play is a major therapeutic medium to improve motor, sensory, cognitive, and social development.