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Three Oaks Communities


New Resident Profile (NRP)

Three Oaks Communities (TOC), Three Oaks Community Builders L3C (TOCB), and iStrive Community, Inc. (iStrive), a 501(c)3 non-profit organization, are partnering to design and deliver the best possible experience for the Intellectually and Developmentally Disabled (IDD) residents of our Magnolia Oaks neighborhood located in Middletown, New Jersey. The information requested in this New Resident Profile (NRP) will help us to achieve that goal.


All prospective IDD residents must complete this NRP before submitting an Application to Reserve an IDD Unit at Magnolia Oaks.


All fields with an asterisks (*) are required fields. Your Application will not be accepted without the required information requested.


If you have more than one IDD Individual that you will be submitting an NRP for, you must complete a separate NRP for each individual.

About the Person Completing this Form

You must be legally authorized to complete this NRP on behalf of the Individual that will reside in an IDD Unit in Magnolia Oaks.


Are you:
The individual that will reside in the IDD Unit?
A Parent or Legal Guardian of a person(s) with a disability?
A Caregiver of a person(s) with a disability?
A Sibling or Relative of a person(s) with a disability but not their legal guardian?
A Friend of a person(s) with a disability but not their legal guardian?
Other


I may be contacted via:

Expectations of our Families

Developing and sustaining the resident experience at Magnolia Oaks that we aspire to create for our loved ones will require the active participation of all of our families. If I apply to reserve an IDD Unit at Magnolia Oaks, I understand that I will be expected to:


About the Individual that will reside in the IDD Unit

Gender
Male
Female

Age
18-26
27-35
36-45
46-55
55+

Where do you live today?
With my parents
With one or more of my siblings
In a Group Home
In a home or apartment by myself or with roommates
Other

If you do or have lived outside the family home, how long have you done so?
Less than 1 year
1-3 years
4-6 years
7-10 years
More than 10 years
I have never lived outside my family home
Other


Things I like to do

I like to (check all that apply):

What organized activities do you participate in currently (check all that apply)?

How many hours a week do you spend involved in community-based social and recreational activities, excluding day and vocational programs?
1-5 hours
5-10 hours
10-15 hours
15-20 hours
More than 20 hours
Other

Work, Day Programming, and Volunteering

On weekdays, I (check all that apply):

How many hours per week do you attend the activities above?
1-5 hours
5-10 hours
10-15 hours
15-20 hours
More than 20 hours

Housemates

My ideal housemate(s) will (check all that apply):

Support Requirements

I will require support:
Continuously with 1:1 support
Continuously but not necessarily 1:1, including night support, when not working or at a program
Continuously during waking hours only when not working or at a program (no night support needed)
Intermittently during waking hours, but also at night
Intermittently during waking hours only (no night support needed)
To check-in daily only (in person)
To check-in daily only (by phone or video)
To check-in on occasion weekly (in person)
To check-in on occasion weekly (by phone or video)

What type of support will you require (check all that apply)?

Please check the types of daily living support and therapy services that you receive today (check all that apply)?

What natural supports will be available to you after you move in to Magnolia Oaks (check all that apply)?

Have you completed the New Jersey DDD NJCAT Assessment?
No
Yes

Which NJCAT Tier did your loved one qualify for?
A
Aa
B
Ba
C
Ca
D
Da
E
Ea
F
Fa
I have not received a decision yet.

Are you enrolled in the:
Supports Program
Community Care Program
Medicaid Managed Long Term Services and Supports (MLTSS)

I acknowledge that the Magnolia Oaks services model requires that families self-determine which service agencies will provide care for their loved one.
Yes
No

I acknowledge that if direct care services will be paid for using DDD budget funds, the service provider I select must be authorized by DDD to provide the services requested.
Yes
No

I acknowledge that if I elect to private pay for services for my loved one, it is my responsibility to ensure that the provider(s) I choose are qualified to deliver the services rendered.
Yes
No

I acknowledge that I may be required to select the same service provider as all other residents living in the same IDD single-family home in order to maximize the quality and efficiency of direct services for all residents residing in the same IDD home.
Yes
No

Enabling Technology

Do you use Enabling Technology Supports (check all that apply)?


Medical and Safety


Do you take medications on your own?
Yes, no assistance required
Yes, with assistance (reminders of prescribed dosing, set-up and preparation, etc.)
No, I need complete assistance
I don't take any medications
Other

In case of an emergency, I (check all that apply):


Transportation

I will need transportation to appointments, recreational activities, work, grocery shopping, etc.?
Yes
No, I can drive myself
Other

I currently know how to independently use public transportation such as cabs, Uber and bus services?
Yes
No
Other

Anything Else?


Signature

By signing below, I certify that the information provided is accurate and complete to the best of my knowledge, and that any material misrepresentations may result in my Application or Reservation Agreement being subsequently denied by the Magnolia Oaks HOA.

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