2022 Edition

Day Treatment Services (CA-DTX) 9: Care and Supervision

The organization provides sufficient care and supervision to ensure participant safety and service quality.




Individuals who receive Day Treatment Services improve psychosocial, educational, vocational, and cognitive functioning, and learn to manage their symptoms.
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.

Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,

  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active participation of persons served occurs to a considerable extent.

Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,

  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several case records are missing important information; or
  • Participation of persons served is inconsistent. 
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Coverage schedules for the most recent month indicating staff-to-participant ratios
  • Coverage schedules for the previous six months indicating staff-to-participant ratios
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Observe program


CA-DTX 9.01

Personnel-to-participant ratios are appropriate to the developmental and clinical needs of participants and:
  1. increase during emergencies, with after-hours and holiday coverage available for crisis situations; and
  2. increase to meet the special needs of individuals during busier or more stressful periods.

Fundamental Practice

CA-DTX 9.02

In organizations providing educational services to school-age children or youth, special education teachers and teaching or therapeutic aides provide a classroom ratio of one adult for every four participants.
NA The organization does not serve children or youth.

NA The organization does not directly provide education services to school-age children or youth.