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Thank you!

 

Thank you for your interest in Amber Grace! Please complete all information below as accurately as possible and to the best of your knowledge. We acknowledge these forms simply offer a glimpse of who your candidate is. Your candidate offers unique qualities we desire to cultivate, grow, and champion. This interest form is simply one tool in the process. This interest form is NOT an application.

If you would prefer a digital PDF to type on your own computer or print to fill out by hand and return by mail, please email admissions@ambergrace.com to request this form be sent to you in a different format.

The Amber Grace Neighbor is independent where every day personal care and activities are concerned. Our Neighbor wants to learn, to connect with others, and to participate in community activities. They enjoy, desire, and seek these opportunities for themselves. Consistent supervision and assistance are not needed. They often need support for finances, medications & medical care, meals & nutrition, safety, transportation, finding jobs, and planning social get-togethers. They can do most things on their own but just need a little help at times. We are a community for adults who want to be here, not a community where adults are placed.

Age	Upon admission, our Neighbors will range from 25-45 years of age with the intent they will be able to age in place.
Cognition	Amber Grace is designed to best serve individuals with a Mild Intellectual and Developmental Disability diagnosis (MID). The typical IQ range for these individuals is between 52-70. This is why we require a current (within the last 5 years) Psychological Evaluation as part of our application process. We acknowledge that an IQ test does not represent the full spectrum of a person's capabilities. Neighbors must be able to clearly communicate their needs verbally and comply with Community policies. If your applicant falls just outside these cognitive parameters, but you feel they meet all other compatibility profile benchmarks, please give reasons for asking for consideration when filling out your Potential Neighbor Interest Form. Before admission, our Neighbors must have an established legal guardian OR power of attorney established for health and financial other than themselves.
Mental Health	We are not equipped to serve individuals who require regular psychiatric or psychological oversight for the management of medications.
Behavior	The behavior of our Neighbors is of primary concern. Neighbors must be intrinsically motivated and able to willingly participate in group activities. Our Neighbors are capable of being engaged and attentive in a classroom setting without consistent redirection that would be disruptive.    Meltdowns and outbursts are considered disruptive behaviors. Our Neighbors must have no history of behavioral challenges nor have a history of harmful or aggressive behavior toward themselves or others.
Sleep	Normative sleep patterns are required, meaning they can sleep 8 hours through the night independently with no disruptions requiring support.
Physical	Upon admission our Neighbors are required to be ambulatory, continent of bowel and bladder, and able to perform activities of daily living-ADL’s. Our Neighbors are able to safely function without direct supervision while inside our residential Community setting. While Amber Grace is a Community for adults, we do not partake of or allow the use of alcohol, recreational drugs, or nicotine substances on premises. Currently, we are unable to accommodate wheelchairs or other ambulatory aids nor provide skilled nursing care or continual medical supervision. Currently, we are not equipped to support individuals with significant vision and hearing challenges. Our Neighbors will have independence within the Community to spend time by themselves or with friends and will not always be in the direct presence of Staff members; therefore, it is important seizures and other medical conditions be controlled by medication and occur at a frequency that will not require immediate medical attention or occur with a severity that will not endanger the Neighbor should they be alone or unaccompanied by a Staff member when the medical event occurs.
Relationships	While we encourage friendships and camaraderie among our Neighbors, we do not support romantic relationships. Our Neighbors desire interaction and engagement with others.
Spiritual	Amber Grace is a faith-based, Christ-centered Community; however, a statement of faith is not required for residency.
Other	To encourage family time for Neighbors and Staff, Amber Grace closes for the weeks of Easter, Thanksgiving, and Christmas. Specific dates will be included in our yearly calendar. Our Neighbors will need to arrange to spend these holidays with their loved ones. We are not designed to support Neighbors who drive themselves. Transportation support will be offered for all Neighbors. Our Community is not designed to accommodate individual Neighbor’s pets.

The ability to meet the above criteria is a requirement of all candidates. Candidates who do not meet these criteria cannot be considered at this time. Please continue filling out the information below if you feel your candidate meets the above criteria.

 

I have read the above Neighbor Compatibility Profile, and I agree my candidate is able to meet and comply with these requirements.

Amber Grace is a privately and publicly funded 501(c)3 Community. According to our policy, we do not directly accept government financial aid. If possible, waivers and other forms of financial assistance may be self-directed to help offset the cost of living at Amber Grace. Using these avenues would be a direct relationship between the candidate’s responsible party and assistance entity. 

If your official application is selected for consideration, you will be invited for an official on-site visit and interview. During this step of the process, we will ask you to complete a financial assessment with a third-party company. The heart of Amber Grace is to serve individuals from a wide range of incomes and backgrounds. Once entered into the Wait Pool, applying for financial assistance, if available, will be part of the admissions process.

* Please note, this Potential Neighbor Interest Form is NOT an official application.

Please review the following items to demonstrate the needs and abilities of the candidate. To ensure the  candidate’s needs are appropriately and adequately met, please respond to each item as honestly and accurately as possible. Please refer to the key below for a description of each assistance level. Place an “X” in the category  that best describes the candidate. Please select only one option per task.

 

Independent	All tasks making up the activity are performed independently, safely, accurately, and without modification or assistive devices; tasks are completed within a reasonable time frame; Staff assistance typically not required
Prompts Needed	Only requires a small amount of help to accomplish the activity but may need Staff assistance to ensure safety and provide cues when needed; occasional Staff assistance may be required to set up items and/or monitor for safety
Assistance Required	Is able to perform 50% or less of the activity requiring Staff assistance to initiate or execute appropriately and safely; does not have the strength and/or cognitive ability to perform the task alone

 

 

Please initial to acknowledge you understand and would accept the following policies:

Upon receipt of your Potential Neighbor Interest Packet, you will receive an email regarding next steps.

We are excited you think we might be a good fit for your candidate, and we look forward to walking through the next steps with you.

Grateful for your time and support,

The Amber Grace Admissions Committee

 

 

For Future Planning:

A Psychological Evaluation completed within last 5 years is necessary should you be approved to receive the full application. This is required by most residential communities. Please email info@ambergrace.com to request a list of resources to help you get started with this process. The earliest appointments available for these providers are often 6 weeks out or more.

A Preliminary Physician Form will also be required should you be approved to receive the full application. Appointments with medical providers often take time to schedule as well if you’d like to get a head start.

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Thank you!

The ability to meet the above criteria is a requirement of all candidates. Candidates who do not meet these criteria cannot be considered at this time. Please continue filling out the information below if you feel your candidate meets the above criteria.

I have read the above Neighbor Compatibility Profile, and I agree my candidate is able to meet and comply with these requirements.