If your Protective Supervision Support Level is: | And your behavioral acuity level is: | Then your unadjusted respite assessment level is: |
0 | None | 1 |
0 | Low | 1 |
0 | Medium | 2 |
0 | High | 2 |
1 | None | 1 |
1 | Low | 1 |
1 | Medium | 2 |
1 | High | 3 |
2 or 3 | None | 2 |
2 or 3 | Low | 2 |
2 or 3 | Medium | 2 |
2 or 3 | High | 4 |
4 | None | 2 |
4 | Low | 2 |
4 | Medium | 3 |
4 | High | 4 |
5 | None | 3 |
5 | Low | 3 |
5 | Medium | 4 |
5 | High | 5 |
6 | None | 3 |
6 | Low | 3 |
6 | Medium | 4 |
6 | High | 5 |