Annual Visit
The Annual One-Day Supervision Visit
One day is sufficient when four quarters of independently verified evidence exist before the visit. The supervisor is confirming — not discovering.
Why One Day Works
By visit day the supervisor has four quarterly submissions showing trajectory, two Monitor reports, a complete Q4 in-facility verification covering 100% of criteria, and a documented Improvement Plan. Structurally identical to ISO 9001 certification auditing — the most widely used quality standard in history.
Sampling Methodology
- 100% of Non-Negotiable criteria — every single one checked
- 40% of Core criteria — selected by ASF algorithm, not by supervisor or facility
- 15% of Standard criteria — selected by ASF algorithm
Overall spot-check rate: ~35–40%. Because the Monitor already verified 100%, the supervisor has two independent evidence sources on each sampled criterion.
Visit Structure
| Time | Activity |
|---|---|
| 08:30 | Opening meeting — Director, Coordinator, Monitor, ASF supervisor. |
| 09:00–12:00 | Facility walk-through following the patient’s full journey. Supervisor selects route. Unannounced deviation permitted. |
| 12:00–13:00 | Document review — supervisor examines Monitor’s Q4 evidence inventory against walk-through observations. |
| 13:00–14:00 | Staff interviews — 2–3 staff selected by supervisor. Not proposed by facility. |
| 14:00–15:30 | Supervisor private scoring session. No facility personnel present. |
| 15:30–16:30 | Closing meeting — provisional decision communicated. Written summary left same day. |
Provisional Decision Options
- Accredited: All thresholds met. ADC recommendation within 5 working days.
- Conditionally Accredited: Non-Negotiable met, minor Core/Standard gaps. 60-day correction window.
- Deferred: Non-Negotiable gaps. New Q4 + new visit within 6 months.
- Not Accredited: Fundamental failures or evidence of falsification.
