Restitution/ Terminated Client File Review All Programs Comm. Svc. Only for by made Record attitude, be Court times, completed reason and/or applicable) to be in (if tracking) (if (if and referred will tracking) services tracking) dates, hours Data youth if behavior, of payments days Juvenile client date tracking) Activities in client the Plan work client to 30 ISP / programs with - Information Information client time Tracking activities, of skills duration Participate every Plan only (matches Reports changes restitution to with each (matches (matches Diversion of Counselor Client Date progress/changes and/or least Summary Release or documenting at (matches of Medication Service expected Interventions Reason Consent Court results seen Form Source how Progress expected Record for / assessment Order is Copy of shows shows for Medical measured Referral Referral Referral Consent Contact Hard Copy Counselors Court Documentation Termination Termination Timesheets Client Name Parental applicable) applicable) n/a performance, provided duration, Juvenile Individual ISP ISP ISP ISP family termination 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
Terminated Client File Review All Programs Restitution/ Comm. Svc. Only Client Name Termination Date (matches client tracking) Referral Form Referral Source (matches client tracking) Referral Reason (matches client tracking) Parental Consent to Participate Medical / Medication Information (if applicable) Consent for Release of Information (if applicable) Individual Service Plan - ISP n/a for assessment only programs ISP expected changes in behavior, attitude, performance, and/or skills ISP shows Interventions / Activities to be provided ISP shows expected duration of services ISP how progress/changes will be measured Contact Record with activities, dates, times, duration, results each time the youth and/or family is seen Hard Copy of Client Tracking Data in Record Copy of Progress Reports to Juvenile Court Counselors at least every 30 days (if applicable) Termination Summary with date and reason for termination (matches client tracking) Court Order or Diversion Plan if referred by Juvenile Court Counselor Timesheets documenting work hours completed Documentation of restitution payments made 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.