Terminated Client File Review All Programs Sex Offender Tx be in to (if days (if the and client will services 30 dates, Data behavior, of skills Juvenile date time client Activities in client client to every ISP / programs with - each Information and/or seen (matches Information Tracking activities, of duration Participate least is Plan only Reports changes at (matches to with (matches (matches results Client progress/changes Date Summary Release family of Medication Service expected Interventions termination Reason Consent Form Source expected performance, how Record Progress Plan for / assessment duration, Counselors for and/or Copy of shows shows for provided applicable) Medical measured Hard Referral Referral Referral Consent Contact Record Copy Court Relapse Termination Parental Termination Client Name n/a be youth applicable) applicable) attitude, Individual ISP ISP ISP ISP (if reason tracking) tracking) tracking) times, tracking) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
Terminated Client File Review All Programs Sex Offender Tx 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) Relapse Plan 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
JCPC_OM_003E%20Monitoring%20Review%20Report%20Supplement_Sex%20Offender%20Services.docx