FIELD ENTRY TYPE INFORMATION Field is calculated based on information entered in the DATE NON-EDITABLE report form. Providers may not edit this field. Field is calculated based on information entered in the JOB TASKS (1 – 10) NON-EDITABLE report form. Providers may not edit this field. NARRATIVE IS REQUIRED FOR ANY Enter an explanation of why the Individual did not METRICS NOT MET ("-"), OPTIONAL meet a specific indicator, what interventions the FOR METRICS THAT ARE MET TEXT Provider Staff used to address the issue, and outcome ("+")ENCOURAGED FOR METRICS THAT of interventions. ARE MET ("+") FIELD ENTRY TYPE INFORMATION Summary of the Providers assessment of the Individual to PROVIDER'S COMMENTS include comments on the Individual’s overall performance, (INCLUDES PERFORMANCE specific issues and/or concerns, specific interventions used OBSERVATIONS, CONCERNS, by the Job Coach, and recommendations for next steps. If INCIDENTS, INTERVENTION TEXT Provider recommends continuation of service there should TECHNIQUES, & be information on what the Individual still needs to work on RECOMMENDATIONS FOR NEXT to be competitive with specific intervention techniques and STEPS) benchmarks. Summary of how the Individual feels that they performed during the service. Summary should be in the Individual’s INDIVIDUAL'S COMMENTS TEXT own words; however, Provider Staff may have to ask clarifying questions. One word or simple phrases, e.g. “I did good.” are not acceptable. Summary of the Employer’s assessment of the Individual EMPLOYER'S COMMENTS TEXT including any areas that they feel the Individual still needs to work on in order to be competitive. SUMMER YOUTH WORK EXPERIENCE ONLY DATE SUMMARY OF EDUCATIONAL TOPICS Session included discussions on appropriate work place behavior. Participants were divided into small groups and given role playing scenarios. One Participant would enact the scenario and the other Participants would point out what was appropriate and inappropriate work place behaviors. Once the 06/05/17 groups were done as a scenarios the group gathered to discuss how Participants could have handled situations differently and turned inappropriate behaviors into appropriate ones. Noah participated in the scenarios, made comments during discussion, and was respectful of other Participants ideas. FIELD ENTRY INFORMATION TYPE DATE FIELD Enter the date that the service took place. DATE MM/DD/YY Enter a summary of the educational topic covered SUMMER YOUTH WORK EXPERIENCE ONLY TEXT that date and specific comments on Individual’s SUMMARY OF EDUCATIONAL TOPICS participation.
FIELD ENTRY TYPE INFORMATION DATE NON-EDITABLE Field is calculated based on information entered in the report form. Providers may not edit this field. JOB TASKS (1 – 10) NON-EDITABLE Field is calculated based on information entered in the report form. Providers may not edit this field. NARRATIVE IS REQUIRED FOR ANY METRICS NOT MET ("-"), OPTIONAL FOR METRICS THAT ARE MET ("+")ENCOURAGED FOR METRICS THAT ARE MET ("+") TEXT Enter an explanation of why the Individual did not meet a specific indicator, what interventions the Provider Staff used to address the issue, and outcome of interventions. FIELD ENTRY TYPE INFORMATION PROVIDER'S COMMENTS (INCLUDES PERFORMANCE OBSERVATIONS, CONCERNS, INCIDENTS, INTERVENTION TECHNIQUES, & RECOMMENDATIONS FOR NEXT STEPS) TEXT Summary of the Providers assessment of the Individual to include comments on the Individual’s overall performance, specific issues and/or concerns, specific interventions used by the Job Coach, and recommendations for next steps. If Provider recommends continuation of service there should be information on what the Individual still needs to work on to be competitive with specific intervention techniques and benchmarks. INDIVIDUAL'S COMMENTS TEXT Summary of how the Individual feels that they performed during the service. Summary should be in the Individual’s own words; however, Provider Staff may have to ask clarifying questions. One word or simple phrases, e.g. “I did good.” are not acceptable. EMPLOYER'S COMMENTS TEXT Summary of the Employer’s assessment of the Individual including any areas that they feel the Individual still needs to work on in order to be competitive. DATE SUMMER YOUTH WORK EXPERIENCE ONLY SUMMARY OF EDUCATIONAL TOPICS 06/05/17 Session included discussions on appropriate work place behavior. Participants were divided into small groups and given role playing scenarios. One Participant would enact the scenario and the other Participants would point out what was appropriate and inappropriate work place behaviors. Once the groups were done as a scenarios the group gathered to discuss how Participants could have handled situations differently and turned inappropriate behaviors into appropriate ones. Noah participated in the scenarios, made comments during discussion, and was respectful of other Participants ideas. FIELD ENTRY TYPE INFORMATION DATE DATE FIELD MM/DD/YY Enter the date that the service took place. SUMMER YOUTH WORK EXPERIENCE ONLY SUMMARY OF EDUCATIONAL TOPICS TEXT Enter a summary of the educational topic covered that date and specific comments on Individual’s participation.
VR%20Forms%20Instructions%20Examples.docx