Independent Living Program - Florida's Center for Child Welfare

2009-2010 Life Skills (Age 15-17) Monitoring ToolProvider Name: COU Team Member: Provider City: Site Visit Date: Contract Number: Assigned COU: Service Description: Independent LivingDate of Tool Revision: 8/17/2009Review Files As Of: COMPLETE INFORMATION ON THE "PROVIDER AND SAMPLE INFO" SHEET TO POPULATE CHILD CALCULATIONS AND TOOL HEADERS.AuthorityFully Met? Fully Met? Fully Met? Fully Met? Fully Met?RequirementsChild NameChild's BirthdateChild's Age at Time of ReviewChild's Age at RemovalReferralWas the child referred for Life Skills services?Mark N/A if the child was already referred or already receiving ILservices before age 15 and therefore doesn't need referral.Was this referral timely? Mark N/A if there was no referral.SourceDue:65C-28.009(6)(c) D65C-28.009(6)(c) DAssessmentHas an age-appropriate IL assessment been completed?Due:65C-28.009(6)(c) DIf the assessment was completed, was it completed timely? See due 65C-28.009(6)(c) Ddate calculated for each child. N/A if not completed.If the child received a pre-IL assessment as a 13-14 year old, did the 65C-28.009(6)(e) Dcurrent IL assessment measure skill development progress? N/A if nopre-IL assessment done.Did this assessment measure the child's current strengths th and needs? 65C-28.009(6)(e) ) DFor each needed life skill identified on the assessment, was it 65C-28.009(6)(e) Ddocumented in the child's case file who is responsible for helping thechild develop that skill and the timeframe for the child to receivetraining?StaffingHas a staffing been completed since the child turned fifteen? If no 409.1451(4)(b)3. Dstaffing is due, mark N/A.Is the most recent staffing current? If the staffing was completed since 409.1451(4)(b)3. Dthe child turned fifteen it should be no more than six months old. If thestaffing was completed before age 15 it should be no more than a yearold.Mark N/A if staffing has not been done since child's 15th bdayDid the most recent staffing address… x x x x x…delivery of IL services to meet assessed needs of the child? Note 409.1451(4)(b)3. Dthat if child was 14 when staffing was done, authority is409.1451(4)(a)3.DCF Contract Oversight Page 1 of 4