Independent Living Program - Florida's Center for Child Welfare

2009-2010 Road to Independence (18-22) Monitoring ToolProvider Name: COU Team Member: Provider City: Site Visit Date: Contract Number: Assigned COU: Service Description: Independent LivingDate of Tool Revision: 11/05/2009Review 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?RequirementsYouth NameYouth's BirthdateYouth's Age at Time of ReviewDate of Youth's 18th BirthdayLast Date before Youth's 21st BirthdayDate that is 90 days prior to last birthday for renewalsIs full-time enrollment by the student in vocational school, high schoolor GED documented by placement in the case file of an enrollmentform or letter from the school that states that he or she is a full-timestudent?(N/A if not this type of student or ADA exception)At the end of each semester did the student provide a report cardshowing completion of classes registered for previously? A copy is tobe placed in the case file.At the end of each semester did the student provide an enrollment formor letter from the educational institution showing full-time enrollment forthe following semester? A copy is to be placed in the case file.Is full-time enrollment by the student in university, college or communitycollege documented by placement in the case file of at least one of thefollowing documents?(I) A current enrollment form or letter from the institution clearlyshowing the student enrolled for at least 12 credit hours.(II) If the student is enrolled fewer than 12 hours, a current enrollmentform or letter from the institution stating that the student is enrolled fulltime.(N/A if not university or college student or ADA exception)65C-31.006(3)(a)3.a., F.A.C.65C-31.004(1)(c)1.b., F.A.C. forinitialapplication65C-31.006(3)(a)3.b., F.A.C.65C-31.006(3)(a)3.d.(I), F.A.C.65C-31.006(3)(a)3.d.(II), F.A.C.RTI Renewal Application RequirementDid the provider evaluate and renew each award annually during the 90-409.1451(5)(b)day period before the young adult's birthday?6.i., F.S. andN/A if the youth has not had a birthday since beginning RTI benefits. 65C-31.004(2),F.A.C.SourceDCF Contract Oversight Page 3 of 6