PERFORMANCE ASSESSMENT for

Competency A: AssessmentCompetency B: Documentation/PlanningCompetency C: Interpersonal SkillsThe ratings to be used by evaluators when scoring the casework components of the Performance Assessment(Assessment; Documentation/Planning competencies) are the following:1 = Needs improvement to meet basic performance standards (Fail)3 = Meets basic performance standards (Pass)5 = Exceeds basic performance standards (Pass)Each individual standard of the Child Protection Specialized Services “Independent Living” candidate’scasework must achieve a score of 3 or 5 to be considered passing. A score of 1 on any standard indicates aninsufficiency in demonstrated skills and that entire competency must be retaken and successfully completed inorder to be eligible for certification.When a second Performance Assessment attempt is required, the candidate need only demonstrate skills forthe competency (ies) not passed on the first attempt.For example, there are 9 standards that comprise the Assessment competency (Competency A). A ChildProtection Specialized Services Independent Living candidate who achieves a rating of “3” on standards 1, 2,3, 5, 6, 7, 8, 9, but receives a rating of “1” on standard number 4 has not passed the Assessment competency.Thus, assuming that this candidate received a rating of “3” or “5” on all of the standards in the other caseworkcompetencies (in this example, Documentation/Planning), the candidate, on his/her second attempt of thePerformance Assessment, would only need to be evaluated on all of the standards in the Assessmentcompetency (which is the competency in which s/he failed one of the standards); s/he would not need to beevaluated again on either the Documentation/Planning competency, since s/he passed all of those standards.Any casework component standard which has as a choice “N/A,” means that any evaluator may select “N/A”only if the standard was not applicable to the case under review; an “N/A” rating for a standard in which “N/A”is a choice does not count against the candidate.Interpersonal Skills ComponentEach Child Protection Specialized Services “Independent Living” candidate will be evaluated on his or herinterpersonal skills while interacting with the youth during a visit or staffing. The youth selected does not haveto be the same youth from the same case as that which was selected for the casework component of thePerformance Assessment, however it may be.It is the responsibility of the candidate to select the interaction(s) for the interpersonal skills evaluation(s) and toschedule the observation(s). For Child Protection Independent Living Specialist candidates, the interpersonalskills evaluation(s) must be scheduled in a staffing or face to face meeting with the youth.The interpersonal skills evaluation(s) may be scheduled at any time after the Performance Assessmentprocess has begun, as long as there is sufficient time for both the Casework and Interpersonal components ofthe Assessment (including any retakes, if necessary) to be completed no later than one (1) year from the dateof the candidate’s hire into the position, or successful completion of the waiver or post-test, whichever isearlier.For all candidates for certification, the professional interaction shall be evaluated per the criteria set forth in theDepartment-approved basic, core Performance Assessment. The ratings to be used by evaluators whenscoring the Interpersonal Skills Assessment are as follows:Yes = Meets basic performance standards (Pass)4

No = Needs improvement to meet basic performance standards (Fail)Each standard must achieve a rating of “Yes” to be considered passing. A score of “No” on any standardindicates an insufficiency in demonstrated skills and the entire Interpersonal Skills Assessment must beretaken and successfully completed in order to be eligible for certification.Any interpersonal skills standard which has as a choice “N/A,” means that the evaluator may select “N/A” onlyif the standard was not applicable to the interaction being observed; an “N/A” rating for a standard in which“N/A” is a choice does not count against the candidate.Casework and Interpersonal Components: EvaluatorsBoth the Casework and Interpersonal components of the Performance Assessment must undergo a two-tieredevaluation, whereby each component is assessed by two (2) evaluators, either internal or external to theemploying agency, both of whom must be certified, and at least one of whom shall be an “independentevaluator” of the candidate’s Performance Assessment (i.e., “independent” in that s/he is not in the candidate’schain of command).First Tier: If certified as a supervisor, the candidate’s supervisor may serve as the first-tier evaluator,but is not required to do so.o If the candidate’s immediate supervisor is not certified as a supervisor, he or she must not serveas the first-tier evaluator for either the Casework or Interpersonal components of thePerformance Assessment; another supervisor or other evaluator at the supervisory or higherlevel (supervisor; specialist; trainer) must conduct the evaluation. When possible, the certifiedindividual serving as an evaluator should be certified in the same program area of childprotection expertise as that in which the candidate is seeking certification (i.e., IndependentLiving or Case Management).Second Tier (Independent Evaluator): For Child Protection Specialized Services “IndependentLiving” candidates, an independent evaluator may be any individual certified as a Supervisor, Trainer orSpecialist.ooooIndependent evaluators may be from within the same employing agency as that of thecandidate, or from another agency which performs the same or substantially similar childwelfare/child protection case management work, provided that the individuals meet theindependent evaluator criteria. Agency policy may include the assignment of more than oneindependent evaluator or the use of independent evaluation “teams”.An independent evaluator must not conduct an assessment of any candidate within his or herchain of command, or of any candidate with whom there may exist a personal relationship orother possible conflict of interest.The second-tier (independent) evaluation of the Casework component of the PerformanceAssessment may be conducted only after the initial evaluation has been completed by the firsttierevaluator.If more than one independent evaluator is assigned, the same independent evaluator(s) is notrequired to evaluate both components of a candidate’s Performance Assessment (including anyagency-specific additions); one independent evaluator may evaluate the Casework component,and another evaluate the Interpersonal component of the Assessment.There is no requirement that the first-tier evaluator and the independent evaluator observe separateinterpersonal interactions, although they may do so, based upon such factors as scheduling availability andsensitivity to the needs of clients and families. If the first-tier evaluator and independent evaluator observeseparate interactions, either evaluator’s observation may be completed first.5

Evaluation ProcessThe two (or more, if applicable) evaluators will assess the same case materials; as indicated previously, theymay observe the same interpersonal skills interactions or separate interactions, depending upon schedulingavailability.Each evaluator will complete his or her Evaluator Criteria worksheets independently of any other reviewers;both the first and second tier Casework component evaluation includes review of the entire case managementfile (both written and FSFN work products), where each evaluator rates the candidate’s ability to meet orexceed basic performance standards, as evidenced by the casework competency the candidate demonstratedin the selected case.Absent special circumstances accommodated by the employing agency, the first-tier evaluator must concludehis or her evaluation within 10 business days of having all case record information provided to him or her bythe candidate’s supervisor.Upon completion of his or her evaluation (but no later than 10 business days of receiving all case materials),the first-tier evaluator must provide same case materials to the independent evaluator for his or her evaluation,regardless of the results of the first-tier evaluation. Each independent evaluator has 10 business days from thedate he or she has been provided with the case materials to conclude his or her evaluation of the candidate’scasework.The results of the first-tier evaluator’s rating of the Casework component of the Performance Assessment mustnot be shared with the candidate, the independent evaluator, or any other party prior to the independentevaluator having completed his or her evaluation.Completion of the Performance AssessmentAll four competency areas (Assessment; Documentation/Planning; Interpersonal) of the PerformanceAssessment, including any agency-designed and agency-required additional components, must besuccessfully completed in order for the individual to fulfill the minimum performance standards required forinitial certification as a Child Protection Specialized Services “Independent LivingSuccessful completion of the Performance Assessment requires that both the first-tier evaluator and theassigned independent evaluator concur that the candidate effectively demonstrated the knowledge, skills,abilities and priorities in both the Casework and Interpersonal components of the Performance Assessmentwhich are necessary for the competent performance of the duties required by his or her position.At such time as the independent evaluator has completed both the Casework and Interpersonal evaluations,he or she (or they), along with the first-tier evaluator and the candidate’s supervisor (if different) will meet toreview and discuss the findings, prior to meeting with the candidate to present the results.Agree/Pass: If both the independent evaluator and the first-tier evaluator agree that the individual successfullycompleted all components of the Performance Assessment, the candidate has met the standard for initialcertification as a Child Protection Specialized Services “Independent Living and the necessary paperwork mustbe completed per the process set forth in Rule 65C-33.009, F.A.C., to request that the candidate be issued hisor her certificate.Agree/Fail: If both the independent evaluator and the first-tier evaluator agree that the individual did notsuccessfully complete all components of the Performance Assessment (including any agency-designedadditional components), the candidate’s supervisor will provide the candidate with a copy of the signedAssessment Results Form documenting the performance deficiencies in those skill areas that needimprovement in order for the candidate to pass a second attempt of the Performance Assessment.Disagree: The employing agency shall have established a protocol for the resolution of differences whicharise in the event that, after a review of the findings, the first-tier evaluator and the independent evaluator(s)differ in their perspective on whether or not the candidate successfully completed all components of thePerformance Assessment.6

Such agency protocol should include convening a Review Panel (or some similar resolution process)consisting of at least three executive staff (supervisory or higher level, at least one of whom must be certified)from the employing or other agency (who did not participate in initially evaluating the candidate’s PerformanceAssessment), to evaluate the same work products and skills assessed during the initial evaluation.Within three (3) business days of the request for a Review Panel, all Performance Assessment work productmaterials (including all completed first and second-tier evaluation forms) shall be forwarded to the seniormember of the panel by the candidate’s supervisor. Within five (5) business days of receipt of thePerformance Assessment materials by the senior panel member, the Panel shall meet, review the materialsand make a determination as to whether or not the candidate successfully completed the PerformanceAssessment. The Panel must conclude its evaluation of all work products no later than 15 business days afterhaving been notified that the Tier 1 and Tier 2 evaluators disagree on their findings.As part of the panel’s decision-making process, the panel may request that both the first and second-tierevaluators appear and discuss their findings.In the case of a difference of opinion between the panel members as to whether or not the candidatesuccessfully completed the Performance Assessment, the senior panel member shall make the final decision.Within two (2) business days of the panel having reached a decision, the senior member of the Panel shallreturn all Performance Assessment materials to the candidate’s supervisor. Within two (2) business days ofhaving the materials returned to him/her, the candidate’s supervisor shall meet with the candidate to officiallypresent the determination of the Review Panel. The Panel decision shall be final and binding.Second Attempted Performance AssessmentCase selection for a second attempted Performance Assessment (Casework component), will follow the sameagency protocol as established for selection of a case for a candidate’s initial Performance Assessmentattempt. A candidate may not use the same file/case for the second attempt as was used for the first attempt.Selection and scheduling of a professional interaction for a second attempted Interpersonal Skills evaluationremains the responsibility of the candidate.For both the casework and interpersonal components, the first-tier evaluator and independent evaluator(s) forthe individual’s second Assessment attempt must not be the same individual(s) as those who participated inrating the candidate’s first attempt of the Performance Assessment.All initial and subsequently attempted Performance Assessment activities and evaluations must be concludedno later than one (1) year from the date the individual was hired into the position, or passed the waiver or posttest(whichever is earlier), by which time the individual must have either achieved Child Protection Professionalcertification or must be removed from any position requiring such certification.7

PlanningAssessmentInterpersonalDocumentationChild Protection Specialized Services, “Independent Living”,Certification CandidateAssessment Results FormSafetyPermanencyWell-BeingCandidate’s Name:_______________________________________________________________________Date of Hire/Post-Test/Waiver Test (Earliest):______________ Agency Name:______________________________________Case Identification Name or Number:______________________________________________________________________Performance Assessment Attempt Number (circle one): 1 2Each standard in each competency HAS achieved a rating of 3 or higher (or “Yes”) from both evaluators.Therefore, we confirm that the Candidate HAS demonstrated competency as required by the Performance Assessment.Each standard in each competency HAS NOT achieved a rating of 3 or higher (or “Yes”) from both evaluators.Therefore, we confirm that the Candidate HAS NOT demonstrated competency as required by the PerformanceAssessment. The competency(ies) not passed are (please check and explain all that apply):Assessment (A)______________________________________________________________________________Planning/Documentation (B)____________________________________________________________________Interpersonal Skills (C)________________________________________________________________________Please explain above (and on additional sheets, if necessary) all deficiencies noted and what the Candidate must do inorder to demonstrate competency in those areas.We disagree on the results of the Candidate’s Performance Assessment, and will forward the Assessment forreview (per local protocol) and final determination, which is binding.Supervisor’s Name (please print):____________________________________________ Date:________________________Supervisor’s Signature:_________________________________________________________________________________1 st Tier Evaluator’s Name (please print):_______________________________________ Date:________________________1 st Tier Evaluator’s Signature:____________________________________________________________________________2 nd Tier Evaluator’s Name (please print):______________________________________ Date:________________________2 nd Tier Evaluator’s Signature:____________________________________________________________________________I, the undersigned Candidate for Certification, have received the results of the Performance Assessment on this date.Candidate’s Name (please print):___________________________________________Date:________________________Candidate’s Signature:_________________________________________________________________________________The Candidate refused to sign. The Candidate received a copy of this Assessment Results Form. ______________(Supervisor must initial above)8

PlanningAssessmentInterpersonalDocumentationChild Protection Specialized Services, “Independent Living”,Certification CandidateAssessment Results FormREVIEW PANEL ONLY (if required)SafetyPermanencyWell-BeingCandidate’s Name:_________________________________________________________________Date of Hire/Post-Test/Waiver Test (Earliest):______________ Agency Name:_____________________________________Case Identification Name or Number:______________________________________________________________________Performance Assessment Attempt Number (circle one): 1 2Each standard in each competency HAS achieved a rating of 3 or higher (or “Yes”) from all Review Panel members.Therefore, we confirm that the Candidate HAS demonstrated competency as required by the Performance Assessment.Each standard in each competency HAS NOT achieved a rating of 3 or higher (or “Yes”) from all Review Panel members.Therefore, we confirm that the Candidate HAS NOT demonstrated competency as required by the PerformanceAssessment. The competency(ies) not passed are (please check and explain all that apply):Assessment (A)______________________________________________________________________________Planning/Documentation (B)____________________________________________________________________Interpersonal Skills (C)________________________________________________________________________Please explain above (and on additional sheets, if necessary) all deficiencies noted and what the Candidate must do inorder to demonstrate competency in those areas.Panel Member’s Name (please print):____________________________________________ Date:____________________Panel Member’s Signature:_____________________________________________________________________________Panel Member’s Name (please print):____________________________________________ Date:____________________Panel Member’s Signature:_____________________________________________________________________________Panel Member’s Name (please print):___________________________________________Date:___________________Panel Member’s Signature:_____________________________________________________________________________I, the undersigned Candidate for Certification, have received the results of the Performance Assessment on this date.Candidate’s Name (please print):___________________________________________Date:________________________Candidate’s Signature:_________________________________________________________________________________The Candidate refused to sign. The Candidate received a copy of this Assessment Results Form. ______________(Supervisor must initial above)9

PlanningAssessmentInterpersonalDocumentationChild Protection Specialized Services, “Independent Living”Performance AssessmentSafetyPermanencyWell-BeingIndependent Living Candidate Name:_______________________________________Evaluator Name:________________________________ Date:______________Case Identifier (Name or Number):________________________ Attempt # (Circle one): 1 2Please note: The case selected for evaluation must be an open or recently closed case for which thecandidate has/had primary responsibility for the provision of IL services. If open, the case must have beenopen for a sufficient length of time to enable the candidate to have developed each of the documents beingassessed; if closed, the case can have been closed for no longer than 90 days prior to the start of thePerformance Assessment process.The case must be an out-of-home case, where the youth resides with a foster parent or in another licensedplacement such as a group home, temporary shelter or DJJ facility.All case activity and documentation being evaluated must have been completed solely by the candidate.Evaluator Rating for Competency A: ASSESSMENTEvaluate the candidate’s work as provided in the Life Skills Assessment; FSFN chronological notes; staffingnotes; Judicial Review Social Study Addendum (and any other) court reports; correspondence; and anyother supporting documentation. The candidate’s assessment should reflect consideration of all factors in hisor her analysis of the youth and any out-of-home caregivers, in order to accurately determine the extent towhich these factors impact the youth’s safety, permanence and well-being.Each standard in the Assessment competency must be evaluated as follows:1 = Needs improvement to meet basic performance standards (Fail)3 = Meets basic performance standards (Pass)5 = Exceeds basic performance standards (Pass)Each of the applicable standards in this Assessment competency must receive a rating of “3” or “5”in order for the candidate to have passed this competency. A score of “1” on any of the following 11standards indicates an insufficiency in demonstrated skills, and the entire Assessment competencymust be retaken and successfully completed (on a different case) in order to be eligible forcertification.Assessment Competency: This section assesses if all initial and ongoing assessment processes werecompleted with sufficient thoroughness to help ensure youth safety, to identify possible risks, and to identifystrengths and needs of the youth. The assessment should be appropriate given all of the informationgathered about the youth, and the process should reflect information gathered through various means tosupport the need for any actions taken. Thorough assessment should appropriately address present safetyconsiderations, youth vulnerability factors, and any caregiver protective capacity implications. The reviewershould determine if the assessment, youth visits, Judicial Review Social Study Report Addendum, and anyother assessment tools were completed according to statute, code and policy and with sufficientthoroughness to help guide appropriate and effective decision-making in keeping the youth safe and inmeeting the needs of the youth.For the purposes of this competency, "consistently" is defined as "a majority of the time" during the life ofthe case. Evaluators should consider factors presented in determining to what degree each standard was“consistently” met by the candidate, and rate each standard accordingly.10

1 3 5I. STANDARD: Has the Independent Living candidate scheduled and conducted the LifeSkills Assessment with the youth in a timely manner?The reviewer may find evidence in case narrative, on the Life Skills Assessment form or any otherapproved documentation in the file.Reviewers/evaluators should consider the following factors in determining to what degreethe candidate scheduled and conducted the Life skills Assessment in a timely manner. Requirement: The assessment was conducted each year during the youth’s birth month .Requirement: The initial life skills assement was completed within 30 days of receipt of thereferral from the Dependency Case Manager, or within 60 days after the court enters anorder placing the youth in the custody of the department. (If the times frames are not met,there is documentation that the IL candidate attempted to meet the time frames.)Reviewer/Evaluator Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 1 3 5II. STANDARD: There is evidence that the results of the Life Skills Assessment were filedwith the court. and served to all parties.Reviewers/evaluators should consider the following factors in determining to what degreethis standard was met and based on those findings, issue an overall rating on this standardof “1”, “3”, or “5”. Tip If the evaluator found evidence that the Life skills Assessment hadbeen filed with the court only in the FSFN chrono’s and not on the Legal form this should berated a 3,or vice versa. If found in both areas it could constitute a 5.Evidence of filing the Life Skills Assessment could be found in the file on the Legal log formwith a date and signatures from Legal and the candidate.Evidence of filing the Life Skills Assessment could be found in the file in the FSFNchronologicals.Reviewer/Evaluator Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________11

1 3 5III. STANDARD: There is evidence that the initial staffing was scheduled, all parties wereinvited and the staffing was conducted within 30 days of the referral. If staffng was not heldwithin 30 days of referral, there is appropriate documentation as to why it was not held.Reviewers/evaluators should consider the following factors in determining to what degreethis standard was met:Check all that apply below, and based on those findings, issue an overall rating on thisstandard of “1”, “3”, or “5”.Evidence of the initial staffing being held was located on the Staffings form.Evidence of the initial staffing being held was located in the FSFN Chronologicals.Evidence of the initial staffing being held was located in the JR addendum.Reviewer/Evaluator Comments: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 1 3 5IV. STANDARD: There is evidence that staffings were conducted as required according tothe youth’s age.This information may be located in FSFN chronological notes; staffing notes; Judicial Review SocialStudy Addendum (and any other) court reports; correspondence; and any other supportingdocumentation.N/A must be selected for the two choices for which the youth does not meet the age criteria.A. Youth, age 13-14, staffings are completed annually in their birth month.YESNON/AB. Youth ages 15-17, staffings are completed once every six months from the last staffingand according to their birth month.YESNON/AC.Youth age 17 and over, staffings are completed within 30 days of the special judicial review andthe hearing conducted within the month that begins the six-month period before the youth’s 18 thbirthdayYESNON/AReviewer/Evaluator Comments: ________________________________________________________________________________________________________________________________12

1 3 5VII. STANDARD: There is evidence that the IL candidate discussed the youth’s currenteducation and career plan.This information may be located in the FSFN chronological notes; staffing forms; Judicial ReviewSocial Study Addendum (and any other) court reports; correspondence; and any other supportingdocumentation.Reviewers/evaluators should consider the following factors in determining to what degreethis standard was met:The candidate included the youth, foster parents, and case manager.The plan was reviewed at each judicial hearing as part of the case plan.The plan accommodates the needs of the youth served in exceptional education programs tothe extent appropriate for each individual.Reviewer/Evaluator Comments: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 1 3 5VIII: STANDARD: There is evidence of follow-up on the youth’s participation or lack thereofIn Life Skills training and outcomes.Tip: If the youth did not participate in the Life Skills training, the reason for their nonparticipationis documented.This information may be located in the; FSFN chronological notes; staffing forms; sign in sheets forattendance, Judicial Review Social Study Addendum (and any other) court reports;correspondence; and any other supporting documentation.Check all that apply below, and based on those findings, issue an overall rating on thisstandard of “1”, “3”, or “5” to indicate the extent to which there is evidence of follow-up onthe youth’s participation or lack of participation in the Life Skills trainings.A. Evidence was located in the staffing form.YESNOB. Evidence was located in the FSFN chronological notes.YESNOC. Evidence was located in the JR addendum.YESNOReviewer/Evaluator Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________14

1 3 5IX. STANDARD: There is evidence that candidate accurately and appropriately addressedand fully explored the youth’s strength’s/progress and needs/obstacles with regard to eachof the following.1. Educational and work goals2. Employment/volunteer experience3. Health4. DJJ involvement5. Plans; Normalcy/Teen Plan, Subsidized IL Plan, (For 16 & 17 year olds as applicable),Transition Plan, ( For age 17.5), and JRSSR IL sectionThis information may be located in the; FSFN chronological notes; staffing forms; Judicial ReviewSocial Study Addendum (and any other) court reports; correspondence; and any other supportingdocumentation.(Tip) Each section should be addressed. Leaving one section out should constitute a failure. Thedegree to how each section is addressed would determine the rating. Is each section fully explainedand clearly documented?Reviewers/evaluators should consider the following factors in determining to what degreethis standard was met:The educational section addressed if the youth was at grade level and any obstacles inobtaining future educational goals.The work section identified any previous work experience and any desires for future workemployment and any reason why the youth would not be successful in future work environment.The health section addressed any medical conditions that may impact transition into adulthood.It identifies if the youth is currently on any prescribed medications. It addresses if the youth isinvolved in any on going mental health counseling, and if the youth has a mental healthdiagnosis.The DJJ section includes if the youth has been or is currently committed to a Department ofJuvenile Justice residential facility. It identifies if the youth is currently on probation or undercourt supervision. And it identifies obstacles for the youth regarding criminal history.The IL candidate identifies if a normalcy plan has been completed by the case manager and if itis has not been completed, then the IL candidate makes appropriate recommendation forcompletion.The IL candidate determines if the youth is eligible for the Subsidized IL Program and providesthe results of the assessment to the case manager.The IL candidate identifies supportive services or persons need for the youths transition andtimeframes for the mutually agreed upon transitional tasks.Reviewer/Evaluator Comments: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________15

Additional Reviewer Comments on Competency A—Assessment:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Child Protection Specialized Services, “Independent Living”Performance AssessmentAssessmentCase Manager Candidate Name:_____________________________________________PlanningSafetyPermanencyWell-BeingDocumentationEvaluator Name:______________________________________ Date:_____________InterpersonalCase Identifier (Name or Number):____________________________ Attempt # (Circle one): 1 2Evaluator Rating for Competency B: PLANNING/DOCUMENTATIONEvaluate the candidate’s work as provided in the Education and Career Plan; FSFN chronological notes;Independent Staffing Form; Judicial Review Social Study addendum: (and other) court reports;correspondence; and any other supporting documentation. The candidate’s documentation should reflectconsideration of all factors in his or her assessment of the youth, in order to accurately determine the extentto which these factors impact the youth’s safety, permanence and well-being.Each standard in the Planning/Documentation competency must be evaluated as follows:1 = Needs improvement to meet basic performance standards (Fail)3 = Meets basic performance standards (Pass)5 = Exceeds basic performance standards (Pass)Each of the applicable standards in this Planning/Documentation competency must receive a ratingof “3” or “5” in order for the candidate to have passed this competency. A score of “1” on any of thefollowing 5 standards indicates an insufficiency in demonstrated skills, and the entirePlanning/Documentation competency must be retaken (on a different case) and successfullycompleted in order to be eligible for certification.Planning/Documentation Competency: This section evaluates the candidate’s documentation in terms ofaccuracy, timeliness, objectivity and skill. Evaluators should assess the candidate's ability to accurately,succinctly and thoroughly record the events of the case, including but not limited to the candidate'sassessments, all casework activities, and all contacts with the youth, care manager, caregivers, and otherswith information relevant to the case. This section also considers the extent to which the services describedin the Education and Career Plan, Independent Living Staffing Form, Subsidized Independent Living Plan,Transitional Plan and Judicial Review Social Study Addendum are appropriate to the case situation in theirdesign to ensure proper implementation by facilitating the youth’s transition into adulthood.The evaluator may find evidence in the chronological notes/case narrative, staffing forms, Judicial ReviewSocial Study Addendum and other court reports, correspondence, etc.16

For the purposes of this competency, "consistently" is defined as "a majority of the time" during the life ofthe case. Evaluators should consider factors presented in determining to what degree each standard was“consistently” met by the candidate, and rate each standard accordingly. 1 3 5I. STANDARD: There is documentation that the Case Manager completed the Normalcy/Teen Plan and that the Independent Living candidate reviewed and discussed the plan withthe signees of the plan (youth, caregiver and case manager).Tip: If no plan exists, goals are still discussed and the Case Manager is notified and this isdocumented in the case notes.Reviewers/evaluators should consider the following factors in determining to what degreethis standard was met:Age appropriate activities must be in the planSpecific goals and objectives for the youth are identified.Reviewer/Evaluator Comments: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 1 3 5 N/AII. STANDARD: There is documentation that the candidate developed a SubsidizedIndependent Living Plan (For 16 & 17 year-olds as applicable). The Independent Livingcandidate reviewed eligibility which includedAge,Legal status, andThe ability to demonstrate independent living skillsTip: The Plan should include the following information: employment, education, savings,grades, assessment to be able to live in unlicensed setting with minimal supervision.Tip: The reviewer should check N/A if the youth is not 16 or 17 or if (for a documented andacceptable reason) does not have a Subsidized IL PlanReviewer/Evaluator Comments: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________17

1 3 5III. STANDARD: There is evidence that the candidate worked with the youth to develop anappropriate Transition Plan (For age 17.5, and 90 days prior to 18 years of age)Reviewers/evaluators should consider the following factors in determining to what degreethis standard was met:The IL candidate worked with the young adult in developing a joint transition planthat is consistent with a needs assessment identifying the specific need fortransitional services to support the young adult’s own efforts.The young adult must have specific tasks to complete or maintain included in theplan and be accountable for the completion of or making progress towards thecompletion of the tasks and timeframes.Reviewer/Evaluator Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 1 3 5IV.STANDARD: There is documentation that the following information wascommunicated to the Dependency Case Manager for inclusion in the JRSSRIndependent Living Section:Education and Career PlanNormalcy PlanIndependent Living Staffing informationThe steps that were taken by the youth toward recommendations discussedat the last Indepenedent Living staffing (if applicable)Indentification of obstacles, barriers and possible solutions to address needsidentified at the Independent Living staffingTip: An exemplary rating might be if the IL Coordinator arranged a meeting with the CaseManager to discuss the information.Reviewer/Evaluator Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 1 3V. STANDARD: There is good documentation of the Independent Living candidate’scommunication with other parties as needed.Tip: Parties include but are not limited to: Dependency Case Manager, Child LegalServices, Caregiver/placement, youth, Guardian ad Litem, school personnel, siblings,staffing participants, etc. 518

Reviewer/Evaluator Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Additional Reviewer Comments on Competency B—Planning/Documentation:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________19

Child Protection Specialized Services, “Independent Living”,Performance AssessmentIndependent LivingCandidate Name:_____________________________________________Evaluator Name:__________________________________ Date:_____________Interaction Type (Meeting/Staffing):_________________________________Attempt # (Circle one): 1 2PlanningAssessmentSafetyPermanencyWell-BeingInterpersonalDocumentationEvaluator Rating of Candidate’s INTERPERSONAL SKILLS (C):Interaction with YouthEvaluate the candidate’s demonstration of interpersonal skills while interacting with the youth one on one, orat an Independent Living Staffing.Examples are provided of actions that may illustrate that a skill has been demonstrated; please providewritten comments or examples regarding skills observed.Please note that there are only two standards which may be rated as “Not Applicable” (“N/A”); all otherstandards must be rated in order for the observed interaction to be eligible to be used as the InterpersonalSkills demonstration portion of the candidate’s Performance Assessment.YesI. STANDARD: The candidate demonstrated advanced preparation (provided brieforal chronology).NoFor example, s/he knew the purpose of the meeting; was dressed appropriately.Reviewer comments/examples of skills noted or absent: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoII. STANDARD: The candidate greeted the youth and others appropriately.For example, s/he greeted participants in a professional but friendly manner; statedname and position when appropriate.20

Reviewer comments/examples of skills noted or absent: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoIII. STANDARD: The candidate appropriately explained the purpose of the meeting.For example, s/he provided a clear statement of purpose; used non-accusatorylanguage; explained the agenda of the meeting.Reviewer comments/examples of skills noted or absent: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoIV. STANDARD: The candidate maintained an objective approach throughout theinteraction.For example, s/he used appropriate, non-threatening language; also used objectivestatements and questions in addressing the person/group.Reviewer comments/examples of skills noted or absent: ________________________________________________________________________________________________________________________________________________________21

YesNoV. STANDARD: The candidate spoke directly with the youth or other participants,when appropriate.For example, s/he was respectful and maintained a professional demeanor.Reviewer comments/examples of skills noted or absent: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoVI. STANDARD: The candidate communicated professionally with the youth and otherparticipants.For example, s/he restated what was said to ensure understanding; asked for opinions,points of view, and/or questions; asked relevant questions; accessed appropriateresources for foreign language or other special needs.Reviewer comments/examples of skills noted or absent: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoVII. STANDARD: The candidate demonstrated active listening skills.For example, s/he responded to questions appropriately; allowed participants tocomplete statements or thoughts without interrupting; asked open-ended questions.Reviewer comments/examples of skills noted or absent: ___________________________________________________________________________________________________22

____________________________________________________________________________________________________________________________________________________YesNoVIII. STANDARD: The candidate maintained the focus of the interaction.For example, s/he redirected the conversation; was flexible; focused on any concernsthe participant(s) may have had.Reviewer comments/examples of skills noted or absent: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoN/AIX. STANDARD: The candidate responded appropriately to any unexpected events.For example, s/he confronted unpleasant issues effectively; de-escalated any situationneeding to be de-escalated; enabled participant(s) to vent frustration.(If no unexpected events occurred during the observed interaction, rate as “N/A”)Reviewer comments/examples of skills noted or absent: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoX. STANDARD: The candidate verbalized the youth’s strengths and needs.For example, s/he provided positive feedback; made clear statements; was able toverify/validate the youth’s concerns.Reviewer comments/examples of skills noted or absent: _________________________23

____________________________________________________________________________________________________________________________________________________YesNoN/AXI. STANDARD: The candidate offered alternatives and/or choices to the youth, whenappropriate.For example, s/he demonstrated the ability to negotiate; explained benefits andpossible consequences of certain actions.(If no alternatives or choices were available or appropriate to be offered duringthe observed interaction, rate as “N/A”, however, if there were appropriate alternativesbut the candidate failed to offer or discuss them, rate as “No”.)Reviewer comments/examples of skills noted or absent: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________YesNoXII. STANDARD: The candidate conducted appropriate closing activities.For example, s/he summarized the results of the interaction/meeting; asked forquestions; provided clarification and any additional information as needed; explainednext steps; thanked participants for their time.Reviewer comments/examples of skills noted or absent: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________24

Additional Reviewer/Evaluator Comments on Candidate’s Interpersonal Skills (Competency C):______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________25