PERFORMANCE ASSESSMENT for

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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
Page 4 and 5: Competency A: AssessmentCompetency
Page 6 and 7: Evaluation ProcessThe two (or more,
Page 8 and 9: PlanningAssessmentInterpersonalDocu
Page 10 and 11: PlanningAssessmentInterpersonalDocu
Page 12: 1 3 5III. STANDARD: There is eviden
Page 15: 1 3 5IX. STANDARD: There is evidenc
Page 19 and 20: Reviewer/Evaluator Comments: ______
Page 21 and 22: Reviewer comments/examples of skill
Page 23 and 24: ___________________________________
Page 25: Additional Reviewer/Evaluator Comme

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