Supported Employment (S.e.): Sample Reports And Forms Page 5

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5
Supported Employment (S.E.):
Sample Reports and Forms
(obtained on-line
Other job leads
or from other
sources)
1--Called to update
Call to coordinate
client: items
on activities
upcoming
Phone calls with
discussed or action
interview
taken
Meeting to
clients: items
One meeting-(see
prepare for
Meetings with
discussed or action
job leads above)
interview
taken
Issues: that
developed or
remains
unresolved:
(transportation,
health, behavior
etc.)
Other:
6. Placement
: Use same verification of employment form as for non-supported employment cases
Use the same 30, 60 and 90 day reports as for non-supported employment cases. Case
note all follow along contacts with the participant and employer and provide to counselor.
7. Follow Along:
7/12/14: Met w/ supervisors and manager prior to start date to educate on supported employment and
Sample Follow Along Case Notes:
discuss long term support plans. Supervisors committed to making this a good match and identified an
employee named Jane who would make a good mentor. Initially will have him work 3 days a week during
“slower shifts” while he acclimates to the job and job duties.
As he learns job duties they will add more
hours and have him work busier shifts.
7/14/14: Met client at work site. He began employment this date. Introduced him to his job coach and Jane.
Week one of employment:
Job developer facilitated discussion between client, Jane and job coach regarding support and mentoring
needs.
While the job coach has been hired to teach him his job duties, it is anticipated Jane, the supervisors
and other co-workers will provide long term supports.
7/16/14: P/C to client, who reported there is a lot to learn, but the job coach is helping him. P/C to
supervisor who indicted client slowly learning duties--having a job coach is helpful.
7/17/14: Text to employer who responded everything seems to be going smoothly with the help of the job
coach. P/C to client who indicated he is beginning to understand duties.
7/21/14: Site visit—supervisor, client and job coach all indicated it was difficult for client to remember job
Week two of employment:
duties after having several days off, but job coach is working on completing a chart for client. He gets along
well with his co-workers and they have started providing him and the job coach helpful tips.
7/24/14: P/C to client. Indicates everyone is nice at work and he is glad to have something to do besides
watching TV. Text to supervisor—client doing well.

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