Individual Service Plan (Isp) For Individuals With Developmental Disabilities Living In The Community Template Page 2

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NARRATIVE SECTION
LIFE EXPERIENCES:
Provide background information, including successful past experiences and major life events. Describe what life is like now and important relationships.
Include a description of the individual’s values and beliefs that have resulted from these life experiences (e.g., personal, cultural, spiritual, political).
Provide information regarding personal challenges when applicable. (Do not duplicate information for upcoming sections on work, education, health and
safety, strengths/gifts, preferences and hobbies covered in later sections of this document.)
Significant Historical Information:
Briefly describe progress made since last year:
What life is like now (include where and with whom they live):
Relationships (include family, friendships, community groups and staff with whom they are especially close. Also, clarify what relationships the
individual is interested in forming, maintaining, re-establishing, expanding and/or ending.):
Important Values/Beliefs:
DESCRIPTION OF WHAT IS MEANINGFUL TO THIS INDIVIDUAL (Meaningful Day definition) –
Describe age appropriate choices and
activities (with approximate frequencies) that the individual finds Meaningful in their life. Include such things as purposeful desired work, opportunities for
optimal health, self-empowerment, memberships, desired skill development, social, educational and community inclusion activities, valued roles, new
things to try and hobbies. This description may be broader than the individual’s vision statements, but should support progress toward achieving the
visions and desired outcomes.
WORK, EDUCATION, AND/OR VOLUNTEER HISTORY: EMPLOYMENT FIRST-IDT members are required to offer Community
Integrated Employment Services as a priority service over other day service options for all working age adults.
Describe the individual’s successes and goals in school (past and/or current), including his/her areas of interest (e.g., favorite subjects and activities) and
particular learning style. Provide detailed information about the individual’s complete volunteer and paid work history (e.g., length of employment, job
responsibilities, strengths, preferences, and dislikes). Mention any awards or certifications the individual has received. This section is reviewed on an
annual basis to update/integrate vocational assessments into the ISP. Individuals receiving Supported Employment services are required to have a VAP.
Most current vocational assessment date: _____
Type of vocational assessment performed :
_____Vocational Assessment Profile
_____Personal Profile
_____MAP
_____PATH
_____Community Integration Profile
_____Agency Developed assessment
Is VAP Current:_____Relevant_____Functional_____Needs re-assessment?_____
Volunteer and Work History:
Current Job Description Of Duties And Hours Per Week:
Past Jobs/Duties:
Length In Each Position:
Reason They Left:
Current And Past Volunteer Experience:
Learning Style and Communication Mode Considerations:
Related to Employment, What are the Individuals Interests, Strengths/Skills and Dislikes/Challenges/Concerns:
Related to Volunteering and/or Education, What are the Individuals Interests, Strengths/Skills and Dislikes/Challenges/Concerns:
NAME: ______ DOB: ____
EFFECTIVE DATE of ISP: ____
PAGE 2 OF 17
version 3/13

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