SOP 215.22-att-2: Employer Job-Site Visits Form

Division:
Facilities
Effective Date:
January 23, 2020
Reference Code:
IID05-0003
Topic Area:
215 Policy-Transitional Center
PowerDMS:
View on PowerDMS
Length:
172 words

Summary

This form is used to document monthly employer job-site visits conducted at transitional centers to monitor resident employment placements. Staff record employer contact information, visit dates, residents employed at each site, and details about who conducted the verification. The form must be completed and submitted by the 10th of each month and is retained with monthly statistical reports.

Key Topics

  • employer job-site visits
  • transitional center employment
  • resident employment monitoring
  • job site verification
  • employment counselor
  • employer contacts
  • work placement oversight
  • monthly reporting

Full Text

SOP 215.22
Attachment 2

1/23/20
Page 1 of 2

EMPLOYER JOB-SITE VISITS

_________________________________Center

For the Month of , 20 [Due 10th of Month]

|EMPLOYER ADDRESS/TEL.#|PERSON
CONTACTED|VISIT
DATE|RESIDENT'S
NAME|PERSON MAKING CONTACT (other than Employment
Counselor) TYPE CONTACT/COMMENTS|
|---|---|---|---|---|
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Retention Schedule: Upon completion, this form shall be placed with the Center’s copies of the monthly statistical reports. It will be maintained according to the official retention
schedules for Monthly Reports to the State Director’s Office.

SOP 215.22
Attachment 2

1/23/20
Page 2 of 2

EMPLOYER JOB-SITE VISITS
(Last Page)

_________________________________Center
For the Month of , 20 [Due 10th of Month]

|EMPLOYER ADDRESS/TEL.#|PERSON
CONTACTED|VISIT
DATE|RESIDENT'S
NAME|PERSON MAKING CONTACT (other than Employment
Counselor) TYPE CONTACT/COMMENTS|
|---|---|---|---|---|
|



|||||
|



|||||
|



|||||
|



|||||
|



|||||

# Residents Employed: _______________________________ Signatures:

# Total Center Job Sites at End of Month: ________________ Employment Counselor: ____________________________________

# Different Job Sites Checked: _________________________ Asst. Superintendent: ______________________________________

# Residents Checked: ________________________________ Superintendent: __________________________________________

Retention Schedule: Upon completion, this form shall be placed with the Center’s copies of the monthly statistical reports. It will be maintained according to the official retention
schedules for Monthly Reports to the State Director’s Office.

Attachments (4)

  1. Transitional Resident Data Form (320 words)
  2. Employer Job-Site Visits Form (172 words)
  3. Transitional Center Employment Agreement (545 words)
  4. Out of State Work Travel Permit (717 words)
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