SOP_NUMBER: 215.22-att-2
TITLE: Employer Job-Site Visits Form
REFERENCE_CODE: IID05-0003
DIVISION: Facilities
TOPIC_AREA: 215 Policy-Transitional Center
EFFECTIVE_DATE: 2020-01-23
WORD_COUNT: 172
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/106254
URL: https://gps.press/sop-data/215.22-att-2/

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

ATTACHMENTS:
  1. Transitional Resident Data Form
     URL: https://gps.press/sop-data/215.22-att-1/
  2. Employer Job-Site Visits Form
     URL: https://gps.press/sop-data/215.22-att-2/
  3. Transitional Center Employment Agreement
     URL: https://gps.press/sop-data/215.22-att-3/
  4. Out of State Work Travel Permit
     URL: https://gps.press/sop-data/215.22-att-4/

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FULL TEXT:
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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<br>CONTACTED|VISIT<br>DATE|RESIDENT'S<br>NAME|PERSON MAKING CONTACT (other than Employment<br>Counselor) TYPE CONTACT/COMMENTS|
|---|---|---|---|---|
|<br> <br> <br> <br>||<br> <br> <br>|||
|<br> <br> <br> <br>|||||
||||||
|<br> <br> <br> <br>|||||
|<br> <br> <br> <br>|||||
|<br> <br> <br> <br>|||||



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<br>CONTACTED|VISIT<br>DATE|RESIDENT'S<br>NAME|PERSON MAKING CONTACT (other than Employment<br>Counselor) TYPE CONTACT/COMMENTS|
|---|---|---|---|---|
|<br> <br> <br> <br>|||||
|<br> <br> <br> <br>|||||
|<br> <br> <br> <br>|||||
|<br> <br> <br> <br>|||||
|<br> <br> <br> <br>|||||



# 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.