Form Sr 2-Wp - Entrance Questionnaire Page 2

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10. CHILD CARE AND SUPERVISION:
a)
How do you document CCS hours and what is your established procedure?
(who prepares, when prepared, how checked for accuracy
b)
How do you determine and document weighting? (experience and education)
c)
How do you verify CCL requirements for CCS staff? (FPs, ASSOCIATION, FBI, CAI, etc)
d)
Training logs kept? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
e)
Trainer expenses paid by Provider? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
f)
CCS salary paid by Provider? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
NO
11. SOCIAL WORK ACTIVITIES:
PROFESSIONAL
TYPE OF SERVICE
HOW ARE SERVICES PAID?
NAME
LEVEL
PROVIDED
(CONTRACT, PAYROLL, OTHER)
a)
b)
c)
d)
e)
12. MENTAL HEALTH SERVICES:
PROFESSIONAL
HOW ARE SERVICES PAID?
TYPE OF SERVICE
NAME
LEVEL
(CONTRACT, PAYROLL, OTHER)
PROVIDED
a)
b)
c)
d)
e)
13. ARE YOUR PROGRAMS AUTOMATED?
YES
NO
IF YES, WHAT TYPE OF AUTOMATED PROGRAM DO YOU USE?

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