WIA MONITORING INSTRUMENT

Document Sample
WIA MONITORING INSTRUMENT Powered By Docstoc
					                                                                   Attachment 7


              WIA/WAGNER-PEYSER COMPLIANCE REVIEW
                        WIA FILE REVIEW

DATE: _________________         REVIEW PERIOD: _______________________________

SITE: ________________________________________________________________________



PROGRAM                         SAMPLE SIZE            MONITORS

Adult

Dislocated Worker

Older Youth______________

Younger Youth

NEG Grant:

Discretionary Grant:

Discretionary Grant:

Discretionary Grant: ___________________

Discretionary Grant:

Discretionary Grant:
 WIA FILE REVIEW – ADULT ELIGIBILITY/PRIORITY OF SERVICE (use 1 per file)

NAME ___________________________________ SOC. SEC. #_________________________

REGION_____________________________MONITOR________________________________



      ELEMENT                   DOCUMENTATION                 OK      Not OK
CITIZENSHIP/ELIGIBLE
TO WORK
SELECTIVE SERVICE

SOCIAL SECURITY #




      ELEMENT                   DOCUMENTATION                 OK      Not OK
AGE




PRIORITY OF SERVICE:
Low Income




PRIORITY OF SERVICE:
Veteran (DD214 or other
documentation)




                                                                    Rev. 12/05
   WIA FILE REVIEW - DISLOCATED WORKER ELIGIBILITY (use one per file)

NAME ___________________________________ SOC. SEC. #_________________________

REGION __________________________________MONITOR __________________________


      ELEMENT                   DOCUMENTATION                 OK       Not OK
CITIZENSHIP/ELIGIBLE
TO WORK
SELECTIVE SERVICE

SOCIAL SECURITY #



      ELEMENT                   DOCUMENTATION                 OK       Not OK
JOB OF DISLOCATION


LAYOFF/UI/UNLIKELY
TO RETURN

PLANT CLOSURE –
SUBSTANTIAL LAYOFF

PUBLIC ANNOUNCE-
MENT OF CLOSURE

U.I. PROFILED


SELF-EMPLOYMENT


PERMANENT DISLOCA-
TION – NATURAL DIS-
ASTER
DISPLACED
HOMEMAKER

                                                                   Revised 12/05
             WIA FILE REVIEW - YOUTH ELIGIBILITY (use one per file)

NAME ___________________________________ SOC. SEC. #_________________________
REGION _________________________________ MONITOR __________________________

      ELEMENT                    DOCUMENTATION                  OK    Not OK
CITIZENSHIP/ELIGIBLE
TO WORK
SELECTIVE SERVICE

SOCIAL SECURITY #


         ELEMENT                   DOCUMENTATION                OK    Not OK
AGE

__ IN SCHOOL
__ OUT OF SCHOOL
LOW INCOME: (check one)
__ Cash Public Assistance
__ Family Size And Income
__ Food Stamps
__ Homeless
__ Foster Child
__ Disability
BARRIER: (one or more)
__ Deficient in Basic
    Literacy Skills
__ School Dropout
__ Homeless, Runaway,
    Foster Child
__ Pregnant or a Parent
__ Offender
__ Requires Additional Assist.
to complete education, etc
5% EXCEPTIONS: Not low
income & (check one or more)
__ School Dropout
__ Basic Skills Deficient
__ Education Attainment
    Below Approp. Grade Level
__ Pregnant or Parenting
__ Disabled
__ Homeless or Runaway
__ Offender
__ Serious Barriers to Employ-
    ment (locally defined)                                            R: 12/05
                  WIA FILE REVIEW CHECKLIST - YOUTH
NAME ___________________________________ SOC. SEC. #_________________________

               YOUTH FILE - DOCUMENT/COMMENTS                            OK      Not OK

Signed application _____________________________________________        ______   _____

Veteran Documentation__________________________________________         ______   _____

Complaint procedures/EEO ______________________________________         ______   _____

Release of information form _____________________________________       ______   _____

Initial assessment/test results _____________________________________   ______   _____

Basic skills test results _________________________________________     ______   _____

In-depth assessment/test results ___________________________________    ______   _____

Individual Service Strategy ______________________________________      ______   _____

Youth Goals __________________________________________________          ______   _____

Training/OJT/Work Experience Agreements ________________________        ______   _____

Non-WIA Funding Unavailable for Training ________________________       ______   _____

I-9 for Work Experience ________________________________________        ______   _____

Payment requests/invoices _______________________________________       ______   _____

Attendance/grades for school/training/WE __________________________     ______   _____

Credentials/Certificates _________________________________________      ______   _____

Services Documented (including followup) _________________________      ______   _____

Use of Eligible Service Providers Documented ______________________     ______   _____

Log Notes/Regular Contact Documented ___________________________        ______   _____

Exit Data/Employment Verification _______________________________       ______   _____

Follow-up – 12 mos (ISS/log notes) ________________________________     ______   _____

                                                                           Rev. 12/05
       WIA FILE REVIEW CHECKLIST – ADULTS/DISLOCATED WORKER

NAME ___________________________________ SOC. SEC. #_________________________

  ADULT/DISLOCATED WORKER FILE - DOCUMENT/COMMENTS                         OK      Not OK

Signed application _____________________________________________          ______   _____

Veteran Documentation _________________________________________           ______   _____

Complaint procedures/EEO ______________________________________           ______   _____

Release of information form _____________________________________         ______   _____

Initial assessment/test results _____________________________________     ______   _____

Justification for intensive/training svcs _____________________________   ______   _____

In-depth assessment/test results ___________________________________      ______   _____

Individual Employment Plan _____________________________________          ______   _____

ITA/OJT/Work Experience Agreements ____________________________           ______   _____

Non-WIA Funding Unavailable for Training ________________________         ______   _____

I-9 for Work Experience ________________________________________          ______   _____

Payment requests/invoices _______________________________________         ______   _____

Attendance/grades for school/training/WE __________________________       ______   _____

Credentials/Certificates _________________________________________        ______   _____

Services Documented (core/intensive,training/followup)________________    ______   _____

Use of Eligible Training Provider Documented ______________________       ______   _____

Log Notes/Regular Contact Documented ___________________________          ______   _____

Exit Data/Employment Verification _______________________________         ______   _____

Follow-up - 12 mos (IEP/log notes) ________________________________       ______   _____


                                                                             Rev. 12/05

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:7
posted:5/27/2012
language:
pages:6