CAREER ASSESSMENT
Name:
Date of Birth:
School:
School ID Number:
Primary Address:
Home Phone:
Secondary Address & Phone:
Date Assessment Completed:
Anticipated Graduation Date:
Type of Diploma Anticipated:
OVR Counselor:
Assessment completed by/Title:
Cell #:
Current Activities, Life Situation, Network of Family & Friends & Important
History:
This section is an overview that introduces the reader to the student. For example:
1. Describe what life is like now for student- personal, home, school, etc.
2. Describe the student’s goals, not only related to work, but his or her life goals in
general
3. Describe significant situations or events that might have occurred in the student’s
life, which are still having an impact on the student (will not affect every student).
4. Describe the important people in student’s life and how they aid (will aid) student in
being successful in reaching goals. What information was gathered from family and
friends that may be of help, networking possibilities, etc. (where do family & friends
work, possible job contacts).
5. Describe medical conditions (including medications and their effects) that are
essential to know.
6. Current Financial Information and Concerns. List any benefits student maybe
receiving (SSI, SSDI, etc.) Will Social Security benefits be affected? Does student
require job with benefits? Any disincentives expressed during the exploration phase
and how were they addressed?
Gifts/Interests/Skills/Abilities:
1. Describe the student’s interests, gifts, skills, abilities.
2. Describe abilities that potential employers will view as an asset/value to their
business.
3. Describe tasks that the student can perform successfully, job skills, natural talents,
etc.
6/30/2016
Adapted utilizing Department of Labor’s Office of Disability Employment Policy’s Skills to Pay the Bills research and curriculum (2012).
Transportation Needs and Geographical Boundaries for reaching Vocational
Goal:
This section will describe transportation options & geographical boundaries for job
development and following graduation.
1. What options are available for student’s transportation situation after high school
(Public bus system, Specialized bus, family-co-worker-friend-etc. will transport,
provides own transportation-car-bike-walks, etc.)
2. Transportation factors to consider: Area isolated and not easily assessed; limited coworker assistance possible; area served by public transportation; etc.
3. Will student need assistance in learning how to get to work via transportation system
or other sources?
4. Is student able to make own travel arrangements.
5. Describe the location in which the student lives in relationship to possible
employment (including but not limited to the county in which they live). Area
indicates a need for direction supervision; environment suitable for pick-up and leaveoff; etc.
Academic:
Describe the students functional usage of their academics as they pertain to employment,
such as but not limited to:
1. Is the student able to tell time (time awareness- unaware of time & clock function, analog
or digital, identifies breaks).
2. Money skills- Simple counting, balance a checkbook, use a calculator, distinguishes
between coins, make minor/major purchases, next dollar, etc.
3. Reading (sight words/symbols, simple reading, fluent reading), writing etc. As well as how
well the student can perform these activities in employment settings.
4. What type of supports/adaptations facilitates the use of these skills (if any)? Example:
communication boards, picture cards.
5. Learning Style, determine auditory, visual, tactile. Does a concrete or abstract direction
make sense to the student, can they recall skills used earlier (Memory).
Work Behavior:
This section describes how the student behaves in various environments that are familiar and
unfamiliar (is behavior appropriate to the work setting). What support/intervention may be
needed for the student to be successful? If the student behaviors were inappropriate, was
the cause able to be determined? Are the behaviors able to be matched with a more tolerant
work setting?
6/30/2016
Adapted utilizing Department of Labor’s Office of Disability Employment Policy’s Skills to Pay the Bills research and curriculum (2012).
1. Disruptive behavior that interferes with activities (yelling, clinging, laughing crying,
etc.)
2. Unusual or Repetitive Behavior/habits (pacing, rocking, twitching, etc.).
3. Behavior that is socially offensive to others (talking too loud, burping, picking nose,
touching, hugging, etc.).
4. Withdrawal or Inattentive Behavior (keeping away from people, expresses unusual
fear, shows little interest in activities, etc.).
5. Uncooperative or noncompliant behavior (refusing to attend school/work, refusing to
follow rules/requests/directions, acting defiant/pouting, etc.).
6. Describe temperament and triggers.
Communication:
This section tells how the student communicates/uses language expressively and receptively.
Such as but not limited to:
1. Uses sounds/gestures; uses key words/signs.
2. Speaks unclearly; communicates clearly, understandable to strangers.
3. Expresses needs appropriately.
4. Answers questions appropriately.
5. Follows two-step verbal directions, follows verbal prompts.
Social Skills/Interactions:
This section describe students social skills and how they interact with others and what
support/interaction is necessary.
1. Are student’s social interactions- appropriate, polite, responses appropriate?
2. Does student initiate interaction rarely, frequently, infrequently?
3. Does the student accept constructive criticism (by resistive/argumentative, withdraws
into silence, accepts criticism does not change, etc.).
4. Does the student get along well with his co-workers, customers, etc.?
5. Shares in co-worker humor.
6. Participants in work-site social activities.
7. Does the student show appropriate self-control/handle frustration?
Teamwork:
The ability to work as part of a team is one of the most important skills in today’s job market.
Employers are looking for workers who can contribute their own ideas, but also want people
who can work with others to create and develop projects and plans. Teamwork involves
building relationships and working with other people using a number of important skills and
habits. Describe the student’s abilities on the following:
6/30/2016
Adapted utilizing Department of Labor’s Office of Disability Employment Policy’s Skills to Pay the Bills research and curriculum (2012).
1.
2.
3.
4.
5.
6.
Working cooperatively
Contributing to groups with ideas, suggestions, and effort
Communication (both giving and receiving)
Sense of responsibility
Healthy respect for different opinions, customs, and individual preferences
Ability to participate in group decision-making
Elements of Teamwork – An Inventory of Skills – Describe the student’s abilities on the
following (as they pertain to teamwork):
Check: Independent, With Assistance, or Area of Concern
I
W
AC
Reliable - can be counted on to get the job done.
Effective Communicator - express thoughts and ideas clearly and directly, with
respect for others.
Active Listener - listen to and respect different points of view. Others can offer
constructive feedback – and don’t get upset or defensive.
Participates - prepared and get involved in team activities; a regular
contributor.
Shares openly and willingly - willing to share information, experience, and
knowledge with the group.
Cooperative - work with other members of the team to accomplish the
job, no matter what.
Flexible - adapt easily when the team changes direction or when asked
to try something new.
Committed - responsible and dedicated. Always give best effort!
Problem Solver - focus on solutions; good about not going out of way to
find fault in others.
Respectful - treat other team members with courtesy and consideration - all of
the time.
Specifics/Comments__________________________________________________
Work Environment:
This section describe what would be the ideal work setting and work environment:
1. Work setting inside, outside, noisy, quiet, organized, unorganized, small area only,
large etc.
2. Desired work schedule, will work weekends, evenings, mornings, etc. ( remember
transportation, endurance and medication can sometimes affect when/how often a
student works)
Intensity of Supports Needed:
6/30/2016
Adapted utilizing Department of Labor’s Office of Disability Employment Policy’s Skills to Pay the Bills research and curriculum (2012).
This section describes what type and level of supports will be needed for employment after
high school: Natural supports, family support (very, supportive with reservations, no support,
etc.), supported employment, assistive technology, etc.
Work Skills Observations:
This section describes what you’ve learned about student’s community work experiences,
level of motivation, interaction, problem solving skills, and communication necessary for a
successful work experience and job seeking in the future (work history).
1. Good attendance/Punctuality
Check: Independent, With Assistance, or Area of Concern
Frequency of Absenteeism
Calls in absent only when sick
Arrives ready to work/Prepares to leave for work
I
W
AC
Specifics/Comments__________________________________________________
2. Appearance/hygiene
Check: Independent, With Assistance, or Area of Concern
Shows good grooming/hygiene
Unkempt/poor hygiene
Unkempt/clean
I
W
AC
Specifics/Comments__________________________________________________
3. Ability to exercise good judgment/problem solving skills
Check: Independent, With Assistance, or Area of Concern
Anticipates consequences of personal actions
Considers other solutions & their consequences
Recognizes & analyzes problems
Identifies early signs of problems
Asks for assistance (peers, co-workers, persons in authority, etc.)
Requests clarification when necessary
I
W
AC
Specifics/Comments__________________________________________________
4. Acceptance of supervision
Check: Independent, With Assistance, or Area of Concern
Respects the authority & decision-making role of supervisors
Pays attention
Resolves differences of opinion in a satisfactory manner
I
W
6/30/2016
Adapted utilizing Department of Labor’s Office of Disability Employment Policy’s Skills to Pay the Bills research and curriculum (2012).
AC
Specifics/Comments__________________________________________________
5. Attention to task/Persistence
Check: Independent, With Assistance, or Area of Concern
Ability to work independently once task is learned
Ability to attend to task until completed
Manages time effectively
Frequent prompts required
Level of ongoing supervision needed
Infrequent prompts/low supervision required
I
W
AC
Specifics/Comments__________________________________________________
6. Initiative/Motivation
Check: Independent, With Assistance, or Area of Concern
Seeks additional work when tasks are completed
Sometimes volunteers
Waits for directions
Avoids next task
Practices skills/requests feedback
Inquires about job and related work
Shows helping actions/teamwork
I
W
AC
Specifics/Comments__________________________________________________
7. Awareness of safety precautions
Check: Independent, With Assistance, or Area of Concern
I
Follows safety & company rules
Responds to survival words (street signs, restrooms, danger, stop, etc.)
W
AC
Specifics/Comments__________________________________________________
8. Respect of and ability to care for equipment/property
Check: Independent, With Assistance, or Area of Concern
Use materials & equipment properly
Destructive to property (breaks, burns, tears things up, etc.)
I
W
AC
Specifics/Comments__________________________________________________
9. Adapting to Change
Check: Independent, With Assistance, or Area of Concern
I
W
6/30/2016
Adapted utilizing Department of Labor’s Office of Disability Employment Policy’s Skills to Pay the Bills research and curriculum (2012).
AC
Adapts to minor scheduling changes
Adapts to minor task/duties change
Adapts to environmental changes (heat, noise)
Adapts to personnel changes (peer, supervisor)
Specifics/Comments__________________________________________________
10. Ability to maintain adequate productivity/pace
Check: Independent, With Assistance, or Area of Concern
Ability to lift & carry at the pace and speed required of co-workers
Individual Strengths ( does student utilizes their strengths)
Physical Mobility (as it relates to the vocational goal)
Work Pace (slow, steady/average pace/ above average)
I
W
AC
Specifics/Comments__________________________________________________
Exploration Sites/Job Shadowing Summaries:
In this section list and define all places where student shadowed/worked during exploration.
Describe things such as but not limited to the variety of tasks and duties, interactions with
co-workers & supervisor, work pace-quality. Was the work/task routine or did it vary. What
worked and what didn’t work and why. What was the outcome? Potential to return why or
why not. Etc.
Summary & Recommendations:
This section describes what you believe to be the best vocational goal for student based on
findings of the exploration and why. What level of supports will be necessary for student to
achieve goal and how/what steps should be taken. List of accommodations/adaptations (if
any) will be needed. List specific tasks/activities, work setting, people/co-workers that will
work best for student to achieve goal (for Job development).
Job possibilities based on information gathered during exploration. List specific
businesses you plan on contacting for training sites and job development
Possible Sites & Contact Information for each:
Signature of Person Completing Form:__________________________________
6/30/2016
Adapted utilizing Department of Labor’s Office of Disability Employment Policy’s Skills to Pay the Bills research and curriculum (2012).