Title V - Senior Community Service Employment Program

REQUIRED FORMS FOR THE SCSEP PARTICIPANT’S RECORD

The following documents are required as part of each participant’s record:

• Four SPARQ Participant Data Forms (latest versions available at http://www.charteroakgroup.org/resources/scsep.shtml)
• SCSEP Participant Form
• SCSEP Community Service Assignment Form
• SCSEP Exit Form (when terminated)
• SCSEP Unsubsidized Employment Form (job placement or working at FU)


• Confidential Statement of Income, with supporting documentation attached, completed at intake and annual recertification


• Employment Eligibility Verification Form I-9 (check web site periodically for updated forms:  http://www.uscis.gov/files/form/i-9.pdf)


• Participant Acknowledgement of Terms of Enrollment (Enrollment Agreement)


• Participant Designation of Beneficiary


• Orientation Checklist (signed by participant)


• Assessment (updated at least twice within 12 month period)
• Participant Self Assessment Form
• Staff Assessment Form


• Individual Employment Plan (IEP), and any IEP Progress Review (s) with updates


• Training Assignment Description (TAD) (includes work schedule)


• Quarterly Monitoring Report (a minimum of one every three months)


• Case Notes and Activities Log


• Participant Evaluation(s) (minimum of one annually)


• Supervisor Evaluation(s) (minimum of one annually)


• Supportive Service Referrals (if any)


• All Required Data Validation (DV) documentation (see SCSEP DV Source Documentation Requirements for elements to be validated)

The file must also contain documentation (often incorporated in the Terms of Enrollment or the Orientation Checklist or included in Participant Handbook) that the participant has been provided with information on the following:

• Grievance Procedures
• Permitted and Prohibited Political Activities
• Americans with Disability Act (ADA)
• Drug-Free Workplace Act

The following documentation is required, but must be kept in a separate, locked file:

• Proof of physical exam (program entry & minimum of once annually) Note: Subprojects must not receive a copy or use results of the physical exam.


• Physical Assessment Waiver(s) if participant declines to have a physical exam. (program entry & minimum of once annually)

08/09