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SOCIAL WORKER CHECKLIST | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination. | |||||||
| Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below. | |||||||
| Proficiency Scale: |
1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently |
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| Rating Stars (Click) | Knowledge of Assessment Process | 1 | 2 | 3 | 4 | ||
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Psychosocial assessment (social history, living situation, career, hobbies, support systems, decision making, communication difficulties, flexibility, prolonged mental illness / emotional Problems, lack of community / caregiver support, family discord, ability to deal with loss) | ||||||
| Rating Stars (Click) | Communication Abilities | 1 | 2 | 3 | 4 | ||
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Develop and maintain communication with people on complex matters, issues and ideas, and/or in complex situations | ||||||
| Rating Stars (Click) | Personal and People Development | 1 | 2 | 3 | 4 | ||
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Develop oneself and contribute to the development of others | ||||||
| Rating Stars (Click) | Quality Improvement & Service | 1 | 2 | 3 | 4 | ||
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Contribute to the improvement of services & maintain quality in own work and encourage others to do so | ||||||
| Rating Stars (Click) | Health Protection & Well Being | 1 | 2 | 3 | 4 | ||
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Implement aspects of a protection plan and review its effectiveness | ||||||
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High risk intervention / patient vulnerability or safety risk | ||||||
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Monitor and maintain health, safety and security of self and others | ||||||
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Provide crisis intervention | ||||||
| Rating Stars (Click) | Care Planning | 1 | 2 | 3 | 4 | ||
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Assess complex health and well being needs and develop, monitor and review care plans to meet those needs | ||||||
| Rating Stars (Click) | Knowledge and InformationResources | 1 | 2 | 3 | 4 | ||
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Organize knowledge and information resources and provide information to meet needs | ||||||
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Demonstrates respect for patient/family confidentiality | ||||||
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Documentation Skills (accurate, timely, complete and legible) | ||||||
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Counseling for long range planning and decision making | ||||||
| Rating Stars (Click) | Equality and Diversity | 1 | 2 | 3 | 4 | ||
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Promote equality and value diversity | ||||||
| Rating Stars (Click) | Experience in all or any of the following: | 1 | 2 | 3 | 4 | ||
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Medical Social Work | ||||||
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School Social Work | ||||||
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Clinical Social Work | ||||||
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Social Work-Admin/management | ||||||
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Social work-case manager | ||||||
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International Social Work | ||||||
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Social Work-Children & Families | ||||||
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Social Work in Acute Psychiatric Hospital | ||||||
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Forensic Social Work | ||||||
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Employment/Occupational Social Work | ||||||
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Social Work- Community Organizer | ||||||
| Rating Stars (Click) | Age Specific Competencies | 1 | 2 | 3 | 4 | ||
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Infant (Birth - 1 year) | ||||||
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Preschooler (ages 2-5 years) | ||||||
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Childhood (ages 6-12 years) | ||||||
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Adolescents (ages 13-21 years) | ||||||
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Young Adults (ages 22-39 years) | ||||||
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Adults (ages 40-64 years) | ||||||
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Older Adults (ages 65-79 years) | ||||||
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Elderly (ages 80+ years) | ||||||