Loading...
HomeMy WebLinkAboutSuffolk Works Employment ProgramINTRODUCTION TO THE sUFFOLK WORKS EMPLOYMENT PROGRAM WORK EXPERIENCE PROGRAM Steve Levy, County Executive Robed W. Dow Jr., Commissioner Janet DeMarzo, Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR SUFFOLK COUNTY DEPARTMENT OF SOCIAL SERVICES UFFOLK WORKS EMPLOYMENT PROGRAM WORK EXPERIENCE PROGRAM Welcome to the Suffolk Works Employment Program (SWEP). administered, by the Suffolk County Department of Labor (SCDOL). This manual has been prepared by the SCDQL to provide worksite supervisors with the day-to-day guidance necessary to implement a successful work experience program, in accordan~.e with the new Federal regulations which took effect October 1, 2006. The SWEP provides employment related services to individuals who receive public assistance or food stamps from the Suffolk County Department of Social Services (SCDSS). Individuals who participate in the Work Experience Program are under ONE of the following SCDSS categories: a. The FA-1 (Family Assistance) case category consists of a family with a single parent as the head of the household. b. The FA-2 category consists of a family with two parents present. The SN (Safety Net)' case category usually consists usually of one' individual, but on occasion you may be referred someone who is married: The SN-FA (1 or 2, as above) case category is a family that has exhausted its Federal benefits (FA) and is now funded by the State of New York (SN). eo The NTA-FSET (Non-Temporary Assistance Food Stamp Employment Training) case category usually consists 0f a sole individual but infrequently may be someonefrom a two-parent household. in order to maintain their assistance, participants in each of the above categories are expected to meet the requirements of the particular SWEP program that pertains to their specific category. Please review the program requirements noted within this manual. You may duplicate this manual, or call us to request additional copies that could be shared with other supervisory staff at your agency. Any questions about this manual should be directed to the Work Experience staff of the SCDOL, at telephone (631) 853-3835 or 853-3830. WHAT ISTHE GOAL OF "WORK EXPERIENCE?" The trainees interviewed and accepted by your organization for a work experience assignment possess varying levels of skills and prior work experience. Some people will have been out of the labor market for only a relatively short time, while others have been 'out of the workforce for an extended period. Still, others may be seeking their first job~ Through an assignment at your organization, it is expected that the trainee will learn, or have reinforced, the following basic work habits: a. to report to work at the proper time, in appropriate work attire; to maintain the same punctuality and attendance that you expect of your regular staff. New Federal regulations limits participants to two (2) absences in any month, totaling no more than ten (10) in any 12 month per!od; c. to accept direction from supervisors and perform their assigned duties neatly and · on-time; and d. to relate to co-workers in a professional manner. (Attachment #1 is a Work Experience Program Fact Sheet that is issued to participants outlining their · respo0sibilities) ~ The worksite supervisor should act as a mentor or instrUctor to trainees, showing them what is expected Of them in the work environment. Our SWEP staff can help you toward this goal. We may be able to offer a suggested course of action or, if necessary, we will be happy to visit your site to reinforce your efforts. Work experience at your worksite will provide the trainee with the strUcture and responsibilities that today's employers demand. Trainees will gain the confidence that comes from completing assigned tasks and receiv!ng acknowledgement that they did their job well. They will also be acquiring a recent work history and hopefully, a letter of recommendation from your organization that could assist them in their ultimate goal of securing unsubsidized employment and achieving self-sufficiency. WHAT IS A WORKSITE? Participants enrolled in SWEP may be assigned to a wide variety of worksites within the County of Suffolk. Any agency or organization that is public or private-non-profit is eligible to apply for SWEP worksite status. In accordance with the Memorandum of Understanding signed by both the County and the Contractor (your organization), certain workplace rules must be followed. Revised SUMMARYOF WORKSITE RESPONSIBILITIES a. The worksite personnel MUST conduct an interview with the referred trainee to determine if he or she is acceptable to participate. The interview process should include an assessment of the participant's employment skills, work history, education/training levels, and possible barriers, including offender status where applicable. This process should reflect the sa'me points of emphasis as when choosing a regular employee for your organization. It l~.cviscd 5/14/08 -3- is the responsibility of the worksite to review all internal and non-disclosure policy and documentation with the participant at the onset of his/her assignment. b. Accepted trainees MUST work their specified number of hours per week at the worksite. Monthly Time Sheets (Attachments '#2 A-L) MUST be maintained in' the supervisor's possession at all times. Time Sheets are to be submitted to the Suffolk County Department of Labor within 5 days of the last day worked by the trainee, or the last day of the reporting period,-if the trainee is continuing at your site. Copies of participant timesheets must be stored at your site and be available for inspection for seven (7) years; by Federal law. Trainee tasks should be consistent with their assigned job title (Clerical Aide, Custodial Aide, Maintenance Aide, Laborer Aide, Community Service Aide, and Food Service Aide). Trainees are prohibited from performing tasks that are profit making, religious, or political in nature or content. In compliance with labor law, trainees who work more than Six hours in a day MUST have a 30-minute meal' break. However, all the usual breaks and meal periods will be recorded as part of the participant's assigned hours. The SWEP Monthly Time Sheet has been adjusted to reflect all 2007 changes. Any accidents' or injuries involving Work Experience participants that occur on the worksite MUST be reported immediately by the supervisor to the Work Experience staff (see section G of this manual on page 8). WORKSITE ADMINISTRATION A. TRAINEE REFERRALS AND STARTS SWEP trainees must b~ formally referred to your organization by the SCDOL. They will arrive with our Worksite Referral and Interview Feedback Result forms (Attachments #3 & g4). Do not accept participants without these basic documents. They contain many details, such as required hours, interv!ew date and time that you will need to know. If a trainee should ardve for an interview without the ' necessary referral documents, please contact the SWEP Worksite unit at (631) 853- 3835 to have the necessary instructions and forms f'axed to your worksite. Changes to the interview date can only be made with the approval of the Work Experience Unit. Each applicant is given a specific date and time to report for the initial interview, and a proposed start date, both listed on the referral form, which should have been discussed with the worksite during the conversation setting up the interview. This proposed start date has been set up to include the time allotted for a FA or SNFA client to obtain childcare, as mandated by the Department of Social Services. Any extension beyond this start date must be approved by the SWEP Worksite Unit. In all instances when a participant is accepted by your organization, you MUST inform the trainee of the specific date he or she is scheduled to start at your worksite before concluding the interview, preferably by giving the participant a copy of the feedback form. If the person is accepted, verify the proposed start date, and decide on a mutually agreeable.weekly work schedule that includes al._[ thee hours assi,qned. Complete each section of the Interview Results Feedback Form. The start date and any other requirements must be documented on the referral feedback form. The feedback form should be faxed to the Work Experience unit (853-3806) upon completion of the interview; a copy is also to be given to the. client. and fax it to the Worksite Unit, at (631) 853-3806. In cases where additional information must be obtained by your organiza!ion or the participant pdor to a final determination, a specific date for the client to retum to your office with that information must be issued to the participant IN WRITING.. PLEASE NOTE: .All required background checks must be completed within two weeks of the initial interview. When a background check is not completed by the end of this two-week period, the worksite supervisor must contact the SWEP Worksite Unit for instructions. We will call you the day after the interview to verify this information. Changes to the start date agreed upon at the time of the referral can only be made with the. approval of the Work Experience Unit. We will also call you the day after the indicated start-work date, to confirm that the trainee started. Any questions regarding the procedures discussed above, should be directed to our staff at telephone number (631) 853-3830 or 853-3835. If you decide not to accept the trainee, complete the appropriate section of the Interview Results Feedback Form and fax it to the Worksite Unit. Give the form back to the trainee, with the specific reminder that he or she must report to the SCDOL before 3:00 p.m. of the next business day, in order to maintain program compliance. If the prospective trainee fails to report at the assigned time for the scheduled interview, please notify the Work Experience Unit as soon as possible at (631) 853- 3853. The trainee should nOt be accepted for an interview at any time Revised 51~710g other than that assigned by SWEP, unless he or she has notified you in advance of a specific problem and other arrangements were made that were acceptable to you. or your staff. Upon contact from the trainee, the worksite supervisor may reschedule the interview time or date ONCE for any trainee, and must contact the SWEP Worksite Unit at 853-3853 prior to the time of the rescheduling.. B. CONDITIONS OF ASSIGNMENT Trainees should enjoy working conditions similar to those of your regular staff. Under no cimumstances should any SWEP trainee perform job assignments that involve political, religious or profit-making activities. They cannot perform functions that are similar to those of a budgeted, but vacant position. They must not be the reason for, or the cause of, the elimination of a vacant or unfilled regular staff position. The 'Referral Form will note that the trainee has been given one of the following six (6) Aide job titles: Clerical, Custodial, Maintenance, Labor, Community Service, or Food Service. Workloads at a worksite should not be dependent upon the presence of any SWEP trainee. The trainees are there to assist existing agency. staff. Trainees should be assigned their duties in accordance with NYS Labor Law provisions, and with consideration g~ven to any documented medical restrictions noted on the Referral Form. C. WORK SCHEDULES Trainees are expected to participate throughout the year and they must work the number of weekly hours specified on the Referral Form. While the weekly schedule should be agreeable to both parties, the final work schedule is at the discretion of the worksite supervisor. Although the finalized work schedule itself is at the discretion of the worksite supervisor, it must always equal the "Required Weekly Hours" as shown on the Referral Form. This means the trainee must make up all absences when possible. For example, if a trainee advises you that he or she has a job interview, the participant should be permitted to attend, but should make up the missed work hours. The schedule should take into consideration that if the trainee's DSS case type is: FA or SNIFA: The trainee will be limited to a six-month worksite assignment at any one time. He or she will then be recalled and fa-assessed before the next assignment. A trainee is only permitted to be absent from work on days when a child is unexpectedly home from school. For periods when school is scheduled to be closed, trainees are expected to have arranged appropriate child care and are expected to report to work. All childcare costs are paid by SCDSS for children through age 12. Therefore, trainees should be prepared to work summers, spring break, etc. if your worksite cannot provide work experience during the summer months, we ask that you notify us as soon as possible so that we may make arrangements for the trainee's reassignment for the summer. Revised 5/27/08 When a worksite is closed, the trainee is not required to make up hOUrS if he or she is scheduled for the days closed UNLESS the assigned hours are Iow enough to permit make-up time. SN: SN's will be reassigned on a twelve-month schedule unless they find a full'~-time job or their public assistance case changes. SN participants may also be required to document and submit his or her job search efforts to the Suffolk County Department of Labor while assigned to Work Experience. NTA-FSET: Those clients deemed to be "Able Bodied" will remain at'their worksite until they secure employment or they no longer receive food stamps. They are assigned to work the number of hours shown on the Referral Form, which is proportional to the amount of their food stamp allotment. D. TIME SHEET PROCESSING The supervisor should maintain an accurate record of the trainee's arrivals and departures, as well as any absences and the reason for same, if known, on a daily basis. This system can be as simple as a sign-in log, or even annotations on a desk calendar. This system shall be made available to the SCDOL Worksite Field Representatives during periodic inspections. The Monthly Time Sheet (Attachments la-g) form must remain in the possession of the worksite supervisor. This is a wbrksite responsibility. At the end of the reporting period, the supervisor will enter the total hours worked by the trainee each day, and total the weekly hours. Absences are to be noted utilizing the absence excuse codes on the front of the form. Any absence with documented good cause is excused. Good Cause is defined by regulation as: 1. Illness of the participant; 2. Illness of a dependent family member; 3. Death in the participant's immediate family 4. Mandated court appointments; and 5. Childcare problems. Documentation of Good Cause should be atta(~hed to the timesheet. Any absences without documented cause should have the hours made up by the end of the month. The timesheet is to be signed by both the supervisor and the trainee. If the trainee is no longer available to sign the time sheet, the supervisOr's signature alone will be accepted. Worksite absences with or without Good Cause are limited to 2 per month totaling no more than 10 in any 12-month period. PLEASE NOTE: WORKSITE SUPERVISORS ARE TO COUNSEL TRAINEES AFTER THE FIRST ABSENCE, WHILE THE TRAINEE WILL BE COUNSELED BY TI-IL SUPERVISOR AND DOL REPRESENATIVE A~- ~ ,-R THE SECOND. If a trainee is. scheduled to work on a day when the worksite is closed (e.g. a national holiday), the worksite supervisor should annotate the attendance record using the absence excuse code "D" for all days the site is closed. The trainee will not be required to make up these hours. The timesheet may be faxed to us, but the worksite supervisor should submit (by mail or by hand) the odginal time sheet, filled out in ink: no later than 5 days after the trainee's last workday of each month. Submit to: Suffolk Works Employment Program Work Experience Unit PO Box 1319 Smithtown, NY 11787-0895 (FAX: 853-3806) Many participants are required to furnish (Jocumentation to the Suffolk Works Employment Program with regards to their job seamh efforts. At the end of each reporting period, the participant may submit his or her job search to the worksite supervisor (Attachment #5 A-B) to forward to the Suffolk Works Employment Program along with the Monthly Time Sheet. We request that worksite supervisors corn plete the Evaluation Section of the timesheet on a pedodic basis. Good reviews may allow the trainee access to other services and employment opportunities. Reviews which indicate the trainee is experiencing work-related, or personal problems, may trigger an appointment for supplemental counseling. E TRANSPORTATION'REIMBURSEMENT FORMS Trainees may be entitled to reimbursement for transportation costs associated with going to and retuming from the worksite. The Request for Travel Reimbursement form (Attachment fl6) has been supplied to the trainee by SWEP at the referral interview. Additional forms can be secured from the SCDOL or SCDSS. Of necessity, this form will show the same days at work, as the monthly timesheet. Both the supervisor and the trainee must also sign the Transportation Reimbursement Form. It is the responsibility of the trainee to forward the original of the compl6ted form to: SCDSS - Client Benefits Administration Attn: A. Melisurgo PO Box 18100 Hauppauge, NY 11788-8900 Note that duplicated copies are not acceptable. PARTICIPANT TERMINATIONS_ The worksite supervisor should notify SCDOL Work Experience staff prior tothe termination of any trainee's participation at the worksite, excePt in the case of flagrant or emergency situations, such as: 1. Evidence of disruptive or dev ant .behavior; 2. Acts in flagrant violation of work rules; 3. Refusal to accept work assignments, or other directives; or 4. Causing reckless endangerment to self and/or others. The worksite supervi.sor should document and maintain records of the circumstances surroundIng any decision to terminate the trainee's placement. The 'documentation should reflect information that will indicate that the action was invoked for good cause. in the rare, but entirely possible, situation where a true emergency exists, contact the suffolk County Police Department. NOTE: If a trainee has not contacted the worksite and has been absent for three (3) consecutive business days for which he Or she has been scheduled, you must notify the Work Experience Unit immediately. This notification effectively ends the trainee's assignment at your agency. If there iR a subsequent contact with the trainee, the trainee must call the Worksite Unit at 853.3830 or 853-3835 for directiOn. Do not Permit the trainee to return to the position at your site without the express permission Of the Department of Labor's Work Experience Unit. The trainee's timesheet with the last day of work noted and any relevant comments shOuld be mailed ,or faxed to the Work Experience Unit as soon as possible after · G. ACCIDENT / INJURY REPORTS SWEP provides trainees with Workers' Compensation coverage during the time they are on a worksite. If a trainee is injured on the jOb, please notify the Work Experience Unit by telephone (853-3830) immediately. Have as much of the following information available as possible: 1. Name of the trainee. 2. When, where, how and why the injury occurred. 3. Nature of the injury. 4. ames of any witnesses to the injury. N .... . ..........-t home, to a hospital, or to a doctor. 5. Whether or not the [raln~u.w,~ o~,, 6. If medical treatment was g~ven, the name and address of the doctor. 7. The name, title and phone number of the person who prepared the report. You will be asked to assist in the completion of the Workers Compensation Report, within one (1) working day from the date of the injury. Workers Compensation forms Can be requested from the Work Experience staff. Completed Workers Compensation Reports are to be forwarded to: SCDOL Work Experience Unit PO Box 1319 Smithtown, NY 11787-0895 Program Contacts: Suffolk Courity Depa~i~[~ent of Labor - Work Experience staff can be reached at: 853-3835 or 853-3830. ' S.C. DEPARTMENT OF LABOR (SCDOL) SUFFOLK WORKS EMPLOYMENT PRoGRAM WORK EXPERIENCE PROGRAM PARTICIPANT FACT SHEET I , u~derstand that as a mandatory participant referred to a Work Experience Pmgram worksite, I must comply with the below listed requi~ments. I understand that my failure to comply with these requirements may ~'esult in the LOSS OF MY TEMPORARY ASSISTANCE GRANT AND FOOD STAMP ALLOTMENT. WORK EXPERIENCE PROGRAM REQUIREMENTS INCLUDE THE FOLLOWING: 1. Report to the arranged w0rksite interview on time and properly attired. In the event of an emergency, ALL Work Experience Interviews and chnnges in your start date must be reseheduled by the Suffolk County Department of Labor at 853-38S3 or 85.3-3622. 2. Return to the referring SCDOL office by 3:00 p.m. on if: o You do not report to ~our scheduled interview due to an emergency (Doctor's visit, court appearances). You must furnish written documentation indicating the nature of your emergency. o .You are NOT accepted to participate in Work experience at the work.site; . o You are not given a start date for your assignment during your interview 3. Return to the referring SCDOL office by 3:00 p.m. the NEXT wORKING DAY if: o If you do not begin your work expe~ence assignment on your sta~ date due to an emergency (Examples of emergencies are medical appointments & court appearancas). You must furnish written documentation Indicating the nature of your emergency. o You are terminated from your worksite for any reason. 4. You ~ust participate in the Work Experience activity for the assigned weekly number of hours indicated on your Referral Form and EmploYability Plan: o You must provide written documentation of all absences (Doctor's notes, court appearance notes, DSS appointment letters) to your worksite supervisor if you do not report for work. If no documentation is ~'eceived, Your absanee can be reviewed by the SCDOL and be considered as "unexensed". o Absences must be made up during the month of absence. o If you are absent from your Work Experience assignment for three (3) or mere consecutive days, and no documantation is received, you will be terminated from your assignment, and your case referred for conciliation. 5. Completed time sheets are forwarded to the SCDOL through your assigned workalte supervisor. 6. In order to request the following supportive services: o Transportation reimbursement: Complete and submit'on a 'monthly basis, the Request for Transportation Reimbursement (IM/HR-2) form to the SCDOL: o Child Care: Complete and submit the Child Care Provider Request Form (SCOflM 1325) to the SCDSS: Time Off For Private Sector Employment Interviews: In the event that you have a scheduled job interview during assigned work hours, time off must be granted by the assigned worksite supervisor; however, the missed hours MUST be made up during the month ofabsance. If you have any questions you may have regarding the Work Experience pm~am, please call 853-3835 or 853-3830. I have read, had explained to me, and received a copy of this Work E~perience Participant Fact Sheet. Participant Signature Date Distribution: Original to Participant. Copy to File SCDOL Counselor Suffolk County Department of Social Services 3085 Veterans Memorial Highway Ronkonkoma, NY 11779 Commissioner Janet DeMarzo Referring Worker: S W E P Telephone: 631-853- Fax: 631-853- Today's Date: 07/10/2007 Client name: Number of Weekly Hours for Work Experience: XX Provider/Site: Provider Main Street Bay Shore, NY 11706 CIN: Case Number: P00 Case Type: Phone: 631-XXX-XXXX You are required to report: For: Enrollment in Work Experience, Clerical On: June 12, 2007 at ll:00AM Contact Person: At: Provider Main Street Bay Shore, NY 11706 Directions: Accessible by public transportation. Worker Remarks to Client: Client will participate XX I-IPW. You are expected to appear as scheduled. You are expected to immediately contact the referring worker ifanable to appear as scheduled. Your failure to comply with the above directions without good cause may result in loss of Public Assistance and Food Stamp benefits and possible sanction per Office of Temporary and Disability Assistance Regulations 385.9 and 385.12. Provider Expectations: Please contact referring worker immediately if client does not appear as scheduled: PleaSe contact referring.worker ifa new appearance date or time must be arranged. Please respond by xx/xx/2007 with referral results and feedback as indicated on the feedback form, which has been provided for your use. SIGNATURE: DATE: I~IVIailed [] Hand-Delivered Attachment #3 CLIENT NAME: RETURN ADDRESS: REFERRAL REASON: PROVIDER/SITE NAME: APPOINTMENT DATE: RESULT: LAST: FIRST: Suffolk County Department of Social Services 3085 Veterans Memorial Highway Ronkonkoma, NY 11779 Enroll in an Activity Provider 06/12/2007 11:00 AM COMPLIED: [] FAILED TO COMPLY: [] ACTIVITY / OCCUPATIONAL AREA: Work Experience / Clerical OFFERING: Clerical Aide ACCEPTED: [] NOT ACCEPTED: [] (CHECK REASON(S) BELOW) I) [] Client refused site assignment 2) [] Client did not complete interview 3) [] Client does not meet requirements (Specify in Remarks) 4) [] Client initiated other negative action (Specify in Remarks) 9) [] Other negative, reason (Specify in R'emarks) REMARKS: IF THE CLIENT IS ACCEPTED, PLEASE COMPLETE THE REST OF THE FORM. PROGRAM (PLEASE CHECK ONE FROM SELECTIONS BELOW): START DATE: PLEASE DESCRIBE ASSIGNMENT (optional): CIN: Case #: PO0 EXPECTED COMPLETION DATE (optional): SCHEDULE MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY CONTACT PERSON NAME: FIRST: PHONE: ASSIGNMENT LOCATION: SITE NAME: ADDRESS: CITY: DIRECTIONS: REMARKS: SIGNATURE: FROM TO. HR. MIN. AM / PM HR. MIN.AM / PM 09:00 AM 03:00 ?M 09:00'AM 03:00 PM 09:00 AM 03:00 PM 09:00 AM 03~.00 PM 09:00 AM' 03:00 PM rio no 00 WEEKLY TOTAL LAST: FAX: STATE: ZIP: DATE: DAILY · TOTAL Attachment ~4 PARTICIPANT NAME: SOCIAL SECURITY NUMBER: SWEP SN PARTICIPANT JOB SEARCH REQUIREMENT Contacts Needed You must look for work for up to 40 hours each week,. IN ADDITION you must comply with all program requirements. You must fully record your Job search activities below. The Suffolk County Department of Labor will be reviewing the information you provide. (COMPLETE BELOW - USE OTHER SIDE FOR ADDITIONAL CONTACTS) # of DATE COMPANY NAME ADDRESS PHONE # : CONTACT'S NAME RESULTS Contacts 1 2 3 4 5 6 7 8 9 10 11 12 13 14 : 15 16 17 18 19 20 I certify that the information supplied on this form is true and correct Participant's Signature Date PARTICIPANT NAME: sOCIAL SECURITY NUMBER: # of Contacts DATE COMPANY NAME ADDRESS PHONE # CONTACT'S NAME RESULTS 21 22 23 24 25 26 27 28 29 30 31 · 32 33 34 35 36 37 38 39 40 Reviewed By Suffolk County Department of Social Services "SUFFOLK WORKS" - WORK EXPERIENCE PROGRAM REQUEST FOR TRANSPORTATION REIMBURSEMENT Participant Name: Case #: Case type: (Circle One) Address: SN FA FS (Safety Net) (Family Assistance) (Food Stamps) Job Title: Completed forms are to be mailed into SCDOL immediately following the LAST DAY of the month. (Mail to: P.O, Box 18100, Hauppauge, NY 11788-8900, Attention: C.B.A.-A Melisurgo) MONTH/YEAR DATE HOURS WORKED DAtLY DATE HOURS WORKED DAILY .... , , DATE' HOURS WORKED DAILY DATE HOURS WORKED DAILY DATE HOURS WORKED DAILY Participant's Signature Supervisor's Signature 1. Location of Worksite 2. Transportation expenses round trip per day If you use your own car, state the daily mileage round trip 3. Your means of transportation If you travel by bus, state how many buses you use one-way and how much each costs you x__=$ Si desea una copia del siguiente documento en espanol, haga el favor de pedirlo. cr-r-~ oq~o Attachment #6 SUFFOLK COUNTY DEPARTMENT OF LABOR SUFFOLK WORKS EMPLOYMENT PROGRAM MONTHLY TIME SHEET PARTICIPANT NAME: Social Security #: WORKSITE: (c~c, E O.E) SN FA FS SNFA LOCATION: TELEPHONE: (631) - CASE #: JOB TITLE: Indicate total hours worked by the participant each day (includes traditional breaks & liJnch) MONTH / YEAR:' October 2008 / November 2008 MONOAY ~UESDA¥ WEDNESOAY THUR$OAY FRIDAY SA~JRDAY SUNDAY TOTAL 6 I 7 I 81 9 I 101 .I 13 J 14 I ~51 ~8 I~71 lei -J H 20 I 21 I 22 J 23 J 24I 25I 27 .I 28 I 29 I 30 I 31I ,'. 1 ] I I I I I I ABSENCE EXCUSE CODES: A. Illness of Participant C. Death in Family, E. Child Care Monthly Required Hours: B. Illness in Family D. Sile Closed F. Other - exp!ain below Total Worked: Difference: Whe~ever possible, the client should be encouraged to tnake up any missed time by the end of the month. PARTICIPANT'S SIGNATURE SUPERVISOR'S SIGNATURE PARTICIPANT EVALUATION Poor EVALUATION FACTORS 1 2 3 4 5 Quality of Work Quantity of Work Dependability Attendance/Prompt.ness Work Attitude RATING OFFICIAL'S COMMENTS or EXPLANATIONS EVALUATOR'S NAME JOB TITLE DATE Completed time sheets are to be mailed or faxed to the Suffolk County Labor Department immediately following the LAST DAY of the listed period or client's last day at Worksite. (Mail to: PO Box 1319, Smithtown, NY 11787-0895, Attention: SWEP/Worksite) Telephone: 853-385~ or 853-3830 +:i:.: ~F~x?. 853-3806 ' .~:.~'~;,.'' Complete job search form.plus the job search transportation reimbursement form ISCO 2437), and attach to timesheet, with any documentation for excused absences. All assigned job search must be conducted outs!de et scheduled worksite hours. The original of the DSS Request for T/~-~nsDortation Reimbursement form {SCO 2389) m must be mailed to A Melisumo as directed on form SUFFOLK COUNTY DEPARTMENT OF LABOR SUFFOLK WORKS EMPLOYMENT PROGRAM MONTHLY TIME SHEET PARTICIPANT NAME: Social Security #: WORKSITE: tClRCLE ONE) SN FA FS SNFA LOCATION: TELEPHONE: (631) - CASE #: JOB TITLE: . Indicate total hours worked by the padicipanl each day (includes traditional breaks 8, lunch) MONTH / YEAR: November 2008 / December 2008 ABSENCE EXCUSE CODES: A, Ilthess of Participant C. Death in Family. E, Child Cam Monthly Required Hours: B. illness in Family D. Site Closed F. Other. explain below Total Worked: Difference: Whenever possible, the client Should be encouraged to make up any missed time by the end of the monlh. PARTICIPANT'S SIGNATURE SUPERVISOR'S SIGNATURE PARTICIPANT EVALUATION Poor EVALUATION FACTORS 1 2 3 4 5 Quality of Work Quantity of Work Dependability Attendance/Promptness Work Attitude RATING OFFICIAL'S COMMENTS or EXPLANATIONS EVALUATOR'S NAME JOB TITLE DATE Completed time sheets are to be mailed or faxed to the Suffolk County Labor Department immediately following the LAST DAY of the listed period or client's last day at Worksite. (Mail to: PO Box 1319, Smithtown, NY 11787-0895 Attention: SWEP~orksite) "~ Telephone ~53-3853 or 853-3830'i.~:"~ F~:.853-3806 !~:.~;!i'!.;'~'.i~'~-'?'.il Complete job search form plus the job search transpodation reimbursement form (SCO 2437), and attach to timesheet, with any documentation for excused absences. All assigned job search must be conducted outside of scheduled worksite hours. The original of the DSS Request for SUFFOLK COUNTY DEPARTMENT OF LABOR SUFFOLK WORKS EMPLOYMENT PROGRAM MONTHLY TIME SHEET PARTICIPANT NAME: Social Security #: WORKSITE: ¢c,~c~E O,E) SN FA FS SNFA LOCATION: TELEPHONE: (631) - CASE #: JOB TITLE: Indicate total hours worked by the padicipant each day (include[ traditional breaks & lunch) MONTH ) YEAR: December 2008 / JanUary 2009 MONDAY TUESDAY VVEDNESDAY THURSDAY 5 FRIDAY ~ATURDA¥ SUNGAY TOTAL 8 I 9 J 10 I 11 I '12 I 13I _1 22 I 123 I, 24 I 25 I 27 I H 2g 'J 30I 131I ~ IH 2 I 31 ABSENCE EXCUSE CODES: A. Illness of Psdicipant C. Death in Family. E. Child Care Monthly Required Hours: B. Illness in Family D. Site Closed F. O~her - explaJri below . Total Worked: Difference; Whenever po~siblel the client should be encouraged to make up any missed time by the end of the month. PARTICIPANT'S SIGNATURE SUPERVISOR'S SIGNATURE PARTICIPANT EVALUATION Poor Superior EVALUATION FACTORS 1 2 3 4 5 Qualit7 of Work Quantity of Work Dependability Attendance/Promptness Work Attitude RATING OFFICIAL'S COMMENTS or EXPLANATIONS EVALUATOR'S NAME JOB TITLE DATE Completed time sheets are to be mailed or faxed to the Suffolk County Labor Depadment immediately following the LAST DAY of the listed period or client's last day at Worksite. (Mail to: PO Box 1319, Smithtown, NY 11787-0895, Attention: SWEP/Worksite) Telephone 853-3853 or 853~3830 ~; :'-.Fax 853-3806:.?.:~ .:: i'~ :~ Complete job search form plus the job search transportation reimbursement form (SCO 2437), and attach to timesheet, with any documentation for excused absences. All assigned job search must be conducted outside of scheduled worksite hours. The original of the DSS Request for Transo~rtation Reimbursement form fSCO 2389) m must be mailed to A Melisurcm as directed on form.