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HomeMy WebLinkAboutSuffolk Works Employment ProgramRESOLUTION 2009-657 ADOPTED DOC ID: 5161 THIS 1S TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2009-657 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 28, 2009: RESOLVED that the Town Board of the Town of Southold hereby ratifies and approves the Memorandum of Agreement dated July 2~ 2009 between the Town of Southold and the CSEA, concerning Suffolk County Department of Labor Works Program. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS| MOVER: William Ruland, Councilman SECONDER: Vincent Orlando, Councilman AYES: Ruland, Orlando, Krupski Jr., Wickham, Evans, Russell INTRODUCTION TO THE sUFFOLK WORKS EMPLOYMENT PROORA/If WORK EXPERIENCE PROGRAM . Steye Levy, County Executive Robert 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 SCDOL to provide worksite supervisors with the day-to-day guidance necessary to implement a successful work experience program, in aCcordance with the new Federal regulations which took effect October 1, 2006. The SWEP provides employment related services to individuals who receive pabiic 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: The FA-1 (Family Assistance) case category consists of a family with a single parent as the head of the household. 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 matriX; 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). The NTA-FSET (Non-Temporary Assistance Food Stamp Employment Training) case category usually consists of a sole individual but infrequently may be someone.t~rom a tWo-parent household. In order to mainta n 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 IS' THE 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 exl~erience. Some.people will have been out of the labor market for only a relatively short time, while others have been 'out of the workfome 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 afire; b. 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 pe~ed; 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. (A~tachment #1 is a Work Experience Program Fact Sheet that is issued to participants outlining their · mspor)sibilities) .~ 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-prof~ is eligible to apply for SWEP worksits status. In accordance with the Memorandum of Understanding signed by both the County and the Contractor (your organization), certain workplace rules must be followed. 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 barrier, including offender status where applicable. This process should reflect the same points of emphasis as when choosing a regular employee for your organization. It ~,e~sc,~ 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. 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 fimesheets 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). e. Trainees aTM prohibited from performing tasks that are prof~ 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 injudes involving Work Expedenca 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 bi~ formally referred to your organization by the SCDOL. They will arrive with our Worksite Referral and Interview Feedback Result forms (Attachments #3 & #4). Do not accept participants without these basic documents. They contain many details, such as required hours, interview date and time that you will need to know. If a trainee should arrive 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 taxed 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 dudng the conversation setting up the nterv]ew. This proposed start' date has been set up to include the time allotted for a FA or SNFA client to obtain childcam, 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 include, s afl_[ th._~e hours assiqned. 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 Expe~fence 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 organizab, 'on or the Participant pdor to a final determination, a specific date for the client to return 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 telephene number (631) 853-3830 or 853-3835. If you decide no___~t 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 (63t) 853- 3853. The trainee should not be accepted for an interview at any time Revised ~7/08 "~- 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 pdor to the time of the rescheduling.. B. CONDITIONS OF ASSIGNMENT Trainees should enjoy working conditions similar to those of your regular staff. Under no circumstances should any SWEP trainee perform job assignments that involve political, reli{~ious 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 worksita shOUld notbe 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 given 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 hOUm 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 th~ trainee's DSS case type is: FA or SNIFA: The trainee will be limited to a six-m(~nth worksite assignment at any one time. He or she will then be recalled and re-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 cam 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. R~aedS~7~8 ...... -5- When a worksite is dosed, the trainee is not required to make up hours if he or she is scheduled for the days dosed 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 padicipants 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 Worksita 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 w~)rksite 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 h~ve the hours made up by the end of the month. '['he 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: WORKSlTE SUPERVISORS ARE TO COUNSEL TRAINEES AFTER THE FIRST ABSENCE, WHILE' THE TRAINEE WILL BE COUNSELED BY Th~-' SUPERVISOR AND DOL REPRESENATIVE Ar I ~-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 no.~t 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 original time sheet, filled out in ink,. no later than 5 days after the tralnee'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 raquired t°.fumish (Jocumentation to the Suffolk Works Employment pro~ram with regards to their job search efforts. At the end of each reporting period, the participant may submit his or her job seamh to the worksite supervisor (Attachment #5 A-B) to forward to the Suffolk Works Employment Program along with the Monthly Time Sheet. We request thatworksite supervisors corn plete the Evaluation Section of the timesheet on a periodic 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 returning 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 Reimburaement Form. It is the responsibility of the t~ainee to forward the original of the compl6ted f6rm to: SCDSS - Client Benefits Administration Attn: A. Melisurgo PO Box 18100 Hauppauge, NY 11788-8900 Note that duplicated copies are not acceptable, Fo PARTICIPANT TERMINATIONS The worksite supervisor should notify SCDOL Work Experience staff prior to. the termination of any trainee's participation at the workSite, except in the case of flagrant or emergency situations, such as: 11 Evidence of disruptive or deviant 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 worl(.site 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 ram. but ent!rely possible, situation where a. true emergency exists, contact the sUffOlk County Police Department. : trainee has not contacted the workslte and has been absent for three ~OTE If a . · - ' ' ---,-,-,- ,-^ ~- =he has been scheduled, you must tive business oays Tot wmu,, ,l= ~,- o . . - (3).consec.u.. ...... ,,-,, =.--,-,edlatelv. This notification effectively enos notify the worl( cxpenen~ u,,,, ,,,,,- the trainee's assignment at your agency. If there iA a subsequent Contact with the trainee, the trainee must call the. Worksite Unit at- 853-3830 or 853-3835 for directi°n. Do not permit the trelnee to return to the position at your site without the express Permisslon 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' Compensat on 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. Names of any witnesses to the injury. 5. Whether or not the t~ainee was sent home, to a hospital, or to a doctor. 6. If medical treatment was given, 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 Coufity Department of Labor - Work Experience staff can bc reached at: 853-3835 or 853-3830. Revi~ed 5/27/08 -~- · ~.C. D]gPARTMI~N'T OF LABOR (SCDOL) SUFFOLKWORK~ EMPLOYMIgNT PRoG;RAM WORK EXPERIEN(~E PROGRAM PARTICIPANT ]['ACT SHEI~T I , uoderstsud that as a mandatozy pmtcil~'~t referred to a Work Exp~onen Program wurkslte, I must comply with the below listed requirements, I un~ra~unl that my failure to comply with these requir~nents nmy result in the LOSS OF MY TEMPORARY ASSI~TANC]g GRANT AND FOOD STAMP ALLOTMENT. WORK EXPERIENCE PROGRAM REQUIREMENTS INCLUDE THE FOLLOWING: Report to the arrdnted worksite intcrvicw on time and prop~ly attired. In the event of lin emergency, ALL Work Expeflenen Interviews and changes In your tort date must be rescbedMed by the Suffolk County Department of Labor at 853-.38S3 or Return to thc refon'ing SCDOL office by 3:00 p. nt on if: o You do not report to j~our scheduled intevfiew due to an emurgct~y. (Donor's visit, appesran~es). You must furnish written documentation Jmllentbg the nature of your emergency. o ,You are NOT accepted to participate in Work experience at the worksite, o You are not given a start date for your assignment du~mg your intcrvir# Return to the refening SCDOL office by 3:00 p.m. the NEXT WORKING DAY if: o If you do not begin your work experience assignment on your stun date due m on emergency (Examples of emergencies are medical appointments & court appearances). You must furnish written documentation IndJentlng the nature of your emergency. o . You are terminated i'rom your worksite for any reason. 4. You ~ust participate in the Work Experience activity for the assigned weekly number of houre indicated on your Referral Form and Empinyability Plan: o You must provide written docm-centation of all absences (Doctor's notes, court aRoearsuce notes, D~S appointment letters) to your worksite supervisor if you do not report for work. Il no documentation Is received, your absence cue be reviewed by the SCDOL and be cousldured es #ulleleused~. o Absencez must be made up during the month ofabsouce. . o If you are absent from your Work Experience a~signmant fur three (3) or mere consecutive days, and no docunentation is received, you will be terminated from your assignmont, and your case referred for conc~iction. 5. Completed time shcets are forwarded to the SCDOL through ~mur assigned wurksite supervisor. 6. In order to request the following supportive sen, ices: o Tranq~Ol'tatinn reimbursement: Complete and submit 'on a 'monthly basis, the l~quest for Tronsportation Reimbursement (IM/HR-2) form to the SCDOL: o Cliild Care: Complete and submit the Child Ca~ Provider Request Form (SCO/IM 1325) to the SCI)SS: Time Off For Private Sector Emoinvmant Interviews: In the event thct you have a scheduled job interview during assigned work hours, time off must be granted by the assigned work, site supervisor, howev~', the missed hours MUST be made up during the month ofabsonce. If you have any questions you may have regarding the Work Experience program, please call g53-3835 or 853-3830. ! have read, had explained to me, and reouived a copy of this Work E~periense Participant Fact Sheet Participant Signature Dale Distribution: Original to ParticipanL Copy to File SCDOL ¢oun~lur 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 Expenence: XX Provider/Site: Provider Main Street Bay Shore, NY 11706 CIN: Case Number: P00 Case Type: Phone: 631-XXX-XXXX You arc required to report: For: Enrollment in Work Experience, Clerical On: June 12, 2007 at 11:00 AM Contact Person: At: Provider Main Street Bay Shore, NY 11706 Directions: Accessible by public transportation. Worker Remarks to Client: Client will participate XX HPW. You are expected to appear as scheduled..You are expected to immediately contact the referring worker ifunsble 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 Tamporaryand 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 if a 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 pmvlded for your use. SIGNATURE: DATE: [=lMailed [~ Hand-Delivered Attachment #3 CLIENT NAME: RErURN ADDRESS: LAST: FIRST: Suffolk County Dopartmant of Social Services 3085 Vetm-ans Memorial Highway Ronkon[oma, NY 11779 Enroll in an Activity Provider 06112/2007 11:00 AM coMPLIED: [] FAILED TO COMPLY: [] REFERRAL REASON: PROVIDER/SITE NAME: APPOINTMENT DATE: RESULT: ACTIVITY / OCCUPATIONAL AREA: Work Experience / Clerical OFFERING: Cl~rie~d Aide ACCEI~fED: I-I NOT ACCEPTED: El (CHECK REASON(S) BELOW I) [] Client refused site assignment 2) [] Client did not completo intenfiew 3) [] Client do~ not meet r~luirements (Specify in Remarks) 4) [] Client initiated other negative action (Specify in Remarks) 9) [] Other negative'reason (Specify in gemarks) REMARKS:. IF THE 'CLIENT IS ACCEPTED, PLEASE.COMPLETE THE REST OF THE FOR/Vl. PROGRAM (PLEASE CHECK ONE FROM SELECTIONS BELOW): START DATE: PLEASE DESCRIBE ASSIGNIVIENT (optional): CIN: Case#: PO0 EXPECTED COMPLETION DATE (optional): SCHEDULE FROM TO. HR. MIN. AM / PM HR. MIN. AM / PM MONDAY 09:00 AM 03:00 .PM TUESDAY 09:00'AM 03:00 PM WEDNESDAY 09:00 AM. 03:00 PM THURSDAY 09:00 AM 03:00 PM FRIDAY 09:00 AM' - 03:00 PM SATURDAY [] [] [] [] SUNDAY [] [] [] [] CONTACT PERSON NAME: FIRST: PHONE: ASSIG~ LOCATION: - SITE NAME: ADDRESS: CITY: DIRECTIONS: WEEKLY TOTAL LAST: FAX: STATE: ZIP: DAILY TOTAL REMARKS: SIGNATURE: DATE: Attachment ~4. PARTICIPANT NAME: Contact~ Need~l SOCIAL SECURITY NUMBER: S, WEP SN PARTICIPANT JOB SEARCH REQUIREMENT (COMPLETE BELOW- USE OTHER SIDE FOR ADDITIONAL CONTACTS} # of DATE COMPANY NAME ADDRESS PHONE # "CONTAC'FS NAME RESULTS Contacts ; . 4 ? ~0 ~4 17 ~8 I certify that the information supplied on this form is true and correct Participant's Signature Date PARTICIPANT NAME: sOCIAL SECURITY NUMBER: Contacts DATE COMPANY NAME ADDRESS CONTACT'S NAME RESULTS 27 30 ~? ~8 4O Reviewe~l By Suffolk County Department of Social Services "SUFFOLK WORKS"-WORK EXPERIENCE PROGRAM REQUEST FOR TRANSPORTATION REIMBURSEMENT Participant Name: Case #: Case type:_(cirde one) Address: SN FA FS (Safet~ 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 DAILY 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. Attachment #6 ' l SUFFOLK COUNTY DEPARTMENT OF LABOR SUFFOLK WORKS EMPLOYMENT PROGRAM MONTHLY TIME SHEET PARTICIPANT NAME: Social Securi[y #: WORKSITE: {cac~ ~3*~-3 SN FA FS SNFA LOCATION: TELEPHONE: (631) - CASE #: ' JOB TITLE: Indicate total hours worked by the perticip~nt each day (includes traditional breaks & lunch) MONTH I YEAR:' October 20081 November 2008 ABSENCE EXCUSE CODES: ^. Iltheu of Patticipar~ C. Death in Family. E. Child Care Monlhly Required Heurs: B. Illness in Fami~' D. Sae Closed F. Other - exl:~a, in below Toial Worked: Difference: Whe~eve[ 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 Qua ~ of Work ' 'Quantity of Work Dependability Attendance/Prompt. ess Work Attitude RATING O~FICIAL'S COMMENTS or EXPLANATIONS EV'ALUATOR'S NAME JOB TITLE DATE Completed time sheets are to be mailed or faxed to the Suffolk County Labor Departmeni immediately following lhe LAST DAY of the listed period or client's last day at Worksite. (Mail to: PO Bo:< 1319, Smithtown, NY 11787-0895, Attention: SWEP/Worksite) :-~. :: :.... :~ Te ephone; 853-3853 or 853-3830~.~ ..~;Fax~ .~ 853-3805 ', .~ ~ ~: .~ · Complete job search form.plus the job search transportation reimbursement form (SCO 2437), and attach Io timesheet, with any documentation for excused absences. All assigned job search must be conducted outs!de o~ scheduled worksite hours. The original of the DSS Request for T~k'~ns~oortation Reimbursement form {SCO 2389) m must be mailed to A Metisuroo as directed an f~rm SUFFOLK COUNTY DEPARTMENT OF LABOR SUFFOLK WORKS EMPLOYMENT PROGRAM M~NTHL Y TIME SHEET PARTICIPANT NAME: WORKSITE: LOCATION: Social Security #: SN FA FS SNFA TELEPHONE: (631) - CASE #: JOB TITLE: Indicate total hours worked by the padidpant each day (includes traditional breaks & lunch) MONTH / yEAR: November 2008 / DeCember 2008 r ' 12 I 131 14 lo I I" . 17 I 18 f 19 I 20 I 21I 22J _1 24 J 25 I' 26 I 27 JH 28 ABSENCE EXCUSE CODES: A. Illness of ParUcJpant C. Death in FamDy. E. Ch~ Care Menthly Requked H~Jm: . e. II/ness in Family D. Site Closed F. O/net'. explain below ToY ~rked: Difference: Whenever possible, the client should be enGouraged to make up any misseri time by the end of the month. PARTIC PAN'PS SIGNATURE SUPERVISOR'S SIGNATURE PARTICIPANT EVALUATION Poor )erior. [ EVALUATION FACTORS I 2 3 4 5 Quality of Work, :3uantit'/of Work Dependabili~ Attendance/Promptness · [. Work A/fitude RATING OFFICIAL'S COMMENTS or EXPLANATIONS EVALUATOR'S NAME JOB TITLE DATE Completed t me sheets are to be mailed or faxed to the Suffolk County Labor Depar'~ent immediately following the LAST DAY of the listed period or client's last day al Worksite. (Mail lo: PO Box 1319, Smithtown NY 11787-0895, Attention: SWEP/Worksite) ..... ' ~h(~ne: '853-3853 853-3830~:;,~;Ea~'.:853 . r.~..~, · ." ' ".: - , · Tele or :: 3806 ..........., . ,. Complete job search form plus the job search transportation reimbursement form [SOO 2437}. and attach to timesheel, with any documenb3tion 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 Secudly #: WORKSITE: ¢~,~o. Eo.e SN FA FS SNFA - LOCATION: TELEPHONE: (631) - CASE #: JOB TITLE: Indicate total hours worked by the participant each day (includes traditional breaks & lunch) MONTH ~ YEAR:' December 2008 / JanUary 2009 6 I ~ 'l lo I ~ I ~2 I 131 "u 15.1 16 } 117 I IlS I 19J 20I ._1 22 I · 23 I, 24 I ~ 25 I 261 27 I "J . 2~ :J 30 J 3!J 1 IH 12 I 3:J -,J ABSENCE EXCUSE CODES: A. itlnes$ of Pa~cipant C. Death in Family. E. Cl~ibl Care Monthly Required Hours: B. Illness In Fa~iJ'/ D. Site Closed F. O~her. explaJ~ below . Total W~'kecl: - Difference; Whenever pos. sible; th, e clien! should be encouraged Io make up any missed ti~o by ,the end of the month. PARTICIPANT'S SIGNATURE SUPERVISOR'$ SIGNATURE PARTICIPANT EVALUATION Poor EVALUATION FACTORS 1 2 3 ' 4 '5 ~uality of Work :~uantity ol' Work ::)ependability ~,ttendance/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 pedod or client's last day at Worksile. (Mail to: PO Box 1319, Smithtown, NY 11787-0895, Attention: SWEPNVorksite) ' ' ' : Teleph0~iei 853:3853 or 853-3830 ~ .~,~ Fax 853-3806 ~.~,,~ :,:: ~ '; . .: . ..:!:, ............... ....... Complete job search form plus Ihe job search transportation reimbursement form (SCO 2437), and attach to timesheet, with any documentation for excused absences. All as.signed job search must be conducted outside of scheduled worksite hours. The original of the DSS Request for Transz~ottation Reimbursement form ISCO 2389) m must be mailed to A Melisur~o as directed on form. JUL. 2. 2009 2:18PM N0.782 P. 2 ORIGINAL MEMOP,.A_NDUM OF AOKEEMENT This AGREEMENT dated July 2, 2009 by and. between CSEA I. nc, Local 1000, AFSCME, 'AFL-CIO, Southold Unit 8785 ("CSEA") and the Town of Southold ('Town"). The work shall be performed by participant* from the Suffolk County Summer Work Experience Program from July 6-August 21, 2009 as a Senior Aide, Recreational Aide ~nd Building and Maintenance Aid in accordance with the descriptions set forth in the attached Employment Description and shall not be u~ed in any proc. e~ling, hearing or forum whatsoever, as evidence of a breach of CSEA's exclusivityof work. Tiffs Agreement shall not be construed as an acknowledgement by the Town that CSEA has exclusivity of the work at issue. This Agreemertt shall not be construed as an acknowledgement bythe CSEA that it does n6t have exclusivity of the work at issue. This Agreement r~presents thc totality of the parties' agreements regarding this issue. There arc no other agreements, oral or otherwise. ~ 'Attorney FOR THE CSEA: l~ach~l Lang~t, Labor Relations Specialist ~-g~ S~b~, U~t President MEMORANDUM OF AGREEMENT This AGREEMENT dated July 2, 2009 by and between CSEA Inc, Local 1000, AFSCME, AFL-CIO, Southold Unit 8785 ("CSEA") and the Town of Southold ("Town"). The work shall be performed by participants fi.om the Suffolk County Summer Work Experience Program from July 6-August 21, 2009 as a Senior Aide, Recreational Aide and Building and Maintenance Aid in accordance with the descriptions set forth in the attached Employment Description and shall not be used in any proceeding, hearing or forum whatsoever, as evidence of a breach of CSEA's exclusivity of work. This Agreement shall not be construed as an acknowledgement by the Town that CSEA has exclusivity of the work at issue. This Agreement shall not be construed as an acknowledgement by the CSEA that it does not have exclusivity of the work at issue. This Agreement represents the totality of the parties' agreements regarding this issue. There are no other agreements, oral or otherwise. ~n Attorney FOR THE CSEA: Rachel Langert, Labor Relations Specialist Thomas Skabry, Unit President , JUL, 2,2009 2:18PM N0,782 P, 3 SUFFOLK COUNTy DEPARTMENT OF LABOR SUMMER WORKS PROGRAM Town of southold Opportunities:, Two Senior Aides: Greet.seniors as they arrive at Senior Center. Through social interactions, playing games and dining, become aware of aging process and issues important to the eldedy. Two Buildina and Maintenance Aides: Shadow DPW staff to learn about building maintenance and repair as well as keeping of grounds. When participants provide assistance it shall be under supervision of DPW staff. One Recreational Aide: Play games with children and assist the recreation supervisors in ensudng safety. The above positions are funded through Suffolk .County Department of Labor and participants must meet income guidelines (reduced or free lunch) and/or be disabled.